Neuronetics Reports Fourth Quarter and Full Year 2020 Financial and Operating Results
Neuronetics, Inc. (NASDAQ: STIM) announced its financial results for Q4 and full year 2020, reporting revenues of $15.6 million for Q4, down 10% year-over-year, primarily due to COVID-19. Annual revenue also declined 21% to $49.2 million. Despite a challenging year, fourth quarter revenue increased 25% from Q3. The company raised approximately $80.6 million through a stock offering and amended its credit facility. The gross margin for Q4 was stable at 75.8%. Looking ahead, Neuronetics anticipates 2021 revenue between $58 million and $62 million.
- Fourth quarter 2020 revenue increased by $3.1 million, or 25%, compared to Q3 2020.
- Amended credit facility improved financial flexibility.
- FDA clearance for a new three-minute treatment protocol enhances product offerings.
- Pro forma cash position of approximately $130 million as of year-end 2020.
- Q4 2020 revenue of $15.6 million, down 10% compared to Q4 2019.
- Full year 2020 total revenue decreased by $13.4 million, or 21% year-over-year.
- U.S. NeuroStar Advanced Therapy System revenue decreased by 33% compared to Q4 2019.
MALVERN, Pa., March 02, 2021 (GLOBE NEWSWIRE) -- Neuronetics, Inc. (NASDAQ: STIM), a commercial stage medical technology company focused on designing, developing and marketing products that improve the quality of life for patients who suffer from psychiatric disorders, today announced its financial and operating results for the fourth quarter and full year of 2020.
Fourth Quarter 2020 Highlights
- Fourth quarter 2020 revenue of
$15.6 million , compared to$17.4 million in fourth quarter 2019, primarily due to the impact of the COVID-19 pandemic - Fourth quarter 2020 revenue increased
$3.1 million , or25% , compared to third quarter 2020 - Fourth quarter 2020 U.S. treatment session revenue of
$11.0 million , compared to$11.2 million in fourth quarter 2019 - Fourth quarter 2020 U.S. NeuroStar® Advanced Therapy revenue of
$3.6 million , compared to$5.4 million in fourth quarter 2019
Full Year 2020 Highlights
- Full year 2020 revenue of
$49.2 million - Full year 2020 U.S. treatment session revenue of
$34.9 million - Full year 2020 U.S. NeuroStar Advanced Therapy revenue of
$11.1 million
Recent Operational Highlights
- Added 18 new Business Development Managers and 10 new NeuroStar Practice Consultants as part of our sales organization optimization initiative
- Received FDA clearance for three-minute TouchStar® treatment protocol with our NeuroStar® Advanced Therapy System
- Completed an offering of 5,566,000 shares of our common stock raising approximately
$80.6 million in net cash in February 2021 - Amended our credit facility with Solar Capital Partners to reset revenue covenant requirements and to divide our
$15.0 million Tranche B loan into three separate$5.0 million tranches - Pro forma cash of approximately
$130 million at the end of 2020 including the debt refinancing and equity refinancing
“The fourth quarter was a strong finish to the year as we continued to see increased demand for NeuroStar Advanced Therapy systems as well as a rebound in the volume of patients undergoing treatment despite the continued uncertainty related to COVID-19,” said Keith J. Sullivan, President and Chief Executive Officer of Neuronetics. “We have done tremendous work in recent quarters to optimize our organization and build out a patient-focused commercial strategy. Looking ahead, we have a massive opportunity in front of us, and we will work diligently to bring the benefits of NeuroStar Advanced Therapy to all of the patients suffering from drug-resistant depression and other psychiatric disorders.”
