electroCore, Inc. (ECOR)·Q4 2024 Earnings Summary

Executive Summary

• Q4 2024 revenue was $7.0M, the ninth consecutive record quarter, up 36% year over year; full-year 2024 revenue reached $25.2M (+57% YoY), driven by 85% growth in VA/DoD prescription gammaCore and 174% growth in Truvaga wellness sales .
• Gross margin remained strong at 85% for FY2024 (vs. 83% in FY2023), with management expecting mid‑80s% going forward; operating leverage improved materially as net loss narrowed 37% for the year .
• Management withheld formal 2025 guidance pending closing of the NeuroMetrix acquisition (expected Q2 2025), while highlighting VA growth, DTC Truvaga momentum, and new channel/product catalysts (Quell Fibromyalgia, Spark Biomedical) .
• Near-term stock reaction catalysts: (1) new five-year VA Federal Supply Schedule contract effective June 15, 2025, validating VA demand and improving contracting clarity ; (2) Truvaga Plus launched on Amazon, expanding DTC reach ; (3) pending NeuroMetrix acquisition to add Quell Fibromyalgia across the VA channel .

What Went Well and What Went Wrong

What Went Well

• VA/DoD channel growth accelerated: Q4 VA revenue was $4.6M (+47% YoY), with 170 VA facilities purchasing gammaCore and ~9.1M covered lives; strong clinical adoption sustained .
• Truvaga DTC momentum: Q4 Truvaga revenue was ~$1.2M (+271% YoY), with ROAS improving to 2.99 in Q4 (FY ROAS 2.7); >11,500 handsets sold and ~0.5M app sessions, indicating favorable unit economics and engagement .
• Operating leverage: FY gross margin 85% (vs. 83% prior year) and FY net loss improved to $11.9M (from $18.8M), reflecting scale benefits and disciplined R&D spend, particularly winding down Truvaga Plus development .
• Quote: “Our focus now is to expand our presence within the key sales channels we have developed to deliver continued growth and progress towards profitability.” – CEO Dan Goldberger .

What Went Wrong

• TAC‑STIM variability and DoD procurement opacity continued to make sales difficult to predict; FY TAC‑STIM fell to $1.2M (from $1.7M) .
• U.S. commercial prescription channel declined 15% for FY2024 as some cash‑pay prescribers migrated to Truvaga; Joerns/Kaiser ramp slower than expected, with only 1–2 prescriptions processed per month to date .
• VA macro distractions (e.g., early retirement offers, RIF memos) created supply‑chain side noise, though clinical cadence remained steady; the FSS contracting office extended in short increments before the follow‑on award .

Financial Results

Revenue, EPS, Margins (Quarterly)

Notes: Q4 2024 YoY revenue growth was +36% . Quarterly EPS for Q4 was not broken out in available filings/transcripts .

Full-Year 2024 vs 2023

Segment/Channel Breakdown

• FY Channel Revenue | Channel | FY 2023 ($USD Millions) | FY 2024 ($USD Millions) | % Change | |---------|--------------------------|--------------------------|----------| | Rx gammaCore – VA/DoD | $9.636 | $17.788 | 85% | | Rx gammaCore – U.S. Commercial | $1.797 | $1.536 | -15% | | Outside the United States | $1.821 | $1.850 | 2% | | Truvaga | $1.027 | $2.811 | 174% | | Total Before TAC‑STIM | $14.281 | $23.985 | 68% | | TAC‑STIM | $1.749 | $1.197 | -32% | | Total Revenue | $16.030 | $25.182 | 57% |

• Q4 Select Channel Metrics | Channel | Q4 2023 ($USD Millions) | Q4 2024 ($USD Millions) | % Change | |---------|--------------------------|--------------------------|----------| | Rx gammaCore – VA/DoD | $3.1 | $4.6 | +47% | | Truvaga | ~$0.32 | ~$1.2 | +271% |

