MiMedx Group Inc (MDXG) 2023 Q3 法說會逐字稿

Good afternoon, and thank you for standing by. Welcome to the MiMedx Third Quarter 2023 Operating and Financial Results Conference Call. (Operator Instructions) As a reminder, this conference is being recorded.

下午好，感謝您的耐心等待。歡迎參加 MiMedx 2023 年第三季營運與財務績效電話會議。 （操作員指示）謹此提醒，本次會議正在錄製中。

I would now like to turn the conference over to your host, Mr. Matt Notarianni, Head of Investor Relations for MiMedx. Thank you, you may begin.

現在我想將會議交給主持人 MiMedx 投資者關係主管 Matt Notarianni 先生。謝謝，你可以開始了。

Thank you, operator, and good afternoon, everyone. Welcome to the MiMedx Third Quarter 2023 Operating and Financial Results Conference Call. With me on today's call are Chief Executive Officer, Joe Capper; and Chief Financial Officer, Doug Rice.

謝謝接線員，大家下午好。歡迎參加 MiMedx 2023 年第三季營運與財務績效電話會議。與我一起參加今天電話會議的是執行長喬·卡珀 (Joe Capper)；和財務長道格·賴斯。

As part of today's webcast, we are simultaneously displaying slides that you can follow. You can access the slides from the Investor Relations website at mimedx.com. Joe will kick us off with some opening remarks, and Doug will provide a summary of our operating highlights and financial results for the quarter. And then Joe will conclude with some additional updates, including a discussion of our financial goals. We will then be available for your questions.

作為今天網路廣播的一部分，我們同時展示您可以觀看的幻燈片。您可以從投資者關係網站 mimedx.com 存取這些投影片。喬將發表一些開場白，道格將總結我們本季的營運亮點和財務表現。然後喬將總結一些額外的更新，包括討論我們的財務目標。然後我們將回答您的問題。

Before we begin, I would like to remind you that our comments today will include forward-looking statements, including statements regarding future sales, EBITDA, free cash flow and cash balance growth, future margins and expenses and expected market sizes for our products. These expectations are subject to risks and uncertainties, and actual results may differ materially from those anticipated due to many factors. Actual results and market sizes will depend on a number of factors, including competition, access to customers, the reimbursement environment, unforeseen circumstances and delays and other factors.

在開始之前，我想提醒您，我們今天的評論將包括前瞻性陳述，包括有關未來銷售額、EBITDA、自由現金流和現金餘額增長、未來利潤和費用以及我們產品的預期市場規模的陳述。這些預期存在風險和不確定性，實際結果可能因多種因素而與預期有重大差異。實際結果和市場規模將取決於多種因素，包括競爭、接觸客戶、報銷環境、不可預見的情況和延誤以及其他因素。

Additional factors that could impact outcomes and our results include those described in the Risk Factors section of our annual report on Form 10-K and our quarterly reports on Form 10-Q. Also, our comments today include non-GAAP financial measures, which we provide a reconciliation to GAAP measures in our press release, which is available on our website at www.mimedx.com.

可能影響結果和我們結果的其他因素包括我們的 10-K 表年度報告和 10-Q 表季度報告的風險因素部分中所述的因素。此外，我們今天的評論還包括非 GAAP 財務指標，我們在新聞稿中提供了與 GAAP 指標的對賬，該新聞稿可在我們的網站 www.mimedx.com 上取得。

With that, I'm now pleased to turn the call over to Joe Capper. Joe?

至此，我現在很高興將電話轉給喬·卡珀。喬？

Thanks, Matt, and good afternoon, everyone. Thank you all for joining us on today's call. It is my pleasure to report on another excellent quarter. As you will hear today, the company is executing across the board, commercially, operationally and financially. In addition to delivering outstanding results for the period, we continue to improve the operational effectiveness of the company and prepared for the launch of another new product. I will detail these positive developments one by one, starting with our strong financial performance.

謝謝馬特，大家下午好。感謝大家參加今天的電話會議。我很高興能夠報告又一個出色的季度。正如您今天所聽到的，該公司正在商業、營運和財務方面全面執行。除了期內取得優異的業績外，我們還不斷提高公司的營運效率，並為推出另一款新產品做好準備。我將從我們強勁的財務表現開始，一一詳細介紹這些積極的進展。

Q3 marked the third consecutive quarter during which we grew revenue by 20-plus percent. This type of consistent sales performance with above-market growth rates is a testament to the team's stellar execution and our sound strategic plan. We've also been clear in our messaging that we expect to generate greater profitability as the business grows. In fact, on our last call, we guided to an adjusted EBITDA margin of above 20% for the second half of 2023, demonstrating excellent leverage as the business scales. We are happy to report that we did indeed achieve this objective in Q3.

第三季是我們連續第三個季度營收成長 20% 以上。這種穩定的銷售業績和高於市場的成長率證明了團隊的出色執行力和我們健全的策略計畫。我們在訊息中也明確表示，我們希望隨著業務的成長而產生更大的獲利能力。事實上，在上次電話會議中，我們預計 2023 年下半年調整後的 EBITDA 利潤率將超過 20%，隨著業務規模的擴大，展現出卓越的槓桿作用。我們很高興地報告，我們確實在第三季實現了這一目標。

We have a powerful combination of highly talented individuals, innovative solutions that help people heal and industry-leading sales and operations infrastructure. Our multifaceted approach in the wound and surgical markets is generating the impressive results we were targeting when we repositioned the business this past summer. As importantly, the organization is well situated to continue our momentum and significant growth for the foreseeable future. More on our long-term growth plan in a minute.

我們擁有高素質人才、幫助人們康復的創新解決方案以及業界領先的銷售和營運基礎設施的強大組合。我們在傷口和外科市場上的多方面方法正在產生令人印象深刻的成果，這是我們去年夏天重新定位業務時所瞄準的目標。同樣重要的是，該組織處於有利地位，可以在可預見的未來繼續保持我們的勢頭和顯著增長。稍後詳細了解我們的長期成長計劃。

First, I'd like to touch on some of the more noteworthy accomplishments from the quarter. Q3 year-over-year net sales grew by approximately 21% to $81.7 million, another outstanding growth quarter. Gross profit margin was 82% and would have been even higher but for a contractually committed last time buy of some lower-margin products. Adjusted EBITDA was $17.6 million or 21.6% of sales. up from the adjusted EBITDA of $2.4 million in Q3 of last year, representing a year-over-year increase of over $15 million.

首先，我想談談本季一些更值得注意的成就。第三季淨銷售額年增約 21%，達到 8,170 萬美元，又一個成長強勁的季度。毛利率為 82%，如果不是上次按照合約承諾購買一些利潤率較低的產品，毛利率可能會更高。調整後 EBITDA 為 1,760 萬美元，佔銷售額的 21.6%。與去年第三季調整後的 EBITDA 240 萬美元相比，年增超過 1,500 萬美元。

We ended the quarter with $81.2 million in cash, up $12.5 million in the quarter. We announced the collaboration with MediWound, a global leader in wound care, which plans to use our EpiFix product during the wool healing phase of its EscharEx Phase III study in venous leg ulcers. And we recently announced the launch of EPIEFFECT, a new product designed to meet the expanded needs of customers in the private office segment.

本季結束時，我們的現金為 8,120 萬美元，比本季增加了 1,250 萬美元。我們宣布與傷口護理領域的全球領導者 MediWound 合作，該公司計劃在其針對腿部靜脈潰瘍的 EscharEx III 期研究的羊毛癒合階段使用我們的 EpiFix 產品。我們最近宣布推出 EPIEFFECT，這是一款旨在滿足私人辦公領域客戶不斷擴大的需求的新產品。

I'd also point out that our efforts to streamline operations and build on our leadership position in the wound and surgical markets are working as designed and have helped to dramatically improve our financial profile over the last few quarters. As you will recall, this was the course we target when I arrived 9 months ago. My intent has been to create value by focusing our commercial efforts and unlocking leverage in the business as we grow. We are clearly on the right track as evidenced by the nearly 22% adjusted EBITDA margin in the third quarter.

