Bioventus Inc. (BVS) Q2 2026 Earnings Report, Transcript and Summary

Hello, and thank you for standing by. My name is Regina, and I will be your conference operator today. At this time, I'd like to welcome everyone to the Bioventus Inc. Second Quarter 2026 Earnings Conference Call. [Operator Instructions] I'd now like to hand today's conference over to Dave Crawford. Please go ahead.

Thanks, Regina, and good morning, everyone, and thanks for joining us. It is my pleasure to welcome you to the Bioventus 2026 Second Quarter Earnings Conference Call. With me this morning are Rob Claypoole, President and CEO; and Mark Singleton, Senior Vice President and CFO. Rob will provide an update on our 2026 priorities and the second quarter highlights, and then Mark will review second quarter results and discuss our 2026 financial guidance. We will finish the call with Q&A. A presentation for today's call is available on the Investors section of our website, bioventus.com. Before we begin, I would like to remind everyone that our remarks today contain forward-looking statements that are based on the current expectations of management and involve inherent risks and uncertainties that could cause actual results to differ materially from those indicated, including the risks and uncertainties described in the company's filings with the SEC, including Item 1A Risk Factors in the company's Form 10-K for the year ended December 31, 2025, as such factors may be updated from time to time in the company's filings made with the SEC. You are cautioned not to place undue reliance upon any forward-looking statements, which may speak only as of the date made. Although the company may voluntarily do so from time to time, it undertakes no commitment to update or revise the forward-looking statements, whether as a result of new information, future events or otherwise, except as required by applicable securities laws. This call will also include references to certain financial measures that are not calculated in accordance with U.S. generally accepted accounting principles or GAAP. We generally refer to these as non-GAAP or adjusted financial measures. Important disclosures about the definitions and reconciliations of those non-GAAP financial measures to the most comparable measures calculated and presented in accordance with GAAP are available in the earnings press release on the Investors section of our website at bioventus.com. And now, I'll turn the call over to Rob.

