Hello, and welcome to the Miomo, Inc. First Quarter 2021 Earnings Conference Call. All participants will be in listen only mode. After today's presentation, there will be an opportunity to ask questions. Please note, Today's event is being recorded.
I would now like to turn the call over to Kim Golodetz. Ms. Golodetz, please go ahead.
Thank you, operator, and good This is Kim Golodetz with LHA. Welcome to the Myomo First Quarter 2021 Financial Results Conference Call. Earlier today, Myomo issued a news release announcing financial results for the 3 months ended March 31, 2021.
Ms. Golas, I accidentally dropped off the line. I will
just continue going on from where she left off. Before we begin, I'd to caution listeners that statements made during this conference call by management other than historical facts are forward looking statements. The words anticipate, believe, estimate, expect, intend, guidance, outlook, confidence, target, project Other similar expressions are typically used to identify such forward looking statements. These forward looking statements are not guarantees of future performance Except as required by law, Myomo undertakes no obligation to revise or update It's now my pleasure to turn over the call to Paul Gudonis, CEO of Myomo. Paul, please go ahead.
Thank you, Dave, and good afternoon, everyone, and thanks for joining us today. After I provide a business Update, Dave will review our Q1 financial results and discuss our financial outlook. And following the financial update, I'll give some closing remarks, then we'll take your questions. With about half of the U. S.
Population now having received at least one injection of the COVID-nineteen vaccine, we're encouraged that our business is well on its way to operating in a more normal pre pandemic environment, while our clinicians continue to take precautions to protect themselves As I've discussed on past calls, during 2020, we adjusted our operations in particular regarding our use of telehealth This adoption of digital technologies supported the continued growth of Myomo last year and to date in 2021. We continue to utilize telehealth and online marketing as these modes of reaching patients are not only mainstream now, They're also cost effective and very efficient. Last fall, we engaged a new marketing firm with a particular expertise in digital advertising. We've already seen a very positive impact from their work. I'm pleased to report that our revenue growth has been accelerating, Rising from 50% to 60% just a few years ago to doubling last year and further accelerating to year over year growth of 132% During Q1 of 2021, our first quarter revenues were $2,300,000 and 65 revenue units, which is up 117% With the strategic shift to our own direct billing channel, where we bill patients insurers directly and provision of MyoPro with our own clinical staff, we continue to report year over year increases in average selling price.
During the Q1, revenue from the direct billing channel was 73% of revenue compared with 62% a year ago. Our gross margin has also improved with the emphasis on the direct billing approach compared with other channels as Dave Henry will describe in a moment. With approximately 3 quarters of revenue coming from the direct billing channel for the past two quarters, it appears that the shift is largely complete. Note also that we establish a reimbursement track record with additional insurers, we expect to be able to recognize revenues faster, thus shortening the cycle time from lead to revenue. Our backlog, which is defined as MyoPro's that have been authorized by payers, but are either in the process of being delivered to users or are awaiting payment to us was 118 units at quarter end.
As we expected, this was down sequentially from 131 units at year end 2020 As authorizations and orders were lower sequentially in the Q1. We received authorizations and orders for 66 patients to receive MyoPro during the Q1. However, we expect the number of patients approved for MyoPro to increase sequentially as we already had 35 authorizations and orders in April, The 1st month of Q2. We had the strongest growth ever in our patient pipeline in Q1 after adding about This is a result of increased ad spending, less competition from political ads on social media platforms after the November elections And potentially a positive shift in consumer sentiment as the pandemic abates and people are more confident about their health and financial situation. As of March 31, 2021, our pipeline was up 22% sequentially and stands at 9 40 MyoPro units in the reimbursement process.
We're spending more in advertising in order to reach prospective candidates and to grow our pipeline and part of this increase in advertising we expect to advertise in other outlets beyond digital media in the coming quarters. The increased marketing spending is an important part of our growth strategy and it's showing clear results. As a reminder, it will take several months for these candidates to work their way through the insurance process to an authorization, then eventual delivery and payment. Also, we expect between 10% and 20% of the pipeline to fall out each quarter Due to personal patient issues and or lack of insurance approval, so we take this into account in our planning. Since we had HCPCS codes for the MyoPro issued in 2019, we've seen an increase in patient access to our devices with more payers covering the MyoPro on a case by case basis for the beneficiaries, in particular, we've experienced strong growth among Medicare Advantage plans covering the MyoPro.
