Earnings Labs

Accuray Incorporated (ARAY)

Q1 2016 Earnings Call· Thu, Oct 29, 2015

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Transcript

Operator

Operator

Good day, ladies and gentlemen and welcome to the Accuray Incorporated Fiscal Q1 2016 Earnings Conference Call. At this time, all participants are in a listen-only mode. Later, we will conduct a question and answer session and instructions will follow at that time. [Operator Instructions] As a reminder, this conference is being recorded. I would now like to hand the call over to your host for today's conference, Mr. Doug Sherk. Sir, you may begin your conference.

Doug Sherk

Analyst

Thank you, Chelsea and good afternoon everyone. Thank you for joining us today on our conference call, as we review Accuray's first quarter fiscal 2016 financial results for the quarter that ended September 30, 2015. Participating on today’s call are Josh Levine, President and Chief Executive Officer of Accuray as well as Kevin Waters, Accuray's Senior Vice President and Chief Financial Officer. Before we begin, I would like to remind you that our call today includes forward-looking statements that involve risks and uncertainties including statements regarding our business plans and strategies as well as our outlook for the second quarter and full fiscal year 2016. There are a number of factors that could cause actual results to differ materially from our expectations, including but not limited to risks associated with the adoption of the CyberKnife and TomoTherapy Systems, commercial execution, future order growth, future revenue and macroeconomic factors outside of the company's control. These and other risks are more fully described in the press release we issued after the market closed this afternoon, as well as in our filings with the Securities and Exchange Commission. The forward-looking statements on this call are based on information available to us as of today’s date and we assume no obligation to update any forward-looking statements. During the question-and-answer session we request that questioners limit themselves to two questions and then re-queue if you have any additional follow-ups. We thank everyone in advance for their cooperation with this process. And now, I would like to turn the call over to Accuray's President and Chief Executive Officer, Josh Levine.

Joshua Levine

Analyst

Thank you, Doug and good afternoon everyone. Accuray is out of the gate in fiscal year 2016 in strong fashion. Performance in the first quarter of FY 16 saw continued momentum in order activity for both the CyberKnife and TomoTherapy Systems, driven by our continued focus on commercial execution. For the first quarter we reported gross orders of just under $65 million which represents an 18% increase on a constant currency basis compared with the prior year first quarter. Additionally, on a constant currency basis revenues increased 12% while operating expenses decreased 10% demonstrating our ability to drive significant operating leverage in the business. Those results led to a $10.8 million improvement in EBITDA year-over-year and generated an increase in cash and investments of $9.2 million. To put that in perspective comparatively, in the first quarter of the prior year we had a decrease in cash and investments of approximately $19 million. On the gross order front we continue to see strong traction in CyberKnife System orders with growing unit volumes of our M6 series with the InCise Multileaf Collimator. It is clear that commercial lease of the MLC is transforming the overall functionality and utility of the CyberKnife M6. As more customer sites gain clinical experience they are continuing to see significantly reduced treatment times, increased throughput and a growing volume of patients that can be treated with CyberKnife. On the product registration front, we've obtained regulatory approval for the InCise MLC in the U.S., EU and Japan and we are pursuing approval in additional markets which should drive our opportunity with CyberKnife. Turning to our TomoTherapy System, we are pleased with our continued momentum in the new TomoTherapy orders, both in terms of unit volume as well as the expansion of the types of facilities that TomoTherapy is…

Kevin Waters

Analyst

Thank you, Josh and good afternoon everyone. I will start off my portion of our prepared remarks with further detail on product orders and then provide additional color on our P&L and balance sheet. As Josh noted in his comments gross orders were $64.9 million which represented a 10% increase from the prior year first quarter. On a cost and currency basis gross orders increased 18%. With regards to the reconciliation between gross and net orders, age outs, which are orders that have not gone to revenue in 30 months since being recorded offset by orders going to revenue that were previously aged out were $18 million in the first quarter. Our age outs for the first quarter were lower than our forecast of $20 million to $23 million. Cancellations, which occur when a customer definitively cancels their backlog order were $3 million representing one order during the first quarter. With regard to the impact of foreign currency on backlog, the U.S. dollar was fairly stable in the quarter, which resulted in $1.3 million increase to backlog. Net orders totaled $44.8 million in the quarter an increase of 39% over the prior year first quarter. To provide additional color around gross order performance we are pleased with the momentum around CyberKnife orders with strong year-over-year unit volume improvement at our EIMEA and U.S. regions. Additionally, TomoTherapy gross orders were also strong with the EIMEA region experiencing the largest percent growth in regards to TomoTherapy unit volume. As mentioned on our previous call, we are looking for the EIMEA region to generate growth that is significantly in excess of overall market growth in fiscal 2016 and thereafter get started. Moving on to our income statement. Total revenues for the first quarter of $89.6 million represents 9% increase from the prior fiscal…

