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Operator
Good day and welcome to the Census Healthcare Second Quarter 2024 Financial Results Conference Call. All participants will be in listen-only mode. Should you need assistance, please signal a conference specialist by pressing the star key followed by zero on your telephone keypad. After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star, then one on your telephone keypad. To withdraw your question, please press star, then two. Please note this event is being recorded. I would now like to turn the conference over to Kim Golodets for opening remarks. Please go ahead.
Kim Golodets
Thank you. This is Kim Golodets with LHA. Thank you all for participating in today's call. Joining me from Census Healthcare are Joe Sardano, Chairman and Chief Executive Officer, Michael Sardano, President and General Counsel, and Javier Rampolla, Chief Financial Officer. As a reminder, some of the matters that will be discussed during today's call contain forward-looking statements within the meaning of federal securities laws. All statements other than historical facts that address the Census Healthcare assumes, plans, expects, believes, intends or anticipates, and other similar expressions will, should, or may occur in the future are forward-looking statements. The forward-looking statements are management's beliefs based on currently available information as of the date of this conference call, August 8, 2024. Census Healthcare undertakes no obligation to revise or update any forward-looking statements except as required by law. All forward-looking statements are subjects to risks and uncertainties as described in the company's forms 10-K and 10-Q. During today's call, references will be made to certain non-GAAP financial measures. Census believes these measures provide useful information for investors, yet they should not be considered as a substitute for GAAP, nor should they be viewed as a substitute for operating results determined in accordance with GAAP. A reconciliation of non-GAAP to GAAP results is included in today's financial results press release. With that said, I'd like to turn the call over to Joe Sardano. Joe?
Joe Sardano
Thank you, Kim, and good afternoon, everyone. Our sales momentum continued in the second quarter of 2024 with very strong -over-year revenue growth, along with positive net income and positive adjusted EBITDA. We continue to drive sales as our customers appear to have adjusted to the current macroeconomic environment. We shipped 23 systems during the quarter with three going international markets. This compares with 13 systems shipped in the year ago to the quarter. We were pleased that many of the shipments were for our SRT vision systems with image-guided SRT with a higher number of such systems sold to a very large customer. We appreciate the dedication of this customer in choosing a far more patient-friendly and equally efficacious option versus MOH surgery. Our fair deal agreement, which reflects our new recurring revenue model, is off to a fantastic start. We launched this option in March at the American Academy of Dermatology annual meeting, and it augments our leasing programs as well as outright sales. As I speak with you today, we have 15 signed contracts under this program, and I wouldn't be surprised if the total number reaches up to 50 by the end of the year based on our current activity levels. Our fair deal agreement addresses customer needs to deploy capital to other areas of their businesses, especially under challenging macroeconomic conditions. Given the growing utilization of SRT to treat non-melanoma skin cancer and keloids and the interest we've generated to date, we expect this option to contribute to our growth for years to come. All these agreements will begin to provide recurring revenues to census beginning in 2025 with significant volumes projected for the second half. During the second quarter, I was honored to be asked to join the industry advisory council of the American Society of Dermatologic Surgery. In that role, I participated in a small but select seminar with important KOLs. At the event, there was keen interest in our fair deal program, and we generated a number of leads. That response, along with the signed agreements to date, underscores my optimism about our prospects. Turning now to transdermal infusion, or TDI, recall that we filed our 510K application with the U.S. FDA in the fourth quarter of 2023. The response times have been impacted from the agency due to overwhelming number of submissions by the healthcare industry since COVID. Our engineers have continued to develop this product with feedback from our KOLs and the many pharma companies interested in this technology. As a result, we've decided to add these many new features, which were considered to be phase two development to the current product. Therefore, we will resubmit our application with a more robust, features-rich technology. We feel that we will submit this application in Q3, which is pretty much past the peak bottleneck period at the FDA. With those remarks, I'll turn the call over to Michael Sardano for a brief update on our international business. Michael.
