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Penumbra Inc (PEN)·Q4 2024 Earnings Summary

Executive Summary

  • Q4 2024 revenue was $315.5M (+10.8% YoY), with adjusted revenue of $321.3M (+12.9% YoY) and adjusted gross margin at 67.4% (+170bps YoY), driven by strong U.S. thrombectomy performance .
  • GAAP diluted EPS was $0.86; non-GAAP diluted EPS was $0.97, with adjusted EBITDA margin of 19.8% (vs. 18.8% in Q4 2023) .
  • U.S. thrombectomy sales rose 27.3% YoY to $180.6M; U.S. VTE grew 41% YoY, while international revenue declined on China headwinds (–$15.4M YoY) .
  • 2025 guidance was initiated: revenue $1.34B–$1.36B (+12–14% YoY), U.S. thrombectomy +19–20% YoY, GM >67%, operating margin 13–14%—management reiterated path to >70% GM exiting 2026, with operating margin expansion outpacing GM .
  • Potential stock catalysts: continued CAVT share gains, Thunderbolt neurovascular clearance (not in guidance), and manufacturing scale-up (Costa Rica) supporting margin expansion and growth .

What Went Well and What Went Wrong

What Went Well

  • U.S. thrombectomy strength: sales +27.3% YoY to $180.6M; U.S. VTE +41% YoY, with December the highest VTE procedure month ever .
  • Margin execution: adjusted gross margin reached 67.4% (+170bps YoY); adjusted EBITDA margin 19.8% (vs. 18.8% LY) on favorable mix and productivity .
  • Management confidence and scale: “we are on track to achieve a gross margin profile over 70% by the end of 2026… and expect operating margin expansion to outpace gross margin expansion” .

What Went Wrong

  • International softness: Q4 international revenue –16.5% YoY (–16.6% cc), primarily China decline of ~$15.4M YoY .
  • GAAP EPS down YoY: $0.86 vs. $1.38 in Q4 2023, reflecting prior-year tax benefits and mix; GAAP net income margin fell to 10.7% vs. 19.0% in Q4 2023 .
  • Italian payback provision ($5.8M) reduced Q4 GAAP revenue and gross profit; non-GAAP metrics exclude this reserve .

Financial Results

Summary metrics (quarters ordered oldest → newest)

MetricQ2 2024Q3 2024Q4 2024
Revenue ($USD Millions)$299.4 $301.0 $315.5
Adjusted Revenue ($USD Millions)N/AN/A$321.3
GAAP Diluted EPS ($)$(1.55) $0.75 $0.86
Non-GAAP Diluted EPS ($)$0.64 $0.85 $0.97
GAAP Gross Margin (%)54.4% 66.5% 66.8%
Adjusted Gross Margin (%)65.5% N/A67.4%
Adjusted EBITDA Margin (%)15.5% 18.8% 19.8%

Notes: Q4 adjusted revenue/gross margin exclude the Italian payback provision . Q2 GAAP GM includes Immersive Healthcare inventory impairment; adjusted removes it .

Segment revenue breakdown ($USD Millions)

SegmentQ2 2024Q3 2024Q4 2024
Thrombectomy$203.5 $204.1 $220.1
Embolization & Access$95.9 $96.9 $95.4

Geography mix and revenue

GeographyQ2 2024Q3 2024Q4 2024
U.S. (% of revenue)72.9% 75.2% 78.6%
International (% of revenue)27.1% 24.8% 21.4%
U.S. revenue ($M)$218.2 $226.3 $247.9
International revenue ($M)$81.2 $74.7 $67.6

KPIs and operational metrics

KPIQ2 2024Q3 2024Q4 2024
U.S. Thrombectomy Revenue ($M)$153.7 $162.1 $180.6
U.S. VTE YoY GrowthN/A+32% YoY +41% YoY
Operating Cash Flow (quarter)N/A$51.3M before buyback impact $49.1M
Non-GAAP Operating Income ($M)$31.7 $40.3 $48.6

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
Total RevenueFY 2025N/A$1.34B–$1.36B (+12–14% YoY) Initiated
U.S. Thrombectomy GrowthFY 2025N/A+19–20% YoY Initiated
Gross MarginFY 2025N/A>67% (≥+100bps YoY) Initiated
Operating MarginFY 2025N/A13–14% of revenue Initiated
Long-term GM targetExit 2026>70% >70% (reaffirmed) Maintained

Earnings Call Themes & Trends

TopicPrevious Mentions (Q2 2024)Previous Mentions (Q3 2024)Current Period (Q4 2024)Trend
CAVT product momentum (Flash 2.0, Bolt 7/6X/12)Flash 2.0 emerging; updated 2024 guidance, product launch timing, Europe delay FDA cleared Bolt 6X/12; Flash 2.0 drove record VTE volumes; CE Mark for EU Continued U.S. share gains; 41% U.S. VTE growth; December peak volumes Improving
China headwindsCut H2 outlook: China –$20M; broader pressure Int’l down on China; fewer headwinds expected in 2025 Q4 int’l –16.5% YoY; ~$15.4M China decline; headwinds to fade 1H25 Stabilizing over 2025
Gross margin trajectoryAdjusted GM 65.5% (ex-Immersive), path to expansion GM 66.5%; positive mix/productivity; +100–150bps FY ex-Immersive Adjusted GM 67.4%, management on track >70% by end-2026 Improving
Thunderbolt (neuro CAVT)THUNDER enrollment completion timing outlined Enrollment complete; follow-up by year-end; commercialization after clearance Follow-up completed; not yet submitted; timeline data/clearance TBD (not in 2025 guide) Neutral near term
Europe reimbursement/adoptionDelay to EU CAVT launches impacted H2 outlook CE Mark; measured adoption due reimbursement landscape Early adoption positive where reimbursable; continued work on market access Gradual ramp
Manufacturing capacityN/AN/AContract signed for Costa Rica facility to expand capacity Capacity build
Market access initiatives (economics vs. lytics/AC)N/AOngoing initiatives; data to support hospital economics Retrospective analysis showed fewer complications and better hospital economics with CAVT; more datasets forthcoming Building evidence

