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Operator
Operator
Good morning and welcome to PROCEPT BioRobotics Third Quarter 2024 Earnings Conference Call. At this time all participantsâ are in a listen-only mode. We will be facilitating a question-and-answer session towards the end of todayâs call. As a reminder, this call is being recorded for replay purposes.
早安,歡迎參加 PROCEPT BioRobotics 2024 年第三季財報電話會議。此時所有參與者都處於只聽模式。我們將在今天的電話會議結束時安排一個問答環節。提醒一下,本次通話正在錄音,以便重播。
I would now like to turn the call over to Matt Bacso, Vice President of Investor Relations, for a few introductory comments.
現在,我想將電話轉給投資者關係副總裁 Matt Bacso,請他作一些介紹性評論。
Matt Bacso - Vice President, Investor Relations
Matt Bacso - Vice President, Investor Relations
Good morning, and thank you for joining PROCEPT BioRobotics third quarter 2024 earnings conference call. Presenting on today's call are Reza Zadno, Chief Executive Officer; and Kevin Waters, Chief Financial Officer. Also present is Sham Shiblaq, Chief Commercial Officer, who will participate in the Q&A session.
早安,感謝您參加 PROCEPT BioRobotics 2024 年第三季財報電話會議。參加今天電話會議的有執行長 Reza Zadno;以及財務長 Kevin Waters。首席商務官 Sham Shiblaq 也將出席,並將參加問答環節。
Before we begin, I'd like to remind listeners that statements made on this conference call that relate to future plans, events, or performance are forward-looking statements as defined under Private Securities Litigation Reform Act of 1995. While these forward-looking statements are based on management's current expectations and beliefs, these statements are subject to several risks and uncertainties, assumptions, and other factors that could cause results to differ materially from the expectations expressed on this conference call. These risks and uncertainties are disclosed in more detail in PROCEPT BioRoboticsâ filings with the Securities and Exchange Commission, all of which are available online at www.sec.gov. Listeners are cautioned not to place under reliance on these forward-looking statements, which speak only as of today's date, October 28, 2024. Except as required by law, PROCEPT BioRobotics undertakes no obligation to update or revise any forward-looking statements to reflect new information, circumstances or unanticipated events that may arise.
在我們開始之前,我想提醒聽眾,本次電話會議上與未來計畫、事件或表現相關的陳述均為《1995 年私人證券訴訟改革法案》定義的前瞻性陳述。雖然這些前瞻性陳述是基於管理階層目前的期望和信念,但這些陳述受若干風險和不確定性、假設和其他因素的影響,這些因素可能導致結果與本次電話會議上表達的預期有重大差異。這些風險和不確定性在 PROCEPT BioRobotics 提交給美國證券交易委員會的文件中進行了更詳細的揭露,所有這些文件都可以在 www.sec.gov 上查閱。請聽眾不要依賴這些前瞻性陳述,這些陳述僅截至今天(2024 年 10 月 28 日)有效。除法律要求外,PROCEPT BioRobotics 不承擔更新或修改任何前瞻性聲明以反映可能出現的新資訊、情況或意外事件的義務。
During the call, we will also reference certain financial measures that are not prepared in accordance with GAAP. More information about how we use these non-GAAP financial measures, as well as reconciliations of these measures to their nearest GAAP equivalent are included in our earnings release.
在電話會議中,我們也會參考某些未依照 GAAP 編製的財務指標。有關我們如何使用這些非 GAAP 財務指標以及這些指標與最接近的 GAAP 等值的調整的更多信息,都包含在我們的收益報告中。
With that, I'll turn the call over to Reza.
說完這些,我將把電話轉給 Reza。
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
Good morning and thank you for joining us. For today's call, I will provide opening comments and a general business update followed by Sham, who will provide an overview of the HYDROS Robotic Systems commercial launch. Lastly, Kevin will provide additional detail regarding our financial performance and updated 2024 guidance.
早安,感謝您加入我們。在今天的電話會議上,我將致開場白並介紹一般業務更新,隨後 Sham 將概述 HYDROS 機器人系統的商業發布。最後,Kevin 將提供有關我們的財務表現和更新的 2024 年指引的更多詳細資訊。
Starting with our quarterly revenue results. We are pleased to report another quarter of strong financial performance with total revenue for the third quarter of 2024 of $58.4 million, representing growth of 66%, compared to the third quarter of 2023. Growth in the quarter was driven by strong demand and higher average selling prices for our robotic system, increased utilization from our expanded US installed base and record international revenues. We exited the third quarter of 2024 with a US installed base of 445 systems, representing growth of 64%, compared to the prior year period.
從我們的季度收入結果開始。我們很高興地報告又一個季度的強勁財務業績,2024 年第三季的總收入為 5,840 萬美元,與 2023 年第三季相比增長了 66%。本季的成長得益於我們機器人系統的強勁需求和更高的平均銷售價格,擴大美國安裝基數帶來的利用率提高以及創紀錄的國際收入。截至 2024 年第三季度,我們在美國安裝了 445 個系統,與去年同期相比成長了 64%。
Additionally, we exceeded our utilization per account expectations for the quarter, despite substantial growth in our US installed base and the temporary removal of sales representatives from the field as we began training our sales team on the hydro system. We knew following our HYDROS announcement that the third quarter was going to represent unique challenges for our company given we were launching a new robotic system midway through the quarter. But I am incredibly proud of the entire PROCEPT team for their collective efforts.
此外,儘管我們在美國安裝基數大幅增長,並且由於我們開始對銷售團隊進行水力系統培訓而暫時將銷售代表從現場撤出,但我們本季度的每個帳戶利用率仍超出了預期。我們在 HYDROS 發布之後就知道,由於我們將在本季中期推出一個新的機器人系統,因此第三季將為我們公司帶來獨特的挑戰。但我對整個 PROCEPT 團隊的共同努力感到無比自豪。
During the third quarter, we successfully converted the capital pipeline, manufactured sufficient quantities of commercial product, reported record gross margins of 63.2%, began training our field-based teams, while mitigating downside pressure on procedures and effectively managed the market during this transition. As a result, we delivered a very strong quarter that reflects the team's dedication and steady commercial execution.
在第三季度,我們成功轉換了資本管道,生產了足夠數量的商業產品,報告了創紀錄的63.2%的毛利率,開始培訓我們的現場團隊,同時減輕了程序上的下行壓力,並在此過渡期間有效地管理了市場。因此,我們取得了非常強勁的季度業績,反映了團隊的奉獻精神和穩定的商業執行力。
Turning to international market development activities, we generated $6.2 million of international revenue in the third quarter of 2024, representing growth of 86%, compared to the prior year period. Growth in the third quarter was once again driven primarily by strong sales momentum in the United Kingdom. Our international pipeline continues to increase nicely, giving us further confidence as we enter 2025.
談到國際市場開發活動,我們在 2024 年第三季創造了 620 萬美元的國際收入,與去年同期相比成長了 86%。第三季的成長再次主要受到英國強勁銷售勢頭的推動。我們的國際通路持續穩定成長,讓我們在進入 2025 年時更有信心。
With that, I will turn the call over to Sham to provide more detail on our HYDROS launch.
說完這些,我將把電話轉給 Sham,讓他提供有關 HYDROS 發布的更多細節。
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Thanks, Reza. First, I want to reiterate Reza's comments on the team's exceptional performance in a quarter that required flawless execution and dedication from every part of the organization. Turning to the HYDROS launch itself, once we received FDA clearance in mid-August, the capital sales team immediately shifted their focus to educating hospitals and surgeons on the benefits of the HYDROS system and converting the immediate AQUABEAM pipeline to HYDROS.
謝謝,Reza。首先,我想重申 Reza 對團隊本季出色表現的評價,這需要組織每個部分的完美執行和奉獻精神。談到 HYDROS 的發布本身,當我們在 8 月中旬獲得 FDA 批准後,資本銷售團隊立即將重點轉移到向醫院和外科醫生宣傳 HYDROS 系統的優勢,並將當前的 AQUABEAM 管道轉換為 HYDROS。
Awareness and excitement around the launch spread quickly, which certainly played into our favor, allowing for a fairly smooth transition and resulted in an outstanding capital quarter. Initial feedback from customers is very encouraging. Aside from HYDROSs fully integrated and sleek design, surgeons were very impressed with the new First Assist AI feature. As a reminder, First Assist AI supports the surgeon in interpreting the live ultrasound image for key anatomical landmarks and suggest an optimal treatment plan for each patient. The addition of AI to our precise robotic assisted resection has the potential to enable all urologists to improve outcomes for their patients. This is very appealing to both surgeons and administrators.
圍繞產品發布的認知和興奮迅速蔓延,這無疑對我們有利,使得過渡相當順利,並帶來了出色的資本季度。客戶的初步回饋非常令人鼓舞。除了 HYDROS 完全整合且時尚的設計之外,外科醫生對新的 First Assist AI 功能也印象深刻。提醒一下,First Assist AI 可幫助外科醫生解釋即時超音波影像中的關鍵解剖標誌,並為每位患者提出最佳治療方案。在我們的精確機器人輔助切除術中加入人工智慧,有可能使所有泌尿科醫生都能改善患者的治療效果。這對於外科醫生和管理人員來說都非常有吸引力。
Other feedback, we received, particularly from hospital support staff, is how improved the surgeon and staff experience is at every stage of the Aquablation Therapy procedure. Specifically with a single footprint and improved user interface, the integrated tower facilitates efficient operating room setup, procedural workflow, and operating room turnover. Additionally, hospital CFOs were happy to see that the new HYDROS handpiece utilizes a single-use digital scope that eliminates the need for scope reprocessing and further streamline setup, which saves time and money.
