This conference call transcript was computer generated and almost certianly contains errors. This transcript is provided for information purposes only.EarningsCall, LLC makes no representation about the accuracy of the aforementioned transcript, and you are cautioned not to place undue reliance on the information provided by the transcript.
spk04: Good afternoon, and welcome to the Cientra Third Quarter 2023 Financial Results Conference Call. My name is Dave. At this time, all participants are in a listen-only mode. After Cientra executives provide their business updates, we will open the floor for a question and answer session. Today's conference call is being recorded. I'd like to turn the conference call over to your host, Oliver Bennett. Cientra's Chief Legal Compliance and Corporate Development Officer. Mr. Bennett, you may begin.
spk02: Welcome, and thank you for joining us on today's call to discuss Cientra's third quarter 2023 financial results. On our call today, we have Ron Menezes, Cientra's President and Chief Executive Officer, Denise Dylers, Cientra's Chief Technology Officer, and Andy Schmidt, Cientra's Chief Financial Officer. Before I turn the call over to Ron, I must remind everyone that we will include forward-looking statements in our prepared remarks and response to any questions you may ask. These forward-looking statements are based on management's current assumptions and expectations of future events and trends. Our actual results may differ materially from those expressed in or implied by the forward-looking statements. The company undertakes no obligation to update or review any estimate, projection, or forward-looking statements. For a more detailed discussion of the company's risks and uncertainties, I would refer you to our SEC filings, including our Form 10-K and Form 10-Q to be filed later this month, available on the company's website. With that, I'll ask Ron to comment on our third quarter results.
spk05: Thank you, Oliver. The third quarter was a challenging quarter for Centrix. as we experienced a much larger impact from seasonality during the summer months than we had in prior years. This impact was most pronounced in our augmentation business, which is more prone to seasonality and changes in consumer spending. Our reconstruction business, which is less vulnerable to these trends, was less impacted by seasonality this quarter. Importantly, those trends were not unique to Sientra or to Brassene plants. There has been a broad trend across aesthetic companies reporting lower than expected procedural volumes during the third quarter. This also has been reflected in our discussions with surgeons. We have reported lower than average surgical cases during the third quarter, driven by consumer uncertainty over microeconomic trends, as well as an increase in physician inpatient leisure travel during the summer. We believe that those trends are cyclical and short-term, and there remains a durable market for breast procedures. The American Society of Plastic Surgeons, for example, recently reported that breast augmentation procedural volumes had returned to pre-pandemic levels, while also seeing an increase in other breast procedures, such as breast lifts. This highlights the importance of Cientra's strategy of having a diversified portfolio of products designed to meet the needs of plastic surgeons in both augmentation and reconstruction procedures. We're encouraged by the fact that over half of our total revenue in Q3 came from reconstruction. This supports our growth strategy of portfolio diversification, which we believe will give us a competitive edge by allowing surgeons, hospitals, and accounts to source all their breast procedures products from us. It is early Q4, but we're seeing some recovering seasonality so far. We're also encouraged by the customer response to Violity and Simply Derm, as we are in the initial stages of our control launches of those products. As a reminder, with the launch of those two new products, Cientra has more than doubled its total addressable market and set up the platform for growth. We're now one of only two companies that offers the full suite of products for brass reconstruction procedures. Given the early stages of those launches, however, the microeconomic uncertainty specific to aesthetics and economy more broadly We felt it prudent to withdraw guidance at this time. In the meantime, we'll continue to take steps to improve our cost structure, and we're focusing on cash flow and profitability goals, which will position us well when demand rebounds. I'll now turn the call over to Denise to review the impressive clinical data on a biology fat transfer system that we presented last month at the plastic surgery, the meeting in Austin, Texas. Denise?
