MiMedx Group Q1 2025 Earnings Call Transcript

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Provided by Quartr
April 30, 2025

There are 7 speakers on the call.

Operator

Good afternoon and thank you for standing by. Welcome to the MieMedix First Quarter twenty twenty five Operating and Financial Results Conference Call. At this time, participants are in a listen only mode.

Operator

A question and answer session will follow the formal presentation. As a reminder, this conference is being recorded. I would now like to turn the conference over to your host, Mr. Matt Notariani, Head of Investor Relations for Mimetics. Thank you.

Operator

You may begin.

Speaker 1

Thank you, operator, and good afternoon, everyone. Welcome to the Mimetics first quarter twenty twenty five operating and financial results conference call. With me on today's call are Chief Executive Officer, Joe Capper and Chief Financial Officer, Doug Rice. As part of today's webcast, we are simultaneously displaying slides that you can follow. You can access the slides from the Investor Relations website at mimetics.com.

Speaker 1

Joe will kick us off with some opening remarks and a summary of our operating highlights, and Doug will provide a review of our financial results for the quarter, and then Joe will conclude with some additional updates, including a discussion of our financial goals. We will then be available for your questions. Before we begin, I would like to remind you that our comments today will include forward looking statements, including statements regarding future sales, operating results and cash balance growth, future margins and expenses, our product portfolios and expected market sizes for our products. These expectations are subject to risks and uncertainties, and actual results may differ materially from those anticipated due to many factors, including competition, access to customers, the reimbursement environment, unforeseen circumstances and delays. Additional factors that could impact outcomes and our results include those described in the Risk Factors section of our annual report on Form 10 ks and our quarterly report on Form 10 Q.

Speaker 1

Also, our comments today include non GAAP financial measures, and we provide a reconciliation to the most comparable GAAP measures in our press release, which is available on our website at mymedix.com. With that, I'm now pleased to turn the call over to Joe Capper. Joe? Thanks, Matt,

Speaker 2

and good afternoon, everyone. Thank you for joining us on today's call. I am pleased to report that we had a very good start to the year, growing the top line by 4% against what should be our toughest comparison from Q1 last year when we posted 18% growth, and this was with one less business day in this year's quarter. Importantly, you will hear today that we are well positioned to accelerate our growth as we advance through the remainder of 2025 and beyond. Our efforts in our Surgical business continued to pay dividends, producing double digit growth in the quarter.

Speaker 2

We also held our own in the private office and associated care settings, notwithstanding the continued disruption caused by the current Medicare reimbursement system that lacks any rational fiscal accountability. As you may know, on the eve of their scheduled implementation of the proposed LCDs, the federal government once again announced a delay, this time until 01/01/2026. It goes without saying another day another delay was a head scratcher as the private office setting is in tremendous need of Medicare reform. This action, without any other immediate step to slow down the out of control spend, represents another blow to Medicare beneficiaries, the trust fund and U. S.

Speaker 2

Taxpayers. I am proud of MieMedix's rich history of developing products based on clinical needs and backed by robust peer reviewed evidence, which are tenets of any high quality medical technology company. We firmly believe this is the right approach to all aspects of medicine and certainly welcome the reform, which would have made basic evidence a requirement to commercialize products in the wound care market. That said, we must adapt to the current environment. Naturally, we had contingency plans in place in the event of another such delay, and we have modified our approach to ensure we remain competitive in these affected care settings as we bridge to a period of reform for which we will continue to actively advocate.

Speaker 2

I will discuss our plans in more detail, but first, let me touch on some of the highlights of the quarter. Q1 net sales grew year over year by 4% to $88,000,000 representing another solid quarter, especially given that Q1 twenty twenty four is our strongest quarterly growth comparison. Adjusted gross profit margin was 84% in the quarter. Adjusted EBITDA was $17,000,000 or 20% of net sales. We ended the quarter with $106,000,000 in cash, an increase of $2,000,000 during the quarter.

