Q1 2021 Sientra Inc Earnings Call
Good day and thank you for standing by welcome to the Central first quarter 2021 earnings Conference call. At this time all participants are in a listen only mode. After the speaker's presentation. There will be a question and answer session to ask a question. During the session you will need to press star one on your telephone.
Please be advised that today's conference is being recorded.
Do you require any further assistance. Please press star zero I would now like to hand, the conference over to your Speaker today Oliver Bennett. Please go ahead.
Thanks, operator, good afternoon, and welcome to the CN trusts first quarter 2021 earnings call.
I'd like to remind everyone that in our remarks today. We will include statements that are considered forward looking statements within the meaning of United States Security laws. In addition management may make additional forward looking statements in response to your questions.
Forward looking statements are based on management's current assumptions and expectations of future events and trends, which may affect the company's business strategy operations or financial performance.
A detailed discussion of the risks and uncertainties that the company faces is contained in its previously filed annual and quarterly reports on form 10-K, and 10-Q and in its quarterly report on form 10-Q that the company filed this afternoon.
Actual results may differ materially from those expressed in or implied by the forward looking statements.
The company undertakes no obligation to update or review any estimate projection or forward looking statement.
I would also like to note. That's Yatra uses its investor relations website to publish important information about the company, including information that may be deemed material to investors.
Natural and other information about Sketchup is routinely posted and is accessible on the company's investor Relations website at Www Dot <unk> Dot com.
Did that call, we have Ron minutes edge T interest, President and Chief Executive Officer, and Valerie Miller, Vice President corporate controller, and interim Chief Financial Officer.
I will now turn the call over to Rod.
Right.
Thanks, Oliver and thank you all for joining us today on our first quarter 2021 earnings call.
I'm very proud and Sanford team for their outstanding execution of our 2021 priorities in the first quarter.
On our last call identified three strategic priorities and growth drivers for this year.
First fueling our organic growth within the augmentation and reconstruction by growing market share within existing accounts.
The new accounts.
Accelerating our efforts to be a top two implant and expander company in two years.
Second increasing our focus on innovation and executing our development pipeline.
And finally, establishing a culture of focus and accountability.
I'd like to take the next few minutes to highlight the exciting progress we have made on each priority.
We'll continue this strong momentum on our breast products business during the first quarter or are we saw both revenue acceleration and market share growth.
Net sales for the breast products segment totaled $18 3 million, a record quarter, representing 47% growth year over year.
We believe that Nebraska augmentation market grew in Q1 as more patients continue working from home and use that extra discretionary income towards breast augmentation purchases.
According to third party market research data. This market grew 8% in Q1 euro per year, while our U S breast augmentation business outperform versus the market and grew over 90% year over year.
Our U S reconstruction business, which includes both expanders any plants grew approximately 19% over the same time.
The growth in our broth business came from accelerating market share within current accounts and opening new accounts.
We added over 200, new accounts in Q1 and ended the quarter with a little over 2400 total active accounts.
Now turning to our commercial execution.
In Q1, 'twenty, one we'll remain focused on accelerating market share growth through marketing innovation and execution excellence.
We know that patients use company websites is one of the top two sources of information and research has shown us that 71% of surgeons would add a new breast implant brand if more patients ask for it.
And the first week of January we launched a successful marketing program focused on driving consumer brand awareness and patient acquisition.
This include our new brand campaign, a modernized central website and are highly focused DTC campaign, which included social media and digital marketing.
Through this marketing efforts, we have reached now 3.4 million consumers with almost 90000 web visits yielding an exciting four fold increase in traffic versus last year.
The outcome of those website visits was 22000 surgeons searches and thousands of referrals directly to adult surgeons.
We'll hit the ground running by hosting our national sales meeting the first week of January with a larger fully trained sales force as well as a whole relaunch the central brand sales toolkit.
This readiness put our company in a position to capitalize on the market trends and uptick in both cosmetic reconstruction segments.
We're successful in expanding our customer base during the quarter by targeting the high volume hospitals, leveraging our innovative all works to tissue expander.
