Bioventus Inc (BVS) 2022 Q4 法說會逐字稿

Good day, and welcome to the Bioventus Inc. Fourth Quarter 2022 Earnings Conference Call. (Operator Instructions) Please note, this event is being recorded. I would now like to turn the conference over to Dave Crawford. Please go ahead.

美好的一天，歡迎來到 Bioventus Inc. 2022 年第四季度收益電話會議。 （操作員說明）請注意，正在記錄此事件。我現在想將會議轉交給 Dave Crawford。請繼續。

Thanks, [Betsy,] and good morning, everyone, and thanks for joining us. It's my pleasure to welcome you to the Bioventus 2022 Fourth Quarter Earnings Conference Call. With me this morning are Ken Reali, CEO; and Mark Singleton, Senior Vice President and CFO. Ken will begin his remarks with an update on our settlement agreement related to CartiHeal and the progress of our work streams to enhance our financial position. Next, we will review the quarter and provide commentary on the recent headwinds to our HA franchise.

謝謝，[Betsy]，大家早上好，感謝您加入我們。很高興歡迎您參加 Bioventus 2022 年第四季度收益電話會議。今天早上和我在一起的是首席執行官 Ken Reali；高級副總裁兼首席財務官 Mark Singleton。 Ken 將首先介紹我們與 CartiHeal 相關的和解協議的最新情況，以及我們為改善財務狀況而開展的工作流程的進展情況。接下來，我們將回顧本季度並對我們的 HA 特許經營權最近的逆風發表評論。

Mark will then offer further detail on our fourth quarter results. We will finish the call with Q&A. A presentation for today's call is available on the Investors section of our website, bioventus.com.

馬克隨後將提供有關我們第四季度業績的更多細節。我們將通過問答結束通話。我們網站 bioventus.com 的投資者部分提供了今天電話會議的演示文稿。

Before we begin, I would like to remind everyone that our remarks today may contain forward-looking statements that are based on the current expectations of management and involve inherent risks and uncertainties that could cause actual results to differ materially from those indicated. Including the risks and uncertainties described in the company's filings with the SEC Commission -- the SEC, including Item 1A Risk Factors in the company's Form 10-K for the year ended December 31, 2021, as well as our most recent 10-Q and our upcoming Form 10-K and other company filings made with the SEC.

在我們開始之前，我想提醒大家，我們今天的評論可能包含基於管理層當前預期的前瞻性陳述，並涉及可能導致實際結果與所示結果大不相同的固有風險和不確定性。包括公司提交給 SEC 委員會的文件中描述的風險和不確定性——SEC，包括公司 10-K 表格中截至 2021 年 12 月 31 日的第 1A 項風險因素，以及我們最近的 10-Q 和我們即將向美國證券交易委員會提交的 10-K 表格和其他公司文件。

You are cautioned not to place undue reliance upon any forward-looking statements, which speak only as of the date made. Although it may voluntarily do so from time-to-time, the company undertakes no commitment to update or revise the forward-looking statements whether as a result of new information, future events or otherwise, except as required by applicable securities laws.

請注意不要過分依賴任何前瞻性陳述，這些陳述僅代表截至作出之日的情況。儘管公司可能會不時自願這樣做，但公司不承諾更新或修改前瞻性陳述，無論是由於新信息、未來事件或其他原因，除非適用的證券法要求。

This call will also include references to certain financial measures that are not calculated in accordance with U.S. generally accepted accounting principles or GAAP. We generally refer to these as non-GAAP or adjusted financial measures. Important disclosures about and definitions and reconciliations of those non-GAAP financial measures to the most comparable metrics calculated and presented in accordance with GAAP are available in the earnings press release on the Investor Relations portion of our website at bioventus.com. And now I'll turn the call over to Ken.

此電話會議還將提及某些未根據美國公認會計原則或 GAAP 計算的財務指標。我們通常將這些稱為非 GAAP 或調整後的財務指標。關於這些非 GAAP 財務指標與根據 GAAP 計算和呈現的最具可比性指標的重要披露、定義和調節，可在我們網站 bioventus.com 投資者關係部分的收益新聞稿中找到。現在我會把電話轉給肯。

Thanks, Dave. Good morning, everyone, and thank you for your continued interest in Bioventus. Let me begin with an update on our recent actions to address the financial obligations for CartiHeal as well as the efforts across multiple work streams to enhance our financial position.

謝謝，戴夫。大家早上好，感謝您對 Bioventus 的持續關注。讓我首先介紹一下我們最近為解決 CartiHeal 的財務義務而採取的行動，以及為提高我們的財務狀況而在多個工作流中所做的努力。

At the end of February, we announced an agreement with CartiHeal's shareholders to eliminate the entire $350 million of deferred purchase obligations and sales milestone payments along with a release from all future claims or obligations to the CartiHeal shareholders. In exchange, we agreed to pay $10 million. The agreement also provided us with a 30-day window to evaluate options to sufficiently fund the $215 million of deferred purchase obligations to CartiHeal and retain the business.

2 月底，我們宣布與 CartiHeal 股東達成協議，取消全部 3.5 億美元的延期購買義務和銷售里程碑付款，並免除未來對 CartiHeal 股東的所有索賠或義務。作為交換，我們同意支付 1000 萬美元。該協議還為我們提供了一個 30 天的窗口來評估選項，以充分資助 CartiHeal 的 2.15 億美元延期購買義務並保留業務。

As we stated in our release announcing this agreement, we would only pursue funding the deferred obligations on an opportunistic basis in which terms were believed to be favorable to our stakeholders. Over the past month, we, together with our investment banking partner evaluated multiple pathways. In the end, our leadership and Board of Directors were unable to secure terms that met our criteria for retaining the business. While we are disappointed to move on from CartiHeal, we remained financially disciplined and declined to dilute our existing shareholders to raise the necessary capital.

正如我們在宣布該協議的新聞稿中所述，我們只會在機會主義的基礎上尋求為遞延債務提供資金，據信這些條款被認為對我們的利益相關者有利。在過去的一個月裡，我們與我們的投資銀行合作夥伴一起評估了多種途徑。最後，我們的領導層和董事會無法獲得符合我們保留業務標準的條款。雖然我們對離開 CartiHeal 感到失望，但我們仍保持財務紀律，並拒絕稀釋現有股東以籌集必要的資金。

Over the past several months, in conjunction with the effort to fund the CartiHeal obligation, we took action to enhance earnings and improve our balance sheet. First, restructuring our business to reduce costs; second, diligently prioritizing investment and aggressively managing remaining spending; third, evaluating the divestiture of noncore assets; and fourth, working with our banking partners to amend our debt agreement to provide covenant relief.

