Q4 2022 Sera Prognostics Inc Earnings Call
Good afternoon, and welcome to the Cera Prognostics conference call to review fourth quarter and fiscal year 2022 results.
At this time, all participants are in listen only mode.
We will be facilitating a question and answer session towards the end of today's call.
As a reminder, this call is being recorded for really replay purposes.
I would now like to turn the call over to Peter Denardo of Telecom partners for a few introductory comments.
Thanks, Jay Good afternoon, everyone welcome to Sara Prognostics fourth quarter fiscal year 2022 earnings conference call at the close of the market today, Sara Prognostics released its financial results for the quarter ended December 31, 2022, but then equally pumping today will be great Critchfield Chairman President.
CEO Jay Moyes, our CFO during the call. We will review the financial results. We released today after which we will host a question and answer session.
Not had a chance to review our quarterly earnings release, it can be found on our website at Cerro prognostic Stockholm.
All can be heard live via webcast <unk> dot com and a recording will be archived in the investors section of our website.
Please note that some of the information presented today may contain projections or other forward looking statements about events and circumstances that have not yet occurred including plans and projections for our business future financial results and market trends and opportunities. These statements are based on management's current expectations and the actual events or results may differ materially.
And adversely from these expectations for a variety of reasons. We refer you to the documents the company files from time to time, the Securities and Exchange Commission specifically the company's annual report on Form 10-K, its quarterly reports on Form 10-Q, and its current reports on form 8-K. These documents identify important risk factors.
It could cause the actual results to differ materially from those contained in our projections and other forward looking statements.
A reminder, a webcast replay of this call will be available on the investors section of our website I will now turn the call over to Greg Sarah Prognostics, Chairman, President and CEO Greg.
Thank you Peter and good afternoon, everyone.
Fiscal 2022 was a solid Europe continued progress in positioning their prognostic for commercial growth in the quarters and years ahead. During 2022, we made incremental progress in adding new payer contracts and more recently have publicized new data that we believe will support the growth of our business in future periods.
Although our revenue was nominal for the year, we are seeing percentage growth in test volumes for Q4 year over year of 2022 versus 2021. The increase was six fold and port totaled 2022 versus 2021. It was 11 four of course. These are increases from a small base layer in.
2021, well it takes time to broaden commercial relationships. We are seeing positive results from our strategy in terms of both payer and physician response, and we look forward to reporting additional traction during 2023.
Ultimately at this time the single biggest way to further accelerate adoption of our preterm technology and testing volumes is the publication of compelling new data that continues to demonstrate the value of our tests. This growth is first manifested in the use of our technology by doctors and should result in growing reimburse.
And by increased numbers of payers, while we execute our strategy.
And we have strong and we share a strong new data published from clinical.
Clinical studies in terms of customers. We've maintained a continued focus on early adopter system. For example is it.
Delivery networks or ideas hospital systems and physician practice groups.
We continue to work with early adopters systems, not only by sharing data, but also by discussing ways with them to implement the preterm testing within their institutions, we anticipate making selective announcements as permitted in the course of bringing the preterm tests entry strategy into these systems implementations.
Among these customers take time, we believe there will there may be an inflection point ahead as multiple customers among our growing relationships reached scale in future quarters, the number of tests and the amount of revenue increases accordingly.
Another important event in our quest to help build up testing volumes. Among these customers is to broaden preterm testing availability, while reducing our costs and growing our business towards that in last quarter I touched on the successful validation and blood collection to transport system for a pre term testing, which we launched commercially in disk.
This not only expands the number of sites where patients can be more easily collected by reducing the need for dry ice availability for transport to our labs, but it also reduces our costs just as importantly, we know that ambient shipping now newly deployed is growing as a proportion of tests being ordered this year and we believe you.
That even from these early moments of ambient collection shipping launch it will continue to contribute to increases in tests volume over.
Over the next months and years to come.
Let's now turn to the growing body of published new data supporting our mission to improve the health of mothers and babies first the accord study.
Building strong evidence for the use of the preterm test as an important part of your strategy in terms of addressing health care disparities. During Q4, we announced the publication of results from Accordant, a clinical utility and cost effectiveness modeling study based on rigorous clinical utility health economic analysis. This.
Work published in the journal of Health Economics illustrates the impact of serious test and treat strategy and its specific benefits in underserved racial and ethnic populations of course was the secondary analysis of 847 women from the multi center assessment of spontaneous preterm birth predictors study or <unk>.
