Good morning, everybody. Welcome to Day Three of the JP Morgan Healthcare Conference. I'm Bhavana, an associate with the Healthcare Investment Banking team. Thank you for joining us today at Vericel's presentation. We have with us Nick Colangelo, Chief Executive Officer, and in the audience is Joe Mara, Chief Financial Officer. We'll leave some time in the end for Q&A. For now, over to you, Nick.
Okay, well, great. Thank you very much. It's a pleasure to be here today. Before I begin, I just want to remind our listeners that this presentation contains forward-looking statements, and you should refer to our documents on file with the SEC for further information. Vericel is a leading provider of advanced therapies for the sports medicine and the severe burn care market. We have a highly innovative portfolio of cell therapies and specialty biologics that repair damaged tissue and restore function. Our lead product is MACI, which is an autologous cell therapy product that uses a patient's own cells to repair damaged cartilage and restore function.
This is a product that we launched back in 2017 for the treatment of cartilage defects in the knee, and it's become by far the leading restorative cartilage repair product on the market and the only FDA-approved product in its class. Recently, in the third quarter of last year, we also received FDA approval of the arthroscopic administration of MACI, which we think will allow us to significantly increase our penetration into the MACI addressable market. In the severe burn care market, we're really focused on hospitalized patients with severe burns. The treatment pathway for these patients entails first removing the burn tissue or eschar and then grafting the wound to promote healing. We have products that address both aspects of that treatment pathway.
The first is NexoBrid, which is a product we launched a little over a year ago, which is indicated for removing eschar from pediatric and adult patients with severe burns, and it's an enzymatic debridement product that we think will really change the standard of care over time. And then again, once eschar is removed, you have to cover the wound, and that's where Epicel comes into play, so Epicel is the only FDA-approved permanent skin replacement for patients with large full-thickness burns. So having two products that address both aspects of the treatment pathway, we think positions us to have the premier portfolio in the severe burn care market, and in addition to being the only approved products in their class, we think our portfolio is very unique in that we have very strong competitive barriers to entry.
Both MACI and Epicel are regulated by the FDA as combination device biologic products, with the biologic component, of course, being the use of a patient's own cells. There are no established generic pathways for combination products. Anybody who wants to enter these markets has to run full-blown clinical development programs, which are very difficult in these areas. There really are no like competitors, either currently in the market or really on the horizon for either MACI or Epicel. Similarly, NexoBrid obviously has patent protection, but also as an orphan biologic product, has orphan market exclusivities as well as biologic data exclusivities that provide protection for the product as well. We think it's an exceptional portfolio to continue to build the company and sustain our high revenue and profit growth. We think the company is really well positioned to do that.
It starts with our strong financial position. In addition to generating high revenue growth over the past several years, we've also generated sustained positive adjusted earnings and operating cash flow every quarter for almost five years now. We really kind of turned the corner on profitability and actually achieved GAAP net income profitability, as I'll talk about in a moment, in 2024. We also have a very strong balance sheet, ended the year with about $167 million in cash and no debt. A really strong financial foundation for the company. Second, we are the market leader in the cartilage repair market and have built a very high-performing, high-growth sports medicine franchise. It's really been built on the sustained high growth of MACI, where we've basically had a 20% compound annual growth rate since we've launched the product.
And we think that will be amplified with the launch of MACI Arthro as we continue to expand our surgeon base and penetrate the addressable market. We've also built a second high-growth franchise in our burn care franchise, which grew 22% in 2024 based on continued uptake for NexoBrid and increased utilization as we have a larger footprint now for Epicel. And then finally, we're continuing to focus on expanding our portfolio, both in the nearer term, exploring opportunities for commercializing MACI outside the U.S., once we move into our new manufacturing facility and begin commercial production there in 2026, and initiating a MACI Ankle study later this year, which we think will provide sustained growth for MACI over the longer term as well. So really well positioned to continue the strong growth that we've achieved to date.
