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Operator
Ladies and gentlemen, thank you for standing by. Welcome to the Cutera, Inc., second quarter 2009 earnings conference call. During today's presentation, all parties will be in a listen-only mode. Following the presentation the conference will be open for questions. (Operator Instructions). This conference is being recorded today, Monday, August 3rd, 2009. I'd now like to turn the conference over to John Mills. Please go ahead, sir.
John Mills - IR
Thank you. By now everyone should have access to the second quarter 2009 earnings release which went out today at approximately 4:00 PM Eastern Time. The release is available on the Investor Relation's portion of Cutera's website at Cutera.com and with its Form 8K filed today with the SEC and available on its website at SEC.gov. Before we begin, Cutera would like to remind everyone that these prepared remarks contain forward-looking statements, including statements concerning: domestic and international growth opportunities and strategies, future spending, expense management and execution on various aspects of our operations and business, expectations for increasing revenue, generating additional cash and regaining profitability, the development and commercialization of existing and planned products, and also management may make additional forward-looking statements in response to your questions.
These forward-looking statements do not guarantee future performance and therefore you should not rely on them in making investment decision without considering the risk associated with such statements. Cutera also cautions you to not place undue reliance on forward-looking statements which speak only as of the date they were made. Cutera undertakes no obligation to update publicly any forward-looking statements to reflect new information, events or circumstances after the date they were made or to reflect the occurrence of unanticipated events. For a complete list of risk factors that could cause Cutera's actual results to differ materially from the forward-looking statements, please refer to the section entitled risk factors in our most recently filed 10Q August 3rd, 2009, with the Securities and Exchange Commission. With that, I'll turn the call over to the Company's President and Chief Executive Officer, Mr. Kevin Connors. Go ahead, Kevin.
Kevin Connors - President, CEO
Thank you, John. Good afternoon, everyone, and thanks for joining us today to discuss Cutera's results for the second quarter ended June 30, 2009. On today's call I'll provide an overview of our results and Ron Santilli, our CFO, will provide additional details on our operating and financial results. Finally I'll provide some closing comments and open the call to your questions. Our revenue in the second quarter of 2009 was $11.7 million or 53% lower than the $24.8 million reported in the second quarter of 2008. Even though revenue declined our cash flow from operations was breakeven in the second quarter, as our net loss was offset primarily by reductions in accounts receivable and inventory balances. In addition, we ended the quarter with almost $105 million in cash and investments with no debt.
We believe our customers continue to expand demand for our products, however many of our current and prospective customers are reluctant to spend significant amount of money on capital equipment during these unstable economic times. As we recently announced, we're pleased that Chris West will be leading our North American sales organization, and in addition to the leadership change we plan on implementing the following key initiatives: enhance preliminary development and improve our clinical selling efforts, refocus the messaging of our product offerings and penetrate the core physician market, greater emphasis on sales training, which we believe is of particular importance now that we are targeting dermatologists and plastic surgery physicians.
With these important changes and initiatives, we expect to capture a larger portion of the laser light based aesthetic market. This will also strategically position us to return to increased growth rates as the market recovers from its economic slump. We are experiencing some signs of softness in our international business which are reflected in our recent quarters revenue performance. Although the overall international revenue is less than expected, we are pleased with the revenue contribution from Australia and some of the other companies where we are represented by distributors. During the second quarter 2009 we had expenses associated with restructuring charges, bad debt expense and higher than normal non-cash stock-based compensation charges that we do not expect will recur in the second half of 2009. Ron will explain these in more detail later.
Due to our restructuring efforts during the past six months beginning in the third quarter we expect profitability to be achieved in the $15 million per quarter revenue range. We are continuing to evaluate our spending decisions in light of the current environment, but are committed to retaining strong talent to be prepared to take advantage of growth opportunities when the market conditions improve. I'd like to point out that we have not reduced any sales territory since the beginning of the year and have materially changed R&D headcount. We will continue to manage our expenses carefully during these uncertain times and make appropriate decisions in an effort to better align our expenses with the current revenue. In the current market environment we believe the core market of dermatologists, plastic surgeons and other established medical offices provides us with the best opportunities in the industry. Therefore, we are actively focusing our sales, marketing and new product development efforts on the segment of our market. During the second quarter 2009 almost 50% of our US orders were sourced from these core physicians.