在過去的幾個月裡，結合為 CartiHeal 義務提供資金的努力，我們採取了增加收益和改善資產負債表的行動。首先，重組我們的業務以降低成本；二是認真安排投資重點，積極管理剩餘支出；第三，評估非核心資產的剝離；第四，與我們的銀行合作夥伴合作修改我們的債務協議以提供盟約減免。

In December, we announced a company-wide restructuring designed to simplify our organization and streamline processes while ensuring our actions avoided materially impacting revenue growth. During the first quarter, we completed the restructuring, and we anticipate generating $9 million to $10 million in annual savings going forward with the majority realized this year. Meanwhile, in building our annual plan for 2023, we prioritized investment in key near-term growth drivers for our business. We anticipate a year-over-year incremental investment of a few million dollars as we launch products like SONASTAR ELITE, BoneScalpel Access and L360 and the submission of TalisMann, our next-generation peripheral nerve stimulation device for 510(k) clearance.

去年 12 月，我們宣布了一項全公司範圍的重組，旨在簡化我們的組織和流程，同時確保我們的行動避免對收入增長產生重大影響。在第一季度，我們完成了重組，我們預計每年將節省 900 萬至 1000 萬美元，其中大部分將在今年實現。同時，在製定 2023 年年度計劃時，我們優先投資於我們業務的主要短期增長動力。隨著我們推出 SONASTAR ELITE、BoneScalpel Access 和 L360 等產品以及提交用於 510(k) 批准的下一代外周神經刺激設備 TalisMann，我們預計每年將增加數百萬美元的投資。

To help offset these investments, we have curtailed spending in other parts of our organization by reducing marketing, research and development and G&A.

為了幫助抵消這些投資，我們通過減少營銷、研發和 G&A 來削減組織其他部門的支出。

Next, we continue to explore divesting noncore assets and are actively engaged with counterparties around potential transactions. The potential divestitures vary in transaction size and multiple and the net proceeds would be used to repay debt. The agreement to remove the obligations related to CartiHeal allows us to remain disciplined in our negotiations, and we will not enter into any divestiture where we failed to receive what we believe to be an attractive value.

接下來，我們繼續探索剝離非核心資產，並圍繞潛在交易積極與交易對手接觸。潛在資產剝離的交易規模和倍數各不相同，所得款項淨額將用於償還債務。取消與 CartiHeal 相關義務的協議使我們能夠在談判中保持紀律，並且如果我們未能獲得我們認為具有吸引力的價值，我們將不會進行任何資產剝離。

Lastly, we recently reached an agreement with our lenders to provide covenant relief for our debt compliance for the fourth quarter of 2022 and additional covenant flexibility through the first quarter of 2024. Mark will provide you with additional details on this amendment. While we are disappointed in our inability to secure suitable financing for CartiHeal, our current business possesses multiple growth drivers and eliminating the obligations related to CartiHeal, along with the recent actions we have taken has significantly enhanced our financial position.

最後，我們最近與我們的貸方達成協議，在 2022 年第四季度為我們的債務合規提供契約減免，並在 2024 年第一季度提供額外的契約靈活性。馬克將為您提供有關此修正案的更多詳細信息。雖然我們對無法為 CartiHeal 獲得合適的融資感到失望，但我們目前的業務擁有多種增長動力，取消與 CartiHeal 相關的義務，以及我們最近採取的行動顯著改善了我們的財務狀況。

Now let me turn to our fourth quarter results. For the fourth quarter, revenue of $126 million, was down 4% compared to the same period a year ago. Our revenue and earnings for the quarter fell below our expectations as we experienced continued pressure across our HA franchise. Unanticipated rebate claims from one private payer, [United Optum], along with lower volume growth and decreased selling price across our HA businesses impacted our top line performance and placed pressure on our gross margin and overall profitability.

現在讓我談談我們的第四季度業績。第四季度收入為 1.26 億美元，比去年同期下降 4%。我們本季度的收入和收益低於我們的預期，因為我們的 HA 特許經營權持續面臨壓力。來自一家私人付款人 [United Optum] 的意外退稅索賠，以及我們 HA 業務的銷量增長放緩和銷售價格下降影響了我們的營收業績，並對我們的毛利率和整體盈利能力造成壓力。

Let me first address [United Optum's] unexpected rebate claims of approximately $4 million, which represent claims previously not billed to us. United Optum recently notified us that they had found these unbilled claims in their system through their internal audit of their rebate process in the fourth quarter, which revealed that they had underbilled us. We continue to work with United Optum to assess the validity of these claims and on the reporting of rebate claims in an effort to avoid future volatility.

首先讓我談談 [United Optum] 大約 400 萬美元的意外退稅索賠，這些索賠是以前沒有向我們收取的。 United Optum 最近通知我們，他們在第四季度對他們的回扣流程進行內部審計時，在他們的系統中發現了這些未開票的索賠，這表明他們向我們開出了少付的賬單。我們將繼續與 United Optum 合作，以評估這些索賠的有效性和退稅索賠的報告，以避免未來的波動。

Going forward, we would expect to see any similar dynamic to have a substantially lower impact on our results, given the renegotiated rebate rates that began in the third quarter and lower pricing on which the rebates are based.

展望未來，鑑於從第三季度開始重新協商的退稅率以及退稅所依據的定價較低，我們預計任何類似的動態對我們的業績的影響都會大大降低。

As we continue to be impacted by a significant increase in the percentage of volume of contracted business in DUROLANE and GELSYN related to private payer contracts, this is due to the lag in receiving invoices, which can be 2 to 4 quarters in arrears, consequently impacting our visibility to changing trends. The magnitude of this increase of $6 million to $7 million was above our expectations, and our team has worked with our private payers to review their claims data and understand the change.

