electroCore, Inc. (ECOR) 2023 Q3 法說會逐字稿

Greetings and welcome to the electroCore Third Quarter 2023 earnings conference call. (Operator Instructions) It is now my pleasure to introduce your host, Dan Goldberger. Thank you, sir. You may begin.

您好，歡迎參加 electroCore 2023 年第三季財報電話會議。 （操作員說明）現在我很高興向大家介紹你們的主持人 Dan Goldberger。謝謝你，先生。你可以開始了。

Thank you all for participating in today's electroCore's earnings call. My name is Dan Goldberger. I'm the Chief Executive Officer of electroCore, and I am also a member of the Board of Directors. Joining me today is Brian Posner, our Chief Financial Officer. Earlier today, electroCore released results for the third quarter ended September 30, 2023. A copy of the press release is available on the company's website.

感謝大家參加今天的 electroCore 財報電話會議。我叫丹‧戈德伯格。我是 electroCore 的首席執行官，也是董事會成員。今天加入我的是我們的財務長布萊恩·波斯納 (Brian Posner)。今天早些時候， electroCore 發布了截至 2023 年 9 月 30 日的第三季業績。新聞稿的副本可在該公司網站上取得。

Before we begin, I'd like to remind you that management will make statements during the call that include forward-looking statements within the meaning of the federal securities laws, which are made pursuant to the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995. Any statements contained in this call that are not statements of historical fact to be deemed to be forward-looking statements.

在我們開始之前，我想提醒您，管理層將在電話會議期間發表聲明，其中包括聯邦證券法含義內的前瞻性聲明，這些聲明是根據《私人證券訴訟改革法案》的安全港條款制定的1995年。本次電話會議中包含的任何非歷史事實陳述的陳述均被視為前瞻性陳述。

All forward-looking statements including, without limitation, any guidance, outlook for future financial expectations or operational activities and performance, based upon the company's current estimates and various assumptions. These statements involve material risks and uncertainties that could cause actual results or events to materially differ from those anticipated or implied by these forward-looking statements.

所有前瞻性陳述包括但不限於基於公司當前估計和各種假設的未來財務預期或營運活動和績效的任何指導、展望。這些陳述涉及重大風險和不確定性，可能導致實際結果或事件與這些前瞻性陳述預期或暗示的結果或事件有重大差異。

And accordingly, you should not place undue reliance on these statements for a list of the risks and uncertainties associated with the company's business, please see the company's filings with the securities and exchange commission. Electrocore disclaims any intention or obligation, except as required by law to update or revise any financial projections or forward-looking statements, whether because of new information, future events or otherwise.

因此，您不應過度依賴這些聲明來獲取與公司業務相關的風險和不確定性列表，請參閱該公司向證券交易委員會提交的文件。 Electrocore 不承擔任何意圖或義務，除非法律要求更新或修改任何財務預測或前瞻性陳述，無論是因為新資訊、未來事件或其他原因。

This conference call contains time sensitive information, that is accurate only as of the live broadcast today, November 8, 2023. electroCore was founded in 2005 to commercialize the use of our proprietary non-invasive vagus nerve stimulation for medical and general wellness applications. The vagus nerve is the longest cranial nerve in the body, bringing information from the visceral organs to the brain.

本次電話會議包含時間敏感信息，僅截至今天（2023 年11 月8 日）直播時準確。electroCore 成立於2005 年，旨在將我們專有的非侵入性迷走神經刺激技術在醫療和一般健康應用中商業化。迷走神經是體內最長的腦神經，將內臟器官的訊息傳送到大腦。

Stimulating the vagus nerve affects many important autonomic functions in the brain and in the body, including neurotransmitter levels, inflammation levels and metabolism. Surgically implanted vagus nerve stimulators has been available from other companies for more than 40 years for chronic conditions like epilepsy and depression. So a large and growing database confirms the safety and efficacy of the technique.

刺激迷走神經會影響大腦和身體的許多重要自主功能，包括神經傳導物質水平、發炎程度和新陳代謝。其他公司則透過手術植入的迷走神經刺激器用於治療癲癇和憂鬱症等慢性疾病已有 40 多年的歷史。因此，一個龐大且不斷增長的資料庫證實了該技術的安全性和有效性。

Building on that science, electroCore pioneered non-invasive vagus nerve stimulation and our products are now available by prescription for certain headache conditions and without a prescription for general loans, we have a growing pipeline of additional indications that we plan to launch in the future. We're thrilled to report a fourth consecutive record revenue quarter with sales of $4.5 million for the three months ended September 30, 2023.

在此科學的基礎上，ElectroCore 率先推出了非侵入性迷走神經刺激技術，我們的產品現在可透過處方購買來治療某些頭痛病症，並且不需要一般貸款的處方，我們計劃在未來推出越來越多的其他適應症。我們很高興地報告，截至 2023 年 9 月 30 日的三個月銷售額連續第四個季度創紀錄，銷售額達 450 萬美元。

That's a 128% increase over the prior year and 27% increase sequentially, gross margins held steady at 85%. And Brian will discuss the financials in more detail later on during the third quarter, we strengthened our balance sheet by raising net proceeds of approximately $7.5 million, registered direct and private placements of equity to returning institutional and accredited investors and certain directors and officers.

比上年增長 128%，比上一季增長 27%，毛利率穩定在 85%。布萊恩將在第三季稍後更詳細地討論財務狀況，我們透過籌集約750 萬美元的淨收益、向回歸機構和認可投資者以及某些董事和管理人員註冊直接和私募股權來加強我們的資產負債表。

We believe that our increased cash balance, along with potential future increases in revenue and continued discipline around operating expenses should provide us with enough runway to operate our business through 2024 and beyond.

我們相信，我們增加的現金餘額，加上未來收入的潛在增長以及對營運支出的持續約束，應該為我們提供足夠的跑道來運營我們的業務到 2024 年及以後。

Our prescription headache business continues to grow worldwide. We launched two new nonprescription general wellness product lines in late 2022. The Vagus is a direct-to-consumer brand and tax and for human performance for our active duty military personnel. Both new brands continued to exceed our expectations in the third quarter and are driving excitement about the future.

我們的處方頭痛業務在全球持續成長。我們在 2022 年底推出了兩條新的非處方一般健康產品線。Vagus 是一個直接面向消費者的品牌，旨在為我們現役軍人提供稅收和人類表現。這兩個新品牌在第三季度繼續超越我們的預期，並引發人們對未來的興奮。

Vagus is currently available exclusively through our e-commerce platform at www.va.gov.com. We are positioning through Vagus as a direct to consumer general wellness product for stress relaxation, sleep and mental acuity. We are carefully managing our true Vagus advertising spend as we fine tune our messaging and explore various platforms.

Vagus 目前僅透過我們的電子商務平台 www.va.gov.com 提供。我們將 Vagus 定位為直接面向消費者的一般健康產品，用於緩解壓力、睡眠和精神敏銳度。我們正在仔細管理我們真正的 Vagus 廣告支出，同時微調我們的訊息傳遞並探索各種平台。

We held the total spend fairly constant from Q2 to Q3. So we're not surprised that sequential revenue was relatively flat in the quarter for the true Vagus brand, for vagus recorded net sales of $267,000 in the third quarter of 2023, in line with our second quarter 2023 to vagus revenues of $290,000 based on this continued success. We're making targeted investments in marketing for vagus and remain confident in our previous guidance that true vagus sales will be approximately $1 million for the full year 2023.

