Q3 2023 Sight Sciences Inc Earnings Call
Ladies and gentlemen, thank you for standing by welcome to the site Sciences third quarter 2023 earnings results 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 one on your telephone you wouldn't.
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Your question. Please press Star one one again please be advised that today's conference is being recorded I would like now to turn the conference over to your speaker today trip Taylor Investor Relations. Please go ahead.
Thank you.
During today's call.
Co founder and Chief Executive Officer, Paul <unk>, Chief Financial Officer.
Ali Bauerlein and Chief commercial officer.
Thanks, Brian.
April results for the three months ended September 32023.
A copy of the press release is available on the company's website at investors.
Thanks.
I'd like to remind everyone that comments made by management today and answers. The questions will include forward looking statements.
Any of the federal Securities Law.
Include statements related to <unk>.
The financial performance and operating results cost savings initiatives market opportunity is missing product reimbursement strategy clinical trial results and plans for developing and marketing new products.
Forward looking statements are based on estimates and assumptions as of today are neither positive nor guarantees and are subject to risks and uncertainties that may cause.
Our actual results to differ materially from those expressed or implied by these statements.
A description of some of the risks and uncertainties that could cause actual results to differ materially from those indicated by the forward looking statements on this call can be found in the risk factors section of the company's public filings with the Securities and Exchange Commission.
The company undertakes no obligation to publicly update or revise any forward looking statements, except as required by law.
On this call management may refer to financial measures that were not prepared in accordance with generally accepted accounting principles in the United States.
Adjusted operating expenses.
These non-GAAP financial measures are important indicators of its operating performance because they exclude items that are unrelated to it may not be indicative of its core operating results.
The company's earnings release for a reconciliation of these non-GAAP financial measures to the most directly comparable GAAP measures.
I will now turn the call over to Paul.
Thanks Tripp sites.
<unk> Sciences mission is to elevate the standard of care for glaucoma and dry eye patients by providing high doctors with market, leading interventional technologies focused on the preservation of site and improving the quality of life for all patients.
We are confident that we are redefining the glaucoma and dry eye treatment paradigms.
To continue these efforts currently our main focus is on establishing and maintaining and enhancing market access to our innovative technologies and clinically effective procedures to ensure the best treatment options are available to all patients.
Based on the clinical efficacy profile of our product coupled with demonstrated integration into routine clinical practice, we strongly believe our surgical glaucoma products should continue to have broad reimbursed access.
Turning to discuss where we stand with market access in our surgical glaucoma segment. We were extremely disappointed with the final LCD that was published by WPS on October 26.
<unk> identified certain procedures as investigational and patients over the age of 18 for glaucoma management, including can alloplasty in combination with trabecular <unk> <unk> turn out to the procedural description WPS associated with omni.
We strongly disagree with the LCD coverage limitations with respect to these procedures and we are pursuing all remediation possibilities to maintain Medicare coverage in the states administered by WPS.
We do not have any further updates at this time about the draft LCD is published by the other formats and jet.
If these proposed LCD are implemented as currently drafted.
Any non implantable makes technologies would be considered investigational and non covered for Medicare beneficiaries in the state administered by these Max.
We believe coverage for omni is supported by a significant body of peer reviewed clinical evidence demonstrating consistent safety and efficacy.
Broad FDA cleared indication for use for IOP lowering in adults with primary open angle glaucoma.
And broad adoption by ophthalmic surgeons, we strongly disagree with the LCD and are working tirelessly to prevent loss of coverage for <unk> in combination with trabecular <unk> internal.
With regard to our scion technology used for Goniotomy procedures, we are seeking further clarity as to whether it falls within the coverage limitations of WPS is final LCD as well as the other draft LCD.
Gemini to a prospective multicenter study to obtain 36 month follow up for patients treated in the original 12 months. Gemini study has been completed and favorable results demonstrates sustained IOP and medication reduction at 36 months for Ami.
