Earnings call transcript Q4 2022

Due to licensing restrictions, you must log in to view earnings call transcripts.

Operator

Good day and thank you for standing by. Welcome to Axonics' Fourth Quarter 2022 Results Conference Call. At this time, all participants are in a listen-only mode. After the speakers' presentation, there will be a question-and-answer session [Operator Instructions] Please be advised that today's conference is being recorded.

I would now like to hand the conference over to your host today, Neil Bhalodkar. ahead. go Please

Neil Bhalodkar

Dearen, Good fourth Shannon. today's thank for and you are Financial Thank XXXX afternoon results Axonics' Dan Officer; Executive quarter Cohen, on and conference joining Chief Raymond Officer. you, Chief and President call. call Presenting

begin, performance remind listeners I'd Private as under are this forward-looking made that plans, future Securities to relate Act the that statements call to like of Litigation events, we statements on Before conference prospects, XXXX. Reform or defined

are statements these to number and forward-looking While from management's beliefs, this expressed of cause on assumptions, the these expectations and could on materially conference based statements current uncertainties, to that are a differ call. other expectations results subject factors risks,

as Axonics' which the all statements, by not events these statements only These new Exchange Commission, available speak arise. any of and are to filings on forward-looking circumstances, with Listeners XXXX. risks are to March place detail undertakes and uncertainties X, update may are of revise Securities forward-looking at to unanticipated disclosed or online www.sec.gov. in Axonics reliance which obligation information, law, cautioned as or undue date, in required more that reflect today's Except no

to call turn would I like now over to the Ray.

Raymond Cohen

Neil. Thanks,

afternoon's welcome to everyone like I'd joining call. this

an has the our marked which grown in So increase This million, nothing in record of fourth revenue the short compared year results of quarter XX% the period. financial revenue XX% at XXXX and year-over-year. a of $XX our quarter were of generated outstanding. Axonics third prior least row to

onboarding driven representing from customers. of the Record is existing accounts driven existing were SNM of the prior higher an and of revenue and increase the an compared $XX.X $XX.X prior by the level period. to a of Bulkamid XX% neuromodulation accounts our results of year solid of compared sacral increase combination year reorder by record specifically, More was in XX% million, to revenue period. new systems being million, This was new accounts. addition rates revenue utilization of

margin high gross the a new fourth of watermark hit in XX.X% Our quarter.

of our generated to We leverage discuss our million Dan in benefit prepared model. further performance will operating in outlook the business and $XX his inherent quarter also we financial EBITDA in adjusted from continue detail as the remarks. in

would to captured marketing, in on FXX completed a the launch initiatives. existing product our XXXX, like neuromodulation accounts. a portfolio. activated I now competitive of share We long-lived provide few high wallet new sales, updates accounts In and our recharge-free of development system sacral and

commercial X,XXX systems. SNM the United customers launch From now in in XXXX, Axonics late we have offers continually we physicians of the our U.S. enhanced States implanting the our have time value nearly proposition and to Axonics

only all addition, incontinence. stress the bladder - it for we for urgency acquired urgency, unique of hydrogel of female We're In that for solutions bowel stress, urinary and incontinence. forms offers or treatment fecal Bulkamid, the our company be frequency, incontinence,

We their and have therapy to physicians team support and service group field provide best-in-class in our support specialist patients. grown U.S. to

public increased can in a campaign with the is DTC We to and that therapies. stigma normal awareness symptoms then and have advanced invested multi-channel treated incontinence reduce not be

launched people to local connecting in incontinence specialists also center We in have to call who community. a their assist

patients practices seminars on education best conducted for to pathway. the We implanting neuromodulation how their and have through numerous medical staff navigating and clinical sacral care physicians improve

seeing into efficacious symptom Axonics that deserve. relief to headquarters market patients senior course, Physicians of of the the meet our discuss at how can like to their they physicians ensure are care we getting and with act making see are leader. management, that and more of that long-lasting our quality facility Irvine goes to dozens in products, our firsthand the tour hosted manufacturing We've the

SNM that clear our market just causing has and U.S. U.S. limited ago. definitive at U.S. sacral our demonstrated the have the back we been is on the data to of the they directional from our sacral going into neuromodulation information healthcare XXXX a time external specifically, that Axonics and market it the years since expanding the disclosed, the this outlook consistent growth XXXX, we entry XXXX competitor market We commitment significantly of few to the annual way of estimate our claims IPO. matter an More and category, from to to based from XXXX that compounded mid-teens XX% projected XX% rate neuromodulation all with

and you It's important teams pandemic midst to growth heard of previously. that widespread discuss that physicians note this a shortages the management many level have was global in staffing generated of and

As XXXX at to had X% to for for provide year. market pegged that we some it context growth that I - year Analyst want U.S. specifically, important this to pertains last understand figure.

estimated that i.e., and there significant first First, overall is impact the was in COVID-XX disruption adverse to by in from contracted the period. have XXXX, an so X% market much Omicron, so that of quarter

If third growth Omicron quarters that we exclude and most three year-on-year sacral market encouraging the growth quarter market the approximately look quarter. has XXXX, fourth U.S. growth at grew last XXXX, quarter the during X% the to quarter just neuromodulation XX% period. that is first generating accelerated and the perhaps due in in each XX% of the of And

IQVIA, noting were remains many large in Definitive United is three States Healthcare, said worth that According diagnosis their highly addressable to OAB million OAB over alone. the It XX for times, XXXX Americans written in received we million to an in physician drugs under-penetrated. total XXXX. As the according over have and market prescriptions from

years at that annual expand we factors, growth will for these the to sacral all at rate mid-teens come. a neuromodulation market confident remain Looking

management we our an United XXX commercial States are to in on which sales of the personnel turning or selling involved clinical with the balance now them being field-based update have Now of team, personnel our of specialists. in XXX directly

