Nevro (NVRO) 1 Aug 232023 Q2 Earnings call transcript

Ladies and gentlemen, good afternoon. My name is Abby, and I will be your conference operator today. At this time, I would like to welcome everyone to Nevro's Second Quarter 2023 Financial Results Conference Call. All lines have been placed on mute to prevent any background noise. After the speakers' remarks, there will be a question-and-answer session. Instructions] [Operator

now introductory the remarks. would Greg over to for Chodaczek Please like I call turn to And go ahead.

afternoon. call. are Good XXXX Chief Financial President; Abby. And Nevro's MacLeod, to Thanks, second and earnings Rod conference Thornal, With Kevin today Officer. me CEO and welcome quarter

And up guidance today's open before On results. it will the with conclude up second discuss will Kevin open call we questions. for detailed business -- quarter Rod financials and

website our Earlier over Nevro's call being webcast also Investor results are on slides released ended X, to of XXXX. copy release Relations quarter on is the available available will there Internet June its on second quarter the XXXX note, copy website. the available A our second related parties of Relations Events Nevro's nevro.com. Please performance broadcast & and today financial is in at Investor earnings on live website this our all be the of Relations interested XX, to Presentations for section. archived August Investor an Nevro This Nevro's section

revise Before detailed from call these include Results as risks. statements we that the the the to on of only XX-K remind to any certain Please or securities within federal XX, Form a and of speak of a including those for filed this statements. materially today, risks no report company filings may annual expressed meaning of February SEC of the obligation forward-looking or presentation as statements call could update Nevro's to forward-looking result on XXXX undertakes The in on made differ begin, laws. like uncertainties. refer comments I'd today's everyone implied and

stock-based restructuring such and charges. the GAAP performance. refer and as to as within and to expenses, adjusted measure depreciation EBITDA, non-cash Please charges Non-GAAP and tables Nevro’s adjustments, In non-GAAP EBITDA amortization, certain to business ongoing used to addition, items litigation-related other release. non-GAAP litigation reconciliation interest, as credits as such excludes help compensation, well and investors understand earnings taxes management a refer the will adjusted

the now, Kevin. my over call to And pleasure it’s turn to

Thanks, months believe the passed know as the everyone. continue productive very to already afternoon, pathway busy you assess for hard three opportunities CEO. ahead in SCS of that us. the and good Greg, as joining on We I've to to have It's It's and fully me us. our and been appreciate capitalize forward to win and market organization gotten

has build my product indications top new the platforms and As I significant on said Costa in to progress like innovative launching establishing market, to be priorities manufacturing the the our last organization, bringing call, will Rica, on a company made, plant iQ. new professionalizing

sales meeting our During already. teams, three the significant and spent in months, opinion have the last U.S. field, the time with leaders in a and lot internationally, customers, key I've learned

Our our their superior that company to that's technology to partner with field business in care customers do the partner and with easy want people with in believe teams. and a

launch has iQ kHz well highly been HFX Our differentiated, and products XX in received. are our Therapy

We pipeline years. and the by currently new have teams also clinical developed products we in coming to a of being great launch intend our that R&D

talented, driven. and determined, is team resilient, Our mission

to improvement forward. business be areas in our areas we However, have for need that key move and will laser these focused

for must which success, execution. Our First on are focused pillars are: do's commercial three key

every and the Siller physician position productivity, sales consider commercially have are excellence that the performed increase in we hiring of A+ moving demands quickly CCO Starting to ensure world-class market talent Greg levels to to We that salesforce engagement, to improve we role, with the have open we execution. not in and territories a of sales improve and our opportunity our the external sales productivity the quota, some performance changes, and rep will internal with These improving our rightsizing on maximize focused our faster. to filling coupled teams, enhance growth our We're also experience. business. goals customer sales in aligning this of at territories

penetration. Second, market

We as PDN, evidence pursue our clinical R&D our with ongoing as Study will extensions our -- for pipeline such Sensory continue strong ongoing HFX support indications and development. to expand robust line

We our strategic consider augmenting also through product will portfolio opportunities.

