SIBN - Earnings call transcript Q1 2024

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Operator

Good afternoon, and welcome to SI-BONE's First Quarter 2024 Earnings Conference Call. [Operator Instructions] As a reminder, this call is being recorded for replay purposes. I would now like to turn the call over to Saqib Iqbal, Senior Director of Investor Relations at SI-BONE for a few introductory comments.

Saqib Iqbal

Thank you for participating in today's call.

Joining me are Laura Francis, Chief Executive Officer; and Anshul Maheshwari, Chief Financial Officer. Earlier today, SI-BONE released financial results for the quarter ended March 31, 2024. A copy of the press release is available on the company's website.

Laws, like this you statements provisions call meaning Federal I'd make management within of begin, pursuant of during made Litigation statements that Securities of the we Private to safe Reform that remind will the to Securities Before the are Act harbor XXXX. which include forward-looking statements in this forward-looking or events, future of performance contained call are expectations Any results statements. predictions that relate or to risks its SI-BONE's involve uncertainties. These products These commercialize for of undergo elective current maintain impact are of expectations SI-BONE's the forward-looking to of risks authorization financial the and favorable based by company's renormalization potential to and procedures, future its our manage economic of capital impact examination estimates our for ability enrollment operating and SI-BONE's to are health patients of trial for the physician inherently of to statements include the ability the to procedures, driven our new on and products physicians, desire requirements ability reimbursement new forward-looking and expectations, adoption, risks assumptions. future operating care in introduce such supply statements risks and products clinical as trends and requirements and weakness indications, upon involving based and products, payer procedures environment. Other include SI-BONE's on changes ability training and introductions product the and various and current expectations chain active new continued to statements. and anticipated implied events materially those to statements uncertainties or could or results forward-looking these differ involve that These material cause risks actual by from these statements. reliance Accordingly, you on should not undue place

with Form and most refer business, Factors the a section and of filed and Commission. to risks recent uncertainties with associated our of the Exchange please For list description Risk our XX-K Securities the

discuss also measures, EBITDA adjusted results. management the non-GAAP this call, including company's may certain During

except accounting, earnings future today, events SI-BONE as information accurate [indiscernible] release [indiscernible] any intention to financial the issued statements, any these obligation, broadcast or reconciliation Conference time-sensitive please measures or disclaims forward-looking to only or law, projections otherwise. GAAP is a update For today. the earlier or of revise of see new required as live non-GAAP of with by company's that full call information, contains whether because and

Laura Francis

when with for Thanks, prior afternoon, quarter with robust $XX.X us. I'm and pleased representing Good U.S. our Saqib. growth demand in maintained XX% industry thank the across a evident results, completed compare impressed momentum quarter delivered typical you also of particularly all in the first markets. solid target number a trends in joining training. by demand performance and active you record near quarter, year impressive first U.S. our our first million over we seasonality the our physicians period. procedure In continued We of and the worldwide in engagement number to new the in physician prior stellar of physician revenue, our record-breaking trends. driven was performance year. The I'm

about we of fueled remain acceleration As at key the by tailwinds. enthusiastic revenue we the look XXXX, rest three growth

record level the engagement First, the of by physician base seeing. our continued we're in driven growth

development our XXX(k) Second, building the leverage our opportunity TORQ family expanding These iFuse-XD success core granted a on [ expanded adoption Colorado, of the and for pediatric expanding key received SX us. We diameter, of in market of of the points; recognized Columbia exciting cases guided utilizing with to deformity. Clack third, per a Mezawala and Bedrock Dr. Granite to of implants performing Dr. the in with opinion leader X.X for adoption increased pedicle the spine the Lehman of procedures fixation iFuse head adult pelvic the strong physician. In both for first Ronald implant first options, the placement our ], this University, but end ], conditions physician launched clearance April FDA at [ and nationally country. pediatric from at technology; and across new a Granite [ University millimeter ] the and a our who are expert with of treatment base accelerate Dr. the surgeon in Ali within all at opportunities market quarter, open and active [ we indication adjacent ], and C.J. the implant closed

fixation The new results in points now impact XXXX, among from active the high physician launched XXX,XXX we annual iFuse-TORQ this XX as revenue annual Granite needs XXXX XXXX. We've the leveraged and XX of the clinical extension of highly and Granite closed pace since well anticipation in our industry-leading this to line procedures, revenue strategy to level Given extension In call portfolio trauma. growth. and solutions strong organization diversify as in markets public will XX we XXXX, to Granite which XXXX target we're in and and as build surgeon of in and intra our XX% delivered Granite's Line growth of our and our expand our and successfully in X the differentiated our broad a in augment our base. we products public doubled strategy, that reflected adoption. The of Granite address XXXX, of this and last unmet head a in enthusiasm create community commercial accelerate continuation is of addition streams, the laid cumulative years, out confident innovative is franchise Granite