These results have been submitted for peer reviewed publication and we expect they will be published in the coming months, which will add further long term evidence of the safety and effectiveness for omni that we believe should meet wps's coverage requirements to be deemed medically necessary and reasonable.
Our position is at WPS should pause implementation of its final LCD and the other format should institute a temporary hold on publishing additional future effective makes LCD is to allow for full consideration of multiple missing studies pending studies for Gemini two and Iris registry data.
As well as resolution of what we believe are material substantive and procedural flaws in the WPS LCD and LCD process.
As a result of the uncertainty in the reimbursement environment. We are also actively taking steps to protect our cash reserves and reduce our operating expenses, while driving enhanced focus on our key strategic priorities.
Separately as part of our long term market access strategy back in May of this year, we applied to CMS to establish new procedure codes and assign them to new technology ambulatory payment classification, or new technology apc's for the unique multi modal and comprehensive intervention procedures.
Enabled by our omni technology, which we call. It T core are trabecula canalicular outflow restoration.
New technology APC designation as provided by CMS to establish payment for facilities like hospitals and <unk> for procedures that are not fully and appropriately reported with existing codes. We believe the T core procedure fall squarely into this category.
And our applications, we requested that CMS create three new C codes to describe the Standalone T core procedure and the T core procedure when performed in conjunction with routine or complex cataract surgery.
We also requested that CMS has signed the Standalone T core procedure and combination cataract procedures to new technology APC is consistent with the cost data and invoice is provided to CMS associated with furnishing these procedures.
We are awaiting feedback from CMS on our request to establish new C codes as part of the new technology APC designation process.
<unk> issues. These determinations on a rolling quarterly basis.
In summary, we believe WPS should pause implementation and revise its final LCD. The other formats should stay their publication and revised future effective makes LCD and CMS should create new C codes to describe T core.
While we do not control the timing or ultimate outcomes. We believe the evidence clearly and convincingly supports continued fair access to our omni technology for patients and providers.
On other fronts and one of the more exciting clinical developments for omni. This year, we collaborated with Verona health to leverage the AOS Iris registry to better understand the clinical value proposition of mixed technologies in real world settings on a very large scale. We believe this represents the most comprehensive.
<unk> dataset ever assembled.
Parana health compiled data from over 100000, glaucoma patient dies to evaluate long term two year post surgical outcomes for the three most commonly used FDA approved or cleared makes devices in the United States as well as cataract surgery alone.
9000 of these eyes were treated with either omni hydrous microstat for Istent inject combined with cataract surgery.
The remaining is received cataract surgery alone. The complete details of this study have been submitted and are under peer review by top tier journal.
At the two year endpoint and in the full omni cohort of 428 patients and 541 eyes treated specifically with omni technology.
The T core procedure delivered clinically and statistically significant improvements in mean IOP and medication reduction.
Moving to the larger cohort of all patients in this study receiving any of the mix interventions at the two year endpoint. The T core procedure with omni technology delivered the numerically greatest IOP and medication reductions compared to hydrous, istent inject and cataract surgery alone.
This study corroborate existing peer reviewed literature and supports our thesis that technology that enable comprehensive interventional procedures by targeting the underlying causes of disease in a minimally invasive manner can deliver highly compelling long term safety and efficacy outcomes for patients.
This analysis.
Assist developed from the independent Iris data is extremely valuable and we think it can help inform surge in decision, making when considering treatment options for glaucoma patients going forward.
We expect to continue our work with Verona health to explore additional datasets the leverage of the Irish registry to further validate the clinical efficacy of our technologies.
Turning now to our dry eye business, our care care technology can provide safe and effective procedural intervention for millions of patients suffering from <unk> gland disease.
The traction generated by our controlled commercial launch in a cash pay environment is evidence of not only the technology's market fit with our eye care provider customers, but also the consumer demand for interventional dry eye procedures, which address the root underlying cause of evaporative dry eye disease.
With extensive clinical experience and feedback from the market. We believe this demand would accelerate with appropriate insurance reimbursement.
On our last call we reviewed the top line success of our Sahara RCT.
