NOTE TO EDITORS: The Following Is an Investment Opinion Issued by Spruce Point Capital Management
Provides Evidence From Interpreting Legal Filings That the Department of Justice Is Investigating a Possible Cover-up by iRhythm Management Related to Potentially Fatal Product Flaws
Raises Serious Concerns About iRhythm Management’s Credibility Given the Company’s Track Record and Communications Before and After the Onset of Regulatory Scrutiny
Questions the Defensibility, Differentiation, Quality, and Regulatory Compliance of iRhythm Cardiac Monitors and Its Patient Data Analysis Operations
Presents Evidence That iRhythm’s Targeting of the Asymptomatic Market Opportunity Is Likely to Disappoint, Particularly as Consumer Devices Incorporate Near-Medical Grade Cardiac Monitoring and Multi-Sensor Capabilities
Highlights Concerning Data Suggesting Growing Revenue Headwinds, Historically Poor Operating Leverage, and Decreasing Financial Transparency
Estimates That iRhythm Shares Face 40%-70% Long-Term Potential Downside Risk Given Its Deteriorating Growth Profile, Commoditized Product, and Emerging Competition
Spruce Point Capital Management, LLC (“Spruce Point” or “we” or “us”), a New York-based investment management firm that focuses on forensic research and short-selling, today issued a detailed report entitled “Investor Complacency is Off the Charts” that outlines why we believe and estimate that shares of iRhythm Technologies, Inc. (Nasdaq: IRTC) (“iRhythm” or the “Company”) face up to 40% – 70% potential long-term downside to approximately $43 - $94 per share, representing material risk of market underperformance. Download and view the report, disclaimers, additional information, and exclusive updates by visiting www.SprucePointCap.com.
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Spruce Point Report Overview
Based in San Francisco, CA, iRhythm is a medical technology and services company that supplies ambulatory cardiac monitors used to detect arrhythmias and other cardiac abnormalities that can indicate atrial fibrillation. iRhythm launched its Zio Service in 2009, and the Company’s first product was the Zio XT (updated and renamed “Zio Monitor”), a wearable long-term cardiac monitor (LTCM) that records a patient’s electrocardiogram (ECG or EKG) data for up to 14 days. The Zio XT was one of the first extended wear monitors and has captured a dominant (~70%) share of the market. In 2019, iRhythm launched the Zio AT, which added a wearable cellular gateway to transmit patient data back to the Company. Marketed by iRhythm as a mobile cardiac telemetry (MCT) device, this transmission capability is meant to enable real-time surveillance and notification to doctors of cardiac events for more acute patients. Heralded by the Company as a disruptive product that would incrementally increase its addressable market, the Zio AT has been the subject of intense regulatory scrutiny for potentially fatal product flaws. As a company that has long been focused on a single product, single market, and single application, iRhythm has increasingly pitched investors on a breadth of emerging growth opportunities, including the targeting of asymptomatic patients, a new MCT product, and international expansion, to name a few.
After conducting a forensic review of iRhythm, including a proprietary survey of 100 practicing cardiologists, Spruce Point has serious concerns about the safety and competitiveness of the Company’s products, the growth potential of the oft-touted asymptomatic market, looming business headwinds (particularly when coupled with the Company’s poor profitability), and, perhaps most of all, the credibility of its management team. We believe investors have cut iRhythm management too much slack and have failed to properly acknowledge the magnitude of the Company’s failures. In addition, evidence from the U.S. Food and Drug Administration (FDA) suggests iRhythm’s own analysis revealed multiple product deficiencies that threatened the lives of patients. Yet, by the time it was first called out by the FDA in 2022, at least three years had lapsed without the Company taking any action to address complaints or warn patients or cardiologists. During this period of inaction, depending on the issue referenced, iRhythm insiders sold approximately $90 to $160 million of Company stock. Investors are acting as though the Company’s regulatory risks have been fully remediated and that new market opportunities will be realized, which have driven a 141% share price rise over the past year. In contrast, we see material downside risks for iRhythm.
The issues we analyze in our report include the following:
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We believe the market has prematurely dismissed concerns about the multiple FDA Form 483s and Warning Letter received by iRhythm, as the evidence calls into question the Company’s capabilities and management’s credibility. Recently unsealed legal filings suggest the Department of Justice is investigating a cover-up by iRhythm management.