Michael
Thanks, Joe. As I stated in our last call, over the past couple of years, we have been pushing to open up new international territories. During that span, we have opened with sales to Ireland, Guatemala, and Turkey. And now I am proud to announce that Census has filled the first ever image-guided SRT-100 vision system into Asia at Far Eastern Memorial Hospital in Taipei, Taiwan. Far Eastern is one of the largest private hospitals in the region, and we are optimistic this sale will lead to future sales of Census's image-guided SRT-100 vision system into the Asian market. I had the privilege of visiting with our distributor and physician customers at Far Eastern in Taipei in June, and they are very proud to be offering their patients with the best technology possible to treat skin cancer and keloids. We are also thrilled that Far Eastern is planning to conduct research on new indications utilizing the vision in addition to publishing their patient data and cure rates with skin cancer and keloids. We also shipped another two SRT-100 systems to China as they continue to be our largest market outside of the United States. While in Asia, I also visited with distributors in South Korea and Japan as we continue our work to expand the international markets. Our goal remains to open two to three new territories per year, which we achieved over the past two years. With that, I'll turn the call over to our CFO, Javier Rampolla, for a discussion of our financial results.
Javier Rampolla
Thanks, Michael, and good afternoon, everyone. Revenues for the second quarter of 2024 more than doubled to $9.2 million, up 104% from $4.5 million in the second quarter of 2023, as we shipped 23 SRT units versus 13 a year ago. The increase was primarily driven by a higher number of SRT systems sold to a large customer. Gross profit for the second quarter of 2024 was $5.4 million, or .7% of revenues, compared with $2.6 million, or .9% of revenues for the second quarter of 2023. The increase was primarily due to the higher number of units sold in the 2024 quarter. Selling and marketing expense for the second quarter of 2024 was $1 million, compared with $1.6 million for the second quarter of 2023. The decrease was primarily attributable to a decline in marketing agency expense, lower headcount, and a decrease in attracial costs. As I mentioned during our conference call this past May, this year we shifted our focus to emphasize products and sales options versus hosting key opinion leaders events. General and administrative expense for the second quarter of 2024 was $1.6 million, compared with $1.3 million a year ago. The increase was primarily due to higher professional prison compensation. Research and development expense for the second quarter of 2024 was $0.9 million, compared with $0.8 million in the same quarter last year. The increase was primarily due to expenses related to a project to develop a drug delivery system for aesthetic use. Other income of $0.2 million for the second quarter of 2024 was mostly related to interest income and was unchanged from the prior year. Net income for the second quarter of 2024 was $1.6 million or $0.10 per value of share, and this compares with a net loss of $0.4 million or $0.02 per share for the second quarter of 2023. Adjusted EBITDA, which we defined as earnings before interest, taxes, depreciation, amortization, and stock compensation expense was $2.1 million for the second quarter of 2024, compared with $-1 million for the second quarter of 2023. Turning now to our financial results for the first half of 2024. Revenues for the first half of 2024 were $20 million, compared with $8 million for the first half of 2023, an increase of $12 million for 152%. The increase was primarily driven by a higher number of units sold to a large customer. Cost of sale was $7.8 million for the first half of 2024, compared with $3.7 million for the first half of 2023. The increase was primarily related to higher sales in the 2024 period. Gross profit was $12.1 million, or .7% of revenue, compared with $4.2 million, or .4% of revenue for the first half of 2023. The increase was primarily driven by a higher number of units sold in the 2024 period. We expect gross margin to be in the 16% level for the remainder of the year. The increase was $2.3 million for the first half of 2024, compared with $3.7 million for the first half of 2023. The decrease was primarily attributable to a declining marketing agency expense, lower headcount, and a decrease in threshold costs. General and an excess expense was $3.2 million for the first half of 2024, compared with $2.7 million for the first half of 2023. The increase was primarily due to higher professional fees and compensation. Leashes on development expense was $1.8 million for the first half of 2024, compared with $1.9 million in the prior year period. The decrease was primarily due to expenses related to a project to develop a drug delivery system for aesthetic use. A higher income of $0.4 million and $0.5 million for the first half of 2024 and 2023, respectively, relates primarily to interest income. The net income for the first half of 2024 was $3.9 million or 24 cents for the loaded share compared with a net loss of $2.3 million or a loss of 14 cents per share for the first half of 2023. Adjusted EBITDA for the first half of 2024 was $5.1 million compared with negative $3.7 million for the first half of 2023. Turning now to our Banshees. Cash and cash equivalents were $19 million as of June 30, 2024 compared with $23.1 million as of December 31, 2023, and we had no outstanding borrowings under our Reborging Credit Line. Accounts receivable was $18.3 million as of June 30, 2024 compared with $10.6 million as of December 31, 2023. At this time, approximately $8 million of those receivables have been collected. For the past seven quarters, we have been building inventory in anticipation of growing unit placements. As a result, we paid inventory worth $3.3 million compared with $3 million and inventors worth $12.8 million compared with $11.9 million as of December 31, 2023. Our cash spend continues to be very focused and highly disciplined. We maintain a strong balance sheet to position up to take advantage of the complete growth opportunities we may come across or create. As a final comment, please see the table in the news release we issued earlier today for our consideration of gaps and un-gaps financial measures. With that, I'll turn the call back to Joe.
