ATEC Reports Fourth Quarter and Full-Year 2023 Financial Results and Recent Corporate Highlights
- 37% growth in total revenue for full year 2023 to $482 million
- Approximate $595 million total revenue expected for full year 2024, reflecting a 23% growth compared to 2023
- Improved adjusted EBITDA margin by approximately 890 basis points
- Non-GAAP gross margin at 69.7% for full year 2023
- Strategic portfolio transformation complete with updated non-GAAP financial measures
- Expectation of $22 million non-GAAP adjusted EBITDA for full year 2024, implying 560 basis points improvement compared to 2023
- None.
Insights
The reported 37% growth in total revenue to $482 million for Alphatec Holdings, Inc. in the full year 2023, alongside an improved adjusted EBITDA margin of approximately 890 basis points, indicates a robust financial performance for the company. The expected revenue for the full year 2024 to approximate $595 million, with a 23% growth compared to 2023 and an adjusted EBITDA margin expansion of approximately 560 basis points, suggests a positive outlook for the company's growth trajectory. It is important to note, however, that the company has updated its non-GAAP financial measures to include the non-cash impact of the provision for excess and obsolete inventory, which could affect the comparability of these results to prior periods and industry peers.
From an investor's perspective, the substantial improvement in gross margin and operational efficiency could be seen as indicators of effective cost management and operational leverage. However, the GAAP net loss of $187 million raises questions about the company's profitability under standard accounting practices. Investors should closely monitor the reconciliation of non-GAAP to GAAP measures to fully understand the implications of these adjustments on the company's reported financial health.
The expansion of Alphatec's lateral platform and the launch of new products such as Lateral TransPsoas (LTP™) and Calibrate LTX™ may contribute to the company's market share growth within the spine surgery sector. The reported 27% increase in surgeon users and the training of over 500 surgeons in 2023 reflect the company's commitment to market penetration and education, which could lead to increased adoption of its products. This strategic focus on innovation and training is essential in a competitive market where technological advancements and surgeon preferences play a critical role in product selection.
Additionally, the company's forward-looking statements regarding revenue growth and EBITDA margin improvement in 2024 provide insights into its strategic priorities and expected market performance. While these projections are promising, they are contingent upon the company's continued operational execution and market conditions. Stakeholders should consider external factors such as regulatory changes, competitive pressures and market dynamics that could impact the company's financial outlook.
The medical device industry, particularly the spine surgery segment, is highly specialized and requires continuous innovation to meet the evolving needs of healthcare providers and patients. Alphatec's focus on revolutionizing spine surgery through its 100% spine-focused knowhow positions the company as a niche player with the potential to capitalize on specific market demands. The mention of a strategic portfolio transformation nearing completion suggests that Alphatec is transitioning from a period of investment in research and development to a phase of commercialization and market expansion.
The company's emphasis on procedural innovation and the full launch of advanced surgical approaches could enhance its competitive edge by offering comprehensive solutions that improve surgical outcomes. It is essential for stakeholders to understand the significance of these product launches and training initiatives in driving long-term growth. However, the true impact of these innovations on the market will depend on their clinical effectiveness, cost-efficiency and the ability to gain market acceptance against established competitors.
-
Full year 2023 total revenue grew
37% to$482 million - Full year 2023 adjusted EBITDA margin improved ~890 basis points
-
Full year 2024 total revenue expected to approximate
$595 million
Fourth Quarter and Full Year 2023 Financial Results
| Quarter Ended December 31, 2023 |
Year Ended December 31, 2023 |
|||||
| Total revenues | $ |
138 |
|
$ |
482 |
|
| GAAP gross margin |
|
69.0 |
% |
|
64.3 |
% |
| Non-GAAP gross margin (prior definition)* |
|
72.9 |
% |
|
72.6 |
% |
| Non-GAAP gross margin (updated definition)* |
|
69.7 |
% |
|
69.8 |
% |
| Operating expenses | $ |
140 |
|
$ |
484 |
|
| Non-GAAP operating expenses | $ |
106 |
|
$ |
387 |
|
| GAAP net loss | $ |
(49 |
) |
$ |
(187 |
) |
| Non-Gaap adjusted EBITDA (prior definition)* | $ |
6 |
|
$ |
4 |
|
| Non-Gaap adjusted EBITDA (updated definition)* | $ |
2 |
|
$ |
(9 |
) |
| Ending cash balance | $ |
221 |
|
|||
|
||||||
*Refer to discussion of updated non-GAAP financial definition. Numbers and percentages may not foot due to rounding. |
||||||
Business Highlights
-
Portfolio-wide strength drove fourth quarter 2023 surgical revenue growth of
34% with an acceleration in volume growth to29% compared to24% in the prior quarter; - Expanded lateral platform with full launch of Lateral TransPsoas (LTP™) + Midline ALIF approaches and Calibrate LTX™, a lateral expandable implant;
- Elevated the procedural sophistication of comprehensive portfolio with launch of 15 new products and line extensions in 2023;
-
Trained over 500 surgeons in 2023, contributing to a
27% increase in surgeon users compared to 2022.
