Brandon Vazquez

David Rescott

Nathan Treybeck

Shagun Singh Chadha

William Plovanic

Adam Maeder

Anthony [for Joanne Wuensch]

Anthony Petrone

Avi Dahan

Bill Plovanic

Carolyn [on for Travis]

Justin Lin

Matthew Taylor

Richard Newitter

Robbie Marcus

Robert Marcus

Robin [on for Robbie Marcus]

Suraj Kalia

- **Merger Completed:** On April 3, 2025, Nevro Corp completed its merger with Palmer Merger Sub, becoming a wholly owned subsidiary of Globus Medical. **[0001193125-25-071904_d912761dex32.htm:1]** **[0001193125-25-071904_d912761d8k.htm:1]**
- **Special Shareholder Meeting:** A virtual meeting on April 2, 2025 met quorum with 75.9% of voting shares; the merger proposal was approved, though the merger compensation proposal did not receive the requisite vote. **[0001193125-25-071341_d929985d8k.htm:1]**
- **Change in Control & Leadership:** As a result of the merger, existing directors resigned and new directors from Palmer Merger Sub were appointed. **[0001193125-25-071904_d912761dex32.htm:1]** **[0001193125-25-071904_d912761dex31.htm:2]**
- **Delisting Initiation:** Nevro requested that the NYSE halt trading and initiate delisting procedures for its shares following the merger completion. **[0001193125-25-071904_d912761dex31.htm:1]**

Nevro Completes Merger, Control Change & Special Meeting Vote

24f4b61f35638a29b35c4a74ffd42a99b9f510eb609428db5c0d55fb1b7a1cde

- **Merger Completed:** On April 3, 2025, Nevro Corp completed its merger with Palmer Merger Sub, resulting in Nevro becoming a wholly owned subsidiary of Globus Medical.  **[0001193125-25-071904_d912761dex32.htm:1]** **[0001193125-25-071904_d912761d8k.htm:1]** 
- **Change in Control and Leadership:** As part of the merger, a change of control occurred with the resignation of existing directors and the appointment of new directors from Palmer Merger Sub.  **[0001193125-25-071904_d912761dex32.htm:1]** **[0001193125-25-071904_d912761dex31.htm:2]** 
- **Delisting Notification:** Nevro requested that the NYSE halt trading and initiate delisting procedures for its shares, aligning with the completed merger process.  **[0001193125-25-071904_d912761dex31.htm:1]**

Nevro Completes Merger and Undergoes Control Change

5344d5be43db41a92c44f620880d59de9703e03156d18efb686786240acd7431

- **Nevro Corp** held a virtual special meeting on April 2, 2025, where shareholders voted on merger-related proposals as part of the merger agreement with Globus Medical.  **[0001193125-25-071341_d929985d8k.htm:1]**   
- A quorum was met with **75.9%** of the voting shares present; the merger proposal was approved, while the merger compensation proposal did not receive the requisite vote.  **[0001193125-25-071341_d929985d8k.htm:1]**