Joshua Levine

Analyst

Thanks Kevin. I'm encouraged by our performance in Q1 as we show continued momentum in commercial execution across all of our strategic initiatives and we outperformed the markets. We believe that as we continue to execute our fiscal 2016 operating plan, Accuray will finish this fiscal cycle in a vastly different position from a financial perspective relative to growth in orders and revenue, operating profit and positive cash flow generation. And we are now ready to open the call for questions.

Operator

Operator

[Operator Instructions] And our first question today comes from Steve Beuchaw with Morgan Stanley. Your line is now open.

Steve Beuchaw

Analyst

Hi guys, thanks for taking the questions. I think I'll start actually on the service revenue piece of the story. The one thing that was a little surprising relative to our expectations with service revenue, I wonder if you could just refresh us a little bit on how you're thinking about driving revenue when you could just refresh little bit on how you think about driving service revenue faster, I know part of that is attach rates and then part of it might be service contract structures. Can you give us a sense for how that can evolve over the next year or two? Thanks.

Kevin Waters

Analyst

Yes David, it is Kevin. So as I have mentioned in my prepared remarks our constant currency service revenue growth rate in Q1 was 5% which are comparable to the most recently completed fourth quarter. So the growth rate year-over-year is consistent. Also I pointed out that Q1 is typically our lowest quarter in regards to service revenue. There are two factors that contribute to our lower Q1 that would make me believe that moving out the quarters should be higher than the Q1 rate. Those two things are installation and training revenue. So Q1 is when we install typically the least amount of systems. But with every one of those systems we also record installation and training revenue which causes the slight decrease in Q1. In terms of driving future service revenues, we continue to work on our contract vacancy rate. We’ve seen improvement over the last kind of five sequential quarters in terms of driving that number that is basically right around 10% at this time and we’re continuing to look to improve on that.

Steve Beuchaw

Analyst

Got it. And then Josh for you, I would love to just get a bit of reflection. I think about the commentary around orders this year and the 295 figure, I mean the 295 figure is organically actually a little bit bigger number than it was two or three months ago just given that currencies have actually been volatile and negative in some important areas. So number one, am I interpreting this right thinking that your optimism on orders is maybe very slightly incrementally higher than it was when we heard from you on the prior call? And I guess secondarily, are there any things you might spike out as being particularly interesting in terms of how the fiscal year has evolved thus far? Thank you.

Joshua Levine

Analyst

So, to answer the first part of it, Steve, I mean I would say we have a robust view of and a positive view of the momentum that the business is now showing over the last several quarters. When you look at the things that we’ve introduced from product portfolio standpoint in terms of the commercial availability of MLC a continued market penetration that TomoTherapy is enjoying some of the things we've talked about with regards to GPO and strategic account, portfolio management have started to kick in and I'd say we have a, from an outlook standpoint we've got pretty strong view of continued momentum. With that said, I think we are working hard to try not to get ahead of ourselves and we want to encourage you and the people listening in on this call to not do that either. We are across all of the commercial execution drivers of the business, we feel strongly about how we’re performing and our ability to execute - to continue to execute going forward. On your question from mix and geography standpoint, I mean I think if you go back to the fourth quarter call in terms of absolute growth percentage relative to orders – gross orders we expected and we are seeing the Americas and the EMEA region will be the largest growth contributors in this fiscal cycle in the year. And we think that that is due to the opportunity for both installed base replacement sale impact as well as taking advantage of the MLC availability and its impact on M6 going forward. When you think about EMEA though, prior year 2015 EMEA was down about 14% in unit impact. So we would on a comparable basis expect that to grow comparably with prior year well in excess of overall market growth rates. We share the same thing obviously with the Americas region relative to expected growth in 2016 and I would say that in general we would expect it to be comparable with what we saw in 2015 which was north of 20%. So with just a final look at China and the Asia-Pacific regions, obviously these are strategic, very significant strategic areas of focus for the business and, but we forecasted probably more modest numbers for the region overall based on really primarily the tough comparables to prior year.

