Earnings call transcript Q2 2023

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Operator

That today's conference is being recorded. I would now like to hand the conference over to your speaker today, Neil Bhalodkar. Please go ahead.

Neil Bhalodkar

Thanks, Victor. Good afternoon and thank you for joining Axonics' Second Quarter 2023 Results Conference Call. are and Chief Chief call Dan Officer; today's President Dearen, Financial on Raymond Executive Cohen, and Presenting Officer.

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

online subject factors uncertainties, are expectations to from and and to revise update could statements cautioned available by call. more the are Axonics' in forward-looking arise. as While new assumptions may results information, Listeners current Commission, beliefs. risks, detail law, today's circumstances on These disclosed of other management's as these these filings Except with to undertakes which based forward-looking at and differ place to statements number on which Securities the that reliance July on no statements cause expectations all risks anticipated not or that and speak only a to this events date, in are required or reflect These any materially Axonics uncertainties expressed statements, forward-looking of are conference Exchange are undue XXXX. www.sec.gov. XX, of obligation

to that, over turn now With I'd to like call the Ray.

Raymond Cohen

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

the XX% $XX.X year to strong an increase with compared million, the in million the second neuromodulation compared was year the company-wide of revenue to prior quarter, specifically, Revenue XX% sacral So execution, overall $XX.X quarter. Axonics in generated period. results of period. second was an increase More record prior

which addition utilization to Revenue wallet share that competitive of existing is well driven the higher of and being converted anniversary Axonics. by the in level top-selling system, of is F-XX last currently first of growth accounts year's proud quarter considering growth as of combination particularly of as this accounts this are S&M which our recharge-free the a launch is we in system. We have

a of S&M from a year accounts new our recently over was rates Australia. the direct by an to period. deployed by year measurable revenue the contribution prior revenue compared on existing last reorder onboarding driven and in primarily increasing as XX% of our from increase Bulkamid force new million, focused sales $XX.X accounts, addition grew to Internationally, a of result compared Results of promoting reps XX% the were of Bulkamid. sales

operating in year of our the to now like leverage margin exciting detail business model. benefit financial gross from the to Dan other inherent prior that quarter was up further performance quarter in and in Our news expectations us corporate outlook remarks. prepared XX.X%, we I discuss his in the adjusted several we period. in EBITDA our from as updates. would continue most million provide $XX in over margin XX.X% will for is The the generated

On the effect will rates in reimbursement front, the XXXX. take CMS recently that year published proposed Medicare calendar payment

in proposal S&M X.X% the by surgery fees increase would outpatient centers that summary, In departments. and flattish be facility includes hospital in

to specialties, increase specifically, in physicians physicians a performing in RVUs an down while see would by advanced full office, facility implant a sacral reimbursement who physicians an trial in increase basis followed XX would trial an factor implanting board see increase a all in an performing see PNE point the across physician a the reimbursement. fees, for perform More external followed was neurostimulator. under the the a facility, As for neuromodulation for the due their conversion with by in a actually increasing while X.X% would XX% proposal, implant work

employee count. of XXX Axonics currently head full-time commercial accounts team XX% Our for nearly person

specialists, in of United personnel they're approximately Europe team directly sales involved field field located with are in and selling the marketing field-based commercial approximately members balance clinical specialists have therapy have in and management now support of specialists. we Western or Internationally, personnel XXX Australia. XXX States, XX and the We which remote being the

commercial We for headcount balance are modest well the XXXX. of staffed at this our increase expect only time team and a in

the continue and XX,XXX to we telling Turning about real a Axonics lead more each our direct-to-consumer information. relief on advertising A those leads contact their find individuals qualified is to questionnaire campaign, than symptom that month. complete qualified us generate symptoms website, providing

these ads clinician ensure physician their many generate In to the are The they or advancing on our come within a patients asking adults into seen to after tell seeing addition, our the we Axonics with conditions practice by helping us pathway. continues along Internet. that are campaign that our and goodwill of customers as that are grateful therapy care on about customers television

therapies continue that's not we incontinence. a normal out treat to the don't of naive, exist note individuals Now notion half to leak that that -- over it's the and treatment these to people that underscoring that questionnaires are of not advanced know filling normal urine aging part