KPIs

Guidance Changes

Earnings Call Themes & Trends

Management Commentary

• “Revenue for 2024 was $25.2 million, up 57%. In the fourth quarter, we recorded revenue of $7 million, our ninth consecutive record revenue quarter” – CEO Dan Goldberger .
• “Sales in the VA channel grew 85% to $17.8 million… 170 VA facilities have purchased prescription gammaCore products” .
• “Truvaga return rates remained steady at approximately 11% to 12%… ROAS was approximately 2.7 for FY2024 and 2.99 for Q4” .
• “We are refraining from providing guidance for 2025, pending the close of the previously announced acquisition of NeuroMetrix” .
• “Our FSS contract has been extended to June 14, 2025” (later replaced by new 5‑year contract announced Mar 31, 2025) .

Q&A Highlights

• NeuroMetrix integration: Plan to add Quell Fibromyalgia to FSS/Level contracts; train sales teams; target 150–160 VA hospitals; broader payer contracts and potential OTC channel later .
• Joerns/Kaiser: Ramp slower than expected; 1–2 prescriptions per month; prescriber process and facility access constraints but sticky once embedded .
• VA contracting and channels: FSS extensions ongoing; ~40% of business via Level contracts; Level absorbs processing fees, slightly improving margins .
• TAC‑STIM procurement: Quotes for a few thousand handsets; DoD acquisition pathway opaque; aim for “contract of record” over 3–4 years .
• Capital and ATM: ~$200k utilized briefly to test ATM facility; warrant exercises post quarter boosted cash; no plans to raise capital; Q4 cash use < $1M .
• Truvaga holiday spike: December particularly strong; Q1 normalized but continues sequential growth; Amazon to expand reach .
• App roadmap: Multi-user considerations and Apple Health interoperability on development pathway, balanced with disciplined R&D spend .

Estimates Context

• Wall Street consensus (S&P Global Capital IQ) for Q4 2024 could not be retrieved at time of analysis due to SPGI daily request limit being exceeded. As a result, we cannot definitively categorize revenue/EPS as beats or misses versus consensus at this time.
• Management commentary suggested strong growth drivers into 2025 (VA channel, Truvaga, and new products); estimates may need to reflect added VA contracting clarity and incremental products (Quell Fibromyalgia, Sparrow Ascent) post-close/distribution .

Key Takeaways for Investors

• VA channel remains the core growth engine with expanding facility penetration, robust YoY growth, and contracting clarity via the new five-year FSS—supports visibility and potential revenue acceleration in 2H 2025 and beyond .
• DTC Truvaga economics are attractive (ROAS ~2.7 FY; 2.99 Q4), with Amazon launch providing a distribution catalyst; monitor conversion, return rates, and contribution margin as mix shifts .
• Operating leverage is improving materially (FY GM 85%; net loss down 37%; adjusted EBITDA loss down 42%); incremental scale should continue to compress losses if sales/margin trends persist .
• Near-term revenue variability from TAC‑STIM persists given DoD procurement; potential civilian crossover could mitigate in time—treat as optionality rather than a base case .
• Strategic pipeline expansion via NeuroMetrix (Quell Fibromyalgia) and Spark Biomedical (Sparrow Ascent) can leverage existing VA/channel infrastructure—focus on contracting inclusion and sales force enablement post-close .
• U.S. commercial prescription channel is currently subdued; Joerns/Kaiser ramp may be slow but sticky once established—watch for prescriber count and monthly script cadence improvements .
• Withheld formal guidance reduces near-term visibility; however, catalysts (FSS award, Amazon DTC, acquisition close) provide multiple potential triggers—position sizing should reflect estimate uncertainty and channel execution risks .

Additional Relevant Press Releases (Q4 Period)

• NeuroMetrix to be acquired by electroCore (adds Quell platform; expected close late Q1/Q2 2025) .
• Awards for Truvaga Plus (brand visibility; Nov 2024) .
• Q3 2024 results (context for trend) –.