Neuronetics Inc (STIM) 2022 Q3 法說會逐字稿

Good day, and thank you for standing by. Welcome to the Neuronetics Report Third Quarter 2022 Financial and Operating Results Conference Call. At this time, all participants are in listen-only mode. After the speakers' presentation, there will be a question-and-answer session. To ask a question during the session, you will need to press *11 on your telephone and you will then hear an automated message advising your hand is raised. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Mark Klausner from ICR Westwicke. Please go ahead.

美好的一天，謝謝你的支持。歡迎參加 Neuronetics 報告 2022 年第三季度財務和經營業績電話會議。此時，所有參與者都處於只聽模式。演講者的演講結束後，將進行問答環節。要在會議期間提問，您需要在電話上按 *11，然後您會聽到一條自動消息，提示您已舉手。請注意，今天的會議正在錄製中。我現在想把會議交給今天的演講者，來自 ICR Westwicke 的 Mark Klausner。請繼續。

Good morning, and thank you for joining us for Neuronetics Third Quarter 2022 Conference Call. Joining me on today's call are Neuronetics President and Chief Executive Officer, Keith Sullivan; and the Senior Vice President, Chief Financial Officer and Treasurer, Steve Furlong. Before we begin, I would like to caution listeners that certain information discussed by management during this conference call will include forward-looking statements covered under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, including statements related to our business, strategy, financial and revenue guidance, the impact of COVID-19 and other operational issues and metrics.

早上好，感謝您加入我們參加 Neuronetics 2022 年第三季度電話會議。與我一起參加今天電話會議的還有 Neuronetics 總裁兼首席執行官 Keith Sullivan；以及高級副總裁、首席財務官兼財務主管 Steve Furlong。在我們開始之前，我想提醒聽眾，管理層在本次電話會議上討論的某些信息將包括 1995 年《私人證券訴訟改革法案》安全港條款所涵蓋的前瞻性陳述，包括與我們的業務、戰略相關的陳述、財務和收入指導、COVID-19 的影響以及其他運營問題和指標。

Actual results can differ materially from those stated or implied by these forward-looking statements due to risks and uncertainties associated with the company's business. For a discussion of risks and uncertainties associated with Neuronetics business, I encourage you to review the company's filings with the Securities and Exchange Commission, including the company's annual report on Form 10-K and Form 10-Q, which will be filed later today. The company disclaims any obligation to update any forward-looking statements made during the course of this call, except as required by law. During the call, we'll also discuss certain information on a non-GAAP basis, including EBITDA.

由於與公司業務相關的風險和不確定性，實際結果可能與這些前瞻性陳述明示或暗示的結果存在重大差異。關於與 Neuronetics 業務相關的風險和不確定性的討論，我鼓勵您查看公司向美國證券交易委員會提交的文件，包括公司將於今天晚些時候提交的 10-K 表格和 10-Q 表格年度報告。除非法律要求，否則公司不承擔任何更新本次電話會議期間所做的任何前瞻性陳述的義務。在電話會議期間，我們還將討論非 GAAP 基礎上的某些信息，包括 EBITDA。

Management believes that non-GAAP financial information taken in conjunction with U.S. GAAP financial measures provide useful information for both management and investors by excluding certain noncash and other expenses that are not indicative of trends in our operating results. Management uses non-GAAP financial measures to compare our performance relative to forecast and strategic plans to benchmark our performance externally against competitors and for certain compensation decisions. Reconciliations between U.S. GAAP and non-GAAP results are presented in the tables accompanying our press release, which can be viewed on our website. With that, it's my pleasure to turn the call over to Neuronetics' President and Chief Executive Officer, Keith Sullivan.

管理層認為，非 GAAP 財務信息與美國 GAAP 財務措施相結合，通過排除某些非現金和其他不代表我們經營業績趨勢的費用，為管理層和投資者提供了有用的信息。管理層使用非 GAAP 財務指標來比較我們相對於預測和戰略計劃的績效，以在外部將我們的績效與競爭對手進行基準比較，並用於某些薪酬決策。美國 GAAP 和非 GAAP 結果之間的調節顯示在我們新聞稿隨附的表格中，可以在我們的網站上查看。因此，我很高興將電話轉給 Neuronetics 的總裁兼首席執行官 Keith Sullivan。

Good morning, and thank you for joining us. I'll begin by providing an overview of the third quarter performance, followed by an operational update. Steve will then review our financial results, and I'll conclude with our thoughts on the balance of 2022 before turning to Q&A. Starting with our financial review for the third quarter. Total revenue was $16.5 million, up 20% over the third quarter of 2021. This represents the third straight quarter of over 15% year-over-year growth and the second straight quarter during which we delivered revenue of over $16 million, bringing us back to consistent levels of top line performance that the business has not seen since 2019.

早上好，感謝您加入我們。我將首先概述第三季度的業績，然後是運營更新。然後，史蒂夫將回顧我們的財務業績，在轉向問答環節之前，我將總結我們對 2022 年餘額的看法。從我們第三季度的財務審查開始。總收入為 1650 萬美元，比 2021 年第三季度增長 20%。這是連續第三個季度實現超過 15% 的同比增長，也是我們連續第二個季度實現收入超過 1600 萬美元，使我們重新回歸達到該業務自 2019 年以來未見的一致收入水平。

The strong performance was primarily driven by increased utilization in our per-click accounts and the continued capital equipment sales growth. It is clear that the investments made over the last 2 years in the various marketing programs, our practice development team and the patient awareness tools are paying off. U.S. NeuroStar revenue was $3.9 million, up 51% over the third quarter of 2021. The performance comes as a result of the continued excellence from our commercial organization who hit their stride in cultivating and converting a strong pipeline, which was bolstered by yet another sold-out NeuroStar Summit. The U.S. treatment session revenue was an all-time record of $11.9 million, up 16% over the third quarter 2021. The record revenue was the result of improving utilization, due in large part to the local per-click customer utilization rates increasing 20% year-over-year.