由於我們繼續受到 DUROLANE 和 GELSYN 中與私人付款人合同相關的合同業務量百分比顯著增加的影響，這是由於收到發票的滯後，可能會拖欠 2 至 4 個季度，從而影響我們對不斷變化的趨勢的可見性。 600 萬至 700 萬美元的增幅超出了我們的預期，我們的團隊已與我們的私人付款人合作審查他們的索賠數據並了解變化。

In reviewing the information and through numerous discussions with the private payers, we have determined their invoices to be largely valid. As a result, our average selling price, or ASP, for both DUROLANE and GELSYN is now lower than previously expected.

在審查信息並通過與私人付款人的多次討論中，我們確定他們的發票基本有效。因此，我們現在的 DUROLANE 和 GELSYN 的平均售價或 ASP 低於之前的預期。

Due to the mechanics of how ASP is calculated, which is a 4-quarter look back that includes rebates paid, we expect that these larger rebate payments will continue to reduce our forecasted ASP throughout 2023. The extent of the quarterly reduction should lessen as the year progresses, and the higher rebate claims are removed from the calculation and replaced with significantly lower rebate claims due to our team's successful renegotiations with payers last year.

由於 ASP 的計算機制（包括支付的回扣在內的 4 個季度回顧），我們預計這些較大的回扣付款將在整個 2023 年繼續降低我們預測的 ASP。隨著隨著時間的推移，由於我們的團隊去年與付款人成功重新談判，較高的退稅申請已從計算中刪除，取而代之的是顯著較低的退稅申請。

Similar to the third quarter, the most significant impact to volume was in GELSYN, our 3-injection therapy. Given the competitive dynamics, volumes shifted above our expectations by $1 million to $2 million and more price-sensitive or non-contracted accounts. This results in a higher portion of our GELSYN revenue being in our contracted business, further increasing pressure on ASP.

與第三季度類似，對銷量影響最大的是我們的 3 次注射療法 GELSYN。考慮到競爭動態，交易量超出我們的預期 100 萬至 200 萬美元，以及更多對價格敏感或非簽約的客戶。這導致我們 GELSYN 收入的更高部分用於我們的合同業務，進一步增加了 ASP 的壓力。

As we progress into 2023, we expect the decline in our ASP will enable us to regain market share related to non-contracted volume. While we anticipate continued pressure on GELSYN revenue through 2023, we believe that the mechanics of ASP reporting will lead to GELSYN pricing stabilizing by the end of the year.

隨著我們進入 2023 年，我們預計 ASP 的下降將使我們能夠重新獲得與非合同量相關的市場份額。雖然我們預計到 2023 年 GELSYN 的收入將繼續面臨壓力，但我們相信 ASP 報告的機制將導致 GELSYN 的定價在年底前趨於穩定。

Meanwhile, revenue for DUROLANE, our clinically differentiated single-injection HA therapy was impacted less than GELSYN. While we experienced double-digit price loss, we continue to see double-digit volume growth. Overall, DUROLANE revenue declined high single digits for the quarter. As with GELSYN, we anticipate price erosion to subside as we progress through 2023. But given our competitive positioning, clinical differentiation and the continued market shift to single injection therapy, we anticipate continued strong volume growth, which should offset pricing pressure and lead to overall 2023 growth for DUROLANE.

同時，我們的臨床差異化單次注射 HA 療法 DUROLANE 的收入受到的影響小於 GELSYN。雖然我們經歷了兩位數的價格損失，但我們繼續看到兩位數的銷量增長。總體而言，本季度 DUROLANE 收入下降了高個位數。與 GELSYN 一樣，我們預計到 2023 年價格侵蝕將消退。但鑑於我們的競爭定位、臨床差異化以及市場持續向單一注射療法轉變，我們預計銷量將持續強勁增長，這將抵消定價壓力並導致整體DUROLANE 的 2023 年增長。

Across our HA portfolio, we believe market growth, combined with an increase in share from lower selling price will drive volume growth. However, we expect an overall reduction in HA revenue of high single to low double digits due to the impact of lower selling price. We do expect by Q4 '23 and Q1 '24 to begin to see a turnaround and an improvement in HA revenue growth driven by price stabilization and volume growth.

在我們的 HA 產品組合中，我們相信市場增長，加上較低售價帶來的份額增加，將推動銷量增長。然而，由於較低售價的影響，我們預計 HA 收入將整體減少高個位數到低兩位數。我們確實預計，到 23 年第四季度和 24 年第一季度，價格穩定和銷量增長將推動 HA 收入增長出現好轉和改善。

Now turning to Surgical Solutions, where we continue to deliver strong double-digit organic growth. OSTEOAMP Flowable, our injectable allograft bone graft substitute solution continues to drive rapidly -- to grow rapidly following its introduction last year. During the quarter, we fully launched BoneScalpel Access and combined with OSTEOAMP Flowable, we now offer a complete portfolio in minimally invasive spinal fusion, the fastest-growing area in spine.

現在轉向外科解決方案，我們繼續實現強勁的兩位數有機增長。 OSTEOAMP Flowable 是我們的可注射同種異體骨移植替代解決方案，自去年推出後繼續快速發展。在本季度，我們全面推出了 BoneScalpel Access 並與 OSTEOAMP Flowable 相結合，我們現在提供完整的微創脊柱融合產品組合，這是脊柱中增長最快的領域。

Additionally, our ultrasonics continues to grow double digits in the U.S. on a pro forma basis.

此外，我們的超聲波在美國繼續以兩位數的速度增長。

Finally, as we move into 2023, we forecast that our double-digit organic growth will continue because our overall smaller market share and market growth rates provide a strong backdrop for continued market penetration and growth. Within restorative therapies, organic revenue growth contracted mid-single digits, driven by a decline in Exogen. However, Exogen revenue grew mid-single digits sequentially and we see momentum building as we continue to re-engage with physicians after our sales force realignment at the start of 2022.

最後，隨著我們進入 2023 年，我們預測我們的兩位數有機增長將繼續，因為我們整體較小的市場份額和市場增長率為持續的市場滲透和增長提供了強大的背景。在恢復性療法中，受 Exogen 下降的推動，有機收入增長收縮了中等個位數。然而，Exogen 的收入連續增長了中個位數，我們看到勢頭正在增強，因為我們在 2022 年初的銷售人員調整後繼續與醫生重新接觸。

Within Advanced Rehabilitation, revenue grew despite the impact from the anticipated supply chain disruptions and regulatory approval challenges we discussed on our prior earnings call. Exiting the quarter, we received EU MDR approval for our Advanced Rehabilitation portfolio and resolved our domestic supply chain challenges.

