All right. Yeah, I think we can kick things off. Thank you all for joining. Mike Kratky, I am our senior med tech analyst here at Leerink, and very pleased to be joined today by Vericel, Joe Mara, Eric Burns. Thank you both for coming.
Thanks for having us. Appreciate it.
Awesome. Joe, maybe to kick things off from your perspective, you know, would love to hear you start a little bit just on how this business has evolved over the past year and as you look out to the next 12 months or so, you know, what gets you most excited?
Yeah. First off, again, thanks for having us to the conference. Really appreciate being here. You know, do want to mention that we will be making some forward-looking statements today, so please refer to our filings with the SEC for further information. You know, I'd say we're very excited about 2026. You know, we feel like we're coming into the year with a ton of momentum. You know, we closed out last year very strong, you know, particularly the second half of the year and, you know, in particular, the fourth quarter, I would say, where if you look at, you know, across the business, we had from a top-line perspective, 23% company growth, 23% MACI growth, burn care a strong quarter at 25% growth as well.
You look at our profitability metrics in the fourth quarter, 79% gross margin, you know, over 40% adjusted EBITDA, and, you know, continued strong cash generation. You know, on that point, you know, one thing that we talked about as we closed out 2025 and we're excited for 2026 and beyond is, you know, a bit of that inflection in our cash generation. You can see how we closed the year with about $200 million in cash and investments and actually increased our cash balance by over $30 million in the back half of the year. With our new building behind us, and that was just approved by the FDA last week for MACI manufacturing, so very excited about that news. With that investment behind us, we think there's really an opportunity to inflect our cash generation as well.
From a full year perspective, MACI had a strong year as well with its third consecutive year of more than 20% growth. You know, strong margins with gross margin in the mid-70s and EBITDA in the mid-20s actually outperformed our initial margin guidance, you know, despite some incremental investments, most notably the acceleration of our sales force expansion. You know, really strong year overall, and as we talked about on our call a couple weeks ago, we feel like we have a ton of momentum heading into Q1 as moving to 2026. I would say as we think about 2026 really and beyond, you know, we laid out three key strategic imperatives a couple weeks ago on our call. One is just to make sure that we maximize our sales force expansion from a MACI perspective.
We increased our size of our sales force by around 30%. You know, very excited about that, as we move into this year. Certainly wanna make sure we're maximizing that not only in 2026, but beyond. The second piece we laid out was continuing to leverage the Arthro launch. You know, I think we laid a very strong foundation last year from an arthro perspective. You know, we're coming into the year with around 1,000 trained surgeons. You know, last year we entered with 150. We wanna continue to kinda use arthro to drive that growth in the smaller defects, which, you know, is a very large part of the TAM, but it has been a relatively small part of our business. That's the second one to point out.
Then lastly, I would say just a significant focus on both, I would say, commercial excellence, but really operational excellence as well. If you think about MACI, we're trying to capitalize on that larger sales force, the contributions from arthro, and we have a number of commercial excellence initiatives on, you know, things like better tools and analytics to try to drive better execution from a sales force perspective. You know, we're doing that really across both franchises. As we think beyond 2026 operationally, you know, in addition to our news in terms of last week on the approval of our new manufacturing facility, we are ramping up our ankle trial, so that'll be important. Ankle represents a significant opportunity over the next few years, and also potentially ex-U.S. launch of MACI as well.
You know, a lot going on. I think we're excited about kinda where, how we finalized 2025, but really excited for 2026.
Yeah. Yeah, lots to dig in on there. You know, let's just start with MACI. In terms of kind of the two to three most important factors that are driving some of that commercial momentum that you're seeing, what would you call out in particular?
Yeah. I would say, you know, MACI, again, its third straight year of over 20% growth. You know, I'd say from a metric perspective, I mean, one thing we pointed out was, you know, Q4 was extremely strong across the board. Actually December in particular, we saw some of our highest metrics really by a wide margin. You know, we're pretty excited about that. You know, obviously, you know, continuing to drive high biopsy growth. You know, I would say, you know, one thing that's been consistent over the last number of years, even really through the COVID years, has been strong surgeon growth. You know, we'd love to see kind of more of that biopsies per surgeon start to tick up, and we actually did see that, you know, tick up in the second half of last year.
You know, certainly I think seeing some good signs there. You know, we also talked about, as you think about how we closed 2025, the small condyle defect segment, which again has been a relatively small contributor, actually grew from a growth perspective similar to patella, which is by far our largest segment and our highest growth segment as well.