Speaker 2

This is an excellent result as we typically burn more cash in Q1 compared to the remainder of the year due to certain front end loaded expenses and other cash requirements. Our Surgical business grew by 16% with contributions across the portfolio, including an uptick in HelioGen sales as adoption gains traction. We continued enrollment in our randomized controlled trial for EpiFend, and we advanced conversations on a few complementary business development opportunities for both our wound and surgical markets. I would also like to address a central topic of the day, and that is tariffs. I am pleased to report that Mimetics currently has no direct exposure to tariffs, and we do not expect them to affect our results.

Speaker 2

Turning now to our strategic priorities. As articulated on prior calls, we have our team's collective efforts organized and focused around three primary objectives. Our top strategic priority is to continue to innovate and diversify our product portfolio. Over the years, the company has built a tremendous core competency in its ability to develop and commercialize unique product configurations designed to meet explicit customer needs. We have successfully introduced multiple new products in the last few years in both our Surgical and Wound Care businesses.

Speaker 2

Our Amneal branded products continued to do well, led again by Amnealophenic, which grew by 22% in Q1. These products are now complemented by HelioGen, our first xenograft, which grew nicely on a sequential basis, albeit off of a low base. We are receiving excellent real world feedback on the clinical effectiveness of HelioGen and remain bullish on its ability to continue gaining traction in a variety of surgical applications. In our Wound Care business, the story is a bit more complex. While our epi branded products led by our flagship EpiFix remain unchallenged from a clinical perspective, a portion of these sales are within the private office and associated care settings, which is where we are experiencing the Medicare reimbursement related disruption.

Speaker 2

Put simply, our product price points are far lower than most of those currently on the ASP list, making them less attractive to many providers. While lower prices are certainly helpful for Medicare beneficiaries, given the inexplicable set of incentives that persist in this market, the higher a product is priced, the more money practitioners make. Therefore, our comparatively lower priced products in wound care resulted in us having essentially flat revenue in the quarter, which was actually an incredible feat by our sales team given the environment. Additionally, we are now complementing our organic portfolio with allografts manufactured and priced by a third party in order to retain as many customers as possible. And yes, they are priced higher than our organic portfolio.

Speaker 2

As part of our contingency planning in the event of further LCD delays, we added a third party manufactured amnion chorion algora branded Solara to our offering, which contributed to our recent results. We are in discussions to potentially distribute other third party manufactured allografts as well. I expect these products to be helpful in retaining business. However, I would caution against expecting this pivot in our approach to create a windfall for MiMedix for a few reasons. First, only approximately 25% of our overall business has ASP exposure.

Speaker 2

Second, while priced higher than our current Epi brands, they remain well below the eye popping prices of some of the newer products or recently repriced products on the market. Third, MiMedix will not engage in the aggressive selling practices that have become more common and which we believe cross the line of appropriate marketing behavior. I credit our strong management team for being well prepared to pivot and take steps to protect our business. However, make no mistake, we will continue to advocate for much needed performance this market. It is certainly very frustrating to see our tax dollars wasted.

Speaker 2

Second priority is to develop and deploy programs intended to expand our footprint in the surgical market. As we've discussed, this objective calls for a significant commitment to the production of real world clinical evidence and scientific research. We have studies in several publications and others underway, all designed to support use of our placental allografts in a variety of surgical procedures. Our technology has demonstrated the potential for reduced scarring or adhesion formation, which could enable accelerated and improved quality of healing, leading to enhanced surgical and economic outcomes. In addition to research and awareness, it is critical that we continue to expand our product and service offering to build a stronger presence in the surgical setting.

Speaker 2

As I mentioned, Kileogen is gaining traction, and we are actively developing and evaluating additional products to help expand our surgical footprint. Over the past few years, we have grown our commercial team in surgery, increased funding for targeted research and expanded our product portfolio, and we will continue to do so as we believe this is a winning formula. We are in the early market development phase for placental derived products in many surgical applications. The development of these markets will take time and perseverance, but the potential clinical benefits for patients, the health care economic payoff and the immense business opportunity for years to come certainly make it a worthwhile pursuit. Our third initiative is to introduce programs designed to enhance customer intimacy.

