All right. Good morning, everyone, and thanks for joining us for the Evolus presentation. Today with us, we have David Moatazedi, who's the CEO (sorry, I almost demoted you) CEO of the company, Sandra Beaver, CFO, and Rui Avelar, who is CMO. So thank you all for joining us. And Evolus, as you know, is a rapidly growing, and I will say aesthetics, but it's really a beauty performance company. I'll use your nomenclature. So maybe, David, you can just give us a quick overview of the company and where you stand, and we can launch into questions.
Sure, well, thank you for having us at this Stifel conference. Evolus is a performance beauty company. We operate in this medical aesthetics category, but we're a very different player. We're the first company that's dedicated to aesthetics, 100% cash pay. That enabled us to operate very differently from the existing competitive set that straddles both cash pay and reimbursed medicine with the neurotoxin. We've been commercial now in the United States for five years. We celebrated five years in May. We've captured 13% of the market. In our fifth year this year, we're growing at roughly 30%. We've expanded now into Europe. I was just on the call right before this with a group of key opinion leaders in the U.K. That was the first market we entered in Europe, and then we've expanded since into seven markets outside the U.S.
Our international business is a small part of our business today, but as we've guided out to $700 million in 2028, it will become a more meaningful part of that business, roughly 10%-15% of the revenue as we get further out. And then about a year ago, we licensed the rights to a very innovative dermal filler line. It's a hyaluronic acid gel that's manufactured very differently from anything currently on the market anywhere in the world. And it was developed by a team that has experience developing market-leading hyaluronic acid gels. We'll talk a little bit about that. But we're excited to launch the first two of five products next year in the U.S. And we just received European approval for those fillers as well, and we'll launch those next year. So we see a lot of pathways to growth.
We have a base business that is halfway penetrated in the U.S. We're in roughly 15,000 of the 30,000 clinics. So we have a lot of runway to continue to add more clinics going forward. We have an inflection point of growth coming with the launch of a dermal filler line that we believe unlocks a lot of value because there's a base of business that we believe will adopt this dermal filler line, but it also opens up new doors for the company and then an international business that's in early stages of expanding and becoming a meaningful contributor to our growth.
Great. So maybe we can start high level and talk to us about the state of the market because we've been in this constant debate of whether we're in a good economy or a bad economy. And we've always seen the toxin market as being quite resilient. And we've seen this through very, very difficult markets. And this market seems like almost child's play to what we've seen in the past. So why don't you just talk about that and what that's actually done to demand in the state of the aesthetics space?
Sure. So this toxin market has been resilient going back over 20 years now. Even in the height of the recession or the trough of the recession, this category was flattish in toxins, and we're nowhere near that. So this category, we believe, this year is growing in this sort of mid to high single-digit range. It's not at the upper end of the range it's been over the last decade, but it's certainly still very healthy. Keep in mind that this procedure is very affordable. It's $300-$500 for a consumer. It's part of her beauty regimen, her hair, her nails, her makeup. And we view injectables as now becoming a bigger part of that. In the U.S. today, we're just cracking double-digit penetration of consumers getting treated with injectables.
We see a tremendous runway for greater penetration, especially because this younger generation of consumers views it as part of her beauty regimen. That's going to continue to drive more demand. That's why this market has been healthy and will continue to be healthy over the long term.
Okay. Well, that's the tailwind. Let's talk about the headwinds. So what do you see as the biggest headwind for you? It's not necessarily the economy because obviously it's resilient. So can we talk about competitive landscape? Do you see this as a major headwind for you going into the next coming years?
Yeah. We look at our business model as very different, so when we approach a practice, our reps spend a lot of time talking about our focus on being a beauty company. They bring Jeuveau in because it's an established toxin with the largest head-to-head studies versus the market leaders, so it is a very differentiated product when it goes into an office, but importantly, they also view our Jeuveau as a driver of growth. We're investing back into these offices to bring in this younger demographic of consumers, and it's a bold, edgy brand, and when you partner with Evolus, we're doing co-branded media and advertising for these offices. We're giving them a consumer loyalty program, which we recently enrolled our millionth patient in that program, and the majority of our practices, now over 80% of our practices, are using that program.
So it's been very sticky to keep these consumers coming in. And so we see the growth potential here is very significant as we partner with these practices over time. And importantly, over 90% of them are interested in bringing on our filler once we launch it. So we've established a lot of trust because of our differentiated business model. And we think that carries over to the dermal filler.
