Nevro Corp. (NYSE:NVRO) Q3 2023 Earnings Call Transcript

Rod MacLeod: This is Rod. You are hitting the two big things. We have a confluence of an iQ launch and a transfer of manufacturing to Costa Rica. And as we have talked about in the past, as iQ ramps, we also have pricing pressure on our legacy products. And in Q3, legacy products still represented over 50% of our mix. And as we have reported over the last couple of quarters and continuing into this quarter, continue to have some pricing pressure there. Similarly, as we are a little bit behind that curve as we answered in one of the previous questions and don’t have that BSI approval to sell in the Europe. Our volumes a little bit are a little bit lower, which also means we have to continue to sell-through contract manufactured products at a higher rate than we would have anticipated.

So we kind of have the confluence of those two things happening in Q3, which obviously put some pressures on the margins as you noted. We should get better going into Q4, our mix on iQ will improve. We will have to sell some of our contract manufactured products in Q4, but over time, we do transitioning more and more to the Costa Rica towards products, and now that will certainly help margins. I would anticipate that, for 2022, we are not providing guidance for 2024, but we do expect that over time, we have a pathway still to kind of that mid-70s that we have talked about. It just could take a little bit of time, in terms of us getting there both from a cost and a price perspective.

Unidentified Analyst: I just had a quick follow-up on PDN, and apologies if someone may have already touched on this. But are you seeing any competitive pressures here specifically? And do you have any thoughts qualitative on 2024, and your expectations for the market as well as competition next year?

Kevin Thornal: Yes. So we did answer the PDN 1, but I will just wrap it up again. Yes. We do know that, all of our competitors have indications. However, that is obviously FDA approval. You still need to have clinical studies to show the doctors to convince them, to try that, and that is continually where we are the only company that has the large RCT, that is out there that shows the benefits of high frequency paresthesia-free. And like I said, just earlier before, why would you want to put a patient into paresthesia, who is already experiencing numbness and tingling in their legs? So we feel very confident about our leadership there in PDN, and we talk about it every day. And I use the word moral obligation other words, moral obligation, because we know when we win, that means patients get the best therapy that is been clinically proven in the PDN space.

So we feel good that we will continue to maintain our leadership there. We are – it is a benefit to have other competitors in the space, because all those rise with the rising tide, of course. So, that will help from an education standpoint. And on 2024, we are a month into Q4. So, we need to get a few more months underneath our belt in the transition with our commercial teams before we provide anything for 2024. So, we are not going to provide any guidance at this time.

Operator: The next question is from Richard Newitter with Truist Securities.

Unidentified Analyst: This is [Sam] (Ph) on for Rich. Just one just to follow-up on gross margin there. And I know we are not going to provide guidance for 2024, yes. But just directionally, is there any way you could speak to with all those moving parts going forward and hopefully getting resolved. Should 2024 on a quarter to quarter basis see better gross margin than 4Q? Can 4Q basically be a taking off point for gross margin next year?