Lastly, progress. profit

We will internal operational improve Costa scale continue and our facility, to Rica streamline efficiency our manufacturing processes.

building our organizations front, markets track continue to high be On as pain, non-surgical and joined instrumental having and will back such accelerating growth, record Officer. and developing as passion our on proven Siller performing including realigned iQ underpenetrated as is structure. start Greg Commercial has He fast neuropathy recently focus Greg's diabetic off reporting the on system. his a our to sales products, of Chief impact commercial commercial HFX positive our success new a new launching new we painful commercial for organization. and revenue is Greg already

proven So further the patients. quarters. and in their of best sets us common opportunities This Greg's for market us ability our in teams our are success bolster to and with service clinically stimulating capitalize front the future therapy confident that growth will performance. closer accelerate appointment the up working together to our and goal, one clinicians I'm change providing on

Okay.

now Let's updates. our results second and to turn quarter business

forward results. of currency guidance, Nevro's both stronger a year on million quarter in execution revenue move Although, prior a and for compared we $XXX.X to lowered basis commercial lay X% increased continue foundation business to our and we improved reported quarters. future second the constant

year. perm PDN was continues driver X% XX% to quarter year-over-year, Our in second growth and a strong a be to of with growth significant revenue increase U.S. procedure compared last

improving. options have or four main an and SCS growth. today, don't of challenges clear SCS Nevro reported are option. more of last competitors and don't recovery disclosed although the in continue used therapy simply It's to surgeries quarters treatment linear, to either their evident to are or to improve optimal ahead. patients our chronic And that late As not expected it conservative considered is market the relief SCS their market a when we to our work of one the pain relieve QX results. expect provide Remember, participants isn't line of three and be just

growth and seen positive pain recovery, have funnel. indicators We entering patients treatment the including of

come patients and their ready appointments make treatment through recent our remarks. non-linear along with fully this of I and confident market led to see who are us are the SCS to the The salesforce the growth we'll continue end for specialists pathway, we will pain however their back year. to return for patients As guidance rates. my our more to execution recovery, take have historical time which prepared move changes, will at re-gauge implement, to for

iQ our from up XX% a expect the and QX, of implant of permanent HFX accounted In meaningful XX% shift HFX approximately procedures, the our in QX, throughout for year. rest iQ we to

physicians differentiate further. positive feedback deliver pain our and ability relief patients position regarding receive has personalized We the the our competitive HFX using opportunity technology to this continue to convinced to algorithm. from I'm

All of progress this high-frequency paresthesia-free our superior builds SCS on technology.

our XX an trial total from our last our of million now That's expansion, of We XX% Turning indication compelling patients. in this PDN of U.S. XX% our resulting to implant volume up of patients, last physicians XX% difficult and trial XX% in total our the large in business, continued total outreach and compared PDN regarding represented second PDN outcomes in Among year. worldwide the real measure XX and in to approximately the to quarter million direct attribute to year. sales, sales enthusiasm procedures approximately procedures, U.S. of represented world increase permanent volume. these PDN general of trials the PDN treat to in otherwise initiatives data organization QX referral

In well. procedures We DTC PDN continue approximately our came success of PDN with generated to our see as U.S. marketing leads by QX, our direct-to-patient XX% from for trial programs.

awareness imperative the efforts PDN and indication. physician continue drive We both of believe to to patient marketing are

policy place. health FDA is huge criteria This to suffering and a and our updated the continues Blue, front, new grow. on June pain the coverage had in therapy on for we SCS Advantage NSBP Novitas Medicare million is have very provides largest July medical access PDN, their became pleased plans. include XXXX. back HFX to SCS Coverage for patients covered First to XXth. coverage see Options to Medicare Medicare that in and NCD effective cover decided therapy represented immediate both PDN Coast PDN of payer National patients July and who or positive On already from no LCD and policy access Service non-surgical limited to Florida indication retire which XXth And PDN Medicare approval or lives to that coverage Coverage effective in Determination administrative for using or have Medicare win Determination their PDN, who Florida, became to and since development X.X commercial Local coverage meet This NCD are coverage contractors, the

