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Leerink Global Healthcare Conference 2026

Mar 11, 2026

Marc Goodman
Senior Research Analyst, Leerink Partners

Good. Okay, great. Thank you. Thanks everybody for joining us. Welcome back to our next session at the Leerink Conference. I'm Marc Goodman, one of the biopharma analysts, and we have Evolus with us. We have the whole team, David Moatazedi, who's the CEO, we have Tatjana Mitchell, who's the CFO, and Rui Avelar, who is head of R&D. If anybody needs Nareg, he, you know, from IR, he's also here afterwards if you have any questions. Thank you guys for joining us. Obviously an interesting time for Evolus, an interesting time for the markets. It just feels like, you know, things are kind of starting to get a little better, you know? It feels hopefully they are. Let's start high level with the markets, David.

Talk about, you know, the toxin market over the course of the past. You know, give us a little perspective too. You know, like, what did you see last year? What are you seeing so far this year? Put that in the context of what have you seen in the past decade, you know, in this market? I guess we should talk about toxins and fillers kind of separately, I think, just 'cause they have a little bit different dynamics.

David Moatazedi
President and CEO, Evolus

Sure

Marc Goodman
Senior Research Analyst, Leerink Partners

I'll let you kind of start high level.

David Moatazedi
President and CEO, Evolus

Yeah. Thanks for having us, Mark. Couple things. One is I think we're feeling a lot better about the toxin market, just to get to the punchline. We started to see improvement in the fourth quarter. We're seeing that improvement carry into the first quarter. This is probably where the context is helpful for those who haven't followed aesthetics for a while. You know, this category's been around for 25 years, and in 25 years there's only been three events that have caused the market to go into negative growth. The first was the 2008-2009 recession. The second were the forced shutdowns of COVID, and then last year was the third. What's interesting is we've never had four consecutive quarters of negative growth in this category.

In all three of those events, once you eclipse a year, the market returns back to growth for toxins, and that's certainly the case this go around. I think what we saw last year, one, it was unanticipated. The slowdown that we saw was related to this middle-class consumer pulling back on their spending, feeling the impact of rising costs, and concerned about the overall environment, and that really surfaced. We saw it broadly in the market in uncertain if you look at the market leader and what they reported. We didn't feel it as acutely until we got into the second quarter. We did quite a bit of work to understand what was driving it. It's really isolated to this middle-class consumer. We get a lot of questions around, is it the younger demographic versus the older?

Is it more concentrated in medical spas versus derms and plastics? The answer is no, it's not. It's widespread. What's interesting is just like the prior three slowdowns, well, the recessionary period slowdown, not necessarily COVID, what happens is consumers start to stretch their intervals between treatments, and they're just trying to get more out of each treatment dollar. That's consistent, by the way, with what we're hearing with consumer brands as well, where women are extending their intervals between hair treatments.

Marc Goodman
Senior Research Analyst, Leerink Partners

Mm-hmm.

David Moatazedi
President and CEO, Evolus

This is, you know, playing out along the same lines. We're still seeing that those consumers that stretch are holding that stretch. It's not getting worse, it's not getting better. That being said, we're wrapping around on a year, so now you have a comp that we're building from. I think as, the middle class is starting to see that prices aren't rising on them and unemployment hasn't materially worsened, they're starting to open up their wallets, and you see that slight increase in Consumer Confidence Index. We hear it in the market. These clinics are busier than what they were earlier in the year last year. I think all of it points to our guidance, which is, a guidance of low single digit growth, which reflects sort of how we exited the market last year.

Our assumption is when we get to 2027 and 2028, the market moves to mid single digit growth, which is an interesting view because historically, as you know Marc, you follow this category, the market rebounds after down periods. We've taken a more conservative stance on this and said we wanna watch that play out. The good news is we know we're signing contracts with national accounts, we're dealing with big clinics. They're all signing up for growth. They all feel optimistic. They're hiring, they're adding clinics, and we see a healthy market going forward of positive growth.

Marc Goodman
Senior Research Analyst, Leerink Partners

When did you start to see that inflection point where it just wasn't getting worse anymore, it started to get a little better? That was in 4Q? Was it late 3Q? I don't remember.

