Tactile Systems Technology Inc (TCMD) 2025 Q1 法說會逐字稿

Welcome, ladies and gentlemen, to the first-quarter 2025 earnings conference call for Tactile Medical. (Operator Instructions) Please note that this conference call is being recorded and will be available on the company's website for replay shortly.

女士們、先生們，歡迎參加 Tactile Medical 2025 年第一季財報電話會議。（操作員指示）請注意，本次電話會議正在錄音，並將很快在公司網站上提供重播。

I would now like to turn the call over to Sam Benzinger, Investor Relations at Gilmartin Group, for a few introductory comments. Please go ahead.

現在，我想將電話轉給 Gilmartin Group 投資者關係部門的 Sam Benzinger，請他發表一些介紹性評論。請繼續。

Good afternoon and thank you for joining the call today. With me from Tactile's management team are Sheri Dodd, Chief Executive Officer; and Elaine Birkenmeier, Chief Financial Officer.

下午好，感謝您參加今天的電話會議。和我一起的還有 Tactile 管理團隊的執行長 Sheri Dodd 和財務長 Elaine Birkenmeier。

Before we begin, I'd like to remind everyone that our remarks and responses to your questions today may contain forward-looking statements that are based on the current expectations of management and involve inherent risks and uncertainties. These could cause actual results to differ materially from those indicated, including those identified in the risk factor section of our annual report of Form 10-K, as well as the most recent 10-Q filing to be filed with the Securities and Exchange Commission. Such factors may be updated from time to time in our filings with the SEC, which are available on our website. We're going to take no obligation to publicly update or revise our forward-looking statements as a result of new information, future events, or otherwise.

在我們開始之前，我想提醒大家，我們今天的評論和對你們問題的回答可能包含基於管理層當前預期的前瞻性陳述，並涉及固有的風險和不確定性。這些可能導致實際結果與所示的結果有重大差異，包括我們 10-K 表年度報告的風險因素部分以及向美國證券交易委員會提交的最新 10-Q 文件中確定的結果。這些因素可能會在我們向美國證券交易委員會提交的文件中不時更新，這些文件可在我們的網站上查閱。我們不承擔因新資訊、未來事件或其他原因而公開更新或修改我們的前瞻性聲明的義務。

This call will also include references to certain financial measures that are not calculated in accordance with generally accepted accounting principles, or GAAP. We generally refer to these as non-GAAP financial measures. Reconciliations of those non-GAAP financial measures to the most comparable measures calculated and presented in accordance with GAAP are available in the earnings press release on the investor relations portion of our website.

此次電話會議也將提及某些未依照公認會計原則 (GAAP) 計算的財務指標。我們通常將這些稱為非公認會計準則財務指標。這些非 GAAP 財務指標與依照 GAAP 計算和呈現的最具可比性的指標的對帳表可在我們網站投資者關係部分的收益新聞稿中找到。

With that, I'll now turn the call over to Sheri.

說完這些，我現在將電話轉給 Sheri。

Thanks, Sam. Good afternoon, everyone, and welcome to our first-quarter 2025 earnings call. Here with me is Elaine Birkenmeier, our Chief Financial Officer.

謝謝，山姆。大家下午好，歡迎參加我們的 2025 年第一季財報電話會議。和我一起的是我們的財務長 Elaine Birkenmeier。

In the first quarter, total revenue grew 0.3% year over year to $61.3 million. In our lymphedema business line, revenue decreased 3% year over year to $50.6 million, and airway clearance revenue increased 22% to $10.7 million. Q1 growth margins increased 290 basis points year over year, while adjusted EBITDA decreased 125% year over year as expected, due to our planned technology and order process investments, including the launch of our new Salesforce CRM module.

第一季度，總營收年增0.3%至6,130萬美元。在我們的淋巴水腫業務線中，營收年減 3% 至 5,060 萬美元，氣道清除收入成長 22% 至 1,070 萬美元。第一季的成長利潤率年增了 290 個基點，而調整後的 EBITDA 較去年同期下降了 125%，這符合預期，這得益於我們計劃的技術和訂單流程投資，包括推出新的 Salesforce CRM 模組。

Ultimately, these investments will enable increased efficiency, speed, and data-driven analytical insights, all necessary components for mid- and long-term growth. Meanwhile, we ended the quarter in a strong cash position with $83.6 million on the balance sheet. The $10.7 million sequential decrease in cash is attributable to stock buyback under our stock repurchase program.

最終，這些投資將提高效率、速度和數據驅動的分析洞察力，這些都是中長期成長的必要要素。同時，本季末我們的現金狀況良好，資產負債表上有 8,360 萬美元。現金連續減少 1,070 萬美元是由於我們股票回購計畫下的股票回購。

Elaine will elaborate on our full financial results in greater detail shortly. I'll focus my remarks in two categories: a review of our business line performances, including factors that impacted Q1 lymphedema results, the expected carry-forward impact through the second quarter; and the rationale behind our full-year financial guidance revision. I will also discuss market tailwinds and strategy execution milestones aligned with our key strategic priorities. We are making high-value investments and operational enhancements that will best position our business for mid- and long-term success.

伊萊恩將很快詳細闡述我們的全部財務表現。我的評論將集中在兩類：回顧我們的業務線表現，包括影響第一季淋巴水腫結果的因素、預計第二季度的結轉影響；以及我們全年財務指導修訂背後的理由。我還將討論與我們的關鍵策略重點一致的市場順風和策略執行里程碑。我們正在進行高價值投資和營運改進，以使我們的業務獲得中長期成功。

Beginning with the review of our lymphedema business line. Lymphedema revenue declined on a year-over-year basis in the first quarter. The shortfall relative to initial expectations was driven by two primary factors. First, due to a strategic optimization of our sales organization that we started in Q4 and completed this February, we experienced a decline in sales headcount, which resulted in a higher than expected headcount vacancy rate in Q1.

從審查我們的淋巴水腫業務線開始。第一季淋巴水腫收入較去年同期下降。與最初預期相比的差距主要有兩個因素。首先，由於我們從第四季開始並於今年2月完成的銷售組織的策略優化，我們的銷售人員數量下降，導致第一季的人員空缺率高於預期。

While some attrition is common earlier in the year, we saw an outsized impact this quarter. As I shared last quarter, we see value in investing in our sales organization with technology, as well as resourcing, with the right people in the right location and in the right type of role.

儘管今年早些時候出現一些人員流失的情況很常見，但本季我們看到了巨大影響。正如我上個季度所分享的，我們認為在銷售組織上投資技術和資源，並在合適的地點安排合適的人員擔任合適的角色是有價值的。

The first phase of this sales optimization process included an analysis of both our current and desired future state headcount, with an eye on growth and future leverage. During this phase, we paused on backfilling vacant roles until our rebalanced analysis was complete, avoiding prematurely placing resources that could be a mismatch in roles and location. The effect of this decision resulted in net fewer field resources, as we ended the quarter with 264 total reps split between 161 account managers and 103 specialists. This compared to 280 total reps at the end of Q4.

銷售優化流程的第一階段包括分析我們目前和未來期望的員工人數，同時關注成長和未來的槓桿作用。在此階段，我們暫停填補空缺職位，直到重新平衡分析完成，避免過早放置可能與角色和位置不符的資源。這項決定導致現場資源淨減少，因為本季結束時我們共有 264 名代表，分為 161 名客戶經理和 103 名專家。相比之下，第四季末的總代表人數為 280 人。

We are working with a sense of urgency to mitigate the impact of vacant territories and accelerate efforts to achieve complete territory coverage. We have open headcount requisitions aligned with the new territory alignment and have finalized role clarity for all customer-facing roles.

我們正在緊急努力減輕空置地區的影響並加快實現全境覆蓋的努力。我們已經根據新的區域調整開放了員工人數申請，並已確定了所有面向客戶的角色的明確性。

We have staffed our talent acquisition team and we are already seeing positive talent acquisition metrics, including an increase in our sales headcount from quarter end to 277 total reps currently, with an expectation to be over 285 total reps by the end of Q2 and over 300 by the end of 2025. This path will put the most resources in the field that Tactile has ever had and is an investment we can leverage and optimize as we scale our revenue and technology toolkit.

我們已經配備了人才招募團隊，並且已經看到了積極的人才招募指標，包括我們的銷售人員數量從季度末增加到目前的總銷售代表人數 277 人，預計到第二季度末總銷售代表人數將超過 285 人，到 2025 年底將超過 300 人。這條道路將為 Tactile 所擁有的領域投入最多的資源，也是我們在擴大收入和技術工具包時可以利用和優化的投資。

We also expect our sales optimization strategies to have a beneficial impact on our lymphedema channel mix dynamics. As a reminder, our sales reps have call points across vascular and oncology practices, vein centers, and lymphatic therapists who treat patients across government and commercial payers. Our territory optimization provides an appropriate human capital roadmap to strategically invest in the right roles in the right locations to meet and drive demand.

