Executive Summary

Q1 2025 revenue grew 23% year over year to $6.7M but was a slight miss versus S&P Global consensus ($6.72M actual vs $6.93M estimate; GAAP EPS -$0.47 vs -$0.447 estimate), with softness in U.S. commercial Rx and TAC-STIM offset by strong VA channel and Truvaga growth . Revenue Consensus Mean and EPS estimates from S&P Global shown with asterisks below.*
Mix and operating cost seasonality mattered: gross margin held at 85% (up 100 bps YoY), but SG&A rose on seasonality and one-time NeuroMetrix transaction/severance (~$665k total) .
Management introduced 2025 revenue guidance of ~$30M and net cash use for the next three quarters of $3.8–$4.3M, and reiterated mid‑80s gross margin expectations, framing a path to cash neutrality at ~$9M quarterly revenue via 65% contribution margins on incremental sales .
Near-term catalysts: (1) five-year VA Federal Supply Schedule (FSS) contract effective June 15, 2025; (2) NeuroMetrix/Quell integration and potential lift in H2 2025–2026; (3) Truvaga expansion (Amazon channel, Apple Health integration) .

What Went Well and What Went Wrong

What Went Well
- VA and wellness momentum: Rx gammaCore VA revenue up 22% YoY to $4.7M; Truvaga up 187% YoY to $1.1M; gross margin held at 85% . “We maintained gross margins...” .
- Structural wins: new five-year VA FSS contract begins June 15, 2025, supporting durable VA access .
- Portfolio expansion: closed NeuroMetrix; Quell added ~$170k unaudited Q1 net sales and broadens addressable market; pilot distribution for Spark Biomedical’s Sparrow underway in limited VA sites .
What Went Wrong
- Softer channels: U.S. commercial Rx down 33% YoY to $289k as cash-pay users migrate to Truvaga; TAC-STIM down 70% YoY to $90k and remains lumpy .
- Higher operating costs: SG&A rose on seasonality, severance, and NeuroMetrix transaction-related expenses (~$665k) .
- Cash burn: cash, cash equivalents, restricted cash and marketable securities fell to ~$8.0M at 3/31/25 (from ~$12.2M at 12/31/24), and net cash used in operating activities in Q1 was $4.4M (seasonal) .

Financial Results

Revenue, EPS, and Gross Margin vs prior year and consensus

Metric	Q1 2024	Q1 2025 (Actual)	Q1 2025 (Consensus)
Revenue ($USD Millions)	$5.443	$6.719	$6.929*
GAAP Diluted EPS ($)	-$0.53	-$0.47	-$0.447*
Gross Margin (%)	84%	85%	—

Q1 2025 revenue and EPS were slight misses vs S&P Global consensus; gross margin matched management’s mid‑80s expectation . Revenue Consensus Mean and EPS from S&P Global shown with asterisks.*

Quarterly revenue trend (for context)

Period	Q3 2024	Q4 2024	Q1 2025
Revenue ($USD Millions)	$6.554	$7.0	$6.719

Channel/segment detail (YoY)

Channel (in $000s)	Q1 2025	Q1 2024	YoY Change
Rx gammaCore – VA	4,721	3,875	22%
Rx gammaCore – U.S. Commercial	289	433	-33%
Outside the United States	513	449	14%
Truvaga	1,106	385	187%
Total Before TAC-STIM	6,629	5,142	29%
TAC-STIM	90	301	-70%
Total Revenue	6,719	5,443	23%

Profitability and operating metrics

Metric	Q1 2025	Q1 2024
Gross Profit ($USD Millions)	$5.706	$4.555
Gross Margin (%)	85%	84%
Total OpEx ($USD Millions)	~$9.528	$8.404
Loss from Operations ($USD Millions)	-$3.822	-$3.849
GAAP Net Loss ($USD Millions)	-$3.855	-$3.506
GAAP Diluted EPS ($)	-$0.47	-$0.53
Adjusted EBITDA Net Loss ($USD Millions)	-$3.054	-$3.163
Cash, Cash Equivalents, Restricted Cash & Marketable Securities ($USD Millions)	~$8.0 at 3/31/25	~$12.2 at 12/31/24 (for ref)

KPIs

KPI	Q1 2025	Prior Period
VA facilities purchasing gammaCore (cumulative)	175 (through 3/31/25)	151 (through 3/31/24)
Truvaga ROAS	~2.26x	—
Truvaga return rate	~10–11%	—
Monthly VA revenue cadence (Mar/Apr 2025)	~$1.7M per month	—

Non-GAAP adjustments include D&A, stock comp, inventory reserve changes, severance/other related charges, and one-time transaction charges related to NeuroMetrix, among others; reconciliation provided in the release .

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Total Revenue	FY 2025	None (withheld pending NeuroMetrix close)	~$30.0M	Introduced
Net Cash Used (next 3 quarters)	Q2–Q4 2025	—	$3.8–$4.3M	Introduced
Gross Margin	Ongoing	“Mid‑80s%” expectation	“Mid‑80s%” expectation	Maintained
SG&A – Variable Sales & Marketing	2025	~30% of related sales	~30% of related sales; fixed G&A in line with 2024	Maintained/clarified
R&D Expense	Near-term	—	~steady around $642k per quarter near term	New color
VA FSS Contract	2025–2030	Extension in process	New 5‑year contract effective 6/15/2025–6/14/2030	Finalized

