MYOMO, INC. Q4 FY2025 earnings call

CEO Paul Godonis mentioned progress on four major objectives: growing revenue through direct-to-patient marketing and recurring sources, increasing market access via payer contracts, managing cost structure, and innovating in product development. Fourth quarter was strongest revenue quarter with $11.4M, full year up 26%. US O&P channel had record quarterly revenue, up 81% q-o-q and doubled y-o-y. MyoConnect program had over 100 qualified candidates in first six months, referrals 10% of total pipeline ads in Q4. International operations grew 46% q-o-q and 48% y-o-y. Steps taken to manage cost structure, including activating Myomo mobile app and rolling out other enhancements.

Fourth quarter of 2025 revenue was $11.4 million, full year revenue was $40.9 million, up 26% over 2024. US O&P channel had quarterly revenue over $1 million for the first time, up 81% quarter-over-quarter and doubled year-over-year, contributing 9% to total revenue. International operations had quarterly revenues over $2 million for the first time, growing 46% quarter-over-quarter and 48% year-over-year, contributing 19% to total revenue. Recurring patient sources represented 42% of fourth quarter revenue.

First quarter revenue expected to be in range of $9 to $9.5 million. 2026 revenue expected to be in range of $43 million to $46 million. Expect gross margin to benefit from higher volume and lower COGS per unit, and operating leverage with limited growth of other operating expenses. Cash burn expected to be reduced by roughly half in 2026 compared with 2025.

Risks include operations of China joint venture on hold due to majority shareholder bankruptcy. Challenges with Medicare Advantage payers issuing high preauthorization denials and appeals process. High cost per pipeline ad from direct-to-patient marketing.

Q: Please detail what drove up pipeline ad costs in the quarter and plan to lower acquisition cost on direct side.

A: MyoConnect program gaining traction with no advertising cost, but Q4 had higher advertising cost due to holiday and election cycles. Brought on new head of marketing and digital agency, expecting cost per call to decrease over time.

Q: Give KPIs on O&P channel, number of units in Q4, ASP.

A: Couple dozen O&P providers trained, over $1M revenue in quarter, about 36 units in Q4.

Q: Detail assumptions for 2026 guidance regarding U.S. O&P business.

A: Expect growth in O&P channel and international, direct billing relatively flat due to uncertainty in marketing changes.

Q: Comment on pipeline ads, dropout rate, gross margin.

A: Pipeline ads 676 in Q4, a bit lower due to shutdown at end of 2025. Dropout rate related to Medicare Advantage payer issues. Gross margin expected to fluctuate with volume, expecting to get back into 70% range by end of 2026.

Q: Color on German market growth drivers and 2026 outlook.

A: Main drivers include recruiting O&P practices, good social court rulings, expecting continued growth.

Q: Use of RCT data and timeline for MyoPro 3.0.

A: RCT with University of Utah to start seeing first readouts by end of 2026, use data to convince payers. MyoPro 3.0 is a total redo with more functional benefit.

Q: Gross margin in international vs domestic and operating leverage.

A: International gross margin a bit lower than domestic, manufacturing in US, operating leverage as sales grow.

Q: Percentage of pipeline ads from recurring referral sources and target breakdown.

A: About 10% of pipeline ads and orders from referrals in Q4, target recurring sources to approach half of revenues by end of 2026.