在 Advanced Rehabilitation 中，儘管我們在之前的財報電話會議上討論了預期的供應鏈中斷和監管審批挑戰的影響，但收入仍在增長。本季度結束時，我們的高級康復產品組合獲得了歐盟 MDR 批准，並解決了我們國內供應鏈的挑戰。

Removing these headwinds should enable strong double-digit growth as we move into 2023. We expect this growth, combined with stability for Exogen will drive overall mid-single-digit growth for our entire Restorative Therapies portfolio.

隨著我們進入 2023 年，消除這些不利因素應該會實現強勁的兩位數增長。我們預計這種增長，加上 Exogen 的穩定性，將推動我們整個恢復性療法產品組合的整體中等個位數增長。

Finally, our International segment grew 13% on a reported basis, driven by our Misonix acquisition and strong organic growth for DUROLANE and our bone graft substitutes portfolio. Constant currency growth was 20%. Growth was negatively impacted due to the EU MDR-related regulatory headwinds in our Advanced Rehabilitation portfolio.

最後，我們的國際業務在報告的基礎上增長了 13%，這得益於我們對 Misonix 的收購以及 DUROLANE 和我們的骨移植替代品組合的強勁有機增長。恆定貨幣增長率為 20%。由於我們高級康復產品組合中與歐盟 MDR 相關的監管不利因素，增長受到了負面影響。

As we move into 2023, we anticipate above-market growth for our International segment as we realize the benefits of our broader portfolio.

隨著我們進入 2023 年，我們預計我們的國際業務將實現高於市場的增長，因為我們意識到我們更廣泛的投資組合的好處。

Finally, upon reflecting on the challenges and performance in the second half of 2022, we are shifting our attention and prioritization inwards as we focus on improving our execution, internal processes and operational efficiencies with the resolve to accelerate our margin profile, rebuild our balance sheet and regain investor confidence. These outcomes will come through: one, delivering on our annual operating plan where we achieve our sales plan, drive EBITDA growth and improve operating margins; two, completing our integration of Misonix and exploring additional financial savings across our business; and three, reducing working capital through decreased inventory and improved accounts receivable to drive cash flow.

最後，在反思 2022 年下半年的挑戰和業績後，我們正在將注意力和優先級向內轉移，因為我們專注於改善執行、內部流程和運營效率，決心加快我們的利潤率，重建我們的資產負債表並重拾投資者信心。這些成果將通過：第一，實現我們的年度運營計劃，實現我們的銷售計劃，推動 EBITDA 增長並提高運營利潤率；第二，完成我們對 Misonix 的整合，並在我們的業務中探索額外的財務節省；第三，通過減少庫存和改善應收賬款來減少營運資金，以推動現金流。

Despite recent challenges, Bioventus still retains a strong diversified business with market tailwinds. We have multiple growth drivers obtained through our recent acquisitions, such as our ultrasonic surgical solutions portfolio, peripheral nerve stimulation and Advanced Rehabilitation. Each of these should be coming to fruition over the next few years and enable us to accelerate growth by leveraging our leading medical devices, scale and commercial infrastructure. And we remain confident in our ability to deliver cost synergies from our acquisitions and improve our overall expense profile across the business to further bolster our margin profile.

儘管最近面臨挑戰，但 Bioventus 仍然保持著強大的多元化業務和市場順風。我們通過最近的收購獲得了多個增長動力，例如我們的超聲外科解決方案組合、周圍神經刺激和高級康復。這些中的每一個都應該在未來幾年內取得成果，並使我們能夠通過利用我們領先的醫療設備、規模和商業基礎設施來加速增長。我們仍然相信我們有能力通過收購實現成本協同效應，並改善我們整個業務的整體費用狀況，以進一步提高我們的利潤率。

Finally, over the course of the next several quarters, we look to regain your confidence in our ability to execute as our results improve, and we deliver on our commitments. Now I'll turn the call over to Mark.

最後，在接下來的幾個季度中，隨著我們業績的改善和我們兌現承諾，我們希望重新獲得您對我們執行能力的信心。現在我會把電話轉給馬克。

Thank you, Ken, and good morning, everyone. Let me begin with a review of our fourth quarter results. Revenue of $126 million, was a 4% lower compared to the prior year. On a constant currency basis, sales were down 3% compared to the prior year. We saw a 10-percentage point decline in organic revenue, along with a 6-percentage point increase related to our acquisition of Misonix.

謝謝你，肯，大家早上好。讓我首先回顧一下我們第四季度的業績。收入為 1.26 億美元，比上年下降 4%。按固定匯率計算，銷售額較上年下降 3%。我們發現有機收入下降了 10 個百分點，而與我們收購 Misonix 相關的收入增加了 6 個百分點。

Lower gross margin impacted our earnings as we generated adjusted EBITDA of $15 million and adjusted diluted earnings per share loss of $0.06.

較低的毛利率影響了我們的收益，因為我們產生了 1500 萬美元的調整後 EBITDA 和 0.06 美元的調整後攤薄每股收益損失。

Across Pain Treatments, sales declined 23% compared to the prior year as we faced unanticipated rebate claims and pricing pressure related to our HA franchise and a decline in volume for GELSYN, as Ken described earlier.

在 Pain Treatments 中，銷售額比上一年下降了 23%，因為我們面臨與我們的 HA 特許經營權相關的意外退稅索賠和定價壓力，以及 GELSYN 的銷量下降，正如 Ken 之前描述的那樣。

In Surgical Solutions, we grew 27%. We saw 14-percentage points of organic growth, representing 3 consecutive quarters of double-digit growth as we maintain momentum across both our Bone Graft Substitutes and Ultrasonics portfolios. The fourth quarter included a 13-percentage point contribution for 1-month related to Misonix ultrasonics portfolio.

在外科解決方案方面，我們增長了 27%。我們實現了 14 個百分點的有機增長，連續 3 個季度實現兩位數增長，因為我們在骨移植替代品和超聲波產品組合中保持了增長勢頭。第四季度包括與 Misonix 超聲波產品組合相關的 1 個月 13 個百分點的貢獻。

Finally, Restorative Therapies delivered 4% growth. Organic growth declined 6 percentage points as anticipated supply chain headwinds, along with the delayed receipt of EU MDR certification and Advanced Rehabilitation impacted revenue. Inorganic growth related to our wound portfolio acquired a year ago, totaled 10-percentage points.

