But the guidance we put out, I think, is being a little prudent in making sure that we’re able to maintain that cash burn at or below the levels we’ve seen historically. And overall, we believe the trend will continue where that burn will come down so that we can use the cash we have on hand to get cash flow breakeven without needing to go out and raise more money.
Operator: Our next question comes from the line of Robbie Marcus with JPMorgan. Please proceed with your question. Our next question comes from the line of Matthew O’Brien with Piper Sandler. Please proceed with your question.
Matthew O’Brien: Can you guys hear me okay?
Nadim Yared: Yes.
Matthew O’Brien: Fantastic. And Nadim, yes, best of luck to you in the future. Hopefully, it takes a long, long time to find a replacement for you, I say that selfishly. So just two questions here, and I’ll ask them both together. They’re a little bit that’s long-winded, so forgive me. But just on the pricing side, Jared, are we assuming pricing essentially flat versus 2023? Or can you take that up given how healthy that code is? I guess I’m not sure why it would go down. And then the second piece is just on the — as I look at the guidance and I look at where the stock is trading and the aftermarket is down a little bit, I think it’s on the guide. It’s assuming a pretty meaningful slowdown in growth in terms of units sold this year.
It’s actually about the same number of units at the midpoint of the range or the math that I have anyway. But it seems like expanded label and more centers and everything else like that, the absolute number of units should go up this year versus what you did last year in terms of growing total number of units. So why would that be the case? Why wouldn’t it be even faster? And why wouldn’t growth in the U.S. be a little bit more healthy given all these tailwinds that you’re seeing? Thank you.
Jared Oasheim: Yes, Matt, on the pricing piece, I think that one is a little bit easier to cover first. So we had talked about U.S. Heart Failure average selling prices being around $31,000 in 2023 and setting expectations with this guidance to be around $29,000 to $30,000. I will add, we have also seen a list price increase in 2024 for Barostim. And so there are opportunities for the price to go up as we go into 2024 from what we saw in 2023. But our assumption from the beginning was that as we continue to see more and more volume, we are going to continue to see more and more pressure from our customers to see bigger discounts and bigger rebates. And so I think we’re just being a little prudent on that price expectations at the beginning of the year to see how it actually plays out with this new code for customers throughout 2024.
So I’m sure we’ll continue to monitor what that average is coming in at here in the first quarter and the second quarter and then be able to make some updates if it’s necessary for the rest of the year. And then for the guide as far as per units, yes, we will continue to see growth in the number of patients that are getting treated between — from ’23 to ’24. Seen it, like I said, a slight down tick in that average selling price. When we come out at the beginning of the year with our guidance, we want to feel confident being able to go out and meet these numbers. And so when we put together the model, we were looking at productivity staying flat because we were able to achieve these levels of about two revenue units per active implanting center per quarter throughout 2023.
So that’s a number that we’ve been able to achieve in the past, and that’s a number that we thought was pretty good to set for expectations as we move into 2024. And then same thing on the new center adds when building out the model. We’ve been able to deliver about 18 new center adds on a quarterly basis throughout 2023. And I think when you factor that into the model, that’s towards the top end of that guidance for the U.S. as well. One thing I’d just like to address as well as Europe, where we’ve been seeing a flat quarterly revenue of about $1 million for the last four to six quarters. And so when you look at the overall growth rate for revenue worldwide, that does hinder us a little bit with expectations that there is no growth, just hoping for a flat result from ’23 to ’24 with that European revenue.
I hope that answers your question.
Matthew O’Brien: Yes, understood. Thank you so much.
Operator: Our next question comes from the line of Robbie Marcus with JPMorgan. Please proceed with your question.
Robert Marcus: Great. Thanks. This time, I’ll not hit the hangup button instead of the talk button. First off, Nadim well, congratulations on the retirement. We’ll miss you. For the question, I was wondering if you could just walk us through what the change, if any, in hospitals has been since the reimbursement has been finalized end of last year. Has it — have you seen any easier times getting into hospitals, talking about reimbursement, getting doctors excited, initiation of potential new programs at hospitals? Just any change in the sentiment out there?
Nadim Yared: Robbie, thank you, first, for your nice words. And great question. The answer is going to be qualitative at this stage because the code just entered right, January 1, and we are now couple of weeks, and we’re not commenting on the results in January at this stage. But qualitatively, we expect it to help, particularly with the site activation which would lead to the — possibly in the future, the less delay between the first two patients they do at a site and patient number 3, number 4. I don’t know if you recall, but earlier when — after we did the IPO, we tried to explain that phenomenon that we are observing and we kept observing over the past couple of years, which is what a site becomes an actively implanting centers after doing their first one or two implants.
