AxoGen Q1 2023 Earnings Call Transcript

Quartr
Provided by Quartr
May 9, 2023

There are 9 speakers on the call.

Operator

Good day, ladies and gentlemen, and welcome to the AxoGen Incorporated Reports First Quarter 2023 Financial Results. All lines have been placed on a listen only mode and the floor will be open for questions and comments following the presentation. At this time, it is my pleasure to turn the floor over to your host, Ed Joyce, Director of Investor Relations. Sir, the floor is yours.

Speaker 1

Thank you, Kat, and good morning, everyone. Joining me on today's call is Karen Zaderej, Axosin's Chairman, Chief Executive Officer and President and Pete Mariani, Executive Vice President and Chief Financial Officer. Karen will discuss the quarter and our outlook for the year, and Pete will provide an analysis on our financial performance, followed by a question and answer session. Today's call is being broadcast live via webcast, which is available on the Investors section of the AxoGen website. Following the end of the live call, a replay will be available in the Investors section of the company's website at www.axogeninc.com.

Speaker 1

Before we get started, I'd like to remind you that during this conference call, the company will make projections and forward looking statements, including our 2023 financial outlook, timing of our BLA submission, penetration of core accounts, marketing opportunities with nerve repair applications associated with breast, OMF and the surgical treatment of pain and new products timing of our APC renovations and balance sheet positions. Forward looking statements are based on current beliefs and assumptions and are not guarantees of future performance are subject to risks and uncertainties, including, without limitation, the risks and uncertainties reflected in the company's annual and payer audit reports, such as hospital staffing issues, regulatory process and approvals, APC renovation timing and expense, surgeon and product adoption and market awareness of our products. The forward looking statements are representative only as of the date they are made and except as required by applicable law, we assume no responsibility publicly update or revise any forward looking statements. In addition, for a reconciliation of the non GAAP measures, including adjusted core and active account numbers, excluding the impact of Avaya purchases, please reference today's press release and our corporate presentation on the Investor section of the company's website.

Speaker 1

And with that, I'd like to turn the call over to Karen.

Speaker 2

Karen? Thank you, Ed, and thanks to everyone for joining us this morning on the call. We're delighted to announce the 1st quarter revenue of $36,700,000 representing an 18% increase from the Q1 of previous year. This marks the 3rd consecutive quarter of solid commercial execution and revenue growth, continuing on the momentum we established in the second half of last year. We believe the steady progress is due to our ability to execute in an improved environment hospital staffing and surgical capacity.

Speaker 2

We had a solid start to the year in terms of our focus in gaining deeper adoption in our core and active accounts. As a reminder, active accounts are those that have ordered at least 6 times in the last 12 months and may still be in the early stages of adoption. Core accounts represent more penetrated accounts, defined as those with greater than $100,000 in revenue in the trailing 12 months. Core accounts have increased to 350 this quarter, an increase of 23% year over year and 5% sequentially. Approximately 60% of our revenue is derived from core accounts, which usually consists of at least one surgeon who's adopted the AxoGen nerve of these early surgeon adopters with our products to gain more cases within that account and to encourage additional surgeons to adopt our products.

Speaker 2

We believe that our greatest opportunity for growth lies with deepening our penetration in our core accounts for the treatment of traumatic injuries and additional planned nerve repair applications, including breast, OMF and the surgical treatment of pain. The number of our active accounts increased to 9.94 in the quarter, representing growth of 9% year over year and 3% sequentially. Active accounts represent about 85% of our total revenue, with the top 10% contributing about 35% of revenue. We ended the Q1 with 116 direct sales representatives, up 1% from the end of the 4th quarter and in line with 116 a year ago. We believe our revenue growth can be driven primarily by increased productivity of our sales force, and we will evaluate and add additional sales reps as their territories approach targeted levels.

