Alphatec Holdings, Inc.
- Open
- 9.02
- Day high
- 9.09
- Day low
- 8.53
- Prev close
- 9.27
- Volume
- 2.2M
- Mkt cap
- $1.3B
- P/E (TTM)
- —
- EPS (TTM)
- —
- P/B
- 71.9
- P/S
- 1.7
- Yield
- —
- Per share
- —
- ▲Insiders net buying $948K over the last 3 months (3 open-market buys, 1 sale)
- 🏛Institutions accumulating (13F)
Alphatec Holdings, Inc. (ATEC) is a Healthcare company listed on NASDAQ. The stock is down 19% over the past year. Over the trailing 3 months, insiders filed 3 open-market buys and 1 sale (SEC Form 4).
Alphatec Holdings, Inc. (ATEC) financials & analyst ratings
Fundamentals (TTM)
Analyst consensus · 10 analysts
Source: exchange market data + company filings. Figures are trailing-twelve-month or as most recently reported. For informational purposes only — not investment advice.
ATEC earnings date, history & EPS estimates
| Report date | EPS est | EPS actual | Surprise | Revenue | Rev. surprise |
|---|---|---|---|---|---|
| May 5, 2026 | $-0.01 | $-0.22 | -2100.0% | $192M | -2.7% |
| Feb 24, 2026 | $0.04 | $0.06 | +50.0% | $213M | +5.3% |
| Oct 30, 2025 | $-0.03 | $0.03 | +200.0% | $197M | -6.1% |
| Jul 31, 2025 | $-0.06 | $0.02 | +133.3% | $186M | +1.6% |
| May 1, 2025 | $-0.12 | $-0.23 | -91.7% | $169M | -5.4% |
| Feb 26, 2025 | $-0.19 | $-0.23 | -21.1% | $177M | +2.3% |
| Oct 30, 2024 | $-0.27 | $-0.28 | -3.7% | $151M | -11.5% |
| Jul 31, 2024 | $-0.26 | $-0.29 | -11.5% | $146M | -1.1% |
| Feb 27, 2024 | $-0.28 | $-0.37 | -32.1% | $138M | +5.3% |
| Aug 3, 2023 | $-0.30 | $-0.43 | -43.3% | $117M | +6.4% |
| May 4, 2023 | $-0.32 | $-0.40 | -25.0% | $109M | +4.2% |
| Feb 28, 2023 | $-0.30 | $-0.33 | -10.0% | $106M | +3.7% |
ATEC insider trading activity (SEC Form 4)
| Date | Insider | Type | Shares | Price |
|---|---|---|---|---|
| Jun 12, 2026 | Demski David Mdirector | Grant | 32,012 | — |
| Jun 12, 2026 | Berkowitz Mortimer IIIdirector | Grant | 32,012 | — |
| Jun 12, 2026 | Blackford Quentin S.director | Grant | 32,012 | — |
| Jun 12, 2026 | Valentine Keithdirector | Grant | 32,012 | — |
| Jun 12, 2026 | MCGINNIS KAREN Kdirector | Sell | 6,050 | $8.01 |
| Jun 12, 2026 | Pelizzon David Rdirector | Grant | 32,012 | — |
| Jun 12, 2026 | MCGINNIS KAREN Kdirector | Grant | 32,012 | — |
| May 11, 2026 | Valentine Keithdirector | Buy | 43,847 | $7.54 |
| May 11, 2026 | Valentine Keithdirector | Buy | 35,000 | $7.00 |
| May 11, 2026 | Valentine Keithdirector | Buy | 56,153 | $7.49 |
| Apr 9, 2026 | Marshall Tyson Eliotofficer: GENERAL COUNSEL & CORP. SEC. | Tax | 23,393 | $11.03 |
| Apr 9, 2026 | Marshall Tyson Eliotofficer: GENERAL COUNSEL & CORP. SEC. | Option | 15,000 | $1.98 |
| Apr 9, 2026 | Marshall Tyson Eliotofficer: GENERAL COUNSEL & CORP. SEC. | Option | 12,500 | $3.34 |
| Apr 9, 2026 | Marshall Tyson Eliotofficer: GENERAL COUNSEL & CORP. SEC. | Option | 60,000 | $2.69 |
| Mar 17, 2026 | Koning John Toddofficer: CHIEF FINANCIAL OFFICER | Sell | 79,789 | $12.36 |
Source: ATEC SEC Form 4 filings, latest Jun 12, 2026. For informational purposes only — not investment advice.