Nevro Corp Special Meeting Approves Merger Proposal

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| Name                  | Is Executive | Is Board Member | Position                                   | External Roles                                                                 | Short Bio                                                                                                                                                                                                                  | Start Date   |
|-----------------------|--------------|------------------|-------------------------------------------|-------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------|
| Kevin Thornal         | true         | true             | President and CEO                         | None                                                                          | Appointed CEO in April 2023; previously Group President of Global Diagnostic Solutions at Hologic, Inc.; over 20 years of experience in the medical device industry.  **[0000950170-23-024932_nvro-20230525.htm:1]**                                                    | April 2023   |
| Roderick H. MacLeod   | true         | false            | Senior Vice President and CFO             | None                                                                          | Joined in June 2020; previously VP of Finance at Stryker Endoscopy; extensive finance leadership experience in the medical device industry.  **[0000950170-24-044100_nvro-20240412.htm:32]** **[0000950170-23-012576_nvro-20230412.htm:31]**                                                                          | June 2020    |
| Kashif Rashid         | true         | false            | Senior Vice President, Corporate Development and Chief Legal Officer | None                                                                          | Joined in December 2017; previously VP, Legal at Atara Biotherapeutics; extensive legal and corporate development experience.  **[0000950170-24-044100_nvro-20240412.htm:34]**                                                                                          | December 2017|
| Greg Siller           | true         | false            | Senior Vice President and Chief Commercial Officer | None                                                                          | Appointed in June 2023; previously VP and GM of Stryker Interventional Spine; 16 years at Stryker in various leadership roles.  **[0000950170-23-026355_nvro-20230605.htm:1]** **[0000950170-24-044100_nvro-20240412.htm:51]**                                                                                       | June 2023    |
| Michael DeMane        | false        | true             | Lead Director                              | Board member at private companies                                            | Joined Nevro in March 2011; previously CEO and Executive Chairman of Nevro; extensive leadership experience in the medical device industry, including at Medtronic.  **[0000950170-23-012576_nvro-20230412.htm:13]** **[0000950170-24-044100_nvro-20240412.htm:13]** **[0001564590-22-014129_nvro-def14a_20220526.htm:13]**                                             | March 2011   |
| Shawn T. McCormick    | false        | true             | Director                                   | Board member at Inspire Medical Systems, Inc.                                | Joined in September 2014; extensive financial leadership experience, including CFO roles at Tornier N.V. and ev3 Inc.; serves on the board of Inspire Medical Systems.  **[0000950170-24-044100_nvro-20240412.htm:15]** **[0000950170-23-012576_nvro-20230412.htm:15]**                                              | September 2014 |
| Kevin O’Boyle         | false        | true             | Director                                   | Audit Committee Chairperson at Sientra, Inc.                                 | Joined in March 2019; extensive financial and operational leadership experience, including CFO roles at NuVasive and Advanced Biohealing.  **[0000950170-24-044100_nvro-20240412.htm:16]** **[0000950170-23-012576_nvro-20230412.htm:15]**                                                                           | March 2019   |
| Karen Prange          | false        | true             | Director                                   | Board member at Embecta Corp., Atricure, Inc., ViewRay, Inc., WS Audiology   | Joined in December 2019; extensive healthcare leadership experience, including roles at Henry Schein and Boston Scientific.  **[0000950170-24-044100_nvro-20240412.htm:16]** **[0000950170-23-012576_nvro-20230412.htm:16]**                                                                                        | December 2019|
| Susan Siegel          | false        | true             | Director                                   | Board member at Illumina, Inc. and Align Technology, Inc.                    | Joined in December 2020; previously Chief Innovation Officer at GE and CEO of GE Ventures; extensive experience in healthcare and life sciences.  **[0000950170-24-044100_nvro-20240412.htm:17]** **[0000950170-23-012576_nvro-20230412.htm:16]**                                                                   | December 2020|
| Elizabeth Weatherman  | false        | true             | Director                                   | Board member at Insulet Corporation, Vapotherm, Inc., Silk Road Medical, Inc.| Joined in March 2019; Special Limited Partner at Warburg Pincus LLC; extensive investment and healthcare experience.  **[0000950170-24-044100_nvro-20240412.htm:17]**                                                                                                   | March 2019   |
| Kirt P. Karros        | false        | true             | Director                                   | Senior VP, Finance and Treasurer at Hewlett Packard Enterprise; Executive Chairman of H3C Technologies | Appointed in February 2024; extensive financial and investment experience, including roles at Relational Investors LLC.  **[0000950170-24-017929_nvro-ex99_1.htm:0]** **[0000950170-24-017929_nvro-20240221.htm:3]**                                                                                            | February 2024|
| David Caraway, M.D.   | true         | false            | Senior Vice President and Chief Medical Officer | None                                                                          | Joined in April 2014; nationally recognized expert in chronic pain treatment; extensive experience in interventional pain medicine.  **[0000950170-24-044100_nvro-20240412.htm:33]** **[0000950170-23-012576_nvro-20230412.htm:32]** **[0001564590-22-014129_nvro-def14a_20220526.htm:34]**                                                                            | April 2014   |
| Christofer Christoforou| true         | false            | Chief Operating Officer                   | None                                                                          | Joined in July 2016; promoted to COO in May 2024; extensive experience in R&D and technical operations.  **[0001193125-24-135347_d784712d8k.htm:1]** **[0000950170-24-054492_nvro-ex99_1.htm:0]** **[20240507SF07403:0]**                                                                                                        | May 2024     |
| Donald A. Middlebrook | true         | false            | Senior Vice President, Clinical, Regulatory, and Quality | None                                                                          | Joined in January 2020; previously VP of Corporate Quality and Regulatory Affairs at Thoratec Corporation; extensive regulatory and quality leadership experience.  **[0000950170-24-044100_nvro-20240412.htm:34]** **[0000950170-23-012576_nvro-20230412.htm:33]** **[0001564590-22-014129_nvro-def14a_20220526.htm:35]**                                              | January 2020 |
| Shana Ross            | true         | false            | Senior Vice President and Chief Human Resources Officer | None                                                                          | Joined in August 2023; previously VP, HR and Chief Diversity Officer at Bayhealth Medical Center; extensive HR leadership experience.  **[0000950170-24-044100_nvro-20240412.htm:34]**                                                                                   | August 2023  |
| Peter A. Socarras     | true         | false            | Vice President, General Counsel, and Corporate Secretary | None                                                                          | Joined in October 2012; extensive experience in intellectual property and corporate governance.  **[0000950170-24-044100_nvro-20240412.htm:34]** **[0000950170-24-044100_nvro-20240412.htm:31]**                                                                                                                    | October 2012 |

192b606078e3956607f63d92f53fc6043950a8f830444b11deffadca5d089cac

Merger update: Monteverde & Associates PC is investigating the merger of Nevro Corp with Globus Medical, where **$5.85** per share has been proposed for all NVRO shares. Investors holding common stock should assess potential impacts.  **[20250206DC13821:0]** 

d56aa5b20520ec42410f99bf05a43ae4d3fc4189557183e6feff1b664aefb1e5

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abbed7acadcc754f6f0d8f0bb033aa5b382dab20d7c86302dc87dee700a75abb

- Nevro's launch of **HFX AdaptiveAI**, an AI-powered spinal cord stimulation (SCS) therapy that personalizes treatment using over **100 million data points**, reduces patient burden by decreasing charging frequency from once per week to **six times per year**. This innovation improves operational efficiency by reducing the need for reprogramming visits and staff involvement, potentially driving adoption and revenue growth while lowering costs.  **[NVRO_3407662_3]** **[NVRO_3407662_2]** **[NVRO_3407662_10]** **[NVRO_3407662_9]**
- The company has achieved significant cost reductions of over **$30 million annually**, enhancing profitability and cash flow. By strategically reinvesting in key areas like direct-to-consumer advertising and commercial execution—areas already showing positive impacts on trial volumes—Nevro is positioned to drive future revenue growth.  **[NVRO_3407662_3]** **[NVRO_3407662_17]** **[NVRO_3407662_2]** **[NVRO_3407662_12]** **[NVRO_3407662_9]**
- Nevro is focusing on innovation and diversification by committing to research and development projects with clear return on investment. Expanding their product portfolio beyond SCS therapy, including offerings like SI joint fusion, and entering new established markets in pain management can open additional revenue streams and support long-term growth.  **[NVRO_3407662_2]** **[NVRO_3407662_12]** **[NVRO_3407662_9]**