最後，恢復性療法實現了 4% 的增長。由於預期的供應鏈逆風，以及歐盟 MDR 認證和高級康復的延遲收到影響了收入，有機增長下降了 6 個百分點。與我們一年前收購的傷口產品組合相關的無機增長總計 10 個百分點。

Moving down the income statement, adjusted gross margin of 71%, was 510 basis points compared to the prior year and was driven by 2 primary factors. First, we were impacted by the unanticipated rebate claims, the increased percentage of HA revenue going through private payers and the decline in our overall ASP, which Ken discussed earlier. Second, we had an unfavorable product mix given higher revenue from businesses recently acquired combined with the impact of lower revenue from Exogen.

向下移動損益表，調整後的毛利率為 71%，與上一年相比為 510 個基點，並受到 2 個主要因素的推動。首先，我們受到了意想不到的退稅索賠、通過私人付款人支付的 HA 收入百分比增加以及 Ken 之前討論過的整體 ASP 下降的影響。其次，鑑於最近收購的業務收入增加以及 Exogen 收入減少的影響，我們的產品組合不利。

Overall, adjusted total operating expenses were $1 million higher compared to the prior year as investments in selling and general and administrative expenses more than offset reductions in spending on research and development.

總體而言，調整後的總運營費用比上一年增加了 100 萬美元，這是因為對銷售和一般及管理費用的投資抵消了研發支出的減少。

Now turning to our bottom line financial metrics. Adjusted EBITDA totaled $15 million compared to $28 million in the prior year. Lower gross margin, as discussed a moment ago, drove the majority of the decline. Adjusted operating income decreased to $12 million from $22 million in the prior year. Adjusted net loss totaled $9 million compared to the income of $18 million a year ago due to lower gross profit and higher interest expense.

現在轉向我們的底線財務指標。調整後的 EBITDA 總計 1500 萬美元，而上一年為 2800 萬美元。正如剛才所討論的那樣，較低的毛利率推動了大部分下降。調整後的營業收入從上一年的 2200 萬美元減少到 1200 萬美元。由於較低的毛利和較高的利息支出，調整後的淨虧損總計 900 萬美元，而一年前的收入為 1800 萬美元。

Now for a brief recap of our full year results. Net sales increased to $512 million, a 19% increase compared to 2021. Organic sales increased 1% while the acquisitions of Bioness and Misonix contributed 18 percentage points of growth. For the year, adjusted EBITDA totaled $66 million. Adjusted gross margin for the year was 75% compared to 78% a year ago. Our 2022 adjusted gross margin reflects the impact of our Misonix acquisition along with a lower average selling price in the second half of the year in our HA franchise, which I mentioned previously.

現在簡要回顧一下我們的全年業績。淨銷售額增至 5.12 億美元，與 2021 年相比增長 19%。有機銷售額增長 1%，而對 Bioness 和 Misonix 的收購貢獻了 18 個百分點的增長。這一年，調整後的 EBITDA 總計 6600 萬美元。今年調整後的毛利率為 75%，而一年前為 78%。我們 2022 年調整後的毛利率反映了我們收購 Misonix 的影響，以及我之前提到的下半年 HA 特許經營權的平均售價較低。

Adjusted operating income for the year totaled $48 million compared to $85 million in 2021. The decrease is primarily due to lower gross margin discussed earlier and higher interest expense from increased debt and higher interest rates.

與 2021 年的 8500 萬美元相比，今年調整後的營業收入總計 4800 萬美元。下降的主要原因是之前討論的毛利率下降以及債務增加和利率上升導致的利息支出增加。

Now turning to the balance sheet and cash flow statement. We ended the quarter with $32 million of cash on hand and $418 million of debt outstanding. Our revolving credit facility remained undrawn at the end of the fourth quarter. Operating cash flow represented an inflow of $5 million for the quarter as we saw an improvement in the working capital. As Ken mentioned, we engaged our banking partners upon the termination of CartiHeal and have amended our debt agreement to provide additional headroom and leverage and interest coverage covenants beginning with the fourth quarter of 2022 and extending through the first quarter of 2024. Our covenants will revert back to their existing level for the second quarter of 2024. The amendment will increase the spread of our term loan by 100 basis points. Thus, we pay SOFR plus 425 basis points on our debt.

現在轉向資產負債表和現金流量表。本季度結束時，我們手頭有 3200 萬美元的現金和 4.18 億美元的未償債務。截至第四季度末，我們的循環信貸額度仍未動用。由於我們看到營運資金有所改善，因此本季度的運營現金流為 500 萬美元的流入。正如 Ken 所提到的，我們在 CartiHeal 終止後與我們的銀行合作夥伴進行了接觸，並修改了我們的債務協議，以提供從 2022 年第四季度開始到 2024 年第一季度的額外淨空、槓桿和利息覆蓋契約。我們的契約將恢復回到 2024 年第二季度的現有水平。修正案將使我們的定期貸款利差增加 100 個基點。因此，我們支付 SOFR 加上 425 個基點的債務。

We received relief against our financial covenants and project compliance through Q1 of 2024 based on our financial plan. However, our business will continue to carry a going concern qualification based on the risk. We will not be compliant with the covenants after the expiry of the relief and for qualitative factors that remain and may impact our ability to execute effectively, which we are in the process of addressing.

根據我們的財務計劃，到 2024 年第一季度，我們的財務契約和項目合規性得到了緩解。但是，我們的業務將繼續基於風險進行持續經營。在救濟期滿後，我們將不遵守契約，因為仍然存在並可能影響我們有效執行能力的定性因素，我們正在解決這些問題。

Finally, due to the timing from any upcoming potential divestitures and uncertainty around the amount of rebates related to our HA business, we have decided to delay establishing our 2023 sales and earnings guidance until the impact of these can be firmly quantified. However, as we end the first quarter, we would like to provide some color on our expectations for the quarter. We see revenue growth of low single digits compared to the prior year as strong growth across Surgical Solutions and Restorative Therapies is offset by a decline in Pain Treatments. Additionally, we expect adjusted EBITDA to be flat to slightly above the prior year.