Okay. So I'm going to talk about the elephant in the room. Sandra, you just recently narrowed guidance a little bit. Is there anything that got you concerned looking into the end of the year? I mean, the guidance still falls. I mean, the number is going to fall still within your guidance. So what was the need for changing it? What did you see that got you concerned?
Yeah, I guess I'll first say there's nothing to be concerned about as a direct comment to that question. Why did we narrow? So we made the decision in the second quarter to raise our guidance. So we had originally guided this year to $255-$265. We raised to $260-$270. Fundamentally, we had incredibly high confidence that $255 just wasn't in the cards for us this year. And we felt it was really important to signal to our investors that that opportunity to have the floor moved up by $5 million was something that we were committed to and was a meaningful move. As we got into fourth quarter, it's actually quite typical for us to narrow the range in our guidance because as you look at one quarter, a $10 million range is an incredibly wide range for a single quarter on revenue.
And so we have historically done that narrowing of the guidance. And as we looked at what should we narrow the guidance to, we remained very committed to that $260 but felt it was responsible to put us in a tighter window for the year-end numbers.
Okay. So nothing, I mean, is there any competition that you see coming on the horizon that you may be preparing for? Just talk about those couple. Hugel is out there and maybe Galderma also is coming in. So maybe you can just talk about those two potential competitors, not Galderma in terms of competition, but their new product coming out.
Sure. We had contemplated Hugel arriving in the U.S. in the fourth quarter. So nothing's changed on that front. I think Galderma, we don't expect them to enter in the next several quarters in the U.S., but they'll enter in Europe first with the liquid is how we understand it. So looking back on the latest entrant, when Daxxify entered the market about almost two years ago now, I believe, you saw our growth accelerate. And I think what happens when new entrants come in is there's a greater focus on the category as a whole. And that means they're talking to patients more about it. There's more coverage of it, of the category overall in consumer media. So I think it's helpful for the overall market as we see new entrants. Nothing changes for us as it relates to our positioning in the space.
Of course, we're aware of competitors. We want to make sure that our customers continue to work closely with us. But I think we've seen as new entrants have come in that we continue to fare well because our positioning is so different from anything out there. And I think for us, it's an execution story going forward with new entrants coming in.
So what I'm hearing is that competitors don't actually eat into your share. They just expand the market.
That's what we've seen.
That's how it's been. Okay, great. I guess one of the things that we get asked a lot is Jeuveau is just like any other product. What are some of the product characteristics that you don't think people recognize that is different for Jeuveau?
First of all, that's a compliment because depending on who you ask, some will talk about how it works without ever having experience. I think probably the most underappreciated element of Jeuveau is the fact that it works really well. When we came in, we were the fourth entrant. People would rightly so ask, well, how does it compare against Botox? That is probably the standard you need to measure yourself against. That's exactly what we did. In a phase III study, we published those results. You can see that we fare really well. In fact, there's 30 endpoints that you look at. They never reach statistical significance. It's interesting to see that numerically, at least we beat them 26 out of 30 times. Probably the next thing is it seems to have a really precise field of effect.
And when you're using a toxin, that's a big attribute because you want to be able to control that field of effect. And then the last thing is really interesting that just came out this year was the fact that a plastic surgeon out of Philadelphia independently took all the toxins and ran her own test. So she did it herself, got all the toxins herself, and showed that Jeuveau, compared to the other approved toxins, actually had the fastest onset, the highest peak of effect and longest duration. So it's kind of a nice validation to all the work that we did when it comes out from left field from someone who did it by themselves.
Great.
Maybe the only thing I'd add to that is you look at this brand this year growing roughly 30%. The majority of our growth is coming from existing accounts, so to Rui's point, once they start using Jeuveau, they start to see the uniqueness of the product and how well it performs, and it continues to expand its share within existing practices. We're really pleased to see that.
So maybe we can talk about that growth rate because that's what we've been most impressed by. You continue five years into the market, growing at not just double the market rate, but multiples of the market rate. So I guess part of that is coming off of a low base. But at the same time, that just begs the question that it's not necessarily, is it always the product or was there a secret sauce to approaching this market that was missing that you're now filling that hole and addressing? So maybe you can talk about that. It's not just a product-based story, but it's really a marketing story.
Yeah. Look, the average clinician is focused on how they grow their practice, whether they're adding more injectors, whether they're adding new facilities. And so they want to partner with companies that are like-minded. And when you think about growth in this category, it's driven by this younger generation. Practices that are growing at a high clip are attracting that younger generation of consumers that can get in and treat it the same day or get in that week. They can fill that demand. Jeuveau was positioned from the outset as a millennial brand. And our consumer loyalty program is SMS text-based. That's how this younger generation consumes. It's not like a traditional airline loyalty program. The co-branded media, all of our advertising, we build that all in-house. It's modern. It's edgy. So our look and feel is very different when we partner with these practices.
