Q3 2023 Sensus Healthcare Inc Earnings Call
Good afternoon, and welcome to the Central tell Petcare third quarter 2023 financial results conference call.
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Please note. This event is being recorded I would now like to turn the conference over to Kim Sutton Golar. That's L. A K Investor Relations. Please go ahead.
Thank you. This is Kim go what else with L O J.
You all for participating in today's call joining me from Sensus healthcare are Joseph Giordano, Chairman and Chief Executive Officer, Michael Sardana, President and General Counsel, and Javier Juan Paulo, Chief Financial Officer.
As a reminder, some of the matters that will be discussed during today's call contains forward looking statements within the meaning of federal securities laws.
All statements other than historical facts that address activities sensus healthcare.
In plans expects believes intends or anticipates and other similar expressions will should or may occur in the future are forward looking statements.
Forward looking statements are management's beliefs based on currently available information as of the date of this conference call November 9th 20, twenty-three Sensus healthcare undertakes no obligation to revise or update any looking for any forward looking statements, except as required by law. All forward looking statements are subject to risks and uncertainties.
As described in the company's Form 10-K and 10-Q.
During today's call references will be made to certain non-GAAP financial measures Sensus believes these measures provide useful information for investors that they should not be considered as a substitute for GAAP, nor should they be viewed as a substitute for operating results determined in accordance with GAAP.
A reconciliation of non-GAAP to GAAP results is included in today's financial results press release.
With that said I'd like to turn the call over to Joe Giordano Joe.
Thank you Kim and good afternoon, everyone. Our third quarter financial results reflect the typical summer seasonality and macro economic conditions with economic challenges continuing to affect many dermatologists. During Q3, we shipped 11 systems, including three SRT systems outside.
The U S and five SRT 100 visions to a very large customer.
Total unit sales now stand at almost 720 units and we expect the seasonally strong fourth quarter to help us advance towards our yearly and long term goal.
For Q3 revenues were $3 9 million compared with nine point <unk> million a year ago as discussed last quarters conference call. Many of our customers depend on elective aesthetic procedures as a meaningful source of practice and revenue profit.
And despite hearing encouraging feedback that patient volumes of procedures mix are improving macroeconomic conditions, along with our usual seasonal summer lull made for a soft quarter. However, please note that our main focus has always been on the second half of 2023, we continue to believe in a strong.
On Q4 with five weeks and we used our strong cash position to continue to build inventory. So that we will be able to quickly address demand as our customers adjust to inflation and interest rates utilization.
Utilization of SRT to treat non melanoma skin cancer continues to increase driven by favorable reimbursement and aging population and clinical results that are at least as good if not better than most surgery I'll.
I'll remind you the last quarter. We told you that our review of Medicare's shows that SRT experienced a 27% year over year treatment growth rate for the past six years. If this growth rate continues at its current pace SRT will soon become the treatment of choice for non melanoma skin.
Cancer.
Our confidence remains high and we continue to work concurrently on programs that will address any remaining hesitancy for our prospects and put us back in a growth trajectory.
Our advanced technology is expected to play a key role in our growth with Sentinel I T front and center. This is our HIPAA compliant software with clinical billing and asset management utility that also allows us to track utilization, we enhanced Sentinel earlier this year by adding Sensus club.
<unk> with its remote monitoring capabilities to track and monitor SRT systems. This is ideal for better managing dermatology clinics, we showcased Sentinel and census cloud at the American Academy of Dermatology annual meeting this past March and looking ahead, the fourth quarter is off to a good start with.
And in the fall clinical Dermatology conference and the American Association of radiation oncology annual meeting both in October we are seeing a trend based on the activity at our booth and the attention our products received that these important tradeshows in particular, the SRT 100 vision Sentinel It T incentives cloud.
<unk> abilities. It bolsters, our optimism for the future as we enter Q4, which traditionally is our strongest sales quarter. As a reminder, the census cloud system also allows providers to monitor any service issues, such as calibration monitoring voltage and temperature with.
Having to send an engineer to the field as you May expect satellite T allows us to attract system use in real time and important features that may support new sales programs. We also introduced this year, an important new and improved high resolution ultrasound technology to provide seed entries capability.