David Moatazedi
President and CEO, Evolus

Well, in Q3 we saw a step in the right direction.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

David Moatazedi
President and CEO, Evolus

... which was important for us to see sequentially coming off of a challenging, you know, front half of the year. In fourth quarter we saw further improvement. We're also looking at some of the third party data metrics that we track, including point of sale data, and we see a similar trend. Of course, we're listening to commentary from some of the other players in the space, and I think it all triangulates to we're all seeing the same thing.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right. That was very specific to toxins, but also probably plays into the filler question as well, but I'll let you answer filler-

David Moatazedi
President and CEO, Evolus

Yeah

Marc Goodman
Senior Research Analyst, Leerink Partners

different way if you choose.

David Moatazedi
President and CEO, Evolus

Yeah. I, without going too deep in filler, I would just say that it's trailing behind the toxin in its recovery. It was a bit further depressed because of negative sentiment around overfilled faces and try to get a natural look with fillers and that dampened the HA market in particular quite a bit.

Marc Goodman
Senior Research Analyst, Leerink Partners

When did that start? 'Cause that was not last year. It would seem like it was even the year before.

David Moatazedi
President and CEO, Evolus

It really has been a two-year cycle, and we're starting to see now clinics are actively messaging two things. One is they're talking about the safety of hyaluronic acid, and rather than talking about it as a filler, we're talking about it as an injectable HA. That's something we brought to the forefront with a campaign when we launched Evolysse called Drop the F Word, 'cause we wanted to get to clinics and tell them to stop doing this. Stop using the word filler 'cause it evokes a negative response in the consumer's mind. Replace the word filler with injectable HA, and the response you're gonna get is very different. That's one thing we're seeing.

The other is across the board, all of the HA products on the market have introduced campaigns in the back half of last year that were focused on HAs are natural ingredients. You can get a natural look with hyaluronic acid. I do believe that sentiment is turning. In Europe, where they did not feel any of the economic pressure.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

We're seeing in the U.K., which is one of the strongest markets that we're in, that market's starting to turn to positive in terms of the HA market.

Marc Goodman
Senior Research Analyst, Leerink Partners

In the fillers, absolutely.

David Moatazedi
President and CEO, Evolus

We do believe the U.S. follows that. We're probably about a year behind.

Marc Goodman
Senior Research Analyst, Leerink Partners

Oh, interesting. You know, it's funny 'cause there's been a lot of conversation around the GLP-1s and whether that would actually help the filler market, right? Yet, here we have kind of two years difficulties in fillers and, you know, the GLP-1s have been growing like a weed for the past two years. How does that, you know-

David Moatazedi
President and CEO, Evolus

Yeah. These things take time.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

The consumers that are on GLP-1s, once they get to their desired weight, they are seeking treatment with clinics. If you did channel checks within aesthetic clinics, you would find that they are seeing GLP-1 patients and they're starting to treat them. The question is, why aren't we seeing this influx of what 15% of women are on GLP-1s in the United States?

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

you know, you've got mid-single digit penetration of toxins.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

David Moatazedi
President and CEO, Evolus

in that same segment. There's a wide gap there between those two. It is a big idea, and it will play out over time, but not overnight. These things take time for them to identify the right clinic, to seek treatment, and to go in and get treated. There's a pocketbook issue there as well, and I think now the price of GLPs are going down. That I think is alleviating some of that.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah. Talk a little bit about how your filler is differentiated. Maybe Rui, you can talk about, you know, what are you hearing out there about the characteristics that you know, you're excited about with the product? Are they translating out there? Are people excited about the same thing? Yeah.

Rui Avelar
Chief Medical Officer and Head of R&D, Evolus

I'll start with what the differentiation is.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

Rui Avelar
Chief Medical Officer and Head of R&D, Evolus

I'll go into the second part. The hyaluronic acid gels, of course, are made from hyaluronic acid. Kind of the simplistic view is hyaluronic acid was designed by Mother Nature and it's a long, complex structure. The reason it works so well in your skin and your joints and everything else is because of that length. That complexity is what gives it a lot of its properties. Kind of in a simple way of describing it, we basically manufacture these HA gels at near freezing temperatures. Fundamentally, we just do a really good job of preserving that natural HA structure. That's it. It's that simple.

