Good morning, everyone, and welcome to the Axogen BioCircuit Technologies acquisition conference call. On today's call is Michael Dale, Axogen's Chief Executive Officer, and Lindsey Hartley, Axogen's Chief Financial Officer. This morning, we issued a press release and posted a slide presentation covering the transaction, both of which can be accessed on the investor relations section of Axogen's website at www.axogeninc.com. Today's call and presentation are being broadcast live via webcast, which is available on the investor section of Axogen's website. Following the end of the live call, a replay will be available on the investor section of the company's website at www.axogeninc.com. Before we begin, I'd like to remind you that during the conference call, management will be making forward-looking statements.
Forward-looking statements include statements regarding the anticipated timing and consummation of the BioCircuit acquisition and related closing conditions, the expected benefits of, and integration of BioCircuit, the financial guidance and outlook, and anticipated performance of both Axogen and BioCircuit, including the expected financial impact of the transaction, clinical development and regulatory efforts, commercial growth initiatives, reimbursement and market access efforts, training and education initiatives, research and development activities, and overall business strategy and performance. These forward-looking statements are subject to risks and uncertainties that could cause actual results to differ materially, including, without limitation, the risks and uncertainties reflected in the company's filings with the Securities and Exchange Commission, including the most recent annual report on Form 10-K, subsequent quarterly reports on Form 10-Q and other filings made with the Securities and Exchange Commission.
Forward-looking statements speak only as of the date they are made, and the company undertakes no obligation to update any forward-looking statements except as required by law. In addition, for reconciliation of non-GAAP measures, please refer to today's press release, presentation with highlights from today's call, and the corporate presentation on the investor section of the company's website.
Now I'll turn the call over to Michael. Michael, please go ahead.
Thank you, operator, and good morning, everyone. Today's call will start with an overview of the transaction we announced this morning. Lindsey will then walk through the financial terms. Following our prepared remarks, we will open the call to questions. Axogen will provide additional details regarding the financial impact of the transaction when we report results post-closing of the acquisition, which is expected in the fourth quarter of 2026. Earlier today, we announced that Axogen and BioCircuit Technologies have entered into a definitive agreement under which Axogen will acquire 100% of BioCircuit's outstanding equity for a total price of $200 million in cash, subject to customary adjustments for cash indebtedness, transaction expenses, and net working capital. The cash portion will be financed with the equity offering that we announced today.
This transaction is a strong strategic fit for us, with NerveTape currently selling in the exact same markets as Axogen and is expected to strengthen our own existing financial profile. It is financially accretive to our revenue growth and adjusted EBITDA margin in 2027, assuming the transaction closes by year-end 2026. In addition, we expect to remain free cash flow positive. Strategically, we believe BioCircuit is as close to an ideal fit as one could find. It aligns with our mission to make restoration of peripheral nerve function an expected standard of care, and it advances our innovation agenda by adding a differentiated technology that simplifies one of the most challenging aspects of nerve surgery. NerveTape is the first FDA-approved device for suture-less nerve repair. Most of the work we do in nerve care is addressing one problem, reconnecting two severed nerve ends.
Historically, that's been the exclusive domain of microsurgery. Using sutures under a microscope, surgeons painstakingly align and connect the nerve, either directly or using a connector or a graft. This is a slow and technically demanding procedure, so it has been limited to a small population of microsurgeons trained to perform this work, which we see as one of the barriers to more patients receiving appropriate nerve care. NerveTape has the potential to change that equation for many applications. It is faster and stronger than traditional microsuturing. Because it's so easy to use, surgeons in many applications no longer need the same level of microsurgical training to perform nerve repair. That means we're not just improving how existing nerve surgeons operate, we're also enabling the expansion of the universe of surgeons who can perform nerve repair.
That's why we see NerveTape as critical in unlocking the total addressable market of nerve repair. We believe it allows us to address new indications that our current portfolio does not serve, and it lowers the barrier to entry on the current indications for our portfolio. We've been following BioCircuit and NerveTape for some time as the technology, commercial adoption, and clinical evidence have developed. As clinical data accumulated, the product gained commercial traction, and surgeons have gained experience with the product. We've become increasingly confident in the technology's performance and safety profile. That growing confidence in our strategic goal to be at the forefront of innovation in nerve repair is what brings us to this transaction today. The company's commercial traction is impressive in its short period of commercialization.
