Good afternoon, ladies and gentlemen, and welcome to the STAAR Surgical 4th Quarter 2020 Financial Results Conference Call. At this time, all participants are in a listen only mode. Later, we will conduct a question and answer session and instructions will follow at that time. I would now like to turn the conference over to your host, Mr. Brian Moore, Vice President, Investor, Media Relations and Corporate Development.
Please go ahead, sir.
Thank you, operator, and good afternoon, everyone. Thank you for joining us on the STAAR Surgical conference call this afternoon to discuss the company's financial results for the Q4 fiscal year ended January 1, 2021. On the call today are Karen Mason, President and Chief Executive Officer and Patrick Williams, Chief Financial Officer. The press release of our 4th quarter results was issued just after 4 p. M.
Eastern Time and is now available on STAAR's website at www.staar.com. Before we begin, let me quickly remind you that during the course of this conference call, the company will make forward looking statements. We caution you that any statement that is not a statement of historical fact is a forward looking statement. This includes remarks about the company's projections, expectations, plans, beliefs and prospects. These statements are based on the judgment and analysis as of the date of this conference call and are subject to numerous important risks and uncertainties that could cause actual results to differ materially from those described in the forward looking statements.
The risks and uncertainties associated with the forward looking statements made in this conference call and webcast are described in the Safe Harbor statement in today's press release as well as STAAR's public periodic filings with the SEC. Except as required by law, STAAR assumes no obligation to update these forward looking statements to reflect future events or actual outcomes and does not intend to do so. In addition, to supplement the GAAP numbers, we have provided non GAAP adjusted net income and adjusted earnings per share and sales in constant currency. We believe that these non GAAP numbers provide meaningful supplemental information and are helpful in assessing our historical and future performance. A table reconciling the GAAP information to the non GAAP information is included in today's press release.
Following our prepared remarks, we will open the line to questions from publishing analysts. We ask analysts limit themselves to 2 initial questions, then re queue with any follow ups. We thank everyone in advance for their cooperation with this process. And with that, I would now like to turn the call over to Karen Mason, President and CEO of STAAR.
Thank you, Brian. Good afternoon, everyone, and thank you for joining us on today's call. The 4th quarter and fiscal 2020 results we reported today are consistent with our January 11th preannouncement and represent yet another year of record results, increased consumer awareness and growing surgeon commitment to our proprietary EVO Visian family of implantable polymer lenses. The COVID-nineteen global pandemic challenged our generally high levels of growth, particularly in the first half of twenty twenty. However, for the second half of twenty twenty, we were able to meet the original sales targets we entered the year with prior to the global pandemic taking hold in late January.
2020 demonstrated the continuing momentum of the industry shift towards our lens based solutions for patients seeking visual freedom. In addition, in 2020, we launched a new presbyopic lens, EVO VIVA and made progress towards introducing our EVO family of lenses in the U. S. And introduce new programs to increase customer engagement. Our 2020 performance confirms our position as a consistent and rapidly growing innovative leader in the refracted industry.
Turning now to the 4th quarter, ICL unit growth in the 4th quarter continued to rebound we saw in the Q3 as more of our markets more fully reopened. We achieved strong growth in several markets including China up 17%, Japan up 52%, Germany up 28%, APAC distributor markets up 71% and Latin America up 26%, all as compared to the prior year quarter. We also saw a significant sequential improvement in India during the Q4 where ICL units on a year over year basis were down just 10% in the Q4 of 2020 as compared to down 55% in the Q3. The Middle East remained our most challenged market due to COVID-nineteen during the Q4. For fiscal year 2020, ICL units were up 11% as compared to the prior year.
Our positive ICL unit growth must be considered in the context of the global pandemic and also the total market for refractive procedures. Industry reports estimate a decline of 21% in total refractive industry procedures in 2020 as compared to the prior year. The chasm between Starz positive ICL unit growth rate and the decline in total refractive industry procedures demonstrates that we are continuing to capture market share. Therefore, while our growth in certain markets remains impacted by COVID-nineteen, our enthusiasm for even brighter days ahead is bolstered by solid second half results in 2020 and a solid start to 2021. Our strategic imperative remains to position our EVO ICL family of implantable lenses as a transformational pathway to visual freedom for patients seeking a life independent of glasses and frequent replacement contact lenses.