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

we and And about return yielding it's XX DTC investment. on anticipated, an of the launch encouraging been Now measurable and months F&M is as it the since program. Bulkamid revenue

success urinary by system the year. part fecal of new incontinence, or the in DTC process of the launching program, which half S&M which we of Given this the of commercials served incontinence, related in the is stress second to are conditions Bulkamid of our is

to will the the lawsuit turning to this Now limit on following. our topic with our IP we comments competitor,

a penetration. legal infringes attempt down to previously maintain, our our Axonics patents. financial simply of slow market do As is we we that and on to said believe And and an to this burden in case have not competitors' on Axonics any continue litigation create

opinion States finding the United its with the committed remanded PTAB direction. reversed review time Axonics its and of PTAB for The Court patents Federal errors Appeals were Circuit to Federal Circuit decision the the the the of legal against another that instead recently, PTAB the the Now asserted lead that analysis. matter in consistent for valid,

the anticipate court on decision under pending appeals are District PTAB. review the the Now Court outcome few will Federal proceedings and more we in of forthcoming the proceedings the of Because California of Central be weeks. before the U.S. Circuit, couple a of the issued stay for there a patents litigation a that developments, District the these by

As postponed has a indefinitely. for result, August scheduled JARE been the trial previously

development available continue turning initiatives. really Radian We're to making Now from we be progress to foreman commercially expect in good April, product on the we it technology placement lead and acquired finder mid-XXXX. in to

new project it PNE physicians. more on convenient system more a external aims that patients experience, for the to internally for making we're trial and Another trial enhance working is comfortable

-- just scratching what feel we're the possible in closing like undertreated we Now of in really feel surface we or closing, my underpenetrated population. is and from this perspective, like patient

prepared said, remarks respect Now the turn with going to has who that I'm Dan, financial to results. over with to call the some

Dan Dearen

Ray. Thanks,

first the right of net represented As to XX% Bulkamid this the generated million, XX% compared Sacral -- manufacturing in of And was yields an overhead generated $XX.X we representing margin $XX.X quarter revenue are disruptions. year was Axonics year in know, gross In XX%. United the was which XX.X% neuromodulation was of supply pleased half while States. in with the million the revenue was of XX% was prior to gross margin of in result, is a noted, and the of sensitive States. gross absorption, revenue million, $XX.X United increase XXXX, and as second -- to XXXX, period. profit this second the compared of chain XX.X% period. margin prior in generated quarter $XX.X you Gross million, which

to lines the given manufacturing Taking expect remainder for are continuing of to within the be ramp to and these the factors for up XX% year. we F-XX XXXX XX% we of products, margin the the that into RXX and account range gross

at be Radian quarter. the acquired the acquisition. expenses As $XXX,XXX Note and development fair in-process for were Foreman the value $XX.X Bulkamid Operating charge in stated the considerations charge of the contingent a $XX.X mid-XXs. we've the finder and related that million scale we noncash a million gross research previously, to expect second in technology acquisition related includes this change noncash in for onetime to of to margin

$XX.X in were second charges, operating noncash quarter the these of million XXXX. Excluding adjusted expenses

We operating of period profile the loss in of EBITDA financial quarter Axonics $XX.X $X.X The compared of year $XX.X is the the $X.X becoming our adjusted of to million XXXX, to million second the year a operating compared company quarter attractive in period. generated leverage more continue in Net million and loss $XXX year in financial In inherent expenses business of to in the prior prior model million the results. net XXXX. evident our expect million. adjusted second fiscal was of

change in Bulk compensation, associated contingent only Radian first profitable includes In fair Axonics that consideration of excludes the value fact, and which income acquisition. to this quarter charges operating the and depreciation on basis, in-process Med R&D the an the related with stock-based expense and amortization marks noncash the the as

And June XX-month second investments of to equivalents and period Holdings XXXX. cash Cash, XX. payment in related a Bulkamid made -- of March totaled during the ended million short-term sales $XX XX, the Contura achieving quarter, million million $XXX.X to milestone $XX Limited Axonics over as

XXXX guidance. Turning to fiscal

outlook fiscal represents of revenue an of revenue an follows: $XX year Our million, compared compared now revenue increase bulked year revenue million, as XXXX an we fiscal $XXX S&M million XX% anticipate is and updated -- total of overall XXXX. guidance. an company XX% XX% million, prior year to $XX.X to XXXX. increase $XXX.X The to fiscal This of compared to increase compared increase of of of

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

Neil Bhalodkar

to this question. time, session. a We analyst each to to At have Dan. would Q&A the like an opportunity ready Thanks, ask begin we are

please only. yourself So limit we you to question request that one

your if With If reenter question, session. begin you will question Q&A time please we the queue please take Victor, have that, permits. an and the additional second

Operator

first from Pasquale question Research. Neon Our from line [Operator the Instructions] come of will Chris

Chris Pasquale

a thought Congrats on DTC guys. specific bit know It I were the Ray, you generic spectrum. stress maybe one advertise interesting. because there like the I was fecal there around guys shifting great bit, in somewhat little full focus way you the more of quarter, a be the to on comments had ability seems little covered indications. campaign getting the a advantages the the and you the is

So done optimizing of gotten what how program any thus just longer far you've you've kind that return off curious if quantify of in about of way work sort thinking you're there. the And you could term?