As a reminder, our pen Alex to expander on expander in the market that provides surgeons with access of the peri prosthetic space for diagnostics simply and treatment of Sirona is leading to less complications reduce we operation rates for patients.
We were recently awarded on innovative technology contract from visa and the nation's largest member driven healthcare improvement company.
This distinction recognizes the unique features and benefits of Alex too and it makes the product more broadly available to all major hospitals in the U S performing reconstruction surgery.
She answers field force is ready to go and they kicked off on accelerated promotion to pull through the contracting 3500 reconstruction hospitals with a heavier focus on the top 10 per cent of those hospitals.
Now turning our focus on innovation and our development pipeline.
We are very excited to announce on our recent partnership with butterfly network to promote their ultrasound device.
Plastic surgeons can now make more informed decisions about the condition of their implants using imaging information for the butterfly IQ plus the.
The partnership with full display at the most recent American Statics meeting in Miami.
See interest medical affairs, and reconstruction managers have begun promoting butterfly IQ plus to hospitals and key customers.
We have also made significant progress on our next generation tissue expander that builds upon our novel patent dual port design.
The new expander will promote better patient outcomes due to its minimally invasive drainage system and will also low for MRI and targeted radiation therapy.
As previously reported with file our five 10-K application for this next generation expander last year and is presently under active review within the F. D. A.
We'll continue to work with FDA on this application now optimistic for a commercial launch in the first half of 'twenty 'twenty two.
When I came aboard seven months ago, I was committed to accelerates the interest focus on our core business and remove distractions from our team.
After a rigorous process. We're thrilled to have reached an agreement with 13 shifting as a buyer for merit right. This.
This is great for our customers and for patients as a mirror dry as wanted to mostly highly rated aesthetic treatments for hyperhidrosis.
And we're committed to a smooth transition following closing to ensure high level of customer service.
In terms of our expectation for the full year 2021 and based on our strong first quarter results. We have updated our guidance and expect achieve breast product net sales between 72 to 76 million, representing 31% to 38% growth year over year.
I will now turn the call over to al for a more detailed review of our first quarter financial results fell.
Thanks, Brian and.
In the first quarter of fiscal 2021 center achieved consolidated net sales of $23 2 million or 37% year over year increase with the increase driven specifically by a strong performance in our breast products segment.
Continued high level of operational execution on cost efficiencies and substantial progress across the strategic initiatives outlined earlier.
Net sales for the breast products segment totaled $18 3 million in the first quarter 2021, representing an increase of 47 per cent compared to 12.5 zone for.
For the same period in 2020.
This was also the highest ever breast products quarterly sales never in company history.
This represented sequential growth from Q4, 2020, even though historically first quarter sales tend to be lower due to seasonality of sales.
Net sales for the segment totaled $4 9 million in the first quarter 2021 a 10% increase year over year.
Largely driven by biotech sales on.
On may 10th.
We entered into an asset purchase agreement with 13, 15 capital, where we agreed to sell certain assets related to the maritime business for a total of $10 million in cash subject to adjustment as provided in the purchase agreement and the assumption of certain liabilities. The sale is subject to routine closing conditions and we expect to close within.
Approximately 30 days.
Gross profit for the first quarter 2021 was $12 3 million or 52, 9% of sales compared to gross profit of $10 1 million or 59, 9% of sales for the same period in 2020.
Excluding the impact up on Maritime segment, which included unfavorable overhead absorption gross profit for the first quarter 2021 was $10 2 million or $55 four per cent of sales.
Operating expenses for Q1 of 'twenty, one were $22 1 million. This compares to 29 million in Q1 of last year, excluding impairment and restructuring charges.
On a non-GAAP basis, adjusted EBITDA loss for the first quarter 2021 decreased by 66 per cent to $5 3 million from $15 5 million for the same period in 2020.
Net loss for the first quarter 2021 was $54 7 million or one dollar and one cent per share compared to a net loss of $28 6 million or 57 cents per share for the same periods in 2020.
