使用警語:中文譯文來源為 Google 翻譯,僅供參考,實際內容請以英文原文為主
Operator
Operator
Good afternoon, and welcome to the Agile Therapeutics Fourth Quarter and Full Year 2022 Financial Results Conference Call. Please note, today's event is being recorded. I would now like to turn the conference over to Matt Riley, Head of Investor Relations.
下午好,歡迎參加 Agile Therapeutics 第四季度和 2022 年全年財務業績電話會議。請注意,今天的活動正在錄製中。我現在想將會議轉交給投資者關係主管 Matt Riley。
Matthew Riley - Head of IR & Corporate Communications
Matthew Riley - Head of IR & Corporate Communications
Hello, everyone, and welcome to today's conference call to discuss our fourth quarter and full year 2022 financial results and corporate update. Before we start, let me remind you that today's call will include forward-looking statements based on our current expectations, including statements concerning our financial outlook and financing prospects for the future; our outlook for the first half and full year of 2023; management's expectations for our future financial and operational performance, including our expectations regarding the market growth of Twirla and our operating expenses; our business strategy; our partnership with Afaxys and its ability to promote growth; our product supply agreement with Nurx and its ability to make Twirla broadly in [hub] locations; our digital advertising campaign and its ability to promote growth; and our assessment of the combined hormonal contraceptive market generally, among other statements concerning our plans, prospects and expectations.
大家好,歡迎參加今天的電話會議,討論我們的第四季度和 2022 年全年財務業績和公司更新。在我們開始之前,讓我提醒您,今天的電話會議將包括基於我們當前預期的前瞻性陳述,包括關於我們的財務前景和未來融資前景的陳述;我們對 2023 年上半年和全年的展望;管理層對我們未來財務和運營業績的預期,包括我們對 Twirla 市場增長和運營費用的預期;我們的業務戰略;我們與 Afaxys 的合作夥伴關係及其促進增長的能力;我們與 Nurx 的產品供應協議及其在 [hub] 地點廣泛生產 Twirla 的能力;我們的數字廣告活動及其促進增長的能力;以及我們對聯合激素避孕藥市場的總體評估,以及關於我們的計劃、前景和期望的其他陳述。
Such statements represent our judgments as of today, are not promises or guarantees and may involve risks and uncertainties that may cause actual results to differ from the results discussed in the forward-looking statements. Further, during the course of today's call, we will refer to certain non-GAAP financial measures. A reconciliation of GAAP to non-GAAP measures is included in our press release issued today, which can be found on the Investor Relations section of our website. Please refer to our filings with the SEC, which are available through the Investor Relations section of our website, for information concerning risk factors that may affect the company. We undertake no obligation to update forward-looking statements, except as required by law. The information on today's call is not intended for promotional purposes and is not sufficient for prescribing decisions.
此類陳述代表我們截至今天的判斷,不是承諾或保證,可能涉及可能導致實際結果與前瞻性陳述中討論的結果不同的風險和不確定性。此外,在今天的電話會議中,我們將參考某些非 GAAP 財務指標。我們今天發布的新聞稿中包含 GAAP 與非 GAAP 措施的對賬,可在我們網站的投資者關係部分找到。有關可能影響公司的風險因素的信息,請參閱我們提交給美國證券交易委員會的文件,這些文件可通過我們網站的投資者關係部分獲得。除非法律要求,否則我們不承擔更新前瞻性陳述的義務。今天電話會議上的信息不用於促銷目的,不足以做出處方決定。
Joining on today's call is Al Altomari, Agile Therapeutics' Chairman and Chief Executive Officer. Following our prepared remarks, we'll open the call to your questions. I will now turn the call over to Al.
Agile Therapeutics 董事長兼首席執行官 Al Altomari 也參加了今天的電話會議。在我們準備好的評論之後,我們將開始回答您的問題。我現在將把電話轉給 Al。
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
Great. Thank you, Matt. Thank you, all, for joining us on our call this afternoon. 2022 was a turning point for Agile as we continue to advance revenue growth for Twirla and transform and streamline our operating model to reduce expenses, which we believe sets Agile up for a strong year of continued revenue growth in 2023. We think the third quarter of 2022 was a breakout quarter for Agile and Twirla because we saw meaningful growth in net revenue, total demand and Twirla factory sales. Following the third quarter, many of you have been asking an important question: How do we know that the performance is sustainable and not just an anomaly? Today, I believe we can answer that question with our fourth quarter 2022 performance, which we saw continued double-digit quarter-over-quarter revenue growth combined with disciplined spending and provides insight into why we are encouraged by what we're seeing so far in 2023.
偉大的。謝謝你,馬特。感謝大家今天下午加入我們的電話會議。 2022 年是 Agile 的轉折點,因為我們繼續推動 Twirla 的收入增長,並轉變和簡化我們的運營模式以減少開支,我們認為這將為 Agile 在 2023 年實現強勁的持續收入增長做好準備。我們認為第三季度2022 年是 Agile 和 Twirla 的突破性季度,因為我們看到淨收入、總需求和 Twirla 工廠銷售額有了顯著增長。第三季度之後,你們中的許多人一直在問一個重要問題:我們如何知道業績是可持續的,而不僅僅是反常的?今天,我相信我們可以通過我們 2022 年第四季度的業績來回答這個問題,我們看到收入持續實現兩位數的環比增長,加上嚴格的支出,並讓我們深入了解為什麼我們對目前所看到的情況感到鼓舞2023年。
Earlier today, we issued a press release with our detailed fourth quarter and full year 2022 results. I want to walk you through a few of those results now. Net revenue for the fourth quarter was $4 million, which represented a 33% increase from the $3 million we reported in the third quarter of 2022. The 33% increase comes after we reported a 43% quarter-over-quarter from the second quarter to the third quarter of 2022. We think this is notable because we finished the second half of 2022 with momentum that contributed to full year 2022 net revenue of $10.9 million, a 165% increase over 2021 net revenue of $4.1 million.
