Good afternoon, and thank you for joining us at this year's Canaccord Genuity Growth Conference. My name is Caitlyn Cronin, and I'm one of the medical device analysts here at Canaccord Genuity. With us today is Bioventus, a medical device company commercializing innovations for active healing across the orthopedic landscape. We're very pleased to be joined today by Rob Claypoole, CEO. Before we begin, I want to remind everyone of any relevant disclosures, which can be found on our conference and our firm website. We will begin with a brief presentation by the Bioventus team, followed by a fireside chat, and I will try to leave a couple of minutes for any questions from the audience. With that, I'll turn it over to Rob.
All right. Thank you, Caitlyn. Good afternoon, everybody. Thanks for joining today. At Bioventus, we're on a mission to help patients recover and live life to the fullest. I'm in my second year as CEO of the company, and over the next few minutes, I hope to convey to you why I'm even more excited about the company today than when I joined and our potential to drive significant shareholder value. Before I do that, let me just, there we go, take care of this. During my remarks today, I'll be making some forward-looking statements and also discussing some non-GAAP metrics. For more information on those, please refer to our latest 10-K and 10-Q filings, which are filed with the SEC and also available on our website. With that out of the way, let me provide you with a brief overview of Bioventus. We have three businesses.
We have Pain Treatments, Surgical Solutions, and Restorative Therapies. In a minute, I'll provide you with more information about each of those portfolios. On an annual basis, we generate over $550 million in revenue. When you look across our product categories, they represent a market opportunity of over $6 billion. One of the really special aspects of Bioventus, especially for a small-cap company, is that we have multiple paths to creating shareholder value. First, we have a very diverse portfolio, and we play in large and growing markets. In each one of those spaces, we're either a category leader or a growth leader. With that world-class portfolio, we have the ability to drive above-market revenue growth on a consistent basis. Importantly, we also have a very healthy pure leading gross margin.
When you combine that pure leading gross margin in the mid-70s with above-market revenue growth, and you add to it the cost efficiencies that we have the ability to drive as we scale, that combination provides an excellent platform for us to continue to expand our margins while increasing profitability and cash flow. As we look ahead, we're very excited about our ability to drive consistent shareholder value as we aim to become a $1 billion high growth, high profit, high cash flow company. Over the past few years, we've made significant progress with our financial performance, and we believe we are well positioned to sustain that moving forward. When I first arrived at the company, I told everybody that our first priority was to increase and accelerate our revenue growth. We did that last year, bringing strong growth back to the company and driving organic revenue growth over 14%.
This year, despite challenging first half comparables, we'll still grow nearly 2x of the categories that we plan. The second priority for us was improving our profitability. That's from, again, growing above the market and leveraging that very strong mid-70s gross margin. When you look at our guidance for this year, which infers a margin just over 20%, that's exactly what we're doing with another 100 basis points improvement. Going forward, we expect to sustain that, again, by leveraging above-market growth, strong profit margin to drop profitability to the bottom line and expand our margins. Now, from a cash flow and a leverage standpoint, this is an area where we've been challenged in the past, but we've also made significant progress in this area. It wasn't that long ago that we were cash flow negative, and now we expect to nearly double cash flow again this year.
Significant improvement, but more importantly, we see another significant step change this year in both our cash flow and our leverage. As you can see, we're encouraged by our early progress, but important to emphasize that we feel like we've just begun and that we're, again, very well positioned moving forward to sustain this performance, especially with our very strong portfolio, the strategy that we have in place, and this increased financial discipline with the business. We expect that combination to drive continued improvement across our financials moving forward. All right. Now I got to go back some. There we go. Hold on one second. Okay. As mentioned earlier, sorry about that. As mentioned earlier, three businesses with pain, surgical, and restorative. Let me just briefly tell you about the portfolio across each. Within each space, we're either a category leader or a growth leader.
Starting with pain treatments and our hyaluronic acid or HA line, this is led by our flagship single injection therapy, DUROLANE. We believe in this big market that we have an unbeatable combination. We have strong clinical differentiation. We have the largest dedicated sales organization in the HA space. We have a very strong platform of private payer contracts, which give us broad access to the market. We believe position us to continue to grow above the market. Recently, we've announced the expansion of our pain treatments business with the addition of a world-class PRP system called XCELLL, which we added to our portfolio through a distribution agreement with APEX Biologix. The XCELLL system is designed to provide both precision and efficiency to the physician.
