Globus Medical Q1 2023 Earnings Call Transcript

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May 4, 2023

Key Takeaways

  • Globus delivered record Q1 sales of $277 million (+21% constant currency), non-GAAP EPS of $0.53 (+25%) and free cash flow of $37 million (+51%) with 31% adjusted EBITDA.
  • U.S. Spine revenue rose 14% driven by expandables, biologics, MIS screws, 3D-printed implants and cervical offerings, supported by the Mars Cheelift retractor and ProneLateral positioning system integrated with ExcelsiusGPS.
  • Enabling Technologies sales jumped 91% to $25 million as the highest Q1 robot placements to date fueled growth in ExcelsiusGPS robotics and the newly introduced Excelsius 3D imaging system, positioned as a major growth driver for 2023.
  • International spinal implant revenue (ex-Japan) grew 30% constant currency and Japan sales rose 17% CC, while the trauma business expanded 53% year-over-year aided by the Autobahn EVO Femoral Nail System launch.
  • The proposed merger with NuVasive received over 99% shareholder approval but was delayed to Q3 2023 due to an FTC second request; it is expected to deliver over 20% non-GAAP EPS accretion and $170 million in cost synergies within three years.
AI Generated. May Contain Errors.
Earnings Conference Call
Globus Medical Q1 2023
00:00 / 00:00

There are 12 speakers on the call.

Operator

Welcome to Globus Medical's First Quarter 2023 Earnings Call. At this time, all participants are in listen only mode. After the speakers' presentation, there will be a Q and A session. You will then hear an automated message advising your hand is raised. Please be advised that today's conference is being recorded.

Operator

I would now like to hand the conference over to your speaker today, Brian Kearns, Senior Vice President of Business Development and Investor Relations. Please go ahead.

Speaker 1

Thank you, Antoine, and thank you everyone for being with us today. Joining today's call from Globus Medical will be Dan Scavilla, President and Chief Executive Officer and Keith Pfeil, Chief Financial Officer. This review is being made available via webcast Accessible through the Investor Relations section of the Globus Medical website at www.globusmedical.com. Before we begin, let me remind you that some of the statements made during this review are or may be considered forward looking statements. Our Form 10 ks for the 2022 fiscal year and our subsequent filings with the Securities and Exchange Commission identify certain factors That could cause our actual results to differ materially from those projected in any forward looking statements made today.

Speaker 1

Our SEC filings, including the 10 ks, are available on We do not undertake to update any forward looking statements as a result of new information or future events or developments. Our discussion today will also include certain financial measures that are not calculated in accordance with Generally Accepted Accounting Principles or GAAP. We believe these non GAAP financial measures provide additional information pertinent to our business performance. These non GAAP financial measures Should not be considered replacements for and should be read together with the most directly comparable GAAP financial measures. Reconciliations to the most directly With that, I will now turn the call over to Dan Scavilla, our President and CEO.

Speaker 2

Thanks, Brian, and good afternoon, everyone. Globus achieved strong results in Q1, delivering record sales of $277,000,000 A 21% increase in constant currency or $46,000,000 in growth versus Q1 2022. Non GAAP EPS $0.53 increasing 25 percent and free cash flow was $37,000,000 up 51% versus Q1 'twenty two. Adjusted EBITDA for the quarter was 31%. Keith will speak more about these items in his section.

Speaker 2

2023 is starting out to be a strong year for the Globus standalone business that should deliver record sales, Strong cash flows, mid-30s EBITDA and gains in EPS. Looking deeper into Q1 performance, U. S. Spine grew 14% in the quarter with notable gains across our product portfolio in expandables, biologics, MIS screws, 3 d printed implants and cervical offerings. This above market growth is driven by competitive rep recruiting from prior quarters, Robotic pull through and a normalization of post COVID procedures versus prior year.

Speaker 2

In Q1, we launched our Mars Cheelift Pedicle based retractor as part of our focus on procedural efficiency to offer specialized options to meet surgeon preferences. We also continue to make significant progress in launching our pronelateral patient positioning system. It is an interactive adjustable bed mount that enables a single position, single stage lateral surgical approach for direct and indirect decompression Designed to maximize operational efficiency, increase ease of implant placement and minimize surgeon fatigue. It integrates seamlessly with our ExcelsiusGPS and E3D solutions and also enables significant capabilities in non robotic procedures. When combined with our Excelsius platform and our range of expandable interbody offerings, we can provide unique and customizable lateral solutions for our surgeons.