今天早些時候,我們發布了一份新聞稿,其中包含詳細的第四季度和 2022 年全年業績。我現在想向您介紹其中的一些結果。第四季度的淨收入為 400 萬美元,比我們在 2022 年第三季度報告的 300 萬美元增長了 33%。增長 33% 之前,我們報告的第二季度環比增長 43% 2022 年第三季度。我們認為這是值得注意的,因為我們以勢頭結束了 2022 年下半年,2022 年全年淨收入達到 1090 萬美元,比 2021 年的 410 萬美元淨收入增長 165%。
Our fourth quarter net revenue reflects improvements in the following key areas. Twirla demand for the fourth quarter, as reported by Symphony, was 37,452 total cycles, a 25% increase from the third quarter of 2022. Full year 2022 total Twirla demand was 105,667 total cycles, a 213% increase from 2021. Twirla factory sales for the fourth quarter of 2022, as reported by our wholesalers, were 43,230 total cycles, a 30% increase from the third quarter of 2022. For the full year 2022, Twirla factory sales were 114,546. This total exceeded the 113,600 total cycles which we previously guided for the year and represents a 235% increase from full year 2021. As a reminder, the difference between the demand and the factory sales cycle is that not all the prescription demand in the nonretail channel is reported into third parties like Symphony or IQVIA. The demand numbers we received from our wholesalers do include the sales to nonretail channel. And therefore, we believe that the factory sales more closely represent the total demand for Twirla across all our channels.
我們第四季度的淨收入反映了以下關鍵領域的改善。據 Symphony 報告,第四季度 Twirla 需求為 37,452 個總週期,比 2022 年第三季度增長 25%。2022 年全年 Twirla 總需求為 105,667 個總週期,比 2021 年增長 213%。Twirla 工廠銷售額為據我們的批發商報告,2022 年第四季度總循環次數為 43,230 次,比 2022 年第三季度增長 30%。2022 年全年,Twirla 工廠銷售額為 114,546 次。這一總數超過了我們之前指導的全年 113,600 個總週期,比 2021 年全年增長了 235%。提醒一下,需求與工廠銷售週期之間的差異在於,並非所有非零售渠道的處方需求報告給第三方,如 Symphony 或 IQVIA。我們從批發商那裡收到的需求數據確實包括對非零售渠道的銷售。因此,我們認為工廠銷售額更能代表我們所有渠道對 Twirla 的總需求。
Net revenue, demand and factory sales are all key components of our overall growth plan. So growth in these areas is only meaningful if we can simultaneously manage our operating expenses. As you can see from our results, we were disciplined in managing our spending in the fourth quarter and total year of 2022. Non-GAAP operating expenses for the fourth quarter 2022 were $9.2 million, which is identical to the $9.2 million reported for the third quarter of 2022. Full year 2022 non-GAAP operating expenses were $45.5 million, a 29% decrease from the $64.4 million reported for the full year of 2021.
淨收入、需求和工廠銷售額都是我們整體增長計劃的關鍵組成部分。因此,只有在我們能夠同時管理運營費用的情況下,這些領域的增長才有意義。正如您從我們的結果中看到的那樣,我們在管理第四季度和 2022 年全年的支出方面遵守了紀律。2022 年第四季度的非美國通用會計準則運營支出為 920 萬美元,與第三季度報告的 920 萬美元相同2022 年季度。2022 年全年非 GAAP 運營費用為 4550 萬美元,比 2021 年全年報告的 6440 萬美元減少 29%。
Before I move on to the outlook for 2023, I want to take a moment to put 2022's year-over-year performance into perspective. From the end of the fourth quarter 2021 to the end of the fourth quarter 2022, factory sales increased 205% while OpEx decreased from $18.2 million to $9.2 million. So in the past year, we were able to grow our sales over 200% while decreasing our spending by 49%. We plan to maintain spending discipline and therefore, expect to see our total operating expenses for 2023 to be lower than 2022. Our outlook for all these measures is primarily attributable to the reengineering of our business plan as a commercial company that focuses on leveraging external partnerships while keeping our internal infrastructure lean and efficient. We are confident in our ability to execute on our business plan, and we believe that our lean commercial platform can continue to produce strong results in 2023.
在繼續展望 2023 年之前,我想花點時間回顧一下 2022 年的同比表現。從 2021 年第四季度末到 2022 年第四季度末,工廠銷售額增長了 205%,而運營支出從 1820 萬美元下降到 920 萬美元。因此,在過去的一年裡,我們的銷售額增長了 200% 以上,同時支出減少了 49%。我們計劃保持支出紀律,因此預計 2023 年的總運營費用將低於 2022 年。我們對所有這些措施的展望主要歸因於我們作為一家專注於利用外部合作夥伴關係的商業公司的業務計劃的重新設計同時保持我們的內部基礎架構精簡和高效。我們對我們執行業務計劃的能力充滿信心,我們相信我們的精益商業平台能夠在 2023 年繼續產生強勁的業績。
To that end, in January of 2023, we reported that we expect 2023 net revenue to be in the range of $25 million to $30 million, which would represent a year-over-year growth of 129% to 175%. We recognize this goal may sound ambitious, so let me explain why we think it's attainable.
為此,我們在 2023 年 1 月報告稱,我們預計 2023 年的淨收入將在 2500 萬美元至 3000 萬美元之間,同比增長 129% 至 175%。我們認識到這個目標可能聽起來雄心勃勃,所以讓我解釋一下為什麼我們認為它是可以實現的。
Our initial review of January 2023 demand saw a single-month record high for Twirla demand and a single-month record high for retail cycle demand, which is important because the retail side of our business is our most profitable. As we continue through the first quarter of 2023, we expect to see factory sales reflect wholesaler work down of inventory levels, which rose slightly at the end of 2022, but are encouraged by these initial trends. From what we can tell in 2023 thus far, February demand numbers appear to be on par with January and February factory sales appear to be slightly higher than that of January. The preliminary reports for the first 2 months of 2023 give us confidence that we can continue to grow Twirla and meet our 2023 goal of achieving net revenue of $25 million to $30 million and our greater financial goal of generating positive cash flow.
我們對 2023 年 1 月需求的初步審查發現,Twirla 需求創下單月曆史新高,零售週期需求創下單月曆史新高,這很重要,因為我們業務的零售方面是我們最賺錢的業務。隨著我們持續到 2023 年第一季度,我們預計工廠銷售將反映批發商庫存水平的下降,庫存水平在 2022 年底略有上升,但受到這些初步趨勢的鼓舞。從我們目前在 2023 年可以看出的情況來看,2 月的需求數字似乎與 1 月持平,2 月的工廠銷售似乎略高於 1 月。 2023 年前兩個月的初步報告讓我們相信,我們可以繼續發展 Twirla 並實現我們 2023 年實現淨收入 2500 萬至 3000 萬美元的目標以及產生正現金流的更大財務目標。
Our commercial plan is designed to create growth by focusing on the 5 states that have the highest level of reimbursement potential for Twirla and are estimated to allow us to reach 45% of U.S. women between the ages of 18 and 24. We believe there's still a lot of room for growth in this segment of the contraceptive market by going deeper into these 5 states. We believe our lean commercial platform can continue to deliver the growth needed to meet our goals and, in part, because of our continued focus on collaborations with our telemedicine providers, which we hope to accelerate in the second half of 2023; and our relationship with Afaxys, which allows us to grow the nonretail channel through the Planned Parenthood centers and public health center clinics.