And in addition to that, there's value there. There's greater profitability relative to the market leader when you transition to Jeuveau. And so when you look at a practice overall P&L, when they look at a brand like Jeuveau, this is the number one procedure that they offer. You improve the profitability on that procedure, and we reinvest back into the practice to help drive their growth. And that's the recipe that's driving this brand to very high growth rates in its fifth year. And really, there isn't a precedent when you look at other products in this category to be growing at multiples above this mature into the market. We believe it's our business model along with the differentiated product that does that.
Okay, and as a performance beauty company, only you are singularly able to do that. Do you see any potential for any of the other companies to come in and do something similar having seen your success here?
We anticipate over time that this category, as it transitions to beauty, it will move away from pharma, so I wouldn't be surprised if over time you start to see more companies that enter to be dedicated to cash pay because it does have unique differences, and we've brought those to life, and I suspect others will try also. The one thing I'd say is bringing it to life took a lot of effort. The digital platform we built, we started working on that several years before we got our first drug approved. We have engineers in the company that have developed the way that this company interacts with each customer all through an Evolus app. They can order product. They can track their orders. They can run our consumer rewards program on it. We recently launched Club Evolus, where a consumer enrolls for $49 a month.
They enroll all directly through our digital platform, which also powers all of our co-branded media. We're talking about thousands of campaigns that happen in any quarter. And we handle that all internally through our digital platform. So we have unique capabilities that are proprietary that we've been investing in. But we also have a runway from an R&D standpoint in digital of capabilities that we'll continue to build. And the latest one was a subscription model that is in its early stages of being rolled out to roughly 100 accounts right now. But that's built by our engineers. And it's the first subscription program to enter in the toxin space.
All right. That's something new for us therapeutics people because there's not only a development pipeline, but there's a digital pipeline that we don't even think about. So that's interesting. So just on Evolus, really quickly, can you just tell us how that's been productive for your company? What percent of accounts go through that? What percent of revenues go through that? What's the reorder rates in these in Evolus? And just share with us how productive those Evolus customers are versus just a standard account that you have?
Okay. Maybe I'll describe Evolus and talk a little bit about the numbers behind it. So when we first launched in the U.S., the question was, how do you compete against a portfolio when you only have a single product? And we said, well, we're cash pay, and we're going to offer accounts different benefits to compete. That's why we designed Evolus. So we're the first program where not only do you get better pricing as you purchase more, which every company offers in the space, but you earn back an investment into your practice. And that comes in the form of digital media, social media. It could be in the form of billboards. We've placed thousands of billboards around the United States or TV spots. And we've done hundreds of TV spots. And the more you purchase, the more media that you earn.
You can imagine with the filler, you'll also earn and get more media as well. So we see this being something that continues to build as our portfolio builds. But you also see that it's directly tied to volume. And that's why you're getting the operating leverage in the company that you've been seeing over time because we control that relationship between what you earn and what we spend. And interestingly, we're spending a lot less on the same media because we're purchasing more media over time. So we're getting a lot of efficiency at scale now. We anticipate we'll continue to see that grow as well. But I'll let Sandra talk a little bit about the performance of Evolus.
Yeah. So Evolus is more than just a pricing program. As we say, and David outlined a lot of the benefits that customers get as they participate in Evolus. Over 80% of our customers in one way or another participate in Evolus. So there is very high engagement from our customer base. And it is, as he mentioned, a part of what differentiates us as a company and differentiates us as a provider to practice that's allowed us to gain the level of share that we've gained. Part of the program above and beyond sort of what you get for co-branded media, what you get for pricing in those Evolus tiers as you purchase up is also the component of Evolus Rewards. And over 85% of the revenue we get is those customers are offering Evolus Rewards to their patients.
So that ability to directly influence the consumer decision to provide that $40 coupon at every treatment to the consumer is of high value to the practice. And when you look at that relationship of revenue versus practice volume of co-branded media and Evolus and Evolus Rewards, what you see is that the customers that are really opting into all of these programs, they're growing much faster than those that are not. That just demonstrates the value of how these programs are accelerating consumer adoption and accelerating their ability to market their practice with our product.
Okay. That's great.
The reorder rate question, it's 70%.
70%. And the share of Jeuveau in these practices, is it typically it's higher. Can they go?