Relief Axonics advertising continues at time increase well. in expect direct-to-consumer Real to this XXXX. campaign headcount commercial Find well-staffed are in progress We and modest a team The

with television adults visit encourage our advertisements As landing to findrealrelief.com, many on incontinence Facebook and know page. patient-facing symptoms national of you the

The The commitment incontinent campaign female, questionnaire. long to symptom individuals for due about undertreated of our quiz and to gone solutions Axonics primarily to therapies. or provides advanced website a and awareness that population, underscores too lack has complete information short direct of underserved a

grateful tell XXX,XXX The our patients helping customers are website Many visit to their come television continue us practice to therapies. learn to we as into our individuals or Axonics continues XXXX, seen our of Axonics physician are these the on they that seeing Internet. fourth ads our to asking goodwill with about after ensure generate on and about the care therapy customers are that In unique more over a pathway. of clinician with campaign adults being we the by advancing quarter along that conditions had

the is as We in million number. 'XX, well, campaign Since totaled X.XX take the April of excuse web number but visitors individuals. unique approximately X.XX X.XX launching the of - X.XX me - right

this website. important as complete Now, that we on the are questionnaire leads the part, is them our qualified symptom refer to individuals

quarter, these the launching April, since has fourth there responders. such generated XX,XXX and or qualified were leads questionnaire of responders XX,XXX In in survey campaign our

of January number who filled questionnaire there year, January people over alone. in a in the and fact, out symptom is XX,XXX accelerating In this were

in with Our call connect leads qualified physician center specialist diligently continues local a their community. work to to

weekend. field in X,XXX we sales approximately to experience off kicked has Australia, company's Sydney a Physician turning recently neuromodulation implanters SNM launched President's SNM held strong with with Australia. sacral million market procedures started Day that years Australia the and activities, with Now commercial who currently Seminar a have annually. during four Axonics The with professionals we International of operations which $XX team well-received relationships performed in in estimates in is

regulatory Our competitor approvals short-lived for and InterStim Micro. X has InterStim their product

- and as reimbursement our currently for rechargeable system for Australia, Axonics as approvals Now Bulkamid. has a in and has regulatory well private regulatory private

Now we by coming the system, FXX, or the review expect the in regulatory TGA under is the weeks. currently this approval and Australian non-rechargeable is recharge-free

submitted also recently rechargeable device in of our XXXX. called approval expect We review the for RXX regulatory second half and the latest

their in - already Our legacy approvals products regulatory has for products competitor Australia.

have note reimbursement FXX, to important expect come to it's approval even for our by we Australia, private for in approval wait will regulatory Okay, receiving year-end. which we after will that

contribution forecasting a to with of XXXX. contribution As in coming $X such, XXXX, revenue in Australia significant are only more we million from much million $X.X

for from Health previously turning Now received approval U.S. approval December regulatory regulatory and rechargeable - in we RXX Axonics simulator year XXXX. development the initiatives, product Canada to this of of January in

positive. for previous one an have Now, least utilizes hour our the this once months have customers has device the six RXX, body XCC from feedback same just factor rechargeable at every product and form life requires been implanted years. XX of device to XX Early that recharging in the useful expected however, overwhelmingly as small the

objectives operational we're summary, in to last XXXX, looking Now of forth the and year. we start at proud exceeded on have commercial set back the that

Axonics of bowel that the importantly, having More people impact we dysfunction. is on the changing with and recognize bladder lives

in neuromodulation participate. In sacral XXXX in fact, of and large the underserved XX,XXX alone, are were the Bulkamid treat still is markets we used undertreated to which systems scratching what yet patients possible over worldwide, our surface in we and

team our dedicated to and Our customers committed physician raising remains mission-driven innovating, best-in-class and supporting our therapies. of awareness their patients,

said, to financial quarter that Dan? I'll all his results. Dan detailed turn the over call now fourth review with of So for

Dan Dearen

Thanks, Ray.

of Sacral compared which net As year of in States. to XX% the represented neuromodulation an Ray United generated which quarter $XX.X was revenue U.S. generated XXXX. This Axonics was was XX% the prior XX% generated was $XX.X the fourth of of revenue million of period. $XX.X million Bulkamid million noted, increase revenue in in the

the favorable to representing the compared mix period. in period. was Bulkamid sales, a compared in fourth of prior FXX gross contributed Higher neurostimulator the profit XX.X% gross to toward quarter product million, a $XX and margin 'XX the volume, margin year to sales weighted Gross XX.X% prior of a year

in operating for Bulkamid change a consideration charge in million non-cash contingent fourth XXXX related the of value to the included the expenses quarter $X.X in were expenses of acquisition. $XX.X million fair Operating as

in of income. of and Excluding $X.X in loss in year operating XXXX was $XX.X adjusted other quarter were million million. charges, period income the from XXXX quarter $XXX,XXX Net fourth $XX.X prior in period. and the and Net the acquisition-related million fourth year $XX.X prior expenses million interest was benefited

XXXX, In of quarter of the Axonics fourth $XX.X million EBITDA. adjusted generated

proper leverage our third between in there swing Axonics in and has positive generated forth the attractive inherent positive in We this that our set To the a back the is business margins. and the on row, and based becoming in EBITDA seasonality adjusted company operating where top-line the EBITDA. marks gross we adjusted more periods results financial negative will are of will profile model financial ahead, corresponding quarters expectations and evident results. be of pleased quarter to The note

Based be revenue consistent flow level an positive on trends, adjusted approximately cash on current and annualized EBITDA we at Axonics to $XXX of a expect basis million.

flow in cash free positive the fourth generated quarter. also We

cash to As of million $XXX cash, as overall we were to are fiscal of million XXXX guidance, the September compared $XXX short-term December respect XX, investments equivalents, outlook reiterating revenue year With and XX. year that XXXX. in each to million sacral provided revenue based our January the growing XX to XX% fiscal pre-announcement, company be neuromodulation compared is $XXX was and revenue, Bulkamid on anticipated

concludes our turn call to That will back the now I and remarks, prepared Neil.