Steve Beuchaw

Analyst

That is as always very helpful. Thanks so much, guys.

Joshua Levine

Analyst

Thanks Steve.

Operator

Operator

And our next question comes from the line of Tycho Peterson with JP Morgan. Your line is now open.

Tycho Peterson

Analyst · JP Morgan. Your line is now open.

Thanks. Maybe Josh just dovetailing off the last question, can you comment specifically on Japan given the opportunity there of $400 million or so target bunker, how are you thinking about the set up there for this year?

Joshua Levine

Analyst · JP Morgan. Your line is now open.

So, we expect Japan will be a good contributor Tycho. I think the opportunity that you’re referring to in those 450 bunkers is with a product that is something other than what we currently have in the portfolio and I would say that this is probably an opportunity that we don’t start to see activated until probably the back half of this year or maybe in late Q3, early Q4. So I would say, I would caution on being too aggressive in factoring that impacting in but we expect that we would be in the market with that product sometime towards the latter part of the year.

Tycho Peterson

Analyst · JP Morgan. Your line is now open.

And then on the U.S. market in the commentary on competitive wins is encouraging, can you add a little bit more color, I mean presumably these are almost all Tomo systems, but are any of them CyberKnife and maybe also just talk about the pricing dynamics as you are going to swap out competitive systems?

Joshua Levine

Analyst · JP Morgan. Your line is now open.

I mean, for us the opportunity in the U.S. market is two-fold. The first one is the replacement sale opportunity. That one is primarily TomoTherapy, although it is not exclusively Tomo, but I would say primarily TomoTherapy in the U.S. replacement opportunity. As you have seen the numbers, the customer sat rates, the third party data, we are I would say well beyond questions about the product performance, product reliability issues. That is certainly helping us in terms of driving wins competitively, both in competitive sockets and obviously becoming a more important option in terms of the existing customer base in terms of trade in, trade up opportunities. CyberKnife is really being driven by the MLC discussion and MLC availability. I think you’ve seen probably some of the information that we’ve put out. We had more information at ESTRO around the product performance improvement side, significant reductions in treatment time, overall throughput. The things that had been the biggest obstacles to adoption around CyberKnife are really quickly being pulled off the table at this point in terms of customer perception. So we feel pretty bullish on where CyberKnife will be overall this year relative to market – for the market impact – for the market penetration based on MLC availability.

Tycho Peterson

Analyst · JP Morgan. Your line is now open.

Okay. And then last one, you made an interesting comment about some of the older systems age-outs are kind of coming back to revenue. I’m wondering if you can maybe just elaborate a little bit on that are you changing your selling effort or is there some other dynamic and then how big is that opportunity for some of those older age-outs actually turning to revenue?

Kevin Waters

Analyst · JP Morgan. Your line is now open.

Yes Tycho, this is Kevin. It represents an opportunity for us and in the last two quarters we have had two units in each quarter, two in this first quarter and two last quarter that would have aged-out and now gone to revenue. I think we feel cautiously optimistic, at this point I would say with orders that have aged-out where we see that it’s really an end user side issue. It could be we saw a lot of issues around currency in countries where the dollar has strengthened and the distributor would pay us in dollars and the end user contract is in local currency. So I’m not prepared to give kind of a percent as to what we think can come back in the future, but the fact over the last two quarters, we have added $10 million in product revenue that is previously aged-out and gone back into revenue.

Tycho Peterson

Analyst · JP Morgan. Your line is now open.

That is interesting, thanks guys.

Kevin Waters

Analyst · JP Morgan. Your line is now open.

Yep.

Operator

Operator

And our next question comes from Brooks O’Neil with Dougherty & Company. Your line is now open.

Joshua Levine

Analyst

Brooks are you there? Brooks O’Neil: I’m sorry, congratulations on the strong results in Q1. I’m looking forward to the rest of the year.

Joshua Levine

Analyst

Thank you. Brooks O’Neil: So, you mentioned that some of the CyberKnife momentum was related to the recent release of the MLC. I just want to be sure that you feel there is sustainability to the momentum in that product line that goes beyond just taking advantage of backlog or systems that have been waiting for the availability of the MLC?