我們的商業計劃旨在通過專注於 Twirla 報銷潛力最高的 5 個州來創造增長,據估計這 5 個州將使我們能夠覆蓋 45% 的 18 至 24 歲美國女性。我們相信仍有通過深入這 5 個州,避孕藥具市場的這一部分有很大的增長空間。我們相信我們的精益商業平台可以繼續實現實現目標所需的增長,部分原因是我們繼續專注於與遠程醫療提供商的合作,我們希望在 2023 年下半年加速合作;以及我們與 Afaxys 的關係,這使我們能夠通過計劃生育中心和公共衛生中心診所發展非零售渠道。
I'd like to take a moment to comment on a few of our other financial results, which we believe also demonstrate a year of progress in 2022. Cost of goods sold, or COGS, which consists of direct and indirect costs related to manufacturing Twirla [solely], were $1.7 million for the fourth quarter and $6.8 million for the full year of 2022 compared to $5.7 million and $10.7 million for the same periods of time in 2021. We closed out the fourth quarter and the full year of 2022 with a net loss of $3.9 million or $0.10 per share and $25.4 million or $1.18 per share, respectively, compared to a net loss of $19.5 million or $6.63 per share and $71.1 million or $29.28 per share for the comparable periods in 2021. These reflect the reclassification of certain warrants, which were issued in conjunction with the financing in 2021 and 2022. The reclassification of these warrants as liabilities resulted in $3.8 million in other income for 2021 and $25.5 million in other income for 2022.
我想花點時間評論一下我們的其他一些財務業績,我們認為這些業績也表明 2022 年取得了一年的進展。銷售成本或 COGS,包括與製造 Twirla 相關的直接和間接成本[僅],第四季度為 170 萬美元,2022 年全年為 680 萬美元,而 2021 年同期為 570 萬美元和 1070 萬美元。我們以淨虧損分別為 390 萬美元或每股 0.10 美元和 2540 萬美元或每股 1.18 美元,而 2021 年同期的淨虧損為 1950 萬美元或每股 6.63 美元和 7110 萬美元或每股 29.28 美元。這些反映了重新分類某些認股權證,與 2021 年和 2022 年的融資一起發行。將這些認股權證重新分類為負債導致 2021 年的其他收入為 380 萬美元,2022 年的其他收入為 2550 萬美元。
Moving forward, we expect to see fluctuations in our net income or loss depending on the valuation of these warrants, which will need to perform on a quarterly basis and are expected to result in noncash accounting adjustments. We do not expect these adjustments to have any effect on the company's previously reported revenue, operating expenses, cash flows or cash. After deducting the other income attributed to the valuation of these warrants and the onetime only noncash charge associated with the transfer of our equipment to Corium in the third quarter of 2022, non-GAAP loss was approximately $39.8 million for the year ending December 31, 2022, or $1.84 per share. We believe excluding these items represents a more useful comparison of the results from our operations in the periods we're discussing.
展望未來,我們預計我們的淨收入或虧損會根據這些認股權證的估值而波動,這將需要按季度執行,並預計會導致非現金會計調整。我們預計這些調整不會對公司先前報告的收入、運營費用、現金流量或現金產生任何影響。扣除歸因於這些認股權證估值的其他收入以及與 2022 年第三季度將我們的設備轉讓給 Corium 相關的一次性唯一非現金費用後,截至 2022 年 12 月 31 日止年度的非美國通用會計準則虧損約為 3980 萬美元,或每股 1.84 美元。我們認為,排除這些項目代表了對我們正在討論的時期內運營結果的更有用的比較。
We ended 2022 with $5.2 million of cash on hand, in addition to the $75 million at-the-market, or ATM, arrangement. We will continue to evaluate all available options to finance the company and continue to explore opportunities that can potentially accelerate our time line to generating positive cash flow, including exploring business development opportunities.
到 2022 年底,我們手頭有 520 萬美元的現金,此外還有 7500 萬美元的市場或 ATM 安排。我們將繼續評估為公司提供資金的所有可用選項,並繼續探索可能加快我們產生正現金流的時間表的機會,包括探索業務發展機會。
Before we open to Q&A, I want to emphasize that the entire organization remains focused on achieving our goals of growing Twirla, attaining the 2023 net revenue target of $25 million to $30 million and ultimately, generating cash flow positive. We remain confident we can accomplish these goals by: first, focusing on the 5 states that have the highest level of reimbursement potential for Twirla and are estimated to allow us to reach 45% of U.S. women between the ages of 18 and 24; second, continuing to cultivate the nonretail channel through [every reach] of the Afaxys customer network, which includes Planned Parenthoods and student health centers; third, increasing our footprint in telemedicine through our collaboration with Nurx, which has provided contraceptive options to more than 1 million patients. Our vision and ambition is that Nurx can accelerate the retail channel growth similar to the way Afaxys help us accelerate the nonretail channel growth.
在我們開始問答之前,我想強調整個組織仍然專注於實現我們發展 Twirla 的目標,實現 2023 年 2500 萬至 3000 萬美元的淨收入目標,並最終產生正現金流。我們仍然相信我們可以通過以下方式實現這些目標:首先,關注 Twirla 報銷潛力最高的 5 個州,據估計,我們可以覆蓋 45% 的 18 至 24 歲美國女性;其次,繼續通過 Afaxys 客戶網絡的[每個範圍]培育非零售渠道,其中包括計劃生育和學生健康中心;第三,通過與 Nurx 的合作,增加我們在遠程醫療領域的足跡,Nurx 已為超過 100 萬患者提供了避孕選擇。我們的願景和雄心是 Nurx 可以加速零售渠道的增長,就像 Afaxys 幫助我們加速非零售渠道增長的方式一樣。
Now we'd like to give an opportunity for our covering analysts to ask any questions. Operator, you can now open the line for Q&A.
現在我們想給我們的覆蓋分析師一個機會來提出任何問題。接線員,您現在可以打開問答線路了。
Operator
Operator
(Operator Instructions) Our first question will come from the line of Oren Livnat from H.C. Wainwright.
(操作員說明)我們的第一個問題將來自 H.C. 的 Oren Livnat。溫賴特。
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Can you hear me?
你能聽到我嗎?
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
Yes, Oren.
是的,奧倫。
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Okay. Great. So I was hoping, first, to just talk about this $25 million to $30 million guidance that you've reiterated. I mean that would be a pretty remarkable growth year-over-year. And I'm hoping we can dig a little bit into, I guess, the contributors to that and visibility on that. First, I guess, can you characterize what contribution you expect, I guess, year-over-year from the retail and nonretail channels to that number? I mean, currently, I think volume-wise, retail -- or nonretail is already at or above 40%. Do you expect like a major change in the mix for 2023?