Understood. Maybe to take a step back, in terms of where you are today, in terms of the accessible commercial opportunity for MACI, you know, what inning would you say you were in, and how would you characterize the size of that market overall?
Yeah, I'll take that one. The MACI TAM is, you know, 60K. But as we look at, you know, biopsies we're getting from our larger territories or the penetration we're seeing in patella, it tells us there's still a lot of room to go here on MACI. Interestingly, as you look at kind of truly restorative treatments, so MACI being a leader, OCA and OATS, only about 10,000 patients are receiving those types of treatments today. Most patients, I would say, are getting probably an inferior treatment for their long-term cartilage health. We're gonna compete against these other restorative options, but also there's a lot of patients that really are not getting an optimal treatment that we can pull in with MACI and MACI Arthro.
Got it. Yeah, really helpful. Now, in terms of 2026, you laid out MACI growth in the high teens range. You know, a lot of growth drivers that you outlined earlier. Can you help frame what's being factored into the guidance, what's not, and just the different components of growth that you're kind of factoring in?
Yeah. I'll take that one. You know, I would say from a broader perspective, maybe just to briefly touch on burn care as well, and they really wanted to start the year, I'd say, with a very balanced, you know, and prudent guidance framework for the year. You know, on the burn care side, you know, we pivoted last year back to this kinda run rate concept from a burn care revenue perspective, this, call it, $9 million-$10 million per quarter on average. You know, we know that certainly could vary and we will call that out if we think we're not trending to that. For example, we did that in the fourth quarter. You know, we felt like we were trending behind.
We ended up having a really strong final month with Epicel and kinda got into that range. But you know, I think we have a very appropriate burn care framework to start the year. Just as a reminder, we talked about a couple of weeks ago, you know, obviously the government shutdowns have kind of been on and off over the last few months, but there certainly is, I would say, a reasonable possibility that, you know, there could be some BARDA contributions that could both de-risk, you know, the company and the burn care guidance and potentially be additive. I think we're in a good place from a burn care perspective.
I would say on MACI, you know, we also feel like we're starting the year kind of at the right place in the sense that, you know, we had that strong second half and we saw some acceleration. From a full year perspective, you know, we're gonna try to start very balanced and say, you know, across all our key growth drivers, just assume similar trends, you know, on a year-over-year basis. Really what that points to are a couple things that we think is the right starting point. Number one, similar incremental revenue on a year-over-year basis, kind of in that, you know, $42 million-$43 million range. We know our business is highly seasonal. From a MACI perspective, we typically have more than 60% in the second half of the year.
Q4 is our largest quarter by far. We did feel like, you know, we've obviously seen some really strong trends to start the year, but from a guidance framework perspective, what we did not want was, you know, an assumed acceleration, you know, first half to second half, call it. The starting point here really is, I would say, similar seasonality from a mix perspective. As importantly, I would say similar growth across, you know, both halves of the year, call it all four quarters, which, you know, I think is a nice kind of balanced place to start on a full year perspective.
Understood. Maybe just to dig in on MACI a little bit more. In terms of, you know, the contribution that you've seen from MACI Arthro, you know, what have you seen to date, and how is that kinda influencing your outlook for 2026?
I'll take that one.
Sure. I think, you know, one thing we touched on is a small condyle area of the TAM, which again is the largest segment of the TAM, but historically been a lower penetration area for us. You know, as we looked at, you know, the growth acceleration we saw in 2025, and you look at also the acceleration in growth in the small condyles, you know, they kind of correlate to each other.
Mm-hmm.
Some of the acceleration we saw in volume last year was driven by that small condyle ticking up. Now, I think what Joe has said is kind of high level, the guidance assumes kinda similar trends kinda carrying into this year. You kinda think of that trend kinda continuing as kinda the base case. I'm sure we'll get more in arthro in a minute, but I think there's probably reasons to believe that can probably tick up, but from a starting point standpoint, kind of similar trends to what we saw last year.
Understood. You know, you talked a little bit about what you've seen so far in the first quarter to help kinda factor into the 1Q guide, you know, especially coming off the back of a really strong December and fourth quarter. Maybe just talk a little bit about what you've seen so far year to date and how that momentum has kinda continued from last year.