We have the large under-penetrated markets that really support our growth, both in the near term and longer term. Currently, about a $3.5 billion plus TAM for both our burn care and sports medicine franchise, which we think will grow over the coming years with, again, OUS commercialization opportunities for MACI and adding a MACI Ankle indication. We come into 2025 with a great deal of momentum based on our performance in 2024. We announced preliminary results yesterday. We had total revenue growth of 20% to $237-$237.5 million. That's our expected revenues for the year. Strong MACI growth for the year of 20% to over $197 million and strong growth in the fourth quarter as well.
I think one of the unique aspects of our company is the profitability profile, and we continue to significantly expand our margins, with the gross margin expanding about 400 basis points to 72.5%. Our Adjusted EBITDA margin grew about 500 basis points to about 22%, representing 55% growth versus 2023. So very strong profitability metrics. And as I mentioned earlier, we did achieve GAAP profitability for the year. So really strong results from a financial perspective and operationally as well, with the approval of MACI Arthro in the third quarter, a pediatric label expansion for NexoBrid in the third quarter as well, and completed construction on our new corporate headquarters and manufacturing facility late in the year as well. So we expect that momentum to continue into 2025.
The guidance we gave yesterday was for total company growth of 20%-23% for 2025, really driven by the momentum in our core portfolio, the first full year of MACI Arthro, which we think will, again, allow us to get greater penetration into our addressable market, maintaining a second high-growth franchise in burn care, and as I'll talk about, expanding our margins even further in 2025 and beyond. So we do expect to initiate the MACI Ankle clinical study in the second half of the year. As I mentioned, after discussions with the FDA, we're on track to begin commercial production out of our new facility in 2026, which, again, will allow us. That facility is designed to meet global manufacturing requirements so that we can support any OUS markets that we decide to commercialize MACI in down the road.
So in light of these large market opportunities, the momentum of the business, we think we're very well positioned with our current portfolio and new products to drive sustained high revenue growth. Obviously, our core portfolio of MACI and Epicel have demonstrated durable high growth, where we've had a 20% compound annual growth rate since we launched MACI back in 2017. Expect further strong growth this year and into beyond 2025. And again, those mid and longer-term opportunities for OUS commercialization of MACI and the MACI Ankle indication. So well positioned to sustain our high revenue growth. And again, I think what sets our company apart, certainly at our scale, is sort of the profitability profile.
For the second straight year, we had strong top-line growth of 20%, but actually more than double the growth in profitability with, again, the 22% adjusted EBITDA margin and GAAP net income positive for the year. For 2025, we expect continued gross margin expansion from 72.5% this year to 73%-74%. We expect continued adjusted EBITDA margin expansion from 22% to 25%-26%. Really, we're at a point now where we'll see inflecting cash generation as well. This facility that I was talking about, it was upwards of a $100 million project over the last two years when we've been self-funding that. We've actually increased our cash balance by almost $30 million.
Now that that CapEx is behind us, we'd expect to kind of resume our normal CapEx rates of sort of mid-single-digit millions a year, and we'll see that cash generation actually flow onto the balance sheet. Really at an inflection point, not only for profitability, but for cash generation as well. I'll start as we turn to our products with the cartilage repair market and MACI. Cartilage defects or injuries in the knee represent a significant unmet medical need. About 60% of knee arthroscopies reveal a cartilage injury, which is essentially like a pothole on the surface of the knee. These injuries are significant because cartilage does not have any intrinsic healing properties. There's no blood vessels to bring blood or reparative cells to that injured space. There's no lymphatics, no nerves.
So once you have one of these cartilage injuries and it's treated, you basically, obviously, in addition to pain and loss of function, head down the road to osteoarthritis and ultimately partial or knee replacements. And that's what we're trying to avoid with the MACI treatment. So given the significant incidence of cartilage injuries, there's a very large commercial opportunity. So based on a quantitative market research project that we did a few years ago, there's approximately 3/4 of a million cartilage injuries in the U.S. each year. When you look at the number of those injuries that fall within the MACI label, MACI has a very broad label, so no limit on the size or location of injuries in the knee. So about 40% of those injuries essentially fall within the MACI label.
