ALLURION TECHNOLOGIES, INC. (ALUR)·Q4 2024 Earnings Summary

Executive Summary

• Q4 revenue was $5.591M, down 32% year over year due to the temporary suspension in France and macro headwinds; gross margin fell to 45% from 78% YoY and 58% in Q3 .
• EPS materially beat Wall Street consensus in Q4 (actual -$6.99 vs. -$30.25 consensus; bold beat), while revenue was in-line and EBITDA missed (more negative than consensus) [Values retrieved from S&P Global].
• Management initiated 2025 guidance of approximately $30M revenue, with operating expenses expected to decline ~50% versus 2024; they reiterated a path to EBITDA positive in 2026 and profitability in ex-U.S. by end-2025 .
• Strategic catalysts include PMA submission for U.S. approval of the Allurion Balloon (AUDACITY topline positive), clearance to resume sales in France (Feb 12, 2025), and accelerating B2B2C commercial pivot with pilot accounts tracking >30% procedure volume growth in Q1 2025 vs. Q4 2024 .

What Went Well and What Went Wrong

What Went Well

• “Momentum built in the fourth quarter as our new commercial strategy began to take hold,” with FY24 procedure volume up 4%; clearance to resume sales in France and positive AUDACITY topline readout strengthen the regulatory and growth backdrop .
• Initial data on the balloon + low‑dose GLP‑1 combination showed promising weight loss, lean mass preservation, and adherence; management plans prospective studies to validate the approach .
• Restructuring lowered Q4 operating expenses by 39% YoY and set up ~50% OpEx reduction in 2025; pilots in key markets indicate >30% procedure volume growth potential under B2B2C strategy .

What Went Wrong

• Revenue declined YoY in Q4 due to France suspension and macro headwinds; gross margin compressed to 45% driven by lower volumes and inventory obsolescence related to France .
• Q3 revenue was hit by a $1.2M recall adjustment and broader destocking/credit risk management; France contributed >$1M lost sales plus the recall adjustment against Q3 revenue .
• EBITDA in Q4 missed consensus (more negative), reflecting restructuring/financing costs and lower absorption of manufacturing overhead; cash fell to $15.4M at year‑end prior to subsequent financings .

Financial Results

Quarterly Actuals (oldest → newest)

Notes: Q4 OpEx included ~$3.8M restructuring costs (S&M $3.1M; R&D $0.3M; G&A $1.1M) . Q4 gross margin was impacted by lower production volumes and inventory obsolescence tied to France .

Q4 YoY Comparisons

Actuals vs. S&P Global Consensus (oldest → newest)

Values with asterisk (*) retrieved from S&P Global.

KPIs

Guidance Changes

Earnings Call Themes & Trends

Management Commentary

• “In 2024, we restructured and refocused Allurion for the future… Momentum built in the fourth quarter as our new commercial strategy began to take hold” .
• On 2025 plan: “We expect operating expenses to decline by approximately 50%… and are expecting revenues of approximately $30 million in 2025” .
• On France: “We were cleared to resume sales in France… [ANSM] concluded that the benefits of our technology outweigh the risks” .
• On PMA: “Completing the PMA submission… in the first half of this year” .
• On combo therapy: “We believe that combining the Allurion program with low‑dose GLP‑1s could become a new standard of care” .

Q&A Highlights

• Revenue cadence: management expects a steady quarter‑over‑quarter build in 2025 as B2B2C rolls out and sales hiring ramps; minimal France contribution until late 2025/2026 .
• Gross margin trajectory: recovery beginning Q1 2025; Q4 decline tied to France recall/obsolescence, with further lift from direct-market mix (France) in 2026 .
• PMA milestones: full PMA submission in H1 2025, then FDA feedback and ongoing dialogue; U.S. opportunity significant with GLP‑1 prevalence .
• GLP‑1 combo details: lower‑dose reduces side effects/muscle loss; balloon drives satiety; VCS supports behavior change and adherence .
• 2025 framework: maintaining 2024 procedure volumes despite OpEx cuts; revenue guide ~$30M; ex‑U.S. profitability targeted by end‑2025 .

Estimates Context

• Q4 2024: revenue in‑line ($5.591M actual vs. $5.60M consensus*), EPS a significant beat (‑$7.95 actual vs. ‑$30.25 consensus*), EBITDA a miss (actual more negative than consensus*) .
• Q3 2024: revenue missed (actual $5.367M vs. $8.55M consensus*), EPS slightly beat, EBITDA beat (less negative than expected*) .
• Q2 2024: revenue beat (actual $11.766M vs. $10.90M consensus*), EPS major beat (positive GAAP EPS vs. negative consensus*) .
• Implications: Street likely revises EPS higher given Q4 beat, while EBITDA expectations for near‑term may be tempered; revenue trajectory tied to France rebuild and B2B2C execution .
  Values with asterisk (*) retrieved from S&P Global.

Key Takeaways for Investors

• The quarter’s narrative: in-line revenue but a bold EPS beat vs. consensus; gross margin depressed by France-related effects with recovery expected starting Q1 2025 .
• 2025 guide (~$30M revenue, ~50% OpEx cut) sets a leaner base; execution in direct markets and B2B2C is the swing factor for sequential growth .
• Regulatory momentum (AUDACITY topline, PMA submission, France resumption) is a key stock catalyst over the next 6–12 months .
• Combo therapy with low‑dose GLP‑1s and VCS could expand TAM and drive better adherence and outcomes, supporting medium‑term growth .
• Watch gross margin normalization and France’s re‑onboarding pace; 2026 could bring margin expansion from direct‑market mix and next-gen balloon approvals .
• Liquidity improved post‑Q4 via financings; management targets EBITDA positive in 2026 and ex‑U.S. profitability by end‑2025 .
• Near‑term trading: catalysts include PMA submission and early evidence of sequential revenue/gross margin recovery; medium‑term thesis hinges on B2B2C scalability and France/U.S. ramps .

Sources: Q4 2024 8‑K press release and financials ; Q4 2024 earnings call transcript ; Q3 2024 8‑K press release and transcript ; Q2 2024 8‑K press release . Estimates retrieved from S&P Global for Q2–Q4 2024.