Speaker 2

As a reminder, the primary focus of this initiative is to develop programs which improve relationships and ultimately lower our customer turnover. We have several initiatives underway aimed at institutionalized customer centric behavior throughout the organization. We continue to experience excellent adoption of Mimetics Connect, our proprietary customer portal, and we are actively developing additional features designed to improve workflow and strengthen the bond between Mimetics and our customers. We believe our commitment to this approach will lead to enhanced customer relationships, improved Net Promoter Scores, higher margins and ultimately an increase in the average lifetime value of a customer. Now let me turn the call over to Doug for a more detailed review of our financial results.

Speaker 2

Doug? Thank you, Joe,

Speaker 3

and good afternoon to everyone on today's call. I'm pleased to review our results with you all today. As Matt mentioned, many of the financial measures covered in today's call are on a non GAAP basis, so please refer to our earnings release for further information regarding our non GAAP reconciliations and disclosures, including the reconciliation tables in the back of our press release that provide more detail regarding the adjustments made to calculate our non GAAP metrics. Moving on to the results. As Joe mentioned, our first quarter twenty twenty five net sales of $88,000,000 represented 4% growth compared to the prior year period.

Speaker 3

By product category, first quarter wound sales of $56,000,000 declined 2% versus the prior year period, while surgical sales of $32,000,000 were up 16%. We saw significant contributions from many parts of our business in the first quarter, including another solid double digit year over year growth quarter from AmnioFect, a continued ramp in sales of our Xenograft HelioGen, which combined with strong sales of Amniofix to drive the performance in Surgical. Our wound business was up against a tough comparable following the strong sales of EpiEffect in the first quarter last year. Additionally, the ongoing behavior in the private office and the turnover in sales reps that we experienced in the middle of last year have created some challenges for our wound franchise. These declines were partially offset with contributions from our newest wound care product, Solara.

Speaker 3

Our first quarter twenty twenty five GAAP gross profit was about $72,000,000 flat compared to the prior year period. Our GAAP gross margin was 81% in the first quarter twenty twenty five compared to 85% last year. Excluding the incremental acquisition related amortization expense of roughly $3,000,000 in the quarter, our non GAAP adjusted gross margin was 84%, down modestly compared to the first quarter of twenty twenty four. We continue to expect our full year non GAAP adjusted gross margin to be around 82% to 83%. Turning to our operating expenses.

Speaker 3

Sales and marketing expenses were $47,000,000 in the first quarter compared to $44,000,000 in the prior year period. The increase was due to a combination of higher commissions associated with higher sales as well as increases that we made to our sales comp plans in the middle of twenty twenty four. Looking ahead, we continue to expect our full year 2025 sales and marketing expense to be approximately 51% to 52% of net sales, which would be flat on a percent of sales basis to 2024 and up in absolute dollars. General and administrative expenses, or G and A, were $13,000,000 in the first quarter compared to $11,000,000 in the prior year period. The increase was driven in part by higher legal expenses, specifically related to actions that we initiated against Surgenics and in defense of our intellectual property portfolio.

Speaker 3

Over the balance of the year, we continue to expect G and A expense to be 12% to 13% of net sales, which would be roughly flat on a percent of sales basis to 2024 and up in absolute dollars. Our first quarter R and D expenses were $3,000,000 or about 4% of net sales, up 17% compared to the prior year period, driven primarily by increased costs associated with our ongoing Epi Effect RCT as well as additional spend related to future products in our pipeline and is consistent with our expected R and D spend ramp, which we detailed during our last call. As we continue to ramp enrollment in the trial this year, we continue to expect our full year R and D expense to be about 5% of net sales. GAAP income tax expense for Q1 twenty twenty five was around $2,000,000 reflecting an effective tax rate of 18%. Our effective tax rate was favorably impacted by vestings of certain equity awards during the period.

Speaker 3

We continue to expect our long term non GAAP effective tax rate to be approximately 25%. Our first quarter GAAP net income was $7,000,000 or $05 per share compared to GAAP net income of $9,000,000 or $06 per share in the prior year period. Adjusted net income for the first quarter was $10,000,000 or $06 per share compared to $10,000,000 or $07 per share in the prior year period. First quarter twenty twenty five adjusted EBITDA was $17,000,000 or 20% of net sales compared to $19,000,000 or 22% of net sales in the prior year period. Turning to our liquidity.