872dbbb0127b5c3ec72057ab40fbb60c70b7bcc0c8e7477496333378064d76b9

**Annual guidance for FY 2024:**  
- **Worldwide revenue**: $400 million to $405 million  **[NVRO_3407662_7]**  (no change from $400 million to $405 million  **[NVRO_3396850_6]** **[NVRO_3396850_5]** )  
- **Gross margin**: 66%-68%  **[NVRO_3407662_7]**  (no change from 66%-68%  **[NVRO_3396850_6]** )  
- **Operating expenses**: $369.1 million  **[NVRO_3407662_8]**  (lowered from $383 million  **[NVRO_3396850_6]** )  
- **Adjusted EBITDA**: negative $18 million to negative $16 million  **[NVRO_3407662_8]**  (raised from negative $20 million to negative $18 million  **[NVRO_3396850_6]** )  

a42b1a759ae17545f8c606926244830479935bd5bb0da55f0a661d1e5dabfd11

1. **Revenue Growth Amid Cost Cuts**  
   **Q:** How will you grow revenue in 2025 despite expense cuts?  
   **A:** We believe that by focusing on investments that drive revenue, like increasing our direct-to-consumer (DTC) spend and leveraging AdaptiveAI technology, we can grow revenue even with reduced expenses. We're confident that our actions will reverse the trial decline and close the gap experienced in Q3, and AdaptiveAI allows us to grow without needing to add a one-to-one ratio of personnel.  **[NVRO_3407662_13]** **[NVRO_3407662_22]** 

2. **R&D Spending Reduction**  
   **Q:** How do you balance cost cuts with future innovation?  
   **A:** We are prioritizing projects with clear return on investment and focusing on investments that drive future growth. While R&D spend decreased by about **one-third**, we are protecting investments that generate ROI and continue to fund meaningful clinical trials.  **[NVRO_3407662_12]** 

3. **Decline in U.S. Trials**  
   **Q:** Can you elaborate on the 15% decline in U.S. trials?  
   **A:** The decline is due to factors like competitive pressure and reduced DTC spending. We turned down DTC earlier in 2024, which impacted trials, but as we increase DTC spend, we're already seeing trial volumes return. Also, replacements are growing, which don't require trials, affecting the trial numbers but not revenue.  **[NVRO_3407662_11]** **[NVRO_3407662_14]** 

4. **Impact of DTC Spending Adjustments**  
   **Q:** What is the effect of adjusting DTC spending?  
   **A:** Reducing DTC spend led to a decline in patient leads and trials after several months. Upon increasing DTC spend in mid-third quarter, we're seeing patient flow return, but it takes **4–6 months** for patients to move from consultation to trial. We expect improvements by the second half of **2025**.  **[NVRO_3407662_14]** **[NVRO_3407662_21]** 

5. **Confidence in Cost Cuts**  
   **Q:** Are you confident you haven't cut too deep into muscle?  
   **A:** Yes, we believe we got about **90%** of the cost reductions right. The main area we adjusted was DTC spending, which we've corrected. We're investing in areas that drive revenue and profit, and focusing on efficiency, including leveraging AdaptiveAI and our Costa Rica operations.  **[NVRO_3407662_13]** **[NVRO_3407662_17]** **[NVRO_3407662_22]** 

6. **AdaptiveAI Benefits and Rollout**  
   **Q:** How will AdaptiveAI impact efficiency and growth?  
   **A:** AdaptiveAI personalizes therapy and reduces the need for patient visits and reprogramming. Early results show a **40%** reduction in patient visits and **50%** reduction in call time compared to previous versions. This allows us to grow without adding proportional costs.  **[NVRO_3407662_18]** **[NVRO_3407662_23]** 

7. **Sales Force Expansion**  
   **Q:** What's the plan for U.S. sales force dynamics?  
   **A:** We are promoting associate sales reps who have been in the field for **1.5 years** to take on their own territories. These reps are familiar with the physicians and areas, enabling effective expansion without significant added cost.  **[NVRO_3407662_11]** **[NVRO_3407662_19]** 

8. **Versa Integration Progress**  
   **Q:** How is the integration of Versa progressing?  
   **A:** We are still in the integration process, building necessary infrastructure and training physicians. The progress is aligning with our expectations, and we anticipate a more meaningful impact as we head into **2025**.  **[NVRO_3407662_16]** 

9. **R&D Focus Areas**  
   **Q:** What areas were affected by R&D cuts?  
   **A:** We've focused R&D on projects with clear ROI. Some clinical trials have completed, reducing spend in those areas. We continue to invest in diversifying our product portfolio and developing next-generation devices like AdaptiveAI.  **[NVRO_3407662_12]** 

