Good morning, and welcome to Needham's twenty-third Annual Healthcare Conference. I'm Serge Belanger, one of the healthcare analysts at Needham, and for our next session, we're happy to have Evolus with us this morning. We have the company's CFO, Sandra Beaver. She's gonna give us an overview of the company, and then we'll jump into Q&A. I think Evolus is one of the more exciting pure play aesthetics company right now. So I'll hand it over to Sandra, so she can tell us more about it.
Thank you, Serge. Really nice to be here. Appreciate, appreciate the opportunity to, to chat with you today. Evolus is a performance beauty company. Our flagship product is a neurotoxin called Jeuveau. Jeuveau is the number 3 market share product in the U.S. for neurotoxins and the number 2 in brand awareness. We've been the fastest-growing neurotoxin for the past 3 years. We currently have 12% market share in the U.S. We operate in a TAM within neurotoxin in the U.S., that's about $2.6 billion, and it's about one point... Well, $900 million OUS for us. We're also selling the product under the brand name Nuceiva in the U.K., Italy, Germany, and we have the rights to 31 countries in Europe, Australia, and Canada for Nuceiva.
We've recently licensed a line of hyaluronic acid dermal fillers that we will bring to market in 2025 in the U.S. and Europe. We're very excited about that line. It's branded Evolysse in the U.S., and so you'll hear us talk about Evolysse. That puts us in a position where we'll have a portfolio of assets in the medical aesthetics space. However, we approach the market in a very different way than our competition. We are not a traditional biopharma-type company. We very much see ourselves as a beauty company. We are focused on the millennial segment, which is the fastest-growing users of these products in this space, and they're driving the growth in the category.
The category is a very healthy category, growing at a high single-digit, low double-digit growth consistently over many years, and expected to do so for a number of years to come, which puts us in a really unique space compared to other products, where we offer things to practice that are different than anyone else. We offer co-branded media using a very edgy beauty-type branding style, where we're really positioning the product as a beauty procedure, not a medical treatment, and that's really where the industry and the category is going. So Evolus really carves out its own niche and challenges the status quo of how these procedures have been viewed in the past, and we're very excited about what's coming ahead.
Great. Well, thanks for that overview. And before I forget, for those listening online, you do have the option to submit questions via the portal you're watching the Fireside Chat on. So I guess maybe to start off with, before we talk about the overall market trends and things like that, maybe just highlight what the aesthetic-only focus allows you to do in terms of your marketing strategy and how that differentiates you from the various other players that are in this space.
So in other competitors that have a neurotoxin, they also have a therapeutic indication as well as a cosmetic indication, the cosmetic being the cash pay. With that therapeutic indication, the FDA requires that they maintain price parity between the two products, although the same product, the different indications. That puts them in a position where they can't offer incentives and/or meaningful discounts on the cosmetic without impacting the therapeutic and having to reduce the price on the therapeutic. We don't have that constraint, and so not only does that give us pricing flexibility, it really gives us the opportunity to partner with practice in a different way.
We see this ability to add value back into the practice by offering such programs as co-branded media, as well as having an Evolus Rewards program that is one of the most accretive consumer loyalty programs available on the market today. And to allow practice the ability to grow, utilizing the assets that we've developed a lot more efficiently in the market. We've done over 1,600 billboards, over 300 TV campaigns. We've done over, I think, 6,000 digital campaigns to help advertise that practice, and all of these campaigns are co-branded.
What that means is you see the practice and you see our product right alongside the practice, so it's very clear where you can go to get it, unlike a traditional DTC campaign, where you might only see the product, but you don't have a call to action as to where you can access or purchase the product. This gives a very clear return to the practice, and these are benefits they earn based on the amount of Jeuveau that they purchase, right? So as they purchase up into our Evolus tiers, which is our customer loyalty program, they get access to these additional benefits, and everyone has access to our Evolus Rewards program. And this is different than any other neurotoxin on the market today.
Okay. I think in the past, you've talked about kind of an app-based technology that facilitates appointments and the couponing. Is that also a differentiated aspect, or is that pretty commonplace now in the aesthetic category?