Fourth Quarter 2020 Financial and Operating Results
| Revenues by Geography | ||||||||||||
| Three Months ended December 31, | ||||||||||||
| 2020 | 2019 | |||||||||||
| Amount | Amount | % Change | ||||||||||
| (in thousands, except percentages) | ||||||||||||
| United States | $ | 15,046 | $ | 17,030 | -12 | % | ||||||
| International | 533 | 326 | 63 | % | ||||||||
| Total revenues | $ | 15,579 | $ | 17,356 | -10 | % | ||||||
Total revenue for the fourth quarter of 2020 was
| United States Revenues by Product Category | ||||||||||||
| Three Months ended December 31, | ||||||||||||
| 2020 | 2019 | |||||||||||
| Amount | Amount | % Change | ||||||||||
| (in thousands, except percentages) | ||||||||||||
| NeuroStar Advanced Therapy System | $ | 3,620 | $ | 5,413 | -33 | % | ||||||
| Treatment sessions | 11,029 | 11,243 | -2 | % | ||||||||
| Other | 397 | 374 | 6 | % | ||||||||
| Total United States revenues | $ | 15,046 | $ | 17,030 | -12 | % | ||||||
| United States NeuroStar Advanced Therapy System Revenues by Type | ||||||||||||
| Three Months ended December 31, | ||||||||||||
| 2020 | 2019 | |||||||||||
| Amount | Amount | % Change | ||||||||||
| (in thousands, except percentages) | ||||||||||||
| NeuroStar Capital | $ | 3,445 | $ | 4,959 | -31 | % | ||||||
| Operating lease | 79 | 176 | -55 | % | ||||||||
| Other | 96 | 278 | -65 | % | ||||||||
| Total U.S. NeuroStar Advanced Therapy System revenues | $ | 3,620 | $ | 5,413 | -33 | % | ||||||
U.S. NeuroStar Advanced Therapy System revenue for the fourth quarter of 2020 was
As of December 31, 2020, the number of active sites was 916, up from 870 as of December 31, 2019.
U.S. treatment session revenue for the fourth quarter of 2020 was
In the fourth quarter, U.S. treatment session revenue per active site was
Gross margin for the fourth quarter of 2020 was
Operating expenses during the fourth quarter of 2020 were
Net loss for the fourth quarter of 2020 was
EBITDA for the fourth quarter of 2020 was
Cash and cash equivalents were
Full Year Financial and Operating Results
| Revenues by Geography | ||||||||||||
| Year ended December 31, | ||||||||||||
| 2020 | 2019 | |||||||||||
| Amount | Amount | % Change | ||||||||||
| (in thousands, except percentages) | ||||||||||||
| United States | $ | 47,519 | $ | 60,760 | -22 | % | ||||||
| International | 1,725 | 1,896 | -9 | % | ||||||||
| Total revenues | $ | 49,244 | $ | 62,656 | -21 | % | ||||||
Total revenues decreased by
| United States Revenues by Product Category | ||||||||||||
| Year ended December 31, | ||||||||||||
| 2020 | 2019 | |||||||||||
| Amount | Amount | % Change | ||||||||||
| (in thousands, except percentages) | ||||||||||||
| NeuroStar Advanced Therapy System | $ | 11,094 | $ | 18,007 | -38 | % | ||||||
| Treatment sessions | 34,852 | 41,120 | -15 | % | ||||||||
| Other | 1,573 | 1,633 | -4 | % | ||||||||
| Total United States revenues | $ | 47,519 | $ | 60,760 | -22 | % | ||||||
| United States NeuroStar Advanced Therapy System Revenues by Type | ||||||||||||
| Year ended December 31, | ||||||||||||
| 2020 | 2019 | |||||||||||
| Amount | ||||||||||||
| (in thousands, except percentages) | ||||||||||||
| NeuroStar Capital | $ | 10,518 | $ | 16,196 | -35 | % | ||||||
| Operating lease | 437 | 730 | -40 | % | ||||||||
| Other | 139 | 1,081 | -87 | % | ||||||||
| Total U.S. NeuroStar Advanced Therapy System revenues | $ | 11,094 | $ | 18,007 | -38 | % | ||||||
U.S. NeuroStar Advanced Therapy System revenue decreased by
U.S. treatment session revenues decreased by
Gross margin for the full year 2020 was
Operating expenses during the full year 2020 were
Net loss for the full year 2020 was
EBITDA for the full year 2020 was
Amendment of Solar Capital Credit Facility
On December 8, 2020 we amended our term loan agreement with our current lenders and investment affiliates managed by Solar Capital Partners, LLC (“Solar”). The amendment includes the resetting of certain revenue covenants, and the dividing of the second tranche of the term loan (“Term B Loan”), originally
FDA Clearance for Three-Minute TouchStar Treatment Protocol
On November 23, 2020, the U.S. Food and Drug Administration (“FDA”) granted clearance for our TouchStar treatment, a three-minute intermittent theta burst (iTBS) protocol with our NeuroStar Advanced Therapy System, administered with patented Contact Sensing technology.