Yeah. You know, we talked about on the call, you know, if you kinda look at our first quarter guidance, I would say across the entire business, you know, it's pointing to, you know, more than 20% growth at the company level. Again, just on burn care, you know, I think we're off to, you know, a pretty strong start there in terms of our trends and felt like we're very much tracking to that run rate, you know, to start the year, which is great. I would say on the MACI side, you know, you, we kinda touched on it a bit and you did in your question, but I think with such a strong fourth quarter and such a, you know, really strong December, that really set us up well to start the year.
That strength has continued into the first quarter. You know, we feel like there's a ton of momentum there. You know, I think to start the year, you know, if you look at our 1Q guide, it's a bit higher than, you know, we'd started the year from a guidance perspective the last couple of years. You know, certainly from a performance perspective, you know, trending a bit higher as well. You know, certainly feel good about the start of the year, which we think positions us not only for a strong Q1, but gives us a strong start from a full year perspective as well.
Got it. Yeah, very helpful. The other thing that you mentioned, Joe, is just the 1,000 trained MACI Arthro surgeons. You know, any additional details that you could provide there just in terms of utilization trends among these trained surgeons? You know, what portion of them have already started implanting MACI? You know, what portion of them are prior versus kinda new users or any other color there?
Yeah, I'll take that one. The mix, we'll start there. It's about a third, a third, a third split between surgeons that came in to MACI for the first time through this arthro training, so not historically using MACI. A third that used to only use MACI on the patella. By definition, by thinking about arthroscopic, they're starting to think about a wider patient population in their practice. Then the remaining third would already have done condyles in the past. I was gonna start with the new surgeons. You know, they were certainly a feeder for our biopsy growth in sort of new surgeons last year, and that will continue to be the case, the way they kinda ramp in training to do their biopsies and drive that growth.
I would expect their ramp will look very similar to any other surgeon that we've brought on over the years, except for one difference is that they're now trained on arthro right out of the gates. They might look at, you know, MACI a little bit differently from their start versus a historical MACI user. You know, time will tell, but I think that would be the assumption. You know, our patella only docs, you know, they might do a lot of patella cases, but we haven't to date unlocked their condyle business, and this is a way to unlock that condyle portion of their business. You know, the, what we said broadly is that whether we looked, you know, quarter-over-quarter, whenever we saw surgeons get trained, their biopsy growth ticked up and their implant growth ticked up.
That was pretty consistent throughout the year. Most importantly, I would say, as we kind of got to the second half of the year, we were able to see the, you know, conversion rates for surgeons doing arthro cases were going up noticeably. Which matches up with anecdotally what we've heard from the surgeons of what they would expect to happen with arthro, given the kind of patient benefits and, you know, conversation with the patient is a little bit easier to have talking about a minimally invasive version of MACI versus open. Kinda lining up with what we expected, and we think those trends will kind of continue into this year.
Got it. Now, the other thing you mentioned I certainly think is a point of focus this year is just the 30% or so sales force expansion. You know, would love to maybe hear a little bit more about why now is the right time, and really what you've seen so far in terms of the progression of adding that sales force and what that sales force productivity level has kind of tracked over time.
Yeah. I'll start on that one. You know, I would say, you know, from a sales force expansion perspective, as I talked about earlier, I mean, that's definitely one of our, you know, key strategic imperatives to maximize that. Just to take a step back, you know, typically, you know, we've actually expanded our sales force a number of times, you know, kind of in the early years of MACI, but have not done that in, you know, about five years.
You know, what you typically do is you kind of work, you know, you kind of hire an expert in this area, and you do a workflow analysis and think about, you know, how much reach and frequency do we need in terms of making sure we're calling on all our targets, setting ourselves up to kind of maximize that reach and frequency from a biopsy growth perspective, and then also making sure we have the right number of individuals that can kind of pull those through to implants, you know, over time, both in the near term and call it the midterm.
You know, we went through that analysis last year and, you know, just, you know, again, we actually ended up accelerating that a bit, you know, last year and did all our hiring in Q4 with our sales force fully in their new territories to start this year. You know, typically in prior years, we would do kind of a, we would typically hire in the first half of the year and then start in our new territories in the second half. We just felt like, you know, based on the analysis and the opportunity, it was worth accelerating that.
You know, one thing I would just point out is, you know, there's often concern around disruption when you're expanding your sales force, and I think for us, you know, we often got the question, you know, this was during the fourth quarter, which is your largest quarter, and, you know, we feel like, you know, the teams really just did an outstanding job driving that strong Q4 in the midst of us kind of adding those new sales reps and, you know, we kind of got all that hired at the end of last year. I think our team did a great job from a timing perspective. We feel very good about the quality of the individuals, the experience they're bringing, and, you know, feel very good to kind of start the year.