spk00: Thank you, Ron. Biality is setting a new standard in fat transfer. At Plastic Surgery The Meeting, we were pleased to present interim data from our ongoing fat retention study with up to 102 patients at the 3-, 6-, and 12-month time zones. This first-of-its-kind study is the largest ever multicenter prospective study looking at retention after fat grafting to the breast. The results of our study are showing unparalleled fat retention. As we reported at the meeting, Viality is achieving over 80% fat retention with a high degree of predictability. Importantly, this is across all patient types, all procedures, including fat with implants, fat alone, and autologous reconstruction at all time points. This is an incredible result, making this technology a game changer for fat transfer procedures as surgeons can now, for the first time, confidently relocate a patient's fat knowing that what they see on the operating table is what the end result will look like. This sets viability apart from the other alternatives. We believe that this presents a unique opportunity for Sientra in the rapidly growing fat transfer market, opening up procedure opportunities in augmentation and reconstruction as it offers the first truly minimally invasive way for patients to confidentially increase their breast size even without the need for an implant. We also saw great excitement at the meeting around our new MRI-compatible tissue expander, Allux 2 Pro. As a reminder, this was the first tissue expander to be cleared as MRI-compatible in the United States, and is the only dual-force MRI-compatible tissue expander. This next-generation expander adds to our comprehensive portfolio, as we are the only company to offer the full suite of tissue expander options, including extremity expanders, single port, dual port, and now MRI-compatible breast expanders. Our AlloX2 Pro uses the revolutionary dual-port AlloX2 design to allow access to the periprosthetic space and builds up on this platform with additional benefits supported by peer-reviewed publications. Once on the market next year, this will truly be the most innovative t-shirt expander available since it includes dual ports, MRI conditional labeling, negligible interference with radiotherapy planning, and less dose disturbance, and four times faster billing. We look forward to updating you on this unique new technology as we prepare to launch it in 2024. And now I will turn the call over to Andy to review Cientra's financial results report.
spk05: Thanks, Denise. As Ron mentioned earlier, our Q3 2023 financial results included seasonally challenged revenue results. However, we continue to realize favorable year-over-year EBITDA and free cash flow results. Our key QTREE 2023 financial results include revenue of $19.5 million as compared with $22.6 million for the prior year period, a decrease of 13.7%. Non-GAAP operating expense of $17.8 million as compared to $21.7 million for prior year period, an 18% reduction. Non-GAAP EBITDA was a $6.4 million loss as compared to an $8.6 million loss for the prior year period, representing a 25.6% improvement. Free cash flow usage was $3.6 million as compared to free cash flow usage of $3.7 million for the prior year period. A revenue sector mix continues to favor the reconstruction space, however, Our current period revenue does not reflect the full launch and expected revenue contribution from Simpliderm and includes only a small contribution from Violity as we continue our controlled launch of Violity to our hospital and cosmetic customers. Our free cash flow performance continues a favorable trend as our operating expense discipline combined with efficient working capital management provide for strong results. This is the fifth consecutive quarter of improved free cash flow performance. During the past five quarters, we saw free cash flow usage decrease from $56.5 million to $18.4 million from a year-over-year perspective. A $38.1 million improvement, or 67%. This trend is the result of the hard work we have been communicating to the street over the past year, and we expect continued favorable free cash flow results going forward. Completing the P&L view, our pro forma gross margin for Q3-23 was 58.4%, which compares to 57.9% for the same period last year. The current period's performance includes viability launch costs, which will decrease as the launch matures. Additionally, our year-over-year decline in revenue has a negative effect on current period gross margins, as certain expenses, such as the costs of running our distribution center, are fixed costs. Gap gross margins of 51.3% is negatively affected by a non-cash depreciation and amortization charge of 1.4 million. This charge is primarily due to the inclusion of non-cash amortization of viability manufacturing know-how and developed technology in cost of sales. This cost is fixed in nature, hence will not impact gap gross margins as significantly in future periods as viability sales continue to increase. Total gap operating expense for Q3 23 was $19.4 million compared to $25.3 million in Q3 22, a $5.9 million or 23.3% decrease. Total gap loss from continuing operations for Q3 23 was $14.8 million. However, includes a $3.2 million non-cash charge for change in fair value of derivative liability. and compares to a $14.9 million loss for the previous year period. Switching to key balance sheet items, cash at September 30, 2023 was $15 million, a decrease of $3.6 million from the previous quarter. We continue to focus