This leads to great outcomes and patient reassurances, because the physician can actually see the impact of each treatment on the lesion and lesion resolution after treatment.
Turning to the hospital market radiation oncology is a highly attractive opportunity as it gains interest in the skin cancer treatment market, although selling to hospitals is a longer selling cycle. It is a market well worth pursuing as we build footholds in the channel recall that earlier this year, we sold the system to our heart.
Spittle in the northeast the Beth Israel Deaconess Hospital employment, Massachusetts, and now during Q3, we sold another SRT to Cape Cod Hospital in Hyannis, Massachusetts, and we're engaged with several more hospital systems and believe that the positive experiences of these recent hospital customers will serve as supporting.
As we penetrate this market.
Veterinary market also offers some longer term potential for growth we were delighted that the Colorado State University Veterinary teaching hospital posted on social media. This week that in a clinical trial that they call groundbreaking they treated in horses diagnosed with suites squamous cell carcinoma with us our T. This is the.
Common island tumor in horses.
As you said I quote the initial results are showing excellent success, where eagle are eagerly awaiting the eventual completion of this trial and the publication of this results in a peer reviewed journal so with that overview I'd like to turn the call over to Michael <unk> for a bit more color on our plans and priorities Michael.
Thanks, Joe.
Last quarter I spoke about our efforts to open up new international territories are demanding process that requires regulatory approvals and engaging the right distributors earlier. This year, we were thrilled to sell our first SRT system to Beacon Hospital in Dublin, Ireland, which came just before we announced a new distribution partner.
In the United Kingdom, Mras Health care, we are delighted with this partnership and M. I asked has a good backlog of potential hospitals interested in our SRT systems.
Our focus on international opportunities continues and during the quarter, we sold three systems outside the United States for a total of 10 systems sold internationally. So far this year.
Our goal is to enter three to four new territories over the coming years building. Upon our recently added opportunities in the U K, Ireland, and Latin America, where we sold the first unit into Guatemala during the second quarter.
With regard to the near future as we discussed previously our plan is to expand our Latin American and Asian footprint as quickly as possible with Brazil, and Japan being longer term goals as they are highly regulated.
With that I'll turn the call over to Javier for a discussion of our financial results.
Thank you Michael and good afternoon, everyone.
As Joe mentioned, our revenues for the third quarter of 2023 were $3 9 million as compared with revenues of $9 million, a year ago, and a $4 5 million in the second quarter of 2023.
Increases versus the prior year was primarily due to a longer number of SRT unit sold as customers continued to defer purchases.
Lower sales to a large customer.
Note that the third quarter is typically slower.
Gross profit for the third quarter of 2023 it was two.
$2 million or 51% of revenues compared with $5 9 million or 65, 6% of revenue for the third quarter of 2022.
Increase was primarily due to the lower number of units sold in mid 2023 quarter.
Going forward, we anticipate that gross margins will remain in the mid 60% range as our sales continue to improve.
So our marketing expense for the third quarter of 2023 was $1 3 million compared with $1 8 million for the third quarter of the document 'twenty. Two the decrease was primarily attributable to a decrease in marketing activity as well as lower operational cost and commission expense.
General and administrative expense for the third quarter of 2023, it was $1 5 million compared with $1 2 million for the third quarter of 2022, the increase was mostly due to higher professional fees, including costs associated with entering into a new credit facility.
Great.
Search and development expense for the third quarter. After 2023 was $1 1 million compared with $27 million in the same quarter of last year. The increase was primarily due to expenses related to a project to develop a drug delivery system for the ice thetic market.
We recently submitted our five 10-K obligations to the U S food and drug administration, and we expect the completion of work on this project by the end of 2023.
Other income of <unk> 3 million for the third quarter of 2023 was mostly related to interest income and this compares with one 1 million in other income for the third quarter of 2022.
Net loss for the third quarter of 2023, it was $1 5 million or <unk> <unk> per share and this compares with net income of $1 8 million or <unk> 11 per diluted share for the third quarter of 2022.
Adjusted EBITDA, which we define our earnings before interest taxes, depreciation and amortization and stock compensation expense was negative one 7 million for the third quarter of <unk> compared with positive $2 3 million for the third quarter of the document.