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The FDA found that iRhythm products and practices put patients’ lives at risk, and subsequent revelations suggested systemic problems. Despite iRhythm frequently touting its products as the “gold standard”, the Zio AT contained several fatal flaws. As revealed in an FDA Form 483 received in August 2022 and a subsequent FDA warning letter received in May 2023, the Zio AT had been designed with a transmission limit, above which the device ceased transmitting patient data, which prevented the device from meeting the definition of an MCT because doctors could no longer receive real-time alerts for high-risk patients. The FDA found that at least two patients died because of this issue, in part because iRhythm failed to disclose this serious product shortcoming to doctors, patients, or the FDA (as required by law) despite having received complaints for at least three years. The FDA also found that incomplete patient registration could prevent real-time data transmission, an issue iRhythm had known about since 2017, further endangering high-risk patients. Despite these issues, FDA evidence shows that iRhythm continued marketing the Zio AT as an MCT to high-risk patients. Following a simultaneous FDA inspection of both iRhythm facilities in July 2024, we believe a clear sign of government distrust, iRhythm received two additional Form 483s. Once again, the FDA found that iRhythm jeopardized patient safety, this time by failing to investigate, report, and remediate over 4,000 complaints related to patient data reporting errors and data measurement and algorithm mistakes, issues which call into question the Company’s promotion of its artificial intelligence (AI) capabilities. Alarmingly, subsequent revelations suggested there were systemic issues with iRhythm’s results analysis operations, including that technicians were encouraged to delete patient data that highlighted inconsistencies between transmitted and saved readings in order to produce “clean” reports for cardiologists. We believe iRhythm’s defense of its actions was troubling, as the Company argued the results analysis activity should be viewed as separate from the monitor product and thus not subject to the same regulatory oversight. Regulatory consultants we interviewed believe this interpretation was indefensible.
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The FDA’s findings paint a troubling picture of iRhythm’s capabilities and management credibility. The FDA investigation yielded evidence that iRhythm’s claims of product superiority, AI expertise, and results reporting compliance are highly suspect. Moreover, we believe that reviewing the multi-year fact pattern in totality produces an extremely unfavorable view of management’s actions and credibility. We believe iRhythm management continually delayed and downplayed its disclosure of its regulatory troubles and that iRhythm’s alleged violations demonstrate a disregard for some of the most basic regulatory tenets meant to ensure consumer safety. Management has repeatedly been forced to backtrack as new revelations emerged or the seriousness of the FDA's findings sank in. We believe management has not only violated investor trust, but the evidence presented by the FDA suggests they have also violated the Company’s own Code of Conduct. We believe the FDA findings are damning and that this should not be a survivable event for management, even if the issues are eventually fully remediated. We believe investors should question the actions of the iRhythm Board during this period. They have adjusted executive incentive compensation to reward management for remediating the troubles they oversaw (effectively compensating them for not endangering patient safety and operating within standard regulatory guidelines) and, curiously, overseen the significant watering down of the Company’s Code of Conduct.
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Newly unsealed court documents suggest the Department of Justice (DOJ) is investigating a cover-up by iRhythm management. In May 2023, iRhythm disclosed it had received a DOJ subpoena, the subject of which was later revealed to be the Zio AT issues. As stated in an iRhythm petition, the “Government issued a Subpoena with thirty-two requests—ranging in subject matter from quality control policies, to scientific studies, to coverage and reimbursement by federal and state healthcare programs, to communications with the FDA—spanning over a decade.” Subsequently, the government filed an enforcement action against the Company on July 1, 2024. We believe investors may have lost sight of the significant risks entailed. We would make three key observations regarding the DOJ process: (1) the Company sought privilege on potentially damaging internal documents it produced in anticipation of a whistleblower lawsuit by a Senior Regulatory Affairs Specialist, (2) despite management’s suggestions to the contrary, the DOJ and FDA remain engaged and focused on the case, and (3) the court recently ruled against the Company on the long fought discovery issue (subsequently appealed), increasing the risks of an adverse ruling against the Company. iRhythm has repeatedly questioned the government’s efforts to obtain the internal documents in question by stating that the government already knows their contents. However, we believe this line of argument is undermined by its own ongoing efforts (including its recent appeal) to avoid their disclosure, as the Company’s core argument regarding privilege seems to have weak legal foundation in our layman’s opinion. Most importantly, a recently unsealed petition suggests that the government is investigating a cover-up by iRhythm management. That is, the government seeks to investigate “what executives knew at the company and when they knew it.” The fact that both sides continue to fight this court battle should be an ominous sign for investors.