You know, again, as you go through sales force expansions and you're thinking about territories, there's a qualitative aspect as well, you know, in terms of kind of landing on the number of reps. You want to make sure you're not disrupting key relationships. You're thinking territory by territory, does this make sense, et cetera. You know, again, we feel like the teams have done a really good job. You know, obviously they need to get up to speed as they come into the company and they're new to the company. You know, we did say if you kind of look at our sales productivity metrics, you know, if you look at last year, for example, you know, we did about $240 million on MACI, around 75 reps.
That's kind of in the $3.1 million-$3.2 million revenue per rep. You know, if you look at this year's guide, it's kind of not that far off, call it $2.8 million plus at 100 reps. You know, we said as early as next year, we would expect to kind of get back to 2025 levels, and really if, you know, with any reasonable, you know, growth from a MACI perspective, we should really be exceeding that next year. You know, we feel good. Obviously, it's only been a couple of months to date, but feel really good about who we've added and again, have pretty high expectations for them to get up the curve as we get to the, you know, toward the end of the year and into next year and beyond.
Yeah.
No, I would just add maybe, you know, I think 2020 is probably the last year of kind of adding to greenfield accounts where we had some kind of white space to fill into the map. Now, you know, this is largely kind of more breaking territories up to make them more manageable, you know, add reach and frequency for those territories so that reps can focus on both adding new surgeons as well as kind of hitting their key customers on a regular basis. You know, I think of productivity as like a macro and not necessarily looking at productivity on just the new reps.
Yeah, really helpful, and you guys beat me to it a little bit, but I would love to hear any color you can add just in terms of as you added the new reps, what portion of them were just focused on greenfield accounts versus, you know, what level of kind of like reorganization was there among your existing sales force?
I would say it's really more a reorganization of the sales force around, you know, manageable territories and less about the greenfield for this add, I would say.
Got it. Just in terms of where the reps were placed, is this largely kind of like MACI Arthro? Was there some level of focus there? How did you kind of like help address that as kind of something that's still relatively early in the launch?
Yeah. I mean, I think of arthro as kind of a, you know, enablement technology for MACI. You know, they're really selling MACI and, you know, now these new reps are coming in with arthro already in the bag, you know, whereas legacy reps, you know, had it in the bag along their tenure with Vericel. These reps are coming in trained on arthro on day one. Obviously, we'll be using that as a tool to sell MACI right out of the gates.
Yeah, I'd just go back to, if you think about MACI and kind of our imperatives for this year, it's really about the sales force expansion, you know, driving arthro usage and that commercial excellence kind of execution concept, and I think all three of those really work together as we think about that, you know, for 2026 and beyond.
Got it. Yeah, really helpful. Maybe just to stick with MACI Arthro, but, you know, now that we're call it over a year into the launch, how do you characterize the initial level of adoption you've seen, you know, the commercial trajectory so far, and how has that influenced your outlook for MACI Arthro moving forward?
Take that one?
Yeah, I think in terms of the overall contribution from Arthro, you know, it's generally tracking with our expectations. If you think about MACI's growth curve, we're heading into year 10, and it continues to grow very strongly, so it's certainly a durable growth product, and that's just the nature of, you know, how surgeons adopt technology over time in this space. If you look at, you know, where that growth has come from, it's largely come from patella. It was about a quarter of the business when MACI was launched. It's moved up to about half the business today, and that's what's been growing much faster than the overall MACI business.
You know, we think that with the small condyle defects being, you know, the largest part of the TAM and arthro unlocking that opportunity, that this is gonna be a multi-year kind of multiplicative impact over the years to get that to be a larger percentage of our business as well. We started seeing that last year, so we're gonna continue to hopefully see that throughout this year and beyond, and that will end up being the kind of key growth driver for arthro.
Got it. Now maybe just last one on MACI, but, you know, if you can add any color in terms of just the volume and the implant growth you're seeing relative to your pricing impact, and how investors should be thinking about your pricing strategy for MACI over time.
Yeah. I'd say, you know, kind of on an annual basis, you know, we always say there's kind of multiple growth drivers from a MACI perspective. You know, from a volume perspective, it's again been primarily driven by that surgeon breadth, but I think we're starting to also see some depth. I would say if you look at our initiatives this year, I'd say there's a renewed focus on really thinking about that opportunity from a depth perspective. You know, pricing has certainly been part of our growth algorithm. You know, I would say when we think about pricing, it kinda starts with access or access position and whatnot. You know, I think we talked on the call a couple weeks ago, you know, we have really strong access positions.