我還想指出的是，我們在簡化營運和鞏固我們在傷口和外科市場的領導地位方面所做的努力正在按計劃發揮作用，並有助於在過去幾個季度顯著改善我們的財務狀況。您可能還記得，這是我 9 個月前到達時我們的目標課程。我的目的是透過專注於我們的商業努力並隨著我們的發展釋放業務槓桿來創造價值。第三季調整後 EBITDA 利潤率接近 22%，證明我們顯然走在正確的軌道上。

Moving now to the company's progress on our 3 primary growth drivers. As a reminder, these are the areas in which we are concentrating our time and resources in order to best position the company for long-term success. Our highest priority is to continue to build on our leadership position in the wound and surgical markets by enhancing our product portfolio and expanding geographically. For the third quarter, this focus again produced growth in all sites of service.

現在談談公司在三個主要成長動力方面的進展。提醒一下，這些是我們集中時間和資源的領域，以便為公司長期成功提供最佳定位。我們的首要任務是透過增強我們的產品組合和擴張地理來繼續鞏固我們在傷口和外科市場的領導地位。第三季度，這項重點再次帶動了所有服務站點的成長。

Sales grew by about 18% over the prior year quarter in the hospital sector, which continues to benefit from our 2 new product introductions late last year. We continue to invest in clinical research and are looking to expand our medical affairs efforts, investments which are critical to support our growth in general and more specifically in the surgical suite, which is certainly a focus for the customer. In the private office segment, we grew sales by 17%. While still a healthy click this growth rate slowed a bit sequentially, likely driven by the massive amount of confusion created by the ill-fated attempt to introduce new local coverage determinations, or LCDs, for skin substitutes by 3 of the Medicare administrative contractors or MACs.

醫院領域的銷售額比去年同期成長了約 18%，這繼續受益於我們去年底推出的 2 個新產品。我們繼續投資於臨床研究，並尋求擴大我們的醫療事務工作，這些投資對於支持我們的整體成長至關重要，更具體地說是在手術室方面，這無疑是客戶的焦點。在私人辦公室領域，我們的銷售額成長了 17%。雖然仍然是一個健康的點擊率，但這一增長率連續放緩，這可能是由於3 名Medicare 行政承包商或MAC 試圖為皮膚替代品引入新的本地承保決定（LCD），但結果不幸，造成了大量混亂，從而造成了巨大的混亂。 。

The proposed LCDs, which cover 15 states were scheduled to go into effect on October 1 and would have set an arbitrary cap of 4 outlets for applications per patient, potentially reducing levels of care. The LCDs also have dramatically restricted the number of products and companies eligible for reimbursement. Ultimately, the plan was abandoned but not before creating much confusion. We believe this uncertainty impacted ordering behavior during the quarter, as providers grappled with how they might have to modify care protocols.

擬議的 LCD 覆蓋 15 個州，計劃於 10 月 1 日生效，並將為每位患者的申請設置任意 4 個網點的上限，這可能會降低護理水平。 LCD 也大大限制了有資格獲得報銷的產品和公司的數量。最終，該計劃被放棄，但在此之前造成了許多混亂。我們認為這種不確定性影響了本季的訂購行為，因為提供者正在努力解決如何修改護理協議的問題。

Our position on this subject has been clear. We will continue to advocate in favor of changes that would level the playing field by eliminating the opportunity to gain a reimbursement system while ensuring access to products like ours that have proven to be highly effective. That said, we recently strengthened our offering in the private office setting. The newest addition to our advanced wound care solutions product portfolio, EPIEFFECT, was recently added to the Medicare ASP list, clearing the way for its full commercial launch now underway.

我們在這個問題上的立場是明確的。我們將繼續倡導變革，透過消除獲得報銷系統的機會，同時確保獲得像我們這樣已被證明非常有效的產品，從而創造公平的競爭環境。也就是說，我們最近加強了在私人辦公室環境中的服務。我們先進傷口護理解決方案產品組合的最新成員 EPIEFFECT 最近被添加到 Medicare ASP 清單中，為其目前正在進行的全面商業推出掃清了道路。

EPIEFFECT offers a thick tri-level configuration of amnion/chorion an intermediate virus with handling characteristics and product attributes that make it a preferable treatment option for deep tunneling wounds or cases or securing the graph in place with sutures to desire. We are excited to highlight this product to so many of our customers at SAWC later this week. We remain committed to organic product development and innovation of our market-leading placental drive technology as we see this as an essential element of future growth.

EPIEFFECT 提供羊膜/絨毛膜的厚三層配置，一種中間病毒，其處理特性和產品屬性使其成為深層隧道傷口或病例的優選治療選擇，或根據需要縫合將圖形固定到位。我們很高興本週稍晚在 SAWC 上向許多客戶展示這款產品。我們仍然致力於市場領先的胎盤驅動技術的有機產品開發和創新，因為我們認為這是未來成長的重要要素。

Speaking of best-in-class products, as I mentioned, we are pleased to be supporting MediWound, which has chosen to use our EPIEFFECT or EpiFix product in its Phase III trial for EscharEx, its next-generation debridement product now in development. According to MediWound, by incorporating market-leading and extensively studied EpiFix into its trial, it aims to maintain consistency among study subjects and optimize the potential for complete healing throughout the study duration. It's rewarding to receive such a high-quality third-party validation of our technology.

說到一流的產品，正如我所提到的，我們很高興能夠支援MediWound，該公司選擇在EscharEx 的III 期試驗中使用我們的EPIEFFECT 或EpiFix 產品，EscharEx 是其下一代清創產品，目前正在開發中。據 MediWound 稱，透過將市場領先且經過廣泛研究的 EpiFix 納入其試驗中，其目的是保持研究對象之間的一致性，並在整個研究期間優化完全治癒的潛力。獲得如此高品質的第三方對我們技術的驗證是值得的。

Finally, we remain encouraged by the strides we continue to make in developing a Japanese market. Those that are familiar with launching new products in Japan, know there is typically a longer lead time to realize the potential of a product than in other geographies. However, given the large market opportunity, it is well worth the time and effort. We are encouraged by the early strides we are making and remain optimistic about the future of this business. Our next priority is to develop opportunities in adjacent markets to create additional growth drivers for the company.

最後，我們在開發日本市場方面不斷取得的進展仍然令我們感到鼓舞。熟悉在日本推出新產品的人都知道，與其他地區相比，實現產品潛力的準備時間通常更長。然而，考慮到巨大的市場機會，花時間和精力是值得的。我們對早期的進步感到鼓舞，並對這項業務的未來保持樂觀。我們的下一個優先事項是在鄰近市場開發機會，為公司創造額外的成長動力。

As I stated on previous calls, we are evaluating ways to expand our skin substitute portfolio beyond amniotic tissue to include xenograft and/or synthetics. Notwithstanding the superior qualities of our placental drive allografts, this is a market-driven strategy, which will open up segments of the market where it is difficult, if not impossible, for us to compete today. We believe this approach will be highly complementary to our current business, allowing us to leverage our entire commercial infrastructure.

正如我在先前的電話會議中所說，我們正在評估如何將我們的皮膚替代品組合擴展到羊膜組織之外，包括異種移植和/或合成材料。儘管我們的胎盤驅動同種異體移植物具有卓越的品質，但這是一項以市場為導向的策略，它將打開我們今天難以甚至不可能競爭的細分市場。我們相信這種方法將與我們目前的業務高度互補，使我們能夠利用我們的整個商業基礎設施。

On the surface, this seems like an area where an inorganic effort could make sense. And given our much improved financial profile, I know many of you are excited to see us move in that direction. As applicable opportunities arise, we will give them careful consideration. To be clear, any potential inorganic target would have to, first and foremost, be an excellent cultural and strategic fit, which would accelerate our growth plan. It would also have to have a clear pathway for becoming accretive.

從表面上看，這似乎是一個無機努力可能有意義的領域。鑑於我們的財務狀況有了很大改善，我知道你們中的許多人很高興看到我們朝這個方向前進。當出現合適的機會時，我們會仔細考慮。需要明確的是，任何潛在的無機目標首先必須具有良好的文化和策略契合度，這將加速我們的成長計畫。它還必須有一條清晰的增值途徑。

And finally, our last objective is to build a corporate discipline around expense management, rationalization and continuous process improvement. While we continue to exceed the goals put in place to measure our progress in this area, this objective is really more about building a culture that is focused on getting the best return from our limited resources. It has been my experience that institutionalizing this mindset early on will pay dividends in terms of gaining operating expense leverage as the business scales.