強勁的業績主要是由我們的點擊賬戶利用率提高和資本設備銷售持續增長推動的。很明顯，過去 2 年在各種營銷計劃、我們的實踐開發團隊和患者意識工具方面的投資正在取得回報。美國 NeuroStar 收入為 390 萬美元，比 2021 年第三季度增長 51%。這一業績得益於我們的商業組織的持續卓越表現，他們在培養和轉化強大的管道方面取得了長足進步，而這又得到了另一項銷售的支持-out NeuroStar 峰會。美國治療會議收入創歷史新高，達到 1190 萬美元，比 2021 年第三季度增長 16%。創紀錄的收入是利用率提高的結果，這在很大程度上是由於本地每次點擊客戶的利用率提高了 20%一年又一年。

These positive trends come as a result of our investment in the Five Star training program, the expansion of our PHQ-10 tool into more offices and greater availability of practice management training. Now turning to operational highlights. Our first focus area is increasing customer and patient awareness. Similar to previous quarters, we hosted another completely sold-out NeuroStar Summit held in Charlotte, North Carolina at our recently opened NeuroStar University. This event included over 60 attendees representing 42 practices. Feedback from this event was phenomenal and resulted in the conversion of a number of highly qualified prospective customers as well as the highest number of systems sold in a single day.

這些積極趨勢源於我們對五星級培訓計劃的投資、將我們的 PHQ-10 工具擴展到更多辦公室以及實踐管理培訓的更多可用性。現在轉向運營亮點。我們的第一個重點領域是提高客戶和患者的意識。與前幾個季度類似，我們在北卡羅來納州夏洛特市最近開設的 NeuroStar 大學舉辦了另一場座無虛席的 NeuroStar 峰會。該活動包括代表 42 個實踐的 60 多名與會者。此次活動的反饋是驚人的，並導致許多高素質的潛在客戶的轉換以及單日售出的系統數量最多。

Our newly launched patient marketing campaigns have delivered tremendous value, both in terms of increasing our overall patient awareness of NeuroStar and in providing patients better access to information. For example, our recently launched "Tap into a New Possibility" campaign aimed at driving awareness among patients and their caregivers, drove over 30 million impressions in Q3, a 150% increase as compared to campaigns run in the prior year, resulting in thousands of new patients beginning their search for a NeuroStar treatment.

我們新推出的患者營銷活動在提高我們對 NeuroStar 的整體患者意識以及為患者提供更好的信息訪問方面都帶來了巨大的價值。例如，我們最近發起的“挖掘新的可能性”活動旨在提高患者及其護理人員的意識，在第三季度獲得了超過 3000 萬次展示，與去年開展的活動相比增加了 150%，產生了數千次開始尋找 NeuroStar 治療的新患者。

Our relationships with NeuroStar Partners, including Drew Robinson, a former Major League baseball player and Dr. Melissa Shepard has steadily gained traction. Drew continues to share his depression journey and the role NeuroStar had in giving him a new possibility in a hopeful future. He continued to post social media content in September on World Suicide Prevention Day and in July to draw attention to the need for increased focus on mental health in the athletic community. These partnerships drove nearly 2,000 potential patients directly to our website to learn more and help drive significant increases in NeuroStar related web searches, both sequentially and year-over-year.

我們與 NeuroStar Partners 的關係，包括前美國職業棒球大聯盟球員 Drew Robinson 和 Melissa Shepard 博士，都在穩步發展。 Drew 繼續分享他的抑鬱症之旅，以及 NeuroStar 在為他帶來充滿希望的未來的新可能性方面所發揮的作用。他繼續在 9 月的世界預防自殺日和 7 月發布社交媒體內容，以引起人們對體育界需要更加關注心理健康的關注。這些合作夥伴關係將近 2,000 名潛在患者直接帶到我們的網站，以了解更多信息並幫助推動與 NeuroStar 相關的網絡搜索的顯著增加，無論是順序還是同比。

The implementation of the proprietary PHQ-10 tool, a digital patient assessment tool, which allows our NeuroStar practices to easily identify patients within their practice who are candidates for and expressed interest in a NeuroStar treatment, have been extremely fruitful. To increase the tools impact, we will keep expanding it to more and more practices.

專有 PHQ-10 工具的實施是一種數字患者評估工具，它使我們的 NeuroStar 實踐能夠輕鬆識別他們實踐中的患者，這些患者是 NeuroStar 治療的候選者並表示對 NeuroStar 治療感興趣，已經取得了極大的成果。為了增加工具的影響，我們將繼續將其擴展到越來越多的實踐中。

To support this rollout, we released a number of TrakStar upgrades, which helped streamline the patient journey by bridging our PHQ-10 tool with our HIPAA-compliant TrakStar patient data management system, making it even easier to identify new patients and those needing retreatment. In September, we hosted a ribbon-cutting ceremony to celebrate the grand opening of NeuroStar University in Charlotte, North Carolina, where we were joined by 75 attendees, including local government officials, NeuroStar patients and providers and leaders in the mental health industry.

為支持此次推出，我們發布了多項 TrakStar 升級，通過將我們的 PHQ-10 工具與符合 HIPAA 標準的 TrakStar 患者數據管理系統連接起來，幫助簡化了患者的旅程，從而更容易識別新患者和需要再治療的患者。 9 月，我們在北卡羅來納州夏洛特舉辦了剪彩儀式，慶祝 NeuroStar 大學的盛大開幕，75 名與會者參加了此次活動，其中包括當地政府官員、NeuroStar 患者以及提供者和心理健康行業的領導者。

The event was highly successful, underscoring the need for an interest in advanced mental health treatments. It also garnered attention from local media sources with segments on both NBC and Fox evening news, which generated over 20 million combined impressions. NSU will teach new and existing customers how to become NeuroStar experts, connect with other specialists in their field and grow their practices using clinical education, enhanced patient awareness and consultation techniques.

