electroCore Q2 2024 Earnings Report

electroCore EPS Results

• Actual EPS: -$0.38
• Consensus EPS: -$0.39
• Beat/Miss: Beat by +$0.01
• One Year Ago EPS: -$1.03

electroCore Revenue Results

• Actual Revenue: $6.14 million
• Expected Revenue: $5.85 million
• Beat/Miss: Beat by +$290.00 thousand
• YoY Revenue Growth: N/A

electroCore Announcement Details

• Quarter: Q2 2024
• Date: 8/7/2024
• Time: After Market Closes
• Conference Call Date: Wednesday, August 7, 2024
• Conference Call Time: 4:30PM ET

electroCore (NASDAQ:ECOR) is a commercial-stage bioelectronic medicine company headquartered in Rockaway, New Jersey. The company specializes in the development and commercialization of non-invasive vagus nerve stimulation (nVNS) therapies designed to address a variety of neurological and inflammatory conditions. Established in 2006, electroCore has focused its efforts on translating neuromodulation science into a compact, patient-administered treatment device.

The company’s lead product, gammaCore®, is a handheld, battery-powered device that delivers nVNS through the skin to the cervical branch of the vagus nerve. gammaCore is cleared or approved for use in both the acute and preventative treatment of primary headache disorders, including cluster headache and migraine. The device has obtained U.S. Food and Drug Administration clearance, as well as CE mark approval in Europe, enabling electroCore to serve patients and healthcare providers in multiple major markets.

In addition to its commercial offerings for headache disorders, electroCore is actively exploring broader applications of its nVNS platform. Ongoing clinical trials and research collaborations are evaluating gammaCore in areas such as inflammatory respiratory conditions and gastrointestinal disorders. The company’s strategy involves leveraging its established regulatory approvals and real-world evidence to pursue label expansions and new indications.

electroCore operates in the United States and Europe, working with headache specialists, neurologists, and pain management clinics to integrate nVNS into treatment paradigms. The company is led by a management team with backgrounds in medical device development, neurology, and regulatory affairs, supported by a board of directors with expertise in biopharmaceutical innovation. Through strategic partnerships and clinical research, electroCore aims to expand access to non‐invasive neuromodulation therapies and advance the field of bioelectronic medicine.

electroCore Q2 2024 Earnings Call Transcript

Key Takeaways

• electroCore reported a record Q2 revenue of $6.1 million, up 73% year-over-year, with 86% gross margins and a 46% reduction in net loss compared to Q2 2023.
• The Veterans Administration channel remains the largest, with sales up 120% to $4.6 million, covering roughly 9 million lives across 160 VA facilities.
• Truvega direct-to-consumer wellness sales more than doubled to $572,000, achieved a media efficiency ratio of 2.81, and launched the mobile app-enabled Truvega Plus, selling ~1,200 handsets with 60,000 sessions.
• TacStim human performance product sales were $55,000 in Q2 as customers awaited the second-generation handset, with expectations for higher, lumpier revenue in Q3/Q4 from military pilot deployments.
• Investigator-initiated trials in stroke and Parkinson’s gait are fully enrolled with topline data due later this year, and electroCore is working on label expansions for PTSD and opioid use disorder.

Presentation

[Operator]

Welcome to the electroCore second quarter 2024 earnings conference call. At this time, all participants are in listen-only mode. Please make sure you mute yourself. A question-and-answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star then zero on your phone. As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, Dan Goldberger. Thank you, sir. You may begin.

[Dan Goldberger, CEO at electroCore]

Thank you all for participating in today's electroCore earnings call. My name is Dan Goldberger. I'm the Chief Executive Officer of electroCore, and I'm also a member of the board of directors. Joining me today is Brian Posner, Chief Financial Officer. Earlier today, electroCore published results for the second quarter ended June 30, 2024. 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 the call that include forward-looking statements within the meaning of the 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 are not statements of historical fact should be deemed to be forward-looking statements.

[Dan Goldberger, CEO at electroCore]

All forward-looking statements, including, without limitation, any guidance, outlook, or future financial expectations or operational activities and performance, are based upon the company's current estimates and various assumptions. 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. Accordingly, you should not place undue reliance on these statements. For a list of the risks and uncertainties associated with the company's business, please see the company's filings with the Securities and Exchange Commission. electroCore 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. This conference call contains time-sensitive information that is accurate only as of the live broadcast today, August seventh, twenty twenty-four.