Neil Bhalodkar

Thanks, have Shannon, Dan. to one analyst this please to to begin session. At We the question, follow-up. are each a the to ready and Q&A Q&A yourself we we question you please ask time, an request session. limit that opportunity so begin would one like

Operator

from Instructions] Steed Travis of [Operator question Our America. line comes with of Bank the first

Your now is open. line

Travis Steed

market numbers you the if database growth. kind you is source have for with thanks those the you on the came know that gave. those the I appreciate with numbers market don't had I how everybody, guess or of taking Hi, if numbers there growth. start you a up claim for questions. I your I'll

market to green seeing color growth we could from on some that momentum DTC, think the in the well, shoots provide that market if sustained similar from any seeing I to in around in here. talk pretty for you're about growth the year, what of mid-teens had also you're getting the other help just mid-teens model marketplace next you as kind our numbers in but path confidence

Raymond Cohen

part? first the take you Would

Neil Bhalodkar

this Travis, Neil. is So,

sources claims quarterly the further it's details. over and that data I'll have date, the for for so the the claims their of as using partially it uploaded XXXX turn about question market also that's discloses this for then On in information healthcare the been Medtronic results. to Ray of partially that definitive the driver growth,

Raymond Cohen

market creating Yeah, what is the future, them. is website to incontinence whether mean, campaign think of pretty incontinence or the happening about lot of people might advanced in seen mean and it, of this clear, you as stress our it whatever be the I I so of three urinary certainly the think a terms it's I look, these in inquiring green quarters about shoots and is we've referred case of I for therapies, right, in are it's think accelerating, XXXX DTC magnitude be. number that the the visiting urge real-time

that's think I last happening, despite that to as think their note the increases that also this quarter. pressures, competitor competitive saw I in our they it's So in interesting are to in category referred revenue

So thrilled to along float this that we're and good news, it all in. raising that since duopoly see tide involved we're We've we as and the current the take about that beginning in will here, that. it's everybody's boat said

out many not DTC 'XX going and on placed in more than hard the a justice to we're to going want local fill just a did there's these area. people spend 'XX, we - physician that with so to So in initiatives. consult we for our quizzes who in with We're the them people to much get continue qualified that to inquiring press because give

whether body rechargeable not could are or longer you lineup what in need to non-MRI even years think a market I have XX years you at decades think would use, was was I I hour thing in think has for rechargeable going now with of was this innovation and you say we've from thing a or about device person's six is time. is that only if your what months and of that from standpoint last whole five XX a in or okay, a months now last body an this transpired to rechargeable comment body And done and a some standpoint, they products get are about where in back as years, and just three that will to a recharge last to easy the not a long step November you or would to get in one maybe mean XXXX, we as here last compatible cases that two in in the take your maybe XX and every product you

that is innovative and it's urine, that contributing. people course, combination leak So then, then we number the many are factors feet the of I of normal advertising, know it's on that of of the street let and the a so key, think have piece whole not Innovation to that puzzle.

long-winded why the not of this. we're that's bullish So too of hopefully about but covers kind basis

we've has you a approximately little bit number that time to a today, better to taken it's Axonics seems but get November we started we years only because just and we and think XXXX. about are of now this through months rates be commercialize much a very for everybody and of forget it's to partially since lived if actually, to had for environment" be to in operated able things "normalized clear in of to about data how Now, seeing the third-party that and funny be able to been want growth pandemic four

Travis Steed

I quickly Okay, course EBITDA margins Dan like seems get And and a move be it hit color million the for and maybe your one you profitability in so margins, gave Ray. once XX% then XXXX, business? of over of and the of comments start on how on there heard by XXXX, more forth can on as the sustained number, $XXX you great. end pathway into XXXX, XX%, back you'd to what's margins to and the the kind Thanks, that, for you EBITDA you this but maybe little

Dan Dearen

looking see specific increase - absorption, driven and over supply point a on it. we're profit a basis as basically we 'XX at manufacturing yield, outlook chain that's on XXXX a gross to mentioned is and always basis we've we're a throughout inflation partially expecting margin in never on timeframe gross by XXX the We've put better by 'XX overhead and offset costs. What

roughly flow we've into and sales said you same the as expect crossover And and then have marketing positive we revenue we've ads. to in operating the on, point positive, with as goes spend double increase, leverage cash XXXX and said here, the and cases, at the look into and get this times, out with adjusted time significantly numerous some EBITDA you minimal we

you when your get XX% EBITDA to that think operating you just out I can margins. So look not far,

as don't in put So ground happen. what quarter want to I just to the to stake that's a going

Travis Steed

That's fair. Thanks let for you. jump taking the others questions, and in. I'll Thank

Dan Dearen

Thanks.

Operator

you. Thank

Our next question comes Biegelsen from Larry the Fargo. line with Wells of

Your is now line open.