從第二季到第三季度，我們的總支出保持相當穩定。因此，我們對真正的Vagus 品牌本季的連續收入相對持平並不感到驚訝，因為Vagus 在2023 年第三季度的淨銷售額為267,000 美元，與我們基於此得出的2023 年第二季度Vagus 收入290,000 美元一致持續的成功。我們正在對迷走神經行銷進行有針對性的投資，並對我們先前的指導充滿信心，即 2023 年全年真正的迷走神經銷售額將約為 100 萬美元。

For the three months ended September 30, 2023, our revenue return on advertising spend, what the industry calls a media efficiency ratio or MER was 2.09, In other words, we're spending $1 to generate $2.09 of revenue. We're carefully monitoring through vagus return rates as well, which have decreased slightly to approximately 12% so far this year. We believe that the true vagus business can scale nicely and we can maintain or improve these metrics.

截至 2023 年 9 月 30 日的三個月，我們的廣告支出收入回報（業界稱為媒體效率比或 MER）為 2.09，換句話說，我們花費 1 美元產生 2.09 美元的收入。我們也仔細監測迷走神經回流率，今年到目前為止，迷走神經回流率已略有下降至約 12%。我們相信真正的迷走神經業務可以很好地擴展，並且我們可以維持或改進這些指標。

TAC-STIM for human performance is being sold to select Air Force, Special Forces and Army Special Forces units for accelerated training, sustained attention, reduced the key and improved mood as defined by the Air Force Research Laboratory or AFRL.

用於人類表現的 TAC-STIM 正在出售給選定的空軍、特種部隊和陸軍特種部隊單位，以按照空軍研究實驗室或 AFRL 的定義，加速訓練、持續集中註意力、減少音調並改善情緒。

No prescription is required and more information is available at www.tac-stim.com. We recorded $601,000 of TAC-STIM revenue in the third quarter of 2023, up from $311,000 in the second quarter of 2023 or in the nine months ended September 30th, 2023 we've already met our previously stated guidance of $1 million of revenue from detection brand for the full year 2023.

無需處方，更多資訊請造訪 www.tac-stim.com。我們在2023 年第三季的TAC-STIM 收入為601,000 美元，高於2023 年第二季的311,000 美元，或在截至2023 年9 月30 日的九個月內，我們已經達到了先前規定的檢測收入100 萬美元的指導目標2023年全年品牌。

Sales funnel for this product continues to grow as word spreads across active duty military units have the potential human performance benefits provided by TAC-STIM. In parallel, we're developing a second-generation product known internally as TAC-STIM 2.0 in collaboration with AFRL, and we continue to build prototypes for evaluation by our government research partners. We have stated before the revenue growth for this product line is likely to be lumpy as active duty units purchasing bulk for pilot deployment.

隨著 TAC-STIM 提供的潛在人類績效優勢在現役軍事部隊中的傳播，該產品的銷售管道不斷擴大。同時，我們正在與 AFRL 合作開發內部稱為 TAC-STIM 2.0 的第二代產品，並繼續建立原型以供政府研究合作夥伴進行評估。我們之前曾說過，由於現役部隊大量採購用於試點部署，該產品線的收入成長可能會不穩定。

Turning now to our prescription headache business, the VA/DoD hospital channel continues to be our largest customer. You'll recall that our gammaCore prescription therapy is free to patients covered by Veterans Administration benefits, representing about $9 million covered lives across approximately 1,300 health care facilities.

現在轉向我們的處方頭痛業務，退伍軍人管理局/國防部醫院管道仍然是我們最大的客戶。您可能還記得，我們​​的 gammaCore 處方療法對退伍軍人管理局福利覆蓋的患者免費，涵蓋約 1,300 個醫療機構的約 900 萬美元的生命。

Sales in the VA/DoD channel grew 135% from $1,167,000 in Q3 2022 to $2,737,000 in the third quarter of 2023. 141, VA and DoD military treatment facilities have purchased prescription gammaCore products through September 30, 2023, as compared to 113 through September 30, 2022. The VA hospital administration, headache centers of excellence or HCOE. estimates. Approximately 600,000 patients are being treated for headache in the VA hospital system.

VA/DoD 通路的銷售額成長了135%，從2022 年第三季的1,167,000 美元成長到2023 年第三季的2,737,000 美元。截至2023 年9 月30 日，VA 和國防部軍事治療設施已購買處方gammaCore 產品141 家，而截至9 月30 日為113 家，2022 年。退伍軍人管理局醫院管理部門，頭痛卓越中心或 HCOE。估計。大約 60 萬名頭痛患者正在 VA 醫院系統中接受治療。

Since we dispense approximately 4,000 gammaCore devices to veterans, that represents less than 1% of the total addressable market within the VA system. We look forward to continued penetration of this important channel. Our physician dispense cash paid channel, including GC direct and G concierge, grew 19% from $359,000 in the third quarter of 2022 to $427,000 in the third quarter of 2023. These channels have grown from 938 prescribers at the end of the third quarter of 22 to $2,599 at the end of the third quarter of 2023. We added 362 new prescribers during the third quarter of 2023.

由於我們向退伍軍人分發了大約 4,000 個 gammaCore 設備，因此這僅佔 VA 系統內總目標市場的不到 1%。我們期待繼續滲透這一重要管道。我們的醫生配藥現金付費管道（包括GC direct 和G concierge）成長了19%，從2022 年第三季的359,000 美元成長到2023 年第三季的427,000 美元。這些管道的處方人數從2020 年第三季度末的938 名處方者增加到22到 2023 年第三季末達到 2,599 美元。我們在 2023 年第三季增加了 362 名新處方者。

We believe that the increase in prescribers could be a leading indicator of future growth, last year we announced a distribution agreement with insurance health care that we believe will add more than $12.5 million covered lives within a select managed care health system. The business model, which earns is similar to how we work with the VA hospital system during handles adjudications billing and collections. While electroCore shipped directly to patients and provides in-servicing and patient support.

我們相信，處方者的增加可能是未來成長的領先指標，去年我們宣布了與保險醫療保健部門的分銷協議，我們相信這將在精選的管理式醫療保健系統中增加超過1,250 萬美元的承保生命。獲利的商業模式類似於我們在處理裁決、計費和收款期間與 VA 醫院系統的合作方式。 electroCore 直接運送給患者並提供服務和患者支援。

Our field sales team is responsible for educating clinicians within those managed care systems. We continue to work with turns on the implementation, and we are pleased to have recorded small initial revenue from this relationship during the third quarter of 2023. Our field sales function will continue developing champions within the market within the target managed care system, and we think variance could be a significant revenue source in 2024 and beyond.