Speaker 2

Our direct sales force is supplemented by independent sales agencies that represent approximately 10% of our total revenue. Product and procedure innovation is a key strategic pillar for our long term growth, and we look to provide leading innovative treatments for patients with peripheral nerve injuries. Last quarter, we announced an expansion of our resensation technique for breast reconstruction neurotization to include a new technique that can be applied for some patients who choose an implant based reconstruction. As a reminder, Our original resensation program was developed to provide sensation for patients receiving an autologous flap reconstruction, which represents roughly 20% of breast of reconstruction procedures. The remaining 80% of breast reconstruction procedures are implant based.

Speaker 2

We believe that this new neurotization technique developed in collaboration with pioneering breast reconstruction surgeons, can currently be applied to an incremental 10% to 15% of breast reconstruction patients. We've seen strong surgeon interest in learning this technique and are well on our way towards our goal of training at least 20 surgical teams this year. Today, we're also pleased to announce new innovation in our nerve protection portfolio. The category covers a wide range of nerve injuries, including compression, crush and complex traumatic injuries where the nerve remains intact. We also it also involves protecting the coaptation sites with nerve transfections.

Speaker 2

We believe that the diversity of these entry types and their anatomical locations presents some unique challenges. Optimizing outcomes for these patients requires targeted solutions to adequately address and specific aspects of the injury and the healing process. Guided by feedback from surgeon experts, we've identified certain unmet needs in nerve and are developing new technologies to address them. The first of these advances is AxoGuard plus nerve protector. We're happy to announce that we received 510 clearance in April of this year.

Speaker 2

AxoGuard Plus builds upon the success of our existing AxoGuard protector and adds new proprietary design features. This new protector features a hyaluronate alginate gel on an ECM based material. In the short term healing process, the gel layer enhances nerve gliding and aids in minimizing soft tissue attachment. The base material is remodeled to form a new long term protective tissue layer. In addition to these benefits, the configuration and handling characteristics of with regard to HA plus were optimized based on surgeon feedback to address challenging nerve protection applications such as cubital tunnel revisions and nerve trauma near major joints where nerve mobility is critical.

Speaker 2

We believe this addition to the AxoGuard portfolio improves our access to this nerve protection category. Additionally, we continue to see the need and strong surgeon interest for our resorbable nerve product that provides temporary protection and tissue separation during the critical phase of healing for non transected nerve injuries. This application was previously addressed by Avaya soft tissue membrane. We're currently developing a replacement solution to address this important market opportunity and expect that will that this will further strengthen our position in nerve protection. We look forward to updating you on this new innovation in the coming quarters.

Speaker 2

Turning to our new production facility. I'm happy to report that we're on track with our transition plans to the APC in Dayton, Ohio this summer. This state of the art facility will provide capacity to meet our expected sales growth and support the BLA for AVANCE Nerve Graft. This new facility will be included in our submission of the BLA for Avance, which is also proceeding on schedule, and we expect to submit it by the end of 2023. Following that, we anticipate receiving approval in 2024.

Speaker 2

A BLA approval will complete the regulatory transition of Avance Neurograph from a 361 based product to a 351 biological product. And importantly, we believe Avance would be designated as the reference product, which would in turn provide 12 years of data exclusivity with regard to potential biosimilars. We continue to build market awareness of nerve repair with health care providers and through our direct to patient initiatives, particularly for breast and pain applications. Our marketing initiatives are designed to engage patients and direct them to our Resensation and rethink pain websites. These websites are aimed at educating patients and raising awareness about the potential benefits of nerve repair procedures.

Speaker 2

In addition, patient resources are available for locating surgeons skilled in these advanced techniques, particularly for those undergoing mastectomy and for individuals suffering from chronic neuropathic pain. Our surgeon education programs on nerve repair remain a top priority for AxoGen and continue to generate interest in the surgical community. Our education initiatives encompass a wide range of learning events, including hands on best practices training, educational conferences and presentations aimed at surgical residents. At the end of Q1, we surpassed our goal of training at least 75% of this year's class of hand and microsurgery fellows. Moving on to updates in our growing body of clinical evidence.