celebrated help focusing back history. XXX,XXX procedures our our [indiscernible] pride market and pelvic into work on the awareness education, get want We We recognize who products. priorities, take to details honored patients and recently market I physicians impressive so milestone in Before our We give the take of of their using in to strategic day. major completion opportunity this I access which leadership in lives of execution, every includes conditions. many the feel with to company's a

long-term shareholder value. Starting our initiatives on infrastructure. our position, sales key update as growth we an drive create extend to provide me let and look with Now strong leadership

marketing and for grew sales and sales, commercial sales education effectiveness impressed infrastructure a support our the and marketing in tremendous industry-leading across reflecting professional growth commercial consistently that case delivering portfolio in physicians. This the models in known expertise period coverage. unparalleled of expense compared as is specialists XX-month quarter sales evident per provide teams with revenue the well the support trailing end hybrid We're cumulative expanded bandwidth first agents us by We markets. for approximately quarter expanded quarter Our the of revenue U.S. trailing and augment with extensive to while territory target competitive XX% We've the select third-party teams and our hybrid sales model with XX The agents creating as education for first of our and leverage our resulted with first clinical growth continued quota-carrying XX%, with sales experience of advantage. ended XX-month manager during while with operating We X-year the territory managers. territory XXXX period. XX% and ended marketing $X.X in P&L million, their XXXX. of at

we to our facilitate the steadily territory next annual million. few to maximize of We with and ensure grow the plan deeper portfolio We per $X revenue growing add over potential our methodically engagement toward physicians. to territories expect years the

to year active ability quarter over active physician active The X,XXX on prior grow physicians of over confident physicians physicians to quarter our XXX first remain over year-over-year consecutive nearly we XXXX XX% compared XX,XXX to of the the Moving quarter physicians, We target was U.S. an our growth, first in the in the quarter growth in XXth engagement. with physician exited increase period. of with active base. double-digit the potential

volumes programs. quarters have group education. the year. exciting in force Granite the adoption of products for significant degenerative important quarter quarter than these our the strong years which In procedures, active we drive from since first active growing one over been of active XX per strong nearly XXXX, physicians Our XXX of XXXX, revenue the excited initiative XX% adoption type. our to the implant opportunity residents going XXXX see has resulted academic We're is XX% over their period. of deeper portfolio fellows, targeting trained also and position this accounts X,XXX and training in engagement. We've portion physicians XXXX, to for performed physician current sales base a to our In our increase procedure academic including of prior to With leveraging compared grow another our our an first proprietary from trends that revenue to follow XXXX, year physicians, in physician the time. Since more spine procedure

Turning to Products & Solutions.

U.S. The techniques demonstrated substantiates and building to in a volume and have growth innovative outcomes. sustained value of track and address products improve our We we've experienced of proprietary the surgical unmet innovation. clinical procedure the needs record patient

revenue over being an XX% pipeline of products active product clinical have reinvested development our in evidence. new We with of and

products coming pelvic and when the to differentiated year joint launch our further sacropelvic industry-leading applications to pelvic in dysfunction, expect to revenue leadership iFuse-XD physicians accelerate access solutions SI trauma, portfolio iFuse-TORQ and fixation across growth. With give and performing We procedures. extend

across years, X strong as physician built contributor well to target all acceleration is on last and as demand success engagement iFuse-XD of iFuse-TORQ the Over active been key the a our markets.

portfolio. complementary trauma up XXXXX. We're procedure, in reimbursed and under sacral the XX% bedrest, and experience a their suggest of breakthrough the device our insufficiency and the outcomes. Adoption of by is iFuse-TORQ as physicians, iFuse-TORQ as physicians ] interventional transfixing them of engage training pain interventional well performing confidence this of excitement on patient in best XXXX, pain comprehensive iFuse product. for by most adopt preferred product over the the the a operative with our continues driver be adoption support interventional surface growing leading pain our technique with code game-changing that CPT to as and treating solution. our terms mortality for XXX,XXX increasing better first when iFuse-Intra, we're just us. Within allograft of fixation, being Bedrock to we're Advisory SI rate we pain physicians. fusion fractures our Board, in technique trauma active an The Granite for iFuse-TORQ iFuse-TORQ pace the Based insure treated addition scratching patients. after a approach, market common we'll be portfolio well the [indiscernible] as we're the the increase select the expressed also the adoption Granite, quarter encouraged to encouraged guidance trends [ joint a X-year have As currently, with the the lateral treated market implant interventional the Toward demand likelihood Interventional pelvic has long-term patients surgical launch pleased on and penetration physicians that about with been end for and of pelvic of of year which will a We're for to growth

conditions. we typically As fixation construct. Since strong the spine shorter procedures, volume target larger care of base lumber the level in of to annual procedures. providing of the to at these become The X-level the procedures long fusion granite SI Granite community XX,XXX and fusion XXXX, undergoing Granite degenerative increasing believe current public standard we will that patients used in fixation [indiscernible] among case shorter has adoption X- interest fusion include been illustrates in the treat a of adult our high-risk procedures, of these for diameter XX% surgeon the over to a joint foundation

best-in-class pedicle Granite in additional earlier, appropriate well that planning XX, an smaller the length We surgeons approximately launch as the diameter the [indiscernible] implant. Granite fusions I engage a have our rollout in as for in for who to June. sacrum, provide deformity an initiated and annual preference XX are replacement highlighted XXX,XXX a shorter including As expressed expanded the implant believe will offering of April, we