Precision from the standpoint that allows for easy customization of the PRP treatment based on different patient applications, and efficiency because it saves significant procedural time. We're very excited to have this in the portfolio now, piloting it in the back half of this year, and plan on driving it aggressively going forward. We just made a major step forward in our pain treatments business with respect to PNS with the 510(k) FDA clearances of StimTrial and TalisMannn. For those of you who are unfamiliar with it, StimTrial is our first ever trial lead. Not having this in our portfolio in the past has significantly hindered growth because many physicians prefer to test if a patient, to assess if a patient responds to PNS therapy before doing an implant. We haven't had that in our portfolio. Also, many payers require this for reimbursement. This is complemented by TalisMann.
This combines our patented electric field conduction technology with an integrated pulse generator to potentially reach deeper, thicker nerves. We think that it has tremendous potential going forward. For a physician, this means that it gives the physician the ability for easier placement and to potentially broaden their patient population for addressable nerves. For the PNS business, I should say that in this, I feel like it's just the start. We're determined to build the most complete and best portfolio in the PNS market. I think you can see from our recent innovation and our clearances of StimTrial and TalisMann that we have the internal R&D team to do exactly that. Now on to Surgical Solutions, and I'll start with our world-class ultrasonics platform. Many of you may be familiar with this space. We're focused primarily on spinal surgery and bone cutting.
For ultrasonics today, that market for spine surgery is dominated by drills and hand tools. We believe we have the potential to change the standard of care in that space. Our ultrasonics platform provides exceptional precision and control to the surgeon. It also reduces patient blood loss, and it saves a significant amount of time. One surgeon told me recently that it's saving him 45 minutes per case. This isn't a little bit of time that when you add it up over the course of a year, amounts to a lot. Every case, it's saving him 45 minutes. Another surgeon told me that he was about to retire, and this has elongated his career because it's so much easier on his body. Yet another one said that during his career, it's rare that he's seen revolutionary technology, but that our ultrasonics technology is exactly that.
We agree, and we're going to invest in it aggressively and drive it hard over the coming years. We also have in our surgical business bone graft substitutes with our flagship product, OSTEOAMP. This is also in a very large market. We're focused on the premium segment, and that segment alone is another billion dollar segment. In that space, we have a product with OSTEOAMP that provides similar results across a broad range of procedures, but also has the potential to provide material savings to a hospital. We have both the clinical and the economic value proposition in this market, and we intend to continue to drive this business aggressively as well by raising awareness of both that clinical and economic value proposition with bone graft substitutes. I'll move on to the last one, which is restorative therapies with our proven fracture care technology, EXOGEN.
This is a business that the company had deprioritized in the past, and the result was that it declined for five years in a row. We've restored growth to that business, and we did that by increasing the focus on the business, improving the commercial fundamentals, and making a series of small investments that have had a very high ROI over the last couple of years. The result last quarter, as we just reported, this business grew in the double digits. A very nice improvement here. As you can see, we're really excited about the portfolio we have and our ability to drive significant growth short, mid, and long term, which is a good segue to the next slide. We look at our growth through this lens. First, we have our core businesses that I referenced, HA, BGS, and Fracture Care.
These businesses make up a significant portion of the company's overall revenue. As referenced on the previous slide, we believe we have the ability to continue to grow these above the market with a combined growth rate in the mid-single digit to high single digit. HA, with that unbeatable combination that I mentioned, BGS, with both that clinical and economic value proposition, and as I mentioned with Fracture Care, really just by returning focus and discipline to the fundamentals within that space. Now, we're layering on top of that what we consider to be our expansion businesses. In that, we have our ultrasonics and our international business. Both of these today are less than $100 million in size. They represent combined about a quarter of the company's revenue. With ultrasonics, as I mentioned, we have the opportunity to change the standard of care in that space.
With international, we've grown up as a U.S. company, so we have significant untapped potential within our international business. Naturally, that's why we believe strongly that we can grow double digits in those spaces. We also just brought in a new leader recently over our Surgical Solutions business that ultrasonics is a part of and over our international business in order to ensure that we reach our full potential with both of those expansion businesses. We have our emerging businesses. What might have occurred to you is that our core businesses here, those big, stable, growing businesses, we're leveraging those to fund both our expansion and our emerging growth opportunities. The emerging businesses that we're layering on top of our core and our expansion consist of the new technology that I just mentioned with PNS and PRP. Again, tremendous opportunity for growth here.