Management Commentary

  • “We are on track to achieve a gross margin profile over 70% by the end of 2026… and we expect operating margin expansion to outpace gross margin expansion for the foreseeable future.” — CEO Adam Elsesser .
  • “The sequential growth in our total revenue of 6.7% was primarily driven by an increase in U.S. thrombectomy revenue of $18.6 million.” — CFO Maggie Yuen .
  • “Revenue for Thunderbolt is not currently in our guide… we don’t totally control that process.” — CEO Adam Elsesser .
  • “Right now… we have the best commercial team ever assembled in medtech… we’re only 10% penetrated with this market.” — CEO Adam Elsesser .

Q&A Highlights

  • Guidance philosophy: 2025 guide set conservatively; excludes Thunderbolt until more visibility; fewer 2024 headwinds expected in 2025 (China/Europe) .
  • Thunderbolt regulatory path: follow-up complete; not yet submitted; timing of clearance/data presentation TBD; two major U.S. conferences (July/Nov) likely venues .
  • Gross margin drivers: primarily product mix and manufacturing efficiency, not price; path to >70% by 2026 reiterated .
  • Seasonality and growth cadence: front-end loaded 2025 implied; Q4 2025 a tough comp; U.S. thrombectomy growth modeled mid-point or better in early 2025 .
  • China assumptions: remaining headwinds mostly in 1H25, then de minimis; excluding China shows acceleration across businesses .

Estimates Context

  • Wall Street consensus (S&P Global/Capital IQ) was unavailable at time of analysis due to data access limits. Values retrieved from S&P Global were not available for comparison to reported results or guidance.
  • Based on company disclosures, Q4 2024 GAAP revenue of $315.5M and GAAP diluted EPS of $0.86; adjusted revenue $321.3M and non-GAAP diluted EPS $0.97 .

Key Takeaways for Investors

  • CAVT-led U.S. thrombectomy momentum remains the core growth engine (U.S. VTE +41% YoY), supporting mix-driven margin expansion; expect continued share gains in 2025 .
  • 2025 guide (+12–14% revenue; GM >67%; Op margin 13–14%) appears prudent, with upside potential from Thunderbolt neuro clearance (not included in guide) and European adoption as reimbursement improves .
  • International softness is concentrated in China and expected to fade by 1H25; excluding China, management sees acceleration across businesses .
  • Manufacturing expansion (Costa Rica) and disciplined OpEx should support sustained operating leverage, with management targeting >70% GM by end-2026 and operating margin expansion outpacing GM .
  • Near-term trading catalysts: Thunderbolt submission/clearance updates, additional market access datasets for CAVT (PE/DVT/arterial), and evidence of sequential gross margin improvement .
  • Watch for non-GAAP adjustments (Italian payback, Immersive Healthcare wind-down) when modeling; use adjusted metrics to track underlying profitability trends .
  • Segment mix: Thrombectomy growth offsetting flat embolization/access; continued innovation (Bolt 6X/12, RED72 update) should broaden treatable vessel sizes and maintain leadership across vascular beds .
All values and statements are sourced from Penumbra’s Q4 2024 press release and 8‑K (including reconciliations) and the Q4 2024 earnings call: **[1321732_0001321732-25-000010_pen-123124exhibit991.htm:1]** **[1321732_0001321732-25-000010_pen-123124exhibit991.htm:2]** **[1321732_0001321732-25-000010_pen-123124exhibit991.htm:5]** **[1321732_0001321732-25-000010_pen-123124exhibit991.htm:9]** **[1321732_0001321732-25-000010_pen-123124exhibit991.htm:10]** **[1321732_0001321732-25-000010_pen-123124exhibit991.htm:11]** **[1321732_0001321732-25-000010_pen-123124exhibit991.htm:12]** **[1321732_0001321732-25-000010_pen-123124exhibit991.htm:13]** **[1321732_0001321732-25-000010_pen-123124exhibit991.htm:14]** **[1321732_0001321732-25-000010_pen-123124exhibit991.htm:15]** **[1321732_20250218SF21823:1]** **[1321732_20250218SF21823:9]** **[1321732_20241030SF43861:0]** **[1321732_20241030SF43861:1]** **[1321732_20241030SF43861:4]** **[1321732_20241030SF43861:5]** **[1321732_PEN_3404934_1]** **[1321732_PEN_3404934_2]** **[1321732_PEN_3404934_4]** **[1321732_PEN_3404934_12]** **[1321732_20240730SF72253:0]** **[1321732_20240730SF72253:5]** **[1321732_20240730SF72253:6]** **[1321732_20240730SF72253:7]**.