Anshul our and over grip XXX,XXX team, to Before the nearly to to relentless enables products, all clinical to solutions. for world-class discuss that that lives I'll physicians I payers do. With our congratulate get target helping to over evidence, X.X call financial their To high-quality Thank I hand us you commitment back. patients nearly employees ensure develop want breakthrough our performance. for hand call Anshul, you the by backed and your patients the best-in-class educate access to that, and have million annual

Anshul Maheshwari

growth, Good gross Laura. revenue everyone. productivity quarter comments trends, today afternoon, My will and liquidity. focused Thanks, be margin on first

the otherwise. Starting revenue all unless provided Additionally, year comparisons in growth. the be the period same noted versus with will prior

U.S. procedure growth first revenue grew $XX.X due our flat. quarter representing million, also first procedure quarter XX% quarter of was first revenue million was XX%. International being growth. Our increasing with relatively $XX.X revenue the million, X% in to in U.S. $X.X to the worldwide representing volumes ASP

leverage. operating and margin gross to Moving

margin impact increase deployment gross Operating freight the representing was [indiscernible]. reflects in Our first procedure by of for from commissions the revenue gross of driven The as development which $XX.X our operating and related compensation XX%. second growth. the higher timing was as was million higher expenses expenses by and investments. to The and depreciation in growth this was research increase from quarter of global quarter year. held additional margin by mix, were well revenue versus quarter also the meeting, first the The last sales year growth, quarter, instrument impact in of product XX% stock-based the driven of impacted

per Our our to of per share. X% increase the May follow-on common diluted the Net XXXX net share also million loss loss reflects for by outstanding first offering stock XXXX. in diluted to due improved in or $X.XX $XX.X quarter shares

flat to the was million, prior in loss the which nearly compared was first quarter Our adjusted $X period. year EBITDA

exited quarter improvement with from cash securities. We the of XXXX operations. marketable including liquidity. robust $XXX.X flow Turning our net in a delivered XX% to first million sheet, and We cash balance in

our asset-light business breakeven, of our Given sight priorities long-term position, going we EBITDA line liquidity model our growth have to strong the a resources self-fund adjusted forward. financial relatively and to clear

first million our for Finally, XXXX. goal. With XXXX, in and will adjusted potential within that, expect implying Laura. guidance. operating to to of between Based our significant us $XXX million increasing growth improvement breakeven turn XXXX Xx over quarter XX%. revenue of full the for outlook worldwide results, year-over-year we are of I business, on worldwide Considering we $XXX the approximately our XXXX moving We to our EBITDA XX% revenue expect adjusted the updated EBITDA reach call leverage now the year putting

Laura Francis

to set strong Thanks, XXXX. Anshul. a Based we're up portfolio, on the momentum in the deliver

new beyond As to top-tier target commercial happy coming us across the look we're planned that in the portfolio to years product questions. revenue take allow markets footprint, XXXX, continue and differentiated launches we we're multiple that, combination medical confident device will of Operator? growth. With delivering our

Operator

Our first Young line Instructions] the question of comes of from [Operator Jefferies. Li

Young Li

I little I a kind right. you? the All still TORQ expanding [indiscernible]. of the the hear launched sounds bit to of is physicians I opening start, portfolio, lot a weren't the to since from feedback is guess early wanted Is for it focus the to just curious, market interest before? doors it. of combined And new mean guess the I'm like for about Great. you it who I interventional progress referring

Laura Francis

question, the Yes. Young. are Thanks seeing we thus with far. what we're pleased Intra And for with

especially early So we're still patient to and obviously discrete setting untapped very early in this a journey, but ] of how wanted we like up, interventionalists results of get and [ we this our and the perspective subset engage access the from strategy, funnel. they're to

additive As to surgeons. our current with is you sales this our said,

in the break as but trends adoption of interest level with So their planning we're is not do physicians engagement they're by the in early technique. Within to and but We're trained to pleased initially going a trained impressive -- there's believe with procedure a who the interventionalists to still as use in days TORQ as we Intra, well TORQ interventionalist subset being type, and or we're are the lateral what's metal down hesitant Intra. of with with physician revenue that of being implant. be

physicians are users. these Intra so going be And to

are. And as need regardless preferred market. partner a actually what needs we a their really we're So to a leader, be to point this this strong of to felt call positioned market address

We sales have the commercial best force.

unparalleled educational advocacy have and We infrastructure.

have the a interventionalists And respected by market begun impressed us already who is And with from gotten getting the of are are highly we large clear number that for our portfolio. trained. comprehensive We process working or of leadership have interventionalists feedback position. we've product SI-BONE particularly

Young Li

That's helpful. Great. I productivity. about maybe up, guess follow wanted I right. to ask to very All rep

get $X on about I as What's increased before recent to think hit they your so of range. that, closer in contribution you you far out? And think ceiling. about of agent their I more the can the a million doing a territory had $X.X has more not you Maybe or before bit maxing also milestone, agents plus. million thoughts forward. a and million milestone lot to hear going quarters. managers are a target $X-plus little a It's base adding goal But next wanted

Laura Francis

Yes, yes.