I mean, yeah, so use of digital, I think, is somewhat pervasive in the category. I think, obviously, a little biased, right? But our digital is unique, and it is custom-built internally by our own engineers. One of the things that enables is transparency with the practice in terms of pricing. They also have the ability to pay their bills through either an app or a portal, and they get all the clarity around the status of their account in those systems, as well as any promotions that we might be offering. They can see all of that real time. So they have the ability to have transparent visibility into what the offerings are at any given point in time that's available to that account, and that is a custom-built platform.
They can also track all of their Evolus Rewards programs in there as well. So any consumer loyalty that they're offering and the status on that consumer loyalty. The consumer loyalty program is actually text-based. The consumers don't typically want to put an app on their phone. It's a pretty high friction experience, and what we're intending to do with our digital platform is reduce the friction that people interact with in terms of getting access to the procedure, right? So the lower the friction, the easier the access, and we really are focused on reducing friction in their ability to access this procedure, and our digital platform is a way to do that. The other side benefit for us at Evolus is that it's very efficient. So we can engage with a customer, and we can purchase product, sell product without having to send a sales rep.
We probably have one of the more efficient sales forces in the industry today, and a lot of that is owing to the digital platform and the efficiency that it offers our customers.
So let's talk about overall aesthetic market trends. I think there was concern for most of 2023 that we would see a slowdown after a very strong 2022. But what's the expectations for growth now for 2024? And I don't know if you can talk about what the first quarter looked like. We typically see a slowdown. Curious if that was the same kind of slowdown we usually see.
Yeah. So this is an incredibly healthy market, right? And although we've seen some ups and downs related primarily to the timing of COVID, if you sort of look over time, it's been growing at this high single-, low double-digit rate consistently across many years, and the expectation is that it continues to do so. Last year, we estimate the market grew in the high single digits. It's hard to know with precision because we do have two neurotoxins in the market that are not publicly reported companies, so we do have to estimate those products. But we estimate in this 7%-8% growth range is what we saw last year in 2023, and we bring back half of 2023 momentum into 2024.
So if you were to look across the year in 2023, the second half of the year was growing faster than the first half of the year. And so we're exiting 2023 with this great momentum in 2024, and we expect that we'll continue to be in this high single-digit, low double-digit growth range this year for the toxin. You did see a relatively flat filler market last year. So as you talk about economic pressure, the share of wallet, the higher price procedure being the filler, that was a relatively flat market last year, as opposed to the high single-digit, low double-digit growth we saw in the toxin.
However, we do expect that will rebound, if not in 2024, over a multi-year term, that it will continue to grow in the same range as the toxin, as we enter into the filler market in 2025. Seasonality is a very real thing in this market. So Q4 is always the strongest performance quarter that we have in the entire market. That's not unique to Evolus. And Q2 is the second to Q4, which leaves you with a bit of a lower Q1 and Q3, and that means that Q1 tends to be a step down from Q4 in terms of absolute performance on a revenue basis. And that's just owing to the high procedure volume that we see in the fourth quarter.
It's nothing to do with any concerns on the health of the market, but you can typically expect to see a modest step down quarter-over-quarter from Q4 to Q1. We don't expect 2024 to be any different, but too soon to give any indicators on actual performance for Q1.
Yeah. Okay. And if I recall, in 2023, Jeuveau grew by 50% year-over-year or around that range?
The global revenue growth for last year was 36%. However, we exited the year over 40. So in the back half, we were in the low 40s. That represents a minimum of 3x the market every quarter that we were growing as a product, right? So if the market's growing high single, we're growing at least 3x. In some quarters, we did up to 5x market.
That outperformance is expected to continue in 2024. I think based on guidance, you're still trending or expecting significantly higher growth over the market.
Yeah, we tend to expect a minimum of 2x market. We tend to be closer to 3. In some quarters, we outpace by a little bit more. The reason for that is we're incredibly underpenetrated in the market. So as I mentioned, we had 12% share. However, we estimate there's about 30,000 medical aesthetics and practices in the U.S. That includes plastic surgeons, dermatologists, and med spas. We are in, exiting 2023, 12,400 of those accounts, which means we're at about a third of the available market in terms of account volume, which leaves a tremendous amount of white space for us to still penetrate in the market, which is what's fueling that growth. We added 2,900 accounts in 2023, and those accounts typically take up to a year to get to full capacity from a purchasing standpoint.
