Good morning, and welcome to Aroa Biosurgery's quarterly results webinar for the period ending June 30, 2022. On the line today, we have the company's founder and CEO, Brian Ward, and the company's CFO, James Agnew. Before I hand it over to the guys to get started and go through the presentation, I'll just remind you again, if you did wanna ask a question, please do so via the Q&A panel down the bottom of the screen, and we'll get to those post the end of their presentation. Brian and James, I'll now hand it over to you to get started. Thanks very much.
Great, Simon. Thank you, and thank you to everybody for joining our quarterly webinar today. I just wanna quickly go through the highlights, a little bit of background on the company, and then go to Q&A, as Simon said. Just kicking off on the cash receipts. You know, cash receipts for the last quarter were $13.9 million. A big part of this comes from the previous quarter. We did a large shipment to TELA Bio in the last quarter of last financial year, and this cash coming through from that quarter. Our net cash outflow was only $3.2 million. That's also obviously impacted by the large cash receipts coming in.
Net cash outflow from investing activities, NZD 1.1 million for the quarter, and this is reflecting our investment into our additional manufacturing capacity and plant. Overall, you know, cash flow, you know, very strong over the last quarter. We ended the quarter with $55.4 million in the bank, so we're in a very strong position in terms of our cash balance. The company's, you know, very well set up to continue to grow without the need to raise additional capital. I think, you know, very well-placed to drive growth. In terms of revenue guidance, we maintain our revenue guidance at $51 million-$55 million. We've had, you know, a very good quarter on the sales side.
We now have 32 direct field reps selling Myriad, 95 active Myriad accounts, and we also now have two sales reps on an average run rate over $850,000. You know, delighted with what we're seeing with the sales team. Certainly good access to accounts, and we're also seeing, you know, the sales team be able to build those accounts now up to, you know, some quite significant levels quite quickly. You know, we're very focused on improving our sales productivity, and, you know, that's certainly the mode that we're operating in this year, so making sure that we can really lift the level of sales performance right across the team and get that average run rate up.
That's really about, you know, making sure that investment into sales and marketing is proving itself out, and that it's scalable, as we, you know, continue to invest in the sales and marketing team. You know, finishing the quarter in great shape and, you know, really building momentum, you know, as per our plan. Also, very good to see on the TELA Bio side, you know, continuing strong demand both for OviTex and OviTex PRS. You know, we continue to see OviTex succeeding. You know, very good signals in terms of the outlook for OviTex and OviTex PRS, and we have a lot of confidence in the buildup of that business over the rest of the year, and TELA delivering on guidance.
Overall, from a revenue perspective, certainly tracking to plan, and, you know, really encouraged that, you know, hospitals remain open enough so that we continue to build the business. In terms of product development, our Enivo dead space management products continue to track well, and, you know, development testing activities for that for a U.S. FDA submission at the end of the year remains on track. You know, very pleased with how that's going. We're doing small manufacturing runs, and, you know, a lot of the requirements to pull together the regulatory dossiers for that product. We expect to have a pre-clinical publication which details the operation of Enivo to be published shortly.
It's under peer review, and we expect that to be published within the next two to three months. On the clinical study side, you know, Symphony, we've wrapped up our pilot clinical study with Symphony. That was 10 patients, and that was designed to be a precursor to doing a large RCT in the U.S., evaluating Symphony in treatment of diabetic foot ulcers. We've now, you know, got the design of that study locked in. We're working through the contracting process with our CRO in the U.S., and we expect to initiate that study by the end of the year. You know, that's all come together very well, and, you know, we're on track in terms of the execution of that study.
The Myriad registry study is tracking well as well. This is a prospective study of 300 patients in 10 clinical sites, or up to 10 clinical sites. We now have two sites up and running. We have 48 patients enrolled to date into the registry. You know, we're one quarter into the year. We had a target of enrolling 70 this year. We're at 48, so delighted with the progress that's been made on that. That's you know, that registry is expected to deliver a number of publications over the next three years. You know, we expect two publications from that registry this year. Overall, you know, we're very pleased with how the last quarter's gone.
Feel like, you know, from a sales perspective, both on the Aroa side and on the TELA Bio side, things are tracking very well. From a development perspective, projects remain on track, and certainly from a clinical study perspective, you know, clinical development remains on track as well. Just briefly, for those that are not familiar with Aroa, you know, we're a soft-tissue regeneration company. All of our products are based on our AROA ECM material. We have six product families for treating both chronic wounds, acute wounds, and surgical wounds. We also have a partnership with TELA Bio for hernia and breast reconstruction.