XX% $X.X in So commercial we productivity, the that extremely the of XX-month up million. a we here. And getting leveraging had proud team really rep commercial of growth great job are to leadership trailing models us the hybrid has done

help agents of as number specialists, support a territory So cases. selling And we've said, third-party identify our with have of also to managers are new also and covering as they well. physicians junior that cases the product significant as then we added that well to clinical you as working are cover

really significant So has in productivity helped way. us our that to grow a

So really to four drivers productivity. key that

complemented of sales these force, First models. is hybrid commercial the just increasingly seasoned our caliber with

our Secondly, differentiated solutions. of portfolio highly

Third, is density. reduce And in work with capacity field logistical the physician drive implants flow. instruments to the the surgical synergistic allowing the physician which and rollout then call point, of increase finally, us to

of -- that I over So a to have excess significant territory. We reps as $X grow do per million time of already $X in terms going, where our is million intention are per selling territory we're number in manager continue that to to we said, of level.

with our sales support particular driving continue than of profitable us. getting of they actually selectively some a and lot are focused confidence overall, continue currently. But manager this to And expect year. XX a guide But remain growth, force, to others, territory the third-party do we in we continue we're -- can been exit that to territory do specialists. force grow we're little over heavily working those give us leveraging In to of for And to ways productivity actually just some year-over-year And going we're improve those on that's where at X territories, sales so And they're year the so they're agents. clinical sustainable and opportunity that the with at to a strong, managers. that add more to in productivity.

Operator

question Bijou line of of Our from Craig of next Bank the America Securities. comes

Craig Bijou

last maybe good to for Anshul, even talk start. your on operating on sales you Congrats wanted growth. some a spend. Laura, then expenses start, to the for of comments And to expectations rep about question,

of growth and operating adding see in on But should to thoughts be? love -- we -- we of what that comments something that the So for sales rest does the Is would that the reps table? expense year? And your EBITDA this year. spend just mean kind the or or EBITDA, get would positive on EBITDA on the that's QX of could

Anshul Maheshwari

the Craig, how out, the the thanks question. We're pleased also on both leverage line the and with side. quarter for really played on top

said a some to just first of remarks, context, OpEx you've prepared that, the being do first provide sorry. higher included sales Xx quarter of Xx impact our -- in when OpEx got my shared because to global OpEx global The remarks being prior growth So bit in growth did as see timing growth expect than you quarter rate, year revenue also the our happened. And the is meeting sales rate rate of in meeting. we the what I we've

side. OpEx So of some what well of you earn because XX%, higher And higher revenue the at as the guidance is midpoint about you stock-based the could about driven looking it's that the by the primarily the commission at accounting if think of on would imply of rates that X.X%. as growth you're

we really leverage good that. feel continues, So and about the

speak ability very we're breakeven more we're And EBITDA that I and we'll in to leave in really provide the able strategy adjusted to quickly terms that our on making EBITDA of to about we've to results towards we always is year. of the you given the through look, year, cash good we're breakeven would with and the time get adjusted our go Now flow feel asset-light breakeven. But feeling about information and have as progress is also articulated, breakeven we're there what And model. our be trajectory for our on, early good terms get line. adjusted just themselves breakeven, EBITDA in we as to

Craig Bijou

I follow-up, Got it. And to about talk guidance your the for then did maybe want as a year.

million. beat $X.X you by So roughly

progressing? I how about raise maybe think of you see is maybe to -- or that just was that Obviously, talk revenue? bit What if do about that? the the good on can the see see And cadence year. a -- how start for you we do you raise. should little But think And year? the the to the conservatism year

Anshul Maheshwari

happy Yes. to No, take that well, Craig. as

midpoint in early the year. the the did QX at the the of look performance. It what in about from upside in pretty prior is which you of raise midpoint million midpoint, much terms if $X.X is still we the raise, the So on a is of

quarter, interventional out be all good so those on the the We've the traction thoughtful. so of their in want training, And So side, when good you're are in seeing about going we adoption more the business. of you of out coming Granite and sort about to of want feel make was things It got things think our us of that we're surgeon it's thoughtful. second just first of be quarter, -- record being still right. first physicians really lot a favor We the that still side number But good had then the to with a physicians XX in treating. that June. roll on really number seeing

expect cadence, quarters the accelerate to of we do on of growth a basis going each year-over-year terms forward. in In revenue

is in with even expectation rollout the in So help the of June third some the that quarter, our you offset seasonality. typical XX see us should that Granite of the seasonality