[Dan Goldberger, CEO at electroCore]

electroCore was founded in 2005 to commercialize the use of our proprietary non-invasive vagus nerve stimulation for medical and general wellness applications. The vagus nerve is the longest cranial nerve in the body, bringing information from the visceral organs to the brain. Stimulating the vagus nerve affects many important autonomic functions in the brain and in the body, including neurotransmitter levels, inflammation levels, and metabolism. Surgically implanted vagus nerve stimulators have been available from other companies for more than 40 years for chronic conditions like epilepsy and depression, so a large and growing database confirms the safety and efficacy of the technique. Building on that science, electroCore pioneered non-invasive vagus nerve stimulation, and our products are now available by prescription for certain headache conditions, and without a prescription for general wellness and human performance.

[Dan Goldberger, CEO at electroCore]

Our pipeline of potential future indications and products continues to grow as clinicians, researchers, and wellness advocates conduct investigator-initiated trials to become more familiar with the benefits of non-invasive vagus nerve stimulation. We are excited to report our seventh consecutive record revenue quarter at $6.1 million for the three months ended June 30, 2024, a 73% increase over the prior year. That's a 69% five-year compound annual growth rate. We reported 86% gross margins and a 46% reduction in the company's net loss from the same period in 2023. We continue to make progress towards positive cash flow as revenue increases, gross margin expands, and we maintain discipline around operating expenses. Brian will discuss the financials in more detail later in the call. We launched our U.S. prescription headache business in 2017, selling primarily to specialty pharmacies.

[Dan Goldberger, CEO at electroCore]

Since then, our prescription headache business has grown worldwide, including sales that are covered by national health systems such as the VA hospital system in the United States and the National Health Service in the United Kingdom, cash pay sales through prescriber professional channels, and through certain managed care systems in the United States. We launched two new non-prescription general wellness product lines last year. Truvaga is a direct-to-consumer health and wellness brand, and TAC-STIM is our brand for human performance for active duty military personnel. Truvaga sales exceeded our expectations for the quarter. We reported small TAC-STIM sales for the quarter, but added substantially to the funnel of future opportunities. The VA hospital system continues to be our largest revenue channel.

[Dan Goldberger, CEO at electroCore]

You'll recall that our gammaCore prescription therapy is free to patients covered by Veterans Administration benefits, representing about 9 million covered lives across approximately 1,300 healthcare facilities. Sales in the VA channel grew 120% to $4.6 million in the second quarter of 2024, from $2.1 million during the second quarter of 2023. 160 VA facilities have purchased prescription gammaCore products through June 30, 2024, as compared to 138 through June 30, 2023. The VA Hospital Administration Headache Centers of Excellence estimates approximately 600,000 patients are being treated for headache in the VA hospital system. We've dispensed gammaCore devices to approximately 6,100 veterans since 2022, representing approximately 1% of the total addressable market within the VA system.

[Dan Goldberger, CEO at electroCore]

We use several contracting mechanisms to support sales to individual VA facilities, including open market access, our Federal Supply Schedule contract, and our distribution agreement with Lovell Government Services. During the second quarter of 2024, sales through Lovell accounted for approximately 27% of our VA sales, up from 13% during the first quarter of 2024. Truvaga is currently positioned as a direct-to-consumer general wellness product for stress, relaxation, sleep, and mental acuity. For the second quarter of 2024, total Truvaga net sales were approximately $572,000, as compared to $290,000 during the second quarter of 2023. Our revenue return on advertising spend, what the industry calls a media efficiency ratio, or MER, was approximately 2.81 in the second quarter.

[Dan Goldberger, CEO at electroCore]

In other words, we're spending $1 to generate $2.81 of revenue. Truvaga return rates increased slightly to approximately 10% of shipments. In April 2024, we launched Truvaga Plus, our second Truvaga product offering. Truvaga Plus is a mobile, app-enabled general wellness product. The first few months of sales of Truvaga Plus have again exceeded expectations, and we are enthusiastic about the potential our new mobile app-enabled product provides for future iterations of our technology and engagement with consumers. Since launching Truvaga Plus, we've sold approximately 1,200 handsets, and customers have conducted approximately 60,000 sessions using the mobile app. We believe that the Truvaga business can scale nicely if we maintain or improve these metrics. Most of our Truvaga revenue is generated through our e-commerce platform, www.truvaga.com.