10. **AdaptiveAI's Impact on Battery Life**  
    **Q:** How does AdaptiveAI improve patient experience?  
    **A:** AdaptiveAI enables us to personalize therapy, reducing energy use of the battery. Patients may now only need to charge their devices **six times per year**, significantly decreasing the burden of charging.  **[NVRO_3407662_18]** 

e4eae71ffa81c5d9318e862fabc1a346ff31825f8b7a8ae6fad4c2d88e504e96

- The company experienced a significant decline in U.S. spinal cord stimulation trial procedures, down approximately **15.2%**, indicating potential future revenue challenges.  **[NVRO_3407662_11]**
- Cost-cutting measures, including reductions in direct-to-consumer advertising and headcount, have led to decreased sales, and while DTC advertising spend is being increased again, the benefits are not expected until the **second half of 2025**, potentially prolonging revenue weakness.  **[NVRO_3407662_11]**
- The company's research and development spending decreased by about **one-third**, reaching the lowest levels since 2017 (excluding COVID period), which may negatively impact future innovation and growth prospects.  **[NVRO_3407662_12]**

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4b1c9a3ad3d9850bfc53f85d350422339316c1e0b6dbc06fb319e31f424099ec

- **Nevro plans to launch a next-generation spinal cord stimulation (SCS) therapy in early 2026**, developed by the same engineers who created their revolutionary 10-kilohertz therapy. This new platform is expected to bring innovation to the market and potentially drive growth.  **[NVRO_3396850_16]** **[NVRO_3396850_19]**
- **The company is conducting a second randomized controlled trial (RCT) for painful diabetic neuropathy (PDN)**, with anticipated results in early 2025. A positive outcome could lead to inclusion in societal guidelines, boosting referrals and sales in a market that is currently less than **1% penetrated**, presenting significant growth opportunity.  **[NVRO_3396850_16]** **[NVRO_3396850_19]** **[NVRO_3396850_8]**
- **Nevro's SI joint fusion business is expected to contribute significantly to growth and profitability**, as it scales up and leverages the existing sales force. The SI joint device increases gross margin and provides operational efficiencies, which could enhance the company's bottom line as each incremental dollar drops more to the bottom line than before.  **[NVRO_3396850_16]** **[NVRO_3396850_14]** **[NVRO_3396850_17]** **[NVRO_3396850_9]**

fe94e9e7c6c4ee801438a7bc866b74fd76a713357e415e796a9f1be9d7e08f9b

1. **Strategic Review and Potential Sale/Merger**  
   **Q:** Are you considering a merger or sale of the company?  
   **A:** We are exploring all options to accelerate our plans, including potential mergers or sales.  **[NVRO_3396850_7]**  We like our strategy of diversification and can continue on a stand-alone basis, but we felt urgency to explore all possible options.  **[NVRO_3396850_7]**  We're not giving a timeline, but we're in the early stages, and it might be best to remain stand-alone if that brings more shareholder value.  **[NVRO_3396850_7]** 

2. **Guidance Downward Revision and Profitability Impact**  
   **Q:** How does guidance down impact path to profitability?  
   **A:** Bringing revenue down delays our move to adjusted EBITDA positive territory.  **[NVRO_3396850_10]**  In Q2, we had about **$8 million** in negative operating cash flows.  **[NVRO_3396850_10]**  With a bit more revenue, we're not far from breakeven, but we need more revenue to cover fixed costs.  **[NVRO_3396850_10]**  The target range for adjusted EBITDA breakeven is in the mid-**$400 million** revenue range.  **[NVRO_3396850_14]**  The revised guidance reflects competitive headwinds and overall market softness.  **[NVRO_3396850_8]** 

3. **Competitive Pressure and Market Share Loss**  
   **Q:** Why are competitors gaining share, and how will you respond?  
   **A:** Larger competitors with new product launches see a big bump as accounts try the shiny new thing, but often revert back to the benefits of our **10-kilohertz therapy** over time.  **[NVRO_3396850_11]** **[NVRO_3396850_13]**  Competitors leverage larger portfolios; we're diversifying with our SI joint business to bring more value to customers.  **[NVRO_3396850_13]**  We're expanding territories with new reps to go deeper and wider with our portfolio.  **[NVRO_3396850_9]**  We'll use our SI joint product as a door opener to competitive accounts.  **[NVRO_3396850_11]** 

4. **SI Joint (Vyrsa) Product Ramp**  
   **Q:** How is the SI joint business progressing?  
   **A:** Many physicians are still setting up their practices, getting patients through required conservative management before implant approvals.  **[NVRO_3396850_12]**  We're seeing early success with top-performing physicians growing their SI joint business month-over-month.  **[NVRO_3396850_12]**  We continue to have strong physician interest, with heavy attendance at training courses.  **[NVRO_3396850_12]**  Our SI joint business increases gross margin and leverages our existing sales force, contributing more to the bottom line.  **[NVRO_3396850_14]** **[NVRO_3396850_16]** 

5. **Future Products and R&D Pipeline**  
   **Q:** When will new products impact growth?  
   **A:** Our next-generation SCS therapy, backed by science, will be coming out in early **2026**, offering exciting new platform benefits.  **[NVRO_3396850_16]** **[NVRO_3396850_19]**  For PDN, we're excited about our RCT study; if we achieve needed power by interim results and get a publication, it could lead to inclusion in guidelines, boosting sales in **2025**.  **[NVRO_3396850_16]**  Our R&D pipeline anticipates all products in development, and we're balancing investments between SG&A and R&D.  **[NVRO_3396850_16]** 

6. **Pricing Holding Up in U.S. Market**  
   **Q:** Has pricing in the U.S. changed due to competition?  
   **A:** Pricing has held pretty well; our average IPG pricing increased in Q2.  **[NVRO_3396850_18]**  Despite competitive pressures, overall pricing remains firm.  **[NVRO_3396850_18]**  Competitors may gain uplift from new product launches, but we continue to receive premium pricing due to our therapy's technology and clinical results.  **[NVRO_3396850_18]** 

