Summary of Alphatec Conference Call Company Overview - **Company**: Alphatec Spine - **Industry**: Medical Supplies and Devices, specifically focused on spinal surgery Key Points and Arguments Growth and Financial Performance - Alphatec aims for long-term differentiated growth, with a strong track record of execution and significant growth opportunities in the spine market [2][3] - The company finished 2025 with $764 million in revenue, reflecting a 25% growth, and expects to reach $890 million in revenue by 2026, representing a 17% growth [4][6] - Adjusted EBITDA for 2025 was projected at $91 million (12% of revenue), with expectations of $130 million (15% margin) by 2026 [4][6] - The company has committed to becoming a $1 billion revenue company by 2027, with $180 million in Adjusted EBITDA [5] Market Position and Strategy - Alphatec is now the third largest U.S. market share holder in the spine market, with less than 10% market share across the top 10 U.S. markets, indicating significant growth potential [5][24] - The company has focused on creating clinical distinction to compel surgeon adoption, achieving over 20% growth in surgeon adoption this year [7][8] - The strategy includes proceduralization, which emphasizes the assembly of goods for spine surgery rather than selling individual parts [3][11] Innovations and Technology - Alphatec has made significant investments in informatics and procedural tools, including the acquisition of EOS, a full-body imaging system, and the development of SafeOp, a neurophysiology tool [19][13] - The company is focused on integrating informatics into surgical workflows to improve decision-making and outcomes, with plans to launch Valence, a navigation and robotic tool, in 2026 [14][15][19] - The informatics play is seen as a key driver of long-term value, with a focus on capturing data to enhance surgical decision-making [24][20] Market Dynamics and Competition - The company views recent disruptions in the spine market, such as spin-offs from larger med tech companies, as potential tailwinds for growth [40][41] - Alphatec believes its commitment to neurophysiology and sophisticated surgical tools provides a competitive advantage over fast-following competitors [44][46] Future Outlook - The company anticipates continued strong growth driven by surgical volume and adoption, with a target of $100 million in EOS revenue by 2027 [32][25] - Seasonality effects are expected to influence revenue patterns, particularly with the growing presence in pediatric deformity [31][35] - Alphatec is focused on maintaining profitability while investing in R&D and sales channels to support growth [50][51] Conclusion - The financial outlook for Alphatec is positive, with a commitment to achieving $890 million in revenue and $130 million in Adjusted EBITDA by 2026, alongside a focus on innovation and market expansion [29][50]

Financial Data and Key Metrics Changes - Total revenue for the third quarter was $197 million, representing a 30% increase year-over-year and a sequential increase of $11 million from the previous quarter [5][14] - Adjusted EBITDA reached $26 million, or 13% of revenue, marking an improvement of 840 basis points compared to the prior year [4][11] - Free cash flow was reported at $5 million, with total cash and available cash amounting to $260 million [12][14] Business Line Data and Key Metrics Changes - Surgical revenue was $177 million, up 31% year-over-year and 5% sequentially, driven by a procedural volume growth of 28% [5][8] - EOS revenue increased to $20 million, a 29% rise compared to the prior year, with strong demand in the U.S. market [8][9] - Same-store sales in the U.S. grew 30% year-over-year, indicating strong performance in established territories [8][9] Market Data and Key Metrics Changes - The company reported a 30% growth in same-store sales, reflecting strong demand in existing markets [8] - The increase in new surgeon users by 26% in the third quarter indicates a growing adoption of the company's products [5][6] Company Strategy and Development Direction - The company remains 100% spine-focused, emphasizing proceduralization and expanding its product offerings in lateral, cervical, and deformity markets [3][19] - The strategic focus includes leveraging technology integration to enhance surgical outcomes and democratize surgical techniques [20][25] - The company is positioned to meet its long-range plan commitments, aiming for $1 billion in revenue by 2027 [17][29] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's ability to deliver durable revenue growth and strong profitability improvements [11][17] - The company anticipates raising its full-year revenue guidance by $18 million to $760 million, driven by overperformance in case volume [14][15] - Management highlighted the importance of surgeon adoption and the long-term potential of the spine market, indicating a positive outlook for future growth [18][67] Other Important Information - The company has seen a significant improvement in its operating margin, with a 1,100 basis points expansion year-over-year [10][11] - The trailing 12-month adjusted EBITDA now stands at $81 million, reflecting the company's ability to generate cash flow [11][12] Q&A Session Summary Question: Cash flow expectations for next year - Management expects free cash flow for next year to be around $20 million, aligning with revenue growth and EBITDA drop-through [32][33] Question: Update on long-range plan - An update to the long-range plan is anticipated towards the end of next year as the company progresses through 2026 [34] Question: Competitive landscape and consolidation - The company welcomes market disruption and believes it can capitalize on the current dynamics in the spine market [37][39] Question: Role of Valence in lateral space - Valence is expected to enhance efficiency and democratize surgical techniques, benefiting both experienced and new users [40][44] Question: Health of the spine market and competitive dynamics - The spine market remains healthy, with the company taking share from multiple competitors, reflecting decisions made 18 to 24 months ago [48][50] Question: Balancing growth and profitability - The company aims to balance growth and profitability by investing in innovation while leveraging existing infrastructure [52][54] Question: Timing for deformity portfolio contributions - The company is in the early stages of influencing the deformity market, with several products in the design phase and a focus on expanding EOS availability [73][75]