我們的現場銷售團隊負責在這些管理式醫療系統中教育臨床醫生。我們繼續輪流實施實施，我們很高興在 2023 年第三季度從這種關係中獲得了少量的初始收入。我們的現場銷售職能將繼續在目標管理式醫療系統內開發市場冠軍，我們認為差異可能成為2024 年及以後的重要收入來源。

Revenue from channels outside the United States increased by 11% in USD to $464,000 in the third quarter of 2023 as compared to $417,000 for the third quarter of 2022. Most of our OUS revenue was generated in the United Kingdom by prescription gammaCore sales funded by the National Health Service or NHS, which increased 13% in local currency.

2023 年第三季度，美國以外通路的收入成長了 11%，達到 464,000 美元，而 2022 年第三季度為 417,000 美元。我們的大部分 OUS 收入來自英國的處方 gammaCore 銷售，該銷售由國家醫療服務體系（NHS），以當地貨幣計算增加了13%。

On October 17, 2023 we announced that gammaCore therapy will continue to be listed in the United Kingdom's National Health Service or in a NHS supply chain catalog for at least an additional two years through March 17, 2026, the listing, which commenced on June 4, 2019. We're scheduled to terminate on March 18, 2024.

2023 年 10 月 17 日，我們宣布 gammaCore 療法將在 2026 年 3 月 17 日之前繼續在英國國民醫療服務體系或 NHS 供應鏈目錄中繼續列名至少兩年，該列名於 6 月 4 日開始， 2019 年。我們計劃於2024 年3 月18 日終止。

Now turning to our clinical progress on October 24, 2023, we announced top line data from an abstract presented at the 2023 American College of Gastroenterology Annual Meeting regarding the potential for nVNS to decrease the use of acute rescue medications for exacerbations of nausea due to gastroparesis GP. or functional dyspepsia SD.

現在轉向我們2023 年10 月24 日的臨床進展，我們宣布了2023 年美國胃腸病學會年會上提交的摘要中的主要數據，內容涉及nVNS 減少因胃輕癱引起的噁心加重的急性救援藥物的使用的潛力全科醫生。或功能性消化不良SD。

studies entitled noninvasive vagus nerve stimulation reduces nausea, rescue medication in patients with gastroparesis and related disorders with additional benefits on multiple other associated symptoms. Primary endpoint was reducing anti-diarrheal medications. On October 10, 2023, we announced top-line data from two abstracts that were presented at the 15 World Stroke Congress on the possible role of nVNS in the treatment of acute neurological injuries.

題為「非侵入性迷走神經刺激可減少胃輕癱及相關疾病患者的噁心、搶救藥物，並對多種其他相關症狀帶來額外益處」的研究。主要終點是減少抗腹瀉藥物的使用。 2023 年 10 月 10 日，我們公佈了在第十五屆世界卒中大會上提交的兩份摘要的主要數據，內容涉及 nVNS 在治療急性神經損傷中的可能作用。

The first trial entitled non-invasive vagus nerve stimulation is safe and efficacious in the treatment of headache associated with subarachnoid hemorrhage, VANQUISH, was conducted at Northwell Health in New York and showed a significant reduction in the overall pain score and a 14% decrease in the average morphine equivalent doses after two weeks of treatment as well as a trend towards a three day decrease in average hospital stay.

第一項名為「非侵入性迷走神經刺激治療蜘蛛網膜下腔出血相關頭痛安全有效」的試驗 VANQUISH 在紐約 Northwell Health 進行，結果顯示整體疼痛評分顯著降低，疼痛評分降低 14%。治療兩週後的平均嗎啡當量劑量以及平均住院時間三天減少的趨勢。

Second study entitled non-invasive vagus nerve stimulation in acute ischemic stroke or NOVIS is a prospective randomized clinical trial with blinded outcome assessment being conducted at the Leiden University Medical Center. A 150 patients with ischemic stroke are being randomly allocated one to one to invasive an edge for five days in addition to standard treatment versus standard treatment alone.

第二項研究題為“急性缺血性中風的非侵入性迷走神經刺激”或“NOVIS”，是一項前瞻性隨機臨床試驗，在萊頓大學醫學中心進行了盲法結果評估。 150 名缺血性中風患者被隨機一對一地分配到侵入性邊緣，除了標準治療外，還接受單獨的標準治療，為期五天。

On September 27, 2023, we announced the publication of two peer-reviewed publications supporting gammaCore NDNS. in patients with post-traumatic stress disorder or PTSD. Both studies were conducted at Emory University and were published in the peer-reviewed journal of affective disorders. First, publication effect of transcutaneous cervical vagus nerve stimulation on declarative and working memory in patients with posttraumatic stress disorder or PTSD was conducted under the direction of Dr. Bremner with the support of Emory University, the Georgia Institute of Technology and the Atlanta Veterans Affairs Medical Center.

2023 年 9 月 27 日，我們宣佈出版兩篇支持 gammaCore NDNS 的同儕審查出版品。創傷後壓力症候群或 PTSD 的患者。這兩項研究均在埃默里大學進行，並發表在同行評審的情感障礙雜誌上。首先，在Bremner 博士的指導下，在埃默里大學、佐治亞理工學院和亞特蘭大退伍軍人事務醫學中心的支持下，發表了經皮頸迷走神經刺激對創傷後壓力症候群或PTSD 患者的陳述性記憶和工作記憶的影響。中心。

And was sponsored by a Department of Defense Small Business Technology Transfer grant studies suggested the transcutaneous Vagus Nerve Stimulation improves attention and declarative in working memory in patients with PTSD as measured by multiple endpoints. The second published peer-reviewed manuscript entitled transcutaneous vagal nerve stimulation, modulate stress induced plasma granulin levels. A double-blind randomized sham-controlled trial concluded the transcutaneous Vagus Nerve Stimulation could reduce the levels of granulin in response to various stress will stimulate growth is a neuro peptide hypothesized to be involved in this stress response.

由國防部小型企業技術轉移資助的一項研究表明，經皮迷走神經刺激可改善 PTSD 患者工作記憶的注意力和陳述性（透過多個終點測量）。第二篇發表的同行評審手稿題為經皮迷走神經刺激，調節壓力誘導的血漿顆粒蛋白水平。一項雙盲隨機假對照試驗的結論是，經皮迷走神經刺激可以降低顆粒蛋白的水平，以應對各種壓力，刺激生長，這是一種假設參與這種壓力反應的神經肽。

If you recall, the FDA previously awarded prescription gammaCore breakthrough designation to treat the symptoms of PTSD and both publications provide important data that may be leveraged as we work with the agency towards a five 10-K, denovo clearance for APTSV.

如果您還記得，FDA 先前授予了治療PTSD 症狀的處方gammaCore 突破性稱號，這兩份出版物提供了重要數據，在我們與該機構合作爭取APTSV 的5 個10-K、從頭清除時可以利用這些數據。

Indicated on July 6, 2023, we announced that the NFL and NFL Players Association jointly awarded two grants independent medical researchers at the American Society of Pain and Neuroscience ASPN. and Emory University to fund investigations into innovative first of their kind alternative pain management methods that could benefit NFL players and society at large, the study is actively enrolling investigators and will continue to provide updates about the NFL and NFLPA study. Our pipeline and other opportunities in coming months.

