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Myomo, Inc. (MYO)

Q1 2021 Earnings Call· Wed, May 12, 2021

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Transcript

Operator

Operator

Ladies and gentlemen, welcome to the MedAvail's 2021 First Quarter Earnings Conference Call. My name is Bethany, and I'll be coordinating your call for you today. [Operator Instructions] I will now hand over to your host, Caroline Paul of Investor Relations to begin. Caroline, over to you when you're ready.

Caroline Paul

Analyst

Thank you. And thank you all for participating in today's call. Joining me are Ed Kilroy, Chief Executive Officer; and Ryan Ferguson, Chief Financial Officer. Earlier today, MedAvail Holdings released financial results for the first quarter ended March 31, 2021. A copy of the press release is available on the company's website. Before we begin, I'd like to remind you that management will make statements during this call that include forward-looking statements within the meaning of federal securities laws, which are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Any statements contained in this call that relate to expectations or predictions of future events, results or performance or similar statements are forward-looking statements. All forward-looking statements, including, without limitation, those relating to our operating trends and future financial performance, the impact of COVID-19 on our business and prospects for recovery, expense management, expectations for hiring, growth in our organization and reimbursement, market opportunity and expansion and guidance for revenue, gross margin and operating expenses in 2021 are based upon our current estimates and various assumptions. Also, management may make additional forward-looking statements in response to your questions. These statements involve material risks and uncertainties that could cause actual results or events to materially differ from those anticipated or implied by these forward-looking statements and do not guarantee future performance. Accordingly, you should not place undue reliance on these statements and should not rely on them in making an investment decision without considering the risks associated with such statements. For a list and description of the risks and uncertainties associated with our business, please refer to the Risk Factors section in our current report on Form 10-K filed with the Securities and Exchange Commission, SEC, on March 31, 2021. This conference call contains time-sensitive information and is accurate only as of the live broadcast today, May 12, 2021. MedAvail Holdings disclaims any intention or obligation, except as required by law, to update or revise any financial projections or forward-looking statements, whether because of new information, future events or otherwise. And with that, I will turn the call over to Ed.

Edwin Kilroy

Analyst

Thank you, Caroline, and good afternoon, everyone, and thank you for joining us. We have started 2021 with a solid first quarter of 30% sequential revenue growth from fourth quarter 2020. As a reminder, our business model has 2 business segments, the operation of our technology-enabled high-touch retail pharmacy using our proprietary technology and processes, known as our Retail Pharmacy Services segment; and the sale or provision of these technologies to large customers to support their own pharmacy operation known as our Pharmacy Technology segment. During the first quarter, we again had meaningful contribution from both our Retail Pharmacy Services and Pharmacy Technology segments, and as we discussed in our last call, remain on track to open operations in Florida in July. Our double-digit sequential revenue growth was driven by the continued strong demand for pharmacy solutions that improve medication adherence and patient satisfaction as well as growth in our Pharmacy Technology business. As we have discussed on previous calls, our value proposition is fueled by our embedded onsite pharmacy model in which we are viewed as a true partner to clinics and care providers. Our onsite model consists of our propriety robotic dispensing platform called the MedCenter, a full-time clinic account manager or CAM for short, all backed by tech-enabled telepharmacy platform, including a central pharmacy. Let me give you a real-life example of the value of our onsite service in action. In one of our clinics, our onsite clinic account manager was reviewing the day's list of patients prior to the clinic opening. Many of these patients were customers of our pharmacy. So our clinic account manager through the tailored CRM platform we have deployed to them in clinic, was able to review the pharmacy's status and history of the patients. They identified that a patient had not…

