So that’s going to be our focus as it relates to our international business. Again, 85% of that business is in Europe. So we’re going to really be focused on best practices and installing those with our newly strengthened, essentially, team that’s well-focused and well-equipped. So that’s this year. And I think that we’re going to get things moving in a good and solid direction this year, probably harvesting a good bit of the upside in 2025. So we’re setting things up, getting them moving in the right direction. I wouldn’t over-index on the international contribution in 2024. Part of that’s for the reasons that I just talked about, and part of that is what’s going on in Japan. We’re going to put a little bit less than half of the patients into the study that stands between us and sort of freedom that fully operate commercially in Japan.
We are generating revenue through the study that we’re executing, but out of the 140 patients, we’re going to get a third or so of them into this study this year. There’s a lot of startup steps that have to go along the way here, including training the physicians, getting them up and running, and making sure that we’ve got the referral paths all opened up. The good news is that we’re going to be making a lot of noise in Japan as we’re executing on this study, which probably bodes well for us when things open up. But if we get a third of the patients in this year in Japan to populate that study, and the balance in next year, we don’t see material revenue coming out of Japan until 2026 when we’re able to open it up more broadly. And the good news, again, just as a reminder, is that we don’t have to wait for any kind of six-month follow-up or anything like that on those patients.
Once we get through that 140th patient, that gets opened up more broadly in a market that is going to be very well aware of this technology because we handpick these sites, not only because they’re most influential, but also because they’re very well dispersed geographically. So there’s going to be broad awareness, I expect, at the time that this opens up, late 25, early 26 in Japan.
Rick Wise: That’s great. Glenn, thank you for everything and congrats.
Glendon French: Rick, it’s been a pleasure working with you over the last couple decades.
Operator: Thank you. And our next question is going to come, one moment for our next question. And our next question is going to come from the line of Jon Young with Canaccord. Your line is open. Please go ahead.
Jon Young: Hi, good, I’m Jon. I just want to ask my friends congratulations on their retirement. Congrats on a strong Q4. I just kind of want to circle back to some of the comments from the Q&A session. First, I just want to make sure I heard you correctly on Jason’s question when I think about that for next year. These increases sounds like mostly SG&A from the education efforts. I also know you’re enrolling CONVERT II through the year. So how should we think of R&D increases for next year too?
John McKune: I’ll take that one. Jon, thanks for the question. Yes, we expect R&D to be up in 2024 compared to 2023 as we are, as you pointed out, as we enroll in our CONVERT II study and get that going. So we do expect to see on the OpEx front, both increases in SG&A driven by our investment on the commercial side of things. And then in R&D as well as we invest in the CONVERT II study.
Jon Young: Thanks, John. And then Glenn, just on Japan and your comments on Rick’s question there, is that timing a deviation from initial expectations, especially if one third of the patients being enrolled in 2024? And can you talk to maybe a little more color about maybe some of the intricacies of the market and some of the time it takes to enroll these patients?
Glendon French: Sure. I don’t know if it’s a deviation. I will say that these trials are hard to predict when they’re going to be done. Until you get about a third of the patients in, it’s really hard to see when the end is going to be. You probably enroll a third of the patients in the last three or four months of these studies. They absolutely pick up steam over time. There’s also, in all of these studies, non-trivial amount of startup time. Meaning the regulatory authorities give you a green light and that just allows you to go in and negotiate the contracts with the sites. You have to get the approval of ethics committees at those sites, and then you have to open up their referral process. And you can’t do any activity beyond what I just said until you have ethics committee approval.