XXX The patients, PDN who nearly government total. over team lives, for accomplishment market combined effort coverage and health affairs plan increase on entire of access coverage million our million covered expanding from coverage covered XX them debilitating focus want to significant and unrelenting this conditions. I represents of suffer and lives on bringing their these thank to congratulate to

the coverage don't denials, including the high for coverage policy the place approvals place. payer process who PDN addition we a prior PDN, auth appeal payer existing and In through in prior with authorization a of case-by-case of to in level continue positive policies have see to payers

these initial denials. an to indications, approval FDA for rolling own Equally the Access For come necessity have been rate SCS. team XX% through those the of for that, in of Access clinical end HFX continued leveraging guidelines, published XX% prior up rate the strong XX PDN our approval By indication over to trend around across of over various we our XXXX. QX, auth inclusion approved XX%, successfully has impressive prior PDN months authorization our who and cases end at that patients medical XX% have overturn approximately from at our society is QX able meet at all Group, data, through

alone. SENZA-PDN Dr. management in American and XXrd where Diabetes the was conventional of Dr. In body findings use Klonoff correlation the a conventional sessions, high for Nevro's proprietary scientific the June, and the frequency attended comparing weight. between SCS Association plus look Erika medical SCS landmark first from treatment we the medical presented Petersen to the reductions of important and secondary RCT, David implant management XX presentation PDN at kHz This AXC

investor presentation. abstract your data For we've ADA reference, XQ this our in slide included

on as treatment to participants where neuropathy, neurological symposium see than this ADA frequency in an quality clinically in in reviewed months that XX confirmation Therapy. expect the high accepted XX% of spinal participated has XX of Impressively was relief cord also XX as of meaningful month Petersen stimulation of two with term half of from reporting associated RCT she Nevro, pain diabetic painful the relief function recently years been this this pain durability at pain with achieved and received publication Erika year. long improvement with kHz PDN life Dr. We significant data published HFX greater second data and XX% for the reduction. well we

promising addition which results, PDN. neurological of In powered new we've in enrolled function to these is RCT intractable a endpoint patients almost Study, restoration to prospective the patients first as Sensory primary with in XX assess specifically PDN our

reduce that be disease and alleviate SCS therapy and study recall health been sensation You'll we healthcare kHz the of in patients any to burden, and for to active, original are the observed SENZA-PDN quality life, the XX feet, all restoring kHz SCS SCS competitive course therapy. overall would of reported improvements which reduce costs. improve have enable low tremendous unique this and may By frequency not other neurological in amputations XX of more

we feedback their I sales mentioned Now, to Since since earning more one investors break on-label all. continue two that and cover topic. out should received that indication we on last our topic. do other recall PDN, segment we call, to leave at from not were I call, you'll we PDN lot now a whether evaluating of wanted that before PDN SCS this are business there analysts who On competitors

organization, to the used of may the and products serviced All and physicians pain are or technology same are and same reimbursed ideologies developed for by whether pain. used back areas codes utilizing with these the in treat multiple same in failed and SCS planning pain deployed planning by patients and chronic using leg the are by same same have PDN, non-surgical back -- sold that SCS indications the in

we've XXXX decided continue for breakout indication providing PDN this, this Given reporting purposes. to

but our specifically with we this beginning we XXXX continue provide growth on will qualitative results, quarter not to out first important PDN, However, of commentary break indication. will

As we're driving quarter, stated are last that. gains we growth share overall in in interested market just period, doing company and

about words few a say guidance. to our wanted I updated Finally,

lack to a company market, to where of and including XXXX as improved believe margins, we the rates, and not the manufacturing product our drivers with and is confidence changes for Rica a path of our us line. interpret growth We is organizational headed. do leverage, can generate First, along future SCS on outlook growth and of sustained eventually will we the discussed, in future guidance return the market returns, the beyond. are long-term believe historic facility recovery We our the in revenue operating scaling increase growth, success enhanced setting significant Costa our up

