FORWARD LOOKING STATEMENTS This presentation 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 ...

Exhibit 99.1 ATEC Reports First Quarter 2025 Financial Results And Raises Full-Year Guidance Surgical revenue grew 24%; total revenue grew 22% Full-year revenue and profitability guidance increased Successfully refinanced convertible debt to 2030 maturity CARLSBAD, Calif., May 1, 2025 – Alphatec Holdings, Inc. (Nasdaq: ATEC), a provider of innovative solutions dedicated to revolutionizing the approach to spine surgery, today announced financial results for the quarter ended March 31, 2025, and recent corpor ...

Group 1 - The focus has shifted towards offshore drilling, supply industry, and shipping, including tankers, containers, and dry bulk [1] - The fuel cell industry is being monitored as it is still in its early stages of development [1] Group 2 - The individual has extensive experience in auditing with PricewaterhouseCoopers before transitioning to day trading nearly 20 years ago [2] - Successfully navigated significant market events such as the dotcom bubble, the aftermath of the World Trade Center attacks, and the subprime crisis [2]

Alphatec Holdings, Inc. (NASDAQ:ATEC) Q4 2024 Earnings Conference Call February 26, 2025 4:30 PM ET Company Participants Pat Miles - Chairman and CEO Todd Koning - CFO Conference Call Participants Brooks O'Neil - Lake Street Capital Markets Vik Chopra - Wells Fargo Eric Anderson - TD Cowen Phillip Dantoin - Piper Sandler Matt Miksic - Barclays Caitlin Cronin - Canaccord Genuity Jason Wittes - ROTH David Saxon - Needham Kallum Titchmarsh - Morgan Stanley Operator Good afternoon, everyone, and welcome to the ...