When we were talking to individuals, in particular, when we were doing diligence on it, the feedback that we got fairly consistently was, "Wow, this is a really efficient gel." In other words, I don't need a lot of product to get a correction. That resonates really well right now with, A, it's hyaluronic acid natural, and needing less product was really nice. We saw that in the clinical data also. The other thing that we saw was it was very forgiving in that when you take these gels, sometimes, especially the more robust ones, you can't go very superficially in the skin because you'll pay a price, inflammation, all sorts of things. The feedback was, "This gel's really forgiving. I can go very superficial. I can do things with this gel that I couldn't with others." Then, obviously, there's duration.

We saw that that played out in the clinical trials that it has good duration. I think the last one that we got when we were doing diligence, and we're consistently hearing that in practice is the gel gives the injector a lot of control. In other words, they inject to get that optimal outcome. They don't have to under-inject because the gel's going to kind of swell over time, so you have to under-correct. They don't have to over-correct because sometimes some gels have a lot of free HA and some of the stuff goes away over the course of four to six weeks. The feedback is they like the correction, they like the durability, they like how forgiving it is, and they seem to get a lot of impact with the-

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

Rui Avelar
Chief Medical Officer and Head of R&D, Evolus

the little gel.

Marc Goodman
Senior Research Analyst, Leerink Partners

Give us a sense of how the filler's been doing. I mean, it's on the market in the U.S. for, like, a year.

David Moatazedi
President and CEO, Evolus

Yeah. Q2 will be a year on the market.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah, a year-ish. How's it, you know?

David Moatazedi
President and CEO, Evolus

Yeah

Marc Goodman
Senior Research Analyst, Leerink Partners

Give us a sense of how it's been doing.

David Moatazedi
President and CEO, Evolus

The product has really performed well. When you look at the business of fillers down over the last couple of years, despite that, the launch of Evolysse would be right up there with the top launches in the HA space. Really bucking the trend of the market environment that we're in and more around what Rui talked about, which is it is a differentiated gel. We're in 3,000 clinics today and expanding on that. We talked about in the second quarter, we'll have a deliberate effort to go wider with Evolysse to get a larger base of users behind it. What we've learned is a couple things.

One is because of preserving the natural gel, it is more efficient, and clinics are learning that they can use this product and get a really natural look by not having to put in as much gel into that patient's face, which is a net positive with the product. The second is, they're finding that just the overall branding of the product, we have the unique advantage of having mention of weight loss in our label, and we do co-branded media 'cause we're a cash-pay company, that gives them an advantage to go out and advertise this brand at a time when the category needs that share of voice. The big insight that we learned is it really takes the first training for them to get the confidence to start using it.

That second training, hands-on training, gives them the confidence to really create an inflection point in their utilization. We're very active in training. As you know, that's one of our core capabilities. We trained over 12,000 injectors last year hands-on. We have a deliberate effort to get that second training going. With the Evolysse line, of course, there's the Sculpt product that we expect approval of later this year. Right now, the way I describe our category is that every HA brand has sort of a flagship product, and Sculpt is the flagship in our line. It's a mid-face product. It's a very challenging area to develop a gel for. It's a more premium price part of the market.

Getting the Sculpt product into the category as an anchor brand for Evolysse will also be an important point in time to continue building on that momentum going forward. We're really excited about that. The combination now of Evolysse and Jeuveau is really what we've been waiting for six years, which is we haven't competed with a bundle. We piloted this bundle in the fourth quarter with our accounts, giving them the opportunity that if you increase your commitment with Evolysse overall on both Jeuveau and Evolysse, we'll incent you back on that growth that you drive. On that incremental growth, there's an additional incentive. That performed very well in the fourth quarter in a pilot. We launched it broadly across the country in January through our sales force.

That is a six-month program which mirrors the loyalty programs from the larger competitors. We're getting very good feedback on that 'cause a lot of practitioners are looking to diversify. We've been a single-product company, and now we're giving them the opportunity to do that with the first two Evolysse products. Of course, as Sculpt comes in, it only adds momentum to that story.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

We're really excited about it.

Marc Goodman
Senior Research Analyst, Leerink Partners

What percent of your potential customers said to you, "Well, you only have the toxin, you don't have the filler, so, you know, we're gonna use Galderma," whoever else. Now you can go after them. I mean, what, 10%, 20%, 30%? Like, what do you think?

David Moatazedi
President and CEO, Evolus

Yeah. I would frame it slightly differently and say that these customers had our share capped on Jeuveau.