We're expect be how discussed in opportunity. providing PDN for have formal line guidance also the not we PDN but PDN with indication to indication the sales previously year, XXXX

profitability drive look and of about forward driving taking enthusiastic meaningful deliver opportunities advantage shareholder have plan towards value. leverage to are executing growth our and the We strategies, to current and our we

over our to call and results Rod the quarter guidance. pass to details I'll that, second further with on provide And

I'll revenue PDN quarter basis the in for permanent a the procedures, represented XXXX, on X% of sales compared and XXXX. of our approximately second to resulted in of which with $XX the million Kevin, second quarter quarter which Thanks, reported worldwide of implant constant worldwide good XXXX. in increased afternoon. PDN XX% and second begin indication currency

QX quarter XXXX. number included the as of This same days selling

the U.S. XXXX constant increased revenue in quarter revenue of second International of increased the compared and a second X% X% basis. X% the in second reported on quarter as currency XXXX XXXX. of quarter to

the system the the second our was below margins the shift XXXX XXXX. XXXX. of Costa up Now quarter second product progress line. of The iQ moving we expected HFX gross the well, in in facility, in to with meaningful ramp to release HFX to throughout detail beginning to the XX.X% top of Rica a expect and compared on XX.X% continues mix some the market Gross benefit to quarter which of quarter the in full of is iQ XXXX, fourth combined margin

due the in to personnel-related management expenses operating costs Looking in primarily was second increase at to largely in the operating million specific year-over-year, made expenses changes quarter. $X.X

quarter of term was as short the cash $X.X investments the and a EBITDA million of second second to a compared million XXXX. adjusted of million This totaled June for of of Cash, represents in Non-GAAP XXXX equivalents $X.X loss XX, loss XXXX. quarter $XXX.X were operations comfortable in our of we with well sheet as continue of during line and decrease of quarter second our a the capital with XXXX normal business our $XX.X and manage working Uses million. operations. very to balance as cash projections, are to fund

measures It's Turning financial to release note reconciliations. using in tables for that press our important now to to today outlook guidance. we'll be for describe non-GAAP our Please financial issued to business. GAAP the the non-GAAP see

worldwide approximately on quarter of which basis. We currency X% expect $XX decrease to X% million, third million of revenue to constant a a represents $XX

We million. non-GAAP XXXX loss expect $XX to EBITDA a third quarter to of million be approximately adjusted $X of

to increase $XXX We over an basis. revenue expect on as-reported X% of currency reported $XXX X% an worldwide of year full to million year approximately constant both and for XXXX million, prior

XXXX EBITDA the loss compares of to million, adjusted in adjusted $XX.X range year million EBITDA which million non-GAAP $XX $XX XXXX. negative to full in expect of negative a to be We non-GAAP

made closing, quarter our in and and in on track good in In progress ahead. second we years to scale remain the profitably drive core the business growth

aggressively gain technologies, of opportunity, the iQ best future the HFX year. to the significant PDN, the and are clinical of with the execution. look drive and a superior We opportunities in rest our new to the NSBP great commercial opportunity We our in opportunities share class attacking to performance SCS in data remaining strategically improve business position growth forward platform,

over prepared turn to to I'll Q&A the moderate the session. call Greg back concludes That remarks. our

order and as question brief question please Rod. through one to get In limit Thanks, to queue take you can, as efficiently many questions ask the and we follow-up question. related we to a yourself

and can the take queue You allows, rejoin time additional if will we questions.

we ready Abby, for Q&A. are

Singh with first our from question will We take Instructions] Shagun [Operator RBC.

line Your open. is

is Avi on afternoon. Shagun. Good This for

overall, or guidance year? conservative, as where you a is did And Thank you. Just this that you throughout a new overall, progress the in how allows guide guidance think it philosophy? you your the arrive be about at be range? can guidance, to XXXX Is place you rates at what's talking you

for Thanks Yes. question. the

two positive us If part four previous all you reported two the quarters the SCS growth. since This of at of reported quarters, the biggest look last of market quarter first one where -- the is flat. us those

the but the significantly, others competitors of flat Now other we X%, of and negative was one to their up U.S. up in were one per the reports. was

bit recovery. caution we gives that to of And non-linear be so said about And going market. a it's to the just think little us a

