Neuronetics Inc (STIM) 2023 Q2 法說會逐字稿

Thank you for standing by. Welcome to the Neuronetics Second Quarter 2023 Financial and Operating Results Conference Call. (Operator Instructions) As a reminder, today's program is being recorded.

謝謝你的支持。歡迎參加 Neuronetics 2023 年第二季度財務和運營業績電話會議。 （操作員指示）提醒一下，今天的節目正在錄製中。

And now I'd like to introduce your host for today's program, Mr. Mark Klausner. Please go ahead, sir.

現在我想介紹一下今天節目的主持人馬克·克勞斯納先生。請繼續，先生。

Good morning, and thank you for joining us for the Neuronetics Second Quarter 2023 Conference Call. Joining me on today's call are Neuronetics President and Chief Executive Officer, Keith Sullivan; and Chief Financial Officer, Steve Furlong.

早上好，感謝您參加我們的 Neuronetics 2023 年第二季度電話會議。參加今天電話會議的還有 Neuronetics 總裁兼首席執行官 Keith Sullivan；和首席財務官史蒂夫·弗隆。

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.

在我們開始之前，我想提醒聽眾，管理層在本次電話會議中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.

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中明示或暗示的結果存在重大差異。

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 filed in March 2023 as well as the company's quarterly report on Form 10-Q, which will be filed later today.

為了討論與Neuronetics 業務相關的風險和不確定性，我建議您查看該公司向美國證券交易委員會提交的文件，包括該公司於2023 年3 月提交的10-K 表格年度報告以及該公司10-K表格的季度報告10-Q，將於今天晚些時候提交。

The company disclaims any obligation to update any forward-looking statements made during the course of this call, except as required by law.

除非法律要求，否則該公司不承擔更新本次電話會議期間所做的任何前瞻性陳述的義務。

During the call, we'll also discuss certain information on a non-GAAP basis, including 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.

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。管理層認為，非公認會計原則財務信息與美國公認會計原則財務指標相結合，通過排除某些不能反映我們經營業績趨勢的非現金和其他費用，為管理層和投資者提供有用的信息。管理層使用非公認會計準則財務指標來比較我們相對於預測和戰略計劃的業績，以將我們的業績與競爭對手進行外部比較，並做出某些薪酬決策。

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.

美國公認會計原則和非公認會計原則結果之間的調節顯示在我們新聞稿隨附的表格中，您可以在我們的網站上查看這些表格。

With that, it's my pleasure to turn the call over to Neuronetics President and Chief Executive Officer, Keith Sullivan.

至此，我很高興將電話轉給 Neuronetics 總裁兼首席執行官 Keith Sullivan。

Thank you, Mark. Good morning, and thank you for joining us. I'll begin by providing an overview of our recent performance, followed by an operational update. Steve will then review our financial results, and I'll conclude with some thoughts on the rest of 2023 before turning to Q&A.

謝謝你，馬克。早上好，感謝您加入我們。我將首先概述我們最近的表現，然後介紹運營情況的最新情況。然後，史蒂夫將回顧我們的財務業績，在進行問答之前，我將總結對 2023 年剩餘時間的一些想法。

We delivered a solid performance during the second quarter as our commercial and customer education initiatives have continued to gain traction. U.S. capital sales remained consistent, and despite some of the ongoing headwinds associated with the integration of our 2 largest customers, our treatment session revenues continued to increase.

由於我們的商業和客戶教育計劃繼續受到關注，我們在第二季度取得了穩健的業績。美國的資本銷售保持穩定，儘管與我們最大的兩個客戶的整合相關的一些持續的阻力，我們的治療收入繼續增加。

Total revenue was $17.6 million, up 8% over the second quarter of 2022, primarily driven by strong treatment session growth combined with an unplanned NeuroStar system expansion. NeuroStar system revenue was $4.5 million. As previously mentioned, our objective is to ship 45 to 50 systems per quarter as we believe this range enables our team to dedicate sufficient time and resources to ensure the long-term success of our customers with NeuroStar.

總收入為 1760 萬美元，比 2022 年第二季度增長 8%，這主要是由於治療療程的強勁增長以及計劃外的 NeuroStar 系統擴張所致。 NeuroStar 系統收入為 450 萬美元。如前所述，我們的目標是每季度交付 45 至 50 個系統，因為我們相信這個範圍使我們的團隊能夠投入足夠的時間和資源，以確保 NeuroStar 客戶的長期成功。

Consistent with this plan, we concluded the quarter by shipping a total of 54 systems. Importantly, nearly half of the NeuroStar shipped during the quarter were to customers buying their second systems, which points to the value we are delivering to these practices by helping them educate and treat more patients in need.

根據該計劃，我們在本季度末總共交付了 54 個系統。重要的是，本季度交付的 NeuroStar 近一半是購買第二套系統的客戶，這表明我們通過幫助他們教育和治療更多有需要的患者來為這些實踐提供價值。

The sustained strength of our capital equipment sales can be attributed to the continued execution by our experienced capital sales team as well as the positive impacts of our NeuroStar summits. Our most recent summit held in Scottsdale, Arizona was again sold out and ultimately resulted in approximately 20 system sales during the event.

我們資本設備銷售的持續強勁得益於我們經驗豐富的資本銷售團隊的持續執行以及 NeuroStar 峰會的積極影響。我們最近在亞利桑那州斯科茨代爾舉行的峰會再次售空，最終在活動期間銷售了大約 20 個系統。

These NeuroStar summits remain a crucial element of our strategy, providing a platform to educate customers about the impact NeuroStar can have on improving patient lives.

這些 NeuroStar 峰會仍然是我們戰略的重要組成部分，它們提供了一個平台，讓客戶了解 NeuroStar 對改善患者生活的影響。

The U.S. treatment session revenue was $12.3 million, up 9% over the second quarter of 2022. The strong performance was primarily driven by the 19% year-over-year increase in local consumable utilization, along with the improving performance among our national accounts. Across the board, these results were driven by the positive impact of our key initiatives such as NeuroStar University, our comprehensive 5-STARS training program, the expanded utilization of our PHQ-10 tool and the increased accessibility of the practice management training.

