olivLaw · European equity research
Sequana Medical SEQUA.BR
Belgium · Euronext Brussels · ISIN BE0974340722 · Vertical: Listed companies from Belgium
Sequana Medical is a Belgian medical technology company developing the alfapump, an implantable device for refractory ascites from liver cirrhosis, and the DSR therapy for heart failure. In 2023 it was preparing a US launch after filing a PMA with the FDA, following a pivotal study in which 40 patients met the primary success criteria. For the company, the alfapump is the decisive test of whether the device can be commercialised and reimbursed in the US market.
At the close of 04 Nov 2026, Sequana Medical (SEQUA.BR) stock was 0.61 EUR (+0.00% on the day), with market capitalisation 16.3 m EUR, beta 1.00, 52-week range 0.47–0.76 EUR.
Data as of · AI analysis dated · Source: ESEF annual reports and closing prices, computed by olivLaw.
Price history
Loading chart…
Technical reading
- RSI (14)
- 68.9
- strong (55–70)
- Bollinger (20, 2)
- 0.49 – 0.67
- in the upper half of the band · %B 0.67 · band width 32.4%
- SMA 50 / 200
- 0.54 / 0.72
- mixed trend
- MACD (12, 26, 9)
- 0.02 / 0.02
- MACD above signal
Indicators describe past prices; on their own they do not predict direction. On our history the RSI ≤ 40 filter added no return (see the signals methodology).
Performance
| Company | EURO STOXX 50 | vs EURO STOXX 50 | Vertical median | |
|---|---|---|---|---|
| 1 month | unavailable | −0.6% | unavailable | — |
| 3 months | unavailable | −4.2% | unavailable | — |
| 6 months | unavailable | +4.3% | unavailable | — |
| Year to date | −3.6% | +7.5% | −11.1 pp | — |
| 1 year | −9.3% | +9.9% | −19.3 pp | +6.3% |
| 3 years | −74.0% | +49.8% | −123.8 pp | −6.5% |
| 5 years | −92.2% | +42.8% | −135.1 pp | — |
Price returns, dividends excluded.
Quarterly results
ESEF annual reports carry no quarters: the results are annual (below).
E/P over time
E/P = trailing-12-month diluted EPS / price at quarter end. E/P is the inverse of P/E and stays defined when earnings are negative.
Fiscal years
| Fiscal year | 2021 | 2022 | 2023 |
|---|---|---|---|
| Revenue | 370.5 k | 922.7 k | 712.2 k |
| Revenue YoY | unavailable | +149.0% | −22.8% |
| Net income | -23.6 m | -30.8 m | -32.6 m |
| Net income YoY | unavailable | unavailable | unavailable |
| Diluted EPS | -1.30 | -1.35 | -1.22 |
| Diluted EPS YoY | unavailable | unavailable | unavailable |
| net % | -6,373.8% | -3,334.1% | -4,572.4% |
| Free cash flow | -23.9 m | -28.2 m | -29.8 m |
Balance sheet & financial health
Fiscal year 2023 · 31 Dec 2023
- Cash
- 2.6 m EUR
- Financial debt
- 9.0 m EUR
- Net debt
- 6.4 m EUR
- Equity
- -19.5 m EUR
- Total assets
- 10.1 m EUR
- Debt / equity
- unavailable
- Current ratio
- 0.32x
- ROE
- unavailable
- ROA
- -180.3%
- FCF margin
- -4,180.7%
Financial statements (source on every figure)
Revenue and net income (EUR)
Margins
Income statement · EUR
| Line | 2021 | 2022 | 2023 | Source (latest year) |
|---|---|---|---|---|
| Revenue | 370.5 k | 922.7 k | 712.2 k | esef· 01 May 2024verified |
| Cost of revenue | 76.7 k | 204.6 k | 164.1 k | esef· 01 May 2024verified |
| Gross profit | 293.8 k | 718.1 k | 548.0 k | esef· 01 May 2024verified |
| Operating income | -22.6 m | -28.1 m | -28.9 m | esef· 01 May 2024verified |
| Interest expense | 854.5 k | 2.7 m | 4.3 m | esef· 01 May 2024verified |
| Income tax | 393.3 k | 386.6 k | 465.6 k | esef· 01 May 2024verified |
| Net income | -23.6 m | -30.8 m | -32.6 m | esef· 01 May 2024verified |
| Diluted EPS | -1.30 | -1.35 | -1.22 | esef· 01 May 2024verified |
Balance sheet · EUR
| Line | 2021 | 2022 | 2023 | Source (latest year) |
|---|---|---|---|---|