325839f53c87bf4c6d43f8145b1baa4b6a5d5d2dddf7a7606334591705ad7b4a

- Nevro is experiencing increased competitive pressures from larger competitors launching new products, resulting in decreased U.S. trial procedures by approximately 9.5% and loss of market share.  **[NVRO_3396850_5]**
- The company has lowered its full year 2024 revenue guidance to approximately $400 million to $405 million from the previous range of $435 million to $445 million, due to ongoing market headwinds and competitive pressures impacting growth expectations.  **[NVRO_3396850_5]**
- The initiation of a strategic review, including exploring partnerships, mergers, or a sale of the company, indicates uncertainty about Nevro's ability to execute its strategy independently amid market challenges.  **[NVRO_3396850_3]**

d26290711d1ccb54d59d81ae78e620052fc235b8c56890fb91e29be033d1771a

Covered lives for Carelon and Anthem BCBS for PDN (million covered lives)

Total PDN covered lives (million covered lives)

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- **Margin expansion expected in 2025 and beyond due to higher ASPs from HFX iQ devices and cost efficiencies from the Costa Rica manufacturing facility**, leading to strong opportunities to improve profitability. Roderick MacLeod stated that the mix shift to HFX iQ, which represented **58%** of total permanent implants in Q1 2024 (up from **53%** in Q4 2023), will continue, and they are picking up a pricing premium on that product. Additionally, the Costa Rica facility is producing lower labor and material costs, with COGS coming in as expected.  **[NVRO_3387100_17]**
- **Significant cost reductions from restructuring efforts, with over **$25 million** in savings projected for 2024 and over **$30 million** annualized**, will enhance profitability without disrupting operations. As Roderick MacLeod mentioned, they were able to shed about **$25 million** in reductions for this year alone, through increased focus on key aspects and strategies.  **[NVRO_3387100_10]**
- **Strong growth opportunities in the underpenetrated PDN market, which remains around **1%** penetrated**, with Nevro expressing continued strong interest and commitment to educating on the benefits of their therapy. Kevin Thornal noted that PDN came in right in line with expectations and will continue to be a strong part of the business moving forward.  **[NVRO_3387100_21]**

094aa74e749a2016815225bfb52042b545d36d63d5a839e75cb8571abc8b0aed

1. **2024 Guidance and Q1 Outperformance**  
   **Q:** You beat Q1 but didn't raise full-year guidance. Is Q2-Q4 outlook lower?  
   **A:** Management explained that although they overdelivered in Q1 by about **$4 million**, they are maintaining the full-year guidance as they anticipate the first half to be in line with initial expectations. They noted that while Q1 was slightly stronger, Q2 is expected to be a touch softer than earlier projections.  **[NVRO_3387100_9]** 

2. **Gross Margin Outlook**  
   **Q:** Despite strong Q1 gross margin, why expect sequential decline?  
   **A:** The company is transitioning from contract manufacturers to their Costa Rica facility. This shift will introduce some overhead variances that will impact costs in the second half of the year due to prior year volume and mix shifts. However, long-term prospects remain positive with solid labor and material costs in Costa Rica.  **[NVRO_3387100_12]** 

3. **Vyrsa (SI Joint) Business Expectations**  
   **Q:** How much of Vyrsa's sales are baked into guidance?  
   **A:** Vyrsa is still an immaterial part of the business, and the company hasn't provided any **$20 million** sales figures. They are focusing on scaling the business, training over **220 physicians** so far, but it's expected to take time before it significantly contributes to revenue.  **[NVRO_3387100_11]** 

4. **Competitive Dynamics in PDN Market**  
   **Q:** Has Abbott's synergy with Libre changed the PDN dynamic?  
   **A:** Management hasn't observed a change due to Abbott's presence. They emphasize their clinical superiority with **10 kilohertz** therapy, which avoids adding paresthesia to patients already suffering from tingling and numbness. They believe their technology remains the preferred choice for treating PDN patients.  **[NVRO_3387100_15]** 

5. **Spinal Cord Stimulation Market Health**  
   **Q:** How is the spinal cord stimulation market, and when will Nevro regain share?  
   **A:** The company noted that while there was softness in trialing, they and a few competitors grew in Q1. All trialing, replacements, and sales force ramp-up are baked into the 2024 guidance. They are optimistic about reconfirming guidance and see potential for regaining share.  **[NVRO_3387100_13]** 

6. **HFX iQ Adoption and Impact**  
   **Q:** What's the outlook for HFX iQ and its effect on margins?  
   **A:** The mix is shifting towards HFX iQ, reaching **58%** in Q1, up from **53%** in Q4. They are achieving a pricing premium on this product. Despite some COGS pressure in the second half, they expect strong margin expansion opportunities in **2025 and beyond**.  **[NVRO_3387100_15]** 

7. **Restructuring and Cost-Cutting Measures**  
   **Q:** Can you discuss the additional restructuring and expected disruptions?  
   **A:** The company doesn't anticipate significant disruption from restructuring efforts. They have reduced costs by about **$25 million** for this year, with annualized savings over **$30 million**, by focusing on key projects and strategies.  **[NVRO_3387100_10]** 