The new protocol arms physicians with the ability to now offer a third FDA-cleared treatment protocol with NeuroStar Advanced Therapy – a non-drug, non-invasive transcranial magnetic stimulation (“TMS”) treatment for Major Depressive Disorder (“MDD”) that uses magnetic pulses to stimulate areas of the brain that are underactive in depression. The three-minute TouchStar protocol allows clinicians to further customize treatments to best suit patient needs while increasing utilization of the NeuroStar Advanced Therapy System and expanding its benefits to more patients.
Common Stock Offering
On February 2, 2021, the Company closed an underwritten public offering of 5,566,000 shares of its common stock, including the exercise in full by the underwriters of their option to purchase up to an additional 726,000 shares of common stock, at a public offering price of
Business Outlook
For the full year 2021, the Company expects to report total worldwide revenue between
For the full year 2021, the Company expects operating expenses to be between
For the first quarter of 2021, the Company expects to report total worldwide revenue of between
Webcast and Conference Call Information
Neuronetics’ management team will host a conference call on March 2, 2021 beginning at 8:30 a.m. Eastern Time. Investors interested in listening to the conference call on your telephone, please dial (877) 472-8990 for United States callers or +1 (629) 228-0778 for international callers and reference confirmation code 2124449, approximately ten minutes prior to start time. To access the live audio webcast or subsequent archived recording, visit the Investor Relations section of Neuronetics’ website at ir.neuronetics.com. The replay will be available on the Company's website for approximately 60 days.
About Neuronetics
Neuronetics, Inc. is a commercial-stage medical technology company focused on designing, developing, and marketing products that improve the quality of life for patients who suffer from psychiatric disorders. Our first commercial product, the NeuroStar® Advanced Therapy System, is a non-invasive and non-systemic office-based treatment that uses transcranial magnetic stimulation, or TMS, to create a pulsed, MRI-strength magnetic field that induces electrical currents designed to stimulate specific areas of the brain associated with mood. The system is cleared by the United States Food and Drug Administration, or FDA, for the treatment of major depressive disorder in adult patients who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode. NeuroStar is also available in other parts of the world, including Japan, where it is listed under Japan’s national health insurance. Additional information can be found at www.neuronetics.com.
“Safe harbor” statement under the Private Securities Litigation Reform Act of 1995:
Statements in the press release regarding Neuronetics, Inc. (the “Company”) that are not historical facts constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements may be identified by terms such as “outlook,” “potential,” “believe,” “expect,” “plan,” “anticipate,” “predict,” “may,” “will,” “could,” “would” and “should” as well as the negative of these terms and similar expressions. These statements include those relating to: the Company’s business outlook and current expectations for upcoming quarter and fiscal year 2021, including with respect to revenue, operating expense, growth, and any statements of assumptions underlying any of the foregoing items. These statements are subject to significant risks and uncertainties and actual results could differ materially from those projected. The Company cautions investors not to place undue reliance on the forward-looking statements contained in this release. These risks and uncertainties include, without limitation, risks and uncertainties related to: the impact of COVID-19 on the Company’s operational and budget plans as well as general political and economic conditions, including as a result of efforts by governmental authorities to mitigate COVID-19, such as travel bans, shelter in place orders and third-party business closures and the related impact on resource allocations, manufacturing and supply chains and patient access to commercial products; the Company’s ability to execute its business continuity; the Company’s ability to achieve or sustain profitable operations due to its history of losses; the Company’s reliance on the sale and usage of its NeuroStar Advanced Therapy System to generate revenues; the scale and efficacy of the Company’s salesforce; availability of coverage and reimbursement from third-party payors for treatments using the Company’s products; physician and patient demand for treatments using the Company’s products; developments in respect of competing technologies and therapies for the indications that the Company’s products treat; product defects; the Company’s ability to obtain and maintain intellectual property protection for its technology; developments in clinical trials or regulatory review of NeuroStar Advanced Therapy System for additional indications; and developments in regulation in the United States and other applicable jurisdictions. For a discussion of these and other related risks, please refer to the Company’s recent SEC filings which are available on the SEC’s website at www.sec.gov. These forward-looking statements are based on the Company's expectations and assumptions as of the date of this press release. Except as required by law, the Company undertakes no duty or obligation to update any forward-looking statements contained in this press release as a result of new information, future events, or changes in the Company's expectations.