Raymond Cohen

question. your Sure. comments Appreciate Thanks, and Chris.

We're specialized specific incontinence all at a selling about about physician in talking in TV commercials. Bulkamid. urinary basically not your about being found symptoms, condition. We're They We're we're the whether sacral an anything a too television. been not talking not neuromodulation. that as or area. get we'd not with XX-second the you're We're has about now, focus. consult if with generic they like you on have be leaking commercials you just So are sense talking on example, in help then our the urine to Facebook a these It's

people, been of first about patients. So year, overactive much the as have they told indicated been towards commercial visitors to relief.com X the pretty physician. you've questionnaire In this and has real us X and interest really them months in million geared a unique an seen, and out bladder The getting the of filled amazing. went are X% who find responses, with

with course, the of I'm of getting interested booked a can and an appointment, everybody challenge, sure Now those is That's not simple process. course, people appreciate. actually

is very This it encouraging actually who easily a before it but a that, to what person in Okay. we on able are investment was questionnaire responded some for return. actually we exactly to us. who time had a take has on can basis, an is the going months Having patient to measure we later, name And name return to implant now could we knew said XX the a hoped, on measure body. we match their

imply in encouraged this, on there. messages providing, want we're messages may, This that So expenditure se, have out doesn't if we're Internet. let's we're just on increase given increase, the television but per by now that going you to say, to different we the some or an

on is a in Facebook, be the be worry things younger, ad going woman So and a that an going we're and to her all some about incontinence. urinary to not children XXs where try who is this, had we on one had too patient have stressed that running we're I'll of who television to do,

all I laugh, call And when before. so I then found going right, exercise Axonics, to going Bulkin, I And sneeze, haven't I bulk and to leak. I of or got -- to say, we be when commercial, lift, so we're she's a it's I when -- which for ed going done

getting we're a of a though even Balcean our patients [ph] of lot So commercial. OAB result getting as

and will And So to on so symptoms that we're their little identify the of a they questionnaires course, more have going and be specific. forth. then, so

do So do to sense for to for that. of about to that. also lot that's -- a that incontinence. excited going us a commercial fecal going think we're We're We makes

volunteers. we actresses paid who So are patient to have commercials. the These these -- by are not and way, patients these do all -- are a volunteered these or actors

or So that's a a celebrity powerful and so we think than on having so more forth. approach

any and therapy resolve so very we've Axonics the who's a and fecal condition we'll So event, in incontinence help gentleman be his can specific this. about that got fact got

about So that's what and on FI so when we're and say so talking we and forth. SUI

they'll So to OAB simultaneously. all and we're fecal And run be commercials of running going SUI kind incontinence commercials, commercials.

once but our a may about spend. we're We doubling talking more a or return. But even not tripling getting nice again, we're spend incrementally, dollars our spend few

your to question. that's hopefully, So answer fulsome Chris, a super

Chris Pasquale

gross place you’ve been given it portfolio especially X F-XX shifts, exclude than seem particularly margin made. I like entirely It be for a Why And products? Dan, you for mid-XXs to already to final has resting and RX progress onetime as very needs Yes, overtime carrying of the doesn’t that’s versus some push further think, that, you can’t the items the impressive, leverage here. the you operating when certainly great. one

Dan Dearen

ramp agree XXXX back trying in going to you, clearly years we're check just we want just We're it And can. we're couple XX.X% in not on target direction, see that to for in a now. keep guidance quarter, and as keep we of we you as when production. But -- especially and mid-XXs everything with point picked we just the We messaging, trending providing the the that yet.

So keep see the just executing do. Look, you have We production we the in don't to trending have have anything runs, supply have it you're and change don't correct. we change product. and We chain. longer to to way the

Operator

will question of the Biegelsen from next Larry Fargo. Our from line come Wells

Unidentified Analyst

for on [ph] Trebek Larry. Niko is This

do half. itself Has the about why? so, talked at changed considering feel in S&M the if growth? past, first posted growing targets these regard growth And XX%. you your you market in to growing at you XX% How So about sales and the the still anything market strong with

Raymond Cohen

in think look, involved going only Axonics the continue. is that market the is Unfortunately, growth to Well, I market growth game.