我們也希望我們的銷售優化策略能夠對我們的淋巴水腫渠道組合動態產生有益的影響。提醒一下，我們的銷售代表在血管和腫瘤科、靜脈中心和淋巴治療師處都有呼叫點，他們為政府和商業付款人的患者提供治療。我們的區域優化提供了適當的人力資本路線圖，以便在正確的地點策略性地投資正確的職位，以滿足和推動需求。

The second factor in driving Q1 weakness was lower sales productivity as a result of the launch of a new Salesforce CRM module in mid-February. From an execution standpoint, we experienced a smooth launch and have received positive feedback on our training and change management plan. While support and enthusiasm for the tool are strong, mastering any technology requires a learning curve and the resulting impact on productivity for our reps included time out of the field for training and onboarding. Reps also experienced the retirement of the previous tools that they had used to navigate their business with the launch of the new CRM.

導致第一季業績疲軟的第二個因素是 2 月中旬推出新的 Salesforce CRM 模組導致銷售效率下降。從執行的角度來看，我們的啟動過程非常順利，我們的培訓和變更管理計劃也得到了正面的回饋。雖然對工具的支援和熱情很高，但掌握任何技術都需要一個學習過程，這對我們的銷售代表的工作效率的影響包括需要花費時間進行現場培訓和入職培訓。隨著新 CRM 的推出，銷售代表們也經歷了他們用來指導業務的先前工具的淘汰。

The temporary impact of this transition has been more pronounced than we had originally anticipated. With two months of direct hands-on experience, our reps are becoming more proficient and we have data that supports early learning curve associated productivity gains associated with the new CRM. We have additional training plans throughout the remainder of Q2 and continue to share analytic insights and easy-to-use guides for the reps to accelerate their competency.

這種轉變的暫時影響比我們最初預期的更為明顯。經過兩個月的直接實務經驗，我們的代表變得更加熟練，我們擁有支援與新 CRM 相關的早期學習曲線相關生產力提升的數據。我們在第二季的剩餘時間內制定了額外的培訓計劃，並繼續與銷售代表分享分析見解和易於使用的指南，以加速他們的能力提升。

From a strategic perspective, I firmly believe we have made the right decision to pause headcount replacements until we completed our current and future state sales analysis and action plan. I am also pleased that we delivered the launch of our Salesforce CRM module on time.

從策略角度來看，我堅信我們做出了正確的決定，暫停員工替換，直到我們完成當前和未來的銷售分析和行動計劃。我也很高興我們能準時推出了 Salesforce CRM 模組。

Both of these actions encompass transformational change management initiatives that were necessary to advance our business over the short, mid, and long terms. That said, I am disappointed that the cumulative effect of these factors pressured results in Q1 more than I had expected.

這兩項行動都包含了變革管理舉措，這些舉措對於短期、中期和長期推動我們的業務發展都是必要的。話雖如此，我還是感到失望，這些因素的累積效應對第一季的業績造成的壓力超出了我的預期。

Looking ahead, we also expect the transient impact of the sales vacancies and CRM implementation to affect our expected revenue growth throughout the second quarter. Specifically, we project revenue in the second quarter to be in the range of $73 million to $76 million and a full-year revenue to now be in the range of $309 million to $315 million.

展望未來，我們也預期銷售空缺和 CRM 實施的暫時影響將影響我們整個第二季的預期營收成長。具體來說，我們預計第二季的營收將在 7,300 萬美元至 7,600 萬美元之間，全年營收將在 3.09 億美元至 3.15 億美元之間。

I also want to touch on our Q1 airway clearance performance. Sales of AffloVest increased 22% year over year in Q1, a strong start to the year that underscores the quality of the product, as well as the strategic execution and partnership growth with the top 10 DMEs in the market.

我還想談談我們第一季的氣道清除表現。AffloVest 第一季的銷售額同比增長了 22%，這是一個強勁的開端，凸顯了產品的質量，以及與市場上前 10 大 DME 的戰略執行和合作夥伴關係的增長。

For example, we have secured prioritized placement agreements with a select number of these DMEs that further validates AffloVest as a proven, patient-friendly, and differentiated therapy offering that is clinically advantageous to the growing bronchiectasis market. This priority position with our DMEs continues to be strengthened by field activities with physicians, including educating clinical, training and marketing, and sales leaders at all levels of the organizations. In Q1, our team educated nearly 800 respiratory DME partners and clinical customers on bronchiectasis and the benefits of Afflo in its care.

例如，我們已與部分 DME 達成優先安置協議，進一步證明 AffloVest 是一種經過驗證的、患者友好的、差異化的治療方法，對不斷增長的支氣管擴張市場具有臨床優勢。我們與 DME 的這一優先地位透過與醫生進行的現場活動不斷得到加強，包括對組織各個層級的臨床、培訓和行銷以及銷售領導者進行培訓。在第一季度，我們的團隊為近 800 名呼吸道 DME 合作夥伴和臨床客戶講解了支氣管擴張症以及 Afflo 在護理中的優勢。

Finally, broader awareness of bronchiectasis and its available treatment options among patients and clinicians continues to increase. AffloVest treats the entirety of the bronchiectasis disease process, so we are confident in its clinical necessity for generating better patient outcomes. The category is growing, our market share continues to strengthen, and we are maintaining a strong number two position.

最後，患者和臨床醫生對支氣管擴張及其可用治療方案的認識不斷提高。AffloVest 可治療支氣管擴張症的整個疾病過程，因此我們相信其在產生更好的患者結果方面的臨床必要性。該類別正在成長，我們的市場份額持續增強，並且我們保持著強勁的第二地位。

In short, we are pleased with our airway clearance performance in Q1. We will remain focused on fortifying relationships with each of our top DME partners and penetrating further within these accounts to continue this strong growth through 2025 and bring AffloVest to the 5 million diagnosed and undiagnosed bronchiectasis patients in the US.

簡而言之，我們對第一季的氣道清除表現感到滿意。我們將繼續致力於加強與每個頂級 DME 合作夥伴的關係，並進一步滲透到這些帳戶中，以在 2025 年之前繼續保持強勁增長，並將 AffloVest 帶給美國 500 萬確診和未確診的支氣管擴張患者。

With that backdrop on our Q1 lymphedema and airway clearance results, I want to provide an update on our three strategic priorities for growth, improving access to care, expanding treatment options, and enhancing lifetime patient value. These three areas of focus are designed to unlock our TAM and enable scalable, profitable growth. We deliver tangible updates across each of these initiatives in Q1, and I will continue to provide updates on our progress throughout the year.

在我們第一季淋巴水腫和氣道清除結果的背景下，我想介紹我們的三個成長策略重點，即改善醫療服務、擴大治療選擇和提高患者終身價值。這三個重點領域旨在釋放我們的 TAM 並實現可擴展的獲利成長。我們在第一季針對每項舉措提供了切實的更新，我將在全年繼續提供我們進展的最新情況。

Beginning with improving access to care, I want to build off the details from last quarter and provide highlights from three areas of focus, the first being, human capital and technology investments to streamline the sales and order management process.

從改善醫療服務開始，我想在上一季細節的基礎上，重點介紹三個領域，首先是人力資本和技術投資，以簡化銷售和訂單管理流程。

We have routinely shared our progress on this front over previous quarters. In Q1, we again executed our strategy through the modernization of various workflows aimed at increasing efficiency for both clinicians and our back office. Specific to Q1, we launched the Salesforce CRM module in February, as mentioned earlier.

我們在前幾季經常分享我們在這方面的進展。在第一季度，我們再次透過對各種工作流程進行現代化改造來執行我們的策略，旨在提高臨床醫生和後台辦公室的效率。具體到第一季度，正如前面提到的，我們在二月推出了 Salesforce CRM 模組。

This tool represents a substantial upgrade over the previous system and offers significant improvements in sales operations, such as streamlined workflows and visualization of task identification and completion status. Sales rep productivity will be enhanced with the tool's data-driven decision analytic capabilities that informs the rep how best to focus their time and guides them to where the next best opportunity is to pursue.

該工具比以前的系統有了很大的升級，並在銷售營運方面提供了顯著的改進，例如簡化的工作流程和任務識別和完成狀態的可視化。該工具的數據驅動決策分析功能將提高銷售代表的工作效率，該功能可以告知銷售代表如何最好地集中時間並指導他們追求下一個最佳機會。

Our e-prescribing platform, Parachute, is another example of a workflow tool designed to streamline the order process and more efficiently turn referrals into orders. We continue to see growing adoption of this tool, which we expanded from pilot to national rollout late last year. Since then, approximately a quarter of new orders of our Basic Pump, Entre Plus, and now, Nimbl, have been generated through this ePrescribing platform.

我們的電子處方平台 Parachute 是另一個工作流程工具的例子，旨在簡化訂單流程並更有效地將轉診轉化為訂單。我們持續看到這項工具的採用率不斷增長，去年年底我們將其從試點擴展到全國推廣。自那時起，我們 Basic Pump、Entre Plus 以及現在的 Nimbl 的新訂單中約有四分之一都是透過這個電子處方平台產生的。

Given its success since launch, we will be expanding Parachute's e-prescribing functionality to our advanced pump Flexitouch this year, and expect to see similar favorable adoption among clinicians. We know not every clinician will choose to adopt e-prescribing technology. For those that prefer traditional documentation, we are looking forward to an upcoming pilot of an AI-based tool designed to improve speed and increase accuracy for the non-e-prescribed order process. We expect to learn more over the next two quarters regarding the scaled application of this tool in our order management process and will share more details once we begin the pilot.

