NeuroPace(NPCE) - 2025 Q4 - Earnings Call Transcript

Financial Data and Key Metrics Changes - NeuroPace reported Q4 2025 revenue of $26.6 million, a 24% year-over-year increase from $21.5 million in Q4 2024 [4][17] - RNS System revenue was $22.4 million, reflecting a 26% year-over-year growth [4][17] - Gross margin improved to 77.4%, up from 75.4% in Q4 2024, driven by higher margin RNS revenue and manufacturing efficiencies [18] - Adjusted EBITDA was positive at $900,000, marking a $1.9 million improvement year-over-year [22] - For the full year 2025, total revenue grew 25% to $100 million, with RNS System sales also increasing by 25% [24] Business Line Data and Key Metrics Changes - The core RNS business continues to show strong growth, with a 29% increase in the second half of 2025 [5] - Service revenue from data collaborations was approximately $890,000 in Q4 2025 [17] - Revenue from DIXI Medical was about $3 million, a 4% decline compared to Q4 2024, as the commercial partnership ended [17] Market Data and Key Metrics Changes - The majority of growth is coming from Level 4 centers, indicating increased adoption and utilization of the RNS System [5] - The company is expanding access to RNS therapy through community pathways and referral networks [5] Company Strategy and Development Direction - NeuroPace is focused on deepening adoption within the adult focal epilepsy indication while preparing for future indication expansions [5][8] - The company is investing in its commercial organization, including sales representative additions and nurse navigator resources [8] - The submission of a PMA supplement to the FDA for an expanded indication in idiopathic generalized epilepsy (IGE) is a key strategic move [9] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving a minimum of 20% growth in the core RNS business for 2026 [6] - The company reiterated its 2026 revenue guidance of $98 million to $100 million, assuming 20%-22% growth in the core RNS business [7][26] - Management highlighted the importance of ongoing investments in commercial activities and product development to drive future growth [31] Other Important Information - The company achieved its second consecutive quarter of positive adjusted EBITDA and positive cash generation in Q4 2025 [7][22] - NeuroPace is advancing its product pipeline, including AI tools designed to enhance physician workflow and patient outcomes [10][12] Q&A Session Summary Question: How quickly can the company translate from IGE approval to revenue collection? - Management indicated that extending coverage in the private payer community is essential and that preparations are already underway [38] Question: What is the impact of pricing on RNS growth in Q4? - Management noted consistent mid-single-digit pricing increases annually, with Q4 growth primarily driven by initial implants rather than pricing changes [52][54] Question: What is the current state of capacity dynamics across implanting centers? - Management stated that there is sufficient capacity in the channel for prescribers and that nurse navigators are being employed to streamline patient flow [62][64] Question: Will SeizureID be a subscription service for physicians? - SeizureID will be included with the use of the RNS System, aimed at improving efficiency for clinicians [68][70] Question: Any updates on the pediatric NEST collaboration? - Management confirmed ongoing work with NEST to utilize real-world evidence for focal pediatric patients, with no specific submission timeline yet [82]