Investor Contact:
Mark R. Klausner
Westwicke Partners
443-213-0501
ir@neuronetics.com
Media Contact:
Gina Kent
Vault Communications
610-455-2763
gkent@vaultcommunications.com
NEURONETICS, INC.
Statements of Operations
(Unaudited; In thousands, except per share data)
| Three Months ended | Year ended | |||||||||||||||
| December 31, | December 31, | |||||||||||||||
| 2020 | 2019 | 2020 | 2019 | |||||||||||||
| Revenues | $ | 15,579 | $ | 17,356 | $ | 49,244 | $ | 62,656 | ||||||||
| Cost of revenues | 3,763 | 4,219 | 11,554 | 15,389 | ||||||||||||
| Gross Profit | 11,816 | 13,137 | 37,690 | 47,267 | ||||||||||||
| Operating expenses: | ||||||||||||||||
| Sales and marketing | 7,635 | 11,516 | 32,562 | 42,993 | ||||||||||||
| General and administrative | 4,729 | 4,312 | 18,236 | 17,457 | ||||||||||||
| Research and development | 2,112 | 4,248 | 9,201 | 13,747 | ||||||||||||
| Total operating expenses | 14,476 | 20,076 | 59,999 | 74,197 | ||||||||||||
| Loss from Operations | (2,660 | ) | (6,939 | ) | (22,309 | ) | (26,930 | ) | ||||||||
| Other (income) expense: | ||||||||||||||||
| Interest expense | 1,011 | 905 | 4,522 | 3,685 | ||||||||||||
| Loss on extinguishment of debt | - | - | 924 | - | ||||||||||||
| Other expense (income), net | (14 | ) | (290 | ) | (302 | ) | (1,571 | ) | ||||||||
| Net Loss | $ | (3,657 | ) | $ | (7,554 | ) | $ | (27,453 | ) | $ | (29,044 | ) | ||||
| Net loss per share of common stock outstanding, basic and diluted | $ | (0.19 | ) | $ | (0.41 | ) | $ | (1.46 | ) | $ | (1.58 | ) | ||||
| Weighted-average common shares outstanding, basic and diluted | 19,015 | 18,627 | 18,835 | 18,380 | ||||||||||||
NEURONETICS, INC.
Balance Sheets
(Unaudited; In thousands, except per share data)
| December 31, 2020 | December 31, 2019 | |||||||
| Assets | ||||||||
| Current assets: | ||||||||
| Cash and cash equivalents | $ | 48,957 | $ | 75,708 | ||||
| Accounts receivable, net | 7,166 | 6,569 | ||||||
| Inventory | 3,720 | 2,775 | ||||||
| Current portion of net investments in sales-type leases | 1,887 | 880 | ||||||
| Current portion of prepaid commission expense | 1,096 | 689 | ||||||
| Prepaid expenses and other current assets | 2,186 | 1,830 | ||||||
| Total current assets | 65,012 | 88,451 | ||||||
| Property and equipment, net | 730 | 1,107 | ||||||
| Operating lease right-of-use assets | 3,418 | 3,796 | ||||||
| Net investments in sales-type leases | 2,331 | 1,730 | ||||||
| Prepaid commission expense | 5,300 | 3,779 | ||||||
| Other assets | 1,866 | 1,305 | ||||||
| Total Assets | $ | 78,657 | $ | 100,168 | ||||
| Liabilities and Stockholders’ Equity | ||||||||
| Current liabilities: | ||||||||
| Accounts payable | $ | 3,749 | $ | 4,625 | ||||
| Accrued expenses | 7,319 | 9,031 | ||||||
| Deferred revenue | 2,020 | 2,228 | ||||||
| Current portion of operating lease liabilities | 594 | 559 | ||||||
| Current portion of long-term debt, net | - | 11,250 | ||||||
| Total current liabilities | 13,682 | 27,693 | ||||||
| Long-term debt, net | 34,620 | 19,898 | ||||||
| Deferred revenue | 1,741 | 2,106 | ||||||
| Operating lease liabilities | 3,121 | 2,619 | ||||||
| Total Liabilities | 53,164 | 52,316 | ||||||
| Commitments and contingencies | - | - | ||||||
| Stockholders’ Equity: | ||||||||
| Preferred stock, shares issued or outstanding at December 31, 2020 and 2019, respectively | - | - | ||||||
| Common stock, 19,114 and 18,645 shares issued and outstanding at December 31, 2020 and 2019, respectively | 191 | 186 | ||||||
| Additional paid-in capital | 302,842 | 297,753 | ||||||
| Accumulated deficit | (277,540 | ) | (250,087 | ) | ||||
| Total Stockholders' Equity | 25,493 | 47,852 | ||||||
| Total Liabilities and Stockholders’ Equity | $ | 78,657 | $ | 100,168 | ||||
NEURONETICS, INC.