Pat Miles, Chairman and Chief Executive Officer, said, "The success we’ve achieved to date is testament: ATEC lateral sophistication, alone, is capable of building a good, profitable company. But we aspire for much more. We are building a spine monster, and the informatics and procedural innovation that our
Non-GAAP Financial Definition Update
The Company is updating its non-GAAP financial measures to include the non-cash impact of the provision for excess and obsolete inventory (“E&O”) in the calculation of Cost of Goods Sold. With the majority of ATEC’s strategic portfolio transformation complete, the Company has determined that E&O charges are a normal and recurring aspect of operating the business and should be included in the assessment of operating performance. For detail on the impact of this reporting change on previously reported periods and 2024 guidance, a reconciliation of non-GAAP financial measures under both the updated and prior definitions has been included in this release and on the Investor Relations Section of ATEC’s Corporate Website.
Financial Outlook for the Full Year 2024
The Company continues to expect total revenue for the fiscal year ended December 31, 2024, to approximate
Financial Results Webcast
The Company will host a live webcast today at 1:30 p.m. PT / 4:30 p.m. ET. To access the live webcast, please visit the Investor Relations Section of ATEC’s Corporate Website.
To dial into the live webcast, please register at this link. Access details will be shared via email.
A replay of the webcast will be available beginning approximately two hours after the webcast’s completion through March 5, 2024. Access the replay by dialing (800) 770-2030 and referencing conference ID number 97241.
Non-GAAP Financial Information
To supplement the Company’s financial statements presented in accordance with generally accepted accounting principles in
Inducement Awards Granted
As an inducement material to accepting employment with the Company, and in accordance with Nasdaq Listing Rule 5635(c)(4), ATEC today announced that the independent Compensation Committee of the Board of Directors has approved aggregate grants to 22 new employees (who are not executive officers) of, collectively, 31,780 restricted stock units (“RSUs”) under the Company’s 2016 Employment Inducement Award Plan. The RSUs will vest in equal annual installments on each of the first four anniversaries of the grant date, provided that the recipient remains continuously employed by ATEC as of such vesting date. In addition, the RSUs will vest fully upon a change of control of ATEC.
About Alphatec Holdings, Inc.
ATEC, through its wholly owned subsidiaries, Alphatec Spine, Inc., EOS imaging S.A.S. and SafeOp Surgical, Inc., is a medical device company dedicated to revolutionizing the approach to spine surgery through clinical distinction. ATEC’s Organic Innovation Machine™ is focused on developing new approaches that integrate seamlessly with the Company’s expanding AlphaInformatiX Platform to better inform surgery and more safely and reproducibly achieve the goals of spine surgery. ATEC’s vision is to become the Standard Bearer in Spine. For more information, visit us at www.atecspine.com.