Speaker 2

We remain devoted to developing clinical quality clinical evidence to demonstrate safety, performance and utility of our nerve repair solutions. At the end of the quarter, we've reached a total of 220 peer reviewed publications across extremity trauma, breast, OMF and pain. Our focus on providing high quality data to support the benefits of Allograft's overall alternative peripheral nerve repair technique remains a top priority. As we've discussed in the previous quarter, a recently published comparative effectiveness meta analysis has been generating significant interest from our customers. To summarize, this paper analyzed 35 peer reviewed studies and compared the meaningful recovery rates between Allograft, autograft and conduits.

Speaker 2

The authors found that AlloGraft had comparable efficacy to autograft in both sensory and motor nerve types for both short and long gaps up to 70 millimeters without the well documented morbidities associated with harvesting an autograft nerve. Additionally, the study compared Medicare procedure costs and found that allograft and autograft operative costs were comparable in both the outpatient and inpatient setting. In the early part of second quarter, we were delighted to see the publication of an additional peer reviewed paper comparing all payer facility procedure costs for both allograft and autograft repairs. This comprehensive retrospective study included over 1300 nerve repairs from the PREMIER database between 2018 2020. The author's findings were consistent with the conclusions of the meta analysis, where they noted that there were no significant difference in procedure costs when comparing autograft and allograft repair in either the outpatient or inpatient setting.

Speaker 2

Additionally, and importantly for resource constrained hospitals, the authors concluded that OR time was significantly shorter for allograft repairs in both out and inpatient settings. Turning now to our outlook. In today's press release, we reiterated our full year guidance with 2023 revenue in the range of $154,000,000 to $159,000,000 we're pleased with the start of the year and look forward to continuing to execute on our plan. We continue to expect that gross Now I'll turn the call over to Pete for a review of financial highlights. Pete?

Speaker 3

Thank you, Karen. Revenue this quarter was $36,700,000 an 18% increase over the Q1 of 2022. Growth was driven by increases in unit volume of 10% as well as 4% increases in both price and changes in product mix. Gross profit for the quarter was $30,000,000 as compared to $25,500,000 for the Q1 of 2022. Gross margin was 81.7 percent for the Q1 compared to 82.1% in last year's Q1.

Speaker 3

Total operating expenses in the Q1 increased 1% to $37,300,000 compared to $36,800,000 in the prior year. The increase in total operating expenses was primarily the result of increased compensation costs. Sales and marketing expense in the Q1 increased 3% to $21,600,000 compared to $20,900,000 in the prior year. The increase was primarily due to other service costs. As a percentage of total revenue, sales and marketing expense was 59% compared to 67% in the Q1 of 2022.

Speaker 3

Research and development expense increased 6% to $6,700,000 compared to $6,300,000 in the prior year. Product development expenses represented approximately 56% of total R and D in both and innovation across our product portfolio. Clinical expenses represented approximately 44% of total R and D in both the current and prior year and includes spending in support of our various clinical programs. As a percent of total revenue, Research and development expense was 18% in Q1 compared to 20% in the prior year. General and administrative expense decreased 6 percent to $9,000,000 in the Q1 as compared to $9,600,000 in the prior year.

Speaker 3

The decrease was primarily due to lower professional services and bad debt expenses and partially offset by an increase in net compensation. G and A as a percent of revenue was 25% in the quarter compared to 31% in the prior year. Net loss for the quarter was $7,100,000 or $0.17 per share compared to net loss of $11,500,000 or 0.2 $0.07 per share in the Q1 of 'twenty two. Adjusted net loss was $4,100,000 Or approximately $0.10 per share in the Q1 compared to a loss of $8,500,000 or $0.20 per share last year. Adjusted EBITDA loss in the quarter was $3,800,000 compared to an adjusted EBITDA loss of $7,400,000 in the prior year.