Our briefly review our year to date financial results.
Revenues for the first nine months of 2023 were $11 8 million compared with $31 4 million for the same period of 2022, reflecting a lower number of SRP units saw as well as lower sales to our largest customer.
Gross profit year to date was $6 2 million or 52, 6% of revenue compared with $21 3 million.
Or six to seven 8% of revenue for the first nine months of 2022.
The decrease was primarily driven by the lower number of units sold on higher cost charged by vendors in the 2023 periods.
So there isn't a market and expands <unk> 5 million for the first nine months after the phone I'm twenty-three concur with four 8 million for the same period after talking about 'twenty two.
The increase was primarily attributable to higher loss ratio expense and head count costs, partially offset by lower commission, our marketing expenses.
General and administrative expense was $4 2 million for the nine months ended September 32023, compared with $3 6 million for the same period of 2022, the increase were primarily due to higher professional fees.
Research and development expense was 3 million for the first nine months after document 23, compared with $2 3 million for the first nine months. After about 122. The increase was mostly due to expenses related to the development of a drug delivery system for our study.
As I just mentioned, we recently submitted our five 10-K obligation to the FDA for this product unexpected project to be completed by the end of this year.
Other income of <unk> 8 million for the first nine months of 2023 was related to interest income while their income of $12 9 million for the same period of 2022, Westwood Ada primarily to the gain of $12 8 million on the sale of a noncore asset.
Net loss for the nine months ended September 30 of 2023 was $3 7 million or <unk> 23 per share and this compares with net income of $21 4 million or $1 28 per diluted share for the nine months ended September 32022.
Net income what is it doesn't on 22 priority towards at $12 8 million gain on the sale of our noncore assets.
Adjusted EBITDA for the first nine months of production on 23 and was negative $5 4 million compared with positive $23 8 million for the first nine months of 2022.
Turning now to our balance sheet.
Cash and cash equivalents as of September 32023, or $25 million down from $25 5 million as of September 31, 2022. The company had no outstanding borrowings under its revolving line of credit as of September 32023, or December 31, two.
122.
As in previous quarters, we continue to prepare for the growth we ambition most immediately for higher expected unit sales during the fourth quarter of 2023.
<unk> been building finished good inventories on prepaying for materials in part to get ahead of inflationary price increases.
The third quarter of 2023 inventories were $13 2 million up from $3 5 million as of December 31 is a documentary Julien.
Prepaid assets were $3 9 million at September 32023 versus $6 3 million as of December 31, 2022.
Our our cash spending very focus on highly disciplined.
Is intended to support our ability to achieve our business goals. Nevertheless.
Continues to position us well to take advantage of the compelling growth opportunities, we may come across or that way that we make to reenter herself.
Anil comment we see the tailwind the news release, we issued earlier today for a reconciliation of GAAP to non-GAAP financial measures.
With that I'll turn the call back over to Joe. Thanks.
Thanks, Javier Thank you Michael as I mentioned last quarter SRT treatments surpassed 480000 in the last two years alone and the ROI for our premium SRT system under our fair market value leasing program continues to be compelling interest and SRT remains high, especially as it relates to our pre.
<unk> product the SRT 100 vision, we do expect to ship significantly more SRT systems in the fourth quarter of this year.
In a statement I make based on historical trends as well as the high interest in SRT and the booth traffic and recent important trade conferences and current prospect activities clinical results in treating non melanoma skin cancer Noninvasively are excellent with published studies showing that SRT is as good or.
Better than most surgery.
This should be reason enough to choose SRT.
Add to that fact that most procedures can leave scars and raised the risk of infection, even depth and the fact that our reimbursement is so much higher than it was two years ago, while most surgery reimbursement has come down and SRT becomes the clear choice. We're very excited to be working to make this choice even easier as treating skin.
Cancer in keywords with SRT becomes a meaningful way of supporting one's practice, considering the current state of aesthetics as the final topic before we take your questions I want to provide you some color on our transdermal drug delivery system known as <unk> and <unk>.
Have you ever mentioned, we recently submitted our 500 10-K application to the FDA and expect to receive clearance in early 2020 for this system will for example allow PRP.