[Dan Goldberger, CEO at electroCore]

Following the successful launch of Truvaga Plus, we are exploring other channels to reach consumers, including influencers, affiliates, and resellers. TAC-STIM for Human Performance is being sold to select Air Force Special Forces and Army Special Forces units for accelerated training, sustained attention, reduced fatigue, and improved mood, as defined by the Air Force Research Laboratory, or AFRL. No prescription is required, and more information is available at www.tacstim.com. For the second quarter ended June 30, 2024, we recorded $55,000 of TAC-STIM sales, as compared to $311,000 during the same period last year. We announced the commercial launch of our second generation TAC-STIM handset in June 2024. This version was developed in collaboration with AFRL, and we believe that at least some TAC-STIM sales were deferred as customers waited for the new handset.

[Dan Goldberger, CEO at electroCore]

We have a growing sales funnel for TAC-STIM, and we continue to believe that revenue from this product line is likely to be lumpy as active duty units purchase in bulk for pilot deployment. To that end, we expect revenues for TAC-STIM in the third quarter and back half of 2024 to be higher than in the second quarter and first half of 2024, respectively. Our US prescription gammaCore channel, including gCDirect and gConcierge, recorded revenue of $476,000 during the second quarter of 2024, up 7% from $445,000 in the second quarter of 2023. There were 2,216 cumulative revenue-generating cash paid prescribers as of June 30, 2024, up from 1,451 on June 30, 2023.

[Dan Goldberger, CEO at electroCore]

We previously stated that we expect at least some of these customers to migrate to the Truvaga brand as awareness grows, so we are modeling flat revenue from this category for the time being. We began to experience that migration during the quarter as certain gConcierge customers are evaluating the Truvaga product line. Last year, we announced a distribution agreement with Joerns Healthcare LLC that we believe will add more than 12.5 million covered lives within a select managed care health system. The business model with Joerns is similar to how we work with the VA hospital system. Joerns handles adjudications, billing, and collection, while electroCore ships directly to patients and provides in-servicing and patient support. Our field sales team is responsible for building awareness among clinicians within those managed care systems.

[Dan Goldberger, CEO at electroCore]

We continue to work with Joerns on the implementation, including the expansion into new geographic territories. Our field sales function is developing champions within the targeted managed care system, and while it is taking longer than we had hoped, we still believe Joerns could be an important source of revenue growth in the second half of 2024 and beyond. Revenue from channels outside of the United States, OUS, increased by 9% to $464,000 in the second quarter of 2024, as compared to $424,000 for the second quarter of 2023. Most of our OUS revenue continues to be generated in the United Kingdom by prescription gammaCore sales funded by the National Health Service or NHS.... Now I'd like to turn to our scientific progress.

[Dan Goldberger, CEO at electroCore]

Last week, we announced that the Air Force Research Laboratory published a paper entitled "Transcutaneous Cervical Vagus Nerve Stimulation enhances second language vocabulary acquisition, while simultaneously mitigating fatigue and promoting focus" in the journal Scientific Reports. The paper is based on a study that was conducted at the Defense Language Institute in Monterey, California, US Department of Defense's premier language school, and was supported by the DARPA Targeted Neuroplasticity Training Program. The paper showed a significant positive effect of nVNS on language recall. The paper goes on to document that the recall advantage that emerged during training was sustained after the completion of treatment. Two of our investigator-initiated trials, the acute stroke trial in Leiden, Netherlands, and the gait and mobility trial in Parkinson's disease in Newcastle, United Kingdom, have been fully enrolled, and we expect to report top-line data later this year.

[Dan Goldberger, CEO at electroCore]

We continue to work with the FDA on a pathway for post-traumatic stress, or PTSD label, but that timeline continues to be uncertain. We'll provide updates about our pipeline and other opportunities as they become available. Now, I'd like to turn the call over to Brian for a review of our financials. Brian?

[Brian Posner, CFO at electroCore]

Thank you, Dan. Net sales for the three months ended June 30, 2024, were $6.1 million, an increase of 73% as compared to $3.6 million during the three months ended June 30, 2023. The increase of $2.6 million is due to an increase in net sales across the majority of our major channels, including our prescription gammaCore medical devices sold in the U.S. and abroad, and revenue from the sales of our non-prescription general wellness Truvaga brand. Gross profit increased by $2.3 million for the three months ended June 30, 2024, compared to the three months ended June 30, 2023. Gross margin increased to 86% in the three months ended June 30, 2024, as compared to 84% for the three months ended June 30, 2023.

