Matthew Blackman

Matthew Blackman with TD Cowen inquired about the accuracy of his recap of Q4 2025 financial results and 2026 guidance, specifically confirming revenue and increased EBITDA figures. He also asked for clarification on the expected revenue and EBITDA seasonality for 2026, particularly for Q1, given changes due to complex procedure contributions.

Answer

CEO Pat Miles confirmed the accuracy of Blackman's recap regarding Q4 2025 results and the updated 2026 guidance. Pat Miles then provided insights into the expected 2026 revenue seasonality, suggesting a pattern similar to 2025 with Q1 representing about 22.1% of sales, Q2 24.5%, and Q3 25.5%. He also indicated that EBITDA drop-through might be slightly higher in Q1 compared to the annual average.

Matthew Blackman with TD Cowen inquired about the accuracy of his understanding of ATEC's Q4 2025 financial results, specifically confirming pre-announced revenues, higher-than-consensus EBITDA, and the updated 2026 revenue and increased EBITDA guidance. He also asked for clarification on the expected revenue and EBITDA seasonality for 2026, particularly for Q1, given the changing contribution from complex cases.

Answer

CEO Pat Miles confirmed Matthew Blackman's understanding of the Q4 2025 results and the updated 2026 guidance. Regarding 2026 seasonality, Pat Miles suggested using 2025's revenue distribution (Q1: 22.1%, Q2: 24.5%, Q3: 25.5% of sales) as a starting point, noting that Q1 EBITDA drop-through might be slightly higher than the annual average, with the balance of the year being lower.

Matthew Blackman sought clarification on Beta Bionics' Q1 2026 revenue cadence, specifically if it would decline more than the Q4 2024 to Q1 2025 reduction, and if H1 2026 revenue weighting would be modestly higher than H1 2025. Matthew Blackman also asked for a directional quantification of the addressable market covered by Beta Bionics' 63 sales territories in 2025 and how the planned 20 incremental territories would expand this coverage, as well as if the current sales force size has been a rate limiter for iLet adoption.

Answer

CFO Stephen Feider confirmed that the Q4 2025 to Q1 2026 revenue and new patient starts reduction is expected to be larger than the prior year's, due to unique product launches and pharmacy coverage expansion in early 2025. He also confirmed that H1 2026 revenue weighting is expected to be modestly higher than H1 2025. CFO Stephen Feider estimated that an optimal sales force for full U.S. coverage would be 120-180 territories, implying Beta Bionics covered roughly one-third to one-half of the country with 63 territories. CEO Sean Saint emphasized a deliberate and conservative approach to scaling, ensuring systems and manufacturing can support growth.

Matthew Blackman sought clarification on Beta Bionics' Q1 2026 revenue expectations, specifically if the sequential decline from Q4 2025 would be greater than the 14% seen in Q1 2025, and if the first half of 2026 revenue weighting would be modestly higher than the 41% in the first half of 2025. He also asked about the incremental addressable market coverage provided by the 20 new sales territories in 2026 and if the current sales force size has been a rate limiter for iLet adoption.

Answer

Stephen Feider, CFO, confirmed that the Q1 2026 sequential revenue and new patient start reduction from Q4 2025 is expected to be larger than the previous year's reduction due to unique product launches and pharmacy adoption shifts in Q1 2025. He also confirmed a modestly higher revenue weighting in the first half of 2026 compared to 2025. Regarding sales territories, Stephen Feider estimated that 120-180 territories are needed for full coverage, implying Beta Bionics covered about one-third to one-half of the country with 63 territories. Sean Saint, CEO, emphasized a deliberate and conservative approach to sales force expansion.