鑑於其自推出以來所取得的成功，我們今年將把 Parachute 的電子處方功能擴展到我們先進的泵浦 Flexitouch，並期望看到臨床醫生同樣積極採用。我們知道並非每個臨床醫師都會選擇採用電子處方技術。對於那些喜歡傳統文件的人來說，我們期待即將推出基於人工智慧的工具試點，旨在提高非電子處方訂單流程的速度和準確性。我們希望在接下來的兩個季度內了解更多有關該工具在我們的訂單管理流程中的規模應用的信息，並將在開始試點後分享更多細節。

Clinical evidence generation is another driver for improving access to care. In June, two-month data from the Flexitouch versus standard of care for head and neck lymphedema trial will be presented at the annual meetings for both the American Society of Clinical Oncology and the Multinational Association of Supportive Care. While I cannot share the specific results ahead of these meetings, the abstracts are in line with our expectations that Flexitouch provides clinical and quality-of-life benefits in this underserved population.

臨床證據的生成是改善醫療服務的另一個驅動力。6 月份，Flexitouch 與頭頸部淋巴水腫治療標準療法試驗的兩個月數據將在美國臨床腫瘤學會和跨國支持治療協會的年會上公佈。雖然我無法在這些會議之前分享具體結果，但摘要符合我們的預期，即 Flexitouch 為這個服務不足的人群提供臨床和生活品質方面的益處。

The six-month data analysis is underway and on track for journal submission and public dissemination in the second half of the year. We look forward to sharing the long-term results of this first-of-its-kind study and will be advocating for PCD therapy to be reflected in government and commercial payer policies, clinical guidelines, and provider and patient training and awareness.

為期六個月的數據分析正在進行中，並將於今年下半年提交期刊並公開傳播。我們期待分享這項首創研究的長期結果，並將倡導 PCD 治療反映在政府和商業付款人政策、臨床指南以及提供者和患者的培訓和意識中。

Reimbursement has been a dynamic barrier to access to care. And I've spent considerable time on previous earning calls both educating and bringing real-time awareness to the evolving coverage policy landscape. The NCD coverage language continues to require documentation of, quote, unique characteristics, quote, for a patient to progress immediately from conservative therapy to an advanced pump.

報銷一直是獲得醫療服務的動態障礙。我在先前的收益電話會議上花了大量時間來進行教育並即時提高人們對不斷變化的保險政策格局的認識。NCD 覆蓋範圍語言繼續要求記錄、引用、獨特特徵、引用，以便患者立即從保守治療進展到先進的幫浦。

The term unique characteristics remains undefined in the policy. Through successful claims adjudication and ongoing engagement with the MACs, we are learning how the MACs are interpreting unique characteristics, and we believe there is a supportive coverage environment for patients that need advanced pump placement. We are increasingly confident that the MACs approach aligns with our shared goal of ensuring the right patient receives the right product, a mission that is central to everything we do at Tactile.

術語「獨特特徵」在政策中仍未定義。透過成功的索賠裁決和與 MAC 的持續合作，我們正在了解 MAC 如何解釋獨特的特徵，並且我們相信對於需要高級泵放置的患者來說，存在一個支持性的覆蓋環境。我們越來越相信，MAC 的方法符合我們的共同目標，即確保合適的患者獲得合適的產品，而這項使命是 Tactile 所做的一切的核心。

Our second strategic priority is focused on expanding the treatment options for lymphedema patients. In Q1, we saw strong growth and adoption of Nimbl, a first product launched on our new lymphedema platform and the next generation of our basic PCD. Since its full launch for upper and lower extremity lymphedema in February, Nimbl is outpacing the broader lymphedema market growth, which we believe reflects both patient and provider preference. and enthusiasm for the product given its unique features and capabilities.

我們的第二個策略重點是擴大淋巴水腫患者的治療選擇。在第一季度，我們看到了 Nimbl 的強勁成長和採用，Nimbl 是我們新淋巴水腫平台上推出的首款產品，也是我們基本 PCD 的下一代產品。自 2 月全面推出用於治療上肢和下肢淋巴水腫的產品以來，Nimbl 的成長速度一直高於更廣泛的淋巴水腫市場，我們認為這反映了患者和提供者對該產品的偏好，以及由於其獨特的功能和性能而產生的熱情。

Our sales reps are also energized by Nimbl and its ease of selling, particularly when coupled with our e-prescribing platform. Stronger Nimbl adoption benefited from our Medicare channels, specifically in the quarter, where sales grew 6% year over year. Our reps had a stronger presence in vascular practices in Q1, where we typically served more Medicare patients as compared to other channels.

Nimbl 及其易於銷售的特性也激勵著我們的銷售代表，尤其是與我們的電子處方平台結合使用時。Nimbl 的更廣泛採用得益於我們的醫療保險管道，特別是在本季度，銷售額比去年同期增長了 6%。在第一季度，我們的銷售代表在血管實踐方面有更強的影響力，與其他管道相比，我們通常為更多的醫療保險患者提供服務。

This ultimately impacted the bandwidth of our sales reps in certain territories to support oncology and VA patients. And as a result, sales in the VA and commercial channels where we have a higher proportion of Flexitouch patients were pressured in Q1. With the optimization of our sales organization now complete, we expect to see the return to growth in each of our channels moving forward. We have resourced our organization and channels appropriately.

這最終影響了我們在某些​​地區的銷售代表對腫瘤科和 VA 患者的支持能力。因此，我們擁有較高比例 Flexitouch 患者的 VA 和商業管道的銷售在第一季面臨壓力。隨著我們銷售組織的優化完成，我們預計未來每個管道都會恢復成長。我們已經為我們的組織和管道提供了適當的資源。

We are the dominant market leader in advanced pumps. The patients are there and remain underserved, and we believe our Nimbl and Flexitouch products will help drive growth for us and the market broadly through 2025.

我們是先進泵浦領域的主導市場領導者。患者仍然在那裡並且無法得到充分的服務，我們相信我們的 Nimbl 和 Flexitouch 產品將有助於推動我們和整個市場在 2025 年的成長。

The rest of our product roadmap for our next-generation advanced pump, Nimbl enhancements, and incremental features and functionality benefits to Kylee are progressing. We are committed to staying the market leader in medical device lymphatic therapy and delivering clinical effectiveness in both basic and advanced pump therapy.

我們的下一代先進泵浦、Nimbl 增強功能以及 Kylee 的增量特性和功能優勢的其餘產品路線圖正在推進中。我們致力於維持醫療器材淋巴治療市場的領先地位，並在基礎和高階幫浦治療中提供臨床效果。

Our third strategic priority is focused on enhancing lifetime patient value. One of the critical ways we can accomplish this is by helping patients more efficiently navigate the often complex end-to-end lymphedema care journey. This quarter, we centralized two existing teams comprising our patient education consultants, or PECs; and back-office patient support team into one consolidated team called patient services, led by a newly created role on our executive leadership team.

我們的第三個策略重點是提高病患的終身價值。我們實現這一目標的關鍵方法之一是幫助患者更有效地完成通常複雜的端到端淋巴水腫護理過程。本季度，我們將由病患教育顧問（PEC）和後台病患支援團隊組成的兩個現有團隊集中為一個名為「病患服務」的合併團隊，由我們執行領導團隊中新設立的職位領導。

With this action, we combine the two groups who interface most directly with our patients into one team to ensure we have a consistent approach when engaging with patients pre, during and post-order. Certain elements of our business remain unchanged with this action. For example, our PECs continue to be a vital resource for our sales team, and we ended Q1 with 62% of in-home demos performed by our PECs, up from 52% at the end of Q4 and 35% a year ago. We are pleased to see consecutive utilization increases with our PEC staff and expect that trend to continue.

透過這項舉措，我們將與患者最直接接觸的兩個小組合併為一個團隊，以確保我們在診前、診中和診後與患者接觸時採用一致的方法。儘管採取了這項措施，我們業務的某些要素仍保持不變。例如，我們的 PEC 繼續成為我們銷售團隊的重要資源，第一季末，我們的 PEC 完成的家庭演示佔比為 62%，高於第四季末的 52% 和一年前 35%。我們很高興看到我們的 PEC 員工的利用率持續上升，並希望這一趨勢能夠持續下去。

We are also looking at new ways in which our patient services team can engage with the patient earlier and more frequently in the order process, which will further alleviate sales rep engagement with the patient and increase patient support connectivity for our patients. To that end, we will be implementing two pilot programs leveraging our patient services team that will seek to maintain consistent touch points with the patient to keep them engaged with Tactile throughout the pre-order process. We know that this part of the patient journey is particularly complex and drawn out, and there are things we can do to create a better overall experience for our patients.