Marc Goodman
Senior Research Analyst, Leerink Partners

Uh-huh

David Moatazedi
President and CEO, Evolus

because it was too punitive.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right.

David Moatazedi
President and CEO, Evolus

To give us more toxin share in those clinics because the price of their fillers with the competitors would go up.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right

David Moatazedi
President and CEO, Evolus

If they left them on the toxin. This starts to unlock.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

David Moatazedi
President and CEO, Evolus

Thaw. That story no longer works. That was the story.

Marc Goodman
Senior Research Analyst, Leerink Partners

Was that a big part?

David Moatazedi
President and CEO, Evolus

that the competitors going in

Marc Goodman
Senior Research Analyst, Leerink Partners

Was that a big part though? I mean.

David Moatazedi
President and CEO, Evolus

Well, if you look at our share, right, we say we're a mid-teen share product.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

Our share in the clinics that we're in, 'cause we're only in 17,000-30,000, is roughly 25%-30% share.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right.

David Moatazedi
President and CEO, Evolus

It's not 25-30 because they believe Jeuveau is not the product that could be the leader in their clinic.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

It's 25-30 'cause they're managing the economics on their overall franchise.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right.

David Moatazedi
President and CEO, Evolus

There are clinics now that have, through that portfolio pilot that we did.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

David Moatazedi
President and CEO, Evolus

In the fourth quarter, they meaningfully increased their share.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

David Moatazedi
President and CEO, Evolus

on both Jeuveau and brought in Evolysse. Now, keep in mind, as they brought in Evolysse, they still have to partner with other companies for the HA-

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

David Moatazedi
President and CEO, Evolus

'Cause we don't fully fill out their line just yet.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

We're doing that, and we're taking a step in the right direction, but we're not fully there yet either.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah. No, I know they're out there. We found some. I mean, but I just wasn't sure if it was like a, you know, is it a big opportunity. It seems.

David Moatazedi
President and CEO, Evolus

Yeah

Marc Goodman
Senior Research Analyst, Leerink Partners

Like a pretty big opportunity.

David Moatazedi
President and CEO, Evolus

There's a few, by the way, and this is one where we're spending more time, that weren't as interested in working with us at all as a single-product company.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

They wanted to have fewer partnerships.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

These are the much larger clinics. They wanted fewer partnerships, and therefore, with a single product, it made it tough for us to make that cut as one of the few partners.

Marc Goodman
Senior Research Analyst, Leerink Partners

Now you're breaking in.

David Moatazedi
President and CEO, Evolus

There's several now that we are actively moving into because we have the full portfolio.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah, yeah. That's interesting. They're larger too, which is-

David Moatazedi
President and CEO, Evolus

That's right.

Marc Goodman
Senior Research Analyst, Leerink Partners

Great to get that part. Let's talk numbers for a second, Tatjana, to give us a sense of, remind us of the numbers.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

Mm-hmm

Marc Goodman
Senior Research Analyst, Leerink Partners

... of top line, bottom line, and talk about the assumptions that go in there. If things, you know, continue in, you know, what you were describing, and then what if we bounce back to mid-single digits instead of low single. You know, just give us.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

Yeah. Yeah

Marc Goodman
Senior Research Analyst, Leerink Partners

Some sensitivities around the numbers.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

Maybe I'll start with 2026. For 2026 on revenue, we guided to $327 million-$337 million.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

Which is about 10%-13% growth year-over-year. On adjusted EBITDA, we're guiding to a low single- to mid-single-digit margin, which is really meaningful. We were profitable in Q4 and now taking that into 2026, and I'll talk about what underpins that. Then we think about 2028, which we revised our long-term guide. There, we're doing $450 million-$500 million, right? Adjusted EBITDA margins of 13%-15%. If you think about revenue, 2026 we're assuming that the market is returning to growth for toxin, maybe still slightly declining for filler, but really kind of moderating from where it was in 2025. We assume that the market returns to kind of that, you know, mid-single-digit CAGR over time for 2027, 2028.

In terms of our growth, it's really driven by multiple vectors. It's really across the portfolio. For Jeuveau, as you know, it already has 14% share in the U.S. We'll be advancing that. We only need it to get to kinda mid-teens share in this guide. For Evolysse, it's 10%-12% of our global revenue in 2026, and that is gonna grow. Think about 2026, we only have two products. We only have Form and Smooth out of the four products in the portfolio, and David talked about the importance of Sculpt being added, and then lips following that. Third is international. International nearly doubled in 2025. It was 5% of revenue, now 8% of revenue in 2025.