It's important to note that we continue to sell our products on a wholesale basis to O and P providers for resale to their patients And these O and P providers, Veterans Administration, Hospitals and International sales accounted for the remaining 27% of Q1 revenues. We're also recently encouraged by President Biden's speech in which he noted that approximately 800,000 new enrollments Insurance under the Affordable Care Act have occurred recently. Obviously, the more patients with insurance, the more potential users of a MyoPro device. Regarding our international business, we expect it to grow at a meaningful pace this year. During Q1, we announced that additional statutory health insurers have approved reimbursement of the MyoPro on a case by case basis in Germany and these insurers now provide the foundation for reimbursement of approximately 40% of that country's population.
And as other markets reopen from COVID, we've now got patient screening days scheduled in the UK and Australia. We're also adding to our headcount in Europe this year and have launched a German Myomo website and begun online advertising there as well to replicate our marketing success in building the patient pipeline in the U. S. That we've seen. During the Q1, We also announced an important joint venture and technology licensing agreement with Riser Medical, a provider of medical devices and rehab hospital services in China.
We chose Riser after several years of discussions with a number of potential partners for the largest market in terms of population with upper extremity paralysis. The formal launch of the joint venture is expected by the end of this year. We first need to secure all the necessary government approvals from both the U. S. And China.
Once the JV company is established and other milestones are completed, our Chinese partners will provide the initial capital to the JV company to fund its operations to locally manufacture and distribute the MyoPro, Myomo will receive a 19.9% equity interest in this venture. To reiterate, the launch of this joint venture is ongoing and will take some time for over the course of this year to materialize. Now I'll turn the call over to our CFO, Dave Henry, to review our financial results in more detail. Then I'll come back and provide some additional updates and comments on our plans for the rest Dave?
Thank you, Paul. Turning to our Q1 financial results. Revenue for the Q1 of 2021 was $2,300,000 which was up 132% over the prior year Q1. A higher average selling Price along with a higher number of MyoPro revenue units drove this increase and reflects success with our direct billing channel and our marketing efforts. More specifically, we recognized revenue on 65 MyoPro units in Q1 of 2021, an increase of 117% Our backlog of units consists of insurance authorizations received but not yet converted to revenue And our backlog as of March 31, 2021 was 118 units.
Ending backlog reflects 66 authorizations and orders in the Q1 and 14 patients that exited the backlog without becoming revenue. Approximately 92% of the backlog is comprised of direct billing candidates. Gross margin for Q1 was 73%, up from 68% in the Q1 of 2020 and flat sequentially. The year over year increase primarily reflects a higher average selling price, again reflecting the shift to our direct billing channel. There were 50 MyoPro's delivered to patients in the Q1 for which we recorded cost of goods sold.
With 65 revenue units, that means a net 15 revenue units were recorded at 100% margin because cost of goods sold was recorded in the prior period when the units were delivered. This favorably impacted Q1 gross margin as well. Operating expenses for the Q1 of 2021 were 4,600,000 This is up 13% compared with the same quarter a year ago and primarily reflects higher compensation and advertising costs. The operating loss for the Q1 of 2021 narrowed to $2,900,000 from $3,400,000 a year ago. The net loss attributable to common stockholders for the Q1 of 2021 was $3,000,000 or $0.57 per share.
This compares with the net loss attributable to common stockholders of $4,500,000 or $2.51 per share for the same period of 2020. Net loss attributable to common stockholders in the Q1 of 2020 includes a deemed dividend on the repricing of warrants of about 700,000 Adjusted EBITDA for the Q1 of 2021 was a negative $2,700,000 and this compares with a negative $3,300,000 for the Q1 of 2020. Cash and cash equivalents as of March 31, 2021, were $17,400,000 which includes 7 $300,000 received from the exercise of approximately 1,000,000 warrants during the quarter, roughly 1,700,000 warrants remain outstanding. Cash used by operations was $2,100,000 in the first quarter and includes a deposit about $500,000 we paid to one of our contract manufacturing partners to enable the procurement of inventory to support projected 2021 demand Our cash utilization is also benefiting from lower rent as we took advantage of the favorable commercial real estate market to relocate our offices from Boston to to Boston from Cambridge. This move not only reduces facility rent costs, but will also better accommodate our projected growth.