To be applied to the scalp, but a pain free hair restoration experience. In addition, posters have already been presented on the application for hyperhidrosis or overactive sweat glands.
The dermal system includes Sentinel it solutions capabilities as do all six of our sensus branded aesthetics, smart lasers and SRT devices.
We are still in the early stages of tapping the enormous market opportunity for SRT, our systems are well positioned in a large and largely untapped market. They provide a compelling alternative to surgery for millions of patients and arguably the only solution to prevent the recurrence of keloid following surgical excision.
As an overlay to all of this and estimated one in five Americans will develop skin cancer. During their lifetime. This tells us that nearly 70 million people will have non melanoma skin cancer. So clearly there is a need for our SRT systems, both now and even more so in the future. We are confident that census is positioned for success.
<unk>. Despite the challenges we faced since February we have a great staff to drive growth and implement our strategies, which is why we have built inventory to meet the expected demand with those comments I. Thank you for your time and attention and now operator, we're ready to take questions.
Thank you we will now begin the question and answer session to ask a question you May Press Star then one on your telephone keypad.
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This time, we will pause momentarily to assemble our roster.
And our first question will come from <unk> Chen of H C. Wainwright.
Hi, This is mobile and dialing in for <unk>. Thanks for taking the questions. A couple from me so maybe firstly.
Cost of sales remains the same despite a drop in revenue. So is there anything to take note off.
So how should we think about gross margins for the next quarter and maybe in 2024.
So for the next quarter or think about like the low sixties in saying that gross margin.
Okay.
Alright, and then do you expect the macro economy challenges to remain in place through 2024 that could impact your business.
We're expecting Q4 to give us a nice rebound and hopefully launches into a successful 2024 to.
To what point that success will be is going to be determined we will see how Q4 lays out but we're very confident that Q4 would be a good fourth quarter as it usually is and I think it will launch us into a into a better 2024, then of course, what we are experiencing for 2023.
Okay, maybe one final from us. So I was wondering if you could provide some color on the current trend of device utilization rate in the office for dermatology.
Say that again I need to understand it better.
So we.
We would like some extra color on the current trends.
Device utilization rate and the office of dermatologist.
Particularly for SRT.
Yeah, I think that the SRT utilization rate is starting to move up as we've done a review of Medicare Medicaid over the last six years, which shows a 27% compounded increase year over year for the last six years. So we're seeing the volumes in our offices picking up.
That doesn't seem to be a deterrent in any way shape or form a lot more people are choosing SRT versus most surgery, which is more invasive as we know so we see that trend continuing for the foreseeable future and we fully expect that at some point in the very near future.
To have SRT, possibly overtake and most surgery as the treatment of choice.
Thank you very much.
And the next question will come from Alex Nowak of Craig Hallum Capital Group.
Okay, great good afternoon, everyone.
The Q4 bounce back last last Q4, and 2022 I think you did about 36 systems.
Based on the trends and macro environment everything has changed I can't imagine going through 36, but like what's the kind of a ballpark number that youre guiding towards.
Well I think you know.
It's one of those questions were right from day, one I think we talked about 60 units for the year I think that we will reach our 60 unit goal.
After this quarter were at 33 systems I believe so I think that we will get to that 60 unit goal by the end of the fourth quarter.
And that's I mean, that's great to hear can you speak to your your big partners can cure.
What are they seeing out there because obviously the in the capital environment is tough we all know that when you go into the earnings he's been here about other aesthetic names are seeing the impact of the dermatology office.
But.
It sounds like procedures for <unk>, TR, continuing very well.
Same with your partner skincare.
Skincare is seeing that increase as well so that's encouraging but the hesitation for signing on the dotted line to add new installations as we've had the same problem as they've had so we're seeing the same.
Can compare notes and see the same results there, but we're also seeing together with them.
A much better fourth quarter.
I think that we consistently said that the doctors will learn our patients will come back as they learn how to live with the inflationary numbers. So that's on the aesthetics side. The fact of the matter is that skin cancer is something that's not going to go away unless it's treated and theres more skin cancer is being discovered each and every day and so the doctor.