Statements of Cash Flows
(Unaudited; In thousands)
| Year ended December 31, | ||||||||
| 2020 | 2019 | |||||||
| Cash Flows from Operating Activities: | ||||||||
| Net loss | $ | (27,453 | ) | $ | (29,044 | ) | ||
| Adjustments to reconcile net loss to net cash used in operating activities: | ||||||||
| Depreciation and amortization | 941 | 1,065 | ||||||
| Share-based compensation | 4,404 | 3,434 | ||||||
| Non-cash interest expense | 1,192 | 753 | ||||||
| Cost of rental units purchased by customers | 179 | 223 | ||||||
| Loss on extinguishment of debt | 622 | - | ||||||
| Changes in certain assets and liabilities: | ||||||||
| Accounts receivable, net | (597 | ) | (950 | ) | ||||
| Inventory | (945 | ) | (306 | ) | ||||
| Net investment in sales-type leases | (1,609 | ) | (2,610 | ) | ||||
| Leasehold reimbursement | 836 | - | ||||||
| Prepaid commission expense | (1,928 | ) | (4,468 | ) | ||||
| Prepaid expenses and other assets | (641 | ) | (565 | ) | ||||
| Accounts payable | (1,085 | ) | 299 | |||||
| Accrued expenses | (1,733 | ) | 1,549 | |||||
| Deferred revenue | (573 | ) | 138 | |||||
| Net Cash Used in Operating Activities | (28,390 | ) | (30,482 | ) | ||||
| Cash Flows from Investing Activities: | ||||||||
| Purchases of property and equipment and capitalized software | (730 | ) | (813 | ) | ||||
| Net Cash Used in Investing Activities | (730 | ) | (813 | ) | ||||
| Cash Flows from Financing Activities: | ||||||||
| Proceeds from issuance of long-term debt | 41,360 | - | ||||||
| Repayment of long-term debt | (38,860 | ) | - | |||||
| Payments of debt issuance costs | (821 | ) | - | |||||
| Proceeds from exercises of stock options | 690 | 2,420 | ||||||
| Net Cash Provided by Financing Activities | 2,369 | 2,420 | ||||||
| Net (Decrease) Increase in Cash and Cash Equivalents | (26,751 | ) | (28,875 | ) | ||||
| Cash and Cash Equivalents, Beginning of Period | 75,708 | 104,583 | ||||||
| Cash and Cash Equivalents, End of Period | $ | 48,957 | $ | 75,708 | ||||
Non-GAAP Financial Measures (Unaudited)
EBITDA is not a measure of financial performance under generally accepted accounting principles in the United States, or GAAP, and should not be construed as a substitute for, or superior to, GAAP net loss. However, management uses both the GAAP and non-GAAP financial measures internally to evaluate and manage the Company’s operations and to better understand its business. Further, management believes the addition of the non-GAAP financial measure provides meaningful supplementary information to, and facilitates analysis by, investors in evaluating the Company’s financial performance, results of operations and trends. The Company’s calculation of EBITDA may not be comparable to similarly designated measures reported by other companies, because companies and investors may differ as to what type of events warrant adjustment.
The following table reconciles reported net loss to EBITDA:
| Three Months ended | Year ended | ||||||||||||||||
| December 31, | December 31, | ||||||||||||||||
| 2020 | 2019 | 2020 | 2019 | ||||||||||||||
| (in thousands) | (in thousands) | ||||||||||||||||
| Net loss | $ | (3,657 | ) | $ | (7,554 | ) | $ | (27,453 | ) | $ | (29,044 | ) | |||||
| Interest expense | 1,011 | 905 | 4,522 | 3,685 | |||||||||||||
| Income taxes | - | - | - | - | |||||||||||||
| Depreciation and amortization | 200 | 300 | 941 | 1,065 | |||||||||||||
| EBITDA | $ | (2,446 | ) | $ | (6,349 | ) | $ | (21,990 | ) | $ | (24,294 | ) | |||||
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