Joshua Levine

Analyst

Yes I mean just to be crystal clear about this, the order mix is heavily represented by new orders. I think we said last quarter that 80% of the orders that we took for CyberKnife M6 included an MLC. So I think that strongly speaks to that piece. As you know, there were orders in the backlog that had been orders that were placed with the MLC and that were waiting for release in commercial availability. So those are also part, obviously part of the impact and overall contribution. But, I guess the other thing I would note Brooks is that we had probably a maybe five or six month hedge spot in the U.S. in commercial lease just given the difference in timing between when we were getting all the work done at our evaluation sites that we had talked about early on. You will remember that we add some U.S. locations, you will remember that we also add some international locations primarily focused in Western Europe, the Eurozone countries and we were – we had the lease essentially for sale MLC in the U.S. market probably back maybe April, May timeframe of this year, but we didn’t release for sale in Europe which is the other big contributing element to this until probably about two months ago. So we think that there is absolutely no, number one we have not done ramping in the U.S. that is one observation, number two we barely started ramping in Europe at this point and Japan and some of those other markets. So I’m highly encouraged about the trends, the impact that we’re seeing, the momentum relative to order activity and order volume and I’m going to suggest that that will continue. Brooks O’Neil: That is great. And then secondly, you talked about the value priced or sort of let’s call it midstream system you’re planning for China, do you see any opportunity for a system like that in other markets around the world?

Joshua Levine

Analyst

Yes, so the answer is yes, the focus, the near term focus is obviously the China opportunity just given the magnitude of what is – what is in front of us there, but we do think that there are opportunities for that kind of core value product in other markets, either emerging markets or even perhaps in some mature markets. It is probably less likely that you would see that in the U.S. and basically in terms of product segmentation and market segmentation, these are products that from a functionality standpoint well having reasonably strong clinical utility. They probably would not be considered premium products in terms of product positioning. So less likely you would see us in the U.S. market or the Americas region with that kind of an offering. Brooks O’Neil: Okay, good and then just last question. Kevin talked a lot about the focus on the converts in addressing those. I’m just curious if you would be willing to put any parameters around timing, are you thinking you might be able to achieve something sooner rather than later or do you think it will go right down to the August deadline?

Joshua Levine

Analyst

Sooner rather than later would be the strong, strong response to that message. And this has a lot of energy attached to it has a lot of focus attached and we have no intention of waiting until those notes come to maturity next August. Brooks O’Neil: Great, congratulations again.

Joshua Levine

Analyst

Thank you.

Operator

Operator

And our next question comes from Jason Wittes with Brean Capital. Your line is now open.

Jason Wittes

Analyst · Brean Capital. Your line is now open.

Hi thanks for taking my questions. Just wanted to make sure I understand the timelines for the lower cost system. Is sounds like you just submitted in China and is there when should we anticipate approval and it sounds like also Japan has been submitted as well from your earlier discussions, is that the right way to think about it and kind of what timeframe do you have to think about it.

Joshua Levine

Analyst · Brean Capital. Your line is now open.

Yes, Jason. So look we are excited about this opportunity. For competitive reasons I am going to prefer not to get too detailed on this topic, but in a general sense I say from a China standpoint, we have submitted the product registration applications CFDA and we believe that there are other markets as well that offer an opportunity for this product. The estimate right now is that timing of approval in China specifically is likely to be probably sometime in early calendar year 2017.

Jason Wittes

Analyst · Brean Capital. Your line is now open.

Okay, that is helpful and also on China for the Premium segment, you mentioned there is a pause in terms of approvals for new systems, when should we expect that to resume or what is the general thinking in terms of timing on that?

Joshua Levine

Analyst · Brean Capital. Your line is now open.

Just to be specific, I think as I said in my prepared remarks that what we are seeing timing wise right now is actually not inconsistent with what we’ve seen over the course of the last two years. It has been a kind of a rolling experience in starts and stops right. We have had reasonably long time gaps and delays over the course of the last two years, two and a half years in Class A licensed issuance, cadence if you will. So what we’re seeing right now is not inconsistent with what we’ve experienced in the past and we are obviously very focused on this. It’s been a source terrific success for us over the course of last couple of years, but we don’t have any direct influence over the Ministry of Health there relative to timing. So it’s – we are certainly feeling like we’re still well positioned and as those licenses get issued, I’m going to guess it we are going to continue to compete very successfully for them.