Turning to research and development, we're continuing to develop innovative solutions and expand the clinical understanding and applications of our current products. We believe that strategic ongoing investments of product research and development are critical to our future success. In line with that principle we are continuing to invest in R&D. We are pleased with the planned commercialization of our Adjustable Depth Selectivity, or ADS, technology previewed at the American Academy of Dermatology Meeting in San Francisco. This latest innovation is a culmination of five years of clinical research and collaboration for non-invasive body contouring. The two key features are the ability to successfully target and heat fat cells and to vary treatment depth within the fat. These combined effects are expected to result in non-invasive body contouring for a wide range of patients.
During the second quarter we expanded our clinical investigation and are continuing to follow the progress of these subjects. We believe that our extensive portfolio of existing products and continuing investments in R&D will position us well to take advantage of growth opportunities once the market becomes more stable. Now I'd like to turn the call over to Ron to discuss our financials in more detail.
Ron Santilli - CFO
Thanks, Kevin. And thanks to all of you for joining us today on our second quarter 2009 conference call. Second quarter 2009 revenue was $11.7 million, a 53% decrease when compared to the second quarter of 2008. Net loss for the second quarter of 2009 was $2.4 million or $0.18 per diluted share. Included in this net loss is approximately $1.5 million or $0.07 per share net of tax relating to unusual operating expenses that are not expected to recur in the second half of 2009. The breakdown of those expenses was as follows: approximately $650,000 for restructuring charges associated with our April headcount reduction, approximately $500,000 for bad debt expense, primarily related to a leasing source that has significant financial problems and unable to pay us, and approximately $300,000 of stock-based compensation associated with fully-vested shares recently granted to our outside Board of Directors.
Product revenue in the second quarter of 2009 decreased 69% when compared to product revenue in the second quarter of 2008. We believe the global recession continues to affect our industry and customer purchasing decisions, thereby having an adverse effect on sales of new systems. Upgrade revenue for the second quarter of 2009 decreased 44% when compared to upgrade revenue in the second quarter of 2008, due to the global recession; however our customers continue to express interest in our Pearl and Pearl Fractional products and as such they represent an increasing percentage of our upgrade revenue. The clinical results of our Pearl Fractional products are exceeding our expectations, and we will continue our focus on selling to the core specialties and building relationships with that market segments opinion leaders.
Service revenue for the second quarter of 2009 increased by 26% to $3.4 million compared to the second quarter of 2008. Our second quarter 2009 service revenue growth was attributable to increased service contract amortization resulting from an increase install base of customers. Although our service revenue growth varies from quarter to quarter, over the long term, this revenue category has shown consistent growth.
Titan refill revenue for the second quarter of 2009 decreased 10% to $1.4 million compared to the second quarter of 2008. Revenue generated from Titan refills remained fairly flat during the past six quarters. We believe this represents solid patient demand. A significant percentage of our revenue is sourced from existing customers. During the second quarter of 2009 over 50% of our revenue was derived from sales of service, upgrades and Titan refills. We remain committed to strong customer satisfaction and believe we will continue to realize revenue growth from our annuity revenue categories once the economy becomes more stable. I will now address our operating performance.
Our gross margin in the second quarter of 2009 was 56%. This rate is lower than the 59% rate in the first quarter of 2009, due primarily to lower revenue which resulted in reduced leverage of our fixed manufacturing and service expenses, higher service in Titan refill revenue as a percentage of total revenue which has a lower gross margin, and higher international distributer revenue which has lower gross margins. To help you with modeling of our current business we expect gross margins to be in the 60% range when quarterly revenue is approximately $15 million due to the leverage in our business model. Sales and marketing expenses decreased by $4.3 million or 41% from $10.4 million in the second quarter of 2008 to $6.1 million in the second quarter of 2009. As a percentage of revenue the expenses were 52% in the second quarter of 2009 and 42% in the second quarter of 2008. A decrease in expenses in the second quarter 2009 in absolute dollars was due primarily to our downsized sales and marketing organizations in North America and reduced commissions expense. As we increased our revenue we expect our sales and marketing expenses as a percentage of revenue to decline in the second half of 2009.