| Cash | 9.6 m | 18.9 m | 2.6 m | esef· 01 May 2024verified |
| Inventories | 2.1 m | 2.6 m | 2.3 m | esef· 01 May 2024verified |
| Current assets | 12.9 m | 23.1 m | 6.3 m | esef· 01 May 2024verified |
| Property, plant & equipment, net | 1.3 m | 2.1 m | 2.3 m | esef· 01 May 2024verified |
| Total assets | 14.7 m | 26.0 m | 10.1 m | esef· 01 May 2024verified |
| Long-term debt | 7.3 m | 12.2 m | 9.0 m | esef· 01 May 2024verified |
| Current liabilities | 7.2 m | 15.1 m | 19.5 m | esef· 01 May 2024verified |
| Equity | -786.9 k | -2.2 m | -19.5 m | esef· 01 May 2024verified |
| Shares outstanding at year end | 18.2 m | 22.8 m | 26.7 m | esef· 01 May 2024derived |
Cash flow · EUR
| Line | 2021 | 2022 | 2023 | Source (latest year) |
|---|---|---|---|---|
| Operating cash flow | -23.6 m | -27.5 m | -29.1 m | esef· 01 May 2024verified |
| Capex | 325.8 k | 676.7 k | 710.8 k | esef· 01 May 2024verified |
| Free cash flow | -23.9 m ≈ | -28.2 m ≈ | -29.8 m ≈ | esef· 01 May 2024derived |
| Investing cash flow | -338.2 k | -653.1 k | -721.4 k | esef· 01 May 2024verified |
| Financing cash flow | 22.4 m | 37.3 m | 13.5 m | esef· 01 May 2024verified |
≈ computed by olivLaw from the reported lines of the same year: Operating cash flow − Capex.
Computed indicators
Growth
Profitability
Returns
Balance sheet
Liquidity
Cash
Efficiency
Market and valuation
1 indicators that do not apply to the sector.
Valuation
olivLaw classification
- indicators available: 4 of at least 6
- score weight coverage: 25.0% of at least 60%
- valuation methods computed: 0 of at least 1
A scoring methodology on indicators and valuation, not investment advice.
Closing price
04 Nov 2026Source: olivLaw, closing series
Market cap: 16.3 m EUR
Key indicators
Coverage and freshness
The data is older than the freshness threshold.
Score by group
25% · Insufficient data
Estimated value range
unavailable — no valuation method could be computed
Valuation assumptions are editorial choices, not measured; beta is not measured.
Valuation methods
- DCF (discounted cash flow)unavailable · the base of the ratio is not positive
- Peers: EV/EBITDAunavailable · input data missing
- Peers: P/Eunavailable · the base of the ratio is not positive
- Dividend discount (DDM)unavailable · the company pays no dividend: a dividend model needs an explicit initiation assumption
no valuation method could be computed
Assumptions (illustrative, editorial)
- Risk-free rate
- 3.0%
- Equity risk premium
- 5.5%
- Beta (default)
- 1.00
- Cost of equity
- 8.5%
- Terminal growth
- 2.0%
Factor scorecard
Insufficient data
Minimum-evidence gate: indicators available: 4 of at least 6; score weight coverage: 25.0% of at least 60%; valuation methods computed: 0 of at least 1
| Factor | Value | Score | Weight used |
|---|---|---|---|
| ROIC · Quality | unavailable | unavailable | — |
| Net margin · Quality | -4,572.4% | 0 (vs peers) | 25% |
| FCF conversion · Quality | unavailable | unavailable | — |
| Revenue CAGR 3Y · Growth | unavailable | unavailable | — |
| EPS CAGR 3Y · Growth | unavailable | unavailable | — |
| Net debt / EBITDA · Balance sheet | unavailable | unavailable | — |
| Interest coverage · Balance sheet | -6.7x | 0 (on a fixed band) | 25% |
| Current ratio · Balance sheet | 0.3x | 0 (on a fixed band) | 17% |
| P/E (TTM) · Valuation | unavailable | unavailable | — |
| EV/EBITDA · Valuation | unavailable | unavailable | — |
| FCF yield · Valuation | -182.6% | 0 (on a fixed band) | 33% |
| Shareholder yield (distributions) · Returns | unavailable | unavailable | — |
| Payout ratio (FCF) · Returns | unavailable | unavailable | — |
Factors without a value were dropped; the remaining weights were renormalised.