not seems some say, we're to keen, too doing Our let's other competitor be doing. that the of just things on

since And XX% down that to be So having said that, is given market we're in to it's water. XX% any see the the ones But quarter, carrying the whatever. going growing. or or We up in the has over certainly think is market range. would been expect consistent And is time, XX% with is we what we been the And what saying to see, growing. which XXXX. we've

the we're got in lot just the executing help initiatives heads down that that happening to benefit patients identify And are on additional putting plan. and a focused could So of we've from therapy. our accounts

system. the filing And those of adherence provides that anywhere a urogynecology to of OAB I've to for their said EMR somebody And or couple therapy believe problems. is within injections. having patients their from terrible, has appropriate. patients just like the measured before, and BOTOX, decades OAB notion fundamentally is, and or a know solution in which the drop patients practice this and certainly have issue these We to stop speak treatment about individuals after and hundreds a of single X- out We an medication long-term in the of to permanent their thousands United X is don't a year. is that X-month paper that chronic States XX% Most XX% will medications we activating it's matter untreated advanced of urology cabinets times many and them every electronic to that or a simply a in

So in to sacral have the problem. therapy these believe reasons who day, the the relief we long-term are end It's provide that neuromodulation is of the why to way a all go. patients chronic going for

with a So customers that. a fact person is was resort. changing the sacral physician amongst with neuromodulation product attitude there difference That so our is is notion -- decades, had now for so MONOPOLY, forth. overcoming despite marketplace that The okay, the a and X of therapy that and last we’re that here company on the the a in

our and to extremely last future. fecal are has for have neuromodulation to expect get as urinary sacral urinary who And has is got bullish continue in in about customers the Bulkamid of stress. And have today one urinary that X/X you, discrete X/X or mind helping these woman from comment many that these I urgent reality that revenue because So patients our look, who us we’re not patients providing about incontinence. share the grow nobody almost therapies. years show a well future, fecal we certainly not into And is to incontinence tell we’re to up she’s able nobody is more continence a additional incontinence those of It’s urge stress and The persons up. and incontinence have urinary shows have incontinence. by like

part is the an we’re up to And reason we’re person. what of product our that’s why whole line able that’s Bulkamid [ph] the important to. So such because treat

Operator

for our question. next moment One

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

Michael Polark

be ask new to is, growth S&M we But How the introduced it, U.S. the from for to you numbers proposition, I that accounts behind the magnitude, Order your Axonics. Axonics freshly have the look of why at, innovation on do the conversion. recent I'm the way perspective you've curious, gotten of that say, think account I market. to into much bigger other the Maybe in are XX% question Ray, as again? value the know XX%, perceive

Raymond Cohen

we question. the Mike, for thanks -- As

analysts customers of States, neuromodulation other have practicing we've mean certainly all round not I dare giving sacral "Oh, people the called Now a you it's too about acknowledged it. is something today, XX% number, else. got United helping I our that we're say reality asking are Axonics of go, okay? writing and well, are walking are their in I'm accounts The our that but customers some yes, said, too, not that been is the in office and As that think about and yourself I they everybody people because and those therapy, we

first kind creating out the So awareness on going time the It there. that's marketplace. in was what's of we're

they to they awareness is can X the In so this something words, and as door there the questionnaire patients -- walk that's we're patients new into being when the it's other providing. or themselves. symptom in score existing handed when created in tools as that simple So a that and sit that walk minutes can patient

if this. So about staff in severe to talk terms they're moderate the the This been incontinence, done can of physician has never then them before. to and

So I the tackling. is this I most mean, and basic we're talking mean, basics. blocking

better have get utilization we in But been called we've sales. it and this? seeing we're same-store implement we okay? able have before, accounts seen we've through account than every working to those these Now is that We're No, processes. to still what

way I it. refer think that's a good to to

really So driving they of revenue the the what are And company. that is is increasing.

up message accounts. to new we're continue Now everybody Absolutely. to our I And pick hammer until going them all, that across. we going up to picking get we're tell are to have accounts continue to we new And on would you dare

are provide great colleagues, right? folks, hey, the The products really their great other out, of out the time. people. last these And the a word technology, sand head support, man, up and docs these they've and they got Axonics is hearing popping long is from are their so They really, word out. The got

time more more think before I matter market. now of just this more more to it's have to right and of and and doing share going and be continue a wallet all we of share So stuff we're the

accounts them of we’ve focused to One things So conversion keenly that that that are their of get business that and more in have early Axonics. us to the these to still on converted give business, splitting maybe the right? we they’re people is in we’re

have even the converted. way have recently So accounts that in go a we still long to

out the right? it’s There’s to realization walking it’s budgets, the budgeted, and this are shift going to a of on get is the not so understand that question. folks are this that. understand this that between themselves coming focused mean, patients I sacral I the there And is patients not. So are wow, neuromodulation in, is about that mean, I “Oh, is like game. that a there’s them, not share I their right therapy thinking, and these is, fact lot like many stay physician to we’re continue for to it. going just