Thank you, Dave. Good morning, everyone, and thanks for joining our call today. Bioventus continued its positive momentum in the second quarter, delivering solid financial results across our business. As we continue to strengthen our commercial, operational and financial fundamentals, we are seeing encouraging leading indicators that reinforce our confidence in our future growth drivers. As such, we are reiterating our full year guidance on all metrics and are confident that our long-range growth prospects will drive enhanced value for our shareholders. Before going through the details on the second quarter, I'd like to take a moment to address the strategic review we disclosed this morning. As you saw in our press release, following receipt of multiple expressions of interest and an unsolicited acquisition proposal, our Board has formed a committee of independent directors that will evaluate a range of strategic options. Importantly, these options include, but are not limited to, a sale of the company or the continued execution of our stand-alone plan. We have built a strong foundation for growth and success at Bioventus, and I'm confident that the committee, with the assistance of Evercore as financial adviser, will take the time it needs to carefully evaluate all options to maximize value for our shareholders. Turning to the quarter, I'll update you on the 3 priorities we outlined at the start of the year: one, accelerating long-term revenue growth with increased investment in our business; two, increasing earnings even with the higher level of investment; and three, continuing to strengthen our robust cash flow and enhance capital allocation optionality. Let me expand on each priority, starting with accelerating revenue growth and increasing investments into our business. Second quarter revenue grew 4% as we continue to capitalize on the opportunities to grow our core business, led by strong double-digit growth in our Pain Treatments business. Within Pain Treatments, our HA franchise, led by DUROLANE, our market-leading single-injection therapy, continues to be a durable strength for Bioventus, consistently growing well above the market. Our performance is driven by strong commercial focus, the experience of our dedicated sales force, DUROLANE's clinical differentiation and broad private payer coverage. In the second quarter, this compelling combination helped us expand volume in existing accounts and win new ones. We believe our go-to-market approach and disciplined pricing strategy positions us for sustainable above-market revenue growth in HA. Year-to-date, the HA business has outperformed our expectations, allowing us to deploy the significant operating profit generated by this franchise to invest in our key growth drivers, including PRP, PNS, Ultrasonics and International. During the second quarter, we continued to increase investments in these businesses by expanding our commercial team, raising awareness of our differentiated solutions and enhancing physician training programs. I'm pleased to report that these initiatives are generating valuable data-driven insights while producing positive traction across several leading performance indicators. These insights help us determine the optimal mix of future investment and commercial actions to maximize growth and returns. Let me highlight a few examples, starting with platelet-rich plasma. Our momentum is building in PRP, and as capital placements continue to accelerate, we are seeing both larger and more frequent disposable reorders. These leading indicators demonstrate that our PRP system is efficient, customizable solution is gaining traction and beginning to displace competitive offerings. We are also beginning to realize the benefits of leveraging our HA sales force to drive PRP adoption, which helps us win new PRP accounts and creates additional opportunities to expand our HA customer base. With respect to PNS, our world-class differentiated technology, combined with strong commercial execution has created excellent momentum, including increased velocity in surgeon adoption and StimTrial placements with high conversion rates to permanent TelisMann implants, resulting in a growing base of new business. In addition, surgeons consistently expressed strong appreciation and clear recognition of our differentiation, which is translating into competitive conversions and meaningful inroads with larger institutions. The strength of these leading indicators confirms our continued focus on expanding sales force coverage, enhancing clinical support and investing in clinical evidence generation to further augment our differentiation. In Ultrasonics, our technology, combined with our investments in marketing and surgeon training is driving encouraging traction with key leading indicators, particularly increased surgeon adoption, accelerating disposables growth and new wins with larger accounts and market-leading IDNs. We expect these early indicators to translate into revenue acceleration in the second half of this year and beyond. Finally, in our International business, momentum continues to build, following the addition of new talent and the team's greater focus on select markets with the best growth opportunities. We are encouraged by the speed of execution, the depth of our opportunity pipeline and our customer win rates. Together, these indicators give us confidence in delivering strong double-digit growth in the second half and for the full year. Turning to our second priority, increasing earnings even as we invest in our future growth drivers. The second quarter was a powerful demonstration of how we have enhanced the earnings power of the business. Despite accelerating investments, we delivered an adjusted EBITDA margin of 23%. And for the full year, we expect to maintain a margin of at least 20%. Our operating profitability, combined with significant interest expense savings generated adjusted EPS of $0.22 in the quarter. And year-to-date, we have increased our adjusted EPS by 24% compared to the prior year. Looking ahead to the second half of the year, we expect to further accelerate our investments while continuing to grow earnings and deliver on our full year financial guidance. We are able to achieve this by leveraging the earnings power generated from our durable above-market revenue growth and stable peer-leading gross margin. Turning to our third priority, accelerating cash flow. We delivered another strong quarter with cash from operations of $20 million. We used our strong cash generation to repay an additional $24 million of our term loan. We also achieved an important financial milestone, reducing our net leverage to below 2x. And we expect our net leverage to be below 1.5x by the end of the year, reflecting our disciplined capital allocation. We plan to continue to prioritize strengthening our balance sheet by using our strong free cash flow to further reduce debt this year, thereby creating significant capital deployment optionality for the future. Overall, we continue to execute with discipline and deliver strong results against our strategic priorities. We are entering the back half of the year with significant momentum, increased conviction in our strategy and growing confidence in the strength of our portfolio and investment approach. Before I turn the call over to Mark, I'd like to highlight another important milestone. Bioventus was recently recognized by U.S. News & World Report as a Best Company to Work For. This recognition is a testament to the talent, commitment and culture of our world-class team, and it further strengthens our resolve as we continue our journey to build Bioventus into a leading $1 billion medtech company that delivers exceptional value for our customers, employees, shareholders and all other stakeholders. Now I'll turn the call over to Mark.