我們也正在尋找新的方式，讓我們的患者服務團隊能夠在訂單過程中更早、更頻繁地與患者互動，這將進一步減輕銷售代表與患者的互動，並增加患者對患者的支持連結。為此，我們將利用我們的患者服務團隊實施兩個試點項目，力求與患者保持一致的接觸點，以使他們在整個預訂過程中與 Tactile 保持聯繫。我們知道，患者旅程的這一部分特別複雜且漫長，我們可以採取一些措施來為患者創造更好的整體體驗。

Finally, we are increasingly focused on market development initiatives, specifically with respect to generating patient awareness of lymphedema and its current treatment options. One way we are approaching this is through promoting the use of our Kylee patient engagement tool.

最後，我們越來越關注市場開發計劃，特別是提高患者對淋巴水腫及其當前治療方案的認識。我們解決這個問題的方法之一是推廣使用我們的 Kylee 患者參與工具。

Kylee is a free tool available to anyone suffering from lymphedema and provides patients a way to track symptoms, log their lymphatic therapy sessions, their compression garment utilization, and share results with their care team. With Nimbl, their PCD therapy is automatically connected and stored. This is a differentiated offering for patients with lymphedema and a great source of insight for our business.

Kylee 是一款免費工具，可供任何淋巴水腫患者使用，為患者提供一種追蹤症狀、記錄淋巴治療過程、壓力服使用情況以及與護理團隊分享結果的方法。透過 Nimbl，他們的 PCD 治療會自動連接和儲存。這是針對淋巴水腫患者的差異化服務，也是我們業務的重要洞察來源。

We have two milestones approaching. In the next month or so, we will have 50,000 individual patient profiles registered with Kylie and 1 million user check-ins. These are two distinct, but complementary value propositions associated with Kiley and these metrics.

我們即將迎來兩個里程碑。在接下來的一個月左右，我們將有 5 萬名在 Kylie 處註冊的個人病患檔案和 100 萬次用戶簽到。這是與 Kiley 和這些指標相關的兩個不同但互補的價值主張。

First, in addition to tracking symptoms and treatments, Kylee is also a powerful education resource for patients who may be on the front end of their care journey, either undiagnosed or recently diagnosed. And includes information on lymphedema and its available treatments, so that patients can be informed when speaking to their clinician regarding their symptoms and self-management. We believe increased utilization of Kylee will enable a more effective and connected care pathway for patients and their clinicians and provide our organization more insights into opportunities to help support patients with product and service innovation.

首先，除了追蹤症狀和治療之外，Kylee 還是處於治療初期（未確診或最近確診）患者的強大教育資源。並包括有關淋巴水腫及其可用治療方法的信息，以便患者在與臨床醫生談論他們的症狀和自我管理時能夠了解情況。我們相信，提高 Kylee 的使用率將為患者及其臨床醫生提供更有效、更緊密的護理途徑，並為我們的組織提供更多見解，幫助透過產品和服務創新來支持患者。

Second, with access to 50,000 unique patients and 1 million check-ins to date, we have significant data that will inform insights on utilization and outcomes of our product and other treatment , patient symptoms, and disease progression.

其次，迄今為止，我們已經接觸了 50,000 名獨特患者並進行了 100 萬次簽到，擁有大量數據，這些數據將有助於深入了解我們產品和其他治療的利用率和結果、患者症狀和病情進展。

Additionally, it serves as a communication tool where we can personalize touchpoints with patients, survey product features and functionality preferences, test innovation concepts, and much more. We are just getting started and will continue to optimize Kylee as a patient and provider asset and as a tactile asset for our own market development and innovation plans.

此外，它還可以作為一種溝通工具，我們可以透過它來個性化與患者的接觸點、調查產品特性和功能偏好、測試創新概念等等。我們才剛起步，並將繼續優化 Kylee 作為患者和提供者的資產以及作為我們自己的市場開發和創新計劃的有形資產。

With that, I will now have Elaine review our Q1 financial results in more details and provide an update on our guidance for 2025.

有了這些，我現在將讓 Elaine 更詳細地回顧我們的第一季財務業績，並提供我們 2025 年指導的最新資訊。

Thanks, Sheri. Unless noted otherwise, all references to first quarter financial results are on a GAAP and year-over-year basis.

謝謝，謝裡。除非另有說明，否則所有第一季財務結果均基於 GAAP 和同比數據。

Total revenue in the first quarter increased $180,000, or 0.3%, to $61.3 million. By product line, sales and rentals of lymphedema products , and sales of our airway clearance products increased $1.9 million or 22% to $10.7 million.

第一季總營收增加 18 萬美元，成長 0.3%，達到 6,130 萬美元。按產品線劃分，淋巴水腫產品的銷售和租賃以及我們的氣道清除產品的銷售額增加了 190 萬美元，即 22%，達到 1070 萬美元。

Continuing down the P&L. Gross margin was 74% of revenue, compared to 71% in the first quarter of 2024. The increase in gross margin was attributable primarily to lower manufacturing and warranty costs, a testament to improvements in product design and improving collections reflected in our revenue.

繼續查看損益表。毛利率為營收的 74%，而 2024 年第一季為 71%。毛利率的成長主要歸因於製造和保固成本的降低，這證明了產品設計的改進和我們收入中反映出的收集能力的提高。

First quarter operating expenses increased $3.5 million, or 8%, to $49.9 million. The change in GAAP operating expenses reflected a $0.2 million increase in sales and marketing expenses, a $0.4 million decrease in research and development expenses, and a $3.7 million increase in reimbursement general and administrative expenses, including and primarily driven by strategic technology investments.

第一季營運費用增加 350 萬美元，成長 8%，達到 4,990 萬美元。GAAP 營運費用的變化反映了銷售和行銷費用增加 20 萬美元、研發費用減少 40 萬美元以及報銷一般和行政費用增加 370 萬美元，其中包括並主要由戰略技術投資推動。

Operating loss increased $1.6 million, or 53% to $4.5 million.

營業虧損增加 160 萬美元，成長 53%，達到 450 萬美元。

Interest income increased $0.2 million, or 26% to $0.9 million due to our increased cash position. Interest expense decreased $0.1 million, or 25% to $0.4 million. Income tax benefit increased $0.5 million, or 83% year over year to $1.1 million.

由於現金狀況增加，利息收入增加了 20 萬美元，即 26%，達到 90 萬美元。利息支出減少 10 萬美元，即 25%，至 40 萬美元。所得稅收益增加 50 萬美元，即年成長 83%，達到 110 萬美元。

Net loss increased $0.8 million, or 35% to $3 million, or $0.13 per diluted share compared to $2.2 million or $0.09 per diluted share.

淨虧損增加 80 萬美元（即 35%）至 300 萬美元，即每股攤薄虧損 0.13 美元，而之前為 220 萬美元（即每股攤薄虧損 0.09 美元）。

Adjusted EBITDA decreased as expected to a loss of $0.3 million compared to income of $1 million.

調整後的 EBITDA 依預期下降至虧損 30 萬美元，而營收為 100 萬美元。

With respect to our balance sheet, we had $83.6 million in cash and cash equivalents and $25.5 million about standing borrowings at quarter end. This compares to $94.4 million in cash and $26.3 million about standing borrowings as of December 31, 2024. Our Q1 cash balance reflects one-time impacts from certain cash outflow items, including $5.7 million related to our annual bonus payment. We also sponsored an additional $10 million of stock buyback during the first quarter under our repurchase program.

就我們的資產負債表而言，我們在季度末擁有 8,360 萬美元的現金和現金等價物以及 2,550 萬美元的常設借款。相較之下，截至 2024 年 12 月 31 日，現金為 9,440 萬美元，常備借款為 2,630 萬美元。我們第一季的現金餘額反映了某些現金流出項目的一次性影響，其中包括與我們的年度獎金支付相關的 570 萬美元。我們還在第一季根據回購計畫額外贊助了 1,000 萬美元的股票回購。

Turning to review of our 2025 outlook.

回顧我們的 2025 年展望。

For the full year of 2025, we now expect total revenue in the range of $309 million to $350 million, representing growth of approximately 5% to 8% year over year. This revision reflects the sales vacancy and the impact of the CRM launch on sales rep productivity in the lymphedema business during the first half of the year, along with strengths we are observing in the airway clearance business.

對於 2025 年全年，我們目前預計總營收將在 3.09 億美元至 3.5 億美元之間，年增約 5% 至 8%。此次修訂反映了上半年淋巴水腫業務的銷售空缺和 CRM 推出對銷售代表生產力的影響，以及我們在氣道清除業務中觀察到的優勢。

Our 2025 total revenue guidance range assumes that growth for our lymphedema product line will be 4% to 5%, and growth for our airway clearance product line will be 20% to 23%.

我們的 2025 年總收入指引範圍假設我們的淋巴水腫產品線的成長率將達到 4% 至 5%，而我們的氣道清除產品線的成長率將達到 20% 至 23%。

For modeling purposes, for the full year of 2025, we now expect our GAAP growth margins to be approximately 74%, our GAAP operating expenses to increase 9% to 11% year over year, as we invest in our sales organization and advance our tech-related investments throughout the year, net interest income of approximately $2.4 million, a tax rate of 28%, and a fully diluted weighted average share count of approximately 24 million shares.

