Q4 2025 TELA Bio Inc Earnings Call
Operator: Good afternoon, ladies and gentlemen, and welcome to the TELA Bio Q4 and full year 2025 earnings conference call. At this time, all participants are in listen-only mode. A question and answer session will follow the prepared remarks. As a reminder, this conference call is being recorded. I would now like to turn the conference call over to Louisa Smith from Investor Relations.
Operator: Good afternoon, ladies and gentlemen, and welcome to the TELA Bio Q4 and full year 2025 earnings conference call. At this time, all participants are in listen-only mode. A question and answer session will follow the prepared remarks. As a reminder, this conference call is being recorded. I would now like to turn the conference call over to Louisa Smith from Investor Relations.
Speaker #2: Good afternoon, ladies and gentlemen, and welcome to the TELA Bio fourth quarter and full year 2025 earnings conference call. At this time, all participants are in listen-only mode.
Speaker #2: A question-and-answer session will follow the prepared remarks. As a reminder, this conference call is being recorded. I would now like to turn the conference call over to Louisa Smith from Investor Relations.
Louisa Smith: Thank you, Jonathan, and good afternoon, everyone. Earlier today, TELA Bio released financial results for the Q4 and full year ended December 31, 2025. A copy of the press release is available on the company's website. Joining me on today's call are Antony Koblish, Chief Executive Officer, Jeffrey Blizard, President, Roberto Cuca, Chief Operating Officer and Chief Financial Officer, and Jim Hagen, Senior Vice President of Strategic Operations and Marketing. Before we begin, I'd like to remind you that during this conference call, the company may make projections and forward-looking statements regarding future events. We encourage you to review the company's past and future filings with the SEC, including, without limitation, the company's annual report on Form 10-K and quarterly reports on Forms 10-Q, which identify the specific risk factors that may cause actual results or events to differ materially from those described in these forward-looking statements.
Louisa Smith: Thank you, Jonathan, and good afternoon, everyone. Earlier today, TELA Bio released financial results for the Q4 and full year ended December 31, 2025. A copy of the press release is available on the company's website. Joining me on today's call are Antony Koblish, Chief Executive Officer, Jeffrey Blizard, President, Roberto Cuca, Chief Operating Officer and Chief Financial Officer, and Jim Hagen, Senior Vice President of Strategic Operations and Marketing. Before we begin, I'd like to remind you that during this conference call, the company may make projections and forward-looking statements regarding future events. We encourage you to review the company's past and future filings with the SEC, including, without limitation, the company's annual report on Form 10-K and quarterly reports on Forms 10-Q, which identify the specific risk factors that may cause actual results or events to differ materially from those described in these forward-looking statements.
Speaker #3: Thank you, Jonathan, and good afternoon, everyone. Earlier today, TELA Bio released financial results for the fourth quarter and full year ended December 31, 2025.
Speaker #3: A copy of the press release is available on the company's website. Joining me on today's call are Tony Koblish, Chief Executive Officer; Jeff Blizzard, President; Roberto Cuca, Chief Operating Officer and Chief Financial Officer; and Jim Hagen, Senior Vice President of Strategic Operations and Marketing.
Speaker #3: Before we begin, I'd like to remind you that during this conference call, the company may make projections and forward-looking statements regarding future events. We encourage you to review the company's past and future filings with the SEC, including without limitation, the company's annual report on Form 10-K and quarterly reports on Forms 10-Q, which identify the specific risk factors that may cause actual results or events to differ materially from those described in these forward-looking statements.
Louisa Smith: These factors may include, without limitation, statements regarding product development, pipeline opportunities, sales and marketing strategies, and the impact of various additional risk factors as identified in our regulatory filings. With that, I'd now like to turn the call over to Tony.
Louisa Smith: These factors may include, without limitation, statements regarding product development, pipeline opportunities, sales and marketing strategies, and the impact of various additional risk factors as identified in our regulatory filings. With that, I'd now like to turn the call over to Tony.
Speaker #3: These factors may include without limitation, statements regarding product development, pipeline opportunities, sales and marketing strategies, and the impact of various additional risk factors as identified in our regulatory filings.
Speaker #3: With that, I'd now like to turn the call over to Tony.
Antony Koblish: Thank you, Louisa, and good afternoon. Thank you for joining TELA Bio's Q4 and full year 2025 earnings call. For today's call, I'll open with a summary of what we accomplished in 2025 and thoughts on our forward-looking strategy. Jeff Blizzard will then walk through the foundational changes we implemented in the commercial organization and how we anticipate they will impact our future performance. Roberto will review our financials, and then we will open it up for Q&A. 2025, and the Q3 and Q4 in particular, were periods of meaningful strategic change across the entire organization. Following Jeff Blizzard's appointment as president in June, we undertook and executed a significant rebuild of TELA Bio's commercial foundation while maintaining our commitment to improve our operating discipline, and continuing to advance our pipeline strategies.
Antony Koblish: Thank you, Louisa, and good afternoon. Thank you for joining TELA Bio's Q4 and full year 2025 earnings call. For today's call, I'll open with a summary of what we accomplished in 2025 and thoughts on our forward-looking strategy. Jeff Blizzard will then walk through the foundational changes we implemented in the commercial organization and how we anticipate they will impact our future performance. Roberto will review our financials, and then we will open it up for Q&A. 2025, and the Q3 and Q4 in particular, were periods of meaningful strategic change across the entire organization. Following Jeff Blizzard's appointment as president in June, we undertook and executed a significant rebuild of TELA Bio's commercial foundation while maintaining our commitment to improve our operating discipline, and continuing to advance our pipeline strategies.
Speaker #4: Thank you, Louisa. And good afternoon. Thank you for joining TELA Bio's fourth quarter and full year 2025 earnings call. For today's call, I'll open with a summary of what we accomplished in 2025 and thoughts on our forward-looking strategy.
Speaker #4: Jeff will then walk through the foundational changes we implemented in the commercial organization and how we anticipate they will impact our future performance. Roberto will review our financials, and then we will open it up for Q&A.
Speaker #4: 2025 and the third and fourth quarters in particular were periods of meaningful strategic change across the entire organization. Following Jeff Blizzard's appointment as president in June, we undertook and executed a significant rebuild of TELA Bio's commercial foundation while maintaining our commitment to improve our operating discipline and continuing to advance our pipeline strategies.
Antony Koblish: We made meaningful changes to the US commercial organization while delivering 16% full year growth and achieving record Q4 revenues. The ability to maintain that momentum while executing such fundamental change in the organization is a testament to the caliber of our team and the value proposition of the OviTex product portfolio. We enter 2026 with the largest, most effective field team in the company's history, and a commercial strategy designed to drive durable, predictable growth. Demand for our products remains strong, and the opportunity in hernia repair and plastic reconstructive surgery has not diminished. The foundational changes we undertook in 2025 were aimed at ensuring we have the commercial infrastructure to consistently and effectively capture that demand.
Antony Koblish: We made meaningful changes to the US commercial organization while delivering 16% full year growth and achieving record Q4 revenues. The ability to maintain that momentum while executing such fundamental change in the organization is a testament to the caliber of our team and the value proposition of the OviTex product portfolio. We enter 2026 with the largest, most effective field team in the company's history, and a commercial strategy designed to drive durable, predictable growth. Demand for our products remains strong, and the opportunity in hernia repair and plastic reconstructive surgery has not diminished. The foundational changes we undertook in 2025 were aimed at ensuring we have the commercial infrastructure to consistently and effectively capture that demand.
Speaker #4: We made meaningful changes to the U.S. commercial organization while delivering 16% full-year growth and achieving record fourth-quarter revenues. The ability to maintain that momentum while executing such fundamental change in the organization is a testament to the caliber of our team and the value proposition of the Overtex product portfolio.
Speaker #4: We enter 2026 with the largest, most effective field team in the company's history, and a commercial strategy designed to drive durable, predictable growth. Demand for our products remains strong, and the opportunity in hernia repair and plastic reconstructive surgery has not diminished.
Speaker #4: The foundational changes we undertook in 2025 were aimed at ensuring we have the commercial infrastructure to consistently and effectively capture that demand. Revenue growth in 2025 was fueled by strong performance in our European business, further adoption of our IHR, LPR, and Liquifix product lines, and the continued contribution of our tenured reps in the U.S.
Antony Koblish: Revenue growth in 2025 was fueled by strong performance in our European business, further adoption of our IHR, LPR, and LIQUIFIX product lines, and the continued contribution of our tenured reps in the US. The strategic investment we have made in high caliber candidates with the right profile has been an underlying tenet of the commercial rebuild. A meaningful portion of our approximately 90-person sales force is still early in their tenure, with 40% of the reps having joined TELA in the last six months. This has not been a function of rep turnover, but rather an investment in commercial expansion and in recruiting talent with the right profile for the sales model we are building. We already see the newest reps meaningfully outperform their predecessors in the early stages of their onboarding, and we are encouraged by their promise to execute our commercial strategy more effectively.
Antony Koblish: Revenue growth in 2025 was fueled by strong performance in our European business, further adoption of our IHR, LPR, and LIQUIFIX product lines, and the continued contribution of our tenured reps in the US. The strategic investment we have made in high caliber candidates with the right profile has been an underlying tenet of the commercial rebuild. A meaningful portion of our approximately 90-person sales force is still early in their tenure, with 40% of the reps having joined TELA in the last six months. This has not been a function of rep turnover, but rather an investment in commercial expansion and in recruiting talent with the right profile for the sales model we are building. We already see the newest reps meaningfully outperform their predecessors in the early stages of their onboarding, and we are encouraged by their promise to execute our commercial strategy more effectively.
Speaker #4: The strategic investment we have made in high-caliber candidates with the right profile has been an underlying tenet of the commercial rebuild. A meaningful portion of our approximately 90-person sales force is still early in their tenure, with 40% of the reps having joined TELA in the last six months.
Speaker #4: This has not been a function of rep turnover, but rather an investment in commercial expansion, and in recruiting talent with the right profile for the sales model we are building.
Speaker #4: We already see the newest reps meaningfully outperform their predecessors in the early stages of their onboarding, and we are encouraged by their promise to execute our commercial strategy more effectively.
Antony Koblish: In Q4, we accelerated efforts to bolster our US commercial team by advancing recruitment to meet our sales headcount target and by putting the infrastructure in place to support those new hires. That included investing in training, rolling out new sales enablement tools, launching a new US sales leadership structure, and redesigning the 2026 compensation plan to align with our growth strategy and expectations. Heading into 2026, we are focused on two strategic growth priorities. First, and most importantly, we are committed to sustaining the momentum we achieved in 2025 and achieving further US and European sales growth through improved talent, processes, and commercial leadership. Jeff and his team have made incredible progress so far, and this will continue to improve as the new commercial organization matures and tenured sales reps begin to hit their stride.
Antony Koblish: In Q4, we accelerated efforts to bolster our US commercial team by advancing recruitment to meet our sales headcount target and by putting the infrastructure in place to support those new hires. That included investing in training, rolling out new sales enablement tools, launching a new US sales leadership structure, and redesigning the 2026 compensation plan to align with our growth strategy and expectations. Heading into 2026, we are focused on two strategic growth priorities. First, and most importantly, we are committed to sustaining the momentum we achieved in 2025 and achieving further US and European sales growth through improved talent, processes, and commercial leadership. Jeff and his team have made incredible progress so far, and this will continue to improve as the new commercial organization matures and tenured sales reps begin to hit their stride.
Speaker #4: In the fourth quarter, we accelerated efforts to bolster our U.S. commercial team by advancing recruitment to meet our sales headcount target and by putting the infrastructure in place to support those new hires.
Speaker #4: That included investing in training, rolling out new sales enablement tools, launching a new U.S. sales leadership structure, and redesigning the 2026 compensation plan to align with our growth strategy and expectations.
Speaker #4: Heading into 2026, we are focused on two strategic growth priorities. First, and most importantly, we are committed to sustaining the momentum we achieved in 2025 and achieving further U.S. growth.
Speaker #4: And European sales growth through improved talent, processes, and commercial leadership. Jeff and his team have made incredible progress so far, and this will continue to improve as the new commercial organization matures and tenured sales reps begin to hit their stride.
Antony Koblish: Again, I'll let Jeff provide further detail on the specifics, but I'm confident in the new commercial foundation we have laid. Second, we have been and will remain hyper-focused on offering the best soft tissue reconstruction product portfolio on the market. Product innovation is at the core of TELA's identity, and we anticipate announcing additional product launches throughout the year to drive greater share gains in the expansive US market. Demand for our innovative solutions is there, and I believe we have built the commercial infrastructure supported by an expanding portfolio that can consistently capture that demand. To that end, we were pleased to announce the promotion of Dr. Howard Langstein to Chief Medical Officer, effective 1 March. Howard joined TELA nearly two years ago and has been instrumental in how we engage the surgical community.
Antony Koblish: Again, I'll let Jeff provide further detail on the specifics, but I'm confident in the new commercial foundation we have laid. Second, we have been and will remain hyper-focused on offering the best soft tissue reconstruction product portfolio on the market. Product innovation is at the core of TELA's identity, and we anticipate announcing additional product launches throughout the year to drive greater share gains in the expansive US market. Demand for our innovative solutions is there, and I believe we have built the commercial infrastructure supported by an expanding portfolio that can consistently capture that demand. To that end, we were pleased to announce the promotion of Dr. Howard Langstein to Chief Medical Officer, effective 1 March. Howard joined TELA nearly two years ago and has been instrumental in how we engage the surgical community.
Speaker #4: Again, I'll let Jeff provide further detail on the specifics, but I'm confident in the new commercial foundation we have laid. And second, we have been and will remain hyper-focused on offering the best soft tissue reconstruction product portfolio on the market.
Speaker #4: Product innovation is at the core of TELA's identity, and we anticipate announcing additional product launches throughout the year to drive greater share gains in the expansive U.S.
Speaker #4: Market demand for our innovative solutions is there, and I believe we have built a commercial infrastructure supported by an expanding portfolio that can consistently capture that demand.
Speaker #4: To that end, we were pleased to announce the promotion of Dr. Howard Langstein to Chief Medical Officer, effective March 1st. Howard joined TELA nearly two years ago and has been instrumental in how we engage the surgical community.
Antony Koblish: With over 30 years in plastic and reconstructive surgery, he understands this market from the inside out, the procedures, the unmet needs, and what surgeons are looking for. As TELA's CMO, he will drive surgeon awareness, support clinical education, and help generate, disseminate, and translate the growing body of data behind OviTex into a broader market understanding and acceptance. On the European side, our teams are stable, tenured, and delivering above plan. The competitive market in Europe differs from the US with pricing and the bundling dynamics, and we are encouraged to see rapid adoption of OviTex in the UK and the Netherlands. We are winning share based on patient preference and the efficacy of our products in these markets, not because of pricing discounts or volume requirements set by hospital administrators.