Net loss for the first quarter of 2021 includes a $42.7 million non cash loss related to the change in fair value of the derivative liability related to the convertible debt of the company that was announced in the first quarter of 2020.
Turning to our balance sheet, we ended the quarter with 84 million of cash and cash equivalents compared to 55 million at December 31 2020.
Turning to guidance for 2021 as Ron noted, we expect gross products 2021 net sales in the range of 72 to 76 million, reflecting growth of 31 to 38 per cent compared to sales of $55 4 million in 2020.
We expect 2021 annual operating expenses to be in the range of 85 to 90 million compared to $101 1 billion in 2020, excluding impairment and restructuring charges.
With that I would like to turn the call back to Ron for closing remarks.
Thanks, Bill we are very optimistic about the remainder of 2021 and we expect to continue to accelerate market share growth by leveraging our unique strengths. There is false or products. They have unmatched safety profile, which is more important than ever to both surgeons and patients are marketing program innovation.
Regarding patient acquisition surgeon education, and our new partnership with Butterfly and also the addition of reconstruction hospitals during a time when the market is bouncing back.
And now I'd like to open up the call for Q&A operator.
As a reminder, task a question you will need to press star one on your telephone to withdraw your question press the pound key please standby, while we compile the Q&A roster.
Our first question comes from the line of Margaret excellent from William Blair. Your line is now open.
Hey, guys Yeah. Good afternoon, Thanks for taking my question.
So I wanted.
Let's start first with sales rep productivity, because it seems like it's really been climbing pretty significantly certainly versus you know 19, and even versus 'twenty. So where is it today, where do you think it can go in and do you feel a need to hire more sales reps are continuing to grow at a accelerated folks on.
Or on that system.
Yeah Margaret Thanks for the question.
First of all yes, we did add three new P. S. Cease in the beginning of year, we had a couple of recalls managers as well, but from the sales side, we had three even with the three new ones on productivity was close to 400000 per PSC. So training about 1.6 for the year.
Which is much higher than last year's worth about one point to a little rounded up to 1.2 lost share and then I have discussed before we do this territory.
Territory by territory. So for example, we're looking at a couple of areas that as we get closer to 3 million how business, but for one rep. That's what gives us our inclination to split the territory. So it's really systematic in a slow assessing the current environment and current productivity and obviously as we accelerate our growth and our revenue were going on.
On the to evaluate the need to add more represented so right now in the second quarter. We don't have any plans to add but that's a quarter to quarter discussion with our operations and our head of sales, it's not a year <unk> again quarter to quarter discussion. So.
Okay.
As we look throughout the year theoretically we should start to see hospital in recon that that starts to accelerate especially it's hassle free open that you guys still I think grew 19% on the first quarter. So how many hospital accounts are you assuming in guidance that you won't be able to add theoretically that.
That should drive that.
More on PSC productivity I would think just given the ASP per kit.
Now the large majority of the accounts, we're at it worth their cosmetic side, but we did add on the over 200 about a third war hospitals like a little more on that with our hospitals.
As we continue to grow.
I think our key goal here is one is go deeper on account as we add him because he does take sometimes four to sometimes as long as nine months.
We got we're pretty much all I'll ask there is now available on every account not ever kind of every G. P. O now the PSC at working with our recall manager goal is how do we pulled through that contract down from the GPO and you go to that process and sometimes it takes us as little as four months, but sometimes as long as nine months just to your first sale.
And nature counts. So it is a long term thing but.
But we did add a lot of accounts lost share there was seemed productivity already so that's where we're looking at in the next six nine months.
And are you assuming much in my guidance I guess come on in terms of some of these new contracts you have fun.
Or is that more kind of a point to them.
Yeah, where we're building on that guidance that we are going to add more accounts from a hospital side, but also continued to drive our recon business as well and part of that is obviously as patients come back in house more hospitals, which have seen startup will open up the doors for reconstruction or elective.
So that's all built on our guidance for the rest of the year.
Okay. Thanks for that.