We think that's gonna be 15% of revenue in 2028, and that's also really meaningful in terms of some countries like the U.K., we're more mature. We're already kinda touching that double-digit share in toxin. Some countries we're just starting to go direct, like Germany and Italy. Then we're also launching all four of the fillers in Q2 under the Estyme brand. That sort of underpins that growth.

Marc Goodman
Senior Research Analyst, Leerink Partners

OUS all four go out together.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

In Europe, exactly.

Marc Goodman
Senior Research Analyst, Leerink Partners

In Europe.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

All four will be out together.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

Which will be great learning for us too, to see kinda how that's all selling combined. Then the portfolio, so David talked about this quite a bit, right? It's really being able to access some of these accounts and grow share in these larger accounts now that we have the portfolio, and also supporting that with the bundling and portfolio rebates. All of that really underpins the revenue growth. In terms of profitability, we talked about rebasing our expenses in 2025 and really setting up that infrastructure for sales, marketing or training all these teams that are commercial to sell the portfolio, both Jeuveau and Evolysse, both in the U.S. and internationally. We don't need this big step up in OpEx. That's going to drive a lot of operating leverage and really cash flow generation in this time period.

Marc Goodman
Senior Research Analyst, Leerink Partners

When was the step-up in expenses? Just with the launch of the filler, that was a step up.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

That's right. From 2024 to 2025.

Marc Goodman
Senior Research Analyst, Leerink Partners

Now we get the operating leverage going forward is what you're describing.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

That's exactly right.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

Yeah.

Marc Goodman
Senior Research Analyst, Leerink Partners

This importance of Sculpt, like if we went out five years and you have the whole portfolio with Sculpt, you know, what percent of the fillers does Sculpt drive? Like do you think that's a 25% of your-- Is that 50%? Like, you know, how big is Sculpt?

David Moatazedi
President and CEO, Evolus

Yeah. The Sculpt product we expect to be the largest product in dollar revenue of the line.

Marc Goodman
Senior Research Analyst, Leerink Partners

Of the filler line.

David Moatazedi
President and CEO, Evolus

Yeah.

Marc Goodman
Senior Research Analyst, Leerink Partners

Of the four.

David Moatazedi
President and CEO, Evolus

You know, it could approach in that 40-ish% range.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right

David Moatazedi
President and CEO, Evolus

Potentially even above that.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right

David Moatazedi
President and CEO, Evolus

as a flagship.

Marc Goodman
Senior Research Analyst, Leerink Partners

That is a critical launch.

David Moatazedi
President and CEO, Evolus

It is an important product.

Marc Goodman
Senior Research Analyst, Leerink Partners

I mean, listening to you.

David Moatazedi
President and CEO, Evolus

Yeah.

Marc Goodman
Senior Research Analyst, Leerink Partners

Very interesting.

David Moatazedi
President and CEO, Evolus

You know, it doesn't end with Sculpt, right? We have Sculpt this year towards the end of the year. It's followed by eyes next year. We see a lot of, you know, obviously new product flow.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

David Moatazedi
President and CEO, Evolus

that continues to support that bundle as we build that story.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

Just, you know, Tatjana did a really nice job coming in here six months into the role and, you know, looking at the market and sort of setting a base that we thought was achievable. The way we looked at it quite simply is we can achieve double-digit growth in a negative growth environment last year. As the market turns to positive, that puts us in a really strong position.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

David Moatazedi
President and CEO, Evolus

To continue to outperform. We just have a number of growth drivers that can help, you know, offset any market challenges or potentially with the benefit of some market growth, we could have a really strong year this year.

Marc Goodman
Senior Research Analyst, Leerink Partners

We spent a lot of time in the U.S. I want to go OUS now. We started to talk about that. Give us a sense of maybe the same questions that I asked earlier. Give us a sense of how OUS has been doing the past year. Has there been an inflection point, toxins versus fillers? You know, kind of answer it in the same way.

David Moatazedi
President and CEO, Evolus

Starting with our business, the international business nearly doubled from a revenue standpoint. It moved from 5%-8% of our revenue on an annual basis.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right.