Speaker 2

Enabling Technology sales were $25,000,000 up 91% on a constant currency basis versus prior year, driven by robotic and imaging system sales. This represents our highest Q1 robot sales to date. We continue to see increased interest in sales with significant international gains of Celsius GPS and EMEA in Asia Pac that will lead to future implant pull through and strong market share gains. As we enter Q2, we have one of the strongest robot pipelines since launching the system. Robotic procedures continue to accelerate, growing 51% versus prior year and exceeding 49,000 robotic procedures performed to date.

Speaker 2

We continue to make positive inroads with our Excelsius 3 d imaging system. Surgeons have said this is a game changer as they experience the benefits of integrated imaging. Excelsius 3d is a 3 in-one imaging platform offering 3 image modalities in a single cart with high maneuverability, a large field of view And seamless integration with our AxcelSys GPS robotic navigation system. It is a key component of the Globus ecosystem Designed and built from the ground up to communicate with ExcelsiusGPS in the operating room. Market interest remains high for the state of the art technology and customer orders continue to grow.

Speaker 2

Excelsius 3 d is positioned to be a major growth driver for 2023. Our international spinal implant business excluding Japan Delivered record sales in Q1 growing 30% on a constant currency basis compared to prior year. We delivered double digit growth in most markets We continue to see strong growth in key markets. Japan delivered 17% constant currency growth for Q1. We expect to see gains in Japan throughout the year as we focus on recapturing market share.

Speaker 2

Our trauma business delivered its 13th Consecutive quarter of sequential growth, delivering 53% growth for Q1 and 16% sequentially. Trauma performance is driven by sales force expansion and strong uptake in all product lines, delivering strong growth throughout our portfolio, including the Autobahn EVO Femoral Nail System launched last quarter that it continues to take and make inroads for market share gains. To update you on the merger status, Both Globus Medical and NuVasive Class A shareholders voted overwhelmingly in support of the merger with over 99% approving the transaction. This is a major milestone and the support of the combined shareholders moves us closer to realizing the deal. Earlier this week, we received notification from the Federal Trade Commission for a second request, and we are working with the FTC to address their open questions.

Speaker 2

The second request will impact the anticipated deal closure timing moving from mid-twenty 23 to Q3 2023. However, it does not alter our commitment to the deal or our belief that this combination will benefit the surgeons and patients in the markets where we compete. We are placing all resources required to quickly address the FTC questions and drive to a successful outcome. In closing, we remain focused on the core elements for long term sustained growth: 1, innovative new product introductions 2, Robot and Imaging Systems Sales 3, Competitive Rep Recruiting and 4, Merger Integration Planning. 2023 is all about focus and execution to deliver value to our customers and drive growth.

Speaker 2

I know we are well positioned to achieve our mission of becoming the I will now turn the call over to Keith.

Speaker 3

Thanks, Dan, and good afternoon, everyone.

Speaker 4

We are extremely pleased with our Q1 results and they demonstrate our growing position in the market. Strong sales growth was seen across our portfolio and geographies as we've continued to take share, while also not experiencing the procedural softness seen in last year's Q1. Our Q1 revenue was $276,700,000 growing 20% as reported and 21% on a constant currency basis. Net income was $49,100,000 resulting in fully diluted GAAP earnings per share of $0.48 Non GAAP net income was $53,800,000 delivering $0.53 of fully diluted non GAAP earnings per share, representing 25.1% growth over the prior year quarter. Turning our attention to sales.

Speaker 4

Q1 musculoskeletal revenue was 251 point $6,000,000 growing 15.7 percent as reported when compared to the prior year quarter. Growth was led primarily by our spine business driven by strong procedural volumes both in the U. S. And international, driven by continued share taking as well as softer comps when compared to the prior year quarter. 1st quarter 2023 Enabling Technologies revenue grew 90.8% as compared to the prior year quarter, driven by ongoing demand for our robotics and imaging system technologies.