Larry Biegelsen

strong it is, of calendar above share and $XXX and to in at question share million, holds U.S. if year unusual grows so would calendar million I market to to market million XX%, which the you the is about market taking the grow or for over end wanted $XXX do Thanks XX% market SNM here? in a XX% a strong Ray, is about the your ask neuromodulation market something you in QX, of QX, the - below this the is afternoon. some Good $XXX your expect on about sales guidance worldwide, U.S. about guidance, U.S. imply of year. the share your had was congrats sacral XX% just U.S. question there my there XXXX conservatism

Raymond Cohen

going plan be and and took been percentage we Larry, a I Halloween the - the we perfectly can get Larry, I this we've think what XXXX. execution is trying which in down we've doing, has since our public been new, company XXXX. about on the talking not heads execute mean as Axonics game - been predict All in is our about put we short skis mean do answer, little conservative, to just I we're can over grow the to not market in is exact all

give more there I is to focused everybody obviously than other mean So on, what is look, I it don't and and guidance to to is so than overachieve. think that. that's our objective, of course,

Larry Biegelsen

to in on threat. don't access a technology fair Ray, stimulation, because I'd seem guess your anything for Okay, compelled tibial this to on as hear if feel has updated keep the we I'm love internally thoughts about asking, maybe you interested just for getting you why? enough. don't it nor I asked having taking see I ask - question. do you nerve Axonics to seem Thanks it, changed,

Raymond Cohen

thanks, those but boycotting Well, answer. volunteered questions, I'm to Larry. personally, has Dan But

Dan Dearen

them Larry, joke, implant for position companies and changed, of part inside hasn't XX% we Look, efficacy device haven't better our thinking an our know we've an in as look It's our these study, efficacy well. comes has is FDA the of understand, that. for we many know our years XX any tracked now, companies implant, to implantable a you is, well, that close we seen an tibial the

It's CPT there to you procedure a are about these from like market of and looks trained the anatomy lot part of a a how ultimately Editorial do coming and and Panel. that questions reimbursement do, rollout, complex the are doctors obviously what then

I to certainly it concerned to and to So at we'll it would not five don't years out, attention leave competitive will three see that, this, we're watching we're or and as unfold this and short-term the but pay just we see over a threat. next intermediate-term look, plays going how is it

Larry Biegelsen

for the All taking thanks right, questions.

Operator

Thank you.

Chris Our Nephron from line the question comes Research. Pasquale next with of

open. Your is line now

Chris Pasquale

getting with the for how that goals number, more gynecology Wanted planning about a point, the you a is talked Bulkamid, on and involved for talk other and congratulations, you half maybe thinking nice Thank call you're year. guidance dig Larry's year? about round that XX% and and in something guys, is great assumptions the franchise about there the that the in question you're of this on about to 'XX,

Raymond Cohen

the Chris. to to again, very, this Yeah, difficult difficult I year. line very going that. this question. We're at it's very thanks. think again grow Once predict, I XX% particular right. do mean product appreciate it's I Thanks, to that

a and be first-line got So urinary we're think become to trying quickly stress incontinence. once far, conservative. women this with therapy lot legs we very again of We as product seen has for so have is

sling women sneeze impact in treated was cough about we there no you number done difficult operation annoying mean operations to slings back urine the were - question it's that, it, go problem, said some we it XXXX, so agree, and I'd and XXXX, life, having XX,XXX XXXX, leak can patients in yeah, can it imagine, so - XXX,XXX to I people's because directly exercise, if maybe, for there's understand quality like Now call or and of it's we in that. but or or I

But women that's urinary for incontinence, want stress don't they an want. not operation what

us but so think present to right majority women, is And the solution that's persuade not of the physician with for Bulkamid community the vast who it's going I people, just take patients persuade for time challenge. the some to the that these symptoms, our to

awareness Chris, about going get really almost know medicine you to to it's and start just time and option built like as the it's to in for their talking changes an as take slowly, And us this patients. to continue physicians to create

mean, so but you that's offering the Now, right. urogynecology of core mentioned community, market currently urology I community that them we a to GYN but we're to community, right, that community, Bulkamid, are with, aggressive enough now even starting within haven't been not and our

started Now, surface. scratch we to just the

So some about talking but Not that adverse, this there's you no, track that's there to but to the dollars in may time be doing asking me, they hundreds the sling about, annual I what option and to you think consider, an be of me using, really - the going able for to yet millions if is, just potential Bulkamid get is prescribing it's us us take physicians, do potential fact, these and to there's top on of Bulkamid. the operations the there basis, let of well, I've tell for get sales should other of been option, this you're right. work, that want is not this they

really over some not skis do very bullish that our this. and get trying about - to So we're sleeves It's just we're we work on to got it. our

bullish more for Bulkamid incontinence first-line are urinary patients. bullish potential is little a we, therapy to us give to treat about be but for stress more question and as hard So I how the your time inherent it's in

Chris Pasquale

the side, market remaining makes of through terms Thanks, to Switching that. you biggest see for as in thanks sense. That what back curious bottlenecks today. the walking SNM growing that

problem, You practice of who it the their before or today, doing devoting how physicians procedure it are much limiter something is else? the there, the biggest is raising guys technology awareness, got you're or the the to market their number it fixed you of rate

Raymond Cohen

It's question. really really, And our and is internally it's and might management. a spend amongst you a say of Chris, as talking sales managers, question. a good our senior lot about when mean internally, I good people, imagine, time we I this, it really I with mean sales

here's attractive has going facing, I it's what be had a problem want So been implanted and that disparage just sacral because for the it but product careful to the that so they physicians' competitor, neuromodulation that is difficult is years, only was that we're am don't to in XX-something our and minds option, to wasn't I do, fussy.

