Joe Hogan
Analyst · Baird. Please proceed with your question
Thanks, Shirley. Good afternoon, and thanks for joining us. On our call today, I'll provide some highlights from the first quarter and briefly discuss the performance of our two operating segments, Clear aligners and intraoral scanners. John will provide more detail on our financial results, discuss our outlook for the second quarter. Following that, I'll come back and summarize a few key points and open up the call to questions. Our first quarter was a very good start to the year with revenues, volumes, gross margin in EPS all above our guidance. Record Q1 revenues and Invisalign volumes were up 25.6% and 28.3% year-over-year respectively. Reflecting continued strong growth across all geographies and customer channels as well as strong iTero Scanner and Services revenues, which are up 55.1% year-over-year. Q1 sequential growth was driven primarily by North America and EMEA volumes reflecting strength across the Invisalign product portfolio. We saw a nice uptick in adoption of Invisalign treatment with a record utilization overall as well as expansion of our customer base, which totaled 57,000 active doctors worldwide in Q1. Now let's turn to the specifics around our first quarter results starting with the Americas region. For the Americas region, Q1 was a solid quarter with Invisalign case volume up 7.1% sequentially and 21.8% year-over-year reflecting growth in both our orthodontic and GP Dentists channel. Q1 we trained 1,700 new Invisalign doctors in the Americas region of which 1,400 were North American doctors. On a sequential basis Q1 Invisalign volume growth reflects record utilization for the Americas region overall driven by North American Orthros at 18.3 cases per doctor with good initial adoption with Invisalign mandibular advancement in North America driven by the mid-Q4 launch in the U.S. We also had solid performance from GP Dentists with continued momentum from Invisalign Lite, Invisalign Go. Invisalign Go provides a simple pathway for dentists to integrate mild to moderate tooth movement and to comprehensive care. And it makes it easy for GPs to refer out more complex cases to orthodontics in the network. Year-over-year Q1 Invisalign volume growth in the Americas region was driven by continued strength in the Ortho channel, especially from our high volume doctors with 25.9% growth as well as an increase of 15.5% from the GP channel. In March, we announced the collaboration with Digital Smile Design or we call it DSD, a leader in holistic digital dentistry solutions for dental clinics, which features the Invisalign System and iTero element scanners as a digital solution of choice for tooth movement and scanning. As part of the cooperation Align and DSD will deliver dedicated education programs, enable simplified, streamlined integration of digital end-to-end workflows into GP practices and offer doctors more opportunities to learn about digital tools and treatment planning support. We also continue to make great progress in Latin America, led by Brazil. In Q1, Invisalign volume and Latin America was up significantly year-over-year reflecting our ongoing investments as we continue to build our business in the region. Training over 300 Invisalign doctors during the quarter. Next month I'll be in Brazil with the executive team hosting a major customer event with more than 200 doctors discussing the future of digital orthodontics including the science and technology behind both the Invisalign System as well as our iTero Scanners. We’ll also have local social media influences on hand as we kick off our very first Invisalign consumer campaign in Brazil and plan to live stream portions of the event to more than 500 doctors across the region. For our international business Q1 was another good quarter with strong Invisalign volume growth at 38.5% year-over-year reflecting increased Invisalign utilization and continued expansion of our customer base in both EMEA and Asia Pacific regions. On a sequential basis international volume was up slightly reflecting strong growth in the EMEA region and offset somewhat by seasonally lower period in Asia Pacific as expected. In Q1 we trained over 2,400 new Invisalign doctors internationally split roughly between each of the two regions. In EMEA Q1 was a strong quarter with volumes up 37.4% year-over-year driven by growth across the region with record Invisalign volumes in all but one country led by Iberia and France. We saw strength across the Invisalign product portfolio with continued momentum from Invisalign First and Invisalign Go. We also continue to see strong growth across our key expansion markets as well, led by the Nordics and Benelux. For APAC, Q1 Invisalign volume increased 40.4% year-over-year, reflecting continued strong growth from nearly all country markets, led by China, Japan, and ANZ. We also had a strong uptick in teenage patients in Q1, due in part to a teen promotion in China offered along with our Teen-edge sales program, intended to increase adoption of Invisalign treatment with teenagers. We also had strong growth from GP Dentists, which were up 63.5% year-over-year. On a sequential basis, Q1 was flat as expected, due primarily to a seasonally slower period with the lunar New Year holiday. During Q1, we trained nearly 1,100 new doctors in APAC, over half of which were in China, and we opened our second state-of-the-art training facility in China, located in Shanghai. Our new manufacturing facility in Ziyang, China is continuing to ramp, and while we are making good progress, we still expect it to take a couple of quarters to fully transition aligner fabrication from Juarez, Mexico to Ziyang, China to serve the Chinese market and expect manufacturing overhead in Ziyang to be underutilized during this transition period. Overall for the teen market, in Q1 nearly 100,000 teenagers started treatment with Invisalign clear aligners, an