They are finding a very good way of treating that with SRT and I think that it's also a nice complement to the fact that if theyre seeing lower numbers on the aesthetic side. This is certainly a.
Our way of gaining back some of the revenue that they are losing on the aesthetic side. So that they are more balanced as far as their offerings between medical dermatology versus static dermatology. So I think youre going to see a lot of the practices starting to even out on that on those things I think over the last several years.
The whole industry migrated towards the aesthetic side, which was the cash business. It's an easy path to fall into and I think this is a big awakening I remember four five years ago going to all the trade shows and all of the speakers were talking about having a balanced offering to their customers. So they're not too heavily weighted one versus the <unk>.
Other I think this is a reset if you will it's going to help people get back onto the equilibrium. If you will and of course <unk> is going to be one of the main players in that.
Got it. Thank you that's really helpful and.
Now the company Joe you you and the team you've taken the company now through two different environments, one call up the.
The lower interest rate environment, where maybe it's fair value lease could could come a lot cheaper there is more access to capital by these clinics. So they could take place and that's our chief for call. It a little bit of a lower risk and now we've gone through this higher interest rate environment, where now it's becoming a little more difficult for a clinic to sign on the dotted line as you mentioned.
Does it at all make you question or look towards sharing in the economics on the procedures.
Where if a clinic is going to do X number of procedures you can actually.
Get a piece of that economic benefit versus just the capital sale upfront and then the service contract.
You know, it's always been on our minds as far as the ability for us to do that.
<unk>.
It's always available to our customers if they if they want to bring that up with us, but we have a very good partner that is right now fulfilling that they have a very successful model I think it's a proven model the.
The fair market value lease that we offer is not so much.
Laden by the interest rate because the fact that it's an off balance sheet.
Vehicle that provides with no personal guarantees for the customer and it allows them to get into something where literally there's a huge residual base on the system that they are not having to pay for so it's a much less costly way of doing it and it's still an opportunity for them to keep.
100% of the revenues if they have high patient population, which we're seeing it grow it's difficult for a customer to want to give up a certain percentage of that revenue when they can keep at all so I think we provide them with a very very good alternative to what our biggest customer is doing and.
That's one way of supporting our market and until we start seeing a greater demand from our market for us to be involved with that.
As always being considered I can assure you that and maybe one day it'll happen, but it's not going to be this debt.
Okay that makes sense and then just lastly on the expenses the team's done a great job keeping the expenses that are I think a reasonable run rate.
Even during this challenging macro time so.
Going into Q4, and I guess more 2024 do you expect to hold the expenses largely flat or would you need to do something a little bit of increasing but profitability comes back in store in Q4. It twice right well first of all I appreciate you, bringing that up because I think the team.
Digital team in particular led by Javier has really kept us on track and very disciplined on what we do with our dollars and if you noticed we have more cash in the bank at the end of this quarter than we did after the second quarter. So we're very cognizant of it.
We are strict on it it's part of our DNA in the way, we manage our business.
I think that it will remain flat for the balance of the year, we're not looking at increasing expenses. We've had increase in some of the R&D expenses due to the TDI product that we've put through the FDA and all of the.
The fixes that it has to go through it as well as the testing which is extremely expensive even before you get to the FDA. It's done by a third party group all of those things are very very important for us.
It's.
It is something that we live with every day. So I don't think that we're going to increase.
Any of the expenses. It's one of the notes that you had from Javier that was increases in some expenses due to sales and trade shows we had the American Academy of Dermatology trade show was was in a very expensive state and then most recently Astro was in San Diego, If you know anything about the Tradeshows.
Everything in the trade shows that have already been schedule, we got the upcoming American Academy of Dermatology in March also in San Diego, the actual cost to us to any manufacturer to exhibit in California is almost three times. What it was two years ago I mean, they've increased the cost tremendously I'm not sure.
Sure if we're going to continue to see a lot of these big societies continue to have their meetings in in California, because of those costs, but I mean, we were as shocked as everybody else was when we showed up and we learned of the extra cost that were involved so that's pretty much the difference in the expense that we've had in 2022 versus 2023 was.