Research and development expenses declined $.5 million or 25% from $2 million in the second quarter of 2008 to $1.5 million in the second quarter of 2009. This expense reduction was primarily due to reduced material spending resulting from our current project timing, whereby our current efforts are mostly labor rather than material expense intensive. We expect to increase our spending in the future, keeping with our continuing committment to develop and commercialize innovative products and applications. General and administrative expenses increased by over $600,000 from $3 million in the second quarter of 2008 to $3.6 million in the second quarter 2009. The increase in this spending is primarily attributable to: approximately $500,000 of bad debt reserve mostly related to the leasing source that had significant financial problems and is unable to pay us, approximately $300,000 of higher non-cash stock-based compensation expenses for fully vested shares granted to our outside Board of Directors, and approximately $135,000 of general administrative restructuring charges were attributable to our April headcount reduction. As a reminder for the total Company, our restructuring charges were approximately $650,000. Offsetting these increases were primarily lower legal, audit and tax consulting fees.
Interest and other income net was $511,000 in second quarter of 2009 compared to $857,000 in the second quarter of 2008. The lower income is due primarily to lower interest yields on our cash and marketable investments. Also in the second quarter of 2009, we recorded net foreign exchange gains of approximately $130,000 which primarily resulted from a devalued US dollar relative to our foreign subsidiary assets. Our effective income tax rate for the second quarter of 2009 was 43%. For modeling purposes we suggest using an effective income tax rate of approximately 43% for the remainder of the quarters in 2009.
Turning to the balance sheet, our financial position remains strong. As of June 30, 2009, we had $104.9 million in cash, marketable securities and long term investments with no debt. This represents almost $8 per outstanding share. In the second quarter, our cash and investments balance increased by $1.9 million due to the redemption of $3.9 million of our higher risk auction rate securities which were redeemed at their par value of $3.9 million. As of June 30, 2009, we had $7.6 million of auction rate securities per quarter on our balance sheet that had a par value of $9.3 million. We are pleased that our cash flow from operations was breakeven in the second quarter as our net loss was offset primarily by reductions in our accounts receivable and inventory balances.
Net of accounts receivable at the end of the first quarter 2009 were $2.8 million and the DSOs were 22 days. Our DSOs continue to remain strong and were better than our targeted 35 to 45 days due to a thorough credit approval process and strong collection efforts. Inventories decreased $1.1 million from March 31, 2009, to June 30, 2009. We are comfortable with this quarterly inventory position and remain diligent in our efforts to continue further reductions during the second half of 2009. Now that I've concluded my overview of Cutera's financial performance, I'll turn the call back to Kevin.
Kevin Connors - President, CEO
Thanks, Ron. Our focus on the next few quarters will include, one, continuation of our marketing and clinical work on our Pearl and Pearl Fractional products with a heightened focus on dermatology and plastic surgeon offices. Our clinical results for these products are continuing to exceed our expectations and we remain excited about the opportunities these applications present to practitioners and their patients. Two, efficient launch of our planned body contouring product. Three, increased emphasis on our North American luminary development, clinical selling and sales training. While the near term prospects for our industry are difficult to predict due to economic uncertainty we believe our worldwide distributer network, strong balance sheet with almost $105 million in cash and investments with no debt, a broad portfolio of products and various research and development projects underway offer continuing long term growth opportunities for our Company. Now I'd like to open the call for your questions. Operator?
Operator
Thank you, sir. We will now begin the question and answer session. (Operator Instructions). One moment, please, for our first question. Our first question comes from the line of Tom Gunderson with Piper Jaffrey. Please go ahead, sir.
