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CVRx, Inc. (CVRX)·Q1 2025 Earnings Summary

Executive Summary

  • Q1 2025 revenue was $12.35M (+15% YoY) and diluted EPS was -$0.53; both slightly beat S&P Global consensus (Revenue $12.30M*, EPS -$0.57*) while growth fell short of company expectations due to sales force realignment and seasonality .
  • The company lowered FY 2025 revenue guidance to $55–$58M (from $63–$65M) and reduced OpEx guidance to $95–$98M; gross margin maintained at 83–84%. Q2 2025 revenue guidance is $13–$14M, implying sequential improvement vs Q1 .
  • U.S. Heart Failure revenue was $11.1M (+14% YoY) with 353 HF units; active implanting centers grew to 227 and Europe revenue was $1.1M (+23% YoY) .
  • Management highlighted new real‑world evidence (Premier database) showing 85–86% reductions in hospital visits post‑Barostim implant and outlined plans for a pragmatic RCT (1,000–2,000 patients) contingent on CMS coverage—key medium‑term adoption catalysts .

What Went Well and What Went Wrong

What Went Well

  • Real‑world evidence presented at THT and published in Journal of Cardiac Failure showed 85% HF, 84% CV, and 86% all‑cause reductions in hospital visits post‑Barostim—bolstering clinical and economic value proposition .
  • U.S. HF revenue grew 14% YoY to $11.1M with U.S. HF units rising to 353; active implanting centers increased to 227, reflecting expanding commercial footprint .
  • CEO on momentum and talent upgrade: “We added a significant number of new sales representatives, and are very pleased with the talent... As these reps are still in the early stages of building their territories, we expect their contributions to grow as the year progresses.” .

What Went Wrong

  • Revenue growth “didn't meet our expectations” as sales force realignment caused account‑level disruption in “dabbler” accounts; seasonality drove a Q1 step‑down vs Q4, pressuring sequential growth .
  • FY 2025 revenue guidance was lowered to $55–$58M from $63–$65M; Q1 actual revenue ($12.35M) missed prior Q1 guidance of $14.5–$15.0M—reflecting slower rep productivity ramp .
  • Interest expense increased $0.5M YoY on higher term loan borrowings; net loss was -$13.77M, though improved vs -$22.19M YoY .

Financial Results

Quarterly Actuals (oldest → newest)

MetricQ3 2024Q4 2024Q1 2025
Revenue ($USD Millions)$13.37 $15.34 $12.35
Diluted EPS ($)-$0.57 -$0.43 -$0.53
Gross Margin %83% 83% 84%
Total Operating Expenses ($USD Millions)$24.14 $23.05 $23.75
Loss from Operations ($USD Millions)-$13.01 -$10.27 -$13.44

Q1 2025 Actual vs S&P Global Consensus

MetricActual Q1 2025Consensus Q1 2025
Revenue ($USD Millions)$12.35 $12.30*
Diluted EPS ($)-$0.53 -$0.57*

Values retrieved from S&P Global.*

Segment and Volume Breakdown (oldest → newest)

MetricQ3 2024Q4 2024Q1 2025
U.S. Revenue ($USD Millions)$12.30 $14.40 $11.20
Europe Revenue ($USD Millions)$1.10 $1.00 $1.10
U.S. HF Revenue ($USD Millions)$12.20 $14.30 $11.10
U.S. HF Units (number)391 457 353
Europe Revenue Units (number)56 41 59

KPIs (oldest → newest)

KPIQ3 2024Q4 2024Q1 2025
Active Implanting Centers (U.S.)208 223 227
Sales Territories (U.S.)45 48 45
Sales Territories (Europe)6 5 5
Cash & Cash Equivalents ($USD Millions)$100.16 $105.93 $102.67

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
Total RevenueFY 2025$63.0–$65.0M $55.0–$58.0M lowered
Gross Margin %FY 202583–84% 83–84% maintained
Operating ExpensesFY 2025$100–$104M $95–$98M lowered
RevenueQ1 2025$14.5–$15.0M N/A; actual delivered $12.35M below prior guidance
RevenueQ2 2025n/a$13.0–$14.0M initial guidance set