Speaker 3

We had $106,000,000 of cash and cash equivalents as of 03/31/2025, a sequential increase of $2,000,000 During the first quarter, we generated free cash flow of $5,000,000 essentially flat compared to the same period in 2024. In turn, our net cash balance is now at about $88,000,000 up from $86,000,000 just last quarter and $29,000,000 a year ago, marking a nearly $60,000,000 improvement over the last year. The dramatic strengthening and simplification of our balance sheet has unlocked our ability to pursue several opportunities, organic and inorganic, in support of growing and also diversifying our business, and we look forward to updating you on these initiatives as appropriate. I will now turn the call back to Joe. Joe?

Speaker 2

Thanks, Doug. As you've just heard, we had another solid quarter, and MiMedx is well positioned to have a successful year. Once again, grew revenue and recorded a 20% adjusted EBITDA margin. I'm particularly pleased that we added another $2,000,000 to our cash balance in spite of high Q1 cash requirements compared to the remainder of the year. Cash generation is a key measure of any successful enterprise.

Speaker 2

Before I move to the Q and A part of the call, I'll share some final thoughts about the proposed changes to the Medicare reimbursement system for skin substitutes and then touch on guidance. On our last call, in reference to the scheduled LCD implementation, I said the following. Based on feedback from our outside advisers and activity within the new administration, we deem any further delay as highly unlikely. We now know that another delay did, in fact, happen. Over the past few weeks, we've heard from many stakeholders that they were just as frustrated as us that no action was taken to bring down costs.

Speaker 2

With the spend escalating at such an alarming rate, the new administration's stated intent to reduce fraud, waste and abuse, media coverage on the issue and increased activity on the part of OIG and DOJ, it seemed logical that the administration would step in and direct CMS action. But that is exactly what did not happen, at least for now. We spoke to many of you since the latest delay and know you share our disappointment. However, we will not let this setback deter us from achieving our long term goals. Will continue to make the necessary adjustments to remain competitive, and we will continue to advocate for much needed reform.

Speaker 2

Stay tuned. Turning to the question of guidance. After our last call, some of you asked if we would expect to be lowering guidance in the event of another delay. Our answer at the time was not necessarily. While we did anticipate LCD implementation to provide a short term tailwind for our business, we also knew we had other levers to pull, like augment our portfolio by distributing additional third party allografts.

Speaker 2

As such, we are reiterating our full year revenue growth rate outlook to be at least in the high single digits, with higher growth rates in the back half of the year. We also expect our full year adjusted EBITDA margin to be above 20%. We will continue to revisit expectations as we learn more. Importantly, our expectations about the long term prospects for the business are incredibly high. Post some level of reform, LCDs or otherwise, we anticipate resetting top line growth to the low double digits.

Speaker 2

Finally, I want to once again reiterate that we remain hopeful that our industry will soon evolve to incorporate and improve regulatory structure and fiscal accountability, at which point no company will be better positioned than Mimetics to excel. We will continue to advocate for such improvements. And as I've mentioned, in the meantime, we will make the necessary adjustments to ensure we remain competitive. In closing, I would like to sincerely thank the Mimetics team for another solid quarter and for your unwavering commitment to the company and the many individuals who rely on our products each and every day. With that, I would like to open the call to questions.

Speaker 2

Operator, we are now ready for our first question. Please proceed.

Operator

Thank And our first question comes from Carl Byrnes with Northland Capital Markets. Please state your question.

Speaker 4

Congratulations on the results and thanks for the question. I think in your prepared comments, you were looking for adjusted gross profit margin in the 82% to 83% range. I think it was like 84.1% in the first quarter. Do you expect that to be related to mix throughout the course of the year?

Speaker 3

It, Karl. This is Doug. And yes, you're spot on. With regards to mix, we know that some ASPs on some of our products did decrease throughout the year, and so we've got pressure there. And we've also got some higher ASP products that offset some of that, but it's mostly a mix thing with regards to manufacturing sort of COGS and gross margin.