Six months results were presented last month at the American Academy of Optometry is annual meeting and we also held an investor event last Friday at the American Academy of Ophthalmology meeting to review these results in more detail.
This is the HERA trial achieved its primary objective six month endpoint, demonstrating the superiority of interventional island procedures enabled by tier care over Restasis prescription eyedrops and the improvement of tear breakup time are key but at all measured time points, one week, one month three months and six.
Months.
<unk> is a key measure of aqueous retention tier stability and the tier films ability to protect the ocular surface.
Patients receiving care care treatment exhibited statistically significant improvements in <unk>, but from baseline that increased from a one and a half second improvement from baseline at one week, two or two and a half second improvement from baseline at six months.
Dear Karen Restasis also delivered comparable clinically and statistically significant improvements at every time point measured and patient reported outcomes measured by ocular surface disease index, our OSD scores the trial's primary subjective endpoint.
We believe the combination of clinical outcomes from this groundbreaking RCT and a rigorous budget impact model that demonstrates the compelling comparative health economic value of tier care will together serve as the foundational building blocks to achieve fair market access for tier care.
We plan to begin payer discussions in early 2024 upon publication of the six months of HERA clinical data and completion of our budget impact model.
Although the reimbursement process requires considerable time effort and investment we are confident the results of our efforts can improve the lives of the millions of dry eye sufferers, who lack access to effective mgd treatment. We are happy to be leading the way for this important clinical cause and societal need.
Our highest priorities for tier care, our market access execution payer education and existing account support.
As a result, we have scaled down dry eye commercial resources by approximately 50% to focus more on market access execution and the publication of additional clinical data from Sahara, such as the one year crossover data that we expect will further enhance our market access initiatives as we await market.
Access wins.
We expect <unk> sales in 2024 to be modest as we focus instead on building long term value through market access and payer education throughout the year.
In summary at site Sciences, we create and commercialize intervention technologies and procedures that comprehensively address the underlying causes of eye disease. We.
We have produced substantial body of clinical evidence that demonstrate the clinical value of both our interventional T core glaucoma procedure with omni technology and intervention will dry eye procedures with tier care technology.
Both procedures have demonstrated substantial potential to improve treatment paradigms and elevate the standards of care.
As we work to maintain and achieve fair market access for both technologies, we are poised to positively impact millions of patients' lives, while driving more profitable growth.
I will now turn the call over to Ali to discuss our financials.
Thanks, Paul before I go into the third quarter financial results I want to provide additional commentary on our cost reduction initiatives.
As we announced in mid October we implemented a targeted plan intended to reduce operating expenses improved cost efficiencies and better align our operating structure for long term profitable growth and further extend our cash runway we.
We've reduced our head count by approximately 10% or 25 employees.
Specifically, we reduced our commercial infrastructure and operating expenses within our dry eye business segment, including approximately half of our dry ice sales and marketing employees as we shift our commercial focus to market access payer education and higher utilization within existing accounts and secondly, we eliminated certain positions.
<unk> and the surgical glaucoma commercial support infrastructure deemed non essential to continued surgical glaucoma account penetration and revenue growth.
In addition, we reduced our operating expenses principally by implementing measures to limit marketing costs, primarily for care care limiting general administrative costs and delaying replacement hires for certain roles.
We estimate the workforce reductions alone will yield savings of approximately $7 9 million on an annualized basis.
We also estimate that the other cost savings measures should yield SG&A savings of an additional $5 million on an annualized basis, our total annualized savings of approximately $13 million, which such with such savings primarily being realized starting in 2024.
Lastly, given the additional reimbursement uncertainty in our industry, we are evaluating other cost reduction opportunities to extend our cash runway.
We have more material information to share we will provide an update.
Moving back to the third quarter total revenue for the third quarter was $20 million, representing 7% growth compared to the third quarter of 2022 and at the top end of the guidance range. We provided mid September.
Surgical glaucoma revenues for the third quarter were $18 4 million up 8% versus the comparable period.