Antony Koblish: With over 30 years in plastic and reconstructive surgery, he understands this market from the inside out, the procedures, the unmet needs, and what surgeons are looking for. As TELA's CMO, he will drive surgeon awareness, support clinical education, and help generate, disseminate, and translate the growing body of data behind OviTex into a broader market understanding and acceptance. On the European side, our teams are stable, tenured, and delivering above plan. The competitive market in Europe differs from the US with pricing and the bundling dynamics, and we are encouraged to see rapid adoption of OviTex in the UK and the Netherlands. We are winning share based on patient preference and the efficacy of our products in these markets, not because of pricing discounts or volume requirements set by hospital administrators.
Speaker #4: With over 30 years in plastic and reconstructive surgery, he understands this market from the inside out, the procedures, the unmet needs, and what surgeons are looking for.
Speaker #4: As TELA's CMO, he will drive surgeon awareness, support clinical education, and help generate, disseminate, and translate the growing body of data behind OviTex into a broader market understanding and acceptance.
Speaker #4: On the European side, our teams are stable, tenured, and delivering above plan. The competitive market in Europe differs from the U.S. with pricing and the bundling dynamics, and we are encouraged to see rapid adoption of Overtex in the U.K.
Speaker #4: and the Netherlands. We are winning share based on patient preference and the efficacy of our products in these markets, not because of pricing discounts or volume requirements set by hospital administrators.
Antony Koblish: Moving forward, we have a purposeful investment plan to expand our presence within continental Europe and see it as a meaningful contributor to growth in the coming years. Overall, Q4 results reflected a commercial organization in transition, but we remain proud of all this team has and will continue to accomplish. We executed a major commercial upgrade in the back half of 2025, while simultaneously achieving several other key milestones for the company. In that six-month period, we launched OviTex LTR, a new addition to our portfolio that offers durable support during healing and provides surgeons with a tissue-based alternative to synthetic mesh. We enrolled the first patients in our hiatal hernia trial ECHO, which will strengthen our clinical evidence base and deepen our access to alternative surgeon call points in a primarily robotically performed procedure.
Antony Koblish: Moving forward, we have a purposeful investment plan to expand our presence within continental Europe and see it as a meaningful contributor to growth in the coming years. Overall, Q4 results reflected a commercial organization in transition, but we remain proud of all this team has and will continue to accomplish. We executed a major commercial upgrade in the back half of 2025, while simultaneously achieving several other key milestones for the company. In that six-month period, we launched OviTex LTR, a new addition to our portfolio that offers durable support during healing and provides surgeons with a tissue-based alternative to synthetic mesh. We enrolled the first patients in our hiatal hernia trial ECHO, which will strengthen our clinical evidence base and deepen our access to alternative surgeon call points in a primarily robotically performed procedure.
Speaker #4: Moving forward, we have a purposeful investment plan to expand our presence within continental Europe and see it as a meaningful contributor to growth in the coming years.
Speaker #4: Overall, Q4 results reflected a commercial organization in transition, but we remain proud of all this team has and will continue to accomplish. We executed a major commercial upgrade in the back half of 2025 while simultaneously achieving several other key milestones for the company.
Speaker #4: In that six-month period, we launched Overtex LTR, a new addition to our portfolio that offers durable support during healing and provides surgeons with a tissue-based alternative to synthetic mesh.
Speaker #4: We enrolled the first patients in our hiatal study to strengthen our clinical evidence base and deepen our access to alternative surgeon call points in a primarily robotically performed procedure.
Antony Koblish: We reinforced and upsized our debt facility, strengthening our balance sheet for the road ahead. Finally, we upgraded our board of directors with new expertise. In summary, 2025 was a year of deliberate foundational change that required discipline and conviction. That is behind us, and we enter 2026 with our eyes towards the future. With that, I would now like to turn the call over to Jeff for a more in-depth review of our commercial strategy and restructuring. Jeff?
Antony Koblish: We reinforced and upsized our debt facility, strengthening our balance sheet for the road ahead. Finally, we upgraded our board of directors with new expertise. In summary, 2025 was a year of deliberate foundational change that required discipline and conviction. That is behind us, and we enter 2026 with our eyes towards the future. With that, I would now like to turn the call over to Jeff for a more in-depth review of our commercial strategy and restructuring. Jeff?
Speaker #4: We reinforced and upsized our debt facility, strengthening our balance sheet for the road ahead, and finally, we upgraded our board of directors with new expertise.
Speaker #4: In summary, 2025 was a year of deliberate, foundational change that required discipline and conviction. That is behind us, and we enter 2026 with our eyes toward the future.
Speaker #4: With that, I would now like to turn the call over to Jeff for a more in-depth review of our commercial strategy and restructuring. Jeff?
Jeffrey Blizard: Thanks, Antony. As Antony laid out, I don't want to lose sight of the fact that amid transformational reorganization, we grew revenue by 16% and delivered our third straight quarter of sequential growth. We exceeded $80 million in total sales for the full year 2025, all while maintaining operating discipline and improving our operating leverage. The changes that we undertook since coming on board last June could have created significant disruption in productivity and growth in any organization. That didn't happen here. It speaks volumes to the commitment of the entire TELA team and the dedication to the patients and customers we serve. I'd like to take some time to provide a detailed review of the specific changes in our commercial organization that Antony referred to. I'll also highlight the progress we made year-to-date because of these changes and how they set us up for meaningful inflection moving forward.
Jeffrey Blizard: Thanks, Antony. As Antony laid out, I don't want to lose sight of the fact that amid transformational reorganization, we grew revenue by 16% and delivered our third straight quarter of sequential growth. We exceeded $80 million in total sales for the full year 2025, all while maintaining operating discipline and improving our operating leverage. The changes that we undertook since coming on board last June could have created significant disruption in productivity and growth in any organization. That didn't happen here. It speaks volumes to the commitment of the entire TELA team and the dedication to the patients and customers we serve. I'd like to take some time to provide a detailed review of the specific changes in our commercial organization that Antony referred to. I'll also highlight the progress we made year-to-date because of these changes and how they set us up for meaningful inflection moving forward.
Speaker #5: Thanks, Tony. As Tony laid out, I don't want to lose sight of the fact that amid transformational reorganization, we grew revenue by 16% and delivered our third straight quarter of sequential growth.
Speaker #5: We exceeded $80 million in total sales for the full year 2025, all while maintaining operating discipline and improving our operating leverage. The changes that we undertook since coming on board last June could have created significant disruption in productivity and growth in any organization.
Speaker #5: That didn't happen here. It speaks volumes to the commitment of the entire TELA team and the dedication to the patients and customers we serve.
Speaker #5: I'd like to take some time to provide a detailed review of the specific changes in our commercial organization that Tony referred to. I'll also highlight the progress we've made year to date because of these changes and how they set us up for meaningful inflection moving forward.
Jeffrey Blizard: 1, we upgraded and redesigned the US commercial leadership team. By implementing a new sales general manager structure, we brought on decision-making closer to the customer and empowered teams to respond to customer needs in real time. 2, concurrently, we addressed silos within the commercial organization that had been slowing cross-team collaboration. We strengthened our sales leadership bench by upgrading five key senior roles. These changes were implemented to increase accountability in the field, improve coordination across our Hernia and PRS segments, and drive more consistent execution across our commercial footprint. 3, we've rolled out formal promotion pathways within the commercial organization, creating vertical career mobility that rewards our top performers and incentivizes meaningful contribution within the organization. 4, we redesigned the sales talent profile in the US and accelerated our hiring.
Jeffrey Blizard: 1, we upgraded and redesigned the US commercial leadership team. By implementing a new sales general manager structure, we brought on decision-making closer to the customer and empowered teams to respond to customer needs in real time. Two, concurrently, we addressed silos within the commercial organization that had been slowing cross-team collaboration. We strengthened our sales leadership bench by upgrading five key senior roles. These changes were implemented to increase accountability in the field, improve coordination across our Hernia and PRS segments, and drive more consistent execution across our commercial footprint. 3, we've rolled out formal promotion pathways within the commercial organization, creating vertical career mobility that rewards our top performers and incentivizes meaningful contribution within the organization. 4, we redesigned the sales talent profile in the US and accelerated our hiring.
Speaker #5: Number one, we upgraded and redesigned the U.S. commercial leadership team. By implementing a new sales general manager structure, we brought decision-making closer to the customer and empowered teams to respond to customer needs in real time.
Speaker #5: Two, concurrently, we addressed silos within the commercial organization that had been slowing cross-team collaboration. We strengthened our sales leadership bench by upgrading five key senior roles.
Speaker #5: These changes were implemented to increase accountability in the field, improve coordination across our hernia and PRS segments, and drive more consistent execution across our commercial footprint.
Speaker #5: Third, we've rolled out formal promotion pathways within the commercial organization, creating vertical career mobility that rewards our top performers and incentivizes meaningful contribution within the organization.
Speaker #5: Fourth, we redesigned the sales talent profile in the U.S. and accelerated our hiring. We hit our 76 territory manager target back in the third quarter, and as of today, we have 88 quota-carrying territory managers in the U.S.
Jeffrey Blizard: We hit our 76 territory manager target back in Q3, and as of today, we have 88 quota-carrying territory managers in the US with one additional hire imminent and five open positions that we're actively sourcing. This means we won't require any further incremental hiring for the remainder of the year. The team that we need to hit our 2026 targets are largely in place. Tony touched on how we evaluate our field teams by distinct cohorts and how we assess their performance by tenure and productivity ramps. Roughly 40 percent of the US field team have joined us in the last two quarters. They're in the early phases of their ramp-up, and we expect that they'll contribute incrementally each quarter of this year as they build out account relationships and gain clinical familiarity.
Jeffrey Blizard: We hit our 76 territory manager target back in Q3, and as of today, we have 88 quota-carrying territory managers in the US with one additional hire imminent and five open positions that we're actively sourcing. This means we won't require any further incremental hiring for the remainder of the year. The team that we need to hit our 2026 targets are largely in place. Tony touched on how we evaluate our field teams by distinct cohorts and how we assess their performance by tenure and productivity ramps. Roughly 40 percent of the US field team have joined us in the last two quarters. They're in the early phases of their ramp-up, and we expect that they'll contribute incrementally each quarter of this year as they build out account relationships and gain clinical familiarity.
Speaker #5: With one additional hire imminent and five open positions that we're actively sourcing, this means we won't require any further incremental hiring for the remainder of the year.
Speaker #5: The team that we need to hit our 2026 targets is largely in place. Tony touched on how we evaluate our field teams by distinct cohorts, and how we assess their performance by tenure and productivity ramps.
Speaker #5: Roughly 40% of the U.S. field team have joined us in the last two quarters. They're in the early phases of their ramp-up, and we expect that they'll contribute incrementally each quarter of this year as they build out account relationships and gain clinical familiarity.
Jeffrey Blizard: An additional cohort, those who've been with us between 6 and 18 months, have gained meaningful traction, and the vast majority have reached a productivity inflection point. They're actively building account relationships while improving clinical acumen. We expect their contribution to ramp meaningfully each quarter. Finally, we've maintained a very solid base of tenured reps who, on average, deliver over $1 million per year and consistently meet or exceed targets on a monthly, quarterly, and annual basis. This cohort accounts for approximately 35% of our current rep count. Five, as part of the redefinition of our sales talent profile, we've shifted our approach to recruitment. We've been very successful not only in our ability to retain top performers, but in our ability to attract and hire strong candidates.
Jeffrey Blizard: An additional cohort, those who've been with us between 6 and 18 months, have gained meaningful traction, and the vast majority have reached a productivity inflection point. They're actively building account relationships while improving clinical acumen. We expect their contribution to ramp meaningfully each quarter. Finally, we've maintained a very solid base of tenured reps who, on average, deliver over $1 million per year and consistently meet or exceed targets on a monthly, quarterly, and annual basis. This cohort accounts for approximately 35% of our current rep count. Five, as part of the redefinition of our sales talent profile, we've shifted our approach to recruitment. We've been very successful not only in our ability to retain top performers, but in our ability to attract and hire strong candidates.
Speaker #5: An additional cohort—those who've been with us between six and 18 months—have gained meaningful traction, and the vast majority have reached a productivity inflection point.
Speaker #5: They're actively building account relationships while improving clinical acumen. We expect their contribution to ramp meaningfully each quarter. And finally, we've maintained a very solid base of tenured reps, who, on average, deliver over $1 million per year and consistently meet or exceed targets on a monthly, quarterly, and annual basis.
Speaker #5: This cohort accounts for approximately 35% of our current rep count. Five, as part of the redefinition of our sales talent profile, we've shifted our approach to recruitment.
Speaker #5: We've been very successful not only in our ability to retain top performers, but also in our ability to attract and hire strong candidates. We increased our investment and focus on sales training, with the goal of reducing the time between hiring and commercial effectiveness.
Jeffrey Blizard: We increased our investment and focus on sales training, with a goal of reducing time between hiring and commercial effectiveness. The candidates we're bringing in demonstrate stronger performance and higher scores on all evaluation criteria versus any prior cohort. The profile we're recruiting combines high intellect, perseverance, the ability to build deep and lasting relationship, and develop strong clinical acumen over time. This is a change from our previous recruiting strategy, which placed greater emphasis on years of soft tissue sales experience. The caliber of our newest reps is beyond anything TELA's ever seen. We're becoming a destination now for candidates who fit a clear profile for success in the commercial model that we're building. Naturally, as we place less emphasis on prior soft tissue experience, there's a ramp-up period while new hires come up to speed through our clinical education programs.
Jeffrey Blizard: We increased our investment and focus on sales training, with a goal of reducing time between hiring and commercial effectiveness. The candidates we're bringing in demonstrate stronger performance and higher scores on all evaluation criteria versus any prior cohort. The profile we're recruiting combines high intellect, perseverance, the ability to build deep and lasting relationship, and develop strong clinical acumen over time. This is a change from our previous recruiting strategy, which placed greater emphasis on years of soft tissue sales experience. The caliber of our newest reps is beyond anything TELA's ever seen. We're becoming a destination now for candidates who fit a clear profile for success in the commercial model that we're building. Naturally, as we place less emphasis on prior soft tissue experience, there's a ramp-up period while new hires come up to speed through our clinical education programs.
Speaker #5: The candidates we're bringing in demonstrate stronger performance and higher scores on all evaluation criteria versus any prior cohort. The profile we're recruiting combines high intellect, perseverance, the ability to build deep and lasting relationships, and time.
Speaker #5: This is a change from our previous recruiting strategy, which placed greater emphasis on years of soft tissue sales experience. The caliber of our newest reps is beyond anything TELA has ever seen.
Speaker #5: We're becoming a destination now for candidates who fit a clear profile for success in the commercial model that we're building. Naturally, as we place less emphasis on prior soft tissue experience, there is a ramp-up period while new hires come up to speed through our clinical education programs.
Jeffrey Blizard: What we're seeing, however, is that our investment in sales training, this new profile of rep gains clinical proficiency quickly. Once they do, their drive and hustle translate into a higher level of contribution than prior cohorts. While we're still expecting most new hires to reach full productivity within 6 to 9 months, we believe their impact and maturity will be greater. Six, we've developed and rolled out a new sales enablement technology that draws on better market insights to help our sales leaders and reps better prioritize and target their activity. Seven, we have designed and implemented a new 2026 compensation program that incentivizes deeper penetration in target accounts. This represents a change in our geographic coverage, where we are now matching rep density with high volume institutions to cultivate multiple users per site.