我們收到的其他回饋,特別是來自醫院支援人員的回饋,是外科醫生和工作人員在水消融治療過程的每個階段的體驗如何得到改善。具體來說,由於整合塔佔用空間小、使用者介面改進,因此有助於有效地進行手術室設置、程序工作流程和手術室週轉。此外,醫院的財務長們很高興地看到,新的 HYDROS 手柄採用一次性數位內視鏡,無需對內視鏡進行再處理,並進一步簡化了設置,從而節省了時間和金錢。
With the third quarter and the initial launch phase behind us, we feel very good about the underlying trends we are seeing today, particularly around system average selling prices, customer demand, and high-dose user sentiment. Additionally, HYDROS has certainly energized the capital sales team, which has translated into a robust pipeline where we expect to sell a record number of new systems in the fourth quarter of 2024.
隨著第三季和初始發布階段的結束,我們對今天看到的潛在趨勢感到非常滿意,特別是在系統平均銷售價格、客戶需求和高劑量使用者情緒方面。此外,HYDROS 無疑激發了資本銷售團隊的活力,這轉化為強大的銷售管道,我們預計 2024 年第四季將銷售創紀錄數量的新系統。
Speaking briefly on utilization trends, as a reminder, we began sales team training sessions on the HYDROS System in September. We plan to continue training sessions throughout the fourth quarter, which will remove reps from their respective territories for a period of time. Given this dynamic, this will modestly impact volumes due to the reduced case coverage.
簡單談談利用率趨勢,提醒一下,我們在 9 月開始對 HYDROS 系統進行銷售團隊培訓。我們計劃在第四季度繼續開展培訓課程,這將導致銷售代表在一段時間內離開各自的區域。鑑於這種動態,由於案件覆蓋範圍的減少,這將對數量產生一定影響。
As we communicated in mid-August, properly training our sales teams is critical to our commercial and procedural success as we transition into 2025. While pleased with the team's execution in the third quarter, we realize there is a much bigger opportunity ahead for both robot system sales and expanded utilization over time.
正如我們在 8 月中旬所傳達的那樣,在我們邁向 2025 年之際,對我們的銷售團隊進行適當的培訓對於我們取得商業和程序成功至關重要。雖然對團隊在第三季的表現感到滿意,但我們意識到隨著時間的推移,機器人系統的銷售和擴大利用率都還有更大的機會。
As we enter the next phase of our commercial growth, I believe this launch will be a significant milestone in our journey driving widespread adoption and making a profound difference in the lives of our patients.
隨著我們進入商業成長的下一階段,我相信這次發布將成為我們推動廣泛應用和為患者生活帶來深遠改變的旅程上的一個重要里程碑。
With that, I will turn the call back over to Reza.
說完這些,我將把電話轉回給 Reza。
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
Thanks, Sham. Before I pass it over to Kevin, I want to discuss our recent announcement to initiate our new randomized clinical study for prostate cancer. On October 7, we announced that the FDA granted breakthrough device designation to investigate the use of Aquablation therapy for prostate cancer and approved a pivotal investigational device exemption clinical trial comparing Aquablation therapy to radical prostatectomy. Receiving breakthrough device designation is particularly exciting as it expedites the review process of technologies that the FDA considers innovative and that can improve the lives of people with life threatening or irreversibly debilitating diseases or conditions.
謝謝,Sham。在將其交給凱文之前,我想討論一下我們最近宣布的啟動針對前列腺癌的新隨機臨床研究的消息。10 月 7 日,我們宣布 FDA 授予突破性設備稱號,以研究使用 Aquablation 療法治療前列腺癌,並批准了一項將 Aquablation 療法與根治性前列腺切除術進行比較的關鍵研究設備豁免臨床試驗。獲得突破性設備稱號尤其令人興奮,因為它加快了 FDA 認為具有創新性的技術的審查流程,這些技術可以改善患有危及生命或不可逆轉的衰弱性疾病或病症的人的生活。
The trial we will be enrolling known as the WATER IV PCa is a global multi-center prospective random clinical study assessing the safety and efficacy of Aquablation therapy compared to radical prostatectomy in men with grade Group 1 to 3 localized prostate cancer. The study will enroll up to 280 patients at up to 50 centers, most of which are in the United States. The FDA agreed to a six-month co-primary endpoint based on morbidity, specifically rates of incontinence and erectile dysfunction.
我們將要參與的試驗稱為 WATER IV PCa,這是一項全球多中心前瞻性隨機臨床研究,旨在評估水消融療法與根治性前列腺切除術對於 1 至 3 級局限性前列腺癌男性的安全性和有效性。該研究將在多達 50 個中心招募多達 280 名患者,其中大部分位於美國。FDA 同意根據發病率(特別是失禁和勃起功能障礙的發生率)設定六個月的共同主要終點。
Additionally, the FDA agreed to include a 12-month secondary efficacy endpoint measuring the rate of great group progression. Patients will be followed up to 10-years with annual secondary endpoint evaluation focusing on both the reduction in treatment related to harm and oncological events. WATER IV PCa is a unique trial design that will focus on harm reduction when using Aquablation therapy as a first line treatment in comparison to radical prostatectomy.
此外,FDA 同意將 12 個月的次要療效終點納入其中,以衡量重大族群進展率。我們將對患者進行長達 10 年的隨訪,並每年進行次要終點評估,重點關注治療相關的傷害和腫瘤事件的減少。WATER IV PCa 是一種獨特的試驗設計,與根治性前列腺切除術相比,它將專注於減少使用 Aquablation 療法作為一線治療時的傷害。
If successful, we believe Aquablation therapy has the potential to significantly alter the way urologists approach localized prostate cancer for millions of men. To date, PROCEPT is the only company sponsored to ever receive an ID for a randomized clinical trial comparing a novel localized prostate cancer treatment to a standard of care. A significant opportunity exists to improve safety and quality of life outcomes for men needing treatment for prostate cancer, and we believe Aquablation therapy has the ability to become a first-line treatment for localized prostate cancer. Initiating a randomized trial against radical prostatectomy is the first big step in pursuing a prostate cancer-specific indication, which no other treatment has today.
如果成功,我們相信水消融療法有可能顯著改變泌尿科醫師治療數百萬男性局部性前列腺癌的方式。迄今為止,PROCEPT 是唯一一家獲得資助並在一項比較新型局部性前列腺癌治療與標準治療的隨機臨床試驗中獲得 ID 的公司。對於需要接受前列腺癌治療的男性,有一個重要的機會來改善其安全性和生活質量,我們相信水消融療法有能力成為局部前列腺癌的第一線治療方法。啟動針對根治性攝護腺切除術的隨機試驗是尋求攝護腺癌特定適應症的第一步,目前任何其他治療方法都無法做到這一點。
Lastly, we completed enrollment of PRCT002 in September and plan to share six months follow-up data in April 2025 at the American Urological Association Conference in Las Vegas. Furthermore, over the next 12 to 18 months, we will likely share more details regarding our broader prostate cancer commercial strategy.
最後,我們在 9 月完成了 PRCT002 的招募,並計劃於 2025 年 4 月在拉斯維加斯舉行的美國泌尿科會議上分享六個月的追蹤數據。此外,在未來 12 到 18 個月內,我們可能會分享更多有關更廣泛的前列腺癌商業策略的細節。
To conclude, my prepared remarks, multiple factors continue to trend positively, allowing us to execute our long-term strategic plan. In summary, the US HYDROS launch is off to a great start and customers are thrilled with the improved features. Our pipeline and sales funnel continue to grow nicely at the average selling prices of hydro that are trending higher than our previous AQUABEAM system. Our international business continues to build momentum in the UK and Japan.
最後,正如我準備好的發言所說,多種因素繼續呈現正面趨勢,使我們能夠執行我們的長期策略計劃。總而言之,美國 HYDROS 的發布取得了良好的開端,客戶對改進的功能感到非常興奮。我們的管道和銷售管道持續良好成長,水電平均售價趨勢高於我們先前的 AQUABEAM 系統。我們的國際業務在英國和日本持續保持強勁發展勢頭。
Our commercial organization is the largest and most tenured in the company's history, which we believe will lead to increased productivity. We are the first company ever to receive ID approval from the FDA to enroll a randomized trial against the Radical Prostatectomy for prostate cancer. We view this as the first big step in pursuing a prostate cancer specific indication, which no other treatment has today.
我們的商業組織是公司歷史上規模最大、歷史最悠久的組織,我們相信這將會提高生產力。我們是第一家獲得 FDA 身份批准,可以開展針對前列腺癌根治性前列腺切除術的隨機試驗的公司。我們認為這是尋求前列腺癌特定適應症的第一步,目前任何其他治療方法都無法做到這一點。
And lastly, we have continued to exceed our guidance around profitability metrics, primarily with the expansion of gross margins throughout 2024. We believe these underlying fundamentals reflect the technology that is laying the foundation to become the BPH Surgical Center of Care and a business that will be a leading global neurology company.
最後,我們持續超越獲利指標的預期,主要是 2024 年毛利率的擴大。我們相信,這些基本面反映了為成為 BPH 外科護理中心和成為全球領先的神經病學公司奠定基礎的技術。
And with that, I will turn the call over to Kevin.
說完這些,我會把電話轉給凱文。
Kevin Waters - Chief Financial Officer, Executive Vice President
Kevin Waters - Chief Financial Officer, Executive Vice President
Thanks, Reza. Total revenue for the third quarter of 2024 was $58.4 million, representing growth of 66%, compared to the third quarter of 2023. US revenue for the quarter was $52.2 million, representing growth of 62% compared to the prior year period.
謝謝,Reza。2024 年第三季總營收為 5,840 萬美元,與 2023 年第三季相比成長 66%。本季美國營收為 5,220 萬美元,較去年同期成長 62%。
In the third quarter, we sold 45 robotic systems with blended average selling prices of approximately $432,000. Of these 45 systems, approximately 80% were HYDROS. Our HYDROS sales were primarily Greenfield accounts, although we did have a few sales included in the 45 systems that are second systems at existing accounts.