Tom Gunderson - Analyst
Hi, good afternoon. The economy is obviously not in our control and has been the major cloud here. Have you seen, Kevin, any correlation with sales in particularly hard hit parts of the country?
Kevin Connors - President, CEO
Hard to read the tea leaves that accurately, Tom. Typically, it tends to track our sales reps in the length of time they've been in their territory, and the strengths of their personal skills, but I can't say that we can see anything in terms of one part looking worse than the next.
Tom Gunderson - Analyst
International was a little lower than I'd expected and I'm wondering was there any -- you mentioned Australia and other distributor countries being strong. Were there any areas that were surprisingly weak?
Kevin Connors - President, CEO
Well, we had an international review meeting early in July, and from that, I think there was a sense that some of it is a timing issue, so I'm not sure we're ready to declare that our international business on a negative trajectory here. But clearly we're looking for higher production out of our direct operations and we've been fortunate to have pretty strong distributor business in the past and we think that will come back.
Tom Gunderson - Analyst
And then last question and I'll get back in queue, but the tone, and maybe I was hearing too much between the lines, but the tone was that second half will be better than Q2 is showing and that the restructuring and maybe we've gotten a bottoming here. Correct me if I'm getting the tone wrong, but if I'm getting it right what gives you, Kevin, confidence that there's light at the end of the tunnel here in 2009?
Kevin Connors - President, CEO
Well, Tom, I think we are focused on the overall market opportunity and certainly the aesthetic market has contracted pretty significantly, but we still see somewhere around a $700 million global opportunity, and for us to achieve say a 10% share of that is I think something that we think is reasonable, and if we were able to execute a crisp plan with the right people in place I think we could achieve that. From the expense side we've set the threshold down to $15 million a quarter to breakeven, and so we're looking to put together the right plan to go after that $700 million opportunity. And hopefully in the future that $700 million opportunity gets to be a bigger opportunity, but we think we should be able to achieve that.
Tom Gunderson - Analyst
Got it. Thanks.
Operator
Thank you. Our next question comes from the line of Anthony Vendetti with Maxim Group. Please go ahead.
Anthony Vendetti - Analyst
Thanks. I just wanted to follow-up first on that thought, Kevin, on the market share and so forth. You're targeting $15 million to breakeven. Is it safe to say that that is the revenue target for the third and fourth quarter?
Kevin Connors - President, CEO
Yes, Anthony, we aren't really giving any guidance about that. There has been a lot of moving parts in our market and the contraction rate has moved around quite a bit from quarter to quarter, so we're not providing any guidance moving forward, but as of the roll-up that we did when the Q1 results came in from the public companies, we could roll up about a $700 million market as of that time. So no, please don't read that to be revenue guidance estimate on our behalf.
Anthony Vendetti - Analyst
Okay. And on the body contouring product, you've been mentioning this and a lot of R&D efforts going into it. Can you get a little more specific regarding potential launch date and specifically what the product will encompass in terms of the applications?
Kevin Connors - President, CEO
Well, as we said in the script, we vastly expanded our clinical research and development efforts during the quarter and we're pleased with that. We have created -- seen a number of patients and we're following them to measure their progress. We have an FDA clearance for the product for treatment of cellulite and we're looking at continuing to expand our clinical understanding of the technology, and we'll have more to report after the third quarter.
Anthony Vendetti - Analyst
Okay, and then Ron, a couple questions on the financial side. International revenues, can you just give me what it was for the quarter and the year-over-year change, and then the FX gains, what did that contribute to the quarter in terms of dollars and EPS?
Ron Santilli - CFO
Sure. I think international was $7.1 million of revenue this quarter compared to a year ago in the same quarter it was $12.4 million or down 42%. Also, $7.1 million over the $11.7 million revenue number for the quarter represents 61% of our total revenue for the quarter. With regard to foreign exchange, we had about $130,000 of foreign exchange translation, foreign exchange income and our income statement primarily related to the devaluation of the US dollar against the euro and the Japanese yen.