為了建立模型，對於 2025 年全年，我們現在預計我們的 GAAP 成長利潤率約為 74%，我們的 GAAP 營運費用將年增 9% 至 11%，因為我們全年投資於我們的銷售組織並推進我們的技術相關投資，淨利息收入約為 240 萬美元，稅率為 28%，完全稀釋的加權平均數約為 240 萬股。

As a result of our continued investment in the business, we expect to generate adjusted EBITDA of approximately $32 million to $34 million in 2025. Our adjusted EBITDA expectation assumes certain non-cash items, including stock compensation expense of approximately $8.6 million, intangible amortization of approximately $2.4 million, and depreciation expense of approximately $4.3 million.

由於我們對該業務的持續投資，我們預計 2025 年的調整後 EBITDA 將達到約 3,200 萬至 3,400 萬美元。我們調整後的 EBITDA 預期假設某些非現金項目，包括約 860 萬美元的股票薪酬費用、約 240 萬美元的無形資產攤銷和約 430 萬美元的折舊費用。

Based on what we know today, our adjusted EBITDA guidance also includes a $1 million cost of goods sold impact related to tariffs. We are actively monitoring global trade policies and assessing the potential impact of tariffs on our business, which remains a very dynamic and fluid situation.

根據我們今天所掌握的信息，我們調整後的 EBITDA 指引還包括與關稅相關的 100 萬美元銷售成本影響。我們正在積極關注全球貿易政策，並評估關稅對我們業務的潛在影響，我們的業務仍然處於非常動態和不穩定的狀態。

Based on current information, we expect a total tariff impact on cost of goods sold in 2025 of less than $5 million. We are actively pursuing a range of viable mitigation activities to reduce our projected tariff impact. These include options for reshoring manufacturing, contract compliance for supplier tariff absorption, tariff exemption policies, and other cost of goods sold reduction strategies.

根據目前的訊息，我們預計 2025 年關稅對商品銷售成本的總影響將不到 500 萬美元。我們正在積極採取一系列可行的緩解措施，以減少預期的關稅影響。這些包括製造業回流的選擇、供應商關稅吸收的合約合規性、關稅豁免政策以及其他銷售成本降低策略。

With that, I'll turn the call back to Sheri for some closing remarks. Sheri?

說完這些，我將把電話轉回給 Sheri，請她做最後的總結發言。雪莉？

Thank you, Elaine. I just returned from our national sales meeting where we brought together over 400 employees to support training, share best practices, and fine-tune the execution details of our 2025 Commercial Action Plan. My confidence in our team and our business remains high. Our sales leadership and field teams are committed to driving productivity with the implementation of the CRM system and executing on our 2025 Commercial Action Plan.

謝謝你，伊萊恩。我剛結束了全國銷售會議，我們在會議上召集了 400 多名員工來支持培訓、分享最佳實踐並微調 2025 年商業行動計劃的執行細節。我對我們的團隊和業務仍然充滿信心。我們的銷售領導和現場團隊致力於透過實施 CRM 系統來提高生產力並執行我們的 2025 年商業行動計劃。

Our mid- to long-term success requires strategic investments in human capital and technology, which are reflected in our 2025 plan. Every investment is scrutinized to ensure alignment with our three-growth strategies, and I am confident in our ability to deliver value through 2025 and beyond.

我們的中長期成功需要對人力資本和技術進行策略性投資，這反映在我們的 2025 計畫中。每項投資都經過嚴格審查，以確保符合我們的三大成長策略，我相信我們有能力在 2025 年及以後實現價值。

With that, operator, we will now open the call for questions.

接線員，現在我們可以開始提問了。

(Operator Instructions) Margaret Kaczor Andrew -- I'm sorry, Margaret Andrew, William Blair.

（操作員指示）瑪格麗特·卡佐爾·安德魯——對不起，瑪格麗特·安德魯，威廉·布萊爾。

Hey. Good afternoon, everyone. Thanks for taking the question. I wanted to start out with and just push a little bit on the revenue guidance for the year. What assumptions get you to the high and low end of the range? What are you considering, especially as you go into Q4 for sales or productivity metrics? Because it does seem to imply that you're kind of exiting the year at a maybe mid-teens growth rate.

嘿。大家下午好。感謝您回答這個問題。首先，我想稍微推動一下今年的營收預期。哪些假設可以讓你達到該範圍的高端和低端？您在考慮什麼，尤其是當您進入第四季的銷售或生產力指標時？因為它似乎確實暗示今年的成長率可能達到十幾歲。

Hi, Margaret. This is Sheri. I'll actually have Elaine start answering that question relative how we got to our guidance assumption, and I'll wrap up any other points.

你好，瑪格麗特。這是謝裡。實際上，我會讓 Elaine 開始回答有關我們如何得出指導假設的問題，然後我會總結其他要點。

Yeah. So I think a couple of things that were taken into account as we thought about high and low. One of them is a focal point of our discussion, which is around the speed of hiring the planned sales roles. That's an important driver, as well as the sales rep proficiency in the new tool and gaining sales rep productivity.

是的。所以我認為，當我們考慮高低時，需要考慮一些因素。其中之一就是我們討論的重點，即圍繞計劃銷售職位招聘的速度。這是一個重要的驅動因素，同時銷售代表對新工具的熟練程度以及銷售代表生產力的提升也很重要。

I think the other thing that we're encouraged by is the success we've seen with our Parachute rollout. And as we extend that to Flexitouch, we think that we'll start to see traction as well there. We also are continuing with our back office efficiency with some of the AI tools that Sheri mentioned that we think will provide momentum in the back half.

我認為另一件讓我們感到鼓舞的事情是 Parachute 推出後的成功。當我們將其擴展到 Flexitouch 時，我們認為我們也會開始看到它的吸引力。我們也將繼續利用 Sheri 提到的一些人工智慧工具來提高後台效率，我們認為這些工具將在下半年提供動力。

And then lastly, we are excited about what we've been seeing with AffloVest and Nimbl, and really that continued strong adoption and momentum of both products there have also been taken into account. And obviously, there are varying assumptions on both ends, as we thought about the high and low there.

最後，我們對 AffloVest 和 Nimbl 的表現感到非常興奮，而且我們也確實考慮到了這兩款產品持續強勁的採用和發展勢頭。顯然，當我們考慮高點和低點時，兩端的假設都不同。

And then as specific to, I think, your question a little bit around what that implies, maybe more so for Q4, but probably that sequential growth, it will cause our sequentials to look a little bit different than years past. Particularly, Q3 has typically been something that's been in a more modest zero to five range from a growth perspective, sequential growth perspective over Q2.

然後具體到你的問題，我認為這意味著什麼，可能更多是針對第四季度，但可能是連續的成長，這將導致我們的連續數據看起來與過去幾年略有不同。具體來說，從成長角度來看，第三季與第二季相比，通常處於較為溫和的 0 到 5 的範圍內，環比成長也相對較低。

This year, I think we are going to see something closer to the low double-digit growth rate from a sequentials. And then I think Q4 is going to look a lot like and typical Q4s in that range there. So hopefully that gives you a little bit more perspective on the shaping from a sequential perspective.

今年，我認為我們將看到更接近連續兩位數的低成長率。然後我認為 Q4 看起來會很像該範圍內的典型 Q4。所以希望這能讓你從順序的角度對塑造有更多的了解。

Okay, that's helpful. And as a follow-up, I'll follow up on that point and then maybe extend it into 2026. So one, as we look at the reps that you guys are hiring it's going to take 6, 12 months to reach full productivity. I guess, as you point to 2026, I'll start there first, is that when growth should really start to continue to accelerate. And if I do some easy math and just assume 300 reps next year, to start next year versus the 264 that, you guys were at the end of Q1. I think that's 13% to 14% growth just on headcount plus all the other activities that you're referencing.

好的，這很有幫助。作為後續行動，我將繼續關注這一點，然後可能將其延續到 2026 年。因此，首先，我們從你們聘用的銷售代表來看，需要 6 到 12 個月才能達到完全生產力。我想，正如您所說，2026 年是經濟成長真正開始持續加速的年份，我首先會從這個年份開始。如果我做一些簡單的數學計算，假設明年開始時的重複次數為 300 次，而你們在第一季末的重複次數為 264 次。我認為，僅員工人數加上您提到的所有其他活動，成長率就達到 13% 至 14%。

So I guess, long question. But does that imply closer to that mid-teens revenue growth as we move to 2026? And then as a follow-up to the guidance range, does the low end then assume that there are more delays maybe to the hiring versus more accelerated hiring trends? I'm just trying to get a sense of how much risk and reward there is within that range. Thank you, guys.

所以我想，這是一個很長的問題。但這是否意味著到 2026 年，收入成長率將接近 15% 左右？然後，作為指導範圍的後續，低端是否假設招募可能會有更多的延遲，而不是加速的招募趨勢？我只是想了解這個範圍內的風險和回報有多少。謝謝你們。

Yeah. So I think in terms of 2026, I don't think we're prepared yet to comment. We will be able to provide more information as we move further into the year and make some more progress, especially around our strategic initiatives. But we will be exiting the year with more momentum than we have here in the first half of the year.