該活動非常成功，強調了對先進的心理健康治療感興趣的必要性。它還通過 NBC 和福克斯晚間新聞的片段吸引了當地媒體的關注，產生了超過 2000 萬的綜合印象。 NSU 將教導新客戶和現有客戶如何成為 NeuroStar 專家，如何與他們所在領域的其他專家聯繫，並通過臨床教育、增強患者意識和諮詢技術來發展他們的實踐。

To date, we have hosted 4 sold-out customer classes and the 2 additional classes scheduled during the remainder of the year, both of which are already at capacity. One attendee who has been utilizing NeuroStar for over 12 years, said and I quote, "I thought I knew everything there was to know about NeuroStar and connecting with patients until I attended NSU." This was a wonderful testimonial from one of our best customers.

迄今為止，我們已經舉辦了 4 場售罄的客戶課程，並在今年剩餘時間舉辦了 2 場額外的課程，兩者都已滿員。一位使用 NeuroStar 超過 12 年的與會者說，我引用，“在我參加 NSU 之前，我認為我知道關於 NeuroStar 和與患者聯繫的一切知識。”這是我們最好的人之一的精彩證明顧客。

As we continue to evolve the capabilities of the platform as well as the support services that we offer our customers. These classes will continue to be highly beneficial for both new and existing customers as they seek to leverage the power of NeuroStar to help more patients suffering from mental disorders. Our second focus area is the continued optimization of our commercial organization. In the quarter, we implemented new sales force reporting tools to help our PDMs better understand our customers, their patient base and utilization trends. These tools allow the PDMs to help our accounts set goals and measure their progress towards achieving them. In particular, the NeuroStar business review gives accounts a new way to look at and innovate their practices in ways they were not able to before, allowing them to more efficiently and more effectively tap into their existing patient base and help those who would benefit from a nondrug alternative to manage their depression and anxiety.

隨著我們不斷發展平台的功能以及我們為客戶提供的支持服務。這些課程將繼續對新老客戶非常有益，因為他們尋求利用 NeuroStar 的力量來幫助更多患有精神障礙的患者。我們的第二個重點領域是持續優化我們的商業組織。本季度，我們實施了新的銷售人員報告工具，以幫助我們的 PDM 更好地了解我們的客戶、他們的患者群和使用趨勢。這些工具允許 PDM 幫助我們的客戶設定目標並衡量他們實現目標的進度。特別是，NeuroStar 業務審查為客戶提供了一種新的方式來查看和創新他們以前無法做到的方式，使他們能夠更有效地利用現有的患者群，並幫助那些將從中受益的人非藥物替代品來控制他們的抑鬱和焦慮。

Additionally, due to the new account growth over the course of the year, we will follow the plan we previously outlined by adding 4 additional PDMs early next year. These additions will support the growth in our installed base and ensure we provide our customers with the highest level of service and support. Our third focus area is growing the number of exclusive commercial partnerships. We will continue to be excited by the strong relationships we have built with our service provider customers.

此外，由於今年新客戶的增長，我們將遵循我們之前概述的計劃，在明年初增加 4 個額外的 PDM。這些增加將支持我們安裝基礎的增長，並確保我們為客戶提供最高水平的服務和支持。我們的第三個重點領域是增加獨家商業合作夥伴的數量。我們將繼續對我們與服務提供商客戶建立的牢固關係感到興奮。

Now that the word is out about our excellent ongoing support, training and marketing initiatives, several providers with NeuroStar and competitive systems have reached out to benefit from the support we provide. Most recently, Alleviant Health Centers, an Arkansas-based network of full-service mental health clinics signed a 4-year agreement and switched from a competitive system to NeuroStar primarily due to the level of support we provide to help them achieve their growth targets. We have seen good traction from the partnerships and expect a more material impact on the business throughout the rest of the year and in 2023.

現在關於我們出色的持續支持、培訓和營銷計劃的消息已經傳開，一些擁有 NeuroStar 和競爭系統的供應商已經伸出援手，希望從我們提供的支持中受益。最近，位於阿肯色州的全方位服務心理健康診所網絡 Alleviant Health Centers 簽署了一項為期 4 年的協議，並從競爭系統轉向 NeuroStar，主要是因為我們提供的支持水平可以幫助他們實現增長目標。我們已經從合作夥伴關係中看到了良好的吸引力，並預計在今年剩餘時間和 2023 年對業務產生更大的實質性影響。

Lastly, I want to provide an update on our clinical and regulatory progress. In May, we received FDA clearance for NeuroStar as an adjunct treatment for the adult patients suffering from obsessive compulsive disorder. Our 2-stage launch has been going smoothly and we have heard good feedback from our physicians. The first stage started in early July with the training at 40 pilot sites. The major finding with the motor threshold training has been easier than anticipated.

最後，我想提供有關我們臨床和監管進展的最新信息。 5 月，我們獲得了 FDA 的許可，將 NeuroStar 作為患有強迫症的成年患者的輔助治療藥物。我們的 2 階段啟動進展順利，我們從醫生那裡聽到了良好的反饋。第一階段於 7 月初開始，在 40 個試點地點進行了培訓。運動閾值訓練的主要發現比預期的要容易。

The next phase of our launch has begun where we plan to roll out this indication to all of our customers over the next several months. In August, we received 510(k) clearance for D-Tect, a motor threshold accessory. D-Tect simplifies the motor threshold determination for physicians by visually reporting the magnitude of the finger movement during the motor threshold test. As a result of this automated determination, it now only requires one person to do this testing versus 2 on all other systems. D-Tect is compatible with all new and existing NeuroStar systems and was rolled out nationally in mid-September. The initial demand for D-Tect was high with over 100 sold in the quarter.

