Axonics, Inc. (NASDAQ:AXNX) Q4 2022 Earnings Call Transcript

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So I think it’s a combination of many factors that are contributing. Innovation is key, advertising, so that let people know that it’s not normal to leak urine, and then, of course, the number of feet on the street that we have and then the whole innovative piece of the puzzle. So hopefully that’s not too long-winded but covers kind of the basis of why we’re bullish about this. Now, it’s taken a little bit of time to be able to get third-party data and to be able to be very clear about growth rates that we’ve been seeing and partially because of the pandemic and it’s funny how everybody seems to want to forget that we just lived through this for a number of years and things are much better today, but we only had now actually, if you think about Axonics has operated in a “normalized environment” for approximately four months since we started to commercialize in November 2019.

Travis Steed: Okay, great. Thanks, Ray. And then maybe one for Dan on margins, I heard your comments kind of back and forth on EBITDA over the course of 2023, maybe a little more color on that, and you gave the $350 million number, but it seems like you’d be there by the end of 2023, and so as you move into 2024, what’s the pathway for margins once you start to hit the sustained profitability and how quickly can you get to 20%, 30% EBITDA margins in this business?

Dan Dearen: We’ve always basically – we’ve never put a specific timeframe on it. What we’re looking at throughout 2023 as we mentioned on the gross margin outlook is we’re expecting to see a 100 basis point increase in ’23 over ’22 on a gross profit basis and that’s driven by a better manufacturing yield, overhead absorption, and partially offset by inflation and supply chain costs. And then as you get out into 2024 and you look at the crossover point into positive cash flow and adjusted EBITDA positive, as time goes on, the operating leverage here, and we’ve said this numerous times, we expect to significantly increase, and in some cases, we’ve said double the revenue with roughly the same sales and marketing spend we have with minimal ads. So I think when you just look out not that far, you can get to your 20% EBITDA operating margins. So I just don’t want to put a stake in the ground as to what quarter that’s going to happen.

Travis Steed: That’s fair. Thanks for taking the questions, and I’ll let others jump in. Thank you.

Dan Dearen: Thanks.

Operator: Thank you. Our next question comes from the line of Larry Biegelsen with Wells Fargo. Your line is now open.

Larry Biegelsen: Good afternoon. Thanks for taking the question and congrats on the strong end to a strong year. Ray, I wanted to ask about the guidance, you had about a 33% share of the U.S. SNM market in calendar Q4, the market – U.S. market was about $780 million, if the market grows 15% in 2023 and your share holds at 33%, it would imply U.S. sacral neuromodulation sales of over $290 million which is above your guidance of $278 million worldwide, so my question is, is there something unusual about your share in calendar Q4, do you expect the U.S. market to grow below 15% this year or is there just some conservatism here?

Raymond Cohen: I think the short answer, Larry, we’re just trying to be a little conservative, not get over our skis and I mean we can predict perfectly what exact percentage the market is going to grow in 2023. All we can do is put our heads down and execute the game plan as we’ve been doing, which is not new, Larry, I mean we’ve been talking about this – Axonics has been all about execution since we took the company public in – on Halloween in 2018. So look, our objective, of course, is to give guidance and obviously to overachieve. I mean that’s what everybody is focused on, and so I don’t think there is more to it than other than that.

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