美國的治療療程收入為 1,230 萬美元，比 2022 年第二季度增長 9%。強勁的業績主要得益於當地消耗品利用率同比增長 19%，以及國民賬戶業績的改善。總的來說，這些成果是由我們的關鍵舉措的積極影響推動的，例如 NeuroStar 大學、我們的綜合 5 星級培訓計劃、PHQ-10 工具的擴大利用以及實踐管理培訓的可及性的增加。

Along these lines, we wanted to provide an update on the progress made at our largest customer, Greenbrook TMS. During the quarter, we continued to see improving performance across active Greenbrook sites. Treatment session volumes and related revenues remained somewhat depressed as a result of their office closures, but we are actively working with the Greenbrook team to address the ongoing challenges stemming from the merger with Success TMS and the integration process. We have collaborated closely with their leadership team at various levels to implement a mutually beneficial strategy moving forward. This included implementing initiatives to enhance awareness, expand patient access to care and effectively redeploy systems from the recently closed stores.

沿著這些思路，我們希望提供我們最大的客戶 Greenbrook TMS 所取得的最新進展。在本季度，我們繼續看到活躍的 Greenbrook 站點的性能不斷提高。由於辦公室關閉，治療次數和相關收入仍然有些低迷，但我們正在積極與 Greenbrook 團隊合作，解決因與 Success TMS 合併和整合過程而帶來的持續挑戰。我們與他們的各級領導團隊密切合作，實施互惠互利的戰略。這包括實施舉措以提高認識、擴大患者獲得護理的機會以及有效地重新部署最近關閉的商店的系統。

In total, approximately 50 systems were taken out of service due to store closures. And to date, over 35 of these systems have been relocated into existing stores, where they have replaced competitive systems.

由於商店關閉，總共約有 50 個系統停止服務。迄今為止，超過 35 個此類系統已遷移到現有商店，並取代了競爭系統。

We expect the remaining systems to have been relocated by the end of the third quarter. Additionally, in support of Greenbrook's growth, all of the Greenbrook Regional Vice Presidents have attended a NeuroStar University class and we are scheduling their trainers and treaters to attend upcoming classes to provide them with a proven playbook for practice success so they can better serve their patients.

我們預計其餘系統將在第三季度末完成搬遷。此外，為了支持格林布魯克的成長，所有格林布魯克地區副總裁都參加了NeuroStar 大學課程，我們正在安排他們的培訓師和治療師參加即將舉行的課程，為他們提供經過驗證的實踐成功手冊，以便他們能夠更好地為患者服務。

As we continue to support the Greenbrook team, we are encouraged by the positive impact that tactics learned at NSU have had as they deployed them in their clinic. While legacy success stores are currently lagging behind Greenbrook stores in terms of performance, we are confident that through education and training efforts we can help get that portion of the business back on track.

當我們繼續支持格林布魯克團隊時，我們對在 NSU 學到的策略在診所中部署時所產生的積極影響感到鼓舞。雖然傳統的成功商店目前在業績方面落後於格林布魯克商店，但我們相信，通過教育和培訓工作，我們可以幫助這部分業務重回正軌。

We look forward to continuing our strong partnership with Greenbrook as we work together to advance the adoption of TMS as the therapy for mental illness.

我們期待繼續與 Greenbrook 保持強有力的合作夥伴關係，共同努力推動 TMS 作為精神疾病治療方法的採用。

Now turning to our operational highlights. Our first focus of 2023 is increasing the number of customers who participate in NSU. NeuroStar University continues to receive excellent reviews from our customers. By quarter end, we had hosted 13 fully booked classes with over 260 attendees. We are experiencing sustained high demand with all of our courses fully booked out on a 3-month rolling basis.

現在轉向我們的運營亮點。我們 2023 年的首要重點是增加參與 NSU 的客戶數量。 NeuroStar 大學繼續獲得客戶的好評。到季度末，我們已經舉辦了 13 門課程，課程已訂滿，參加人數超過 260 人。我們面臨著持續的高需求，我們的所有課程在 3 個月的滾動基礎上都被訂滿。

In August, we will celebrate the 1-year anniversary of the program, which we have updated twice to streamline our customers' experience at NSU to make it as impactful as possible. Our customers continue to derive significant benefits directly from the NSU training session.

八月份，我們將慶祝該計劃的一周年紀念日，我們已對該計劃進行了兩次更新，以簡化客戶在 NSU 的體驗，使其盡可能具有影響力。我們的客戶繼續直接從 NSU 培訓課程中獲得顯著收益。

For example, for sites that became active before January 1, 2022, NeuroStar University attendees have experienced a 68% increase in utilization, whereas nonattendees from that same period only experienced an 8% increase. Additionally, attendees have increasingly leveraged our other programs, such as the 5-STARS and co-op marketing, which has, over time, led to increased overall performance.

例如，對於 2022 年 1 月 1 日之前活躍的網站，NeuroStar University 的與會者的利用率增加了 68%，而同期未與會者的利用率僅增加了 8%。此外，與會者越來越多地利用我們的其他計劃，例如 5-STARS 和合作營銷，隨著時間的推移，這導致了整體績效的提高。

This highlights the positive impact of our techniques when properly deployed, empowering practices to better serve their patients. We remain committed to providing the support and training to our customers ensuring that they can fully leverage their potential.

這凸顯了我們的技術在正確部署時所產生的積極影響，使實踐能夠更好地為患者服務。我們仍然致力於為客戶提供支持和培訓，確保他們能夠充分發揮自己的潛力。

Our second focus for 2023 was to incorporate a higher percent of our customers into the co-op marketing program, to continue to build awareness of NeuroStar. We have seen the positive impacts of our new co-op marketing program, which launched on April 1. The program features a prescriptive road map of effective marketing tactics to market inside and outside the practice. New marketing and training collateral were created. And we revamped myneurostar.com to digitize the execution of the program.