Our strategy supports the transformation to a lens based future for refractive vision correction and should allow Star to capture a in 2025. Today and as we look ahead, in 2025. Today and as we look ahead, we are laying the foundation for a star that can grow from selling 100 of 1000 of lenses per year to 1000000 of lenses per year through increasing consumer awareness, surgeon commitment, new product introductions and appropriate investments to scale the company consistent with our significant growth opportunity. I will briefly touch on each of these areas to illustrate our focus and commitment. First, we have increasing evidence that our multi channel consumer awareness and marketing activities globally are showing positive results.
Where we promote the exceptional survivability of our EVO ICL family of lenses to consumers, we see greater enthusiasm among consumers on social media. More visits by consumers to our doctor finder and higher ICL unit growth, including in China, Japan, Korea and Germany to name a few. EVO, VIZI and ICL patient influencers from television or music personalities to everyday people are creating meaningful interactions with their followers on various social media platforms such as TikTok, Little Red Book and Instagram that result in these followers becoming prospective patients. Our investment in consumer marketing is supported by marketing research that shows 40 point plus uptick in ICL interest in key markets when consumers understand the advantages of our ICL lenses, including removability, no dry eye syndrome and excellent night vision. This same marketing research shows a 60 point increase in interest among U.
S. Consumers. 2nd, we are gaining increasing search and commitment with our lenses, which is supported by clinical validation. 2020 is the 1st year STAR sold more lower diopter lenses between -0.5 and -ten than higher diopter lenses between -ten and -twenty. Our opportunity with surgeons includes training and certifying more refractive surgeons globally and increasing the number of ICM lenses implanted by currently certified surgeons.
Increasing lens utilization remains a significant growth opportunity for STAR as surgeons can move from implanting tens of lenses per year to 100 or even 1,000 as we've seen in certain Asian markets. Turning to a third strategic priority, which is introducing our innovative products to large and new markets globally, we are continuing the controlled rollout of our EVOVEVA ProSBIOPIA lens in Europe. The initial commercial surgeons are implanting the VIVA lens while gaining valuable insights for delighting patients at each distance, near, intermediate and far. These insights will be part of the evoViva playbook of best practices that we will share with certified surgeons during full commercialization of the lens expected in the second half of twenty twenty one. In the coming weeks, we will add more surgeons as part of our phased rollout of the VIVO lens.
In the U. S, we have implanted all patients in the study for our EVO family of myopia lenses and follow-up is being conducted for the trial protocol. Our plan remains to submit the data to the FDA for marketing approval in late April. We will provide an update on the status of our submission and any other details when appropriate and permitted. The U.
S. As the number 2 market in the world for refractive procedures has long been a market where we look forward to introducing our family of vivo lenses. We believe we remain on track pending FDA approval to introduce our EVO lenses to the U. S. Market in the Q4 of this year.
Finally, we continue moving forward with scaling the company to meet increasing demand and position Star to sell millions of lenses in the future. Capital investments include the following: establishment of our EVO manufacturing operations in Lidau, Switzerland and our advanced presbyopia VIVALENZ manufacturing facility in Lake Forest, California, also expanding capacity of our Monrovia manufacturing facility. Operating investments include scaling our revenue generating sales and marketing teams and programs. We have recently added key hires to the U. S.
Sales team and will continue to support our growth in China with additional in country star account executives. We will also invest in marketing programs in geographies that can demonstrate strong returns by driving higher levels of ICL unit growth. Before turning the call over to Patrick, let me conclude my prepared remarks by welcoming 2 new members to the STAAR Board of Directors, Doctor. Elizabeth Yu and Doctor. Pammi Yu, who joined the Board as previously announced on January 21.
I would also like to thank retiring Board member, John Moore for his more than decade of service to STAAR. Patrick?