Jason Wittes

Analyst · Brean Capital. Your line is now open.

Okay. That's very helpful. One last question, in terms of CyberKnife with the InCise MLC, how are customers using that system now versus how they were using CyberKnife without the MLC, are you seeing a noted changed in procedures are doing, maybe you could elaborate, that would be very helpful?

Joshua Levine

Analyst · Brean Capital. Your line is now open.

Yes, so the answer is what the most immediate impact is probably directly related to deal size. So you’ve got the benefits of a greater deal size with the MLC. You also have an efficiency obviously relative to treatment speed and throughput that is really vastly different. I mean it is a significant step change in terms of what customers had experienced Jason, prior to MLC availability. The biggest areas of our clinical case mix or application through the evaluation size continue to be things like SRS or intra-cranial is still a heavy piece of the mix, but basically liver, prostate SBRT, prostate cases and so I would say a reasonably broad mix of clinical application and case mix focused since we've launched it.

Jason Wittes

Analyst · Brean Capital. Your line is now open.

And so it sounds like I definitely understand the efficiency help as to your SBRT procedures, but I’m just curious if even some centers are starting to venture off and do some more standard relation type procedures like IMRT and things like now that they can do it?

Joshua Levine

Analyst · Brean Capital. Your line is now open.

I know that there are accounts that are experienced CyberKnife users that have MLCs being installed at literally at present, kind of as we speak, that are talking about things like breasts. That's another interesting one I think that probably would not have been kind of keyed up in the old days before MLC availability. If you think about the advances that have been made in SBRT prostate over the course of the last several years, I think there are a lot of folks out there that are starting to believe that breasts could be that same kind of ramp potentially.

Jason Wittes

Analyst · Brean Capital. Your line is now open.

Okay. Very helpful, thank you Josh.

Operator

Operator

And our next question comes from Anthony Petrone with Jefferies. Your line is now open.

Anthony Petrone

Analyst · Jefferies. Your line is now open.

Thanks and good afternoon. Maybe to start on gross order growth in the quarter and even guidance for the year, I’m just wondering if you could maybe breakout the extent how much of the growth is actually coming from competitive wins and how much Josh, you alluded to replacement orders as well, how much is coming from replacement orders from renewal of the base?

Joshua Levine

Analyst · Jefferies. Your line is now open.

So, I’m going to, we could be in a race here to see if Kevin finds it first or I find it first.

Kevin Waters

Analyst · Jefferies. Your line is now open.

Let me address your replacement question going forward because we’re not going to provide specific numbers around how much of the gross order forecast is specific to replacements. However, what we can remind you is that we do have approximately five times the number of units coming up on the replacement cycle as compared to the previous three years. So this does represent a tremendous opportunity for us that is factored into our guidance. We think given the increased TomoTherapy reliability, customer satisfaction, those are really critical elements achieving those replacement wins and we have been able to win our replacement bunkers at a fairly high rate.

Anthony Petrone

Analyst · Jefferies. Your line is now open.

And maybe just to quantify that a bit, I mean can you give us an update on the total installed base today and maybe a percentage of that that is coming up for renewal? I mean by our estimates I think the total installed base between CyberKnife and Tomo is around 700 systems, but maybe just to clarify and get fresh numbers on that would be helpful?

Kevin Waters

Analyst · Jefferies. Your line is now open.

Yes, I mean so we have stopped giving exact installed base estimates. I think to do a replacement model you could assume between 775 and 800 or so installed. We presented at the Morgan Stanley Conference I'd encourage you to look at the breakout between the gross units that are coming up on replacement cycle, but it represents roughly 200 units that are coming on their tenure life over the next three years.

Joshua Levine

Analyst · Jefferies. Your line is now open.

I mean you say in round numbers Anthony you'd say somewhere between 25% and a third of the installed base over the course of the next 36 months which is really a very unique situation for us. It is heavily concentrated in the U.S. and Western Europe. It represents both product platforms, probably just given the mix between the installed base of Tomo versus CK, certainly heavier Tomo, but both are represented and it’s coming, quite frankly it’s coming at a good time given the work we have done quite frankly to drive the improvement in customer satisfaction and overall market perception about the utility, the functionality improvements in the product. I mean treatment speed, treatment planning capability. We've got the best products this company has ever had in the market place today and customers are recognizing that and that’s an important lever for us in our install base for placement sales strategy.