Jeffrey Blizard: What we're seeing, however, is that our investment in sales training, this new profile of rep gains clinical proficiency quickly. Once they do, their drive and hustle translate into a higher level of contribution than prior cohorts. While we're still expecting most new hires to reach full productivity within 6 to 9 months, we believe their impact and maturity will be greater. Six, we've developed and rolled out a new sales enablement technology that draws on better market insights to help our sales leaders and reps better prioritize and target their activity. Seven, we have designed and implemented a new 2026 compensation program that incentivizes deeper penetration in target accounts. This represents a change in our geographic coverage, where we are now matching rep density with high volume institutions to cultivate multiple users per site.
Speaker #5: What we're seeing, however, is that our investment in sales training—this new profile of reps—gains clinical proficiency quickly, and once they do, their drive and hustle translate into a higher level of contribution than prior cohorts.
Speaker #5: While we're still expecting most new hires to reach full productivity within six to nine months, we believe their impact and maturity will be greater.
Speaker #5: Six, we've developed and rolled out a new sales enablement technology that draws on better market insights to help our sales leaders and reps better prioritize and target their activity.
Speaker #5: Seven, we have designed and implemented a new 2026 compensation program that incentivizes deeper penetration in target accounts. This represents a change in our geographic coverage.
Speaker #5: We are now matching rep density with high-volume institutions to cultivate multiple users per site. Instead of a wide and shallow approach, we're going deeper to generate sustainable, recurring revenue opportunities.
Jeffrey Blizard: Instead of a wide and shallow approach, we're going deeper to generate sustainable, recurring revenue opportunities. Our new comp plan is now explicitly aligned around that strategy. Additionally, this philosophy expands beyond the comp plan itself. It also minimized the geographical areas that reps needed to cover, maximizing efficiency and supporting better operating expense optimization. As part of this renewed approach, we're also ensuring meaningful executive presence in the field. Tony was calling on strategic accounts as recently as last week, and others and I are doing the same. It's a signal in the organization to our customers where our priorities lie, building deeper, more meaningful physician relationships. Eighth, we've adjusted our sales and marketing focus to center on the mechanism of action of OviTex and the science that fundamentally differentiates our portfolio. Surgeons have embraced our data and the long-term patient outcomes it demonstrates.
Jeffrey Blizard: Instead of a wide and shallow approach, we're going deeper to generate sustainable, recurring revenue opportunities. Our new comp plan is now explicitly aligned around that strategy. Additionally, this philosophy expands beyond the comp plan itself. It also minimized the geographical areas that reps needed to cover, maximizing efficiency and supporting better operating expense optimization. As part of this renewed approach, we're also ensuring meaningful executive presence in the field. Tony was calling on strategic accounts as recently as last week, and others and I are doing the same. It's a signal in the organization to our customers where our priorities lie, building deeper, more meaningful physician relationships. Eighth, we've adjusted our sales and marketing focus to center on the mechanism of action of OviTex and the science that fundamentally differentiates our portfolio. Surgeons have embraced our data and the long-term patient outcomes it demonstrates.
Speaker #5: Our new comp plan is now explicitly aligned around that strategy. Additionally, this philosophy expands beyond the comp plan itself. It also minimized the geographic areas that reps needed to cover, maximizing efficiency and supporting better operating expense optimization.
Speaker #5: As part of this renewed approach, we're also ensuring meaningful executive presence in the field. Tony was calling on strategic accounts as recently as last week, and others and I are doing the same.
Speaker #5: It's a signal in the organization to our customers about where our priorities lie: building deeper, more meaningful physician relationships. Eight, we've adjusted our sales and marketing focus to center on the mechanism of action of OBITEX and the science that fundamentally differentiates our portfolio.
Speaker #5: Surgeons have embraced our data and the long-term patient outcomes it demonstrates. The source material, OBITEX, and the way it integrates within the body differentiates us from any Gen One biologics, synthetics, or biosynthetics, and it's foundational to why surgeons adopt OBITEX.
Jeffrey Blizard: The source material, OviTex, and the way it integrates within the body differentiates us from any Gen one biologics, synthetics, or biosynthetics, and it's foundational to the why surgeons adopt OviTex. We also increased our sales and marketing focus on LiquiFix. With great support from our partners at AMS, LiquiFix is not only a better fixation solution, we've seen it open doors with hernia surgeons who may not yet be familiar with OviTex. Finally, number nine, we've instilled spending discipline within the organization, which has allowed us to fund more customer education and training events. This helps us meet customers where they are in their adoption life cycle while simultaneously improving operating margins. How does this all come together with respect to driving revenues?
Jeffrey Blizard: The source material, OviTex, and the way it integrates within the body differentiates us from any Gen one biologics, synthetics, or biosynthetics, and it's foundational to the why surgeons adopt OviTex. We also increased our sales and marketing focus on LiquiFix. With great support from our partners at AMS, LiquiFix is not only a better fixation solution, we've seen it open doors with hernia surgeons who may not yet be familiar with OviTex. Finally, number nine, we've instilled spending discipline within the organization, which has allowed us to fund more customer education and training events. This helps us meet customers where they are in their adoption life cycle while simultaneously improving operating margins. How does this all come together with respect to driving revenues?
Speaker #5: We also increased our sales and marketing focus on Liquifix. With great support from our partners at AMS, Liquifix is not only a better fixation solution, we've seen it open doors with hernia surgeons who may not yet be familiar with OBITEX.
Speaker #5: And finally, number nine, we've instilled spending discipline within the organization, which has allowed us to fund more customer education and training events. This helps us meet customers where they are in their adoption lifecycle, while simultaneously improving operating margins.
Speaker #5: So, how does this all come together with respect to driving revenues? For the full year 2026, with each of the three cohorts performing as expected, we're confident that we will grow revenue over 2025 by at least 8%.
Jeffrey Blizard: For the full year 2026, with each of the three cohorts performing as expected, we're confident that we will grow revenue over 2025 by at least 8%. For the first quarter, to which much is already completed, we expect that we'll deliver revenue of approximately $18.5 million. The breadth of change that we execute in six months was significant, and we recognize what it takes to sustain this level of momentum going forward. Our goal was to have everything in place by the end of Q1 so that H2 2026 reflects this full benefit. We are well on pace, and as of today, all significant material changes have been implemented across the entire organization. We've set our revenue guidance to account for some of the inherent variability that may arise given the scope, scale, and speed of changes I've just laid out.
Jeffrey Blizard: For the full year 2026, with each of the three cohorts performing as expected, we're confident that we will grow revenue over 2025 by at least 8%. For the first quarter, to which much is already completed, we expect that we'll deliver revenue of approximately $18.5 million. The breadth of change that we execute in six months was significant, and we recognize what it takes to sustain this level of momentum going forward. Our goal was to have everything in place by the end of Q1 so that H2 2026 reflects this full benefit. We are well on pace, and as of today, all significant material changes have been implemented across the entire organization. We've set our revenue guidance to account for some of the inherent variability that may arise given the scope, scale, and speed of changes I've just laid out.
Speaker #5: And for the first quarter, to which much is already completed, we expect that we'll deliver revenue of approximately $18.5 million. The breadth of change that we executed in six months was significant.
Speaker #5: And we recognize what it takes to sustain this level of momentum going forward. Our goal was to have everything in place by the end of Q1 so that the second half of 2026 reflects this full benefit.
Speaker #5: We are well on pace, and as of today, all significant material changes have been implemented across the entire organization. We've set our revenue guidance to account for some of the inherent variability that may arise given the scope, scale, and speed of changes I've just laid out.
Jeffrey Blizard: We believe that particularly in H2 of this year, the annualization of our commercial restructuring and the ramp of our newest cohort, combined with the pipeline and clinical investments, position us to be able to deliver achievable and sustainable results moving forward. I'll now turn the call over to Roberto for further details on the Q4 and full year financial results.
Jeffrey Blizard: We believe that particularly in H2 of this year, the annualization of our commercial restructuring and the ramp of our newest cohort, combined with the pipeline and clinical investments, position us to be able to deliver achievable and sustainable results moving forward. I'll now turn the call over to Roberto for further details on the Q4 and full year financial results.
Speaker #5: We believe that, particularly in the second half of this year, the annualization of our commercial restructuring and the ramp of our newest cohort, combined with the pipeline and clinical investments, position us to be able to deliver achievable and sustainable results moving forward.
Speaker #5: I'll now turn the call over to Roberto for further details on the fourth quarter and full-year financial results.
Roberto Cuca: Thank you, Jeff. Revenue for Q4 2025 increased 18% year-over-year to $20.9 million, and grew 16% for the full year to $80.3 million, with revenue from OviTex growing 12% and OviTex PRS growing 20% for the year. The growth was primarily due to the addition of new customers, growth in international sales, and the US launch of larger PRS units. Growth was partially offset by a mix shift in our hernia product line as we saw an increased share of smaller-sized IHR units. OviTex unit sales grew 20% for the quarter and 22% for the year, while PRS unit sales grew 12% for the quarter and for the year.
Roberto Cuca: Thank you, Jeff. Revenue for Q4 2025 increased 18% year-over-year to $20.9 million, and grew 16% for the full year to $80.3 million, with revenue from OviTex growing 12% and OviTex PRS growing 20% for the year. The growth was primarily due to the addition of new customers, growth in international sales, and the US launch of larger PRS units. Growth was partially offset by a mix shift in our hernia product line as we saw an increased share of smaller-sized IHR units. OviTex unit sales grew 20% for the quarter and 22% for the year, while PRS unit sales grew 12% for the quarter and for the year.
Speaker #6: Thank you, Jeff. Revenue for the fourth quarter of 2025 increased 18% year over year to $20.9 million and grew 16% for the full year to $80.3 million, with revenue from OviTex growing 12% and OviTex PRS growing 20% for the year.
Speaker #6: The growth was primarily due to the addition of new customers, growth in international sales, and the U.S. launch of larger PRS units. Growth was partially offset by a mixed shift in our hernia product line as we saw an increased share of smaller-sized IHR units.
Speaker #6: OBITEX unit sales grew 20% for the quarter and 22% for the year, while PRS unit sales grew 12% for the quarter and for the year.
Roberto Cuca: LIQUIFIX revenue more than tripled over Q4 2024, reflecting early commercial traction as we expand adoption alongside our core OviTex portfolio. European sales accounted for 15% of total revenue, or $12.1 million in 2025, a 17% increase from $10.3 million in 2024, reflecting the traction we are seeing in key markets and our continued investment in expanding access globally. Gross margin was 66% for Q4 and 68% for the full year, compared with 64% and 67% for the prior year periods, respectively. The improvement was driven by lower excess and obsolete inventory expense as a percentage of revenue.
Roberto Cuca: LIQUIFIX revenue more than tripled over Q4 2024, reflecting early commercial traction as we expand adoption alongside our core OviTex portfolio. European sales accounted for 15% of total revenue, or $12.1 million in 2025, a 17% increase from $10.3 million in 2024, reflecting the traction we are seeing in key markets and our continued investment in expanding access globally. Gross margin was 66% for Q4 and 68% for the full year, compared with 64% and 67% for the prior year periods, respectively. The improvement was driven by lower excess and obsolete inventory expense as a percentage of revenue.
Speaker #6: Liquifix revenue more than tripled over the fourth quarter of 2024, reflecting early commercial traction as we expand adoption alongside our core OBITEX portfolio. European sales accounted for 15% of total revenue, or $12.1 million, in 2025, a 17% increase from $10.3 million in 2024, reflecting the traction we are seeing in key markets and our continued investment in expanding access globally.
Speaker #6: Gross margin was 66% for the fourth quarter and 68% for the full year, compared with 64% and 67% for the prior year periods, respectively.
Speaker #6: The improvement was driven by lower excess and obsolete inventory expense as a percentage of revenue. Sales and marketing expenses were $14.5 million in the fourth quarter and $63.2 million for the full year, compared to $14 million and $64.6 million for the prior year periods, respectively.
Roberto Cuca: Sales and marketing expenses were $14.5 million in Q4 and $63.2 million for the full year, compared to $14 million and $64.6 million for the prior year periods, respectively. This was mainly due to commissions rising with stronger revenue in both periods, offset by lower compensation, severance, consulting, and travel costs for the year. General and administrative expenses were $3.8 million for Q4 and $15.7 million for the full year, compared with $3.6 million and $14.7 million for the prior year periods, respectively. R&D expenses for Q4 were $2.1 million and for the full year were $9.2 million compared to $2 million and $8.8 million for the prior year periods.
Roberto Cuca: Sales and marketing expenses were $14.5 million in Q4 and $63.2 million for the full year, compared to $14 million and $64.6 million for the prior year periods, respectively. This was mainly due to commissions rising with stronger revenue in both periods, offset by lower compensation, severance, consulting, and travel costs for the year. General and administrative expenses were $3.8 million for Q4 and $15.7 million for the full year, compared with $3.6 million and $14.7 million for the prior year periods, respectively. R&D expenses for Q4 were $2.1 million and for the full year were $9.2 million compared to $2 million and $8.8 million for the prior year periods.
Speaker #6: This was mainly due to commissions rising with stronger revenue in both periods, offset by lower compensation, severance, consulting, and travel costs for the year.
Speaker #6: General and administrative expenses were $3.8 million for the fourth quarter and $15.7 million for the full year, compared with $3.6 million and $14.7 million for the prior year periods, respectively.
Speaker #6: R&D expenses for the fourth quarter were $2.1 million, and for the full year were $9.2 million, compared to $2 million and $8.8 million for the prior year periods.
Roberto Cuca: Loss from operations was $6.6 million in Q4 2025 and $33.8 million for the full year compared to $8.4 million and $34.1 million in the prior year periods. Net loss was $9 million in Q4 and $38.8 million for the full year compared to $9.2 million and $37.8 million in prior year periods. We ended 2025 with $50.8 million in cash and cash equivalents, having further strengthened our financial flexibility by refinancing our debt facility and raising incremental and equity capital. As Jeff described earlier, for 2026, we anticipate revenue growth of at least 8% over 2025, with Q1 2026 revenue of approximately $18.5 million.
Roberto Cuca: Loss from operations was $6.6 million in Q4 2025 and $33.8 million for the full year compared to $8.4 million and $34.1 million in the prior year periods. Net loss was $9 million in Q4 and $38.8 million for the full year compared to $9.2 million and $37.8 million in prior year periods. We ended 2025 with $50.8 million in cash and cash equivalents, having further strengthened our financial flexibility by refinancing our debt facility and raising incremental and equity capital. As Jeff described earlier, for 2026, we anticipate revenue growth of at least 8% over 2025, with Q1 2026 revenue of approximately $18.5 million.
Speaker #6: Loss from operations was $6.6 million in the fourth quarter of 2025 and $33.8 million for the full year, compared to $8.4 million and $34.1 million in the prior year periods.
Speaker #6: Net loss was $9 million in the fourth quarter and $38.8 million for the full year, compared to $9.2 million and $37.8 million for the prior year period.
Speaker #6: We ended 2025 with $50.8 million in cash and cash flexibility by refinancing our debt facility and raising incremental equity capital. As Jeff described earlier, for 2026, we anticipate revenue growth of at least 8% over 2025, with Q1 2026 revenue of approximately $18.5 million.