第三季度,我們銷售了 45 套機器人系統,綜合平均售價約為 432,000 美元。在這 45 個系統中,約 80% 是 HYDROS。我們的 HYDROS 銷售主要是來自 Greenfield 帳戶,儘管我們確實有一些銷售包含在 45 個現有帳戶的第二個系統中。
Additionally, we recorded approximately $200,000 of incremental system revenue for a few AQUABEAM system sales executed in previous quarters that were exchanged for HYDROS in the third quarter. We do not view these as true replacements as this is a limited offering for customers who recently purchased our AQUABEAM system.
此外,我們記錄了前幾季執行的一些 AQUABEAM 系統銷售的約 20 萬美元增量系統收入,這些收入在第三季兌換為 HYDROS。我們不認為這些是真正的替代品,因為這是針對最近購買我們的 AQUABEAM 系統的客戶的限量產品。
To be clear, these exchange systems are not included in the reported number of 45 systems sold and thus did not impact the installed base. When accounting for all of these variables, we generated total US system revenue of $19.6 million, representing system revenue growth of 46%, compared to the third quarter of 2023.
需要明確的是,這些交換系統不包括在報告的 45 個銷售系統中,因此不會影響安裝基數。考慮到所有這些變量,我們在美國系統的總收入為 1,960 萬美元,與 2023 年第三季相比,系統收入成長了 46%。
US handpiece and consumable revenue for the third quarter of 2024 was $29.6 million, representing growth of 74%, compared to the third quarter of 2023. Handpiece growth was driven by an increase in the installed base of robotic systems. Additionally, monthly utilization per account increased approximately 7%, compared to the third quarter of 2023. We shipped approximately 8,740 handpieces in the US in the third quarter, representing unit growth of 79%, compared to the third quarter of 2023.
2024 年第三季美國手機和消耗品收入為 2,960 萬美元,與 2023 年第三季相比成長 74%。手機的成長是由機器人系統安裝基數的增加所推動的。此外,與 2023 年第三季相比,每個帳戶的每月使用率增加了約 7%。我們第三季在美國出貨了約 8,740 支手機,與 2023 年第三季相比,單位成長了 79%。
Third quarter average selling prices were approximately $3,200. We also recorded approximately $1.8 million of other consumable revenue in the third quarter of 2024. International revenue for the third quarter was $6.2 million, representing growth of approximately 121%.
第三季的平均售價約為 3,200 美元。我們也在 2024 年第三季記錄了約 180 萬美元的其他消耗品收入。第三季國際營收為 620 萬美元,成長約 121%。
Gross margin for the third quarter of 2024 was 63.2%, representing an all-time high. Gross margin expansion in the third quarter was primarily due to strong execution from our operations team and significantly higher high-growth system average selling prices. It is important to note that following a full quarter of manufacturing our new HYDROS system, it is roughly 10% more costly than AQUABEAM today. Over time with scale, we expect material costs to come down. However, this headwind is being more than offset by increased average selling prices.
2024年第三季毛利率為63.2%,創歷史新高。第三季毛利率擴大主要得益於我們營運團隊的強勁執行力以及高成長系統平均銷售價格的大幅上漲。值得注意的是,經過整整一個季度的生產,我們的新 HYDROS 系統的成本比目前的 AQUABEAM 高出約 10%。隨著時間的推移和規模的擴大,我們預計材料成本將會下降。然而,平均銷售價格的上漲足以抵銷這一不利因素。
Moving down the income statement, total operating expenses in the third quarter of 2024 were $59.3 million, compared to $44.5 million in the same period of the prior year, and $58.3 million in the second quarter of 2024. The year-over-year increase was driven primarily by increased sales and marketing expenses, mostly to expand the commercial organization and increase general and administrative expenses offset by lower sequential research and development expenses following the significant effort around HYDROS development in the second quarter of 2024.
沿著損益表向下移動,2024 年第三季的總營運費用為 5,930 萬美元,而去年同期為 4,450 萬美元,2024 年第二季為 5,830 萬美元。年比成長主要由於銷售和行銷費用的增加,主要是為了擴大商業組織和增加一般及行政費用,但 2024 年第二季度在 HYDROS 開發方面做出重大努力後,研發費用連續下降,抵消了這一增長。
We are very pleased with the operating expense leverage we have demonstrated year-to-date. When comparing revenue growth to operating expense growth, revenues increased 69% in the first nine months of 2024 and 32% operating expense growth. Net loss was $21 million for the third quarter of 2024, compared to $24.6 million in the same period of the prior year.
我們對今年迄今展現的營業費用槓桿感到非常滿意。將收入成長與營業費用成長進行比較,2024 年前 9 個月收入成長了 69%,營業費用成長了 32%。2024 年第三季淨虧損為 2,100 萬美元,去年同期為 2,460 萬美元。
Adjusted EBITDA was a loss of $12.4 million, compared to a loss of $19.4 million in the third quarter of 2023. Our cash, cash equivalents, and restricted cash balances as of September 30 were $200 million, and we reported a cash usage in the quarter of $17.3 million.
調整後 EBITDA 虧損 1,240 萬美元,而 2023 年第三季虧損 1,940 萬美元。截至 9 月 30 日,我們的現金、現金等價物和受限現金餘額為 2 億美元,我們報告本季的現金使用量為 1,730 萬美元。
Moving to our 2024 financial guidance. We now expect full-year 2024 total revenue to be in the range of $222.5 million to $223 million, representing growth of approximately 63% to 64%, compared to 2023. Starting with US systems, we continue to expect to sell approximately 186 robotic systems in 2024, which is approximately 56 new systems in the fourth quarter. While pleased with the direction of new system pricing in the third quarter, we want to maintain pricing flexibility at this point in the HYDROS launch as we work through our fourth quarter pipeline. Thus, our updated guidance assumes new system pricing in the fourth quarter to be in the range of $420,000 to $430,000.
轉向我們的2024年財務指導。我們現在預計 2024 年全年總營收將在 2.225 億美元至 2.23 億美元之間,與 2023 年相比成長約 63% 至 64%。從美國系統開始,我們繼續預計 2024 年將銷售約 186 個機器人系統,即第四季約有 56 個新系統。雖然我們對第三季新系統定價的方向感到滿意,但我們希望在 HYDROS 發布期間保持定價彈性,因為我們正在進行第四季度的籌備工作。因此,我們更新後的指引假設第四季新系統定價在 42 萬美元至 43 萬美元之間。
Turning to US handpieces, we expect to sell approximately 9,950 handpieces in the fourth quarter, which would equate to full-year handpieces of approximately $33,500, representing 80% unit growth, compared to 2023. We expect fourth quarter handpiece average selling prices comparable to the third quarter. We also expect other consumables revenue to be approximately $7.3 million for the full-year. Additionally, we now expect US service revenue to be approximately $11 million for the full-year.
談到美國手機,我們預計第四季手機銷量約為 9,950 台,相當於全年手機銷量約為 33,500 美元,與 2023 年相比,單位成長率為 80%。我們預計第四季手機平均售價與第三季相當。我們也預計全年其他消耗品收入約為 730 萬美元。此外,我們現在預計全年美國服務收入約為 1,100 萬美元。
Lastly, on international revenue, given another strong quarter and positive momentum in the United Kingdom, we now expect full-year international revenue to be approximately $22.4 million, representing annual growth of 88%. Moving down the income statement, we now expect full-year 2024 gross margins to be approximately 61%, an increase from our previously issued guidance of 59%.
最後,關於國際收入,鑑於又一個強勁的季度和英國的積極勢頭,我們現在預計全年國際收入約為 2,240 萬美元,年增 88%。在損益表中,我們現在預計 2024 年全年毛利率約為 61%,高於我們先前發布的 59% 的預期。
Turning to operating expenses, we continue to expect full-year 2024 operating expenses to be approximately $231.5 million, representing growth of 29%. Given current interest rates, we expect to generate net interest income of $5.5 million in 2024. Given the increase in revenue and gross margin along with our continued view on operating expenses, we now expect full-year 2024 adjusted EBITDA loss to be approximately $60 million, which is an increase of almost $13 million from our initial guidance provided in February.
談到營運費用,我們繼續預計 2024 年全年營運費用約為 2.315 億美元,成長 29%。鑑於當前利率,我們預計 2024 年將產生 550 萬美元的淨利息收入。鑑於收入和毛利率的增加以及我們對營運費用的持續關注,我們現在預計 2024 年全年調整後 EBITDA 虧損約為 6,000 萬美元,比我們 2 月提供的初步指引增加近 1,300 萬美元。
At this point, I'd like to turn the call back to Reza for closing comments.
現在,我想將電話轉回給 Reza,請他發表最後評論。
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
Thanks, Kevin. In closing, I want to thank our employees, customers, and shareholders for all their support to help us along our journey to becoming the standard-of-care for BPH. We will continue to leverage our commercial and clinical investments to execute on our long-term strategy. Have a great day and I look forward to seeing many of you at upcoming investor conferences.
謝謝,凱文。最後,我要感謝我們的員工、客戶和股東,感謝他們的大力支持,幫助我們成為 BPH 治療的標準。我們將繼續利用我們的商業和臨床投資來執行我們的長期策略。祝大家有愉快的一天,並期待在即將召開的投資者會議上見到大家。
At this point, we will take questions. Operator?
現在,我們將回答問題。操作員?
Operator
Operator
Thank you. (Operator Instructions)
謝謝。(操作員指令)
Craig Bijou, Bank of America Securities.
克雷格‧比喬 (Craig Bijou),美國銀行證券。
Craig Bijou - Analyst
Craig Bijou - Analyst
Good morning, guys. Thanks for taking questions and congrats on another very strong quarter. I want to start with HYDROS and so it seems like HYDROS ASP, if you come back in the numbers, is somewhere around 450,000. And Kevin, I understand your comments on, you wanted to be, I guess, conservative now with the ASP to start, but how should we think about your ability to get price there? And then maybe if you just give a little bit more color on the customer reaction, the HYDROS, it sounds like it was pretty strong. But more specifically, did you see new customers either purchase or kind of get in the pipeline that may have been hesitant or reluctant before?
