Executive Summary

Q1 delivered 29% YoY revenue growth to $91.4M, with both Sacral Neuromodulation (SNM) and Bulkamid growing double-digits; gross margin reached a record 75.8% on higher manufacturing yields .
Profitability was pressured by higher operating expenses and merger-related dynamics: net loss widened to $19.1M (vs. $9.2M LY) and adjusted EBITDA was $3.0M; ~$6M of compensation that would have been equity shifted to cash due to the pending Boston Scientific merger and was added back to adjusted EBITDA .
Sequential revenue fell from Q4 seasonality ($109.7M in Q4’23) but remained above Q3’23 ($93.1M), while gross margin continued to expand (74.2% → 75.4% → 75.8%) .
Management emphasized sustained commercial execution and anticipated broader impact “as part of Boston Scientific”; no new guidance was issued amid the pending merger, a key near-term stock catalyst .

What Went Well and What Went Wrong

What Went Well
- Broad-based top-line strength: SNM revenue rose 30% YoY to $71.7M and Bulkamid rose 27% YoY to $19.7M in Q1 .
- Record gross margin: 75.8% in Q1, with management attributing expansion to higher yields achieved by the manufacturing and operations team in Irvine; “Our commercial team continued to execute at a high level…” .
- Positive adjusted EBITDA: $3.0M in Q1 (vs. $0.9M LY), despite merger-related cost dynamics; cash, equivalents, ST investments and restricted cash totaled $349M at quarter-end .
What Went Wrong
- Loss widened: Net loss increased to $19.1M from $9.2M in the prior-year quarter on higher operating expenses and tax expense .
- Elevated operating costs: Q1 OpEx was $88.4M, including $3.8M of acquisition-related costs (vs. $66.9M OpEx and $1.8M acquisition-related costs LY) .
- Equity-to-cash comp shift: ~$6M that typically would have been equity moved to cash compensation due to the pending merger, pressuring reported GAAP results (added back in adjusted EBITDA) .

Financial Results

Metric	Q3 2023	Q4 2023	Q1 2024
Revenue ($M)	$93.1	$109.7	$91.4
YoY Revenue Growth	+32%	+28%	+29%
Gross Margin %	74.2%	75.4%	75.8%
Net Income (Loss) ($M)	$3.9	$6.6	$(19.1)
Diluted EPS	$0.08	$0.13	$(0.38)
Adjusted EBITDA ($M)	$14.0	$18.9	$3.0
Cash, ST Inv., Restricted Cash ($M)	$344.7 (as of 9/30/23)	$358.0 (as of 12/31/23)	$349.0 (as of 3/31/24)

Segment and geographic mix (Q1 2024 vs. Q1 2023):

KPI ($M)	Q1 2023	Q1 2024
SNM – U.S.	$53.853	$69.840
SNM – International	$1.305	$1.839
SNM – Total	$55.158	$71.679
Bulkamid – U.S.	$11.613	$15.219
Bulkamid – International	$3.879	$4.511
Bulkamid – Total	$15.492	$19.730
Total Net Revenue	$70.650	$91.409

Additional P&L and non-GAAP items (Q1 2024 vs. Q1 2023):

Metric ($M unless noted)	Q1 2023	Q1 2024
Gross Profit	$52.5	$69.3
Operating Expenses	$66.9 (incl. $1.8 acq. costs)	$88.4 (incl. $3.8 acq. costs)
Net Income (Loss)	$(9.2)	$(19.1)
Adj. EBITDA	$0.9	$3.0
Stock-Based Comp	$10.7	$9.6
Cash Comp in lieu of Equity (Merger-Related)	—	$5.6

Notes: Q1 2024 non-GAAP reconciliation includes add-backs for acquisition-related costs and the cash compensation in lieu of equity grants tied to the pending merger .

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Revenue	FY 2024	Not provided (post-merger announcement)	Not provided due to pending Boston Scientific merger	Maintained: no guidance
Gross Margin	FY 2024	Not provided	Not provided	Maintained: no guidance
Operating Expenses	FY 2024	Not provided	Not provided	Maintained: no guidance
Other items (OI&E, tax rate, dividends)	FY 2024	Not provided	Not provided	Maintained: no guidance

Context: Management commentary and filings during Q1 reference the pending Boston Scientific transaction; no new forward guidance was issued .