Thank you. Our next question comes on the line of Richard Richard New Winter from SBB Leerink. Your line is now open.
Hi, Ron This is Jamie Morgan on.
H.
Thanks for taking my question I guess.
On the guidance.
It seems a little bit conservative.
Thank you be one he was typically a seasonally lower quarter. So I was just wondering if you could talk about how you're thinking about the quarterly revenue cadence as we move through the rest of this year.
They usually have seasonality from a cosmetic side you have a very high second quarter net.
On the number two quarters, if you did the first quarter or the fourth quarter and then as things dropped down the third quarter. So our expectation is.
Obviously, we're going to go back to a seasonality for the cosmetic which we have not seen by the way in second quarter, It's still a very.
Fast paced very.
Busy offices of plastic surgeons, but we are Gonna Ann Inc. Third quarter competing against are high numbers.
Unlike most years third quarter is always the worst quarter.
Core cosmetic specific plastic surgery. In this case was not the case last year for obvious reasons because of COVID-19 in the second quarter. So we're going to compare against those two so that's where we're looking at 72 to 76.
But really being sensitive of what it's going to happen in the next six months so.
So it sounds like.
Yeah.
There'll be to see your typical like strength in the second quarter.
And maybe something a little bit lower in the third quarter just from a seasonal perspective, and then obviously parking is typically a little bit stronger as well as that.
Way to be thinking about it just relative to you know.
The 18 roughly.
Roughly 18 million that you saw on the first quarter, just trying to get a sense.
Whether we should be thinking about that dollar.
Stepping down in the second quarter relative to the first quarter strength.
No I think if you look at second quarter on the way. We started the second quarter is still very similar trends that we saw first quarter, even some acceleration. So you see that the expectations from a high.
Volume second quarter as patients.
Patients get ready for summer and then you can see that back off on third quarter. So I assume that seasonality back after second quarter, but obviously again second quarter is always a busy quarter for everyone. So.
Okay.
And then I guess just between the two different market segments.
It sounds like the recon market is coming back a little bit one of your.
Our expectation for when that market should be.
More normalization and I guess, just kind of how should we be thinking about the two businesses.
Kind of what.
What's contemplated and in the $72 million to $76 million.
We've seen well first of all.
Some of the teaching institutions day nasty, a whole lot of impact of their reconstruction.
Surgeries is more the others hospitals day did see an impact a day or closed for an elective surgeries and those are now coming back.
So, we obviously see us slow down on diagnosis.
And throw them as activities. So you you really if I'm sorry for surgeries. So you've seen the whole thing was backed up so that's going to start coming in now as hospitals are open up we're seeing more and more hospitals open up some more interest in our expander and Australian plants in hospitals.
And so we see the next again six to nine months, even from a recall accelerating in the second half, specifically third quarter or fourth quarter and the individuals.
Individuals that were on the sideline waiting to see what happened from elective surgery on now would be probably making that decision.
It was just sellers in Q3 and Q4 for reconstruction.
Okay. That's helpful and then I guess, if I just squeeze in one more.
On the CFO search process is going and when can we potentially expect to learn a little bit more about that.
It's going very well, we're are hoping shooting a target to get somebody on board by the end of June that's the goal.
Depending on what this individuals.
Commitments, but that's our goal right now end of June.
Beginning on July ish, that's we're looking at so.
Thanks for taking my question.
Thank you.
Thank you. Our next question comes from the line on Jon Block from Stifel. Your line is now open.
Maybe the first one on the I think you alluded to 200, new accounts can make a big number and accelerate notably from I believe what was 100, the prior quarter or so solid step up there maybe if you can elaborate on the acceleration was there any I don't know changing comp plans or instead.
Give us to help aid that and then if we think about the 2400 active accounts and I think you also alluded to.
Do we think about that longer term in terms of where that goes over the next maybe 12 to 24 months.
Yeah, you're right on the money there John It is a double what do we have saw in first quarter in regards to additional new accounts. It is one of the goals that are Kirk our head of sales set is to us in a certain edition in new accounts for each of our PSC, Our representatives and we've seen the results of that.