好的。偉大的。因此,我希望首先談談您重申的 2500 萬至 3000 萬美元的指導意見。我的意思是,這將是一個非常顯著的同比增長。我希望我們可以深入了解一下,我想,貢獻者和可見性。首先,我想,你能描述一下你期望零售和非零售渠道對這個數字的同比貢獻嗎?我的意思是,目前,我認為零售或非零售已經達到或超過 40%。您預計 2023 年的組合會發生重大變化嗎?
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
Yes. So Oren, this is Al. Besides Matt and I in the room, Amy Welsh, our Chief Commercial Officer; and Jason Butch, our Chief Accounting Officer, are joining me. So I'll turn it over to Amy, but at a high level, we expect all boats to rise. I mean we expect significant contributions both from the retail, which, as I mentioned in the script, we had an all-time high in January. So retail seems to be performing well. That's our most profitable book and nonretail, but maybe you can go in a little bit more detail.
是的。奧倫,這是阿爾。除了馬特和我,還有我們的首席商務官艾米威爾士;我們的首席會計官傑森·布奇 (Jason Butch) 也加入了我的行列。所以我會把它交給艾米,但在高層次上,我們預計所有的船都會上升。我的意思是,我們期望零售業做出重大貢獻,正如我在腳本中提到的那樣,我們在 1 月份創下了歷史新高。因此,零售業似乎表現良好。這是我們最賺錢的書和非零售書,但也許你可以更詳細一點。
Amy Welsh - Chief Commercial Officer
Amy Welsh - Chief Commercial Officer
Yes, thank you for the question, Oren. I don't -- I expect the growth to be the same as you saw in Q4. From a nonretail perspective, that growth came from one large account and a couple of handful of moderate to smaller accounts. We look at 2023 and we see here we'll have one large account each quarter. So we should be able to see that type of growth. And what we're learning from the growth of a large account or the addition of a large account is when they come on board, that's where Al used to always say it looks a little lumpy. They'll maybe buy a lot in the beginning, and then they'll normalize and then they'll buy consistently. So I think that, that mix should look the same. Retail is where our bread and butter is. So we're ensuring that we have a field that's optimized and growing and augmented by partners like Nurx. But I think that we're going to stay consistent to the type of mix you're seeing in the same type of growth rate.
是的,謝謝你的提問,奧倫。我不——我希望增長與你在第四季度看到的一樣。從非零售的角度來看,這種增長來自一個大客戶和幾個中小型客戶。我們看看 2023 年,我們在這裡看到我們每個季度都會有一個大客戶。所以我們應該能夠看到這種增長。我們從一個大賬戶的增長或增加一個大賬戶中學到的是,當他們加入時,Al 過去常常說它看起來有點凹凸不平。他們可能一開始會買很多,然後他們會正常化,然後他們會持續購買。所以我認為,這種組合看起來應該是一樣的。零售業是我們賴以生存的地方。因此,我們確保我們擁有一個由像 Nurx 這樣的合作夥伴優化、發展和增強的領域。但我認為我們將與您在相同類型的增長率中看到的混合類型保持一致。
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
Yes. So Oren, to answer your question, I mean, like mathematically, the fourth quarter, we did $4 million. So on a run rate basis, we're $16 million plus business. So we -- if you apply the same growth, as Amy was saying, that we've seen particularly in the fourth quarter and then if we could stay on that curve, you'd start seeing the numbers we've seen. So there's no reason to believe we can't keep growing this business the way we've been. At the same time, we'll keep our hand on the rudder of the OpEx, and that's the 1-2 combination that gets us across the goal line and starts generating cash.
是的。所以奧倫,為了回答你的問題,我的意思是,就像數學上一樣,第四季度,我們做了 400 萬美元。所以在運行率的基礎上,我們的業務超過 1600 萬美元。所以我們 - 如果你應用相同的增長,正如艾米所說,我們特別是在第四季度看到的,然後如果我們能夠保持在這條曲線上,你就會開始看到我們看到的數字。因此,沒有理由相信我們不能像以前那樣繼續發展這項業務。與此同時,我們將繼續掌控 OpEx 的方向舵,這是讓我們越過球門線並開始產生現金的 1-2 組合。
Amy Welsh - Chief Commercial Officer
Amy Welsh - Chief Commercial Officer
Does that answer your question, Oren?
這是否回答了你的問題,奧倫?
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Well, sure. I'm going to keep digging in there until you tell me to stop. So you kind of anticipated my next question, which is this nonretail channel growth. So it's pretty amazing how big an impact one large, I guess in California, Planned Parenthood network win can add to the total volume picture here. And you mentioned expecting one large account win each quarter. What sort of visibility do you have on that? Are you already through the process with, I guess, the P&T equivalent there and highly confident in these new wins? Do you know we have a good grasp on what kind of volume each one of those can produce? And I have more...
嗯,當然。我會繼續挖下去,直到你叫我停下來。所以你有點預料到我的下一個問題,即非零售渠道的增長。因此,我猜想在加利福尼亞州,計劃生育網絡的勝利可以增加這裡的總銷量,其影響有多大,這真是令人驚訝。你提到期望每個季度都能贏得一個大客戶。您對此有何看法?我想,您是否已經完成了與 P&T 等同的過程,並對這些新勝利充滿信心?你知道我們很清楚每一個能產生什麼樣的體積嗎?而我還有更多...
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
Yes, so I'm going to give you kind of a 30,000 view, and then Amy will -- can take you through. It's really interesting, Oren. I think you, more than anybody, would appreciate that Governor Gavin Newsom, as you probably saw with one of the big chain accounts, kicked them off the medical formulary to defend women in the state. So in his press statement, he said that the California economy, on a GDP basis, would be the fourth largest economy in the world, which just -- I know that's [astounding]. And so it talks about the 5-state strategy we're on. When we look at our 5 states, they represent -- we talk about 45% of the market. That's 41% of the GDP in this country. So I'll turn it over to Amy on the visibility. So California is a good state for us, Oren. So I'll let Amy tell you our visibility.