Over 1100 customers ordered surgical glaucoma products in the third quarter up 16% compared to the third quarter of 2022, but down 2% from the record second quarter of 2023.
Utilization of ordering count was relatively flat in the third quarter compared to the same period in the prior year, but down sequentially by approximately 10%.
Well our customer retention remains strong we believe we experienced lower utilization from ordering accounts and lower new account additions than expected primarily as a result of the uncertainty, resulting from the proposed LCD and more pronounced summer seasonality.
While this impact was higher than the areas covered by the <unk>, we saw an impact to utilization and ordering accounts across all geographic regions.
Our drive <unk> revenues for the third quarter or $1 6 million down 1% compared to the third quarter of 2022 and down 24% compared to the record second quarter of 2023.
We believe the decline was primarily due to the evolution of our commercial strategy, which emphasizes driving higher utilization within existing accounts as we focus on market access and more pronounced seasonality pattern.
For the third quarter of 2023, we had 318 active dry eye customers over a 40% increase versus the third quarter of 2022.
Additionally, we sold 5090 dry eye treatment lids in the quarter and 8% increase versus the comparable period.
Both of our core operating metrics for dry eye improved compared to the same period in the prior year. Our total revenue was down 1%, primarily due to fewer new customers added in the period, which led to lower smart hub revenue.
Gross margin for the third quarter was 86, 6% compared to 84, 3% in the same period in the prior year.
Our continued strong gross margin was due to improvement in both surgical glaucoma gross margin and dry iqos market.
Michael Glaucoma gross margin improved primarily due to manufacturing efficiencies generated because of higher production volumes, partially offset by lower average selling price due to product mix.
Gross margin improved primarily due to lower manufacturing costs and increase of higher gross margins heartlands versus smart hub and higher average selling price of smart hub.
Total operating expenses for the third quarter were $30 7 million, a decrease of 18% compared to $37 6 million in the third quarter of 2022.
Adjusted operating expenses were $26 8 million for the third quarter down from $33 3 million in the same period in the prior year and well below expectations of our average quarterly target of $35 million.
The decrease in operating expenses in the comparable periods was primarily driven by $3 $6 million lower personnel related expenses, including lower incentive based commission expense of $1 9 million, mostly due to lower than expected revenue and <unk> 9 million of restructuring costs incurred in the third quarter of 2022.
Did not repeat this quarter.
In addition, we incurred $1 $2 million lower clinical trial costs in the third quarter compared to the same period in the prior year.
R&D expenses were $4 2 million compared to $6 1 million in the third quarter of 2022.
SG&A expenses were $26 5 million compared to $31 $5 million in the comparable period in the prior year.
Our loss from operations for the third quarter was $13 4 million compared to a loss of $21 8 million in the third quarter of 2022.
Our net loss was $13 million or 27 per share in the quarter compared to a net loss of $22 2 million or <unk> 46 per share for the third quarter of 2022.
We ended the quarter with $144 5 million of cash and cash equivalents and $35 million of long term debt, excluding debt discounts and amortized debt issuance costs.
We used $10 million of cash in the quarter, representing continued operational discipline and a sequential improvement from $12 8 million cash used in the second quarter of 2023.
Moving to guidance, we are withdrawing our full year 2023 revenue and adjusted operating expense guidance due to the uncertainty caused by the final LCD published by WPS and the proposed LCD issued by four other Mac.
Due to the lower sales volume, we expect gross margin in the fourth quarter of 2023 to decrease sequentially as overhead cost per unit increase versus the prior period.
However, we still expect gross margin in the fourth quarter of 2023 to increase compared to the same period in the prior year.
We expect to record a cash restructuring charge of approximately $1 3 million in the fourth quarter of 2023 related to a reduction in force consisting primarily of one time employee severance and benefit contribution costs, which will be excluded from adjusted operating expenses.
We plan to continue to be prudent in our spend and identify additional cost reduction opportunities to extend our cash runway.
Now I'll turn it back to Paul for closing remarks.
Yes.
Thanks Ali.