<unk> study finding showcased.
The care management with or without pharmaceutical.
Pharmaceutical treatment was effective in reducing maternal and neonatal hospital length of stay result indicated that by combining the preterm chest with enhanced prenatal care management real progress maybe made in better serving the most disadvantaged populations to enable better medical outcomes.
A bit on new clinical outcomes data supporting the preterm test and treat strategy the avert preterm trial.
Six ago, we announced.
The topline results for our large of preterm trial, which showed statistically significant improvements in both of its primary endpoints you need it.
The hospital length of stay and neonatal help as measured by a composite neonatal morbidity and mortality index.
We believe that these we believe these results, but what defines the benefit of the preterm test and treat strategy to improve the health of babies, giving those most vulnerable a better chance at a stronger start in Hawaii.
Detailed results.
The advert trial, including secondary endpoints and additional subgroup analyses are being prepared for submission to a peer reviewed scientific journal in the coming months.
One of the top line study results, we mentioned that we believe these results bode well for our very large prospective multicenter randomized controlled study.
I'm pleased to announce that prime has surpassed 2800.
Enrolled patients the number of required to enable the preplanned interim look.
And though there are moving parts that can delay.
Believe that the interim analysis is on track to take place during this year.
I would like to take a minute to describe how the different pieces of evidence fit together in a broader strategy by clarifying why do we believe.
Bert topline results bode well bode well for Brian .
First both studies have identical co primary endpoints reduction in neonatal hospital length of stay and decreased neonatal morbidity and mortality.
Second both studies heavy diverse demographic that is representative of broad racial socioeconomic and pre existing risk profiles.
Third the multimodal clinical intervention strategies prescribed in the protocols of both studies are the same or similar specifically this includes the use of low dose aspirin.
At the same form of progesterone and additional care management for mothers identified by the preterm tests to be at higher risk of premature delivery.
Care management consist of more frequent clinical monitoring and more intensive education for higher risk patients.
It's also important to note that while these similarities between averts and Prime gives us optimism for the Prime study, there's always the potential that differences could weigh in the other direction.
Pointed out a few of the preterm trial was performed within a single cell system, while prime involves over 15 sites, which could lead to possible differences in administration of the study and adherence to the trials clinical protocol across these sites as.
As another difference all patients who returned in a burst were treated before COVID-19 was prevalent locally in Delaware and ended the study early well some patients in prime will have been treated during the pandemic and others. After the pandemic is substantially Wei Wang.
Finally, the prospective randomized controlled as a sign of prime is a stronger study design.
The evidenced generated that historically controlled avert preach from trial.
Furthermore, the overt included approximately 10000 historical controls prime is a much better powered study in that it includes approximately twice as many subjects and its prospective arm at the interim look analysis and almost four times as many at full enrollment the larger size of the testing.
Armed with the Prime study helps to provide higher statistical power.
Oftentimes clinical studies are statistically powered at approximately 80% to see the effect of interest the primary outcomes at school enrollment. The Prime study was designed to have that level of statistical power for the interim look analysis before the trial is fully enrolled and even higher power for the final readout.
Considering these and other factors while we believe these results are encouraging given these differences are clinically not completely predictable.
But the other prime trial, and we must wait but we missed the weight results to know to what extent they support serious preterm test and treat strategy.
In that regard. It's also important to recognize that many studies and for a number of reasons interim look analyses analysis endpoints are met and studies usually proceed to their original Prespecified final enrollment numbers at which time. The final analysis occurs it is.
Room look allows the external monitoring group overseeing the study did you.
Determine whether the study enrollment should continue and then recommend either continuing enrollment of the trial, which happens in most cases or ending enrollment early because the interim look the results are good enough that continuing to enroll patients who is inadvisable.
We are encouraged by the data, resulting from controlled prospective studies, thus far and look forward to sharing the results of the Prime study with you as soon as we can.
Now a word on serum biomarker pipeline Leslie let me take a moment to update you on our biomarker pregnancy pipeline, specifically, our preeclampsia preeclampsia prediction.
About 5% to 8% of all pregnancies are impacted by preeclampsia sizable medical problem among expectant mothers.
Most serious preeclampsia is preterm preeclampsia occurring before the 37th week of pregnancy, and which is more severe for mothers and babies preterm preeclampsia poses a most challenging clinical decision for the physician at the time of when to deliver the baby is that there's a need to belt serious.