是的,所以我會給你一個 30,000 的視圖,然後艾米會 - 可以帶你通過。這真的很有趣,奧倫。我想你,比任何人都更感激州長 Gavin Newsom,正如你可能在其中一個大型連鎖賬戶中看到的那樣,將他們踢出醫療處方集以保護該州的女性。所以在他的新聞聲明中,他說加州經濟,以 GDP 為基礎,將成為世界第四大經濟體,我知道這 [令人震驚]。所以它談到了我們正在進行的 5 州戰略。當我們查看我們的 5 個州時,它們代表——我們談論 45% 的市場。那是這個國家 GDP 的 41%。所以我會把它交給艾米來討論能見度。所以加州對我們來說是個好州,奧倫。所以我會讓艾米告訴你我們的能見度。
Amy Welsh - Chief Commercial Officer
Amy Welsh - Chief Commercial Officer
Yes. I think your question was where are we with the process. And I think the last couple of times, we've explained that the Afaxys sales process took a little bit longer. Yes, we, from a clinical perspective, so that it's clear to the next handful of large accounts that provides meaningful option for their patients, so we're past the clinical phase with all of those larger accounts. And what we're doing is we're trying to work with them from a financial perspective of when it makes sense to partner with Twirla and bring them on. So it's sort of the last phase from most of those larger accounts, which is why my guesstimate we'll see that happening sort of like quarterly -- quarter-over-quarter throughout the year.
是的。我想你的問題是我們的流程在哪裡。我想最近幾次,我們已經解釋過 Afaxys 的銷售過程需要更長的時間。是的,從臨床的角度來看,我們很清楚接下來的少數大客戶會為他們的患者提供有意義的選擇,所以我們已經過了所有這些大客戶的臨床階段。我們正在做的是,我們正在嘗試從財務角度與他們合作,了解何時與 Twirla 合作並吸引他們。所以這是大多數大型賬戶的最後一個階段,這就是為什麼我猜測我們會看到這種情況有點像每季度發生一次——全年環比增長。
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
So we won the battle clinically, Oren. So now it tends to be when is the right system, when they buy and the purchasing people who work with us. So we have optics to all of this. So we have the wins, so we expect to see volume now.
所以我們在臨床上贏得了戰鬥,奧倫。所以現在往往是什麼時候是正確的系統,他們何時購買以及與我們合作的採購人員。所以我們對所有這些都有光學。所以我們取得了勝利,所以我們希望現在能看到銷量。
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
So there are additional large accounts. This is also in California theoretically?
所以還有額外的大賬戶。理論上這也在加州?
Amy Welsh - Chief Commercial Officer
Amy Welsh - Chief Commercial Officer
Yes, believe it or not, yes, most of these large accounts are right there on the West Coast, specific to the State of California.
是的,信不信由你,是的,這些大客戶中的大多數都在西海岸,特定於加利福尼亞州。
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
What makes California peculiar, Oren, is just a little bit of a -- a lot of times, a Planned Parenthood can be a single clinic like we've talked before or in a buying group. In California, some of the affiliates tend to be in one buying group. So they -- so one purchasing person or one P&T represents a number of individual affiliates. So in a lot of ways, Amy has one-stop shopping. So I think they just aggregate their volume, and look, they use that as a negotiating tool. So California seems to be, I don't know, Amy, the most organized, for lack of better words. I mean I think...
奧倫,加州的獨特之處只是一點點——很多時候,計劃生育可以是我們之前談過的一家診所,也可以是一個購買小組。在加利福尼亞州,一些附屬公司往往屬於一個購買集團。所以他們 - 所以一個採購人員或一個 P&T 代表許多獨立的分支機構。所以在很多方面,艾米都有一站式購物。所以我認為他們只是匯總了他們的數量,然後看,他們將其用作談判工具。所以加利福尼亞似乎是,我不知道,艾米,最有組織的,因為沒有更好的詞。我的意思是我認為...
Amy Welsh - Chief Commercial Officer
Amy Welsh - Chief Commercial Officer
Yes, that's [a really good way] of putting it. Yes.
是的,這是[一種非常好的表達方式]。是的。
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
And when we win, we win big, Oren.
當我們贏了,我們就贏了,奧倫。
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Right. And so obviously, as we see volume accelerate, it's been pretty remarkable how it can ramp in that nonretail channel already in the last quarter or 2. As we see that to continue to grow, before we get carried away with how that might translate to revenue, on our end before you report, I guess an important factor is that economic side. I mean I know it's less profitable, of course, than retail. But do you feel pretty confident that, I guess, the gross to net -- or the net pricing per cycle going forward will be consistent with what you've managed to achieve so far in the Planned Parenthood or other nonretail?
正確的。很明顯,當我們看到成交量加速增長時,非零售渠道在上一季度或第二季度的增長已經非常了不起。正如我們看到的那樣繼續增長,在我們對這可能轉化為收入,在你報告之前,我想一個重要的因素是經濟方面。我的意思是,我知道它的利潤當然低於零售。但是,我猜,您是否非常有信心相信,未來每個週期的淨價或淨價將與您迄今為止在計劃生育或其他非零售業中取得的成就保持一致?
Amy Welsh - Chief Commercial Officer
Amy Welsh - Chief Commercial Officer
Yes. Yes, contractually, we don't expect any changes there from our pricing, 340B pricing. That should be locked, so you shouldn't see any surprises. And one thing that, when you were asking a question, Oren, that made me think about that I wanted to share is we're also seeing a positive effect on the retail through these gains in California. I think that Al, on a couple of these calls, had explained that these physicians who work in a Planned Parenthood very often work in the community as well. So we're starting to see a very positive effect on the nonretail account wins in California coming over into the retail side, too. So -- but yes, to answer your question, no, we're going to be consistent on the pricing.
是的。是的,根據合同,我們預計我們的定價 340B 定價不會有任何變化。那應該被鎖定,所以你不應該看到任何驚喜。有一件事,當你問一個問題時,奧倫,讓我想到我想分享的是,我們也看到了通過加利福尼亞州的這些收益對零售業產生的積極影響。我認為 Al 在其中一些電話中解釋說,這些在計劃生育協會工作的醫生也經常在社區工作。因此,我們開始看到對加利福尼亞州非零售客戶的勝利也產生了非常積極的影響。所以 - 但是,是的,要回答你的問題,不,我們將在定價上保持一致。
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
I'll give a big picture answer. But Oren, maybe Jason can comment if I get it wrong. The mix in our third and fourth quarter hasn't changed much. So the [barge almost rose]. So our average yield per cycle is pretty consistent, right, quarter-over-quarter?
我會給出一個宏觀的答案。但是 Oren,如果我說錯了,Jason 可以發表評論。我們第三季度和第四季度的組合沒有太大變化。所以[駁船幾乎上升]。所以我們每個週期的平均收益率是相當一致的,對吧,季度環比?
Jason Butch - Principal Financial Officer, VP & CAO
Jason Butch - Principal Financial Officer, VP & CAO
Yes, that's exactly right. So like Al mentioned, Q3, Q4 is consistent. And from a forecasting perspective looking into '23, I'm seeing a point or 2 maybe increase in the discounting across the board. So the mix does remain relatively consistent in and throughout '23.