Our main priorities are maintaining reimbursement for omni and scion, creating new coding that specifically defines the comprehensive interventional procedure delivered by our omni technology, creating a pathway for tier care reimbursement.
Optimizing our cost structure and protecting our cash reserves.
All while maintaining long term investments in core research and development projects for the surgical glaucoma and dry eye market.
Before we open the call for Q&A I want to introduce Matt link, our new Chief commercial officer.
That is a highly talented med tech leader with a track record of success scaling our high growth public medical device company predictably quarter after quarter.
When Matt joined new bases are disruptive orthopedics company to transform spine surgery. It had similar revenue to <unk> sciences today.
Matt methodically and persistently helped lead and scale new bases business over a decade to over $1 billion in revenue.
We believe is market development experience with procedurally focused less invasive solutions utilizing disruptive technology that transform spine surgery is exactly analogous to the procedural transformation of glaucoma and dry eye disease, we have undertaken.
He has already made a significant impact on our commercial strategy and execution rigor.
His leadership will be crucial as we enter our next phase of growth.
Matt will now join us for Q&A.
Operator, please open the line for questions.
Thank you.
A reminder to ask a question. Please press star one on your telephone and wait for your name to be announced to withdraw your question. Please press star one again.
Please standby, while we compile the Q&A roster.
The first question comes from Margaret Kaczor with William Blair. Your line is open.
Hey, good afternoon, guys. Thanks for taking the questions.
Maybe just to start at this point I imagine you've had.
A few if not many discussions with your customers on the WPS update.
Just curious if you can give us any sense on the distribution of discussion so far how many people have indicated they are willing to at least keep using omni for patients outside of Medicare.
Or are they indicating kind of the other way around where maybe unfortunately they'll have to pull back on use until there's a more firm reimbursement update.
Yeah, I can start with that Margaret and.
Paul and Matt can join in as as needed here, but.
This is a very dynamic environment that we're in and at this point most of the industry is still trying to understand what.
What is in that LCD, what does it mean, what are the nuances of coverage.
So that is really what we're seeing from surgeons at this point is first of all seeking to understand and then second of all.
Significant disappointment of the lack of coverage for <unk>. So.
Those seem to be the most prominent factors that we're hearing at this point.
But it is very early since the Ltvs have been published and.
There is a lot of.
Work being done to try and change course here from many parties.
Yes, Margaret we were just completed.
The American Academy of Ophthalmology.
Annual meeting and I can just say that there was there is so much support from the surgical community, they're passionate committed our omni customers.
Who now.
For years have relied on omni to take care of their glaucoma patients there is tremendous support.
From from our surgeon community from our society's state societies National societies.
We're all rallying behind this to get it to the right place and address address these LCD that would ultimately.
If they go into effect takeaway treatment options for.
Glaucoma providers, taking care of glaucoma patients again this is the leading cause of irreversible blindness.
We do need to get this right.
Okay. That's helpful.
Yeah. It was a follow up.
I'm curious if you guys had any discussions with commercial payers either on these proposed macros that final the vps rule at this point.
Give us a sense, let's maybe they would at least hold potential reimbursement changes should they try to copy.
There'll be less WTS headset.
And maybe just kind of a similar question have the society is kind a banded together and said hey, Here's our game plan here is how we can respond more strongly.
Sure.
Yes, so margaret since since the proposals.
There has not been any change in commercial payer cigna around the same time as the proposals.
<unk> is doing.
Diligence on our clinical evidence.
It arrived at our coverage a positive coverage determination. So that's one example in the interim over the past several months since we've been in this LCD process. There hasnt been any change on the commercial side.
Commercial payers will regularly go through their annual cycle to review coverage.
Payers summer some have positive coverage for procedures performed dominate some are silent on it and none of those policies has changed as far as we know during this period. So so far so good on the commercial front.
Great. Thank you guys I appreciate it.
Thanks.
Please standby for the next question.
Yeah.
The next question comes from Callum Titchmarsh.
With Morgan Stanley Your line is open.