See the full ATEC insider & 13F page →Alphatec Holdings, Inc. company profile
Overview
Alphatec Holdings, Inc. (NASDAQ:ATEC) is a medical technology company founded in 1990 and headquartered in Carlsbad, California. The company has undergone significant transformation over the past decade, evolving from a diversified medical device manufacturer into a pure-play spine surgery specialist. Since going public in 2006, Alphatec has focused exclusively on developing and commercializing advanced technologies for spinal disorders, positioning itself as an innovative challenger in the competitive spine surgery market. The company has experienced rapid growth in recent years, expanding from a small market participant to capturing over 5% market share in the U.S. spine surgery market through its focus on lateral surgery procedures and advanced imaging technologies.
Business
Alphatec operates in the spine surgery medical device industry, which is a specialized segment of the broader orthopedic medical device market. The spine surgery market focuses on treating spinal disorders through surgical intervention, including conditions like degenerative disc disease, spinal stenosis, scoliosis, and other spinal deformities that cause pain and mobility issues. The company's core business revolves around two main product categories. Surgical implants and instruments represent approximately 89% of total revenue ($545 million of $612 million in 2024). These include spinal fixation systems like the Invictus and Arsenal platforms that use screws, rods, and plates to stabilize the spine after surgery. The company also offers interbody implants that replace damaged disc material between vertebrae, and specialized instruments for minimally invasive procedures. Alphatec's particular strength lies in lateral surgery procedures, which approach the spine from the side rather than the back, potentially reducing tissue damage and recovery time. The second segment is EOS imaging technology, contributing about 11% of revenue ($67 million in 2024). EOS is an advanced imaging system that provides full-body, weight-bearing X-rays with significantly lower radiation exposure than traditional CT scans. This technology allows surgeons to see how the spine functions under natural load-bearing conditions, enabling better surgical planning and post-operative assessment. The EOS platform also includes software solutions like EOS Insight, which provides automated measurements and surgical planning tools. Additionally, Alphatec offers biologics products including bone grafts and tissue barriers that promote healing, and neurophysiology monitoring systems like SafeOp that help surgeons avoid nerve damage during procedures. The company is also developing robotic and navigation technologies to further enhance surgical precision.
Revenue model
Alphatec generates revenue primarily through direct product sales to hospitals and surgical centers. The company sells its surgical implants, instruments, and EOS imaging systems through a network of independent distributors and direct sales representatives across the United States, with limited international presence in Australia, New Zealand, and Japan. The business model is based on procedural volume growth and premium pricing for advanced technology. Revenue growth comes from two main drivers: increasing the number of procedures performed using Alphatec products (surgical volume grew 17% in Q1 2025) and growing the average revenue per procedure through more sophisticated, higher-value implants and technologies (average revenue per procedure grew 6% in Q1 2025). Key customers are orthopedic and neurosurgeons who specialize in spine surgery, along with the hospital systems where they practice. The company invests heavily in surgeon education and training, having conducted over 200 surgeon training engagements in recent quarters. This relationship-based selling approach is critical since surgeons typically develop strong preferences for specific implant systems and are reluctant to switch. Several factors influence Alphatec's margins and profitability. Positive margin drivers include the company's focus on premium lateral surgery procedures which command higher prices, the recurring revenue nature of EOS imaging installations, and economies of scale as volumes grow. The company's technological differentiation, particularly in lateral surgery and neurophysiology monitoring, allows for premium pricing compared to commodity spine products. Margin pressures come from intense competition with larger players like Medtronic and DePuy Synthes who have greater scale and resources. Hospital consolidation creates pricing pressure as larger health systems negotiate more aggressively. The company also faces significant ongoing investments in R&D, sales force expansion, and regulatory compliance that pressure near-term profitability. Additionally, the lengthy sales cycles and surgeon adoption process means new territory investments take 12-24 months to generate meaningful returns.