Financial Performance - Total revenue for 2024 was $611.6 million, an increase of $129.3 million or 27% compared to $482.3 million in 2023[14] - Total revenue for the year ended December 31, 2024, was $611,562,000, an increase of $129,300,000 or 27% compared to $482,262,000 in 2023[209] - Cost of sales increased by $15,241,000 or 9% to $187,300,000 in 2024 from $172,059,000 in 2023, primarily due to increased product volume[211] - Research and development expenses rose by $10,603,000 or 15% to $80,718,000 in 2024, driven by increased personnel and stock-based compensation[212] - Sales, general and administrative expenses increased by $76,119,000 or 20% to $450,199,000 in 2024 compared to $374,080,000 in 2023[212] - Total operating expenses for 2024 were $560,431,000, an increase of $76,833,000 or 16% from $483,598,000 in 2023[212] - Litigation-related expenses decreased by $12,488,000 or 56% to $9,799,000 in 2024 from $22,287,000 in 2023[212] - Amortization expense increased by $1,974,000 or 14% to $16,258,000 in 2024 compared to $14,284,000 in 2023[212] - Transaction-related expenses significantly decreased by $1,903,000 or 90% to $210,000 in 2024 from $2,113,000 in 2023[212] - The company has experienced a 40% compound annual growth rate in revenue since its transformation began in 2018[199] - The company does not anticipate paying any cash dividends in the foreseeable future, intending to retain all available funds for business operations and expansion[184] Product Development and Innovation - Surgical volume grew by 19% in 2024, while average revenue per surgery expanded by 8% compared to 2023[24] - The surgeon user base increased by 18% in 2024, driven by the "ATEC Experience" educational program[26] - The company launched EOS Insight™ in 2024, a software platform designed to enhance spine patient care from pre-operative planning to post-operative assessment[18] - The acquisition of SafeOp™ technology has integrated real-time information about nerve health into surgical procedures, enhancing predictability and reproducibility[16] - The AIX™ product platform includes EOS imaging and SafeOp systems, with significant development expected to bring new functionalities to market in 2025 and beyond[36] - The PTP approach, launched in 2020, allows for single-position surgery, minimizing patient repositioning and enhancing surgical efficiency[34] - Invictus is a next-generation spinal fixation solution designed for various pathologies, emphasizing intraoperative adaptability and surgical predictability[44] - The company offers a range of biologics for spinal fusion, including 3D ProFuse™ Osteoconductive Bioscaffold and AlphaGRAFT® products, enhancing handling and endplate contact[45] - The research and development team is focused on reducing the time from product conceptualization to market commercialization, aiming to enhance clinical outcomes across multiple spine pathologies[47] Market and Competitive Landscape - The spinal implant industry is highly competitive, with significant competitors including Medtronic, Johnson & Johnson, and Stryker, which have greater financial resources and established distribution networks[60] - Continued consolidation in the healthcare industry may lead to increased competition and pricing pressures, adversely affecting the company's market position and financial condition[120] - The company faces intense competition from well-established medical device companies, which may hinder its ability to compete effectively[107] Regulatory and Compliance - The company’s products are subject to extensive FDA regulation, requiring either 510(k) clearance or PMA for commercial distribution in the U.S.[65] - The average FDA review time for 510(k) submissions is approximately six months, although the goal is to complete reviews within 90 days[73] - The PMA process is more complex and costly than the 510(k) process, requiring extensive data to demonstrate safety and effectiveness, with a typical review period of 180 days, often taking longer in practice[77] - Clinical trials are generally required for PMA applications and may also be needed for 510(k) submissions, with strict adherence to FDA regulations and oversight by Institutional Review Boards[78] - Compliance with FDA regulations post-market includes registration, quality system regulations, labeling, and advertising requirements, with potential enforcement actions for non-compliance[79][81] - The company must adhere to various federal and state laws regarding healthcare fraud and abuse, with significant penalties for violations, including exclusion from government healthcare programs[84][85] - The federal Anti-Kickback Statute prohibits remuneration for referrals related to federal healthcare programs, with broad interpretations that could impact various business arrangements[85] - The number of qui tam actions under the federal False Claims Act has increased, leading to more healthcare companies facing legal challenges, with potential penalties of up to three times the actual damages[88] - HIPAA regulations govern the use and disclosure of protected health information (PHI), impacting the company's access for marketing and research purposes[91] - The ACA includes provisions for increased enforcement against fraud and abuse, requiring disclosures of payments to physicians and teaching hospitals, with risks of fines for non-compliance[90] Human Resources and Workforce - As of December 31, 2024, the company had 867 employees worldwide, with 681 located in the U.S. and 186 outside the U.S.[97] - The company has experienced a low undesired turnover rate of approximately 5% for 2024, indicating high employee satisfaction and engagement[99] - The company employs a robust recruiting program to attract and retain a diverse workforce, which is crucial for its innovation in the medical device market[98] - The company has never experienced a work stoppage due to labor difficulties and maintains good relations with its employees[100] Financial Risks and Liabilities - The company has an accumulated deficit of $1.3 billion as of December 31, 2024, and has historically incurred net losses since inception[141] - The company may need to raise additional funds in the future, but such funds may not be available on acceptable terms, which could adversely affect its ability to repay debt or develop products[138] - The company’s financial results are subject to significant fluctuations due to factors such as product acceptance, demand, pricing, and regulatory approvals[143] - The company relies on its subsidiaries for cash flow, and any inability of these subsidiaries to provide dividends could impact the company's financial obligations[133] - Economic downturns or volatility could materially impact the company’s revenues and cash flows, particularly due to fixed costs associated with operations[142] - The company carries product liability insurance, but coverage may be inadequate, potentially harming financial condition if claims exceed limits[152] - The company is exposed to product liability claims related to biologics products, which may lead to significant legal fees and reputational harm[153] Strategic Initiatives and Future Outlook - The company aims to continue creating clinically distinct procedures to improve surgical outcomes and increase market share in the U.S. spine market[22] - The strategic initiatives focus on creating clinical distinction, compelling surgeon adoption, and elevating distribution to drive growth[22] - The company plans to pursue acquisitions of complementary businesses and technologies, but successful integration remains uncertain and could disrupt ongoing operations[126] - The effectiveness of the company's operations relies on its senior management and key personnel, with potential adverse effects on business if there are significant changes in these teams[128] Cybersecurity and Operational Risks - The company is vulnerable to cybersecurity threats, which could lead to data breaches and significant costs, impacting its reputation and financial condition[130] - Operations are conducted in areas at risk of natural disasters, which could cause substantial delays and financial losses, with insurance coverage potentially inadequate[131] Intellectual Property - As of December 31, 2024, the company owned or exclusively licensed 180 issued U.S. patents and 250 foreign patents, indicating a strong intellectual property position[63] - The company’s ability to protect its intellectual property is crucial, as inadequate protection could result in loss of market share to competitors[146] - The company is subject to potential patent litigation, which could incur substantial costs and divert management's attention from core business operations[148] Stockholder and Corporate Governance - As of February 19, 2025, executive officers, directors, and principal stockholders beneficially own approximately 30% of the outstanding common stock, allowing them to significantly influence corporate decisions[158] - As of February 19, 2025, there are approximately 425 holders of record for a total of 144,149,232 outstanding shares of common stock[183]