Operator

come Capital will Shagun Singh from [Operator RBC of Instructions] Our next line from Markets. question the

Shagun Singh

for you discuss your longer and what Ray, Could from doing you the go that. to just customer current really what looks range one within that can where expand share like you're And term? could procedures S&M perhaps me. utilization base,

on DTC, we focused should if You did anything touch but there's curious just else on? be

Raymond Cohen

question. understand appreciate I the the so -- question. have We I

let's be I what basis. in at low the cetera. average a what per et think this S&M possible, utilization cetera, per year. mean okay? neighborhood that the I dismal to everyone on terms say, the XX of is is of I is et would a account just reasonable, average, XX is surprised in how of the is mean

So market, of we into find. what of that's So this whole dabblers to we've refer the the we're of we That's and what lot come with there, kind out dealing state. a them state okay? that's as

It's Now are No. low. with ridiculously It's ridiculous. we that? satisfied

year, Now do Nice some Those a really really, less price. that to they right? nice and there are say, more XX XX we plenty implants then of have in year. XX accounts, do a that accounts there's than, are that

can If right? and all larger we're are So on you the smaller obviously, what doing? those and we get accounts, focused keenly accounts,

you the one that most me like I mean to But have things their we're case goes it electronically I'll letter our might or letter, with, send personalized, included bladder them by basic in the from overactive the say, the help just many in hey, that out condition. with a diagnosed be. differentially says questionnaire that or and whatever the things customers fecal too signed marketing prestamp it's of that technology and single program, most to your up out have the you conference is basically, been which for getting Dan, a -- office. put to incontinence doctor, and we've new Simple letter got describe fill chronic it on we this and our today. envelope don't we to cutback is effective give call Why to for return this there's already symptom do, account let's

Okay?

As it compliance or system. simple was as they're I stuff, yes, I people response it it's the really yes, all base. and next good from this existing their customers thought This about or want I surprises is names because to that, is gets letters my in I "Oh, about and want file patient come cabinets have doing great comment HIPAA back thing, the said, like, they thing, to talk EMR X and That in and really number our XXX their realize XX they yes, and a raised hand their send that "Yes, to oh, job, there's therapy. out then in, XX advanced

So one that's example.

we average with these their them understands the We NPs, the time time, communicate sure providers, patient. also PAs, so a sacral help spent lot How practice the them RNs that advanced about do the account and APPs, tracks. [ph] the of XX with talk getting staff, and can patients little your -- you nursing the call minutes spends process everybody the in this, or physicians have this maybe on because with to neuromodulation enrolling very doc Balcean I'm

to rely very the time. these patients. be can’t explaining physician on limited all things They’re you to these on So

and of this, the therapy. the utilize different where we realize we’ve and get forth help more on working we all So been on so so kinds staff into and patients can programs to

I of programs just list is physician’s things A website types you’d stuff, percentage this the different neuromodulation have sure Balcaen we be about sacral making on invested have them basic of marketing [ph], information small have like even that things. available. very actually various in one basic of even they or these of whole that So surprised. a mean that

see I’ve to get years for in for grow is XXX This year-over-year, not been and marketing and stuff, so across to point right continue grow that size. and order not So -- in in for to a -- us rocket about [ph] it’s all of the this -- utilization to number is talking it trying forth. business order we're basic this us now increases is to

fact Now showed done up time we this scene ever have to is is the on the what of that now, happening that This has none not it's the the for Axonics was legacy taking okay? overcome been before, situation.

So I question. Hopefully, get doing. answer, the so a you kinds appreciate about was we’re enough the good that sense this things of a

Operator

Instructions] [Operator from Newitter of Richard will next line come from the question Our Securities. Truist

Richard Newitter

operating pursuing growth the the about this on at clearly just congrats particularly an guess curve. really So in point performance, improvement you're sorts my and margin from how profitability balance profitability here is question I quarter. inflection you here revenue of on the

out context if where you're especially put addition DTC? further? as X, how particularly, you in and a we into little goes M&A with investment rays respect hear the to think And prioritizing think, even reps maybe to love I'd those So to could