Financial Data and Key Metrics Changes - The company reported sustained revenue growth, with a guidance of approximately 21% top-line growth for the year [10][12] - Q2 cash usage was at the high end of the guidance range of $0 to $5 million, with expectations of slightly positive free cash flow for the year [5][9] - Adjusted EBITDA profitability is ahead of expectations, contributing to confidence in achieving free cash flow profitability by 2025 [6][26] Business Line Data and Key Metrics Changes - The company added 21% new surgeons in Q2, maintaining a consistent new surgeon metric around 20% over the past eight quarters [15] - Existing territories grew by 29% in Q2, indicating strong surgeon interest and demand [18] Market Data and Key Metrics Changes - The company anticipates a step down in market performance from Q2 to Q3, followed by a rebound from Q3 to Q4 [10][11] - The two-year stack growth rate for Q1 was about $31 million, while Q2 was approximately $34 million, with expectations of $33 million each quarter in the second half [11][12] Company Strategy and Development Direction - The company aims to focus on unique clinical solutions that drive surgeon interest, with a long-term view of improving spine surgery [15] - The upcoming launch of the Valence robot is expected to address clinical challenges and expand the addressable market in spine surgery [31][33] - The company is committed to investing in sales and R&D to drive sustainable growth opportunities while achieving financial commitments [28][74] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the second half of the year, citing strong surgeon adoption and procedural volume growth as tailwinds [30] - The company is optimistic about the clinical value of its solutions, which is expected to drive adoption and utilization rates [48] Other Important Information - The company has been expanding its international presence, particularly in Australia, New Zealand, and Japan, with plans for growth in these markets [49][50] - The PTP Corpectomy launch is seen as a natural evolution within the PTP ecosystem, aimed at enhancing clinical value and procedural volume [55][58] Q&A Session Summary Question: What investor feedback have you received since Q2 results? - Management noted that investors are focused on the durability of top-line growth and the company's profitability profile [4] Question: What gives you confidence in achieving free cash flow profitability in 2025? - Management highlighted better-than-expected performance in the first half of the year and effective cash flow management [5] Question: How do you see the rest of the year playing out from a cash flow perspective? - Management projected free cash flow generation of $1 million to $5 million in Q3 and high single digits in Q4 [9] Question: Can you discuss your recruitment efforts and market environment? - Management indicated a favorable environment for recruitment, with a focus on adding reps to support new surgeon additions [14][15] Question: What are the key performance metrics for new sales reps? - Management explained that new reps typically ramp up over a two-year period, with significant growth potential by year three [20][21] Question: How do you balance attracting new sales talent while achieving cash flow positivity? - Management outlined a structured investment approach in sets and inventory to support revenue growth while maintaining cash flow [24][26] Question: What are your international plans for 2025 and beyond? - Management confirmed a focus on Australia, New Zealand, and Japan, with plans for profitable growth in these markets [49][50] Question: How does the PTP Corpectomy fit into your broader strategy? - Management described PTP as a platform approach that allows for addressing various pathologies, with corpectomy being a natural addition [55][58]

Financial Data and Key Metrics Changes - The company reported a cash usage of $5 million in Q2, at the high end of the guidance range, and expects to achieve slightly positive free cash flow for the year [4][5] - The guidance for top-line growth has been raised to approximately 21% for the year, with expectations of $130 million in total revenue for 2023, 2024, and 2025 [10][12] Business Line Data and Key Metrics Changes - The company achieved a 21% increase in new surgeon adds in Q2, maintaining a consistent growth rate over the past eight quarters [15] - Existing territories grew by 29% in Q2, indicating strong demand and interest from surgeons [19] Market Data and Key Metrics Changes - The company anticipates a slight step down in market performance from Q2 to Q3, followed by a rebound in Q4 [10] - The two-year stack growth rate for Q1 was approximately $31 million, and for Q2 it was about $34 million, with expectations of $33 million for each quarter in the second half [11][12] Company Strategy and Development Direction - The company is focused on compelling surgeons with unique clinical solutions and aims to expand its market share in the spine sector [15] - The upcoming launch of the Valence robot is expected to address clinical challenges in spine surgery, with a focus on integrating it with existing procedures [33][36] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving free cash flow profitability in 2025, citing better-than-expected performance in the first half of the year [4][5] - The company is optimistic about strong surgeon adoption rates, which are expected to drive procedural volume growth [31] Other Important Information - The company plans to maintain a narrow and deep international strategy, focusing on profitable markets like Australia, New Zealand, and Japan [55][56] - The PTP Corpectomy launch is seen as a natural evolution within the PTP ecosystem, aimed at enhancing clinical value and procedural volume [61][62] Q&A Session Summary Question: What investor feedback have you received since Q2 results? - Investors are focused on the durability of top-line growth and the company's profitability profile [3] Question: What gives you confidence in achieving free cash flow profitability in 2025? - Confidence stems from better-than-expected cash flow performance in the first half of the year [4] Question: How do you see the rest of the year playing out from a cash flow perspective? - Expectations for Q3 are a free cash flow generation of $1 million to $5 million, with high single digits anticipated in Q4 [9] Question: Can you discuss the overall spine market and recruitment efforts? - The company is benefiting from market disruptions and is onboarding sales representatives to support surgeon interest [14] Question: What are the key performance metrics for new sales reps? - New reps typically ramp up over a two-year period, with significant revenue growth expected by year three [21][22] Question: How do you balance attracting new sales talent while achieving cash flow positivity? - The company has a structured investment approach, spending $0.75 for every dollar of year-over-year growth [27][28] Question: What are your international plans for 2025 and beyond? - The focus remains on Australia, New Zealand, and Japan, with plans for growth and profitability in these markets [55][56] Question: How does the PTP Corpectomy fit into the broader ecosystem? - It is seen as a natural evolution that adds clinical value and supports procedural volume growth [61][62]