我們 2023 年的第二個重點是將更高比例的客戶納入合作營銷計劃，以繼續提高 NeuroStar 的知名度。我們已經看到了 4 月 1 日啟動的新合作營銷計劃的積極影響。該計劃提供了有效營銷策略的規定路線圖，可在實踐中和外部進行營銷。創建了新的營銷和培訓材料。我們改進了 myneurostar.com，以數字化程序的執行。

Since its implementation, we've observed increased use of the co-op program. especially by NSU attendee. Existing co-op account are also demonstrating increased engagement with the program with a 27% increase in activity quarter-over-quarter. This reflects the deeper adoption of and partnership with our platform.

自實施以來，我們觀察到合作項目的使用有所增加。特別是 NSU 的與會者。現有的合作社賬戶也顯示出對該計劃的參與度有所提高，活動量環比增加了 27%。這反映出我們的平台得到了更深入的採用和合作。

Additionally, participating co-op accounts saw a notable increase in utilization sequentially. This enhanced program is driving growth and increasing patient access to NeuroStar therapy.

此外，參與合作社賬戶的利用率連續顯著增加。這一增強計劃正在推動增長並增加患者接受 NeuroStar 治療的機會。

Our third and final focus area for 2023 is creating a network of accounts across the country that follow NeuroStar [best] practices. This program will provide the opportunity for our customers to be part of a premier group that demonstrate their commitment to providing the best patient experience and care with NeuroStar.

我們 2023 年的第三個也是最後一個重點領域是在全國范圍內創建一個遵循 NeuroStar [最佳] 實踐的賬戶網絡。該計劃將為我們的客戶提供成為一流團隊一員的機會，展示他們致力於通過 NeuroStar 提供最佳患者體驗和護理的承諾。

After soliciting feedback from our NeuroStar patient advocate and 800 people who have been diagnosed with depression, we are branding this program, the Better Me Guarantee, and intend to launch it in the third quarter of this year. By establishing specific benchmarks such as delivering consistently high levels of service and expanding patient marketing efforts within and outside the practice, we anticipate observing tangible advancement among customers who fully leverage the distinctive benefits of being a Better Me Guarantee provider.

在徵求 NeuroStar 患者倡導者和 800 名被診斷患有抑鬱症的人的反饋後，我們將這一計劃命名為“更好的我保證”，並打算在今年第三季度啟動。通過建立具體的基準，例如提供始終如一的高水平服務以及在實踐內外擴大患者營銷工作，我們預計在充分利用“更好的我保證”提供商的獨特優勢的客戶中觀察到明顯的進步。

We will expand on the specifics of this program on our third quarter earnings call.

我們將在第三季度財報電話會議上詳細介紹該計劃的具體細節。

Shifting gears to an update on the clinical and regulatory efforts. In June, we announced the 510(k) clearance for the OCD MT cap technology for NeuroStar. This unique innovation streamlines the treatment process by simplifying coil placement and reducing steps involved in determining a patient's motor threshold. The OCD cap complements NeuroStar's existing capability, positioning it as the only TMS system on the (inaudible) OCD and major depressive disorder. This advancement signifies our commitment to delivering the latest technology to optimize treatment efficiency and provide effective care for individuals struggling with OCD.

轉向更新臨床和監管工作。 6 月，我們宣布 NeuroStar 的 OCD MT 上限技術獲得 510(k) 許可。這項獨特的創新通過簡化線圈放置並減少確定患者運動閾值所涉及的步驟來簡化治療過程。 OCD 上限補充了 NeuroStar 的現有功能，將其定位為治療（聽不清）強迫症和重度抑鬱症的唯一 TMS 系統。這一進步標誌著我們致力於提供最新技術來優化治療效率並為強迫症患者提供有效的護理。

We are continuing to work to expand the use for our unique therapy. We have recently filed a 510(k) submission with the FDA seeking to expand our potential patient population. While we don't want to comment on the specifics of the filing for competitive purposes, we do expect to hear back from the FDA on the filing by the end of the year and look forward to sharing progress as it occurs.

我們正在繼續努力擴大我們獨特療法的用途。我們最近向 FDA 提交了 510(k) 申請，尋求擴大我們的潛在患者群體。雖然出於競爭目的，我們不想評論該申請的具體細節，但我們確實希望在今年年底前收到 FDA 關於該申請的回复，並期待分享進展情況。

Moving to reimbursement. We are pleased to announce BlueCross BlueShield of Michigan has expanded eligibility for depression patients to receive TMS treatment. This policy update reduces the requirement of attempted antidepressant medications from 4 to 2 prior to TMS treatment eligibility. By prioritizing early access to relief, BlueCross BlueShield of Michigan is enabling millions of people to benefit from our therapy.

轉向報銷。我們很高興地宣布密歇根州的 BlueCross BlueShield 擴大了抑鬱症患者接受 TMS 治療的資格。此政策更新將 TMS 治療資格之前嘗試抗抑鬱藥物的要求從 4 種減少到 2 種。通過優先考慮儘早獲得救濟，密歇根州的 BlueCross BlueShield 使數百萬人能夠從我們的治療中受益。

This policy change reflects the growing recognition by commercial and government payers of the need for enhanced mental health coverage, particularly in light of the nationwide shortage of mental health care providers.

這一政策變化反映了商業和政府付款者日益認識到加強精神健康保險的必要性，特別是考慮到全國范圍內精神衛生保健提供者的短缺。

Additionally, Aetna, one of the largest health care plans in the country, covering over 16.8 million lives, has implemented changes that will make our treatment more accessible. Aetna now allows TMS treatment to be ordered and conducted under the supervision of behavioral health nurse practitioners. Also, Aetna has removed the 4-month psychotherapy trial requirement before a patient can receive their initial TMS treatment, making it easier for individuals to start their treatment sooner.

