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Chief Innovation Officer Ahmet Tezel described the Highmark decision as a positive step from exception-based approvals to direct coverage, which could influence other insurers. Regarding OSA, CEO Vladimir Makatsaria expressed confidence in commercializing it internally by leveraging existing neuromodulation expertise, but remains open to a partnership if it is beneficial. He highlighted the product's clinical differentiation as a key advantage.

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CFO Alex Shvartsburg explained that LivaNova is well-positioned to manage tariffs due to its manufacturing footprint, with neuromodulation products made in the U.S. for the U.S. market and most cardiopulmonary products made in Europe for the global market. He confirmed the less than $5 million adjusted operating income impact is baked into guidance and assumes some marginal pricing actions. Regarding cadence, he noted the Street's revenue ramp estimates are reasonable but reminded that operating expenses typically ramp up after Q1 and that Q2 will reflect new interest expense accounting.

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CEO Vladimir Makatsaria stated that price, excluding equipment, contributed 250-300 basis points of growth in 2024 and that pricing capability is well-reflected in the 2025 guidance. He noted upside would come from share gains and Essenz penetration. Chief Innovation Officer Ahmet Tezel explained that the OSA device will be MRI compatible at full commercial launch. He stated the company is not actively working on a primary cell, as the current rechargeable design allows for more energy-intensive, personalized therapy via its unique 6-electrode architecture, which is a key focus for future upgrades.

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CFO Alex Shvartsburg confirmed the $20 million pretax savings from DTD would drop through to 2025 earnings. CEO Vladimir Makatsaria stated that for OSA, a 'good result' would be clinical data competitive with the current standard of care. Chief Innovation Officer Ahmet Tezel highlighted the program's advantages, including not requiring a DICE procedure and the early study truncation based on a high probability of success.

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EVP and CFO Steven Pfanstiel explained that the Q3 to Q4 ramp is consistent with historical seasonality, where Q3 is typically slower due to summer holidays before a significant rebound in Q4. Regarding gross margins, he stated the primary driver is the revenue mix between the NeuroStar and Green Brook businesses. He anticipates margin improvement from leveraging fixed clinical infrastructure as volume grows and from optimizing the profitability of the SPRAVATO buy-and-bill model relative to its Q2 baseline.

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Executive Stephen Furlong confirmed the previously communicated revenue guidance split between Neuronetics and Greenbrook remains the target. Executive Keith Sullivan noted that in Q1, TMS revenue was roughly double SPRAVATO revenue at Greenbrook clinics, but he expects this ratio to change significantly as the buy-and-bill model for SPRAVATO is rolled out. Stephen Furlong added that the 49% Q1 gross margin was in line with internal plans and expects margins to improve sequentially in Q2 and Q3 due to revenue scale, approaching the 55% target.

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CFO Steve Furlong outlined the company's typical seasonality, with Q1 representing 19-20% of annual revenue, followed by a ramp to ~25% each for Q2 and Q3, and ~30% in Q4. He specified that SPRAVATO accounts for approximately 75% of Greenbrook's projected growth, with minimal revenue from medical management. He also noted the buy-and-bill transition is a months-long process per site due to payer contracting.

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Chairman, President & CEO Tim Herbert identified the slow customer transition to the Inspire V system and Medicare billing delays as the two predominant headwinds. He confirmed the company expects revenue growth in 2026 to exceed the 12-13% guided for 2025, citing planned investments in marketing and footprint expansion.

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CEO Tim Herbert affirmed high confidence in the device, which is fully FDA-approved with a robust data set. He explained the primary reason for the rollout timing was the need to scale up manufacturing to build sufficient inventory for a full launch, a challenge that has now been overcome. Herbert also confirmed that reimbursement is secured with the new CPT code and that feedback from the limited release has been positive.

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CEO Tim Herbert expressed confidence in Inspire's established position against potential competition and viewed GLP-1s as a complementary tailwind. Regarding Inspire V, he explained the launch timing depends on building sufficient inventory and completing operational readiness, including new contracts and training. He confirmed that eliminating the sensing lead will reduce COGS, making the new device slightly gross margin accretive over time despite price parity.