Anthony Petrone

Analyst · Jefferies. Your line is now open.

It is interesting feedback and may be just to kind of segway into a theme at ESTRO which was stereotactic radiosurgery and sort of kind of factor that back into the renewal. Do you think that a larger amount of the base could actually switch over to CyberKnife just considering that the estimates out there for us are quite higher in terms of growth, so you think is that a theme that can potentially happen?

Joshua Levine

Analyst · Jefferies. Your line is now open.

So it’s an interesting question. I think when you think about mainstream product configuration and mainstream products, market acceptance, market adoption, I think the Tomo will still be more of a mainstream product based on a couple of factors, not the least of which is just the overall footprint. You are talking about product replacement in a way [indiscernible] situation. If you talk about a competitive situation, you are talking about a bunker that would be probably need more modification based on the power, the system and the footprint. Tomo is certainly much more of a replacement sale in that kind of a situation. But there is no question that the trend towards SBRT and SRS from both a clinical adoption standpoint and a reimbursement methodology standpoint are driving probably greater usage of those modalities over time for the foreseeable future. I mean it trends towards hyperfractionation. I am going to predict they are not going away. I mean I think that the market has clearly both clinically and from a patient experienced patient quality of life standpoint come to recognize hyperfractionation and SBRT and SRS are the if not the preferred approach, certainly an approach that more and more people are trying to adopt and give themselves capability around. So I do think that also says that it should be a reasonably strong level of contribution in terms of continuing CyberKnife momentum.

Anthony Petrone

Analyst · Jefferies. Your line is now open.

That's helpful. And may be just turning to the P&L last one from me is just the service margin. If we could just get an update there, sequentially it came in a bit, but [indiscernible] certainly. I am just wondering if what happened sequentially in the quarter with service margins and maybe as we look forward do you still expect that sort of kind of increase to a blended rate that you know can be anything upward 30s? Thanks.

Joshua Levine

Analyst · Jefferies. Your line is now open.

Yes, so what we said in our guidance is that we have a blended lower end margins to be flat and up 200 basis points on the high end and I think that will be a good proxy for full year service margins as well. So Q1 has always historically had lower service margins frankly due to the lower revenue in the first quarter. So I would expect service margin improved throughout the year and you know I guess more in line with our historical 2015 margin rate, which is kind of more into the 35% that 37% range for the rest of the year.

Anthony Petrone

Analyst · Jefferies. Your line is now open.

Thanks again. A - Joshua Levine No problem.

Operator

Operator

And our next question comes from Suraj Kalia with Northland Securities. Your line is now open.

Suraj Kalia

Analyst · Northland Securities. Your line is now open.

Good afternoon gentlemen.

Joshua Levine

Analyst · Northland Securities. Your line is now open.

Hi Suraj.

Kevin Waters

Analyst · Northland Securities. Your line is now open.

Hey Suraj.

Suraj Kalia

Analyst · Northland Securities. Your line is now open.

Josh and Kevin, congrats again on a nice quarter. It’s good to see you guys sharpening the company pretty well. Josh three questions if I may, you know let me start out with the first again on China and I'll piggyback on Jason’s question. My apologies that this is a little unfair. So you guys are coming out with a new system that potentially we don’t know all of the details, but is at a lower price point just given my experience interacting with you guys, the customer feedback in the field, and I doubt you guys would trade-off reliability, throughput, efficacy of the machine to save cost. Having said that Josh, why can’t this platform, however in the final form it is, why can't it be you know translated to let the U.S. or O-U.S. other geographies, I guess I am just trying to understand, there is some price elasticity of demand. We have [indiscernible] fighting with each other on price, would such as system help you all in such bidding situations or you are saying no, we are just going to stick with China in the certain target market.

Joshua Levine

Analyst · Northland Securities. Your line is now open.