Score groups
- Balance sheet0/100 · 2/3 factors with a value
- Growth· partialunavailable · 0/2 factors with a value
- Quality· partial0/100 · 1/3 factors with a value
- Returns· partialunavailable · 0/2 factors with a value
- Valuation· partial0/100 · 1/3 factors with a value
A «partial» group is computed from under half of its weight or from one factor: it is not a full assessment of the group.
Memo
Sequana Medical (SEQUA.BR). Latest full fiscal year: 2023; data up to 2023-12-31.
Figures computed from the financial statements: revenue 712.2 k EUR in 2023; YoY growth -22.8%; net margin -4,572.4%.
Valuation cannot be computed from the available data.
Insufficient data for a verdict (indicators available: 4 of at least 6; score weight coverage: 25.0% of at least 60%; valuation methods computed: 0 of at least 1).
Text generated deterministically from the figures shown; no language model. Not investment advice.
What supports the thesis
No signal among the computed factors. That is not an absence of risk: factors without data were not assessed, and business risks (margins, inventory, demand) are in the source-based analysis.
What contradicts it
- Net margin: -4,572.4%
- Interest coverage: -6.7x
- Current ratio: 0.3x
- FCF yield: -182.6%
Not assessed (insufficient data or a ratio without meaning): ROIC, FCF conversion, Revenue CAGR 3Y, EPS CAGR 3Y, Net debt / EBITDA, P/E (TTM), EV/EBITDA, Shareholder yield (distributions), Payout ratio (FCF).
Versus the vertical median
Listed companies from Belgium · same country · compared with 39 companies
Multiples and returns vs the median
Price rebased to 100 (monthly, 5 years)
Companies in the vertical
| Market cap | P/E | ROE | Net margin | Revenue YoY | 1A / 3A | |
|---|---|---|---|---|---|---|
| ELI.BRElia Group | 11.9 bn | 23.3 | 9.6% | 13.6% | −2.0% | +28% / +34% |
| LOTB.BRLotus Bakeries | 11.4 bn | 66.4 | 20.9% | 12.7% | +10.0% | +82% / +76% |
| GBLB.BRGroupe Bruxelles Lambert - Groep Brussel Lambert | 10.6 bn | 82.4 | 0.8% | 2.1% | +1.0% | +6% / +9% |
| DIE.BRD'ieteren Group | 9.7 bn | 23.2 | — | 5.3% | −1.5% | +22% / +16% |
| ACKB.BRAckermans & Van Haaren | 8.8 bn | 22.2 | 8.4% | 7.6% | +18.6% | +22% / +77% |
| COLR.BRColruyt Group | 4.4 bn | 14.6 | 9.4% | 2.9% | +3.1% | +12% / −6% |
| DEME.BRDeme Group | 4.2 bn | 12.2 | 15.5% | 8.3% | +1.3% | +21% / +72% |
| AZE.BRAzelis Group | 2.9 bn | 16.1 | 6.6% | 4.3% | +1.5% | +29% / −42% |
| MELE.BRMelexis | 2.1 bn | 12.4 | 30.7% | 18.4% | −3.3% | −1% / −38% |
| BEKB.BRNV Bekaert SA | 2.1 bn | 30.7 | 3.1% | 1.8% | −6.4% | +10% / −5% |
| FAGR.BRFagron | 1.8 bn | 22.2 | 16.7% | 9.2% | +14.3% | +15% / +40% |
| KIN.BRKinepolis Group | 1.4 bn | 33.9 | 19.3% | 7.0% | −4.5% | +62% / +11% |
| JEN.BRJensen Group | 706.9 m | 17.2 | 15.1% | 9.1% | +13.3% | +28% / +111% |
| BAR.BRBarco | 563.5 m | 9.1 | 7.9% | 6.7% | −9.9% | −48% / −59% |
| IBAB.BRIon Beam Applications | 487.2 m | 39.5 | 10.7% | 2.1% | +24.5% | +48% / +52% |
| DECB.BRDeceuninck | 341.3 m | 24.6 | 4.3% | 1.7% | −4.5% | +8% / +8% |
| CAMB.BRCampine | 272.3 m | 12.2 | 28.6% | 6.1% | +13.4% | −12% / +161% |
| CFEB.BRAannemingsmaatschappij Cfe | 266.8 m | 11.1 | 9.9% | 2.0% | −5.3% | +22% / +48% |
| EVS.BREvs Broadcast Equipment | 245.9 m | 6.0 | 20.8% | 21.7% | +14.3% | −49% / −36% |
| BPOST.BRBpost | 229.8 m | 3.5 | 6.3% | 1.5% | −2.6% | −39% / −75% |
| ECONB.BREconocom Group | 210.7 m | 40.5 | 1.2% | 0.2% | +4.3% | −1% / −36% |
| IMMO.BRImmobel | 172.2 m | — | -7.4% | -25.2% | −32.8% | −24% / −36% |
| MONNI.BRKeyware Technologies | 171.0 m | 162.0 | 3.5% | 4.5% | −5.9% | −5% / −17% |
| HYSG.BRHybrid Software Group PLC | 121.3 m | — | -2.5% | -5.5% | +7.2% | −4% / +13% |
| HYL.BRHyloris Pharmaceuticals | 96.4 m | — | -21.6% | -87.9% | −14.8% | −42% / −69% |
1- and 3-year price returns: for SEQUA.BR from daily closes (the same as the performance table), for the other companies from month-end closes.