Speaker 4

I specifically note that our robotic pipeline and its development Was strong coming out of Q4 and remain so heading into our Q1 of 2023 both in the U. S. As well as internationally. 1st quarter U. S.

Speaker 4

Revenue was $234,100,000 growing 19.2% as reported, led by our Spine and INR businesses as well as our Biologics and Trauma businesses as Dan mentioned earlier. International revenue was $42,600,000 Growing 24.7% as reported and 31.5% on a constant currency basis. Growth is again led by our international spinal implant businesses mainly in Australia, Brazil, Poland, the U. K, Spain and Germany. Our Gross profit in the Q1 of 2023 was 74.4%, essentially flat to the 74.3% in the prior year quarter.

Speaker 4

Increased product costs as a result of product and geographic mix were partially offset by lower inventory write offs related to scrap as well as improved manufacturing and supply chain efficiencies. Research and development expenses for the quarter were $21,100,000 or 7.6% of sales consistent with the prior year. The increased dollar spend remains consistent with our strategy of growth around procedural solutions As reflected in higher spend, mainly in our Spine and Enabling Technologies businesses, which will help sustain sales growth as we move ahead. SG and A expenses in the Q1 of 2023 were $122,400,000 or 44.2 percent of sales compared to $100,700,000 or 43.7 percent of sales in the prior year quarter. The increased spending is primarily reflective of higher personnel related expenses, primarily driven by sales compensation as well as higher meetings, travel and training expenses.

Speaker 4

Sales compensation increases are primarily the result of achieving growth targets, while travel is the result of the timing of our annual global sales meeting. The effective income tax rate for the quarter was 22.3%, up slightly to the 22.1% noted in the prior year and in line with expectations. Adjusted EBITDA was 30.8% in the quarter and is reflective of my earlier comments on gross profit and SG and A impacts and is largely in line with our Q1 2023 expectations. Non GAAP EPS in the Q1 of 2023 was $0.53 compared to $0.42 in the prior year quarter. The $0.11 growth includes $0.03 of non operating items, namely higher interest income and a lower share count, partially offset by higher depreciation expense.

Speaker 4

Free cash flow was $37,300,000 in Q1, dollars 12,600,000 higher versus the prior year quarter, driven by higher cash profits and lower CapEx, partially offset by working capital investments in inventory and accounts receivable. We ended the Q1 with $984,400,000 of cash, cash equivalents and marketable securities. The company remains debt free. Our standalone 2023 guidance remains unchanged at $1,100,000,000 in net sales and $2.30 in fully diluted non GAAP EPS. In closing, I want to reiterate a few brief comments in addition to Dan's earlier comments as it relates to the Globus NuVasive merger.

Speaker 4

Once regulatory approvals are obtained and the transaction closes, we expect to deliver 20 plus percent non GAAP EPS accretion by the completion of the 1st full year following deal closure. We expect near term sales dis synergies to be partially offset by revenue synergies around complementary product offerings of both companies. In addition, we expect to deliver on $170,000,000 of cost synergies, of which we expect to achieve 50% by the end of year 1 following deal closure, 75% by the end of year 2 and 100% by the end of the 3rd year. We remain confident in the strength of our Globus business and remain steadfast in driving organic growth, while seeking to close and integrate our merger with NuVasive. Post close, we will continue to seek both organic and inorganic growth opportunities As we continue to develop new and exciting technologies internally, we're also deploying cash for complementary M and A opportunities.

Speaker 4

We seek to achieve on our long term objectives and want to thank our Globus team members as we continue to improve the lives of patients with musculoskeletal disorders. Operator, we will now open the call for questions.

Operator

Thank you. At this time, we will conduct a Q and A session. And our first question comes from Mike Miksic from Barclays. Please go ahead.

Speaker 5

Hey, good evening. Thanks so much for taking the questions and congrats on a really strong quarter guys.

Speaker 2

Thanks. Thanks. So,

Speaker 5

and one question about, the sort of pending merger and one on the operations, if I could. So on the merger, just wondering if you have I know that you were spending a fair amount of time together to the extent that you're allowed at this stage. And I'm wondering if there's anything that you have learned or seen to either strengthen some of the areas of Synergy and opportunity that you saw before and you talked about before you went through 5 year or Anything that's sort of incremental in terms of your insights in those meetings and And then I have one follow-up.