2023 年 7 月 6 日，我們宣布 NFL 和 NFL 球員協會聯合向美國疼痛和神經科學協會 ASPN 的獨立醫學研究人員授予兩項資助。該研究與埃默里大學合作資助首個創新性替代疼痛管理方法的研究，該方法可能使NFL 球員和整個社會受益，該研究正在積極招募研究人員，並將繼續提供有關NFL 和NFLPA 研究的最新資訊.未來幾個月我們的管道和其他機會。

Now I'll turn the call over to Brian for a review of our financials and other guidance items. Brian?

現在我將把電話轉給布萊恩，以審查我們的財務狀況和其他指導項目。布萊恩？

Thank you, Dan. For the quarter ended September 30, 2023, electroCore reported net sales of $4.5 million compared to $2 million during the same period of 2022, which represents an approximately 128% increase over the prior year. The increase of $2.5 million is due to an increase in net sales across major channels, including the sale of our prescription gammaCore devices in the US and abroad, and revenue from the sales of our nonprescription general wellness for vagus and taxed in brands.

謝謝你，丹。截至 2023 年 9 月 30 日的季度， electroCore 報告淨銷售額為 450 萬美元，而 2022 年同期為 200 萬美元，比上一年增長約 128%。增加 250 萬美元是由於主要管道的淨銷售額增加，包括我們在美國和國外的處方 gammaCore 設備的銷售，以及我們用於迷走神經的非處方一般健康產品銷售和品牌徵稅的收入。

Total operating expenses in the third quarter of 2023 were approximately $8 million as compared to $7.3 million in the third quarter of 2022.

2023 年第三季的總營運費用約為 800 萬美元，而 2022 年第三季為 730 萬美元。

Research and development expense in the third quarter of 2023 was $1.2 million as compared to $1.6 million in the third quarter 2022. This decrease was due to a decrease in compensation associated with cost cutting measures offset by our targeted investments to support the next generation of the Company's non-invasive nerve stimulators.

2023 年第三季的研發費用為120 萬美元，而2022 年第三季為160 萬美元。這項減少是由於與成本削減措施相關的薪酬減少，但被我們支持下一代技術的目標投資所抵消。公司的非侵入性神經刺激器。

Selling, general and administrative expense in the third quarter of 2023 was $6.7 million as compared to $5.7 million in the third quarter of 2022. This increase was due to greater variable selling and marketing costs, consistent with our increase in net sales. GAAP net loss in the third quarter of 2023 was $4 million compared to the $5.5 million net loss in the third quarter of 2022.

2023 年第三季的銷售、一般和管理費用為 670 萬美元，而 2022 年第三季為 570 萬美元。這一增長是由於可變銷售和行銷成本增加，與我們淨銷售額的成長一致。 2023 年第三季的 GAAP 淨虧損為 400 萬美元，而 2022 年第三季的淨虧損為 550 萬美元。

Adjusted EBITDA net loss in the third quarter of 2023 was $3 million as compared to a net loss of $4.8 million in the third quarter of 2022. Our reconciliation of GAAP net loss to non-GAAP adjusted EBITDA. Net loss has been provided in the financial statement tables included in today's press release, cash, cash equivalents and restricted cash at September 30, 2023 totaled approximately $13.7 million as compared to approximately $18 million as of December 31, 2022. In July 2023, the company raised net proceeds of approximately $7.5 million through our registered direct offering and concurrent private placements price cap to market under NASDAQ rules.

2023 年第三季調整後 EBITDA 淨虧損為 300 萬美元，而 2022 年第三季淨虧損為 480 萬美元。我們對 GAAP 淨虧損與非 GAAP 調整後 EBITDA 進行了調整。今天新聞稿中包含的財務報表表格中已提供淨虧損，截至2023 年9 月30 日的現金、現金等價物和限制性現金總計約為1,370 萬美元，而截至2022 年12 月31 日約為1,800 萬美元。2023 年7 月，公司透過註冊直接發行和根據納斯達克規則同時進行的私募發行價格上限籌集了約 750 萬美元的淨收益。

Looking ahead for the full year 2023 we are increasing our net revenue guidance to $15 million to $15.5 million from $14 million to $15 million, representing more than 70% growth over 2022. And now I'll turn the call back over to Dan.

展望 2023 年全年，我們將淨收入指引從 1,400 萬美元提高到 1,500 萬美元到 1,550 萬美元，比 2022 年增長 70% 以上。現在我將把電話轉回給 Dan。

Thank you, Brian. I am very proud of our third quarter 2023 operating results and with the continued momentum in our prescription headache business and strong balance sheet. We continue to be enthusiastic about the company's long-term prospects across all brands and product lines. vagus continues to show tons of potential as a direct to consumer general wellness offering.

謝謝你，布萊恩。我對我們 2023 年第三季的經營業績以及我們的處方頭痛業務的持續成長勢頭和強勁的資產負債表感到非常自豪。我們繼續對公司所有品牌和產品線的長期前景充滿熱情。作為直接面向消費者的一般健康產品，迷走神經繼續顯示出巨大的潛力。

We've started with an e-commerce business model, which will continue to be the focus. And I look forward to launching a next-generation app enabled product platform next year. Our metrics remain strong through the first nine months of two vaguss sales. We will continue to monitor our KPIs and metrics and adjust our investments in all of our consumer channels as the year progresses.

我們已經從電子商務商業模式開始，這將繼續成為焦點。我期待明年推出下一代應用程式支援的產品平台。在兩次迷走銷售的前九個月中，我們的指標仍然強勁。隨著時間的推移，我們將繼續監控我們的關鍵績效指標和指標，並調整我們對所有消費者管道的投資。

Pipeline of interest from different branches of our active duty military continues to develop for our tax and products. The taxing brand is likely to be lumpy as active duty units purchased in bulk for pilot deployment. Longer term, we also believe that there may be civilian crossover as first responders, elite athletes, transportation workers, traders and e-gamers become aware of the human performance benefits published so far.

我們現役軍隊不同部門對我們的稅收和產品的興趣不斷發展。由於大量購買現役部隊進行試點部署，徵稅品牌可能會很不穩定。從長遠來看，我們也相信，隨著急救人員、精英運動員、運輸工人、貿易商和電子遊戲玩家意識到迄今為止公佈的人類表現優勢，可能會出現平民交叉。

Demand for our prescription gammaCore therapy in the VA/DoD channel continues to grow based on clinical performance and our increased presence in the field. We have about 35 straight commission sales agent entities, representing about 60,1099 reps in the field, managed by by our small team of territory business managers and supported by our customer experience team. This growing number of sales agents continues to open new facilities and increased the number of orders coming from existing accounts.

