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.
spk01: Ladies and gentlemen, thank you for standing by. Good afternoon, and welcome to the Strata Skin Sciences, Inc. first quarter of 2024 financial results and corporate update conference call. At this time, all participants are in a listen-only mode. And should you need any assistance during the call, please signal a conference specialist by pressing the star key followed by zero. 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. And to withdraw a question, please press star, then two. Participants of this call are advised that the audio of this conference call is being broadcast live over the internet and is also being recorded for playback purposes. A webcast replay of the call will be available approximately one hour after the end of the call through November 15th, 2024. And with that, I'd like to turn the call over to Joey Delahousie. Please go ahead.
spk04: Good afternoon, and thank you for participating in today's conference call. Earlier this afternoon, the company released its financial results for the quarter ended March 31st, 2024. A copy of that press release can be found on the company's website at www.stratuskinsciences.com under the Investors tab. Joining me on today's earnings call from Stratuskin Sciences Management Team are Dr. Dolab Rafiali, Chief Executive Officer, and Chris Lesovitz, Chief Financial Officer. During this call, management will be making forward-looking statements, including statements that address Stratiskin Sciences' expectations for future performance or operational results. Forward-looking statements involve risks and other factors that may cause actual results to differ materially from those statements. For more information about these risks, please refer to the risk factors described in Stratiskin Sciences' most recently filed annual report on Form 10-K and subsequent periodic reports filed with the SEC and Stratiskin Sciences' press release that accompanies this call, particularly the cautionary statements in it. The content of this call contains time-sensitive information that is accurate only as of today, May 15, 2024. Except as required by law, Stratiskin Sciences disclaims any obligation to publicly update or revise any information to reflect events or circumstances that occur after this call. It is now my pleasure to turn the call over to CEO, Dr. Dola Rappialli.
spk02: Thank you, Joey, and good afternoon for everyone on the call. During the first quarter, we continued to execute on the multifaceted turnaround strategy introduced when I was appointed CEO late last year. Clinical results using extract are proven across the hundreds of thousands of patients treated for psoriasis, vitiligo, and eczema. And our strategy primarily focuses on adjusting our extract device placements and increasing our DTC marketing to drive extract device utilization and recurring revenue per device over the coming quarters. across our domestic installed base of approximately 900 devices. During my previous tenure here at Strata, we have been successful with these strategies, and we feel comfortable driving similar results in 2024 and beyond. We started our DTC spend ramp up at the beginning of the first quarter in a limited region of the country. and expect to increase our marketing allocation to DTC in the coming quarters to drive patient appointments and expand the program into additional geographical areas. During the first quarter, we have expanded from our original four targeted areas to six and generated over 500 patient appointments at a cost per appointment of under $300 and a cost per lead of under 40. These metrics are in line with our previous DTC campaigns from my previous 10 years and in stark contrast to the 21 appointments scheduled by Strata in the first quarter of 2023 when the company did not apply DTC. These metrics are in line with those achieved in the first quarters of each 2019 and 2021 in which with a full DTC spend budget across the nation, we achieved 1,900, 1,800 appointments respectively after three quarters of ramp up. The first quarters in each of those years followed periods of no DTC spend And as a reminder, domestic gross recurring revenue in both 2019 and 2021 experienced strong double-digit growth. Another strategic initiative is optimizing our extract device placement. We have some underperforming dermatology partners, so instead of staying saddled with underperforming assets, we constantly consider removing these devices from such clinics and placing the devices in other dermatology clinics that have demonstrated the potential for higher utilization. Higher utilization is a benefit for both the clinic and StrataSkin. So we are always looking to optimize our install base of extract placements. The opportunity to increase utilization of our extract devices from both increased DTC stand and a repositioning of underperforming devices is significant. Successful execution of our strategy could increase the average gross recurring revenue per device from approximately $21,000 in 2023 to $30,000, which we less enjoyed in fiscal 2019, right before the COVID pandemic. This transition will take some time. As a similar turnaround, that started in mid 2018 resulted in the fourth quarter of 2019 reaching nearly $8,000 in gross recurring revenue per device. A return to these efficiencies across our installed base of over 900 devices could mean an incremental $8 million in high margin revenue, allowing us to reach profitability and positive cash flow in the process. We have seen evidence that our domestic business may have already been positively impacted by our strategic initiatives and are encouraged by that we are on the right path. In the first quarter of 2024, our gross domestic recurring billings were down