David Moatazedi
President and CEO, Evolus

As Tatjana said, we expect it to get to 15% by 2028. The international markets did not feel the economic pinch. There's been questions around is there fundamentally something shifting with consumer habits? The answer is no. It's purely economic driven. In Europe, where there's no economic challenges, the markets continue to grow. We think it was roughly a mid-single-digit growth rate for toxins, which is in line with where Europe has been growing historically. On the HA side, it has also had challenged growth. It's been in negative growth for a couple of years like the US. As I was mentioning earlier, we're seeing some very positive signs coming out of the year in the fourth quarter. We believe that major markets like the UK may have gotten to that right around flattish point.

We're going to be watching that really closely because we do believe that's a lead indicator for the U.S. Overall, healthy markets, we've got a lot of growth potential there. Whether it's going wider or going deeper, introducing new products.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah, talk about that a little bit.

David Moatazedi
President and CEO, Evolus

Yeah.

Marc Goodman
Senior Research Analyst, Leerink Partners

What markets are we in right now?

David Moatazedi
President and CEO, Evolus

We've had a focus in our markets in Europe. As you know, we have the rights for both the toxin and the HA in the U.S. as well as Europe. We focused on Europe on the key big five markets. We have a direct presence in U.K., Germany, Spain, Italy, and then France is through our partner, Symatese.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

David Moatazedi
President and CEO, Evolus

That's launched both our toxin as well as the ESTYME filler line. Outside of that market, the only other two markets we have a presence in, one is Australia where we are direct, and then the other's in Canada through our partners. That will leave us with two markets where we have distribution partners.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right. France and Canada with the partners. As you mentioned, the UK has started to improve a little bit. Germany, Spain, Italy, what's going on there?

David Moatazedi
President and CEO, Evolus

Yeah. Great question. We are so new into those markets that we just don't have as strong of a pulse on how the filler space is performing.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right.

David Moatazedi
President and CEO, Evolus

The U.K. is the first market we launched in Europe, and we're entering our fourth year there. We're approaching a double-digit share. We did quite a bit of work on the HA market to understand what was happening there, and so we have a great pulse there. In fairness, it's not necessarily a positive or negative on those other markets. We just haven't done the deep dive just yet.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah. I mean, those are fairly big countries. I mean.

David Moatazedi
President and CEO, Evolus

Yeah

Marc Goodman
Senior Research Analyst, Leerink Partners

Germany is huge. I mean

David Moatazedi
President and CEO, Evolus

Yeah

Marc Goodman
Senior Research Analyst, Leerink Partners

Is the filler market over there a big market? Toxins, do they use them? I mean

David Moatazedi
President and CEO, Evolus

Oh, these are sizable markets.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

I mean, the markets that we operate in represent close to a $2 billion opportunity. We have a presence.

Marc Goodman
Senior Research Analyst, Leerink Partners

In OUS

David Moatazedi
President and CEO, Evolus

... in toxin and filler combined.

Marc Goodman
Senior Research Analyst, Leerink Partners

OUS.

David Moatazedi
President and CEO, Evolus

OUS.

Marc Goodman
Senior Research Analyst, Leerink Partners

Only.

David Moatazedi
President and CEO, Evolus

when you layer in the fact that we're in about 70% of those markets, it takes you to roughly $1.5 billion in market potential that's in those categories.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right.

David Moatazedi
President and CEO, Evolus

We're in very early days. Our combined share across those markets is low single digits.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right.

David Moatazedi
President and CEO, Evolus

We just see a lot of opportunity to continue to build our footprint.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah. Interesting. Okay. In the 2028 total revenue guidance, let's just use the midpoint, $475, right? The midpoint revenues.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

Yeah.

Marc Goodman
Senior Research Analyst, Leerink Partners

You were saying what % of that is international?

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

50. About 15%.

Marc Goodman
Senior Research Analyst, Leerink Partners

15%. Okay. Of that 15%, is it mostly toxin? Is it a little bit of filler or it's a little bit of both? Or just give us a sense of how you're expecting that.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

It's a combination of both, but just remember the filler is only approved in Europe for us, so Australia and Canada will remain just toxin in this time period.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

through 2028

Marc Goodman
Senior Research Analyst, Leerink Partners

I see.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

in our guide.