Anthony Vendetti - Analyst
Okay. And lastly on the long term investments, you obviously have a very large cash on the balance sheet, cash and investments. How much of that, of the $105 million or $104.9 million, is long term investments?
Ron Santilli - CFO
The $7.6 million is long term investments and that's all auction rate security.
Anthony Vendetti - Analyst
Okay, and you have taken a write-off for that, so the $7.6 million that's left in auction rate securities, do you feel is an amount that you're comfortable with or an amount that won't require a future write-off?
Ron Santilli - CFO
Yes. That amount at par is worth $9.3 million so it's about a $1.7 million writedown thus far, and as you've seen over time, actually, we've been able to redeem some of our auction rate securities including the higher risk ones at par. So we're very comfortable with that valuation and hope at some point to actually receive even a higher value than what's on the balance sheet at this point.
Anthony Vendetti - Analyst
Okay, great. Thanks, I'll hop back in the queue.
Operator
Thank you. (Operator Instructions). Our next question comes from the line of Dalton Chandler with Needham & Company. Please go ahead.
Dalton Chandler - Analyst
Hi, good afternoon. Let me try to ask this question a little different way. Historically, the third quarter has been the seasonally weakest and it is usually down sequentially from the second quarter. Is there a reason you see that maybe that wouldn't happen this year?
Kevin Connors - President, CEO
Well, I think the trends have been [abhorrent] for the last three quarters, so it's hard to predict what the industry trends will look like, but you are correct that historically when the markets cooperate, the summer quarter tends to be a light one. We have basically looked at the business and the target that we've discussed earlier at $15 million, we think that on a normalized basis that's probably a good level for us to set our expense levels. While we have continued to monitor our expenses we did not initiate any material changes in headcount after the second quarter.
Dalton Chandler - Analyst
Okay. And you talked about interest in your products but reluctance to purchase, but I know financing has also been an issue. Can you talk about what's in the pipeline for new business that actually would like to purchase but just can't get financed?
Kevin Connors - President, CEO
Yes. So there's a finance issue, there's the appetite for making the major capital equipment a purchase, and then in the case of our business, for many years, we're extremely successful and targeting the non-core physician segment of the market, and in our case that accounted for about 80% of our business. And it's our belief that the non-core physicians don't have the appetite for making a major purchase like this moreso than what we're experiencing with the derms and plastics, so that's why on our calls we talk about the importance of us aligning with a healthier segment of the business. So that's where our exposure was. The leasing side, it is tougher, but we still find that people that have decent credit scores are able to get financing, but the thresholds certainly have gone the wrong direction.
Dalton Chandler - Analyst
Okay, and then --
Ron Santilli - CFO
It's just taking a lot longer to get financed than it did in the past, so that's causing customers to have more time to think during that purchasing process.
Dalton Chandler - Analyst
Okay. And then I know you don't like to I guess preview new products, but could you talk about at least the quantity of new products that might be in the pipeline? I know we're six months or so away from AAD at this point.
Kevin Connors - President, CEO
Well, we have multiple major endeavors underway, Dalton, and we do for competitive purposes refrain from discussing those. Our sales organization isn't even informed of those things, so obviously we want to keep silent to our investors as well.
Dalton Chandler - Analyst
Okay. The last question, can you just remind us how many sales territories you have in North America right now?
Ron Santilli - CFO
At the end of June we still had the 34 territories but with a few openings at that time.
Dalton Chandler - Analyst
Okay. Thanks a lot.
Operator
Thank you. At this time, I'm not showing any further questions. I would now like to turn the call back over to Kevin Connors. Please go ahead.
Kevin Connors - President, CEO
Thank you for participating in our call today. We look forward to seeing you at various investor events during the quarter and updating you on our third quarter conference call in November. Good afternoon and thanks for your continuing interest in Cutera.
Operator
Thank you. Ladies and gentlemen, that does conclude our conference for today. If you'd like to listen to a replay of today's conference call, please dial 303-590-3030 or 1-800-406-7325 using the access code 4110289.