Earnings Call Themes & Trends

TopicPrevious Mentions (Q-2: Q3 2024, Q-1: Q4 2024)Current Period (Q1 2025)Trend
Sales force and territoriesQ3: sales territories 45; expanding centers . Q4: priority to build “world‑class” sales org .25% of TMs hired Dec–Mar; comp plan revamped; model adding ~3 territories/quarter; disruption in “dabbler” accounts .Transition headwind, improving through 2025
Reimbursement outlookQ3: IPPS reassignment to MS‑DRG 276 (~$43k inpatient); Category I CPT codes approved for 2026 .Request for Level 6 Neurostimulator APC; expect July OPPS proposal; outpatient reimbursement remains ~$45k via APC 1580 if unchanged .Positive momentum
Clinical evidenceQ3: JACC HF publication on durable QoL benefits .Premier real‑world analysis shows 85–86% reductions in hospital visits; strong reception by physicians/payers .Strengthening evidence base
SeasonalityNot highlighted in Q3/Q4 .Q1 step‑down typical; patients schedule around deductibles; expect recurring Q1 seasonality .Recognized, recurring
Pragmatic RCTNot discussed in Q3/Q4 .Planning 1,000–2,000 patients; 100–150 centers; $20–$25M over 5–7 years; proceeding contingent on CMS coverage .New strategic initiative
Site of service mixQ3: inpatient payment increased effective Oct 1 .Increased inpatient share; outpatient payment path outlined .Shift to inpatient rising
APP outreach/awarenessNot emphasized in Q3/Q4 .Expanded education; ACC infographic to ~50k cardiologists/APPs; sustained conference presence .Stepped-up outreach

Management Commentary

  • “While revenue growth in the first quarter didn't meet our expectations, we added a significant number of new sales representatives... we expect their contributions to grow as the year progresses.” — Kevin Hykes, CEO .
  • “The vast majority of the softness... was related to the disruption in the sales team... in accounts with TM turnover, they were half as likely to increase business and twice as likely to decrease business vs Q4.” — Kevin Hykes .
  • “We’ve requested that CMS create a Level 6 Neurostimulator APC… CMS will either propose that or keep technologies in New Tech APC 1580 (~$45,000) for 2026.” — Kevin Hykes .
  • “As currently contemplated, [RCT] would enroll between 1,000 and 2,000 patients… net costs ~$20–$25M over 5–7 years… proceed only if CMS agrees to cover these costs.” — Kevin Hykes .
  • “We introduced a new compensation plan in late January… generated strong enthusiasm and driven positive behavior change among our sales team.” — Kevin Hykes .

Q&A Highlights

  • Sales changes were largely self‑initiated; comp plan a “true strength.” Turnover expected to normalize in coming quarters; model ~3 territories added per quarter .
  • FY 2025 guidance reflects reset baseline from Q1; expect high‑single to low double‑digit adds in new centers; sunsetting low‑productivity “relationship‑driven” accounts to focus on deep adoption .
  • Softness primarily from rep/territory disruption rather than seasonality; no accounts abandoned Barostim—utilization slowed in dabblers with turnover .
  • Adoption not tied to patient sub‑segment; physician practice patterns matter. HFSA consensus suggests considering Barostim after 3–6 months if symptoms persist on GDMT .
  • RCT timeline: finalize FDA protocol then seek CMS reimbursement; decision later in calendar 2025; scale 1,000–2,000 patients, 100–150 centers .

Estimates Context

  • Q1 2025: Actual revenue $12.35M vs consensus $12.30M*; actual EPS -$0.53 vs consensus -$0.57* — both slight beats; narrative miss vs company’s prior Q1 guidance ($14.5–$15.0M) reflects internal sales force transition .
  • Q2 2025: Company guides revenue $13–$14M, broadly aligned with consensus revenue $13.22M* and consensus EPS -$0.52* .

Values retrieved from S&P Global.*

Key Takeaways for Investors

  • Slight beat vs consensus on revenue/EPS, but a meaningful reset to FY 2025 revenue ($55–$58M) and OpEx ($95–$98M) increases sensitivity to execution on sales force ramp and program‑focused selling; watch Q2 sequential growth vs Q1 .
  • The primary near‑term headwind is sales force disruption in “dabbler” accounts; management expects stabilization and improved productivity as newer reps progress through ramp curves .
  • Reimbursement backdrop remains supportive (inpatient MS‑DRG 276, outpatient path via APC; CPT Category I codes in 2026), which should underpin access and adoption through 2025–2026 .
  • Real‑world evidence showing large reductions in hospital visits post‑Barostim is a compelling catalyst for payers and hospital administrators; expect continued emphasis in selling and market access narratives .
  • Q2 2025 guide ($13–$14M) signals sequential recovery; monitor center additions (high‑single to low double‑digits) and sunsetting of low‑productivity accounts to drive utilization per center .
  • The contemplated RCT (1,000–2,000 patients) is a medium‑term investment that could expand TAM and raise profile; CMS coverage decision later in 2025 is the gating factor .
  • Liquidity remains solid ($102.7M cash); interest expense trending higher on term loan; continued use of ATM for proceeds (Q1: $9.5M) provides optionality for growth investments .