Speaker 2

Thanks, Matt. This is Dan. I'll answer that. You're right. We continue to work together for planning and organization and learning with this.

Speaker 2

And I would tell you that throughout the value streams and the work streams that we've set up, It's really been more positive the more we work together. And I know there's a lot of talk about culture out there and I'll admit that there are differences in culture. What I've learned is it's over exaggerated. I think we are more similar than folks would realize when you get down to the core of it. How to move forward is very aligned.

Speaker 2

So, I'll be honest, the more I work, the more encouraged I am to see that. I think as I learn about their Strengths as we've talked about before, whether it be the surgeon experience or even marketing or how they do training, seeing how that could further Globus Going forward as well, to me, remains enticing to do.

Speaker 5

Great. And then just on the strength in the quarter, The lead was quite a bit stronger, stronger than we were expecting, quite a bit stronger than I think most folks were expecting. Could you talk a little bit about, I'm sure you're going to get this question and we might as well tackle it upfront, is the strength in the quarter and then the sort of Tempering aspects of holding back on a raise. So sources of the strength, if there were surprises to you and then why not take up Something here for the remainder of the year.

Speaker 4

This is Keith. I'll take that and Dan could add anything He wants at the end, but I think the Q1 was extremely strong. I talked a little bit about the robotic pipeline remaining strong coming into the quarter. That was definitely a benefit. But I As I look at the year and look at the quarter specifically, we had a very, very strong international quarter.

Speaker 4

In some of our international markets, We do have some distributors and there could be some stocking orders in there that may have kind of pushed that up a little bit. And quite honestly, when I step back and look at the year, we still feel extremely good about the business. We still think it's too early to give a raise to the full year. Lockett still happened in the year, but we're really happy with how the quarter landed.

Speaker 2

Yes. And Matt, I'll build on that. We don't plan on exiting the year as a standalone company. We're expecting to execute on this. And so any standalone guidance for the year, While directional for you isn't really meaningful as we get into the rest of the year.

Speaker 5

Sure. That's fair. Well, thanks so much. Thank you.

Operator

Thank you, Matt. One moment for our next question. Our next question comes from Shagun Singh from RBC. Please go ahead.

Speaker 6

Great. Thank you so much for taking the questions and congratulations on the shareholder support for the deal. So I understand The big focus right now is to get through the FTC process and they have made a second request. Does that come as a surprise to you? Are there any specific areas of products You know, that have been identified, you know, interbody cages, biologics.

Speaker 6

I know one of your filings mentioned neuro monitoring and enabling tech, where you guys Have leading positions. Just I'm just wondering if there's anything you can share on the FTC process and potential divestitures? And then I have a follow-up.

Speaker 2

Thanks, Shagun. This is Dan. I would tell you that as you know, second requests are not unusual. And I would say that Certainly no need for alarm with this. We remain committed to the deal.

Speaker 2

It doesn't do anything to change where we are, what we want to do with this, Shifts the timing a little bit. I can't go into the specifics of it. There's nothing out there that felt alarming in what was given to us. I will tell you that. And everything I had seen so far has been fairly general, nothing focused in specifically that I think right now we're Aware of or that I could share.

Speaker 2

So to me, I think it's an overall data search. We have to step up and give them what they need. We'll do that as fast as we can so that we can progress forward and realize the potential that's in front of us.

Speaker 6

Got it. And can you talk about the sales force morale as the deal has announced, but it's still pending closing? Is it driving any amount of uncertainty among your sales reps? What steps are you taking to ensure that competitors don't poach on your sales reps? And then also, maybe you can talk a little bit about the trends you're seeing in competitive rep recruitment versus recent quarters.

Speaker 6

Thank you for taking the questions.

Speaker 2

You got it. So I would tell you all of us are really looking forward to consummating this and moving forward. So any delay is certainly not a Welcome, Singh. But I would tell you that as I talk directly with the sales leaderships of both companies and down to the rep level, The excitement remains there and it's incumbent upon us to work through this and push it forward. Our field and the NuVasive field realize That bringing together our teams and looking at those technologies and combining them can really drive incredible benefits for surgeons and patients.