Preliminary Financial Information - Alphatec Holdings, Inc. announced preliminary unaudited financial information for the year ended December 31, 2024 [11] - The financial information is subject to adjustments and risks due to the ongoing closing process [11] - The press release containing the preliminary financial information is attached as Exhibit 99.1 [5][12] Stock Market Information - The company's common stock is traded on the Nasdaq Global Select Market under the symbol ATEC [8] Executive Signatory - The report was signed by J. Todd Koning, Executive Vice President and Chief Financial Officer, on January 13, 2025 [7]

Company Overview - Alphatec (ATEC) shares increased by 9.1% to $10.88 in the last trading session, with a higher-than-average trading volume, compared to a 3.6% gain over the past four weeks [1] - The company is part of the Zacks Medical - Instruments industry, which includes other companies like DexCom (DXCM) [4] Financial Performance - For the fourth quarter of 2024, Alphatec expects total revenue between $175.5 million and $177.0 million, while full-year 2024 revenue is projected to be between $610.3 million and $611.8 million, reflecting a 27% year-over-year increase [2] - The Zacks Consensus Estimate for fiscal 2024 revenue indicates a growth of 25.5% [2] - The upcoming quarterly report is anticipated to show a loss of $0.18 per share, which is a 51.4% year-over-year change, with revenues expected to be $170.5 million, up 23.6% from the previous year [3] Earnings Estimates - The consensus EPS estimate for Alphatec has been revised 19.2% lower over the last 30 days, which typically does not correlate with price appreciation [4] - The stock currently holds a Zacks Rank of 2 (Buy), indicating a positive outlook despite the recent downward revision in earnings estimates [4]

Analyst Consensus and Price Targets - A tight clustering of price targets, indicated by a low standard deviation, suggests high agreement among analysts about the stock's price movement direction and magnitude [1] - The mean price target for ATEC is $17.29, indicating a potential upside of 73.4% from the current price of $9.97 [6] - The price targets range from $10 to $22.50, with a standard deviation of $4.06, where the lowest estimate suggests a 0.3% increase and the highest estimate points to a 125.7% upside [7] Earnings Estimate Revisions - The Zacks Consensus Estimate for ATEC's current year has increased by 4.5% over the past month, with one positive revision and no negative revisions [4] - Strong agreement among analysts in revising EPS estimates higher indicates increasing optimism about the company's earnings prospects [3] - A positive trend in earnings estimate revisions has historically shown a strong correlation with near-term stock price movements [3] Zacks Rank and Analyst Bias - ATEC currently holds a Zacks Rank 2 (Buy), placing it in the top 20% of over 4,000 stocks ranked based on earnings estimate factors [5] - Analysts' price targets are often influenced by business incentives, leading to overly optimistic estimates that may not accurately predict stock price movements [11] - While the consensus price target may not be reliable, the implied direction of price movement can still serve as a useful guide [12]