Speaker 3

The balance of all cash, cash equivalents and investments on March 31, 2023 was $44,100,000 compared to a balance of $55,000,000 at the end of Q4. The net change includes capital expenditures of $3,300,000 related to the construction of the company's new Processing facility in Dayton, Ohio and $7,600,000 of other cash burn, including 7 point $2,000,000 of items typically or of items that typically occur in the Q1, including bonuses, sales meetings and awards and insurance premiums. Excluding these first quarter payments, we had less than $1,000,000 of other operating burn in the quarter. We anticipate spending $1,700,000 to 2 point primarily in the 2nd quarter. We also expect our operating cash flow to continue trending towards breakeven driven by leverage over our fixed cost infrastructure and our focus on thoughtful operating expense management.

Speaker 3

We believe this trend combined with normalized capital expenditures will allow us to maintain our strong balance sheet position providing ample support as we continue our path to profitability. Lastly, today we reiterated our full year revenue guidance in the range of $154,000,000 to $159,000,000 We also continue to anticipate the gross margins will be reduced with the transition to the company's new processing facility and expect gross margins will return to approximately 80% in the Q4 of 2023. We are pleased with the momentum and continued strength of our execution this quarter, including strong top line growth and solid gross margins. We believe we have built a solid foundation based on innovation and clinical evidence that will drive our long term sustainable growth. At this point, I'd like to open the line for questions.

Speaker 3

Kath?

Operator

Thank you. The floor is now open for questions. And our first question comes from Chris Pasquale from Nephron. Go ahead, Chris.

Speaker 4

Thanks and congrats on the nice quarter, guys.

Speaker 5

Thank you. Pete, I wanted to follow-up

Speaker 4

on the guidance. So you delivered high teens growth now 3 quarters in a row adjusted for OVIVE. The midpoint of the guidance range implies about 11% growth over the balance of the year. Just walk through the thought process there. Is there any reason we shouldn't expect revenue growth Stay at the higher level, was there anything you felt was unusual about the strength here in 1Q?

Speaker 3

Nothing unusual. We're really pleased with the progress that we've made. Look, this is the Q1. I think we've had good execution. We'll continue to See, how things move, we typically have a seasonal uptick in the second quarter.

Speaker 3

We expect that we'll continue to see that. But let's get another quarter under our belt before we think about adjusting guidance.

Speaker 4

Okay, fair enough. And then Karen, would love to hear some more about the new plus product, how you size that opportunity, How those injuries are being treated today, the extent to which this is cannibalistic of the existing portfolio or something you think is a new opportunity?

Speaker 2

Yes. We're really excited about the Actuarant Plus product, and this really comes out of the deep knowledge that we have about the problems And so while it's not an expansion of our total addressable market, as we started to We just recognize that there are ways that we can provide some enhanced support for some of the more challenging cases, especially if you think about In trauma, where you have a fracture adjacent to a joint and it's really a major joint. If you're bending or moving an extremity, You need that nerve to glide freely while it's going through the healing process and post that healing process. And if it doesn't glide and get tethered or sort of locked down in a spot that can impact mobility, it can impact pain and it can impact the Functioning of the nerve itself with compression reducing the signal signaling of that nerve. And so we Set out to solve that problem and in consultation with a number of leading surgeons really think that the H8 Plus provides an ideal option For those surgeons, today, does it cannibalize our products?

Speaker 2

They could use ActoGuard in those applications. So there is some use of ActoGuard in those applications. But what we found was that they were more likely to use a fat pad or again a surgical technique to try and protect that nerve because they were so concerned about gliding. So this helps to continue our penetration. It doesn't expand the total addressable market, but helps us continue to expand our penetration into those procedures.

Speaker 4

Great. Thank you.

Operator

Thank you. And our next question comes from Mike Sarcone from Jefferies. Go ahead, Mike.