Joe Sardano
Thanks, Michael and Javier. Our excitement for the future of Census healthcare is supported by our financial results for the first half of the year. Our products offer excellent solutions for treating non-melanoma skin cancer and keloids, and I applaud our talented staff for doing the hard work to get us to this point. We never rest on our laurels, and with the -the-art consistently upgraded technology along with three different purchase options, we believe we have a compelling offering for all types of practices. SRT offers a patient-friendly alternative to most surgery with cure rates that are as good or better. These cure rates have not gone unnoticed by hospital radiation oncology departments, and although this channel has a longer selling cycle, it continues to be an area of focus as interest and inquiries continue to increase. Our FDA or Fair Deal Agreement program continues to draw attention. With 15 contracts already in-house since our introduction at the American Academy of Dermatology Conference this past March, our prospect base is growing. We should have as many as 50 contracts by year end. Although we are very tight on inventory, ensuring that we are able to meet the demands of all of our customers, we will have inventory delivered and available in Q4 to accommodate this demand. This will ensure a significant volume at the beginning of 2025, encompassing an entire year of recurring revenues, building up to significant revenues for the second half of 2025. Recall that our survey of six years of Medicare claims documented a 27% annual growth rate for SRT. As we continue to survey our customer base, we are seeing continued and consistent growth in this area. With this rate continuing, SRT will soon become the treatment of choice for non-melanoma skin cancer. Further, an estimated one in five Americans will develop skin cancer during their lifetime, representing some 70 million people. So whether Medicare or private insurance, we are in the early stages of tapping the enormous opportunity for SRT just in non-melanoma skin cancer and keloids. With those comments, I thank you for your time and attention. And now, operator, we're ready to take questions.
Operator
We will now begin the question and answer session. To ask a question, you may press star then one on your telephone keypad. If you are using a speakerphone, please pick up the 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 then two. At this time, we will pause momentarily to assemble our roster. The first question comes from Jason Wittes with Roth. Please go ahead.
Jason Wittes
Hi. Thanks for taking the questions and congrats on a solid quarter here. Maybe some questions on... Yeah, sure. So on fair deal agreement, it sounds like you're off to a pretty fast pace here. A couple things. One, are these placements for fair deal going to be in this year or fall into next year? And secondly, can you kind of characterize the type of customers that are buying into the program?
Joe Sardano
Yeah. These are all going to be installed this year. Most of them will be installed in the fourth quarter due to inventory. So we're going to have most of these or all of these accounts prepared to provide us with revenue starting from day one when you begin 2025 and a little earlier. So we should have a full year of about 50 units generating that revenue as we continue to add more to the base. The type of customer that is looking at this is a customer who wants to use their cash for other things within their practice, whether it's an additional office that they're opening up or additional equipment that they're opening up. It also helps out with the larger private equity-backed groups that want to use their cash for buying more clinics rather than buying medical devices. So we're seeing a big advantage in those areas. And the customers that I think are the onesies and twosies, they continue to buy and use our fair market value lease program. So we provide them now with this fair deal agreement along with the fair market value lease. It's pretty much a great opportunity for them to take advantage of all of the opportunities they have from us in acquiring equipment. We're just giving them every option that they can to utilize SRT in their practice.