Adverse outcomes.
And completely developed newborn against the rapidly deteriorating health of the expectant mother medical that can be at odds with one another identification of these cases well in advance before clinical preeclampsia occurs enables more informed and proactive decision, making and management.
Late last year, we successfully clinically validated the prediction.
Preterm frequents, yet and made the validation and the public to the scientific community and now the manuscript is being prepared to submit the data shortly or publication in peer reviewed scientific journal.
The only rigorously validated pre.
Preeclampsia predictor when it finishes in asymptomatic, we believe that our work on pre term pre classic is groundbreaking and valuable.
We will determine how and when it is commercially.
It sort of a broader portfolio of pregnancy test will provide valuable information to doctors and patients.
In summary, we are continuing to build the solid foundation of data to enable us to carefully implement our commercial strategy as we can.
Also work to extend our runway we are pleased to see the progress and expected to continue strongly during this year I'll now turn over the call to Jay for a review of our fourth quarter financial results.
Thanks, Greg and good afternoon, everyone.
Let me briefly review our financial results for the fourth quarter, and then I'll provide some color on what our views are for 2023.
Revenue for the fourth quarter of 2022 was $65000 compared to $26000 for the fourth quarter of 2021 as we noted in our last earnings call. We expect the testing adoption and commercial traction will be more impactful on our top line in 2023.
Total operating expenses for the fourth quarter up $10 $5 million were down from $12 $6 million for the same period a year ago.
Research and development expenses for the fourth quarter were $3 5 million compared to $3 $1 million for the fourth quarter of 2021 as a result of increased head count and research activities.
Selling general and administrative expenses for the fourth quarter of 2022 were $6 9 million. This was down significantly from $9 $5 million for the same period, a year ago due primarily to the steps we outlined in our prior earnings call to streamline our sales force and focus our commercial strategy on.
Early adopter systems. It is noteworthy that this.
The significant decrease in SG&A did not negatively impact our revenue during the year.
Net loss for the fourth quarter of 2022 was $9 $7 million down from $12 $5 million for the fourth quarter of 2021.
As of December 31, 2022, the company had cash cash equivalents and available for sale securities of approximately $104 million, which did not include the AR receivable of approximately $6 million collected in the first week of January .
With the cost reduction actions, we took in the third quarter of last year, coupled with our solid balance sheet and prudent management of our capital resources. We continue to expect this will give us operational room to execute our strategy into 2026 without having to raise additional capital.
Given that we are still in the early stage of market development, the availability of new positive data both the preterm trial and other Readouts later this year all of which are of keen interest to early adopter customers and the growth we experienced last year on a small base. It is still difficult to predict precisely what the revenues will be for this year.
However, we currently believe that 2023 revenues will be less than $1 million.
I'll now turn the call back to Greg Greg.
Thank you Jay and thanks to all of you for attending our call today.
We are looking forward to an exciting 2023 and see a number of valuable achievements potentially taking place this year, but I think as you.
The anticipated positive impact of the adverts study additional study results being published completion of the interim look analysis of prime and announcements of additional commercial implementations. We are strongly positioned to address prematurely and other adverse conditions of pregnancy.
That's what drives us improving the health of both mothers and babies by providing valuable pregnancy information to the medical community and patients.
<unk> of health can actually drive down health care costs. We believe that this provides a win for all parties mothers babies and families as well as medical professionals and payers.
And with that we'll open up the line for questions operator.
Thank you Greg we will now begin the question and answer session to ask a question you May Press Star then one on your telephone keypad.
Using a speakerphone please pick up your handset before pressing the keys.
To withdraw from the question queue. Please press Star then two.
At this time, we will pause momentarily to assemble our roster.
Today's first question comes from Patrick Donnelly with Citi. Please go ahead.
Hey, guys. Thank you for taking the questions you bet, Greg Greg maybe you Wanna be avert interim readout. There obviously the data looks pretty good can you just talk about the.
Potential for that to increase some payer conversations is that enough, where we're folks you can kind of bring that I know a lot of the reimbursement kind of was thinking they will come after the full trial readout, but does this.
Start some of those conversations and maybe pull forward potential payer decisions, maybe just help frame up how we should think about that yeah. Great question. Patrick first of all the the averts readout was not an interim look just to just to be clear those were top line results.
From from.
From the final analysis, we will make sure that's clear to people.