是的。因此，我認為就 2026 年而言，我們還沒有準備好發表評論。隨著今年的進一步推進，我們將能夠提供更多資訊並取得更多進展，特別是在我們的策略舉措方面。但今年我們將會以比上半年更強勁的勢頭結束這一年。

And then, yes, to your question around the high and the low end, those factors that I mentioned, really -- it's really the and the speed of hiring. So we have one set of assumptions that's a little bit more modest in terms of speed where others were able to hire up faster. So as you remember, our Q4 is our largest quarter. So us having our hires done earlier in the year will benefit us versus taking longer.

是的，對於你關於高端和低端的問題，我提到的那些因素，實際上——實際上是招募速度的問題。因此，我們有一組在速度方面更為溫和的假設，即其他人能夠更快地招募。所以大家記得，我們​​的第四季是我們最大的季度。因此，如果我們在年初完成招聘，那麼相對於花費更長時間，我們將受益匪淺。

So those kind of things are kind of what helps us with that high and low, in addition to that productivity that we mentioned as far as the gaining competency of our sales team, and the new CRM, and the speed in which they start to grow comfortable with a new tool.

所以，除了我們提到的生產力之外，這些東西還可以幫助我們解決高低問題，例如提高銷售團隊的能力、新的 CRM 以及他們開始適應新工具的速度。

Yeah.The other thing that I would say with that, Margaret, is for this earnings call, we are specifically stating the number of reps that we expect to have by Q2. That wouldn't be a normal piece of information that we would typically share right on the quarter basis.

是的。瑪格麗特，我想說的另一件事是，在這次收益電話會議上，我們特別說明了預計第二季的銷售代表數量。這不是我們通常每季分享的正常資訊。

But because our plans are mapping to having that number by the end of Q2, and then as I said, we'll be at 300 by the end of the year, which will be the most reps that we've ever had, we're very committed to making sure that we get those reps hired and again located in the right part of the country and the right type of rep.

但因為我們的計劃是在第二季末達到這個數字，然後正如我所說的，到今年年底我們將達到 300 名代表，這將是我們有史以來最多的代表，我們非常致力於確保我們僱用這些代表，並再次將這些代表安置在該國的正確地區並擔任正確類型的代表。

You mentioned the onboarding and productivity at rep. That ramp time is typically actually between about six and nine months. Our TAM, or our territory managers, tend to be a little bit longer and those product specialists is typically shorter. So also with these reps coming in, they don't have to learn an old tool and then convert to a new tool.

您提到了代表處的入職培訓和生產力。這個提升時間實際上通常約為六至九個月。我們的 TAM，或者說我們的區域經理，任期往往較長，而產品專家的任期通常較短。因此，當這些代表加入時，他們不必學習舊工具，然後再轉換到新工具。

They'll be starting right off the bat with the Salesforce CRM tool. I know many of these reps coming in will have already had exposure to CRM. So we're anticipating even some improvement in that time to productivity, if you will, for those new hires.

他們將立即開始使用 Salesforce CRM 工具。我知道許多新來的銷售代表已經接觸過 CRM。因此，如果您願意的話，我們預計新員工的生產力在那段時間內會有所提高。

Okay, great. Thank you.

好的，太好了。謝謝。

Thank you.

謝謝。

Adam Maeder, Piper Sandler.

亞當梅德、派珀桑德勒。

This is Kyle. I'm for Adam. Thanks for taking the questions. Maybe just to dig in a little bit more on the guidance, in particular, between the lymphedema business versus the afloves business and the growth rates there. I believe the prior guidance was about 8% to 10% for lymphedema and about 6% to 9% for AffloVest.

這是凱爾。我支持亞當。感謝您回答這些問題。也許只是為了更深入地了解指導意見，特別是淋巴水腫業務與 afloves 業務之間的指導意見以及那裡的增長率。我相信之前的指導是淋巴水腫約為 8% 至 10%，AffloVest 約為 6% 至 9%。

So I'm just kind of curious how that changes now with the new guidance with all the different puts and takes that you've discussed tonight. Just, yeah, would appreciate any specifics you can give there.

所以我只是有點好奇，根據您今晚討論的所有不同的觀點和看法，新的指導方針現在將如何改變這種情況。是的，如果您能提供任何具體資訊我將非常感激。

Yeah. So as shared in our call, we've revised the lymphedema product line growth rate to 4% to 5%, and then airway clearance is 20% to 23%. So that has been updated since our last guidance.

是的。因此，正如我們在電話會議中所分享的，我們已將淋巴水腫產品線成長率修改為 4% 至 5%，氣道清除率為 20% 至 23%。自從我們上次提供指導以來，情況已經更新。

Okay, great. Thanks. And then, I guess, to follow up, could you just give us any update on Nimbl? Can you kind of just walk us through how you envision the commercial launch progress, what's kind of the feedback been like so far, and any of these sort of restrictions around manufacturing, inventory levels, just any color you could give there?

好的，太好了。謝謝。然後，我想，為了跟進，您能否向我們提供有關 Nimbl 的任何最新消息？您能否向我們簡單介紹一下您對商業發布進度的設想，到目前為止的反饋如何，以及在製造、庫存水平方面是否存在任何限制，您能提供任何細節嗎？

Sure, happy to share more. I mean, we're really pleased with the launch of Nimbl, being able to have both the upper extremity, which we launched in November, and then the lower extremity we launched on time in February. And as shared on the call, we're seeing about a quarter of all of the orders on Nimbl coming through Parachute as well. So we have a product that's easy to use.

當然，很高興分享更多。我的意思是，我們對 Nimbl 的推出感到非常高興，我們能夠在 11 月推出上肢，然後在 2 月準時推出下肢。正如電話中所分享的，我們發現 Nimbl 上大約四分之一的訂單也來自 Parachute。所以我們有一款易於使用的產品。

It's growing fast. We believe that growth is coming both from market share gains as well as just expanding and opening up the market in general, because of that ease of use, lightness, portability is really a great feature benefit profile for Nimbl. So Nimbl, coupled with Parachute, is really making a streamlined experience for both the patient and the provider.

它正在快速成長。我們相信，成長不僅來自於市場份額的成長，也來自於整個市場的擴大和開放，因為易用性、輕盈性和便攜性確實是 Nimbl 的一大特色優勢。因此，Nimbl 與 Parachute 結合，確實為患者和提供者帶來了簡化的體驗。

We don't have challenges in our manufacturing. We've been able to meet all product demand and are in really good shape in that way. Did I miss an aspect of your question for Nimbl?

我們的製造過程中並沒有遇到挑戰。我們已經能夠滿足所有產品需求，目前狀況非常好。我是否遺漏了你關於 Nimbl 的問題的某個方面？

No. No, that's great. That's all very helpful. Thanks.

不。不，那太好了。這一切都非常有幫助。謝謝。

Yeah, you bet. It's really an exceptional product. We're so glad to have it available to our patients.

是的，沒錯。這確實是一款卓越的產品。我們很高興能夠為我們的患者提供這種藥物。

Ryan Zimmerman, BTIG.

Ryan Zimmerman，BTIG。

Good afternoon. Thanks for taking the questions, Sharon and Elaine. I want to start with the exit rates of March, particularly in the lymphedema business. Just given some of the commercial changes that you're doing, maybe you could talk a little bit about the end market?

午安.感謝 Sharon 和 Elaine 回答這些問題。我想從三月的退出率開始，特別是淋巴水腫業務的退出率。考慮到您正在進行的一些商業變革，也許您可以談論終端市場？

And I think, Sheri, you made a comment about how Nimbl is outperforming the lymphedema market. I'm trying to reconcile that with just kind of the guidance and some of those changes and how you can point to that specifically relative to the guidance changes?

而且我認為，Sheri，你對 Nimbl 如何超越淋巴水腫市場做出了評論。我試圖將其與某種指導和一些變化相協調，以及您如何具體指出與指導變化相關的變化？

Sure. So Elaine, why don't you talk about how we -- would you mind kind of sharing what we can about informing the guidance as it relates to both product and payer, because there's a bit of -- because the Nimbl product, especially when we launch lower extremity, that is a product that's like -- especially because it's a basic pump, is likely going to be in vascular, Ryan. And so those vascular practices have a lot of these patients. It's a larger part of our business than the oncology Flexitouch-type of business.

當然。那麼 Elaine，你為什麼不談談我們如何——你介意分享一些我們可以提供的有關產品和付款人的指導資訊嗎？因為有一點——因為 Nimbl 產品，特別是當我們推出下肢產品時，這是一種類似的產品——特別是因為它是一種基本的泵，很可能會在血管中，Ryan。因此，這些血管診所有許多這樣的患者。與腫瘤學 Flexitouch 類型的業務相比，它在我們的業務中所佔的比重更大。

Elaine, why don't I have you kind of walk through kind of that in-market and the guidance input? And then I'll weigh in as well if there's more color.

伊萊恩，為什麼我不讓你介紹市場內部和指導輸入呢？然後，如果有更多的顏色，我也會考慮。

Yeah. So I think in terms of the end market, so we're not seeing any change in where patients are coming through in terms of point of call or any changes in demand. And it really -- our mix in terms of our channel as well as seeing strength and nimble more so even than in Flexitouch really had to do more so with where our reps spend the majority of their time.