8. **SI Joint Training Impact**  
   **Q:** What's the expected disruption from SI joint training?  
   **A:** SI joint training requires physicians and sales reps to spend time away from clinics, causing some impact on trials. This is expected to continue slightly into Q2 but isn't a massive disruption. Training is conducted efficiently by training physicians and reps together.  **[NVRO_3387100_18]** 

bbd1e7516d64d424eaad846707aafefc1938518cd27d40440f2a83540ba9aed6

- Despite exceeding Q1 revenue expectations by about **$4 million**, Nevro did not raise its full-year guidance, suggesting potential concerns about lower sales in the remainder of the year.  **[NVRO_3387100_9]**
- The spinal cord stimulation (SCS) market experienced **softness in trialing activity** during Q1, which could indicate persistent challenges in market growth.  **[NVRO_3387100_13]**
- The company anticipates **gross margin pressure** in the second half of the year due to **overhead variances** associated with the transition to the Costa Rica manufacturing facility, which may impact profitability.  **[NVRO_3387100_12]**

4cb7e01e2f4eb751c4e65252c5c56561ff01cf5f37d27d0b22ebb74af4ab14fd

0ecc7dbc2a727f5e62505dd8339429977a4e33b7ce6b3b0c30f67783218724c2

Current Assets (USD, thousands)

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52ab360fed0606b7fcc23aab1409438694119ed22d1e5ea1b4c44eecb62bedd8

1. **2024 Guidance and Market Growth**  
   **Q:** Why is 2024 guidance lower than historical market growth?  
   **A:** Nevro guided for **2% to 5% topline growth** in 2024, which is lower than the historical SCS market growth of **6% to 9%**. The company is cautious due to competitors being flat to down in some U.S. markets. They believe they'll outperform competitors with a new salesforce and new products but recognize the market currently grows at low to mid-single digits.  **[NVRO_3374478_6]** 

2. **Impact of New Competition**  
   **Q:** How will new SCS competitors in 2024 affect your market share?  
   **A:** Nevro remains confident in its unique **high-frequency 10-kilohertz therapy**, while new competitors offer low-frequency devices. They believe these entrants target physicians preferring low-frequency technology. Nevro focuses on clinical superiority and has accounted for new competitors in its guidance.  **[NVRO_3374478_9]** 

3. **Vyrsa Revenue Guidance**  
   **Q:** What is included in the 2024 guidance for Vyrsa revenue?  
   **A:** Vyrsa is in early stages with revenue currently **not material**. Nevro is transitioning from a distributor to a direct sales model, which will take time. They're not providing specific revenue figures for Vyrsa at this time.  **[NVRO_3374478_22]** 

4. **Salesforce Realignment and Market Share**  
   **Q:** When will Nevro return to gaining market share?  
   **A:** After realigning the salesforce and making talent changes, Nevro expects their reps to **hit their stride by Q2/Q3 2024**. Training takes 6 to 9 months, and they believe the new sales reps will compete effectively as they become fully trained.  **[NVRO_3374478_10]** 

5. **Expense Management and OpEx Guidance**  
   **Q:** Why is OpEx guidance higher despite headcount reduction?  
   **A:** Despite a **5% headcount reduction**, operating expenses are expected to remain roughly flat due to merit increases, inflation, and investments in Vyrsa training. Q4 expenses are seasonally low; Q1 OpEx is anticipated to be around **$105 million**, including restructuring charges.  **[NVRO_3374478_19]** 

6. **PDN Growth and Adoption**  
   **Q:** Can you provide metrics on PDN adoption and physician engagement?  
   **A:** PDN penetration is currently **under 1%**, indicating early adoption stages. Nevro is building relationships with referring physicians, who are seeing positive results and gaining confidence in referring patients.  **[NVRO_3374478_16]** 

7. **SCS Market Growth Potential**  
   **Q:** What needs to happen to revive SCS market growth to high single digits?  
   **A:** Nevro focuses on increasing salesforce effectiveness to take market share. They believe opportunities with new indications like nonsurgical back pain and PDN can help the overall SCS market recover and grow.  **[NVRO_3374478_17]** 

8. **New Revenue Streams and Indications**  
   **Q:** Are new revenue streams still pain-related, and what's the timing?  
   **A:** Nevro is developing projects leveraging their salesforce, staying close to core expertise. They aim to offer products aligning with their focus on clinical superiority. Timing details were not specified.  **[NVRO_3374478_11]** 

9. **Strategic Direction and Board Changes**  
   **Q:** Will the strategy change with the new board member?  
   **A:** Nevro's strategy remains unchanged despite board changes. They've welcomed a new board member experienced in acquisitions and investments. They believe there's strong alignment to stay the course.  **[NVRO_3374478_19]** 

10. **Pricing Outlook**  
    **Q:** How should we think about pricing in 2024 with the iQ launch?  
    **A:** As the product mix shifts toward the **iQ device**, average selling prices are expected to be **flat to slightly up**. This modest increase is incorporated into Nevro's guidance.  **[NVRO_3374478_11]** 

df286310d2fae43e6adaa8e16278fdeecf2b711b144dba0805fc01ceefc72930

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58ea31880651cd6aa60d085791dc268aef99b3fb662a03d96c6d59f2c284945b