Marc Goodman
Senior Research Analyst, Leerink Partners

The growth to get there, so let's just say you hit your 2026 numbers, 2027 and 2028, have you kind of just said, "Okay, bounce back," you just kind of each year is the same kind of thing? Or is it one's better than the other? Or how, you know, just curious.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

Yeah. We will obviously observe how the market.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

performs, right? There is, we assume, a step up.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

in each of those years for both toxin and filler. 2027 is an important year, looking for Sculpt approval in Q4. That will be a launch year, and then 2028 is really where you see kind of a full year where we have.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

Sculpt and then Lips also coming in.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah. The fillers kind of really start to kick in there.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

That's right.

Marc Goodman
Senior Research Analyst, Leerink Partners

It really seems. David, every year it always seems like you have some new program. You mentioned the bundling. What else is going on as far as the programs, and give us a sense of just how your, you know, the loyalty program is going and your customers and, you know, 'cause you know, that's what keeps the share through ups and downs.

David Moatazedi
President and CEO, Evolus

Yeah. Yeah, I mean, the way we designed Evolus from the beginning was about building a complete value proposition that supports the clinician and the consumers that they treat. By being digitally focused, we're the only company, because of our cash-pay advantage, that can go in there and reinvest back in these clinics.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

The majority of our infrastructure is now fully built out, whether you think about the U.S. or international, which is why you're seeing all this operating expense leverage reflected this year and going forward.

Marc Goodman
Senior Research Analyst, Leerink Partners

You came at a good time.

David Moatazedi
President and CEO, Evolus

Yeah, great time to see that all play out. That's what's happening, right? You look at our consumer loyalty program, it's been an incredibly fast-growing program, up to 1.4 million consumers that are in that program. We expect over a quarter million patients to get treated just this quarter alone. It's a fast-growing program. It offers consumers a lot of benefit. For the practice, it's the only program that reminds that consumer to go back to that clinic.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

It's co-branded with them. Then in addition to that.

Marc Goodman
Senior Research Analyst, Leerink Partners

Nobody else does this?

David Moatazedi
President and CEO, Evolus

Nobody else does it co-branded.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

In addition to that, we also reinvest back into the clinics to advertise. You may recall our co-branded media program, it's all based on the volume you purchase from us. The more you purchase, the more we reinvest back. Now that you're bringing in Evolysse into the clinics, they're able to purchase more and we're able to reinvest back with greater advertising. What's interesting about that program is that if you look at our spend, because we report it annually, it's largely stayed in this, call it $9 million-$12 million range on an annual basis, 'cause we're getting so much efficiency in the digital advertising.

Marc Goodman
Senior Research Analyst, Leerink Partners

You say 9 to 12, what do you mean?

David Moatazedi
President and CEO, Evolus

million a year invested in co-branded media.

Marc Goodman
Senior Research Analyst, Leerink Partners

I see.

David Moatazedi
President and CEO, Evolus

So it's not-

Marc Goodman
Senior Research Analyst, Leerink Partners

Per year.

David Moatazedi
President and CEO, Evolus

Per year.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right.

David Moatazedi
President and CEO, Evolus

Yeah. It's been the range. It's traded around there.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right.

David Moatazedi
President and CEO, Evolus

So-

Marc Goodman
Senior Research Analyst, Leerink Partners

That's in the SG&A line?

David Moatazedi
President and CEO, Evolus

Correct.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

That's right. That's in the OpEx.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

It's a really efficient vehicle because we're getting more advertising out there as we scale more, and we're finding more efficient ways to do the advertising. It's a great way to get things like weight loss out in the market. It's a great way to get Jeuveau out for new clinics, and to get Evolus branding out into the market, but always in partnership with the clinics. Lastly, medical education's such a critical part of our infrastructure. We've invested heavily to build these unique capabilities. I talked about a number of them on the earnings call if you didn't get a chance to hear them. We are training tens of thousands now on an annual basis, hands-on, through different ways, whether it's cadaver training, through key opinion leaders, smaller trainings, or in their office locally.

