RXST Q2 2024: 11 LAL per LDD lifts Q3/Q4 guidance
- Accelerating Procedure Utilization: Executives highlighted that LAL procedures per LDD installation have increased sequentially (from around 10.1 to 11 per LDD per month), with sustained gains expected. This suggests strong demand and efficient customer onboarding, supporting higher future revenue growth.
- Innovative Product Enhancements: The introduction and FDA approval of LAL+ with an expanded diopter range (from –2 to +3) was noted as a key differentiator. This innovation offers faster visual recovery and serves as a door opener for new customer adoption, potentially expanding the addressable market.
- Growing Premium Market Adoption: The executives emphasized robust conversion rates, with approximately 40% of LAL patients coming from monofocal candidates, and an increased market share for premium IOLs (now over 10%). This reflects the company’s ability to convert conventional cataract procedures into higher-margin premium procedures, driving long-term growth.
- Growing Operating Expenses Risk: The guidance update reveals significantly higher operating expenses, notably from increased SG&A and noncash stock-based compensation, which might pressure margins despite revenue growth.
- Seasonality and Volume Variability: Analysts highlighted that LDD placements and associated procedure volumes are subject to seasonality, suggesting potential quarterly volatility and a risk of underperformance during slower periods.
- Regulatory and International Expansion Uncertainty: Management acknowledged that regulatory approvals in international markets, such as Europe and Asia, are unpredictable and complex, which could delay expansion and revenue diversification.
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Guidance & Utilization
Q: What's driving Q3/Q4 guidance increase?
A: Management highlighted that increased procedure mix—evidenced by an acceleration from 10.1 to 11 LAL per LDD per month—combined with strong new customer activity, supports sequential Q3/Q4 guidance despite seasonal effects. -
Margin Guidance
Q: Why maintain 68–70% margin guidance?
A: They kept the forecast conservative due to period cost variability and mix effects, even with improved results, to ensure realistic margin expectations. -
LAL Power Range
Q: What changed in the LAL power range?
A: The FDA approval shifted the range from +4 to +30 diopters to -2 to +3 diopters, targeting a broader spectrum of high myopic patients, though the precise opportunity remains to be defined. -
LAL+ Opportunity
Q: How does LAL+ drive new customer interest?
A: LAL+ offers faster visual recovery with an extended depth of focus, serving as a door opener for prospective customers without altering pricing, thereby bolstering overall adoption. -
Commercial Investment
Q: Will you accelerate investments in sales?
A: With a robust cash position and revised guidance, RXST intends to increase spending in sales, marketing, and R&D, leveraging strong noncash compensatory structures to support growth. -
Utilization Sustainability
Q: Can current LAL growth be sustained?
A: Consistent acceleration across newer customer cohorts and continuous training efforts underline a sustainable trajectory for LAL procedure growth over time. -
International Outlook
Q: What's the timeline for EU approvals?
A: While progress is underway in Europe, regulatory approvals are unfolding gradually across varied markets, so specifics remain uncertain in the near term. -
Conversion Rates
Q: How stable is premium conversion from monofocal?
A: Third-party survey data shows a steady 40–44% conversion rate from monofocal to premium IOL, with little indication of change over time. -
LDD Seasonality
Q: Will LDD placements dip seasonally?
A: Management anticipates only a nominal seasonal effect in Q3, with overall LDD growth remaining robust despite typical fluctuations. -
LAL+ Utilization Mix
Q: Does LAL+ boost overall lens utilization?
A: They noted that while LAL+ offers clinical enhancements, doctors treat LAL and LAL+ similarly, with the focus on maximizing adjustable lens adoption overall. -
Premium Share
Q: How is the 10% premium IOL share affecting performance?
A: Reaching over 10% premium market share is significant, yet conversion from monofocal remains steady and reflects diverse market definitions that modestly impact overall premium figures. -
Europe Differentiation
Q: Can US success be replicated in Europe?
A: Although Europe comprises multiple distinct markets with unique regulatory challenges, similar clinical needs suggest comparable long-term potential, albeit with a gradual rollout. -
Customer Adoption
Q: Who is adopting the LDD – new or existing customers?
A: LDD placements are typically made in new office settings to serve distinct patient populations, with adoption patterns mirroring those seen in earlier customer cohorts.
Research analysts covering RxSight.