[Brian Posner, CFO at electroCore]

Total operating expenses in the second quarter of 2024 were approximately $7.9 million, as compared to $8 million in the second quarter of 2023. Research and development expense in the second quarter of 2024 was $600,000, as compared to $1.2 million in the second quarter of 2023. This decrease is primarily due to a significant reduction in investments. Selling, general, and administrative expense of $7.3 million for the three months ended June 30th, 2024, increased 458,000 or 7%, as compared to $6.8 million for the comparable period in 2023. This increase was primarily due to our greater variable selling and marketing costs, consistent with our increase in sales.

[Brian Posner, CFO at electroCore]

GAAP net loss for the second quarter of 2024 was $2.7 million or 38 cents per share, as compared to the $4.9 million net loss of $1.03 per share for the second quarter of 2023. This significant improvement was primarily due to the increase in net sales to $6.1 million for the second quarter of 2024. Adjusted EBITDA net loss in the second quarter of 2024 was $1.9 million, as compared to adjusted EBITDA net loss of $4.5 million in the second quarter of 2023. These improved results are also primarily due to the 73% increase in the second quarter of 2024 net sales.

[Brian Posner, CFO at electroCore]

A reconciliation of GAAP net loss to non-GAAP Adjusted EBITDA net loss has been provided in the financial statement tables included in today's press release. Cash, cash equivalents, marketable securities, and restricted cash at June 30, 2024, totaled approximately $14.5 million, as compared to approximately $10.6 million as of December 31, 2023. In June 2024, the company raised net proceeds of approximately $9 million through a registered direct offering and concurrent private placements priced at the market under NASDAQ rules. Now I'll turn the call back over to Dan.

[Dan Goldberger, CEO at electroCore]

Thank you, Brian. I am incredibly proud of our continually growing revenue and the operating leverage we're seeing in the business. Our operating metrics, especially revenue and gross margin, continue to beat internal expectations, and I'm very enthusiastic about the company's long-term prospects across all brands and product lines. Demand for our prescription gammaCore therapy in the VA channel continues to grow based on clinical performance and our increased presence in the field. Our FSS contract has been extended to September fourteenth, 2024, and we continue working with our VA contract specialists to secure a new follow-on contract. We have approximately 40 straight commission sales agents representing about 90 1099 reps in the field, managed by our small team of territory business managers and supported by our customer experience team. This hybrid structure is very scalable as we deploy prescription gammaCore around the country.

[Dan Goldberger, CEO at electroCore]

The Truvaga Plus launch has been favorably received by the market. The brand continues to show tons of potential as a direct-to-consumer general wellness offering. We're selling Truvaga products through our e-commerce site, www.truvaga.com, and we will explore expanding the Truvaga proposition through new product offerings and new channels to increase the lifetime value of each customer as we go forward. The pipeline of interest from different branches of our active duty military continues to develop for our TAC-STIM products. Q2 2024 sales of TAC-STIM were impacted by the timing of the launch of our new handset and should resume in the back half of the year. We expect the TAC-STIM revenue will be hard to predict in the short term, as active duty units evaluate and purchase in bulk for pilot deployment.

[Dan Goldberger, CEO at electroCore]

Longer term, we continue to believe that there may be civilian crossover as first responders, elite athletes, transportation workers, traders, and e-gamers become aware of the human performance benefits published so far. During the second quarter of 2024, our sales and marketing expense increased by approximately $286,000 over the second quarter of 2023, while sales grew by $2.6 million. Most of the top line revenue growth of $2.6 million dropped to the bottom line as our net loss declined by $2.2 million, signaling real leverage in the P&L. Further out, we're working towards establishing additional indications for prescription gammaCore to treat Post-Traumatic Stress Disorder, Opioid Use Disorder, and other clinical opportunities.

[Dan Goldberger, CEO at electroCore]

In June 2024, we raised net proceeds of approximately $9 million through a registered direct offering in concurrent private placements, priced at the market under NASDAQ rules. We had $14.5 million of cash and equivalents on June 30, 2024, and we will maintain discipline around fixed operating expenses. We expect that commissions and media spend will scale with revenues, and we model approximately 30% of related sales on a blended basis. Therefore, we expect that our cash used will continue to decline sequentially as revenue increases. In summary, I believe the business is demonstrating operating leverage, and we will have a variety of levers to pull to continue growing the business. I'm confident that we can generate positive cash flow early next year with the financial resources on our balance sheet at June 30, 2024.

[Dan Goldberger, CEO at electroCore]

At this time, I'll turn the call over to the operator. Operator, please open the line for questions.