You know, if you look at last year, we said that more than 95% of prior authorizations from MACI perspective were approved and got through and, you know, that that's pretty significant. You know, obviously MACI is a biologic, it's an innovative cell therapy product, so, you know, we do expect pricing to remain part of our growth algorithm. You know, having said that, I would say across our entire franchise, you know, we want to be balanced. We do research to, you know, kind of inform our decisions. You know, I would say going forward from a MACI perspective, you could probably think about it in, you know, in the high single digits or call it the mid to high single digits.
That could vary a bit, but, you know, that's kinda how we think about pricing over multiple years.
Understood. Very helpful. You know, maybe shifting to the burn care business. You know, you talked about some of the strength last year. At a high level, how has your kind of outlook on burn care evolved over the last twelve months between Epicel and NexoBrid, and maybe we go from there?
Yeah, again, I would kinda go back to you know, if you look at burn care, I mean, we always say fortunately there's not, you know, a huge number of potential Epicel patients. It's almost like a rare disease product each quarter in terms of severely burned patients. The dynamic we've seen in particular over the last couple years is, you know, a fair amount of variability in terms of, you know, quarters. You know, we've also seen that on an annual basis. For example, 2024, actually burn care grew faster than MACI in the overall company. You know, last year, you know, Epicel just did not get off to a good start to the year and, you know, unfortunately you pointed out things like patient health, you know, it kind of had a big impact there.
You know, in 2025 it took a bit of a step back. You know, I would say, you know, if you look at burn care over a longer period of time, you know, it tends to be a contributor to growth, you know, over the longer period of time. I think this year, again, I think our guidance is pretty balanced to start the year. You know, it assumes, you know, a similar kind of level of revenue. There's some variability there, and obviously our goal will be to outperform that. You know, again, we feel like Q1's off to a good start, and again, there can be variability by quarter, but, you know, feel like we're well-positioned. You know, NexoBrid, you know, did grow 40% last year, so that continues to tick up.
You know, Epicel, we think this year can, you know, do a bit better. We probably don't want to get ahead of ourselves there, but, you know, certainly, you know, I think again, our guidance framework captures a reasonable scenario that I would say we'll try to outperform.
Understood. Yeah, maybe it's a little bit too early to say, but just as we think about burn care beyond 2026, like the, you know, $36 million-$40 million or so in burn care guidance for this year, I think is about, call it flat to 8% growth from 2025. You know, is that the right way to think about the growth profile for the business moving forward? Or what would be some of the key points of sensitivities within that?
Yeah. Again, I think our, you know, our expectation is, you know, NexoBrid will continue to, you know, so we'll see higher utilization there. You know, it hasn't happened quite as quickly as we would've liked, but obviously it still remains kind of a focus to drive incremental NexoBrid utilization. You know, again, if you look at burn care over longer periods of time, I mean, we have seen, you know, that dormant account concept from an Epicel perspective in terms of getting new accounts. We have, you know, a team that's now selling both products. You know, so we do think, you know, over multiple years, again, we think it can be a contributor to growth.
I mean, if you kinda go back in time, we would typically say, you know, call it high single digits or maybe low double digits from a growth perspective, and, you know, we'd often beat that. Again, we probably want, just wanna be a little bit prudent to start this year, but, you know, our expectation is that will continue to tick up, but, you know, we just have to realize there is some variability quarterly, and, you know, we've seen that on an annual basis as well, including the last couple years.
Yeah. Understood, and think that makes total sense. Now, in terms of NexoBrid specifically, you know, it was down slightly quarter-over-quarter in the fourth quarter, so would love to hear you know, if you could kind of help frame how much of that was destocking from a really strong 3Q versus any other factors there.
Yeah, I think, I mean, that's essentially what it was in the sense that if you look at, you know, NexoBrid on a year-over-year basis, as we said on the full year, you know, grew over 40%. If you look at 4Q, actually the orders, the number of hospital orders, and I think the number of orders were both up a bit on a year-over-year basis. I think we actually have seen really in both fourth quarters a bit of this destocking dynamic that's obviously out of our control, you know, at the specialty distributors, which is where we recognize revenue. You know, we did hear from the teams, you know, perhaps a bit at the hospital level as well, which we have kind of less visibility in.
