SI-BONE(SIBN) - 2025 Q4 - Earnings Call Transcript

Financial Data and Key Metrics Changes - The company generated record annual worldwide revenue of nearly $201 million, marking over 20% growth year-over-year [5][20] - Fourth quarter worldwide revenue grew 15% to a record $56.3 million, with U.S. revenue at $53.5 million, representing 13.9% growth [19][20] - The company achieved its first full year of positive Adjusted EBITDA, with a margin of 9% in the fourth quarter [6][23] - Net loss narrowed to $1.6 million or $0.04 per diluted share in the fourth quarter, compared to a net loss of $4.5 million or $0.11 per diluted share last year [22][23] - The company exited 2025 with $147.8 million in cash and equivalents, an increase of $2.1 million from the third quarter [24] Business Line Data and Key Metrics Changes - The U.S. physician base grew by 22%, with over 2,400 physicians performing nearly 22,000 procedures in 2025 [5][20] - The company launched the INTRA Ti product, which is expected to enhance procedural efficiency in ambulatory surgery centers [9][10] - iFuse Bedrock Granite has been one of the fastest-growing platforms, significantly outpacing the overall deformity market growth rate [11] Market Data and Key Metrics Changes - International revenue in the fourth quarter was $2.9 million, growing 38.8%, driven by the reception of iFuse TORQ [19][20] - The company secured favorable reimbursement positions, including NTAP for iFuse TORQ TNT and TPT for iFuse Bedrock Granite, enhancing access and adoption [5][11] Company Strategy and Development Direction - The company aims to lead the sacroiliac joint fusion market and expand into new clinical adjacencies, targeting unmet needs for patients with compromised bone [6][8] - The partnership with Smith+Nephew is expected to enhance market penetration in trauma solutions [16][30] - The company anticipates an innovation super cycle over the next five years, with regular product launches targeting new clinical adjacencies [7][57] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the long-term growth potential of the business, supported by a robust pipeline of innovative products and expanding market opportunities [27] - The company expects worldwide revenue of $228.5 million to $232.5 million in 2026, implying year-over-year growth of 14%-16% [25][26] - Management highlighted the importance of allowing tailwinds to materialize before fully incorporating them into revenue expectations [54][86] Other Important Information - The company achieved positive free cash flow in the fourth quarter, generating nearly $500,000, ahead of its previously stated goal [24] - The company plans to add 10 new territories in 2026 to capture market opportunities [16][69] Q&A Session Summary Question: How did the Smith+Nephew partnership come about and its potential contribution? - Management expressed excitement about the partnership, highlighting its potential to expand access to trauma solutions and allow the sales force to focus on spine and interventional markets [30][32] Question: Will the INTRA Ti product create more engagement among interventional physicians? - Management confirmed that the INTRA Ti product is designed to improve procedural efficiency and is expected to drive growth in the interventional business [34][49] Question: What is the rationale behind the high teens growth guidance for 2026? - Management explained that the guidance considers the impact of new products and reimbursement coverage, with a focus on prudent expectations early in the year [86] Question: What is the expected ramp-up for the Smith+Nephew partnership in 2026? - Management indicated that activity is expected to start in March, with a ramp-up in Q2 and Q3 in preparation for Q4 [74][75]