Operator: Thank you. Please stand by for our next question. Our next question comes from the line of Cecilia Furlong with Morgan Stanley. Your line is open.
Cecilia Furlong: Great. Good afternoon, and thank you for taking the questions. I wanted to ask a follow-up on TearCare, really thinking about ’23 specifically and how you think about just install-based growth ahead of SAHARA and tied in with that to just your outlook, that is incorporated in OpEx, for further Dry Eye sales team growth post SAHARA 6-month data?
Paul Badawi: Yes. Hey, Cecilia. In terms of the second part of your question on sales team growth, we haven’t factored in significant increase in commercial activity due to SAHARA this year, because once we get the 6-month data, we’ll take a few months to publish and get out there and be in a format ready to present to payers. So we don’t expect significant impact until 2024. And I think we’re expecting to see reimbursement when happen on a — on an incremental basis, not just flipping a switch and having the entire country go live at once. I think it’s — I think we’ll be able to deploy resources regionally as we accumulate payer wins and be able to effectively and efficiently cover new markets — cover markets that have new reimbursement wins very effectively and show really strong growth that way.
Cecilia Furlong: Great. And if I could follow-up as well. Just incorporating your OpEx outlook for about $30.5 million, how should we think about R&D on a relative basis versus what we saw in 4Q tying in some of your pipeline products as well as clinical studies ongoing?
Paul Badawi: We expect to see a similar mix of R&D and SG&A as we saw in Q4 into 2023. And we’re planning to be very diligent in our — in any of the investments we make as we continue to manage the OpEx targets that we’ve set in our path to cash flow breakeven.
Cecilia Furlong: Great. Thanks for taking the questions.
Paul Badawi: Thank you.
Operator: Thank you. Please stand by for our next question. Our next question comes from the line of Margaret Kaczor with William Blair. Your line is open.
Margaret Kaczor: Hey, good afternoon, guys. Thanks for taking the questions. I wanted to follow-up maybe to start on the Ergo-Series of products. And if you can share any specifics, I guess, on the average time of procedures, maybe efficiency stats or the data empirical versus the last generation?
Paul Badawi: Yes. Hi, Margaret. Yes, in terms of Ergo and the name of the game and in MIGS and making a product or procedure, the go-to preferred MIGS option comes down to procedural ease of use and usability and obviously clinical outcomes. And with OMNI, we’ve seen the differentiated clinical outcomes and differentiated safety and efficacy profile over and over, and we continue to publish on that. So there remains opportunity to enhance the procedure and the usability, and that’s what we were focused on with OMNI Ergo. And we’ve upgraded the ergonomics, the hand piece, we’ve also upgraded and enhanced the technology at the most distal end of the device that allows the surgeon to access the diseased outflow pathway. And that’s critical.
Improving how a surgeon accesses the diseased outflow pathway is critical. And we think that there was an opportunity to modify some of the dimensions on our cannula and catheter and allow the surgeon more reproducible, quiet, less traumatic and consistent access into the canal. And once they — once the surgeon gets into the canal with OMNI, the brilliant engineering of the device and design kind of takes over. So, in terms of circumnavigating the canal up to 360 degrees and up to 2x for both canaloplasty and trabeculotomy. So, the early feedback in terms of the enhancements we made to help the surgeon more reproducible get into Schlemm’s Canal has been very, very positive. And I think I’d say it surpassed even our expectations.
Margaret Kaczor: Okay. Yes, that’s helpful. And then, if we could move to some of the DTC pilots that you guys have spoken to. Can you share, I guess, any progress in terms of being able to reach the patients or maybe those who have had kind of a stent and planted in the past, who might be looking for standalone solution. Have the DTC pilots, I guess, been useful and any other initiatives to — that you guys could put out there to reach these patients? Thanks.
Paul Badawi: Yes. Well, yes, thanks for that question. We’re excited about the possibilities here. We have been working with a leading MedTech DTC provider. I’ll say that, they conducted their own pilot prior to us entering into an engagement with them to understand whether the diseases that we’re addressing Glaucoma and Dry Eye would be good candidates for DTC strategies. And those pilots that our partner did on their own, executed on their own, seemed very favorable. And so we’ve decided to enter into an agreement with them and run a pilot. Now, in terms of timing, Margaret, the first month, sorry, first quarter of the year, this quarter has been the setup phase for the pilot DTC program. And the second quarter of this year will be the actual execution phase where we’ll run it, we’ll run the program and hopefully by the end of that exercise we’ll be able to have an early read on how DTC is helping with our OMNI market development efforts. So stay tuned.