根據臨床表現和我們在該領域的影響力的增加，VA/DoD 管道對我們的處方 gammaCore 療法的需求持續增長。我們擁有約 35 個直接佣金銷售代理實體，代表該領域約 60,1099 名代表，由我們的區域業務經理小團隊管理，並由我們的客戶體驗團隊提供支援。越來越多的銷售代理繼續開設新設施，並增加來自現有帳戶的訂單數量。

Our sales and marketing expense increased by approximately $1 million in the third quarter of 2023 over the third quarter of 2022, while sales grew by $2.5 million signaling signaling that there may be real leverage opportunities in the P&L. Further out, we're working towards establishing additional indications for prescription gammaCore to treat post-traumatic stress disorder and or opioid use disorder look for new product launches in 2024, featuring our app enabled technology that can provide digital health solutions.

2023 年第三季度，我們的銷售和行銷費用比 2022 年第三季增加了約 100 萬美元，而銷售額成長了 250 萬美元，這表明損益表中可能存在真正的槓桿機會。此外，我們正在努力為治療創傷後壓力症候群和/或阿片類藥物使用障礙的處方gammaCore 確定更多適應症，並期待在2024 年推出新產品，其中採用我們的應用程式支援技術，可以提供數字健康解決方案。

That product platform will initially be launched in general wellness with future uses and prescription indications as we ramp up our supply chain, we see many potential growth drivers for the remainder of 2023 and 2024, including number one continued growth in our US prescription headache business in both the VA and DOD and commercial channels.

隨著我們擴大供應鏈，該產品平台最初將在一般健康領域推出，並具有未來用途和處方適應症，我們看到2023 年剩餘時間和2024 年有許多潛在的增長動力，包括我們在美國處方頭痛業務的第一大持續成長VA 和 DOD 以及商業通路。

Second, further development of the vagus product line for general wellness, mental acuity and sleep driven by ongoing consumer marketing efforts, number three, further development of ataxia and brand for human performance in the active duty, military and future civilian crossover number for revenue through our distribution agreement with Journeys healthcare with the sale of prescription gammaCore within a select managed care health system. Number five, our app enabled new product platform that will facilitate consumer facing digital health solutions and unlock new business models and number six, prescription gammaCore label extensions into PTSD and OUD in 2024 and 2025.

其次，在持續的消費者行銷努力的推動下，進一步開發用於一般健康、精神敏銳度和睡眠的迷走神經產品線。第三，進一步開發共濟失調和品牌，以提高現役、軍事和未來民用領域的人類表現，透過交叉數字獲得收入我們與 Journeys Healthcare 簽訂了分銷協議，在精選的管理式醫療保健系統內銷售處方 gammaCore。第五，我們的應用程式支援新產品平台，該平台將促進面向消費者的數位健康解決方案，並解鎖新的商業模式；第六，處方gammaCore 標籤將在2024 年和2025 年擴展到PTSD 和OUD 。

Finally, in 2023, we strengthened our balance sheet. Our cash balance, along with increased revenue and consistent reduction in expenses should provide us with enough runway to operate our business at this time, I'll turn the call over to the operator. Operator, please open the line for questions.

最後，到 2023 年，我們加強了資產負債表。我們的現金餘額，加上收入的增加和費用的持續減少，應該為我們提供足夠的跑道來運營我們的業務，我會將電話轉給接線員。接線員，請開通提問線。

Thank you. (Operator Instructions) And our first question comes from the line of Jeff Cohen with Ladenburg Thalmann. Please proceed with your question.

謝謝。 （操作員說明）我們的第一個問題來自 Jeff Cohen 和 Ladenburg Thalmann 的對話。請繼續你的問題。

Hi, thank you. This is actually Destiny on for Jeff. Firstly --

嗨，謝謝你。這實際上是傑夫的命運。首先 -

Hi Destiny.

嗨，命運。

Hi. Congratulations on a really strong quarter that was really wonderful to see and quite a beat even for our models -- with our models as well. And I guess what I would like to start with is your increased guidance just wanted to kind of gauge, is that going to be mostly again driven by growth within the VA and DoD cotton prescription channel? Or is that going to be a little more heavily weighted towards true vagus or taxed? And can you just help me understand how that could look for the remainder of the year and Twitter?

你好。恭喜這個非常強勁的季度，這真是太棒了，甚至對我們的模型也是如此——我們的模型也是如此。我想我想首先是您增加的指導只是想衡量一下，這是否將主要再次受到退伍軍人管理局和國防部棉花處方渠道內增長的推動？或者說這對真正的迷走神經的影響會比較大還是要課稅？你能幫我了解今年剩餘時間和 Twitter 的情況嗎？

Yes. So you've got the VA hospital system is our biggest number, though. That's obviously where more of the dollar growth has to come from. We're just we're several weeks into the quarter, and we feel really good about that. That growth from the VA hospital system being consistent with the percentage growth that we go from sequentially for the last few quarters.

是的。所以，退伍軍人管理局醫院系統是我們人數最多的。顯然，更多的美元成長必須來自於此。本季度剛過去幾週，我們對此感覺非常好。退伍軍人管理局醫院系統的成長與我們過去幾季持續成長的百分比一致。

And that will be the largest dollar contribution. Even though it may not be the largest percentage contribution, the vagus will be relatively flat because that's driven by our our advertising marketing spend on we may do a black friday promotion, for example, that it's yield on a percentage basis or rather on a dollar basis compared to our larger panels. It's not going to be meaningful taxed in we've got a lot of momentum there. So I think you'll see a solid percentage increase in that panel and our UK business, it continues to be in that sort of mid to high 10s growth.

這將是最大的美元捐款。儘管它可能不是最大的百分比貢獻，但迷走神經將相對平坦，因為這是由我們的廣告行銷支出驅動的，我們可能會進行黑色星期五促銷，例如，它是按百分比或更確切地說按美元計算的收益與我們較大的面板相比。由於我們在那裡有很大的動力，所以徵稅不會有任何意義。因此，我認為您會看到該面板和我們的英國業務的百分比穩步增長，並且繼續保持 10 多倍的中等到高增長。

Okay. Got it. Thank you for that. And I guess maybe sticking with my question around like the DoD and the VA channel you noted 35 sales agents and about 60 1099. How has that changed over the nine months in 2023 as compared to 2022. Can you just remind me?

好的。知道了。謝謝你。我想也許會繼續我的問題，例如國防部和退伍軍人管理局管道，您注意到有35 名銷售代理和大約60 1099 名銷售代理。與2022 年相比，2023 年的9 個月裡情況發生了怎樣的變化。您能提醒我嗎？

I don't think we had any in 2022.

我認為 2022 年我們還沒有。

Okay, perfect. So, you've onboarded a lot of fees this year already this year. And how are you seeing the time from onboarding to revenue generation? And how long are you seeing that pace typically?

好的，完美。所以，今年你已經支付了很多費用。您如何看待從入職到創造收入的時間？您通常會看到這個速度多久？

So what happens is not so much a steady cadence, but rather 20% to 30% of the folks that we enrolled, get it and and bring relationships with them and become productive very quickly. And then the rest take either more time or they just don't cut it and we end up replacing them. But the best situation is one in which we engage a sales agent who already has other product lines in a particular facility already has relationships in that facility and can turn on the business very quickly.