So you not only have this effect of we're still continuing to add accounts at a very high pace, we expect to add a minimum of 500 accounts a quarter for at least a couple of years, but you then have the 2,900 accounts from last year continuing to increase their penetration rate. So as we say, we intend to go wider and deeper because we do see opportunity in the accounts we're currently selling to take more share, but we also have this opportunity to increase our overall coverage rate across the accounts available in the U.S. In addition, we continue to launch in Europe, right? So I mentioned we're in the U.K. Last year, we launched in Germany and Italy. This year, we expect to launch in Spain and Australia. There's five major markets in Europe that drive the majority of the share there.
We're focused on those markets. They include Germany, Italy, the U.K., Spain, and France. France, we've licensed the neurotoxin to Symatese. So that gives us this great balance of the U.S. presence and the OUS presence as we continue to expand outside of the U.S.
... And you mentioned you're in about a third of accounts right now, that's driving your 12% market share. So is there anything specific to that first one-third of accounts? Are they the ones most likely to adopt a new product?
Yeah, I mean, there's not a, you know, typical sort of Jeuveau customer. It's a product that's great for everybody. But obviously, our business model is more appealing to certain clients versus others, right? So, the 30,000 accounts, roughly two-thirds of those accounts are med spas, as opposed to traditional derms and plastics. We slightly over-index the market in terms of med spas, so we're closer to 70% of our accounts being med spas. And there's a, a value for them in terms of using Jeuveau, not just because of the quality and the precision of the product, but they really do benefit tremendously from this co-branded marketing, and I think their newer emerging accounts.
The growth in accounts in this space has been tremendous, particularly post-COVID, where you have a lot of owner injector practices, where you have an individual running their own practice, and they're, you know, they're coming out of traditional medicine environments and choosing to go into this space. It's just a nicer place to be, and we're a great product for that particular use case, and that's where we do see a lot of great adoption. However, what we're finding is the product itself is unique, right? It has a very precise field of effect, which is different than the other neurotoxins on the market. What that means is it gives the injector a lot more control over the outcomes for their patients. I always say the injector is a bit like an artist with a paintbrush, right?
If you give them a finer tip brush, they're gonna get a more refined result. That's really what Jeuveau does for them. What's happening is, as we're hitting this kind of tipping point of market share, that word of mouth from injector to injector is building momentum behind the brand. A lot of that comes from the confidence in the performance of the product itself. It's an excellent product. It's the only other 900 kilodalton molecule neurotoxin on the market besides Botox, and it spreads less. So as they learn that personality profile of this product, the adoption rate continues to increase. We're taking more inbound, I think, interest these days than we have ever in the past. Another big piece of adoption is training. So last year, we actually launched a training bus.
It does cadaveric trainings on-site at practices where you can get 12-15 injectors on this bus training at the same time. It allows us to really tap into some of the smaller markets and do more cultivated training specific for practice. But we also have a team of medical affairs clinicians that go to practice directly and train injectors on Jeuveau and the product.
Okay. And I think you've talked about the level of awareness of Jeuveau is, it now ranks second or third among the neurotoxins. Do you think that could be a strong tailwind as you target the other two-third of accounts that you're not penetrated in right now?
I mean, we're certainly focused on the brand, and our brand is very different. We don't look or feel pharma, and that is very intentional. And so that allows that branding to not just develop customer awareness, customer loyalty, but to be a real consumer brand. And we really see that opportunity to build a consumer brand. And ideally, you know, you get to a place where you've got consumers going into practice asking for Jeuveau. Right now, we've got a bit of runway to go to get to that place, right? It takes quite a bit of focus on a DTC campaign to drive that kind of consumer awareness, but we've already eclipsed the number two entrant into the market, which has been in the market for over 20 years, and we've been in the market for 5, right?
Yeah.
So our focus on that branding and on that differentiation is clearly demonstrating a more accelerated awareness of our brand. And that really, I think, comes from the quality of our campaigns and the quality of the media that we're putting out into the market and the beauty focus of that media. And if you look at our investor deck online, you can see it there, right? A lot of it is much more edgy, beauty-looking than a traditional pharmaceutical model.
Previously talked about 12% market share. How high does the market share climb in the account, that one-third of accounts that you've talked about?
Yeah, so we have some that are 90%, some that are 50%. The average is about 20.
Okay.