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The FDA found that iRhythm products and practices put patients’ lives at risk, and subsequent revelations suggested systemic problems. Despite iRhythm frequently touting its products as the “gold standard”, the Zio AT contained several fatal flaws. As revealed in an FDA Form 483 received in August 2022 and a subsequent FDA warning letter received in May 2023, the Zio AT had been designed with a transmission limit, above which the device ceased transmitting patient data, which prevented the device from meeting the definition of an MCT because doctors could no longer receive real-time alerts for high-risk patients. The FDA found that at least two patients died because of this issue, in part because iRhythm failed to disclose this serious product shortcoming to doctors, patients, or the FDA (as required by law) despite having received complaints for at least three years. The FDA also found that incomplete patient registration could prevent real-time data transmission, an issue iRhythm had known about since 2017, further endangering high-risk patients. Despite these issues, FDA evidence shows that iRhythm continued marketing the Zio AT as an MCT to high-risk patients. Following a simultaneous FDA inspection of both iRhythm facilities in July 2024, we believe a clear sign of government distrust, iRhythm received two additional Form 483s. Once again, the FDA found that iRhythm jeopardized patient safety, this time by failing to investigate, report, and remediate over 4,000 complaints related to patient data reporting errors and data measurement and algorithm mistakes, issues which call into question the Company’s promotion of its artificial intelligence (AI) capabilities. Alarmingly, subsequent revelations suggested there were systemic issues with iRhythm’s results analysis operations, including that technicians were encouraged to delete patient data that highlighted inconsistencies between transmitted and saved readings in order to produce “clean” reports for cardiologists. We believe iRhythm’s defense of its actions was troubling, as the Company argued the results analysis activity should be viewed as separate from the monitor product and thus not subject to the same regulatory oversight. Regulatory consultants we interviewed believe this interpretation was indefensible.
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We believe iRhythm’s products are undifferentiated and that there are several competitive threats on the horizon.
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iRhythm’s claims of product superiority and differentiation are suspect. We believe iRhythm’s products are relatively low-technology devices, as factors such as strength of adhesive and form factor (within a narrow range) are often noted as distinguishing features (rather than accuracy). In fact, all medical-grade cardiac monitors use the same electrode measurement techniques, and virtually all monitor suppliers use machine learning-developed algorithms to aid patient data interpretation. Although iRhythm claims research supports their statements of product superiority, we find most major competitors can make similar claims, and we question a number of the Company’s product marketing claims. Our research shows that cardiologists generally view the monitor as commoditized. More importantly, due to their general distrust of suppliers’ analysis of patient data, cardiologists rarely rely on supplier final reports and almost always read the raw data to form their own diagnosis. In fact, FDA findings highlight serious shortcomings in iRhythm’s AI capabilities and even its ability to perform basic data analysis.
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Emerging competitive threats create risks for both current and anticipated future products. The cardiac monitoring market has seen an influx of small competitors offering comparable products at lower prices. In addition, as we discuss in the context of treating asymptomatic patients, research has shown that smartphone-paired devices and smartwatches offer near-comparable detection abilities. One strategy iRhythm has discussed to differentiate and enter new markets is to expand its breadth of sensor capabilities, yet we believe the Company is already too late, as integrated multi-sensor solutions already exist. While iRhythm plans to launch a new MCT product, we find little to be excited about as the product seems incremental at best in our view. Moreover, iRhythm only recently disclosed that the market for its MCT product is smaller than previously understood due to the trend toward data analysis insourcing. Beyond reducing the MCT market opportunity, we believe this poses a broader threat to iRhythm’s business model.
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iRhythm’s claims of product superiority and differentiation are suspect. We believe iRhythm’s products are relatively low-technology devices, as factors such as strength of adhesive and form factor (within a narrow range) are often noted as distinguishing features (rather than accuracy). In fact, all medical-grade cardiac monitors use the same electrode measurement techniques, and virtually all monitor suppliers use machine learning-developed algorithms to aid patient data interpretation. Although iRhythm claims research supports their statements of product superiority, we find most major competitors can make similar claims, and we question a number of the Company’s product marketing claims. Our research shows that cardiologists generally view the monitor as commoditized. More importantly, due to their general distrust of suppliers’ analysis of patient data, cardiologists rarely rely on supplier final reports and almost always read the raw data to form their own diagnosis. In fact, FDA findings highlight serious shortcomings in iRhythm’s AI capabilities and even its ability to perform basic data analysis.