最後，我們的最後一個目標是圍繞費用管理、合理化和持續流程改善建立企業紀律。雖然我們繼續超越為衡量我們在這一領域的進展而製定的目標，但這個目標實際上更多的是建立一種專注於從我們有限的資源中獲得最佳回報的文化。根據我的經驗，儘早將這種心態制度化將在隨著業務規模擴大而獲得營運費用槓桿方面帶來紅利。

During the quarter, we made excellent progress executing against these 3 strategic objectives. Our results demonstrate that our approach is having the desired effects. We will continue to identify and execute against most relevant growth drivers for our business as we see sustained long-term performance as the best way to create tremendous value.

本季度，我們在執行這 3 個策略目標方面取得了巨大進展。我們的結果表明我們的方法正在產生預期的效果。我們將繼續識別並執行與我們業務最相關的成長動力，因為我們認為持續的長期業績是創造巨大價值的最佳方式。

Before I turn the call over to Doug, I'd like to provide a few comments on the series B preferred stock repurchase we executed this past Friday. First, I would like to thank Hayfin for their past and continued support of the company. We could not ask for a better partner. As our stock started to show signs of meeting the mandatory conversion criteria, we began conversations with Hayfin about how we might help them manage an orderly transition. Ultimately, this resulted in us buying back half of their position at $6.13 per effectively converted common share for a total of $9.5 million.

在將電話轉給 Doug 之前，我想就我們上週五執行的 B 系列優先股回購提供一些評論。首先，我要感謝 Hayfin 過去和持續對公司的支持。我們找不到比這更好的合作夥伴了。當我們的股票開始顯示出滿足強制轉換標準的跡象時，我們開始與 Hayfin 討論如何幫助他們管理有序轉換。最終，我們以每股有效轉換普通股 6.13 美元的價格回購了他們一半的頭寸，總價值為 950 萬美元。

A stock repurchase at this point in the company's evolution would not typically be my highest priority for use of capital. However, this was opportunistic and made good sense since it stopped the 6% preferred dividend on the shares repurchased and was executed at a discount at a convert price of $7.70. Given the rate at which we are building cash and our much improved borrowing capacity, we do not see this as in any way impairing our ability to capitalize on strategic opportunities that may arise.

在公司發展的這個階段，股票回購通常不是我使用資本的最優先事項。然而，這是機會主義的，也是有道理的，因為它停止了回購股票的 6% 優先股股息，並以 7.70 美元的轉換價折價執行。考慮到我們累積現金的速度以及借貸能力的大幅提高，我們認為這不會以任何方式損害我們利用可能出現的策略機會的能力。

Now let me turn the call over to Doug for more detail on our financial results. Doug?

現在讓我將電話轉給道格，以了解有關我們財務表現的更多詳細資訊。道格？

Thank you, Joe. Good afternoon, everyone, and thanks for joining us today. I'm pleased to once again be presenting these strong quarterly results to you all today. Before diving in, I wanted to note that many of the financial measures covered in today's call are on a non-GAAP basis, so please refer to today's earnings release for further information regarding our non-GAAP reconciliations and disclosures.

謝謝你，喬。大家下午好，感謝您今天加入我們。我很高興今天再次向大家展示這些強勁的季度業績。在深入探討之前，我想指出，今天的電話會議中涵蓋的許多財務指標都是基於非公認會計原則的，因此請參閱今天的收益報告，以了解有關我們的非公認會計原則調節和披露的更多資訊.

First, as Joe mentioned, our third quarter 2023 was the third consecutive quarter in which our net sales growth exceeded 20% year-over-year despite having one fewer shipping day than the prior year period. Third quarter net sales of $81.7 million also represented modest sequential growth compared to the second quarter of 2023, which is all the more impressive given the traditional Q3 dip in health care seasonality, as well as the broad-based strength we have seen across all of our sites of service during the first half of the year.

首先，正如 Joe 所提到的，儘管發貨日比去年同期少了一個，但 2023 年第三季度我們的淨銷售額同比增長連續第三個季度超過 20%。第三季的淨銷售額為8,170 萬美元，與2023 年第二季相比也呈現適度的環比增長，考慮到傳統的第三季醫療保健季節性下降以及我們在所有領域看到的廣泛實力，這一點更令人印象深刻我們上半年的服務站點。

The commercial team has once again executed across all of our sites of service with strong double-digit growth in each segment, despite some of the confusion Joe mentioned related to the ons and off reimbursement changes during the quarter.

儘管喬提到了與本季時斷時續的報銷變化相關的一些困惑，但商業團隊再次在我們所有的服務站點上執行，每個細分市場都實現了兩位數的強勁增長。

Moving to gross profit and gross margin. Our third quarter gross profit was about $67 million, an $11 million improvement compared to $56 million last year, and our gross margin was roughly flat on a year-over-year basis at around 82%. In the third quarter, our quality operations and regulatory team continued to make progress on its yield improvement plans, which we expect will benefit us moving forward.

轉向毛利和毛利率。我們第三季的毛利約為 6,700 萬美元，比去年的 5,600 萬美元增加了 1,100 萬美元，毛利率與去年同期基本持平，約 82%。第三季度，我們的品質營運和監管團隊繼續在產量改善計劃上取得進展，我們預計這將有利於我們前進。

These efforts include the introduction of certain automation enhancements that are designed to help us realize additional scale as we grow. As Joe mentioned, gross margin was negatively impacted in the quarter by a contractual last time buy for a noncore market white-label product that we are manufacturing for a third party. This line was essentially being sold at cost, so we expect this pressure on our gross margin to subside moving forward. With that said, we remain focused on continuing to leverage our growing scale and driving our gross margin percentage back into the mid-80s over the long term.

這些努力包括引入某些自動化增強功能，旨在幫助我們隨著業務的發展實現更大的規模。正如喬所提到的，本季毛利率受到上次合約購買我們為第三方生產的非核心市場白標產品的負面影響。該產品線基本上是按成本價出售的，因此我們預計毛利率面臨的壓力將在未來消退。話雖如此，我們仍然專注於繼續利用我們不斷增長的規模，並將我們的毛利率長期推回到 80 年代中期。

GAAP selling, general and administrative expenses, or SG&A, was $52.6 million or 63% of net sales compared to $53.5 million or 79% of net sales in the prior year period. The decrease in SG&A, both on a dollar and relative basis was a result of our ongoing expense management, which more than offset the higher commissions we paid in the quarter due to our higher sales.

GAAP 銷售、一般及管理費用 (SG&A) 為 5,260 萬美元，佔淨銷售額的 63%，而去年同期為 5,350 萬美元，佔淨銷售額的 79%。 SG&A 的下降（以美元計算和相對計算）是我們持續進行費用管理的結果，這足以抵消我們在本季度因銷售額增加而支付的較高佣金。

Our GAAP R&D expenses were $3.2 million, a $2.8 million decrease compared to $6 million in the prior year period. This year-over-year decline in R&D spend was principally driven by the strategic realignment we announced in June of this year and the associated wind-down of the regenerative medicine business unit and its R&D activities.

我們的 GAAP 研發費用為 320 萬美元，比去年同期的 600 萬美元減少了 280 萬美元。研發支出較去年同期下降的主要原因是我們今年 6 月宣布的策略調整以及再生醫學業務部門及其研發活動的相關縮減。

Moving forward, we anticipate our R&D spend to generally be in the range of 3% to 4% of sales, which we believe will provide sufficient support in developing our wound and surgical product pipeline. I'm also pleased to report that our investigation, restatement and related expenses were immaterial for the third quarter of 2023 as we have been able to finalize many of the matters over the last few months. We anticipate spending on these expense lines will be immaterial moving forward.

展望未來，我們預計研發支出將佔銷售額的 3% 至 4%，我們相信這將為開發我們的傷口和外科產品管道提供足夠的支援。我還很高興地報告，我們的調查、重述和相關費用對於 2023 年第三季來說並不重要，因為我們在過去幾個月中已經完成了許多事項。我們預計這些開支項目的支出今後將變得無關緊要。

GAAP net income was $8.5 million compared to a net loss of $8.4 million in the prior year period. I share in Joe's excitement to be able to report this year-over-year improvement as a clear sign of the meaningful progress the organization has made over the last 12 months. Adjusted EBITDA was $17.6 million or 21.6% of net sales compared to an adjusted EBITDA of $2.4 million or about 3.5% of net sales in the prior year period. As a reminder, in light of our strategic realignment, we anticipate that after this quarter, we will no longer bifurcate our business on a segment basis.