Thank you, Karen, and good afternoon, everyone. Total net sales of Q4 2020 were 46,000,000 dollars up 18% as compared to the $38,900,000 of net sales in Q4 2019 and down 2% on a sequential basis from Q3 2020. The year over year increase in net sales was attributable to the growth Karen highlighted earlier. The sequential decrease in sales was due to the moderate seasonality in our business. As a reminder to our investors and analysts, Q1 and Q4 have historically represented our seasonally lowest quarters and thus we continue to believe Q1 2021 will be slightly down from our Q4 2020 results.
In terms of product mix, ICL sales represented 87% of total company net sales Q4 of 2020 and other products represented 13%, which is consistent with recent trends. Gross profit for Q4 2020 was $34,300,000 or 74.6 percent of net sales as compared to gross profit of $28,800,000 or 74.1 percent of net sales for Q4 2019 and $34,900,000 or 74.1 percent of net sales for Q3 twenty twenty. The 50 basis point increase in gross margin as compared to Q4 2019 is primarily due to geographic sales mix, partially offset by inventory reserves taken on certain lower margin IOL products which are being discontinued and manufacturing projects. The sequential increase in gross margin from the Q3 is due to sales mix, partially offset by inventory reserves taken on certain lower margin IOL products which are being discontinued. We expect Q1 fiscal year 2021 gross margins to be similar or slightly up from our Q4 2020 results.
Moving down the income statement, total operating expenses for Q4 2020 were $30,200,000 as compared to $26,500,000 in Q4 2019 $30,000,000 for Q3 twenty twenty. Taking a closer look at the components of operating expenses, G and A expense for Q4 2020 was $9,500,000 compared to $7,900,000 for Q4 2019 and $8,600,000 for Q3 2020. The year over year increase in G and A is due to increased salary related costs, variable compensation, corporate insurance and facilities costs. The increase from Q3 2020 was due to increased variable compensation, corporate insurance and salary related costs. We expect G and A dollars for Q1 2021 to be slightly higher than Q4 2020 and to continue at a similar level of absolute dollars each quarter for the balance of 2021.
Selling and marketing expense was $11,800,000 for Q4 2020 compared to $11,200,000 for Q4 2019 $12,600,000 for Q3 2020. The increase in selling and marketing expense from the prior year was due to increased salary related costs and advertising and promotional expenses, partially offset by decreased travel and sales meetings and trade shows expenses. And the decrease from Q3 2020 was due to decreased advertising and promotional expense, partially offset by increased salary related costs and variable compensation. We expect selling and marketing as a percent of sales to represent approximately 33 percent of sales for the Q1 and the full year of 2021 as the company makes appropriate investments in scaling the company consistent with Karen's comments earlier. Research and development expense was $9,000,000 in Q4 2020 compared to 7,400,000 dollars for Q4 2019 and $8,800,000 for Q3 2020.
The increase in research and development expenses compared to the prior year quarter was primarily due to increased clinical expenses associated with our EVO clinical trial in the U. S. And increased variable compensation. The slight sequential increase in R and D is due to an increase in salary related costs, partially offset by lower clinical spending. We expect quarterly R and D for 2021 to remain similar to our Q4 2020 in absolute dollars, which should yield some leverage in R and D as a percentage of a higher level of anticipated sales throughout 2021.
Operating income in Q4 2020 was $4,100,000 or 8.8 percent of sales as compared to $2,300,000 or 6% of sales for Q4 2019. The 280 basis point year over year expansion in operating margin is due to leverage on the fixed and variable operating expense during the quarter. Net income in Q4 was $3,300,000 or $0.07 per diluted share compared to a net income of $6,400,000 or $0.14 per share in Q4 2019. The lower net income in the Q4 of 2020 as compared to 2019 is due to a higher provision for income taxes as a result of a $0.07 per share tax benefit from our 2019 tax valuation release. On a non GAAP basis, adjusted net income for Q4 2020 was 6,800,000 dollars or $0.14 per diluted share compared to adjusted net income of $5,500,000 or $0.12 per diluted share in Q4 2019.
A table reconciling the GAAP information to the non GAAP information is included in today's financial release.