We're tracking how they're performing versus those goals and also a certain guidelines with regard to the number of calls per day et cetera, but keep in mind, we did add over 200 on your accounts, but 90 over 90% of our growth in the first quarter came from existing accounts.
It's just our existing accounts that had a low market share and they were expanding their market share. So a lot of the growth coming from existing accounts that were not the big work all the big whales or to tier one that's really from a accounts that they had opportunity to expand and that's well rps he's done a fantastic job from executing there.
And expanding market share. So that's a really way to go from a total accounts on 2400.
Is that like a 15% growth.
Over the last year were about little over 2000 accounts last year at the same time, so you've seen that acceleration, but the key thing is how do we ensure that counts are come on board stay with us. So we're close to about 60% reorder rate right now of accounts and that's a part of our goal is not just one order but multi.
Orders in the future so.
Got it very helpful. Thanks for that and then.
Can you just sort of the word rumor, but on the competitive landscape. There are some chatter of rumors out there that certain businesses maybe per sale just your thoughts around I mean does that further embolden what you've laid out. It is your road map. If you would to a top two implant and expander company in two years.
If we were to see something like that take place as that bring into the equation a certain level of disruption, which would even give you know further conviction.
On on your market share gains in coming quarters.
Yes, John there's a lot of rumors out there from the competitors.
We are looking on what can we do to really improve patient outcome and industrial focus on regards to innovation on X.
<unk> and we've seen that from a commercial team bolster sales and marketing teams did a fantastic job and also for our manufacturing is all we ever plan, Wisconsin now going seven days.
The week all the time they'd actually it was to have production abilities. There, but our goal is how do we control we can focus on and we saw that at the last aesthetics meeting in Miami two weeks ago, a central was the center as you walked in on the floor. We had a lot of surgeons coming by our Booth I talk to us.
They know Sandra is committed to plastic surgeons there no.
Sanchez committed to improve patient's outcome and that's what they are seeing the difference right now versus daughter companies out there that have different questions about their future. So we're really focused on what can we control right now which is accelerating our growth accelerating our market share are taken away from the competition and find a way to support payer.
<unk> and surgeons got it that's helpful. One last one for me Val maybe over to you I want to make sure I heard some numbers correctly. So the G M. As you know.
I think we're 53% in print or 52 nine I think you said maybe specific to the breast business. It was 55 and change if I had the right number there and then maybe documents going forward do you still think you can exit the year in the high Fifty's in his mid 60 still attainable when we think about the back part of 'twenty two thanks guys.
Yeah in terms of gross margin the breast product business was 55, 4% as you mentioned.
We still expect to end the year in the upper fifties and we have a target for next year on the 16th.
Great. Thank you.
Thank you. Our next question comes from the line of Kyle Rose from Canaccord. Your line is now open.
Great. Thank you for taking the question.
Strong strong performance on the breast side wondering if you could just talk a little bit about what you're seeing internationally, Japan was it was a new entrant in in 2020, how has that trended to start this year and then expectations for you on any additional new countries I'm thinking Canada. When we think about over the course of the next six to nine months.
Kyle we Japan came in at close to 600000. So it was kind of in line our value expectations, which will be in line for the whole year as well on the ended the year.
In regards to enter the new markets, we're still waiting for health, Canada, we are assessing different markets within the next six to 12 months. So we have a team that's looking at how do we get into different markets, where theres a possibility of a good margin for the product. Obviously, we will discuss that in the past are some areas and regions, where the margin stool.
Low for us to get into but there are some areas that makes sense for us. So that is part of our expansion from our adjacencies to look at different markets.
Great and you talked a little bit about.
The expectations for recon, when we think about the.
Growth in the Q3 into Q4, but maybe help us just better understand.
How much of that comes from you know the backlog you're seeing in the channel as far as you know account recon accounts you have now that are going to have new patients coming in.
We're not diagnosed or non operated on versus just progress as far as you're bringing on new accounts.
Help us understand that those dynamics in recon.