just 3% year over year, making that the smallest year over year decline in the past seven quarters since the end of the second quarter of 2022. During the most recent three quarters, from second quarter of 2023 to the fourth quarter of 2023, this metric was down 15%, 12%, and 14% respectively. Thus, this much smaller decline in gross domestic recurring billing of 3% in the first quarter of 2024 was a marked improvement, providing some optimism that this metric can turn positive in the upcoming quarters further cementing the business turnaround. As a part of our strategic turnaround, we successfully removed 32 extract devices in the first quarter of 2024 and placed 16 devices into new accounts, including six that were placed into comeback accounts that represent clinics with existing extramural laser business that opted to re-engage with Strata through our partnership model. These changes have resulted in a domestic recurring installed base of 907 extract devices at the end of the first quarter, down from 923 at the end of 2023. We expect this optimization to continue in the upcoming quarters. Beyond extract, we continue growing our domestic installed base of TheraClear X devices. through the implementation of our recurring revenue model. In the first quarter, we successfully grew the TheraClear Axe install base from 92 at the end of 2023 to 104 at March 31st, 2024. We are encouraged by the uptake of clinics beginning to use the Acne Surgery CPT code. The first quarter ended with 47 of the 104 clinics submitting RDX insurance reimbursement charts at a rate of 65 charts per week as compared to none in the same period previous quarters. There are over 50 million patients with acne in the U.S., and the unique and reimbursable underlying photognomatic approach with Teraflare X can address limitations of existing acne treatments and drive reimbursable recurring revenue for our dermatology partners, similar to the extract model. Lastly, continued penetration in key international markets is also an objective for us. In late December, 2023, we've extended our exclusive distribution agreement with our distributor in Korea. And in early April, We did the same with our exclusive distributors in China and Japan. International revenue typically accounts for approximately 30 to 35% of our total revenue. And these three territories alone account for over 50% of those revenues. So to extend these long lasting relationships is mutually beneficial for both sides. Going forward, we expect to see continued growth in our DTC marketing efforts, driving extra utilization and gross domestic recurring billings, each of which are key components for us to demonstrate improved operating leverage and reaching profitability. A key initiative in this turnaround is our focus on cost controls. Notably, in the first quarter, we've reduced our cash burn by $1.1 million, or 41%, and our operating expenses by $1 million, or 14%, compared to last year. We talked about these collective strategies, strategic initiatives before, and we will continue discussing them in the future. Calls and future calls. As these tangible financial changes and results are proof of our commitment to narrowing our losses, extending the cash runway of the company, and becoming profitable. Now I'd like to turn the call over to Chris, who will review our financial results in much more detail. Chris?
spk00: Thank you, Dolev. Our total revenue for the first quarter of 2024 was $6.8 million versus $7.6 million in the first quarter of 2023. Revenue was negatively impacted by deferred gross billings, lower domestic equipment revenue, and the discontinuation of Stratapen. Global recurring revenue for the first quarter of 2024 was $4.7 million versus $5.2 million in the first quarter of 2023. Excluding deferred billings and other gaps adjustments, extract gross domestic recurring billings were $4.6 million in the first quarter of 2024, down 3% from $4.7 million in the first quarter of 2023. Equipment revenue was $2.1 million in the first quarter of 2024, versus 2.4 million in the first quarter of 2023. International sales of X-TRAC and V-TRAC devices compromised the majority of the equipment revenue in both periods. Gross profit decreased to 3.1 million for the three months ended March 31st, 2024 from 4.4 million during the same period in 2023. As a percent of revenues, the gross profit was 45.6% for the three months ended March 31st, 2024 as compared to 58% for the same period in 2023. The decrease in gross profit percentage was primarily the result of lower recognition of Q4 deferred revenue and Q1 from the prior year in the same period, higher depreciation costs due to more extract lasers and new TheraClear X devices placed into service, higher material and production costs, and the write-off of obsolete ferrous inventory assets. Total operating expenses in the first quarter of 2024 were $6 million versus $7 million in the first quarter of 2023. The decrease in operating expenses is a direct result of our right-sizing efforts and a purposeful leaner cost structure implemented in late 2023. Sales and marketing declined by approximately $725,000 year-over-year, and G&A declined by approximately $200,000 year-over-year. The goal was to return a leaner cost structure last seen in 2019. Our cash, cash equivalents, and restrict cash position of $6.6 million at March 31, 2024, along with our modified credit facility with mid-cap financial, supports our growth initiatives and leaner cost structure. We continue to believe we can execute on our strategic goals for 2024, given our current financial position. As of March 31, 2024, the company had 35,060,920 common shares outstanding. That concludes my prepared remarks, and I'd like to turn the call back over to Dolev for any remaining comments.