Speaker 5

Thanks. Good morning, Karen, Pete and Ed, and thanks for taking my questions.

Speaker 3

Good morning. Good morning.

Speaker 5

So just to follow-up on Chris's AXAGuard question. Can you talk about how you're thinking about for the plus The financial contribution from this product and can you touch on any changes you might have in economics like do you get an ASP lift for this?

Speaker 2

There is a modest ASP lift. It is a premium to our current AxoGuard product. So it is a it also provides some larger sheets so that there's a higher ASP product that provides a larger area where they might have in the past had to have used 2 Or felt it wasn't just quite big enough. So we've expanded the range of the product and also there's a slight price premium.

Speaker 5

Got it. Thank you. That's helpful. And then could you just touch on how things are trending so far through 2Q, just with the operating Environment and customer demand. And then just separately, a pretty impressive core account growth in 1Q.

Speaker 5

Can you talk about what you're seeing or any benefits from the meta analysis that was published late last year and You've got an increasing amount of data coming out that shows costs for allograft are comparable. So maybe just touch on how that's Turning into rep conversations and demand?

Speaker 2

Yes, I'll start with the meta analysis. We have been 1st of all, we were really pleased with that data, felt it was a very both high quality paper and impactful paper in terms of the Report showing that allograft and autograft clinically are the same And without the downside morbidities of what an autograft can cause. And it was frankly surprising for many Surgeons that an allograft performed in these very long gaps, the same as an autograph and in some of the mixed in motor, some of the more Challenging cases. And so this has been a very influential tool to help reps as they are working with surgeons and In their adoption process to help them move along the curve to start to expand into again long gaps and mix in motor nerve. And so we've seen some nice uptick in both of those categories, that contributed somewhat to our mix as well as surgeons are starting to move into, Again, expanding their algorithm.

Speaker 2

That helps us to continue to drive penetration into our core accounts. That's Again, our first priority is go deeper in the accounts we're in, working with our reps to go both deeper with our trauma surgeons, but also And those planned cases of breast, OMF and the surgical treatment of pain. All of those we think will contribute ultimately to rep productivity. So bottom line, I would say that's been our plan. We're working the plan and it's Surgeons who haven't read it or know about it yet.

Speaker 2

So that's part of the work that our reps will continue doing through the summer here.

Speaker 5

Okay. Thank you.

Operator

Thank you. And our next question comes from Ryan Zimmerman from BTIG. Go ahead, Ryan.

Speaker 6

Good morning. Thanks for taking my questions, Karen and Pete. Congrats on the quarter. Just a couple of questions for me. Just to touch back on some of the guidance and the seasonality.

Speaker 6

I mean, if I look at sequential growth, And Pete, help me understand. I mean, Street's kind of looking for about 7% increase in the 2nd quarter. Historically, we've seen a kind of more normalized market environment, it's more of a double digit increase in 2nd quarter. And so I just want to understand, is there any Seasonal dynamics that you want us to be aware of? Or should we expect a more normalized market environment as we move through the balance of the year?

Speaker 3

Yes, I think we're moving into a more normalized environment. I think the pace of that is still open for question. I think we're And that's why we're just going to continue to be measured. We're pleased with what we ended up doing in the Q1. Let's continue to see how that goes.

Speaker 3

We're entering or we have entered the spring and summer trauma season where we typically see an increase in Trauma procedures. We think that hospitals like we've talked about and you've probably seen from other hospital reports are Dealing with their staffing issues, but they're still at a place where not all ERs are at full capacity, not all ORs are able to be opened. And so for that reason, we just continue to be measured in how we think the pace of this might go. But that's the only thing that causes us to cause some measurement in our outlook. The rest of it, all The data that we're seeing and the progress that we're making across the business, I think is really positive for us.

Speaker 3

And I think we're just Really well positioned to continue to execute as things continue to improve in hospitals.