Yeah. If you look at Q1, the majority of our growth and reconstruction actually came from what we call the tier two which is the.
The accounts that are have been with us they they already were purchasing from us and Theyre, just really did extremely extremely well.
And I have example of a well known academic teaching institution to southeast that we were able to flip a 100% to central but it took a while and it's taken a while to get the inventory they had for the previous company and get our residents and our surgeons trained on our product. So that's why I said in.
The beginning this is a four to six months, sometimes nine months process.
After you get the hospital on board it takes about four to six months to get everything moving so that that's why I'm thinking Q3, Q4, but the majority of growth for Q1 still came from existing accounts just like the cosmetic side.
Okay and then the last one for me I know you talked about overall.
Overall sales rep metrics I appreciate that those numbers, but you did talk about also adding on the three reps I think in a couple of key stage do you think about you know Florida.
Florida.
The great lakes areas. There, maybe just how has the underlying productivity in those new reps trended and I guess, what will trigger you to bring on an additional cohort when we think about the back half of this year or even into 2022.
Yes R. P S in Nebraska, the extremely well on the first quarter. Obviously, you know the individual has a lower base because the person is growing.
The business in Florida, If you look at a top three states is Zach what do you think from a actually New York is not top three is really number one, California and number two is Florida and number three is Texas and York's Rai after from our cosmetic now argumentation. So those are the areas that usually assess a territory by territory and our cut or MEH.
Our goal is if a territory gets closer to a $3 million per PSC. That's one of our SaaS and start to think about dividing the territory.
And then your house and have 215 or close to $1.5 million.
But the way, we're moving and growing fast.
It will be assessed every quarter.
And if theres, a need to add more or be anymore, but probably will not be surprised if those three or four states in which you had in New York are the states will be looking at opportunities to add a PSC, if we see territories against the $3 billion Mark.
Great. Thank you very much for taking the questions.
Yes.
Thank you. Our next question comes from the line.
Alex Nowak from Craig Hallum Your.
Your line is now open great.
Great. Good afternoon, everyone on so the company really solidify this shift to a plastic surgeon focused organization with the mirror drive sale. So Ron you mentioned, a new expanded the butterfly partnership, but what other products do you develop internally using your manufacturing facilities that you have and put through the existing sales channel into the plastic suite.
Yeah, So I share it at the beginning some or are we doing from a new expander in new technology for next year, obviously butterfly brings us a value added that brings that safety at the forefront. It is the number one thing that.
Patients potentially.
Consumers look for on the researching costs me number two is because number one safety number two and I flipped and that ultra butterfly network ultrasound device gives us stability to gift that surgeon on ability to assess the implant assess where the patient is etcetera and supports our.
Our planned 28 year warranty, which is one of the things we talk about in regards to 10 year data is the safety of our implants now, but there are products, we're looking as well in regards to within.
Breast augmentation and within reconstruction as well, but also starting at the end of this year next year, we'll be looking at is anything within plastic surgery that makes us sense for us to get into but everything will be looking at is start with our core business, which which is breast augmentation and reconstruction then we'll look as any growth.
Alex out there that we can invest it makes sense for us.
On the past a lot of those ideas are coming from surgeons they have ideas on products.
What are some of them have prototype they just need help on development than you helpful. Commercialization. So we're assessing those ideas coming in as well. In addition to look at different things outside our expertise, but our focus right now is really the core business. The core business. We are very busy with lots of opportunities to take share away from the competition on lots of opportunity to Eaton.
Enhance our current offerings of core products and then we start thinking how do we expand our offerings outside the core business most likely 'twenty two.
In 2023.
That's great. It makes a ton of sense and then you said that central wants to become a number two on plant two years, what would the breast product revenue beat hit that number two provider status and then a third question here is just.
What other DTC programs you plan for the rest of the year.
Yeah, I think if you want a big number two you've got to be you know.
North of $100 million U S sales keep in mind a lot of work.
Writers have outside U S and we're focused on U S. So we have to be thinking how do we get to the acceleration above the $100 million.