And little recovery that on journey. different be so a each quarter-by-quarter may

at off The appropriate Chief fast those us hold out second the the really the the successful. field. territories those changes changes of Those in who in and we the you as time people of Commercial does with to look done of effective at other speed the change XXXX. field sort part some and Siller take that in for are and Officer, getting new second did during one the two as that know the changes of our the unified be trained a are with as if working Greg organizations making we well has in and sure to the reasons the guidance quarter some as is that past It open bringing filling have remainder get which sort take will we made teams unit, got start for made

with our Group. Anthony from Petrone question next will We take Mizuho

Your open. line is

still XXXX fully and if understand we away in PDN And second considering just it's and going little shakes that be that's a implied would too, the assume a PDN and bit dig flat XQ basically to just Thanks. in of XQ go But XQ. maybe in growing, of implied is beginning low to guide down half conservative to is Hi. timeframe blended of here. the a out XQ, the double-digits core outlook for math that sort and that sort in maybe

what's two just competition, market between we those underlying impacting second themes, really and the maybe barbell so? So more of if half sort

the the be is guidance? also replenishment. follow-up then just on play look In core restructuring quick we at SCS Thanks. salesforce at And half division, the would back and when that

implied the numbers the first answer Rod the Yes. I turn for will said. part then to and on that it on part you second the math

salesforce that are are is, are that's field we territories. manager the the we people to in the the of we structures aligning Previous execution, each reporting really With that, regions to different reporting the in doing different organization. within what or underneath closest those leaders had

So is that that it of and meaningful butter some each because versus for to not will matter. I'm the big effect. big is the need to for be -- together, believer made spread that now time drives to change. customers, Every territories And to closest the city or drive every to each the they're sort those take different results what putting outlook same. a a growth same. across that those operating decisions the peanut power for that of whole that But that's is The not in compiling world so making decisions nation territory whole territory, the take on positive

well. We've in the right ourselves anything We so some do, People maybe specifically they the the going opportunities for is in look organize but know new this only teammates, got scale future we And though. have -- ready not look new thing to SCS about to to to bosses. new that's market, be as else have time strategic able as take the to that managers, future. at

asked. the I implied question it other turn that and math, to you Rod So the do will to

this Yes. is Hey, Anthony, Rod.

is is, good seen We growth think growth using first directionally for right, quarter-over-quarter PDN us. driver do continues your with those a business. The math to be assumptions. We've sequential that

of right. our ourselves see two NSBP push out we we're posted in three to driver sitting and growth with NSBP. well QX have and is Kevin to there, growth industry. strong we're two in QX We the as the U.S. We're down one continuing the he all continue mentioned, to quarter, mentioned, quarters competitors bit in little your as of And in growth flat also a here as after second a as the pretty But being as math -- fundamentally, seeing maybe

salesforce for guidance second how And the our with playing is that in the and out kind that's that year. execution half have of of we the place,

comes question from next Maeder with Sandler. Piper of the your And line Adam

taking this to the on for want Hi, dig questions. bit. QX into Simran is Adam. you for I little a Thank

looks is historically. of step a about but And QX like revenues it component we've sequentially. this with maybe bit the the business, a a understand sequential seasonality than seen XX% I guide So there quarter-over-quarter down steeper down implies is

weigh underlying dynamics So and puts QX, can other you in just takes launch, HFX and competition, walk us quarter? do and through this recovery the iQ market like for how you

