Establishment Labs (ESTA) TD Cowen 46th Annual Health Care Conference summary

2025 performance and 2026 outlook

• Achieved significant outperformance in 2025, opening 1,500 accounts and exceeding initial expectations for the Motiva franchise.

• Strong momentum expected to continue in 2026, with plans to add up to 15 new sales reps to drive further growth.

• Preservé launch outside the U.S. has been successful and will be a key growth driver in 2026, with reconstruction indication impact expected in 2027.

• U.S. revenue guidance for 2026 implies at least 30% growth, with the U.S. expected to exceed 30% of total company revenue.

• EBITDA positivity achieved in 2025, with cash flow break-even targeted for 2026 and continued margin expansion anticipated.

Commercial strategy and market expansion

• Direct-to-consumer marketing, influencer partnerships, and surgeon engagement have driven patient demand and brand awareness.

• Premium pricing strategy has been well received, with surgeons passing on 30%-50% higher procedure costs to patients and achieving higher margins.

• Ergonomix implants account for 55%-60% of U.S. sales, with future pipeline products expected to command even higher prices.

• Smaller size Motiva implants expected to expand addressable market by about 10% upon approval in the first half of 2026.

• Market share in the U.S. reached 20% in the first year, with a realistic goal of exceeding 50% share in the future.

Innovation, training, and international growth

• Ongoing investment in innovation and training, including train-the-trainer programs and cadaver labs, to accelerate surgeon adoption of new products.

• International markets show stable demand, with a focus on direct markets and reduced reliance on distributors.

• China market is showing progress after distributor development efforts, with expectations for dominant share in Asia.

• Minimally invasive portfolio (Mia and Preservé) targeted to generate $30M+ in 2026, with conservative guidance and potential upside.

• Margin expansion driven by higher gross margin products, established infrastructure, and disciplined investment.