GAAP 淨利潤為 850 萬美元，而去年同期淨虧損為 840 萬美元。我和 Joe 一樣興奮，因為能夠報告這項同比改進，這是該組織在過去 12 個月中取得的有意義進展的明顯標誌。調整後 EBITDA 為 1,760 萬美元，佔淨銷售額的 21.6%，而上年同期調整後 EBITDA 為 240 萬美元，佔淨銷售額的 3.5% 左右。提醒一下，鑑於我們的策略調整，我們預計本季之後，我們將不再按部門劃分業務。

Turning to our liquidity. The financial results we have posted over the last several quarters have led to strong improvement in our net cash position as the business begins generating meaningful free cash flow. At the end of Q3, the company had $81.2 million of cash, reflecting a sequential step up versus June 30 of approximately $12.5 million. With a continued focus on adjusted EBITDA generation, we believe our much improved financial profile will continue to strengthen and provide us opportunities to grow and diversify the business.

轉向我們的流動性。隨著業務開始產生有意義的自由現金流，我們在過去幾季發布的財務業績使我們的淨現金狀況得到了強勁改善。截至第三季末，該公司擁有 8,120 萬美元現金，較 6 月 30 日增加約 1,250 萬美元。透過持續專注於調整後的 EBITDA 生成，我們相信，我們大大改善的財務狀況將繼續加強，並為我們提供業務成長和多元化的機會。

Additionally, our healthy cash flow allows us to be opportunistic in improving our balance sheet as was the case with the transaction Joe mentioned earlier regarding the $9.5 million repurchase of a portion of Hayfin Series B preferred shares. We are particularly pleased to be able to execute this transaction, utilizing less than this quarter's worth of operating cash flow generated, continuing to provide us with other options for growth funding in the future.

此外，我們健康的現金流使我們能夠抓住機會改善我們的資產負債表，就像喬之前提到的以 950 萬美元回購部分 Hayfin B 系列優先股的交易一樣。我們特別高興能夠執行這項交易，利用少於本季產生的營運現金流，繼續為我們未來的成長融資提供其他選擇。

I will now turn the call back to Joe. Joe?

我現在將把電話轉回給喬。喬？

Thanks, Doug. As you have just heard, we had another outstanding quarter, once again exceeding expectations. Quarterly revenue was up 21% year-over-year. Gross profit margin was 82%. Adjusted EBITDA was $17.6 million. We increased our cash balance to over $81 million, readied EPIEFFECT for launch and continue to realize margin improvement by driving expense rationalization throughout the organization.

謝謝，道格。正如您剛剛聽到的，我們又度過了一個出色的季度，再次超出了預期。季度營收年增 21%。毛利率為82%。調整後 EBITDA 為 1760 萬美元。我們將現金餘額增加到超過 8,100 萬美元，為 EPIEFFECT 的推出做好準備，並透過推動整個組織的費用合理化來繼續實現利潤率的提高。

For the first 3 quarters of the year, we have delivered consistently improving performance, with Q3 having our highest quarterly sales and an adjusted EBITDA margin of over 20%. As you may recall, after exceeding expectations last quarter, we raised full year guidance for revenue percentage growth to be in the mid- to high teens. Following a similar performance in Q3, we are now again raising full year revenue percentage growth outlook to be in the high teens, nearing 20%. As a reminder, sales for the fourth quarter of 2022 were by far our highest quarterly sales of 2022 at $74.4 million, naturally making it our toughest comp for the year.

今年前三個季度，我們的業績持續改善，第三季的季度銷售額達到最高，調整後的 EBITDA 利潤率超過 20%。您可能還記得，在上個季度超出預期後，我們將全年營收百分比成長指引提高到了中位數至高位數。繼第三季出現類似表現後，我們現在再次將全年營收百分比成長預期提高至十幾歲，接近 20%。提醒一下，2022 年第四季的銷售額是我們 2022 年迄今為止最高的季度銷售額，達到 7,440 萬美元，這自然使其成為我們今年最艱難的競爭。

That being said, given the current strength of the business and with the help of the EPIEFFECT launch, we do expect to close 2023 with another strong performance and ride that momentum into the new year. As we stated on our last call, we also expect at least a 20% adjusted EBITDA margin in the second half of 2023. And with the recent Hayfin transaction complete, we now expect to end the year with over $80 million of cash. Additionally, all fundamentals continue to point to a double-digit percentage annual revenue growth rate for the foreseeable future.

話雖如此，鑑於目前的業務實力，並在 EPIEFFECT 推出的幫助下，我們確實預計 2023 年將再次表現強勁，並利用這一勢頭進入新的一年。正如我們在上次電話會議中所說，我們也預計 2023 年下半年調整後的 EBITDA 利潤率至少達到 20%。隨著最近 Hayfin 交易的完成，我們現在預計年底將擁有超過 8000 萬美元的現金。此外，所有基本面繼續表明在可預見的未來年收入成長率將達到兩位數。

Those of you who have been following the company for the past 3 quarters have witnessed a meaningful business transformation, driven by excellent commercial execution, decisive strategic actions to reposition the company and expense reduction initiatives all resulting in a much improved financial profile for the company. I fully expect that we will continue to execute our plan, close the year out strong and set the business up for sustained long-term growth. In closing, I would like to thank the entire MiMedx team for their outstanding performance throughout the first 3 quarters of the year.

那些在過去三個季度一直關注該公司的人見證了一次有意義的業務轉型，這是由卓越的商業執行力、重新定位公司的果斷戰略行動以及費用削減舉措推動的，所有這些都使公司的財務狀況得到了顯著改善。我完全期望我們將繼續執行我們的計劃，以強勁的業績結束這一年，並為業務的持續長期成長做好準備。最後，我要感謝整個 MiMedx 團隊在今年前三個季度的出色表現。

Your enthusiasm and continued dedication to the company and to people in need of care have been a source of personal inspiration during my short tenure. I look forward to working with you as we seek to maximize the potential of this incredible company and take it to new heights. With that, I would like to open the call to questions. Operator, we are now ready for our first question. Please proceed.

在我短暫的任期內，你們對公司和需要照顧的人的熱情和持續奉獻一直是我個人靈感的來源。我期待與您合作，尋求最大限度地發揮這家令人難以置信的公司的潛力，並將其推向新的高度。接下來，我想開始提問。接線員，我們現在準備好回答第一個問題。請繼續。

Thank you. We will now be conducting a question-and-answer session. (Operator Instructions) Our first question comes from the line of Chase Knickerbocker with Craig-Hallum Group.

謝謝。我們現在將進行問答環節。 （操作員說明）我們的第一個問題來自 Chase Knickerbocker 和 Craig-Hallum Group 的線路。

Maybe starting on the physician office segment first. Maybe a little bit of additional color on how kind of customers reacted to that LCD during the quarter. Obviously, still good growth there. Maybe talk as to why you being listed on that LCD would still lead to some pausing? And then if we look at kind of what we've seen so far in Q4, have we seen kind of normal ordering behavior kind of come back now that LCD is on hold? Just some additional color there.

也許先從醫生辦公室部分開始。也許對本季客戶對 LCD 的反應有一些額外的了解。顯然，那裡仍然有良好的增長。也許談談為什麼你被列在 LCD 上仍然會導致一些暫停？然後，如果我們看看第四季度迄今為止所看到的情況，我們是否看到由於 LCD 處於擱置狀態，正常的訂購行為有所恢復？只是一些額外的顏色。

Yes, Chase, thank you. It's Joe. The -- yes, we saw some confusion in ordering patterns in the third quarter, in particular in the regions that were impacted, in the 15 states were covered by those 3 LCDs. It was -- and we could compare that against the other MACs. So there was definitely some confusion and kind of feedback from the field was that docs were trying to figure out what they had to do, how they might have to modified care protocols to adhere to the poor application restriction. And then there was a lot of noise as to what products we were going to be covered and which ones we're not.