Turning to our guidance, cash used by operations is expected to increase in the Q2 of 2021 compared to the Q1 due to our annual incentive compensation payments. We believe that our existing cash it's sufficient to fund operations well into 2022. We expect that cash flow throughout 2021 we'll follow a similar pattern to 2020 with higher cash used by operations in the first half of the year and lower cash utilization in the second half With a goal to reduce cash used by operations for the full year 2021 compared with 2020. With lower cash used in operations in the Q1 compared to the prior year, we are on track to achieve this objective. As Paul mentioned, during the Q4 of 2020, we engaged a new digital advertising agency and the record number of pipeline additions in the Q1 reflect At the beginning of the positive impact of that change as well as other marketing changes and a more favorable digital advertising environment We expect that these pipeline additions will result in a growing number of insurance authorizations in the Q2 with 35 authorizations and orders during the month of April supporting that expectation.
We also expect the number of pipeline additions during the Q2 of 2021 to be approximately equal to the number of additions during the Q1. Year over year revenue growth in the Q2 is expected to be in line with Q1's year over year growth rate. Lastly, so long as we continue the gradual reopening that is underway and travel restrictions and public health lockdowns continue to be in the rearview mirror, we expect we are well positioned for a strong 2021. With that overview, I'll turn the call back to Paul.
Thanks, Dave. Increased authorizations by health insurance companies are an important component of our growth strategy. Our Chief Medical Officer, Doctor. Harry Kovalman is very focused on obtaining what we believe are appropriate coverage policies for the MyoPro Back in January of 2019, the Centers For Medicare and Medicaid Services, CMS, established 2 new billing codes for the MyoPro, which resulted in certain Medicare Advantage plans paying for the device on a case by case basis. And while results of these new billing codes and Medicare Advantage plans are now providing support for much of our current business, we still have work to do to obtain more appropriate and wider We previously discussed that these Medicare Advantage plans cover about 35% of seniors, while the larger portion of Medicare beneficiaries Because the MyoPro is Custom fabricated for each patient and is designed for long term use, we continue to seek a correction in the benefit category And recently applied for such a change with the submission of a code amendment for consideration this year.
However, there's no guarantee that CMS will issue a coverage policy or As you may recall, early in 2020, we began testing our new MyoPal device, which is designed for the pediatric market. Because of the pandemic, we put that work on hold As vaccinations become more widespread and parents are more comfortable with clinicians meeting with their children, we plan to restart the testing final design work We have clinical research underway at several medical facilities and are looking forward to the first of these studies to be published later this year. In the meantime, we're working with other institutions who are proposing breakthroughs, such as using brain implanted electrodes to control a MyoProbe If the patient has insufficient EMG signal strength in the arms. Earlier this year, CBS Sunday Morning highlighted such a patient Thomas Jefferson University Hospital in Philadelphia. We believe that a macro investment thesis is emerging around technologies that With our EMG sensor technology, Myomo is a leader in this space today it is well positioned to benefit in the future as new technologies are introduced.
Returning to the present, we're focusing on increasing Our penetration of the large population of those with chronic paralysis, offering the only solution that works for them After you've tried conventional treatments such as occupational therapy, there's a deep pool of patients that could benefit from OmiaPro and this adjustable market grows each year with 800,000 strokes occurring annually just in the United States, leaving several 100,000 of these individuals with arm and hand paralysis. We're pleased with our efforts to access more of these candidates in the Q1 and we look to continue this success in the coming quarters. This concludes the formal part of our presentation, operator, and we're ready to open the call to questions. And before we take the first question, I want to mention that we're available for virtual investor meetings During this time of limited travel, so please contact LHA Investor Relations to set up a time. Their contact information is on today's news release.
We'll also be participating in some upcoming virtual conferences during the Q2, including the Oppenheimer MedTech Tools and Diagnostics Summit later this month And Sidoti's Virtual Small Cap Conference in June. All right, operator, we're ready for the first question, if you are.
Yes, I am. Thank you. And the first question comes from
Just a couple of questions. First, when I'm just looking at the metrics, it looks like authorizations dipped in Q1 from prior rates. I know it Snap back again in 2Q based on April. But can you talk about what factored into why it went down in Q1? And is that just kind of a one time event or how should we think about that?
Well, it was equivalent to where we were a year ago, Scott. I'd say part of it is there's a big push for authorizations in Q4. As you know, we had a strong Q3, Q4. We've always seen seasonality in this business. It might be that with the holidays back in December, processing these appeals or authorizations may lag and sometimes we don't hear from the insurance companies for 30 to 60 days after an appeal, for example.
That's why perhaps we're seeing more we had a strong March and another strong April. So that may be the reason for that.