Just that one very show, but I would tell you we'd do it again only because the show was very valuable to US we had as much activity at our booth at Astro The American Society for therapeutic radiation as we did several months earlier at the American Academy of Dermatology.
That's good to hear I appreciate the update thank you.
Thank you.
And our next question comes from Ben Hayner of Alliance Global partners.
Good afternoon, gentlemen, thanks for taking the questions.
Just kind of following up on that trade show commentary you. Just made can you just share a little bit more on that front just kind of the leads that you've seen maybe relative to past years, I know COVID-19 kind of messes with that a little bit but.
Quite a lot I guess, but.
Just any any trends you've seen over time.
The level of interest for SRT Yep, Ben Thanks for being on the call first and foremost we started to see this trend since COVID-19.
If everybody understands the American or the Radiological society, and radiation oncology, but CMS centers for Medicare Medicaid services is putting an awful lot of pressure on treatments for cancer and reducing a lot of the reimbursement for the treatment of cancer and when I'm, saying the treatment of cancer.
I'm talking about the regular cancers lung cancer breast cancer prostate all of those cancers theres a huge reduction in a huge push by centers for Medicare and Medicaid services to cut those reimbursements because of the high volumes that are occurring in those areas and those treatments of cancer with that being said a lot of these hospital administrators are safe.
Okay, we're losing revenue on our treatment of cancer with our cancer centers. What are we not doing where can we go and find more revenue to make up for those losses and of course as theyre looking over the fence into somebody else's backyard, what are they treating theyre not treating skin cancer and skin cancers, the low hanging fruit. They can certainly attract a lot of the patient.
So they certainly can attract treatment for that but they have to have the right equipment and so they've identified which they've identified a long time ago that SRT is a very low cost system that would get them back into the game for treating skin cancer and to make up for the losses that they are seeing in the reimbursement for all of their other cancers.
At this meeting we had dozens of hospitals that were pre scheduled coming to our booth for demonstrations on the SRT. They were physicians. They were physically they were administrators. They are all coming to find out what this SRT is all about and how it can treat skin cancer and how big this cancer market skin cancer market is.
And so we were very very happy to help them understand how big the market is and what they can do now you have a lot of also independent radiation oncology centers that are also suffering through the same thing, but want to learn what else can they do and if you recall just a few years ago, we had a doctor out of Red rocks, Colorado that had a system at <unk>.
But setting and he was doing 50 to 60 treatments a month in skin cancer. He was doing a tremendous.
Job until he sold the practice retired and moved back to his home state of Indiana, but that we've had tremendous interest in that market. We think that that market is going to continue to grow if you've noticed we've talked about the three major hospitals that we signed up just in the United States. This year alone with one also being signed up which is beacon hospice.
It'll Dublin, Ireland, which is a private hospital, which is much like the U S market. So we're starting to see that market grow and gain a lot of interest and we expect to have some activity over the next several months with that market.
Okay.
Very helpful commentary and then just.
Yeah kind of recap it sounds like you've got a lot of interest from non tracked non dermatology.
Short of.
Sort of sort of institution.
On the dermatology side, you mentioned that.
Pulse is there may be a reset getting back to more of a balanced practice.
What's your thoughts on on some of these.
Bulks sticking kind of with the unbalanced or hoping for the unbalanced aesthetics versus traditional medical treatments that they've gone to do they are.
Are they hoping against hope that a lot of the aesthetic stuff comes back soon and maybe sitting on their hands when it comes to <unk>.
Is it an SRT or any any additional thoughts there.
An interesting fact, Ben.
We have a bunch of groups out there that are going through roll ups that are supporting being supported by private equity money.
They have anywhere from 100 to close to 300 centers, depending on these groups and I would say that theres about 15 that participates in that area with the private equity money and they are closing in on representing about 20% of the total market.
And how they go about evaluating to buy a practice they buy a practice in the highest evaluation that they get for our practices based on their medical dermatology not their aesthetic dermatology on the aesthetic side, they're looking at anywhere between five and seven 775%.
<unk> of their value, whereas on the medical dermatology side, the medical dermatology, meaning there are CPT codes CMS supports it reimburses that theres existing coding that pays for it they're valued at somewhere between one five and 175, so if a dermatology practices.