是的，蔡斯，謝謝你。是喬。是的，我們在第三季度看到訂購模式出現了一些混亂，特別是在受影響的地區，即這 3 個 LCD 覆蓋的 15 個州。它是——我們可以將其與其他 MAC 進行比較。因此，肯定存在一些困惑，來自該領域的反饋是，醫生試圖弄清楚他們必須做什麼，他們可能需要如何修改護理協議以遵守不良的應用限制。然後，對於我們將涵蓋哪些產品、哪些不涵蓋哪些產品，存在著許多爭議。

So we saw the impact. Good news for us is overall that site of service continued to grow at a very healthy rate. Second part of your question is what are we seeing in October so far? It looks like within those 3 MACs that order behavior starting to revert back to normal.

所以我們看到了影響。對我們來說，好消息是總體而言，服務網站繼續以非常健康的速度成長。你的問題的第二部分是到目前為止我們在 10 月看到了什麼？看起來這 3 個 MAC 的行為開始恢復正常。

Got it. That's helpful. And maybe staying on the physician office segment, if we look at kind of EPIEFFECT kind of growth in initial kind of launch here, do you expect it to cannibalize some EpiCord and EpiFix users? Or is this going to be more de novo uptake or maybe some people who are using your products for commercial patients? Using something else for Medicare patients. How should we think about the customer set for EpiFix early here?

知道了。這很有幫助。也許留在醫生辦公室領域，如果我們看看這裡最初發佈時的 EPIEFFECT 成長，您是否認為它會蠶食一些 EpiCord 和 EpiFix 用戶？或者這會被更多的從頭吸收，或者可能是一些將你的產品用於商業患者的人？為醫療保險患者使用其他東西。我們應該如何考慮早期 EpiFix 的客戶群？

I think earlier on -- I think about it primarily in the private office setting, and it will be used in applications that has not been used in today or used for procedure just not being used in today. So it should expand the market a bit, and then there will be some cannibalization of the EpiFix product.

我早些時候認為——我主要在私人辦公室環境中考慮它，它將用於今天尚未使用的應用程式或用於今天未使用的程式。所以它應該要擴大一點市場，然後就會有一些EpiFix產品的蠶食。

Got it. And then just last for me. I think it's fair to say that your stock may have gotten caught up in the recent GLP-1 craze as we've seen in the market lately. Maybe just some general kind of high-level thoughts there from you guys. Any sort of impact that you expect from proliferation of these drugs in the mid- to long term in the markets that you compete in?

知道了。然後就對我來說最後一次。我認為可以公平地說，正如我們最近在市場上看到的那樣，您的股票可能已經陷入了最近的 GLP-1 熱潮中。也許只是你們的一些一般性的高層想法。您預期這些藥物的擴散在中長期會對您競爭的市場產生什麼影響？

Yes. Chase, I think you're right, the awarding the [property] is a bit of a craze in the marketplace. So here's my thought on it. I worked for 3 different companies that had some business in the diabetes space. And I would tell you that -- so I've been in that space -- I was in that space for almost 20 years. And I can't remember back 15, 20 years ago when we were appalled at the increase in the rate of diabetes in the United States when it surpassed 8%. And since that time, there has been numerous drugs, products like continuous glucose sensors, automated insulin delivery systems, all kinds of education to help drive down the incidence of diabetes in this country.

是的。蔡斯，我認為你是對的，授予[財產]在市場上有點熱潮。這是我的想法。我曾在 3 家不同的公司工作過，這些公司在糖尿病領域都有一些業務。我想告訴你——所以我一直在那個領域——我在那個領域已經待了近 20 年了。我不記得 15、20 年前，當我們對美國糖尿病發病率上升超過 8% 感到震驚時。從那時起，出現了許多藥物、連續血糖感測器、自動胰島素輸送系統等產品，以及各種教育來幫助降低這個國家的糖尿病發病率。

A lot of diet products. And unfortunately, the epidemic continues to expand in the U.S. So I don't know that it's a product that's going to cure the problem. By all indications, everything that I could tell, these GLP-1 drugs do work. People are losing rate with them, which is wonderful if at some point in the future these would expand with minimal adverse effects and it had some potential impact on the rate of diabetes, that would be wonderful. Do I think it's going to happen? I would say that historical evidence would suggest otherwise.

很多減肥產品。不幸的是，這種流行病在美國繼續擴大，所以我不知道這是一個能夠解決問題的產品。從所有跡象來看，據我所知，這些 GLP-1 藥物確實有效。人們的糖尿病發病率正在下降，如果在未來的某個時候這些藥物能夠以最小的不利影響擴大，並且對糖尿病發病率產生一些潛在影響，那就太好了。我認為這會發生嗎？我想說的是，歷史證據顯示事實並非如此。

So I think it's great. I think the more people can use these drugs if it has a weight loss impact, wonderful. So I think it's going to translate into a decrease in the rate of diabetes in the United States. I think that is a bridge too far. Evidence would suggest otherwise, but even if it did, let's talk for a second about potential impact on diabetic foot ulcer, venous leg ulcer indications for use of our product. The evidence would suggest that there is not a strong correlation between obesity and lower extremity ulcers. In fact, I think you cited this in your very thoughtful initiation that you published last week, the evidence would suggest the opposite.

所以我認為這很棒。我認為更多的人可以使用這些藥物，如果它有減肥效果，那就太好了。所以我認為這將導緻美國糖尿病發病率的下降。我認為那座橋太遠了。證據顯示並非如此，但即使確實如此，我們還是談談使用我們的產品對糖尿病足潰瘍、腿部靜脈潰瘍適應症的潛在影響。有證據表明，肥胖和下肢潰瘍之間沒有很強的相關性。事實上，我認為你在上週發表的非常深思熟慮的啟蒙中引用了這一點，但證據表明事實恰恰相反。

In fact, these are often associated with people who have low BMI, but are just generally unhealthy, smokers, hypertension, poor diet, et cetera, et cetera. I just don't think that behavior is going to change much because we've launched a new drug. And I think Ozempic has been out since 2016, and that was the -- one of the first GLP drugs in this category. At the time it was launched, incidence of diabetes was somewhere around 9.1%, 2 or 3 years after its launch, the incidence of diabetes in the U.S. was at 11.3%. That was a number that was published pre-COVID. I can't imagine that COVID did anything positive for that number.

事實上，這些通常與體重指數低但整體不健康的人、吸菸者、高血壓、不良飲食等等有關。我只是認為這種行為不會因為我們推出了一種新藥而太大改變。我認為 Ozempic 自 2016 年以來就已上市，這是該類別中首批 GLP 藥物之一。推出時，糖尿病發生率約 9.1%，推出兩、三年後，美國糖尿病發生率為 11.3%。這是新冠疫情爆發前公佈的數字。我無法想像新冠疫情對這個數字有什麼正面影響。

So maybe it will, at some point, have an impact on the incidence of diabetes in the U.S., but it certainly is not doing so right now. So I just don't see the correlation at this point.

因此，也許它會在某個時候對美國糖尿病的發生率產生影響，但現在肯定還不會。所以我現在還沒有看到其中的相關性。

Our next question comes from the line of Anthony Petrone with Mizuho Group.

我們的下一個問題來自瑞穗集團的 Anthony Petrone。

Congrats on strong quarter year set up into 2024. Maybe I'll pivot back to the LCD, Joe, if I can, for a moment. I'm just wondering when you look at sort of the verbiage in late September, there was references to just the implementation time frame that there wasn't enough time to sort of transition practices over and that potentially could impact patient care. But you also saw just a certain amount of advocacy from the various different medical societies out there in favor of sort of taking a second look here.

恭喜您在 2024 年取得了強勁的季度業績。喬，如果可以的話，也許我會暫時轉向 LCD。我只是想知道，當您查看 9 月底的一些措辭時，其中提到了實施時間框架，沒有足夠的時間來整理過渡實踐，這可能會影響患者護理。但您也看到了來自各個不同醫學協會的一定程度的倡導，支持重新審視這裡。

So maybe just a little bit behind the scenes. What do you think was the tipping point on putting the brakes here? And as we look at the new sort of just common period, I mean, what are the next big updates here that we should be thinking about from these local MACs and as well as other MACs that potentially may look to change their policies heading into 2024 and 2025? And then I'll have a couple of follow-ups.

所以也許只是在幕後一點點。您認為此時踩煞車的轉捩點是什麼？當我們審視新的共同時期時，我的意思是，我們應該考慮這些本地 MAC 以及其他可能會在 2024 年改變政策的 MAC 的下一個重大更新是什麼2025 年呢？然後我會進行一些後續行動。

Thanks, Anthony. Well, first of all, we really don't know because they never pulled back the curtain and let you know why they made the decision that they made. If you're asking me for my personal opinion, I never thought it had a chance of being implemented because I thought it was arbitrary and capricious, quite frankly. And there was no good evidence to support the -- for application cap and it was -- I think, flimsy evidence to support the restriction on some of the products and organizations that were eliminated from participating. But, if you ask me, I think we're maybe trying to make up for some sins of the past.