Okay. Thanks, guys just wondered I know you touched on that briefly.
Whether you could spend some time talking about the steps you're taking to remediate. The current ruling with WPS and just maybe discuss the timelines on any appeals or similar processes here and then I'll have one follow up thanks.
Yes Carlo <unk>.
Collective effort as you can imagine.
A number of different parties involved a number of different.
Activities, we're working.
We're communicating with the Max directly with WPS with the other four Max.
We're working communicating with CMS.
We're communicating with national our National societies.
Communicating with state societies.
As you can imagine with our very strong omni surgeon customer base.
We're also working with one of our medical device associations medical device manufacturers Association MDMA.
So all stakeholders all stakeholders are aligned here, we feel like we've got tremendous support.
I'll be making.
Our arguments to WPS to the other macs.
As we've been doing we're going to continue to do that and <unk>.
We're very encouraged.
By how much support from all of those groups I just mentioned.
And how how aligned we seem to be to get this to the right conclusion.
Okay, Great and then maybe if you could just provide some color around the reorganized commercial teams whats changed here aside from the reduced head count and how you're thinking about the commercial teams in those regions with anticipated Omni conference removal, because I know the focus of the cuts so far have been skewed towards the dry business. Thanks a lot.
Yes. This is Matt thanks for the question so as.
Paul covered in the Allianz in the prepared remarks.
<unk> was really about restructuring the business and allowing us to be in a place for a sustained growth moving forward thinking.
Thinking less about infrastructure are really more focused on capacity and capability.
And as you know.
Dependent of the.
The final LCD with WPS and the posted LCD, we have two businesses that are at very different stages, and so focusing on the growth potential of the surgical glaucoma business.
But as you heard in the.
The ocular surface and tier care business really looking at the environment focusing on market access, we're really working with our existing customers to understand how best to support their efforts towards increasing utilization.
And the use of the tier care product.
Stated in <unk>.
Our response to a couple of different questions, obviously with the LCD posted by WPS and the other is pending we will need to continue to reevaluate how to optimize our structure to respond to the current environment, but again as Paul just covered.
We're very encouraged despite the circumstances that there is a universal and overwhelming support from all the constituency covered from our individual providers. The Academy other National Society State Society, and other surgical and trade organizations that recognize that.
In the case of WPS, they've arrived at what we see and believed to be as a foundational Lee.
Incorrect decision and so we're focused on working with those other constituents and collaboration to arrive at the right outcome, and then turn back to our business and really focus on the scale and growth opportunities, we see in front of us.
Very clear thanks very much.
Please standby for the next question.
Yes.
The next question comes from Tom Stephan with Stifel. Your line is open.
Yes.
Great.
Thanks for the questions, maybe I'll start with omni coverage.
Really good to see the Gemini 36 month data I think Paul you said should be coming in the next couple of months.
But can you elaborate a bit on what the LCD reconsideration process entails.
Maybe how long that might take once you submit that Gemini data too.
WPS and I guess, maybe.
Others.
Yes, sure Tom happy to take that question. So first and foremost we're focused on trying to reverse course before these that LCD is implemented and also.
Working with other formats to not have those additional lcd's move into a final status until they can consider the information from both Gemini and the Irish registry as well as other missing study is and what we deem is substantive.
Substantive and procedural flaws in the process, but if we do have to go through reconsideration you cannot submit a reconsideration until an LCD is effective.
After December 24th we could submit.
A reconsideration request.
New evidence. So we would have to have new information that the Mac had not already considered and we would submit that through a reconsideration process.
That process can vary quite significantly and link based on both complexity as well as <unk>.
Back availability and other priorities, but that process could take multi months in in range. So it certainly is a long process, which we believe would be.
A significant issue for patient access during that period, which is why we are so focused on trying to prevent implementation of that LCD.
In the interim period.
Got it that makes sense that's helpful and then al.
I'll stick with you.
Just on the balance sheet.
If you can it would be helpful.
Maybe you could provide a bit more detail.