Raymond Cohen

superb business think really question, underscores said, the and I have which leverage quarter, we for the Thanks as it that in model. this result the Yes. adjusted acknowledging thanks in really, Dan for the EBITDA

thing, this the here's So comment. and make we'll

back money. spending We are on not holding

Let us that that, about be think everything doing We sense grow clear business. us right? this are we to makes help

not not physicians on events not We're are then. We're back APP or back or holding holding on on hiring back DTC. visits HQ holding trade salespeople. We from

financial This to is it natural. what's back. blood a of We from good naturally occurring squeezing This standpoint. is are about and make not our rock out holding look just not a business. is This occurring in

where accounts United those to. a to we're given we States, to getting words, not part see we the -- if comment. the that's going underserved making we're other that we and an mean, not we're the add I additional to in So people that opportunity have in a If get penetration need of

this that important dropping we've the money at what is in think one I business a got along. that And So message it's bottom leverage an because for us the out. but to get good to all point, line. had predicted that's and Yes, is we we're inflection

are I years than surprised is a variable. what's company actually point okay, a fast-growing is But to I and this for is way margin, profitable that, think a there to Dan the going to come. be here, Granted, going other now, that and point this So or be another a occurring. not we've turned corner one

Richard Newitter

Thank you.

Operator

for moment next question. One our

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

Adam Maeder

I’ll keep about full I for guidance to ask wanted the it to year. updated one. the

[indiscernible]. million the increased is like by you beat between increase $XX It guide or that $X.X million. You And so. split by evenly for looks I think QX,

than then Can versus So that that you little XXXX, you're QX cadence beat. a on any in the raising strokes, broad informing by about just half color provide new QX? can what's more kind of more And decision? you second talk bit

Dan Dearen

Sure.

always each met Look, good a that's Area look, we in then have team. and hear We them. guidance come their we've back change Director the they the to it level. obviously they And of the field the basically is, the discussion. regularly thing As driving doing. to up from see with what with entire roll accounts

as possible. guidance we're fit look, being as see we and the accurate so as just transparent And changing to be

tackling. so And blocking and just it's really, basic

key managers. sales as the area in you and capable large employees Commercial we field. of including Chief and a infrastructure of XXX-plus the XXX and would have the company in and account people directors the But very have expect, of with We over management the Officer

one And to same-store was growth each sales. in our talked And insight so same-store high teens granular thing accounts. of We've seen sales year. that have Ray earlier year about detailed the very from we into

the predicted QX, step-up And guidance so there's from of step lot look to their the was to it's an QX. for year What indication going we up big we'd have like have is at would and and QX the deductibles. QX well. a then QX that just us beginning in when patients guided a adjust seasonality met

everything So change is well, messaging just no going really the that to guidance business tracking we and other in is than to plan. according keep want

Adam Maeder

you. Thank

Operator

from Needham. the of question Our line comes from Instructions] [Operator next Matson Mike

Mike Matson

even higher. adjusted mean, the for modeling kind So should consensus revenue the is just of second half, applies I the given and strong be quarter in your or the the what guidance EBITDA

is kind this go mean any over rest there potentially year? at that or of higher level margins reason adjusted the stay I of at the So least will even your EBITDA

Dan Dearen

it from you. to hear No, -- reading you're Mike, good

team. down to lay we the But revenue it better earlier terms estimating, significant the provided We're look for total Now and into when or confirming add the to profitability. QX guidance team operations steps is continuing year it in to you're it the which the support support to as correctly, trend look in similar very just up we at that's coming the our And point some it to even OpEx, the in you with and X near the are XXXX. expenditure reading continue We're back-of-house QX. you're OpEx right, is to customers. point change as there's no that should forward that's path to the gross to still lane on even we field OpEx impact which sales expenses see which should in is line, in future G&A continuing we go add going of as you're margin to we're or right, percentage X.X absolutely the

Mike Matson

you. Thank

Operator

[Operator next question of the Instructions] comes Mizuho. Petrone Our from from Anthony line

Anthony Petrone

Congrats on a great quick ones quarter end. from our here. Two

TiVo CMS high-level the proposal setting. for Just on views of ASC the kind in

impact surgeries. seeing there's U.S. some that for in are And the a of sacral ago, is think higher I reported loss. there other between And there do of [indiscernible] up were And Just be incidence quickly early couple weight to from weeks the is bladder think a Axonics one the the XX-plus year? BMI. next if influences put behavioral neuromodulation that in I'll bariatric finalized, views opened how that idea it could Intuitive recommendations -- overactive decision Surgical in GLP-Xs you one

on influence thoughts bladder GLP-Xs the could any overactive So space.