[Operator]

Thank you. We will now be conducting the question-and-answer session. If you would like to ask a question, please press star then one on your telephone keypad. If you would like to remove your question from the queue, please press star then two. We will just pause for a moment to allow questioners to enter the queue. Your first question comes from Jeffrey Cohen with Ladenburg Thalmann.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Hey, Dan and Brian, how are you?

[Dan Goldberger, CEO at electroCore]

Hey, Jeff.

[Brian Posner, CFO at electroCore]

Hey, Jeff.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Okay, so, I've got a run somewhat short, though. Shares outstanding where we are currently as far as, a good number, 7 point what?

[Brian Posner, CFO at electroCore]

We have 4.6 million outstanding, and then about another 1.6 million of pre-funded warrants that go into the EPS calculation.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

So what did you use this quarter? 705?

[Brian Posner, CFO at electroCore]

Yeah. For this quarter, on the table was, sorry, an average of $7 million, $7,046.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Okay. That reflects the, the June raise, so.

[Brian Posner, CFO at electroCore]

That's correct.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Okay, got it. So thanks for that. And while I have you on, Brian, what was cash loss for the quarter? I got the adjustment number of $1.9 and the GAAP $2.7. What was the cash number?

[Brian Posner, CFO at electroCore]

The cash use from operations was about a little bit under $1.8 million.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Okay, fantastic. Okay, so, a couple other questions, I guess I wanted to get a little more device related. So the second-gen TAC-STIM in black that I saw, Dan, that's gonna be back half, stronger than front half, perhaps sequentially based, but probably lumpy and a bit shy of what we previously thought. That's more like, I don't know, $1 million, $1.5 million full year, maybe?

[Dan Goldberger, CEO at electroCore]

That's, I've got visibility to at least that number. You know, the deliveries this quarter were held back, waiting for the official launch of the new generation. So those are good numbers for walking around with. And it'll be, we have a large commitment in the fourth quarter for delivery in October, so we're pretty comfortable with the range that you have.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Got it. Okay. Maybe talk a little bit about ex-US. We've heard a lot about the NHS in the UK with gammaCore, but other territories, other territories prescription-wise, as well as other territories, DTC-wise?

[Dan Goldberger, CEO at electroCore]

So yeah, UK, we have expectations that it'll continue to grow sort of mid-single digits in the 4%-6% range. It's a steady Eddie kind of a business. And we do not have visibility on other geographies getting into reimbursement at this point in time. So other geographies are more of a 2025 story.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Okay, got it. Currently commercialized, the Truvaga versus the Plus, the differential is the 352-minute sessions on the regular Truvaga and the Truvaga Plus, which is unlimited with the fancy different colored caps available.

[Dan Goldberger, CEO at electroCore]

Correct.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Okay, and that's 299-

[Dan Goldberger, CEO at electroCore]

That's exactly-

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Four ninety-nine.

[Dan Goldberger, CEO at electroCore]

That's exactly how our marketing folks would like you to describe it.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Yeah. Yeah, I wasn't sure if I wanted the pink or the green one, but I went for the somewhat translucent charcoal color. Just saying.

[Dan Goldberger, CEO at electroCore]

Excellent.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Okay.

[Dan Goldberger, CEO at electroCore]

Excellent.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

I got it. You know, so US payers, in the case of prescription focus, I know you're working on Joerns. Does it feel like more US payers could come around to the viewpoint, perhaps Medicare as well, where in another zero to year or 2 or 3, like there's a large amount of payers being covered?

[Dan Goldberger, CEO at electroCore]

So we're really focused on getting traction and penetration in the Joerns managed care relationship, and we think that's gonna be an excellent benchmark or reference case for the more traditional national and regional payers. We do have had some small payer wins among the regional payers, some of the blue, the blues in local geographies. But we're really, with a small team, we're focused on making the Joerns managed care relationship really jump out later this year.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Got it. And then lastly, talk about those two papers, one on stroke, one on gait. The second one's in the U.K. The first one's where and when will we see that, and will be at a conference?

[Dan Goldberger, CEO at electroCore]

So yeah. The stroke trial is being done in Leiden, in the Netherlands, and was fully enrolled in the first quarter of this year. These are both investigator-initiated trials. We have no influence on the timing of when the data is gonna be available. They're both European trials, one in the U.K., one in Netherlands, and you know better than I do that academics take the summer off, so it's been a little bit frustrating getting any communication from them in the short run. But I'm looking forward to being able to speak more clearly about the top-line data by the end of the year.