There's different vehicles that we offer to get their competency higher to deliver great outcomes, which is an important part. Frankly, the last piece remaining was putting that all together in the portfolio bundle.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

David Moatazedi
President and CEO, Evolus

That's what you're seeing reflected now. We're getting just great feedback on it. When you step back, we're just different in the way that we approach these customers. There's a reason why we have mid-teens market share, and yet we're one of the latest entrants in this category. 'Cause the product is differentiated, and it's differentiated in the platform that we offer it in.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

Evolysse is off to an incredible start on that same platform. We do believe once we partner with a clinic, they stay with us because we're it's a true partnership where our resources and our interests are fully aligned. We think as we continue to build innovation into this category, and we're active on the pipeline side, we do believe that not only does that drive more of that partnership with the clinics, it drives greater profitability with each incremental asset we put in the bag.

Marc Goodman
Senior Research Analyst, Leerink Partners

Why do the competitors not copy that aspect of it? The aspect that you were talking about with the co-branded media and stuff. Why do they not do that?

David Moatazedi
President and CEO, Evolus

Yeah, I mean, to be a cash-pay only company means you're choosing to not participate.

Marc Goodman
Senior Research Analyst, Leerink Partners

Galderma can't.

David Moatazedi
President and CEO, Evolus

in a reimbursement side of the market.

Marc Goodman
Senior Research Analyst, Leerink Partners

Galderma, do they do it?

David Moatazedi
President and CEO, Evolus

They don't engage in co-branded media.

Marc Goodman
Senior Research Analyst, Leerink Partners

They do-

David Moatazedi
President and CEO, Evolus

We're the only company with injectable.

Marc Goodman
Senior Research Analyst, Leerink Partners

I mean, 'cause you've been doing it for years, so if they wanted to, they could say, "Oh, well it's working. Why wouldn't we do it?" But they've chosen not to.

David Moatazedi
President and CEO, Evolus

Correct.

Marc Goodman
Senior Research Analyst, Leerink Partners

It's working, so it's just so interesting. Lastly, just on the customer loyalty program, where are we on that? Like, just give us a sense of numbers. How many people in that customer loyalty?

David Moatazedi
President and CEO, Evolus

In the consumer loyalty?

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

At one point.

Marc Goodman
Senior Research Analyst, Leerink Partners

Sorry, consumer loyalty. Yeah.

David Moatazedi
President and CEO, Evolus

Over 1.4 million

Marc Goodman
Senior Research Analyst, Leerink Partners

1.4 million consumers

David Moatazedi
President and CEO, Evolus

Consumers now in that program.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right.

David Moatazedi
President and CEO, Evolus

These are consumers that are actively treated.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right

David Moatazedi
President and CEO, Evolus

consumers.

Marc Goodman
Senior Research Analyst, Leerink Partners

If I'm in there, basically, you know, I might get something on my phone that says, "Hey, $50 off if you use Jeuveau in the next month" or something, like, is that how it works?

David Moatazedi
President and CEO, Evolus

Correct. If you go in and get treated today, 90 days from today you're gonna get a text back, and it's gonna be from Evolus, and it's gonna be co-branded with the clinic that you got treated.

Marc Goodman
Senior Research Analyst, Leerink Partners

Uh-huh.

David Moatazedi
President and CEO, Evolus

Saying, you have $40 credit, go back into the clinic to get treated.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right, right.

David Moatazedi
President and CEO, Evolus

They go back in with that $40 credit. That credit is all digitally applied to that account.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah

David Moatazedi
President and CEO, Evolus

because they're in our digital platform.

Marc Goodman
Senior Research Analyst, Leerink Partners

Right.

David Moatazedi
President and CEO, Evolus

It's entirely frictionless and automated.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

That's why we've been able to scale it.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

They don't have to put manpower resources behind doing it. It's fully-

Marc Goodman
Senior Research Analyst, Leerink Partners

Right

David Moatazedi
President and CEO, Evolus

fully integrated.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah, it's just a great idea. Great idea. Anything we didn't hit? We're already done on time, but just anything that we didn't hit? I thought that was pretty good. Yeah. Okay. Good. Thank you.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

Mm-hmm.

David Moatazedi
President and CEO, Evolus

Thank you.

Marc Goodman
Senior Research Analyst, Leerink Partners

Thank you.

Tatjana Mitchell
General Counsel, Chief Compliance Officer, and Corporate Secretary, Evolus

Thank you.

Marc Goodman
Senior Research Analyst, Leerink Partners

Yeah.

David Moatazedi
President and CEO, Evolus

All right.

Marc Goodman
Senior Research Analyst, Leerink Partners

Great to see you.

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