Speaker 4

Got it. And then also if you can provide us with a bit of a progress report on Equifax in Japan,

Speaker 2

that would be helpful. Thanks. Yes. It's still relatively small in terms of overall contribution, but we're right where we thought we would be. It's growing nicely.

Speaker 2

It takes a bit of time to open up a new market, new product category, especially in a country like Japan. But it's pretty much on track. It's just not material enough to break out.

Speaker 4

Fair enough. Congrats again. Thanks.

Speaker 2

Thank you.

Operator

Your next question comes from Chase Knickerbocker with Craig Hallum Capital Group. Please state your question.

Speaker 5

Good afternoon. Thanks for taking the questions. Joe, maybe just first for me, a bigger picture question kind of on the overall reimbursement landscape. Just in your conversations with regulators and policymakers recently, can you give us an idea of kind of, I guess, a percentage chance of kind of your confidence level that when it comes to mid January in 2026 that we do see reimbursement change in this market, in the private office market, whether that be price reform or the LCD going into place or both? And then can you just kind of give us your updated thoughts on what you think is most likely to occur from a specifics perspective on those kind of items?

Speaker 2

Yes. Chase, first of all, as we stated, the LCDs would have been a good first step to kind of slow down this wildly out of control spend in the category. As you know, it would have required clinical evidence around efficacy and safety for the first time, which is a good basic standard, right? So while we were originally advocating for something to be done with pricing methodology, once that did not happen within the physician fee schedule last summer, we got behind implementation of the LCDs as kind of our last best chance to rein in the spend and the behavior in the marketplace. Again, we've heard either directly or indirectly from our to our advisers, from many stakeholders that are involved in the process, and everyone was kind of just as frustrated as we were that there was not some change implemented.

Speaker 2

The real answer has always been CMS has to do something with the pricing methodology, again, which is typically done through the physician fee schedule. And we have and we will continue to advocate for that change. And we've not stopped doing that throughout the entire process. I personally was in Baltimore Two Days ago, meeting with CMS on this topic once again. While they can't say much, obviously, during the rulemaking phase, it was clear to me that they understand the situation is at a crisis level.

Speaker 2

So if there is a change in the position fee schedule, that is kind of a structured process. Typically, you get the proposed rule right around July 4. And then there's a comment period. It lasts later into the year. Final rules are usually published sometime in November.

Speaker 2

Implementation, January 1, in this case, 01/2026. We do, however, believe that CMS has statutory authority to take action outside of the physician fee schedule. I can't handicap whether or not they will take that kind of a step. So the natural next step for some sort of change would be within the physician fee schedule. New team at CMS is all in place, including the administrator who has made the elimination of fraud, waste and abuse a centerpiece of not only his confirmation, but his mission moving forward.

Speaker 2

This could be a poster child for that effort. In his initial presentation, he talked about examples that are nowhere near the level of waste that's taking place in this category. But again, I think it's important to remind everyone that only 25% of our business has ASP exposure makes it difficult, but it is manageable. We feel very confident that once there's some semblance of law and order back in the category, we're in great position to continue to grow the company at double digits. And again, we'll continue to advocate on behalf of patients, Medicare, trust fund and the taxpayers as some sort of reform takes place.

Speaker 2

But again, importantly, the company is in tremendous position to grow right through this kind of bridge period. We've been growing revenue every quarter. We have growing profitability. And as we've stated several times in our comments, for continuing to generate cash even in a period where we have a heavy cash burn. So it is an incredibly healthy business.

Speaker 2

We've taken some steps we talked about to protect it in the meantime, but we'll continue to advocate for some level of reform.

Speaker 5

Thanks for those thoughts, Joe. Maybe on the kind of new product side, people are getting pretty aggressive out there on the price. Obviously, now that the LCD has been pushed. Can you just queue us in on kind of to what extent you expect to kind of shift your private office volumes over to Solara or these new product offerings? I mean, how successful do you think you can be in kind of shifting those volumes from kind of a percentage of that business?