We departed a little bit from a normal TAM exercise and asked surgeons, "Well, of the patients you treat, we know there are certain other options in some cases. And so how many of these patients do you actually deem to be clinically appropriate for MACI?" That took it to about 125,000 patients a year. And then based on sort of the size of the defects and payer coverage, about 60,000 patients a year. So at our current price point, that's a greater than $3 billion market opportunity for us and certainly supports the strong growth that we've seen for MACI. MACI itself consists of a patient's own cells, as I mentioned, seated onto a resorbable collagen membrane.
So the entire process entails taking a biopsy from a patient, which a surgeon will do during an arthroscopic procedure, typically in a diagnostic procedure or a chondroplasty where they're cleaning up the knee, send it to our facility in Boston. We isolate the chondrocytes, which produce cartilage. We expand those cells. We freeze them down and cryopreserve them until a surgeon and a patient are ready to move forward. We thaw the cells. We further expand them. And then we seed them onto that collagen membrane at a density of about 500,000-1,000,000 cells per sq cm. The product is shipped to the surgeon at a surgical site. The surgeon prepares the defect area, cuts the membrane to the size of the defect, glues it in with fibrin glue, and done. So a much simpler procedure versus earlier versions of this technology.
And once the membrane's implanted, the chondrocytes, which are spindle cells and kind of hold on to those collagen fibers in the membrane, migrate down to the subchondral bone. They start replicating. They produce the extracellular matrix that produces a hyaline-like cartilage in the knee that allows patients to resume an active lifestyle. So MACI obviously has grown very strongly since we launched the product back in 2017. We think there's a number of attributes that have led to that. First of all, is what I mentioned earlier, a very broad label for MACI. So MACI is indicated for the treatment of cartilage defects anywhere in the knee. No limits on the size or location, whether there's bony involvement or not. So again, very broad label, which we were very pleased to get from the FDA. And it's got unsurpassed clinical data.
So MACI is the only product that's demonstrated superiority versus microfracture, which is the FDA-required comparator in these kinds of studies, and demonstrated significant improvements in pain and function, so very strong clinical data, and now in the label, we have not only the two-year endpoint, but five-year data. There's publications now of 10-year data where you've seen lasting improvements for these patients, so once you regenerate this cartilage, unless there's another injury, it essentially can last a lifetime for these patients, so that obviously is a significant advancement for patients. From a surgeon perspective, as I mentioned, there was a predecessor product that was essentially the same concept: patients' own cells, but in a cell suspension, so it led to a very difficult, highly invasive surgery, so MACI essentially took that procedure, made it much less invasive, much simpler, and faster.
That's what's broadened out the number of surgeons who have adopted MACI as part of their treatment practice. Again, we expect as you take these invasive surgeries and make them less and less invasive, you get broader adoption. We expect that to continue with MACI Arthro, as I'll explain in a moment. Because it's a less invasive surgery, you have shorter published rehab protocols for MACI, which are now in line with other cartilage repair options. That obviously is a great benefit for patients. Then finally, MACI has really strong reimbursement. All the major plans in the U.S. cover MACI under a medical policy. Over 95% of cases that are submitted for prior approval are approved. Really strong reimbursement that has helped the product grow as well.
So as we look back, MACI's growth over the past years, it's really been driven, as I mentioned, by this broader surgeon adoption. This MACI becomes a standard of care for these cartilage injuries. Deeper practice penetration. So we track, obviously, the number of biopsies per surgeon. And that's really a reflection of the depth of the penetration as these surgeons identify more patients in their practice that are eligible to be treated and can benefit from MACI. And then finally, given that MACI is the only FDA-approved advanced cell therapy with the clinical benefits that I've described, the innovation for MACI has allowed us to have really strong pricing power, which has contributed to its growth as well. And we think all of these things, as I'll explain, will be amplified with the launch of MACI Arthro.