此外，Aetna 是美國最大的醫療保健計劃之一，覆蓋超過 1,680 萬人，它已經實施了一些改革，使我們的治療更容易獲得。 Aetna 現在允許在行為健康執業護士的監督下訂購和進行 TMS 治療。此外，Aetna 取消了患者接受初始 TMS 治療之前 4 個月心理治療試驗的要求，使個人更容易儘早開始治療。

The latest update from Aetna opening up access to care through nurse practitioners and reducing eligibility requirements is a step forward and builds on the momentum we have seen with other commercial and government payers expanding coverage for TMS therapy.

Aetna 的最新更新開放了執業護士提供的護理服務並降低了資格要求，這是向前邁出的一步，並且建立在我們看到的其他商業和政府付款人擴大 TMS 治療覆蓋範圍的勢頭之上。

We are pleased with the achievements made in the second quarter. Our commercial team received strong support through effective marketing initiatives, comprehensive training program and dedicated practice assistance, which all contributed to our success.

我們對第二季度取得的成績感到高興。我們的商業團隊通過有效的營銷舉措、全面的培訓計劃和專門的實踐協助獲得了強有力的支持，這一切都為我們的成功做出了貢獻。

I appreciate the ongoing dedication of our entire organization and their efforts in strengthening our leadership position in the industry.

我感謝我們整個組織的持續奉獻以及他們為加強我們在行業中的領導地位所做的努力。

With that, I'd like to turn the call over to Steve.

有了這個，我想把電話轉給史蒂夫。

Thank you, Keith. Unless otherwise noted, all performance comparisons are being made for the second quarter of 2023 versus the second quarter of 2022. Total revenue was $17.6 million, an increase of 8% over prior year revenue of $16.3 million. U.S. NeuroStar Advanced Therapy system revenue was $4.5 million versus $4.4 million in the prior year.

謝謝你，基思。除非另有說明，所有業績比較均針對 2023 年第二季度與 2022 年第二季度進行。總收入為 1,760 萬美元，比上年收入 1,630 萬美元增長 8%。美國 NeuroStar 高級治療系統收入為 450 萬美元，而上一年為 440 萬美元。

We shipped 54 systems, down from 58 systems in 2022. As Keith noted, our current strategy is to ship between 45 and 50 systems per quarter.

我們發貨了 54 個系統，低於 2022 年的 58 個系統。正如 Keith 指出的那樣，我們當前的策略是每季度發貨 45 到 50 個系統。

U.S. treatment session revenue was $12.3 million, an increase of 9% over 2022 revenue of $11.3 million. The revenue growth was primarily driven by strong performance within our consumable customer segment.

美國治療療程收入為 1,230 萬美元，比 2022 年 1,130 萬美元的收入增長 9%。收入增長主要得益於我們消費品客戶領域的強勁表現。

In the second quarter of 2023, revenue per active site was approximately $11,390 compared to approximately $11,280 in the prior year quarter. We are highly encouraged by the fact that despite a material increase in active sites, compared to this time last year, we were able to maintain revenue per site. We see this as evidence that our programs and initiatives are working.

2023 年第二季度，每個活躍網站的收入約為 11,390 美元，而去年同期約為 11,280 美元。儘管活躍網站數量大幅增加，但與去年同期相比，我們仍然能夠維持每個網站的收入，這一事實令我們深受鼓舞。我們認為這是我們的計劃和舉措正在發揮作用的證據。

Gross margins were 72.5% compared to 75.3% in the prior year quarter. The decline in gross margin was driven by an increase in amortization expense associated with the latest product release. We also incurred onetime expenses related to our transition to a new contract manufacturer. Without these expenses, gross margins would have been 75.6%.

毛利率為 72.5%，去年同期為 75.3%。毛利率下降是由於與最新產品發布相關的攤銷費用增加所致。我們還產生了與過渡到新的合同製造商相關的一次性費用。如果沒有這些費用，毛利率將為 75.6%。

Operating expenses during the quarter were $20.1 million, a decrease of $2 million or 9% compared to $22.1 million in the second quarter of 2022.

該季度運營費用為 2010 萬美元，與 2022 年第二季度的 2210 萬美元相比減少了 200 萬美元，即 9%。

In May, our ELT met to review and justify 2023 operating expenses. Consistent with the results achieved with a similar exercise in 2022, the team identified over $4.5 million in expense savings in the balance of 2023, some of which will be offset by increased co-marketing expenses related to Greenbrook.

5 月，我們的 ELT 召開會議審查並論證 2023 年運營費用的合理性。與 2022 年類似活動取得的結果一致，該團隊確定 2023 年剩餘時間將節省超過 450 萬美元的費用，其中一些費用將被與 Greenbrook 相關的聯合營銷費用增加所抵消。

As a result, we have achieved a net reduction of $2.2 million in expenses, demonstrating our commitment to prudent financial management.

結果，我們的開支淨減少了 220 萬美元，體現了我們對審慎財務管理的承諾。

During the quarter, we incurred approximately $2 million of noncash stock-based compensation expense.

本季度，我們產生了約 200 萬美元的非現金股票補償費用。

Net loss for the quarter was $4.9 million or $0.17 per share as compared to a net loss of $10.4 million or $0.39 per share in the prior year quarter.

本季度淨虧損為 490 萬美元，即每股 0.17 美元，而去年同期淨虧損為 1,040 萬美元，即每股 0.39 美元。

EBITDA was negative $3.3 million as compared to negative $9.1 million in the prior year quarter. In the quarter, our EBITDA loss was reduced by $2.9 million related to the recognition of the employee retention credit.