最後，由於任何即將到來的潛在資產剝離的時間安排以及與我們的 HA 業務相關的回扣金額的不確定性，我們決定推遲制定 2023 年的銷售和收益指導，直到這些影響得到明確量化。然而，在我們結束第一季度時，我們想為我們對該季度的預期提供一些顏色。與上一年相比，我們看到收入增長較低個位數，因為手術解決方案和恢復療法的強勁增長被疼痛治療的下降所抵消。此外，我們預計調整後的 EBITDA 將持平或略高於上一年。

In closing, we are focused on enhancing our liquidity and improving our revenue forecasting and expanse management processes. Operator, please open the line for questions.

最後，我們專注於提高我們的流動性並改進我們的收入預測和擴張管理流程。接線員，請打開問題線路。

(Operator Instructions) The first question today comes from Alex Nowak with Craig-Hallum.

（操作員說明）今天的第一個問題來自 Alex Nowak 和 Craig-Hallum。

Okay. Great. Ken, I wanted to do a little bit of a reflecting question here. When you go back and look at the last several quarters, how did we go on the Pain Therapy business? How did we go from the CMS change not expecting to have an impact to it ultimately having a greatly lowering ASPs, impacting volume, impacting the rebate claims that we're seeing here today again. So I mean when you look back, just what did you and the team missed there?

好的。偉大的。肯，我想在這裡做一個反思性的問題。當你回顧過去幾個季度時，我們是如何開展疼痛治療業務的？我們是如何從 CMS 變化中走出來的，而不是期望它最終會大大降低 ASP，影響數量，影響我們今天再次在這裡看到的回扣索賠。所以我的意思是當你回顧過去時，你和團隊錯過了什麼？

Yes. Great question, Alex. And I think when we look at this, what we did not anticipate is largely the percent of contracted business that was going through on our HA business. Keeping in mind 2 factors there, when we ship an HA syringe out, we don't know if it's going to a contracted patient or a non-contracted patient. We don't have visibility to that for 2 to 4 quarters looking back. So as we move forward in the second half of 2022, we saw an unanticipated rise in our contracted business that was beyond what was modeled and beyond the trends that we had in the business.

是的。好問題，亞歷克斯。而且我認為，當我們審視這一點時，我們沒有預料到的主要是我們的 HA 業務所經歷的合同業務的百分比。牢記兩個因素，當我們運送 HA 注射器時，我們不知道它是給簽約患者還是非簽約患者。回顧過去的 2 到 4 個季度，我們看不到這一點。因此，隨著我們在 2022 年下半年向前邁進，我們看到我們的合同業務出現了意想不到的增長，這超出了建模的範圍，也超出了我們在業務中的趨勢。

This factor alone had a significant impact because when you look at this change from wholesale acquisition cost to ASP and then compound with a higher percent of contracted business that obviously not only weighs on higher rebate payments, which were not anticipated but obviously weighs on your ASP because that becomes part of the calculation on the quarter that the rebates paid.

僅這一因素就產生了重大影響，因為當您查看從批發採購成本到 ASP 的這種變化，然後與更高百分比的合同業務相結合時，這顯然不僅會影響更高的回扣付款，這不是預期的，而且顯然會影響您的 ASP因為這成為計算回扣支付季度的一部分。

Going forward, we do feel the lights at the end of the tunnel here. The renegotiated rebates are approximately on a broad basis, 65% lower in the ASP world. And as we go into the second half of 2023, we'll be paying those lower rebates. And that will have the ability to modify or really solidify our price and reduce the price decline and stabilize the price and increase the price as we get into 2024. But obviously, fundamentally on the business, we'll have a big financial difference paying the lower rebates. But that was the biggest issue, Alex, is not having the transparency relative to the amount of contracted business and seeing that increase off a slope that was not anticipated.

展望未來，我們確實感受到了隧道盡頭的燈光。重新協商的回扣大致在一個廣泛的基礎上，在 ASP 世界中低 65%。當我們進入 2023 年下半年時，我們將支付較低的回扣。這將有能力修改或真正鞏固我們的價格，減少價格跌幅，穩定價格，並在我們進入 2024 年時提高價格。但顯然，從根本上講，我們將有很大的財務差異來支付較低的回扣。但這是最大的問題，亞歷克斯，沒有相對於合同業務量的透明度，並且看到這種增長超出了預期。

And I want to continue around that when things start to improve. Because in the last quarter, it was expected during a 12-month after the CMS change went into place was when you start to see the headwinds start to abate, but now it's, call it, into 2024. So like from last quarter to this quarter, what changed there to now we're talking 2024 sort of improvement?

當事情開始好轉時，我想繼續這樣做。因為在上個季度，預計在 CMS 變更生效後的 12 個月內，你會開始看到逆風開始減弱，但現在，可以說是進入 2024 年。所以就像從上個季度到這個季度，那裡發生了什麼變化，現在我們正在談論 2024 年的改進？

When things get back to a growth, a stronger growth.

當事情恢復增長時，會出現更強勁的增長。

Yes. Well, first of all, the [WACC] rebates continue to impact our ASP through the first half of this year. And keep in mind, it's a 4-quarter look back. So due to the extent of the contracted business that we have and what we estimate now, the impact of the WACC rebates because it's a 4-quarter look back, becomes a longer process to actually fall off. So as we start getting to the end of fourth quarter of this year and first quarter of '24, those will be lessened that will cause price stability and actually our prices with GELSYN and DUROLANE to rise as we go through 2024. But really, what's driving that, Alex, and shifting that out is just the percent of contracted business that we have.

是的。好吧，首先，[WACC] 回扣在今年上半年繼續影響我們的平均售價。請記住，這是 4 個季度的回顧。因此，由於我們擁有的合同業務的範圍和我們現在的估計，WACC 回扣的影響因為它是 4 個季度的回顧，成為一個更長的實際下降過程。因此，當我們開始進入今年第四季度末和 24 年第一季度時，這些因素將會減少，這將導致價格穩定，實際上我們的 GELSYN 和 DUROLANE 價格會在 2024 年上漲。但實際上，什麼是亞歷克斯，推動它並將其轉移出去只是我們擁有的合同業務的百分比。

Okay. Got it. And then just a kind of a 2-part question here. I just want to confirm, CartiHeal is completely off the table. There are no further extensions that sit out there as of today? And then the second part of that is how should we be thinking about spin-offs? What is for sale? What are you willing to part with? What are you unwilling to part with?