Speaker 6

Understood. Thanks for that, Pete. And then just, Karen, I heard you say that independent agents are now 10% of sales. That's kind of ticked down through the I think before it was maybe 12% and maybe before it was a little bit higher. So as that comes down, Help us understand kind of what you're thinking in terms of that contribution for independent sales agents maybe over a longer term period?

Speaker 6

And in conjunction with that, how to think about the rise in growth of productivity within your direct sales force? Thanks for taking the questions.

Speaker 2

Sure. So we've been at about 10% for several years on the independent agents. But you're right, in our original layout of our sales team, we had a higher reliance on independents. And we made a strategic Joyce, that we wanted to make sure that we had the highest trained reps in operating rooms working with surgeons to help them address their nerve challenges and really understand the applications of the technology. And so we made some moves, where we've moved to predominantly direct reps in all key Metropolitan areas, but we have increased our number of very small agencies to help our rep productivity.

Speaker 2

So we have Independent agencies in more distant locations where there might be a trauma, because trauma is geographically everywhere. It's Very diffuse, it's not concentrated. So we have independent agencies in those more distant sites of care to make sure that there is still some support for trauma in those locations. And so if I do a forward looking projection. I think the 10% really puts us in a good spot.

Speaker 2

Our independent agencies actually are growing, But they're in terms of their revenue, but their footprint is still pretty much smaller than what our direct team is, but they do aid in our productivity of our direct sales team. So we have several things that we're doing to continue to increase productivity. We do expect productivity to grow on our reps with our direct reps. We are one thing is looking at those territory structures and making sure that they're not spending time on things that are not Productive to our sales process, including driving to distant sites, that's one component. Another component is looking at the going deeper in those core That inherently improves our rep productivity.

Speaker 2

And in doing that, we also bring in more planned cases. So planned cases improve rep productivity. Emergent procedures, it's very hard for a rep to be and if you look at other sales teams, Trauma reps tend to be a little lower on the productivity side because they can't plan out multiple weeks and work with developing a surgeon because They don't know the trauma that's going to happen 2 days from now. They only know the trauma that's going to happen tomorrow. And so or the trauma repair that's going to happen tomorrow.

Speaker 2

So by mixing in both planned cases with our trauma and focusing on the core accounts, we see a path in continuing to improve our rep productivity over

Speaker 6

Thank you.

Operator

Our next Question comes from Kyle Ross from Canaccord. Go ahead, Kyle.

Speaker 7

Great. Thank you for taking the question. So a lot has been asked, but the one thing I want to talk about is just overall price mix trends that you're seeing. I mean, it's been a while since you've really Probably level set, I guess, expectations or revenue mix. Pete, I heard the comment in the prepared remarks about Price and mix were a 4% driver of upside in the quarter.

Speaker 7

So how should we think about, 1, the sustainability of price trends, At least as we move through this year. And then 2, can you maybe kind of walk through what the difference in mix is and the benefit you're seeing there? Thank you.

Speaker 3

Sure. And to clarify, we had 4% in both price and mix. And so price, We always think about this as sort of low to mid single digits and it's I would be more measured as I think about price In the future quarters, I think 4% was a good price impact for the quarter. But I think we come up on an annualized price increase here soon. So That could moderate a bit.

Speaker 3

On the mix piece, I think the thing to understand is a year ago, A lot of the scheduled cases or planned cases that Karen were talking about, the more elective cases in breast, OMF We're being deferred in the early part of the Q1 and those kind of came back in the late Q1 And through the rest of 2022. So we're seeing a mix impact not only from the breast and OMF being back in a more normalized trend line. But we're also seeing a trend towards Longer advanced graphs in trauma, so mixed and motor usage. And some of that is obviously all of that is supported By the meta analysis. And so we're seeing a trend towards the longer advanced graphs both in trauma And RASP and OMF.

Speaker 7

Okay. And then just to be clear, it is when you say mix, it's Primarily longer lengths of AVANCE. You're not seeing different utilization trends amongst like The nerve wrap or some of the other products there?