是的,完全正確。所以就像 Al 提到的,Q3、Q4 是一致的。從 23 年的預測角度來看,我看到全面折扣可能會增加一兩點。因此,混合在 23 年和整個 23 年期間確實保持相對一致。
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
So our gross to net is maybe -- I think it's stabilizing. I don't know, for lack of better words, Jason anticipates it going up a little. But I think -- as I said, we've had the big shift in the third quarter. Fourth quarter was about the same. We're saying going forward, it looks pretty steady. Now if Amy is widely successful in retail, which we hope, that might change it for the good. And if the mix changes more into the other side, we'll take a little bit of a haircut. But all volume is good to us. We like volume.
所以我們的毛淨值可能——我認為它正在穩定。我不知道,因為沒有更好的詞,Jason 預計它會上漲一點。但我認為——正如我所說,我們在第三季度發生了重大轉變。第四季度大致相同。我們說的是向前看,它看起來很穩定。現在,如果艾米在零售業取得廣泛成功(我們希望如此),這可能會改變它。如果混合變化更多到另一邊,我們會稍微理髮一下。但所有的音量對我們都有好處。我們喜歡音量。
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Yes. So speaking of retail, that's growing pretty nicely. I mean I have IQVIA, and that's in the 50%, 60% year-over-year growth. I think Symphony is even better. How much effect of Nurx are we already seeing in the current volume? Or is that really almost all upside in terms of inflection or trajectory in 2023?
是的。所以說到零售,它的增長非常好。我的意思是我有 IQVIA,這是 50%、60% 的同比增長。我認為 Symphony 更好。我們已經在當前卷中看到了多少 Nurx 的效果?或者就 2023 年的拐點或軌跡而言,這真的是幾乎所有的上行空間嗎?
Amy Welsh - Chief Commercial Officer
Amy Welsh - Chief Commercial Officer
Yes, it's going to be -- we have not seen much at all. What we've been doing with our partner in Nurx over the last quarter has been really just making sure that all of our tools will work with them, I think, from our co-pay card to websites and co-promotion and just getting everyone up to speed to make sure that when they're ready to go full bore and completely convert to Twirla, that they are set up systematically and the patients will be able to get it seamlessly. I think you're going to see impact of Nurx in the back half of the year, hopefully as early as Q2, but confidently in Q3.
是的,這將是——我們還沒有看到太多。上個季度,我們與 Nurx 合作夥伴所做的只是確保我們所有的工具都能與他們合作,我認為,從我們的共同支付卡到網站和共同推廣,讓每個人都加快速度,以確保當他們準備好全力以赴並完全轉換為 Twirla 時,他們會被系統地設置,並且患者將能夠無縫地獲得它。我認為你會在今年下半年看到 Nurx 的影響,希望最早在第二季度,但有信心在第三季度。
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Okay. And can you just remind us, that -- you're going to be the exclusive patch, right? So are they just going to -- I guess, similar to Planned Parenthood that have adopted your product, are they just going to exhaust whatever, I guess, Xulane or generic supply they have and then go wholly into Twirla prescribing?
好的。你能不能提醒我們,你將成為獨家補丁,對吧?那麼他們是否會——我猜,類似於採用了你的產品的計劃生育聯合會,他們是否會用盡所有,我猜,他們擁有的 Xulane 或仿製藥供應,然後完全進入 Twirla 處方?
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
Yes. We're -- think of that as a formulary. We're in a preferred position on their formulary. It's going to be up to them how to manage the patient. Amy has been really sensitive to patients. Like if a woman is on Xulane and she's happy, she should stay. She should stay. I mean we really -- that's really some of behind the scenes things we've been talking about. Now we hope a new patient comes in, we get that patient. So -- but our -- we're in a preferred position, which is great. We're a good partner with them. Amy works hand in hand with them. But we say, look, do what's right for the patient. In the long run, we'll benefit. So that's kind of in our philosophy.
是的。我們 - 將其視為處方集。我們在他們的處方集上處於優先地位。如何管理病人將取決於他們。艾米對病人非常敏感。就像如果一個女人在 Xulane 上並且她很開心,她應該留下來。她應該留下來。我的意思是我們真的 - 這真的是我們一直在談論的一些幕後事情。現在我們希望有一個新病人進來,我們得到那個病人。所以 - 但我們 - 我們處於首選位置,這很棒。我們是他們的好夥伴。艾米與他們攜手合作。但是我們說,看,做對病人正確的事。從長遠來看,我們會受益。這就是我們的理念。
Amy Welsh - Chief Commercial Officer
Amy Welsh - Chief Commercial Officer
Definitely.
確實。
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
So it's not going to be black and white like in some of the Planned Parenthood (inaudible). So that's a little different situation. This will be kind of -- as Amy was saying, we'll grow into it.
所以它不會像某些計劃生育(聽不清)那樣是非黑即白的。所以情況有點不同。這將有點——正如艾米所說,我們會成長為它。
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
And I guess just one last one on retail long term. Has there been any noticeable tailwind or change in payer coverage or payer compliance with coverage mandates with regards to Twirla or any other contraceptives that you've seen since the White House started to bring some real heat on to payers?
我想這只是零售業長期的最後一個。自白宮開始給付款人帶來一些真正的壓力以來,您在 Twirla 或任何其他避孕藥具方面是否有任何明顯的順風或付款人覆蓋範圍或付款人遵守覆蓋範圍要求的變化?
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
The answer is yes. I mean Amy and I review that data a lot. I mean what we see is all boats are rising. In the early days, kind of the headwinds would require doctors doing these letters of prior auth, as we talked you through, Oren, or letters of medical necessity. And they were even being stopped, which is what we thought was wrong. We're seeing them go through. So there's less friction, if you will, on the script. The scripts have a better chance of getting filled. Another reason we like Nurx and specialty pharm is that they can talk to patients through and say, "Hey, it might take us a week or 2 to get this paperwork in. In the meantime, here is a sample." So the answer is yes, and we see it across all brands, which is great. When -- your question on formulary, no, we haven't seen much movement in formulary. So doctors, we still think, the big win for us. Imagine today, we get the formulary wins, Oren. The wins -- what we're doing right now is remarkable, I believe, in retail. But formularies, I think a whole different game if we can unlock the formularies.
