Neuronetics Reports Third Quarter 2022 Financial and Operating Results

11/08/22

MALVERN, Pa., Nov. 08, 2022 (GLOBE NEWSWIRE) -- Neuronetics, Inc. (NASDAQ: STIM), a commercial stage medical technology company with a strategic vision of transforming the lives of patients whenever and wherever they need help with the best neurohealth therapies in the world, today announced its financial and operating results for the third quarter of 2022.

Third Quarter 2022 Highlights

  • Third quarter 2022 revenue of $16.5 million, represents a 20% increase as compared to the third quarter 2021
  • Achieved record quarterly U.S. treatment session revenue of $11.9 million in the third quarter 2022, compared to $10.3 million in third quarter 2021
  • Reached an all time U.S. treatment session utilization record in the third quarter
  • Increased NeuroStar System revenue 51% over the third quarter of 2021
  • Raising revenue guidance for full year 2022 to be between $63.0 million and $64.0 million

Recent Operational Highlights

  • Received FDA 510(k) clearance for D-Tect™ MT Accessory
  • Positive TMS coverage policies published or proposed which expand patient access to NeuroStar Advanced Therapy system for both MDD and OCD

Recent Marketing Highlights

  • Grand opening of NeuroStar University (NSU) in Charlotte, North Carolina
  • Tap Into a New Possibility for Depression campaign drove over 30 million impressions, up 150% compared to campaigns run during third quarter of 2021
  • Achieved milestones of over 141,070 global patients treated with more than 5.0 million of our Treatment Sessions, a Company record

“Our strong performance in the third quarter reflects the positive impacts of our ongoing strategic initiatives such as the revamped sales force, innovative marketing programs, and continued physician and patient education. Performance was highlighted by record US Treatment Sessions revenue and utilization, while also achieving 51% year-over-year growth in US NeuroStar System revenue,” said Keith J. Sullivan, President and Chief Executive Officer of Neuronetics. “We will continue to concentrate on execution for the remainder of the year in order to fuel growth and put ourselves in a position to achieve cash flow breakeven in 2024.”

Third Quarter 2022 Financial and Operating Results for the Three Months Ended September 30, 2022

    Revenues by Geography  
    Three Months Ended September 30  
    2022   2021      
       Amount      Amount      % Change  
    (in thousands, except percentages)  
United States   $ 16,244   $ 13,280   22 %
International     254     519   (51) %
Total revenues   $ 16,498   $ 13,799   20  %

Total revenue for the three months ended September 30, 2022 was $16.5 million, an increase of 20% compared to the three months ended September 30, 2021 revenue of $13.8 million. During the quarter, total U.S. revenue increased by 22% and international revenue decreased by 51% over the prior year quarter. The U.S. revenue growth was primarily driven by an increase in Treatment Session sales and the decline in international revenue was primarily driven by the timing of orders in early 2022.

                   
    U.S. Revenues by Product Category  
    Three Months Ended September 30  
    2022   2021      
       Amount      Amount      % Change  
    (in thousands, except percentages)  
NeuroStar Advanced Therapy System   $ 3,934   $ 2,612   51 %
Treatment sessions     11,864   $ 10,259   16 %
Other     446   $ 409   9 %
Total U.S. revenues   $ 16,244   $ 13,280   22 %

U.S. NeuroStar Advanced Therapy System revenue for the three months ended September 30, 2022 was $3.9 million, an increase of 51% compared to the three months ended September 30, 2021 revenue of $2.6 million. For the three months ended September 30, 2022 and 2021, the Company sold 49 and 33 systems, respectively, that were recognized as NeuroStar capital revenue during each period. Additionally, for the three months ended September 30, 2022 and 2021, the Company executed 1 and 7 operating lease agreements, respectively, that contributed to operating lease revenue.

U.S. Treatment Session revenue for the three months ended September 30, 2022 was $11.9 million, an increase of 16% compared to the three months ended September 30, 2021 revenue of $10.3 million. The revenue growth was primarily driven by an increase in utilization, in particular amount our local per-click customer segment.

In the third quarter of 2022, U.S. treatment session revenue per active site increased to $11,364 from $11,163 during the third quarter of 2021.

Gross margin for the third quarter of 2022 was 78.4%, an increase of approximately 120 basis points from the third quarter of 2022 gross margin of 77.2%.