Speaker 2

They know that this is the place to be and they know that this pipeline is stronger than all others. So I think we just have to remind any of those who might be a little weary That this is the place to be and it's incumbent upon us to work through it and get it done that way. As far as recruiting goes, what we've mentioned in the past Is this deal, while it certainly is consuming a lot of our time as it ought to, it's creating a lot of competitive rep interest, folks who want to join this team and look at what the future is. And so it feels to be a bit more proactive competitive rep recruiting coming to us versus us going to

Operator

Thank you, Shigun. One moment for our next question. Our next question comes from David Saxon from Needham and Co. Please go ahead.

Speaker 7

Great. Hi, Dan and Keith. Thanks so much for taking the questions and congrats on a really strong quarter here. Yes. Maybe first on Enabling Tech.

Speaker 7

I mean, you called out good robotics demand trends. It sounds like those Remain strong. So I just wanted to kind of get your thoughts on where we are in terms of robotics penetration in spine, Kind of where does that shake out longer term and is that like a steady grind or is there something that kind of inflect that at some point?

Speaker 3

This is Keith. Thanks for

Speaker 4

the call. I would say that we're still in a trend with the robotic market that the capital is still being accepted in the market Growing. I think that we think about penetration in the market, I still think there's plenty of market for us to grow. I think adopters are still continuing to come on. That's still our belief that as time passes, robots will be part of the future from a surgical perspective for spine procedures.

Speaker 2

Yes. I would add to it too. I think it's more of a steady grind. It's about creating awareness and certainly people's willingness to test and therefore adopt. And so given the new technology that it is for everybody, it's just a matter of working through that versus a large explosion that may occur instantly.

Speaker 7

Okay. Got it. And then maybe on international, specifically on Japan, I mean, they grew or that team grew, Which I mean, I can't remember the last time Japan was in the green. So how is that going? Is the team fully right sized there?

Speaker 7

Is there still wood to chop? And then I think you called out some stocking orders through international distributors. Any way to quantify the benefit you saw there? And thanks so much.

Speaker 2

Thanks. So I'll start it and then Keith can kind of finish it up. So we've been investing, 1st off, in international outside of Japan, giving them the tools to penetrate. And it's great to see the traction there. And I think that team is motivated and driven with every country I speak And I think that team is motivated and driven with every country I speak to, feeling really good about their mindset and the potential that's there.

Speaker 2

Japan, as you know, we've done some rightsizing reorganization, some adjusting of vendors and things like that or customers, excuse me. And I feel as we've been calling out that that would be bottoming out. We've seen that occur really starting in the Q4. And with the team that's in place now regaining traction, when you say more wood to chop, I don't think we're looking to down Size that team, I think we have to enhance its size and we continue to recruit and look as a method to penetrate and grow even more.

Speaker 4

And as it relates to stocking orders, my earlier comment, when I look at internationally, places where we see some stocking orders would be Spain and Brazil. From the standpoint of the growth rate, it definitely would have slowed the growth rate down a little bit, but I would not say materially. We came out of the quarter finished very strong. And as we look ahead, we feel confident that we're going to grow high teens As we look at it internationally the rest of the year.

Speaker 7

Great. Thanks and congrats again on the quarter.

Speaker 2

Thank you.

Operator

Our next question comes from Sam Darno from BTIG. Please go ahead.

Speaker 8

Actually, I think this is Ryan on for sorry, we got our lines crossed. So Couple of things there for me. Couple of questions. So number 1, you guys had a great quarter. Competitively, Where do you think you're taking share from?

Speaker 8

And is there any concern that you're taking from the asset that you may be buying? And just How can you reassure investors that you're not kind of just spinning your wheels, I guess, from a share perspective there?

Speaker 2

Hey, Ryan, it's Dan. It's a great question, and that would certainly be ironic. So I would tell you that while we don't Share that level of detail, especially right now through the planning phase. I would say that our share gains really come again in a market appropriate way. So you look at How you tick down with the big guys being in Medtronic, J and J, Stryker.