Margaret Kaczor: Sounds good. Thank you guys.
Paul Badawi: Yep.
Operator: Thank you. Please stand by for our next question. Our next question comes from the line of Matthew O’Brien with Piper Sandler. The line is open.
Unidentified Analyst: Hey, this is Phil on for Matt. Thanks for taking our questions and congrats on the great quarter. Just on guidance, I don’t think I heard anyone ask, but can you give us your puts and takes for what gives you to the top end of your range versus the bottom? Maybe what you’re seeing in the broader MIGS market in terms of any headwinds, staffing, procedural headwinds, et cetera, and maybe by segment what you’re puts and takes for 2023. And I guess what I’m really trying to get at is TearCare grew about 3 million in 2022. Can it grow another 3 million in 2023?
Paul Badawi: Yes, I think on the OMNI side of our business or Surgical Glaucoma with OMNI and SION, we have a history of taking share in the mild to moderate combo cataract segment. So, we expect to continue building our business there. I think, I think what drives, what will drive, further upside, to our plans and our historical performance is how well we can continue to expand, the surgical glaucoma markets. And again, that’s, moderate to advanced combo cataract and moderate to advanced standalone. So, we talked about a number of initiatives that we’re executing on this year to help drive that, continued market development. I think that’s the market expansion opportunities or what provide I think a lot of the upside.
Unidentified Analyst: That’s really helpful. And I guess just to end it here, on the Verana Health, that partnership, how big could that be for your business in 2024, in terms of additional surgeons and adoption and that just your puts and takes would be helpful.
Tom Huang: Yes, I mean we’re really, really excited about the possibilities with the Verana data. It is — they have access to millions of patients entered by — patient data entered by the members of the American Academy of Ophthalmology. So it is the most comprehensive eyecare database out there. And we are extremely excited about the ability to demonstrate OMNI’s efficacy compared to the other devices out there. I don’t think we’ll be able — I don’t think we can translate that directly into increased penetration next year, but we are very excited to say the least.
Paul Badawi: Yes, and I think it’s — what we love, really love about just a large, a large volume of, of real world clinical data. We design our products to help the — help make the average surgeon deliver optimal clinical outcomes, right. We talked about the Ergo-Series of OMNI. And so that’s success to us. Success is making the average surgeon very successful in taking care of their patients and driving optimized clinical outcomes. So for Sight Sciences having access to many, many, many surgeon — surgeries from many, many different surgeons as opposed to a very — there’s a benefit highly controlled clinical trials and RCTs and whatnot. But there’s also something to be said about how does your product and procedure perform across thousands of surgeons and the average surgeon, not just your preferred clinical trial site.
So we’re very excited about that. We think that we can’t talk about the timing exactly — it depends on the publication. But it’ll offer a powerful clinical marketing. And ultimately we are seeing and hearing that payers going forward are going to be relying more and more on credible, substantial real world evidence. So we would expect to continue mining, Veronica real world data. As we proceed we expect that it will certainly help in terms of growing our businesses from a clinical marketing perspective and how OMNI compares to other MIGS options. And then ultimately as payers begin to rely more and more on these large scale real world evidence studies, we think that that can be helpful as well.
Unidentified Analyst: Great. Thank you so much.
Operator: Thank you. Please stand by for our next question. Our next question comes from the line of David Saxon with Needham & Company. Your line is open.
David Saxon: Hi, good afternoon and thanks for taking the questions. Maybe to start on surgical glaucoma, of the 200 SION accounts. It looks like you have about 130 that are on the accounts, so could you talk about what you’re seeing from a cannibalization perspective?
Tom Huang: Yes, sure. I think we’re seeing very little of it based on the account, as Paul said, his remarks based on the accounts that ordered OMNI in the fourth quarter of 2021 and OMNI and SION in the fourth quarter of 2022, utilization of OMNI actually increased by 12%. So we are really excited about that. We — with no cannibalization you would see, flat utilization. The fact that we are actually able to increase utilization at accounts despite adding SION to their portfolio. They really suggests that we’ve got a lot of runway here.
Paul Badawi: And just keep in mind that the portfolio allows our reps even more time to be with their surgeon customers in the operating room. And so the — that opportunity just creates more opportunity for us to educate and train our surgeons on all the good work that we’re doing across our portfolio and the increasing body of clinical evidence that we’re generating for both OMNI and SION going forward. Okay. Yes, that’s helpful. And then I guess maybe staying on glaucoma, can you talk about the pricing trends you’re seeing just given some competitive launches? Are you seeing anyone get more aggressive with pricing, or doing anything with bundling? Thanks so much for taking the questions.