Operating expenses during the third quarter of 2022 were $20.4 million, an increase of $2.6 million, or 14.6%, compared to $17.8 million in the third quarter of 2021. The increase was primarily driven by our expanded sales force, the opening of NeuroStar University, additional headcount in product development and clinical, as well as increased costs from inflationary pressures. On a sequential basis, compared to the second quarter of 2022, total operating expenses in the third quarter of 2022 were down approximately $1.7 million as a result of cost control measures taken during the period.

Net loss for the third quarter of 2022 was $(7.6) million, or $(0.28) per share, as compared to the third quarter 2022 net loss of $(8.2) million, or $(0.31) per share. Net loss per share was based on 26,964,613 and 26,301,361 weighted-average common shares outstanding for the third quarters of 2022 and 2021, respectively.

EBITDA for the third quarter of 2022 was $(6.1) million as compared to the third quarter of 2021 EBITDA of $(6.9) million. See the accompanying financial table that reconciles EBITDA, which is a non-GAAP financial measure, to net loss.

Cash and cash equivalents were $73.7 million as of September 30, 2022. This compares to cash and cash equivalents of $94.1 million as of December 31, 2021, and $70.9 million as of June 30, 2022.

TMS Coverage Policies Updates

In October of 2022, multiple Medicare Administrative Contractors (MACs) published and proposed Medicare coverage policies to reduce the number of medication trials required for TMS eligibility, leading to increased access to NeuroStar as a non-drug alternative for treatment resistant mental disorders. The published and proposed updates will affect nearly 8 million covered lives. CGS MAC has published an updated TMS coverage policy, effective December 4, 2022, that reduces the number of prior medication failures for TMS eligibility from four down to two for people suffering from major depressive disorder (MDD). NGS MAC has published a proposed Local Coverage Decision (LCD) considering TMS coverage for obsessive-compulsive disorder (OCD) and is also considering an MDD policy criteria change that would reduce the number of prior medication failures for TMS eligibility from four down to two.

510(k) Clearance for D-Tect MT Accessory

The Company has received 510(k) clearance for it’s D-Tect™ MT Accessory, which is the latest innovation in NeuroStar’s commitment to simplify the motor threshold determination for physicians. The FDA-cleared technology aids clinicians by visually reporting the magnitude of finger movements during motor threshold (MT) mapping for treatment of major depressive disorder (MDD). D-Tect also allows the MT determination to be performed by only one person. In addition, practices will be trained on this new product at NeuroStar University, which recently opened in Charlotte, North Carolina.

Grand Opening of NeuroStar University (NSU)

In September, the Company hosted a ribbon-cutting ceremony to celebrate the grand opening of NeuroStar University in Charlotte, NC. Local government officials, NeuroStar patients and providers, and leaders in the mental health industry were among the 75 attendees. NSU will teach new and existing customers how to enhance patient outcomes, connect with other specialists in their field, and grow their practices using clinical education, enhanced patient awareness and consultation techniques.

Business Outlook

For the full year 2022, the Company now expects total worldwide revenue to be between $63.0 million and $64.0 million, up from previous guidance of $60.0 million and $62.0 million.

For the full year 2022, the Company continues to expect total operating expenses to be between $86.0 million and $88.0 million.

For the fourth quarter of 2022, the Company expects to report total worldwide revenue of between $16.0 million and $17.0 million.

Webcast and Conference Call Information

Neuronetics’ management team will host a conference call on November 8, 2022, beginning at 8:30 a.m. Eastern Time.

The conference call will be broadcast live in listen-only mode via webcast at https://edge.media-server.com/mmc/p/h3amkwib. To listen to the conference call on your telephone, participants may register for the call here. While it is not required, it is recommended you join 10 minutes prior to the event start. To access the live audio webcast or subsequent archived recording, visit the Investor Relations section of Neuronetics’ website at ir.neuronetics.com.

About Neuronetics

Neuronetics, Inc. believes that mental health is as important as physical health. As a global leader in neuroscience and the largest transcranial magnetic stimulation (“TMS”) company in the industry, Neuronetics is redefining patient and physician expectations by designing and developing products that improve the quality of life for people suffering from neurohealth conditions. An FDA-cleared, non-drug, noninvasive treatment for people with depression, Neuronetics’ NeuroStar® Advanced Therapy system is the leading TMS treatment for major depressive disorder (“MDD”) in adults with over 4.8 million treatments delivered. NeuroStar is widely researched and backed by the largest clinical data set of any TMS system for depression, including the world’s largest depression Outcomes Registry. Our NeuroStar® Advanced Therapy system is also FDA-cleared to treat people suffering from obsessive-compulsive disorder, as well as for the treatment of comorbid anxiety symptoms (“anxious depression”) for adults with MDD suffering from anxiety symptoms. Neuronetics is committed to transforming lives by offering an exceptional treatment option that aims to produce extraordinary results. For safety information and indications for use, visit NeuroStar.com.