大家早安。感謝您的提問,並祝賀您又一個非常強勁的季度。我想從 HYDROS 開始,所以看起來 HYDROS ASP(如果你回頭看數字)大約在 450,000 左右。凱文,我理解您的評論,我想您現在想以保守的態度對待 ASP,但我們應該如何看待您在那裡獲得價格的能力?然後也許如果您只是稍微描述一下客戶的反應,HYDROS聽起來似乎非常強大。但更具體地說,您是否看到之前可能猶豫或不情願的新客戶現在進行購買或進入管道?
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
Hi Craig, thanks for the question. I'm going to give some general comments about HYDROS, the reaction has been extremely positive. Surgeons are excited about the AI assist, digital scope, the dual screen, the staff is excited about the ease of setup and faster setup, and of course the hospital saves time for sterilization. So overall the reaction has been fantastic.
你好 Craig,謝謝你的提問。我將對 HYDROS 發表一些總體評論,反應非常積極。外科醫生對人工智慧輔助、數位內視鏡、雙螢幕感到興奮,工作人員對設定的簡單性和更快的設定感到興奮,當然醫院也節省了消毒時間。整體來說,反應非常熱烈。
Sham, you want to add anything?
Sham,還有什麼要補充嗎?
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Yes, hi, good morning. I think that the immediate positive reaction by our customers showed in our results the ability for us to flip a pipeline in just over a month with many processes that are required from a hospital's perspective to purchase capital shows the excitement of our surgeons to drive administrators to make that happen. So we're very excited by the touch on the features. When you think about first assist AI, this is something that is not something that routinely gets approved nowadays in the surgical environment. And so we've been able to really, really capture a lot of excitement. The ease of use from the staff, the setup, the enter procedure, the take down, the efficiencies in the OR. We're just beginning to launch these programs and we're seeing immediate excitement from our surgeons.
是的,你好,早安。我認為,客戶立即做出的積極反應表明,我們能夠在短短一個多月的時間內完成一條流程,而從醫院的角度來看,這其中涉及許多購買資本的流程,這也表明我們的外科醫生非常樂意推動管理人員實現這一目標。因此,我們對這些功能的觸動感到非常興奮。當您考慮急救 AI 時,您會發現這並不是如今在手術環境中常規獲得批准的東西。因此,我們確實能夠捕捉到很多令人興奮的事情。工作人員的使用便利、設定、輸入程序、拆卸以及手術室的效率。我們才剛開始啟動這些項目,就看到外科醫生立即表現出興奮之情。
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
And may, I'll just close the loop on your HYDROS ASP question, Craig. So we are very pleased with what we saw in the quarter given HYDROS ASPs, compared to previous AQUABEAM sales. Today, we're not going to comment specifically on kind of where we can see this number going, but we definitely feel good about the launch, we feel good about current ASPs. At the end of the day we want HYDROS in as many hands, customers' hands as possible and we just want to continue to maintain some flexibility there, which is why we provided that range in the fourth quarter, $420,000 to $430,000.
並且,我將結束您對 HYDROS ASP 問題的回答,Craig。因此,與先前 AQUABEAM 的銷售情況相比,考慮到 HYDROS 的平均銷售價格,我們對本季的表現非常滿意。今天,我們不會具體評論這個數字的走向,但我們對這款產品的發布感到非常滿意,對目前的平均售價也非常滿意。最終,我們希望 HYDROS 能夠盡可能地掌握在客戶手中,我們只是希望繼續保持一定的靈活性,這就是為什麼我們在第四季度提供了 420,000 至 430,000 美元的範圍。
Craig Bijou - Analyst
Craig Bijou - Analyst
Got it, thanks guys. And I did want to ask on utilization and I think, and Kevin correct me if I'm wrong, but I think implied utilization in Q4 might be a step down year-over-year. I know you had a pretty strong quarter, but maybe if, you know, let me know if that's correct, but then if, you know, when you think about the impact or disruption to utilization during Q3, I don't know if you'd be willing to quantify that. And then if that would be higher or lower in Q4, just maybe a little bit more color on the impact that you're seeing and even if that bleeds into â25 at all? Thanks.
明白了,謝謝大家。我確實想問一下利用率的問題,如果我錯了,請凱文糾正我,但我認為第四季度的隱含利用率可能會比去年同期下降。我知道您本季的業績表現相當強勁,但也許,如果您知道,請讓我知道這是否正確,但是,當您考慮到第三季度對利用率的影響或中斷時,我不知道您是否願意量化這一點。那麼,如果第四季度的這一數字是更高還是更低,您所看到的影響可能會更加明顯,甚至是否會滲透到 25 年?謝謝。
Kevin Waters - Chief Financial Officer, Executive Vice President
Kevin Waters - Chief Financial Officer, Executive Vice President
Yes, let me start with Q3 then I'll address Q4 and I'll hand it off to Sham at the end here to talk about some of those dynamics. So yes, I can't specifically dollarize what that impact was in the third quarter of taking reps out of the field. But what we will say is we moved throughout the quarter, we definitely saw a strong September in procedures, even with our reps coming out of the field. So it was definitely a headwind, but the procedure environment itself in September felt really strong for us.
是的,讓我先從問題 3 開始,然後再討論問題 4,最後我會把它交給 Sham 來討論其中的一些動態。所以是的,我無法具體用美元來衡量在第三季將銷售代表撤出現場所產生的影響。但我們要說的是,我們在整個季度都取得了進展,即使我們的代表不在現場,我們也確實看到 9 月份的程序運行表現強勁。所以這確實是一個阻力,但 9 月的程式環境本身對我們來說確實非常強勁。
And as we head into the fourth quarter now transitioning, I'll first say that we do believe our 2024 results reflect a very strong underlying business that continues to gain share and momentum from all other respective procedures out there. But specifically your Q4 utilization is a fair one and it does suggest that year-over-year on a per account basis utilization would be down, which by the way was the same dynamic that has always been implied in our guidance that we have been providing for the full-year.
隨著我們進入第四季度的過渡期,我首先要說的是,我們確實相信我們的 2024 年業績反映了非常強勁的基礎業務,該業務將繼續從所有其他相關程序中獲得份額和發展動力。但具體來說,您第四季度的利用率是合理的,這確實表明每個帳戶的利用率同比會下降,順便說一句,這與我們對全年的指導中一直暗示的動態相同。
But specifically we do expect reps to continue to be removed from the field with HYDROS for training in the fourth quarter. I'm going to have Sham talk a little bit about that at the end, and that is going to have an impact on procedures. Our guidance also, Craig, does allow for some of these macro factors that we're all hearing about, particularly some of the things we saw in October around the hurricane incident in the Southeast, we have obviously been somewhat impacted by the saline shortages, but all of those macro factors are considered in our Q4 guide as well.
但具體來說,我們確實預計,第四季度,銷售代表將繼續帶著 HYDROS 離開現場進行培訓。最後我將讓 Sham 稍微談論一下這個問題,這將對程式產生影響。克雷格,我們的指導也確實考慮了我們都聽到的一些宏觀因素,特別是我們在十月份東南部颶風事件中看到的一些情況,我們顯然受到了鹽水短缺的一定影響,但所有這些宏觀因素也都在我們的第四季度指南中考慮在內。
And maybe I'll turn it over to Sham to close here.
也許我會把它交給 Sham 來結束這裡。
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
The one part I guess I'll just add a little bit on is the rep training, since we've talked about it in the past. So coming off of the HYDROS approval, as a PROCEPT team, we felt prepared, fully prepared to help our customers convert their purchases over to HYDROS, get them trained and ready to go. So we were already on our end. We just didn't have visibility to how quickly customers could complete the acquisition process and then how quickly surgeons and staff could get ready for the training aspect of it. So even though we did begin our training process in September with our field team. What we're going to see is the majority of these launches for HYDROS that were purchased in Q3 will now become November and December launches. So those rep trainings and the staff trainings and the surgeon trainings, you want to time those so that they're trained before the launch, not months before launch. So we'll see that begin to really start to pick up here in October and November as we're excited about those launches happening for the other quarter.
我想我要補充一點的是代表訓練,因為我們過去已經討論過它了。因此,在獲得 HYDROS 批准後,作為 PROCEPT 團隊,我們感到已經做好了充分準備,能夠幫助我們的客戶將他們的購買轉換到 HYDROS,對他們進行培訓並做好準備。所以我們已經到達了我們的終點。我們只是無法了解客戶能夠多快完成採購過程,以及外科醫生和工作人員能夠多快為培訓做好準備。儘管我們確實在九月就與現場團隊開始了培訓過程。我們將看到,第三季購買的 HYDROS 大部分發射現在將變成 11 月和 12 月的發射。因此,您需要對那些代表培訓、員工培訓和外科醫生培訓進行時間安排,以便他們在發布之前完成培訓,而不是在發布前幾個月進行培訓。因此,我們將看到這一趨勢在 10 月和 11 月開始真正回暖,因為我們對另一個季度的發布感到興奮。
Craig Bijou - Analyst
Craig Bijou - Analyst
Great. Thanks, guys.
偉大的。謝謝大家。
Operator
Operator
Brandon Vasquez. William Blair.
布蘭登·巴斯克斯。威廉·布萊爾。
Brandon Vasquez - Analyst
Brandon Vasquez - Analyst
Good morning, everyone. Thanks for taking the question and congrats on a nice quarter here. I'll just start with maybe keeping on the train of the last question here. I'll ask it slightly different, are you guys able to disclose at this point what percent of your sales reps have been trained already, so we can get a better understanding of how many reps are left to be trained as we go into Q4 and then piggybacking on that? Are you guys getting the sense that when a rep is pulled, you lose that procedure to another therapy or are they waiting for that rep to come back and perform that procedure with Aquablation?