EBITDA 為負 330 萬美元，而去年同期為負 910 萬美元。本季度，由於確認了員工保留積分，我們的 EBITDA 損失減少了 290 萬美元。

As of June 30, 2023, cash and cash equivalents were $45.9 million. We incurred significant expenses related to our contract manufacturing transition and also recognized significant capital revenue in June, which increased our accounts receivable balance at quarter end.

截至2023年6月30日，現金及現金等價物為4590萬美元。我們產生了與合同製造轉型相關的大量費用，並在 6 月份確認了大量資本收入，這增加了我們季末的應收賬款餘額。

As a reminder, we converted $6 million of Greenbrook accounts receivable into a senior secured loan on which Greenbrook has started making principal and interest payments.

謹此提醒，我們將 Greenbrook 的 600 萬美元應收賬款轉換為高級擔保貸款，Greenbrook 已開始支付本金和利息。

Now turning to guidance. For the full year, we now expect revenue in the range of $69 million to $73 million, increasing the bottom end of the range by $1 million.

現在轉向指導。我們現在預計全年收入在 6900 萬美元至 7300 萬美元之間，使該範圍的下限增加 100 萬美元。

For the quarter, we expect revenue of $17 million to $18 million.

我們預計本季度收入為 1700 萬美元至 1800 萬美元。

We now expect total operating expenses for the year to be in the range of $82 million to $86 million, improved from prior guidance of $84 million to $88 million.

我們目前預計今年的總運營支出將在 8200 萬美元至 8600 萬美元之間，高於之前指導的 8400 萬美元至 8800 萬美元。

We remain confident in our operating plan which indicates that we will reach cash flow breakeven with our current cash on hand. Our path to profitability remains steady, supported by our projections for top line growth, a strong gross margin profile and diligent management of operating expenses.

我們對我們的運營計劃仍然充滿信心，這表明我們將利用當前手頭現金實現現金流收支平衡。在我們對營收增長的預測、強勁的毛利率狀況和對運營費用的勤勉管理的支持下，我們的盈利之路保持穩定。

I would now like to turn the call back over to Keith.

我現在想把電話轉回基思。

Thank you, Steve. We've made significant progress in the first half of the year. The list of achievements is long, and it reflects our team's dedication and hard work towards achieving our goals.

謝謝你，史蒂夫。今年上半年我們取得了重大進展。成就清單很長，它反映了我們團隊為實現目標而付出的奉獻和努力。

Some of our accomplishments include focusing on maximizing revenue growth while efficiently reducing expenses, surpassing our targets on capital placements, heightened attention on Greenbrook, aiming to bring their utilization back up to previous high levels and receiving excellent reviews and fully booking all NSU classes, which has increased attendee utilization compared to nonattendees.

我們的一些成就包括專注於最大化收入增長，同時有效降低開支，超越我們的資本配置目標，提高對Greenbrook 的關注，旨在將其利用率恢復到以前的高水平，並獲得好評並完全預訂所有NSU 課程，這與未參加者相比，提高了參加者的利用率。

Additionally, our clinical data supports the efficacy of NeuroStar for adult patients with anxious depression. And we've achieved positive policy decisions, reducing prior medication failures for TMS eligibility and enabling nonphysician practitioners to order and administer TMS therapy.

此外，我們的臨床數據支持 NeuroStar 對成年焦慮抑鬱症患者的療效。我們已經做出了積極的政策決定，減少了 TMS 資格之前的藥物失敗情況，並使非醫師從業者能夠訂購和實施 TMS 治療。

We've also made notable product developments, enhanced internet connectivity capabilities and software for TrakStar.

我們還為 TrakStar 進行了顯著的產品開發、增強的互聯網連接功能和軟件。

On the regulatory front, we obtained 510(k) clearance for the OCD MT cap and recently submitted for a new label expansion.

在監管方面，我們獲得了 OCD MT 上限的 510(k) 許可，並於最近提交了新標籤擴展申請。

Furthermore, we secured $60 million in new debt financing and successfully improved gross margins by switching contract manufacturers.

此外，我們還獲得了 6000 萬美元的新債務融資，並通過更換合同製造商成功提高了毛利率。

As we move into the second half, we are eager to build upon the momentum. Our proven track record of execution gives us confidence in our ability to continue to deliver solid results. We remain focused on growing the number of customers who take part in NeuroStar University, working to incorporate a higher percentage of customers into co-op marketing programs and create a network of accounts across the country that follow NeuroStar best practices.

當我們進入下半年時，我們渴望繼續保持這一勢頭。我們經過驗證的執行記錄使我們對繼續交付可靠成果的能力充滿信心。我們仍然致力於增加參與 NeuroStar 大學的客戶數量，努力將更高比例的客戶納入合作營銷計劃，並在全國范圍內創建遵循 NeuroStar 最佳實踐的帳戶網絡。

With a well-defined strategy in place, we aim to accelerate the adoption of NeuroStar and provide relief to more patients suffering from mental health disorders.

有了明確的戰略，我們的目標是加速 NeuroStar 的採用，並為更多患有精神健康障礙的患者提供緩解。

With that, I'd like to open the line for questions.

說到這裡，我想開通提問熱線。

(Operator Instructions) Our first question is going to come from the line of Margaret Kaczor with William Blair.

（操作員說明）我們的第一個問題將來自瑪格麗特·卡佐爾和威廉·布萊爾的線路。

I wanted to start -- to talk about the accounts that purchased the second system. So half of the placements this quarter coming from that is -- really seems like a meaningful increase. Is this -- are these national accounts or group practices? And then how should we think about their kind of productivity ramp relative to more traditional new sites?

我想首先談談購買第二個系統的帳戶。因此，本季度一半的安置來自於此——看起來確實是一個有意義的增長。這是國民賬戶還是團體做法？那麼我們應該如何看待他們相對於更傳統的新網站的生產力提升？

This is Keith. The accounts that purchased second systems were mostly private offices. National accounts have not purchased any systems in the last couple of quarters. So these are physicians that have gotten to the level where they're doing 6 or 7 treatments per day on their device. And at that level, they're starting to run into scheduling conflicts with patients and they need a second system to support that demand.

