SI-BONE (SIBN) Piper Sandler 36th Annual Healthcare Conference summary

Business overview and market position

• Focuses on high-growth medical devices for the sacropelvic space, targeting a $3B+ market with three main product categories: SI joint fusion, pelvic fixation (Granite), and sacral insufficiency fracture (TNT).

• SI joint fusion remains the core business, with less than 10% market penetration and significant growth potential.

• Granite 9.5 and TNT products are expanding addressable markets, with Granite 9.5 targeting degenerative spine procedures and TNT addressing sacral insufficiency fractures.

• Hybrid salesforce model leverages over 200 third-party agents, increasing reach and surgeon density.

• Company is recognized as a category creator and market leader in each segment.

Financial performance and outlook

• Achieved 23% average annual growth over the past five years; Q3 2023 saw 19% top-line growth and near adjusted EBITDA break-even.

• Q3 hurricane caused ~$150,000 in deferred cases, but strong KPIs included 150 new active physicians and 20%+ productivity growth per territory.

• Expecting to reach adjusted EBITDA break-even in Q4 2023, with free cash flow following in about 12 months.

• Revenue growth is projected to continue outpacing OpEx, supporting further EBITDA margin expansion in 2025 and beyond.

• Deferred cases from IV shortages and hurricanes are expected to be rescheduled, with strong demand offsetting headwinds.

Product innovation and adoption

• Granite 9.5 adoption is outpacing previous launches, opening up 100,000 additional degenerative spine procedures.

• TNT product targets a $300M market, with a focus on Medicare, frail, osteoporotic patients; full launch planned for Q1 2025.

• SI joint fusion portfolio (iFuse 3D, TORQ, Intra) continues to drive growth, with new reimbursement proposals and increased adoption in office-based labs.

• Training and education are central, with over 1,200 surgeons engaged in Q3 and ongoing expansion into interventional radiology and ortho trauma.

• New reimbursement codes (NTAP, TPT) for Granite and TNT expected to provide tailwinds in 2025.