prescribing more would you physicians neuromodulation that overnight, of re-programing all to market that kind It's actually legacy so then talking to as weren't easy again and need And with tools sacral double other would use, new if time back it drop takes the and would patients this mindset. easy to lead prescribing, patients, just this and to my this I erase for spent maybe and and down then not once to tell their time okay. come word, noise

to results have So clinical beating reinforcing to great mean, that use, making we're easier persistent, have that the all be be does there, that, the keep that out what actually things means drum, getting. we we to

where on, external ones conversion at sure a to out and your say, they're they're we which good program, I which your that patients of presented here's we're mean our actually those we here's and coming sit of each tucked reviews, look, because team have the end the rates, in. many quarter here's has making that down field how an data go with we did you talking business call to satisfaction folks quarterly and instituted trial patients actual our the customers embraced,

and some grandfather's we've it's created going new neuromodulation, time right. and of just called a product, it's take almost think I a if okay, So category as to sacral kind it's

I about expected enthusiastic terms I things can how and that on of this that's business, much we're under-penetrated So the potential mean so you in think I is. mean, to the be what's tell, how really story, out it's going we turned Chris, it all is about it

these time sorry physician lot to work your of of getting and do it's doing - answer. year. get the down, think, - I to but to look, same-store a to sales. surface. at a to to like record spent going It's we've execute. answering we've It's We're of honestly of not lot average question, to I grow we the we're We're our we're But a XX rates accomplished, is things scratched here going more a going our XX We've continue got instead feel heads to continue the year do of but them keep business here. just proud what

that talk is double about that's doctors know getting neuromodulation. finding not I doing, business. X,XXX giving and going mean our who sacral It's about want out we to dabble This how them people with they're what about another sounds more and the again once it simple. execution. quite if easier just one to is, them in tools, support, And and think I real respect, better and really getting requires products, but keen better focus it

Chris Pasquale

Great, thanks, Ray.

Raymond Cohen

Yeah. Thank you.

Operator

you. Thank

comes of with Cecilia next Morgan from Our Furlong the Stanley. question line

is line now Your open.

Cecilia Furlong

the is you Australia benefiting comments Bulkamid around you're just around markets opportunity now 'XX growth kind and in for framework could for in 'XX right, versus where one and those today some Australia put you basis on what I how afternoon thanks to frame beyond we realizing the from All of specifically SNM Europe, then growth relative phenomenon in how about market think OUS and a other should do follow-up you questions. that taking just that, regions? about your the think locations the wanted for Good great. on presence,

Dan Dearen

level nice a you. - as Ray Hi, to Cecilia, high I this mean, is Dan. at hear

yet Ray is but have $XX As million have million expect and and revenue mentioned was market between on we our product, per we remarks, for the to it have is in and that estimated recharge XXXX. made SNM which Australian we statement the coverage, approvals year we we why free FXX million his in $X.X do prepared around don't $X

like so we for that, specific in all in of we sales in towards growth as we time markets for beyond going look, the drive we a grow, Bulkamid, is intend categories continue OUS products market to we these the Now it. is look, put to don't date that. both SNM on for States the even to United just But though a increase do leader, all question market to U.S. it's be and the want product heavily of will and that skewed our help perseverance also

And be will continues story their we market, as worldwide. forever want care be take as of a goal practices to and so probably market the physicians, global and patients, the to U.S. player but leader about a this our

And so that's why efforts, OUS. these we continue

product corporate course, worked and in a off make part and of with being treating have of this in of us a previous so revenue the these also Europe of our we we big and market way to in have in natural move and but started it, margin we we've the for good and company, just we number into were citizen the full We, it's physicians approvals. a line plan, since as patients, and Australia it's of kind

Raymond Cohen

the there a all mentioned not two not here. we'd many market but the like in if the case. an issue that's which States market largest if before one take things Europe. this add times always the market, I've probably that outside were it's markets And question as was and example, the be it U.K., is the largest that hard, of the and markets would If on a you United I capitated fair fundamental to your

XXX is going for pay government to implants. The

country a to companies get So of how each fighting two when, got and U.K. can business fact, in Mississippi it's to right lion's want spend the in that energy Kingdom, throughout of trying grow now, really you've share that in Mississippi lot is the you easier to in state to the other outsailed than United business the do right, much of imagine, expand it our us so you for the efforts

that different so correlation Bulkamid you gives but some in implants of the you having SNM markets and that make program why course That's these patient. a available of need presence U.S. context around on other the line to sure go is completely well a is hopefully focused a some world, to animal. So there market between we're product the

heavier So up lift really it's a much for open new market. to us a

to Now, the We of our future. places right last the continue and understand here we're something the that's knitting now like China, but potential States. and and for to to in future focus the United in are we Japan comment, obviously, Asia in stick mainly going to company, looking big

Cecilia Furlong

release. the and for point market R-XX if as And color. diluted I margin? the where rollout targeting just you if how think you impact Thank that, are in also should the you could And gross pricing this at about up about to just well, follow on 'XX, we think the

Dan Dearen

here's So going nonrechargeable, rechargeable my new because were I I it little you're split - and bit. RXX. between question, predict last time rechargeable to was off to about broken comment . the asked you And think our a I'm think was up, referring I predict to the I not a the that. but your

we're of implanters capturing So optimistic physician imagination their on, States seen the have that and is product patients. in this early United the we

it's product. a pretty I cool mean

So had increase sales already, that the the we few rechargeable weeks marketplace. in product an we've the see in in short

to it's to but predict. - hard So going be

it about I how mean small everything blew else. FXX, and the just and that honestly. is just think the it product people's of longevity I minds, and - nice

it's actually of patients providers. these are really where share we kind mind have products with now thing competing and that So a amazing for fun

good on products. and - least we're that is just got agnostic. these a should at And Axonics. margins happy whatever I say, there physician to their We've margins, it we're we're it's or decide word So is great last that do, patients

Cecilia Furlong

taking Thank the for you question.