Yes, still this end has throughout the when going new sure. on -- year. yes, talked been and the But year script into before where people's their the the QX couple of quarter couple of of the first insurance reasons right, of the one answered historically so in we year also deductibles plans, Simran, the on questions. definitely to QX seasonality, the reset back about lowest were

and started before I four back the the the happened last five guidance knew needed quarter. weeks QX, things we had and change earnings second and And If Commercial month into look one days that we Chief and weeks on I down months what transpired quarter. with the in, the two organization. at in, go and change was Officer the about in made took you the for that X.X role, at call, we that Obviously, I to some

to make up do set future. immediately need we off the those that So it's or for either, us put so changes of can some it we

to time those obviously to with to quickly really middle two assess offense our changes made as need quarter changes be one team well the be to in we he together Greg bringing and the align spend gave sales the in in, teams, to team external reorganization versus with time here? So internal and what the of the able as play and the separate marketing working made him units. organizations So side some of

the So, back of happened that towards quarter. half all second

if is years. So changes, those look previous more down been possible in could of bit at because sequentially changes that's that the why than of would've you occur little those and disruptions QX it

want Rod, that? to to add you

No, it. I it's ramp we you I little thing iQ, covered both pricing, which that a from only receive add The think, while quarters. it see for that is that to or into to and might increase a we up to saw we'll the going take bump mix third should HFX fourth in continue improve and in we QX, as go that and improve the

question line of Larry your Wells Biegelsen with And comes Fargo. next from the

Thanks Nathan is on for questions. taking Larry. This Treybeck for the

had several that pain. to in times Nevro indicated plan you diversify You interventional

new technologies and Can for three what raise indications that years. your you new will all about on us existing equity let talked You And technology know M&A? would and within entail? you

Yes.

question. the as answer -- So indication new as I'll far

XXX need I XX you on we as our have of Study. PDN we enrolled, As the patients the know, for said out script, Sensory

to that already to on claims Our some us and is plan build allow really the extract that will data we good indication. have withdraw on

I But the who we've the That's something away on other we that not we that. of one to that produce the are, tangible we're that's look closer been clinical our the do get We've a we company. from whenever this talked indications with So we're not results areas disclosed in in clinical plan pilot really to have. that's That's team at the there. part and over pain. some phase in that interesting we're get mean, that will already of able more going but we And is never history other yet. been about publicly play. of core superior background, working of that to

think doing that because so, clinical able study. And we're about that we're the things find to

good us claims.” because The showing what, is this in should PDN because “Hey, additional allowed study indications say, saw further explore for you really know offshoot we these is Study to we Sensory first an our this things that early

Now, always far -- about that new I say and to that our constantly And meetings part our diversifying, and main relationships. looking as organization, in our just have talked in diversify this the technologies it biggest taking as have we're I'll yes, in our mean we of got salesforce. is really great revenue. looking should leveraging we've be asset which what we I at pillar

We that service should the our point have said out we publicly same field to to be today able be service stuff people adding we that with XXX leveraged call in in they're doing procedure the could that other patients or could bag help there launched, that a chronic pain. that from standpoint areas other suffer be already that procedures those are that from

steer to from anything going opportunities. not far constantly those we're we So way ship, for the looking But won't we're do stupid.

might talk as far as the raising we that have. of Rod And capital, I'll some let about options

it is. size Nathan. and magnitude the we of Hey, It financing, really Yes. and And depends. it depends deal, what the timing on if enter into the a

are sheet from a balance perspective. good shape in very We

and that. growth, cash flow territory. the getting about not then of a that adjusted of as of be bit equivalents have far on EBITDA, end investments we cash, too positive ourselves and We the million little And $XXX second short-term books And behind quarter. cash growth find with closer should to the

really So it financial what entertain we deal and a that operating like where we point. of depends perspective, perspective. what an on comes are a But when we'd along from at size it from

terms competitive more, follow-up in I just landscape. the of Okay. one Thanks. If with could

lost in say quarter. you One public or think What like you Saluda competitors you and Nevro competitors strong BIOTRONIK, But stacked gained up? smaller of share your reported in QX? do private terms would the of larger

those significant and any those exclusively that we Our that else. try don't that that's we steady us Nevro that calculations or Obviously, we entrants show some use can on had and of impacts accounts data there. held are we time. with think of our of already to somebody two call that the technology new that implant new from physicians But this they by splitters that were get, us going there calculations at out we some

do ex-athlete, Now college, I'm a and any NFL take and both I that, to lightly. not say competitor

vigilant to more share be just only in we have, and to out made up not to take set our tread So organization, changes the some and go we of plan our the keep but will in we us is competitive commercial that water and be share. organization continue will the just to

competitive talent highly here. can have our to organization at changing ensuring why are market. in we we that's continue we team A+ out there We this every go win position so And are and and