on working capital efficiencies. We see consistent strong performance in our inventory management with ending inventories at September 30, of $39.3 million, down from year-end December 31, 2022, of $42.7 million. This performance includes building and violating inventories. Accounts receivable also is performing well. At September 30, 2023, our AR balance was $29.6 million, down from $36.9 million at year-end 2022. Finally, we received amended Finally, excuse me, we recently amended our agreement with our convertible debt provider, Deerfield, to provide a temporary waiver of a September 30, 2023 revenue covenant breach. The amendment, which has been filed under form 8K with the SEC, requires us to revalue our convertible loan facility. The effect was a non-cash expense charge to the P&L, change in fair value of derivative liability of $3.2 million. Regarding the balance sheet, you will see a $3.2 million charge to derivative liability, as well as a reclassification of $58.8 million of long-term debt to short-term debt. At this time, I'll turn the call back to Ron. Thank you, Andy. While Q3 revenue performance was disappointing, we're pleased with the continued improvement on operating results in the quarter as executed on our path to free cash flow positive performance. We're also encouraged by the early trends in October, as well as their early feedback from our control launches of Violity and SimpliDerm. As the market for breast procedures normalizes and Violity and SimpliDerm reach full product launch, we believe that 2024 will be a critical inflection point for our company. I'll now turn the call over to the operator for Q&A.
spk04: We will now begin the question and answer session. To ask a question, you may press star then one on your touch tone phone. If you're using a speakerphone, please pick up your handset before pressing the keys. If at any time your question has been addressed and you would like to withdraw your question, please press star and then two. Our first question comes from Jonathan Block with Stifel. Please go ahead.
spk03: Great, thanks. It's Jordan on for John actually. Thanks for taking my questions. I have two questions. I'll ask them both up front. It's on the viality front. Can you give us an update on the U.S. hospital contracting process? How has that process been ongoing and maybe what level of retention there's been with your current existing accounts? And then I did hear you say some favorable free cash flow trends moving forward given some of the positive momentum you've had there. But is there any update on the, on the specific goal of reaching free cashflow positivity by year end? And then maybe the confidence in that sustainability of that positivity into next year. Thanks.
spk05: Yeah, I'll start, I'll start as I move over to Andy for the second question. We, you know, started the control launch in the summer and we've seen really nice adoption by some of the hospitals. It does take somewhere between nine to 12 months to review because it's not the right timing for RFPs. So you want to make sure you're submitting the RFPs. You also make sure it's happening with support from the right surgeons. So this takes a little longer than we had anticipated, but would have seen an acceleration the last two or three months on adoption by some of the hospitals. We're also very encouraged by the reorder rates. by those number of hospitals is at par with our tissue expanders and implants. So once they adopt a NADD viability, they're already at the same rate, same percentage of our tissue expanders and implants. We have a long ways to go. The majority of our hospitals are still a way to go, and that's going to be part of a full launch plan for next year is accelerating access to hospitals. and continue to get more GPO access as well. So we're very encouraged by the beginning, the first, what, four or five months of this control launch. Andy? Sure. And so, Jordan, in terms of our free cash flow performance, we have our expense structure in place and exactly where we want it. We've showed consistent improvement in our Q3 results are, again, a record for us in terms of non-GAAP and actually GAAP operating expense. As we look forward, as we said before, we're targeting year-end pre-cash flow positive performance. The recent change that's going to affect that particular timing is, as we commented to both myself and Ron, the seasonally challenged performance here in Q3 in terms of revenue. Again, looking forward to Q4. There's uncertainty in the markets in terms of how long this seasonally challenged dynamic is going to continue throughout not just our business but the whole industry. And really when that rebounds back to expected results. So because of that, we're going to, you know, again, it's hard to really forecast free cash flow positive performance in Q4. But we don't expect that to push out any number of quarters going forward. It's just the seasonal nature of what we're seeing in revenue right now. The second other element that's one time in nature that we're looking at in Q4 that we don't have a perfect forecast on, but we'll see the results as they appeal out here in Q4, is really the use by the company of third party advisors in terms of working with our key lender, Deerfield, as we work through our covenant breach dynamic going into the first start here in Q1 of 2024. We don't think that's going to be significant over a period of time, but it is an additional expense that we're going to be monitoring here in Q4.