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5ce27c3c9971b3e6c712e7592977cb58bb36324930e5fa072dc65e48bf06beb5

| Name                     | Position                                              | Start Date           | Short Bio                                                                                                                                                                                                                                                                                                                                                     |
|--------------------------|------------------------------------------------------|----------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Kevin Thornal            | President and Chief Executive Officer                | April 24, 2023       | Kevin Thornal was appointed as President and CEO on **April 24, 2023**, and joined the Board of Directors in May 2023. He has over 20 years of experience in the medical device field, including leadership roles at Hologic, Inc. and Stryker. He holds a B.A. in History from Southern Methodist University.  **[0000950170-24-044100_nvro-20240412.htm:17]** **[0000950170-24-044100_nvro-20240412.htm:51]** **[0000950170-23-013517_nvro-20230419.htm:2]**                                      |
| Roderick H. MacLeod      | Senior Vice President and Chief Financial Officer     | June 2020            | Roderick H. MacLeod joined Nevro in **June 2020**. He previously held leadership roles at Stryker Endoscopy and worked in finance positions at Lumenare Networks, United Airlines, and Arthur Andersen & Co. He holds a B.A. in Economics from Harvard University and a Master of Management from Northwestern University.  **[0000950170-24-044100_nvro-20240412.htm:32]** **[0000950170-23-012576_nvro-20230412.htm:31]**                            |
| Kashif Rashid            | Senior Vice President, Corporate Development and Chief Legal Officer | December 2017        | Kashif Rashid joined Nevro in **December 2017**. He previously held roles at Atara Biotherapeutics, St. Jude Medical, GE Healthcare, Loews Corporation, and Kaye Scholer, LLP. He holds a B.S. in Business Administration from George Washington University and a J.D. from Georgetown University Law Center.  **[0000950170-24-044100_nvro-20240412.htm:32]** **[0000950170-23-012576_nvro-20230412.htm:31]**                                            |
| Greg Siller              | Senior Vice President and Chief Commercial Officer   | June 19, 2023        | Greg Siller joined Nevro on **June 19, 2023**. He previously held leadership roles at Stryker, including Vice President and General Manager of the Stryker Interventional Spine business. He holds a B.S. in Kinesiology from the University of New Hampshire.  **[0000950170-24-044100_nvro-20240412.htm:32]** **[0000950170-24-044100_nvro-20240412.htm:51]** **[0000950170-23-026355_nvro-20230605.htm:1]**                                                                                      |
| David Caraway, M.D., Ph.D. | Senior Vice President and Chief Medical Officer     | April 2014           | David Caraway has served as Chief Medical Officer since **April 2014**. He is a nationally recognized expert in chronic pain treatment and previously served as CEO of The Center for Pain Relief. He holds a B.S., M.D., and Ph.D. from the University of Virginia and is board certified by the American Board of Anesthesiology.  **[0000950170-24-044100_nvro-20240412.htm:33]** **[0000950170-23-012576_nvro-20230412.htm:32]** **[0001564590-22-014129_nvro-def14a_20220526.htm:34]**                   |
| Richard B. Carter        | Chief Accounting Officer                             | September 7, 2022    | Richard B. Carter has been Chief Accounting Officer since **September 7, 2022**. He joined Nevro in 2014 as Corporate Controller and held roles of increasing responsibility. He holds a B.S. in Business Administration from California State University, Chico, and is a Certified Public Accountant (inactive license).  **[0000950170-24-044100_nvro-20240412.htm:33]** **[0000950170-22-018302_nvro-20220907.htm:1]**                            |
| Christofer Christoforou  | Chief Operating Officer                              | May 15, 2024 (expected) | Christofer Christoforou has been with Nevro since **July 2016** and will assume the role of COO on **May 15, 2024**. He previously served as Senior Vice President of Technical Operations and held leadership roles at Thoratec and United States Surgical Corporation. He holds a B.S. and M.S. in Biomedical Engineering.  **[0001193125-24-135347_d784712d8k.htm:1]** **[0000950170-24-054492_nvro-ex99_1.htm:1]** **[0001564590-22-014129_nvro-def14a_20220526.htm:34]** **[0000950170-24-091815_nvro-ex10_2.htm:0]**                      |
| Donald A. Middlebrook    | Senior Vice President of Clinical, Regulatory and Quality | January 2020        | Donald A. Middlebrook joined Nevro in **January 2020**. He previously worked as a Regulatory and Clinical Affairs Consultant for Abbott and held leadership roles at St. Jude Medical and Thoratec Corporation. He holds a B.S. in Biology from California State University, Fullerton.  **[0000950170-24-044100_nvro-20240412.htm:34]** **[0000950170-23-012576_nvro-20230412.htm:33]** **[0001564590-22-014129_nvro-def14a_20220526.htm:35]**                                                               |
| Shana Ross               | Senior Vice President and Chief Human Resources Officer | August 2023         | Shana Ross joined Nevro in **August 2023**. She previously served as Vice President, Human Resources and Chief Diversity Officer at Bayhealth Medical Center. She holds an M.S. in Human Resources and an M.B.A. from the University of Maryland.  **[0000950170-24-044100_nvro-20240412.htm:34]** **[0000950170-24-044100_nvro-20240412.htm:31]**                                                                                                    |
| Peter A. Socarras        | Vice President, General Counsel and Corporate Secretary | October 2012        | Peter A. Socarras joined Nevro in **October 2012**. He has held roles of increasing responsibility within the legal department. He holds a J.D. from The George Washington University Law School and an M.S. and B.S. in Biomedical Engineering from the University of Miami.  **[0000950170-24-044100_nvro-20240412.htm:34]** **[0000950170-24-044100_nvro-20240412.htm:31]**                                                                          |

b865b874829acbfb4241936fff7212a56d0ba8f4421c8f5a62df975604f5d14b

- Painful Diabetic Neuropathy (PDN) Revenue

Total Revenue

58930109eec34241f09a6c12ae20e14f87062ff89fee2fc3cdb04c76de1dae1e

- **Nevro's 2024 revenue growth guidance of 2% to 5% falls below the historical SCS market growth rates of 6% to 9%, indicating potential market share loss or lower growth expectations due to competition or execution challenges.**  **[NVRO_3374478_6]**
- **The company's dependence on new sales reps reaching full productivity to drive back-end loaded growth adds execution risk, especially considering previous instances where back-end loaded guidance did not materialize as expected.**  **[NVRO_3374478_23]**
- **Despite implementing cost-cutting measures like a 5% workforce reduction, Nevro expects operating expenses to remain flat in 2024 due to inflation, merit increases, and acquisition-related expenses, which may limit profitability improvements and cash flow generation.**  **[NVRO_3374478_19]**