Keep in mind that there's, you know, those 2,900 new accounts that aren't at full potential... yet. Every practice carries at least 2, often 3 toxins. You don't see where a practice only has one. They always have at least an alternative option. So even in those where we get to 90, there's something in that 10% that's offered for other patients that are maybe resistant to that one toxin. The reality is 50% is kind of a, a good outcome, and you're kind of the number one toxin in that particular practice. 90% is a bit of an aberration, right? You wouldn't expect to get to 90% in all of your accounts because they do want to offer choice-
Yeah
... to the patients, and they do need a secondary toxin for kind of a backup option for patients. But being only at this 20%-25% range now, and just keep in mind, we're estimating that number. We don't have visibility into what our accounts purchase outside of Jeuveau without literally polling every single account, which we do poll a subset of the accounts a couple times a year, but we're kind of working with our customers to understand their purchasing patterns, so we're estimating around 20%. There's a lot of opportunity between 20% and 50%, right? So what unlocks that additional share in those 12,400 accounts? You know, piece of it is, as I mentioned, training, right?
Part of the reason it takes up to a year for a practice to adopt the product is they want to make sure that they can get the outcomes with their patients that they want with the product. The toxin is the flagship procedure in these practices. It's the single largest driver of new patients into practice, and it also is the kind of catalyst for upselling to other procedures. So if you have a patient who gets an adverse event or doesn't get the outcome they expect, that patient may not come back. And so for the practice, that confidence is very critical, and that's really where our training is playing such a pivotal role.
So it takes a bit of time, and they're going to want to test and learn either on, you know, other folks and friends and family or folks in the practice before they start offering to patients. And these products last four or five months, right? So it does take a little bit of time to come up that purchase curve, and that's why we sort of look at that twelve-month window of when you might get to full capacity. We also are a single product company today, right? And you, you'll probably get to Evolus, but many of the other competitors offer both fillers and toxins as a bundle.
Mm-hmm.
There is a bit of an economic trade-off if you choose Jeuveau and you potentially risk your discounts on your fillers that you're buying from another company today. There is a bit of a tipping point where they'll buy as much as they can without risking the discount they might be getting on the filler, and there could be an opportunity to unlock higher purchasing behaviors when we have a filler in the portfolio.
Okay. Actually, great segue to pricing questions. I think when you launched Jeuveau, goal was to be at 15%-20% discount in, in terms of purchase price, to Botox and some of the other products. Just curious where that stands and what does it mean for the economics of using the product for the injectors?
Sure. So we launched at about a 25% discount to Botox. We're closer to 20% now. We continue to see opportunities to narrow that gap. I think as the confidence level in the product continues to increase, that allows us this ability to continue to narrow the gap. Our goal is not to get to price parity with Botox. We expect to always be at a, a modest discount to that product, and that's part of the value proposition that we offer. But we will opportunistically look to raise price, and we have continuously raised price over the last number of years and, and expect potential upward mobility on price as opposed to any downward pressure on price. So there is certainly that, that dynamic. The majority of practices are charging consumers the same rate, regardless of the toxin they dose them with.
If you're getting 10 units of Botox, 10 units of Jeuveau, 10 units of these other products, they're charging similar rates to the consumer. What that means is the savings on the vial itself is going directly to the practice. It's improving practice economics on the procedure. Then, as they purchase more and more of the product, they then get co-branded media as well. Not only does that defray a cost on their, you know, P&L for them at the practice level, where they don't have to purchase those media campaigns themselves, but they're also getting much higher quality than they could ever afford on their own, right? We have cultivated campaigns. We'll send a TV crew to the practice to film, and we're using the same assets.
We're using the purchasing power that we have as a company across all of our customers to get better pricing on this media and higher quality media. So it's much more efficient with our, you know, backing than it is on anything they could do on their own, which just continues to improve the value to practice of the procedure itself. We also offer the most accretive consumer loyalty program in the market today. So we offer $40 off every single treatment of Jeuveau for all of our loyal consumers. We're up to 750,000 consumers in the program as of the fourth quarter, and we had our highest rate of redemption in Q4 at over 175,000 consumers redeeming in Q4 of 2023.
So we continue to gain traction with direct with consumers by enabling the practice to offer this discount directly to patients that they couldn't get on any other procedure. So you're kind of passing that value on to the consumer with us funding that discount at $40 on every treatment.