So good business in the setup really first have that the of out feel coming about net-net, quarter. we the

Operator

Our Matthew Piper next comes the question from of O'Brien of Sandler. line

David Saxon

last in of the a we than on last much quarters rate saw was strong, for the and -- really the in Laura But quarters these of kind X-year couple Anshul, growth touched U.S. you the X stack here. X And of year. better

that? really I function a new earlier. So question or Is if in the momentum momentum you're good that really other that QX? And we then in could with things what again, of price that, what anything of there, know is like really kind it slow new momentum? Is that that? that's easier [indiscernible] some specifically the driving of really comps some reps driving down it seems factoring reps productivity there the that those amongst would or that's proposed that worried disrupt that don't really of about. are But you're saw

Laura Francis

So thank much point. so Matt, you that for highlighting

As talking you here. XX% at first the you we X-year And stack about year, you're do very strong XX% know, last in a growth, grew quarter. the with if your quarter have that we

So key way seasonality across out as of year feel strong of of the gates, few demand we've if seen really even strong is continuation was the the about quarter the that we think started. And the quarters. about a over has well tough it great a just the last comp, that you all KPIs. trends historical And as it

operating is getting accelerate continue adoption XXX(k) cash momentum look strong from leverage see just flow year then strong with within to we a even in procedure So and and deliver ASP we stable on top robust our well engagement XX% us drivers, as as pelvic then XX% U.S., you improvement call over to all line And U.S. fixation. And clearance physician and across relatively demand if positioning for users, Granite in in ago. the to beyond the growth us maintaining U.S., and further X,XXX with XX, saw active versus which allowed it across a the operations XX%. Granite our volume points, record build up target a markets all near

you continuing introductions. we're but different invest our priorities also the -- product see to from in can as growth So

XXXXX, see So of to throughout starting said, adoption kind what what about rate side TORQ we guidance. with longer-term product. continued as we expect with growth to year. thinking products really order -- needs mentioned, are as that we're given right that the here, XXXX. our seeing coded We're you this code of there whether field our do concerned on interventionalists. the we that given in do currently whatever solutions most we position early and to where the I leadership acceleration think Interventional our our some and Anshul CPT the CPT is surgeons about not be on incredible the that market said, with seeing about because of product for the that wanted they're We're where is issues. physicians really And excited year, surprised And force, have now. But address LCD our not days wanted can XXXXX, or no But we're challenges to have, really trajectory just Code was at to it's that to we're we of go thoughtful

Anshul Maheshwari

we've side, reimbursement Laura And lot some only the thing I side the reimbursement guidance would on experience our like strategy Matt, add, and a anticipated said, got this of the in challenge. of

the don't to impact to on guidance expect said the any we this we at So just have million $XXX $XXX million.

Matthew O'Brien

They're be now specifically, you. about tailwind Is far TORQ intra is covering going be just the this... there everybody that to new guys, to goes, as it would to we a your is seems more that XXX. -- I'm obviously Okay. business Appreciate a and name, that XXXX than the to like as you for comments. And then but LCD dynamic because but those thinking throughout potentially of should that's going and going for better to to use be that later transition me

Laura Francis

Yes, you're correct...

Matthew O'Brien

I suppose XXX.

Laura Francis

to the for that due continuing seen strong uncertainty starting particular interventionalists around have our reimbursement last procedure procedure, over see interest that the year lateral versus already XXXXX. allograft interest using procedures correct you're currently procedure XXXXX and in TORQ, likely Yes, in to from we we're

from our managers lists. support and support We're able a right those products. and to to different territory able provides less this with the specialists given a support education. the XX adequately number as finally, we're So market -- opportunity provide We're to of in a sales particular provide team perspective where leader interventional us reimbursement few and to the the provide at space, clinical with able we're right

Operator

Our next question Drew Ranieri comes Stanley. from the line of of Morgan

Andrew Ranieri

the bit Maybe nuance a you But sequentially. I declining quarter. that in docs in your start, better understand just the I'll Laura, some of what's then And were a right dynamics now. maintaining your reach here? And there a near-record stop dock to of from us guidance. add to happening little here, that know comments embedded help new just year you there's mentioned can for positions it's dynamic maybe full

Laura Francis

Yes.