Turning now to our balance sheet.
Our cash and cash equivalents as of January 1, 2021 totaled $152,500,000 up $24,200,000 dollars compared to $128,300,000 at the end of the Q3 2020. The sequential increase from the Q3 is primarily attributable to $19,600,000 in cash generated from operations. As we look ahead in 2021, we anticipate increasing our CapEx investments as we continue investing and expanding our manufacturing capacity, footprint, scaling production for our new Veeva lens and infrastructure scalability. For the full year 2021, we anticipate a total CapEx spending to be in the range of $15,000,000 to $20,000,000 Finally, Star will be participating in the Credit Suisse Virtual West Coast Investor Bus Trip on March 22 and we look forward to speaking with many of you there. This concludes our prepared remarks.
Operator, we are now ready to take
We have your first question from Chris Cooley from Stephens. Your line is open.
Good evening. Hope everyone is well. Just maybe I guess my first two and then I'll hop back in the queue. When you think about the growth that you saw in the second half of the year, clearly a strong rebound there, Karen, on the ICL front. But didn't you just give reiteration of kind of the long term targets?
I realize you don't have guidance for 'twenty one formally, but just when you think about unit growth longer term for the ICL, Just curious if what you're seeing now still keeps those long range plan targets within reach? And then what gives you confidence along that just off the base business? And I've got a follow-up.
Sure. Thank you very much, Chris. We definitely are very confident around momentum in the business as obviously we're seeing a lot of the great trajectory in the 3 year growth rate of 25% and to your growth rate of 25% and 35 percent ICL unit growth at the end of 2022, we're very committed to achieving those growth levels. Ideally, as we look at 2021, we think about, obviously, in the first half, very fine growth year over year. We talked a little bit about when we look at sequential growth, we'll retain a seasonality, but when we look at year over year growth, especially in the first half, should be very healthy.
And then as we project in the half of the year, we have a number of opportunities either with evoViva addition and in the Q4 with evo in the U. S. To even add on to what we think will be very healthy growth in 2021.
Chris, maybe I can just add something with our prepared remarks that we said it will give hopefully a very strong signal of our longer term confidence. And I talked about the CapEx spend where we are increasing it in 2021 is a really scaling year for us or a scalability year of about $15,000,000 to $20,000,000 which is about twice of what we did in 2020. So hopefully that's another strong signal by us that we have a lot of confidence in where we think this business can go over the next several years.
That's great. I appreciate it. And then just my second question, Patrick, I really appreciate all the granularity you provided down to the middle of the income statement and also as it pertains to the gross line as we think about 2021, it really helps. I'm curious though as you make these understandable investments in infrastructure and personnel getting ready for the launch of Vivo in the Q4 here in the United States and obviously the continued ramp up of Vivo abroad and then hopefully here in the U. S.
Shortly thereafter. When we exit 'twenty one, I'm just curious, are we at the spend rate where I should say, is the company at the spend rate at that point where you can start to drive leverage? Or is that just the initial kind of personal need to further continue that kind of operating spin step up in the year thereafter as we about building out the commercial infrastructure here in the U. S. And it sounds like China as well now?
Thank you.
Sure. It's a good question and certainly Karen can add on. I think it's a little early for us to give, I would say, some of those longer term projections since we're starting to we're awaiting the U. S. Approval and we're starting to see the penetration within some of the other markets including getting our beginnings of Veeva right in Europe and then hopefully as we spread that out throughout the world.
So I think what you've seen in the model is that it's a fairly simplified leveraged on a fairly nominal, what I would say, revenue scale compared to peer groups or other medical device companies that are in a high growth stage like we are. So I'm very confident in our ability to have expansion. I would expect you will see expansion as we move forward through the years. We've got a nice tailwind related to our gross margins as it relates to geography mix. As a reminder that the U.
S. Coming on board, it will be a direct market. It's one of the larger or more premium markets out there from an ASP standpoint. And so we're going to get a nice tailwind over the next several years related to building out that market. And then some of the other direct markets as well, including Veeva, which is right now a premium product for us compared to our current EVO lens.