Okay. How do you view the competitive field in for neurotoxins? There's three, I think, three products that have been out there for a while now, but last year, Daxxify launched the, the Revance product, and most, more recently, the Hugel product, Letybo, was approved. I'm not sure if there's been any other developments on when it could launch, but how do you view those two products and how they could impact the growth trajectory of Jeuveau?
Sure. So obviously the premier product as I call it, the Kleenex of neurotoxins is Botox, right? It's the brand that carries the highest share in the market today, and it's been around certainly the longest, for decades. Dysport came in not long after Botox, and you kind of had those two products in the market for quite some time. You then had Xeomin come into the market, and Xeomin really took a price play. So they are the price player in the space, and they kind of command this price corner of the market, which is relatively small, right? So as I mentioned, sort of performance always trumps price in this market. So Xeomin tends to be in this low double-digit share space and has been for some time.
When Daxxify launched, they created, I think, a very interesting conversation for all neurotoxin providers and I think created some momentum in the market that's really been positive for all of us by introducing the idea of a longer-acting toxin, right? Their strategy was to focus on the premium segment of the market and to go for a higher price product, but a longer duration product. I think that really started to increase practices' willingness to try a new toxin and to change from toxins that they were in, which benefits, I believe, everyone. For those that are looking at sort of adding a longer duration toxin, it potentially expanded the market a little bit, as opposed to really putting pressure on others, and, you know, credit to Daxxify for really focusing on that strategy. They have had some challenges in their launch, right?
So I think there's been an inconsistent relationship between outcomes with patients, whether it become, you know, how do you price it, which is not that easy to figure out, versus how do you dose it across all the areas of the face and get the outcomes that everyone's expecting. And they've taken some reductions in their price as a result to try and compensate for some of their launch challenges, which puts them in a place where they're still, I think, figuring out how to partner effectively with practices and get the right strategy around pricing and dosing. And there's frankly not a lot of overlap with our customer base and the target customer base of the Daxxify product. So we've seen them be successful in some practices, but I think they've had some challenges in their launch.
Until practices get comfortable with the product and the outcomes they can recommend to patients, I think that will continue to happen. Today, you know, as I said, we're about a 20% discount to Botox for a 100-unit vial. They have a 100-unit vial, we have a 100-unit vial. Daxxify also has a 100-unit vial. However, their recommended dosage is 40 units versus our 20 units. Their vial is about a 30% discount to our vial at this point. So as they've continued to reduce price to compete with Botox, as they've stated, that's put them at a discount to Jeuveau at the same number of units. However, their recommended dosage is double our recommended dosage. So that kind of creates a dynamic within the pricing that I think folks are still trying to figure out.
Yeah, makes sense. While we're on the-
Um-
subject of longer duration, you did conduct a Phase II trial to evaluate the duration of extra strength Jeuveau. Maybe just tell us about it, and whether it's been published now, and whether its side effects, and if you're seeing more usage of extra strength Jeuveau.
Yeah, so we've presented the data, but we haven't published the final report. That'll come out later this year, when it's completed. So that'll give absolute clarity, although with the data that we have already presented, many practices are already using 40 units of Jeuveau today. We do see that long-acting market as a relatively small market, right? If you go into practice and you say, "Would you use a long-acting toxin?" 80% of them will say, "Yes, I will." If you go one step further and say, "Okay, walk me through your day. How often are you dosing that longer duration toxin to your patients?" And it's less than 20%. We then have seen in practice, it's actually turning out to be less than 10% of their patient population for those that want long-acting, that are using long-acting.
So we are seeing some practices start to use it, but it is a relatively small percentage of practices that are using it. Our Phase II study proved that there is a correlation between dose and duration, as we expected. So at a 40-unit dose, and we do concentrate it a bit differently, so it is a slightly different dilution of the product as well, we are getting 26 weeks or six months of duration with the product versus the 21 weeks that we get today. So it's five weeks of additional duration for double the dose. So there's a bit of a curve in terms of it doesn't double the duration. You're getting about 20-30% longer with twice the amount of product. And there are folks that have an interest in that usage, but it does cost more, right?
So it's that trade-off between, do I wanna pay for twice the volume to get not twice the duration? And for those that are not price sensitive, that may make sense.
Yeah. So I think it was about a year ago, you announced the in-licensing of Evolysse from Symatese, and that relationship with Symatese has since grown with the European licensing. So maybe just talk about how you found Symatese and what you were looking for when seeking a filler to add to the product portfolio.