大家早安。感謝您回答這個問題,並祝賀本季取得良好業績。我首先想繼續回答最後一個問題。我問的問題稍微不同,你們現在能否透露一下有多少百分比的銷售代表已經接受過培訓,這樣我們就能更好地了解在進入第四季度時還有多少銷售代表需要培訓,然後在此基礎上再進行培訓?你們是否感覺到,當一個代表被拉下來時,你會失去該程序而轉向另一種療法,還是他們在等待那個代表回來並用 Aquablation 執行那個程序?
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hey, Brandon. This is Sham, I'll take that question. So we're not going to comment on a specific percentage of reps, but I will tell you the vast majority of launches will happen in the fourth quarter. Many of them are now scheduled for November and December launches. So I think that you can kind of do the math on the impact of the salesforce coming out of the field. We have a very thorough process. We feel very good that what we're doing is the right thing for the business to ensure that we have great outcomes from day one with the HYDROS launch and that's going to help us long-term, have a great business and our patients will be happier and our surgeons will be happier as well.
嘿,布蘭登。我是 Sham,我來回答這個問題。因此,我們不會對具體的百分比發表評論,但我會告訴你,絕大多數的發布將在第四季度進行。其中許多目前計劃於11月和12月發射。所以我認為你可以計算一下銷售人員離開該領域的影響。我們有一個非常徹底的流程。我們感到非常高興,我們所做的事情對企業來說是正確的,以確保從 HYDROS 推出的第一天起我們就能夠獲得很好的結果,這將對我們長期發展有幫助,讓我們擁有偉大的業務,我們的患者會更開心,我們的外科醫生也會更開心。
Regarding the loss of cases, I don't at any time believe we're losing cases by taking us out of the field? Are we delaying procedures? We are by having surgeons leave their practices to go get trained by having hospitals put procedures on further in the quarter. So we don't believe we're losing cases. We're just delaying them to make sure we have a proper launch and great outcomes.
至於案件的損失,我從來都不認為我們離開實地工作會導致案件損失?我們是否在拖延程序?我們讓外科醫生離開他們的診所去接受培訓,讓醫院在本季進一步進行手術。所以我們不相信我們會輸掉官司。我們只是推遲了它們以確保我們能夠正常發布並取得良好的結果。
Brandon Vasquez - Analyst
Brandon Vasquez - Analyst
Okay. And maybe going a little higher level in terms of you guys made comments about placing some additional second unit systems this quarter. I know this is not something that you guys had really contemplated in your original analysis of the market opportunity or the TAM. So can you guys just talk a little bit about where, what is it that's kind of driving these second unit systems? Any updates you can give us on the number of accounts with second units and what that might mean for kind of your long-term opportunity here? Thank you.
好的。就你們關於本季放置一些額外的第二單元系統的評論而言,也許可以更上一層樓。我知道這不是你們在最初的市場機會或 TAM 分析中真正考慮到的事情。那麼你們能否稍微談談是什麼在推動這些第二單元系統呢?您能否向我們提供有關擁有第二單位的帳戶數量的最新消息,以及這對您在這裡的長期機會意味著什麼?謝謝。
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Yes, so I'll take the near-term and long-term here, Brandon. So specific to our Q4 guidance and what it implies, so the 56 units that we're guiding to in the fourth quarter, those are primarily green fields. We may have, think of less than a handful of second systems, but we still believe the biggest driver of our business today is greenfield opportunities. Although we did see in the third quarter some key KOLs that bought a second system and therefore they've kept our AQUABEAM system and they also bought a HYDROS system. So that's the near-term.
是的,所以我將考慮近期和長期的情況,布蘭登。因此,具體到我們的第四季度指引及其意義,我們在第四季度指引的 56 個單位,主要是綠地。我們可能有過少量的第二個系統,但我們仍然相信,目前我們業務的最大驅動力是綠地機會。儘管我們確實在第三季度看到一些關鍵的 KOL 購買了第二套系統,因此他們保留了我們的 AQUABEAM 系統,並且他們也購買了 HYDROS 系統。這是近期的情況。
When we look longer term, when we think of a replacement cycle, we definitely see that the demand is there. But as we communicated in mid-August, our primary strategy for the remainder of â24 is to sell HYDROS systems to new accounts. It's what we're focused on. It's how the sales force is compensated. And we believe weâre -- still have a huge market to penetrate on Greenfield. So only a few months in, it's too early to talk really about a replacement cycle, but this will probably come in connection with our 2025 guidance on our next call.
當我們放眼更長遠,考慮更換週期時,我們肯定會看到需求存在。但正如我們在 8 月中旬所傳達的那樣,我們 2024 年剩餘時間的主要策略是向新客戶銷售 HYDROS 系統。這就是我們所關注的重點。這就是銷售人員的報酬方式。我們相信,我們仍有龐大的 Greenfield 市場有待開拓。因此,僅僅幾個月的時間,現在談論更換週期還為時過早,但這可能與我們下次電話會議中的 2025 年指導有關。
Operator
Operator
Richard Newitter, Truist Securities.
Truist Securities 的 Richard Newitter。
Richard Newitter - Analyst
Richard Newitter - Analyst
Excuse me. Hi, thanks for taking the questions. Congrats on the quarter. Maybe just on the replacement and trade-in aspect here, Kevin, what was the cutoff for trade-in for the third quarter, or how many did you say there were that had purchased recently enough that you allowed them to swap out? Was there any true up kind of associated with that and what's the ballpark? And then how should we think about your strategy and/or cutoff thresholds for timing of purchases like if you made a purchase in the last 12-months on a rolling basis, are they eligible potentially for some sort of deal, because they were recent enough in their last purchase? So that's our first question and I'll have a follow-up, thanks.
打擾一下。嗨,感謝您回答這些問題。恭喜本季取得佳績。也許只是關於更換和以舊換新方面,凱文,第三季度以舊換新的截止點是什麼,或者您說最近購買了多少輛汽車以至於您允許他們進行換新?是否存在與此相關的真實情況以及大概情況如何?那麼,我們應該如何考慮您的購買策略和/或購買時機的截止閾值,例如,如果您在過去 12 個月內連續進行購買,他們是否有資格獲得某種優惠,因為他們上次購買的時間足夠近?這是我們的第一個問題,我會進行跟進,謝謝。
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
Yes, so and it's important to note, there is a difference between these exchanges that I've brought for today and a true replacement cycle. So in connection with our launch, we always were aware of customers that had recently purchased AQUABEAM, think in the last two quarters, where perhaps the system hadn't even been installed yet, the account hadn't been launched, so therefore we were always allowing for and had a program in place to address those as exchanges as opposed to or compare those to replacements. And those are the few that I mentioned in my script that contributed a nominal amount of revenue was a couple hundred thousand dollars and that, that could persist into the fourth quarter, but I wouldn't view that as a material aspect of how we're thinking about the HYDROS launch now that we've kind of gotten past those initial accounts.
是的,因此,值得注意的是,我今天帶來的這些交換與真正的更換週期是有區別的。因此,在推出產品的同時,我們始終關注最近購買了 AQUABEAM 的客戶,例如在過去兩個季度,可能係統尚未安裝,帳戶尚未啟動,因此,我們始終考慮並製定了一項計劃,將這些作為交換而不是替代品來處理,或將它們與替代品進行比較。這些是我在腳本中提到的少數幾個,它們貢獻了名義上幾十萬美元的收入,而且可能會持續到第四季度,但我不會將其視為我們對 HYDROS 發布的思考的重要方面,因為現在我們已經度過了那些初始帳戶。
And we then get into â25 Rich where we do expect to initiate more of a replacement cycle. Again, we're not going to provide a lot of color around that here today, but that will have an impact on overall ASPs. But with that said, as we communicated mid-August, we have many accounts that purchased AQUABEAM three, four, five years ago that we think are going to be right for replacement. And frankly, the ASPs of those shouldn't be terribly different than a Greenfield system.
然後我們進入“25 Rich”,我們確實預計會啟動更多的更換週期。再說一次,我們今天不會在這裡提供太多細節,但這會對整體 ASP 產生影響。但話雖如此,正如我們在 8 月中旬所溝通的那樣,我們有許多三、四、五年前購買了 AQUABEAM 的客戶,我們認為這些客戶適合進行更換。坦白說,這些的 ASP 與 Greenfield 系統不會有太大差異。
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Rich, one thing I'll add to this is, we have such a massive opportunity that remains with Greenfield hospitals. We're talking about 1,000s of hospitals that we believe are potential opportunities to acquire a system. The sales force has zero incentive right now to trade a system. They're hyper-focused the rest of this year on adding new hospitals, new accounts to ensure that we do everything we can to get these up and going. So in 2025, we'll comment more on the trade and replacements, but for now, we're going to be hyper-focused on launching new hospitals.
里奇,我想補充一點,格林菲爾德醫院為我們帶來了巨大的發展機會。我們正在談論數千家醫院,我們認為這些醫院都有可能獲得該系統。銷售人員現在對系統進行交易沒有任何動機。他們今年剩餘時間將高度集中精力增加新醫院、新帳戶,以確保我們竭盡全力讓這些業務順利啟動和運作。因此,在 2025 年,我們將對貿易和替代品發表更多評論,但目前,我們將高度關注開設新醫院。
Richard Newitter - Analyst
Richard Newitter - Analyst
Richard Newitter
理查德·紐威特
Okay. That's helpful. Thanks. I know you're not giving '25 guidance today, but we all have models that are going to have some flow-through consequences to the back half updated information here, particularly ASPs on the system side. If we don't think about additional revenue streams from replacements of which it sounds like there will be some if we just take your fourth quarter jump off point for ASP, you get to something north of 10% upside to street numbers right out of the gate. I guess help us think through any early commentary as we adjust our models for how to think about next year puts and the takes, don't limit it to the revenue. And particularly, if you can comment on what should happen with system ASPs directionally? Thank you.