Yeah. It's hard to really get one specific share for one specific account. So we've been continuing to penetrate further in average share. So go back a year, our average share across our accounts was 20%. We're now somewhere between 25% and 30% on average share in the accounts that we service today. So we are continuing to penetrate. It's a difficult measure to get accurate. We don't have clear visibility into the full volume that every practice purchases. We just have visibility into ours. So to get to those numbers, we have to do sort of channel checks and questioning our consumers. And we do poll them annually. And we do continue to see that penetration increasing.
Okay. Great. So you touched on fillers.
Now you're about to be able to leverage this platform to the filler. Maybe, Rui, you can talk about the fillers a little bit. We understand cold manufacturing is a differentiated feature, not just on the manufacturing side, but in terms of the product. Can you explain to us what the characteristics of the product are because of this cold manufacturing?
Sure. Taking a step and just explaining the cold manufacturing is important. The thing about fillers and the reason why we're bullish on HA fillers and remain bullish on HA fillers is because they're natural products. Your soft tissue is full of them. Your knee joints are full of them, and we make these gels, and the building material is actually these HA molecules. Mother Nature invented it, and what Symatese did was they figured out a manufacturing process that does a really, really good job at preserving that structure, and that's a really big deal, and when you're able to preserve that structure by taking the thermal energy out of the cross-linking step, you can create these gels, and they're amazing if you think about it. You're asking a liquid to do all sorts of things.
Like in the midface, it has to be robust enough to actually lift tissue. Then you ask the exact opposite of it to put it in a lip in an area where it has to be so soft that it can move with all those lip movements, compress for a pucker or elongate for a smile. And then last, you've got to create another gel with different characteristics where somewhere like the nasolabial fold, where it has to be strong enough to lift tissue, yet soft enough that you can't see it. So using the base raw material, preserving that HA structure allowed Symatese to create all these unique gels with that basic chemistry step. So that's the technology story.
This is an environment where coming in with a novel story, a new technology is generally well received, especially when it's grounded in kind of bringing back the natural roots of the product. How does it work? Well, the nice thing was when we looked at the benchtop testing, true to form, we actually saw benefits. We saw that it lasted longer. You can create these gels and dial in the specifications. Then we were just validated in human studies also. In Europe, we went against Restylane. We saw in a split-face model that we actually hit statistical superiority. Then, for further validation, we just released the pivotal data for the United States where we showed two different products going again against Restylane.
Once again, we saw the exact same results where it met the primary endpoint non-inferiority and actually showed statistical superiority for both products.
Great. So you've filed a PMA for the first two of the, I think it's the line of five different products. So how does that allow you to compete in a market that you're essentially competing with full lines of Juvederm and full lines of Restylane and even full lines of the newest one, which is the RHA filler? So what kind of versatility do you have with the first two products that you have? And how does that change over time?
So from a starting perspective, the first two that are coming out, one is called Form and one is called Smooth. If you look at the characteristics, they're very different. Although they were both approved or in the process of getting approval in wrinkles and folds, like nasolabial folds, so in other words, beyond just nasolabial folds, you can go in areas like marionette lines, the submental lines. There's different things. Those two gels are very different. One is a harder product, if you will. It has a higher lift capacity. And the other one's on the other range of gels. It's very soft. It's actually so soft that it just got approved in Europe just a few weeks ago for very fine superficial lines.
So those two products, although it looks like they just got approved into wrinkles and folds, like nasolabial folds, the gels are very different and can be used in a variety of different ways.
What part of the market can you address? What percent of the market can you address with those two products?
We think the majority of the market's covered with these two gels. When we introduce the other products, they're more specialized products like the Sculpt. When a consumer's coming in specifically for the cheek area, that product would be differentiated for that use. Between the introduction of Smooth and Lift and Sculpt, these products are used in many different ways. It's sort of like when we first launched Jeuveau in the U.S., the indication was in the glabellar lines. We'd often get asked, is it going to get used outside of there? The majority of companies only have an approval here, or they start there. It's the same in the fillers. You start in the nasolabial fold. Every company that's entered started with the nasolabial fold indication. Practices will look at the gel properties and determine where they want to use gels.
They have their preferences. I think there's a sizable TAM, obviously, with the first two fillers to establish these products. Then as we introduce new products, I think we can expand our share opportunity with those introductions.
Okay. The fillers are a little bit different than toxins as far as some of the restrictions you may have around toxins in terms of the competitive products being tied to a medical indication. You don't have that with fillers. So how is your market entry going to be different for the fillers versus how you approach the toxin market?