Forward Looking Statements
This press release contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995 that involve risks and uncertainty. Such statements are based on management's current expectations and are subject to a number of risks and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements. The Company cautions investors that there can be no assurance that actual results will not differ materially from those projected or suggested in such forward-looking statements as a result of various factors. Forward-looking statements include, but are not limited to: references to the Company’s revenue, balance sheet, growth and financial outlook; planned product launches, introductions, regulatory submissions or clearances; efforts to transform sales and distribution channels; the Company’s ability to compel surgeon adoption; and the Company’s future ability to finance its operations and sufficiency of its cash runway. Important factors that could cause actual operating results to differ significantly from those expressed or implied by such forward-looking statements include, but are not limited to: the uncertainty of success in developing new products or products currently in the pipeline; the uncertainties in the Company’s ability to execute upon its strategic operating plan; the uncertainties regarding the ability to successfully license or acquire new products, and the commercial success of such products; failure to achieve acceptance of the Company’s products by the surgeon community; failure to obtain FDA or other regulatory clearance or approval or unexpected or prolonged delays in the process; continuation of favorable third-party reimbursement; unanticipated expenses or liabilities or other adverse events affecting cash flow or the Company’s ability to achieve profitability; uncertainty of additional funding; the Company’s ability to compete with other products or with emerging technologies; product liability exposure; an unsuccessful outcome in any litigation; patent infringement claims; claims related to the Company’s intellectual property; and the Company’s ability to meet its financial obligations. A further list and description of these and other factors, risks and uncertainties can be found in the Company's most recent annual report, and any subsequent quarterly and current reports, filed with the Securities and Exchange Commission. ATEC disclaims any intention or obligation to update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise, unless required by law.
Alphatec Holdings, Inc. |
|||||||||||||||
Consolidated Statements of Operations |
|||||||||||||||
(in thousands, except per share amounts) |
|||||||||||||||
|
|||||||||||||||
| Three Months Ended | Year Ended | ||||||||||||||
| December 31, | December 31, | ||||||||||||||
2023 |
2022 |
2023 |
2022 |
||||||||||||
| (unaudited) | |||||||||||||||
| Revenue: | |||||||||||||||
| Revenue from products and services | $ |
137,970 |
|
$ |
105,944 |
|
$ |
482,262 |
|
$ |
350,852 |
|
|||
| Revenue from international supply agreement |
|
— |
|
|
— |
|
|
— |
|
|
15 |
|
|||
| Total revenue |
|
137,970 |
|
|
105,944 |
|
|
482,262 |
|
|
350,867 |
|
|||
| Cost of sales |
|
42,780 |
|
|
37,093 |
|
|
172,059 |
|
|
117,808 |
|
|||
| Gross profit |
|
95,190 |
|
|
68,851 |
|
|
310,203 |
|
|
233,059 |
|
|||
| Operating expenses: | |||||||||||||||
| Research and development |
|
22,284 |
|
|
11,604 |
|
|
70,115 |
|
|
44,033 |
|
|||
| Sales, general and administrative |
|
104,120 |
|
|
81,920 |
|
|
374,080 |
|
|
300,013 |
|
|||
| Litigation-related expenses |
|
9,472 |
|
|
7,314 |
|
|
22,287 |
|
|
23,943 |
|
|||
| Amortization of acquired intangible assets |
|
3,823 |
|
|
2,934 |
|
|