So that does not keep me up at night, any sort of operating margin expansion. So we feel very good about the ability to move forward. With all that said, we will hold off and know people are eager to see kind of what does this look like since our last Investor Day. We're looking forward to doing an Investor Day at some point in the not so distant future. And you can expect we'll give some future looks not only on the sales side but through some of the leverage in the P and L.
We have your next question from Anthony Petrone from Jefferies. Your line is open.
Thanks. Good afternoon, everyone. I hope everyone's staying healthy. A couple of questions. One would be on Veeva, one on U.
S. EVO and then one for Patrick just on distributor trends. On Veeva, maybe just an update on What are the latest thoughts there just as we continue to navigate COVID? So that would be question 1. And more so, what does that full scale launch look like?
Will there be more direct sales reps added ahead of that? And then also in regards to DTC, will you ramp that up ahead of the EFCRS meeting later this year? The second question on EVO timelines would be similar. Should we expect a ramp in DTC and sales force ahead of that? And then I'll have a follow-up for Patrick.
Thanks.
Okay. Sure. My name is Anthony. When we think about Veeva in Europe, our goal is to continue to add surgeons who are certified and doing very well with EMI Lithia lenses throughout Europe over the next 6 plus months. And during that time, we continue to add, which we've already begun.
We already have initial commentary on what works and what we can advise surgeons to do to well prepare patients for their expected vision near, intermediate and distance, we should have that playbook ready to go for all surgeons who are in approved markets probably by, I would say, September. We were thinking of doing an experts meeting, which we do every year, a few days before EOCRS, having the VIVA lens and playbook being the primary discussion points with surgeons on the podium who would be able to share their pearls as well as the patient experience and the direct to consumer experience. We are hesitating a bit on the timing not because we won't be ready, but because we're really not sure yet whether the if we can either in a combined hybrid virtual in person meeting or an in person meeting. There's so much to share. When you're at one of our experts meeting and there are 3 50 people in the room and everyone's trying to grab the microphone to share their experiences, it's truly exciting and something we think Veeva deserves.
So we'll see what the timing will be of the experts needing to roll out Veeva with our leading surgeons around the world in approved markets. With regard to adding salespeople, we definitely are adding direct, indirect markets and we have been very, very good at building new hybrid markets such as Benelux, France and Italy and we have done a good job of upgrading distributors who are now subsidiary. All 3, direct, hybrid and distributors will be managing the Vivo rollout. In terms of Vivo in the U. S, we had a full rollout that is already in approval phases.
We have been hiring people in the U. S. Who are really strong in strategic account management. We have a number of exceptional programs that we'll be rolling out that have been very successful in Europe and in China, both from social media, from digital marketing as well as testimonials and individuals who are very well respected to share their EVO experience. So the U.
S. Will be a exceptional market, we believe, for consumer outreach. And in each of the markets in the United States where we will be rolling out the EVO lens with significant and strong partners who are strategic partners of Star, who are KOLs, who are in big practices with lots of refractory procedures a year, all of that is being planned
distributor destockingrestocking kind of played out exiting 2020 and how those trends will play out in the first half of twenty twenty one? Thank you so much.
Yes. So we got quite a few questions about that. And I think what everyone needs to take away is that there's no unusualness to the business from a stocking, destocking, etcetera. What we see at the end of the year is what I would call a normal pattern of the business where some of the distributors are looking to make sure that their levels are appropriate across the different SKUs, right? And so they're really looking to right set that.
And so we saw a little bit of that in some of the larger distributors like we have in China, the single one we have there. But people shouldn't read any more into that. We're normal course of business we're moving forward. There's a lot of momentum in the business right now. Everyone's ordering direct markets, distributor markets, etcetera.
So everything is really running at a normal pattern. Thank you. Of course.
We have your next question from Brian Weinstein from William Blair. Your line is open.
Hi, good afternoon. This is Andrew on today. Thanks for taking the question. Maybe we can start on U. S.