Thank you, Rob, and good morning, everyone. Let me start by highlighting that our performance this quarter reflects the strength of our strategy and our disciplined execution against the investment thesis we outlined. The combination of durable growth and momentum in our core business and peer-leading gross margin is enabling us to fund the investment into our 4 growth drivers. In the near term, each of these 4 areas of growth are generating encouraging evidence and increasing our confidence in future revenue acceleration. At the same time, we continue to deliver on our commitment to improve profitability and generate strong cash flow. This powerful combination sets us apart and positions us to create meaningful long-term value for our stakeholders. Turning to our headline results for the second quarter. Revenue of $153 million increased 4% compared to the prior year period. Growth was driven by significant strength in our Pain Treatments business, which was partially offset by a few factors, including a challenging comparison to the prior year in Surgical Solutions and Restorative Therapies and a shift in timing of some orders, which we will discuss in a moment. Adjusted EBITDA of $35 million increased over $1 million compared to the prior year and grew faster than revenue growth. Adjusted EBITDA margin of 23% expanded 20 basis points compared to the second quarter last year, even with our increased investment. And adjusted earnings were $0.22 per diluted share for the quarter compared to $0.21 in the prior year period. Now let me provide some additional commentary on our quarterly revenue. In Global Pain Treatments, we delivered double-digit growth with revenue of $82 million, representing a 12% increase compared to the prior year. As Rob highlighted, the ongoing durability of our performance continues to be driven by strong growth in HA from volume gains with our differentiated single-injection DUROLANE therapy and favorable customer mix. This success reflects the intense focus and strategic collaboration across our sales force, corporate accounts and pricing teams. Additionally, we saw positive contributions from PRP and PNS, and we continue to expect both to ramp in the second half of the year as we have previously discussed. Moving to Surgical Solutions. Revenue in Q2 totaled $50 million, which was a decline of 5% compared to the prior year, although it reflects 5% growth sequentially. In addition to the challenging prior year comparison, performance was impacted by the timing of certain Ultrasonics capital placements and International orders, shifting approximately $2 million of revenue or more than 100 basis points for the company into the second half. Revenue in BGS was also impacted by a challenging prior year comparisons and deliberate portfolio actions to prioritize higher-margin profitable growth opportunities. It is important to note that Ultrasonic disposables performance is accelerating, and we are gaining significant traction within BGS with new large accounts and IDNs, which will propel second half and longer-term profitable growth. In Restorative Therapies, revenue of $21 million declined 2%, resulting from a change in mix, specifically with Medicare patients in addition to a difficult comparison to the prior year. We expect growth to resume based on current business opportunities and the execution that the EXOGEN team has demonstrated over the past 2 years. Finally, International revenue of $19 million was lower than the prior year by 1% or 2% on a constant currency basis, primarily due to the timing of distributor orders, which is consistent with the business. The fundamental growth in International continues to be strong. And given our increased strategic focus, talent additions and improved commercial execution, we expect to generate strong double-digit growth in the second half of the year and for the full year. Moving down the income statement. Adjusted gross margin of 75% was 90 basis points lower than the prior year period as expected, primarily due to higher freight costs and product mix. Additional adjusted total operating expenses and R&D expenses increased by $4 million as we continue to strategically invest in our key growth drivers to accelerate future revenue growth and expand the long-term earning potential. At the same time, we have demonstrated disciplined cost management by controlling expenses and finding efficiencies across the business. Adjusted net income of $20 million increased $1 million compared to the prior year period. This improvement reflects the benefit of continued revenue growth, stable gross margins and lower interest expense, demonstrating the leverage in our business model and the impact of our ongoing focus on operational execution. Adjusted net income was also impacted by an increase in our effective tax rate compared to the prior year due to the removal of the valuation allowance, and we expect to have a higher effective tax rate for the year. Turning to the balance sheet and cash flow statement. We continue to generate strong cash flow driven by our robust profitability, disciplined working capital management and capital-light business model. Cash flow from operations totaled $20 million during the quarter, and we ended the period with $29 million of cash on hand and $248 million of outstanding debt. During the quarter, we reduced debt by an additional $24 million, bringing total debt repayment for the year to $46 million as we continue to prioritize deleveraging and repayment of our term loan. This strengthens our financial position and is expected to drive further interest expense savings while enhancing our ability to strategically deploy capital towards our highest value opportunities. Through the first 6 months of the year, we have achieved 5% revenue growth, 12% adjusted EBITDA growth, 24% adjusted EPS growth and $22 million of growth in cash from operations. Importantly, we expect year-over-year revenue growth to increase in the second half compared to the first half by over 300 basis points, half of which comes from acceleration in our Surgical Solutions business with a portion related to the shift in timing from the second quarter into the second half and the other half from revenue acceleration in both PNS and PRP. In addition, cash from operations is expected to approximately double in the second half compared to the first half of this year. As a result of strong progress to date and our outlook for the business, we are reaffirming our full year financial guidance. We continue to expect 2026 revenue to be in the range of $600 million to $610 million, adjusted earnings per share to be between $0.75 to $0.79 per diluted share and cash from operations to range between $84 million and $89 million. In closing, we are off to a strong start to the year and remain focused on executing our strategy to invest in our 4 growth drivers. We believe we possess a powerful combination of growth, operational discipline and financial strength to position us well as we build a leading medtech company and create meaningful long-term value for our shareholders. Operator, please open the line for questions.