14,284 |
|
|
10,115 |
|
|||
| Transaction-related expenses |
|
(65 |
) |
|
— |
|
|
2,113 |
|
|
120 |
|
|||
| Restructuring expenses |
|
386 |
|
|
106 |
|
|
719 |
|
|
1,810 |
|
|||
| Total operating expenses |
|
140,020 |
|
|
103,878 |
|
|
483,598 |
|
|
380,034 |
|
|||
| Operating loss |
|
(44,830 |
) |
|
(35,027 |
) |
|
(173,395 |
) |
|
(146,975 |
) |
|||
| Interest expense, net: | |||||||||||||||
| Interest expense, net |
|
(4,416 |
) |
|
(1,329 |
) |
|
(16,641 |
) |
|
(5,505 |
) |
|||
| Other income, net |
|
44 |
|
|
1,049 |
|
|
3,121 |
|
|
471 |
|
|||
| Total interest expense, net |
|
(4,372 |
) |
|
(280 |
) |
|
(13,520 |
) |
|
(5,034 |
) |
|||
| Net loss before taxes |
|
(49,202 |
) |
|
(35,307 |
) |
|
(186,915 |
) |
|
(152,009 |
) |
|||
| Income tax benefit |
|
(124 |
) |
|
(524 |
) |
|
(277 |
) |
|
(716 |
) |
|||
| Net loss | $ |
(49,078 |
) |
$ |
(34,783 |
) |
$ |
(186,638 |
) |
$ |
(151,293 |
) |
|||
| Net loss per share, basic and diluted | $ |
(0.37 |
) |
$ |
(0.33 |
) |
$ |
(1.54 |
) |
$ |
(1.46 |
) |
|||
| Weighted average shares outstanding, basic and diluted |
|
133,750 |
|
|
105,858 |
|
|
121,242 |
|
|
103,373 |
|
|||
| Stock-based compensation included in: | |||||||||||||||
| Cost of sales | $ |
481 |
|
$ |
1,157 |
|
$ |
25,082 |
|
$ |
2,597 |
|
|||
| Research and development |
|
9,154 |
|
|
1,029 |
|
|
18,741 |
|
|
5,016 |
|
|||
| Sales, general and administrative |
|
10,880 |
|
|
7,906 |
|
|
37,421 |
|
|
32,943 |
|
|||
$ |
20,515 |
|
$ |
10,092 |
|
$ |
81,244 |
|
$ |
40,556 |
|
||||
Alphatec Holdings, Inc. |
||||||
Consolidated Balance Sheets |
||||||
(in thousands) |
||||||
|
||||||
| December 31, 2023 |
December 31, 2022 |
|||||
| ASSETS | ||||||
| Current assets: | ||||||
| Cash and cash equivalents | $ |
220,970 |
$ |
84,696 |
||
| Accounts receivable, net |
|
72,613 |
|
60,060 |
|
|
| Inventories |
|
136,842 |
|
101,521 |
|
|
| Prepaid expenses and other current assets |
|
20,666 |
|
9,357 |
|
|
| Total current assets |
|
451,091 |
|
255,634 |
|
|
| Property and equipment, net |
|
149,835 |
|
101,952 |
|
|
| Right-of-use assets |
|
26,410 |
|
28,360 |
|
|
| Goodwill |
|
73,003 |
|
47,367 |
|
|
| Intangible assets, net |
|
102,451 |
|
82,781 |
||
| Other assets |
|
2,418 |
|
4,874 |
||
| Total assets | $ |
805,208 |
$ |
520,968 |
|
|
| LIABILITIES AND STOCKHOLDERS' EQUITY (DEFICIT) | ||||||
| Current liabilities: | ||||||
| Accounts payable | $ |
48,985 |
$ |
34,742 |
|
|
| Accrued expenses and other current liabilities |
|
87,712 |
|
72,382 |
|
|
| Contract liabilities |
|
13,910 |
|
11,956 |
|
|
| Short-term debt |
|
1,808 |
|
14,948 |
|
|
| Current portion of operating lease liabilities |
|
5,159 |
|
4,842 |
|
|
| Total current liabilities |
|
157,574 |
|
138,870 |
|
|
| Total long-term liabilities |
|
545,915 |
|
393,162 |
|
|
| Redeemable preferred stock |
|
23,603 |
|
23,603 |
|
|
| Stockholders' equity (deficit) |
|
78,116 |
|
(34,667 |
) |
|
| Total liabilities and stockholders' equity (deficit) | $ |
805,208 |
$ |
520,968 |
|
|
Alphatec Holdings, Inc. |
|||||||||||||||
Reconciliation of Non-GAAP Financial Measures |
|||||||||||||||
(in thousands) |
|||||||||||||||
|
|||||||||||||||
| Three Months Ended | Year Ended | ||||||||||||||
| December 31, | December 31, | ||||||||||||||
2023 |
2022 |
2023 |
2022 |
||||||||||||
| (unaudited) | |||||||||||||||
| Gross profit, GAAP | $ |
95,190 |
|
$ |
68,851 |
|
$ |
310,203 |
|
$ |
233,059 |
|
|||
| Add: amortization of intangible assets |
|
278 |
|
|
27 |
|
|
939 |
|
|
64 |
|
|||
| Add: stock-based compensation |
|
481 |
|
|
1,157 |
|
|
25,082 |
|
|
2,597 |
|
|||
| Add: purchase accounting adjustments on acquisitions |
|
198 |
|
|
565 |
|
|
393 |
|
|
1,349 |
|
|||
