Alphatec Holdings, Inc. (NASDAQ:ATEC) Q4 2022 Earnings Call Transcript

Unidentified Analyst: It’s Eric on for Josh. Just starting on PTP, it seems like adoption and utilization of the procedure has been really solid in recent months. How penetrated do you think PTP is right now, and is it still early innings for PTP adoption do you think?

Pat Miles: It’s fascinating, right? It’s like, if you — what’s been interesting for us is to really look at the established businesses that we have out there from a distribution perspective or a sales force perspective. Those people who are selling PTP are growing at a rate that is far surpasses those people who are — who’ve had less success with it. And that’s what provides us such enthusiasm with regard to when you start to see like the established distributors reflected growth of 46%. I will tell you, it’s in its absolute infancy. The beauty of the technique is the applicability to multiple different pathologic states. And so the opportunity to utilize it in things like deformity, our enthusiasm to utilize it in things like corpectomy.

And so it is such the early phases of PTP. And so the applicability is very, very wide. The thing that thrills me is we’ve made the foundational investments to ultimately exploit the opportunity. And so when someone learns how to apply that technique, their ability to apply to more unique pathologies expands what that avails us as an opportunity to design into those expanded applications. And so I would say that PTP is in its absolute infancy and can’t be more bullish with regard to where the things going.

Todd Koning: And I think Eric, the only thing I’d add to that would be, when you look at PTP, it’s applicability from a relatively straightforward single level degenerative case to the complex procedures as Pat described, it gives us such an opportunity, kind of beyond the existing as we’ve talked about the billion dollar lateral market as it is today. And I think that is one of the true, I think, opportunities that PTP has availed us which is to really expand that market well beyond the billion dollars as we’ve defined it. And frankly, well beyond just dealing with singular or two level degenerative cases, but into complex cases as well. And so as you kind of think about our penetration in surgeon use, obviously, more surgeons is good. But I think the more complexity you can apply with the procedure or you can address through the procedure, you get more utilization out of the existing surgeon base.

Pat Miles: It’s a great point. But the reality is what we have seen in whenever a new technique is created and there becomes an adoption curve, there is people who run forward with more complexity and when people who demonstrate more complexity, you will get more people get on the bandwagon of an early adoption type of pathology.

Operator: The next question comes from the line of Drew Ranieri with Morgan Stanley.

Drew Ranieri: Maybe just to start, and I apologize, this is a multi-part kind of question. But in kind of thinking about your revenue guidance and what you were able to do last year. Just maybe how should we think about any upside potential dropping through to the bottom line, just in the context of your commitment to EBITDA breakeven. Are you more willing to let that fall or are you still really kind of in investment mode to drive volume and surgeon adoption? Just love your thoughts on kind of that dynamic. And I have a follow-up.