我們發布的下一階段已經開始，我們計劃在接下來的幾個月內向所有客戶推出這一指示。 8 月，我們獲得了 D-Tect 的 510(k) 許可，這是一種運動閾值附件。 D-Tect 通過在運動閾值測試期間直觀地報告手指運動的幅度，簡化了醫生的運動閾值確定。由於這種自動確定，現在只需要一個人來進行此測試，而在所有其他系統上則需要 2 個人。 D-Tect 與所有新的和現有的 NeuroStar 系統兼容，並於 9 月中旬在全國推出。最初對 D-Tect 的需求很高，本季度售出了 100 多台。

We have now integrated it into our training programs and at NeuroStar University. Now for a quick update on the expanded Medicare coverage.[2 MAX] recently published and proposed Medicare coverage updates, which would increase TMS eligibility by nearly 8 million covered lives. The number of prior medication failures for TMS eligibility for individuals with major depressive disorder has been reduced from 4 to 2 under a new coverage policy published by CGS, which will take effect on December 4, 2022.

我們現在已將其整合到我們的培訓計劃和 NeuroStar 大學中。現在快速更新擴大的 Medicare 覆蓋範圍。[2 MAX] 最近發布並提出了 Medicare 覆蓋範圍更新，這將使 TMS 資格增加近 800 萬受保人。根據 CGS 發布的一項將於 2022 年 12 月 4 日生效的新承保政策，重度抑鬱症患者因 TMS 資格而導致的既往用藥失敗次數已從 4 次減少到 2 次。

The same reduction from 4 to 2 prior medication failures is being considered by the NGS, who is also considering GMS coverage for OCD. The Neuronetics health policy and reimbursement team was crucial in working with NeuroStar providers to address payer policy limitations, which has been a major factor in these favorable covered decisions. We are encouraged to see the payers adopting policies that reflect TMS as a standard of nondrug treatment for mental health.

NGS 正在考慮將既往用藥失敗次數從 4 次減少到 2 次，NGS 也在考慮 GMS 對強迫症的覆蓋率。 Neuronetics 健康政策和報銷團隊在與 NeuroStar 供應商合作解決付款人政策限制方面發揮了至關重要的作用，這一直是這些有利的涵蓋決定的主要因素。我們很高興看到付款人採用將 TMS 反映為心理健康非藥物治療標準的政策。

We are delighted by the performance in the quarter as we are seeing the benefits from our revamped sales force, marketing programs and physician and patient education initiatives. These successes further support Neuronetics long-standing market leadership position in the TMS space, underlined by NeuroStar having been used to deliver over 5 million treatment sessions on more than 141,000 patients to date. With that, I'd like to turn the call over to Steve.

我們對本季度的業績感到高興，因為我們看到了重組後的銷售隊伍、營銷計劃以及醫生和患者教育計劃帶來的好處。這些成功進一步支持了 Neuronetics 在 TMS 領域的長期市場領導地位，迄今為止，NeuroStar 已被用於為超過 141,000 名患者提供超過 500 萬次治療。有了這個，我想把電話轉給史蒂夫。

Thank you, Keith. Total revenue for the third quarter was $16.5 million, an increase of 20% over third quarter 2021 revenue of $13.8 million. U.S. NeuroStar Advanced Therapy system revenue was $3.9 million, representing a 51% increase as compared to the prior year revenue of $2.6 million. In the quarter, the company shipped 50 systems. Of these systems shipped, 49 were recognized as NeuroStar capital revenue in one system was recognized as an operating lease, up from 40 systems shipped in the third quarter of 2021. U.S. treatment session revenue was $11.9 million, an increase of 16% over third quarter 2021 revenue of $10.3 million.

謝謝你，基思。第三季度總收入為 1650 萬美元，比 2021 年第三季度的 1380 萬美元增長 20%。美國 NeuroStar Advanced Therapy 系統收入為 390 萬美元，較上年收入 260 萬美元增長 51%。本季度，該公司出貨了 50 個系統。在這些出貨的系統中，有 49 個被確認為 NeuroStar 資本收入，其中一個系統被確認為經營租賃，高於 2021 年第三季度出貨的 40 個系統。美國治療療程收入為 1190 萬美元，比第三季度增長 16% 2021 年收入為 1030 萬美元。

Of note in the quarter, local per-click customer utilization, which excludes service providers increased 20% year-over-year. In the third quarter of 2022, revenue per active site was approximately $11,400 compared to approximately $11,200 in the prior year quarter. Gross margins were 78% compared to the third quarter 2021 gross margin of 77%. Operating expenses during the quarter were $20.4 million, an increase of $2.6 million compared to the third quarter of 2021. The increase was primarily driven by our expanded sales force, the opening of NSU, some additional headcount and product development and clinical as well as increased costs from inflationary pressures.

本季度值得注意的是，不包括服務提供商的本地每次點擊客戶利用率同比增長 20%。 2022 年第三季度，每個活動站點的收入約為 11,400 美元，而去年同期約為 11,200 美元。毛利率為 78%，而 2021 年第三季度的毛利率為 77%。本季度的運營費用為 2040 萬美元，比 2021 年第三季度增加了 260 萬美元。增加的主要原因是我們擴大了銷售隊伍、NSU 的開設、一些額外的員工人數以及產品開發和臨床以及增加通脹壓力的成本。

During the quarter, we incurred approximately $2.1 million of noncash stock-based compensation expense. Net loss for the third quarter of 2022 was $7.6 million or $0.28 per share as compared to a net loss of $8.2 million or $0.31 per share during the third quarter of 2021. EBITDA for the third quarter of 2022 was negative $6.1 million as compared to negative $6.9 million for the third quarter of 2021. Moving now to the balance sheet. As of September 30, 2022, cash and cash equivalents were $73.7 million. Now turning to guidance. For the full year 2022, we now expect revenue in the range of $63 million to $64 million. For the fourth quarter of 2022, we expect revenue of $16 million to $17 million.