Dan Dearen

Thank you.

Operator

you. Thank

comes next Rescott from with Truist. Our line the David of question

open. Your line is now

David Rescott

the growth wondering now that the but guys, guidance, basis for then throughout year, I year, XX% QX. just down kind I is seasonality you should if year. right about so maybe the how the on about we could quarter growth year-over-year Obviously, the cadence think year, of around and there quarterly the first wonder taking should consensus has maybe strong congrats Hi, provide easier, comfortable the but strong stepping on first about think color how in growth and and on questions, fourth thanks guess a any end QX to for a just think we of

Raymond Cohen

mid-XXs and already hit met because to and quarter in and impact due that what drop this market, deductibles. These of that to I for the contracted think as for we out expect first does you've and not category, the we're all Omicron of the projects in is Bulkamid, expect XX% Yeah, sensitive of growth aware low QX for people in quarter particularly forward, question? both which year, their I growth seasonality the so QX year-over-year the procedures, see said, then of seasonality so - the Bulkamid having we're drops particular SNM the to and because you've mean, that is XXs and on as it, be this year-over-year noted, low growth we David, remainder and the of we've in the to year-over-year, therapy off in XXXX which answer of of XXXX, impact neuromodulation sacral last both for of we're elective you revenue so - are to guidance look

David Rescott

spend any guess maybe and you with trial, if just any you. jury Yes, about XXXX? second be us, the yes. update that's helpful. thinking Thank of whether incremental that, one litigation any provide ongoing in a of should I maybe not risks we type associated upcoming could from or on

Raymond Cohen

there's to now to scheduled been haven't think I want So, I add? date now and originally - pushed, scheduled you for guess was Dan, mid-April, we're so the that really flash hot it's said more for we that trial much before say don't mid-August, unless, it the has is

Dan Dearen

position, No, claims don't we us, I were mean always on thing any on will patent believe a that we'll which when all it's anything. I August which said XXXX on would infringed and then be claims. the out We take infringing it, this against still filed is very mean back Ray to think we we always I seriously, going way thing were but is we say, report we've these add to the only so, I standard pushed at said, this been our haven't now maintain some as and tried point

David Rescott

Okay, great, thank you.

Operator

Thank you.

the Sandler. from Piper next Our line comes Adam Maeder of question with

now is Your open. line

Adam Maeder

Hi, just Dan the year. Hi, and to and Dan. questions Ray. thanks of of Good for taking out Maybe QX kind you congrats the for some flush and afternoon on XXXX a nice and spending OpEx how to extent the well about level to just of assumptions Thanks. as the kind spend to share as spend, that think of willing DTC around XXXX? P&L cadence in you're wanted of

Dan Dearen

we're just hear Adam, from to So, - Okay, good you.

for or certain Bulkamid. million exclude what consideration as a in Just same would $XX expenses operating Keep that were that amortization, to depreciation as 'XX contingent the we're in mind, working we million $XXX of a sell milestone in trailing the milestone and related we includes stock-based XX-month well when non-cash Bulkamid payment charges compensation, of adjusted amount it acquisition off of so the the have baseline, [technical difficulty] payment period. are the and

you just reiterates year-over-year total operating see. for same to that OpEx with a platform, 'XX above up expect against in the at and expect operating looking Bulkamid revenue and back the to we that Now when increase increase XX% expenses, we in $XXX It's it SNM mid-teens XXXX, be that leverage million. the

Adam Maeder

you're for to market I the bit think give but one part and was staff, more it, that of you that then can Really time? doing of hope are the guess the of to about and And the for of other is how in implanters nearly helpful, thank I where SNM I the taking you there about and you detail questions. you Dan, us heard X,XXX there. kind remarks, States, have guys question kind how physician provided do for the of view fragmented said color concentration of if ask go correctly little you volumes remind Thanks the follow-up, kind I much wondering you it wanted also able in I think a United prepared the it kind over and number how so I

Raymond Cohen

Yeah, thanks, Adam.

question the here. of trying couple pieces to I'm So a parse

how average neuromodulation did you if to is that by of, in practice, this the by owned not be there could are out by kind averages. revenue math XX hard group so given So, look hospital, urology are comes that come so SNM implants right, it, it at these a price physician a in it it, those you the may take number selling we the these is customer per and if or XXXX sacral call divide customers, may of $XX,XXX, count, about divided are so - - to, take right, then and is, physicians we right, accounts, not not four the which you of the to it that's the have

Adam, only bottom silly it's I this doing the I a United may States embarrassing might when that's We've - as great kind you abysmal, mean, the this doing do the I because right, that mean they that year, and think so reinvigorated are as as getting that just a and implanters some is okay, of in XX you line. the may it's know, over and may are. this avoided average avoided they be days, I you in we've early then customer, all that board they few six, about you just get mean, average. some starting that's where come via is customer first

big in big a increases on opportunity these they when presents right. us, that we a in and seeing upside and better for right. than I mean are started XXXX, numbers - Now sales side. are we were mean, same-store today that I incremental

upside standpoint. for us all from that it's So

the now there if So at of to any was substantive colleagues I'm my other looking question. see hopefully, part