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Chairman & CEO Tom Burns clarified the FDA classified the reimplantation petition as an NDA supplement, establishing a PDUFA date of January 28, 2026. For iDose Trio, he stated a U.S. clinical trial is targeted by year-end, with a potential approval by year-end 2027. He emphasized that creating non-facility payment codes with MACs is a key parallel step for enabling in-office use.

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Chairman and CEO Thomas Burns announced that the post-approval supplement for iDose reimplantation was filed in Q1, ahead of schedule, and a decision from the FDA is expected by year-end. CFO Alex Thurman provided quarterly seasonality guidance, suggesting Q2 revenue would be in the 23-24% range of the full-year midpoint, followed by 24-25% in Q3 and 28-30% in Q4.

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CFO Jamie Samath explained that the new curved Vessel Sealer has a slimmer profile and is ideal for procedures in narrow anatomical spaces like thoracic, colorectal, and hiatal hernia surgeries. He stated that while it doesn't open new procedure categories, it is expected to increase penetration of advanced energy in these areas and improve surgeon stick rates. He noted it has a minor positive impact on INA per procedure, reflecting its value proposition.

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CFO Jamie Samath explained that the new curved vessel sealer has a slimmer profile, a 7mm sealing indication, and a tip designed for better tissue manipulation, making it ideal for procedures in narrow spaces like thoracic, colorectal, and hiatal hernia. He stated the goal is to increase penetration of advanced energy in these procedures and improve surgeon stick rates. While it doesn't open new procedure categories, it will have a minor positive impact on the INA per procedure metric due to its value proposition.

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Executive Jamie Samath stated that six different instruments currently have force feedback capability and that 'many thousands' of cases have been performed using them. He outlined a clinical data strategy that progresses from small, single-institution studies to larger, more statistically relevant studies over time. Executive Gary Guthart added that early results are confirming their hypotheses about improved surgeon learning and outcomes. He also clarified that current usage is limited by manufacturing supply constraints for the force-sensing instruments, not by demand.

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CFO Jamie Samath characterized the U.S. capital environment as 'relatively stable,' while noting that capital spending pressures in European countries like the U.K. and Germany have been consistent for the last quarter. CEO Gary Guthart added that China is experiencing broad stress across its healthcare market, including price caps and the entry of domestic competitors with provincial preferences, and he expects these pressures to persist for some quarters.

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CEO Olivier Taelman reiterated confidence in a Q2 approval by outlining the final regulatory steps post-inspection and projected the DREAM publication would be released before the summer. CFO John Landry added that while some costs are deferred pending approval, full-year R&D spending is expected to be in line with 2024, while SG&A will more than double, with spending weighted towards the first half of the year.

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CEO Olivier Taelman acknowledged the CPT code's physician fee isn't the strongest but stressed the value of having an established code at launch. He noted Nyxoah will explore options to enhance reimbursement based on Genio's unique bilateral stimulation. For the launch, he outlined a focused strategy targeting 300-350 high-volume centers, starting with 75+ trained physicians, with plans to scale the 50-person sales team quarterly to cover all target accounts within 12-18 months.

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CEO Olivier Taelman stated that Nyxoah welcomes GLP-1s, viewing them as a market expander for OSA treatment. He pointed out that while GLP-1s reduce AHI, the reduction is less than that shown by hypoglossal nerve stimulation. Taelman emphasized that GLP-1s can help patients lower their BMI, making them better candidates for Genio therapy and ultimately increasing the patient funnel for hypoglossal nerve stimulation.

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President and CEO Dr. Ron Kurtz explained that the international go-to-market strategy is decided on a market-by-market basis, noting that South Korea requires a distributor. He described the third-party LDD treatment center model as an early but promising initiative that has gained traction with growing market awareness, comparing it to successful center models in LASIK.

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Daveen Chopra, Global Leader of TMTT, explained that while the NTAP provides a tailwind and encourages some centers, the overall demand for EVOQUE remains consistently strong regardless. He estimated that the new 56mm valve size could expand the addressable patient pool by approximately 20% to 25% based on data from previously screened patients.

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