ESTABLISHMENT LABS HOLDINGS INC. Q4 FY2024 earnings call

• Revenue in Q4 2024 was $44.5M, inline with expectations, and full-year 2024 sales were $166M.
• US launch: $3.3M in first two months of launch, 650 accounts fully onboarded, 450 placed orders with 88% reordering. Averaged 90 orders per day in February.
• Mia: Forecasted $8-10M in revenue in 2025, with at least double the number of certified clinics and more than double the number of procedures globally.
• Preservé: Launched in Brazil, seeing significant interest.
• China: Investment in distributor, with end consumer sales increasing meaningfully.
• Cost reductions: Operating expenses declined $12.5M in 2024 due to various efficiency initiatives.

In the fourth quarter of 2024, revenue totaled $44.5 million. For the full year 2024, sales were $166 million. Regionally, sales in Europe, Middle East, and Africa (EMEA) were approximately 38% of the global total, Asia Pacific 35%, Latin America 18%, and North America (including $3.3 million of Motiva sales in the US) was 9%. The gross profit for the fourth quarter was $30.5 million, which is 68.5% of revenue, up from $20.6 million (65.2% of revenue) in the same period of 2023. The gross profit was positively impacted by higher production volumes, decommissioning of the B15 manufacturing site, and early US sales contribution.

• 2025 revenue guidance is $205M to $210M, representing 25% growth from 2024.
• US revenue expected to be at least $35M.
• OUS to grow in mid single digits.
• Gross margins to improve 200-300 basis points in 2025.
• Expected to be EBITDA positive in the second half of 2025.
• Cash flow breakeven expected in 2026.

Q: Anthony Petrone from Mizuho Group asked about US Motiva launch details, including number of accounts and if FDA clearance of Ergonomix2 is baked into the $35M guide.

A: Juan Chacón-Quirós responded that there are 650 fully onboarded accounts, 450 placed orders with high reordering, and the $35M guide does not include new US approvals.

Q: Allen Gong from JPMorgan inquired about US launch momentum and SG&A trajectory.

A: Juan Chacón-Quirós stated the US launch is going well with strong ordering patterns, and SG&A should stabilize and leverage as the year progresses.

Q: Josh Jennings from TD Cowen asked about regulatory steps for Femtech minimal invasive portfolio.

A: Juan Chacón-Quirós mentioned ongoing processes for registering tools for Preservé and potential approvals for reconstruction indication in 2026.

Q: Marie Thibault from BTIG asked about OUS revenue guide and EBITDA/cash flow outlook.

A: Juan Chacón-Quirós said OUS has a conservative start with gradual recovery, and EBITDA positive in 2025 second half with cash flow breakeven in 2026.

Q: Joanne Wuensch from Citibank asked about physicians adopting Motiva and sales reps expansion.

A: Juan Chacón-Quirós said physicians are excited about Motiva's innovation, and sales reps are sufficient with selective additions.

Q: Matt Taylor from Jefferies asked about which incumbent is easier to take share from in end markets.

A: Juan Chacón-Quirós responded that Motiva is taking share from all incumbents, not targeting low-price market.

Q: Harrison Parsons from Stephens Inc. asked about US Motiva supply and first quarter impact.

A: Juan Chacón-Quirós stated supply challenges were resolved with ramped capacity, no lingering impact in Q1.