Competitive moat
Alphatec's competitive moat is moderate but growing, primarily built around technological differentiation and surgeon relationships rather than traditional barriers like patents or scale advantages. The company's strongest moat element is its specialized expertise in lateral surgery procedures, where it has developed unique approaches like PTP (Posterior Transpsoas) and LTP (Lateral Transpsoas) that competitors cannot easily replicate. The SafeOp neurophysiology monitoring system provides additional differentiation by reducing the risk of nerve damage during complex procedures. The EOS imaging platform represents another moat component, as it's the only system providing full-body, weight-bearing spine images with low radiation exposure. The installed base of EOS systems creates switching costs for hospitals and generates recurring software and service revenue. The company is building an informatics ecosystem around EOS that could strengthen this moat over time. However, Alphatec's moat faces significant challenges. The company competes against much larger players like Medtronic, Johnson & Johnson's DePuy Synthes, and Stryker, who have vastly superior resources, broader product portfolios, and established relationships with major hospital systems. These competitors can potentially develop similar technologies or acquire innovative companies to close technology gaps. The spine surgery market is also witnessing disruption from robotic surgery systems and advanced navigation technologies. While Alphatec is developing its own robotic platform called Valence, it currently lacks the robotic capabilities that some competitors offer, potentially limiting its competitiveness in certain procedures. Surgeon adoption patterns provide both protection and vulnerability. Once surgeons are trained on Alphatec's systems and see good outcomes, they tend to remain loyal. However, the company must continuously invest in training new surgeons and maintaining relationships, as competitors are constantly trying to win market share. The relatively small size compared to major competitors makes it challenging to achieve the scale necessary for significant cost advantages or comprehensive geographic coverage.
Risks & safety
Alphatec presents moderate financial risk with improving but still concerning cash flow dynamics and high debt levels relative to equity. **Cash and Liquidity:** • Cash position: $153 million as of Q1 2025 • Quarterly cash burn: $15 million in free cash flow (Q1 2025) • Improved from $47 million quarterly burn in Q2 2024 • Management targeting cash flow breakeven in 2025 **Debt and Solvency:** • Debt-to-equity ratio: 10.5 (very high, indicating significant leverage) • Current ratio: 2.75 (adequate short-term liquidity) • Company has negative book value due to accumulated losses • Total liabilities exceed total assets by $86 million **Valuation Metrics:** • Trading at 11x forward revenue (based on 2025 guidance of $734 million) • Negative P/E due to losses, but approaching profitability • EV/EBITDA not meaningful due to minimal EBITDA • Price-to-book ratio extremely high due to negative book value **Other Considerations:** • Revenue growth remains strong at 22% in Q1 2025 • Adjusted EBITDA turned positive at $11 million (6% margin) in Q1 2025 • High cash burn historically but trending toward breakeven • Significant debt service obligations create ongoing pressure
Recent development
Over the past few years, Alphatec has executed a focused transformation strategy centered on becoming the leading innovator in spine surgery. The company has made strategic acquisitions and technology investments to build a comprehensive spine surgery ecosystem, most notably acquiring EOS imaging technology and developing advanced surgical techniques. A key strategic pivot has been the development of proprietary lateral surgery approaches, including PTP (Posterior Transpsoas) and LTP (Lateral Transpsoas) procedures that allow surgeons to access the spine from the side with potentially less tissue damage. The company has invested heavily in surgeon education, training over 500 surgeons annually and increasing surgeon adoption by 18-21% year-over-year. The EOS imaging platform has become central to Alphatec's differentiation strategy. The company launched EOS Insight software in 2024, which provides AI-automated alignment measurements and surgical planning tools. This creates an informatics ecosystem that goes beyond just selling implants to providing comprehensive surgical decision support. EOS orders have grown substantially, with 28% year-over-year growth in Q1 2025. Technology development initiatives include the upcoming Valence robotic navigation platform, enhanced neurophysiology monitoring through SafeOp, and expansion into complex deformity surgery. The company has also launched 15+ new products over recent years, including fully integrated corpectomy systems and advanced fixation platforms. International expansion represents a newer strategic focus, with successful market entry in Australia and New Zealand, and recent launch in Japan with first surgeries performed in 2024. The company is taking a "narrow and deep" approach rather than broad geographic expansion. Operational improvements have been significant, with the company achieving its first quarter of positive cash flow in Q4 2024 and targeting sustained cash flow positivity in 2025. Management has also streamlined operations and focused investments on the highest-return opportunities while maintaining strong revenue growth momentum.
ATEC company profile · for informational purposes only — not investment advice.
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