Our first question will come from the line of Chase Knickerbocker with Craig-Hallum.

So just first on Pain. It's clear that both you and kind of your leading competitor in the single-injection market are growing volumes here in the first half of the year. Maybe just a couple parter there. Can you give us an idea of kind of volume versus price performance in the quarter, again, focusing particularly on DUROLANE? And then kind of just help us with kind of a little bit of characterization around the competitive dynamics that are currently out there in the single-injection market, how kind of both and again, your leading competitor could be kind of grabbing volumes and taking share at the same time?

Chase, this is Rob. Yes, thanks for the question, and we'll try to provide you some insights on that. First, just to reiterate that we've had a great first half, even better than our expectations. And to your question there, it was led by double-digit volume growth for DUROLANE. Again, you know, this is our single injection therapy. And look, I believe our first half performance shows again that HA is a very strong, durable, profitable growth driver for us. So that's a -- we've talked about it before, but it's favorable movement in the market, but that's really due to our clinical differentiation, our broad private payer base, and our overall commercial strength. So we're looking forward to the back half of the year, not just for HA, but for pain overall. And again, whether you're talking about the first half of this year or the second half going forward, our progress and growth in this space is really driven by volume growth.

Helpful, Rob. Maybe just on kind of going to Surgical. Can you just discuss your visibility into that capital kind of getting pushed into the second half and kind of staying there? And then just to follow up on that, even if you kind of place that $2 million in the second quarter, Surgical would have still been essentially flat. Can you maybe just peel back the layers a bit around kind of breaking down growth by Ultrasonics and BGS? And then if you wouldn't kind of talk -- wouldn't mind talking about kind of capital in Ultrasonics versus kind of handpiece growth. I think that would be really helpful for us to just kind of think about that business.

Yes. This is Rob again. There's a lot to unpack there from the question. So maybe I'll broaden it to Surgical and just kind of give you overall perspective on it and also touch on both the capital and disposable pieces that you mentioned. So first, we feel great about the long-term outlook for both Ultrasonics and BGS and for Surgical overall. I think it's important to note that despite a difficult comparison in Ultrasonics in Q2 and the transitory impact of the timing that you mentioned with respect to capital placements, and that alone was nearly a 400 basis point impact for Surgical. The Surgical business grew 5% sequentially in the second quarter. And more importantly, we saw great traction in Ultrasonics with our leading indicators from our investments, including new accounts, new users, capital placements and accelerated sequential growth with disposables. So we're really looking forward to the second half of the year. And in BGS, look, we're constantly managing our business with operating discipline to drive profitable growth. And to that end, we took some proactive actions in the channel in the second quarter that had a temporary impact on our performance. But there, we also saw in Q2, very positive traction with new large account acquisitions and early penetration with accounts that we've recently won, which gives us clear line of sight to acceleration in the back half of the year. So again, a lighter quarter, less than our expectations for known reasons. And part of that was that shift in timing that you alluded to. And we fully expect to see a strong acceleration for our Surgical business in the back half of the year.