MACI Arthro, as I mentioned, we've been working on this for quite some time. And it really represents MACI was a significant procedural advancement versus prior generations. Even with the core MACI open procedure, we've developed custom instrumentation that helps to simplify and allow surgeons to implant MACI even faster. But MACI Arthro really represents a significant step forward. Typically, anything surgeons are doing in the knee is done arthroscopically. So an ACL repair, meniscal repair, most of what's done in the cartilage repair space, whether it's chondroplasties, microfractures, etc., again, are done arthroscopically. So MACI Arthro really is in the wheelhouse for how surgeons are treating these patients. And we think it will allow us to, again, achieve deeper penetration in the MACI addressable market.
When we look at sort of surgeon adoption, which again has been a significant growth driver for us, prior to the MACI launch, we had about 5,000 surgeons that we were targeting. We've reached approximately 50% penetration. We look at biopsy surgeons per year as kind of a penetration rate, and in connection with the MACI Arthro launch, we're expanding our base to include surgeons who do high volumes of cartilage repair, but typically do that predominantly through arthroscopic procedures, so that is the expansion of our target surgeon base, and again, we would expect to achieve that same kind of 50% penetration or more over the coming years, which tells you that continued expansion of the surgeon base is going to be a significant driver for MACI as we move forward.
We've done a lot of market research and segmented our surgeons into a couple of groups where we have existing MACI users obviously now. So of that roughly 2,500 surgeons that typically use MACI right now, you really can subdivide them into surgeons who look to MACI as a go-to product in patella cases or injuries on the back of the kneecap, which are difficult to treat with some of the other options that are out there, or the segment, and it's pretty equally divided of those who do patella cases plus cases on the femoral condyle, so the end of the thigh bone, which, as you can imagine, bears the brunt of the weight, and you have a lot of cartilage injuries on the femoral condyles.
Of the targets that provide an opportunity for us to increase the base, there's the other half of our former targets, 2,500 surgeons plus the new 2,000 surgeons we've added. So there's a lot of surgeons that we believe we can add with a MACI Arthro. And the market research we've done across all surgeons indicated a high interest in a less invasive MACI arthroscopic option, as well as for current MACI users, they would expect to do more procedures with MACI with an arthroscopic option. So across multiple market research projects, the takeaway is that regardless of current usage, surgeons expect to shift a meaningful portion of their procedures to MACI Arthro as it's come to market. So we're really excited about being able to access more surgeons.
And as we mentioned on our third quarter earnings call, in the initial few dozen cases that were either scheduled or completed in the fourth quarter, we actually had surgeons from each of those four segments, which is very encouraging for us as we think about the opportunity for MACI Arthro. When you look at the opportunity through a different lens, which is breaking down the 60,000 patient TAM that I referred to earlier, on the left-hand part of the slide, as I mentioned, MACI has really become a go-to product in patella or back of the kneecap cases. And we have double-digit penetration into that 10,000 patient segment on an annual basis. And also, MACI has become kind of a go-to product for larger lesions. So a four-square-centimeter lesion is kind of referred to as a larger lesion, or so that size or above.
We also have double-digit penetration in that part of the market as well. So that 20,000 patients continue to be a good source of growth for us and, again, kind of a go-to pre-MACI Arthro product for surgeons. On the right-hand side of this slide, you look at the rest of the patient TAM. And the MACI instruments were principally designed to treat two to four square centimeters, so smaller lesions on the femoral condyles. That's the biggest part of our addressable market, about 20,000 patients, so a third of that market or a billion-dollar market opportunity. And we think MACI Arthro, obviously, will be more competitive as the only restorative biologic repair product that can be delivered arthroscopically. But there's also another 20,000 patients that have smaller lesions in different parts of the knee. And that represents an opportunity for us to significantly increase penetration as well.