因此，所發生的並不是穩定的節奏，而是我們招募的 20% 到 30% 的人得到了它，並與他們建立了關係，並很快變得富有成效。然後剩下的要么需要更多時間，要么就是無法解決問題，我們最終會更換它們。但最好的情況是，我們聘請的銷售代理商已經在特定工廠擁有其他產品線，並且已經在該工廠建立了關係，並且可以非常快速地開展業務。

Okay, got it. And I understand the strategy there. Maybe I'll transition over to a question on to vagus. I know you're holding ad spend about the same. So, revenue will likely be consistent. And I'm just wondering what kind of KPI. you're looking for that you're trying to optimize before you ramp up that ad and a bit more.

好，知道了。我了解那裡的策略。也許我會轉向有關迷走神經的問題。我知道您的廣告支出大致相同。因此，收入可能會保持一致。我只是想知道什麼樣的 KPI。在增加廣告以及更多內容之前，您正在尋找您正在嘗試優化的內容。

And that's a very good question, and that's a topic that we're working with the Board on right now as we as we think through our budget for 2024, we're very happy as long as that media efficiency ratio stays comfortably above two. We think that business scales very, very nicely at anything above two. We've consistently been favorable to that metric. And so now it's about convincing or convincing the board to take the gloves off.

這是一個非常好的問題，也是我們目前正在與董事會合作討論的一個主題，因為我們在考慮 2024 年的預算時，只要媒體效率比率保持在 2 以上，我們就非常高興。我們認為，在任何超過兩個的情況下，業務規模都非常非常好。我們一直贊成這個指標。所以現在的問題是說服或說服董事會脫掉手套。

Okay, got it. Thank you for that. And all right. Let me let me ask just one clarification, then I'll allow others to ask questions because I'm definitely hogging the line. Did you say you added 362 new prescribers in Q3 alone that. Did I hear that correctly?

好，知道了。謝謝你。好吧。讓我先澄清一件事，然後我將允許其他人提問，因為我絕對是在佔線。您是否說過僅在第三季就增加了 362 名新處方者？我沒聽錯嗎？

Yes, ma'am.

是的女士。

Wow. Okay. Well, I'll jump back in the queue. Congratulation again

哇。好的。好吧，我會插回隊列中。再次恭喜

More feet on the street brings more new names.

街上的腳步越多，帶來的新名字就越多。

Yes. Love it. Perfect. Thank you.

是的。愛它。完美的。謝謝。

Our next question comes from the line of Swayampakula with H.C. Wainwright. Please proceed with your question.

我們的下一個問題來自 Swayampakula 和 H.C.溫賴特。請繼續你的問題。

And thank you and good afternoon, Dan and Brian, --

謝謝你們，下午好，丹和布萊恩，——

About getting your name.

關於得到你的名字。

No. No. No. No. It's better then something else. So, looking at where you are and looking at the guidance. So, you talked about $10.8 million for the nine months and then guided up between $15 million and $15.5 million let's say $15.3 million on that is flattish from here into the fourth quarter. But your commentary is otherwise. And so, what are we missing or why why be timid.

不，不，不，不，這比其他事情要好。所以，看看你在哪裡，看看指導。因此，您談到了 9 個月的 1,080 萬美元，然後指導在 1,500 萬美元到 1,550 萬美元之間，假設 1,530 萬美元從現在到第四季度持平。但你的評論卻不然。那麼，我們錯過了什麼或為什麼要膽怯。

So management is very bullish as some of our advisors are urging coughing. But the biggest swing is the timing of revenue from the TAC-STIM product line.

因此，管理層非常樂觀，因為我們的一些顧問都在敦促咳嗽。但最大的波動是 TAC-STIM 產品線的收入時間。

Okay.

好的。

Which well we've seen a steady cadence. I just wanted to be out of an abundance of caution, and I want to I want to be careful about the lumpiness in that business.

我們已經看到了穩定的節奏。我只是想謹慎行事，而且我想對這個行業的混亂狀況保持謹慎。

Great enough makes sense. Now I understand why you didn't talk too much about the revenue expectation on the tax business for the fourth quarter, even though you're saying that you're expecting it to grow on. So, moving straight into tax, then obviously looks amazing going from the second quarter to third quarter on that revenue stream alone. But at the same time, you're also making the additional relationships from what I understand within the military services and plus the tax in 2.0 on and so.

夠大才有意義。現在我明白為什麼你沒有過多談論第四季度稅務業務的收入預期，儘管你說你預計它會繼續增長。因此，直接進入稅收領域，從第二季度到第三季度，僅就收入流而言，顯然看起來令人驚嘆。但同時，您也根據我對軍事服務的理解建立了額外的關係，再加上 2.0 的稅收等等。

We have and with the new budget, we have started in September and right.

我們已經有了新的預算，我們已經在九月開始了。

Right.

正確的。

So, I know you don't want to say anything quantitative, but qualitatively, where are the discussions in terms of how things are projecting for yourselves into the new fiscal year, which starts from September. And also, the additional commentary I would like to hear is untaxed and 2.0 on how much. Can you talk to us about and not only the development but the potential deployment and where could it go in? What places could it go?

所以，我知道你們不想說任何定量的東西，而是想說定性的東西，關於如何預測從 9 月開始的新財政年度的討論在哪裡。而且，我想聽到的附加評論是未徵稅的以及關於多少的2.0。您能否與我們談談不僅是開發，還包括潛在的部署以及它可以應用到哪裡？可以去哪些地方呢？

It's a great question, Okay. And I'm going to give you two answers on the special operators, the actual folk who are using it are very, very excited, are very supportive and are looking to deploy rapidly the back row on government shutdown silliness. I mean, this is out of everybody's hands and is an issue.

這是一個很好的問題，好吧。我將給你們兩個關於特殊操作員的答案，真正使用它的人非常非常興奮，非常支持，並且希望迅速部署後排來應對政府關閉的愚蠢行為。我的意思是，這不屬於每個人的控制範圍，而且是一個問題。

Okay. I did that in that context. Okay. And then the 2.0. So, what do you know, where do you envision this from moving forward? Or is that also dependent on start and stop of the government?

好的。我就是在那種背景下這麼做的。好的。然後是2.0。那麼，您知道什麼？您預計這將如何發展？或者這也取決於政府的啟動和停止？

So a little bit of both. We've delivered a significant number of preproduction prototypes. I had two Air Force Research Laboratories primarily and then a couple two Army Special Forces as they are doing their evaluations. There the preliminary informal anecdotal is very, very exciting, supported on most likely. They'll come back with us a punch list of make it a little bit bigger, make it a little bit rounder, but we don't see any I'm highly confident that there won't be any significant changes to the design and that we're going to be able to move quickly into pilot production.

所以兩者都有一點。我們已經交付了大量的預生產原型。我主要有兩個空軍研究實驗室，然後還有兩個陸軍特種部隊，因為他們正在進行評估。初步的非正式軼事非常非常令人興奮，很可能會得到支持。他們會給我們一份清單，讓它更大一點，讓它更圓一點，但我們沒有看到任何我非常有信心設計不會有任何重大變化，我們將能夠快速進入試生產。

Okay. Great. In terms of on the verbiage, I lost my train of thought in terms of the Jones health care, you announced that you said you got and small bit of revenue in the third quarter. Do you think by this time you got all the kinks out of the system in terms of not only the paperwork, but also this of the general flow through some of them of the procedures necessary for deployment?