Dan Dearen

think… I No,

Raymond Cohen

more could... many How

Dan Dearen

the go earlier is X,XXX SNM table new which that we look, call there SNM, for customer and for raised out with time, just track and growth. over or I this marketing team make units perfectly it's find now, smothering sales that it's in many and sales sure innovation X,XXX to to exactly patient we've we of with time and I prepared and or have everything raised one think did XXXX into internally, implanted think and the them solid accounts the in specialists to more we need physicians these questions, perseverance and same-store the the we goes brought fact really physicians to to and well each the clinical that it, XXXX know increase, how their between are, population, don't remarks in bring it's are that -

And their the if volume suite average, at a all or for population. for so, news, these the we're into Ray a see it's time running to to without utilization double big physicians not very operating level, triple access since in but that five patient the going with just easy as years, issues over to great is, and we believe next mentioned increase any

Raymond Cohen

of half it's customers, half Bulkamid that it's know, thing than I the we been are one not our to doing and Adam, them even we what and and have and now more of is way are them right doing I'd sacral not SNM customers found Ray like the of Bulkamid of have right, all because some the we of add only customers are are about half them neuromodulation, accounts. have competitive it, that more about customers have really You we again. interesting by with found

and and forth. numbers neuromodulation, a advantage opportunity Bulkamid, were is is attitude lot of think you're for in that of sacral why it's there us helped, up cross-selling given terms again, got is share that So doing eye-opener of really that legacy big you've products maybe on about is - been for is the so it right, been once in full right, reason into and and true us, bad doing accounts the Bulkamid, out look, that if no for I opportunities a us you're our it have mean and been we showing we've it's just I right, taking normally us wouldn't but a interesting not getting giving so there, market in which really so this having it that which world it's -

the So, that. good about questions, appreciate to chat question, but really a we're happy

Adam Maeder

color. Good Thank you.

Operator

you. Thank

line question next Wolfe Polark the Research. of with from Michael Our comes

open. Your line now is

Michael Polark

opportunity built expansion being with call a evening, just the I've I interest a curious, this that executing boycott real updated the has just asked the asked, the today adding looks is this Bulkamid of I'm Thanks or before, on core curious is in question, so proved what question you've like good a my stool, second third 'XX lot ask successful, set so views, a does to company there be I'll are into Hi, focus focus your to for one, questions in point, vision? I'm platform, therapy highly leg two much.

Raymond Cohen

right? Mike, was, It

Michael Polark

Yeah, yeah.

Raymond Cohen

Mike. thanks, Yeah,

answer way the on something about this do question thinking keep good headline we when I third to the out You might going to show in asking But put going you're so question finish. leg stool, - inspiration. after what's just that the already about you're boycott, know, word your the to in have that's to this I a going headline In up be the right. you've any report event, it's used

Dan Dearen

look, years it's to three quality don't I I been know, we since fit all other Mike, of as that across, word and distribution continue to commercial of company. we've doing kind and this would you early get we're are and products not We a that want and point things to execution as we've with well us kinds focus. just got about urology the even it's thing come that lose just opportunities the that So, within focus, could different various who urogynaecology as with arena. folks there think think Use or if

bring would if other if of a be with on is envious a circumspect this little outside, to that the This to that think lot at. of I companies think would I that be mean we're a big I such sitting I what was quite of the a looking - men I I urology is new greenfield game kind such think we opportunity sudden some were or all product, something maybe that of a deals opportunity

sudden, are kind goal but additional, cetera, the So, that therefore, foreseeable right It's stated, more cetera, to in the one, not of our we incontinence could the this make and say, of to of to and then than so easier and a sacral we're but we're neuromodulation we et now, future, going be going question. add thinking to for more market at to we're say to to area all and we we BPH reevaluate, we'd I continue to like our three-quarters announcement that that things and direction in decided number in we'll et something and focus our grasp won't knitting. change going and we're things to that's goal of let's so way point, that billion future for is leadership we've surprised us, as you're within stick press that's things or that have not about, maybe push some think get going company, to then hard like the that not levers $X.X the to that we but be appreciate that, by into a

Michael Polark

Understood, you. thank

Operator

you. Thank

next Our Shagun RBC of Singh the comes from Markets. Capital line with question

Your is now line open.

Shagun Singh

Great, thank taking for the you question. so much

topic and spend what Just from XXXX? digits, you. options, you about digits, And missed intervention sales awareness you was? me, for you I XXXX, one share? double like these of doubling on tripling from the me awareness, just volume can remind device the single a demand on talked in are volumes, amount quantifiable, is then customers DTC just you levels medical is Thank on like what anything for can I'm it sorry it hearing from the in same-store big the And coming and focus where and anecdotally, what are patients are

Raymond Cohen

a proven back or technology, out questionnaire new to want want scheduled. get you here, we'll may we've to by our the this want your on from, in symptom spent and in we to and door drug may the the out customers the and back consider prescription will in a have customers XXXX. approximately they've problem, the they door every in walking patients the urologists mail and in letter door. spend - getting we XXXX DTC, practice hey, out get to saying, Where coming urogynecologists, lot So and their mail in existing simple got we'll about amount million coming been exist to same of specific a just They and coming you physician's you never walk $XX fill in the