Ryan Ferguson

Analyst

Thank you, Ed. Turning to our Q1 results, net revenue for the 3 months ended March 31, 2021, was $4.0 million, a 185% increase from $1.4 million in the same period of the prior year. These results were driven by a 164% increase in Retail Pharmacy Services sales and a 430% increase in our Pharmacy Technology sales. As Ed mentioned, during the first quarter, we deployed one MedCenter into the Retail Pharmacy Services segment compared to 5 in the first quarter of 2020. Gross margin for the first quarter of 2021 was 8% as compared to negative 1% in the corresponding prior year period. Improvement in gross margin was driven by improved purchasing and lower DIR fees, partially offset by higher utilization of our delivery service and continued reimbursement volatility. Total operating expenses for the first quarter of 2021 were $10.0 million, an 81% increase from $5.5 million in the first quarter of 2020. This expected increase in operating expenses was driven primarily by investments in personnel, facilities and other expenses necessary for continued build-out of our operating footprint, including the launch of operations in Florida. Additionally, we made accelerated investments to automate additional workflows important to our customer service capabilities, including the investment in compliance packaging, as discussed by Ed earlier on this call. Adjusted EBITDA, which we calculate by adding back depreciation and amortization, stock-based compensation and exclude nonrecurring expenses and other income to net loss was negative $8.9 million in the first quarter of 2021 compared to negative $5.2 million in the first quarter of 2020, reflecting the various initiatives and investments in growth that you have heard us talk about. We ended the first quarter of 2021 with $47.6 million of cash and cash equivalents. We now have approximately 31.9 million shares of common stock outstanding,…

Edwin Kilroy

Analyst

Thank you, Ryan. In summary, we are pleased with our first quarter performance. This was a strong quarter financially and operationally. Our team has continued to perform very well. And as we grow, we are bringing in some excellent new people who are adding important depth and additional skills and experience to the organization. It is an exciting time for us, and we remain extremely enthusiastic about our company's future and our growth prospects. We are committed to continue to deliver growth and make the necessary investments to maximize long-term value for all stakeholders. With that, we will now open it up to questions. Operator?

Operator

Operator

[Operator Instructions] The first question comes from Charles Rhyee from Cowen.

Charles Rhyee

Analyst

Congratulations, guys, on the announcements today. Just wanted to ask really 2 questions. First on the guidance here, Ed, you kind of said in terms of total deployments, you expect it to be the same as originally intended, but it's a matter of timing here. But the quarter itself outperformed relative to what we were expecting here. Maybe you can touch on sort of what you think where we are in terms of getting back to more normalized levels as we kind of exit the pandemic here, maybe some sort of the trends that you're seeing given there was commentary the other week from some companies reporting that -- talking about pockets of weakness in terms of certain types of utilization. Just curious if you're seeing any of that or is that just kind of a different market segment compared to the Medicare population? And so I'm just trying to put 2 and 2 together between sort of the guidance and sort of what per-unit per-deployment kind of revenue is.

Edwin Kilroy

Analyst

Sure. Thanks, Charles. A couple of comments. So first of all, as we've talked about before, with the challenges that our clinics have had with regards to COVID, they've done a number of things. One is they've altered some of the workflow within the clinic itself and the number of face-to-face visits. And secondly, as you can imagine with the Medicare population, there's a level of -- at the time nervousness about going into clinic. What we have seen over the past number of weeks and a little -- I'm going to say months but more weeks is -- the volume in the clinic's face-to-face visits is climbing, although it's ramping back up to where we would have expected it to be, and that will take a little bit of time, but it's climbing. And then the second thing is that, as we mentioned, that a number of our clinic partners have now stepped forward and want to begin the planning process to deploy new sites, both our current customers with additional sites and some new customers with new sites. So that's encouraging as well. But again, it's -- I'm going to say, on a ramp back up, it's not a switch that's being just flipped on.

Charles Rhyee

Analyst

Okay. Great, and then just another question on Cano and Access Healthcare here. What is the timing? Because I think when you talk about 45 deployments, if I remember correctly, that was not -- that didn't really include these Florida clients, did it? And if so like you're announcing it today and the central pharmacy starts in July. Are there deployments from these 2 new accounts going to be in the back half of this year? Or should we think of it more as a 2022 start, really?

Edwin Kilroy

Analyst

Well, when -- so when we think about -- with regards to who is in or out, we had a view of we'd be entering Florida this year. And we had an assumption in the 45 of how many sites we thought we could do in Florida. We haven't obviously disclosed down to that level. But you can assume that in our 45, we had an assumption that a handful of sites would be going into Florida. With regards to the deployment of the 2 announcements we made today. I would say that I'm going to use our Michigan site as an example. We opened the pharmacy in the middle of December, and we deployed the first clinics really went live towards the end of January. That's the approximate timing we attempt to have with some of the clinics we've signed. So you can expect us to begin to deploy some of these new clinics approximately that time frame after we open our central pharmacy in July.