好的。這很有幫助。謝謝。我知道您今天不會提供 25 個指導,但是我們所有的模型都會對後半部分更新的資訊產生一些影響,特別是系統方面的 ASP。如果我們不考慮來自替代品的額外收入來源,聽起來如果我們只以第四季度的平均售價為起點,你就會立即獲得比街道數字高出 10% 以上的收益。我想幫助我們思考任何早期的評論,因為我們調整了我們的模型,如何考慮明年的看跌和收益,不要將其局限於收入。特別是,您能否評論一下系統 ASP 應該如何發展?謝謝。
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Yes. So you hit the nail on the head that we're not going to give '25 guidance, but I'll just reiterate our comments that we do feel very good about the HYDROS launch. We feel very good about the receptivity around the ASPs that we saw in the third quarter. But we really, Rich, want to get through our first full quarter of having this product out in the market before we nail down a 2025 ASP. But directionally, as we've commented, we feel great about the launch and our ability to continue to capture robust average selling prices.
是的。所以你說對了,我們不會給出 25 年的指導,但我只想重申我們的評論,我們確實對 HYDROS 的發布感到非常滿意。我們對第三季的平均售價的接受度感到非常滿意。但是,Rich,我們真的希望在確定 2025 年的平均銷售價格之前,完成這款產品在市場上的第一個完整季度。但從方向上看,正如我們所評論的那樣,我們對此次發布以及繼續保持強勁平均售價的能力感到非常滿意。
Operator
Operator
Josh Jennings, TD Cowen.
喬許詹寧斯(Josh Jennings),TD Cowen。
Josh Jennings - Analyst
Josh Jennings - Analyst
Hi, Thanks a lot and congrats on another very strong quarter. I wanted to just ask about the recombinant BPH and localized prostate cancer opportunity. I think there have been some citations that in the US, there's maybe over 400,000 cases that need to be intervened upon annually. I was hoping if you guys could just review kind of your outlook on the size of that opportunity in terms of the number of procedures. And then also just help fill in, I mean, I'm sort understand that currently, I mean it's on label, clearly, and just to check the box, it's our understanding that all those cases that are being done are reimbursed? And then have you seen any uptick in utilization over the first nine months of this year since that prostate cancer update was put on where -- prostate cancer warning was removed from the label?
你好,非常感謝,恭喜你又一個非常強勁的季度。我只是想問一下重組 BPH 和局限性前列腺癌的機會。我認為有人指出,在美國,每年可能有超過 40 萬起案件需要介入。我希望你們能從程序數量的角度來回顧一下你們對該機會規模的看法。然後也只是幫助填寫,我的意思是,我明白目前,我的意思是它在標籤上,很清楚,只是為了檢查一下,我們的理解是所有正在處理的案件都會得到報銷?那麼,自從發布前列腺癌警告更新(將前列腺癌警告從標籤上刪除)以來,您是否看到今年前九個月的使用率有所上升?
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
Yes. Thanks. So yes, as we have said previously, there are about 3 million men in the United States with prostate cancer, and there are about 300,000 new cases. And what we want to accomplish with our clinical study is really generate a Level 1 data, so that we get in the guidelines. Our goal from the beginning we have said our goal is to expand the market because out of those 3 million men, who have prostate cancer, vast majority of them sit on the sidelines, because of the side effects of current treatments. With our randomized study, our goal is to show one, the safety of the product and efficacy and then expand the market. And as we gather more information in the future, we can provide more color into the commercialization strategy.
是的。謝謝。是的,正如我們之前所說,美國大約有 300 萬名男性患有前列腺癌,新病例約 30 萬人。我們希望透過臨床研究真正產生 1 級數據,以便獲得指導方針。我們從一開始就說過我們的目標是擴大市場,因為在患有前列腺癌的 300 萬名男性中,絕大多數人由於目前治療的副作用而選擇放棄治療。透過隨機研究,我們的目標是展示產品的安全性和有效性,然後擴大市場。隨著我們未來收集到更多的信息,我們可以為商業化策略提供更多的色彩。
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hey Josh, so on the concomitant use with meaning a BPH patient that also has localized prostate cancer, I think surgeons have been using BPH technologies, our effective surgeries for many years and feel confident in the safety of treating BPH patients with prostate cancer. We don't specifically, know for years what's been happening with Aquablation is that of the surgeon's decision as to how to treat their patients. But I do believe that the reason we wanted to prove that the safety of it, the FDA removed that contraindication to also show that the safety was there. It's very similar to other receptive procedures. So to answer your question specifically, we don't have an answer other than we do believe that surgeons have always felt safe treating cancer patients that have local life cancer faces that have BPH.
嘿,喬希,所以關於同時使用 BPH 患者和局限性前列腺癌的含義,我認為外科醫生多年來一直在使用 BPH 技術,我們的有效手術,並且對治療患有前列腺癌的 BPH 患者的安全性充滿信心。多年來,我們並不具體了解水消融術的具體情況,這取決於外科醫師如何治療患者。但我確實相信,我們想要證明其安全性的原因,FDA 取消了這項禁忌症也顯示了其安全性。它與其他接受程序非常相似。因此,要具體回答您的問題,我們沒有其他答案,只能相信外科醫生在治療患有 BPH 的局部癌症患者時始終感到安全。
Josh Jennings - Analyst
Josh Jennings - Analyst
Well, thanks for that. Appreciate it. And then I just wanted to -- I may have missed it on the call, I was hoping to hear an update on the ASC channel and the pilot program. And any updated outlook on that opportunity as we think about 2025? Thanks.
好吧,謝謝你。非常感謝。然後我只是想——我可能錯過了電話,我希望聽到有關 ASC 頻道和試點計劃的最新消息。當我們展望 2025 年時,對這項機會有何更新的展望?謝謝。
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Yes. So I'll take that one as well. So we continue to have a lot of success as we've begun that pilot program and get very excited about the opportunity in the ASC setting. Right now, there's one center out of Canada that's published, great data, showing the ability to get patients through an ASC setting same day with high success rates. We have the one center in the US which has been our pilot. We do expect to expand that pilot in 2025 to a limited number of sites, I think a handful of sites in 2025 and that is very deliberate. Once again, kind of going back to what I said a few minutes ago. We have 1,000s of hospitals that still need to acquire a system for Aquablation therapy. We'll remain hyper-focused on that. and then we expect the ASC opportunity to be an accelerator for us in years to come.
是的。因此我也會選擇這個。因此,我們在開始試點計畫後繼續取得許多成功,並對 ASC 環境中的機會感到非常興奮。目前,加拿大有一個中心發布了出色的數據,顯示患者當天就能透過 ASC 設置,而且成功率很高。我們在美國有一個中心作為我們的試點。我們確實希望在 2025 年將該試點擴展到有限數量的站點,我認為 2025 年將會有少數幾個站點,這是經過深思熟慮的。再次回顧我幾分鐘前說過的話。我們還有數千家醫院需要購置水消融治療系統。我們將繼續高度關注這一點。我們期望 ASC 機會成為我們未來幾年的加速器。
Operator
Operator
Matthew O'Brien, Piper Sandler.
馬修·奧布萊恩、派珀·桑德勒。
Unidentified_1
Unidentified_1
Good morning. This is Samantha on for Matt. Congrats on a great quarter and thank you for taking our question. I'd like to start with the competitive dynamics in BPH. What are you seeing in terms of share shift? And maybe are you seeing this accelerate from TURP and Laser in Q3??
早安.這是薩曼莎 (Samantha),代替馬特 (Matt)。恭喜您度過了一個美好的季度,感謝您回答我們的問題。我想先談談 BPH 中的競爭動態。就份額變化而言您看到了什麼?也許您是否看到了第三季 TURP 和雷射的加速發展?
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
So from a competitive on the receptive side, we do not see new technologies coming. As we had said previously, when we talk to our surgeons, vast majority of the cases that we are performing come from TURP and green light. And at the same time, anecdotally, when we are asking the question, do they see the market expansion, majority of them say, yes, the number of cases they are doing is more than what they were doing a year or two years ago.
因此,從接受方面的競爭來看,我們看不到新技術的出現。正如我們之前所說,當我們與外科醫生交談時,我們執行的絕大多數病例都來自 TURP 和綠燈。同時,有傳聞稱,當我們問到他們是否看到市場擴張時,大多數人會回答說是的,他們處理的案件數量比一兩年前多。
Unidentified_1
Unidentified_1
Okay. Thank you. And then I guess, second, we were wondering if you could provide any more color on profitability expectations, maybe both in the short-term, thinking about our models in next year and then also in the longer term?
好的。謝謝。其次,我想,您能否對獲利預期提供更多細節,也許是短期預期,考慮我們明年的模型,然後也是長期預期?
Kevin Waters - Chief Financial Officer, Executive Vice President
Kevin Waters - Chief Financial Officer, Executive Vice President
Yes, thanks for the question, this is Kevin. We're not going to provide kind of any specificity around dates, but what we would suggest is the results that we've demonstrated in 2024 show that we are a company that has a very clear pathway to profitability. We've always said with our revenue growth, it really comes down to our ability to control operating expenses, which I think we've demonstrated quite well this year by raising our revenue guidance now every quarter, while keeping operating expenses flat. And at the same time, our gross margin expansion is really a nice jumping off point here in the third quarter at a record level over 63%.
是的,感謝您的提問,我是凱文。我們不會提供任何有關日期的具體信息,但我們認為,我們在 2024 年展示的結果表明,我們是一家擁有非常明確的盈利途徑的公司。我們一直說,我們的收入成長實際上取決於我們控制營運費用的能力,我認為今年我們透過每季提高收入預期同時保持營運費用平穩,這很好地證明了這一點。同時,我們的毛利率擴張在第三季確實是一個很好的起點,達到了創紀錄的 63% 以上的水平。
Our guidance does suggest another sequential improvement in 2024, ending the year at 61%. I think we'll show that for a business that has our revenue growth, it's just a matter of time for profitability. But at this point, we still think it's prudent to be focus on making investments in the business to continue to grow our top line and outsized amounts. So therefore, we're not going to give any specificity around dates.