答案是肯定的。我的意思是艾米和我經常審查這些數據。我的意思是我們看到的是所有船隻都在上升。在早期,有點逆風需要醫生做這些事先授權的信件,就像我們和你談過的那樣,奧倫,或者醫療必要的信件。他們甚至被阻止了,我們認為這是錯誤的。我們看到他們通過了。因此,如果您願意的話,腳本上的摩擦會更少。這些腳本更有可能被填滿。我們喜歡 Nurx 和 specialty pharm 的另一個原因是他們可以與患者交談並說,“嘿,我們可能需要一到兩週的時間才能完成這份文件。與此同時,這裡有一個樣本。”所以答案是肯定的,我們在所有品牌中都看到了這一點,這很棒。什麼時候——你關於處方的問題,不,我們沒有看到處方有太大變化。所以我們仍然認為,醫生對我們來說是一個巨大的勝利。想像一下,今天,我們獲得了公式的勝利,奧倫。勝利——我相信,我們現在正在做的事情在零售業是非常了不起的。但是處方,我認為如果我們可以解鎖處方,那就是一個完全不同的遊戲。
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Sure. So if there is some improvement on the compliance with letters of medical necessity or whatever -- the waiver, so to speak, for ACA, is it an opportunity for you to go back? I imagine early on some people wrote, especially when you had a broader footprint with sales, some people wrote prescriptions and were probably inappropriately rejected by payers. And I can only imagine that's a tough first impression for a doctor to have with any product launch. Do you have the opportunity to go back and revisit as this landscape has improved a little bit to some of these doctors and say, "Hey, I know you tried and failed before, but try again?"
當然。因此,如果在遵守醫療必要信函或其他任何方面有所改善 - 可以說,對於 ACA 的豁免,這是你回去的機會嗎?我想很早就有人寫信,尤其是當你的銷售範圍更廣時,有些人寫了處方,可能被付款人不恰當地拒絕了。而且我只能想像,對於醫生來說,任何產品發布都會給人留下艱難的第一印象。你是否有機會回去重新審視,因為這種情況對其中一些醫生有所改善,然後說,“嘿,我知道你以前嘗試過但失敗了,但再試一次?”
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
Yes. I mean 2 things. One, it's better than it was, but it's still not perfect. So we're routinely answering questions by Congress and the Senate about is it fixed yet, your question, and the answer is no. We believe we shouldn't even have to do a lot of this work. So not all of them go through at 100%. So it's very plan-specific. Some plans or PBMs do better than others. So while it's improved, it's not perfect. So we're routinely being advised to answer Congress and answer the Senate on this. They still have an active eye on this. So I think while it's getting better, it's not perfect.
是的。我的意思是兩件事。第一,它比以前好多了,但仍不完美。所以我們經常回答國會和參議院關於它是否已修復的問題,你的問題,答案是否定的。我們相信我們甚至不必做很多這樣的工作。所以並不是所有的人都100%通過。所以這是非常具體的計劃。一些計劃或 PBM 比其他計劃或 PBM 做得更好。因此,雖然它有所改進,但並不完美。所以我們經常被建議就此回答國會和參議院。他們仍然在積極關注這一點。所以我認為雖然它越來越好,但並不完美。
And then we do tell doctors. We do tell doctors it's getting better. But rather than just sending the script down the street to the local CVS, give us the script. Once it's in our hands, our hit rate is a lot higher. Amy can -- I mean, it's as close as we can handle that script across the goal line. But if she goes to a CVS and they say, "Your card doesn't work," that's a big customer [die] for them. So that's why we think specialty pharm and telemedicine are so important to us. I mean that's the strategy. The more volume we get there, Oren, our hit rate only can go up.
然後我們會告訴醫生。我們確實告訴醫生情況正在好轉。但與其直接將腳本發送到本地 CVS,不如將腳本提供給我們。一旦到了我們手中,我們的命中率就會高很多。艾米可以——我的意思是,我們可以盡可能地處理越過球門線的腳本。但是,如果她去了 CVS,他們說,“你的卡不起作用”,那對他們來說就是一個大客戶 [die]。所以這就是為什麼我們認為專業製藥和遠程醫療對我們如此重要。我的意思是這就是策略。我們到達那裡的音量越大,Oren,我們的命中率只會上升。
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Okay. And just lastly, I appreciate the patience. OpEx, you mentioned it being down year-over-year. I guess can you talk about that? Is that expected to be sort of flattish or up a little bit from the current level as you sort of have these new programs rolling out and you suddenly get a lot more traction? And I guess on your guidance of $25 million to $30 million, you have an ambition of actually potentially cash flow breakeven at some point before the year-end, which would be pretty remarkable. And I'm just trying to figure out, at what OpEx level do you feel like you can maintain sustainable growth, right? Like you've obviously reorganized a lot, and you've got a lot of momentum on the sales side. How much gross long term do you think you can sustain beyond even 2023 and just reaching breakeven with this footprint? Do you think you're rightsized for substantial growth beyond 2023? Or would you have to start investing more again?
好的。最後,我感謝您的耐心等待。 OpEx,你提到它同比下降。我想你能談談嗎?隨著這些新項目的推出,你會突然獲得更多的關注,這是否會比當前水平略微持平或略有上升?我猜根據你 2500 萬到 3000 萬美元的指導,你有一個雄心壯志,即在年底前的某個時候實際實現現金流收支平衡,這將是非常了不起的。而且我只是想弄清楚,您認為您可以在什麼 OpEx 水平上保持可持續增長,對嗎?就像你顯然已經重組了很多,而且你在銷售方面有很大的動力。您認為您甚至可以在 2023 年之後維持多少長期毛利率,並且僅以這種足跡達到盈虧平衡?您認為您是否適合在 2023 年之後實現大幅增長?還是您必須重新開始投資?
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
No, to answer your last question first, I believe we're rightsized and we can sustain growth, the growth we're on. But it's based on [one where] Amy's ability to partner. We can't do it alone. So I think as long as we have these great partnerships, Oren, maintain a strong presence in the field and a good leader like Amy that can really keep all -- everybody working on all the oars in the water at the same time, I think we can continue to sustain this growth, right? And down the road, we'd love to invest in the business again, I'll be honest. But we're not there yet. But I'm not going to (inaudible) out either. I mean I think we have a good investment to work off of, and I'm happy and I'm pleased with the level.