spk03: Thanks. I appreciate all that color.
spk04: Again, if you have a question, please press star and then 1. Our next question comes from Anthony Vendetti with Maxim Group. Please go ahead.
spk01: Hi. This is actually Jeremy on the line for Anthony. So also two questions from our end. The first one also on the viability and the symposium rollouts, you know, based on the current macro environment, have you changed the strategy of that rollout at all? Or is it just business as usual and then, you know, maybe if the conditions continue and you have to change it, you know, in the future, you'll adapt then?
spk05: Yeah, so the impact of microeconomic is really more on the augmentation side. What we saw in reconstruction in the summer is really the impact of, as I stated before, Potentially leisure travel by patients, delay in some of the surgeries and reconstruction, and also travel by surgeons. We have not seen any impact at all for both Violet and SimpliDerm. It's just the process of going through the hospital RFP process, the BAC committees, the GPOs. So that's progressing extremely well for both brands. That's really falling right within our current strategy of a control launch for both brands. So we're seeing a really nice pace for both products. And Jeremy, just to add, you know, we talked earlier in the year as we were looking forward to these launches, suggesting that when you consider both launches, we would exit the year at 5% to 10% of our revenue coming from these new products. We still feel confident with that performance. And so it's going quite well. And we look forward to this performance.
spk01: Right. Okay. Yeah, I was going to follow up with that. That's still applied because I know you mentioned that in an earlier call. It's Okay, and then just my other question, you know, just back to the base, the core business, augmentation, reconstruction. So I know it's really that diversification is great. You haven't seen really a fall off on reconstruction due to the headwinds, macro headwinds. Just if these, you know, obviously we don't have a crystal ball, but if these headwinds do continue, is there a way that your corporate strategy, your business strategy could shift and to focus more of your sales reps or maybe focus more on the reconstruction side to try and make up the difference?
spk05: Yeah, we started that actually interesting enough in early 21 that they're really the shift, the shift into reconstruction, which is a weird time to do it because in 2021, the cosmetic, uh, breast augmentation market went absolutely crazy. And you saw that year we grew almost 50% of revenues driven mostly by reconstruction at that time, close to 60% of revenues came from the augmentation side. What we saw this past quarter in the last couple of quarters is that well over half of our revenues are coming from reconstruction. And the idea of adding fat grafting or viality and adding an ADM with SimpliDerm is really to add more products. And as I stated before, there are only two companies in the market right now that have the full portfolio products for breast reconstruction. We're one of them, and the other ones are not a big company. And that makes it really nice for us to have a portfolio strategy as we negotiate contracts with both hospitals, GPOs, and different institutions that prefer to deal with one vendor.
spk01: Right. Yeah, I understand. Okay, great. Thank you for all that additional information, and I'll hop back in the queue.
spk04: This concludes our question and answer session. I would like to turn the conference over to Ron Menezes for any closing remarks.
spk05: All right, well, thank you very much for everyone for joining us. We'll look forward for a great finish to 2023, and we'll look forward to Star 24 extremely well. In the meantime, I hope everyone has an upcoming wonderful Thanksgiving. Thank you.
spk04: The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.
Disclaimer