我們的指導確實表明 2024 年將再次出現連續改善,年底將達到 61%。我認為我們會證明,對於收入成長的企業來說,獲利只是時間問題。但目前,我們仍然認為,集中精力對業務進行投資以繼續實現營業收入和超額成長是明智之舉。因此,我們不會給出任何具體的日期。
Unidentified_1
Unidentified_1
Okay, thank you.
好的,謝謝。
Operator
Operator
Chris Pasquale, Nephron Research.
克里斯·帕斯誇萊(Chris Pasquale),腎元研究公司。
Chris Pasquale - Analyst
Chris Pasquale - Analyst
Thanks. Congrats on getting the WATER IV study approved. Can you talk a little bit about the thought process and the decision to actually go for specific labeling here? I know initially that was something you were kind of on the fence about how important you think that is to broad adoption long-term. And then just curious, is there a prespecified radiation component to the treatment regimen just to make sure that, that piece is balanced between the two arms?
謝謝。恭喜 WATER IV 研究獲得批准。您能否稍微談談您的思考過程以及決定進行特定標籤的決定?我知道,最初您對於這對於長期廣泛採用有多重要感到猶豫不決。然後很好奇,治療方案中是否有預先指定的放射成分,以確保兩組之間的平衡?
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
Yes. Thanks. So the thought process, as you mentioned, was to generate Level 1 clinical data so that with a randomized study, if successful, we could get into the guidelines and the goal is to expand the market. Harm reduction is an important benefit that FDA sees for patients because current treatments have high incidence of incontinence and erectile dysfunction. So the primary endpoint, six months, as we have mentioned, is to reduce statistically significant incontinence and erectile dysfunction. And of course, the efficacy on the secondary end point shows the benefit and that is defined as progression to the -- progression of cancer. So that is how efficacy is defined.
是的。謝謝。因此,正如您所提到的,我們的思考過程是產生 1 級臨床數據,以便透過隨機研究,如果成功,我們就可以進入指南,目標是擴大市場。減少傷害是 FDA 認為對患者重要的益處,因為目前的治療方法導致失禁和勃起功能障礙的發生率很高。因此,正如我們所提到的,主要終點,即六個月,是減少統計上顯著的失禁和勃起功能障礙。當然,次要終點的療效顯示了益處,這被定義為癌症的進展。這就是功效的定義。
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Chris, can you restate your question on radiation?
克里斯,你能重述一下關於輻射的問題嗎?
Chris Pasquale - Analyst
Chris Pasquale - Analyst
Just curious, are these patients going to be getting radiation? And is there sort of a prespecified protocol there to make sure that there's not an imbalance between the two arms?
只是好奇,這些病人會接受放射治療嗎?是否存在某種預先指定的協議來確保兩臂之間不會出現不平衡?
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Hisham Shiblaq - Executive Vice President, Chief Commercial Officer
Yes, this is a randomized study that we're looking at with Aquablation specific to prostatectomy so that the radiation component, it's obviously a different when you think about moving to definitive surgery for prostate cancer, obviously, many times prostatectomy and radiation other options for patients. We're looking at localized disease, which would either be a prostatectomy patients or Aquablation patients.
是的,這是一項隨機研究,我們正在研究針對前列腺切除術的 Aquablation,因此當您考慮轉向前列腺癌的確定性手術時,放射部分顯然是不同的,顯然,很多時候前列腺切除術和放射治療是患者的其他選擇。我們正在研究局部疾病,可能是攝護腺切除術患者,也可能是水消融術患者。
Chris Pasquale - Analyst
Chris Pasquale - Analyst
Okay. So they're not going to be getting any radiation. And then just wanted to clarify the comments around the saline shortage and the impact of the hurricanes and what you guys are seeing there? Have you seen procedures delayed because of that? And can you just remind us with the fluid utilization looks like in a typical Aquablation procedure? And is the waterjet itself comprised of clinical-grade sailing?
好的。所以他們不會受到任何輻射。然後只是想澄清有關鹽水短缺和颶風的影響的評論以及你們在那裡看到的情況?您是否曾經看過因這個原因而導致流程延遲的情況?您能否提醒我們典型的水消融手術中的液體利用率?噴水推進器本身是否由臨床級航行組成?
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
So from a quantity of saline used, in fact, the quantity of saline use during the procedure, our procedure uses less saline than TURP does. So broadly, it doesn't -- it hasn't impacted. But depending on the accounts, yes, there has been some impact, but broadly no. And as I mentioned on the quantity of saline, it's not more than TURP. I don't know, Kevin, do you want to add?
因此從使用的鹽水量來看,實際上,從手術過程中使用的鹽水量來看,我們的手術比 TURP 使用的鹽水要少。所以從廣義上講,它沒有產生影響。但根據帳目情況,是的,有一些影響,但總體上沒有影響。正如我之前提到的,鹽水的量並不比 TURP 多。我不知道,凱文,你想補充嗎?
Kevin Waters - Chief Financial Officer, Executive Vice President
Kevin Waters - Chief Financial Officer, Executive Vice President
Yes. No. Just regarding guidance specifically, our guidance, we did see procedures canceled in October. You could think in the 100s, not the 1,000s, if that helps kind of quantify how we're thinking about it in October. And our guidance does allow for that saline in particular, to continue to persist somewhat into November, but it also suggests that the current environment doesn't get worse, right? I think our guidance would assume the worst is behind us, obviously, with weather and with the saline shortage. But we, again, feel very good about the underlying trajectory of the business coming off a very strong September from a procedure standpoint.
是的。不。具體來說,就我們的指導而言,我們確實看到 10 月取消了某些程序。您可以考慮 100 個,而不是 1,000 個,如果這有助於量化我們在 10 月對此的看法。我們的指導確實允許鹽水繼續持續到 11 月,但這也表明當前的環境不會變得更糟,對嗎?我想,我們的指導會假設最糟糕的情況已經過去,顯然,天氣和鹽水短缺的問題已經出現。但是,從程序的角度來看,我們對 9 月份業務的強勁發展趨勢感到非常滿意。
Chris Pasquale - Analyst
Chris Pasquale - Analyst
Thanks.
謝謝。
Operator
Operator
Ryan Zimmerman, BTIG.
瑞安·齊默爾曼(Ryan Zimmerman),BTIG。
Ryan Zimmerman - Analyst
Ryan Zimmerman - Analyst
Hey guys. Good morning and congrats on the quarter. Want to ask, we've been picking up some comments in the field from urologists about a number of dynamics related to reimbursement. I think I've spoken with Barry about this previously, but there's been more chatter about things such as Medicare audits, specifically with RAC auditors and the risk of clawbacks with AQUABEAM cases, as well as some pushback from Cigna and Humana on what they're covering for AQUABEAM. And so I'm just wondering if you can speak to that, whether that's impactful, whether it's small. Just maybe put that to bed, if you can?
嘿,大家好。早安,恭喜本季取得佳績。想問一下,我們一直在從泌尿科醫生那裡收集一些關於與報銷相關的動態的評論。我想我之前已經與 Barry 談過這個問題,但更多的是討論醫療保險審計等事宜,特別是 RAC 審計員和 AQUABEAM 案件的追回風險,以及 Cigna 和 Humana 對其為 AQUABEAM 承保的內容的一些反對意見。所以我只是想知道您是否可以談談這個問題,這是否有影響,是否影響很小。如果可以的話,就把這件事擱置吧?
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
Yes, thanks, Ryan. So related to RAC audit, as you know, this is a common procedure in health care that's done for us. It started in about October of 2023 in the last 12-months. I'm happy to say we have been able to execute despite that audit in FDA, when we see FDA approval, there was no size restriction. But with some of these, these are specific to Medicare, by the way. There is a size restriction and we are working with surgeons and payers to remove this restriction.
是的,謝謝,瑞安。因此,與 RAC 審計相關,如您所知,這是我們在醫療保健領域執行的常見程序。它始於過去的 12 個月,大約在 2023 年 10 月。我很高興地說,儘管經過了 FDA 審核,我們仍然能夠執行,當我們看到 FDA 批准時,發現沒有尺寸限制。但順便說一下,其中一些是專門針對醫療保險的。存在尺寸限制,我們正在與外科醫生和付款人合作以消除此限制。
For example, we have been able, in other cases, that there were some age restriction with some Medicare carriers to remove that. It's just a matter of time. It is not an obstacle for our growth. This is something that we have to resolve. We are working with them. As far as Cigna that you mentioned, what Cigna mentioned was they retired as of September, their policy when a carrier retires a policy, basically, what that means is surgeon can recommend Aquablation. In other words, there is no restriction. So that is definition of retirement.
例如,在其他情況下,我們可以取消一些醫療保險公司設定的年齡限制。這只是時間問題。這不會成為我們成長的障礙。這是我們必須解決的問題。我們正在與他們合作。就您提到的 Cigna 而言,Cigna 提到的是他們從 9 月起就退休了,當保險公司退休時,他們的政策基本上意味著外科醫生可以推薦 Aquablation。換句話說,沒有任何限制。這就是退休的定義。
Kevin Waters - Chief Financial Officer, Executive Vice President
Kevin Waters - Chief Financial Officer, Executive Vice President
I'll add a little bit on the RAC audits of Medicare, Ryan. So specifically with Aquablation, we know that Medicare has a outsized proportion of patients we treat due to the demographic of patients get a BPH and are getting treated. The RAC audits are specifically focused on traditional Medicare. And so when you think about 25% of the market being traditional Medicare, less than 10% of Aquablation procedures are less than 150 grams, which is a restriction currently with Medicare. This size limitation has had a minimal impact on our ability to expand and achieve our utilization targets due to the size range limitation and then the traditional Medicare number of patients we're treating.