本季度，我們產生了大約 210 萬美元的非現金股票補償費用。 2022 年第三季度的淨虧損為 760 萬美元或每股 0.28 美元，而 2021 年第三季度的淨虧損為 820 萬美元或每股 0.31 美元。2022 年第三季度的 EBITDA 為負 610 萬美元，而 2022 年第三季度為負2021 年第三季度為 690 萬美元。現在轉到資產負債表。截至 2022 年 9 月 30 日，現金及現金等價物為 7370 萬美元。現在轉向指導。對於 2022 年全年，我們現在預計收入在 6300 萬至 6400 萬美元之間。對於 2022 年第四季度，我們預計收入為 1600 萬至 1700 萬美元。

We continue to expect total operating expenses for the full year 2022 to be in the range of $86 million to $88 million. In line with our previously announced path to profitability, we remain confident in our ability to reach cash flow positive during 2024. Between our top line growth expectations, our strong gross margin profile and the prudent management of our operating expenses, our path to profitability remains on track. I would now like to turn the call back over to Keith.

我們繼續預計 2022 年全年的總運營費用將在 8600 萬至 8800 萬美元之間。根據我們之前宣布的盈利路徑，我們對在 2024 年實現正現金流的能力充滿信心。在我們的收入增長預期、強勁的毛利率狀況和對運營費用的審慎管理之間，我們的盈利路徑仍然存在在軌道上。我現在想把電話轉回基思。

Thank you, Steve. We are pleased to see the impact of the initiatives we've rolled out over the past 2 years taking hold with sustained results, and we are in great shape to round out the year. As you can see from our guidance, we expect to finish out 2022, demonstrating strong growth. We will continue to focus our efforts on increased customer and patient awareness, the continued optimization of our commercial organization, leveraging exclusive commercial partnerships and continuing to advance our clinical and regulatory programs.

謝謝你，史蒂夫。我們很高興看到我們在過去 2 年中推出的舉措產生了持續的影響，並且我們以良好的狀態結束了這一年。正如您從我們的指導中看到的那樣，我們預計到 2022 年結束，展示強勁的增長。我們將繼續努力提高客戶和患者的意識，持續優化我們的商業組織，利用獨家商業合作夥伴關係，並繼續推進我們的臨床和監管計劃。

Our team has demonstrated significant progress, and I am confident in the team's ability to take advantage of this opportunity over the years to come. Before turning to Q&A, I wanted to highlight a significant achievement as part of our customer and patient awareness efforts. Yesterday, NeuroStar spokesperson Drew Robinson, was featured in a segment called Mind Matters with Carson Daly on the Today Show. His message of encouragement to people struggling with mental disorders was that help is always there, and it takes strength to reach out and ask for it. We are proud that NeuroStar is part of Drew's mental health recovery, and we look forward to a continued partnership with Drew as we collectively seek to bring relief to as many patients as possible who are suffering from treatment-resistant depression and other mental disorders. With that, I'd like to open the line for questions.

我們的團隊已經取得了重大進展，我對團隊在未來幾年利用這一機會的能力充滿信心。在轉向問答環節之前，我想強調一項重大成就，這是我們在提高客戶和患者意識方面所做的努力的一部分。昨天，NeuroStar 發言人德魯·羅賓遜 (Drew Robinson) 與卡森·戴利 (Carson Daly) 一起在今日秀的一個名為 Mind Matters 的片段中亮相。他對精神障礙患者的鼓勵信息是，幫助總是存在的，需要力量去尋求幫助。我們很自豪 NeuroStar 是 Drew 心理健康康復的一部分，我們期待與 Drew 繼續合作，因為我們共同尋求為盡可能多的患有難治性抑鬱症和其他精神障礙的患者帶來緩解。有了這個，我想打開問題熱線。

Thank you. At this time, we will conduct a question-and-answer session. As a reminder, to ask a question, you will need to press *11 on your telephone and wait for your name to be announced. Please stand by while we compile the Q&A roster. Our first question comes from the line of Adam Maeder of Piper.

謝謝你。這時候，我們將進行問答環節。提醒一下，要提問，您需要在電話上按 *11 並等待播報您的姓名。在我們整理問答名冊時請稍候。我們的第一個問題來自 Piper 的 Adam Maeder。

Great. Well, thank you Keith and Steve and congrats on the progress. Maybe just to start on Q4 and the implied -- well, I guess you provided Q4 guidance, I think that implies flattish sequential revenue at the midpoint quarter-over-quarter versus Q3. That seems maybe a bit conservative to us. As I think we typically see more of a sequential step-up quarter-over-quarter in Q4 looking at past years. So maybe just talk about the exit momentum that you had in the third quarter, what you're seeing thus far in Q4. Just any key assumptions in that outlook, maybe it's just a little bit of conservatism?

偉大的。好吧，謝謝 Keith 和 Steve，祝賀你取得的進展。也許只是從第四季度和隱含的開始——好吧，我猜你提供了第四季度的指導，我認為這意味著與第三季度相比，季度中點的連續收入持平。這對我們來說似乎有點保守。我認為，從過去幾年來看，我們通常會在第四季度看到更多的季度環比增長。所以也許只是談談你在第三季度的退出勢頭，你在第四季度看到了什麼。該前景中的任何關鍵假設，也許只是一點點保守主義？

Thanks, Adam. Yes, I would guess, classify the guidance as being responsible. We still are faced with 3 health issues out there with COVID, the flu and RSV. So, we certainly didn't want to get ahead of ourselves. We do agree that Q4 is traditionally our strongest quarter from both capital and treatment session perspectives. So calling me conservative, I guess, is flattering. And I think, like I said, I think it's just a responsible set up for another [beaten] raise as we end the year.