Yeah. It's a great question. So there's two parts to that. The first is Sandra talked about our share in existing practices at about 25%-30%. The reason we generally cap out right around there is because for practices to move more of their share over to Jeuveau, it's very punitive on their filler pricing with the competitors. Having a filler in our portfolio, we believe, unlocks a lot of potential within existing accounts. The second is for the competitors, because they have a reimbursed toxin, all the rules of engagement as it relates to our co-branded media, our cash pay strategy, they can't engage in those on the filler either because the toxin's in the bag. So the cash pay advantage does carry over. I think the only distinction is that with fillers, to your point, because there's not a therapeutic filler, they do have latitude on pricing.
So it's more like any other category that you'd compete in. But for us, it unlocks on the toxin side.
Is the filler side even a price-sensitive market as far as a competitor pricing differently than another competitor? Or is it really more about the actual filler, the technique? So talk to us maybe about what the barriers to entry are on training and technique and how that might proceed with the physician population.
Maybe I'll touch on pricing, and then you can talk a little bit about training and things of that nature, so pricing is very stable in the filler market in the U.S. There's a premium segment of fillers that it's three families of products that capture 90% of the market, and we view this as a differentiated product that should compete effectively in that premium segment, and we've given you some guidance on what that means from a gross margin standpoint, so you get a sense that we'll be competitive in that market, but we don't see this as having to discount our way to gaining market share, that we can establish the product through effective training and differentiation and capture share through that, but I'll let Rui talk a little bit about our training plans.
From training, we really have two different platforms. One is kind of the more traditional, if you will, on-label, where we will have KOLs and various folks who can speak on-label. And that brings in a certain group, if you will. And then just as importantly, we have another platform to address the off-label. And we know that people want to understand the anatomy. And inevitably, when you're in that environment, they will ask you an off-label question. So we have an entire structure there where we can actually have, in a compliant way, the ability to train and address those questions. So we have two very robust platforms. And depending on who the audience is and what they're looking for, we can adapt to both.
And then the final comment I'll make on that is that investment, that value that we provide to them is actually well appreciated by them. So it goes beyond all the other things that we offer as an organization. That's something that people really thank us for.
I guess it's worth noting that these products are not going to be approved in the U.S. probably until next year. So this is not something that we need to worry about near term. But maybe you can talk about what your expectations are for share. I think, obviously, Sandra, you've laid out $700 million in guidance for 2028. And that assumes certain percentage shares for both Jeuveau and the Evolysse filler line. So maybe you can talk about what gets you comfortable with that guidance and what are some of the assumptions that you've put into that and where you can possibly exceed. Let's just hope.
Sure. Yeah. And you'll note when we speak about 2028 and we speak about that guidance, we always say at least $700 million. And it's more than just a nuance. We really do see that $700 million as a floor for us. And to your point, we see lots of opportunities where we can exceed that. The underpinning assumptions that we outlined in our investor day are our current share in the toxin in the U.S. is 13%. We have an aspiration to achieve $100 million of revenue OUS and are well on track to the launches we need to deliver that OUS. In the U.S., then, as you look at the combination of shares between toxin and filler, if we get 7% share on the filler by 2028, we don't have to get any more share on the toxin to deliver $700 million.
That 7% share would imply a discount to the rate at which we gain share with the toxin. It would imply a discount at the rate at which any recent analogs in the market delivered on share penetration as well. So we see it as a very responsible, very modest expectation for ourselves. And as David mentioned, we have these dynamics within customers where they may be limiting their toxin share because of a dynamic of bundling of other customers. So by adding the filler, we actually see opportunity to unlock more share on the toxin. But we haven't contemplated that into our guidance. So there is certainly that ability to exceed expectations on that share on the toxin. So we always frame it as at least we do it on purpose. We see this as a floor that investors can rely on.
And we see lots of ways we can get higher. In fact, as we outlined at an investor day, if we were to increase the share in the toxin at the rate we've done over the last three years, if we were to match the filler share to what we did with the toxin, we'd be over $1 billion in 2028. So when I talk about upside, there's meaningful amounts of upside depending upon how you want to think about the capacity to perform on the revenue side. The other nice thing about it, and we added this to our guidance recently, is that the filler is incredibly synergistic to the toxin. It is literally dropped into the existing infrastructure we have, which means it creates a tremendous amount of leverage for us.
So the addition we made recently was that we expect to be at least 20% operating margins by 2028. We expect to be profitable in 2025, generating cash by 2026. So this business is accelerating at a great pace. And we are delivering that value back in terms of the leverage that we're gaining on this portfolio.
Okay. Great. And we've run out of time with that. Had so many other questions. But thank you.
Thank you.
Appreciate the time.
Thanks for having us.
Thank you, Annabel.