You're absolutely right. There's been there's been keen interest in the announcements payers always wants to see a peer reviewed publication of more fully reports the results of the trial and others because that process typically.
Typically take months the impact on 'twenty through revenues is not yet clear. However, I can tell you that following that announcement, there's been keen interest on the part of payers with whom we are having conversations and we anticipate that to accelerate as the results themselves become available.
Okay. That's helpful. And then maybe on the on the sales side of it Jay touched on the expense side, a little bit there at the at the end just how do you think about 'twenty three on the expense side in terms of scaling up the sales force maybe just in terms of head count whenever wherever the best metrics.
Or just how you think about <unk>.
For this year, just as we kind of think about the model and then also just the sales force side.
Yeah I'll make some.
Some general comments and Jay can add anything to this.
Our focus is really on early adopter systems, and we're configuring ourselves forced to make sure that we can go after them effectively and so that that's one of the things that we're really looking at as we go into this year and clearly those discussions are beneficial because you it's not like getting a single Doctor office to order it.
Youre getting a system to adopt doing the testing and the potential is much much larger and we believe it's a more efficient way of addressing the market. So that's what we're doing as we as we identify reagents and sometimes there are people itself dominate because they have high interest in the test they contact us.
It may be in an area, where we don't yet have people, we evaluate those in real time, and we decided where it makes sense to deploy our people.
And of course, if a customer is interested in doing something we will always talk to them about ways that they could bring bringing the testing on so we react to the data in and that allows us to efficiently.
Grow the market as demand itself grows Jay.
Yeah, I think Patrick that there won't be an appreciable increase in 2023.
Okay.
And maybe just last one just.
Just on the revenue J I think you said kind of below a million for 'twenty three.
Is that just.
Payers coming on a little slower or is it volume I'm just trying to figure out the delta here, Yeah, we were thinking a little more kind of back half ramp maybe it's some conservatism maybe just talk about I guess, the moving pieces and then also just the potential upside is it if you've got a couple of payers on board does that number move meaningfully.
Love some more color on that.
Yeah, I think we just have to understand that we're in the early days of commercialization.
And where we believe were typical of companies in the diagnostic space.
You know beyond that I don't have a whole heck of a lot to add.
And what we mentioned in the call.
So are we.
We.
I look forward to you know more data coming out and we believe that that would be helpful and are growing our revenues.
Understood. Thanks, guys.
The next question comes from Andrew Brotzman with William Blair. Please go ahead hi.
Hi, Andrew.
Oh, Hey, guys, there's some stuff in on for Andrea.
Okay.
Hey, How're you doing.
To maybe fall on Pat's question, I know Theres a lot of.
Uncertainty this year and it's hard to predict revenues, but is that signaling maybe that prime comes in.
Towards the end of the year like maybe in the third quarter fourth quarter and that doesn't allow adopters to really pick up.
Any utilization of the test there that any signaling of a laser that's expected tax rate.
Prime for this year.
That's a really good question and let me, let me give some clarity to the.
Expectations are.
First of all as we said earlier payers want to see final publications ultimately.
Is it indicative of showing benefit.
We will have.
This year, we have we have some anticipated events this year that.
We expect to see more publications this year and being able to show people more data.
As we move forward. So that will help there are some early adopter payers to say there won't be enough data with those kinds of things that they would be willing to move forward in advance of prime well. There are other payers that say they want to wait until the final results are available from prime and remember it's the interim look.
We are that we're going to have this year.
The 2800 patients.
Being enrolled it takes time for those patients took a look at take the several months. It takes time to get to before you go after.
After the last.
While their mother leaves leaves the hospital.
So clean it up and we do that in real time to try to speed it up but there are some requirements there.
Analysis is performed and then the results occur so what what we can commit to right now is that everything is in place.
That oh that trial to habits interim look by the end of the year.
And what if the.
What we will be doing for sure.
We will be we will be giving.
A statement when we complete enrollment it could happen this year.
Or it may have some later, so we'll see where that where that goes but we.
We think that the.
We're fairly confident that the interim look will be able to take place during this year.
And that's the first step then the final analysis again, but with patients will be enrolled in that study. During this year. The final analysis will won't be available once the last patient has been deliberate once the data plays out for the final interim look is first in the final analysis.
Becca.
Yeah that helped make sense, yes.
So more on the early adopter systems I was one wondering if you could go into more detail on the.
The willingness of each of those to interact with you have some them more promising than others, such as like universities or.