謝謝，安東尼。好吧，首先，我們真的不知道，因為他們從來沒有拉開帷幕，讓你知道他們為什麼做出這樣的決定。如果你問我個人的意見，我從來沒有想過它有機會被實施，因為我認為它是任意的和反复無常的，坦率地說。對於申請上限，沒有充分的證據支持，我認為，支持對某些被排除在參與之外的產品和組織的限制的證據是站不住腳的。但是，如果你問我，我想我們可能是在試圖彌補過去的一些罪。

But in any case, I just -- we'll never really know. I think it's probably more the upward across the industry, both clinically and from industry that this was not a great way to approach the problem that we try to solve. And they indicated that they would continue to analyze and collect more evidence and try to see if there's a better way to approach these LCDs in the future. So as I indicated in my commentary, we continue to work with various stakeholders who have an influence on this.

但無論如何，我只是——我們永遠不會真正知道。我認為整個產業（無論是臨床還是產業）都認為這不是解決我們試圖解決的問題的好方法。他們表示，他們將繼續分析和收集更多證據，並嘗試看看未來是否有更好的方法來處理這些液晶顯示器。因此，正如我在評論中指出的那樣，我們將繼續與對此有影響的各個利益相關者合作。

We would -- we continue to advocate for policy that would eliminate some of the gamesmanship that's permitted around reimbursement of these products at the same time, maintain access for products like ours that have tremendous evidence that show effectiveness. So do I think something will change at some point in the future? Yes.

我們將繼續倡導政策，消除這些產品報銷所允許的一些遊戲技巧，同時保留對像我們這樣的產品的訪問權，這些產品有大量證據表明其有效性。那麼我認為未來某個時候會有什麼改變嗎？是的。

Do I know what it is? Absolutely not. I would say though that of all the companies in the category, we are, I believe, far and away best positioned to continue to support the private office setting regardless of the change. If it moved into some sort of a restricted utilization, we have evidence to support use of our product. if, for some reason, it moves towards a bundle, we have probably less impact than some of our other large competitors in the category.

我知道那是什麼嗎？絕對不。我想說的是，儘管如此，我相信，在該類別的所有公司中，無論發生什麼變化，我們都處於繼續支持私人辦公環境的最佳位置。如果它進入某種限制使用狀態，我們有證據支持我們產品的使用。如果出於某種原因，它轉向捆綁銷售，我們的影響力可能會比該類別中的其他一些大型競爭對手要小。

So look, we're going to continue to support this sector. We think it makes a lot of sense. It's great access for patients that can't necessarily be treated in a hospital and it continues to grow as a result. So again, I think we're just really well positioned regardless of the outcome, but we'll continue to try to influence it.

所以看，我們將繼續支持這個產業。我們認為這很有意義。對於那些不一定能在醫院接受治療的患者來說，這是一個很好的機會，因此它的數量持續增加。再說一遍，我認為無論結果如何，我們都處於有利位置，但我們將繼續努力影響它。

That's very helpful. And then maybe just two nuances in there. I mean, one was the advocacy and push from MiMedx that all of these products be sort of disclosed on Medicare B pricing list as opposed to wholesale acquisition cost. And then there was another decision in these LCDs where they actually wanted to limit applications to 4 for ulcer, which was below the 10 applications previously. So maybe just on those 2 specifically, I mean, is there anything that MiMedx is aware of on those 2 levers versus certainly going to Medicare Part B is positive for EpiFix and other products that were included in the 58%. On the other hand, limiting the applications for ulcer just seemed like perhaps too limiting? Is there anything on those 2 levers you can share?

這非常有幫助。然後也許只有兩個細微差別。我的意思是，其中之一是 MiMedx 的倡導和推動，即所有這些產品都應在 Medicare B 定價清單上披露，而不是批發採購成本。然後，這些 LCD 還做出了另一個決定，他們實際上希望將潰瘍的申請限制為 4 次，低於之前的 10 次。因此，也許就這 2 個具體而言，我的意思是，MiMedx 在這 2 個槓桿上有什麼了解，而不是加入 Medicare B 部分，這對 EpiFix 和 58% 中包含的其他產品是積極的。另一方面，限制潰瘍的應用似乎可能太過限制？這兩個槓桿上有什麼可以分享的嗎？

No, not really. Again, we continue to work with them and hopefully, this gets the [clouds] part over time, to get more clarity. We always -- we thought that the application restriction was some of our arbitrarily. It was -- it did point of some evidence, but it was misconstrued in the way that it's being applied. So hopefully, that goes away because that could be disruptive for patients that need more than 4 applications or they end up going into a more expensive care setting, frankly, to get treated. So it's not really good for Medicare, long term.

不，不是真的。再次，我們繼續與他們合作，希望隨著時間的推移，這會讓[雲]部分變得更加清晰。我們總是——我們認為應用程式的限制是我們任意的。它確實指出了一些證據，但它的應用方式被誤解了。所以希望這種情況會消失，因為這可能會對需要超過 4 次申請的患者造成乾擾，或者坦白說，他們最終會進入更昂貴的護理機構接受治療。因此，從長遠來看，這對醫療保險來說並不是一件好事。

As far as continuing to influence the use of the ASP versus the WACC, we think that's the easiest way to go in the near term, it's kind of the low-hanging fruit. And to their credit, the CMS has been pressuring people to move in that direction. As you know, the OIG published a letter earlier in the year, pretty much directing them to adhere to these guidelines. And we have seen a lot of products move on the ASP price gaps. If you look at the list a couple of years ago, there was maybe 12 products on the list and now it's probably up to around 75.

就持續影響 ASP 與 WACC 的使用而言，我們認為這是近期最簡單的方法，這是一種唾手可得的成果。值得讚揚的是，CMS 一直在向人們施壓，要求他們朝這個方向前進。如您所知，監察辦在今年稍早發表了一封信，幾乎指示他們遵守這些準則。我們已經看到很多產品的平均售價差距不斷變化。如果您查看幾年前的列表，您會發現列表中可能有 12 種產品，而現在可能已增加到 75 種左右。

So the market is moving in the right direction. And quite frankly, that could be one of the reasons we performed so well in that site of service for the first 3 quarters of the year because the playing field is starting to level a bit.

因此，市場正在朝著正確的方向發展。坦白說，這可能是我們今年前三個季度在該服務站點表現如此出色的原因之一，因為競爭環境開始變得公平了。

Last one, and I'll hop in real quick. Just on EBITDA, second half [Q3] to exceed 20%. Maybe just high level, there was a restructuring program earlier this year helps in achieving that 20%. As you look forward next couple of years, how much of the EBITDA expansion will just be from organic growth as opposed to a follow-on restructuring program? Congratulations again.

最後一篇，我很快就會跳進去。就 EBITDA 而言，下半年[第三季]將超過 20%。也許只是高水平，今年早些時候的重組計劃有助於實現 20%。展望未來幾年，EBITDA 擴張有多少將來自有機成長，而不是後續重組計畫？再次恭喜。

Thanks, Anthony. This is Doug. I'll take the question. We're excited exiting the year with a lot of momentum. We had a really solid Q3, we saw improved execution that will continue into Q4 and now with the new product introduction, we're going to have a lot of upside and growth. It will help us scale. We expect our gross margin staying stack up from an EBITDA perspective. We also expect to scale in sales and marketing and realize efficiencies all along our P&L.

謝謝，安東尼。這是道格。我來回答這個問題。我們很高興以強勁的勢頭結束這一年。我們的第三季度業績非常強勁，我們看到了執行力的提高，這種情況將持續到第四季度，現在隨著新產品的推出，我們將有很大的上升空間和成長。它將幫助我們擴大規模。從 EBITDA 的角度來看，我們預計我們的毛利率將保持成長。我們也希望擴大銷售和行銷規模，並提高損益表的效率。

So as our improved focus, as you mentioned, from the suspension of our BLA program that helps going into next year, we feel like we have a lot of momentum and ability to continue to grow into the double digits.