Okay, great. And then I guess similarly that the percent of the cumulative pipeline that kind of just goes away, That was a little higher in Q1 than historically just noise there or would you expect it to kind of normalize towards that 15%, which is the midpoint of the 10% to 20%.
Yes. It was probably high the historical range is It occurred in the Q1.
Okay. Fair enough. And then on gross margins, obviously they helped a little bit in this quarter, what would you view as a sustainable gross margin percentage going forward?
I would say on Steady state basis, gross margin in the range of 70% to 75%.
Okay. 70%, 75%, that's great. And then as well, obviously, you're adding patients much better at higher rates than in the past. I mean, should we think about that as kind of the new normal now, this 300 and call it 350 to 400 range, is that achievable on a consistent basis?
Well, I mean, there's a lot of factors that go into that. But we for the things that we can control, which is the advertising money that we spend and The way that we run our operations, we are doing what we can to increase the activity levels throughout the organization And it starts with lead generation that we spend advertising money on and it filters its way down. So If we're to achieve the objectives we're trying to achieve, we need to continue to do what we've been doing.
It's a good leading indicator because Future revenues because those patients will work through their pipeline to revenue over the next 6 to 12 months.
Okay, great. Well, thank you very much for taking the questions.
All right. Thanks, Scott.
Thank you. And the next question comes from Kyle Bauser with Collier
Hi, thanks. This is Kayla Hostetler on for Kyle. Thanks for taking the What do you think is like a reasonable goal for the direct billing channel? Would it be 100% of new business?
I don't think it's going to be it will never be 100%. We're always going to have an international business. We will always hopefully have VA revenues and we want to maintain the O and P channel as well. So I think As it gets I'm hopeful that we that the direct line channel doesn't get above 80% because that means that the other channels or growing, which is what we want to see happen.
Right. Okay. And then can you talk about How headcounts changed over the past 12 months? What's the latest number? And then as you think of adding new employees, which part of the business do you anticipate adding to the most?
Yes. Overall headcount right now is around, I would say, in the mid-70s, 75 people, I believe. And Most of the headcount adds, I would say that the headcount adds have been we expect them to be stronger in the first half of the year and then taper off in the second half of the year as we've been doing a lot of work to put the capacity we need to have in place to service the greater number of leads coming in and the evaluations we have to conduct and all the way through our patient pipeline. So we're setting ourselves up now and I would expect the adds to the headcount To decelerate as we move through the rest of the year.
Yes. Where we've added folks are in the field clinical staff Because there are more people, almost double the amount of candidates now evaluate coming into through the advertising. So we have field clinical staff that does these evaluations and then they'll do the ultimate fittings for these patients in the direct billing channel. We've grown our reimbursement support team under And then we've also added a few quality inspectors and engineers to support the growing volume because we have to make sure every device is inspected before it's delivered to a patient.
Great. Thanks. And then last Question, as far as average selling prices of MyoPro, how should we model this going forward still around 35,000? Yes.
I would from a modeling standpoint, I would use 35,000 as a number to model off of.
Great. Thanks for taking the questions.
All right. Thank you.
Thank you. And the next question comes from Jim Sidoti with Sidoti and Company. Hello, Jim. Hi.
Good afternoon. Glad to hear you're doing well. Just Following up on average selling price, it looks like it was about $35,600 in the quarter based on 65 units shift. What was it in the March 2020 quarter a year ago?
It was a little under 34,000.
Okay. All right. And it seems like accounts receivable dropped Substantially in the quarter, I know orders were down a little from the last quarter, but does that indicate at all your ability to get paid from the 3rd Is that becoming easier now that you're direct billing?
Well, actually, under with direct billing, we don't Except for those certain insurers that were taking revenue on delivery, we actually wait till payment to recognize revenue. So the receivables that we have are from the O and Ps and the VA providers and international channels. And then that portion of our direct billing revenue that we're able to take on delivery. And the reason we're able to take The direct billing revenue now on delivery is that we've established sufficient collection history. So I think Just circling back to the decrease in receivables, I think that's just a function of the decrease sequentially of the revenue, Okay.
Which is expected by the way just because of our the way that traditionally the business has been operating.
Okay. And then last one for me. You raised about $7,000,000 in the quarter from the sale of warrants. Is that something that you can predict going forward or is that going to be more based on the share price? And what is a good share count for 2021?
Yes. We didn't sell any warrants. Just to be clear, they were exercised. So
Right.