And as we mentioned on our third quarter earnings call, we've actually, in the early days of MACI Arthro procedures, seen not only femoral condyle defects being treated, but also defects in other parts of the knee being treated, which again points to the opportunity to penetrate other parts of our addressable market as well. So really exciting opportunity for MACI Arthro and look forward to that being a significant growth driver for the company as we move forward. As I mentioned, we plan to initiate a MACI Ankle study later this year. We've been working with the FDA on all sort of the preclinical work to do that. We expect to file an IND in the first half of the year and initiate the study in the second half of the year. Did a similar quantitative market research project.
There's about 165,000, what are referred to as cartilage resurfacing procedures done in the ankle each year. As you come down the funnel, about close to 20,000 patients a year would be deemed to be clinically appropriate candidates for a MACI Ankle product by these surgeons, which again, at our price point, would represent another billion-dollar market opportunity. So we're looking forward to kicking off that study and, again, would position MACI potentially to be the only product indicated for an ankle cartilage repair in the market. So as we turn to the burn care franchise now, so essentially, as I mentioned, we focus on hospitalized patients with severe burns.
For these patients, if you have a full-thickness burn, which means the burn goes all the way down to the muscle fat or bone of any size, or a partial-thickness burn that's greater than 10% of body surface area, and basically the size of your palm is a 1% of body surface area, so even a 10% burn is a very large burn, those are the patients that are typically hospitalized. As I mentioned, for those patients, you need to remove the burn tissue or eschar and then graft the wound so that you can promote the healing process. When we look at the addressable market in the U.S. for our burn care franchise, there's about 500,000 burns in the U.S. each year. About 40,000 patients are hospitalized based on the American Burn Association data that is out there.
Of those 40,000 patients, when we think about NexoBrid, about three-quarters of those patients require some sort of eschar removal. And at the price point for NexoBrid, which is roughly $10,000 per patient, it results in about a $300 million market opportunity for us. As you go down the funnel, there's fewer patients that have these catastrophic burns that are really 30% body surface area or above. And typically, Epicel is used in 40% or above burns. And there's about 600-800 surviving patients each year that make up the Epicel addressable market. And basically, at our price point and the number of grafts that are used, it's another $300 million opportunity for us. So a pretty substantial market opportunity given that it's a relatively concentrated call point. There's about 140 burn centers in the country.
And so, again, it's a pretty focused commercial effort to be able to address these markets. So looking at the products themselves, as I mentioned earlier, NexoBrid is an orphan biologic product in the U.S. It's basically a mixture of proteolytic enzymes that can selectively dissolve the burned tissue while maintaining or preserving the viable tissue. So right now, or prior to the NexoBrid launch, surgical excision was the standard of care. So you've got these burns. They're obviously of variable depth. And surgeons take patients into the OR, and they basically just cut away the dead tissue, which is obviously very traumatic for the patient. You lose a lot of healthy tissue. There's a lot of blood loss. There are some nonsurgical options that really are sort of regarded as having limited efficacy. And so there's clearly an unmet need for a selective and effective eschar removal agent.
We think that is the opportunity for NexoBrid. NexoBrid is that product. This is a product that is topically applied. Again, these proteolytic enzymes recognize the collagen proteins in the skin that are denatured by a thermal burn, and they remove that or dissolve that tissue and leave the healthy tissue. It is a great advancement for patients. We think it will become the standard of care over time. As I mentioned, once you remove the eschar, you have to graft the wound. That is where Epicel comes into play. Epicel, again, is a skin graft product that is made from a patient's own cells. Skin is highly immunogenic. Even though it is an organ, if you try to use someone else's skin, the body will slough it off.
So really, the only option for these severe burn patients is to do autografts or use a product like Epicel where you're using a patient's own cells. And if you've got these large burns, and we're often treating patients with 70% or 80% or above of their body surface area being burned, you really don't have enough healthy skin to do these serial autografts. So Epicel is a very important, potentially life-saving product for these patients. And there's published data out there that shows the survival rates at each decile, which is how these patients are managed, improves with Epicel versus the standard of care. So we're very pleased to have been able to kind of continue to increase the number of patients each year that are treated with Epicel.