因此，正如您所提到的，隨著 BLA 計劃的暫停，我們的注意力得到了改善，這有助於進入明年，我們感覺我們有很大的動力和能力繼續以兩位數增長。

Yes. And Anthony, the only other thing I might add is just some of those legacy expenses kind of across the board. There's focus. There's SG&A leverage. There's obviously -- you kind of get a sense of where the R&D trend line looks and then obviously not having any other ancillary pieces hitting us whether we adjust them or not should show a really nice kind of leverage P&L.

是的。安東尼，我唯一可以補充的就是一些全面的遺留費用。有重點了還有SG&A槓桿。顯然，你可以了解研發趨勢線的位置，然後顯然沒有任何其他輔助因素影響我們，無論我們是否調整它們，都應該顯示出非常好的槓桿損益。

Our next question comes from the line of Carl Byrnes with Northland Capital Markets.

我們的下一個問題來自 Northland Capital Markets 的 Carl Byrnes。

Congratulations on your quarter and the progress here. I think most of my questions have been addressed. But I was a bit curious if you see an opportunity for further purchases of the Series B preferred such that it's done in an organized and orderly fashion? And then I have a follow-up to that.

恭喜您的季度和取得的進展。我想我的大部分問題都已經得到解答。但我有點好奇，您是否認為有機會進一步購買 B 系列首選產品，從而以有組織、有序的方式完成？然後我有一個後續行動。

Yes. So just a little more clarity on that. And I think I mentioned in my commentary that not my first -- not my highest priority for use of capital at this stage of the company's evolution. However, it was kind of opportunistic. We got real close to the mandatory conversion a few months ago. In fact, we were above the $7.70 mark for several days. As you may recall, requires us to stay above that for 20 out of any 30 consecutive trading days.

是的。所以只是更清楚一點。我想我在評論中提到，這不是我在公司發展的現階段使用資本的第一個優先事項，也不是我的最高優先事項。然而，這有點機會主義。幾個月前，我們非常接近強制轉換。事實上，我們已經連續幾天處於 7.70 美元大關之上。您可能還記得，要求我們在任何連續 30 個交易日中有 20 個交易日保持在該水平以上。

So it did not trigger, but it prompted us to start having conversations with Hayfin as to what is your long-term intent with the common once it converts. So they were pretty transparent that it's typically not the approach to hold that stock for a long period of time, and would look to probably exit it in some organized way. So it was really -- that's how the conversation has evolved. It was very opportunistic. Why we didn't buy all of it? We only bought half, frankly, it was just to keep some dry powder because we are looking to do other things with the business.

所以它沒有觸發，但它促使我們開始與 Hayfin 對話，了解一旦轉換後您對普通股的長期意圖是什麼。因此，他們非常透明地表示，這通常不是長期持有該股票的方法，並且可能會以某種有組織的方式退出。確實如此——這就是對話的演變。這是非常機會主義的。為什麼我們不買全部？我們只買了一半，坦白說，只是為了保留一些乾粉，因為我們想用業務做其他事情。

And they also agreed to a 12-month lockup on the other half of the equity, whether converts or not. So we felt like any potential disruption as they exited the position was limited quite a bit because of our repurchase of half of it and their agreement to lock up the other half for the time being.

他們還同意將另一半股權鎖定 12 個月，無論是否轉換。因此，我們覺得他們退出該部位時任何潛在的干擾都相當有限，因為我們回購了一半倉位，而他們同意暫時鎖定另一半部位。

Great. That's very helpful. And then kind of segueing to EpiFix in Japan. Do you have any updates with respect to the number of docs that have been trained to use product?

偉大的。這非常有幫助。然後又轉向日本的 EpiFix。對於已接受產品使用培訓的文件數量，您有任何更新嗎？

We're well into the hundreds. I think several hundred. I think about one point they might have put out a number of 500. It continues to grow. We're getting nice feedback from the physicians. There are -- several physicians have used the product in various procedures. They have reordered the product and they have gotten paid on the product. All these are very important steps when you're talking about developing a new business in a new market.

我們已經有數百人了。我想有幾百個。我想他們可能已經給了 500 個點。它還在繼續增長。我們從醫生那裡得到了很好的回饋。有幾位醫生在各種手術中使用過該產品。他們重新訂購了該產品，並獲得了該產品的付款。當您談論在新市場開發新業務時，所有這些都是非常重要的步驟。

I want to remind everybody that this is a first of its kind in the Japanese market. So this will take time to develop and get physicians comfortable with how to use it and as importantly, whether or not they're getting paid for it. So we're seeing pretty significant percentage growth on utilization, but off of a very low base, right? So we're pretty optimistic about what this could look like a few years down the road. But again, it's very early on.

我想提醒大家，這在日本市場尚屬首次。因此，這需要時間來開發並讓醫生熟悉如何使用它，同樣重要的是，無論他們是否為此獲得報酬。因此，我們看到利用率的百分比成長非常顯著，但基數非常低，對嗎？因此，我們對幾年後的情況非常樂觀。但話又說回來，現在還很早。

Our next question comes from the line of RK with H.C. Wainwright.

我們的下一個問題來自 RK 和 H.C.溫賴特。

This is RK from H.C. Wainwright. So a couple of quick questions. And looking at what the total revenues for this quarter and comparing it against last quarter, it's kind of similar numbers. And I see that the guidance you gave is higher teens. So what's the -- what's the push or pull on these numbers just on -- at a high level on the business? And also trying to see what's the probability that it will get into lower 20s based on what you're seeing?

我是 H.C. 的 RK。溫賴特。有幾個簡單的問題。看看本季的總收入並將其與上季度進行比較，就會發現數字相似。我發現你給的指導是更高的青少年。那麼，在業務高層，這些數字的推動或拉動是什麼？並且還嘗試根據您所看到的情況看看它進入 20 以下的機率是多少？

I think that the first part of your question was what happened from Q2 to Q3, your comment was relatively flat sequentially which is a home run for this business, right? As you know, these types of businesses typically have a seasonal decline in Q3, which we did not experience this year. On the contrary, we were able to tick the business up a little bit. We also had one less workday. So seasonal decline, one less workday and flat to up is a home run, in my opinion, in this business.

我認為你的問題的第一部分是從第二季度到第三季度發生的事情，你的評論相對平穩，這對這項業務來說是一個本壘打，對吧？如您所知，這類業務通常會在第三季出現季節性下降，但今年我們沒有遇到這種情況。相反，我們的業務略有成長。我們還少了一個工作天。因此，我認為，在這個行業，季節性下降、減少一個工作日以及持平上升是本壘打。

I think the second part of your question was why would we not continue to see something in the low 20s as we move through the rest of the year into next year. The comp for Q4 for 2022 is by far our toughest comp for the year. The revenue was clearly in a way the highest revenue that the business experienced last year. As you recall, that was the quarter in which we launched 2 new products in the surgical setting and revenue was somewhere around $74.5 million. So double-digit growth off of that would be a meaningful number. And we think we're well positioned to do that. We think the business will close out in the high teens, if not 20% but still a pretty good hill to climb to get those numbers.

我認為你問題的第二部分是，當我們從今年剩餘時間進入明年時，為什麼我們不會繼續看到 20 多歲的情況。 2022 年第四季的比賽是迄今為止我們今年最艱難的比賽。從某種程度上來說，這筆收入顯然是該公司去年的最高收入。您還記得，那個季度我們在外科領域推出了 2 款新產品，收入約為 7,450 萬美元。因此，兩位數的成長將是一個有意義的數字。我們認為我們有能力做到這一點。我們認為，該業務即使不是 20%，也將在十幾歲的時候結束，但仍然是一個相當不錯的山峰，需要攀爬才能獲得這些數字。

And as you know, fourth quarter can be disruptive depending on how holidays fall, et cetera, et cetera. We think this year, we have great momentum going into the fourth quarter. Clearly, our sales organization is executing better than other organizations in the market. We have the strongest leadership team than any other company in the marketplace. So I think we're well positioned to continue to drive that momentum.

如您所知，第四季度可能會造成破壞，具體取決於假期的安排等。我們認為今年進入第四季的勢頭強勁。顯然，我們的銷售組織比市場上的其他組織執行得更好。我們擁有市場上任何其他公司最強大的領導團隊。因此，我認為我們處於有利位置，可以繼續推動這一勢頭。

We're launching another product in EPIEFFECT into the private office segment, now takes time to ramp up any new product. So that rollout will happen over the next 2, 3 quarters before we see full effect of it, but we could get a nice impact from that in Q4. So look, could we get there? Maybe. But these numbers are pretty darn good numbers.