And so the It's hard to say what stock price might trigger more exercises. It's hard for me to speculate on that. And in terms of our share count, our share count As of May 1, it was 5,600,000 shares. We're not anticipating We say that we have sufficient cash to go well into 2022. So we're not expecting any financing activities that we initiate.
So it's any increases in shares will primarily come from if there do happen to be additional warrant exercises.
Okay. All right. Thank you.
And the next question comes from Mr. Wu with Ascendiant Capital.
Yes. Congratulations on the quarter. My question is, you mentioned that it takes about 6 to 12 months from when a patient identified, get into the pipeline and eventually recognized as revenue. Have you seen that speed up at all?
I think we're starting I think to see that and I think we'll see that more As we continue through 2021 and as the rate and The numbers of patients circling through all the way to revenue begin to increase. I think we'll see that more as we go forward. But Until that time, I mean, it is dependent on the number of authorizations that we get from that insurance company, and that can fluctuate on a month to month basis. So it's I think the better way to look at it will be probably quarters at a time and not months at a time.
Great. And then, do you guys notice any issues with your supply chain, either Significantly higher costs or shortages on certain parts coming from Asia?
We are seeing some cost increases like, For example, laptops, things like that.
Steel bars used in the MyoPro.
So we are seeing some cost increases, but we are working on cost decreases as we do some of our Engineering projects. But from a supply standpoint, while there are some Obviously, we've heard about and been aware of the shortages of certain electronic components. But right now, we're able to procure what we need. So in terms of straight supply, we're doing okay
right now.
Thank you. And the next question comes from Paul Nouri with NOBLE Equity.
Could you describe in some detail about how much The advertising environment has improved for you guys. And if it is mostly from the presidential election or if there is also And effects from people getting out and shopping more in person as opposed to online and maybe the cadence of the improvement over the past 5 months or how far long it's
been? Well, as you may be aware, the way these platforms like Facebook work is you're in a constant Auction for eyeballs. In the fall, we were competing with a certain budget that we have set with a lot of other advertisers, specifically political advertising. So that calmed down after November and then we increased our spending. While we don't break out the advertising dollars in total, it's just under $100 a lead.
And if that turns out to be a good payer, a medically qualified candidate, that could lead to a $35,000 sale. So we see a pretty good return on that. As I mentioned, we did change agencies to get a specialist in digital online marketing back in the fall. I think that's had a positive impact as well because as you may aware, these are very sophisticated algorithms to target Patients look alikes compared to people who've already clicked on ads. So I think between the increased spending Also, I think consumer behavior, I'm optimistic, has changed more positively.
People are more confident about their health situation or about their job or their spouse's job who might have the health insurance to cover their MyoPro. So I think maybe that has led to more click throughs on our ads in the last couple of months.
Okay.
And you mentioned that you continue to sell product into O and P. How is that part of the business doing for you guys?
Well, that part of business continues to generate sales force. It's a smaller percentage just because Our direct billing activities driven by our own direct marketing has accelerated and taken over 3 quarters of the revenue stream here. But we still have a number of patients in that pipeline that are O and P providers in the United States and then outside the U. S, we work exclusively through We have a whole network of those O and P providers in Germany, some in the UK, Australia as well. So again, As Dave mentioned, the O and P business, both U.
S. Internationally plus VA where we sell to directly is about a quarter of our business.
And are you waiting to see how your experience in Germany goes in terms of how well you can get into that market before you spread into other European markets? Or are you kind of doing it
in tandem?
Well, we're well positioned in Germany. We're getting more of these statutory health insurance payers to pay for this. And Again, it's a deep pool of patients in Germany. It's the biggest country in the EU. It's got the best reimbursement for high-tech devices.
And so our goal there, we just hired another person there to help us penetrate that market. Opening up new countries requires an investment. We're talking to O and P providers in a couple of other countries. But for right now, Germany will be our key market. U.
K. Is opening up again. We've got a screening day going on there as well.
Okay. And the previous caller had mentioned The length of time between the inquiry and when you can actually book it as revenue, but What's the typical length of time between inquiry and when the patient is confident that they can actually get the device? Is it pretty similar?
So if you look at that 6 to 12 month cycle time we quote, let's say you contacted us today, our call center in Fort Worth, Texas would be back in touch with you very quickly. We'd arrange for a telehealth initial evaluation, Which could be done in a few days, then we need you to go to your doctor's office to get all your chart notes about your previous treatments such as occupational therapy, need a prescription, a letter of medical necessity, that could take a few weeks. Then we get that some insurers will kick it out as not approved or denied. Therefore, we have to craft an appeal that could take 30 days to do that. It may be approved at that point.