Roberto Cuca: We expect that operating loss and net loss will continue to decline for both the year and over the quarters of the year, although there is likely to be some step up from the just past Q4 to the Q1, particularly in light of the revenue progression that we typically see over this period. With that, I'll hand the call back to Tony for closing remarks.
Roberto Cuca: We expect that operating loss and net loss will continue to decline for both the year and over the quarters of the year, although there is likely to be some step up from the just past Q4 to the Q1, particularly in light of the revenue progression that we typically see over this period. With that, I'll hand the call back to Tony for closing remarks.
Speaker #6: We expect that operating loss and net loss will continue to decline for both the year and over the quarters of the year, although there is likely to be some step-up from the just-past fourth quarter to the first quarter, particularly in light of the revenue progression that we typically see over this period.
Speaker #6: With that, I'll hand the call back to Tonya for closing remarks.
Antony Koblish: Thank you, Roberto. As we have done in prior quarters, I'd like to end with a patient story to ground us in the impact of our mission. A 57-year-old patient actively being treated for chemo required treatment for a hernia repair in the intercostal region. The surgical team, concerned about where the hernia was located because it was near chest tubes, decided that OviTex Core, with the 4 layers being thin enough, unlike a traditional biologic, would provide less seroma and was the best choice because of Core's resorption profile and its optimal size. The patient underwent an underlay procedure. The surgeon said that the patient is doing great and is extremely pleased to have OviTex Core available for this very sick patient.
Antony Koblish: Thank you, Roberto. As we have done in prior quarters, I'd like to end with a patient story to ground us in the impact of our mission. A 57-year-old patient actively being treated for chemo required treatment for a hernia repair in the intercostal region. The surgical team, concerned about where the hernia was located because it was near chest tubes, decided that OviTex Core, with the 4 layers being thin enough, unlike a traditional biologic, would provide less seroma and was the best choice because of Core's resorption profile and its optimal size. The patient underwent an underlay procedure. The surgeon said that the patient is doing great and is extremely pleased to have OviTex Core available for this very sick patient.
Speaker #1: Thank you, Roberto. As we have done in prior quarters, I'd like to end with a patient story to ground us in the impact of our mission.
Speaker #1: A 57-year-old patient, actively being treated with chemo, required treatment for a hernia repair in the intercostal region. The surgical team, concerned about where the hernia was located because it was near chest tubes, decided that OviTex Core, with the four layers being thin enough—unlike a traditional biologic—would provide less seroma and was the best choice because of Core's resorption profile and its optimal size.
Speaker #1: The patient underwent an underlay procedure. The surgeon said that the patient is doing great and is extremely pleased to have OviTex Core available for this very sick patient.
Antony Koblish: The surgeon commented, in quotes, "We believe that OviTex is the only product that can be used in conjunction with the use of chemotherapy due to the way it rapidly incorporates its porous nature and its functional remodeling of healthy tissue." This is another great example about how OviTex can be used in the most complex of cases with excellent outcomes. Before we open the line for questions, I want to take a moment to recognize the entire TELA team. In H2 2025, this organization undertook a fundamental rebuild of our commercial structure while continuing to grow revenue, serve customers, and maintain operating discipline.
Antony Koblish: The surgeon commented, in quotes, "We believe that OviTex is the only product that can be used in conjunction with the use of chemotherapy due to the way it rapidly incorporates its porous nature and its functional remodeling of healthy tissue." This is another great example about how OviTex can be used in the most complex of cases with excellent outcomes. Before we open the line for questions, I want to take a moment to recognize the entire TELA team. In H2 2025, this organization undertook a fundamental rebuild of our commercial structure while continuing to grow revenue, serve customers, and maintain operating discipline.
Speaker #1: The surgeon commented, "We believe that OBITEX is the only product that can be used in conjunction with the use of chemotherapy due to the way it rapidly incorporates."
Speaker #1: Its porous nature and its functional remodeling of healthy tissue—this is another great example of how OBITEX can be used in the most complex of cases, with excellent outcomes. Before we open the line for questions, I want to take a moment to recognize the entire TELA team.
Speaker #1: In the back half of 2025, this organization undertook a fundamental rebuild of our commercial structure while continuing to grow revenue, serve customers, and maintain operating discipline.
Antony Koblish: To sustain momentum through the transition of this magnitude reflects the quality of the team and the strength of the products. The changes we made in 2025 were difficult but necessary, and we entered 2026 with the strongest commercial team the company has ever had. I look forward to what's ahead for TELA Bio. Jonathan, please open the line for questions.
Antony Koblish: To sustain momentum through the transition of this magnitude reflects the quality of the team and the strength of the products. The changes we made in 2025 were difficult but necessary, and we entered 2026 with the strongest commercial team the company has ever had. I look forward to what's ahead for TELA Bio. Jonathan, please open the line for questions.
Speaker #1: To sustain momentum through a transition of this magnitude reflects the quality of the team and the strength of the products. The changes we made in 2025 were difficult but necessary, and we entered 2026 with the strongest commercial team the company has ever had, and I look forward to what's ahead for TELA.
Speaker #1: Jonathan, please open the line for questions.
Operator: Certainly. Our first question for today comes from the line of Caitlin Cronin from Canaccord Genuity. Your question, please.
Operator: Certainly. Our first question for today comes from the line of Caitlin Cronin from Canaccord Genuity. Your question, please.
Speaker #5: Certainly. And our first question for today comes from the line of Caitlin Roberts from Canaccord Genuity. Your question, please.
Caitlin Cronin: Hi. Thanks so much for taking the questions.
Caitlin Cronin: Hi. Thanks so much for taking the questions.
Speaker #6: Hi, thanks so much for taking the questions. I guess, starting off with the fiscal year top-line guidance for at least 8%—just a little bit more color on why it was below what you guys noted on the Q3 call.
Antony Koblish: Sure.
Antony Koblish: Sure.
Caitlin Cronin: I guess, starting off with the fiscal year top line guidance for at least 8%, just a little bit more color on why it was below what you guys noted on the Q3 call, and if you could provide some cadence to that guidance for the year, that would be great.
Caitlin Cronin: I guess, starting off with the fiscal year top line guidance for at least 8%, just a little bit more color on why it was below what you guys noted on the Q3 call, and if you could provide some cadence to that guidance for the year, that would be great.
Speaker #6: And, if you could provide some cadence to that guidance for the year, that would be great.
Antony Koblish: Yeah, I'll start it off, and then I'll turn it over to Roberto. You know, our thought here is given the change that we've implemented, wholesale change right across almost every dimension, that we thought it would be prudent to set the guidance where we did. There's so many new reps and new moving parts that are in place right now. We wanna give ourselves the best chance to do a great job this year. Given that our territory manager break-even point remains about 6 months to 9 months, and we've hired so many new reps that we're sort of flip scaling into, cascading into the year, we just think there's a lot of variables, and we wanted to make sure that we're giving ourselves plenty of room to allow these reps to mature and drive.
Antony Koblish: Yeah, I'll start it off, and then I'll turn it over to Roberto. You know, our thought here is given the change that we've implemented, wholesale change right across almost every dimension, that we thought it would be prudent to set the guidance where we did. There's so many new reps and new moving parts that are in place right now. We wanna give ourselves the best chance to do a great job this year. Given that our territory manager break-even point remains about 6 months to 9 months, and we've hired so many new reps that we're sort of flip scaling into, cascading into the year, we just think there's a lot of variables, and we wanted to make sure that we're giving ourselves plenty of room to allow these reps to mature and drive.
Speaker #5: Yeah. I'll start it off, and then I'll, I'll turn it over to Roberto. So, you know, our thought here is, given the change that we've implemented, wholesale change, right, across almost every dimension, that we thought it would be prudent to set the guidance where we did.
Speaker #5: There are so many new reps and new moving parts that are in place right now. We want to give ourselves the best chance to do a great job this year.
Speaker #5: And given that our territory manager break-even point remains about six months to nine months, and we've hired so many new reps that we're sort of flow-scaling into, cascading into the year, we just think there are a lot of variables, and we wanted to make sure that we're giving ourselves plenty of room to allow these reps to mature and drive.
Antony Koblish: We really like the contribution from the 40% new reps so far. It looks like they've stepped up quite a bit as a percent contribution over Q4, but we wanna make sure that we're giving ourselves that time and flexibility. You know, there's some other factors that we have in place, I think, that give us confidence to do a good job this year. That is the fact that for the first time in the company's history, we are right on the mark with the number of reps we wanted to hire and at the right time. Right? In the past, we've sort of been stuck between 63 to 68 reps. I feel like that was where we were stuck no matter where our target is. This new commercial leadership team has done a great job of getting those folks in place.
Antony Koblish: We really like the contribution from the 40% new reps so far. It looks like they've stepped up quite a bit as a percent contribution over Q4, but we wanna make sure that we're giving ourselves that time and flexibility. You know, there's some other factors that we have in place, I think, that give us confidence to do a good job this year. That is the fact that for the first time in the company's history, we are right on the mark with the number of reps we wanted to hire and at the right time. Right? In the past, we've sort of been stuck between 63 to 68 reps. I feel like that was where we were stuck no matter where our target is. This new commercial leadership team has done a great job of getting those folks in place.
Speaker #5: We really like the contribution from the 40% new reps so far. It looks like they've stepped up quite a bit as a percent contribution over Q4.
Speaker #5: But we want to make sure that we're giving ourselves that time and flexibility. You know, there are some other factors that we have in place, I think, that give us confidence to do a good job this year.
Speaker #5: And that is the fact that, for the first time in the company's history, we are right on the mark with the number of reps we wanted to hire—and at the right time.
Speaker #5: Right? In the past, we've sort of been stuck between 63 to 68 reps. I feel like that was where we were stuck, no matter where our target is.
Speaker #5: But this new commercial leadership team has done a great job of getting those folks in place. We've got a product that we think is powerful, that's going to launch April 1st, fully.
Antony Koblish: We've got a product that we think is powerful, that's gonna launch 1 April fully. It's been in limited release. It's our long-term resorbable OviTex product, which should give us a great match-up with the leading biosynthetic out there, Phasix. I do think that's gonna be mostly additive to the portfolio along with some cannibalization from our permanent portfolio. I think one of the foundational drivers that we can rely on going forward is European performance. This has been very consistent, and I do think that they're gonna allow us to grow consistently over time. We very much look forward to adding OviTex PRS to their portfolio for sales, hopefully by the end of this year or early next year.
Antony Koblish: We've got a product that we think is powerful, that's gonna launch 1 April fully. It's been in limited release. It's our long-term resorbable OviTex product, which should give us a great match-up with the leading biosynthetic out there, Phasix. I do think that's gonna be mostly additive to the portfolio along with some cannibalization from our permanent portfolio. I think one of the foundational drivers that we can rely on going forward is European performance. This has been very consistent, and I do think that they're gonna allow us to grow consistently over time. We very much look forward to adding OviTex PRS to their portfolio for sales, hopefully by the end of this year or early next year.
Speaker #5: It's been in limited release. It's our long-term resorbable OBITEX product, which should give us a great match-up with the leading biosynthetic out there, Phasix.
Speaker #5: And I do think that's going to be mostly additive to the portfolio, along with some cannibalization from our permanent portfolio. I think one of the foundational drivers that we can rely on going forward is European performance.
Speaker #5: This has been very consistent, and I do think that they're going to allow us to—allow themselves to—grow consistently over time. And we very much look forward to adding PRS to their portfolio for sales, hopefully by the end of this year or early next year.
Antony Koblish: You know, one of the big factors that we have here, Caitlin, in this guidance set is contract conversion. Right? Our sales force has been very focused on getting contracts in place, and we haven't done as well as executing into those agreements. We're gonna shift that focus towards contract execution. We do know that there's a high degree of contracting complexity, right, which does affect timing, which is another factor of safety of why we built the guidance the way we did, right? Contract implementation varies from hospital to hospital. Even if you have a GPO contract in place, we're learning that every day. The way contracts are written in US further complicates things with, you know, a market share, cross-product portfolio bundling, and rebate structure. There is some complexity there.
Antony Koblish: You know, one of the big factors that we have here, Caitlin, in this guidance set is contract conversion. Right? Our sales force has been very focused on getting contracts in place, and we haven't done as well as executing into those agreements. We're gonna shift that focus towards contract execution. We do know that there's a high degree of contracting complexity, right, which does affect timing, which is another factor of safety of why we built the guidance the way we did. Contract implementation varies from hospital to hospital. Even if you have a GPO contract in place, we're learning that every day. The way contracts are written in US further complicates things with, you know, a market share, cross-product portfolio bundling, and rebate structure. There is some complexity there.
Speaker #5: You know, one of the big factors that we have here, Caitlin, in this, guidance set is contract conversion. Right? Our Salesforce has been very focused on getting contracts in place, and we haven't done as well as executing into those agreements.
Speaker #5: So we're going to shift that focus towards contract execution, and we do know that there's a high degree of contracting complexity.
Speaker #5: Right? Which does affect timing. which is another, factor of safety of what why we built the guidance the way we did. Right? Contract implementation, varies from hospital to hospital.
Speaker #5: Even if you have a GPO contract in place, we're learning that every day. And the way contracts are written in the US, further complicates things, with, you know, a market share and a cross-product portfolio bundling and rebate structure.
Speaker #5: So, there is some complexity there. We want to make sure that we give ourselves the time to execute into the contract footprint that we already have in place.
Antony Koblish: We wanna make sure that we give ourselves the time to execute into the contract footprint that we already have in place. Hopefully that gives you a flavor of what we're trying to do here on a bigger picture. We have a lot of factors of safety built in and a lot of potential upside, but we wanna be prudent.
Antony Koblish: We wanna make sure that we give ourselves the time to execute into the contract footprint that we already have in place. Hopefully that gives you a flavor of what we're trying to do here on a bigger picture. We have a lot of factors of safety built in and a lot of potential upside, but we wanna be prudent.
Speaker #5: So, hopefully that gives you a flavor of what we're trying to do here. On a bigger picture, we have a lot of factors of safety built in and a lot of potential upside, but we want to be prudent.
Roberto Cuca: Let me just add two things, Caitlin. You asked about cadence for the year. We do expect the cadence for the year to be similar to that in prior undisrupted years, where you see a step-up from Q1 to Q2, a smaller step-up from Q2 to Q3, and then a bigger step-up again from Q3 to Q4. The step-up from Q2 to Q3 being smaller is driven primarily by the summer holidays. We expect to see that pattern slightly amplified by the addition of all the sales reps that have come in over the course of the end of Q4 and through Q1, who will begin becoming product-productive in about six months.
Roberto Cuca: Let me just add two things, Caitlin. You asked about cadence for the year. We do expect the cadence for the year to be similar to that in prior undisrupted years, where you see a step-up from Q1 to Q2, a smaller step-up from Q2 to Q3, and then a bigger step-up again from Q3 to Q4. The step-up from Q2 to Q3 being smaller is driven primarily by the summer holidays. We expect to see that pattern slightly amplified by the addition of all the sales reps that have come in over the course of the end of Q4 and through Q1, who will begin becoming product-productive in about six months.