| Non-GAAP gross profit | $ |
96,147 |
|
$ |
70,600 |
|
$ |
336,617 |
|
$ |
237,069 |
|
|||
| Add: excess and obsolete write-down |
|
4,420 |
|
|
2,769 |
|
|
13,608 |
|
|
9,792 |
|
|||
| Prior definition non-GAAP gross profit | $ |
100,567 |
|
$ |
73,369 |
|
$ |
350,225 |
|
$ |
246,861 |
|
|||
| Gross margin, GAAP |
|
69.0 |
% |
|
65.0 |
% |
|
64.3 |
% |
|
66.4 |
% |
|||
| Add: amortization of intangible assets |
|
0.2 |
% |
|
0.0 |
% |
|
0.2 |
% |
|
0.0 |
% |
|||
| Add: stock-based compensation |
|
0.3 |
% |
|
1.1 |
% |
|
5.2 |
% |
|
0.7 |
% |
|||
| Add: purchase accounting adjustments on acquisitions |
|
0.1 |
% |
|
0.5 |
% |
|
0.1 |
% |
|
0.4 |
% |
|||
| Non-GAAP gross margin |
|
69.7 |
% |
|
66.6 |
% |
|
69.8 |
% |
|
67.6 |
% |
|||
| Add: excess and obsolete write-down |
|
3.2 |
% |
|
2.6 |
% |
|
2.8 |
% |
|
2.8 |
% |
|||
| Prior definition non-GAAP gross margin |
|
72.9 |
% |
|
69.3 |
% |
|
72.6 |
% |
|
70.4 |
% |
|||
| Three Months Ended | Year Ended | ||||||||||||||
| December 31, | December 31, | ||||||||||||||
2023 |
2022 |
2023 |
2022 |
||||||||||||
| (unaudited) | |||||||||||||||
| Operating expenses, GAAP | $ |
140,020 |
|
$ |
103,878 |
|
$ |
483,598 |
|
$ |
380,034 |
|
|||
| Adjustments: | |||||||||||||||
| Stock-based compensation |
|
(20,034 |
) |
|
(8,935 |
) |
|
(56,162 |
) |
|
(37,959 |
) |
|||
| Litigation-related expenses |
|
(9,472 |
) |
|
(7,314 |
) |
|
(22,287 |
) |
|
(23,943 |
) |
|||
| Amortization of intangible assets |
|
(3,823 |
) |
|
(2,934 |
) |
|
(14,284 |
) |
|
(10,115 |
) |
|||
| Transaction-related expenses |
|
65 |
|
|
— |
|
|
(2,113 |
) |
|
(120 |
) |
|||
| Restructuring expenses |
|
(386 |
) |
|
(106 |
) |
|
(719 |
) |
|
(1,810 |
) |
|||
| Other non-recurring expenses1 |
|
— |
|
|
— |
|
|
(1,349 |
) |
|
— |
|
|||
| Non-GAAP operating expenses | $ |
106,370 |
|
$ |
84,589 |
|
$ |
386,684 |
|
$ |
306,087 |
|
|||
| Three Months Ended | Year Ended | ||||||||||||||
| December 31, | December 31, | ||||||||||||||
2023 |
2022 |
2023 |
2022 |
||||||||||||
| (unaudited) | |||||||||||||||
| Net loss, GAAP | $ |
(49,078 |
) |
$ |
(34,783 |
) |
$ |
(186,638 |
) |
$ |
(151,293 |
) |
|||
| Interest expense, net | 4,372 |
280 |
13,520 |
5,034 |
|||||||||||
| Income tax benefit | (124 |
) | (524 |
) | (277 |
) | (716 |
) | |||||||
| Depreciation |
|
11,918 |
|
|
8,388 |
|
|
40,916 |
|
|
30,989 |
|
|||
| Amortization of intangible assets |
|
4,101 |
|
|
2,961 |
|
|
15,223 |
|
|
10,179 |
|
|||
| EBITDA |
|
(28,811 |
) |
|
(23,678 |
) |
|
(117,256 |
) |
|
(105,807 |
) |
|||
| Add back significant items: | |||||||||||||||
| Stock-based compensation |
|
20,515 |
|
|
10,092 |
|
|
81,244 |
|
|
40,556 |
|
|||
| Purchase accounting adjustments on acquisitions |
|
198 |
|
|
565 |
|
|
393 |
|
|
1,349 |
|
|||
| Litigation-related expenses |
|
9,472 |
|
|
7,314 |
|
|
22,287 |
|
|
23,943 |
|
|||
| Transaction-related expenses |
|
(65 |
) |
|
— |
|
|
2,113 |
|
|
120 |
|
|||
| Restructuring expenses |
|
386 |
|
|
106 |
|
|
719 |
|
|
1,810 |
|
|||
| Other non-recurring expenses1 |
|
— |
|
|
— |
|
|
1,349 |
|
|
— |
|
|||
| Adjusted EBITDA | $ |
1,695 |
|
$ |
(5,601 |
) |
$ |
(9,151 |
) |
$ |
(38,029 |
) |
|||
| Excess & obsolete write-down |
|
4,420 |
|
|
2,769 |
|
|
13,608 |
|
|
9,792 |
|
|||
| Prior definition adjusted EBITDA | $ |
6,115 |
|
$ |
(2,832 |
) |
$ |
4,457 |
|
$ |
(28,237 |
) |
|||
1 Non-recurring consulting fees associated with the implementation of our state tax-planning strategy |
|||||||||||||||
Non-GAAP Definitions
-
Amortization of intangible assets:
Represents amortization expense in connection with business combinations or asset acquisitions associated with acquired intangible assets including, but not limited to customer relationships, intellectual property and trade names. -