In just over two years, over 14,000 NerveTape implants have been sold to date, mostly in breast and extremity procedures across more than 400 hospitals and ambulatory surgery centers. BioCircuit has achieved $24 million of run rate revenue based on an annualized second quarter 2026 revenue, which is a considerable growth from its $11 million in 2025 revenue, with a gross margin of approximately 80% and positive EBITDA year to date on a standalone basis. Our plan is to introduce NerveTape into our commercial organization, leveraging our existing direct sales force, surgeon relationships, and hospital contracting infrastructure to accelerate adoption. We are acquiring a high-growth product in a market we already serve, calling on surgeons we already know, using a sales force that is already in place. We anticipate minimal integration risk and no meaningful commercial disruption.
As with any acquisition, our near-term priority is a smooth transition for BioCircuit's customers, employees, and surgeon partners. We are truly excited about what this acquisition means for surgeons and for the patients they treat. This transaction checks the box for us by every metric. Strategically, it is a great fit. It pushes our innovation frontier and enhances our ability to unlock our under-penetrated total addressable market opportunities. Financially, it is expected to strengthen our existing profile and the integration risk is low. I want to thank the entire BioCircuit team for building NerveTape, a truly novel, simpler, faster, more effective alternative to microsuturing in nerve repair. We cannot think of a more natural synergistic fit with Axogen, and we look forward to welcoming NerveTape and the entire BioCircuit organization to Axogen.
Finally, I want to end my comments by reiterating our confidence in our performance and other strategic priorities, particularly in prostate and breast. As discussed in our last earnings call, our clinical development work remains on plan, and we expect to share more in the next phase of our prostate strategy during our third quarter earnings call. This quarter to date, we are pleased with the continued momentum of our business, and we expect this transaction to be additive to our current trajectory.
I would like now to turn the call over to Lindsey.
Thanks, Mike, and good morning, everyone. Under the terms of the agreement with BioCircuit, Axogen will acquire 100% of BioCircuit's outstanding equity at a total price of $200 million in cash, subject to customary adjustments for cash, indebtedness, transaction expenses, and networking capital. At closing, $1 million of the estimated merger consideration will be withheld pending determination of the post-closing purchase price adjustment. We anticipate funding the purchase price with the proceeds from the public offering of our common stock announced today. The BioCircuit transaction is expected to close in the fourth quarter of 2026, subject to customary closing conditions, including completion of the spin-out of BioCircuit's electronics business. As Mike highlighted earlier, this transaction is financially compelling.
BioCircuit has achieved $24 million of run rate revenue based on annualized second quarter 2026 revenue, which is considerable growth from its $11 million 2025 revenue, with gross margin of approximately 80% and positive EBITDA year to date on a standalone basis. We are not providing 2026 guidance for the partial year impact at this point. We will provide updated full year 2026 guidance, including the BioCircuit contribution, once the transaction closes. Also, assuming a close of the transaction in 2026, Axogen anticipates the acquisition to be additive to 2027 revenue, with accretion to gross margin and adjusted EBITDA margin. We will provide full year 2027 guidance in the first quarter of 2027.
The impact of this acquisition is equally exciting to unlocking our under-penetrated TAM as the impact on our financial profile of our business. In summary, we are very excited about the significant opportunity this transaction represents.
With that, we will now open the line for questions. Operator?
Thank you. We will now be conducting a question and answer session. If you would like to be placed into question queue, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two if you would like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing star one. Once again, that is star one to be placed in the question queue. Our first question today is coming from Larry Biegelsen from Wells Fargo. Your line is now live.
Hi, Larry.
Hi. Good morning. This is Simran on for Larry. Thanks for taking the questions here. So, Mike, I guess our understanding is NerveTape, and I think you addressed this in your prepared remarks as well, but NerveTape appears to be used primarily in the breast segment. Is that the case today? Is that correct? And how broadly applicable is it across your other repair segments? And then maybe can you help us understand what the current attachment rate is of NerveTape to Axogen cases? In what percent of cases is it currently used? And if it is an easier procedure, where does this help accelerate adoption of Avance and NerveTape today or in the future?