Speaker #1: And let me just add two things, Caitlin. You asked about cadence for the year, so we do expect the cadence for the year to be similar to that in prior undisrupted years, where you see a step up from the first to the second quarter.
Speaker #1: A smaller step up from the second to the third, and then a bigger step up again from the third to the fourth quarters.
Speaker #1: the, the step up from the second to the third being smaller is driven primarily by the summer holidays. and we expect to see that, that pattern slightly amplified by the addition of all the sales reps that reps that have come in over the course of the end of the fourth quarter and through the first quarter, who will begin becoming productive in about six months.
Roberto Cuca: We do still see that the most recent cohorts of sales reps hit break even just under 6 months, and then what Jeff and Jim call break out between 6 and 9 months, so become more than just break even positive.
Roberto Cuca: We do still see that the most recent cohorts of sales reps hit break even just under 6 months, and then what Jeff and Jim call break out between 6 and 9 months, so become more than just break even positive.
Speaker #1: So, we do still see that the most recent cohorts of sales reps hit break-even just under six months, and then what Jeff and Jim call break-out between six and nine months.
Speaker #1: So, become more—more than just break-even positive. Profitable.
Antony Koblish: Yeah
Antony Koblish: Yeah
Roberto Cuca: profitable.
Roberto Cuca: profitable.
Antony Koblish: all of these factors, Caitlin, they also add to the frustrations that everybody has had, including us in the past, about our forecasting accuracy, right? We wanna make sure, again, the word is prudent, to make sure that as we're going through all of this, you know, we feel very confident that we'll come out the other side with a much more predictable and forecastable business. Until we get there, we think it's best to be prudent.
Antony Koblish: all of these factors, Caitlin, they also add to the frustrations that everybody has had, including us in the past, about our forecasting accuracy. We wanna make sure, again, the word is prudent, to make sure that as we're going through all of this, you know, we feel very confident that we'll come out the other side with a much more predictable and forecastable business. Until we get there, we think it's best to be prudent.
Speaker #5: Yeah, and all of these factors, Caitlin, they also add to the frustrations that everybody has had, including us, in the past about our forecasting accuracy.
Speaker #5: Right? So we want to make sure, again, the word is prudent, to make sure that as we're going through all of this, you know, we've had to feel very confident that we'll come out the other side with a much more predictable and forecastable business.
Speaker #5: But until we get there, we think it's best to be prudent.
Caitlin Cronin: Understood. Maybe just one more from me. I think, Tony, you touched on the contracting. You know, how many IDNs or GPOs have you transferred to, you know, really recategorize OviTex? You talked about that. You know, the last couple of quarters, what are your expectations to continue doing that this year?
Caitlin Cronin: Understood. Maybe just one more from me. I think, Tony, you touched on the contracting. You know, how many IDNs or GPOs have you transferred to, you know, really recategorize OviTex? You talked about that. You know, the last couple of quarters, what are your expectations to continue doing that this year?
Speaker #6: Understood. And maybe just one more from me. I think, Tony, you touched on the contracting. You know, how many IDNs or GPOs have you transferred to, you know, really re-categorize OviTex?
Speaker #6: You talked about that, you know, the last couple of quarters. What are your expectations to continue doing that this—
Jim Hagen: Hey, Caitlin, it's Jim. I'll take that one. I think as Tony just said, our contracting focus, while we continue to drive a focus on the RTM category, especially into site-level agreements, the team's done a really nice job in 2025 of getting many of those agreements signed. 2026 is an execution year. We have to translate that, move it through the hospital processes, where we have a lot of surgeon advocacy. We have to work it through the admin process and translate that signature now into patients and revenue.
Jim Hagen: Hey, Caitlin, it's Jim. I'll take that one. I think as Tony just said, our contracting focus, while we continue to drive a focus on the RTM category, especially into site-level agreements, the team's done a really nice job in 2025 of getting many of those agreements signed. 2026 is an execution year. We have to translate that, move it through the hospital processes, where we have a lot of surgeon advocacy. We have to work it through the admin process and translate that signature now into patients and revenue.
Speaker #3: Hey, Caitlin. It's Jim. I'll take that one. I think, as Tony just said, our contracting focus—while we continue to drive a focus on the RTM category, especially into site-level agreements—the team's done a really nice job in 2025 of getting many of those agreements signed.
Speaker #3: 2026 is an execution year. We have to translate that, move it through the hospital processes, where we have a lot of surgeon advocacy. We have to work it through the admin process and translate that signature now into patients and revenue.
Antony Koblish: Yeah. I think, you know, as new opportunities present themselves, such as Vizient, that's been delayed, we're certainly gonna go for that, but we have more than enough footprint, that we have to start executing on, as Jim said, before we just, you know, continue to drive agreements. I mean, we'll continue to do both, but we have to focus on execution within the agreements we have.
Antony Koblish: I think, you know, as new opportunities present themselves, such as Vizient, that's been delayed, we're certainly gonna go for that, but we have more than enough footprint, that we have to start executing on, as Jim said, before we just, you know, continue to drive agreements. I mean, we'll continue to do both, but we have to focus on execution within the agreements we have.
Speaker #5: Yeah. I think, you know, as new opportunities present themselves, such as Vizient—that's been delayed. We're certainly going to go for that, but we have more than enough footprint that we have to start executing on, as Jim said, before we just, you know, continue to drive agreements.
Speaker #5: I mean, we'll continue to do both, but we have to focus on execution within the agreements we have.
Caitlin Cronin: Understood. Thanks so much.
Caitlin Cronin: Understood. Thanks so much.
Speaker #6: Understood. Thanks so much.
Operator: Thank you. As a reminder, ladies and gentlemen, if you do have a question at this time, please press star one one on your telephone. If your question has been answered and you'd like to remove yourself from the queue, simply press star one one again. Our next question comes from the line of Frank Takkinen from Lake Street Capital Markets. Your question, please.
Operator: Thank you. As a reminder, ladies and gentlemen, if you do have a question at this time, please press star one one on your telephone. If your question has been answered and you'd like to remove yourself from the queue, simply press star one one again. Our next question comes from the line of Frank Takkinen from Lake Street Capital Markets. Your question, please.
Speaker #1: Thank you. And as a reminder, ladies and gentlemen, if you do have a question at this time, please press *11 on your telephone.
Speaker #1: If your question has been answered and you'd like to remove yourself from the queue, simply press star 11 again. Our next question comes to the line.
Speaker #1: Frank, thank you. From Leak Street Capital Markets, your question, please.
Frank Takkinen: Great. Thank you for taking the questions. Wanted to follow up on the Q1 guidance a little more. Obviously you've heard all the comments about the structural changes you've made with the commercial organization and the disruption that has caused. Was just curious if there was anything else specific to call out with Q1. I know typically the seasonality is kind of up a few percent or down a few percent in some instances, depending on the year, but just the double-digit down quarter-over-quarter. Curious if there's anything beyond the sales force comments that you've made going on Q1.
Frank Takkinen: Great. Thank you for taking the questions. Wanted to follow up on the Q1 guidance a little more. Obviously you've heard all the comments about the structural changes you've made with the commercial organization and the disruption that has caused. Was just curious if there was anything else specific to call out with Q1. I know typically the seasonality is kind of up a few percent or down a few percent in some instances, depending on the year, but just the double-digit down quarter-over-quarter. Curious if there's anything beyond the sales force comments that you've made going on Q1.
Speaker #7: Great, thank you for taking the questions. I wanted to follow up on the Q1 guidance a little more. Obviously, I heard all the comments about the structural changes you've made with the commercial organization.
Speaker #7: And the disruption that that has caused. But I was just curious if there was anything else specific to call out with Q1. I know typically the seasonality is kind of up a few percent or down a few percent in some instances.
Speaker #7: Depending on the year, but just the double-digit down quarter-over-quarter—curious if there's anything beyond the Salesforce comments you've made going on in Q1.
Antony Koblish: Yeah. I'll start, Frank. I think my whole monologue on prudence for the year is transferable to Q1 as well. You know, I think we have one dynamic that I think has added to the general slow start that you see in hernia, plastic, and reconstruction, which is typical in January and February. That is, which I didn't mention before, is part of what Jeff and Jim have done is the territories have been restructured to be smaller, right? To go deeper. Which means there's been some splitting of territories. What we're encouraging is sales force efficiency, right? Which will help from time spent selling to T&E expense. We are gonna concentrate density of reps in smaller areas, preferably adjacent to high population areas that are already successful with us.
Antony Koblish: Yeah. I'll start, Frank. I think my whole monologue on prudence for the year is transferable to Q1 as well. You know, I think we have one dynamic that I think has added to the general slow start that you see in hernia, plastic, and reconstruction, which is typical in January and February. That is, which I didn't mention before, is part of what Jeff and Jim have done is the territories have been restructured to be smaller. To go deeper. Which means there's been some splitting of territories. What we're encouraging is sales force efficiency. Which will help from time spent selling to T&E expense. We are gonna concentrate density of reps in smaller areas, preferably adjacent to high population areas that are already successful with us.
Speaker #5: I'll start. I'll start, Frank. I think my whole monologue on prudence for the year is transferable to Q1 as well. You know, I think we have one dynamic that I think has added to the general slow start that you see in hernia, and plastic and reconstruction, which is typical in January and February.
Speaker #5: And that is, which I didn't mention before, is part of what Jeff and Jim have done, is the territories have been restructured to be smaller.
Speaker #5: Right? To go deeper—which means there's been some splitting of territories. And what we're encouraging is Salesforce efficiency, right? Which will help, from time spent selling to T&E expense.
Speaker #5: And we are going to concentrate density of reps in smaller areas, preferably adjacent to high-population areas that are already successful with us. So that means we may abandon a little bit of the hinterlands and the smaller hospitals that are out in the perimeter.
Antony Koblish: That means we may abandon a little bit of the hinterlands and the smaller hospitals that are out in the perimeter. Not fully abandoned, but de-emphasized a little bit. That's gonna cause a little bit of loss, you know, as we go through these shifts of splitting territories and creating more efficient density in the network. We wanted to make sure that we gave ourselves some room to work through that, which should mostly be taken care of, you know, through the end of Q1, and we should start to see some signals that we're coming out of that transition phase in Q2. Does that make sense, Frank? That's in addition, I think.
Antony Koblish: That means we may abandon a little bit of the hinterlands and the smaller hospitals that are out in the perimeter. Not fully abandoned, but de-emphasized a little bit. That's gonna cause a little bit of loss, you know, as we go through these shifts of splitting territories and creating more efficient density in the network. We wanted to make sure that we gave ourselves some room to work through that, which should mostly be taken care of, you know, through the end of Q1, and we should start to see some signals that we're coming out of that transition phase in Q2. Does that make sense, Frank? That's in addition, I think.
Speaker #5: Not, not fully abandoned, but, de-emphasize a little bit. So that's going to cause a little bit of, of, you know, a, a little these shifts of splitting territories and creating more efficient density in the network.
Speaker #5: So we wanted to make sure that we gave ourselves some room to work through that, which should mostly be taken care of, you know, through the end of the first quarter.
Speaker #5: And we should start to see some signals that we're coming out of that transition phase in Q2. Does that make sense, Frank? That's in addition, I think.
Frank Takkinen: Yep.
Frank Takkinen: Yep.
Speaker #1: Yep.
Antony Koblish: Yep.
Antony Koblish: Yep.
Frank Takkinen: Yep. Yep, that's perfect.
Frank Takkinen: Yep. Yep, that's perfect.
Speaker #5: Yep.
Speaker #1: Yep. Yep. That's perfect.
Antony Koblish: Hey, Frank.
Antony Koblish: Hey, Frank.
Frank Takkinen: I appreciate that.
Frank Takkinen: I appreciate that.
Speaker #5: Thanks, Frank.
Speaker #1: I appreciate that. And then, just.
Jeffrey Blizard: Frank, this is Jeffrey Blizard. I just wanna add one more point onto Tony, and the word disruption is something we've avoided here, and we didn't call this a reorganization. The focus has been on restructuring, right people in right roles, and making sure that we can have a focus on these key customers in key cities and also those academic programs that are hubbed in key cities. What we found in not only the challenges in January that most companies were faced with was over 1,000 square miles of geography in the US was impacted by that blizzard, and we saw a number of elective procedures be impacted by that. So we've heard that from other programs and other companies that have had similar situations.
Jeffrey Blizard: Frank, this is Jeffrey Blizard. I just wanna add one more point onto Tony, and the word disruption is something we've avoided here, and we didn't call this a reorganization. The focus has been on restructuring, right people in right roles, and making sure that we can have a focus on these key customers in key cities and also those academic programs that are hubbed in key cities. What we found in not only the challenges in January that most companies were faced with was over 1,000 square miles of geography in the US was impacted by that blizzard, and we saw a number of elective procedures be impacted by that. So we've heard that from other programs and other companies that have had similar situations.
Speaker #5: Frank, this is Jeff Blizard. I just want to add, one more point on to Tony and the word disruption. is something we've avoided here.
Speaker #5: And we didn't call this a reorganization. The really, the focus has been on restructuring. Right people in right roles. And making sure that we can have a focus on these key customers in key cities and also those academic programs that are hubbed in key cities.
Speaker #5: What we found in not only, the challenges in January that most companies were faced in was over 1,000 square miles of geography in the US was impacted by that blizzard.
Speaker #5: And we saw a number of elective procedures be impacted by that. So we've heard that from other programs, and other companies that have had similar situations.
Frank Takkinen: Yep. That's helpful. As we think about exiting this period where we're maybe returning to a steady state growth rate, how do you view the steady state growth profile of TELA over a longer period of time?
Frank Takkinen: Yep. That's helpful. As we think about exiting this period where we're maybe returning to a steady state growth rate, how do you view the steady state growth profile of TELA over a longer period of time?
Speaker #1: Yep. That's helpful. A-and then, as we think about exiting this period where we're maybe returning to a, a steady state, growth rate, how do you view the, the steady state growth profile of, of Tele over a longer period of time?
Antony Koblish: Yeah. Well, I think the markets that we serve are kind of mid-single digits. We've been above market rate growth since inception. You know, I think we anticipate that we will be able to significantly outgrow the market. You know, the other interesting thing I think as you look at the data that we're presenting here is that our units for both PRS and hernia are high, right? Our growth rate on the hernia units, I think is 20 or 22%.
Antony Koblish: Yeah. Well, I think the markets that we serve are kind of mid-single digits. We've been above market rate growth since inception. You know, I think we anticipate that we will be able to significantly outgrow the market. You know, the other interesting thing I think as you look at the data that we're presenting here is that our units for both PRS and hernia are high, right? Our growth rate on the hernia units, I think is 20 or 22%.
Speaker #5: Yeah. Well, I think the markets that we serve are kind of mid-single digits. We've been above market rate growth since inception. And, you know, I think we anticipate that we will be able to significantly outgrow the market.
Speaker #5: And, you know, the other interesting thing I think is you look at the data that we're presenting here, is that our units for both PRS and, and Hernia are, are high.
Speaker #5: Right? Our growth rate on the Hernia units, I think, is 20 or 22 percent, 22 percent. Right? So that's a very good sign, for the long haul.
