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Thursday, October 31, 2024

Alphatec strong growth cuts cash burn

 

  • Total Revenue: $151 million, up 27% year-over-year.

  • Surgical Revenue: $135 million, 30% growth over the prior year.

  • EOS Revenue: $15 million, up 7% compared to last year.

  • Procedural Volume Growth: 20% increase.

  • Average Revenue per Procedure: 9% growth.

  • Non-GAAP Gross Margin: 69%, down 60 basis points year-over-year.

  • Non-GAAP R&D Expenses: $13 million, approximately 9% of sales.

  • Non-GAAP SG&A Expenses: $100 million, approximately 67% of sales.

  • Non-GAAP Operating Expenses: $114 million, approximately 75% of sales.

  • Adjusted EBITDA: $7.4 million, 5% margin, a 530 basis point improvement year-over-year.

  • Cash Position: $81 million at the end of the third quarter.

  • Term Loan Increase: $50 million, bringing total to $200 million.

  • Full Year 2024 Revenue Guidance: Approximately $605 million, 25% growth.

  • Full Year 2024 Adjusted EBITDA Guidance: Approximately $27 million.

  • Cash Use Expectation for 2024: Between $125 million and $135 million.


Release Date: October 30, 2024

For the complete transcript of the earnings call, please refer to the full earnings call transcript.

Positive Points

  • Alphatec Holdings Inc (NASDAQ:ATEC) reported a 27% increase in total revenue for Q3, reaching $151 million, with surgical revenue growing by 30%.

  • The company achieved a significant reduction in cash burn, with a 50% sequential decrease, and is on track to generate cash in Q4 2024.

  • Alphatec Holdings Inc (NASDAQ:ATEC) has seen a 19% growth in new surgeon users and conducted over 200 surgeon training engagements, indicating strong adoption of its technologies.

  • The company has increased its term loan capacity by $50 million, providing additional financial flexibility.

  • Alphatec Holdings Inc (NASDAQ:ATEC) achieved its second consecutive quarter of positive adjusted EBITDA, with a $7.4 million contribution, reflecting a 5% margin.

Negative Points

  • Non-GAAP gross margin decreased by 60 basis points compared to the prior year, impacted by product mix.

  • Despite strong revenue growth, Alphatec Holdings Inc (NASDAQ:ATEC) continues to face skepticism from investors about its ability to manage spending and resources effectively.

  • The company has a high level of investment in inventory and sets, which may not immediately translate into proportional revenue growth.

  • Alphatec Holdings Inc (NASDAQ:ATEC) faces challenges in converting trained surgeons into active users, with varying adoption rates

    • The company has a significant amount of convertible notes maturing in 2026, which may require refinancing or conversion, potentially impacting financial stability.

    Q & A Highlights

    Q: Investors are concerned about Alphatec Holdings outspending its resources. How can you assure them this won't happen? A: Patrick Miles, CEO, emphasized the company's commitment to self-funding growth, highlighting consecutive quarters of flat operating expenses and adjusted EBITDA above expectations. CFO Todd Koning added that they have narrowed organizational spending and are focusing on efficient asset utilization, which provides confidence in expanding profit margins and achieving cash flow break-even in 2025.

    Q: Are there any impacts from hurricanes or IV solution shortages affecting elective procedures? A: CFO Todd Koning stated there was no significant impact from hurricanes in Q3, and they expect to recover any minor disruptions. Patrick Miles, CEO, noted that spine surgeries are less elective than perceived, indicating no major impact from IV shortages.

    Q: Can you provide more details on the productivity of new sales reps and distributors? A: Patrick Miles, CEO, explained that while new sales reps are ramping up, the process is gradual due to factors like non-compete agreements. CFO Todd Koning added that investments in sales coverage are beginning to contribute, as evidenced by a $5 million sequential revenue increase from Q2 to Q3.

    Q: How does Alphatec Holdings plan to compete with robotic technologies in spine surgery? A: Patrick Miles, CEO, stated that while robotics are valuable, Alphatec focuses on integrating informatics to improve surgical decision-making. The company's strategy involves creating an ecosystem of tools, including robotics and navigation, to drive predictable outcomes in spine care.

    Q: What is the conversion rate for surgeons trained by Alphatec, and how can it be improved? A: Patrick Miles, CEO, noted that conversion rates vary as each surgeon has different comfort levels and training needs. The company focuses on aligning interests and ensuring the right infrastructure is in place to support surgeons who adopt their techniques.


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