Sure. NerveTape, in terms of its initial usage, started primarily in breast applications and oral and maxillofacial. They started in those applications because those are generally long-duration procedures and difficult. Given what NerveTape is about, in terms of providing a very simple and extremely fast and rapid but also very effective attachment mechanism, they thought that that would be the best place to start. That's where the bulk of their experience is. It's still relatively small in terms of the relative usage relative to Axogen's total procedures. From a value add standpoint, that's their beachhead, if you will, in terms of where they developed their experience.
In terms of application, it is applicable to virtually all nerve procedures that we currently prioritize across our portfolio and further extends the potential usage to markets that we don't generally serve. For example, a very simple nerve transaction where you do a direct nerve repair, it does not require advanced usage and generally does not require our other Axoguard portfolio. In this instance, however, because of what NerveTape does, it actually extends the potential TAM for usage to that market as well. In our hands, we will, for each procedure where physicians are interested, obviously we'll be extending the use of NerveTape very broadly.
Got it. That's helpful. Maybe another way to put it, if we assume that NerveTape attaches to about half the procedures that Axogen already touches at roughly the current ASP of NerveTape, we get to sort of a revenue line somewhere around $50 million, which is about 4x what you paid. Is that the right order of magnitude to think about? How much higher does the peak sit because, as you mentioned, NerveTape opens up procedures that you aren't in today or opens up a part of the market that you're not in today?
Forgive me if I'm not completely tracking with your question, Simran. To reiterate, NerveTape can be used in almost every procedure that we presently address across our portfolio, whether it be extremities, breast, oral and maxillofacial, and head and neck. There's a potential application. There's an additional opportunity for NerveTape's usage in direct nerve repair. Maybe I misunderstood, but it literally can be used very broadly. There are situations where it does not apply, but it fills a void. Just to put a fine point on it, work and nerve repair is about connecting two nerves together at the end of the day. All of our work streams, which we're taking down coverage, reimbursement, societal guidelines, building new evidence. In the end, this is all about making and enabling the ability to conduct nerve repair.
At the tactical level, that means connecting two nerves together. NerveTape is exciting to us because it literally represents an entirely new form function, a mechanism by which you do that is actually superior to what was previously the existing gold standard, which is microsuturing. It is simpler, it is very fast, and it is a more effective connection in terms of its relative strength, and it is also atraumatic. Hopefully I answered your question. As we look to the future, we will give guidance in the new year as to what we see with this. But the current growth rate is one that we expect to sustain, and obviously extend in our hand just by giving the multiplier effect of our very large and experienced sales organization.
Great. Thanks, Mike.
Sure, Simran.
Thank you. Next question is coming from Michael Sarcone from Jefferies. Your line is now live.
Hey, good morning, and thanks for taking the questions.
You bet, Mike.
Thanks, Mike. Just to start, can you give us some background on how the transaction came to fruition? How long have you been chatting with the BioCircuit people? Just any context around the deal.
Certainly. I think it's a great question, and it's an important question. If I would ask people to go back a little more than two years ago at our Investor Day, one of the priorities we've always laid out is all about innovation. Fundamentally, commercialization and market development is building upon whatever your value is from a product or therapeutic standpoint as compared to an existing standard of care. So innovation has been every bit as much a priority for us as our market development activities. And we explicitly, if you go back and look at those slides, we addressed three areas that we would invest in, both internally and externally. Number one was next generation Avance. How can we more perfect this very important product? Number two is protection. So when you do a repair, you want to ensure it has the best environment for healing.
We have work ongoing in that work stream. Finally, we have always emphasized connection with a major priority for us. For proprietary reasons, we did not disclose exactly what we meant by that in great detail. This is just a natural step in our strategic plan to make the ability to connect two nerves together more possible and more effective. To answer your question, we have been watching this asset and others for a very long time. We concluded in our first inspections that the NerveTape was unequivocally simple and fast. The question was whether it was benign. Once we got comfortable based upon the clinical evidence and the clinical experience by individual physicians, we felt it was the right asset to add to Axogen so that we continue on our journey.