increase of 41.1% year-over-year driven by continued strong adoption across all major regions – especially in APAC and EMEA regions. For Q1, year-over-year Invisalign teen patient growth for North Americas Orthodontists increased 29.2% and International doctors were up 67.2%. Invisalign First and Invisalign treatment with Mandibular Advancement continue to ramp globally and are helping to increase our share of teenagers and younger patients worldwide. Overall, we’re very pleased to see that use of Invisalign treatment among teenagers continues to outpace adults and that Invisalign First is driving a really strong growth kid and tweens in the kid/tween segment. We’ll continue to drive utilization and growth in our Americas’ teen business this year with the first Invisalign Teen Summit in July. We know that Summits increase engagement and Invisalign adoption, so for the first time we’re focusing a Summit program completely on teen treatment and teen culture, including a tie-in to 2019 VidCon, the top teen culture and community event. Teen Summit is designed to turn low teen submitters into high teen submitters by combining Invisalign specific clinical and practice "how tos" with an immersive teen culture experience. Our consumer marketing efforts are designed to build the category and drive demand for Invisalign treatment through a doctor’s office. We invest over $100 million each year in consumer marketing programs including TV, digital and social media, PR, event marketing and our Patient Concierge service. Our goals are to make the Invisalign brand a household name worldwide and to motivate consumers to seek Invisalign treatment through a doctor’s office. In Q1, we continued to see strong digital engagement with consumers reaching nearly 4 million unique visitors on Invisalign.com sites worldwide for a total of 53 million visitors to date. Other key metrics show increased activity and engagement with the Invisalign brand and are included in our Q1 quarterly slides. In March, we launched a new online tool called SmileView at the International Dental Show IDS in Cologne, Germany. SmileView is designed to help prospective Invisalign patients visualize a new, straighter smile before they opt for Invisalign treatment. Within 60 seconds of taking a smile selfie using the SmileView online tool with their smartphone or tablet, prospective patients can see what their new smile and straighter teeth may look like, with their own facial features. SmileView is available on line, or in GP practices in beta testing in the UK and the U.S. and we are getting really positive feedback. In North America, we continued to invest in strong digital plans for adults and teens. Our teen focused content developed by Awesomeness TV, the fastest growing youth channel and teen influencer program helps strengthen our brand presence among teens and parents, making Invisalign relevant and fun. During South by Southwest, we reached adult consumers with an immersive experience with a RealSelf House and Modern Beauty, where consumers can learn more about Invisalign and see a simulation of their future smile using Invisalign SmileView technology. And Invisalign was voted by consumers as a Most Worth It treatment, continuing to demonstrate continued strength of consumers. In EMEA, we held a recruitment drive for our Influencer Program called Invisalign Smile Squad generating over 100 plus new influencer applications and 350 plus doctor registrations to take part in the program. And our Parent of Teen campaign went live in UK and France – raising awareness amongst a new consumer audience. Q2 will see the launch of our revised patient journey with media campaign strategy for focused markets, better integrating new conversion tools like SmileView and Concierge into the journey. In APAC, we continued to build awareness for Invisalign treatment through use of paid media and our influencer campaign, including expansion of our influencer program in the region and a pilot Invisalign First social media campaign to target parents of younger children. To leverage increasing consumer awareness and demand, we also began to expand the Invisalign Concierge program that connects interested consumers with Invisalign doctors for treatment into new countries. Globally, in the second half of the year, we will launch a new consumer advertising campaign that emphasizes the importance of doctor led treatment with Invisalign clear aligners, while also differentiating our brand. On the professional marketing side, we recently launched two dedicated professional Invisalign brand campaigns that feature Orthodontists and GP Dentists. The Ortho as Hero campaign focuses on Invisalign orthodontists as critical leaders and the heroes of transformative, life-changing smiles, especially for teen and younger patients. The campaign showcases modern orthodontics practices that leverage digital approaches to treatment and are warm and inviting. The Go Beyond campaign is designed to celebrate dentists who go above and beyond every day to serve their patients. It also demonstrates the relevance of tooth movement to General Dentists and the importance of integrating Invisalign within comprehensive dentistry. This was launched in North America, and is now being rolled out in the EMEA and APAC regions. For iTero scanner and services business, iTero revenues increased 55.1% year-over-year, reflecting continued strength growth across all geographies and customer channels. On a sequential basis, revenues were down 9.8% sequentially, as expected, reflecting lower scanner sales following a strong Q4 and consistent with the seasonality in the capital equipment business partially offset by continued growth in services revenues due to the increasing install base. During the quarter, we launched the new iTero Element 5D Imaging System for comprehensive preventative and restorative oral care at the International Dental Show. The iTero Element 5D scanner