“Safe harbor” statement under the Private Securities Litigation Reform Act of 1995:

Statements in the press release regarding Neuronetics, Inc. (the “Company”) that are not historical facts constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements may be identified by terms such as “outlook,” “potential,” “believe,” “expect,” “plan,” “anticipate,” “predict,” “may,” “will,” “could,” “would” and “should” as well as the negative of these terms and similar expressions. These statements include those relating to the Company’s business outlook and current expectations for upcoming quarter and fiscal year 2022, including with respect to revenue, operating expense, growth, and any statements of assumptions underlying any of the foregoing items. These statements are subject to significant risks and uncertainties and actual results could differ materially from those projected. The Company cautions investors not to place undue reliance on the forward-looking statements contained in this release. These risks and uncertainties include, without limitation, risks and uncertainties related to: the impact of COVID 19 on the Company’s operational and budget plans as well as general political and economic conditions, including as a result of efforts by governmental authorities to mitigate COVID 19, such as travel restrictions and third-party business closures and the related impact on resource allocations, manufacturing and supply chains and patient access to commercial products; the Company’s ability to execute its business continuity; the Company’s ability to achieve or sustain profitable operations due to its history of losses; the Company’s reliance on the sale and usage of its NeuroStar Advanced Therapy for Mental Health System to generate revenues; the scale and efficacy of the Company’s salesforce as well as the Company’s ability to retain talent; availability of coverage and reimbursement from third-party payors for treatments using the Company’s products; physician and patient demand for treatments using the Company’s products; developments in respect of competing technologies and therapies for the indications that the Company’s products treat; product defects; the Company’s ability to obtain and maintain intellectual property protection for its technology; developments in clinical trials or regulatory review of NeuroStar Advanced Therapy for Mental Health System for additional indications; and developments in regulation in the United States and other applicable jurisdictions. For a discussion of these and other related risks, please refer to the Company’s recent SEC filings which are available on the SEC’s website at www.sec.gov. These forward-looking statements are based on the Company’s expectations and assumptions as of the date of this press release. Except as required by law, the Company undertakes no duty or obligation to update any forward-looking statements contained in this press release as a result of new information, future events, or changes in the Company’s expectations.

Investor Contact:

Mike Vallie or Mark Klausner
Westwicke Partners
443-213-0499
ir@neuronetics.com

Media Contact:

EvolveMKD
646-517-4220
NeuroStar@evolvemkd.com

NEURONETICS, INC.
Statements of Operations
(In thousands, except per share data)

                         
    Three Months ended   Nine months ended
    September 30   September 30
       2022        2021        2022        2021  
Revenues   $ 16,498     $ 13,799     $ 47,008     $ 40,290  
Cost of revenues     3,570       3,144       11,093       8,115  
Gross Profit     12,928       10,655       35,915       32,175  
Operating expenses:                           
Sales and marketing     11,643       9,827       37,977       27,431  
General and administrative     6,391       6,435       19,125       19,220  
Research and development     2,348       1,575       6,197       6,179  
Total operating expenses     20,382       17,837       63,299       52,830  
Loss from Operations     (7,454 )     (7,182 )     (27,384 )     (20,655 )
Other (income) expense:                           
Interest expense     1,061       993       3,039       2,955  
Other income, net     (906 )     (24 )     (1,554 )     (53 )
Net Loss   $ (7,609 )   $ (8,151 )   $ (28,869 )   $ (23,557 )
Net loss per share of common stock outstanding, basic and diluted   $ (0.28 )   $ (0.31 )   $ (1.08 )   $ (0.94 )
Weighted-average common shares outstanding, basic and diluted     26,965       26,301       26,797       25,179  

NEURONETICS, INC.
Balance Sheets
(In thousands, except per share data)