olivLaw engine forecast
The world engine ran after the company's latest material disclosure. Probabilities are of TOUCHING a level within the horizon (not closing there) and sit next to the random walk (p_rw), the no-information benchmark.
The engine has no published run for this company yet.
Valuation scenarios (editable assumptions)
Illustrative scenarios
Illustrative: not forecasts and without probabilities. Each case is one coherent set of assumptions, computed on today's figures.
Estimated price (EUR)
| Estimated price | Bear | Base | Bull |
|---|---|---|---|
| 1 years | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable |
| 3 years | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable |
| 5 years | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable |
AI analysis
AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.
In brief
Sequana Medical is a Belgian medical technology company developing the alfapump, an implantable device for refractory ascites from liver cirrhosis, and the DSR therapy for heart failure. In 2023 it was preparing a US launch after filing a PMA with the FDA, following a pivotal study in which 40 patients met the primary success criteria. For the company, the alfapump is the decisive test of whether the device can be commercialised and reimbursed in the US market.
SWOT
Strengths
- Positive pivotal data for the alfapump and breakthrough device designation from the FDA.
- Clinical experience in Europe and the United States, with relationships built with opinion leaders.
- A two-pillar portfolio, alfapump and DSR, which reduces dependence on a single product.
Weaknesses
- A history of operating losses and negative cash flow, without sufficient working capital for at least 12 months.
- Reliance on external suppliers, some of them sole-source, and on third parties for clinical and regulatory work.
- A small US commercial team and dependence on clinician adoption to build sales.
Opportunities
- A US launch could open a large market if FDA approval and reimbursement are confirmed.
- A strategic partnership for DSR could accelerate development and commercialisation of the heart failure therapy.
- CMS reimbursement mechanisms such as NTAP and TCET could support patient access to the alfapump.
Threats
- The PMA process can be lengthy, costly and uncertain, and requirements may change.
- Payment pressure and possibly insufficient reimbursement could reduce the company's margin.
- Competition from large device and pharmaceutical companies could grow over time.
Risks
- Funding and working capitalhigh
The company lacks sufficient capital for at least 12 months and will need additional funds for investment, which could dilute shareholders.
- Regulatory approvalhigh
PMA approval could be delayed or not obtained, and regulations could change the conditions of commercialisation.
- Reimbursement and pricinghigh
Commercial success depends on third-party payment; if reimbursement levels are insufficient, sales could be limited.
- Supplier dependencemedium
Some components and services come from a single supplier, and interruptions could affect production.
- Clinical outcomes and adverse eventsmedium
Adverse events could delay studies or prevent their completion, and an implantable therapy carries surgical risks.
Investment thesis
What would need to be true (bull case)
- If the alfapump obtains FDA approval and is reimbursed through CMS mechanisms, the company could open a significant commercial market in the US.
- Positive pivotal data and longer-term results could support adoption by transplant centres.
- If DSR finds a strategic partner, development could advance faster without exhausting the company's resources.
What would break the thesis
- The company has historical losses and may need additional funding, which could dilute shareholders.
- If FDA approval is delayed or reimbursement is insufficient, the commercial launch could become more costly than planned.
