Earnings Sentiment

Sentiment Analysis of the earnings transcript to help figure out if there are any bullish or bearish sentiments that could be gathered from it. We're doing ML and AI based analysis on the earnings call to get some more insights.

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Sentiment Distribution

   

Earnings Call Transcript Word Cloud

     

Bullish Statements during Earnings call

Statement
As I mentioned, we are leveraging our sales force that already call in physicians that treat pain to drive profitable growth in SI joint
trails were down just under 1% and in line with our expectations, a net loss from operations of $11.8 million and adjusted EBITDA of positive $8.4 million also ahead of our expectations
These revenue results with slightly stronger second half growth also reflect what Kevin mentioned earlier regarding our efforts to improve our commercial execution
We are excited about the Vyrsa transaction for several reasons
And I think, we'll exit that one also feeling good about heading into the year with our team
Don't forget, we're still early and this was a really small company with some really great technology that we're excited about and there are market checks and due diligence showed that we think we have a differentiated device in the V1 device, which is the flagship one
Last year, we developed and implemented our strategy to improve our commercial execution and strengthen our foundation, so we can deliver stable, consistent performance, achieve long-term profitable growth, enhance stockholder value and continue to provide best-in-class therapies for patients suffering from chronic pain
We're excited about the opportunities ahead of us and remain committed to executing our strategy to deliver enhanced stockholder value
We believe we'll outperform some of our competitors in the space given our ramp up a new sales force as well as the excitement around new products and the indication growth with PDN and non-surgical back pain
And so right now, we believe we have good alignment and a good cooperative agreement with our shareholder and the change in our Board
10 kilohertz therapy, which is supported by superior clinical data and multiple RCTs across several indications, is enabling us to provide patients greater access to our innovative therapies
Now that in international markets, there was still a lot of pent up demand and a lot of hospital staffing shortages that still were going on, believe it or not, in 2023 and likely a little bit into 2024, but we believe our international team has a good opportunity next year
As a reminder, there are significant growth opportunities in SCS including non-surgical back pain and traditional back and leg pain and we have been at the forefront of driving awareness of new indications and our differentiated technology as demonstrated by our success in PDN
We really feel good about our leadership and our international teams and our opportunities
The second pillar of our strategy is market penetration through expanded indications, HFX iQ line extensions, a robust R&D pipeline, strong clinical evidence and targeted additive acquisitions
That's why it gave us confidence that this was a fast moving space and addressing a clinical need for patients
For many of the participants, this was their first Nevro sales meeting and team members showed great enthusiasm for our core business, new entry into the SI joint space and excitement for our future
We're excited about the cost improvements Costa Rica can deliver and we continue to project longer term gross margins in the mid-70s assuming pricing holds at current levels
That's why it's one of the top three pillars and we feel great about the teams that we have coming into this year where they are
We are focused on further developing this market with our best in class technology and superior clinical data showing that patients treated with 10 kilohertz therapy experienced durable pain relief and significant improvements at 24 months
Our goals are to improve efficiencies through streamlined processes, scale our Costa Rica manufacturing facility and have disciplined expense management
We believe that this along with our 24-month data and differentiation of our innovative therapy will help us further penetrate the PDN market and achieve our goal of having 10 kilohertz therapy referenced in additional society guidelines for the treatment of refractory PDN
We won't go into detail here for competitive reasons, but as I previously communicated, one of the reasons why I joined Nevro was because of the impressive pipeline of products
I'm really proud of our team
We're pleased with our fourth quarter performance and the progress we are making on advancing our core three pillar strategy
We'll start there, but then continue to expand because this is, we believe, a really good device for patients to experience
I feel really good about the energy and passion and what we've done to realign our sales force and adding the new talent there
This has the added benefit of strengthening our relationship with these physicians as many of them are already our customers
So, I think we still have a long way to go and we're excited about helping that patient population
PDN sales grew 29% to nearly $22.4 million
       

Bearish Statements during earnings call

Statement
To help with your modeling, we expect normal seasonality with Q1 sales to be our lowest quarter, down approximately 16% from Q4 2023
You've obviously got some softer comps from 23%
We expect adjusted EBITDA to be negative $8 million to negative $14 million
So the market for SI fusion devices seems to be crowded
While this was a very difficult decision, it was necessary to position Nevro for long-term growth and profitability
Even with our success in PDN, the market remains underpenetrated at nearly 1%
So, that gives us a little bit of a pause as we're looking for the year and don't want to get out in front of our skis and think that the market is going to be already overnight back to that 6% to 9%
Operating expenses of approximately $105 million, which include higher than normal spend related to restructuring costs and SI joint training and adjusted EBITDA to be approximately negative $15 million to negative $16 million
What do you think needs to happen here now that you've had a little more experience with it to get it from this flat to down to that maybe closer to the high single-digit range? It seems to be one of the markets that still hasn't seemed to have recovered post-COVID
I mean, it seems like from an expense standpoint, I mean, that's a real low bar unless I'm missing something
Excluding the Vyrsa related expenses, operating expenses finished down 5% versus prior year
Results could differ materially from those expressed or implied as a result of certain risks and uncertainties
Operating expenses decreased 1.4% to $93.3 million primarily due to reduced spend across the business offset by $3 million of onetime Vyrsa related spend
However, obviously, there's headwinds and tailwinds that come and go and I always like to have more opportunities in different revenue streams to do that
For instance, you might have back and leg pain and also be suffering from painful diabetic neuropathy at the same time
Please refer to Nevro's SEC filings, including our Annual Report on Form 10-K for detailed presentations of risks
But there's also the traditional merit increases, inflationary pressures
   

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