is the first integrated dental imaging system that simultaneously records 3D, intra-oral color and NIRI images or near-infrared images and enables comparison over time using iTero TimeLapse. Integrated 3D, intra-oral color and NIRI technology of the new iTero 5D Imaging System aids in detection and monitoring of interproximal caries lesions above the gingiva without using harmful radiation. The iTero Element 5D scanner is available for sale in the majority of European and APAC countries, and is not yet available in the United States or Latin America. Cumulatively, 13.5 million orthodontic scans and 3.6 million restorative scans have started with iTero scanners. Use of the iTero scanners for Invisalign case submissions continues to grow and remains a positive catalyst for Invisalign utilization. For Q1, total Invisalign cases submitted with a digital scanner in the Americas increased to 76% from 67.3%. In Q1 last year, international scans increased to 59.3% up from 43.5% in the same quarter last year. Within the Americas, 91.2% of cases submitted by North American Orthos were submitted digitally. And China remains at 45% for the quarter. We continue to anticipate that in another year or two, nearly all Invisalign cases will be submitted digitally – primarily through an iTero scanner. Given our continued progress and increased use of digital scans for Invisalign case submission, we continue to get questions regarding interoperability with other third-party scanners. With recent product introductions, we want to make sure we are clear about which scanners are not qualified to submit Invisalign case submissions. We developed an interoperability matrix that has been distributed to our sales and customer facing teams to help inform doctors. It also included our Q1 2019 conference call slides. So please reference it for more detail. However, to ensure there is no confusion in the marketplace then I quickly reiterate our interoperability position on this call with two new scanners, the Trios 4 and Primescan. Regarding the Trios 4, Align will not qualify Trios 4, or any future 3Shape scanner product, for Invisalign interoperability in the U.S. or globally. Regarding Primescan, Align has received a request from Dentsply/Sirona to evaluate Primescan for Invisalign case submissions and we are considering that request. Until we make a decision to move forward and can conduct testing, Primescan is not qualified for Invisalign case submissions. Before I turn the call over to John, I want to update you on two other important topics. Our plans to reorganize Align’s corporate entity structure to better align with the growing international nature of our business, and the recent settlement agreement with Straumann. First, our plans to reorganize our corporate entity structure: Given the rapid expansion of our business globally, we must continue to scale and optimize our operations to help support our growth and financial profile. In March, we announced internally that we would be making changes to our EMEA headquarters located in Amsterdam, The Netherlands. Specifically, we will relocate our current EMEA Headquarters and move the majority of our corporate functions: Finance, IT, HR, Legal, and Regional EMEA Marketing from Amsterdam to Switzerland. We will begin the transition to the new headquarter location mid-year and expect to complete it in 2020 early. We will maintain an Amsterdam office to support local commercial operations. In addition, in August we will be relocating our current Order Acquisition or OA facility from Amsterdam to Poland to create a centralized operational hub for EMEA co-located with our new Treatment Planning facility that we just opened. This new hub in Poland will include iTero business operations, customer success and clinical support teams, and IT operations. As we evaluated our options, relocating our EMEA headquarters to Switzerland quickly became our top choice on many factors including: a more favorable and stable operating environment. An opportunity to accelerate our transition to a more decentralized commercial structure for EMEA that reflects the localization we’ve been working toward. A more centralized geographic location in Europe within EMEA’s largest potential market. An available talent pool to support key strategic roles required in the new EMEA headquarters. While we expect these proposed changes will allow us to obtain financial and operational efficiencies, it was a difficult decision to make and we are committed to supporting our impacted employees throughout this transition. Moving onto the settlement agreement with Straumann. On March 28, we announced a settlement with the Straumann Group to settle patent disputes with ClearCorrect, who was purchased by Straumann in 2017. As many of you know, for years Align has been engaged in complicated, multi-country, multi-court patent litigation with ClearCorrect. The settlement with Straumann ends all current and pending litigation and provides $35 million in settlement fees to Align. In addition, we have signed a non-binding letter of intent, LOI with Straumann for an iTero development and distribution agreement. If we reach an agreement, Straumann will purchase and distribute 5,000 iTero scanners over the next five years and co-fund development with us to integrate Straumann’s digital workflow into those scanners. The letter of intent we’ve signed is non-binding, which means either one of us can walk away from the LOI. However, if we don’t reach a development and distribution agreement with Straumann by early July, Straumann will pay us an additional $16 million, for a total of $51 million. We have always been passionate about defending our intellectual property and the hard work and innovation by the Align team that it represents. We’ll continue to do that and to protect our technology through all the ways that our legal system provides. With that, I'll now turn the call over to John.