[Jeffrey Cohen, Analyst at Ladenburg Thalmann]

Okay, perfect. Thanks for taking all my questions. Appreciate it.

[Dan Goldberger, CEO at electroCore]

Of course, Jeffrey. Thanks for your support.

[Operator]

Your next question comes from Anthony Vendetti with Maxim Group.

[Anthony Vendetti, Director of Research and Senior Healthcare Analyst at Maxim Group]

Thank you. So Dan, and, you know, the commercial payers, I know that's something you're working on, and I know that it takes time, as we know, but maybe just an update on where you are with some of them and what the expectation is for the rest of this year in 2025.

[Dan Goldberger, CEO at electroCore]

Yeah. So, you know, the VA hospital system is fully reimbursed for veterans that are covered by the VA hospital system. In the Joerns managed care system, which is larger, as measured by covered lives. We went on formulary in January of this year, and it's really now more of a develop clinical champions and get penetration within the system than it is getting payers. So that's what our field sales team is focused on right now, demonstrating clinical adoption and driving penetration of that healthcare system. And, you know, similar to Mr. Collins' question, we really want to demonstrate that we can grow the business at... Before we start directing resources to some of the other more traditional national payers in 2025.

[Anthony Vendetti, Director of Research and Senior Healthcare Analyst at Maxim Group]

Okay, makes sense. And then, would you attribute the year-over-year decline in TAC-STIM to the maybe anticipation of your commercial launch of the next generation of TAC-STIM?

[Dan Goldberger, CEO at electroCore]

Yeah, it's That's exactly what I was trying to say, is that, the Air Force and Army are very, were very aware, very closely involved in the development of, of a new version of TAC-STIM, and so all of those orders were deferred until we could reliably supply, the new, heavier black, handset.

[Anthony Vendetti, Director of Research and Senior Healthcare Analyst at Maxim Group]

Okay, makes sense. And then lastly, just I know there's a number of potential applications for the gammaCore. What is the next one you intend to hone in on and focus the team on?

[Dan Goldberger, CEO at electroCore]

Yeah. So PTSD, we announced breakthrough designation, a few years ago. We've been working with the agency on, on the path forward to get a specific indication for PTSD. Substance abuse, there's a pivotal trial that's being sponsored by NIDA, National Institute on Drug Abuse, that is enrolling patients, and it'll read out in the beginning of next year. So those will be the next two, sort of, categories, of, label extensions that we're looking for for vagus nerve stimulation.

[Walter Schenker, Analyst at MAZ Partners]

Perfect. Great. Thank you so much. I'll hop back in the queue. Appreciate it.

[Dan Goldberger, CEO at electroCore]

Yep. Thanks, Anthony.

[Operator]

Your next question comes from Sean Lee with H.C. Wainwright.

[Sean Lee, Analyst at H.C. Wainwright]

Hi, good afternoon. This is Sean standing in for RK. Thanks for taking my questions.

[Dan Goldberger, CEO at electroCore]

Hi, Sean. Of course.

[Sean Lee, Analyst at H.C. Wainwright]

Hi, guys. So, with VA still being your biggest customer and the U.S. federal fiscal year coming up soon, I was wondering if you could elaborate a bit more on the contract extensions and how that's going on. Can we expect any changes for next year? Are there any extensions that you could go into? Thanks.

[Dan Goldberger, CEO at electroCore]

So yeah, so we're working with the contract agent to get a new five-year FSS contract. There, that office, has just been slow, and as a result of their, your, you know, their, their backup, they've been giving us these three-month extensions, which is frustrating, but it doesn't impact our business on a regular basis. We do expect to get a small price increase through that process. A larger percentage of our business is going through Lovell, where the economics are slightly more favorable. Lovell, you may recall, is a small service-disabled veteran-owned small business. You know, they, they did 13% of our VA hospital business in the first quarter.

[Dan Goldberger, CEO at electroCore]

They did 27% of a larger number in the second quarter, and we're perfectly comfortable moving a larger portion of the business to their contracting mechanism, and you know, having multiple channels to be able to service that customer.

[Sean Lee, Analyst at H.C. Wainwright]

Well, great. Thanks for that. And my second question is on the... In the prepared remarks, you mentioned the effectiveness of vagus nerve stimulation for accelerating language learning. Just wondering, is that something that's specific to TAC-STIM, or is that also applicable to Truvaga? And do you have any plans to market towards that?