I'm super excited about the partnership with Symatese. I'm very excited about the product itself. We looked at over 150 different fillers, right? The market in Europe is very rich with lots of different fillers. However, it was very important to us that we found an incredibly high-quality product that had a differentiation to it, with a high-quality company. And Symatese is an excellent company, so I think they're really been in the background of medical aesthetics for some time. They're not a name that I think many people recognize, but if you look at some of the work that they've done, they developed the latest line of Restylane fillers for Galderma. This is the next generation of that product with a new technology. They also partner with L'Oréal, providing collagen products for L'Oréal.
They developed the Mentor breast implant that is now sold by J&J. Right? So they've got a long history. They've been around for decades in the development and manufacturing space for medical aesthetics products, and they've got tremendous expertise inside of Symatese that I think is a great value to what they've developed here with Evolysse. The technology is different because what they've figured out how to do is they've figured out how to cross-link the hyaluronic acid chains at cold temperatures. So all the other hyaluronic acids on the market today are cross-linked in heat. What happens when you heat up the hyaluronic acid chain is it develops fragments, so it can break. And you use these things called BDDE to cross-link, but you have more fragmentation in the product, which reduces the kind of what I call integrity of the gel itself by having that fragmentation.
If you can imagine a long chain, when it has breaks in it, it's not gonna be as strong as a chain that doesn't have breaks in it. So what they've done is they've figured out how to cross-link the hyaluronic acid with the BDDE at near freezing temperatures, preserving the integrity of the hyaluronic acid chain. So we're very excited about what that means for patients. The lower fragmentation would likely have a better safety profile for the product. It could potentially impact the duration of how long the product will last. And it is a sort of more substantive product, so there's less correction needed to get the results that you would want from the product. We recently released the results from our European trials on Evolysse.
Those are facilitating the European approval, which we expect to get in the back half of this year, for the line. And so you'll see in there, there was a head-to-head on our nasolabial fold product Lift, and there were single-arm studies on the NLF product, Smooth, as well as the midface product, Sculpt, and the lips product called Lips. Make it easy.
There's still some clinical development that needs to be completed. Like you said, there's four different products. Approvals start coming in back half this year in Europe and 2025 for the U.S. market?
Yeah. So we've completed the trials for Smooth and Lift here in the U.S., and we expect to submit to the FDA back half of this year. And so we will get approval for those two products in 2025, and we will commercially launch those two products in the U.S., as well as the four products we have in Europe in 2025. We then have the Sculpt, which is the midface product. We're also completing that trial. However, it has a two-year follow-up period, given that it is a more substantive midface product. So we expect to get that approval in 2026. And then in the U.S., we have Lips and Eyes, and we expect to get those approvals in 2027. So we'll have a cadence of commercial launches throughout 2025, 2026, and 2027.
The reason for launching the nasolabial fold products first, as we call them, they're the Swiss Army knife of fillers. They have the broadest use across all areas of the face, although they're indicated for the nasolabial fold. And they have the highest volume of use in the market. So the highest market share is coming from those products. Second to that, the midface product, it is the highest priced product, but not necessarily the highest volume. It's in the premium segment of the market. Really, the only product that is effective in that space today is Voluma, which is made by Allergan. And we're consistently hearing from our KOLs that this Sculpt product is going to be able to really meaningfully compete with Voluma. And so we're very excited about that particular product as well.
But that will, once we have the two nasolabial fold products and the midface product, that'll cover 70%-80% of the available market for fillers, and then you're filling in with Lips and Eyes as the smallest kind of niche products with smaller volume usage in 2027. So there's a thoughtfulness to how we're phasing these products into the market, where we're looking at the opportunity in the market and the usage of the product inside of the practice.
So obviously, that will give you some a bundling opportunity between Jeuveau and Evolysse. But curious how you, you know, in terms of a launch strategy, you just add the filler products to the bag and continue expanding to new accounts, or do you go back to existing accounts and introduce the filler?
Yeah, I mean, we're in a very different place launching the filler than we were launching the toxin, right? So your filler strategy is not going to look, we're in 12,400 accounts already. We'll certainly be in many more than that by the time the filler is available to market. So we'll have the opportunity to offer the product into the practices that we already sell to today, right? So you've got this built-in team. A filler was a very thoughtful second add of a product for us because it's got the highest leverage rate, let's call it, off of our operating expense base. It really does just drop into the bag. It's the same point of sale.