spk02: Thank you, Chris. With both X-Rack and TerraClearX, we have two solutions for the dermatology market that benefit patients, the dermatology clinics, and healthcare systems through reimbursed treatments, and of course, Travis Skin. Our turnaround strategy is starting to take root, and some of the metrics in the first quarter, including narrowing decline in recurring revenues and a significant reduction in operating expenses point to that. We have successfully right-sized our operating and corporate overhead, re-emphasized the DTC growth engine domestically to drive device utilization and anticipate adjusting our domestic extract device footprint on a routine basis to remove devices from underperforming accounts and placing them with more promising accounts. We expect to be successful with our multi-pronged strategy, but as I've said before, it will take some time to reach the finish line and complete the turnaround. Our team and strategies are proven and we are resolute in our drive. We thank our investors, for their support and look forward to reporting continued corporate progress. Now I'd like to turn the call over to the operators so that we can begin the question and answer session. Operator?
spk01: 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're using a speakerphone, please pick up your handset before pressing the keys. And to withdraw a question, Please press star, then two. At this time, we will pause momentarily to assemble our roster. And our first question here will come from Jeffrey S. Cohen with Laneberg Thalman & Company. Please go ahead.
spk03: Hi, Delevingne. Chris, how are you? Hi, Jeff.
spk02: Good afternoon. Good afternoon.
spk03: So I guess firstly, could you talk about or identify the region of the country you're referencing in DTC, and then maybe give us a sense of number of regions that you'll have in place, say, by the end of 24?
spk02: Good question. So we anticipate to be covering all regions by the end of the year. We hope to get there soon. by the middle of the third quarter in terms of DTC spend. We moved the needle up in terms of DTC spend based on efficiencies. We need to see the cost per lead and the cost per appointment remain within these ranges. We also need to see the uptake of these patients into the funnel and converting into X to patients in extra treatment. And as we do that, we grow gradually. So as I said, end of Q2 or the middle of Q3 to be fully deployed.
spk03: And you're saying all regions this year?
spk02: Yes, I'm saying that by the end of this year, we're going to be advertising in all regions. I refer the listeners to the the investor deck presentation that we have online, which shows the outcome of the first quarter in terms of patient leads in the New York City area, which was one of the four areas we advertised. That page has both the placement, so the devices in the market, as well as the patient leads, and we anticipate the same visual to be in all of the regions. These advertisements, these leads that come in that are converted into an appointment, the appointments happen two, three weeks later as these are being scheduled in, and then patients start to be treated. So revenue follows that with a couple of weeks. But, yes, by the end of this year, we're going to be covering all regions.
spk03: Okay, got it. So could you talk about for a bit and kind of in a perfect world and what you're planning for, Give us kind of a guesstimate of where you think extract placements could be through Q2 at the end of the year, and the same with TheraClear.