[Dan Goldberger, CEO at electroCore]

So, the trial was done with gammaCore handsets. So, it was funded by the Department of Defense. The clinical results absolutely transferred to TAC-STIM and could probably be inferred for Truvaga, but the Truvaga delivers a lower dose, so you would need more sessions with Truvaga to get the same mental acuity benefits. But the more general comment is, yes, it's fundamental. The learning advantage, the cognitive enhancement is fundamental to the way this vagus nerve stimulation works and should be applicable across our product lines.

[Sean Lee, Analyst at H.C. Wainwright]

Okay, great. That's all I have. Thanks for taking my questions.

[Dan Goldberger, CEO at electroCore]

Of course.

[Operator]

Your next question comes from Tyler Bussian with Brookline Capital Markets.

[Tyler Bussian, Analyst at Brookline Capital Markets]

Hey, Brian, again. Can you hear me okay?

[Dan Goldberger, CEO at electroCore]

Yep.

[Tyler Bussian, Analyst at Brookline Capital Markets]

Oh, okay.

[Dan Goldberger, CEO at electroCore]

Hi, Tyler.

[Tyler Bussian, Analyst at Brookline Capital Markets]

Fantastic. Thanks for taking my questions. I got two quick ones for you. I don't know if I missed it during the presentation or not. Do you happen to have an updated VA/DoD facility count for this quarter?

[Dan Goldberger, CEO at electroCore]

The number that we reported on the prepared remarks was 160.

[Tyler Bussian, Analyst at Brookline Capital Markets]

Okay, 160. Thanks. Must have missed it in there. The language learning data was very interesting. I noticed on ClinicalTrials.gov there were a few new indications that had popped up from independent investigators, amyloid clearance, or supplemental amyloid clearance, and then also the VA running, looks like an alcohol use disorder trial. Do you have any comments?

[Dan Goldberger, CEO at electroCore]

Yeah.

[Tyler Bussian, Analyst at Brookline Capital Markets]

on those type, those new, kind of, indications or, studies?

[Dan Goldberger, CEO at electroCore]

Yeah, the... Yeah. So, the alcohol is a spin-out of the work that's being done on opioid use that NIDA is supporting, and the pilot results are very compelling. These are all investigator-initiated trials, so we're not necessarily privy to the structure of the trial. And in many cases, we're actually selling handsets to the investigators who have independent funding. So we don't have a lot of input, but, you know, we love the research interest, and it all adds to the body of knowledge around vagus nerve stimulation and could lead to future indications.

[Tyler Bussian, Analyst at Brookline Capital Markets]

Great. Well, thank you guys very much. Appreciate the time.

[Dan Goldberger, CEO at electroCore]

Yep. Thanks.

[Operator]

Your next question comes from Walter Schenker with MAZ Partners.

[Dan Goldberger, CEO at electroCore]

Walter?

[Operator]

Walter, your line is open.

[Walter Schenker, Analyst at MAZ Partners]

Yes, if I take myself off mute, it works better than if I leave the mute button on.

[Dan Goldberger, CEO at electroCore]

Good. We hear you better now, Walter. How are you?

[Walter Schenker, Analyst at MAZ Partners]

Okay. Well, I'm good.

[Walter Schenker, Analyst at MAZ Partners]

... And my plug on the thing, my wife is good, too, as an enthusiastic user of the device. We both are.

[Dan Goldberger, CEO at electroCore]

Thank you.

[Walter Schenker, Analyst at MAZ Partners]

I've got my brother-in-law-

[Dan Goldberger, CEO at electroCore]

I'm glad.

[Walter Schenker, Analyst at MAZ Partners]

A whole bunch of people.

[Dan Goldberger, CEO at electroCore]

Great.

[Walter Schenker, Analyst at MAZ Partners]

It would be correct that the majority of the dollars raised in the recent equity raise was raised from people who are either in management or in some way affiliated with the company?

[Dan Goldberger, CEO at electroCore]

Absolutely. Yeah, directors and officers.

[Walter Schenker, Analyst at MAZ Partners]

Right. So they put in $5 million odd dollars of the $9 million, correct?

[Dan Goldberger, CEO at electroCore]

More than that.

[Walter Schenker, Analyst at MAZ Partners]

More than that. Probably closer to

[Walter Schenker, Analyst at MAZ Partners]

Well, I know it's more.

[Dan Goldberger, CEO at electroCore]

And change. Yeah.

[Walter Schenker, Analyst at MAZ Partners]

Okay.

[Dan Goldberger, CEO at electroCore]

Yes.