Jason Wittes
And can you remind us what the total number of agreements signed to date are as of this quarter? Is it 15 or I think there were some last quarter as well?
Joe Sardano
Yeah, but we have 15, keeping in mind that we've introduced this in March at the AAD. So when you look at it, it's pretty much since that time to now, which is very much the second quarter, so 15 units. And based on the prospect and activity levels that we have, we're anticipating up to 50 before the end of the year.
Jason Wittes
And then you kind of alluded to this, but are you supply constrained this year because of all these orders or is that something you can make up in the fourth quarter?
Joe Sardano
I think that we have had an ample supply to supply our customers up until now, and we placed an order for additional units anticipating the activity levels that we're seeing now with a lot of those units starting to be delivered towards the end of the third quarter and the start of the fourth quarter. So we anticipate to be able to address all of the needs of all of our customers for this year when they give us an order, whether it's for an outright purchase, a lease, or the fair deal agreement.
Jason Wittes
And let me one last question, and that is in terms of how we should think about modeling these fair deal agreements, can you give some parameters that we should be thinking about, especially going into next year?
Joe Sardano
Well, I would think that, you know, as you look at it, you're going to see more and more customers wanting to go into this area where the fair deal agreement meets their needs. And the reason why we call it the fair deal agreement is because it provides our customers with very reasonable terms and conditions that are amenable to add to their practice. So there's not a lot of high risk involved for them, and it's just a lot easier to implement without any restrictions or anything hanging over their head for both the short term or the long term. So I think it's a much more user-friendly type of agreement.
Jason Wittes
Got it. I'll jump back and queue. Thanks again. Okay. Thanks, Jason. Thanks, Jason.
Operator
The next question is from Anthony Vendetti with Maxim Group. Please go ahead.
Anthony Vendetti
Sure. Thank you. Yeah, just following up on the fair deal agreement. So since March at AAD, you've signed 15, and that's to date, so right up until today is how we should look at that, correct? Correct. Okay, great. And so that's in addition to, so 15 of those plus your shift 23 in the quarter, including three to Asia, so, and that compares with 13, so the 23 over 13 is the growth in ship systems. These 15 fair deal agreements are separate and will be installed throughout the remainder of this year, correct? Exactly. Excellent. Okay, good, good, good. Okay, so this is all in addition. And then maybe just to delve in, I know each one of these may be slightly different, but how do we look at the utilization of these systems, and is there, as part of this agreement, is there a sort of a minimum, or the way it works is based on how much they use it, how much they use it, and maybe just, if you can give us just some general parameters around that.
Joe Sardano
Sure, I'll let Michael talk to that one.
Michael
Hey Anthony, it's Michael. Hey Michael. So the way that this fair deal agreement works is it's really just, they make money as we make money and vice versa. I think it's a win-win arrangement for both the practice and us, and it takes the operational headaches away from the practice and puts it on us, which we've been doing for 10 to 15 years already, and we know it as the proprietors of SRT, we put it back into the market in 2010, and we've been doing this for 15 years now.
Anthony Vendetti
Okay, okay, so the more they utilize it, obviously the more money they make, and you get a piece of that, depending on the, and your percentage of that sounds like it's a scale, right, sliding scale depending on the actual number of procedures performed.
Michael
Right, and it allows the practice complete maneuverability, and they get to treat the patients the way that they want to. A lot of people out there would like to dictate how the practices treat. We do not do that. The practices love the fact that they can have complete autonomy over the way they treat their patients and utilize great technology, and yeah, the support has been overwhelming and the receptiveness of the dermatology industry has been great so far.
Anthony Vendetti
And then, I know this is probably tied to Sentinel, right, in terms of utilization and so forth. Are these systems more tightly tied to your Sentinel system that tracks all these usage and utilization and whether or not there's downtime and how quickly you can fix it, sometimes software fix, or is it that Sentinel is separate and works with this as the same way it does with the ones you shipped?
Michael
No, you got the right idea there. Without Sentinel and without this technology, no company could achieve what we can under the fair deal agreement. We couldn't offer it. The technology is vital to operationally making this simplified from both a regulatory standpoint and from an operational standpoint with patients and the ease of use for the practice.
