Shagun Singh: Yeah. So what we were hearing is that Medi-Cal may not be reimbursing to procedures the tile and the implant, is that correct? And how is it being? And if there’s anything inputs there that would be helpful.
Raymond Cohen : So, okay, so Medi-Cal, which is Medicaid California, Medicaid. They don’t pay for sacral neuromodulation at all. So we don’t have any customers that are using Medicare or Medi-Cal. So, I don’t know where that came from. But there is no reimbursement today. It’s a non-issue. Okay. There were a few others, Neil help me.
Neil Bhalodkar : Yes. Sure, if we had any additional color on share gains or end-utilization increase in that accounts.
Raymond Cohen : Look, we have not been that prescriptive. And – this is not a really good time for us to start that. I don’t believe. What I can say is that, there – I think we mentioned the last time, we’re up to a little over 1,000, SNM customers now and they’re not all created equal. There’s a whole group of legacy folks who’ve dabbled in sacral neuromodulation because the product that came before us was fussy and, was bit of a hassled and it had this reputation of being a therapy of last resort. I’ve said this before, this is actually what has – without there when we entered the market. And so, we’ve slowly, but surely now changing that perception. And as physicians that we work with find it easier, better results, better support, not to mention DTC and the other things that we’re doing to normalize, you know, SNM technology or get people into these therapies.
People are doing more procedures. I mean, it’s flat up. So, same-store sales are increasing. And that’s happening and at the same time, the docs who’ve been resistant to us for sacral neuromodulation, we’ve penetrated a lot of these accounts with Bulkamid. They get to know Axonics. They realize, wow, these guys got a great product here. This is fantastic. Look at the quality of their people and so on, so forth. Why am I resisting? Sure, I’ll give you a try on sacral neuromodulation. I can tell you, once they start working with us for SNM, they are never going back. And a lot of this has been about rep relationships. Oh I really like my rep and blah, blah, blah. Okay, well fine, but eventually, their eyes open up and go we’ll, wait a minute, all the other physicians I know have already switched to Axonics and they’re talking about what a great experience that their patients are having.
And that they’re having working with Axonics. So that’s what’s going on. And it’s not as spirit. Right this is just flat-out execution, blocking and tackling and doing the right things for customers. So that’s in terms of the dynamics. And I’ll tell you, I’ve been saying one more comment. I’ve been saying all along. Our objective is to be the market leader in sacral neuromodulation. And that’s exactly what’s happening. And it’s just a matter of time before we can statistically point to that and so forth. So, so we’re seeing market expansion. We’re, Axonics is a cause in the matter of market expansion. We’re seeing more customers come our way and we’re seeing increases in procedure of volume from our customers. And now Dan has a couple comments he’d like to make.
Dan Dearen: Hi, Shagun. I apologize for saying this as you heard us say it a thousand times. But, the market expanded based on third-party data by at 14% per year from 2019 through ‘22, And so, what you’re hearing from us and from Ray is that, look, we are capturing market share and we’re capturing customers. But the same-store sales is also increasing. And so, this is playing out, like we’ve projected going back to the time of the IPO, which is, we’re still forecasting 15% year-over-year market expansion. And then some points of market share captured to hit the numbers. And it’s working on both fronts.