好的。偉大的。就措辭而言，我在瓊斯醫療保健方面失去了思路，您宣布說您在第三季度獲得了少量收入。您認為此時您是否已經解決了系統中的所有問題，不僅包括文書工作，還包括部署所需的一些程序的一般流程？

Yes. So, the back-office stuff is working as smoothly as it will, and that was really the time continuing piece of this. Currently, we are actively recruiting champions in different-on-different facilities along the West Coast. Those champions will start off with a three month or six month prescription on select patients as they start to have success with those patients.

是的。因此，後台工作正在盡可能順利地進行，這確實是繼續這件事的時間。目前，我們正在西海岸的不同設施中積極招募冠軍。當這些冠軍開始在這些患者身上取得成功時，他們將開始為選定的患者提供三個月或六個月的處方。

They start telling their colleagues, they open the doors for us to it talk to other departments and of course, they start prescribing for larger numbers of their patients. It's a very similar cadence to what we do in the VA in the VA hospital system. Where there's a lot of effort that goes into opening up the new facility. And then once we are once, we have a champion two, we can drive broader adoption within that facility.

他們開始告訴他們的同事，他們為我們與其他部門交談敞開大門，當然，他們開始為更多的患者開處方。這與我們在 VA 醫院系統中所做的非常相似。為了開設新設施付出了很多努力。一旦我們成為了冠軍，我們就可以在該設施內推動更廣泛的採用。

One way that I like to think about it in 2020 was our first full years of sales in the VA hospital system. I think we did do $1.7 million, $51.8 million in revenue in the VA hospital system in 2020. And so, I think that's a that's a reasonable goal for the insurance health care opportunity in 2024.

我喜歡在 2020 年思考這個問題的一個方式是我們在 VA 醫院系統中的第一個全年銷售。我認為 2020 年我們確實在 VA 醫院系統中實現了 170 萬美元、5,180 萬美元的收入。因此，我認為這是 2024 年保險醫療保健機會的合理目標。

Okay, Thanks. One last question from me. Just as you spoke about MER and an MER of 2.09 delivering on the Truvaga, is there a similar metric for the VA hospital system? Because you have been in this and streamlined bulk of it, just as you said, about four plus years now, almost four years now on what is I understand COVID came and scrutinize all up soon. What is the what is the thing that can ignite that growth factor? Because you, as you said, you were only 1% penetration into the market?

好的謝謝。我的最後一個問題。正如您談到 MER 以及 Truvaga 的 MER 為 2.09 一樣，VA 醫院系統是否有類似的指標？因為你已經參與其中並簡化了大部分工作，正如你所說，大約四年多了，據我所知，現在已經快四年了，新冠病毒很快就來了，並對其進行了全面審查。到底是什麼東西能夠激發那個生長因子呢？因為你，如你所說，你的市場滲透率只有1%？

Yes. So, on the marketing advertising spend in in either the VA hospital system or the insurance relationship is very small. The variable expense is overwhelmingly commissions. And what drives adoption is heat on the street. It's not that very elegant, but you've seen that model over and over again in MedTech.

是的。因此，無論是退伍軍人管理局醫院系統還是保險關係中的行銷廣告支出都非常小。可變費用絕大多數是佣金。推動採用的因素是街頭的熱度。它不是那麼優雅，但您在 MedTech 中一遍又一遍地看到這種模型。

Yes. Okay. Okay. So, do you think that the money that you raised and will that go into that and feed on that? And then on the street down more to help that, or is this more for making ensuring operations some the operations as they are right now?

是的。好的。好的。那麼，您認為您籌集的資金會投入其中並以此為生嗎？然後在街上進行更多的幫助，或者這更多的是為了確保操作像現在一樣？

Yes. So, you'll see a steady increase in our sales and marketing expense, either because we're spending money to drive advertising for Turvaga or because our commissions are going up tied to hospital sales revenue.

是的。因此，您會看到我們的銷售和行銷費用穩定成長，這要么是因為我們花錢為 Turvaga 做廣告，要么是因為我們的佣金與醫院銷售收入掛鉤。

Okay, perfect. It was great quarter, and I'm sure things are going to get better from here.

好的，完美。這是一個很棒的季度，我相信事情會從這裡開始變得更好。

Thank you. Thank you. We think it was a great quarter as well.

謝謝。謝謝。我們認為這也是一個很棒的季度。

And our next question comes from the line of Nick Sherwood with Maxim Group, LLC. Please proceed with your question.

我們的下一個問題來自 Maxim Group, LLC 的 Nick Sherwood。請繼續你的問題。

Congrats on the quarter. I just yes, just first question, how do the vagus and TAC-STIM gross margins compare to the prescription business.

恭喜本季。我只是是的，只是第一個問題，迷走神經和 TAC-STIM 的毛利率與處方業務相比如何。

And so we haven't been giving out that regular data, our pricing in the prescription business is significantly higher. So you can you can connect the dots from there?

因此，我們沒有提供常規數據，我們在處方藥業務中的定價要高得多。那麼你能從那裡把這些點連結起來嗎？

And then kind of switching gears, can you provide any color on the distribution agreement with relief?

然後是那種開關裝置，你能在分銷協議上提供任何帶有浮雕的顏色嗎？

Yes, so on, we've had say we're closing rather to press pause on that relationship on our business is growing so quickly in the VA hospital system, we just our sales guys just don't have the bandwidth to really get fully trained up on that new product line. So, I look forward to returning our attention to that in 2024. But on, we've got to take care of our own house first.

是的，等等，我們已經說過我們要關閉而不是暫停我們的業務關係在 VA 醫院系統中增長如此之快，我們只是我們的銷售人員沒有足夠的頻寬來真正充分了解接受了新產品線的培訓。所以，我期待在 2024 年重新關注這一點。但接下來，我們必須先照顧好我們自己的房子。

Understandable. And then another question. How what sort of response have you seen with your partnership with the NFL for the season from the concussion headache pain study?

可以理解。然後還有一個問題。從腦震盪頭痛研究中，您在本賽季與 NFL 的合作中看到了什麼樣的反應？

They won't tell us those thing. Okay.

他們不會告訴我們這些事。好的。

Sorry to hear that.

很遺憾聽到這個消息。

I keep I keep hoping to get something that plug into my fantasy football team, and they won't tell me. Yes, yes, I would tell you if Josh sounds easy, but certainly I think a lot of those are all my questions, then I'll get back in that thinking.

我一直希望能得到一些東西來加入我的夢幻足球隊，但他們不告訴我。是的，是的，如果喬希聽起來很容易，我會告訴你，但當然我認為其中很多都是我的問題，然後我會回到這個想法。

Thank you.

謝謝。

Our next question comes from the line of Walter Schenker with MAZ partners. Please proceed with your question.

我們的下一個問題來自 Walter Schenker 與 MAZ 合作夥伴的聯繫。請繼續你的問題。

Hi, Dan.

嗨，丹。

Hi, Walter. How are you today?