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We have grave concerns about patient data analysis at iRhythm.
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Based on FDA findings, subsequent revelations, and our own research, the Company’s results reporting shortcomings appear endemic, and additional compliance issues may remain undisclosed. Our review of employee feedback on Glassdoor highlights concerns around (1) heavy workloads negatively impacting reporting quality, (2) a general lack of care regarding patient safety, and (3) the implications of continued outsourcing of reporting personnel overseas. iRhythm’s efforts to outsource its CCT operations to India and the Philippines may face pushback from some cardiologists based on our survey results. More importantly, we find that iRhythm may have used unqualified personnel to interpret patient data, creating additional potential legal liability.
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We believe iRhythm overstates its AI capabilities and the extent to which cardiologists trust their results reporting. While we acknowledge that cardiac data results analysis is a valid application for machine learning, we believe iRhythm’s AI capabilities are suspect. For example, in its 2024 Form 483 (San Francisco), the FDA revealed that the Company’s internal analysis misstated the accuracy of its algorithm by excluding data points that would have demonstrated lower levels of algorithm accuracy. Moreover, despite iRhythm’s claims of “99% physician agreement” with its final reports, our survey of cardiologists finds widespread and material distrust of all supplier reports. For example, 66% to 69% of surveyed physicians disagreed with the supplier final report more than 20% of the time. As we discuss, we believe distrust of final reporting has massive negative implications for iRhythm’s strategy to target asymptomatic patients.
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Based on FDA findings, subsequent revelations, and our own research, the Company’s results reporting shortcomings appear endemic, and additional compliance issues may remain undisclosed. Our review of employee feedback on Glassdoor highlights concerns around (1) heavy workloads negatively impacting reporting quality, (2) a general lack of care regarding patient safety, and (3) the implications of continued outsourcing of reporting personnel overseas. iRhythm’s efforts to outsource its CCT operations to India and the Philippines may face pushback from some cardiologists based on our survey results. More importantly, we find that iRhythm may have used unqualified personnel to interpret patient data, creating additional potential legal liability.
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We believe the asymptomatic patient market opportunity is overstated and will disappoint investor expectations.
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Given iRhythm’s relatively small addressable market, expansion into testing asymptomatic patients is expected to be a key driver of the Company’s anticipated growth, yet we see numerous risks to this strategy. The current market served by iRhythm products is quite small, at roughly 6.5 million patients a year. Three million of those tests are served by iRhythm’s core LTCM product, the Zio XT/Monitor. Yet, not only does iRhythm already have ~70% share of this market, but this is also the product that we believe is most commoditized and subject to competitive inroads. Another 2.5 million patients are currently being served by traditional Holter monitors. While we acknowledge Holter share is slowly declining, we see a structural floor as the practical reality is that Holter monitors (1) are more accurate as multi-lead devices, and (2) will simply be the more appropriate device depending on certain clinical situations. Thus, iRhythm’s promotion of the asymptomatic opportunity is understandable, as the Company needs to find a new leg of growth to support its hefty valuation. The Company settled on the opportunity to have primary care physicians (PCPs) proactively prescribe monitors for asymptomatic patients, suggesting there is widespread support because (1) such pre-emptive monitoring can avoid more costly future medical interventions, and (2) doing so can relieve the burden on cardiologists. Of course, the Company excitedly pitches that the asymptomatic market could expand its addressable market by 27 million patients annually.
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Our research finds that the testing of asymptomatic patients has not been adopted as a standard of care by any credible organization. Moreover, we found that cardiologists are not supportive of asymptomatic testing because they believe PCPs are not qualified to interpret the data. This highlights what we believe is a major disconnect in iRhythm’s strategy. In stark contrast to iRhythm’s claim of “99% physician agreement” with their final reports, our cardiologist survey found materially more frequent disagreements with final report conclusions, meaning PCP reliance on those reports may not be in patients’ best interests. Our survey of cardiologists also found a high incidence of re-testing after PCP involvement and a belief that testing asymptomatic patients will inevitably result in over-testing while doing little to improve outcomes. Moreover, while iRhythm likes to point to the widespread prevalence of arrhythmias, the reality is that cardiologists believe monitoring is only justifiable when the patient diagnosis involves certain types of strokes, suggesting a much more limited patient population. We also question the ROI on asymptomatic monitoring, as most tests need to be repeated (in part due to PCP errors) and because of short patient coverage duration for a given insurer (making proactive intervention less economical).