Speaker 2

I still feel like that's where most of that will come from. Certainly, To the best of my knowledge, we've never been strong at taking share from NuVasive. We've always tended to kind of go after the market and run-in parallel versus Really heavily compete against each other. Happens occasionally, but I would say it's more rarely than a fact.

Speaker 8

Okay. And then Keith, SG and A was a bit higher than we expected this quarter. And just want to understand kind of where your why 1, why is it up so much and kind of how you think about it for the balance of the year?

Speaker 4

Yes. So SG and A definitely was up a little bit more than we expected in the quarter as well. I commented on sales training being higher as well as some travel. We had our global sales meeting Q1 this year. Last year, we had it later in the year because of COVID.

Speaker 4

So there is a little bit of a timing flip year over year. And then just generally speaking, we're out there Down to the street from a meetings perspective, but most importantly sales comp was up really driven by achieving quotas So as the growth of the sales force from competitive recruiting in the past. As we look ahead, This should balance out a bit, but on a full year basis, I would say that it feels a little bit it feels like it will be a little bit higher, but it doesn't change the fact that we still think we're a mid-30s EBITDA

Speaker 8

Okay. I'll hop back in queue. Thanks, guys. Good

Speaker 4

quarter. Thanks.

Operator

Thank you, Ryan. Our next question comes from Richard Newitter From Trust Securities, please go ahead. Hi.

Speaker 9

This is Sam on for Rich. Thanks for taking our question. The first one I'll ask On robotics, did you see any greater mix of competitive accounts in this quarter than you've seen with placements in the past?

Speaker 2

Yes. We have. We've seen that we're making inroads beyond just the Global Trendlies. And I think that's a trend we've seen for a while, but

Speaker 9

Great. Thanks. And then just can you parse out at all imaging versus robotics, sort of How we should think about the mix of that through this year that would be great. Thanks.

Speaker 4

No. Thanks Sam. But no, we're not parsing out imaging versus robotics. We look at our enabling tech. We're going to continue to bring a suite of products to the market, and it's another SKU within that portfolio.

Speaker 9

Got it. Thank you.

Operator

Thank you. One moment for our next question. Our next question comes from Kyle Rose from Canaccord. Please go ahead.

Speaker 3

Great. Thank you for taking the questions. Just wondering if you could talk a little bit more about the trauma business.

Speaker 10

I mean, it seems like it's

Speaker 3

kind of hitting a bit of an inflection point here. I mean, you clearly have the manufacturing scale to be able to probably flex inventory a little bit higher there. So just wondering what realistically we should expect to see some sort of I can stick or a larger step up from a growth perspective, if that's Building out additional territories and things of that sort. Is there any expectation to kind of push the gas pedal down, so to speak here?

Speaker 2

Thanks, Kyle. It's Dan. I was kind of thinking 50 some percent was putting my foot down on the gas, but I kind of get it. We can certainly go deeper. What I would tell you it's a factor of right now is the recruiting and the continuation of adding sets.

Speaker 2

I think we've got a bag Very capable of level 1, level 2 trauma centers and going through and I think we're seeing that growth come from there. I would tell you, I'm not overly concerned. We are investing in it. There's nothing related to the pending Nuva acquisition or merger that would actually

Speaker 3

Great. Yes, it's our job to ask what's next. So on the competitive rep hiring, I guess just maybe From a high level, I mean, how have those discussions changed with the non Nuva, non GMED type of reps now that you're Out in the public, you're talking about this future marriage. Just is there any difference in the type of reps that might be interested in a broader combined portfolio?

Speaker 2

Yes, it's a great question. I would say that the conversation is Slightly different, but you still have obviously a mix of folks. I wouldn't say I'm able to categorize them as a particular type. I do know that as People, including Wall Street, really understand the potential of this deal and what this company can do long term. You're really looking at, individuals who want to grow And who want to make a difference.

Speaker 2

And that's really who's coming to the door and saying how do I become part of this. They know we're going to invest in these portfolios, but we're going to drive this forward And we're going to continue to invest and expand. And so those folks interested in being part of that story and actually realizing that are the ones from all different levels coming to us and

Operator

Thank you. Our next question comes from Matt Taylor from Jefferies. Please go ahead.