Litigation-related expenses:
We are involved in various litigation matters that from time-to-time result in settlements. Litigation matters can vary in their characteristics, frequency and significance to our operating results and core business operations. We review litigation matters from both a qualitative and quantitative perspective to determine whether such matters are a normal and recurring part of our business. We include in our GAAP financial statements litigation fees and settlement expenses that we determine to be normal, recurring and routine to our business. When we determine that certain litigation matters are not normal and recurring to our core business operations, we believe excluding these expenses will provide our management and investors with useful incremental information. Litigation fees and settlement expenses excluded from our non-GAAP financial measures in the periods presented relate primarily to patent litigation and other litigation matters that relate directly to the business transformation that we started in 2018 and are discussed more fully in our periodic reports filed with the Securities Exchange Commission. -
Other non-recurring expenses:
These expenses represent non-recurring expenses that we consider to be one-time in nature. -
Purchase accounting adjustments on acquisitions:
Includes non-cash expenses incurred as a result of fair value asset step-ups associated with tangible assets acquired from business combinations or asset acquisitions. -
Restructuring expenses:
From time-to-time, in order to realign the Company’s operations or to achieve synergies associated with an acquisition, the Company may eliminate roles or restructure its operations and footprint. In such cases the Company may incur one-time severance and personnel costs associated with workforce reductions, or costs associated with exiting and/or relocating facilities. We exclude these costs as we do not consider such amounts to be part of the ongoing operations. -
Stock-based compensation:
Stock-based compensation is charged to cost of revenue and operating expenses. We exclude stock-based compensation from certain of our non-GAAP financial measures because we believe that excluding these non-cash expenses provides meaningful supplemental information regarding operational performance. Because of the variety of equity awards used by companies, the varying methodologies for determining stock-based compensation expense, the subjective assumptions involved in those determinations, and the volatility in valuations that can be driven by market conditions outside the Company’s control, the Company believes excluding stock-based compensation expense enhances the ability of management and investors to understand and assess the underlying performance of its business over time. -
Transaction-related expenses:
These expenses represent one-time costs associated with business combinations and asset acquisitions. These items may include but are not limited to consulting and legal fees, contract termination costs and other related deal costs. -
Adjusted EBITDA:
Represents earnings before non-operating income/expense, taxes, depreciation and amortization, as adjusted for the applicable non-GAAP adjustments previously described.
View source version on businesswire.com: https://www.businesswire.com/news/home/20240227112817/en/
Investor/Media Contact:
Tina Jacobsen, CFA
Investor Relations
(760) 494-6790
investorrelations@atecspine.com
Company Contact:
J. Todd Koning
Chief Financial Officer
investorrelations@atecspine.com
Source: Alphatec Holdings, Inc.
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