In terms of market sizes, you know, the opportunity being addressed by Aroa is in excess of $1.4 billion in the U.S., and then the opportunity being addressed by TELA Bio is in excess of $1.3 billion in the U.S. You know, we have a very large opportunity in front of us. We're only just getting started in these markets. You know, we're less, certainly on the Aroa side, less than 5% of the total market opportunity that we're, you know, we're participating in at the moment. We sort of see a lot of opportunity for growth with our products over the coming years.
We feel like we're in a strong position to capitalize on that and certainly, from an execution perspective, you know, performing very well to date. Just in terms of the outlook, certainly, you know, we are seeing, despite, you know, ongoing interruptions with COVID, certainly plenty of opportunity to keep our sales reps busy. We're certainly seeing cases continue. You know, we're seeing our access improve into accounts. You know, we don't at this stage believe that, you know, COVID will hold us back in terms of, you know, achieving our guidance. You know, we've continued to build our direct sales team. Very pleased with how that's gone. Very pleased with how TELA Bio is performing as well.
You know, on both of those counts, feel like that's really coming together for us. Product synergies, we're continuing to see those product synergies between our products. People use Myriad Matrix, Myriad Morcells, and Endoform, through the continuum of care. Building our clinical data, as I sort of outlined earlier, so both on the Myriad side and on Symphony side, so really pleased with how that's gone. Our GPO access, you know, is very strong as well, so on contract with Vizient and HealthTrust, and Ascension, and we're also selling, very successfully, into Premier accounts as well. You know, very pleased with how GPO contracting is going.
In terms of pipeline products, we've got a very strong pipeline of products coming through, based on our existing Aroa ECM technology, so line extensions for both Aroa and TELA Bio, and also our new Enivo platform, you know, expect to take that to the FDA by the end of the year. In terms of global expansion, a smaller part of our business at the moment, but, you know, we continue to see expansion globally and certainly revenue building quite nicely now in those markets as they move past COVID. Certainly, you know, looking good on that front as well. Simon, I'm gonna hand it back to you for Q&A.
Perfect. Thanks, Brian. First question's from Elyse Shapiro at Canaccord. How many sales-
How many sales reps?
Sorry, there's a bit of an echo. How many sales reps do you anticipate having by the end of the year?
Look, we sort of, you know, we were looking at 40 or so, and I think it's probably gonna be a little bit less than that. I mean, we really wanna make sure that sales productivity is working, so it's probably in the region of 37, 38.
Perfect. Thank you. Next question from Elyse. What's the impact of TELA Bio's inclusion into Premier? Any synergies with Myriad here?
Yeah. I think, you know, we are seeing that, where we're both on contract or we're both in hospitals, that helps both businesses. It means that the, you know, those facilities are familiar, with our technology. I think, you know, as their access increases, then that can only help us.
Great. Thanks, Brian. Question from Melissa Benson at Wilsons. She's just asked about the TELA Premier. How broad is the contract? i.e., does it cover all SKUs, including open, laparoscopic, and robot-assisted procedures?
Yeah. Look, we don't have the details of the exact details of that contract, but our understanding is that it is, you know, across the full product portfolio.
Great. Thanks, Brian. Just a question from Sebastian Clemens at Jarden. Can you give us a sense of how procedural volumes and hospital access has improved over the June quarter relative to the previous quarter, and what momentum was like going into the month of June?
Yeah. Look, we, you know, we're certainly up, you know, significantly up on our first quarter. We continue to see that build up. You know, in terms of procedure volumes, you know, they're not back to the pre-COVID levels, but they're up at that sort of 90%, and that's plenty of volume for what we need in order to succeed. You know, from a sales run rate sales perspective, we're certainly, you know, seeing enough procedure volume to keep those sales levels up.
All right. Thanks, Brian. Another question from Seb. Any comment on inflationary pressures that may have emerged over the quarter? If so, can you elaborate on where, i.e. wage inflation, supply chain inflation, et cetera?
Yeah. Look, there is a little bit of inflationary pressure. I think, you know, for us, the thing that's really making a difference is that, you know, our margins are, you know, we expect our margins to improve because our sales mix is changing. We are increasingly selling more Myriad. Myriad's a very high-margin product for us. And that's gonna, you know, help us in terms of, you know, lifting those margins up. You know, we don't expect inflationary pressure to have an impact on dragging margin down, and we expect margin to improve in the coming year.
Thanks, Brian. That concludes the Q&A. I'll hand it back to you for closing remarks.
Great. Well, look, thank you, everyone for joining. You know, Aroa, I think, you know, continues to build really nicely and, you know, we're looking forward to, you know, delivering a really strong half year result. Thank you, and appreciate your ongoing support.
Thanks, Brian. Thanks, James. Thanks, all.