Botox. that It the customers - talked about got the many Botox fact activated. had the treat Botox previously that all in XXXX, XXX,XXX about new well, patients all of is numerous or unbelievable We've times, we patients women get XX% that how XX% have

the ours back campaign long-term that problem, a them just to you're that multi-decade across temporary a here, let's So physicians in getting patients, solve of to big chronic for get to let's solution you're a will about say, temporizing giving talk them solution problems. these look, is their them a

the it's So already they're patients see to we you, and and that, spend with issue. spending maybe reality going don't only the well, of urogynecologist, to is patients, went going you treatment watching counterintuitive, all these talk a with time but actually installed need time they're stop I or to options, point if think happened, the to and what so think you you about mean part just to is going take they're minutes that find, you the minutes, in and that's go is counterintuitive, urologist, a are there, I a spend they're we this

front another providing can all do have give me help DTC, we hey, Why we and do these I've prescription see doesn't drug got identify problem, work. we're help we're trying the say, themselves office in to are patients So you doing and clinical Why their we storybooks? things. don't why that specialists, why me, this hands other wave have of

and customer think of across, people saying, DTC they on our out systems number and again that a sitting if evaluated, point community once already I know of get questionnaire States. right really to the of file there's we're there and United it's of don't or that they're cabinets this, are mean do there XXs in I and see and XX,XXX out these treated I please and are get And just more the mean are the XX,XXX not patients me get our - to in mean part these getting of that with comparison provider to local deserve sitting people are what's the going the just numbers what that would. in going is treatment really around connect I to don't about I locations So, filling millions little EMR my nothing new this are patients incredible else pale symptom numbers. now

topic. inform appreciate we that question, about helped this really So further you've us even

Shagun Singh

you. Thank

Operator

Thank you.

of Our next Sarcone line the question Michael with from comes Jefferies.

Your is now line open.

Michael Sarcone

does in Neil. gaining and Dan, campaign. It here. steam me Ray, Hi, on there. follow-up for you're DTC That's Thanks like just Thanks. squeezing one look the some

give the know about over mix talked January, of on leads could those the qualified about looks in kind think I treatment-naive, through update so an that just talked past then, in of what you able us might you You you've update like, any terms patients the patients there? the some of do come mine XX% being of to And when start in you funnel? implants in XX,XXX

Raymond Cohen

for It's thanks already question. Michael, happening. the So,

patient now truly period we We a are have about could filled before it's six-month make expect start numbers are and who a getting out we've growing. treated. stuff. The to able that We're said questionnaires to between correlation those seeing gestation are direct - names

very to We're is starting encouraged by see We measurable. are it it, that.

who changed, these - more said be it questionnaires Having who patients has filling out that are may more that, or even nothing I treatment-naive. are people mean,

that here just speaking the the think is advanced that United therapies I States to this problem. in population once So there generally again treat underscores are unaware how

we and not try to who already I to kind DTC anything, rest. money so to people break and because what more practices mean, them good, get we phone towards it's are raised but process, right, can XX,XXX concierge the keep and the XXXX we're moving and that's if them differently an doing book you all got and So all the we're hand, in is in it's on the their to those the where direction, individuals line appointment out down, their kind justice do of the to because busy reach a people that want raise on get have of spending hand, of right all all them individuals is simply it's XX,XXX in reason those get things more a service, moving appointment, on try to

set, on everything and which need don't every call. management we to else, this - repeat So has team other

big - justice do that to yes, we're task we So generate with. we could could to a it's do to yeah, more, getting interest, we able begin once yeah, could to "leads" but the spend be but more more, again right

Michael Sarcone

thank you. right, All

Raymond Cohen

Michael. Thanks,

Operator

Thank you.

the Our question next from comes Mike and line with of Matson Needham Company.

Your line now is open.

Mike Matson

I to about near-term can the for just launching I'm terms of seem here, we've nearing improvements and short wondering ask of that guess question, seen since we're these we you and things of these that of period so kind version devices? Thanks, a tremendous in size have one I'll you the new XX-minute pipeline devices so kind pace a and Okay. like in the mark fairly of just time, limits are passed and lifespan and been sort size the annually, battery and life continue of in

Raymond Cohen

feel out overachieved. pulse So, really answer very question, for rolling on these down had confident this kind kind think think very lot I can longevity moment. the anybody the don't so really of we're another a We on interesting thin Mike, with of fair IPGs devices. very I kind expected has engineering be is what I small, that our think for the of we've there side, implantable - that generator pencils team of

Our process on streamlining of people for External something the trials and care to external our comfortable things that's more of our through whole all and these Trial things. so kinds is pathway focusing initiative people, attention patients with the interfacing company now and just re-imagining the other related System, getting and an that's inside

not months you going it's going or innovation it's next may to be in it's the be the term defined to for not two, going going year So being be just side, to future system. Axonics, near see the you're the if no as IPG on question, to more other from

Mike Matson

Okay, got you. Thank it.

Operator

Thank you. hand Cohen I to remarks. Raymond would to now like conference for the back closing over

Raymond Cohen

really was well, a right, good That We questions coming the you. from really thank session. community. the Q&A appreciate All robust analyst

of placed that grateful remain like just we just patients, say and shareholders trust the course, Axonics. that I'd closing, physicians, So have in to for in

like unfolds, to efforts you and a Irvine our call good and my in so all us evening. and mission diligent and team thank in I Axonics the I'd for we adults fulfilling thank the joining look all their today's you of dedication colleagues of field to always, lives with to As on speaking the the with for forward incontinence year as have you more and improving

Operator

conference today's concludes This call. Thank you participating. for

may disconnect. now You

Axonics (AXNX) 1 Mar 232022 Q4 Earnings call transcript