我將對 RAC 對 Medicare 的審計做一些補充,Ryan。因此,具體到 Aquablation,我們知道,由於患者的人口統計特徵,即患有 BPH 並正在接受治療,因此在 Medicare 治療的患者中,有很大一部分是來自我們治療的患者。RAC 審計特別關注傳統的醫療保險。因此,當您考慮到 25% 的市場屬於傳統醫療保險時,不到 10% 的 Aquablation 手術重量少於 150 克,這是目前醫療保險的限制。由於規模範圍的限制以及我們所治療的傳統醫療保險患者數量,這種規模限制對我們擴大和實現利用率目標的能力影響甚微。
Also, you mentioned Humana. Humana is the only major private payer to have a size limit restriction of 150 grams. So a very small percentage of our patients we treat and once again, when you look at the major payers, we don't have restrictions on most of them, other than Humana is 150-gram limitation.
另外,您提到了 Humana。Humana 是唯一一家將尺寸限制設為 150 克的大型私人付款人。因此,我們治療的患者中只有很小一部分人,再說一次,當你查看主要付款人時,我們對大多數患者都沒有限制,除了 Humana 有 150 克的限制。
Ryan Zimmerman - Analyst
Ryan Zimmerman - Analyst
Okay. Very, very helpful. And then just, Kevin, in terms of the guidance philosophy, I can appreciate there's some macro dynamics with IV solutions and reps are out of the field for training. But seasonally, I mean, even if that were the case, why wouldn't fourth quarter kind of follow a similar quarter-to-quarter step up, if you will, particularly for systems in the fourth quarter as it did maybe last year?
好的。非常非常有幫助。然後,凱文,就指導理念而言,我可以理解 IV 解決方案有一些宏觀動態,並且代表們不在現場進行培訓。但從季節性來看,我的意思是,即使是這樣,為什麼第四季不會遵循類似的季度間成長趨勢,特別是對於第四季的系統而言,就像去年一樣?
Kevin Waters - Chief Financial Officer, Executive Vice President
Kevin Waters - Chief Financial Officer, Executive Vice President
Well, so I'll address systems first. I mean we are guiding to a number of 56 systems, which is up significantly. It's up 27%, compared to prior year, up 11 incremental units, compared to the third quarter and will represent an all-time high for PROCEPT by a significant margin. I think our all-time high number of systems in any quarter previously was 47%. So we feel a ton of momentum around systems. When we think of the utilization dynamic, I do think it's important, Sham has referenced this a few times that launching a completely new platform and what that requires from a time to installation, it has elongated somewhat when we install these accounts to make sure that we do it the right way.
好吧,我先來討論系統。我的意思是我們正在指導 56 個系統的數量,這個數字大幅增加。與去年同期相比,成長了 27%,與第三季相比增加了 11 個增量單位,將大幅創下 PROCEPT 的歷史新高。我認為我們之前任何一個季度的系統數量的歷史最高水準是 47%。因此,我們感受到系統上的巨大動力。當我們考慮利用率動態時,我確實認為它很重要,Sham 曾多次提到這一點,推出一個全新的平台,以及從安裝到啟動所需的時間,當我們安裝這些帳戶時,它會有所延長,以確保我們以正確的方式進行。
And our guidance suggests that we sell close to 100 systems in the back half of the year, which would roughly be almost 20% of the total installed base as we exited June. So we're just going to be very methodical about our launch. Does that mean we sacrifice some procedures in the fourth quarter? It does absolutely, but we feel it's the best opportunity to set us up for 2025 moving forward to become the standard of care here.
我們的預期是,我們在今年下半年銷售近 100 套系統,約佔 6 月底總安裝基數的 20%。因此,我們將非常有條不紊地進行我們的發布。這是否意味著我們在第四季要犧牲一些程序?確實如此,但我們認為這是讓我們在 2025 年成為這裡的護理標準的最佳機會。
Ryan Zimmerman - Analyst
Ryan Zimmerman - Analyst
Thank you.
謝謝。
Operator
Operator
Thank you. And our next question coming from the line of Mike Kratky with Leerink Partners. Your line is open.
謝謝。我們的下一個問題來自 Leerink Partners 的 Mike Kratky。您的線路已開通。
Brett Gasaway - Analyst
Brett Gasaway - Analyst
Hey, good morning, guys. This is [Brett] on for Mike. Congrats on another great quarter and a successful HYDROS rollout. I just want to go back to the ASP guide in 4Q. Obviously, there's a little bit of flexibility there with what's been going on with the rollout. But how should we be thinking about if there's any discounting on the legacy AQUABEAM or if there's any dynamics we should be thinking about that's driving that, that may persist into 2025?
嘿,大家早安。這是 [Brett] 為 Mike 主持的。恭喜又一個出色的季度以及 HYDROS 的成功推出。我只是想回到第四季的 ASP 指南。顯然,在推出過程中存在一些靈活性。但是,我們應該如何考慮傳統 AQUABEAM 是否會有任何折扣,或者是否有任何推動這種折扣的動態,而這種折扣可能會持續到 2025 年?
Kevin Waters - Chief Financial Officer, Executive Vice President
Kevin Waters - Chief Financial Officer, Executive Vice President
Yes. I don't see anything unusual here. As we've mentioned, the majority of our sales implied in our Q4 guide, they are greenfield and perhaps a handful of sales second systems to existing accounts. So I think it's better on an ASP front than we are expecting initially. And again, we want to just get through a full quarter of launch where we have HYDROS now to sell for a full quarter prior to getting too aggressive on guiding the 2025 ASPs. But there's no unusual dynamics in the fourth quarter regarding replacements, or exchanges or trade-ins. These are all primarily greenfield accounts.
是的。我沒有發現這裡有任何不尋常的東西。正如我們所提到的,我們的第四季指南中暗示,大部分銷售額都是未開發的,或許還有少數銷售額是針對現有帳戶的第二系統。因此我認為 ASP 方面比我們最初預期的要好。再說一次,我們希望能夠度過整個發布季度,在此期間,HYDROS 可以銷售一整季,之後再積極引導 2025 年的 ASP。但第四季在替換、交換或以舊換新方面沒有出現異常動態。這些主要都是綠地帳戶。
Brett Gasaway - Analyst
Brett Gasaway - Analyst
Understood. And then just a follow-up there, I guess, on the profitability side, primarily on the COGS side. Obviously, 10% higher at this point, and that's going to scale down over time. But how should we be thinking about just kind of the base level COGS versus legacy AQUABEAM long-term? And I know you're not commenting on cadence, but just overall, how we should be thinking about that level.
明白了。然後我想,接下來就是獲利能力的跟進,主要是銷貨成本方面。顯然,此時成長率為 10%,並且隨著時間的推移,成長率將會逐漸下降。但是,從長期來看,我們應該如何考慮基礎水準的 COGS 與傳統 AQUABEAM 之間的差異呢?我知道您不是在評論節奏,而是在評論總體,我們應該如何思考這個水平。
Kevin Waters - Chief Financial Officer, Executive Vice President
Kevin Waters - Chief Financial Officer, Executive Vice President
Yes. Maybe I'll just talk about overall gross margins in general. I did mention, and we wanted to update the investment community that HYDROS is currently costing about 10% more than AQUABEAM. To clarify some, I would say, misinformation that was out there in August regarding the cost being the same. With that said, we do think the ASP of HYDROS is going to more than offset kind of what we're seeing with the increase in costs. We do think over time, HYDROS becomes much more comparable to where AQUABEAM was. And over a greater period of time, I would expect it to cost less in AQUABEAM longer term. And we continue to have a lot of operational efficiencies in manufacturing the single biggest lever in manufacturing for us to expand margins really is producing more product and scale.
是的。也許我只會整體談論整體毛利率。我確實提到過,我們想向投資界通報,HYDROS 目前的成本比 AQUABEAM 高出約 10%。為了澄清一些事實,我想說,八月關於成本相同的資訊是錯誤的。話雖如此,我們確實認為 HYDROS 的平均售價將足以抵消我們所看到的成本上漲。我們確實認為,隨著時間的推移,HYDROS 會變得更與 AQUABEAM 相提並論。而從更長遠的角度來看,我預期 AQUABEAM 的長期成本會更低。我們在製造過程中持續提高營運效率,製造過程中我們擴大利潤率的最大槓桿實際上是生產更多的產品和擴大規模。
And we're seeing that and while not commenting on profitability or margins, we do think the third quarter is a jumping off point for our business now at 63%, and we should expand from here. And I feel very good about our margin profile as we head into 2025. Not only around production, but we talked in the fourth quarter last year about things like product quality, scrap, yield, all of these metrics that we're focusing on as a business continue to improve and give us a ton of conviction that this, again, is a business that has a very clear pathway to profitability.
我們看到這一點,雖然沒有對盈利能力或利潤率發表評論,但我們確實認為第三季是我們業務的起點,目前為 63%,我們應該從這裡開始擴展。當我們邁入 2025 年時,我對我們的利潤率狀況感到非常滿意。不僅在生產方面,我們在去年第四季還討論了產品品質、廢品、產量等方面的問題,所有這些我們作為企業關注的指標都在不斷改善,並讓我們堅信,這項業務具有非常明確的盈利途徑。
Brett Gasaway - Analyst
Brett Gasaway - Analyst
Makes sense. Thanks guys.
有道理。謝謝大家。
Kevin Waters - Chief Financial Officer, Executive Vice President
Kevin Waters - Chief Financial Officer, Executive Vice President
Thank you.
謝謝。
Operator
Operator
Thank you. I'm showing no further questions in the queue at this time. I will now turn the call back over to Reza Zadno for final comments.
謝謝。目前隊列中沒有其他問題。現在我將把電話轉回給 Reza Zadno 進行最後的評論。
Reza Zadno - President, Chief Executive Officer, Director
Reza Zadno - President, Chief Executive Officer, Director
Yes, Iâm going to thank everyone for joining our earnings call. I hope to see many of you at the upcoming conferences, and I wish all of you a happy, a very good day. Thank you.
是的,我要感謝大家參加我們的財報電話會議。我希望在即將召開的會議上見到你們,並祝福大家有個愉快的一天。謝謝。
Operator
Operator
Ladies and gentlemen, that does conclude our conference for today. Thank you for your participation, and you may now disconnect.
女士們、先生們,今天的會議到此結束。感謝您的參與,您現在可以斷開連接。