不,首先要回答你的最後一個問題,我相信我們的規模是合理的,我們可以維持增長,我們正在進行的增長。但它是基於 [one where] Amy 的合作能力。我們不能單獨做。所以我認為,只要我們擁有這些偉大的合作夥伴關係,奧倫,在該領域保持強大的影響力,並像艾米這樣的優秀領導者能夠真正保持所有人 - 每個人同時在水中的所有槳上工作,我認為我們可以繼續維持這種增長,對嗎?老實說,在未來,我們很樂意再次投資這項業務。但我們還沒有。但我也不會(聽不清)退出。我的意思是我認為我們有很好的投資可以解決,我很高興,我對這個水平感到滿意。
To your next question about the range, we -- Jason, I think it's in a range. So I think before, we said $9 million to $10.5 million, something like that, because it gets a little lumpy at times. When we buy samples, for instance, we had to buy the batch and expense it that quarter. So I think we're in kind of a range of, I'll call it, $9.5 million to $10.5 million, I think was what we said before. The $9.2 million we're proud of. That's done in a great day. That's a lot of belt tightening. But we didn't cut corners. Amy got the investments she needed to grow this business. She wasn't complaining. She always wants more, but she's not complaining.
對於你關於範圍的下一個問題,我們 - 傑森,我認為它在一個範圍內。所以我想之前,我們說過 900 萬到 1050 萬美元,大概是這樣,因為它有時會有點起伏。例如,當我們購買樣品時,我們必須購買整批樣品並在當季計入費用。所以我認為我們的範圍是 950 萬到 1050 萬美元,我想這是我們之前說過的。我們引以為豪的 920 萬美元。這是在美好的一天完成的。這是很多勒緊褲腰帶。但我們沒有偷工減料。艾米獲得了發展這項業務所需的投資。她沒有抱怨。她總是想要更多,但她沒有抱怨。
And then with -- I just want to clarify the profitability, I mean, cash flow sustainability. We're not going to be sustainable this year. We're not going to throw off the year. There's not going to be -- I know you know this. But we see the fourth quarter or maybe the last couple of months of the year that will break through there. So -- and then hopefully, we don't go back and then we go into '24 that way. So we're shooting for the fourth quarter-ish. That's where the lines cross. And if we can keep the OpEx in roughly the same zone of like $9 million to $10 million, we probably, Jason, need a $12 million net on the top line. And then we have the cost of goods sold that would -- that's the math. So it really is just arithmetic. So you say, what level of sales do we need to cover the OpEx? It's probably $12 million net. So that's -- and that number doesn't look scary to us.
然後 - 我只想澄清盈利能力,我的意思是現金流的可持續性。今年我們不會持續下去。我們不會放棄這一年。不會 - 我知道你知道這一點。但我們看到第四季度或今年的最後幾個月將在那裡取得突破。所以 - 然後希望我們不要回去然後我們以這種方式進入 24 年。所以我們正在為第四季度拍攝。這就是線條交叉的地方。如果我們能夠將 OpEx 保持在大約 900 萬到 1000 萬美元的大致相同區域,那麼傑森,我們可能需要 1200 萬美元的淨收入。然後我們有銷售商品的成本——這就是數學。所以它真的只是算術。所以你說,我們需要什麼水平的銷售額來支付運營支出?淨值可能為 1200 萬美元。這就是 - 這個數字對我們來說並不可怕。
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
Oren Gabriel Livnat - MD & Senior Healthcare Analyst
All right. Well, I look forward to future results, and keep up the good work.
好的。好吧,我期待著未來的結果,並繼續努力。
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
We're losing questions, Oren. I think you got everybody's questions. We're listing questions out of the queue, but thank you.
我們失去了問題,奧倫。我想你得到了每個人的問題。我們將問題列在隊列之外,但謝謝。
Operator
Operator
I'd now like to turn the conference back to Al for closing remarks.
我現在想把會議轉回 Al 作閉幕詞。
Alfred F. Altomari - Chairman, President & CEO
Alfred F. Altomari - Chairman, President & CEO
Great. Thank you very much, operator. I'd like to take a couple of minutes to comment on the recent special meeting we had with our shareholders. To continue to execute on our business plan and achieve our objective for 2023 and beyond, it was really important that we regain our compliance with our NASDAQ listing and -- so to put us in a position to raise capital across a broader base of sources. While we believe the notable growth in 2022, it just wasn't enough to regain our compliance with NASDAQ listing standards in our first compliance period.
偉大的。非常感謝你,接線員。我想花幾分鐘時間評論一下我們最近與股東舉行的特別會議。為了繼續執行我們的業務計劃並實現我們 2023 年及以後的目標,我們重新遵守我們在納斯達克上市的合規性非常重要,這樣才能使我們能夠通過更廣泛的來源籌集資金。雖然我們相信 2022 年會出現顯著增長,但這還不足以讓我們在第一個合規期重新符合納斯達克上市標準。
We've been granted a second compliance period with NASDAQ, but we needed to obtain authorization by our shareholders to implement a reverse stock split. If and when the Board believes it's the right time, we explored all -- to let the shareholders know, we explored all the available -- all options available to us before concluding that our ability to implement a reverse stock split puts the company in potentially the best position to regain the NASDAQ listing requirements and to appeal to a broader base of investors and to improve the perception of our common stock and overall, the investment and -- with the investment community -- the scrutiny by the investment community.
我們已獲得納斯達克的第二個合規期,但我們需要獲得股東的授權才能實施反向股票分割。如果董事會認為時機成熟,我們會探索所有——讓股東知道,我們探索了所有可用的——所有可供我們選擇的選項,然後得出結論認為我們實施反向股票拆分的能力可能會使公司陷入困境重新獲得納斯達克上市要求並吸引更廣泛的投資者基礎並改善我們普通股和整體投資的看法以及 - 與投資界 - 投資界的審查的最佳位置。
So we would take a minute to thank our shareholders for your understanding of this issue. It was a challenging issue for us to think through that -- we really appreciate your support and your understanding and your support of this important resolution. So we just want to say thanks. And we're just off to a great start in '23. We're proud of 2022. We're off to a great start in '23, and we're not going to sleep until we hit the commitments we've given you. We take pride in that. And the ultimate prize is to grow a sustainable business that generates strong cash. So thank you to the shareholders, and thank you for those that are following us. We really do appreciate it. So thank you.
因此,我們要花一點時間感謝我們的股東對這個問題的理解。考慮到這一點對我們來說是一個具有挑戰性的問題——我們非常感謝您對這一重要決議的支持、理解和支持。所以我們只想說聲謝謝。我們剛剛在 23 年有了一個良好的開端。我們為 2022 年感到自豪。我們在 23 年有了一個良好的開端,在我們履行給您的承諾之前我們不會睡覺。我們為此感到自豪。最終的獎勵是發展可持續的業務,產生大量現金。因此,感謝股東們,感謝那些關注我們的人。我們真的很感激。所以謝謝。
Operator
Operator
This concludes today's conference call. Thank you for participating. You may now disconnect. Everyone, have a great day.
今天的電話會議到此結束。感謝您的參與。您現在可以斷開連接。大家,祝你有美好的一天。