Speaker 3

No, it's really about Avance, More Avance units. Avance used to be more around 50% of our revenue and AxoGuard was the remaining 50. That's been trending up, right? So it's Avance is getting closer to that 60% range in our mix. And again, that's supported by longer events units used in trauma as well as breast and OMF.

Speaker 7

Okay, great. Thank you very much for taking the questions.

Speaker 3

And just to finish that, when I think about the expectation, I don't expect That same mix impact for the remaining quarters of the year. I do think that normalizes because that those planned cases were beginning to normalize Q2 through Q4 of last year. Okay.

Operator

Thank you. And the next question comes from Dave Turkaly from JMP Securities. Go ahead, Dave.

Speaker 8

Thank you and good morning. How are you guys? I think I should say that the facility in Dayton has 1.7 to 2.7 left to be complete. I wanted to confirm that that's That ends the capital expenditures on that facility. And then what is the normalized CapEx range For AxoGen post those expenses?

Speaker 3

Yes. First of all, you're right. It's something less than $3,000,000 to get it done Primarily here in the Q2, there can be a few things trail off in the Q3, but we're coming to the end of that With about $3,000,000 or less than $3,000,000 to go. And then I think about normal CapEx on an annualized basis of sort of $3,000,000 to 5,000,000 For us and that would be for a full annualized year. This year our CapEx is more focused obviously on The Dayton facility without a lot of additional CapEx in the plan.

Speaker 3

But think about it as 3 to 5 in any Annualized year.

Speaker 8

Thank you for that. And then maybe just a follow-up on the new product. I think people are trying to sort of get their hands around The size of sort of the AxoGuard Protector, what these products are doing. Karen, I don't know if there's any way to sort of ballpark us in terms of What percent of the mix is protector or how often are you using in Avance with that product? Just trying to again get some Understanding of what this could mean for you guys?

Speaker 2

Yes. So obviously, Avance is the biggest portion of our revenue. There are cases where an advance is used either with a connector action both sometimes as a protection for the injury site, sometimes as a co op patient protection. And then it's also used actually frequently alone for these non transacted nurse. In the market for trauma, there is a sizable number of non transfected nerves where They don't end up being able to there's no need for an advance at all, yet there's still a damage, a contusion, a crush to the nerve and they need to do something to protect that nerve.

Speaker 2

So when we look at the overall, we've talked about there are 700 1,000 traumatic nerve injuries that are repaired, almost 300,000 of those are non transfected nerves where there needs to be some sort of And as I mentioned before, while we play in that with our AxoGuard, what we found is that there are places that is they really need something with this gliding layer. And so we think it really helps to continue to expand our penetration into those areas where they need to protect a non transected nerve near a major joint. If you ask about Characterizing our existing sales force advances, the majority of our sales. Actagard, Protector and Connector are the majority of the split of the rest. NERVECAP is still much smaller.

Speaker 2

I'll let you do some math to figure that out, But it does allow us to continue to expand our protection business, which we think has a lot of application for these traumatic injuries.

Speaker 8

Great. Thank you.

Operator

Thank you. And our next question comes from Ross Osborne from Cantor Fitzgerald. Go ahead. Ross, are you on mute?

Speaker 8

Okay. Not sure. Ross?

Speaker 3

All right. Let's move on.

Operator

Okay. That seems to be our last question. I'd like to now turn it back to Karen Satterday for any closing remarks.

Speaker 2

Thanks, Kat. Want to thank the AxoGen team who remain very committed to our mission of improving nerve function and quality of life for patients with peripheral nerve injuries. We're very happy with our current progress. We remain focused on ensuring our long term success. And I want to thank everyone for joining us this morning, and have a great day.

Operator

Thank you. This does conclude today's conference. We thank you for your participation. You may disconnect your lines at this time and have a wonderful day.

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Earnings Conference Call
AxoGen Q1 2023
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