very we So training few performed great with a in combination And of this gives QX. pleased, QX less seasonality more QX. We're as docs. active Last confidence, rule, with that We It training it first very in that as such to quarter lot well, too. information is had X,XXX about But exception bit in a a these however, all at, just least the strong give that's actually well of was I surgeons having product few coming had into we're us. quarter. very did less particular it us a a also of from of will the of training, surgeon lot next number pleased than at little is confidence versus as typical The few new we're trends indicators is a have but think, acceleration well. for forward-looking as we very as interventionalists us procedures surgeons at That a the case forward-looking even with that quarters year, number of indicator us. qualitative that the in one the of out here. end in where and over perspective the throw for performing a typical we is doctors are

around increased in you number density of in expectation So X,XXX XXX,XXX spine Granite particular, XX and exciting. that's total. targeting with procedures that, target interventionalists And going degenerative to in to around about addition that's finally, physician the the is our XX,XXX increase physician the from is future think if

So per physician the opportunity to and physicians procedures increase us to quarter. to sell opportunity number also additional gives the of the per

Andrew Ranieri

Got it. for Maybe side moment. quarter-over-quarter. it utilization just on I mean, relatively a the looks stable

Just of the piggybacking off launch. XX Granite

do what more when progress the up? see Just that in we far some of some a drivers inflection are see utilization? products of on true of kind utilization understand when making to maybe that. of physicians I do side, the surgeon of -- I your like really surgeons, we but there's the help expecting? But or you're us of better real pick start you're mean utilization great know really excess kind utilization And using the in

Laura Francis

yes. Yes,

did about little a physician we talk density. bit So

of early quarter, procedure expanding I and degenerative mention these seeing growing our active we're back We in surgeon. a of our physicians procedure. But of to again, the and more performing in that's number types. XX targeting of physicians perform go spine our are if Now one than multiple of that target did But is are XX, type the specifically XX% butter first bread portfolio. procedures, innings Granite that Granite we around procedure once

month going And so the April. is majority procedures of in we the first June. XX Granite expanded in And with category. And -- to expect we're be their and out, just of practice launch and that completed we rollout our had rolling particular then in

the of So second the start I quarter, going second think I to half year. the accelerate going that really in to but see you're think in you're see to to start impact the

physicians, density with So very our of our we're And interventionalists the and increase physicians quarter-by-quarter. number surgeons working excited that's further increasing active opportunity there the with with then about to the there. opportunity

Operator

Question.

Our of next of question Dave line Turkaly comes JMP. the from Citizen

David Turkaly

Laura, just and or you of seeing of I or some of several happening quickly, terms to on of are see that there you get Granite know It was you're just I've like MIS what thoughts the follows you in other kind like Bedrock imitators I'm front. But seems the forward? SI what's seen TORQ these expect sort creating for or that and moving the markets on don't maybe curious targeting. competition sort joint there your market. And core on competitive curious, fast of one what I'm

Laura Francis

Yes.

needs for -- ourselves the what I unmet identifying is question. And thanks on products Dave then pride those clinical we needs. differentiated unmet and clinical think, developing around

And so some cases. identifying we're in markets new

they're where on patient a physician patient. a not operating on So is performing a a typically procedure

that SI Fusion treated conservatively Most category. certainly, are insufficiency was sacroil So as fractures. those Joint cases in And well. of

both these needs identify a and new or granite that need product an category. either So more goal develop into them unmet is unmet in clinical really develop to improved that solutions significantly or technique clinical or falls addresses our around

market really have capabilities we there widgets competition and are where coming we having unmet clinical we selling the so is those doing that especially that And see in. they're think is a to important. when in the And into market. you're basically. expect an What creating need,

supported clinical sales the it's continue approach we it X, by well, So educational to markets. force. Those have, Level of product, really what Granite as going that's in both these leading including reimbursement in as market the whether do. these X group support, that's by well whether the we that differentiated, which is and professional the all example, as to are that for taking know patent-protected by we physicians that education and our are we're Level ways really data And markets, NTAP, our for an is to appreciated then just

So about by far we're year. I We've to the launched a going we're so of the third to end that that this We've the keep going two launch talked market. think products disrupting year.

and these have patients, You're these going competitive these utilize company. markets, the grow order build support treat to the continue to to innovate see in we us and advantages physicians build that and

David Turkaly

Great. think mentioned you ASPs. And even I

an opportunity think I flattish. increases? of mean, about, you're were some what is opportunity But just I given there of for pretty -- said it curious, you to for seem that think over there's shouldn't look peers. potentially something curious I do that think you your we you seen they you kind declining from modeled talking Or know price and we've I'm we've differentiation as an but have that some time, things I'm is about? and are just price? unique, ahead,

Anshul Maheshwari

Yes.

for question. the is Dave, this So Thanks Anshul.

after. when going us, that's of got procedures ASP, annual almost about In million of we've ahead the that you the think opportunity we're X.X target terms

there's so huge a opportunity. And

we're We make very our margins market So standpoint. This about to and alongside that that. allow basis driving the continue manage R&D Tony maintain sure to something focused ASPs so regular the for ASP can us, review an we in attractive development. is on gross good how team on that maintain from a business on reinvest us we to can adoption. We feel

] Our ASP DGEN versus X SI using some versus X X. When using procedure procedure mix Fusion versus [ price Joint doing you're to you're procedure is extent. a based deformity the a using implants generally the trending on erosion

things said on we implant holding impact. an that. But overall, ASP, So disciplined have from per can pretty those to a be

Operator

Caitlin line of Our next the question from Canaccord Cronin of comes Genuity.