Got it. That is helpful. Thanks, Mike. You mentioned that NerveTape is in over 400 hospitals and ASCs. I was wondering if you could talk about just the overlap between those 400 customers for BioCircuit and how that compares with Axogen's current customer base.
Sure. Amongst the 400 hospitals that they currently have access to, there is almost a complete overlap with our existing customers. They do not have full penetration in those 400 hospitals. It is a small organization, but they have access. What we intend to do is extend that access to our entire universe that we service, which is more than 2,000 accounts.
Got it. Okay. Last one from me, then I will thank you for taking the questions. Is there any potential risk of cannibalization here, or is NerveTape completely complementary?
Yes, but it's a natural evolution in product mix. It's no different than a gen one product and a gen two product. One will ultimately supplant the other. Certain parts of the portfolio will evolve in favor of NerveTape. That's expected and planned for. In the end, in totality, this is accretive on a revenue standpoint as well as EBITDA.
Great. Thanks so much, Mike.
You bet.
Thank you. Our next question is coming from Mike Kratky from Leerink Partners. Your line is now live.
Awesome. Good morning, everyone, and thanks for taking our questions. Can you just start with talking[crosstalk].
Morning, Mike.
A little bit about the size of BioCircuit's existing sales force, to what extent you see opportunities for synergies moving forward, or any cross-selling opportunities from your existing portfolio?
Sure. It's principally an engineering and supply chain organization. There's a very small technical support, a clinical support part of the organization. The majority of their distribution is through independent distributors and agents at present. With regards to the team, in general, without disclosing explicitly the details, the vast majority of this organization will come and become part of the Axogen organization. They have a headquarters in Atlanta, and our intention is to continue those operations and welcome them into the team. There is a deep body of engineering and subject matter knowledge in the organization, and we look forward to further building on that.
Awesome. Thanks. Maybe just one separate one, but Mike, could you talk a little bit more about the rationale here? I mean, another business development deal announced where you're on the buying side. How are you thinking about capital allocation moving forward and whether this deal at all signals any underlying health of your base business?
The signal that I would speak to is that we're doing great and our goal is to do even greater. I'm not trying to be flippant. Axogen, everything that we have reiterated heretofore remains sound. Our goal is to build NerveTape and, actually, build Axogen as we've described. There's tremendous opportunities to add great clinical value to patients and physicians in the world. Ultimately, that's about continuing all the initiatives we've previously described, our market development activities, expanding our commercial footprints. But alongside that is continuing to innovate. Because at the end of the day, you're commercializing innovation. When your innovation goes stale, your commercialization goes stale. We will never let that happen. We are currently the leaders today in every element that we practice, and our goal is to remain so. NerveTape's just part of that natural evolution.
We're not trying to signal that there's a particular cadence of innovation, but that innovation is core to our future. While we don't know if it's going to happen every other year or every year or every quarter, we will continually look and aim towards perfecting. Now, in terms of the metrics by which we do that, I would guide people to look at this transaction. This is a fair multiple that is accretive to the organization almost immediately based upon the current plans that we have. In that sense, it's responsible to shareholders. That's the kind of discipline that we intend to apply in anything that we do in the future.
Understood. Thanks, Mike.
You bet.
Thank you. Next question is coming from Jayson Bedford from Raymond James. Your line is now live.
Hey, Jayson.
Hey, Mike. Good morning, and congrats on the deal. My first question is, are you starting to see NerveTape used over Axoguard? And how do you position the two in the portfolio?
Sure. Why don't I turn that call to Jens and just let him describe some of the clinical applications?
Yeah. As Mike alluded to, NerveTape really is what we consider a next-generation connection device. In cases where the Axoguard Connector is used as a direct coaptation mechanism, NerveTape could be another option that surgeons use. But it's not completely replaceable of Axoguard Connector use cases. Axoguard Connector is also used, for example, where there is a small gap between the nerves, right? And that would not be applicable for NerveTape. For a direct nerve repair where you have a direct coaptation, that's really where we see the fit for NerveTape. And that can be a direct coaptation of two native nerves, and it could also be as a coaptation aid with Avance Nerve Graft.