Speaker 5

And then just kind of your general thoughts on you're taking kind of a middle ground here. Can you help us out with kind of how physicians are thinking about, at least what you're hearing from them in the near how they're thinking about even these higher priced offerings versus kind of where you will be in the marketplace, how they're thinking about kind of the differences of those and how they're willing to utilize them in their practices?

Speaker 2

Yes. I'm going stay away from forecasting how much of our business might convert to a higher priced product. Look, this was not our first choice. This was a step we felt it was necessary to take to protect some portion of our business. It's a little bit more nichey for us.

Speaker 2

Again, 25% exposure in that category and within our current customer mix. You don't have the majority of them are probably not moving in that direction, let's just put it that way. And to the extent that they do because there's some fear of missing out, they're looking for products that are priced higher than our existing portfolio, but more moderately priced as compared to what we're seeing out there in the marketplace today. What we're seeing out there is rather obscene. And remember, when a doctor decides to use a product that's several thousand dollars, they still have exposure and risk around audit.

Speaker 2

And we know that audits are increasing at quite a high rate, right? So the higher the build of charges, the higher the potential callback in the event of an unsuccessful audit outcome. So I think for us, it's a little bit more niche. That's why in my prepared remarks, I cautioned against looking at this as some sort of a windfall. I would look at it as just a tactic or a step that we're taking to protect as much business as we can until reform takes place.

Speaker 5

And just last for me. Strong surgical growth in the quarter. Can you cue us in on what portion of growth was driven by HelioGen? And then is there any specific surgical indication that is having an outsized impact on the growth? And then kind of what's driving that?

Speaker 5

Is it just better sales execution? Or was there a recent data set that's kind of really driving volumes in the surgical side?

Speaker 2

I think it's just better execution. We had growth across the category. We've EmneoFect obviously is growing nicely. And then fixed continues to grow nicely. Heligen, as you mentioned, is new to the off of a base of zero last year.

Speaker 2

So any growth is good there. We actually still continue to retain a good portion of our axial fill business waiting for an outcome there. So really across the portfolio. And I would just say more use in areas where product had already been used. It wasn't some new revelation in some new data set.

Speaker 2

But I do appreciate you pointed it out because again, that's a portion of our business that has no ASP exposure and you see the kind of execution we're getting there. If you go back a few years prior to when we had this flood of new products out of the category, even our private office business was growing at a very nice clip. So look, we again, we feel really good about the business at large and our ability to grow the entire business at double digits once we get through this phase. But obviously, the Surgical business is a bright spot for us.

Speaker 5

Thanks, Joe.

Operator

Thank you. Our next question comes from Ross Osborne with Cantor Fitzgerald. Please state your question.

Speaker 5

Hey guys, thanks for taking our questions. Maybe just one for me at this point in the call. Would you walk through what efforts you guys are putting in place now to get ready for what is hopefully a better market environment next year? I think you called out some sales turnover. So I was curious what the bench looks like there in terms of hiring, any manufacturing initiatives that are planned to support incremental demand next year when we're in a much better marketplace?

Speaker 2

Yes. I think sales force turnover you mentioned, that was relatively high about a year ago, and that's come way down. Once we got through sort of that late second quarter, third quarter surge last year with we had folks chasing dollars, we got through that as, I would say, at a more normalized rate. In terms of growth for the rest of this year and into next year, it's just executing our plan, right? We talked about the continued to expand our product portfolio and service offerings within the wound care business and within the surgical markets.

Speaker 2

That's really important for us. We know we need to continue to invest in the commercial strength, the clinical and scientific research to support additional surgical applications or use of the product. So we'll continue to do those things. We're teetering around from a corp dev standpoint a couple of new assets we might be able to bring into the portfolio in some format, and that could help augment growth next year as well as long as it fits within our strategic plan. So we have a lot going on.

Speaker 2

I feel really good about it. Once this kind of distraction settles down and we can stop talking about it so much, we get some advancement and the industry gets cleaned up and becomes much more investable, we think the business is going be in great shape.