Caitlin Cronin

on great a Congrats quarter.

with the training. to Just start

record training You on would start of for mentioned TORQ were in those thinking And you and many quarter. those thoughts uptake interest interventionlists? the of a interventionalists, as well? trajectory given number docs XD the with this first them about training of lateral and just How

Laura Francis

for Thanks Caitlin. the question, Yes.

definitely we procedures. strong So number there yes, the for we first saw that we certainly being heightened a to record and that demand. in was first trainings, quarter, are excited trainings interest a contributor of but about number the the trained was also And interventionalists of saw. during from surgeon across interest our

So we're in pelvic driver cleared the with that knowledge was the side the and Granite was work particular, imminent certainly doing XX then fixation too. of And a as well. been some had trauma on that

of the then really the it's across board that of we question? the me part And So saw second interest? remind that actually

Caitlin Cronin

XD the to uptake for interventionalists point? training Yes, them of think that just at TORQ thoughts given trajectory you we're the any some start training. kind in Would in lateral those of

Laura Francis

are TORQ that So into would orthopedic of more has iFuse-XD interventionalists really the category The in a technique. we're product falls procedure call interested the been in choice those that lateral not. nature.

product data technique performing particular outcomes are starting and definitely use users that that the product. But out a it's interventionalists with that ease see the the to. It little of a actually the the the clinical early of of -- have product they're bit at around interventionalists has some TORQ. to And gravitating a the and not it, surprised this, are loyal procedure. naturally there. some It very we is that's interventionalists So the gold that's product standard most

as really, TORQ technique choice. And lateral are interventionalists is it the the a certainly ] now right product [ then prefer of relates BONE that to there product. So allograft

Level the with do so evidence you product. that think thinking I more product there's think at technique. But about about interventional data said, that clinical comfortable iFuse-XD. mentioned they X evidence. of SI-BONE, on physicians And before about And some that's lateral as have are get they really we clinical least And X the these and lists Level most when the

called study the iFuse-XD, study, evaluating coming one have up of results this second SALI was half we the expect SALI in we so X-year the study year. to And see which and

clinical leader then it's technique the closely with the we're or and focus in our Bedrock with and market TORQ whether of our with the Granite our study, data with continuing [indiscernible] portfolio to we're So study SILVIA STACI to this products, work being iFuse-XD space. continuing on and study whether study with it's with really the SAFFRON

Caitlin Cronin

off to the the studies? SAFFRON updates progress jumping Just of on that Any quickly. the or really STACI

Laura Francis

Yes.

little later think seeing I be you'll this more year. a here bit

summer So enrollment be in exciting. and results completed very STACI is are early promising expected the this to and

performed interventionalists. purpose lateral information minimally the so STACI on TORQ, And procedures to Fusion performed provide Joint when of post-market was by with SI invasive

actually give available be will us SI you're physicians performing this initial product. SAFFRON, TORQ going on that later Joint our information to Fusion using year. expect more So procedures results going lateral interventional to the it's to see some

well. with the trauma our So launch line of in new be that will as product

as coming clinical You'll as product through data well new see well. some as

see. can SALI to are in things a of So addition couple those expect you to

Operator

Saxon of Our next David Needham Company. question of the from comes line &

David Saxon

up the question pricing. Congrats wanted a follow I to on on is quarter. This probably around Anshul. previous for

than it's better that's to assumed tracking a mid-single-digit low is guidance. I decline pricing think So in

year? the So guidance? of would think worse is know get is Or the conservatism anything as we about more pricing that there to don't of that the XX it's cause launch? an if throughout I area

Anshul Maheshwari

you question. thank Dave, for Yes, the

the there. you of think of reflected that guidance, the some ASPs end when on conservatism low about So are

the and changed our ASP rest We for year of the expectations really guidance. the haven't

year. But the versus think there's could we per the construct Now progress shorter price using change an on an ASP, there It's deformity you're have launch, X impact, the on is no potential for procedures potential could procedure front but in implant, terms right in as implants impact through upside it's the again, what of the with the year. early quarter. in first for four, the have we the even ASP though XX using the

that conservatism see it in the of hold and to some quarter to the think we prudent how quarter. unfolds second third just it's So

David Saxon

Great. maybe for Laura. Okay. And then

out So next I runs NTAP, October. Granite the think that

So work you've that you procedure Granite over premium fee? And pro any preserve NTAP to how Granite this couple relates do as can even or seen to Granite there impactful it has last way that about How should around the years. fee think that adoption we been coding a to volumes? is like of facility

Laura Francis

Yes.