嗨，沃特。你今天怎麼樣？

Is there a point from, I guess potential is the answer where in the VA system, you have enough penetration that somebody higher up near the top says, if it's good for 10%, 15%, 20%, 25% of hospitals, we have a major new champion. We really want to roll this out across the whole system. If we're having very good results for you expect it's just going to be down adding hospitals every quarter for the rest of our lives to get through the whole system?

我認為潛力就是答案，在VA 系統中，你有足夠的滲透率，以至於接近高層的人說，如果這對10%、15%、20%、25% 的醫院有好處，我們是否有這樣的觀點？有一個重要的新冠軍。我們真的希望將其推廣到整個系統。如果我們取得了您所期望的非常好的結果，那麼在我們的餘生中每個季度都會增加醫院才能通過整個系統？

So that's a very good question. I'd love to believe that there is a higher-level policymaking com entity within the VA system on it hasn't been my experience in other businesses, but we think we can certainly hope. The VA hospital administration is divided up into I believe it's 17 or 18 VISNs, and it is more likely that there could be a business level, so in other words, a regional level on policy decision in parallel, the hospital administration has something called a heardache center of excellence in HCOA, which is at a national level. And they have written gammaCore into their neuromodulation headache, a policy. But I don't know exactly what it says, and I'd love to know more but keeping that close to their chest.

這是一個非常好的問題。我很願意相信 VA 系統內有一個更高層級的決策 com 實體，這不是我在其他行業的經驗，但我們認為我們當然可以希望。 VA 醫院管理部門分為17或18個VISN，更有可能是業務級別，所以換句話說，並行的政策決策的地區級別，醫院管理部門有一個叫做“業務級別”的東西。HCOA 耳痛卓越中心是國家級的。他們已經將 gammaCore 寫入了他們的神經調節頭痛中，這是一項政策。但我不知道它到底說了什麼，我很想知道更多，但不要讓他們知道。

Okay. And kind of related vaguely related question. As you move forward, TAC-STIM and DoD, you now are in for a few. Okay. I'm just trying to get some sense as to so I can sort of look at the metric on VA and say this our penetration is X. On DoD, for high performance type applications. You still are in just a hand now a very very small percentage of the content. I mean, it puts all soldiers, all everyone in the military in the high-performance area, you are still in just a few select locations?

好的。還有一種相關的模糊相關的問題。隨著 TAC-STIM 和 DoD 的不斷前進，您現在將面臨一些挑戰。好的。我只是想了解一下，這樣我就可以看看 VA 上的指標，並說我們的滲透率是 X。在 DoD 上，對於高效能類型的應用程式。現在你手上的內容仍然只是非常非常小的一部分。我的意思是，它把所有士兵、軍隊中的所有人都放在高性能區域，你仍然只在幾個選定的位置嗎？

Exactly right. Where we are in pilot deployment with have you airport special units. And if you Army Special Forces unit and then we've deployed one or two demonstration devices in other places, the total addressable market is roughly $3 million active duty personnel within the Army, Navy, Marines, Air Force and coastguard.

非常正確。我們正在與你們機場特種部隊進行試點部署。如果您是陸軍特種部隊，然後我們在其他地方部署了一兩個演示設備，則總的潛在市場約為陸軍、海軍、海軍陸戰隊、空軍和海岸警衛隊的現役人員 300 萬美元。

And then beyond that, we think there's going to be civilian crossover to first responders to lead athletes. So, the total addressable market, if you start to think about it in the context of civilian crossover or NATO allies, the total number keeps getting bigger and bigger, the total opportunity rather gets bigger and bigger.

除此之外，我們認為民間將與急救人員交叉領導運動員。因此，如果您開始在民用跨界或北約盟友的背景下考慮整個潛在市場，那麼總數會越來越大，總機會也會越來越大。

Okay. And lastly, I think we discussed this slightly once before in the VA hospital you had mentioned before we're opening up in some of these hospitals from more departments. Do you have the sense anecdotally that people are using it outside of headache as they're seeing just general phase I of the stress, we're seeing a lot of other benefits that probably are accruing to the people who are using it.

好的。最後，我想我們之前在您提到的退伍軍人管理局醫院中稍微討論過這個問題，然後我們在其中一些醫院開設了更多科室。您是否聽說過，人們在頭痛之外使用它，因為他們看到的只是壓力的一般第一階段，我們看到使用它的人可能會獲得許多其他好處。

So absolutely on we started off in neurology with a headache specialists live we spend a lot of time in pain management. We spend a lot of time in behavioral health where we talk about headache and depression, headache in PTSD and headache in substance abuse.

因此，我們絕對是從神經病學開始，與頭痛專家一起，我們花了很多時間在疼痛管理上。我們花了很多時間討論行為健康，討論頭痛和憂鬱、創傷後壓力症候群（PTSD）引起的頭痛和藥物濫用引起的頭痛。

Women's Health is a call point. More and more of the VA hospitals have a general wellness department, frankly. And then ultimately we get into primary care as well, where they see headache where they see stress and anxiety and on and on. So as word gets out, we just have more and more call points within each facility.

婦女健康是一個呼籲點。坦白說，越來越多的退伍軍人管理局醫院設有綜合健康部門。然後最終我們也進入初級保健，在那裡他們看到頭痛，他們看到壓力和焦慮等等。因此，隨著消息傳出，我們在每個設施內設有越來越多的呼叫點。

Okay, thank you, Dan.

好的，謝謝你，丹。

Thank you, Walter.

謝謝你，沃特。

And it looks like we have reached the end of the question-and-answer session. I'll now turn the call back over to CEO, Dan Goldberg for closing remarks.

看來我們的問答環節已經結束了。現在，我將把電話轉回執行長 Dan Goldberg 致結束語。

Thank you, operator, and thank you, everybody, for joining our call. I want to give a special thanks to all of our employees who work tirelessly to deliver this amazing therapy to patients team has done a great job of staying nimble, scaling the business and responding to the needs of our customers and healthcare providers alike.

謝謝接線員，也謝謝大家加入我們的通話。我要特別感謝我們所有的員工，他們孜孜不倦地工作，為患者提供這種令人驚嘆的療法。團隊在保持靈活性、擴展業務以及響應客戶和醫療保健提供者的需求方面做得非常出色。

I also want to thank healthcare professionals and their patients for their loyal support of gammaCore therapy. We're thankful for the support of AFRL, NIDA, the National Institute on Drug Abuse, the NFL Players Association for supporting our new product initiatives and working on those grants for investigator initiated trials. And of course, Veterans Day is coming up. And so we greatly appreciate your service for those of us for those of you who are participating in Veteran's Day activities.

我還要感謝醫療保健專業人員及其患者對 gammaCore 療法的忠實支持。我們感謝 AFRL、NIDA、國家藥物濫用研究所、NFL 球員協會的支持，感謝他們支持我們的新產品計劃，並為研究者發起的試驗提供資助。當然，退伍軍人節即將到來。因此，我們非常感謝您為我們這些參加退伍軍人節活動的人們提供的服務。

Thank you all. And we look forward to speaking with you again in a few months.

謝謝你們。我們期待在幾個月後再次與您交談。