謝謝，亞當。是的，我猜，將指南歸類為負責任的。我們仍然面臨 3 種健康問題，包括 COVID、流感和 RSV。所以，我們當然不想超越自己。我們確實同意，從資本和治療會議的角度來看，第四季度傳統上是我們最強勁的季度。所以說我保守，我想，是在奉承。而且我認為，就像我說的那樣，我認為這只是一個負責任的設置，以便我們在年底時再次 [擊敗] 加薪。

Okay. Understood. That's helpful, Steve. And then we're at the time of the year when folks are starting to look ahead to 23 certainly recognize you're not at a point to give guidance at this juncture, but wondering if you're willing to give us some puts and takes around the setup for 2023. I show consensus, precall estimates at around $73 million. I think that's 19% growth year-over-year. Any reaction to that figure or just any broader puts and takes that you can provide, sessions growth versus systems would be much appreciated.

好的。明白了。這很有幫助，史蒂夫。然後我們正值一年中人們開始展望 23 年的時候，當然認識到您此時此刻還不能提供指導，但想知道您是否願意給我們一些建議和要求圍繞 2023 年的設置。我表示共識，預估約為 7300 萬美元。我認為這是 19% 的同比增長。對這個數字的任何反應或您可以提供的任何更廣泛的投入和投入，會話增長與系統將不勝感激。

Yes, Adam, I think our recent performance really speaks to itself. At the beginning of the year, we still had some impacts from Omicron. We had a very slow January and really have rebounded very nicely since Q1. I would say if you look at our growth rates year-over-year for Q2, Q3 and even what's implied for Q4, I think you get a sense of where we're heading for 2023. We certainly don't anticipate any steps backwards. The headwind should continue to lessen. Again, I would be comfortable with our current year-over-year performance into 2030. Very helpful you.

是的，亞當，我認為我們最近的表現確實說明了一切。今年年初，我們仍然受到 Omicron 的一些影響。我們在 1 月份的表現非常緩慢，但自第一季度以來確實反彈得非常好。我想說的是，如果您查看我們第二季度、第三季度的同比增長率，甚至是第四季度的隱含增長率，我想您就會了解我們 2023 年的發展方向。我們當然預計不會出現任何倒退.逆風應該會繼續減弱。同樣，我對我們目前到 2030 年的同比表現感到滿意。對你很有幫助。

Our next question comes from the line of Malgorzata Kaczor of William Blair.

我們的下一個問題來自 William Blair 的 Malgorzata Kaczor。

I wanted to start with utilization because obviously, a really nice pickup series like on the consumables side. I'd imagine there's very minimal impact from NeuroStar University at least at this point. So I guess I'm just trying to figure out what's the primary driver? Is it the PDMs? Is it finally picking up traction. So that it's [durable] benefit that you continue to see going forward? Is it something that you saw maybe the larger TMS centers or something else? It's obviously nice numbers.

我想從利用率開始，因為很明顯，這是一個非常好的皮卡系列，比如在消耗品方面。我想至少在這一點上，NeuroStar 大學的影響非常小。所以我想我只是想弄清楚主要驅動因素是什麼？是 PDM 嗎？它終於獲得了牽引力嗎？這樣您就可以繼續看到它的[持久]好處嗎？它是您看到的更大的 TMS 中心還是其他東西？這顯然是不錯的數字。

Yes. Thanks for the question, Margaret. So our utilization has been steadily ticking up. I think our practice development managers in the field have been doing a great job putting out our 5 stars to success, talking about the Precision Pulse program and really helping the accounts focus their education and marketing on to patients that can benefit from NeuroStar treatment. So our biggest growth this quarter was really in our per-click accounts, which is demonstrating to us that the programs that we have put forth are working.

是的。謝謝你的問題，瑪格麗特。所以我們的利用率一直在穩步上升。我認為我們在該領域的實踐開發經理一直做得很好，使我們的 5 星獲得成功，談論 Precision Pulse 計劃並真正幫助客戶將他們的教育和營銷重點放在可以從 NeuroStar 治療中受益的患者身上。因此，本季度我們最大的增長實際上是在我們的每次點擊帳戶中，這向我們證明了我們提出的計劃正在發揮作用。

Okay. And so I think part of the other piece of this is trying to understand the durability of that. We've seen some stronger quarters in the next quarter, maybe a tick down in part because of COVID and other things. I'm just trying to see if you guys can you give us any color in terms of the durability of that, any leading indicators that support the forward look. I'll sneak in a third question on the side, just to follow up on Adam. When you talk about kind of seeing the same growth as implied kind of year-to-date, is that kind of a mid-teens number? Am I doing that quick math the right way? Is that what you guys are looking forward for '23?

好的。因此，我認為另一部分的一部分是試圖了解它的持久性。我們在下個季度看到了一些更強勁的季度，可能部分是由於 COVID 和其他因素而有所下降。我只是想看看你們是否可以在耐久性方面給我們任何顏色，任何支持前瞻性的領先指標。我會偷偷提出第三個問題，只是為了跟進亞當。當你談論看到與今年迄今為止隱含的增長相同的增長時，這是一個十幾歲的數字嗎？我是否以正確的方式進行快速數學運算？這就是你們期待的 23 年嗎？

Margaret, Steve. Just regarding the 2023 expectation, I would [wait] the Q2, Q3 and Q4 performance more heavily than what we saw in Q1. So, I think you're looking at the mid-teens, maybe slightly higher into next year.