這是基思。購買第二套系統的客戶大多是私人辦公室。國民賬戶在過去幾個季度沒有購買任何系統。這些醫生已經達到了每天在他們的設備上進行 6 或 7 次治療的水平。在這個級別上，他們開始遇到與患者的日程安排衝突，他們需要第二個系統來支持這一需求。

Okay. And the productivity ramp and increase seems like maybe that should be a little faster than normal given they're already familiar with the system. Is that fair?

好的。鑑於他們已經熟悉了該系統，生產率的提升和增長似乎應該比正常情況要快一些。這公平嗎？

Yes, it is. And I think they've already -- most of these accounts have already been to NSU. They understand exactly how to speak to their patients and get them into the chair. So these are the accounts that have really accelerated.

是的。我認為他們已經——其中大部分賬戶已經去了 NSU。他們清楚地知道如何與患者交談並讓他們坐在椅子上。所以這些是真正加速的賬戶。

I think we've said in the past that it typically takes 6 months for accounts to get their system and get it up and running. And we have worked hard over the past several quarters to reduce that. So we're now in the 90 to 120 days range to get new accounts up and running.

我想我們過去曾說過，帳戶通常需要 6 個月的時間才能獲得系統並啟動並運行。在過去的幾個季度中，我們一直在努力減少這種情況。因此，我們現在需要 90 到 120 天的時間才能建立並運行新帳戶。

Okay. That's helpful. And what I'm trying to tear into, you referenced the 68% increase in utilization for attendees from NSU. That's a pretty meaningful increase. You're referencing those sites are the ones that are coming back, I guess, for second system purchases.

好的。這很有幫助。我想解釋的是，您提到了 NSU 與會者的利用率增加了 68%。這是一個相當有意義的增長。我猜你提到的這些網站是那些回來購買第二個系統的網站。

So as we think about both the next several quarters in 2024, is this something that can continue to pick up traction where more of the accounts that attend NSU? And then I have 1 more follow-up and I'll hop back in the queue.

因此，當我們考慮 2024 年接下來的幾個季度時，這是否會繼續吸引更多就讀 NSU 的學生？然後我還有 1 個跟進，我會跳回到隊列中。

The simple answer is yes. We're putting an emphasis and we're using the staff that you just mentioned, the 68% increase, to get more accounts there. Quite honestly, we've held 15 classes now and they have -- we are getting repeat customers coming back. So we are using this data to get our legacy accounts and all the new accounts to come to NSU as soon as possible.

簡單的答案是肯定的。我們正在重點關注，我們正在使用您剛才提到的員工，增幅為 68%，以便在那裡獲得更多客戶。老實說，我們現在已經舉辦了 15 期課程，而且我們正在吸引回頭客。因此，我們正在使用這些數據來讓我們的舊帳戶和所有新帳戶盡快來到 NSU。

Okay. So just last question for me just because these steps do seem pretty meaningful. Can you give us a sense of, I guess, what the revenue per account would have been this quarter or this year, excluding Greenbrook or excluding the national accounts, as we kind of lap the Greenbrook headwinds, obviously, that will maybe be a better signal of what that underlying business can do.

好的。所以對我來說最後一個問題只是因為這些步驟看起來確實很有意義。我想，您能否讓我們了解本季度或今年每個賬戶的收入是多少，排除格林布魯克或排除國民賬戶，因為我們有點克服格林布魯克的逆風，顯然，這可能會更好該基礎業務可以做什麼的信號。

Margaret, this is Steve. We haven't done that math yet, but we did have 50-or-so Greenbrook office closures. So the revenue per site would obviously be a bit lower. But we'll have to go back and quantify that for you and get back to you.

瑪格麗特，這是史蒂夫。我們還沒有計算過，但我們確實關閉了大約 50 個格林布魯克辦事處。所以每個網站的收入顯然會低一些。但我們必須回去為您量化並回复您。

Our next question is going to come from the line of Bill Plovanic with CG.

我們的下一個問題將來自 Bill Plovanic 的 CG 線。

It's Zachary Day on for Bill today. So you've talked a lot about easier payer rules with BlueCross BlueShield and the Aetna improvements. Can you possibly quantify that importance and think about when it comes to other commercial payers beyond Aetna, what percent of them do you think will get a similar policy update? And how can that drive revenue and other financial metrics?

今天是比爾的紮卡里日。您已經談論了很多有關 BlueCross BlueShield 和 Aetna 改進的更簡單付款人規則的內容。您能否量化這種重要性，並考慮一下當涉及 Aetna 以外的其他商業付款人時，您認為其中有多少百分比會獲得類似的政策更新？這如何推動收入和其他財務指標？

Well, we are very encouraged by the changes in the policies. The biggest one that we had was back in March when UnitedHealthcare went from 4 drugs to 2. And I think most of the other payers are going to follow suit with it.

嗯，我們對政策的變化感到非常鼓舞。最大的一次是在三月份，當時 UnitedHealthcare 將藥物種類從 4 種減少到 2 種。我認為大多數其他付款人也會效仿。

I think we've said in the past that there are plenty of patients out there that have failed 4 drugs and we are making a concerted effort to drive awareness to those patients. What the reduction in failed drugs means to those patients is they can get into the chair sooner.

我想我們過去曾說過，有很多患者使用 4 種藥物都失敗了，我們正在齊心協力提高這些患者的認識。失敗藥物的減少對這些患者意味著他們可以更快地坐上椅子。

So we have a large patient population for us to treat. The payers are just making it easier for them to get it. So I think our job and the physician's job is to help drive that awareness.

因此，我們有大量的患者需要治療。付款人只是讓他們更容易獲得它。所以我認為我們的工作和醫生的工作就是幫助提高這種意識。

And our next question is going to come from the line of Adam Maeder with Piper Sandler.