We have very modest increases to our sales force planned, and we have really, other than the launch expenses, we'll get a tremendous amount of leverage off of adding the filler into the portfolio. So still a bit of early days for us in terms of exactly how we're going to position it in the market. But, you know, as I've outlined, we're very confident in the quality of the product. We continue to see higher adoption of Jeuveau and, and a really healthy growth in our customer base, and that provides us a, a tremendous platform to launch Evolysse off of, and it allows us to really leverage the existing sales force that we have to get a, a really strong launch on this product.
Okay. We only have a few minutes, so let's talk a little bit about the ex-U.S. commercialization. I think you're in four or five countries right now and expected to continue expanding to additional ones. But I guess in Europe, which I think is the biggest market opportunity, ex-U.S., maybe just talk about where you are and whether the differentiation of the marketing strategy that you employed in the U.S. has been helpful in those markets.
Yeah, Europe is a very different market. One, it's quite a bit smaller. The price, competition is more significant, so you're seeing lower margins, because there's lower prices in Europe. And you don't have the same opportunity to offer the marketing programs that you do in the U.S. The regulation doesn't allow it. So there aren't DTC campaigns that we can do in Europe the same way we do the co-branded media in the U.S. What we benefit from in Europe as it relates to the U.S., is the learnings we've had around the product itself, right? This precision profile of Jeuveau is not something we knew when we launched Jeuveau five years ago. It's something we've learned.
By the time we launched Nuceiva, we had a lot more understanding of how to engage with a practice to really maximize the value to practice of that precision profile of the product. Where we've been really successful in Europe is around training around the practices. That's been a big focus area for us, and that was a big learning coming out of the U.S. We position Nuceiva differently than we position Jeuveau. It's not a discount to Botox, right? It's right up there in the premium space in that market, and we've been very successful with that approach and with that differentiated performance profile with the practices. So we're very excited about the adoption we've been seeing in Europe with Nuceiva, and we've been focused on getting into the big five European markets, which carry over 80% of the market in Europe.
So although there's 31 countries that we can launch in, five of them really drive the majority of the adoption. U.K., we launched first in the fall of 2022, was actually the fourth quarter. We then launched into Italy and Germany last year, and we'll launch into Spain this year. And then we've licensed the toxin to Symatese, who will commercially launch it in France, and those are the big five markets in Europe. So we continue to see a growth and adoption in the product in Europe, and we're very excited about that opportunity.
Maybe just to finish off, we can just talk about the financials, and I think you revised your guidance earlier this year. Your profitability timeline-
Yeah
Moved up a little bit, which I think, obviously very exciting. If you can just touch on that-
Sure.
Before we wrap it up.
So we're guiding to $255 million-$265 million of revenue for 2024, $185 million-$190 million of operating expense and gross margins of 68%-71%. We expect to be profitable, so that's positive non-GAAP operating income in the fourth quarter of 2024 and for the full year of 2025. I frame 2025 as the full year because we will potentially have some quarters within the year where we're launching the filler, that we may be unprofitable, just associated with one-time filler launch expenses. But we expect the full year to be profitable.
So that helps, I think, folks understand that although we've got some launch expenses with the filler, they're relatively modest, and that the business is expected to continue to gain more and more leverage over these coming years and expand those operating margins. So from 2025 and beyond, you can expect us to continue to expand operating margin every year. Our long-term guidance is $700 million of revenue, at least by 2028. So we fully expect there's lots of head, of catalysts that could come to play that will allow us to beat that $700 million. We expect the market to be a $10 billion market in 2028. So that would only imply 7% market share across all products, and we're at 12% market share today on the toxin alone.
So that gives us a lot of room to outperform, but we've been very thoughtful about making sure our long-term guide is really responsible, bordering on conservative.
Yeah.
We can expect to see a meaningfully profitable company at that time. Inside of that $700 million, just to give you some of the frame on some of the other questions you asked, we expect about $100 million of that to be OUS, so just in terms of what contributes from the OUS, and we expect $200 or so to come from the filler. That would include the OUS portion.
Okay. Well, I think we're over time, so we'll have to end it here. Thanks again for spending time with us this morning and telling us more about Evolus and Jeuveau.
Thank you so much, Serge. Appreciate the time.