Kevin Thornal: On market conditions, spine sometimes can’t be a good analog and then sometimes it’s not, right? We do know that there are a lot of different procedures that patients need to go through before they can get to a spinal cord stimulation approval for implementation. And as a reminder, if you jump off that journey, you don’t get to start where you left off, you have to go back to go and sort of go through that conservative care before you get there. So that says a lot about that lagging. I don’t know if 9 to 12 months is the right number there, but we are we do like some of the trends that we’re seeing in other procedural growth and rebound, that we’re hearing from sort of markets that are sort of peripheral peripherally close to us.
But it will take the time for those patients to sort of go through that continuum of care before they get to spinal cord stimulation implant. One of those is obviously mechanical back pain as well before you treat neuropathic back pain, which is what led us to get into the SI joint procedure market. That’s like I said 15% to 30% of patients will experience both mechanical as well as neuropathic pain. So that gives us a chance to may be grab some of these patients a little bit earlier in their continuum of care. And as far as the close as well with the Board, yes, we routinely work with our shareholders. It’s something that we do. We talk to them after all of our calls. We’re excited to have Kurt on our Board as we mentioned in the announcement as local down the street for us and you’ve got an extensive experience and acquisition financial acumen and he’s also worked on the other side as an investor as well.
So we believe he’s going to be helpful for us. And so right now, we believe we have good alignment and a good cooperative agreement with our shareholder and the change in our Board. I do want to make sure that through this it gives us opportunity to say thank you to one of our Board members that will be outgoing towards the opening period this summer with Frank. He will be leaving our board in the summertime and he has been instrumental to our growth and instrumental for taking us public, for taking us through a lot of variations that we’ve had through the business. And we wanted to thank him for his time. And it’s been a longstanding Board member and he’s been with the Company for a really long time. So we do not believe that our strategy will change and we have good supported Board members with a plethora of experience, both in medical devices and financial acumen.
So, we believe we will stay the course here.
Operator: Your next question comes from the line of Suraj Kalia with Oppenheimer. Please go ahead.
Suraj Kalia: Kevin, I know your one year anniversary is coming up, and I was curious if you could just frame a couple of things for us. So, Kevin, as you’ve looked at the business, our recollection is roughly about a third of the traditional SCS for Nevro was from NSRBP. Has that changed, because I sensed the shift in the tone on the call more so towards traditional opportunities versus PDN? So if you could just characterize where NSRBP is today, that would be great. And the second question, Kevin, if I could, our field checks have told us that, Vyrsa did roughly around 78-ish million in ’23 and was on track for doing 15 million in ’24. Correct me if I’m wrong so that we can, slice or dice it in terms of FY24 guide? Thanks for taking my questions.
Kevin Thornal: Yes. First one, no, I think we have a lot of opportunities for the core markets, which we say back and leg as well as nonsurgical back pain and PDN. And so we take all comers. There are patients that probably experience both of those at the same time. For instance, you might have back and leg pain and also be suffering from painful diabetic neuropathy at the same time. So, no, we believe that the market still has a big opportunity. Non-surgical back pain is still the largest opportunity that we have. And then fell back surgery would be second and then PDN, just because it’s still early in the game would be the third. So, not really a lot of change there, other than the fact of you’re seeing a really tremendous growth in the PDN space because we’re coming from the brand new start of that.
As far as the field checks, we’re not commenting anything on there. One thing I will add is just we are moving from a primarily distributor model to a direct model. And so it will take us time to make sure that we have our direct sales force trained and up to speed, as well as scale that organization from an operational perspective from both manufacturing and for some of the trades that are needed to perform the procedure.
Operator: Your next question comes from the line of Mike Polark with Wolfe Research. Please go ahead.
Mike Polark: I’ll just ask again on Vyrsa. So, look, I it sounds like you don’t want to say a number about what’s built into the 24 guide. I can appreciate that. I suspect on calls like this moving forward, we’ll be asking what the number is at least to get a level set. So, maybe I’ll ask it for a third time here at the end of the queue. Can you comment about what’s considered in the 2024 guidance for Vyrsa revenue? And if not, just, I guess, I’ll making formally making a note, we’ll probably be asking every quarter on calls like this until you give it to us or at least train it. So thanks for taking the question.
Kevin Thornal: Yes. I completely appreciate the desire to want to know where we are right now. Don’t forget, we’re still early and this was a really small company with some really great technology that we’re excited about and there are market checks and due diligence showed that we think we have a differentiated device in the V1 device, which is the flagship one. So we did that and I just mentioned we’re going from distributor to direct and so that takes some time. We have to ramp up the organization. It’s so non material right now, that it’s just not the right time to start breaking that out. But we can appreciate that that will be something that will be desired into the future.
Operator: Our next question will come from the line of Robbie Marcus with JPMorgan. Please go ahead.
Robbie Marcus: Maybe I won’t ask for Vyrsa, but maybe as you help us understand the assumed ramp in sales growth in the second half of the year. Nevro’s had several guides that were back end loaded, some like in 2022 worked out, others didn’t. So, I think investors want to help understand the drivers there. You talked about the sales force restructuring. We were under the impression Vyrsa was also about 7 million on track to do about 15, 16 this year. Is that really where it’s coming from? Is it sales force revamp and selling more SCS? I think organic and inorganic and I understand immaterial, but the guide is a few percentage points, so even $4 million is it’s a percent. So maybe help us understand exactly where it’s coming from and get confidence in the back half ramp.
Kevin Thornal: Yes. There’s really it’s really all the above. I mean, as we mentioned, I think in the past, the hard part was we did have PDN as a new indication in non-surgical back pain, but it was a prediction of a little bit more of a market recovery that all those would rise with the rising tight a little bit there on top of the foundation that key prior to me that it setup professionalize the organization and we have the opportunity to jump off all the hard work that he’s done and that had been done here by the Nevro team prior. But at the same time, we did have some we didn’t call it restructuring, realignment of the sales force and also some turnover that we caused by upping some sort of sales talent in a couple of spots across the organization, which does take them time to get up speed, right?
So that’s a little bit of why it’s back end loaded. The other part is just seasonality. I mean, you look at all four of us in this space, Q4 is always much bigger than a Q1 or a Q2, and it’s just seasonality with people’s co-pays and everything else that happened. So that’s just natural seasonality that’s been there for decades in this space. And then lastly, yes, I mean, its non-material right now in our business going from really small to well, yes, we’re expected that to do better every single quarter as we move forward. And so, we have a new device, a new market that we’re in, three new devices in our new markets that we’re in. And so, I think that helps justify a little bit of the back end of the year specifically since we need to train so many of our reps out there.
Training 20 reps is a lot different than training over 400 or 500 to be experts in this device. So, it will take us some time to do that.
Operator: Ladies and gentlemen, that does conclude today’s call. We thank you all for joining, and you may now disconnect.