瑪格麗特，史蒂夫。就 2023 年的預期而言，我會 [等待] 第二季度、第三季度和第四季度的表現比我們在第一季度看到的更多。所以，我認為你正在關註十幾歲左右，明年可能會略高一些。

I'll take the other part of your question, Margaret. I think on the durability of the utilization and the revenue, and we look at both. So we want to make sure that our sell-in is equal to the revenue and to the utilization. When we look at these accounts and using our PHQ-10, we're helping these accounts identify patients that are not only candidates because they failed the proper number of drugs, but are waving their hands saying, we want a nondrug alternative. We are still just scratching the surface on deploying those PHQ-10s into our accounts and getting the accounts educated on how to capture those patients. So from a durability standpoint, I think we will see our normal seasonality next year, but I believe that we will continue to grow on our per-click business.

瑪格麗特，我會回答你問題的另一部分。我認為關於利用率和收入的持久性，我們會同時考慮兩者。所以我們要確保我們的銷售量等於收入和利用率。當我們查看這些賬戶並使用我們的 PHQ-10 時，我們正在幫助這些賬戶識別患者，這些患者不僅是因為他們沒有使用適當數量的藥物而成為候選人，而且還在揮手說，我們想要一種非藥物替代品。在將這些 PHQ-10 部署到我們的賬戶中以及讓賬戶了解如何捕獲這些患者方面，我們仍然只是觸及表面。因此，從耐用性的角度來看，我認為明年我們將看到正常的季節性，但我相信我們將繼續在每次點擊業務上增長。

Our next question comes from the line of Bill Rivanek of Canaccord.

我們的下一個問題來自 Canaccord 的 Bill Rivanek。

Just a couple of questions here, just on kind of operations and cash to start with. Your SG&A was down pretty significantly on a sequential basis with revenues that were slightly up. I was wondering if you could just help us understand kind of the moving parts there. Then it was nice to see the cash go up sequentially this quarter, and I think some of that was getting some cash back from one of your prior partner investments. But how should we think about just cash usage over the next 12 to 18 months and maybe major uses of cash?

這裡只有幾個問題，只是關於運營類型和現金。您的 SG&A 連續下降相當顯著，收入略有上升。我想知道你是否可以幫助我們了解那裡的活動部分。然後很高興看到本季度現金連續增加，我認為其中一部分是從您之前的合作夥伴投資中收回一些現金。但我們應該如何考慮未來 12 到 18 個月的現金使用情況以及現金的主要用途？

Bill, Steve. Yes, you're correct with the Q3 cash positivity. We did receive repayment of the $10 million term loan from Success TMS as part of their transaction with Green Brook, so that did help us with a decent influx. Historically, Q3 and Q4 are lower cash burn quarters. We are forecasting a significantly lower burn in Q4 than we traditionally see. We've started the operating planning process for 2023. Our cash target is quite a bit lower than what it was for 2022. We've repeatedly stated that our OpEx was artificially high in 2022.

比爾，史蒂夫。是的，您對第三季度的現金積極性是正確的。作為與 Green Brook 交易的一部分，我們確實收到了 Success TMS 提供的 1000 萬美元定期貸款的還款，因此這確實幫助我們獲得了不錯的收入。從歷史上看，第三季度和第四季度是現金消耗較低的季度。我們預測第四季度的消耗量將比我們傳統上看到的要低得多。我們已經開始了 2023 年的運營規劃流程。我們的現金目標比 2022 年的要低很多。我們一再聲明我們的 OpEx 在 2022 年是人為的高。

A lot of one-time events surrounding the sales team and some marketing initiatives. Those will not recur in 2023. So we're going to be able to leverage OpEx and bring that cash burn down. Obviously, it's a function of working capital and the revenue growth next year. I don't want to be pinned down to a number, but it will be, I would say, significantly lower than '22 and really set us up for that cash flow break-even target in 2024.

圍繞銷售團隊的許多一次性事件和一些營銷計劃。這些不會在 2023 年再次發生。因此我們將能夠利用 OpEx 並減少現金消耗。顯然，這是營運資金和明年收入增長的函數。我不想被固定在一個數字上，但我會說，它會大大低於 22 年，這確實讓我們為 2024 年的現金流收支平衡目標做好了準備。

Then if I could just ask on the PHQ-10 tool. You bring that up a lot. I think we've had some discussions, but my understanding, and correct me if I'm wrong, is really the difference between PHQ-9 and -10 is one extra question that they're asking the patient. It's a pretty simple tool. Do I understand that right? Two, I think how penetrated or how many of the account base you have it into today? Is this something you think will be 100%? If so, when? Or kind of what's the final target of penetration for utilization of that tool in the existing accounts and new accounts.

那麼我是否可以在 PHQ-10 工具上提問。你經常提到這一點。我想我們已經進行了一些討論，但我的理解是，如果我錯了請糾正我，PHQ-9 和 -10 之間的區別實際上是他們問病人的一個額外問題。這是一個非常簡單的工具。我理解對嗎？第二，我想你今天有多少滲透或多少客戶群？您認為這是 100% 的事情嗎？如果是這樣，什麼時候？或者在現有賬戶和新賬戶中使用該工具的最終滲透目標是什麼。

Yes. Bill, this is Keith. You have the PHQ-10 right. There are many pieces to it, though. So we do add that 10th question on to it, but it's the way that we also capture the information and bring it back to the account that helps them identify that patient and then educate them. So right now, we have PHQ-10s in just slightly less than 25% of our accounts, and we are growing that on a daily basis. So we have seen that it is the #1 tool to help us drive awareness to these accounts. But we are deploying it in a way that we have to do education so that the accounts know how to then talk to the patient itself. It's a great tool, but it's not just something that we can put into an account and have them know how to use it, know how to talk to the patient.

是的。比爾，這是基思。您擁有 PHQ-10 權利。不過，它有很多部分。所以我們確實在上面添加了第 10 個問題，但這是我們捕獲信息並將其帶回幫助他們識別患者然後教育他們的帳戶的方式。所以現在，我們只有不到 25% 的賬戶擁有 PHQ-10，而且我們每天都在增加。所以我們已經看到它是幫助我們提高對這些帳戶的認識的第一工具。但我們正在以一種我們必須進行教育的方式部署它，以便賬戶知道如何與患者本身交談。這是一個很棒的工具，但它不僅僅是我們可以記入帳戶並讓他們知道如何使用它，知道如何與患者交談的東西。

Please stand by for our final question. Our final question comes from the line of Marie Thibault of BTIG.