And your the line next of Morgan. JP Marcus with from comes question Robbie

open. is line Your

Robbie. Hi, team. This for is Allen on

XXXX you of you first is going be have the to do for XXXX going you be growth changes kind organization. the the work of rest kind normalized of commercial by is as the and that of of do a question, to return refocus level to confidence Just you then What then? clearly, by going impacted rate are the behind to majority a pretty

early with Stryker. I years at both direct from we level XX of reporting all and we to competitiveness change leaders team. with the in our bring mean, where was and as Stryker organizations well all and that the have on we making same know operate we my that and that had world-class passion Rod I do, that know organizations sales other came plan And people intensity, the and from other here Greg. that how Greg build the

that everything are in highly We competitive group a do. we

our thing we traditionally from believe people a in mentioned groundwork are it And going of of that is they for so that of to specifically start our believe they're really as this to most performers, if is we that question, we medtech. taken sort top to And a new that, but for and ramped shareholders, up, side so, we the different mark get of coming of can get be month takes other XXXX. six that employees maybe of it as to us And come care off doing the investors out as all early was right at I good do year. what

market, think, the is never the to alone And of I follow-up, bumpy, of pretty you before hope the then after historical saw it. rates air rates. of kind Got in the idea not as enter historical the COVID. growth to we after in that's market, confidence returning then, slowdown back I up quick enter growth leading saying been years in one you and a the has kind the in market this market And referenced that because both been first I'm

you when of? about are growth what you thinking rate, normalized talk a So market

X% competitors be historical And you quarters, two where as really the -- at we quarter were previous like if quarter previous would from the growth large had last flat, We typically this U.S. and this and to was double-digit anywhere X% mentioned, we you or good in the had Yes, competitor look our the growth, one mentioned, and had down that the X%. X% was question then one rate two quarters in we one then calculate of that had all growth. there

likely a this starting is it little So, to -- But quarter. to going is the market show show diverge growth bit. in overall,

return. It's some So other elective -- it's going and the just remarks, up straight back to that little be to right. right we into go to left bottom as those to procedures a going nature, in the non-linear not see graph choppy a top it's

it's direction you not the look from just now. if line, quarters two a the right is but in going trajectory the last to back So linear three

will Blair. [Operator we from Brandon Instructions] And next William with Vazquez take question our

earlier a brief you make comment some about you filling some potentially commercial made open Kevin, replacing as territories guys or changes. had

update can the been a an a Thanks. one, have to elongate territories been in higher to open curious of and they So give you any you usual market like kind salesforce some than has to what Is guys that result there's in having volatility some ramp? how changes? Are recently, or perhaps turnover. you recovery look could does just of turnover, just fill have since core do territories? wanted given the that Just on their in commercial clarify, if there's open

that quickly These great and people bringing as hiring, from Greg's some we sales territories Yes. known before XX% still behind people us to a XX% are both No, was announcement of we're handful well. doing before lot turnover med within behind that in since that of norms even that known only been public traditional even the have the with have range. last Stryker, our and A we've we've professionals. type those open. scenes We results-driven this that device me -- of that's our what are

A+ change to competitors. a handful take it openings of sales with even share rep have and our you built a them taking we So a there, get time when underperforming right does now. make anytime star But a those yes, from in put to rep, relationships you start

by territories, So is. double what higher that's areas again we what's to absolutely the national we that had start Because that seeing our that sometimes and in going national than us to have market over. crushing market share changed territories we've take our six those are months of have share, some way, some for it some some of proactively non-performing have territories

right So we do have can we territories. the when know people in we the it, right

with the your And from of comes line Securities. question Newitter Richard Truist next

for Thanks questions. on Sam for our Rich. taking is this Hi,

one growth X% to one the Just quick X%. rate, on market

Just PDN that to clarify, that when of is amount? inclusive you say

Yes.