the that we've left on NTAP, the NTAP Medicare. the strong So XX months -- go doing of Seeing X, Granite more been what the will on approximately with And utilization NTAP. October is Granite NTAP. through we XXXX. at It have looking utilization

that's to cases. the to help to of And pelvic particular fixation is us and value of in Granite these do quantify going so what

number payment And right now, so after we're different that incremental looking is at of continues order the make a in the NTAP complete. sure ways to

all right X for could important. be different increase to we example, think higher-value with with be a it We the Those in is have reimbursement through potentially midway it options pointing new code, an a or or could existing are So do this. code. code that now. We're that

building reimbursement We no across coverage. Fusion when build there Fusion. XXXX, for the coverage that have and that was of we United now we Joint complete in very data Joint market and our work lives clinical started a in have on company SI have SI-BONE to was the big I And covered as States. part the SI always order a ensuring Us focused

we see a the our pelvic I incremental similar on And for clinical as order fixation focus to to to data to pelvic data Granite in economic with and that. as reimbursement way in expect Granite. So fixation and continue well health support using

Operator

Brodovsky comes question Sam of Truist line of next from the Securities. Our

Samuel Brodovsky

on year? end the ask especially about on high a just one this the quick start I'll the guide good quarter, margin, solid little to we year. result. above of How for Congrats gross that a progressing should a through EBITDA bit think the

Anshul Maheshwari

question. Yes. for that thanks Sam,

it margin range. being quarter of have margin for early still timing guidance year. with of going out holding point. The But the especially on are gross that high key just to end out to side, we're as we're of XX% we is and of gross a the the second half our the how and on the in capacity margin. in reason impact at there, surgical get again, this the gross the might terms we into On pleased more margin sort put coming gross played really year, in

to of want there. how it before year again half guidance in first out we the any So plays see we make changes the to the

Samuel Brodovsky

should a of ask for long OpEx just growth, we rep the broader while the is And Is operating it. to to can thinking here? more ratio then a think bit one, Got model, that of I'll hold happening we But that term. something growth think this X:X on company consistent being about to year? able

Anshul Maheshwari

terms Sam, thanks haven't a provided I look, of we lot. in long-term how leverage mean, guidance OpEx work would out.

like Our view have in pretty talked all a strong growth we about, got Plus with in investment significant the R&D. line that we've tailwinds is remain to that going XXXX. is top we've

we new So launches expect product come out. to

that million, got we've $X to do than that like So be should drive we product more or that do physician, and our getting more earlier, density support, next agents. junior milestone on point, is sales reps million to more how but how drive focus said coverage with the $X whether reps sort our And it's more more per you of leverage. Laura translate is going today additional to or by driven force [indiscernible] do leverage ancillary into procedures

really forward. Xx for a think at that So clip think good we think sort leverage. healthy but continue end of year we've it about that. leverage the leverage, we will will with We'll continue. pretty what don't of stay We provided it's going We the at the just feel

Operator

next the line Ross [Operator Instructions] Osborn question of comes of from Our Fitzgerald. Cantor

Ross Osborn

Just discuss adoption the within level launch, pediatric one, with would or you diameter of smaller population? a Granite feedback to of the regard early

Laura Francis

X.X. the indications Yes. We're about expanded actually excited for Granite

deformity as pediatric including SX as and the -- So pedicle in well. as well

be XX that think them. potential solution a like patients, surgeons Granite is granted actually So deformity we going inquiries their we and to to a have with smaller use gotten that from implant pediatric for would

That's for and surgeons quite addressing we're patients. But with that this SX is be that pedicle previous the we're those part product. us our able opportunity address a at not in need to particular market significant So the too. of to happy for and those time for point significant

these what both that And implants larger product products And surgeons XX.X so [ starting from to third we of sides then and implants than that they use already the X we both or that newer XX.X area public they're then to uncomfortable -- fusion. was said some get that's using surgeons for the focus. And remarks, in on ] or wanted some is did purpose. or second feedback provides they use, stacked fixation prepared that of [ about ] talked which the felt just our the that just

to use smaller opportunity surgeons provides using And X implant an instead so implants. also are the diameter currently X who implants

a opportunity with smaller smaller. XX it's here the bit X, there's it's use or needed little the have of but I So whether or it's whether pediatric about mentioned, a deformity, you product I'd to that's implant S-X talked Granite that those finally, felt as I want surgeons trajectory lot that something said they a previously whether like that that's

the cases So half excited really forward, first getting see into April. great going June we had few about in year. opportunity the for and those some can May to just just of We're and done started, acceleration do us second what in going

Operator

closing turn further would for comments. at to Laura I I'm this over now you. Thank questions to time. like no showing it

Laura Francis

you participation to Thank there. are America going call, Bye-bye. you. Conference, be seeing wanted Bank just will you of see and that your to the in forward Healthcare for look today's I say at you. we to Those you thank of we

Operator

This Thank program. you for your participation in the conclude does today's conference.

now may disconnect. You

SI-BONE (SIBN) 6 May 242024 Q1 Earnings call transcript