Market dynamics here. Karen, you've sort of always about the core demographic for EVO in Asia as sort of being that bucket of what will come young professionals with a higher level of disposable income. So maybe as we think about the U. S. Market here, can you just give us a little bit of an idea of how you view the demographic here for that product?
And as a corollary to that, differences in how we should be thinking about maybe some consumer macro sensitivity to the product here versus other areas around the globe?
Thank you for joining us, Andrew. And answer to your question, yes, we do believe the demographic holds globally. 21 to 35 year olds, many of whom daily contact lenses and glasses more than they would like, the strong interest in having visual freedom, able in the workplace through exercise, sports and outdoor activities just be totally free to do whatever they need to do without any dependence on a vision correction apparatus. So we expect that to continue and to be very strong. We believe that the U.
S. Consumer is especially interested in lenses that have such great benefits such as the ability to be upgraded, the and also an estimation that this is quiet in the eye and biocompatible. And so I think with all of these tremendous strengths, which are picked up so beautifully in social media around the world as really excited and happy recipients of the EVO lenses love sharing their stories. So we expect it to happen in the U. S.
And maybe even be more aggressive in that we have the greatest consumers in the world in the United States. And I think that in terms of going forward, our enthusiasm for being prepared and ready for a consumer world in the United States that becomes aware of Vivo, I know that we're there.
Great. Thank you. That was very helpful. And then I guess maybe a question on cash here. Obviously, what a difference a couple of years makes for you guys and certainly congrats to the team for all the cash flow generation over the last couple of years.
But now I guess with over $150,000,000 sort of on the balance sheet and recognizing Patrick, you gave a lot of good color on the internal investments here. We did notice that shelf that you have. So maybe I guess bringing it out bigger picture here, can you talk maybe some longer term strategic functions that you might be investing in behind what you've outlined today or even maybe some thoughts on M and A that might make you want
to tap into that shelf? Thanks for the question. Yes. No, great question. And I actually guess kind of glad you brought it up.
People should not be reading into the shelf other than that's just good corporate governance. Public companies should have a shelf that's registered in current at all times. So that will be my response related to the shelf. In terms of capital deployment, etcetera, in my short time here and you can look back, the company has done just an incredible job of generating nice cash flow. Once again, what I consider to be off of a smaller revenue base compared to other high growth companies.
And so I think that's an attestment to the discipline that we have in making good investments as well as the simplicity and beauty of the model that we have in our ability to penetrate. We'll continue to make investments primarily in the sales and marketing side as we talked about to drive market share, but we will continue to believe that we can generate the cash. So at this point, we've got a healthy balance sheet, no debt to speak of, and we're in a good space to grow our business organically. And I think from that standpoint, that will be our answer unless something else pops up. But we've got early endings in terms of where we're on in the EVO business.
And so we're very excited and have the capital needs to support that.
We have your next question from Bruce Jackson from The Benchmark Company. Your line is open.
Hi, good afternoon. Thank you for taking my question. I'd like to go back to a comment you made during your prepared remarks about the product mix now being tilted more towards the low diopter lenses. And I was wondering if you got there with any actions in price or promotion? And what other further actions you might take to get more of a low diopter mix because you're coming up against the LASIK procedures where price might become a factor.
I'd like to hear your thoughts just generally on that.
Sure. Thank you, Bruce for joining us. In terms of what we have done over the past few years to encourage the lower diopter ranges for the refractive patients. First of all, we on the pricing front, for Steric lenses only did have lesser cost associated with those lenses for the surgeon with their choice as to whether or not they wanted to pass that advantage on to a patient to further encourage them to go with LEMS rather than a LASIK procedure. At the same time, and I think this is really important, a number of our strategic partners around the world and KOLs did clinical validation studies and presented papers about the fact that the lower diopter patient is equally well served as the higher diopter patient with outstanding results.
And then we also made sure that in the societies in major countries, which we talked about before, such as Japan and Germany, the standards of care has really then reflected these changes in practice patterns for lens based practices by moving approval levels from maybe a minus 8 or minus 9 down to minus 3 and in certain instances down to a minus 0.5. So it is a combination of clinical validation backing by the leading KOLs with papers in society, standard of care and then by properly pricing to incentivize the surgeon and the patient to look at the ICL as always premium and primary and will be more expensive than laser vision, but we believe deservedly so, but narrowing the gap a bit.