Just on the construct of the runway you believe the business has I know you guys, obviously pulled the opex.
Our guidance this year, but.
Maybe if you can just give us a general framework of what the burn maybe looks like in the near to intermediate term.
Sure. So Tom as we said, we're first of all pulling guidance. So we're not going to provide any specific guidance either for 2023 or 2024 as you can imagine. This is a very dynamic situation that we're in and there are many variation and flavors.
What could happen in terms of coverage for omni and scion and how that may play out with WPS and the other macs. So we are running a variety of scenarios and then focused on what our infrastructure needs to look like in each of those scenarios, but first and foremost priority.
The upcoming week is really on what can we do to try and reverse course here with WPS and potentially.
Our resolve the issue with the other formats.
In terms of our balance sheet as you see we do have significant cash resources right now with.
Sure.
With our cash balances and we've done a good job of managing cash with only $10 million of burn in the third quarter. We would expect to continue to be very focused on where we're spending money in the interim waiting for these solutions too.
<unk> themselves and then we can set appropriate infrastructure, but in terms of absolute dollars. Our scenarios frankly, it's just there's just so many different variations of outcomes here.
We're working through internally, we can't provide that today, which is why we withdrew guidance.
Very fair.
As a reminder to ask a question. Please press star one one on your telephone and wait for your name to be announced.
Please standby for the next question.
Our next question comes from Matthew O'brien with Piper Sandler Your line is open.
Hi, This is Amanda on for Matt Thanks for taking our question.
Hi, guys.
And then on the restructuring here I guess.
You mentioned that some of that would be the next sales force then.
Does that imply or suggest that you are not expecting a quick quick reversal of the final LCD.
Yes, just to start while a portion of the restructuring was associated with our surgical glaucoma business that was really focused on management infrastructure on the commercial side not on the.
The sales rep capacity. So there was some small combining of regions, but really the focus of that reduction enforce on surgical glaucoma with not.
Quota carrying reps, but more management infrastructure that we think really allowed us to be more efficient and effective in our overall structure.
It did not imply anything about our likelihood of success or feelings about the surgical glaucoma business. All of this was done in advance of any decision by WPS. This was done in the middle of October.
Yeah, and just to follow up on Ali's comments, it was actually quite the opposite who is moving the structure flattening the structure.
In a way that we thought it would allow us to enhance our responsiveness to the opportunities in front of US further our engagement with our customers who value the technology Ami and the procedures. We support it was really all about our ability to both sustain and drive more consistent predictable growth in the future. So.
We believe with the structure, we can scale into the future. We obviously understand we need to deal with the matters in front of us, but the moves were all about our ability to support.
And sustained growth moving forward.
Yeah, and just just to add onto that when we were.
Recruiting Matt.
His background scale.
Scaling our business of a similar size to site and scaling it into the one hundreds of millions and beyond two to over $1 billion in revenue.
He sees experienced all the different stages of growth that we're going to be going through now and into the future and I think I think a lot of what we're doing is very familiar to him and it's.
Kind of in his mind, the best in class way of operating our business at today's scale.
Perfect. Thank you for all of that.
Last question from Us.
Could you give us more in details on.
Timing of future WPS interactions or with.
Any of the other formats as well.
Yeah at a high.
High level, we are communicating with the Max I really think it wouldn't be appropriate for us to comment on the specific conversations our upcoming timing obviously.
The timeline that we're trying to address all of this is before December 24th implementation. So the next six weeks is really the critical timeframe for us before it moves into the more formal reconsideration process. So that is really the timing that we would expect to.
<unk> been working with the WPS as well as the rest of the Mac as well as all of the key societies and CMS to try and address that but in terms of specific communication.
At this point were.
We're just working through those.
With the Max directly.
Okay. Thank you so much.
I show no further questions at this time.
I would now like to turn the call back to Paul for closing remarks.
Thank you, we'd just like to thank thank everybody for your time listening into this call. Thank you for your support have a great day.
This concludes today's conference call. Thank you for participating you may now disconnect.
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