Outset Medical, Inc. (NASDAQ:OM) Q4 2023 Earnings Call Transcript

Unidentified Participant: Thanks for that color. And Nabeel, what are the factors that could potentially get you to deliver at or above the top end of your guidance in ’24?

Nabeel Ahmed: Yeah. Hey, Avi. So guidance, as you may remember from the last time from our November call, we’ve assumed at the midpoint of guidance that we are placing roughly the same 1,400 console round numbers as we placed in 2023 and 2022. We’re also assuming, again, within guidance here at the midpoint that our — that capital spending doesn’t change, meaning its impact on our sales cycle doesn’t change. And so as we think about moving anywhere through our guidance range, it really depends, number one, on the number of consoles we place, and that could be either as a result of getting TabloCart earlier or it could just be a underlying demand in both our large end markets. We’ve also seen in the past, overperformance come from ASP and also from more treatment sales than we have modeled. So we can see upside in a variety of ways.

Unidentified Participant: Thanks.

Operator: Thank you. One moment for our next question. And our next question comes from the line of Kristen Stewart from CL King. Your question, please.

Kristen Stewart: Hi. Thanks for taking my question. Can you hear me okay?

Leslie Trigg: Yes. Perfect.

Kristen Stewart: Okay. Perfect. I was just wondering if you could just provide [indiscernible] on the cost reductions that you guys are taking the initiatives across the company. And what gives you confidence that you can get the cash burn down in 2024?

Nabeel Ahmed: Yeah. Hey, Kristen. So the expense reduction initiatives are the ones we announced on our last call as well. And what we did is we really took a look at all of our spending and anchored around two pillars. So one thing we wanted to protect was our commercial ability to execute into our guidance range and beyond as we think about our long-range horizon here, so meaning out through 2027 and beyond. So we wanted to preserve our ability to sort of — to perform on the top line. And then we wanted to make sure that we preserved R&D capability both to continue to drive cost down on our console and to fund software, which we’ve long talked about as kind of where we think the future is going to be. So once we have these two pillars, we sort of went through everything else in our P&L and just made sure that we were spending at an appropriate level given our expected rate of growth.

That resulted in taking out roughly $25 million worth of OpEx in round numbers and allows us to — last — in 2023, we just printed about $162 million of OpEx non-GAAP, and our guidance for 2024 is about $140 million to $145 million. So that’s kind of the exercise we went through. Now from a cash perspective, we burned just under $120 million in 2023, and our expectation is to burn significantly less than that, about $100 million in 2024, and then to burn incrementally less each year moving forward as we have revenue growth, gross margin expansion and OpEx leverage off this new lower base.

Kristen Stewart: [Technical Difficulty]

Jim Mazzola: Great. Thanks, Kristen.

Operator: Thank you. One moment for our next question. And our next question comes from the line of Drew Ranieri from Morgan Stanley. Your question, please.

Andrew Ranieri: Hi, Leslie. Hi, Nabeel. Thanks for taking the question. Maybe for Leslie, just your comments about the home market. You mentioned one of the MDOs is averaging about 25 patients on the home with Tablo. And you mentioned the historical reference of like one to five patients on incumbent devices. Just maybe help us bridge what the characteristics are of that MDO that’s now up to like 25 patients. And there’s such a significant population of home patients still out there. What’s really going to get the market to make more progress in getting patients from in-center to the home over the next 12, 24 months? Kind of how are you thinking about that and thanks for taking the question.

Leslie Trigg: Sure. Yes. Good to hear from me, Drew. The — so I guess, one comment, first and foremost, we really were excited by the examples that we have amongst the home programs of getting into, I’ll call it, elevations of a home patient census that have never been seen before. We do have, as I said, our highest home program has been averaging 25 patients. That’s not a ceiling. And one of the things that I’m the most excited about and sort of curious about is how much higher above 25 can we go? And I think it’s quite a bit higher. That is because our training time on Tablo really irrespective of patient demographics is materially faster than the incumbent devices. So we’re just enabling patients to get home more quickly.

And again, our retention rates. The retention rate is absolutely critical here. We have had a markedly higher retention rate, both short term within 90 days and longer term at 12 months. And that helps tremendously. What our goal is to get patients home and enable them to stay home. And I think our team is — that our technology has done a really good job of doing that. So second part of your question was how do we reach for even, again, higher shelves, if you will, of the number of patients’ home. I think it’s twofold. With the existing dialysis providers, it is growing the number of patients per home program. We’re really focused on going deep with the programs that we have, which we’re starting to see. Part two, keeping that retention rate high.