Okay, that's great. Very helpful. And then if I could just get one more question in about China. Coming out of the Chinese New Year, if you
could just like give us a
little color around how things are developing and how it versus your plan for the year?
We're very excited about China's enthusiasm with our lens. And as a result of that, yes, after Chinese New Year, we already are picking up to levels at or above where we were priced and our growth trajectory in China is to be very strong. We're very excited about Q1 and getting ready for the real business in Q2 and Q3. So things are just going very, very well in China.
All right. Fabulous. Thank you very much.
Thank you.
We have your next question from Ryan Zimmerman from BTIG. Your line is open.
Yes. Thanks for taking the questions. Appreciate it. Just made a follow-up around some of the pricing trends. It was up about a little over 5%, I think.
And just some of the bets we've seen in a while and Patrick, maybe if you want to chime in, just kind of how to think about pricing into 'twenty one and what was the result in the quarter here? Was it a function of geography, lens type, maybe more torics? Help us understand that and maybe how you think that plays out particularly in 2021 with all of the new products that you are potentially introducing really in the later part of the year?
Yes, sure. I think go ahead, Karen.
I'll take it. So where we really are is that pork is becoming a bigger part of mix in almost every market. There's just tremendous enthusiasm in bringing patients who have traditionally and to this day not had very good options with any if they need a toric lens. And so we're getting a lot of demand, even more than usual in Asia as a percentage. In some cases, we're moving beyond 47% to 50% or above 6% for tourists.
That obviously benefits us in terms of ASP. In terms of price around the world, we are marketing based on what we think is the value story. We also work very diligently with our partners on their strategic commitments and so we ask our partners to grow their businesses in excess of 20% or 30% on average in terms of what they are going to commit to in return for a lot of what we provide. But definitely in terms when you admit and when you add much increasing volume and a consistency around the way we sell and the way we reward, we expect this positive pricing trend to continue and advantage us in 2021.
Okay. That's very helpful. And I don't know if Patrick, do you have anything else to add on that one before you ask the other one?
No, she put it on his.
Okay, great. And then Karen just another one with the EVO launch over the course really in the back half of 'twenty one in the U. S, given the number of physicians that are currently implanting this how do you expect adoption to play out with EVO in the U. S? Should this mimic kind of how VIVA is going right now?
Or do you expect all those physicians that are in the U. S. To adopt EVO, let's call it day 1. Just trying to get a sense for how quickly kind of out the gate you could have sales on that lens in the U. S?
So different story, with movement from VIZIYA and ICL without the Central Port to EVO VIZIYA and ICL versus VIVA. Myopia and distance only correction is straightforward. And so what we expect is that right out of the gate, there will be a number of surgeons who have either participated in a clinical trial, are already KOLs, were already signing strategic partners or who have very successfully joined us in Refractive Restart over the last several months. We have surgeons who are committing to almost lens based and others who expect that their percentage of laser vision correction versus ICL procedures will flip. So if they were 70 before laser vision, it will be 70 evo.
So expect a much faster adoption and a much stronger prospect at the gate on purpose because it is a multi corrective correction procedure. It just forms every possible vantage point. We have a great lens like ours. We want to make this as simple as possible. Very few surgeons have done refractive presbyopia.
So this is a whole new game to be able to do this wonderful lens without doing an inlay or a clip on the cornea. So we are taking our time to have an extraordinary experience when all surgeons can handle EVA. So bottom line is stay tuned with the FDA approval in the U. S, we expect to have a great launch.
I'm showing no further questions at this time. I would now like to turn it back to Ms. Karen Mason, President and CEO, for any closing remarks.
Thank you, operator, and thanks everyone for your participation on our call today. Forward to speaking with many of you in the days and weeks ahead. We appreciate your interest and investment in DuraSurgical. Please take good care and all the best to all
of Ladies and gentlemen, this concludes today's conference call. Thank you for your participation. You may now disconnect.