So the opportunity for our burn care franchise going forward, as I mentioned, we've turned this into a high-growth franchise for the company. With our 20% company growth, the burn care franchise was up 22% last year. And a lot of that had to do with continued, obviously, the NexoBrid uptake, increased Epicel utilization, and having a larger commercial footprint that we expanded in 2024. Another important sort of driver is that we know when we first launched NexoBrid, because the training on Epicel is so it takes a while to get reps up to speed to be able to kind of be the point on Epicel. So we had an overlay configuration where each rep was selling one or the other products. And in the middle of the year, we basically went to a portfolio selling approach.
We think that with a larger footprint will help drive growth as we move into 2025. We had good, strong underlying demand in the fourth quarter for NexoBrid where hospital orders were up about 40%. We expect NexoBrid uptake to continue to increase. What we've seen as we have more reps selling both products that you get pulled through in institutions or burn centers that hadn't used Epicel previously. We think that will continue to drive growth moving forward as well. In addition to our current portfolio, obviously, given our sort of financial position, we have a lot of strategic flexibility to kind of think about expanding our portfolio through strategic transactions. That's typically focused on sports medicine opportunities.
A little bit in burn care where we could augment our portfolio as well as sort of leveraging our expertise in developing and commercializing advanced cell therapies. So we have a pretty broad, dedicated effort to look at opportunities. But I will say we're pretty selective. Obviously, our portfolio currently consists of highly innovative products, first and only approved products in their class. And so we look first and foremost for innovative products that have a similar kind of financial profile so that we maintain our revenue and profit growth. And so pretty high hurdle, but we do spend a lot of time looking at opportunities in the space. But we're in a fortunate position where we've got plenty of growth opportunities ahead of us. And so we'll continue to look, but be pretty selective in what we might decide to do.
So, just to close, the company over the last 10 years really has had a lot of successes as we've built one of the leading high-growth med tech companies added to our portfolio. And as we move forward, we expect to continue to expand that portfolio, as I mentioned, with the launch, strong momentum in our core portfolio, launch of our new products with NexoBrid and MACI Arthro, potential expansion outside the U.S., and then, of course, the MACI Ankle in potential indication in 20 30, and beyond. So we think we have a really good, strong runway for sustained profit and revenue growth. And with that, I'll kind of finish up, and we can take any questions.
Awesome. Thanks so much, Nick. Want to open it up to the room for questions? Yes, go ahead. Sorry. Okay, I thought there was a mic coming, but go ahead.
So, last thing I do, just to check if my memory is correct. So, for your U.S. BLA approval, you actually leverage quite a lot of data from European countries and real-world data rather than a large pivotal trial. Am I right?
So you're talking about MACI, right?
Yes, MACI, sorry.
The approval pathway for the BLA. So back in 2016, when MACI was approved, yeah, we were pretty fortunate. We purchased this business back in 2014 from Sanofi. It was part of the Genzyme Biosurgery business, and they divested this plus the rest of the business. And the pivotal study that Genzyme had run was conducted in Europe. So there was a European study that supported the approval in the EU at the time, almost coincident with when we bought the business. I think Sanofi and Genzyme assumed they were going to have to run a clinical study in the U.S. And we basically took a different approach with the FDA where we said, "Look, Carticel has been on the market for 20 years. It's a similar process where you take patient cells. Again, it's a safer and less traumatic surgery, less invasive with MACI.
So we think this should be a supplemental BLA to the Carticel BLA." And the FDA said, "No, we think it's a new product, but yes, you can use the pivotal study from Europe, the extension study with the five-year data plus the Carticel data to submit your application." And that's what allowed us to get approval without having to do additional clinical work. So it was a great sort of regulatory strategy by our team and really allowed us to get to the market probably five years earlier than we otherwise wouldn't leapfrog some of the companies that were working in the space and really set us off on a great growth trajectory.