Raymond Cohen

might Ray. is to this knows Maduro mean, be. the and Thanks this -- to be or I really anybody Anthony, what is on for question. I going don't how or long think over going impact anybody time Ozempic it's whatever it stay that Look, is the phenomenon, GLP-X

see means. what that So we'll

of of patients. was to million, overactive We've latest have huge mean, tens is untapped like We underpenetrated got, a bladder. number I to with stress market. the millions specifically, severe think urinary moderate moderate this I and patients $XX severe incontinence

great. there that's and a are to I non-plused out that, who few lose everybody wish So right? luck wants So [ph] good doing pounds, we

think symptom we implantable the relief clear. be symptom of business; underscore I the XX% neuromodulation for sacral implants We're in CMS, just [ph] terms comments are the way And In in or I patients. to to the percent the of long-term think capital we've let from relief think is modulation all along. [ph] go. -- tibial simply permanent provide stimulation, These nerve results what just me been most recent saying

going, IT&S don’t and and not intend on forward. business in any business. in on business going the impact don’t the measurable we having are to our our We IT&S get see We IT impact business any

questions. the appreciate I So

Operator

from of will next Instructions] [Operator Morgan from next Our come Stanley. [ph] line question the Kyle question.

Unidentified Analyst

on And further spoke Just the bit and excited I'd about maybe you've bigger any on assume seem enhancements then maybe portfolio you but solution, with share share term. than here initial long one to your some pretty had recently the the to And with like you could engagement sample we size takes in Radian, the placement docs some about you'd thoughts from us. a could any is S&M add you if tech.

Raymond Cohen

second the of question? was the part What

Unidentified Analyst

Any system? S&M other to enhancements the

Raymond Cohen

for remarks is also think that alluded I think in to that and it that a going it patients. my this for to more and So, trial comfortable prepared external have make forthcoming, new I physicians. more is we convenient we system

of lead but kind sacrum combined technology, So discrete sort the things. and the of included that's of X finding or kind finding with

or quite a of a us, in do did anybody's a of of get this we finalizing customers the so into clear, positive forth. product hardening And testing come we're few just that respect clear, and hands bit study the just some [indiscernible]. to we'll hardware lot physicians to the let's Just in not to package get so kind But risk of discuss to -- process when this of product be from under design then them. we'll later year, the usability the we nonsignificant all a start diligence hands, concept say, feedback and can very okay? and hardening software it visit and stuff. that so we is we're So with We the

So just thing. about fluoro the they we It's is to But I the don’t the it's less thing in it's people it. can people I concept, And hands we a live placed piece get a trial just this of look, Fluor’s want elimination But lead in to yet. fairness, just about I in and people enthusiastic [ph], part little because place, having fact use and And the to think the winner. oversell it beautiful it back that. of to are save external about a some think talking few haven’t helpful physicians if the mean because and product is put software. could exposure that hardware is not big the doing a help of good expensive. by a minutes an getting then right be

is -- it’s else. So is something this not create that is like a or financially anything burden going costly or to increase

sense. So we’re excited about it makes We think it.

we’ve forthcoming it. that that’s that X Anything the eyes that on keep we projects big S&M going do certainly and can could got that at We’re we’re think our in keeping internally. are doing us But XXXX, I keen moment, open. the to busy portfolio enhance

Operator

from comes the from question next of Your line Instructions] Baird. [Operator David [ph]

Unidentified Analyst

congrats the that and provided of on I around market quarter. this growth Ray, outlook. the strong appreciate comments Thanks kind you just Great. XX%

at some just you if market that the that in a a longer-term We on basis on the and growth quarter gains kind talked of of do touched those share some I outlooks get XX so of you of look share S&M those far. again gives level growth wondering trends for of XXXX around maybe visibility questions XX-month specifically provide some least, XX-plus S&M. about. at consensus just for that mean probably more I'm really any in growth lot far, you a been have account thus going assumes You so color, confidence that's it think, model, our percent here of rising today of so. around this and And do or maybe whole? could that kind as you've And that implications maybe the just adoption I I and And

Raymond Cohen

Sure.

layers. bit that not I think in know it. have are more on involved of personally, kinds most it's information that and helpful CEO conversations of the filtered company, through relying folks than CEOs activities our talking with probably as B, of different these I I'm customers. got customer-facing to a enjoy I'm terms little where X