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Insofar as a meaningful asymptomatic market develops, we believe it will be dominated by near-ubiquitous consumer devices. Apple and Samsung smartwatches and smartphone-paired devices all have the ability to test for arrhythmias with near-comparable sensitivity and specificity at practically zero cost to insurers. Recent reports indicate Apple is poised to disrupt the hearing aid market with its earbuds, and we expect the same here. Moreover, as outlined above, these consumer device platforms already incorporate a broader array of sensor technologies, enabling their use beyond cardiac monitoring alone.
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Given iRhythm’s relatively small addressable market, expansion into testing asymptomatic patients is expected to be a key driver of the Company’s anticipated growth, yet we see numerous risks to this strategy. The current market served by iRhythm products is quite small, at roughly 6.5 million patients a year. Three million of those tests are served by iRhythm’s core LTCM product, the Zio XT/Monitor. Yet, not only does iRhythm already have ~70% share of this market, but this is also the product that we believe is most commoditized and subject to competitive inroads. Another 2.5 million patients are currently being served by traditional Holter monitors. While we acknowledge Holter share is slowly declining, we see a structural floor as the practical reality is that Holter monitors (1) are more accurate as multi-lead devices, and (2) will simply be the more appropriate device depending on certain clinical situations. Thus, iRhythm’s promotion of the asymptomatic opportunity is understandable, as the Company needs to find a new leg of growth to support its hefty valuation. The Company settled on the opportunity to have primary care physicians (PCPs) proactively prescribe monitors for asymptomatic patients, suggesting there is widespread support because (1) such pre-emptive monitoring can avoid more costly future medical interventions, and (2) doing so can relieve the burden on cardiologists. Of course, the Company excitedly pitches that the asymptomatic market could expand its addressable market by 27 million patients annually.
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We believe numerous headwinds will constrain growth, and our concerns are exacerbated by indications of declining revenue quality and poor and declining financial transparency.
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While we acknowledge the market’s reaction to iRhythm’s recent reported results, we believe these results represent only transitory strength. We see numerous growth headwinds facing iRhythm. Q1 2025 disclosure suggested that, excluding referral activity from PCPs, YoY revenue growth was modest at best, and iRhythm failed to disclose the information needed to update this analysis. With increases in “non-contracted” revenue, contractual adjustments, and accounts receivable write-offs, we observe a marked decline in iRhythm’s reported revenue quality. We also believe it is possible that revenue has benefitted from inflated reimbursement related to its CCT operations. Reimbursement issues have historically been a negative catalyst for iRhythm shares, and we see risks of continued reimbursement decreases for the Zio AT (or any future MCT product) due to decreasing service delivery costs and alternative solution costs. Importantly, most of iRhythm’s recent outperformance versus expectations came from its core LTCM market, where its high market share limits continued gains, rather than oft-cited new market opportunities. Investors may have missed it, but iRhythm disclosed on its Q2 2025 earnings call that the MCT market opportunity is smaller than assumed. iRhythm has also pitched a massive international opportunity, yet we find that growth in the UK (its largest ex-U.S. market) has been modest, and a recent reimbursement ruling in Japan was a disappointment that we believe management should have foreseen. Given historic preference for Holter monitors and a lack of reimbursement, we question both the topline growth potential and profit prospects for international markets. Taken together, our analysis highlights real risks to the Company meeting 2027E revenue expectations. All these headwinds are particularly concerning for iRhythm, as we believe the Company has a structurally unattractive margin model. We believe investors should also be concerned that the Company’s regulatory issues have been accompanied by a material decrease in business and financial transparency, we believe a harbinger for future financial disappointments.