Jeffrey Blizard: Twenty-two.
Jeffrey Blizard: Twenty-two.
Antony Koblish: 22%. Right? That's a very good sign for the long haul, you know, given that that's the bulk of the procedure. Making inroads into those smaller piece procedures is super important. It does have an impact with mix shift and top line revenue, but that should straighten out as well. You know, we certainly believe that once we get to steady state, we should be back into double digit growth or beyond. You know, this is a way for us to give ourselves to clear the decks. We've never done a change this comprehensive that affects territory planning, compensation plans to drive that.
Antony Koblish: 22%. Right? That's a very good sign for the long haul, you know, given that that's the bulk of the procedure. Making inroads into those smaller piece procedures is super important. It does have an impact with mix shift and top line revenue, but that should straighten out as well. You know, we certainly believe that once we get to steady state, we should be back into double digit growth or beyond. You know, this is a way for us to give ourselves to clear the decks. We've never done a change this comprehensive that affects territory planning, compensation plans to drive that.
Speaker #5: You know, given that, that's the bulk of the procedures. So making inroads into those smaller piece procedures is super important. it does have an impact with mixed shift.
Speaker #5: And top-line revenue. But that should straighten out as well. You know, we certainly believe that once we get to steady state, we should be back into the double-digit growth or beyond.
Speaker #5: You know, this is a way for us to give ourselves the chance to clear the decks. We've never done a change this comprehensive that affects territory planning, compensation plans, to drive that.
Antony Koblish: You know, this is so comprehensive, we're just giving ourselves the room to get back to that double digit plus growth. I think we have a great shot at getting there in H2 of this year, hopefully.
Antony Koblish: You know, this is so comprehensive, we're just giving ourselves the room to get back to that double digit plus growth. I think we have a great shot at getting there in H2 of this year, hopefully.
Speaker #5: You know, this is so comprehensive, we're just giving ourselves the room to get back to that, double-digit plus growth. I, I, I think we have a great shot at getting there in the second half of this year, hopefully.
Frank Takkinen: Yep. Got it. That's helpful. If I could just squeeze one more in, as it relates to your point on unit growth that's been really solid, obviously, in both product categories. What's your latest thought on how we should think about when ASPs in hernia could start to flatten out and stabilize?
Frank Takkinen: Yep. Got it. That's helpful. If I could just squeeze one more in, as it relates to your point on unit growth that's been really solid, obviously, in both product categories. What's your latest thought on how we should think about when ASPs in hernia could start to flatten out and stabilize?
Speaker #1: Yep. Got it. That's helpful. Then if I could just squeeze one more in, as it relates to your, your point on, on unit growth, that's been really solid, obviously, in, in both product categories.
Speaker #1: what's your latest thought on how we should think about when ASPs and, and Hernia could start to, to flatten out and, and stabilize?
Antony Koblish: Yeah, that's a good question. You know, I was looking at that before the call to prepare, and one of the metrics I look at is what type of hernia procedures we're doing, right? I think for the longest time, we were about a 70% ventral company, and that is shifting. I think we always had about 10% to 15% of inguinal. Right now, I'm just thumbing through it. I'll go by memory, and Jim can correct me if I'm wrong, but I think we're at about 50% of our business right now is ventral and 25% of our business is inguinal. 14% is hiatal.
Antony Koblish: Yeah, that's a good question. You know, I was looking at that before the call to prepare, and one of the metrics I look at is what type of hernia procedures we're doing, right? I think for the longest time, we were about a 70% ventral company, and that is shifting. I think we always had about 10% to 15% of inguinal. Right now, I'm just thumbing through it. I'll go by memory, and Jim can correct me if I'm wrong, but I think we're at about 50% of our business right now is ventral and 25% of our business is inguinal. 14% is hiatal.
Speaker #5: Yeah, that's a good question. You know, I'm just looking—I was looking at that before the call to prepare. And one of the metrics I look at is what type of hernia procedures we're doing.
Speaker #5: Right? I think for the longest time, we were about a 70% ventral company. And that is shifting. And I think we always had about 10 to 15% of inguinal.
Speaker #5: But right now, I'm just thumbing through it. I'll go by memory and Jim can correct me if I'm wrong. But I think we're at about 50% of our business right now is ventral.
Speaker #5: And 25% of our business is inguinal. Fourteen percent is hiatal. So we were really a 10 to 14 percent company on both inguinal and hiatal when we, you know, in the past, before this shift of getting more involved in the fat part of the bell curve of hernia procedures.
Antony Koblish: We were really a 10 to 14% company on both inguinal and hiatal when, you know, in the past, before this shift of getting more involved in the fat part of the bell curve of hernia procedures. Now we're already up to, you know, we're down to 50 from 70 on ventral, and we're up from 10 to 12 on inguinal, up to 25. It's hard for me to say, you know, where that balance goes. There's almost 1 million inguinals done a year. You know, we're gonna keep mining that until we hit some kind of a steady state, right? It's gonna have to do with the mix between inguinals and ventrals.
Antony Koblish: We were really a 10 to 14% company on both inguinal and hiatal when, you know, in the past, before this shift of getting more involved in the fat part of the bell curve of hernia procedures. Now we're already up to, you know, we're down to 50 from 70 on ventral, and we're up from 10 to 12 on inguinal, up to 25. It's hard for me to say, you know, where that balance goes. There's almost 1 million inguinals done a year. You know, we're gonna keep mining that until we hit some kind of a steady state, right? It's gonna have to do with the mix between inguinals and ventrals.
Speaker #5: But now, we're already up to—you know, we're down to 50 from 70 on ventral. And we're up from 10 to 12 on inguinal, up to 25.
Speaker #5: So it's hard for me to say, you know, where that balance goes. There's, there's almost a million inguinals done a year. so, you know, we're going to keep mining that until until we hit some kind of a steady state.
Speaker #5: Right? So, it-it's going to have to do with the mix between in-inguinals and ventrals.
Jim Hagen: The other comment I would say on this one, Frank, is not just the type of hernia, but the modality of the procedure. As we see procedures moving away from opens into laparoscopic and robotic procedures, we're well positioned. That's also why you see our LPR portfolio outpacing much of our growth, along with IHR. I do think surgeons are voting with their preferences, using us more where procedures are going, which is laparoscopic robotic for us. That ASP shift, to Tony's point, is gonna continue. We're gonna continue to see more of our volume moving to those lower pieces with an ASP that's a bit lower than we historically had been with the large opens. As I think Roberto will continue to remind everyone, that does not impact gross margins.
Jim Hagen: The other comment I would say on this one, Frank, is not just the type of hernia, but the modality of the procedure. As we see procedures moving away from opens into laparoscopic and robotic procedures, we're well positioned. That's also why you see our LPR portfolio outpacing much of our growth, along with IHR. I do think surgeons are voting with their preferences, using us more where procedures are going, which is laparoscopic robotic for us. That ASP shift, to Tony's point, is gonna continue. We're gonna continue to see more of our volume moving to those lower pieces with an ASP that's a bit lower than we historically had been with the large opens. As I think Roberto will continue to remind everyone, that does not impact gross margins.
Speaker #1: The other comment, I would say, on this one, Frank, is not just the, the type of Hernia, but the modality of the procedure. As we see procedures moving away from opens into laparoscopic and robotic procedures.
Speaker #1: We're well-positioned. That's also why you see our LPR portfolio outpacing much of our growth, along with IHR. So I do think surgeons are voting with their preferences, using us more, where procedures are going, which is laparoscopic and robotic for us.
Speaker #1: So that ASP shift, to Tony's point, we see more of our volume moving to those lower pieces. With an ASP that's a bit lower than we historically had been with the large opens.
Speaker #1: but as I think Roberto will continue to remind everyone, that does not impact gross margins.
Antony Koblish: Right. Yeah, just to put a little finer point on it, Frank, what we're seeing is we're seeing the start of robotic surgery starting to make more and more inroads into the open complex cases. We're there, you know, ready to serve those cases beautifully with our LPR product, right? Certainly, our IHR product is robot compatible as well. We're well-positioned for how the hernia market's evolving. How long that takes, it's hard to say. I do think the future is gonna be higher unit growth volume, more procedures, but smaller pieces. I think you're gonna start to see our 1S, 2S, and Core start to give way to IHR and LPR, and hopefully in the future, LiquiFix as being the main unit drivers going forward.
Antony Koblish: Right. Yeah, just to put a little finer point on it, Frank, what we're seeing is we're seeing the start of robotic surgery starting to make more and more inroads into the open complex cases. We're there, you know, ready to serve those cases beautifully with our LPR product, right? Certainly, our IHR product is robot compatible as well. We're well-positioned for how the hernia market's evolving. How long that takes, it's hard to say. I do think the future is gonna be higher unit growth volume, more procedures, but smaller pieces. I think you're gonna start to see our 1S, 2S, and Core start to give way to IHR and LPR, and hopefully in the future, LiquiFix as being the main unit drivers going forward.
Speaker #5: Right. Yeah. Just to put a little finer point on it, Frank, what we're seeing is we're seeing the, the start of robotic surgery starting to make more and more inroads into the open complex cases.
Speaker #5: And so w-we're there. W you know, ready to serve those cases, beautifully with our LPR product. Right? And certainly, our inguinal product is robot compatible as well.
Speaker #5: So, we're well-positioned for how the hernia market's evolving—how long that takes, it's hard to say. But I do think the future is going to be higher unit growth volume, more procedures, but smaller pieces.
Speaker #5: And I think you're going to start to see our 1S, 2S, and Core start to give way to inguinal and LPR, and hopefully, in the future, Liquefix as being the main unit drivers going forward.
Antony Koblish: You know, we'll certainly get all the opens that we can with our older portfolio. One more thing to add. I'm sorry, a little stream of consciousness here. The long-term resorbable hernia product has zero permanent polymer in it, and a lot of these old-time surgeons do have an allergy to putting anything permanent. I mean, our product works beautifully in these cases, and many surgeons do, but there are just some category of surgeons that wants nothing permanent. Our long-term resorbable product, I think, has a shot of opening up some of those more difficult, complex trauma, complex abdominal cases down the line in the future, but that remains to be seen. I think the global trend is towards robotic for everything and smaller pieces, which favors our LPR product portfolio.
Antony Koblish: You know, we'll certainly get all the opens that we can with our older portfolio. One more thing to add. I'm sorry, a little stream of consciousness here. The long-term resorbable hernia product has zero permanent polymer in it, and a lot of these old-time surgeons do have an allergy to putting anything permanent. I mean, our product works beautifully in these cases, and many surgeons do, but there are just some category of surgeons that wants nothing permanent. Our long-term resorbable product, I think, has a shot of opening up some of those more difficult, complex trauma, complex abdominal cases down the line in the future, but that remains to be seen. I think the global trend is towards robotic for everything and smaller pieces, which favors our LPR product portfolio.
Speaker #5: But, you know, we'll certainly get all the opens that we can, with our, our, our older portfolio. And, one more thing to add. I'm sorry.
Speaker #5: It's a little stream of consciousness here. But the long-term resorbable hernia product has zero permanent polymer in it. And a lot of these old-time surgeons do have an allergy to putting anything permanent.
Speaker #5: I mean, our product works beautifully in these cases. And many, many surgeons do. But there are just some category of surgeon that wants nothing permanent.
Speaker #5: So our long-term resorbable product, I think, has a shot of opening up some of those, more difficult complex trauma complex ab wall cases down the line in the future.
Speaker #5: But that remains to be seen. But I think the global trend is towards, robotic for everything and smaller pieces, which favors our LPR product portfolio.
Frank Takkinen: Got it. Very helpful. I appreciate the color. Thanks, guys.
Frank Takkinen: Got it. Very helpful. I appreciate the color. Thanks, guys.
Speaker #1: Got it. Very helpful. I appreciate the code. Thanks, guys.
Antony Koblish: Thanks, Frank.
Antony Koblish: Thanks, Frank.
Operator: Thank you. Our next question comes from the line of Mike Sarcone from Jefferies. Your question, please.
Operator: Thank you. Our next question comes from the line of Mike Sarcone from Jefferies. Your question, please.
Speaker #5: Thanks, Frank.
Speaker #6: Thank you. And our next question comes from the line of Michael Sarconi from Jefferies. Your question, please.
Mike Sarcone: Good afternoon, and thanks for taking the question. Just a follow-up on one of the first questions, and not to belabor this, but when you provided that kind of at least 15% directional outlook in mid-November, you mentioned there was some built-in cushion in there. Just trying to get a better sense for, you know, what changed, understanding you're trying to be even more prudent and you wanna de-risk the guide. Did anything else change, you know, over the last three months around, you know, expected rep productivity ramp or anything like that? Just trying to get a bridge from the 15 to the 8.
Mike Sarcone: Good afternoon, and thanks for taking the question. Just a follow-up on one of the first questions, and not to belabor this, but when you provided that kind of at least 15% directional outlook in mid-November, you mentioned there was some built-in cushion in there. Just trying to get a better sense for, you know, what changed, understanding you're trying to be even more prudent and you wanna de-risk the guide. Did anything else change, you know, over the last three months around, you know, expected rep productivity ramp or anything like that? Just trying to get a bridge from the 15 to the 8.
Speaker #7: Good afternoon and thanks for taking the question. just a, a follow-up on, on one of the first questions. And, and not to, to belabor this, but, when you provided that kind of a-at least 15%, directional, outlook in mid-November, you mentioned there was some built-in cushion in there.
Speaker #7: Just trying to get a better sense for, you know, what changed to, understanding you're, you're trying to be even more prudent and, and you want to, de-risk the guide.
Speaker #7: But did anything else change, you know, over the last three months around, you know, expected rep, productivity ramp, or, or anything like that? Just trying to get a, a bridge from the 15 to the 8.
Jim Hagen: Yeah. Hey, Michael, it's Jim. I'd say one of the biggest things is really just the tenure Jeff and I had in role. We started in June. We had that call in the fall. We were in the midst of the change. I think what we've learned since then is it was a sizable change. There were multiple things we put on the field organization at the same time, while we concurrently were hiring rapidly into the organization. I would say our assumptions changed from when we had the Q3 call to now, just appreciating the change curve it takes to move an organization through all of that is a bit longer and more complex, I think, than when we originally planned it out. It's not saying it's not going well, it's actually going very well.
Jim Hagen: Yeah. Hey, Michael, it's Jim. I'd say one of the biggest things is really just the tenure Jeff and I had in role. We started in June. We had that call in the fall. We were in the midst of the change. I think what we've learned since then is it was a sizable change. There were multiple things we put on the field organization at the same time, while we concurrently were hiring rapidly into the organization. I would say our assumptions changed from when we had the Q3 call to now, just appreciating the change curve it takes to move an organization through all of that is a bit longer and more complex, I think, than when we originally planned it out. It's not saying it's not going well, it's actually going very well.
Speaker #5: Yeah. It may not go to Jeb. I'd say one of the biggest things is really the tenure Jeff and I had in role, we started in June.
Speaker #5: We had that call in the fall. We were in the midst of the change. I think what we've learned since then is it was a sizable change.