Earnings Call Themes & Trends

Note: A Q1 2024 earnings call transcript was not available via our tools; themes below are drawn from Q1/Q4/Q3 press releases and Q1 forward-looking statements.

Topic	Previous Mentions (Q3’23, Q4’23)	Current Period (Q1’24)	Trend
Manufacturing yields / margin	74.2% GM in Q3; margin expansion noted	Record 75.8% GM on higher yields; operations cited	Improving margins driven by yields
Product performance (SNM, Bulkamid)	SNM and Bulkamid grew; raised FY23 revenue to $362M in Q3	SNM +30% YoY; Bulkamid +27% YoY	Continued broad-based growth
Operating leverage / EBITDA	Q3 adj. EBITDA $14.0M; Q4 $18.9M	Q1 adj. EBITDA $3.0M; equity→cash comp added back	Seasonal step-down; merger-related comp mix
M&A (Boston Scientific)	—	Emphasis on strategic fit; stockholders approved merger on Mar 22, 2024	Transaction pending; key near-term focus
Regulatory/legal	—	Medtronic litigation and regulatory risks noted in FLS	Ongoing risk disclosure
Guidance policy	FY23 raised in Q3	No new guidance due to merger	Suspended while merger pending

Management Commentary

“Our commercial team continued to execute at a high level in the first quarter, generating revenue growth of 29% year over year…” .
“Gross margin expanded to 75.8%, a new record, as we benefited from higher yields that were achieved through the diligent efforts of our manufacturing and operations team in Irvine.”
“We remain confident that our commitment to innovation, quality, direct-to-consumer advertising and providing strong clinical support will continue to drive market expansion. We look forward to the global impact we can make as part of Boston Scientific…”

Q&A Highlights

A Q1 2024 earnings call transcript was not available via our document tools; therefore, Q&A highlights and guidance clarifications could not be verified in primary sources. We searched for “earnings-call-transcript” and “other-transcript” documents for AXNX (none found for Q1 2024) and also performed broader web searches without locating a primary-source transcript. We will update if a verified transcript becomes available [Search results show none via tool].

Estimates Context

S&P Global consensus data: unavailable via our estimates tool for AXNX due to a missing mapping at the time of query. Values retrieved from S&P Global were unavailable.
Third-party media reported an EPS miss (actual $(0.38) vs. estimate $(0.08)) and a slight revenue beat ($91.41M vs. $89.59M), but these are not S&P Global figures and should be treated as indicative only .

Key Takeaways for Investors

Momentum intact: Q1 revenue +29% YoY with balanced growth across SNM and Bulkamid; record gross margin underscores durable operational improvements .
Merger dynamics matter: Equity grant pause and comp mix shift to cash increased GAAP OpEx; adjusted EBITDA remains a better proxy near-term given merger-related adjustments .
Seasonality visible: Sequential decline from Q4’s high watermark is consistent with historical patterns, while margin continued to improve .
Balance sheet strength: $349M in cash, equivalents, ST investments and restricted cash provides flexibility during the merger process .
No guidance during merger: Absence of FY24 guidance limits near-term estimate precision; focus should be on operational metrics (share gains, margin trajectory) and merger milestones .
Watch risk disclosures: Ongoing litigation (e.g., Medtronic) and regulatory processes are cited in forward-looking statements; monitor for updates that could affect the combined entity’s outlook .
Trading lens: Near-term stock narrative likely tied to merger progress and any updates on integration/clearances; fundamentals (share gains, high-70s GM) provide a constructive backdrop if the deal timeline stays on track .

Sources

Q1 2024 8-K 2.02 press release with full financials and non-GAAP reconciliation .
Q4 2023 8-K 2.02 press release and financials .
Q3 2023 8-K 2.02 press release and financials .
Merger-related 8-K/press (stockholder approval) .
Third-party coverage of Q1 2024 estimates comparison (non-S&P): InvestorPlace .

Axonics, Inc. (AXNX)·Q1 2024 Earnings Summary