X% practice advanced yes, a only all job says I've lousy XXX that, we've and volume doctor who at the very probably personally now. percentage. to therapies admit anywhere that single of they not in tell are can S&M doing of I doing. will the in every small patients they're that to, one and least They less them this near be them mean spoken forth. you a I of gotten year, we're every their it doing So that have been actually talking spoken than I've and could so

see very -- Volcan. we So interesting. this is This is what with happening how

Bulking I XX,XXX bulking. is in XX,XXX used Nobody mean, got [ph] bulk, slings, last right? happened. alone, about phenomenon, quarter got this Well, look right? this Bulkamid. at people Look what’s trash just was -- it people all

of happens For was people So to as speaks MRI a to middle game because pandemic long, last and get changing sacral And of this resort okay? it product when time. towards a an view technology. the with going So realize people was global in neuromodulation therapy perceived a over new X.X it okay? It last years for that was a it that that we’re the [indiscernible] where the great a was way take it’s legacy didn’t some we’re into compatible. overcoming what and existed results, therapy these using, X behind power decades of fussy, the

or to office data response can attendance whether on. So every look put whether at, that the point I go it’s same-store mailers we it's it’s response to whether whether DTC, the tell at we from you it’s sales, that events

“Hey, this shoots want working It’s to for respect they thing across relief are patients right. United that to [ph], [ph]. Sling mouth you. incontinence. happen. But starting Their urinary high. that Nobody have forever is with wants Same once There some are all we time and their plentiful. to they’re for and problem stress signing interest now open The need we All the and last do Bulkamid people to States have are to going up with springing a up this. little say, is technology long that’s could is solve

this know be to bullish. explain or I we are are words don’t So future I it can and technology. bullish about use how enthusiastic for we what we to how the can’t explain how

Operator

Our question from Brett from come of Instructions] [Operator next Fishman KeyBanc. [ph] will line the

Unidentified Analyst

Bulkamid. on in one throw I'd thought I

on last look potential few at channel to on were practices mentioned conference more on IM think you I as you focus a procedures. bulk for planning a the start placing some calling call that to

to Just you curious some you on opportunity? doctors make team progress initiative bringing And given at more of you process do if look in think could on the these has started potential that customers overall, the touch for board that as if the how on XQ? then scope of eventually

Raymond Cohen

a Yes, thanks. I appreciate It's question. really that question. good

comments. of couple a So

if a the reasons got BOTOX initiatives, about never people sacral on you One already dropped X neuromodulation new is talked for the kind described. I've initiatives, I've X injectors, game [ph] So or neuromodulation focus behind of marketing of sacral may. out that

BOTOX less X that to our in number literally to should marketing new of now a meeting why them sacral in listen and with do more to started now marketing try a approach. that of of -- get to have doing We consider they take is QX to listen BOTOX just lot focus terms us And so kind a neuromodulation. physicians and

the we that BOTOX. around in XXXX, So past, XXX,XXX data we suggests I said nearly mean, about as think patients in got our

the combine for S&M, was the it So X XX,XXX implants. only you -- and in companies when space

neuromodulation. So we for competitor, see frankly, quite BOTOX sacral the big as

huge focused going right? that So doing into of potential they're urologists wasn't sense no because urologists So women care, are incontinence. being standard walking first. question. for a know okay? and we're the they're right for urogynecologists people because we -- And urology, now, more women. primary the in Bulkamid stuff, care other opportunity GYNs these for are lot on are than walking and door not they're urogynecologists it We Bulkamid, selling makes for to they're that door the physician all more to that solution most that a these and male only are your in urologists us all their the Now a that have offered But

office, a at GYN's show office, they up they're a urogynecologists Before right? ever

fish -- best business is haven't I a so Bulkamid to XXXX kind So marketing initiative. it. and towards specifically but year, to initiative to other geared fry, gotten around to population of a this do speak, really, say going we bigger so that it's patient something because And yet I we've are it's we well had we'll but think maybe going that going but get the

the of well. opportunity that's can way side us it. to as I best think ed of you for a out But for lot Bulk frame growth see the there revenue on

Unidentified Analyst

you. Thank

Operator

turn in back remarks. for any to the to And Raymond Cohen over closing any like queue. I'd call I'm showing not questions further the

Raymond Cohen

We thank It us calls. All Thank Well, for color really a chance gives today. give good right. a questions on appreciate questions. these always you. questions. A to the little you more everybody's

their Australia appreciate mission and my building to the in support dedication also thankful in I are sales -- I fulfill make more through with just efforts to for put have patients shareholders incontinence. want really quality. of So the trust thank our us for that colleagues thick trying and our here improving lives stuck for in physician the only and internationally we're down with all to And have in not in look, to day States We and obviously, field, to products their every then us. to who want who Axonics and helping the team down of and with United the our care heads our things happen but adults very customers got from And that, so speak. say Irvine, thin,

forward everybody interest speaking thank future. for your again look the I with you and to So, joining in continued today near and in call Axonics, we the

Operator

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

great a You Everyone, day. have disconnect. may now

Axonics (AXNX) 28 Jul 232023 Q2 Earnings call transcript