Financial Data and Key Metrics Changes - Fourth quarter revenue was $46.4 million, a decrease of 6.9% compared to the same quarter in 2024 [12] - Procedure revenue declined 13% to $31.8 million, while dietary supplement revenue grew 16% to $11.7 million [12][13] - Gross profit margin was 68.0%, down from 71.8%, primarily due to a $1.3 million charge related to a voluntary recall [14] - Adjusted EBITDA decreased to $11.7 million with an adjusted EBITDA margin of 25.2%, compared to $15.1 million and 30.3% in the previous year [16] Business Line Data and Key Metrics Changes - Procedure revenue was primarily impacted by a lower number of net new clinic additions and lower procedure volume [12] - Dietary supplement revenue growth was driven by the continued expansion of the e-commerce channel [13] - The company anticipates dietary supplement revenue to grow at a mid- to high-single-digit rate in 2026 [14] Market Data and Key Metrics Changes - The company ended 2025 with over 90 salespeople, up from approximately 60 at the time of the sales reorganization [8] - The number of new Biote certified practitioners is a leading indicator of future procedure growth, with training sessions at full capacity [8] Company Strategy and Development Direction - The company aims to prioritize new clinic growth, maximize value from existing clinics, and strengthen accountability and discipline [6][9] - In 2026, the company plans to expand its sales personnel from over 90 to approximately 120 and invest in technology to enhance the practitioner experience [10][11] - The company is focused on operational excellence and improving internal processes to drive sustainable growth [9] Management's Comments on Operating Environment and Future Outlook - Management expressed cautious optimism about re-accelerating procedure revenue growth and scaling the business more efficiently [9] - The company expects procedure revenue to decrease at a mid- to high-single-digit percentage rate in the first half of 2026, with a return to growth anticipated in the second half [17] - Planned investments in 2026 are expected to impact adjusted EBITDA but are seen as essential for long-term growth [11] Other Important Information - Cash flow from operations for 2025 was $35.2 million, with cash and cash equivalents at $24.1 million as of December 31, 2025 [16] Q&A Session Summary Question: Impact of FDA's removal of black box warnings for certain HRTs - Management views the removal as a positive tailwind, recognizing hormone optimization as a beneficial option for patients [21] Question: Details on the voluntary recall and FDA feedback - The company is working closely with the FDA and has received positive feedback regarding the recall process [22] Question: Procedure revenue growth in the first half of 2026 - The decline is attributed to higher attrition rates and lower volumes, with expectations for growth in the second half of 2026 [25][26] Question: Anticipated procedure revenue decline in Q1 versus Q4 - Management expects stabilization in attrition and monitoring of new customer growth, with a focus on the impact of the recall [30][33] Question: Clarification on EBITDA guidance - The decrease in EBITDA is primarily due to investments in sales personnel and technology to drive future growth [34][37] Question: Areas of focus for improving the tech platform - The company aims to enhance the practitioner experience through system improvements, both internally and with outside help [43][46] Question: Quarterly sales decline expectations for Q1 - Management anticipates a similar decline to Q4, with a focus on stabilizing attrition and monitoring recall impacts [48][49] Question: Current pellet supply through Asteria - The company is currently at about 50/50 on overall pellets being used from Asteria versus other providers, with plans to increase Asteria's share [52][56]