07d7fe03ee5916c9333dd8415678618d55107f0b64cd71c786b7f3a7987d6a5f

- Nevro's **unique high-frequency 10-kilohertz therapy** differentiates it from competitors, giving the company a competitive advantage as new competitors with low-frequency devices enter the market. This differentiation is expected to help Nevro maintain and potentially grow its market share.  **[NVRO_3374478_9]**
- The acquisition of **Vyrsa Technologies** positions Nevro to enter the **large and fast-growing SI joint fusion market**, estimated at $2 billion in the U.S. They plan to leverage their existing relationships and their **extensive salesforce**, which will become the **largest SI joint salesforce** once fully trained, to drive growth in this market.  **[NVRO_3374478_8]** ,  **[NVRO_3374478_23]**
- The **salesforce restructuring and realignment**, with new sales reps coming up to speed, is expected to enhance commercial execution. Nevro anticipates these sales reps will **hit their stride by Q2 and Q3 of 2024**, contributing to improved performance and growth in the second half of the year.  **[NVRO_3374478_23]** ,  **[NVRO_3374478_10]**

70d166f59f424bb77fc0d7ab4b205f04d1c978771f04f5d8e455f224f9321a25

Nevro Corp. is a global medical device company headquartered in Redwood City, California, specializing in innovative solutions for chronic pain management. The company develops and markets advanced neuromodulation systems, including its proprietary 10 kHz Therapy™, which has transformed the lives of over 115,000 patients worldwide. Nevro's offerings include spinal cord stimulation platforms, SI joint fusion products, and support services designed to improve patient outcomes and enhance physician practice management.  **[0001444380-25-000012_nvro_4q-fy24selectfinancia.htm:1]** **[0000950170-24-127066_nvro-ex99_1.htm:4]** **[0000950170-24-054685_nvro-20240331.htm:16]** **[0000950170-24-019464_nvro-20231231.htm:4]** **[0000950170-24-054492_nvro-ex99_1.htm:5]** **[0000950170-24-091842_nvro-ex99_1.htm:4]** **[0000950170-24-003196_nvro-ex99_1.htm:2]** 

1. **HFX™ Spinal Cord Stimulation (SCS) Platform** - Provides evidence-based neuromodulation systems, including the Senza® SCS system, for treating chronic pain conditions such as back and leg pain, non-surgical back pain (NSBP), and painful diabetic neuropathy (PDN). The platform features the proprietary, paresthesia-free 10 kHz Therapy™, which has demonstrated superior efficacy compared to traditional SCS therapies.  **[0000950170-24-054685_nvro-20240331.htm:16]** **[0000950170-24-019464_nvro-20231231.htm:4]** 

   - **Senza HFX iQ™** - Offers a versatile range of waveforms, including the proprietary 10 kHz Therapy™, for personalized chronic pain treatment.  **[0000950170-24-054685_nvro-20240331.htm:16]** **[0000950170-24-019464_nvro-20231231.htm:4]** 

2. **SI Joint Fusion Products** - Includes minimally invasive devices for treating chronic sacroiliac joint (SI joint) pain, acquired through the purchase of Vyrsa Technologies.  **[0000950170-24-054685_nvro-20240331.htm:16]** **[0000950170-24-019464_nvro-20231231.htm:4]** 

3. **Support Services** - Enhances patient and physician experiences through tools like the HFX Coach™ for patient support and HFX Cloud™ for providing actionable insights to physicians.  **[0001444380-25-000012_nvro_4q-fy24selectfinancia.htm:1]** **[0000950170-24-127066_nvro-ex99_1.htm:4]** **[0000950170-24-054492_nvro-ex99_1.htm:5]** **[0000950170-24-091842_nvro-ex99_1.htm:4]** **[0000950170-24-003196_nvro-ex99_1.htm:2]**

0b6718ef0461ccd1a9019caf1803664477e274d7634785c0cb963716fe6c24bf

1. With U.S. trial procedures declining by approximately 15.2% and ongoing market challenges, what specific strategies are you implementing to reverse this trend and drive growth in 2025, especially considering the cuts in DTC advertising and sales force changes?
2. Given that you've significantly reduced R&D spending—down about one-third—how do you plan to balance these cost cuts with the need for future innovation to maintain competitive advantage?
3. Your guidance implies a substantial increase in operating expenses in the fourth quarter; is this primarily due to increased DTC spending and sales force expansion, or are there other factors contributing to this rise, and how will it impact profitability?
4. Core SCS trials have been declining over the past three years, with larger declines each quarter; do you feel a need to generate new clinical data to support SCS use in the core market, and how do you plan to regain momentum amid stagnating interest?
5. After aggressive cost-cutting measures, what gives you confidence that you haven't trimmed essential operations that could hinder revenue growth in 2025, and how will you ensure that further headcount reductions won't negatively impact commercial execution?

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Company not found (NVRO)

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