Earnings Call Themes & Trends

Topic	Q3 2024 (two quarters ago)	Q4 2024 (prior quarter)	Q1 2025 (current)	Trend
VA channel momentum & contracting	Strong VA growth; 75% YoY VA/DoD in Q3; record revenue	FSS extensions; VA/DoD +85% FY; 170 VA facilities by YE	Sequential recovery; new 5‑yr FSS effective 6/15/25; 175 facilities; field force expansion	Improving access; durable
Truvaga (DTC wellness)	147% YoY in Q3; scaling with ROAS leverage	Q4 seasonal spike; ROAS 2.99; Amazon pilot in Feb’25	Q1 sales $1.1M (+187% YoY); ROAS ~2.26; Amazon traction; Apple Health integration	Expanding channels
NeuroMetrix (Quell)	Definitive agreement announced Dec’24	Target close in Q2’25; cross-sell into VA	Closed; ~$170k unaudited Q1 Quell; supply-limited near term; expect H2’25/2026 contribution	Integration underway
Spark Biomedical (Sparrow)	—	Distribution deal announced; limited VA pilots planned	Pilots starting Q2’25; large TAM; revenue more 2026-dependent	Early pilot
Gross margin	Mid‑80s sustainable	Mid‑80s expected despite tariffs	85% in Q1; mid‑80s view reiterated	Stable
Tariffs/macro	—	Low exposure to recent tariff policy	Minimal exposure; components largely domestic/S.E. Asia; limited GM impact	Low risk
R&D/Regulatory	—	PTSD program FDA sponsor meeting in March	Awaiting FDA feedback on PTSD; R&D steady; medical affairs support	Pending

Management Commentary

“electroCore delivered continued growth in the first quarter, increasing total revenue 23% and growing total revenue excluding TAC-STIM by 29%.”
“We maintained gross margins but incurred increased G&A expenses… seasonality… severance… and… NeuroMetrix transaction, for a combined $665,000…”
“March and April ’25 monthly revenues in our VA channel have accelerated to about $1.7 million.”
“We model that the business could be cash neutral with quarterly revenue of about $9 million… toward the end of this year or early in 2026.”
“We received a new FSS contract… effective on June 15, 2025, for at least 5 years until 2030.”
On Quell margin: “I’m optimistic that we’ll be well above the 60% mark [gross margin], but… we’ll have better numbers… in 90 days.”

Q&A Highlights

Quell integration and margin outlook: Management expects better overhead absorption than legacy NURO; supply-limited near term; targeting >60% GM but specifics pending manufacturing restart in Rockaway .
Tariff exposure: Minimal; parts largely domestic/S.E. Asia; even doubling some component costs would be only a few GM points .
TAC-STIM trajectory: Lumpy and hard to model; near-term ~$100k/quarter; larger RFPs outstanding but timing uncertain .
VA growth and salesforce: New 5-year FSS; adding W‑2 managers and 1099 reps to reaccelerate VA and integration of Quell/Sparrow .
Truvaga KPIs: ROAS ~2.26; scaling media 5% monthly; early Amazon traction with a few hundred units sold since mid‑Feb .
Cash/capex cadence: Q1 operating cash outflow $4.4M due to seasonal/legal/audit; modeling ~$4.0M net cash required for rest of 2025 .

Estimates Context

Q1 2025 vs S&P Global consensus: Revenue $6.72M vs $6.93M estimate (slight miss); GAAP EPS -$0.47 vs -$0.447 estimate (slight miss). Management cited seasonal one-time costs and mix (soft TAC-STIM, U.S. commercial Rx decline) offset by VA/Truvaga strength . Revenue and EPS consensus values marked with asterisks below.*
Forward consensus (as of current period): revenue estimates rise into 2026; EPS loss narrows sequentially (see table). These imply modest upward trajectory consistent with management’s ~$30M FY25 revenue outlook and path to improved cash burn .

Forward consensus (S&P Global)*

Metric	Q3 2025	Q4 2025	Q1 2026	Q2 2026
Revenue Consensus Mean ($)	7,875,600*	9,023,600*	9,759,000*	10,683,200*
Primary EPS Consensus Mean ($)	-0.4000*	-0.3920*	-0.3100*	-0.2220*
Revenue – # of Estimates	5*	5*	5*	5*
EPS – # of Estimates	5*	5*	5*	5*

Q1 2025 point-in-time consensus (S&P Global)*

Metric	Q1 2025 Consensus	Q1 2025 Actual
Revenue ($)	6,929,000*	6,719,000
Primary EPS ($)	-0.44667*	-0.47

*Values retrieved from S&P Global.

Key Takeaways for Investors

VA resilience + contracting durability: The new five‑year FSS and sequential VA rebound (Mar/Apr run‑rate) underpin near-term growth and visibility in the core Rx channel .
Portfolio catalysts layered onto established channels: Quell (closed) and Sparrow (pilots) create incremental growth vectors in H2’25/2026 through the VA and DTC ecosystems .
DTC flywheel: Truvaga growth remains strong with improving channel breadth (Amazon, Apple Health), ROAS >2x, and a systematic 5% monthly media ramp—supporting continued mix diversity and contribution leverage .
Margins steady; cost discipline matters: Mid‑80s gross margin intact; S&M variable at ~30% of sales with fixed G&A aligned to 2024, enabling operating leverage as revenue scales .
Cash path: Management modeling ~$3.8–$4.3M net cash use across Q2–Q4 and a cash-neutral inflection around ~$9M quarterly revenue, framing potential upside if Quell ramps faster than expected .
Modeling notes: Expect continued VA-led growth with U.S. commercial Rx flat near-term (cash-pay migration to Truvaga), TAC‑STIM lumpy; watch Quell manufacturing restart and VA add‑to‑contract timing for upside risk .
Trading setup: Slight top- and bottom-line misses appear execution- and mix‑driven against steady GM and healthy VA/DTC trends; narrative likely pivots to contract durability (FSS), NeuroMetrix integration updates, and DTC channel KPIs as near-term stock catalysts .

electroCore, Inc. (ECOR)·Q1 2025 Earnings Summary