Self insured employers.
And then what is really required to drive that utilization. Once these networks are signed.
Yeah, a great question.
What I would say.
The integrated delivery networks.
Of the physician groups is positioned to hospital groups.
Yeah.
Managed Medicare groups are very very interested in that.
Discussions are very positive about how we could move forward.
Toward implementation. So those are those are key targets that were really going after.
And what does it take it takes our commitment and our coordination of all the activities so that the.
Physicians are parts of these of these systems.
And Andy and the operational parts of the system can be coordinated to actually perform the testing and as I said before in my remarks, not only are we talking about the data and how important the ADR, we're actually exploring ways to help them to implement the testing within their systems.
Okay, great. Thank you.
Okay.
Reminder, to ask a question you May press the star key followed by one.
The next question comes from Todd Stevens with T. D. Cohen. Please go ahead.
Okay excellent. Thanks for taking the question here. So this is more focused on on kind of crime and what you have out there is always kind of mean that so if we assume you kind of hit statistical significance in that interim.
Once the material impact on making more policy there.
Yeah.
How does the materiality of that impact your ultimate ASP.
You hope to get from some time.
Well I'll.
I'll, let Jay talk about ESP, what I would do I will talk about the material impact.
A positive interim.
Means that one or one or the other or both.
The primary endpoint.
Okay.
And Oh.
In the case of the Averts two trial both of them are met.
And with that.
It is substantiate even strong more strongly.
Of the.
That's the strategy that we had up for free.
So that that allows discussions to take place.
With systems.
And for people to to be to be thinking about what this means in terms of.
Their risk and as with any with any new product there are early adopters.
Doctors are late adopters.
And we believe they will be beneficial.
More positive data is always beneficial and our strategy is to ultimately.
Get to a point, where the data are overwhelmingly strong from multiple studies showing that there's a positive impact on the outcomes that matter most and those our length of stay because that's what generates cost.
And secondly, and most importantly, the individual a benefit.
So that's those are the primary outcomes.
Got it.
Jay do you want to say.
Yeah.
Yeah sure I think that anytime you get stronger data, it's going to help improve our you know our our speeds.
As more payers adopt the.
Strong reimbursement of the pre term test.
Got it thanks, and then just just kind of looking long time, so it sounds like it's very much linked since yeah.
We'll read out maybe mid 'twenty four and then there's going to be a long sign up get reimbursement. There just a couple of details on the reimbursement angle and then just.
A question on kind of the mature team of revenue when you kind of get that so.
On the first one just like.
Yeah, I mean, he thought that my timeline to think about.
Finding things off and then secondarily.
Well they also reimburse all the follow up treatment required.
And treatment interventions required to actually see those cost benefits and how do those play into your house economic models.
Yeah.
Yeah, Okay I'll.
I'll try to answer that.
Make sure I got it right, Okay, Tom it's just making sure.
With.
Garden to the reader.
And Readouts.
<unk>, what we've what we're.
The guidance that we're giving to people.
Those are the best part of this year, we will complete be a term book of the Prime study.
Once the Prime study is fully enrolled.
And that could be at the time of the interim.
Once it is fully enrolled at that point.
You still have to wait for the babysitter, most recently intervals.
To be born.
The outcomes.
And for the data cleanup was effectively take playbook.
It is is several months, we're not we're not prepared to something.
At this point in time.
The what we what we can tell you is we have we.
We have the 2800 patients need it for the for the interim look to take place this year.
And it would be it'll be later.
The final look would be available.
That makes sense.
That that makes more sense and then just just following up on.
On the reimbursement side.
Positive plot it out do you expect.
Insurance to cover all of the other interventions required to ensure that you know you get the impact on Nikki mortality.
Patrick.
You've.
You actually answered the question somewhat and in all expanded.
The health economics are really important.
And what we've demonstrated in multiple health economic analysis is very.
Very cost effective.
Savings to payers are enormous.
But through.
Through the implementation of the test and treat strategy identify the patients.
Who have higher risk of pre term delivery and as.
Clinical data are showing by impacting them positively they spend less time in the in the NICU. They have fewer complications the baby's are healthier and that paid benefits 2222, the sort of a child and mother first.
Families to the.
To the medical community to the payer. So we believe that it's totally aligned with me with the idea of saving money and that also gives you a sense of the amount of savings.
It generates it gives you some sense of where we're pricing makes it makes good it makes it makes it you make good decisions about pricing and.