Speaker 1

Yes. And maybe, Ross, just to add to that real quick. I mean and you see it with SAWC later this week as well as DDW next week. I mean the commitment to generating and publishing all the various proof points that we can to show the breadth of the utilization of our portfolio, I think is meaningful. DDW in particular is a show that you wouldn't normally think of as a skin substitute showcase.

Speaker 1

And yet, we've got normal presentation there. And I think that's the sort of the tip of the spear as it relates to various surgical applications for the products.

Speaker 2

Great. Thanks guys. Thank you. Our

Operator

next question comes from Anthony Petrone with Mizuho Group. Please state your question.

Speaker 6

Thank you. And I hope everyone's having a good afternoon. Hope everyone's well. Maybe Joe to just jump jumping back to obviously LCDs, I know not a topic that obviously team wants to continue to focus on here, two parter here for you on this topic. One is in prior announcements on LCD changes as this has evolved, the primary channel kind of shifted their purchasing patterns.

Speaker 6

So do you think this latest iteration will drive any changes in purchasing pattern shifts near term? So that would be the first part. The second part is, it seems like for Doge, looking at fraud and waste, the company has previously put out $1,000,000,000 up to $1,000,000,000 of billable claims here that potentially are fraudulent. And so how do you look at this under the lens of Doge and sort of tackling waste? Thanks.

Speaker 2

I'll go backwards. So Doge is we're led to believe or told that Doge is well aware of the issue. It's on the work list. I sincerely believe that folks were able to convince the new administration that a postponement was necessary because the LCDs weren't necessarily the right way to address a pricing and spending issue. And there was some merit to that argument.

Speaker 2

I get it, right? It was the last best option. And I think the MAX were put in a position that they had to do something. This is a project that they worked on for some time. So yes, I think it's a dose issue.

Speaker 2

But again, if you take Doctor. Oz for his word, he's said that eradicating fraud, waste and abuse within CMS, which has, I don't know, dollars 1 point trillion budget out of the nearly $7,000,000,000,000 total U. S. Budget. He's got a big portion of it.

Speaker 2

If you take him at his word that this is going to be a focus area for him. And again, this is kind of low hanging fruit for him, right? So your number that you stated of $1,000,000,000 we started stating that number last year as a run rate. We know the total spend prior year was close to 4,000,000,000 We had gotten that number directly from the MAX that the run rate by midyear was closer to $1,000,000,000 a month. And more recently, we've heard numbers that are much higher than that, right?

Speaker 2

I won't quote them because I'm not 100% sure of the sourcing on it. But it would make sense that the issue continued to escalate. All that makes it very difficult to answer first part of your question, ordering patterns with delays. Do I think there's going to be some shift in ordering pattern? Probably because folks can make more money for a longer period of time and more people hear about it.

Speaker 2

There's more and more folks out there talking about these products and selling them. So I think it just makes that much more difficult to predict. And again, calls on, I think, CMS to take steps possibly sooner rather than later. I mentioned that we believe they have statutory authority to take those steps sooner rather than later. Whether or not they do that, don't know.

Speaker 2

We'll see. But look, we haven't spoken to anybody within MAX, within CMS, congressional staffers for all of the oversight committees, Senate Finance, Ways and Means, Energy and Commerce. Everybody is aware of this issue. Nobody thinks that this is something that does not need to be addressed. It's escalated at such an alarming rate.

Speaker 2

So again, logic would tell you that something is going to happen. We felt like based on feedback from everyone we were hearing in the community that the LCDs had a high probability of being implemented. And obviously, we know now that the administration postponed them. So hopefully, that means and again, the right answer was for CMS to do something on this issue, right? This is really a pricing issue.

Speaker 2

So hopefully, they take action sooner rather than later.

Speaker 6

I appreciate that. And good luck as this proceeds. We'll get back in queue.

Speaker 2

Thanks.

Operator

Thank you. And ladies and gentlemen, there are no further questions at this time. So I'll hand the floor back to Joe Capper, CEO for any closing remarks. Thank you.

Speaker 2

Thank you. And thank you, everybody, for your attendance and your continuous interest in the company. We will talk to you all after our next quarter. Operator, that concludes today's call.

Operator

Thank you. And all parties may disconnect. Have a good day.

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