And that's a key goal for us.
Sooner than later.
On the other side from a marketing where transition.
Turning to leverage our great digital work are great social media work on getting patients to ask force the intra now into.
Physicians and surgeons education peer to peer education.
Help them understand the uniqueness of our products uniqueness of our implants uniqueness of our expander and do a lot more peer to peer education second half and really expand our name a brand out there in front of a surgeons as well to support our PSC is support our reconstruction managers and that'll be the day shift again, we're not.
On a walk away from our consumers will be on continuing to everything we do for consumers, but we're going to be adding a lot of peer to peer education on the next six months.
That's great I appreciate the update thank you.
Thank you. Our next question comes on the line of Chris Cooley from Stephens. Your line is now open.
Good afternoon, and thanks for taking the questions.
Just two for me.
Think about it spend and account base.
Plus there's the union.
200 <unk>.
Active accounts now and Sofia two back.
To kind of free.
Brazil on the computer.
On one of them thousands of accounts.
Yes.
One could you give us a roadmap for kind of how you see the 'twenty 200 accounts kind of scaling to help you achieve that goal becoming.
The number two or potentially on the top two let's say low platelet here in the U S.
And then you can also maybe characterize for you on now within your existing account base.
Just in terms of share helped us kind of think about that exist in 'twenty.
Are there.
Relative to where you could go in terms of growth. If you just drove deeper within net existed in 2005 hundred and I'm kind of quick.
Thanks.
The China, Inc.
Answer your question because it sounds like gear was hard to understand big from your phone was cracking up a little bit but from how do we go and grow on a 2400.
Accounts and number two is our market share yes market share is an interesting thing because we've got the data from the different societies.
And they are one society of plastic surgeons had the market down 5% auto one ahead of market down a little over 30% in 2020 versus 19, so it's hard to figure out, but we were able to get data from for a run on solutions is a team that is able to track life data on 380 plus surgeon.
So that looks to have life data on 380, plus surgeons and what they share with us the micro was down 5% in 'twenty versus non king and the market was up 8% in the first quarter. This year versus last day last quarter. So if you're utilizing that data and adding on as wall as a not just surgeries augmentation, but on.
So anyone who went in for a revision which is you'll get a go in and for some reason you you'll make a decision they should make a decision to get a new implant you add all of that we actually.
It went from a 6% share to a 9% share in first quarter on.
This year, so the three share point increase in one quarter.
So that's you know that's on Hawaii.
That did it is kind of interesting because there's life day to 380 and extrapolate it to the market and it's a plus minus 5% from a confidence interval. So that as we are about 9% now so where do we how do we grow to be a number two is one.
Continue to add new accounts, but it's just like not adding new accounts, but also the ability to sustain those accounts to make sure they're reordering as well and continue to accelerate our expansion on market share within our existing accounts and that's where a lot of our growth was in Q1 like I said 90 per cent came from existing accounts.
So we have programs now marketing initiatives that reward surgeons to expand on market share we have.
Initiatives that reward a new surge that comes on board fresh out of residency. So those are programs to get the surgeon.
Use of Sandra and also have programs to have surgeons try out Sandra to see.
Be comfortable with our implants and comparable tax extenders of sales as well. So those are kind of things, we do to expand our market share and once they see the outcome. This suite of patient outcome.
Happy to patient is with their center implants affect a large majority of over 90% of our patients that once they see themselves with the century implant. They are very satisfied with the outcome of the surgery. So those are kind of things we're doing to get the surgeon.
<unk>.
And again part of the goal is to expand account. So we don't have a specific goal of when did you see the 3000 accounts 4000 accounts a preferred to have 2500 counts were higher market share like our tier one to have a 70, 80% share then have 4000 accounts that we are somewhere between 5% to 15% now the challenge to get a mark.
<unk> care for each account because lot of most surgeons care to manufacturer, sometimes three mature of them carries two manufacturers is they don't share that data.
And so it's hard to figure out what if our share is $5 20, but we know that the acceleration of some of those off to start buying from us once they've seen the patient outcome.
