SI-BONE (SIBN) Morgan Stanley 22nd Annual Global Healthcare Conference summary

Strategic platform and product innovation

• Expanded from SI joint focus to a broader sacropelvic solutions platform, leveraging differentiated technologies to address unmet clinical needs in the pelvis.

• Product evolution includes iFuse 3D, TORQ, Granite, and the recent Granite 9.5 and TNT launches, each targeting specific anatomical and procedural requirements.

• Granite 9.5 opens access to a $1 billion pelvic fixation and fusion market, expanding beyond adult deformity to short construct cases.

• TNT, a 510(k) cleared product for fragility fractures, received FDA breakthrough device designation and targets a 120,000-patient annual market in the US.

• Ongoing clinical studies (e.g., SAFFRON, STACIE) and educational efforts support adoption and market development for new products.

Growth drivers and market opportunity

• Active surgeon base grew to approximately 1,150, with procedures per surgeon at 3.5 per quarter; focus is shifting to increasing utilization and surgeon density, especially in 2025.

• Targeting a total addressable market (TAM) over $3 billion and 400,000 annual cases, including SI joint fusion, pelvic fixation, and trauma.

• New product launches and expanded indications are expected to drive both new surgeon adoption and deeper engagement with existing users.

• ASP saw a low single-digit increase in Q2 due to favorable product mix.

• Hybrid sales model leverages both direct reps and third-party agents to maximize reach and productivity.

Financial performance and outlook

• 2024 revenue guidance raised to $165–167 million, with 19–20% growth expected for the year and implied acceleration to 21% in the second half.

• Operating leverage is the primary driver toward profitability, with operating expense growth targeted at about half the revenue growth rate.

• Adjusted EBITDA expected to be positive for the full year 2025, with Q2 2024 showing a 40% year-over-year improvement in adjusted EBITDA loss.

• Gross margin guidance for 2024 is around 78–79%, with future margins expected in the 76–77% range as cost reduction initiatives continue.

• Top sales territories exceed $4 million, with productivity gains driven by increased surgeon density, junior reps, and agent utilization.