PNS today, it's about a $200 million market, and it's expected to exceed $500 million by 2029. Not a lot of spaces out there that are expected to see that type of growth. We just have the 510(k) clearance of StimTrial and TalisMann to aggressively go after this space. We're very excited about what we can do to grow that. PRP, that's almost a $400 million market in the U.S. alone, growing in the high single digits. Again, with our XCELLL system, now we have, we're delivering a precision and an efficiency to the market that differentiates it from other technologies.
Naturally, with both of those, the markets that they're a part of and the differentiation of our technology that we're bringing to market allows us to feel very confident that we can drive not just double digit, but strong double digit growth in the years ahead for both of these businesses. You guys know that driving above market growth is not the only way to create shareholder value. We have, as I mentioned before, a very strong, stable gross margin in the mid-70s. Growth is exciting. It's even more exciting when it's paired with a very strong gross margin. What this really means for Bioventus is that we're in control of our own P&L. We have the ability to continue to invest in our growth while also expanding our margins. In control of our P&L, ability to invest while still expanding our margins.
What we're doing this year is an example of that. As I mentioned, midpoint of our guidance suggests a margin above 20%. That's a 100 basis point improvement. That's why we're investing to grow the business. That's what we're going to continue to do. Grow above market, leverage the gross profit, drop it to the bottom line so that we can continue to improve our margins. We have the opportunity to get more efficient with our operational expenditures to further enhance those bottom line margins. Last, before wrapping up, I'll touch on a part of Bioventus, which is perhaps less understood, but that we're equally excited about in terms of driving shareholder value, and that's our cash flow. Over the past few years, we've made steady progress in improving our cash flow and feel strongly that we're well positioned for that to continue.
How we've been doing that, first through the higher EBITDA, again, above market growth and leveraging that gross profit to drive higher EBITDA. The second is we've significantly lowered our debt over the last couple of years and secured a lower interest rate through our recent refinancing and terms of our new term loan. That obviously lowers our interest expense. That's combined with a decrease, a significant decrease in our one-time cash costs. We've also made good progress on our working capital, mostly from a receivables and payables standpoint. Now we're starting to attack our inventory levels. What's been the result of all of this? You can see it up there, but nearly doubling our cash flow again this year versus last year. That results in a cash flow yield of roughly 60%. Our net leverage is expected to drop below 2.5 x by the end of this year.
A really strong improvement in our cash flow and what we expect to sustain going forward. Last, to wrap it up before we shift to Q&A, I'll just emphasize again that at Bioventus, we feel like we're very well positioned to sustain our momentum. We've made a lot of progress with our execution and our financial discipline over the last couple of years, but it's just the beginning of what Bioventus can achieve. We're very excited to continue that momentum. You'll hear it again and again by driving that above market growth, leveraging that profit to strong gross margin in order to expand our EBITDA performance and also to drive a significant acceleration in our cash flow as we march to becoming that $1 billion high growth, high profit, high cash flow company that helps patients recover and live life to the fullest.
With that, I'll turn it back over to you, Caitlyn, for questions.
Great. I think the best place to start here is the Q2, given you just released the results last week. You had a good quarter where you exceeded top and bottom line expectations. You also maintained your full-year guidance through the P&L and continue to note expectations for a stronger second half than a first half. What are the dynamics that are leading to stronger second half expectations and any signs in the Q2 and early Q3 of momentum building?
Yeah, thanks for the question. What we mentioned at the start of this year is that our focus, and you heard it during the presentation, is to drive above market revenue growth, expand our profitability, and improve our cash flow. What we saw in the first half of the year is good progress across all three of those. When we look at the back half of the year, our guidance suggests an improvement in our growth rate of about 300 basis points. Nearly half of that will come from having the tougher comparables behind us from the first half of the year. The rest of that's going to come from increased growth in several of our businesses, including HA and BGS, where we have good line of sight to our pipeline and the ability to grow by bringing on new business. Other businesses are contributing to that as well.
We feel good about the back half of the year. We're early on, but we're happy with our progress in the second quarter and leading into the third quarter in order to accomplish our goals for the year.
Great. Let's just move to pain treatments. You called out in your presentation PRP and PNS as being emerging businesses for your portfolio. Just starting with XCELL PRP, you announced the partnership earlier this year. Briefly describe the rationale for the partnership here to the audience.