We believe that increases the value of the test. So we continued positive results from our what we're what we're looking for.
We will we will know when the study says I've read out in their final form.
Yes.
Yeah.
Have a good idea.
Alright, thanks for calling back so they're going back.
Well I think well have a pretty good idea from an answer of what we're where we're at where it should track.
Alright, Great and then there's just last quick one so you kind of assume that at $2 50, a S T and twenty-five what kind of gross margin should we be expecting on that.
Oh, we've not really talked about the 50 S.
S P.
We haven't we haven't put anything like that.
Jay.
Kevin we haven't put any guidance out on the S D or gross margins Yep that's right.
Yeah, I'll get out and I'll get back a week.
Just wonder what is the rate we expect it to change.
And we believe in the SPT.
Gross margins will change as the volumes get larger as we get more payers under contract all of those things.
Will we believe will cause changes in that.
We can't we can't quantify the magnitude of them yet, but it is certain that they will not they will not to say I get it.
Robert.
Alright, great. Thank you.
Mhm.
As a reminder to ask a question you May Press Star then one.
The next question comes from Francois <unk> from Oppenheimer. Please go ahead.
Alright, thanks for taking the question.
I dropped off for a second we came back on so I apologize if you mentioned this but.
Can you just maybe you can talk about the importance of after the topline data for a very at the endpoints of the publication.
Can you just maybe explain why you know the publication is there something specific in there that we should really pay attention to that people are going to want to see them and I guess the follow up to that question is when the interim prime topline comes out which I assume will be similar.
You know readout in terms of format that you did for a very.
Is that enough or at that point, our people are going to want to see that publication as well and if so I assume you would you would not have a publication on interim look thank you.
Yeah.
I'll answer the.
I'll answer the first question.
With regard to the convert study we.
We announced topline data.
Herb look its topline data so what's the top line data.
And with a publication coming we believe it will be months before we see it in publication, but we are able to share it.
Data very very carefully.
With with certain individuals.
And does that that that's something that we are we take very seriously as a company to make sure that we when we do things in accordance with the desires of the authors of these things they they want a publication come out we're working as fast as we can with the with them to help them to two.
Submit the paper for review and to get them published as soon as you can.
The payers.
Like to especially the medical policy side of players they want to understand deeply.
What's the source of the data.
The source of the data is it wants to know what the differences are in their control.
There's a population that has intervened to pause it wants to try it in and.
See what the benefits of the strategy actually ends up being.
And to do that they oftentimes.
I would like to see the full the full publication they'll talk about it ahead of time.
And in those kinds of conversations are taking place with people as we prepare clinical our clinical data that have an economic impact.
The kinds of discussions are happening in real time with payers with a number of them.
Does that help.
No that helps a lot in there, but what I was also wondering Dara has understood that Bert was full data, but in terms of crime you I assume you will not have less the interim is so strong that they advise you can stop the study and then yes, you can have a publication on it but is it I guess my question is is there.
We're gonna be as important for the parents to see the publication on our prime or the top line might be mortality given it wont be historical data as a control here.
The the Hum.
One or more of the endpoints is that.
The.
Modest board could could say stop the trial now.
But what was that.
Up until the time that that happens we are continuing to enroll patients.
The actual number of patients that will be.
Why only enrolled is much larger than the 2800 that are there that are in place now.
To take place and it takes time again for those deliveries to be completed.
That.
There are some payors and some systems are there.
The early adopters and say, having having oh look at.
That data thus far gives us gives us a lot of information that work are we are we are comfortable.
Moving forward earlier than that.
The final the final read out of the Prime study there were others that will say well, we want to see that that card flip before we decide.
Two popular so it's variable it depends on what their interests are dependent for sub system. It depends on what they're experiencing with regard to pre maturity, but they have extremely high complication.
Hybrid complications occurring in the population that are insuring and it's a pain point for them.
They are they are oftentimes more apt to want to move forward sooner is that its really variable if you look across all sorts of payers.
Understood that's very helpful. Thank you.
You bet.
Again, if you have a question. Please press Star then one.
Seeing no further questions in the queue I would like to turn the call back over to Mr. Peter Dinardo for any closing remarks.
Thank you M. J. This concludes the call and we look forward to providing an update on our business. When we report first quarter 2023 financial results.
You and good afternoon, everyone.
Yeah.
The conference has now concluded. Thank you for attending today's presentation you may now disconnect.
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