             
       September 30   December 31
    2022     2021  
Assets              
Current assets:              
Cash and cash equivalents   $ 73,698     $ 94,141  
Accounts receivable, net     11,963       7,706  
Inventory     8,573       6,563  
Current portion of net investments in sales-type leases     1,874       2,198  
Current portion of prepaid commission expense     1,871       1,559  
Current portion of note receivables     80       74  
Prepaid expenses and other current assets     3,037       3,090  
Total current assets     101,096       115,331  
Property and equipment, net     2,109       1,220  
Operating lease right-of-use assets     3,459       3,884  
Net investments in sales-type leases     1,617       1,697  
Prepaid commission expense     7,305       6,763  
Long-term note receivable     94       10,110  
Other assets     3,555       2,218  
Total Assets   $ 119,235     $ 141,223  
Liabilities and Stockholders’ Equity             
Current liabilities:             
Accounts payable   $ 2,350     $ 4,299  
Accrued expenses     11,493       8,233  
Deferred revenue     1,732       2,501  
Current portion of operating lease liabilities     818       670  
Current portion of long-term debt, net     8,750        
Total current liabilities     25,143       15,703  
Long-term debt, net     27,009       35,335  
Deferred revenue     981       1,471  
Operating lease liabilities     3,111       3,539  
Total Liabilities     56,244       56,048  
Commitments and contingencies (Note 17)            
Stockholders’ Equity:              
Preferred stock, $0.01 par value: 10,000 shares authorized; no shares issued or            
outstanding on September 30, 2022, and December 31, 2021            
Common stock, $0.01 par value: 200,000 shares authorized; 27,059 and 26,395            
shares issued and outstanding on September 30, 2022, and December 31, 2021, respectively     270       264  
Additional paid-in capital     400,323       393,644  
Accumulated deficit     (337,602 )     (308,733 )
Total Stockholders’ Equity     62,991       85,175  
Total Liabilities and Stockholders’ Equity   $ 119,235     $ 141,223  

NEURONETICS, INC.
Statements of Cash Flows
(In thousands)

             
    Nine months ended September 30
    2022     2021  
Cash Flows from Operating Activities:                    
Net loss   $ (28,869 )   $ (23,557 )
Adjustments to reconcile net loss to net cash used in operating activities:              
Depreciation and amortization     1,044       768  
Share-based compensation     6,633       6,166  
Non-cash interest expense     513       484  
Cost of rental units purchased by customers     92       137  
Changes in certain assets and liabilities:             
Accounts receivable, net     (4,257 )     (3,097 )
Inventory     (2,299 )     (1,870 )
Net investment in sales-type leases     381       341  
Prepaid commission expense     (854 )     (602 )
Prepaid expenses and other assets     176       (453 )
Accounts payable     (2,199 )     (840 )
Accrued expenses     3,260       (405 )
Deferred revenue     (1,260 )     (531 )
Net Cash Used in Operating Activities     (27,639 )     (23,459 )
             
Cash Flows from Investing Activities:              
Purchases of property and equipment and capitalized software     (2,766 )     (1,552 )
Repayment (Issuance) of promissory note     10,000       (7,486 )
Net Cash provided by (Used in) Investing Activities     7,234       (9,038 )
             
Cash Flows from Financing Activities:              
Payments of debt issuance costs     (90 )      
Proceeds from exercises of stock options     52       2,403  
Proceeds from common stock offering           80,972  
Payments of common stock offering issuance costs           (401 )
Net Cash (Used) Provided by Financing Activities     (38 )     82,974  
Net (Decrease) Increase in Cash and Cash Equivalents     (20,443 )     50,477  
Cash and Cash Equivalents, Beginning of Period     94,141       48,957  
Cash and Cash Equivalents, End of Period   $ 73,698     $ 99,434  

Non-GAAP Financial Measures (Unaudited)

EBITDA is not a measure of financial performance under generally accepted accounting principles in the United States, or GAAP, and should not be construed as a substitute for, or superior to, GAAP net loss. However, management uses both the GAAP and non-GAAP financial measures internally to evaluate and manage the Company’s operations and to better understand its business. Further, management believes the addition of the non-GAAP financial measure provides meaningful supplementary information to, and facilitates analysis by, investors in evaluating the Company’s financial performance, results of operations and trends. The Company’s calculation of EBITDA may not be comparable to similarly designated measures reported by other companies, because companies and investors may differ as to what type of events warrant adjustment.

The following table reconciles reported net loss to EBITDA:

                         
    Three Months ended   Nine months ended
    September 30   September 30
    2022     2021     2022     2021  
    (in thousands)   (in thousands)
Net loss      $ (7,609 )      $ (8,151 )      $ (28,869 )      $ (23,557 )
Interest expense     1,061       993       3,039       2,955  
Income taxes                        
Depreciation and amortization     387       216       1,044       768  
EBITDA   $ (6,161 )   $ (6,942 )   $ (24,786 )   $ (19,834 )


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Source: Neuronetics