I do think it was just more kind of coming off, you know, a really strong third quarter, and so it's probably a little bit magnified as you look at Q4. You know, nothing different we would call out. We probably saw a similar dynamic last year, but it's definitely impacted, I would say, the quarterly comps. You know, the utilization was, you know, on a year-over-year basis, still there.
Got it. Just in terms of kind of unlocking maybe more aggressive growth for that product, are there any key points of sensitivity that you'd really call out there?
Ta ke that one.
Yeah. You know, we're targeting about 90 accounts. You know, today we've had about 70 or more, you know, starting to use NexoBrid. From that standpoint, you know, pretty good success. You know, what we've seen is that, you know, to unlock a center to their kind of full potential, you know, takes longer than we would've expected. You know, these surgeons have been doing the same thing to remove eschar their entire careers. To change that takes time, takes involvement of the entire staff. It's certainly something we're able to do. It just takes longer than, you know, before we thought out of the gates. You know, that is probably the key driver at this point.
We have enough centers probably to create a pretty large business for NexoBrid, and now it's about getting deeper penetration within those centers. Our, you know, with our team of 20 reps, we think we're kind of covered now to have capacity to do that while also covering Epicel and driving that business at the same time.
Got it. Really helpful. Maybe just to spend a few minutes on the P&L, but you know, would love to hear you kind of walk through some of the puts and takes of the 75% 2026 gross margin guidance. How does the Burlington facility factor into that, and how do you think about that moving forward?
I'd say, you know, from a gross margin perspective, we've probably gotten up the curve, you know, probably more quickly than we would've expected to already be, you know, essentially in that mid-70% range on a full year basis. You know, again, if you look at 4Q, that's always a good kind of marker for where the business potentially could go, and we typically grow into those over a few years. But you know, on a full year basis last year we were around 74% gross margin. The guide this year is around 75%. You know, I think to kind of your question, there's some puts and takes this year, and we kind of have the natural leverage we see, you know, as we're driving incremental revenue that flows into gross margin.
There are some costs, you know, kind of in the OpEx side that are moving on the cost of goods sold side as we start doing manufacturing in Burlington, and then there's some incremental costs that are hitting the P&L overall as well, so as some of our equipment and whatnot comes online. You know, we do think that's, you know, we've really gotten up the curve nicely from a gross margin perspective and, you know, we think over time that should continue to tick up.
Got it. You know, you recently started on the MACI ankle phase III study for MASCOT, I think in the fourth quarter. How should we be thinking about the cadence of enrollment there and when we could see any interim updates or catalysts on that side?
Yeah. You said we initiated in the fourth quarter, and now we're kind of starting to enroll patients, so I wouldn't expect any big updates this year. We're just gonna focus on kind of getting enrollment up the curve. I think the higher enrollment years will probably be 2027 and 2028, and kind of update as we go from there.
Got it. The other piece you mentioned, you know, OUS expansion on the horizon at some point. What's the right way to think about potential contribution on that side and when we could see more?
Yeah. I would say, you know, as you think about kind of the U.K., on the OUS piece, right?
Mm-hmm.
So in the U.K. perspective-
Mm-hmm
I would say the big kind of big work stream this year is certainly on the regulatory side. That's where the team's focus is kind of moving our regulatory submissions along. You know, there are some pre-commercial activities as well. You know, the hope is we get through the regulatory activities this year. You know, there are a few kind of, as I said, pre-launch activities also going on, but we're hoping to be launching in 2027 and, you know, definitely have, you know, ample capacity, I would say, in our new facility, you know, which is also set up for ex-U.S. standards as well. Definitely excited about that.
Got it. Now with the 30 seconds or so, you know, the other piece, you mentioned the $200 million or so in cash, very clean balance sheet. How should investors be thinking about your appetite for business development, or what we could see on that side?
Yeah, I mean, I think I would say no real change there. You know, obviously we're kind of focused on driving a strong 2026. We feel like we have a number of growth drivers. You know, the idea is to kind of drive this over multiple years. That's where lifecycle management, ex-U.S. and ankle, for example, come into play. You know, arthro is obviously the more near term piece that's contributing. No change there. I would say, you know, there's a number of growth investments that are within our operating P&L, but outside of that, you know, I think we'll be disciplined from a financial perspective. Also, we have a pretty innovative portfolio. Certainly if something made sense from a business development perspective, you know, that's something we would consider.
Awesome. Well, Joe, Eric, thank you both so much for joining us. Really appreciate it, and, thanks all for coming.
Thanks, Mike. Appreciate it.