好的。知道了。然後這裡只是一個由兩部分組成的問題。我只是想確認一下，CartiHeal 已經完全停用了。到今天為止沒有進一步的擴展嗎？然後第二部分是我們應該如何考慮分拆？出售什麼？你願意放棄什麼？你有什麼捨不得？

Yes. I would say with CartiHeal, yes, that is off the table. We have exhausted all possibilities there, and the team worked really hard to try to find solutions that made financial sense but those weren't forthcoming. So we are moving on from CartiHeal.

是的。我會說 CartiHeal，是的，那是不可能的。我們在那裡已經用盡了所有可能性，並且團隊非常努力地嘗試找到具有財務意義的解決方案，但這些解決方案並沒有出現。所以我們正在從 CartiHeal 繼續前進。

Regarding divestitures, we're not going to comment significantly on that. Obviously, we have a great business here at Bioventus and still a thriving business in all aspects with the headwind of HA, which will recede as we go through 2023. We'll provide more updates on divestitures if and when it occurs. But right now, we're focused on building our business the way it is. We got a solid business across multiple specialties in orthopedics that give us a lot of room and a lot of runway for continued growth, really based on market tailwinds that work in our favor for many years to come.

關於資產剝離，我們不會對此發表重大評論。顯然，我們在 Bioventus 有一項偉大的業務，並且在 HA 的逆風下仍然在各個方面蓬勃發展，隨著 2023 年的到來，這種逆風將會消退。如果資產剝離發生，我們將提供更多的更新信息。但現在，我們專注於按照現在的方式建立我們的業務。我們在骨科的多個專業領域擁有穩固的業務，這為我們提供了很大的空間和很多持續增長的跑道，真正基於未來許多年對我們有利的市場順風。

The next question comes from Robbie Marcus with JPMorgan.

下一個問題來自摩根大通的 Robbie Marcus。

This is Allen on for Robbie. I just had a question, I guess, looking out further to say, 2024, clearly, this year, you're still working through quite a few challenges. You were looking to stabilize quite a bit of the business. So when we look at in 2024 and kind of Bioventus and what should hopefully be a much cleaner slate, how should we think about your top line revenue generation capability as well as your ability to continue driving cost savings beyond the $9 million to $10 million in annual savings going forward.

這是艾倫替羅比。我只是有一個問題，我想，展望未來，2024 年，很明顯，今年，你仍在努力應對許多挑戰。您希望穩定相當一部分業務。因此，當我們在 2024 年和 Bioventus 的類型以及應該更清潔的名單時，我們應該如何考慮您的頂級創收能力以及您繼續推動成本節約超過 900 萬至 1000 萬美元的能力每年節省的費用。

Yes, Allen, I can comment, and I'll let Mark make a few comments as well. Obviously, we see a lot of ability to continue to drive growth and growth levers in our business, starts with Surgical Solutions in both our Ultrasonics portfolio, which is expanding with both the BoneScalpel Access launch and then this year, SONASTAR ELITE which is a next-generation tumor ablation product. And we continue to evolve in Bone Graft Substitutes, and the OSTEOAMP Flowable continues to penetrate the market in minimally invasive spinal fusions.

是的，艾倫，我可以發表評論，我也會讓馬克發表一些評論。顯然，我們看到有很多能力繼續推動我們業務的增長和增長槓桿，首先是我們超聲波產品組合中的外科解決方案，隨著 BoneScalpel Access 的推出和今年的 SONASTAR ELITE 的推出而擴展-一代腫瘤消融產品。我們在骨移植替代品方面繼續發展，並且 OSTEOAMP Flowable 繼續滲透微創脊柱融合市場。

Across the portfolio, Advanced Rehabilitation, we expect continued double-digit growth. That acquisition came through with our Bioness acquisition a couple of years ago. And also in that portfolio under Pain Treatments is peripheral nerve stimulation, where we expect in 2024 to launch the TalisMann, our next-generation peripheral nerve stimulation device.

在 Advanced Rehabilitation 的投資組合中，我們預計將繼續保持兩位數的增長。幾年前，我們通過收購 Bioness 完成了此次收購。在疼痛治療下的產品組合中還有周圍神經刺激，我們預計在 2024 年推出我們的下一代周圍神經刺激設備 TalisMann。

So those are some of the near-term growth drivers. As far as expenses, we continue to see opportunities across the business, largely to improve our processes as we consolidate the businesses that we've acquired, we see many opportunities to improve ourselves, improve accounts receivable, our working capital, as we mentioned on the call. But Mark might want to comment further.

所以這些是一些近期的增長動力。就支出而言，我們繼續看到整個業務的機會，主要是在我們整合所收購的業務時改進我們的流程，我們看到許多機會來改善自己，改善應收賬款，我們的營運資金，正如我們在電話。但 Mark 可能想進一步發表評論。

Yes. No, I agree with Ken's comments. I think first, we've done a really good job over the last few months of looking at ourselves in the mirror from a cost structure perspective and making those reductions and improving our efficiencies where we think that is needed the best and so that positions us well to fight some of the headwinds we do have from an HA perspective. And we're going to continue to look at that as we go through 2023. I mean as Ken said in his remarks, we need to be inward focused in 2023 and really figure out how we simplify our business through some of the divestitures that we're looking at, and that brings in cash flow, but it also brings in efficiencies within our organization and allows us to focus on the more important strategic businesses.

是的。不，我同意 Ken 的意見。我認為首先，在過去的幾個月裡，我們從成本結構的角度審視自己，並在我們認為最需要的地方進行了削減並提高了我們的效率，從而使我們處於最佳位置從 HA 的角度來看，我們可以很好地應對我們確實遇到的一些不利因素。我們將在 2023 年繼續關注這一點。我的意思是，正如 Ken 在他的發言中所說，我們需要在 2023 年專注於內部，並真正弄清楚我們如何通過我們的一些資產剝離來簡化我們的業務正在尋找，這帶來了現金流，但它也提高了我們組織的效率，並使我們能夠專注於更重要的戰略業務。

And so we'll continue to do that and continue to look at our cost structure, find out how we can simplify and reduce costs where necessary and then improve our processes, which is an important part of our success.

因此，我們將繼續這樣做，並繼續審視我們的成本結構，找出我們如何在必要時簡化和降低成本，然後改進我們的流程，這是我們成功的重要組成部分。

The next question comes from Kyle Rose with Canaccord.