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While we acknowledge the market’s reaction to iRhythm’s recent reported results, we believe these results represent only transitory strength. We see numerous growth headwinds facing iRhythm. Q1 2025 disclosure suggested that, excluding referral activity from PCPs, YoY revenue growth was modest at best, and iRhythm failed to disclose the information needed to update this analysis. With increases in “non-contracted” revenue, contractual adjustments, and accounts receivable write-offs, we observe a marked decline in iRhythm’s reported revenue quality. We also believe it is possible that revenue has benefitted from inflated reimbursement related to its CCT operations. Reimbursement issues have historically been a negative catalyst for iRhythm shares, and we see risks of continued reimbursement decreases for the Zio AT (or any future MCT product) due to decreasing service delivery costs and alternative solution costs. Importantly, most of iRhythm’s recent outperformance versus expectations came from its core LTCM market, where its high market share limits continued gains, rather than oft-cited new market opportunities. Investors may have missed it, but iRhythm disclosed on its Q2 2025 earnings call that the MCT market opportunity is smaller than assumed. iRhythm has also pitched a massive international opportunity, yet we find that growth in the UK (its largest ex-U.S. market) has been modest, and a recent reimbursement ruling in Japan was a disappointment that we believe management should have foreseen. Given historic preference for Holter monitors and a lack of reimbursement, we question both the topline growth potential and profit prospects for international markets. Taken together, our analysis highlights real risks to the Company meeting 2027E revenue expectations. All these headwinds are particularly concerning for iRhythm, as we believe the Company has a structurally unattractive margin model. We believe investors should also be concerned that the Company’s regulatory issues have been accompanied by a material decrease in business and financial transparency, we believe a harbinger for future financial disappointments.
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iRhythm trades at a $5.4 billion market capitalization and a 7x 2026E revenue multiple despite being a niche and commoditized single product company with a history of poor profitability and questionable new growth opportunities.
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iRhythm’s recent stock run seems overdone and ignores the Company’s persistent risks. Despite allegedly endangering patients and the specter of legal liability, iRhythm shares have rallied toward a two-year high. Even Wall Street analysts, who we believe are largely ignoring both the regulatory risks and looming growth headwinds, are having a hard time justifying iRhythm’s inflated stock price. Despite all but one of the 13 covering analysts having a “Buy” rating on iRhythm shares, the average price target represents just 11% upside from current.
- iRhythm is trading at an approximate 100% to 200% valuation multiple premium. We view iRhythm as a low-margin supplier of a largely commoditized product, yet the Company is currently trading at an approximate 100% premium to other medical device companies. Arguably, iRhythm is actually a services company, a position endorsed by one of the Company’s former CFOs. This is problematic for the stock, since the Company is trading at an approximate 200% premium to medical testing services companies, which we believe more closely approximate iRhythm’s CCT operations and thus represent credible comparable companies. Based on our analysis, even assuming iRhythm can meet the Wall Street forecasted revenue range in 2026, we derive a price target range of $43 to $94 per share, representing approximately 40% to 70% downside from current and material risk of underperformance relative to medical device and services industry peers and the broader market.
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iRhythm’s recent stock run seems overdone and ignores the Company’s persistent risks. Despite allegedly endangering patients and the specter of legal liability, iRhythm shares have rallied toward a two-year high. Even Wall Street analysts, who we believe are largely ignoring both the regulatory risks and looming growth headwinds, are having a hard time justifying iRhythm’s inflated stock price. Despite all but one of the 13 covering analysts having a “Buy” rating on iRhythm shares, the average price target represents just 11% upside from current.
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Please note that the items summarized in this press release are expanded upon and supported with data, public filings and records, and images in Spruce Point’s full report. As a reminder, our full report, along with its investment disclaimers, can be downloaded and viewed at www.SprucePointCap.com.
As disclosed, Spruce Point and/or its clients have a short position in iRhythm Technologies, Inc. (Nasdaq: IRTC) and owns derivative securities that stand to net benefit if its share price falls. Following publication of the report, we intend to continue transacting in the securities covered therein, and we may be long, short, or neutral at any time hereafter regardless of our initial opinion. For additional important information, please review the “Full Legal Disclaimer” contained in the report.
About Spruce Point
Spruce Point Capital Management, LLC is a forensic fundamentally-oriented investment manager that focuses on short-selling, value, and special situation investment opportunities.
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Contacts
Daniel Oliver
Spruce Point Capital Management
doliver@sprucepointcap.com
(914) 999-2019