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

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Now, we just started to scratch the surface. So if you’re asking me, what do I think the potential is, the potential is for hundreds of millions of dollars of sales of Bulkamid on an annual basis, but it’s just going to take us some time for us to be able to get there and to get these physicians, in fact, prescribing Bulkamid. Not talking about, well, there is this other option, I’ve been doing the sling operations and they really work, but let me tell you about the adverse, yet there’s this – there’s this option that you may want to consider, no, that’s not the top track that they should be using, right. So we got some work to do and we’re very bullish about it. It’s just that we’re really trying not to get over our sleeves – our skis on this.

So give us a little more time but I inherent in your question is how bullish are we, and it’s hard to be more bullish about the potential for Bulkamid to treat stress urinary incontinence as first-line therapy for patients.

Chris Pasquale: That makes sense. Thanks, thanks for walking through that. Switching back to the SNM side, curious what you see as the biggest remaining bottlenecks in terms of growing that market today. You guys fixed the technology problem, the market before you got there, you’re raising awareness, it is the biggest rate limiter today, the number of physicians who are doing the procedure or how much of their practice their devoting to it or is it something else?

Raymond Cohen: It’s really, it’s really a good question. I mean it really is a good question. And as you might imagine, Chris, we spend a lot of time internally talking about this, and when I say internally, I mean with our sales people, our sales managers, and amongst senior management. So here’s the problem that we’re facing, and I am going to be careful because I don’t want to disparage our competitor, but they had a product that just wasn’t that attractive and for 20-something years, it was the only option, so what has been implanted in physicians’ minds is that sacral neuromodulation is difficult to do, it’s fussy. It’s not so easy to drop this lead down and the tools maybe weren’t as easy to use, and then my patients would need to come back for re-programing and all this other noise and it just takes time to kind of erase that legacy mindset.

And I would tell you if physicians spent more time talking to their patients, and actually prescribing, once again with that new word, prescribing sacral neuromodulation then this market would double overnight, okay. So what does all that mean, that means that, we have to be persistent, we have to be out there, keep beating the drum, making things easier to use, reinforcing the great clinical results that we’re actually getting. I mean we have instituted a program, which our field team has embraced, which we call quarterly business reviews, where we actually sit down with our customers at the end of each quarter and say, look, here’s how many patients that presented that you did an external trial on, here’s your conversion rates, here’s the satisfaction data coming out of your actual patients because we’re the ones talking to those folks and making sure they’re good to go and they’re tucked in.

So I think it’s just going to take some time and it’s almost as if we’ve kind of created a new category called sacral neuromodulation, okay, and it’s a grandfather’s product, right. So I think that’s the story, so you can tell, Chris, I mean, we’re really enthusiastic about what’s going on about this business, I mean it’s turned out to be all the things that we expected in terms of how under-penetrated it is and how much potential it is. But I think, look, we’re going to continue to keep our heads down, we’re going to continue to execute. We’re going to grow our business at record rates here. We’re proud of what we’ve accomplished, but we honestly feel like we’ve just scratched the surface. We’ve got a lot more work to do and it’s to get – sorry – I spent a lot of time not answering your question, but here is the answer.

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