是的。所以我認為就終端市場而言，我們沒有看到患者的就診地點或需求有任何變化。而且實際上 - 我們在頻道方面的組合以​​及看到的實力和靈活性甚至比 Flexitouch 還要多，這實際上與我們的代表花費大部分時間的地方有關。

So with the excitement of Nimbl, a Nimbl lower extremity specifically, we see patients who require lower extremity basic pump more often in vascular. And those patients tend to be also older, which is why we also saw that increase in Medicare. And so really, that point-of-call focus with the product really also then drove not only the product growth as well as that channel growth.

因此，隨著 Nimbl 的出現，特別是 Nimbl 下肢的出現，我們在血管中更頻繁地看到需要下肢基本幫浦的患者。而這些患者往往年紀較大，這也是我們看到醫療保險費用增加的原因。因此，產品的呼叫點重點實際上不僅推動了產品成長，也推動了通路成長。

Then consequently as well, because of the vacancy we had, we were not able to spend as much time in the oncology and VA points of call. And those, as you recall, we've had this -- I think we've mentioned this in the past, we typically see more commercial patients in oncology as well as a higher mix of our Flexitouch products, because they tend to have lymphedema that extends to their chest and trunk based on their treatment. And then in VA as well, we exclusively distribute are our Flexitouch products in that channel.

因此，由於職位空缺，我們無法在腫瘤科和 VA 呼叫點花費太多時間。正如您所記得的，我們曾經遇到過這種情況——我想我們過去曾提到過這一點，我們通常會看到更多的腫瘤商業患者以及更高比例的 Flexitouch 產品，因為根據他們的治療，他們往往會出現延伸到胸部和軀幹的淋巴水腫。在 VA 中，我們也透過該管道獨家分銷我們的 Flexitouch 產品。

So that gives a little bit of just sort of the market hasn't changed, really sort of the channel mix and why we saw a bit of a different growth rate between our products had more so to do with where our sales reps spent their time.

因此，這說明市場並沒有發生什麼變化，通路組合確實發生了變化，而為什麼我們的產品之間的增長率有所不同，這更多地與我們的銷售代表所花的時間有關。

And then as terms of, I think your question was, what do we contemplate as we were exiting Q1, I will tell you, we not only contemplated Q1 but we also really focused on April results as well. And while we can't share, obviously, any specifics, we did take into account, as Sheri in her comments mentioned, what we're seeing in terms of our hiring and ability to staff up fairly quickly, as well as that growing proficiency with our sales team. And so that, in combination with our Q1, is really what resulted in both our Q2 guide as well as our full-year guide.

然後就此而言，我認為你的問題是，當我們退出第一季度時，我們會考慮什麼，我會告訴你，我們不僅考慮了第一季度，而且我們也真正關注了四月份的業績。雖然我們顯然不能分享任何具體細節，但正如 Sheri 在她的評論中提到的那樣，我們確實考慮到了我們在招聘和快速增加員工的能力方面所看到的情況，以及我們銷售團隊不斷提高的熟練程度。因此，與我們的第一季相結合，實際上是我們第二季指南和全年指南的結果。

Okay, helpful. The other question I have, just around the P&L, Elaine, is given the increases in spend that you're doing this year with the sales force and kind of where we expect growth to be next year from a top-line perspective, I guess would you expect improving leverage in '26 as you get back to, let's say, you've made all those hires, you're at 300 reps, give or take. I mean, when do we start to see leverage again in your model on the P&L? Thanks for taking the questions.

好的，有幫助。伊萊恩，我的另一個問題是，關於損益表，考慮到您今年在銷售團隊上支出的增加，以及我們預計明年從營收角度來看的增長情況，我想您是否預計在 26 年，當您回到之前的位置時，槓桿率會有所提高，假設您已經完成了所有這些招聘，您有 300 名銷售代表，大概如此。我的意思是，我們什麼時候才能在您的損益模型中再次看到槓桿作用？感謝您回答這些問題。

Yeah, absolutely. So I think two drivers here. So one, as you mentioned, is staffing up. And that leverage will come as those resources gain per efficiency. And so -- and that's in that kind of six- to nine-month timeframe that we talked about. But the second piece that we're seeing in the OpEx increase also has to do with an increase in our technology spend.

是的，絕對是如此。所以我認為這裡有兩個驅動因素。正如您所提到的，其中之一就是增加人員。隨著這些資源效率的提高，這種槓桿作用就會顯現出來。所以 — — 這就是我們談論的六到九個月的時間範圍。但我們在營運支出成長中看到的第二個因素也與我們的技術支出增加有關。

While some of it will continue, there's absolutely kind of implementation or more one-time spend that's in there that would not be persistent going forward. And so we'll start to see our ability to scale on that as well. Those costs shouldn't -- once we get past kind of the full deployment, shouldn't continue to increase at the rate that they have been in the past there. So I think once we get past this bolus of our strategic work that we're doing here, we should start to see operating expense leverage once again.

雖然其中一些措施將會繼續，但其中絕對存在某種實施措施或更多的一次性支出，這些支出不會持續下去。因此，我們也將開始看到我們在此基礎上擴展的能力。一旦我們完成全面部署，這些成本就不應該繼續以過去的速度成長。因此，我認為，一旦我們完成了我們正在做的這項策略工作，我們就應該再次看到營運費用槓桿。

Okay. Thank you.

好的。謝謝。

Thanks, Ryan.

謝謝，瑞安。

Suraj Kalia, Oppenheimer.

蘇拉傑·卡利亞（Suraj Kalia），奧本海默。

Hi, Sheri and Elaine. This is Seamus on for Suraj. Thank you for taking our questions. Just to start in airway clearance, you guys had some really nice acceleration there. I guess, can you give us a little bit more as to the cause of steps change and growth, how sustainable that is going forward? And kind of anything you might want to call out there that led to this or we could watch to make sure kind of this is consistent?

你好，Sheri 和 Elaine。這是 Seamus 代替 Suraj 上場。感謝您回答我們的問題。剛開始進行氣道清理時，你們就取得了非常好的加速效果。我想，您能否向我們詳細介紹步驟變化和成長的原因，以及這種變化和成長在未來的可持續性如何？您可能想指出導致這種情況的原因是什麼，或者我們可以觀察以確保這種情況是一致的？

Yeah, Seamus. We're really pleased with the airway clearance business. And I think this is an absolute story of what it looks like when you are focused on strategic accounts and when you develop those strategic relationships, and then starting a calendar year where you have alignment with that strategic partner.

是的，西莫斯。我們對呼吸道清理業務感到非常滿意。我認為這絕對是一個故事，當你專注於策略客戶、發展策略關係，然後開始與策略夥伴保持一致的日曆年時，情況會是什麼樣子。

So as shared, we have some priority placement of our product agreements with some of these DMEs, i.e. they have a preference for AffloVest in the portfolio and the reps then are incented and it's part of the portfolio that they're prioritizing for those reps to be using.

正如所分享的，我們與其中一些 DME 簽訂了優先產品協議，即他們在產品組合中優先考慮 AffloVest，然後銷售代表會受到激勵，並且它是他們優先考慮讓這些銷售代表使用的產品組合的一部分。

Last year, we had some of those agreements in place, but what we did not have in place was alignment from the financial and the P&L standpoint. For example, that may have been a mid-year strategic alignment but for that specific DME may not have allocated the appropriate amount of capital for the purchase of AffloVest because again it's a cap rental so it sits on their books right until it turns over into ownership.

去年，我們已經達成了一些協議，但從財務和損益表的角度來看，我們還沒有達成協議。例如，這可能是一個年中策略調整，但對於特定的 DME 來說，可能沒有為購買 AffloVest 分配適當的資本，因為這又是一個上限租賃，所以它會一直留在他們的帳簿上，直到轉為所有權。

So as we started off this year, not only do we have alignment on what that capital allocation is going to be and commitments from those DMEs, but then we also have the strategic partnership and preferred product placement so we have alignment with the reps. And I think that these are the factors that when everything starts to align, this is then how it takes off.

因此，從今年開始，我們不僅對資本配置和來自這些 DME 的承諾進行了協調，而且我們還建立了策略合作夥伴關係和首選產品佈局，以便與銷售代表保持一致。我認為，當一切開始協調一致時，這些因素就會發揮作用。

On top of that, we have a really great product and our product is very competitive in the marketplace. We're in a very strong number two position and gaining. And so we have patient preference. We've got physician preference and appropriate placement with our DME reps. And I expect that to continue to manifest throughout this year and beyond.

最重要的是，我們的產品確實很棒，而且我們的產品在市場上非常有競爭力。我們目前穩居第二位，而且還在持續進步中。因此我們有患者偏好。我們的 DME 代表有醫生偏好並且安排得當。我希望這種趨勢將在今年及以後繼續顯現。

Got it. I appreciate that. And then next, kind of -- I guess by my math, and you guys probably have a better idea than I do, but REC productivity seemed flat to slightly up year over year. So I guess maybe, can you break down within lymphedema, like what may be -- what difference may have been done due to attrition versus tool training, in terms of REC productivity?