spk02: I'll start with TheraClear, which we have, as I've detailed in previous calls, we have an inventory on hand of just about 200 devices, and we would like to be in a position where by the end of this year or the first quarter of next year, we're gonna be at or close to deploying all of these devices. So utilizing the inventory we own. The deployment of these devices, as we've outlined before, is mostly with accounts that are gonna be using reimbursement. I'm saying mostly because not all of them do. And these accounts need, need the patient flow to go through. And as I've presented in my prepared remarks, we are now up to 65 new patients a week, which is a run rate of over 3000 new patients for this new this new technology. And this is only coming from 47 of the 104 accounts. So the rest of the account and the rest of the accounts 50 57 accounts are still based, these accounts are still based on cash paying patients. So that's with the TheraClear. And as we move forward towards throughout the year, we do anticipate to start talking about account utilization and the same as with extract, the replacement of existing devices in the market if we cannot get the throughput and the utilization from any one of these devices. And there was a press release that came out this week that discussed the nature of the accounts we go into. We mostly target existing extract accounts and mostly with private equity-owned group roll-up clinics where we can have a clear understanding on how they're gonna be utilizing the devices and how they're gonna be utilizing the reimbursement codes because once we put our devices out there, the utilization is the only way, utilization of the device is the only way where we can make money as well as they can make money. So that's for TheraClear. On Extract, we've ended 2023 with 923 devices deployed in the market, just over $5,000 per device average revenue per device for every quarter in 2023. As you can see from the numbers we put out, we actually took that number down to 907, and we will continue the process of redeploying these devices, of taking them out from non-productive accounts, redeploying them with more productive accounts, and using the existing inventory without having to... expands or builds more devices into our own balance sheet before we, uh, uh, we fully utilize these 923 devices.
spk03: Okay. Got it. And then just tie that in. Lastly, the land force, as far as these, um, new accounts, talk a little bit about the funnel or the trends with regards to their, to extract more importantly, as far as utilization trends, the funnel and, um, the upside? Is it coming on the utilization side and how does that funnel of leads or new placements looking? Thank you.
spk02: The utilization is the biggest upside we have because placing more devices is easy. With the approach that says we place the technology free of charge, we charge a fee per use, and there's no minimum charge, we can place as many devices as we want, but the outcome of that is higher depreciation, which we started experiencing in 2022 and more so in 2023. And that's why I'm replacing, repositioning these assets before we extend the number of assets we have in the market. Expanding utilization, we ended 2023 with just over $5,000 per device per quarter. And just for reference, we ended 2019 with $7,500. So the upside is about 50% in the recurring revenue. And that's where the team is focused, both with – And we break the accounts by tiers, so both by working on Tier 1 and Tier 2 accounts, which are the big utilizers, and seeing what we can do to help them grow with either serving them patients through DTC or training or training of their staff, as well as working on the lower tiers to see if we can move accounts from Tier 5 up to Tier 3 and 4. Or if we can't move them up, we move them out. And we cut out from the bottom, that's tier five, and we tried to move them up the tier ladder, if you wish. And we've outlined this in a press release earlier this week by saying that our best result would come from someone that has or had an existing Exumer laser franchise, and they've owned the device, whether this was our device extract or it was a PHAROS device. In the last quarter, we placed 60 new devices, six of which were into accounts that had previously owned an eczema laser and had a business. And the reason we are mostly seeking these accounts, and there are about 250 of these in the market, is that they have an existing business. We don't need to build them from scratch. We come in and we grandfather an existing business And what we need to do is provide them the technology, the training, the support, the reimbursement support, and so on. But it gives us a head start on taking a new account and starting from scratch.
spk03: Got it. Okay, perfect. That does it for us. Thanks for taking the questions.
spk02: Thank you, Jeff.
spk01: And again, if you have a question, you may press star then 1 to join the queue. And this will conclude our question and answer session. I'd like to now turn the conference back over to Dr. Dolo Raffaele for any closing remarks.
spk02: I want to thank all of you for participating in today's call and for your interest in Strata Skin Sciences. We look forward to sharing our progress on our next quarterly conference call when we report our second quarter 2024 financial results, likely in July of 2024. Thank you and have a good day.
spk01: The conference has now concluded. Thank you for attending today's presentation. You may now disconnect your lines.
Disclaimer