We really see it as a really strong complement to our portfolio that offers surgeons more choice for coaptation mechanisms.
Okay. That's helpful. Thank you. Are the economics to Axogen better with NerveTape or Axoguard?
They're very similar, actually.
Okay. It looked like there is another product, I do not know if you mentioned it, ConformaWrap. Is that a relevant contributor to the revenue generation of BioCircuit?
It is not.
Okay.
The acquisition is driven by NerveTape.
Okay. You will continue to sell ConformaWrap or?
We haven't made a final decision, but it's unlikely.
Okay. I'll let others jump in. Thank you.
You bet, Jayson. Thanks.
Thank you. Next question is coming from Ravi Misra from Truist Securities. Your line is now live.
Hey, Ravi.
Great. Good morning. Hi, good morning. Thanks for taking the question and congrats on the deal. I guess two from me. First, can you help us think about the kind of algorithm in breast between Avance and NerveTape, whether it's complementary or what types of procedures there's overlap in, whether it's flap or some other type of repair? Then secondly, Lindsey, maybe one for you. On the guidance, I appreciate you're not giving the partial year guide, given the deal hasn't closed yet, but just want to see how you're still thinking about the current guide heading into 3Q. Thanks.
Yeah, I'll start. I'll answer the question regarding the guidance. Basically, we're not updating our guidance right now, so our current guidance stands. Until we complete the closing of this transaction, then we'll provide updated guidance.
That make sense, Ravi?
Yeah, definitely. And then if you could help me think about the algorithm in breast.
Yeah. So if we think about an implant-based reconstruction, with the Resensation technique, today that involves using one Avance and then typically, two Axoguard Connectors. Axoguard Connectors are used as the coaptation mechanism at the proximal end and at the distal end. So where basically the Avance Nerve Graft connects to the native nerve stumps. NerveTape will then be able to be used as those coaptation mechanisms at both the proximal and the distal end.
Thank you. Our next question is coming from Frank Takkinen from Lake Street Capital Markets. Your line is now live.
Great.
Hey, Frank.
Congrats on the deal, and thanks for taking the questions. I wanted to start with a question around the expansion and surgeons in care settings. I am sure it is challenging to quantify, but you referenced a few thousand or greater than a few thousand accounts that Axogen today, 400 accounts for BioCircuit. Maybe how many accounts are available given the simplicity factor of NerveTape, and maybe how many incremental surgeons are now available to you?
Well, quite literally, every account that we serve is an account that will ultimately have a home and have a need based on their work for NerveTape. So the entire universe. In terms of surgeons, in totality, Jens, is it 4,800?
Yeah. Over 4,000.
Yeah. More than 4,000 surgeon users are potential users of NerveTape. Because, again, it's really important to emphasize in everything that we do, other than protection, where you're just wrapping or protecting a nerve that's otherwise intact. In every other situation, you're using microsurgery to connect two endings. So in that case, almost all of those situations are potential uses for NerveTape.
Got it. That's helpful. Then maybe just my second one on gross margins. Obviously 80% is a great margin already, but at $24 million annualized run rate, I'm sure there's still a scale factor in play that can optimize that gross margin. Maybe any thoughts around long-term gross margin potential of NerveTape?
Not yet. It's simply because, until we get into the details of that ourselves with the BioCircuit team looking at what kind of economies of scale might result, we truly don't have any additional insight beyond the current 80%.
Fair enough. Thanks for taking the questions. Congrats.
Thanks, Frank.
Thank you. We've reached the end of our question and answer session. I'd like to turn the floor back over to Mr. Dale for any further closing comments.
Thank you, operator. On behalf of the Axogen team, I want to first of all thank the collective teams at BioCircuit and Axogen. We are excited about the opportunity to bring our two companies together and to extend our leadership position in peripheral nerve care. Secondly, I want to thank everyone for their time and interest in our work to fulfill the promise and potential for all stakeholders of our business purpose, which as a reminder, is to restore health and improve quality of life by making restoration of peripheral nerve function an expected standard of care.
Thank you. That does conclude today's teleconference and webcast. You may disconnect your line at this time, and have a wonderful day. We thank you for your participation today.