And then just last for me, Rob, if I could sneak one more in. I appreciate all the context there. I know you won't kind of specifically comment on the strategic alternatives process, but maybe could you just help us contextualize it just a little bit as far as kind of where we are? Is this kind of -- is this fresh? Is this kind of brand new? Or is this something we've been kind of working on in the background before announcing it publicly here over the course of the quarter?

Yes. Thanks for that question, Chase. As mentioned, we made the announcement today given the unsolicited acquisition proposal that we received along with multiple expressions of interest. And beyond that, we can't provide a lot of detail beyond what we've already shared. But I will say we continue to be really excited about our significant progress and about the enormous potential ahead. And we have a lot of confidence that the committee that I mentioned is committed to evaluating the full range of options to maximize shareholder value. So we'll leave it at that for now, and we'll keep you updated on anything that we can as time goes on.

[Operator Instructions] Our next question will come from the line of Larry Solow with CJS Securities.

I guess just a little more color, Rob, just on PRP and PNS and [ I know it's unlikely ] you're ready to give us any numbers, but it sounds like that 2% of $12 million number, it sounds like you're headed in the right direction there. But maybe just a little color just on customer reception, just early on anecdotally, how things are going. And I guess, particularly on PRP, I guess it sounds like you're building some capital placements, which will drive more sales too in the back half of the year.

Yes. Thanks, Larry. Great question. So I'll start off with PRP. And look, we're really encouraged by what we saw in Q2, including velocity of new customers, accelerating capital placements which you mentioned there, both an acceleration and an increase in the size of our reorders, all of which further validated the market opportunity in front of us with our differentiated technology. And I'll also point out that we're really starting to leverage our established HA commercial team from PRP in a very synergistic way. And that not only makes this a good profitability driver for Bioventus, but I think it's also important to highlight that HA is helping us win PRP and PRP is now helping us win new HA business. So it's very exciting. And we're looking forward to turning this business into a strong growth driver for Bioventus in the back half of this year and beyond. I'll touch on PNS briefly, too, since you mentioned it. It's -- we're really excited about what we saw in PNS in Q2 as well. It included an expansion of our PNS team, an acceleration of new customers and new trials and a great conversion rate to new implants, and we're receiving really positive feedback from the market. And when it comes to PNS, look, it's roughly a $200 million market today, could reach $500 million over the next handful of years. And we're confident that our highly differentiated technology and our go-to-market strategy positions us very well to scale this business to over $100 million. As to the other part of your question, yes, as expected, still tracking towards the 200 basis points for this year. So again, really looking forward to the back half for both PRP and PNS and the years beyond.

Great. If I could just follow up a question for Mark. Sales growth, 5% you mentioned 5% in the first half and EBITDA actually grew 12%, which showed some margin expansion. Curious, I know when we started the year with the investments -- enhanced investments into the business, we thought EBITDA would be roughly flattish on a margin basis. Is that still your assumption? Because I think sales growth you mentioned was a little bit less than expected, but you saw some nice margin expansion there. Any thoughts on that as you look into the back half?

Yes. Thanks for the question. We feel really good about our -- the control we have with our P&L and the peer-leading gross margins that we have. Overall, our expectations, as we mentioned in our prepared remarks, are pretty consistent with what we've communicated for the full year around the 20%. 2Q EBITDA margin was 23%. So it's just a reflection of the powerful P&L that we have and the ability to control it. But with those really strong performance numbers, we are continuing to invest in our growth drivers. As we mentioned in the beginning of the year, we had highlighted a $13 million of investments actually going to be a little bit more than that as we go into the back half of the year. PNS will get the majority of those drivers because of how Rob just articulated the confidence that we have in that product and our ability to be successful there. So we'll continue to invest in the second half. There'll be more investments into the second half than there was in the first half and very confident about the team's ability to provide a return on investment for those.

Our next question will come from the line of Caitlin Roberts with Canaccord.

I think just starting with EXOGEN, maybe a little bit more color on the change in customer mix and any more color that you guys have on the CMS pricing reversal and how that fits into your expectations?