Speaker #5: There were multiple things we put on the field organization at the same time. While we concurrently were hiring rapidly, into the organization. So I would say our assumptions changed from when we had the Q3 call to now, just appreciating the change curve it takes to move a lar an organization through all of that is a bit longer and more complex.
Speaker #5: I think that when we originally planned it out, it's not saying it's not going well. It's actually going very well. But the prudence point to Tony is, we are going to give ourselves some more time to work through that change curve, get new reps up to speed and up to efficiency where we need them, and get our legacy team in the US kind of through that change curve of new leadership, new comp plan, new territory alignments.
Jim Hagen: The prudence point to Tony is we are gonna give ourselves some more time to work through that change curve, get new reps up to speed and up to efficiency where we need them through, and get our legacy team in the US kind of through that change curve of new leadership, new comp plan, new territory alignments, so everyone's then hitting full stride hopefully in the H2 of the year.
Jim Hagen: The prudence point to Tony is we are gonna give ourselves some more time to work through that change curve, get new reps up to speed and up to efficiency where we need them through, and get our legacy team in the US kind of through that change curve of new leadership, new comp plan, new territory alignments, so everyone's then hitting full stride hopefully in the H2 of the year.
Speaker #5: So everyone's then hitting full stride, hopefully, in the second half of the year.
Mike Sarcone: Got it. That's very helpful. Thank you. Maybe just one on the new kind of account targeting strategy. You talked about deeper penetration in existing accounts. Can you talk to us about, you know, some of the methods, you know, you plan to use to broaden out that penetration in existing accounts?
Mike Sarcone: Got it. That's very helpful. Thank you. Maybe just one on the new kind of account targeting strategy. You talked about deeper penetration in existing accounts. Can you talk to us about, you know, some of the methods, you know, you plan to use to broaden out that penetration in existing accounts?
Speaker #7: Got it. That's, that's very helpful. Thank you. And then maybe just, one on, the new kind of account targeting strategy you talked about, deeper penetration, in existing accounts.
Speaker #7: Can you talk to us about, you know, some of the methods, you know, you plan to use to, to broaden out that penetration in existing accounts?
Jeffrey Blizard: Sure. It's Jeff. So the problem statement that we analyzed over the last few months was too many reps were dependent on one surgeon in one location. We talk about terms like stickiness to our business. In order to do that, especially larger programs that have anywhere from 3 to 7, sometimes even 9 general surgeons or multiple plastic surgeons per site, we couldn't rely on just one user. With the way that the comp program was set up and the goals and objectives in 2025, the need for our territory managers to be spread far and thin was so that we could gain distribution, and they could work their comp program to the best of their ability. We realized that was a limiting factor. That meant product was in hospitals without patients being covered.
Jeffrey Blizard: Sure. It's Jeff. So the problem statement that we analyzed over the last few months was too many reps were dependent on one surgeon in one location. We talk about terms like stickiness to our business. In order to do that, especially larger programs that have anywhere from 3 to 7, sometimes even 9 general surgeons or multiple plastic surgeons per site, we couldn't rely on just one user. With the way that the comp program was set up and the goals and objectives in 2025, the need for our territory managers to be spread far and thin was so that we could gain distribution, and they could work their comp program to the best of their ability. We realized that was a limiting factor. That meant product was in hospitals without patients being covered.
Speaker #5: Sure. It's Jeff. so the problem statement that we analyzed over the last few months was too many reps were dependent on one surgeon in one location.
Speaker #5: And for us too, we talk about terms like stickiness to our business. In order to do that, especially in larger programs that have anywhere from three to seven, sometimes even nine general surgeons or multiple plastic surgeons per site, we couldn't rely on just one user.
Speaker #5: With the way that the comp program was set up and the goals and objectives in 2025, the need for territory managers to be spread far and thin was so that we could gain distribution and they could work their comp program to the best of their ability.
Speaker #5: And we realized that was a limiting factor. That meant product was in hospitals without patients being covered. And that meant users were identified without another person on staff that had bought into the product or the proposal that this was a better device or product than the ones they were using.
Jeffrey Blizard: That meant users were identified without another person on staff that had bought into the product or the proposal that this was a better device or product than the ones they were using. Having this as a focus point allows us to do better in servicing, teaching, and training programs how to handle the product, being present and being bedside so the patients can receive optimal outcomes. The compensation plan was built around that specifically. Smaller geographies as opposed to we had reps that were driving in the car 3 to 5, sometimes even 6 hours in the great state of Texas, that they found themselves racing across the state to deliver product or be present for that one physician and that one program.
Jeffrey Blizard: That meant users were identified without another person on staff that had bought into the product or the proposal that this was a better device or product than the ones they were using. Having this as a focus point allows us to do better in servicing, teaching, and training programs how to handle the product, being present and being bedside so the patients can receive optimal outcomes. The compensation plan was built around that specifically. Smaller geographies as opposed to we had reps that were driving in the car 3 to 5, sometimes even 6 hours in the great state of Texas, that they found themselves racing across the state to deliver product or be present for that one physician and that one program.
Speaker #5: Having this as a focus point allows us to do better in servicing. Teaching and training programs how to handle the product. Being present and being bedside so the patients can receive optimal outcomes.
Speaker #5: And then compensation plan was the compensation plan was built around that specifically. Smaller geographies as opposed to we had reps that were driving in the car three to five, sometimes even six hours in the great state of Texas.
Speaker #5: That they found themselves racing across the state to deliver product or be present for that one physician and that one program. So we know that this density rule will work, as well as having, in many of those large cities as I mentioned earlier, an academic hub where now we can put people in to help support our fellows and our residents that are being trained in this next generation of surgeons.
Jeffrey Blizard: We know that this density rule will work, as well as having in those many of those large cities, as I mentioned earlier, an academic hub where now we can put people in to help support our fellows and our residents that are being trained as the next generation surgeons.
Jeffrey Blizard: We know that this density rule will work, as well as having in those many of those large cities, as I mentioned earlier, an academic hub where now we can put people in to help support our fellows and our residents that are being trained as the next generation surgeons.
Jim Hagen: Michael, the only thing I'll add to that in terms of how we're doing this is leveraging the full portfolio. As we just talked about on Frank's conversation, we grew historically through large open procedures with OviTex 1S and OviTex 2S. As we think about building depth within a hospital, we're talking about more users within that specific site. LIQUIFIX, as an example, gives us a new opportunity to engage a surgeon who may not fully believe in OviTex but wants an alternate fixation technique. That's a new in for us. Driving OviTex IHR and OviTex LPR go after those surgeons who are more proficient on the robot or focusing on the robot.
Jim Hagen: Michael, the only thing I'll add to that in terms of how we're doing this is leveraging the full portfolio. As we just talked about on Frank's conversation, we grew historically through large open procedures with OviTex 1S and OviTex 2S. As we think about building depth within a hospital, we're talking about more users within that specific site. LIQUIFIX, as an example, gives us a new opportunity to engage a surgeon who may not fully believe in OviTex but wants an alternate fixation technique. That's a new in for us. Driving OviTex IHR and OviTex LPR go after those surgeons who are more proficient on the robot or focusing on the robot.
Speaker #7: Michael, the only other thing I'll add to that in terms of a how we're doing this, is leveraging the full portfolio. as we just talked about on Frank's conversation, we grew historically through large open procedures with one S and two S as we think about building depth within a hospital.
Speaker #7: We're talking about more users within that specific site. Liquefix, as as an example, gives us a new opportunity to engage a surgeon who may not fully believe in Overtex, but wants an alternate fixation technique.
Speaker #7: That's a new insight for us. Driving IHR and LPR, we go after those surgeons who are more proficient on the robot or are focusing on the robot.
Jim Hagen: Our portfolio allows us to engage with more users within a specific hospital, and that's what we're asking our field team to do, is leverage the full bag, drive more users per site, and that's one of the key metrics we're gonna measure them on this year. That creates the stickiness for us, and that's what allows us to go after the higher ceiling accounts, and drive a deeper share within those accounts, which for us, to Tony's point, that ability to have a more predictable top-line revenue, that's part of that formula.
Jim Hagen: Our portfolio allows us to engage with more users within a specific hospital, and that's what we're asking our field team to do, is leverage the full bag, drive more users per site, and that's one of the key metrics we're gonna measure them on this year. That creates the stickiness for us, and that's what allows us to go after the higher ceiling accounts, and drive a deeper share within those accounts, which for us, to Tony's point, that ability to have a more predictable top-line revenue, that's part of that formula.
Speaker #7: So our portfolio allows us to engage with more users within a specific hospital. And that's what we're asking our field team to do, is leverage the full bag, drive more ADU, more users per site.
Speaker #7: And that's one of the key metrics we're going to measure them on this year. That creates a stickiness for us, and that's what allows us to go after the higher ceiling accounts.
Speaker #7: and drive a deeper share within those accounts, which for us, to Tony's point, that ability to have a more predictable top-line revenue, that's part of that formula.
Antony Koblish: Yeah. I'll just put a fine point on the end of Jim's comment. You know, if you're wide and shallow, and you got one surgeon four hours away, who's using your product, it's pretty easy to dislodge that surgeon, right, from his usage habit and patterns, when you're not present fully, and you got competitive reps looking to leverage you out with contracting and rebates. We have to get five and six users in a smaller geography. That is really what we're setting ourselves up to do. You become much harder to knock down.
Antony Koblish: Yeah. I'll just put a fine point on the end of Jim's comment. You know, if you're wide and shallow, and you got one surgeon four hours away, who's using your product, it's pretty easy to dislodge that surgeon, right, from his usage habit and patterns, when you're not present fully, and you got competitive reps looking to leverage you out with contracting and rebates. We have to get five and six users in a smaller geography. That is really what we're setting ourselves up to do. You become much harder to knock down.
Speaker #5: Yeah, and I'll just put a fine point on the end of Jim's comment. You know, if you're wide and shallow and you've got one surgeon four hours away who's using your product—
Speaker #5: It's pretty easy to dislodge that surgeon, right, from his usage habit and patterns. When you're not present fully, and you've got competitive reps looking to lever you out with contracting and rebates, we have to get five and six users in a smaller geography.
Speaker #5: That, that is really what we're setting ourselves up to do. You co you become much harder to knock down.
Mike Sarcone: Great. Thank you.
Mike Sarcone: Great. Thank you.
Speaker #7: Great. Thank you.
Operator: Thank you. Our next question comes from the line of Matthew O'Brien from Piper Sandler. Your question please.
Operator: Thank you. Our next question comes from the line of Matthew O'Brien from Piper Sandler. Your question please.
Speaker #2: Thank you. And our next question comes from the line of Matthew O'Brien from Piper Sandler. Your question, please.
Matthew O'Brien: Good afternoon. Thanks for taking the questions. I don't know, Roberto, or if somebody else can maybe talk a little bit about the impact of weather in Q1 because the number is so low versus what we were kind of expecting. I get it's Q1 and everything, and you're still going through this transition, but it's just so low that it then requires you to start putting up some numbers in the, especially in H2 that we haven't seen out of the companies. It requires a lot of faith that you can be able to do that. Maybe just talk about those two components there, the weather impact in Q1 and then what you're seeing that gives you confidence and should give investors confidence that the back-end-loaded guide is achievable.
Matthew O'Brien: Good afternoon. Thanks for taking the questions. I don't know, Roberto, or if somebody else can maybe talk a little bit about the impact of weather in Q1 because the number is so low versus what we were kind of expecting. I get it's Q1 and everything, and you're still going through this transition, but it's just so low that it then requires you to start putting up some numbers in the, especially in H2 that we haven't seen out of the companies. It requires a lot of faith that you can be able to do that. Maybe just talk about those two components there, the weather impact in Q1 and then what you're seeing that gives you confidence and should give investors confidence that the back-end-loaded guide is achievable.
Speaker #6: Good afternoon. Thanks for taking the questions. I don't know Roberto if, if somebody else can maybe talk a little bit about the, the impact of weather in Q1 because the number is so low versus what we were kind of expecting.
Speaker #6: And I get it's Q1 and everything, and you're still going through this transition. But it's just so low that it requires you to start putting up some numbers, especially in the back half of the year, that we haven't seen out of the company.
Speaker #6: It requires a lot of faith that you can be able to do that. So maybe just talk about tho-those two components there, the weather impact in Q1 and then the what you're seeing that, that gives you confidence and should give investors confidence that the, the backend loaded guide is, is achievable.
Matthew O'Brien: I do have a follow-up.
Matthew O'Brien: I do have a follow-up.
Speaker #6: And then I do have a follow-up.
Jim Hagen: Hey, Matthew, it's Jim. I'll take the first half of that. So I'd say it's two variables external to us in Q1. We're trying not to focus on external variables, but they are real sometimes. One, feedback from our field team is just volumes in January were low, right? So I think there was just a market lull coming out of the holidays with, I think, insurance premiums resetting. That was a real impact. As Jeff talked about, the impact of the storms on the East Coast with major population density did shuffle some elective procedures. Some were lost, right, were not happening. Some others got deferred out past Q1. We don't have, I would say, firm guidance for you on kinda what percentage impact that had to us.
Jim Hagen: Hey, Matthew, it's Jim. I'll take the first half of that. So I'd say it's two variables external to us in Q1. We're trying not to focus on external variables, but they are real sometimes. One, feedback from our field team is just volumes in January were low, right? So I think there was just a market lull coming out of the holidays with, I think, insurance premiums resetting. That was a real impact. As Jeff talked about, the impact of the storms on the East Coast with major population density did shuffle some elective procedures. Some were lost, right, were not happening. Some others got deferred out past Q1. We don't have, I would say, firm guidance for you on kinda what percentage impact that had to us.
Speaker #5: Hey, Matthew, it's Jim. I'll take the first half of that. So, I'd say it's two variables. External to us in Q1. We're trying not to focus on external variables, but they are real sometimes.
Speaker #5: One feedback from our field team—low. Right? So I think there was just a market low, low coming out of the holidays, with, I think, insurance premiums resetting.
Speaker #5: That was a real impact. And as Jeff talked about, the impact of the storms on the East Coast with major population density did shuffle some elected procedures.
Speaker #5: Some were lost, right? Just were not happening. Some others got deferred out past Q1. We don't have, I would say, firm guidance for you on kind of what percentage impact that had to us now.
Jim Hagen: Now, what we are trying to focus on is more what our controllables were in Q1, which is really where we spent that time on hiring, getting new people into the organization, getting them trained up and going, along with what we just talked about is that mix shift from shifting accounts from lower ceiling accounts in kinda lower density areas to higher ceiling accounts in more populous areas. I would say that probably had the more material impact for the performance from Q4 to Q1. Those are things we can control, and that's where I think our focus is.
Jim Hagen: Now, what we are trying to focus on is more what our controllables were in Q1, which is really where we spent that time on hiring, getting new people into the organization, getting them trained up and going, along with what we just talked about is that mix shift from shifting accounts from lower ceiling accounts in kinda lower density areas to higher ceiling accounts in more populous areas. I would say that probably had the more material impact for the performance from Q4 to Q1. Those are things we can control, and that's where I think our focus is.
Speaker #5: what we were trying to focus on is more of what our controllables were. In Q1, which is really where we spent that time on hiring, getting new people in to the organization, getting them trained up and going.