請等待我們的最後一個問題。我們的最後一個問題來自 BTIG 的 Marie Thibault。

Congrats on a strong quarter. I want to ask my first question here on the systems side. I noticed that ASPs seemed to step up meaningfully. I wondered if that was linked to the D-Tect motor threshold tool and what might have been driving some of those stronger ASPs? I noticed that you did talk about D-Tect revenue. So I wondered how that's being priced or what sort of contribution we might expect from that going forward?

祝賀一個強勁的季度。我想在系統方面問我的第一個問題。我注意到 ASP 似乎有意義地提高了。我想知道這是否與 D-Tect 電機閾值工具有關，是什麼驅動了一些更強的 ASP？我注意到你確實談到了 D-Tect 的收入。所以我想知道這是如何定價的，或者我們期望從中做出什麼樣的貢獻？

Marie, this is Keith. I think your question on our system sales is one that we look at on a weekly basis. Our ASPs are going up because honestly, the price of the system is not the impediment to them putting a system into their office. So most of our accounts lease them and the reps are able to sell at a higher level because of the value of the programs that we are bringing to the table. So ASPs are steadily creeping up and our accounts are continuing to pay it without a big issues. I missed your second question.

瑪麗，這是基思。我認為您關於我們系統銷售的問題是我們每週都會查看的問題。我們的 ASP 正在上升，因為老實說，系統的價格並不是他們將系統安裝到辦公室的障礙。因此，由於我們提供的項目的價值，我們的大多數客戶都租用了它們，並且銷售代表能夠以更高的水平進行銷售。因此，ASP 正在穩步上升，我們的賬戶繼續支付，沒有大問題。我錯過了你的第二個問題。

Yes, on D-Tect.

是的，在 D-Tect 上。

So the tech, we launched in the second week of September was when we were able to get our first systems out the door. It generated a little over $100,000 in revenue for us in the quarter. We sell the system for a little more than $2,100 and it is in the new system pricing as of October 1. We have raised the price of the system and are including D-Tect with it.

因此，我們在 9 月的第二週推出的技術是我們能夠推出第一個系統的時候。它在本季度為我們創造了略高於 100,000 美元的收入。我們以略高於 2,100 美元的價格出售該系統，它在 10 月 1 日的新系統定價中。我們已經提高了系統的價格，並將 D-Tect 包括在內。

Okay. That's very helpful. Then I wanted to ask my second question here on treatment, treatment volumes, and I think you called out revenue, treatment revenue per active sites, 11,400. I think that's up about 2% year-over-year, maybe 1% sequentially. I want to get an understanding of just how high that could go or what maybe your best sites are doing in terms of revenue per active site at this point? Just to give us sort of a target to work towards long term.

好的。這很有幫助。然後我想在這裡問我的第二個問題，關於治療，治療量，我想你說的是收入，每個活動站點的治療收入，11,400。我認為這比去年同期增長了大約 2%，可能比上一季度增長了 1%。我想了解這可能會達到多高，或者您最好的網站目前在每個活躍網站的收入方面正在做什麼？只是為了給我們一個長期努力的目標。

Marie, Steve. Yes, I mean, that number kind of traditional for a click perspective, it's just under $45,000 annually in treatment session revenue. That represents 2.5 or so patients per day over the course of the year. We think we should be able to get that to 4 or 5. So, essentially doubling where we are in getting patients or customers to that $75,000 to $90,000 annually in treatment session revenue. The per-click segment, which is about 20% of our overall sites, their utilization was up 20% quarter-over-quarter quarter-over-quarter.

瑪麗，史蒂夫。是的，我的意思是，從點擊的角度來看，這個數字有點傳統，每年的治療收入不到 45,000 美元。這代表一年中每天有 2.5 名左右的患者。我們認為我們應該能夠將其提高到 4 或 5。因此，從本質上講，我們在讓患者或客戶每年獲得 75,000 美元至 90,000 美元的治療療程收入方面翻了一番。每次點擊部分約占我們整個網站的 20%，其利用率環比增長 20%。

The programs that our practice development managers are employing along with the PHQ-10 and some other tools are certainly paying dividends. I guess the most simplistic view of this, if we can get a customer to add one patient per day, there's no reason why they can't add to. The data certainly supports it. The program support it, the support that we give our customers support it. So we've been in that $45,000 range, I think, since I've been here. And now it really feels like we have the traction and really the support from the PDM. I think we're going to see nice increases over the next few years...

我們的實踐開發經理正在使用的程序以及 PHQ-10 和其他一些工具肯定會帶來好處。我想這是最簡單的觀點，如果我們能讓客戶每天增加一名患者，他們就沒有理由不增加。數據當然支持它。該計劃支持它，我們為客戶提供的支持支持它。所以我認為，自從我來到這里以來，我們一直在 45,000 美元的範圍內。現在感覺我們確實得到了 PDM 的牽引力和支持。我認為我們將在未來幾年看到不錯的增長......

At this time, I would like to turn it back to Neuronetics President and CEO, Keith Sullivan.

在這個時候，我想把它轉回給 Neuronetics 總裁兼首席執行官 Keith Sullivan。

Thank you, operator. Thank you again for joining us on the call today, and we look forward to updating you on the next quarterly call.

謝謝你，運營商。再次感謝您今天加入我們的電話會議，我們期待在下一個季度電話會議上為您更新。

Thank you for your participation in today's conference. This does conclude the program. You may now disconnect.

感謝您參加今天的會議。這確實結束了程序。您現在可以斷開連接。