Speaker 11

Hi, Dan and Keith. This is Mike on for Matt tonight. Thanks for taking my questions.

Speaker 3

Hi, Mike. Just first,

Speaker 11

You talked about a robust robot pipeline entering 2Q. So it doesn't seem like you're seeing any capital spend hesitancy among customers. But just can you talk about how you're thinking about potential macro headwinds and the potential impact on customer capital spending?

Speaker 2

I'd say the this is Keith.

Speaker 4

I'll take this and Dan you can fill in. But the market is definitely dynamic. Last year, we were talking about a robotic pipeline that didn't mature in the U. S. And coming into Q4 and into Q1, It was anything but that.

Speaker 4

We had a really strong pipeline, lots of demand, lots of really opportunity chasing for the sales team. As we look towards the rest of the year, I still think we have to continue to sell the technology. I mentioned earlier that we're We're at a place where more and more robots are being adopted. And I think as time passes and you call it an inflection point, you see that The other facilities want to get on it and adopt the robotic technology. I think we have to continue to sell those benefits And as we walk into the macroeconomic headwinds, and I think and as we do that, we again have multiple ways to The majority of our sales are outright purchases, but there's other ways that we can sell robots and meet competition with volume based arrangements and things of that nature.

Speaker 4

So I think that we're ready to respond to the market depending on what happens macroeconomically.

Speaker 2

And I'll just build on that, Mike. Certainly, the last 3 years have been more than a training ground for difficult times, whether you get into COVID or post COVID without Staffing or nurses on and on. So again, I think like anything, putting this technology into the hands of surgeons to make a difference will remain top priority. And as Keith said, multiple approaches that work with the customer in a way to get that out there, something we'll keep in mind, especially if we're About to walk into a recession, we have to be mindful of what that can do, but not deny technology to people who can really change lives.

Speaker 11

Got it. That's helpful. And then just the follow-up there, you mentioned U. S. Kind of coming out of 2022.

Speaker 11

You talk about any differences that you see U. S. Versus full U. S. Just in terms of robotic demand and customer purchasing behavior and how you're thinking about that Projectory through 2023?

Speaker 2

Yes. I'd say it really just depends market by market, right? Again, you're still nascent in the U. S. It's a lot of ways to penetrate and grow.

Speaker 2

Again, depending on where you are through the world, there's different uptakes that we're starting to see. I wouldn't necessarily say there's an over focus of where to go or how to do it differently. Right now, it's just about an education and awareness hands on training And they're working with folks to get the technology into their OR. Okay. Thank you.

Speaker 2

Thank you.

Operator

Thank you. One moment for our next question. Our next question comes from Vik Chopra from Wells Fargo. Please go ahead.

Speaker 10

Hey, good afternoon and thanks for taking the questions. I'll echo my congratulations as well. So 2 for me. First one, can you provide an update on the Recon Robotics programming what the latest time lines are?

Speaker 2

Hey, Vic, it's Dan. Yes, I'll be glad to do that. We're still progressing Through, we have not yet filed. We're in testing for a lot of things when it comes into electronic equipment. We're working through those now.

Speaker 2

Actually just had a meeting today about how you scale up and get ready for the launch. So I don't have a date to give you just yet because we need to get through the testing in order to do the filing to get this Not seeing anything that is a concern, just a matter of working through it. Certainly a goal, if all went well, would we the

Speaker 10

And then just one more follow-up. I mean, obviously, very strong Trends in your robotics business, one of the larger orthopedic competitors has talked about coming out with a spine robot in 2024. And I'm just To your ability to continue to sell Excelsius systems? Thanks.

Speaker 2

Yes. Thanks. I would say we're not really. As you remember, when we Came out with this. We always knew that we were one of the first and that the market would continue to have entrance and get eventually more crowded.

Speaker 2

So there's nothing of concern or shock. We are not talking to customers who are thinking about what could happen in 24 months. Right now, they're understanding what the technology is. They recognize ours as The best. And so we'll continue to go ahead and push with that and continue to look and add options and offerings to our platform that's going to even create more value for our

Operator

With no further questions, this concludes the Globus Medical First Quarter Earnings Call. Thank you for joining us today and have a nice evening. We will now disconnect.

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