我們的下一個問題將來自 Adam Maeder 和 Piper Sandler。

This is Simran on for Adam. I guess I'll start off on just the sessions business. Can you provide a bit more color on what you saw from treatment sessions volumes and how that progressed over Q2 and into July and August so far?

這是西姆蘭（Simran）為亞當（Adam）發言。我想我將從會議業務開始。您能否提供更多關於您從治療量中看到的情況以及第二季度以及 7 月和 8 月迄今為止的進展情況？

And I'd be curious to know what your expectations for this part of the business look like once you kind of have the rest of different Greenbrook systems relocated and sort of ramping back up.

我很想知道，一旦您將其他不同的 Greenbrook 系統重新安置並恢復運行後，您對這部分業務的期望是什麼樣的。

This is Keith. The systems that have been moved for Greenbrook have, as I said, over 35 of them have been shipped to new locations. Not all of them have been trained yet and so we are working through getting all of the systems placed, and we have prioritized getting training to those sites that have been using competitive systems so that we can get them up and running.

這是基思。正如我所說，已為 Greenbrook 遷移的系統中有超過 35 個已運往新地點。並非所有人都接受過培訓，因此我們正在努力安裝所有系統，並且我們已優先對那些一直在使用競爭性系統的站點進行培訓，以便我們能夠啟動並運行它們。

In the past, Greenbrook was able to generate in the neighborhood of 4 to 6 patients per day per system and we want to get them back to that level, and we're working with Bill Leonard and his team to help get them to that level.

過去，Greenbrook 每個系統每天能夠接待 4 到 6 名患者，我們希望讓他們恢復到這個水平，我們正在與 Bill Leonard 和他的團隊合作，幫助他們恢復到那個水平。

For the -- our other accounts that are growing in utilization, the ones that per-click accounts at the 19% growth, those accounts are the ones that are following our road map to success, which includes going to NSU, which includes following through on the PHQ-10s and using our co-op marketing to be able to make sure that their website is in shape, make sure that their social media platform follows ours and they're buying the proper Google AdWords to drive greater awareness.

對於我們其他使用率不斷增長的帳戶，即每次點擊增長率為 19% 的帳戶，這些帳戶是遵循我們的成功路線圖的帳戶，其中包括前往 NSU，其中包括遵循在PHQ-10 上，並使用我們的合作營銷來確保他們的網站處於良好狀態，確保他們的社交媒體平台遵循我們的平台，並且他們購買合適的Google AdWords 來提高知名度。

Okay. Perfect. That's helpful. And then for my follow-up, the guidance kind of implies a sequential step-up of around 16% from Q3 to Q4 at the midpoint, which is perhaps a bit steeper than what we've seen in past years.

好的。完美的。這很有幫助。然後，對於我的後續行動，該指導意味著從第三季度到第四季度中點將連續上升約 16%，這可能比我們過去幾年看到的要陡峭一些。

So I guess, what kind of informs that level of confidence? And can you walk us through your assumptions baked in for the fourth quarter?

所以我想，什麼樣的信息表明了這種信心水平？您能否向我們介紹一下您對第四季度的假設？

This is Steve. Yes, if I go back and look at 2022, for example, the third quarter was slightly higher than the second quarter and that's what we're anticipating this year. And then Q4 was up just under $2 million from Q3 to Q4.

這是史蒂夫。是的，例如，如果我回顧 2022 年，第三季度略高於第二季度，這就是我們今年的預期。然後，第四季度比第三季度增長了近 200 萬美元。

And that's the similar assumption and seasonality we're expecting in 2023. Q4 was always our strongest capital quarter. And we do have a significant number of treatment session programs that accompany the capital sales. And so it's really just the normal cadence for the final 6 months.

這與我們在 2023 年預期的類似假設和季節性有關。第四季度始終是我們最強勁的資本季度。我們確實有大量伴隨資本銷售的治療項目。所以這實際上只是最後 6 個月的正常節奏。

We do see Greenbrook their performance to be consistent compared to the first half of this year. As Keith alluded to, the transition from moving NeuroStars from storage into active units is a little time consuming. We do have to have our field service engineers deinstall and install. Many of these accounts that the systems are going into were formerly BrainsWay sites. So there is a significant training effort that goes into these. And so there could be upside depending upon the speed and training activities.

我們確實看到格林布魯克的表現與今年上半年保持一致。正如 Keith 提到的，將 NeuroStar 從存儲設備轉移到活動設備的過程需要一點時間。我們確實必須讓我們的現場服務工程師進行拆卸和安裝。系統要訪問的許多帳戶以前都是 BrainsWay 網站。因此，在這些方面需要進行大量的培訓。因此，根據速度和訓練活動，可能會有好處。

But again, we really don't think the lift in Q4 is significant. As a reminder, we've been growing almost double digits and that's, again, reflective in that Q4 performance forecast.

但同樣，我們確實認為第四季度的提升並不顯著。提醒一下，我們的增長幾乎是兩位數，這再次反映在第四季度的業績預測中。

Okay. And if I could just squeeze one last one on gross margin really quickly. So you hit on some of the impacts with the onetime expenses related to the new contract manufacturer. But just how should we think about the levels of gross margin as we look out over the second half of the year and into 2024?

好的。如果我能很快地壓縮毛利率的最後一項就好了。因此，您發現了與新合同製造商相關的一次性費用的一些影響。但展望下半年和 2024 年，我們應該如何看待毛利率水平呢？

Yes. We'll see. I would say, gradual improvements in Q3 and Q4 of this year. And then once our new contract manufacturer is really up and running in 2024, again, we're going to see gross margins inching up to that 80% range. And so we have a number of cost reduction efforts underway, that transition, as well as an increasing treatment session revenue versus capital revenue, product mix, which also helps margins.