Charles Rhyee

Analyst

Okay, and then just a last question. You talked about how some of your existing clients are now talking to you about expanding, adding potentially new sites. Any of those within the 45 that we're talking about for this year? Or is it really -- these will all be additive to next year?

Edwin Kilroy

Analyst

They would be in the 45 for this year. So we do have clients who have now come back and said, okay, we want to start planning for additional new sites in their network, which is really our model of entering an enterprise customer, deploying, being successful and then expanding throughout their network. That's really, as you know, our model, and we're seeing that resurgence as well. But it's in our expectation of the 45 for this year.

Operator

Operator

The next question comes from Brooks O'Neil of Lake Street Capital.

Brooks O'Neil

Analyst

I was hoping -- and maybe I missed it, but can you just talk a little bit about what you're seeing in the 7 key target markets that you've been in? Is it more or less the same? Are the customers in those markets, are they experiencing the same kind of impact from COVID and response to COVID that you were talking about to an extent in the Florida market?

Edwin Kilroy

Analyst

So Brooks, I would say the answer is yes, that as we look across our fleet of installs in the 4 states we're active in right now most of our clients had changed workflows or clinic processes during COVID, but have begun to ramp out of it. So what I mean by that is beginning to see more patients face-to-face, because that really is a big part of their business model. So we're seeing -- starting to see more activity in the clinic, which is encouraging for us. So I think things are returning. But as I was saying to Charles, it really is a ramp back up again. It's not a switch going off. So we'll expect that to continue to improve in the third and fourth quarters.

Brooks O'Neil

Analyst

All right. All that makes total sense. And then you mentioned, I think one of the things that you're seeing, which is totally understandable, is more utilization of your drive-to-home service versus in-clinic. And I was curious if you have data or you're seeing any difference in terms of adherence, which I think is one of the key elements of the benefit of the MedCenter deployments and whatnot.

Edwin Kilroy

Analyst

So with regards to adherence, we continue to operate at above a 5-star rating for adherence, so extremely high. It's one of the major reason why our clients want to do business with us. Whether we're doing home delivery or in-clinic dispensing, we're still delivering the same level of compliance. What I would say is that a number of our clinic partners, as we talk to them, we are putting some initiatives in place to align our dispensing with the patient's visit. So get more of the patients coming in the clinic, walking out the door with their refills in hand, not just first fills. And so that's important because there's been a number of different studies over time that have been done that pointed to filling your prescription at your point-of-care can have a positive impact on adherence. And so that really is again, one of the reasons why people like our models because we can service the patient with both home delivery and in-clinic dispensing.

Brooks O'Neil

Analyst

Sure. All that makes sense. Let me just ask one more. I'm excited about the compliance packaging opportunity. I see that as a big opportunity. I'm just curious if you feel like you can deploy that in the dispensing machines in the same way you do with medications today, or will it require some change in the way you handle dispensing those packs?

Edwin Kilroy

Analyst

No. In fact, we -- the way it's packaged because they're packaged and then usually put in a box that's sent to the customer. Those boxes we can easily dispense in our MedCenter. Now as you would know, since its compliance packaging, it's specific to an individual, but that's a really good example of patients coming into the clinic for a visit. We ensure their medication that is compliance packaged is in the MedCenter ready for them, and they can pick it up when they leave the appointment. So absolutely, we can handle it, and we absolutely will be doing that as we go forward.

Operator

Operator

We have no further questions registered. So I'll hand the call back to Ed to conclude.

Edwin Kilroy

Analyst

Thank you very much, operator. And I'd just like to thank everyone for joining us today, and I wish everyone a great evening, and we'll talk to you at our next earnings call. Have a good evening. Thank you.

Operator

Operator

Ladies and gentlemen, this concludes today's conference call. Thank you for joining. You may now disconnect your lines.