Anthony Vendetti
Okay, that's what I thought. That's great. That's helpful. And then lastly, just on the transdermal infusion product, TDIs, it sounds like you, based on feedback, there's a couple features. I don't know if you can elaborate on what additional features or what are the main features that this new product will have or that was requested that you're now going to include in the new application to the FDA.
Joe Sardano
Yep, well, you know, the progress and the R&D continue to evolve with the TDI product as we were waiting for the FDA to move on a lot of these things. So, as time went on, we started moving even faster with TDI and the progress became even greater. We had a lot of feedback from a lot of the pharmaceutical companies that are interested in it along with a lot of our KOLs. They started giving us ideas on how we could improve the software attached to the TDI. We've improved that point to help them manage their business, their drugs as they're passing those drugs through to their physicians who are utilizing them. So, we're just implementing a lot more features that adhere to what they want to do with their practices and with the way they want to manage their inventory. And inclusive of that is billing and so on. So we just decided since our R&D was moving so fast, we just may as well pull back, put all these features in, which we would call a phase two upgrade, if you will, put it all in one and resubmit it to the FDA and get everything approved all at the same time rather than wait or have a second phase for it. So this is what we've done. And I guess we have to thank or not thank the FDA for the bottlenecks that they've created, which really isn't them. It's all the companies that have decided to throw everything at them since COVID. So it's created that bottleneck, but it's given us this time to add all of those new features.
Anthony Vendetti
Okay, good. Understood. And then lastly, this is the last question for Javier, housekeeping. Javier, you mentioned something about the gross margin as we go forward. I missed that. What was the number you said that we should look at as a go-forward number? 60%. 60? Okay, great.
Javier Rampolla
Yes.
Anthony Vendetti
Okay, thank you so much. Appreciate it. I'll hop back in the queue. Thank you. Thanks,
Michael
Anthony. Take care.
Operator
Again, if you have a question, please press star then one. The next question comes from Eduardo Martinez with HC Wainwright. Please go ahead.
Eduardo Martinez
Hi there. Thanks so much for taking the question. I was hoping to get a little bit more color on domestic and international sales for the SRT systems. Do you guys have that available?
Michael
Yep. Did you say domestic and international?
Eduardo Martinez
Correct.
Michael
All sales?
Joe Sardano
Okay, so as we announced in the thing, there's 23 total sales with three going to international.
Michael
Yep.
Joe Sardano
So that meant 20 domestic.
Eduardo Martinez
Got it. Okay. And then do you guys have the breakdowns for revenue that came directly from – so obviously nothing yet from the fair market lease, as you guys have alluded to, expecting that to come in probably beginning of 2025. But do you guys have anything else in the recurring revenue stream versus outright equipment sales? Kind of get a feel for the breakdown of how revenue in the second quarter goes either in recurring or through outright equipment sales.
Joe Sardano
Well, as we stated, we've got 15 units that we just started, okay, so the revenue for the fair deal agreement is insignificant. There is a little revenue because we have a few units installed, but it's going to be more significant towards the end of the year. And as this builds up, as we put more units in, of course we're going to see an impact, as we've always said, in 2025 with the second half of 2025 showing significant revenues at that time.
Eduardo Martinez
Got it. So you would say that the bulk of revenue right now is generated from instrument sales outright, correct?
Joe Sardano
Correct. It's outright sales, yes, total revenue.
Eduardo Martinez
Got it. That's helpful. That's all the questions for me. Thanks so much.
Joe Sardano
Great.
Javier Rampolla
Thanks, Eduardo.
Operator
This concludes the question and answer session. I would now like to turn the conference over to Joe Sardano with any closing remarks.
Joe Sardano
Thank you, Debbie, and thank you once again for your time this afternoon and for your interest in Census healthcare. We plan to conduct virtual -on-one meetings with the investment community in the coming days and weeks. Please contact LHA, our investor relations firm, if you'd like to request a meeting. We'll speak with you again when we report the third quarter financial results in November. In the meantime, thanks again for joining us. Appreciate it. Thank you.
Operator
The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.
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