Hopefully I answered some of the questions was hard to hear.
On the book and the question that.
Mrs.
No no I appreciate that was it was a great response and I appreciate all the color and just maybe lastly for me.
I guess, how did you want to ask a little bit here about their dry eye at the end.
Just curious the operating expense guidance for the year that you did provide of $85 million to $90 million I'm, assuming that's still inclusive.
A midrise contribution here in the first quarter or is that and is that excluding mirror dry and then similarly, the $10 million sale price.
The company paid 24, it upfront and it's at $10 million in milestone payments based on all of which had been paid out.
Just curious if you could elaborate on the process there.
Evaluation on on the sale of mere drawing completely support the focus.
On the breast aesthetics, but just trying to level set one day valuation and then too.
What was really does not imply there in the Opex Scott. Thank you.
Yeah, Let me answer the second question I'll, let <unk> answer the first part of your question regards to valuation we did.
Look and talk to at least two companies actually a little more on that and discuss what makes sense for mere drive companies that could bring on board and obviously as he discussed that he also assess the fit you assess also on how the valuation economics of it.
And at that time were looking what makes sense from our revenue goals for 2021 and the $10 million seem to be on proper fit for or are we at in 'twenty 'twenty. One on the same times. It is really the goal is place meera dry with a company like 13th 15th is set up a great team to take.
Kovar mirror dry and so we can refocus on 100% on breast augmentation and reconstruction. It gives the freedom for us to do we.
We may not have a commercial team and U S dedicated 100 per cent to mirror dry, but all of share services, we're working very closely and supporting merge right now after we close this deal would be able to dedicate 100% to.
Sentra and not be distracted by all the different active as a mirror dry and in the meantime, there drives going to have a fantastic support from 13th 15th a great team that is going to focus 100% on capital equipment, 100% tip sales on a per center customers and their team, which will be really a great advantage for them.
Now in terms of Opex, we still expect a range of Opex can be 85 to 90, and we had nearly moved all of the G&A into our normal operating inside the shared service center. So we're not going to see a big downturn in opex because of the <unk>.
On the nation, because we had already eliminated most of the costs.
During.
The process.
In 2020 initiatives taking place.
Thank you.
On slide four.
Thank you. Our next question comes from the line of Matt, but like from Maxim Group. Your line is now open.
Hi, Yeah. This is Matt on for Anthony Vendetti.
Hoping you guys could touch a little bit on the cadence you expect per Opex going go on throughout the rest of 'twenty. One do you expect slightly higher in second quarter, and then scaling down a little bit in the third and coming back up on higher sales on the fourth and then if you could touch on your production capacity. If you foresee needing to increase your manufacturing going forward to support.
Thanks.
In terms of the Opex cadence, we expect that quarterly cadence can be pretty flat.
Over the next three quarters, so about even.
And in regards to manufacturing and Franklin, Wisconsin, the team they've done a great job of improving yield.
Improving and lowering the cost of manufacturing plants there.
To the point that we were really good shape for the future in regards to our cost of goods sold but that we're making today, we're not selling tomorrow, we're making today will probably be selling this fall or an NDA.
The middle of fourth quarter, we're still selling inventory from last year. So that's our outstanding performance and like I said before we are.
Working seven days a week right now I'll have two shifts right now going on.
Also to add more shifts we added additional space.
Space right now right there in Franklin.
For office space.
So we're really good shape right now from our manufacturing facility in making our implants, and obviously would make spenders in Montana, but.
Really well supporting the demand that's being created by the commercial team.
Excellent. Thank you.
Thank you at this time I'm showing no further questions I would like to turn the call back over to Oliver Bennett for closing remarks.
Thank you operator, we would like to thank everyone for joining us on our first quarter 2021 earnings call.
Ron mentioned in his closing remarks, we are very optimistic for the remainder of 2021 and look forward to updating you all on our progress at our second quarter earnings call wish you all the wonderful day.
<unk>.
This concludes today's conference call. Thank you for participating you may now disconnect.
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