Yeah, thanks for the question. First, what we did, we're constantly, even though we're, let me back up and say, we're very happy with the portfolio we have. Over the last couple of years, we've invested in a couple of businesses, and what we have today, we believe positions us very well to drive attractive growth. Nonetheless, we're always going to be looking at the market and seeing what opportunities exist. In this space, when we were doing our research, we saw that over 80% of HA customers out there are using a PRP system, but obviously not ours because we didn't have one. We looked at it and said, you know, it makes sense for us to enter that space, but we didn't want to build our own, and we didn't want to buy a PRP company. That led us to the distribution approach.
We canvassed the market extensively, looking at many different PRP systems, and we identified what we think is the best out there with the XCELL PRP system. Again, that's because of the precision and efficiency that that provides. Fortunately, they were very interested in the partnership as well, and it's off to a good start. We're piloting the new PRP, our new addition to the portfolio in the back half of this year, and we expect to ramp up in 2026.
You mentioned leveraging that specific call point. Will the HA sales force be the one distributing the product, or do you have additional sales team members to add?
Yeah, no, that will leverage our existing HA sales footprint.
Great. What are your expectations for this product to contribute in 2025 and 2026?
Yeah, the way I think about it is when we think, okay, core businesses growing above the market, expansion businesses on top of that with Ultrasonic International, and then these emerging businesses. When we take those two emerging businesses combined with PNS and PRP, we expect those two alone to contribute about 200 basis points of growth to the overall company in 2026. It starts to become meaningful in 2026, but obviously we expect to ramp up significantly from there within both PRP and PNS.
Turning to PNS more specifically, this historically has been a very small portion of your business, but you've called out the subsegment as this emerging growth driver. Just remind us with the clearance of StimTrial, your first lead, why that's a really important piece of the PNS algorithm to add to your portfolio.
Yeah, and to your question, it is important to point that out that in the recent past, we've really been focused on our R&D efforts, not on our commercial efforts in this business. We have just a few million in sales in this business and a handful of people on it. Now we're going to ramp up significantly as we move forward. That combination of StimTrial and TalisMann. StimTrial, again, this is, you know, many physicians prefer to assess whether a patient will respond to PNS therapy before doing an implant. This makes sense. These are patients suffering from chronic and debilitating peripheral pain. Some of these patients have a hard time touching their own skin because of how painful it is. Many physicians don't want to do something else with the patient unless they know it's going to work, and that's in the form of a trial lead.
Also, for insurance companies, many of them prefer that that's assessed before doing a permanent implant. We haven't had that in our portfolio in the past, and that's been a hindrance to growth. Not only do we have it now with StimTrial, but it's also very complementary to our permanent implant with TalisMann. That one-two combination is, for us, it changes the game with our PNS business, which is why we'll be investing in and ramping up that business much more aggressively going forward.
I believe the sales force here differs from the HA sales force. How large is it now, and how much are you planning to add to the team here, and what's kind of the timeline for those additions?
Yeah, so you're correct. It is a different sales force, and as I alluded to briefly there, it's very small today. It's been less than 10 people that have been out in the field with our existing business. Naturally, we're going to ramp that up significantly. For competitive reasons, we're not sharing exactly how many we'll have and when that'll take place, but you can expect it to ramp up moderately this year as we're in the pilot phase, and then much more significantly in 2026 and 2027.
Great. With the last minute here, let's touch on O.U.S. Rob, with your prior experience, I think you're focused on really improving the international strategy, and O.U.S. was strong in Q2. Any early initiatives that you and the team have started to drive there?
Yeah, again, I'll point out that it's a significant untapped opportunity. You think about, we have less than $100 million in our international revenue, and that's really because we as a company have been focused on the U.S., not because there's not patients internationally that would benefit from our technology. The first thing was bringing stronger focus and leadership over the business. We hired somebody in to run this, somebody that worked for me in the past and who has a proven track record not only of knowing the international space really well, but somebody who can drive both strategy and execution, hands-on execution at the same time. The first is bringing that leadership and the focus to the international business. What we're doing now is developing the right strategy to scale effectively and efficiently for international.
What that means is not going all places to do all things, but being focused on the right markets with what aspects of our portfolio with the right go-to-market strategy so that we can invest aggressively in those areas and drive that very strong double-digit growth that we referred to before. We still have a lot more work to do with our international business, but encouraged by some of the early progress and expect to see a lot more moving forward.
Great. I think we'll end it there. Thanks, Rob.
Thank you. Thanks, everyone.