Looking for an exit the best way to get the most money out of it is to have everything leaning towards the medical dermatology space. They get less money based on the aesthetic space and for this specific reason that it's it's controlled by how the markets are how the economy is going how the middle class is growing who's going to go to get their botox.
<unk> removed the wrinkles add this remove that all of those things becomes skeptical and reliant on inflation in the economy. So this is a perfect period for a lot of these places to get a reset and so I think that we're seeing that happen and I have to give credit to our team overall and the flood.
The ability that we show in how we manage our business and being able to go through those things imagine just in the last two years, we've come through Covid and now we're going through an inflationary period of time and the reset time, where the economics in our in our space is very very difficult and so if you look at where our market is in our industry look at <unk>.
All of the companies that are involved on the aesthetic side of dermatology the laser companies. The in most of the world all of those and see where their value this year versus where they were valued a year ago. When the economy was a whole lot better I think that were seeing exactly where it is and then when you look on the oncology side yet.
Magnificent company called view, right, which came out with the first product that was an MRI based electron beam system that used MRI in real time to treat patients for the regular cancers that was a company that over $200 billion was put into it and it recently filed bankruptcy and so.
If you're not managing your business right I think that you have a severe chance of getting hurt and all of these things hurt our market in totality, you don't like to see anybody get hurt, but I think that overall, we've done a very very good job navigating through these these headwinds that we're faced with and I think that will come out of it doing very very well.
Well.
Okay. That's also very helpful commentary.
For me and maybe this is more of my own curiosity than anything.
Utilization for international systems versus what you see in the U S. I mean.
International folks keep these things humming at a greater rate or whats. The way is there any way that you kind of characterize how all these things get used internationally versus in the U S. What that might do for future purchases.
Internationally everything that relates to the radiation oncology world, It's very seldom that dermatologists are allowed to use this technology.
In their practices. There is a couple of places in the World, Germany is one of those places there is a couple of states in Latin America, Brazil is one, but it's very difficult for us to break into which we will break into it just cost us a lot of money and a lot of time to get there, but we will get there, but the rest of the world is pretty much a socialized health care system.
Everything has to go to the radiation oncology department acquiring.
Technology and medical devices is not something that they want to do so a physician who does surgery only in the United States that they consider most surgery practice everywhere else in the world. It's just surgery and so all of these surgeons that exists they are walking around the hospitals, mostly 99% of them all.
Our employees have the state they are part of the social welfare states and so they don't they don't have to buy equipment. They just throw the surge in order to cut it out it's just the way it is and so it's a much more difficult sale, but it also relates to the fact that if you look at our hospital like Beacon Hospital Beacon hospitals, a private hospital it helps.
They have much more sophisticated people the wealthier people, who can afford separate insurance go to those hospitals when they get treated better I know in Canada. They started now.
Practice, where you can buy insurance if you are above the poverty line or if you are in the middle moderate area of the Middle class and you get treated perhaps you don't have to wait for a year and a half to have a C. T scan you might get it in six weeks. If you want on one of these things. So all of these things are taking place. There is always a group of people that it can have.
And it's always going to go to those people first but that's what we're seeing in the rest of the world. Additionally band just to add to Joe's comments, they use in China, Vietnam, Taiwan, and other places in Asia kind of experimentally, sometimes because of the low dose of radiation. So there's all sorts of future potential for indications for uses.
Based on preclinical studies, we know of going over there.
Okay got it well.
Thanks for taking the questions and all the color John Michael.
Thank you Ben and thanks Ben.
Sure.
This concludes our question and answer session I would like to turn the conference back over to get at Sangamo for any closing remarks. Thank.
Thank you Laura.
Thank you once again for your time this afternoon and for your interest in Sensus healthcare I'd like to mention that we'll be holding virtual one on one meetings during the Jpmorgan healthcare conference. The week of January the eighth please contact <unk>, if you'd like to get on the schedule. We will speak with you again, when we report fourth quarter financial results and early <unk>.
February in the meantime, thanks again for joining us today happy Thanksgiving happy holidays to all.
The conference has now concluded. Thank you for attending today's presentation you may now disconnect.