So this is matter of really, you know kind of its basic level of thought process, Suraj. This is a matter of priorities and magnitude. When you think about China or when we think about China, conservatively probably over the course of the next decade there is probably going to be 4000 or 5000 linear accelerators that ends up in the ground over the course of the next decade. The vast majority of those, probably 80% to 85% of them are not in class A, so we have been very successful in the last two years in the Class A radiotherapy space, but that really is not kind of where the big growth drivers are going forward. It’s in the non-Class A products. And just to be clear we are not talking about trading off product functionality, product reliability for to be able to play for bigger piece of the market. We think we have got a product configuration and a solution that will make sense for not – maybe not everybody in that, that universe of opportunity in China. but certainly a large piece of the growth there is going to come from the provinces, it’s going to come from most likely the private sector. There are going to be smaller footprint facilities and having a product that's got regional clinical utility and is used to operate is going to be based on out market research going to have high utility and high-value and a customer appeal. So that’s just primary focus. Could it over time, could it become a fighting brand kind of product at some point down the road if we needed it to be? I guess the answer is yes, but that really isn’t part of the thought process today I think there will be other markets still outside of China that also represents an opportunity for it relative to product configuration and market positioning. So emerging markets are markets that are certainly more price sensitive and maybe a bit more basic in product configuration, but there is a long way between the very, very low end and low, low end of the market and we are replaying at the very upper end into the market. And to be clear we are not talking about a device, like configuration or price point that we are intending to be competing at a low, low end of the market. I mean it’s, I think if you are talking about million dollars, sub million product that isn’t where we're going to be. With that said, there is a lot of room and there is a lot of opportunity we believe between $1 million, $2 million $3 million at the low end and maybe $1 and three quarters of a million, $2 million dollars at the high end and so that core value segment there is really kind of where we envisioned this strategy to play.

Suraj Kalia

Analyst · Northland Securities. Your line is now open.

Fair enough, Josh one question for you and then one for Kevin and I will hop back in queue. The alignment with the research with treatment planning strategy software, Josh can you give us some additional clarity, what is the gap you all realized and how does research help fill that gap?

Joshua Levine

Analyst · Northland Securities. Your line is now open.

So it’s two-fold. The first is on oncology information system platform. We do not, we are the only one of the three major companies that doesn’t have our own oncology information platform, OIS system and that has in certain situations that's proven to be limiting for us relative to market access. If we are a device that is being chosen in a third bunker or a forth bunker and already almost there for running in that facility to support the other devices and the other bunkers, we have a connection requirement to get connected into an interface with that OIS platform, we can make that happen but it’s quite frankly it is not as user friendly as it needs to be. And ultimately that is the focal point here is it needs to be more user friendly and we need to reduce our dependency on our friends at Varian and Elekta to get us connected. That is one, that is on the OIS side. On the treatment planning side, over the course of the last two plus years, we continue to hear from customers that have RayStation which is the number one, market leading, independent treatment planning capability and quite sophisticated quite frankly relative to what is out there from the other players. We continue to hear from people that have that product installed and that also are either using our products on the delivery side or considering using our products on the delivery side and there has been a significant amount of market input around encouragement that we need to figure out how to get ourselves connected with RayStation because more and more people want to use that system to drive all of the equipment in those customer locations. So again it is as workflow efficiency and a customer driven kind of an input that has led us down this path.

Suraj Kalia

Analyst · Northland Securities. Your line is now open.

Got it. Kevin, last question and my apologies if you already highlighted this on the call. For your gross orders can you give us some additional color on geographies and growth rates and the split between Tomo and CK? Thank you for taking my question?

Kevin Waters

Analyst · Northland Securities. Your line is now open.

So what we gave at the end of last quarter in regards to regional full year performance, sometimes we give on a full year basis. However, we are not going to give specific growth rates by region on a quarterly basis. In fact the numbers on growth, they are not terribly meaningful in looking at it on a quarter-to-quarter basis. What I can say though is that our EIMEA region and our Americas region what I said in my prepared remarks are kind of leading the charge in regards to gross order performance which is in line with our plan. I also said in regards to the product specific the CK product represented a higher percent of growth than the TomoTherapy product on a year-over-year basis.

Operator

Operator

Thank you. And our next question comes from Toby Wann with Obsidian Research. Your line is now open.

Toby Wann

Analyst · Obsidian Research. Your line is now open.

Hi guys. Thanks for taking the questions. Could you just kind of talk about the sales funnel with regards to the GPOs? Here in the U.S. you guys have had some pretty decent traction going forwards seems to be accelerating just kind of maybe a little more color on all of that?

Joshua Levine

Analyst · Obsidian Research. Your line is now open.