productivity operating a And the salesforce as think in returns how upfront, forward growth we more about what as rates made and to then then changes 'XX? we just lot the relate does Okay, going ramp think to with see leverage of getting how about productivity thanks. normalized that business should can through XXXX,

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your Plovanic question the line from comes with And next William of Canaccord.

for It's for our Sean Bill on taking questions. tonight. Thanks

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as We we've to amount erosion, And in with legacy continue the over of products. about prior last some disproportionate are couple of we've our mix. make and seeing quarters, some that a seen years talked up the pricing of those

as so anticipate of But offset margins, our become from go the when part to pricing will QX the they margins. continues flow lower some mix the as of of we start QX, start And and to through to another. we'll also year hold one costs Costa a tendency we throughout into gross to greater that a show of that starting we the to QX iQ and benefit see Rica up in in particularly see have some

think -- the managing freeing more coaches and for of the in for patients, a ages you, And reps to terms productive beginning beginning selling the coaches those HFX of productivity still Kevin utilizing in breadth? just sales allows and how at about we and when innings terms be are of you versus sales this

you maybe innings, early it, there. call inning, if will. Xth I'd That's

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think I would and we early of are a So call that, it mid-innings success. on I seeing lot to that

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as and our for customers well. it's patients So better

with of Securities. Brad from [Operator Instructions] your And question Bowers next Mizuho line comes the

open. is line Your

Again, taking just of for to follow-up questions. Mizuho here. Thanks Hi. from wanted one our

been they gotten lot obviously, the on non-surgical wins incremental of reimbursement on have the core that lot the of to business PDN, have back talking are the about more wanted mean, a kind you that both all growth hear outlook. coverage over of I had. a years. to We about just and you the We

trials the meeting to and the to help color. want impacting kind plan wins So as they to of you those for of U.S. do doctors kind are drive and higher with conversations you hear well? on how Thanks with new are --

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a team. So have we

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big So, us. yes, tailwind for that's a

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the comes question line Securities. Turkaly Dave of JMP your from next with And

to just wanted clarify I one thing.

some You market said you growth mentioned there's turnover. been but sort of fluidity, obviously also

that that about talking in implied what and XQ not now? right for turnover, the XQ just that made updated I'm and and and the sure make to more, is folks anticipating XQ include implicit you're that trying changes that replaced you've you're XQ So those

be There guidance. can that took that in we predict the could that our Yes, we set all we as never outside some may of be consideration control. macro-economic things

that just of -- said growing. of our the the into like we prepare took two we us all of in quarters remarks sort However,

being where we we've we've to little U.S. pause. and we're competitors first negative And one some that candidates. handful our made, got one the in to a interviewing us gives flat that the of close This for saw quarter obviously then the a changes of territories

So, we the the took year. that into consideration as back we of set the half for guidance

longer some territory the you, start account with lower to numbers are to those adjusted rebuilding for from fact to I And maybe or out the no from a of contribution their a scratch you've folks that imagine whatever that taken you was might base. have or

going Yes, I see there. you're where

to sure Just make you understand.

So when the rep to we we out therapy that and areas sustained most likely going But wasn't or we lose that are expect are growth just rep, because an the territory than assistant often to -- don't of keep business are period in be So to are a those be right? change. business of, reps the wanted don't only There them, consultants make there, a more have managing X% there. made for left time. decision any sales a able you and person we A+ had to one those player current are at that X% in the to which that’s that least

QX the guidance. set we as well as consideration in that took we yes, So QX and

there further questions this time. And no are at

conference So turn would for closing to the remarks. Mr. now back I to Thornal like

everybody. on Thanks. you I the the joining Thanks to on look then. reporting for next See our forward And call, call. progress

gentlemen, then thank for you and we participation. concludes today's your this conference, Ladies,

disconnect. You now may