- DSR is still at an early stage, and if the MOJAVE study does not confirm earlier results, the value of this direction could be limited.
What to watch
- FDA decision on the alfapump PMA application2025
- US commercial launch and first alfapump sales2025
- MOJAVE study results and progress of the DSR partnership frameworknext 10-K
- Confirmation of NTAP and TCET coverage for the alfapump2025
Products, market & competition
AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.
The business
Sequana Medical operates in medical devices and therapies for cardiorenal and liver conditions. Its lead product, the alfapump, is an implantable pump that drains fluid from the abdomen of patients with recurrent or refractory ascites caused by cirrhosis. In the Pivotal Cohort 40 patients received the implant, and another 29 were included in the Roll-In Cohort 1. The company filed a PMA with the FDA in December 2023 and targets a commercial launch in 2025 1.
The second pillar is DSR (Direct Sodium Removal) therapy for heart failure, designed to remove excess sodium from the body and reduce reliance on loop diuretics. The company reported results from the RED DESERT and SAHARA studies and is running the MOJAVE study to confirm them 1. DSR development is earlier stage and depends on a strategic partnership the company is considering 1.
The revenue model rests on selling the device to hospitals, with reimbursement through CPT codes and DRG payments, and the company targets a price of about 30000 USD per pump 1. The initial commercial focus is on adult liver transplant centres, with a limited US sales team 1.
Segments
Alfapump (liver ascites)
The alfapump is the product with the most advanced development. The pivotal POSEIDON study showed a median 100% reduction in therapeutic paracentesis at six months and an estimated 70% survival at 12 and 18 months after implantation 1. The PMA is under FDA review, and commercial success depends on clinician adoption and reimbursement 1.
DSR (heart failure)
DSR targets cardiorenal syndrome, a clinical problem with few effective options. Preliminary data from RED DESERT and SAHARA show improved diuretic response and reduced need for loop diuretics, but the MOJAVE study is still early 1. The company has no confirmed commercial path and intends to seek a strategic partner 1.
Market context
The US market targeted by the alfapump is concentrated in about 125 adult liver transplant centres, of which 90 cover 95% of implantations 1. The company says NASH-related cirrhosis is becoming an important driver of the North American market, and a patient preference study indicated a 65% likelihood that patients would choose the alfapump over large-volume paracentesis 1.
The DSR heart failure market is broader but competitive and dependent on established therapies. The company points to the lack of treatments that improve outcomes in cardiorenal syndrome and argues that DSR could fill an unmet niche 1.
Trends
- FDA approval processmixed
Breakthrough device status and acceptance of the PMA for substantive review could speed up the evaluation of the alfapump. If approval arrives on the expected timeline, the commercial launch could begin in 2025 1.
- CMS coverage and CPT codestailwind
New category III CPT codes available from July 2024 and a possible NTAP payment could support reimbursement for the alfapump. If these mechanisms work, patient access could grow 1.
- Pricing and margin pressureheadwind
The targeted price and gross margin depend on DRG and NTAP payments, and any cut in reimbursement could affect the alfapump margin 1.
- Geopolitical tensions and supply chainsheadwind
Conflicts in Eastern Europe and the Middle East could disrupt the company's supply chain or macroeconomic conditions 1.
Competitive position
The analysed source does not give a full list of competitors. Competition comes from other medical device companies, pharmaceutical firms and their device subsidiaries, which the filing describes as significant and growing 1. For refractory ascites, the main alternative remains large-volume paracentesis, the standard procedure the alfapump aims to replace 1.
- Large-volume paracentesis (standard of care)
The reference procedure the alfapump aims to replace, according to the patient preference study in the filing.
- Large medical device companies
Competition the filing describes as significant and growing, without named companies in the analysed source.
- Pharmaceutical companies and device subsidiaries
Players that could develop alternative heart failure and cardiorenal therapies, mentioned generically in the filing.
- Loop diuretics (standard heart failure therapy)
The standard treatment DSR seeks to reduce, given their negative effects on cardiorenal syndrome.
News & filings
In the press
No news in our archive over the last 180 days.
Annual reports (ESEF)
- Annual report 202301 May 2024
- Annual report 202202 May 2023
Sources
- [1] Annual report, fiscal year ended 2023-12-31 (ESEF) · SEC / Sequana Medical · 31 Dec 2023
Figures computed by olivLaw from ESEF annual reports and closing prices; the qualitative analysis is AI-generated from cited sources. Not investment advice.