是的。我們拭目以待。我想說，今年第三季度和第四季度逐步改善。一旦我們的新合同製造商在 2024 年真正投入運行，我們將再次看到毛利率逐漸升至 80% 的範圍。因此，我們正在進行一系列降低成本的努力，這種轉變，以及相對於資本收入、產品組合的治療療程收入的增加，這也有助於提高利潤率。

So we are confident we're going to get up to that 80% range in 2024.

因此，我們有信心在 2024 年達到 80% 的範圍。

Our next question is going to come from the line of Daniel Stauder with JMP Securities.

我們的下一個問題將來自 JMP 證券的 Daniel Stauder。

Great. So just real quick, revenue per active site you talked about is up modestly this quarter, back into that mid-$11,000. But I guess, could you just remind us how you think about this metric? Any expectations for this year? Or as you exit into -- exit 2023, any broader near- to midterm targets for these levels? And what's the comfortable cohort here that you expect to reach over time?

偉大的。很快，您提到的每個活躍網站的收入本季度小幅上升，回到 11,000 美元中間。但我想，您能否提醒我們您如何看待這個指標？對今年有什麼期待嗎？或者，當您退出 2023 年時，這些水平有任何更廣泛的近中期目標嗎？隨著時間的推移，您預計會達到什麼樣的舒適群體？

Danny, it's Steve. I mean this is one of the key metrics. It really does highlight the performance of an individual site. I would say with a lot of the activities and initiatives we have, that number will continue to increase. It is a bit variable depending upon the system sold into existing sites and also the different customer segments. So the local consumables segment continues to shine for us, and that's really the focus of many of our initiatives.

丹尼，是史蒂夫。我的意思是這是關鍵指標之一。它確實突出了單個站點的性能。我想說，隨著我們開展的大量活動和舉措，這個數字將繼續增加。根據銷售到現有站點的系統以及不同的客戶群，它有一點變化。因此，本地消耗品領域繼續為我們帶來光明，這確實是我們許多舉措的重點。

And so we would expect that to get maybe 20% higher as we work through next year.

因此，我們預計明年這一數字可能會提高 20%。

That's great. And then just...

那太棒了。然後就...

So I was going to say, Danny, if you look at the average treatment sessions done on a system, it's still the upside getting to that $6 or $7 per system, which is pretty much capacity. There is significant runway in that number compared to where we are right now. And obviously, that will translate into a much higher revenue per site calculation.

所以我想說，丹尼，如果你看看系統上完成的平均治療療程，每個系統達到 6 或 7 美元仍然是有好處的，這已經是相當大的容量了。與我們現在的情況相比，這個數字還有很長的路要走。顯然，這將轉化為更高的每個網站收入計算。

Great. And then just one more on cash usage. You had some onetime items here in the first half of the year, but just any more color you could give us on cash burn rate in the back half of this year as well as your rate exiting 2023 would be very helpful.

偉大的。然後再談一談現金使用情況。今年上半年你有一些一次性項目，但如果你能向我們提供有關今年下半年現金消耗率以及 2023 年退出率的更多信息，將會非常有幫助。

Sure. So we actually had a very good push in AR collections this quarter, but it was masked by, I would say, a pretty healthy June. And so you can see in our 0 to 30-day receivable balance, it's up significantly, which is reflective of the number of systems we shipped in the final month.

當然。因此，本季度我們實際上在 AR 系列方面取得了非常好的進展，但我想說的是，六月的表現相當健康。因此，您可以看到我們的 0 至 30 天應收賬款餘額顯著增加，這反映了我們最後一個月發貨的系統數量。

We do expect leverage with AR and also inventory as we work towards Q4. You also saw in the press release that we did submit for our employee retention credit with the IRS. So that was prepared by KPMG. So we're pretty confident we'll have that in hand either late Q4 or early Q1. So that will help.

我們確實期望在第四季度時利用 AR 和庫存來發揮槓桿作用。您還在新聞稿中看到，我們確實向國稅局提交了員工保留信用額度。這是畢馬威準備的。因此，我們非常有信心我們將在第四季度末或第一季度初掌握這一點。所以這會有幫助。

And so we're expecting a modest burn in Q3. Again, pretty much a function of shipment timing and also collections of the activity in June. It's usually a lower burn for us anyway. And then Q4 should be pretty close to cash burn-neutral. Again, we're going to have historically the strongest quarter of the year and it will be somewhat subjected to timing of the revenue mix that goes out the door in December.

因此，我們預計第三季度會有適度的消耗。同樣，這很大程度上取決於發貨時間以及 6 月活動的收集。無論如何，這對我們來說通常是較低的燒傷。然後第四季度應該非常接近現金消耗中性。同樣，我們將迎來一年中歷史上最強勁的季度，並且會在一定程度上受到 12 月份收入組合的時間安排的影響。

So we think we're going to end the year low to mid-40s in cash. Again, as we've been communicating, the plan is to hold operating expenses flat in 2024 and then continue to grow the top line. And so if we can get, for example, Greenbrook and some other accounts back to their normal cadence, we think our top line can get to where -- the top line growth can get to where we were expecting this year, in that mid-teen range.

因此，我們認為年底時現金將降至 40 多美元左右。同樣，正如我們一直在溝通的那樣，計劃是在 2024 年保持運營支出持平，然後繼續增長收入。因此，如果我們能讓格林布魯克和其他一些賬戶恢復到正常節奏，我們認為我們的營收增長可以達到我們今年中期的預期。青少年範圍。

And I'm showing no further questions, and I would like to hand the conference back over to Keith Sullivan for any closing remarks.

我不會提出任何進一步的問題，我想將會議交還給基思·沙利文（Keith Sullivan）進行閉幕致辭。

Thank you very much, operator. Thank you all for your interest in Neuronetics. We look forward to updating you on our next quarterly call.

非常感謝您，接線員。感謝大家對神經論的興趣。我們期待在下一次季度電話會議上向您通報最新情況。

This concludes today's conference call. Thank you for participating. You may now disconnect.

今天的電話會議到此結束。感謝您的參與。您現在可以斷開連接。