下一個問題來自 Canaccord 的 Kyle Rose。

This is Caitlin on for Kyle. So just on Exogen, you noted on your last call that you thought Exogen's slower-than-expected recovery would remain for the rest of 2022. So what are your updated expectations now? And what's really giving you confidence in recovery in Exogen.

這是凱爾的凱特琳。因此，就 Exogen 而言，您在上次電話會議上指出，您認為 Exogen 的複蘇慢於預期將持續到 2022 年剩餘時間。那麼您現在的最新預期是什麼？什麼真正讓您對 Exogen 的恢復充滿信心。

Yes. Thanks for the question, Caitlin. We saw a nice sequential growth from Q3 to Q4 in Exogen which I think shows signs of stability. And what we expect from Exogen going forward is stability. We don't expect it to be a growth driver, but we expect low single-digit growth in Exogen. The market has come back nicely post pandemic. And that -- and this product, in particular, I think, was the slowest to recover. And then as we mentioned, we did reorganize our sales force in early 2022 that caused a shift in some of our Exogen business just based on relationship changes, and that has now matured the sales force that is driving this, has developed new relationships and rapport that's continued to drive improvement in our Exogen business overall.

是的。謝謝你的問題，凱特琳。我們看到 Exogen 從第三季度到第四季度的良好連續增長，我認為這顯示出穩定的跡象。我們對 Exogen 未來的期望是穩定性。我們預計它不會成為增長動力，但我們預計 Exogen 的個位數增長較低。市場在大流行後恢復得很好。而且 - 我認為特別是這個產品是恢復最慢的。然後正如我們提到的，我們確實在 2022 年初重組了我們的銷售隊伍，這導致我們的一些 Exogen 業務僅基於關係變化而發生轉變，現在推動這一變化的銷售隊伍已經成熟，已經發展了新的關係和融洽關係這繼續推動我們 Exogen 業務的整體改善。

So our hopes as we go into this year is really a low single-digit grower for our business.

因此，我們進入今年的希望實際上是我們業務的低個位數增長。

Great. And just on the unanticipated rebate claims, I know you talked last quarter a little bit about how you're trying to prevent these going forward. Can you maybe talk a little bit more about how you're doing that.

偉大的。就意外的回扣要求而言，我知道你上個季度談到了一些關於你如何試圖阻止這些事情發生的事情。你能不能多談談你是如何做到的？

Yes. We just -- we continue to -- yes, one, I would just emphasize what we talked about is the unknown amount of rebates in the future will be much less and a lot less material to our business. So that's a positive, number one. The second thing is continuing to invest in this area with additional scrutiny and analytics around this to make sure that we're anticipating that, further deeper analysis of the invoices that we receive and working with our different partners across the payers to understand each of those invoices and encourage and work with them to increase the integrity of the invoices that we're getting. So I think it's really a combination of all of those to improve our confidence going forward.

是的。我們只是 - 我們繼續 - 是的，一個，我只是強調我們所談論的是未來未知數額的回扣對我們的業務將越來越少。所以這是積極的，第一。第二件事是繼續在這一領域進行投資，圍繞這一點進行額外的審查和分析，以確保我們預期到這一點，進一步深入分析我們收到的發票，並與付款人的不同合作夥伴合作，以了解每一個發票並鼓勵並與他們合作，以提高我們收到的發票的完整性。所以我認為這真的是所有這些的結合，以提高我們前進的信心。

(Operator Instructions) The next question comes from Drew Ranieri with Morgan Stanley.

（操作員說明）下一個問題來自摩根士丹利的 Drew Ranieri。

This is [Anna] on for Drew. For 2023, I was wondering if there's anything you could give us on cadence through the year either on revenue or margins. Should we be thinking about seasonality similar to historical with the exception of Pain Treatments given the pricing headwind there?

這是德魯的[安娜]。對於 2023 年，我想知道您是否可以在全年的收入或利潤率方面為我們提供任何信息。鑑於那裡的定價逆風，我們是否應該考慮與歷史相似的季節性，但疼痛治療除外？

Yes. This is Mark. I'd say that we don't expect to have a lot different kind of revenue phasing, throughout the year wouldn't be a lot different than we've historically had. We don't expect any big spikes or troughs.

是的。這是馬克。我會說我們不希望有很多不同類型的收入階段，全年不會與我們歷史上有太大不同。我們預計不會出現任何大的峰值或低谷。

Great. And then for gross margin, should we be thinking about maybe low 70 as the right run rate going forward? Or maybe any color on the moving parts for gross margin into '23 would be helpful.

偉大的。然後對於毛利率，我們是否應該考慮將 70 低作為未來的正確運行率？或者，對於進入 23 年的毛利率，移動部件上的任何顏色可能都會有所幫助。

Yes. Well, I'm not going to get into a comment on that since we're not providing guidance but wouldn't expect it to be significantly different than what we've seen coming out of the fourth quarter.

是的。好吧，我不打算對此發表評論，因為我們沒有提供指導，但預計它不會與我們在第四季度看到的情況有很大不同。

This concludes our question-and-answer session. I would like to turn the conference back over to CEO, Ken Reali for any closing remarks.

我們的問答環節到此結束。我想將會議轉回給首席執行官 Ken Reali，聽取任何閉幕詞。

Well, thanks, everyone, for your continued interest in Bioventus. While near-term challenges remain in our business, we are confident in the revenue and earnings growth opportunities as we move through 2023. We participate in large growing markets and provide innovative differentiated products to our patients. Most importantly, we have a dedicated team of employees that are focused on our mission and stakeholder value creation.

好吧，謝謝大家對 Bioventus 的持續關注。雖然我們的業務仍然存在近期挑戰，但我們對 2023 年的收入和盈利增長機會充滿信心。我們參與了大型增長市場，並為我們的患者提供創新的差異化產品。最重要的是，我們擁有一支敬業的員工團隊，專注於我們的使命和利益相關者的價值創造。

In the coming quarters, we look to regain your confidence in our ability to execute and deliver on our commitments as we begin to improve our growth and margin profile to create stakeholder value. Thank you very much.

在接下來的幾個季度中，隨著我們開始改善增長和利潤狀況以創造利益相關者價值，我們希望重新獲得您對我們執行和兌現承諾的能力的信心。非常感謝。

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.

會議現已結束。感謝您參加今天的演講。您現在可以斷開連接。