Yes, I mean, it took a while to get things moving, but it’s moving. I think that we’ve done a good job of working with those organizations to be able to identify joint opportunities and mutual opportunities. Again it probably took longer to start to see traction with it than would have been ideal, but it’s I believe an activity and a support that we are planning with them that is having some – it is having impact. We've got orders in the last two quarters that are really identifiable as opportunities that were not tracked prior to getting GPO agreements signed. So there is kind of a direct linkage there. We actually have been very involved beyond the GPO discussion with strategic accounts, so for some of the proprietary network partners with regards to freestanding centers and that was the order that we highlighted that took place in the quarter, the five system order with four Tomo’s and one CK. So we are starting to get some momentum. We are starting to see some traction. I would – I still think that this is going to be Toby it is going to be on a quarter-to-quarter basis; there is going to be variability.

Toby Wann

Analyst · Obsidian Research. Your line is now open.

Right.

Joshua Levine

Analyst · Obsidian Research. Your line is now open.

So it is the wrong assumption to just kind of take where we are at in the last couple of quarters and start to streamline into the upper right hand corner of the graph. It is going to be – it is going to vary from quarter-to-quarter. But the funnel, the funnel that is related to that I think is improving and we’re starting to show that we can execute against it.

Toby Wann

Analyst · Obsidian Research. Your line is now open.

That’s helpful color and then with regards to kind of trade in, trade up kind of what traction you guys see in there or are you seeing orders come from that program so far?

Joshua Levine

Analyst · Obsidian Research. Your line is now open.

Yes, I mean, I think in my prepared remarks I said during the quarter roughly 20% of the gross orders were replacement sales at our existing customer base. So that is directly linked to that the phenomenon that of Kevin highlighted earlier which is roughly 25%, 30% of our installed base comes in for tenure replacement cycle over the course of the next three years. That is a big opportunity for us. Bunker retention is absolutely a priority and we are bidding at a very high rate or we are retaining those bunkers at a very high rate.

Toby Wann

Analyst · Obsidian Research. Your line is now open.

That's helpful. That's it from me. Thanks so much for the questions.

Operator

Operator

Thank you and our next question comes from Jeff Bernstein with Cowen Prime Services. Your line is now open.

Jeff Bernstein

Analyst · Cowen Prime Services. Your line is now open.

Hi guys, it is a nice quarter. I love the cash generation.

Joshua Levine

Analyst · Cowen Prime Services. Your line is now open.

Thank you.

Jeff Bernstein

Analyst · Cowen Prime Services. Your line is now open.

So just, most of my questions were answered, but I think you talked last quarter that a lot of the line Accuray placements were kind of coming out of old Siemens installed base. Is that still the case or any color there?

Joshua Levine

Analyst · Cowen Prime Services. Your line is now open.

I mean prior quarter I think the opportunity that we talked about or the win we talked related to Siemens bunkers replacement was probably the order that multi-system order that was in kind of a large proprietary strategic account customer that is in the freestanding incentive business. I think that one was really more movement against old Siemens lamps [ph]. I mean we continue to see those bunkers come up for replacement opportunity based on the aging cycle and again Tomo and it's improvement in reliability, functionality or all of it really has made given us an opportunity where we can at least be a viable kind of option to compete with those bunkers. If you go back two or three years, that was not the case. We really did not have a strategy to play. So, based on some of the legacy challenges with the device, it is encouraging to see that movement in those situations because it speaks to the 180 degree turnaround that we've made in product reliability and product performance.

Jeff Bernstein

Analyst · Cowen Prime Services. Your line is now open.

Terrific, keep up the good work guys thanks.

Joshua Levine

Analyst · Cowen Prime Services. Your line is now open.

Thank you.

Kevin Waters

Analyst · Cowen Prime Services. Your line is now open.

Thanks.

Operator

Operator

Thank you and I am not showing any further questions at this time. I would now like to hand the call back to management for closing remarks.

Joshua Levine

Analyst

Thank you, operator. I just want to take this opportunity to thank the 1000 plus Accuray worldwide employees for their contributions in the first quarter of this year and recognize their passion and commitment to what we're doing together to bring benefits to the customers and their patients. For those of you listening in, thanks for joining on this afternoon's call and we look forward to speaking with you on the Q2 call. Thanks very much.