Sure, Caitlin. This is Rob. I'll provide you with some insights on that. First, yes, we saw volume grow in the quarter. We saw a shift for the quarter in the customer payer mix with fewer Medicare orders. And a -- so a little bit lighter quarter, but teams on top of it doing a nice job of growing volume and still see EXOGEN growing low to mid-single digits in the back half of the year, while, as you know, driving great profit and cash flow for the company. On the CMS part of your question, while it was -- when it was initially announced, we communicated that it was not a material change. So we're pleased to see the reversal, and we don't see that as a material change either.

Great. And then just on the PNS portfolio and potential data generation, are you thinking about data generation going forward? And have surgeons in the early days been focusing on that as a point for you guys to work on?

Yes. Thanks. And just to clarify, I think what you're referring to is the evidence generation. And yes, that's been a part of our plan, and we continue to pursue that just to further augment our differentiation in the space. What we're seeing initially in the market is a very strong reception to our technology given its differentiation. But it's natural for us to continue to develop evidence just to further augment that differentiation.

[Operator Instructions] And our next question will come from the line of Michael Petusky with Barrington Research.

I apologize in advance because I've missed part of this call, hopping 3 calls. BGS, did you guys walk away from some business in the quarter? And if so, did you quantify it?

Yes. I'll touch on it, Michael. We mentioned it a little bit earlier, but look, for BGS, constantly managing our business with operating discipline to drive that profitable growth. And to your question, that's why we highlighted that. We took some proactive actions in the channel during the second quarter that had a temporary impact on our business. So -- and I also pointed out earlier that while that was the case, we also saw a very positive traction with BGS, with new account acquisitions and early penetration with accounts that we recently won. And so those give us clear insight -- line of sight to acceleration in the back half. So sorry for there's a little bit of repeat there, but that's what took place in BGS in the second quarter, Michael.

Can I just try to press on that a little bit? You did quantify the impact of the shift in Ultrasonics. I mean, would you be willing to quantify how much business maybe you decided to jettison there in BGS?

Yes. I don't think we'll get into the details on it, Mike, but it was significant enough for us to call it out as, again, positive traction with our leading indicators, but that's why we made a point of mentioning that we took those actions in the quarter consciously and proactively. But I want to really emphasize that the focus there was just the driving of profitable growth, the same operating discipline that you've seen us take in other businesses like HA, where we mentioned that end of last year and this year as well, transparent about our efforts to constantly play the long game and make sure that we have that operating discipline to drive really healthy profitable growth. So that's why we highlighted it for the quarter.

Okay. And again, I apologize in advance if you covered this in the first 5, 7 minutes of the call, but I'm just curious, on the strategic review to the extent you can, I'm just curious, has the PNS asset and what you guys have sort of been able to do there in terms of the regulatory approvals in just very early days, has that been a significant factor, do you believe, in the current strategic review?

Yes. Thanks for the question. So we touched on it briefly before you were able to join and -- so I won't go over those details again. I think to your specific question, look, we have a really strong business overall. We've made a ton of progress, and we have enormous potential ahead. I'd say we -- overall, we have strength, we have momentum and we have potential. And it's natural that, that gets attention from others. PNS is a really exciting part of the portfolio. And of course, there's high valuation of the PNS space overall in the market. But we're also getting a lot of positive feedback from the market about our overall business. When you look at year-to-date, what Mark mentioned earlier, 5% growth overall just for this year, 12% EBITDA, 24% in EPS growth, debt paydown of $46 million, now lower than 2x leverage with line of sight to 1.5. And so again, just tremendous strength, momentum and potential. And of course, what we're building in PNS is a really exciting part of the overall company.

And that concludes the question-and-answer session. I'll hand the call back over to Rob Claypoole for any closing comments.

All right. Thanks, everyone, for your interest in Bioventus. Once again, we delivered solid results in the second quarter and are confident in our ability to deliver above-market revenue growth, increase earnings and accelerate cash flow to create significant shareholder value.

This concludes today's call. Thank you all for joining. You may now disconnect.