Financial Data and Key Metrics Changes - Total revenue for Q3 2024 was $151 million, representing a 27% increase year-over-year and a 4% sequential increase [7] - Surgical revenue was $135 million, up 30% year-over-year, with procedural volume growth of 20% [7][8] - Adjusted EBITDA for Q3 was $7.4 million, a margin of 5%, compared to a loss of $400,000 in the prior year [8][9] - Non-GAAP gross margin was 69%, down 60 basis points year-over-year due to product mix [8] - Cash burn was reduced by over 50% sequentially to $21 million [10] Business Line Data and Key Metrics Changes - Surgical revenue growth was driven by strong contributions from lateral and expandable implant technologies, contributing to a 9% growth in average revenue per procedure [7][8] - EOS revenue for Q3 was $15 million, up 7% year-over-year, with record year-to-date order volume [7][8] Market Data and Key Metrics Changes - The company expects total revenue growth of 25% for the full year 2024, with surgical revenue growth of 28% [12] - The company anticipates cash used to range between $125 million and $135 million for the full year 2024 [12] Company Strategy and Development Direction - The company aims to achieve $1 billion in revenue by 2027, with an adjusted EBITDA of $180 million and a margin of 18% [6][11] - Focus on creating clinical distinction through innovative procedures and informatics, enhancing surgeon adoption and operational efficiency [14][16] - The company is investing in its sales force and streamlining operations to improve efficiency and cash flow [5][19] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in continued revenue growth and profitability, citing a strong surgeon adoption rate and increased training engagements [3][12] - The company is positioned for cash flow breakeven in 2025, with expectations for positive free cash flow in the latter half of the year [13][12] - Management emphasized the importance of improving patient care and operational efficiency as key drivers for future growth [16][19] Other Important Information - The company increased its term loan capacity by $50 million, bringing the total to $200 million, which is expected to provide ample liquidity going into 2025 [11] - The company has a strong focus on integrating informatics into its surgical procedures to enhance precision and outcomes [16][17] Q&A Session Summary Question: Concerns about overspending resources - Management reassured investors of their commitment to self-funding and maintaining flat operating expenses while achieving adjusted EBITDA above expectations [21][22] Question: Impact of hurricanes and IV solution shortages - Management reported no significant impact from hurricanes and minimal effect from IV shortages, with confidence in catching up on procedures [26][27] Question: New representative productivity - Management indicated that new representatives are ramping up, with continued growth in same-store sales and investments in territories beginning to contribute [29][30] Question: Robotics and imaging integration - Management clarified that while robotics is valuable, the focus is on creating an ecosystem that enhances decision-making and outcomes in spine care [36][37] Question: CapEx spending and revenue growth expectations - Management explained that historical investment rates support significant revenue growth, with confidence in achieving higher revenue than currently modeled by analysts [43][44] Question: Conversion rates from surgeon training - Management noted that while not every trained surgeon becomes a customer, there is high engagement and tailored experiences to improve conversion rates [46][47]

Core Viewpoint - Alphatec reported a quarterly loss of $0.28 per share, slightly worse than the Zacks Consensus Estimate of a loss of $0.27, but an improvement from a loss of $0.35 per share a year ago [1] - The company posted revenues of $150.72 million for the quarter ended September 2024, exceeding the Zacks Consensus Estimate by 2.19% and showing a year-over-year increase from $118.26 million [2] Financial Performance - The quarterly report indicates an earnings surprise of -3.70%, with the company having consistently failed to surpass consensus EPS estimates over the last four quarters [1][2] - Alphatec shares have declined approximately 64.1% year-to-date, contrasting with the S&P 500's gain of 22.3% [3] Future Outlook - The company's earnings outlook is crucial for investors, with current consensus EPS estimates at -$0.18 for the upcoming quarter and -$1.08 for the current fiscal year [7] - The estimate revisions trend for Alphatec is currently favorable, resulting in a Zacks Rank 2 (Buy), suggesting that the shares are expected to outperform the market in the near future [6] Industry Context - The Medical - Instruments industry, to which Alphatec belongs, is currently ranked in the top 22% of over 250 Zacks industries, indicating a positive outlook for stocks within this sector [8] - The performance of Alphatec's stock may also be influenced by the overall industry outlook and trends in earnings estimate revisions [5][8]