[Walter Schenker, Analyst at MAZ Partners]

It's worth pointing out to people it's a unusually-

[Dan Goldberger, CEO at electroCore]

Yes

[Walter Schenker, Analyst at MAZ Partners]

strong result for a small company. Not a setup question. It's frustrating to me as an investor, given all of the interest in the VA system, the additional research, the fact that they are the people who have done most of the work on the PTSD, and we've—you've indicated, although there's no hard data, there is some degree of use off-label beyond headaches, that still the penetration, either in the headache area or broadly in the VA system, is so low. Is there a partner or something? I know, Lovell has really upped the game, I guess. Is there some way, except hospital by hospital, region by region, to get, you know, a real step up in penetration, given how few of the hospitals after all this time you're in?

[Dan Goldberger, CEO at electroCore]

Yeah, look, Walter, that's—it's a great observation. I do think, and if you talk to our sales leadership, that we're starting to see a bit of a tipping point, where there's good recognition, awareness, that the technology is available for headache and is available for some of these behavioral health indications off-label. And I think you're gonna start to see that penetration accelerating as we roll into 2025. We're always open to partnerships. We, we've had a variety of conversations, but nothing that's close enough to really start to brag about.

[Walter Schenker, Analyst at MAZ Partners]

Good. And lastly, again, a comment I made this to you, but I wanna make it again. Especially for the Truvaga Plus, and you've mentioned this, more is better in using vagus nerve, your technology and vagus nerve-

[Dan Goldberger, CEO at electroCore]

Absolutely

[Walter Schenker, Analyst at MAZ Partners]

stimulation.

[Dan Goldberger, CEO at electroCore]

A-

[Walter Schenker, Analyst at MAZ Partners]

And that-

[Dan Goldberger, CEO at electroCore]

Absolutely

[Walter Schenker, Analyst at MAZ Partners]

2 minutes twice a day is not as good as 4 minutes twice a day, or 4 minutes 3 times or 4 times a day, which is what my wife does. And I think it, it's useful and important, either on the side or broadly, to continue to explain and try and inform people that if you use it more, it enhances... Even going back to learning, where you said, because the people in the trial used higher levels of stimulation, to get to the same place, you'd have to use, you know, the consumer product more time. There really needs to be a greater push by the company that more is better, as opposed to just-

[Dan Goldberger, CEO at electroCore]

And-

[Walter Schenker, Analyst at MAZ Partners]

-two, you know, again, two minutes twice a day, is not really a great place to be. You should be using it more.

[Dan Goldberger, CEO at electroCore]

You're absolutely right. I think you'll start to see that in our marketing and advertising or promotional information, especially when you're looking at the wellness opportunities for mental acuity, for focus, for quality of sleep. You're absolutely right, Walter. All of the data shows that more sessions leads to better outcomes. But of course, you have to trade off the convenience for the consumer and end user, how much time they're willing to devote to getting those general wellness benefits. But in my personal experience, I do it quite frequently, especially on a stressful day like today.

[Walter Schenker, Analyst at MAZ Partners]

And it's easy enough to use watching TV, looking at your computer, or doing other stuff with your hands. Don't need your hands while you're doing it, just to sit there and do it; it's pretty easy. Okay, my head's done.

[Dan Goldberger, CEO at electroCore]

Yes, sir.

[Walter Schenker, Analyst at MAZ Partners]

Thank you, Dan.

[Dan Goldberger, CEO at electroCore]

Thank you. We appreciate you, Walter. Have a great day.

[Operator]

There are no further questions at this time. I would like to turn the call back over to Dan Goldberger for any closing comments.

[Dan Goldberger, CEO at electroCore]

Thank you, operator, and thank you all for joining today's call. Our employees are working tirelessly to deliver products and therapies that improve the health and wellness of patients and customers. The team's done a great job of staying nimble, scaling the business, creating operating leverage, and responding to the needs of our customers. I also want to thank the healthcare professionals and their patients for their loyal support of gammaCore therapy, and consumers for adopting our Truvaga product for general wellness. Thank you all, and have a good evening.

Participants

Executives

• Brian Posner, CFO
• Dan Goldberger, CEO

Analysts

• Anthony Vendetti, Director of Research and Senior Healthcare Analyst at Maxim Group
• Jeffrey Cohen, Analyst at Ladenburg Thalmann
• Sean Lee, Analyst at H.C. Wainwright
• Tyler Bussian, Analyst at Brookline Capital Markets
• Walter Schenker, Analyst at MAZ Partners