Speaker #5: Along with what we just talked about is that mixed shift from shifting accounts from lower ceiling accounts and kind of lower density areas to higher ceiling accounts and more populous areas.
Speaker #5: I would say that probably had the more material impact, for the performance from Q4 to Q1. those are the things we can control. And that's where I think where our focus is.
Antony Koblish: Yeah, Matt, you know, we have snapped back quite well after poor quarters, right? I think it was Q4 2024, right? We had a little bit of a raid on our sales force, and we snapped back very effectively in Q1 2025. You know, I think we've got enough factors of safety built in with the new product launches. You know, having a fully staffed sales force at 90 reps or a little over 90 reps in the next couple of weeks here, we've never been at that scale, and we've never been, you know, fully to our hiring plan this early in the game. That, and that's by design. Then, you know, I think the talent of the reps, you know, getting them through that six-month bed-in period where they get productive.
Antony Koblish: Yeah, Matt, you know, we have snapped back quite well after poor quarters, right? I think it was Q4 2024, right? We had a little bit of a raid on our sales force, and we snapped back very effectively in Q1 2025. You know, I think we've got enough factors of safety built in with the new product launches. You know, having a fully staffed sales force at 90 reps or a little over 90 reps in the next couple of weeks here, we've never been at that scale, and we've never been, you know, fully to our hiring plan this early in the game. That, and that's by design. Then, you know, I think the talent of the reps, you know, getting them through that six-month bed-in period where they get productive.
Speaker #5: Yeah, and Matt, we—you know, we have snapped back quite well after poor quarters, right? I think it was Q4 2024, right? We had a little bit of a raid on our sales force, and we snapped back very effectively in Q1 of '25.
Speaker #5: So, you know, I think, we've got enough factors of safety built in with the new product launches. You know, having a fully staffed sales force at 90 reps or not or a little over 90 reps, in the next couple of weeks here, we've never been at that scale and we've never been, you know, fully to our hiring plan this early in the game.
Speaker #5: That, that and that's by design. and then, you know, I think the talent of the reps, you know, getting them through that six-month bed-in period where they get productive.
Antony Koblish: There's a lot of factors that are gonna help us and give us tailwind in H2.
Antony Koblish: There's a lot of factors that are gonna help us and give us tailwind in H2.
Speaker #5: There are a lot of factors that are going to help us and give us tailwind in the second half of the year.
Roberto Cuca: Matt, with regard to, you know, the back half versus first half, and confidence with that, with regard to that, we've always grown quarter to quarter across the year. We have built our quotas and expectations for our existing reps, our tenured reps, and for new reps based on that sort of growth. Even if we had not added the number of reps we did in Q1, we would've expected to see growth across the year that would've led to that step up from H1 to H2. That'll be amplified by the addition of these new reps who are, you know, gonna hit break even in about six months and then start breaking through and becoming meaningfully productive in that H2.
Roberto Cuca: Matt, with regard to, you know, the back half versus first half, and confidence with that, with regard to that, we've always grown quarter to quarter across the year. We have built our quotas and expectations for our existing reps, our tenured reps, and for new reps based on that sort of growth. Even if we had not added the number of reps we did in Q1, we would've expected to see growth across the year that would've led to that step up from H1 to H2. That'll be amplified by the addition of these new reps who are, you know, gonna hit break even in about six months and then start breaking through and becoming meaningfully productive in that H2.
Speaker #7: And Matt, with regard to, you know, the back half versus first half, and confidence with that—with regard to that—we have always grown quarter to quarter across the year.
Speaker #7: we have built our quotas, and expectations for, our existing reps, our tenured reps. and for new reps, based on that sort of growth. So even if we had not added the number of reps we did, in the first quarter, we would have expected to see growth across the year that would have led to, that step up from the first half to the second half, that'll be amplified by the addition of these new reps, who are you know, going to hit break-even in about six months and then start breaking through and becoming, meaningfully productive in that second half.
Antony Koblish: Yeah, you have to remember, it's 40% of our sales force has been on board for less than 6 months. These are high-quality reps that we've hired and, you know, we're going through the process now of getting them bedded in and up and running.
Antony Koblish: Yeah, you have to remember, it's 40% of our sales force has been on board for less than 6 months. These are high-quality reps that we've hired and, you know, we're going through the process now of getting them bedded in and up and running.
Speaker #5: Yeah, you, you, you have to remember, it's 40% of our sales force has been on board for less than six months. So, and these are high-quality reps that we've hired, and, you know, we're going through the process now of getting them bedded in and up and running.
Matthew O'Brien: Okay. Appreciate that. The follow-up is on. I'm just trying to square all the different numbers here between the LiquiFix and the OUS growth in the quarter, which was actually really good. When I start to carry that forward, I start to get some softer OviTex numbers for the full year kind of versus what you've been doing. Not sure that makes a lot of sense, just given the sales force expansion. Again, I know you want to be conservative. It just leads you to the conclusion that there's something else going on that isn't quite squared away yet. I don't know if there's a way you can kind of walk us through what you're expecting, OviTex versus PRS versus other revenue and OUS.
Matthew O'Brien: Okay. Appreciate that. The follow-up is on. I'm just trying to square all the different numbers here between the LiquiFix and the OUS growth in the quarter, which was actually really good. When I start to carry that forward, I start to get some softer OviTex numbers for the full year kind of versus what you've been doing. Not sure that makes a lot of sense, just given the sales force expansion. Again, I know you want to be conservative. It just leads you to the conclusion that there's something else going on that isn't quite squared away yet. I don't know if there's a way you can kind of walk us through what you're expecting, OviTex versus PRS versus other revenue and OUS.
Speaker #7: Okay, appreciate that. And then a follow-up is on—and I'm just, I'm trying to square all the different numbers here between the—
Speaker #5: Liquifix and the, the OUS growth that the quarter was actually really good. when I start to, to carry that forward, I start to get some softer OVTEX numbers for the full year kind of versus what you've been doing.
Speaker #5: And not sure that makes a lot of sense. Just given this sales force expansion, again, I know you want to be conservative. It just it, it leads you to the conclusion that there's something else going on that isn't quite squared away yet.
Speaker #5: So, I don't know if there's a way you can kind of walk us through what you're expecting—OVTEX versus PRS, versus other revenue, and OUS?
Matthew O'Brien: Just, you know, help me understand, you know, how the different product lines are gonna play out here in 2026. Thanks.
Matthew O'Brien: Just, you know, help me understand, you know, how the different product lines are gonna play out here in 2026. Thanks.
Speaker #5: But, but just, you know, help me understand, you know, how this—how the different product lines are going to play out here in '26.
Speaker #5: Thanks. I'll start. No, it's Roberto. I'll start, and I'll let Jeff and Jim jump in—and Tony. So, one thing to remember is that Europe is purely OviTex sales, purely hernia sales.
Roberto Cuca: I'll start. No, it's Roberto. I'll start, and I'll let Jeff and Jim jump in, and Tony. One thing to remember is that EU Europe is purely OviTex sales, purely hernia sales. As we get solid growth from Europe, that's going to, you know, that's all going to be dropping to the quote-unquote, you know, hernia bottom line. We, you know, we do expect to see PRS sales grow over the course of the year in part from the launch of, you know, larger pieces and, you know, potentially new technologies. It's not, you know, it's not that we see either one of those softening up.
Roberto Cuca: I'll start. No, it's Roberto. I'll start, and I'll let Jeff and Jim jump in, and Tony. One thing to remember is that EU Europe is purely OviTex sales, purely hernia sales. As we get solid growth from Europe, that's going to, you know, that's all going to be dropping to the quote-unquote, you know, hernia bottom line. We, you know, we do expect to see PRS sales grow over the course of the year in part from the launch of, you know, larger pieces and, you know, potentially new technologies. It's not, you know, it's not that we see either one of those softening up.
Speaker #5: So as we get solid growth from Europe, that's going to, you know, that's all going to be dropping to the quote-unquote, you know, hernia bottom line.
Speaker #5: We, you know, we do expect to see PRS sales grow over the course of the year, in part from the ex—the launch of, you know, larger pieces, and, you know, potentially new technologies.
Speaker #5: So, it's not—you know, it's not that we see either one of those softening up. And, you know, we expect to see LiquiFix continue to grow strongly.
Roberto Cuca: you know, we expect to see LIQUIFIX continue to grow strongly, although it's going from a much smaller base, so it'll have a smaller revenue line impact. I'll let Jeff and Jim add anything to that.
Roberto Cuca: you know, we expect to see LIQUIFIX continue to grow strongly, although it's going from a much smaller base, so it'll have a smaller revenue line impact. I'll let Jeff and Jim add anything to that.
Speaker #5: Although it's growing from a sm much smaller base, so it'll have a smaller revenue line impact. But I'll let Jeff and Jim add anything to that.
Antony Koblish: Yeah. I think we're blessed with AMS's focus on us as a partner. They've made a huge investment in their clinical team to help us with product evaluations and trials. They've matched us. As fast as we're trying to get our organization set, so have they. I would say that, you know, with this focus we have, and we teased a little bit about it in our last quarter earnings, that we're headed towards an academic program. That's brand new to us in 2026. Having the right leader, who we have in Marissa Conrad focused on that, having a partner with AMS, that drives that product adoption in the general surgery residency and fellowship program, as well as the plastics. That's all, again, new.
Antony Koblish: Yeah. I think we're blessed with AMS's focus on us as a partner. They've made a huge investment in their clinical team to help us with product evaluations and trials. They've matched us. As fast as we're trying to get our organization set, so have they. I would say that, you know, with this focus we have, and we teased a little bit about it in our last quarter earnings, that we're headed towards an academic program. That's brand new to us in 2026. Having the right leader, who we have in Marissa Conrad focused on that, having a partner with AMS, that drives that product adoption in the general surgery residency and fellowship program, as well as the plastics. That's all, again, new.
Speaker #3: Yeah. I think we're blessed with AMS's focus on us as a partner. they've made a huge investment in their clinical team to help us with product evaluations and trials.
Speaker #3: They have done—they've matched us as fast as we're trying to get our organization set, so have they. I would say that, you know, with this focus we have, and we teased a little bit about it in the last quarter earnings, that we're headed towards an academic program.
Speaker #3: That's brand new to us in 2026. So having the right leader, who we have, in Marissa Conrad focused on that, having a partner with AMS, that drives that product adoption in the general surgery residency and fellowship programs as well as the plastics.
Speaker #3: that's all, again, new. and then considering what the back half of this year looks like for new product launches. as well as, not necessarily any more organizational disruption, that quote came earlier from you guys, but, more as nuanced changes always adapting and changing with the business that when they identify needs, we solve for it.
Antony Koblish: Considering what the H2 of this year looks like for new product launches, as well as not necessarily any more organizational disruption, that quote came earlier from you guys, but more as nuance changes, always adapting and changing with the business that when they identify needs, we solve for it. Yeah, Matt, I think what you're saying is, you know, you're looking at all the potential growth drivers, and it doesn't make sense that our OviTex business would grow less. I'm just gonna sum it up and just stick with the word prudent. Give us a chance to metabolize, you know, these territory changes, the new reps, the new products, all of it. Prudence.
Antony Koblish: Considering what the H2 of this year looks like for new product launches, as well as not necessarily any more organizational disruption, that quote came earlier from you guys, but more as nuance changes, always adapting and changing with the business that when they identify needs, we solve for it. Yeah, Matt, I think what you're saying is, you know, you're looking at all the potential growth drivers, and it doesn't make sense that our OviTex business would grow less. I'm just gonna sum it up and just stick with the word prudent. Give us a chance to metabolize, you know, these territory changes, the new reps, the new products, all of it. Prudence.
Speaker #7: Yeah. Matt, I think what you're saying is, you know, you're looking at all the potential growth drivers and it doesn't make sense that our OVTEX business would grow less.
Speaker #7: So, I'm just going to sum it up and just stick with the word 'prudent,' give us a chance to metabolize, you know, these territory changes, the new reps, the new products, all of it.
Speaker #7: prudence.
Matthew O'Brien: Understood. Thank you.
Matthew O'Brien: Understood. Thank you.
Speaker #5: Understood. Thank you.
Antony Koblish: I don't see the hernia or PRS business collapsing in any way.
Antony Koblish: I don't see the hernia or PRS business collapsing in any way.
Speaker #7: I don't see the hernia or PRS business collapsing in any way.
Operator: Thank you. This does conclude the question and answer session of today's program. I'd like to hand the program back to Antony Koblish for any further remarks.
Operator: Thank you. This does conclude the question and answer session of today's program. I'd like to hand the program back to Antony Koblish for any further remarks.
Speaker #2: Thank you. This does conclude the question-and-answer session of today's program. I'd like to hand the program back to Antony Koblish for any further remarks.
Antony Koblish: Thank you, Jonathan. Yeah. Thank you. You know, the changes we made were thorough. I hope you got a sense of that. We've never cleared the decks to this level, right? I think in the past, you know, the changes have been a little from this piece, a little from that piece, you know, incremental, 'cause we're, you know, striving to go wide and make numbers, right? We're taking a step back from that to recast this in absolutely the right way across every dimension, whether it's comp, focus, population density, rep density, everything. I think we have it set up correctly for the long haul. There's gonna be much less disruption from this point forward. We have it locked in the way we want it now, the way Jeff and Jim want it.
Antony Koblish: Thank you, Jonathan. Yeah. Thank you. You know, the changes we made were thorough. I hope you got a sense of that. We've never cleared the decks to this level. I think in the past, you know, the changes have been a little from this piece, a little from that piece, you know, incremental, 'cause we're, you know, striving to go wide and make numbers. We're taking a step back from that to recast this in absolutely the right way across every dimension, whether it's comp, focus, population density, rep density, everything. I think we have it set up correctly for the long haul. There's gonna be much less disruption from this point forward. We have it locked in the way we want it now, the way Jeff and Jim want it.
Speaker #5: Thank you, Jonathan. yeah. Thank you. So, you know, the changes we made, we're thorough. I hope you got a, a sense of that. we've never cleared the decks to this level, right?
Speaker #5: I think in the past, you know, the changes have been a little from this place, a little from that piece, you know, incremental, because we're, you know, striving to go wide and make numbers, right?
Speaker #5: So we're taking a step back from that to recast this in absolutely the right way across every dimension. Whether it's comp, focus, population density, rep density, everything.
Speaker #5: And I think we have it set up correctly for the long haul. There's going to be much less disruption from this point forward. We have it locked in the way we want it now—the way Jeff and Jim want it.
Antony Koblish: Now we just gotta operate the machinery in the right way. We really appreciate your interest. Stay patient, and we look forward to what's ahead.
Antony Koblish: Now we just gotta operate the machinery in the right way. We really appreciate your interest. Stay patient, and we look forward to what's ahead.
Speaker #5: And now we just have to operate the machinery in the right way. So we really appreciate your interest. Stay patient, and we look forward to what's ahead.
Operator: Thank you, ladies and gentlemen, for your participation in today's conference. This does conclude the program. You may now disconnect. Good day.
Operator: Thank you, ladies and gentlemen, for your participation in today's conference. This does conclude the program. You may now disconnect. Good day.