知道了。我很感激。接下來，根據我的計算，你們可能比我有更好的想法，但 REC 生產力似乎與去年同期持平或略有上升。所以我想也許，您能否在淋巴水腫中分解一下，例如在 REC 生產力方面，由於人員流失和工具培訓可能產生什麼差異？

And then kind of going forward, you guys are hiring up to 300, I believe, sales reps by the end of the year. What is -- where does the new CRM tool fit into that? Is that increasing just productivity? Is it stopping you from hiring additional sales reps? You know, any color there? Thank you.

然後展望未來，我相信到今年年底你們將招募多達 300 名銷售代表。什麼是－新的 CRM 工具適合於哪裡？這是否只是提高了生產力？這是否阻止您僱用更多銷售代表？你知道，那裡有什麼顏色嗎？謝謝。

Yes. Our entire exercise when we looked at this sales optimization plan was really to say what are the type of roles that we need in the field? And we've talked about this since why we renamed, redescribed what those field roles look like.

是的。當我們研究這個銷售優化計劃時，我們的整個練習實際上就是說出我們在這個領域需要什麼類型的角色？自從我們重新命名並重新描述這些領域角色以來，我們就一直在討論這個問題。

We have the product managers. Those are our quota-carrying reps. We have our product specialists. Formerly, we called them an ATAM. And then we have our PECs, those patient education consultants that are tactile employees that are out in the field engaging with patients.

我們有產品經理。這些都是我們的配額代表。我們有我們的產品專家。以前，我們稱它們為 ATAM。然後我們有 PEC，即病患教育顧問，他們是實地與病患接觸的觸覺員工。

And so when we did that rebalance or that optimization exercise, we took a look at the entire United States and said, where do we currently have people, where is the revenue kind of per rep, i.e. then where do you look at productivity per rep? And what is the ways that we can right-size that, so we have more of an average versus some territories are really small and some are really big.

因此，當我們進行重新平衡或優化練習時，我們考察了整個美國，並問自己，我們目前在哪裡有人，每個代表的收入是多少，那麼您在哪裡查看每個代表的生產力？我們可以用什麼方法來調整規模，以便獲得更平均的面積，而不是有些地區真的很小，而有些地區真的很大。

This is a classic exercise businesses should do. They often don't want to do it because it creates a lot of disruption. And so you kind of continue to throw reps and you're a little bit out of balance. We took the hard right here and did the analysis and did the exercise to say this is how many we need and where we need them and the type of rep that we need.

這是企業該做的經典練習。他們通常不願意這樣做，因為這會造成很多混亂。因此，你繼續做重複動作，但還是有點失去平衡。我們在這裡克服了困難，進行了分析，進行了練習，以確定我們需要多少人、在哪裡需要他們以及我們需要什麼類型的代表。

And by doing that, we were able to say, okay. For us to get to the revenue growth that we need to have and want to have for 2025, and beyond. We want to end the year with 300. To get that amount of revenue as we go into 2026 and 2027, et cetera, is not going to take that same degree of Salesforce investment. I expect to get the productivity out of those reps by having them in the right place, with the right role, right in that right pod of the PECs plus the product specialists and the account managers.

透過這樣做，我們就可以說，好吧。為了實現我們在 2025 年及以後需要並希望實現的收入成長。我們希望今年的成績能達到 300。為了在 2026 年和 2027 年等時候獲得如此多的收入，並不需要對 Salesforce 進行同等程度的投資。我希望透過將這些銷售代表安排在正確的位置、擔任正確的角色、在正確的 PEC 小組、產品專家和客戶經理中，從而最大限度地發揮他們的工作效率。

On top of that, then you have a CRM tool. And the CRM tool, its whole premise is to get to value. So how do you make it faster and more efficient and really direct the rep on where they need to go today? What do they need to do tomorrow? And so it helps them be really efficient, which helps overall productivity.

除此之外，您還擁有一個 CRM 工具。CRM 工具的整個前提就是獲取價值。那麼，如何讓它變得更快、更有高效，並真正指導銷售代表今天需要去的地方呢？他們明天需要做什麼？因此，它可以幫助他們提高效率，從而提高整體生產力。

So it's both having the right reps in the right place in the right role, as well as the CRM tool. These come together to get to that rep productivity that we're making these big investments in 2025 and the result of that will manifest in staying with essentially what our back half guidance was, and delivering on that back half with that productivity as well as then when we get to a time of forecasting and looking at our 2026, you will see the impact of that productivity and leverage.

因此，既需要在正確的位置上安排正確的代表擔任正確的角色，也需要 CRM 工具。這些因素結合在一起，實現了我們在 2025 年進行大規模投資的銷售代表生產力，其結果將體現在我們基本上保持下半年指導方針的基礎上，並在下半年實現這一生產力，然後，當我們進行預測並展望 2026 年時，您將看到這種生產力和槓桿的影響。

Thank you.

謝謝。

(Operator Instructions) Anderson Schock, BR Securities.

（操作員指示） Anderson Schock，BR Securities。

Hi. Thank you for taking our questions. So, first, how many clinicians did you reach through your education platform in the first quarter? And I guess, how are you tracking towards your goal of at least 12,000 this year?

你好。感謝您回答我們的問題。那麼，首先，第一季您透過教育平台聯繫了多少臨床醫生？我想問一下，您今年實現至少 12,000 的目標進展如何？

You know what, we didn't report this quarter on our lymphedema outreach. But according to our tracking from an internal when we're tracking our goals and objectives, we're right on target. As I shared in the prepared remarks, we were able to reach 800 clinicians on our bronchiectasis business, which rolls into that total number. So we're right where we want to be for both our lymphedema and AffloVest clinician outreach.

你知道嗎，我們本季沒有通報淋巴水腫推廣情況。但根據我們內部追蹤的結果，當我們追蹤我們的目標和目的時，我們正朝著目標前進。正如我在準備好的演講中分享的那樣，我們的支氣管擴張業務已經涵蓋了 800 名臨床醫生，總數也達到了這個數字。因此，我們在淋巴水腫和 AffloVest 臨床醫生推廣方面都達到了我們想要的目標。

Okay, got it. And then what percentage of patients are actively using Kylee? And I guess how does therapy compliance differ between these patients and those who are not using Kylee?

好的，明白了。那麼有多少比例的患者正在積極使用 Kylee？我猜這些患者和那些不使用 Kylee 的患者在治療依從性方面有何不同？

You know what, we don't have the data on patients that are not using Kylee, right? Because we have some data that's based on a survey outreach. I mean, we survey all of our patients at 90 days to get some data on satisfaction and their utilization, but we don't have those type of metrics, which would be in a some sort of study you would have to have by enrolling them. So what we know, though, is on the Kylee ones, we're able to see what the check-ins look like.

你知道嗎，我們沒有不使用 Kylee 的患者的數據，對吧？因為我們有一些基於調查的數據。我的意思是，我們會在 90 天內對所有患者進行調查，以獲取有關滿意度和利用率的一些數據，但我們沒有這些類型的指標，這些指標需要透過招募他們來進行某種研究。因此，我們知道，在 Kylee 的記錄上，我們能夠看到簽到的樣子。

And again, when they do their therapy, how long their therapy is lasting, as well as their own self-reporting of symptoms. As I shared, we have over 1 million check-ins. Some patients are going to do it more regularly than others. Just because they're not checking in, doesn't mean they're not doing their therapy. So it is observational, the data that we're collecting, and obviously patient-generated.

再次，他們何時進行治療，治療持續多長時間，以及他們自己報告的症狀。正如我所分享的，我們有超過 100 萬次簽到。有些病人會比其他病人更常這樣做。他們沒有登記，並不意味著他們沒有進行治療。因此，我們收集的數據是觀察性的，顯然是由患者產生的。

But it does give us a lot of insights for us to start testing hypotheses and reaching out to patients to kind of understand what could help support compliance with therapy. Or if the amount of therapy sessions that they're doing are doing and having an impact on symptom reduction then that would be very good to collect as well.

但它確實為我們提供了許多見解，讓我們開始檢驗假設並與患者接觸，以了解什麼可以幫助支持治療依從性。或者，如果他們進行的治療次數對減輕症狀有影響，那麼收集這些資訊也是非常有益的。

Every patient's going to be different and everyone's condition and severity is different so there's not one right answer for everybody and that's why the value of this data I think are going to be very impactful as we learn more about this population during their care continuum and particularly after they get their therapy.

每個病人的情況都不同，每個人的病情和嚴重程度也不同，所以沒有一個適合所有人的正確答案，這就是為什麼我認為這些數據的價值將非常有影響力，因為我們可以在他們的護理過程中，特別是在他們接受治療之後更多地了解這個群體。

Okay, got it. Thank you for taking our questions.

好的，明白了。感謝您回答我們的問題。

Thanks.

謝謝。

Thank you. And we have reached the end of the question-and-answer session. And this also concludes today's conference. You may disconnect your lines at this time. We do thank you for your participation.

謝謝。問答環節現已結束。今天的發表會到此結束。現在您可以斷開線路。我們非常感謝您的參與。