我們正在 EPIEFFECT 中向私人辦公領域推出另一款產品，現在需要時間推出任何新產品。因此，該推出將在接下來的 2、3 個季度內進行，然後我們才能看到其全部效果，但我們可以從第四季度獲得良好的影響。那麼看，我們能到達那裡嗎？或許。但這些數字都是相當不錯的數字。

Yes. I agree with you. I was -- I'm not -- I was not negative on it. My comments are not supposed to be negative. I was actually trying to see what else is there that can actually push this higher. The other question I have is regarding seeking opportunities outside of -- just introducing another product in the fourth quarter as you have previously said and just -- and you also just made some comments on it. But in addition to that, given what you're doing in terms of trying to do this buyback and keep some powder ready. What sort of opportunities would you be looking for as you go into '24 and even into '25?

是的。我同意你的看法。我當時——我不是——我對此並不持消極態度。我的評論不應該是負面的。我實際上是想看看還有什麼可以真正推動這個更高。我的另一個問題是關於尋找外部機會——正如您之前所說，在第四季度推出另一種產品——您也剛剛對此發表了一些評論。但除此之外，考慮到您在嘗試回購並準備一些粉末方面所做的事情。當你進入 24 世紀甚至 25 世紀時，你會尋找什麼樣的機會？

I think you're referencing potential inorganic opportunities. As I've indicated on a couple of calls now, strategically, we have determined that expanding our skin substitute product line to include nonhuman skin subs, xenografts and synthetics make a lot of sense. If we add that -- those products to our portfolio, we double our total available market just in the U.S. because, unfortunately, amniotic tissue is restricted for the use in certain market segments. So that's a priority for us at all. So it gives us more opportunity within the hospital -- within the surgical suite, which is another focus area for us.

我認為你指的是潛在的無機機會。正如我現在在幾次電話會議中所指出的那樣，從戰略上講，我們已經確定擴大我們的皮膚替代品產品線以包括非人類皮膚替代品、異種移植物和合成材料是非常有意義的。如果我們將這些產品添加到我們的產品組合中，我們僅在美國的可用市場總量就會增加一倍，因為不幸的是，羊膜組織在某些細分市場的使用受到限制。所以這是我們的首要任務。因此，它為我們在醫院內的外科手術室中提供了更多機會，這是我們的另一個重點領域。

So products that allow us to move in that direction at an accelerated rate are ones that we would prioritize. And then after that, anything within the Wound care continuum that will allow us to a, broaden our offering, but b, leverage our current operational infrastructure, both commercial and internal infrastructure. So you can imagine what those products might look like. But I think our highest priority would be the expanded skin subline.

因此，能夠讓我們加速朝這個方向發展的產品是我們優先考慮的產品。然後，傷口護理連續體中的任何內容都將使我們能夠：a、擴大我們的產品範圍；b、利用我們目前的營運基礎設施，包括商業和內部基礎設施。所以你可以想像這些產品會是什麼樣子。但我認為我們的首要任務是擴大皮膚子系。

Now I'll also tell you that there's internal development as well, right? We continue to develop placental-derived allograft and we have a rich pipeline for those as well as potentially internal development of xenografts. But we're also looking externally because as you know, that could accelerate the plan. And in my opinion, that's the only time you do acquisitions like this, it will accelerate your strategic plan. I can't just be done for the sake of doing it.

現在我也告訴大家，內部也有發展吧？我們繼續開發胎盤來源的同種異體移植物，我們擁有豐富的產品線以及潛在的異種移植物內部開發。但我們也在外部尋找，因為如你所知，這可以加速該計劃。在我看來，這是你唯一一次進行這樣的收購，它將加速你的策略計畫。我不能只是為了做而做。

Our next question comes from the line of John Vandermosten with Zacks.

我們的下一個問題來自 John Vandermosten 和 Zacks 的對話。

Thank you, and good afternoon, Joe, Doug and Matt. I wanted to understand the MediWound collaboration a little more. That sounds like a great opportunity to get involved with clinical trials, more further proof that the FDA is recognizing your product. Are there any other opportunities like this and with the MediWound, does that guarantee that your product will be used with their device, if it's approved?

謝謝你們，下午好，喬、道格和馬特。我想多了解 MediWound 的合作。這聽起來像是參與臨床試驗的絕佳機會，進一步證明 FDA 正在認可您的產品。是否還有其他類似的機會以及 MediWound，如果獲得批准，是否可以保證您的產品將與他們的設備一起使用？

Yes. First, yes, we were very excited about it, and we're glad to be supporting that trial. We think it's important. It's probably going to be the largest [BLU] trial in at least a decade, and the product looks very promising. EPIEFFECT, EpiFix was selective because it has more evidence and more around its clinical efficacy than then the other product in the category. So they know it works. They want to ensure closure throughout the trial so they get the best results. And that -- and I think they set that in their press release when they announced.

是的。首先，是的，我們對此感到非常興奮，並且很高興能夠支持該試驗。我們認為這很重要。這可能將是至少十年來最大規模的 [BLU] 試驗，而且該產品看起來非常有前途。 EPIEFFECT、EpiFix 之所以具有選擇性，是因為與該類別中的其他產品相比，它有更多的證據和更多的臨床療效。所以他們知道它有效。他們希望確保整個試驗結束，以便獲得最佳結果。我認為他們在宣布這一消息時在新聞稿中也提到了這一點。

As far as other opportunities, we're always looking to work with people who have complementary products. I don't have anything to talk about today. But certainly, working with other people in and around our product category makes a lot of sense.

至於其他機會，我們一直希望與擁有互補產品的人合作。我今天沒什麼好說的。但可以肯定的是，與我們產品類別內及其周圍的其他人合作非常有意義。

And then thinking about free cash flow, should we expect a sequential expansion in that in the fourth quarter?

然後考慮自由現金流，我們是否應該預期第四季會出現連續擴張？

Yes. Doug. We're really pleased with where our free cash flow ended up in the quarter, sequentially an increase versus our Q2 $7 million, I would expect Q4 to look similar. I think there's a lot of puts and takes in Q4, but we signaled in our prepared remarks that we expected adjusted EBITDA to be north of 20%. That's what it was in Q3. We would expect the same in Q4, and I would expect that our free cash flow would look similar.

是的。道格.我們對本季自由現金流的最終結果感到非常滿意，與第二季的 700 萬美元相比連續增加，我預計第四季的情況類似。我認為第四季度有很多調整和調整，但我們在準備好的演講中表示，我們預計調整後的 EBITDA 將超過 20%。這就是第三季的情況。我們預計第四季會出現同樣的情況，我預計我們的自由現金流將看起來相似。

And I want to expand on the earlier analyst question about EPIEFFECT. Do you feel that having more products in the Wound product portfolio will actually provide some kind of synergistic benefit there? Or might there be cannibalization in the group of products?

我想詳細闡述先前分析師關於 EPIEFFECT 的問題。您認為 Wound 產品組合中擁有更多產品實際上會帶來某種協同效益嗎？或者產品組中是否可能存在蠶食？

Yes. I think a little bit of both. Clearly, EPIEFFECT can be used in other procedures, which we talked about specifically when suturing is required. So it's going to expand utilization. But the -- frankly, there might be some cannibalization of EpiFix as well.

是的。我認為兩者都有一點。顯然，EPIEFFECT 可以用於其他手術，我們在需要縫合時專門討論過這一點。所以它將擴大利用率。但坦白說，EpiFix 也可能會被蠶食。

Thank you. There are no further questions at this time. I would like to turn the floor back over to Joe for closing remarks.

謝謝。目前沒有其他問題。我想請喬致閉幕詞。

Thanks, operator. And thanks for your questions and for your continued interest and support in the company. That concludes today's call, and we will talk to you after our next quarterly report. Thank you.

謝謝，接線生。感謝您提出的問題以及您對公司的持續關注和支持。今天的電話會議到此結束，我們將在下一份季度報告後與您交談。謝謝。

This concludes today's teleconference. You may disconnect your lines at this time. Thank you for your participation.

今天的電話會議到此結束。此時您可以斷開線路。感謝您的參與。