If it's denied a second time, we may have to go through an administrative law judge hearing, which we then prepare the case for that. Our team will then conduct that appeal. Once we get that approval, then we have to arrange to visit with you in person, Take a cast of your arm, other measurements, then we get the device fabricated, then we set up a follow-up appointment to actually deliver the device, configure all the software settings. So again, you just look at the time elapsed there, it's about 6 to 12 months and sometimes longer.
Yes. I guess if you were to split it out the and break the pipeline up between what's When we receive an authorization to when it becomes revenue, that's somewhere in the neighborhood of say 3 to 4 months. It can be shorter sometimes, we'll call it 3 to 4 months and then the rest of that 6 to 12 months is in the part from the time the lead is generated to the time we get the authorization.
And do you find that You lose a lot of patience between inquiry and when you get the authorization or not really?
Yes, we find that there's and this was one of the earlier questions dealt with that point. There's about a there's a general about a 10% to 20% dropout rate in the pipeline each quarter that comes from people that we they'll drop off for Various reasons, insurance reasons, health reasons, can't get a hold of them, what have you. It can be all kinds of reasons and we find that that's the rate at which Sure. And it's been fairly consistent at which people will drop out.
Okay.
And just last question, what is the average out of pocket for people?
These are because we're on a case by case basis, we don't have contracts with insurers every unless they've reached their out of pocket That's the sort of the key thing whether they have an out of pocket maximum or not. And besides that, it's probably going to then be eightytwenty, but it depends on the state of that patient's out of pocket maximum.
Okay. Thanks a lot.
Yes.
Thank you. And the next question comes from Warren Hirschman with AIGH Investment Partners.
Hi, how are you? Hi. You alluded to some additional futuristic products. I mean, besides the pediatric product, Any more specific you could be in terms of what else you think you could do or what's in the pipeline, etcetera?
Well, we're looking at how do we continue to enhance the existing MyoPro device and then we're already starting to think about, okay, what's the next generation Product, but we're going to focus on the upper extremity because there are lots of different alternatives For the lower extremity from AFOs, ankle foot orthoses, to wheelchairs, to canes, exoskeletons. So we're looking at what should be that product mix going forward. Are there other new types of sensing technologies that we ought to incorporate into our devices. So all I can say is we have planning sessions on those. And the typical development cycle between conception, prototyping, patient testing, validation, supply chain, it's typically 18 to 24 months before new product can be introduced into the marketplace per FDA regulations.
In terms of the sensing technologies, you mentioned much have been televised. What where is your IP in there? Or is the critical IP really coming from the
Well, yes, our IP is centered around using the body's electromyogram EMG signals To power an orthotic device. And the most recent patents which go out to 2,039 cover multiple joints, which we think is important. So it's not just a hand component, but you've got to have the elbow for to be able to reach and grasp items. So that's that plus our IP around the control algorithms because, yes, this is very sophisticated software to be able to decipher, filter, sample the body's EMG signals to have a true high fidelity motion, which the patient wants to have.
And so in terms of the one that's controlled by Brainwave, for example, what outside IP or technology would you need in that case that has proprietary that you don't have today? Or have you licensed it in today if you don't have it today? If I may
Yes. So there are some of these experimental projects where like at Thomas Jefferson and you've got Neuralink that are using brain implant electrodes, well, that's going to be their intellectual property. What we have to power the device. So we kind of look at it is we've got a platform that in the future multiple sensor technologies could drive that for the patients.
Okay. Is there an important though if I can follow-up on that, is it important for you to own the other sensor The other sensory technology or that's not so critical or you are open to that? What's the general thought and plan?
Well, each of those are going to require substantial investments and a long time to commercialize those. So our view is we are partnering with these other entities to make our API open to them
And as it does conclude the question and answer session, I would like to return the floor to management for any closing comments.
Well, thanks. Well, in closing, We're optimistic that the economy here in other countries is going to continue to open up and that the pandemic will abate over the course of the year. Assuming that's the case, we can expect continued patient pipeline growth and record strong annual revenue growth for the 5th year in a row. We're addressing a large unmet need with a life changing solution while continuing along the path toward our next milestone of breakeven cash flow from operations.
Thank you. The conference has now concluded.