Now, for MACI Arthro, a similar sort of great regulatory strategy where the FDA could have said, "Yes, it's just a different method of administration, but we'd like to see a clinical safety study so that we can see if when you implant the membrane using an arthroscopic device that the membrane stays in place, that the defect fills like it does if it's an open procedure." But we actually ended up doing a human factors study, which is basically a study where you bring surgeons in, demonstrate that they can use the new instruments you've developed to effectively administer the product. And that allowed us really to not have to run a clinical study for MACI Arthro to get that administration added to the label. And again, that saved years of time for us.
Our regulatory team has done an outstanding job with respect to MACI, and we expect them to do the same with the MACI Ankle potential indication.
Congratulations. That does confirm my research. But my question is actually, there are still quite a few things with similar ideas existing in Europe. Do you foresee some of them could take the similar route to be registered here with fundings? And also, specifically, there's a product called Spherox.
Yeah, there are definitely some other technologies in Europe. I would say that none of them that I'm aware of have sort of done the kind of pivotal study like Genzyme ran for or have successfully run those kinds of studies that were done for MACI, so I'm not aware that there are products out there that have sufficient data to be able to just come into the U.S., and I think those that, again, it's a less regulated market essentially in Europe, a lot of sort of hospital exemptions with different kinds of things at the bedside. I'm not aware that any one of those has sufficient data to come into the U.S.
You foresee any competitor coming to the U.S. will need to have a pivotal trial or even had to have comparison with your product?
Well, yeah, I think anybody who wants, as I mentioned earlier, to come into the U.S. will have to run kind of a pivotal study. The FDA will require that. And we know that there have been one with a MACI-like technology that failed and is no longer in clinical development. We know there was another that sort of took 10 years to run sort of a clinical study and recently divested those assets to a company in Canada. So it's a pretty tough, especially with MACI having been on the market, it's going to be pretty tough for anybody to come in with a MACI-like competitor.
Any other questions from the room?
Thanks a lot for your presentation. Very interesting. Congratulations for the success of your company.
Thank you.
Could you elaborate a little bit on the distribution side? I mean, you have two markets that you address.
Yep.
Burn and cartilage. Are these two different sales forces that are in place? And how do you educate your customers?
Yeah. So number one, yeah, there are two separate sales forces, but like any sort of large med tech pharma company, you often have sort of an underlying technology or expertise, and you go into different therapeutic areas. So there is a common platform between MACI and Epicel of cell culturing and expansion, and it's kind of a related process and synergies there. And then, yeah, we commercialize into different markets. So we have two sales forces, one burn care and one in sports medicine. And I would say the similarities and what I refer to from a business development perspective is because these are highly innovative products, advanced cell therapies, we have premium-priced products and pretty concentrated call points. So our burn care commercial organization is, call it roughly 30 people in the field between reps and managers and other support.
In the case of MACI, we have about 76 territories, so a pretty concentrated number of reps. We have a lot of other sort of case management folks who kind of help get prior approvals and things like that. But at the end of the day, for the level of revenue we're generating, it's a very concentrated call point, and that's one of the things we look for as we kind of look at other business development opportunities. Can we kind of replicate that with other products?
Oh, so on the surgeon training side, peer-to-peer programs. We've mentioned this on our past couple of earnings calls with MACI Arthro, the number of programs that we run. So we have KOL, we have speaker groups, and we do a lot of peer-to-peer education and training. And that has been, we've probably doubled them in certain quarters last year versus the prior year, the number of programs. So there's a lot of surgeons who are interested in MACI. And obviously, with the launch of NexoBrid, there's a high degree of interest in that and awareness of that product as well. So lots of time is spent on peer-to-peer education from KOLs teaching their colleagues around the country about MACI and Epicel and NexoBrid.
Thank you. With that, we are at the end of time. Thank you so much, Nick.
Thank you.
Thank you.
Appreciate it.