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Product / Company Performance

NuVasive Reports 4Q18 Revenue of $288.3MM, +6.3% vs. 4Q17 -


NuVasive reported 4Q18 revenue of USD $288.3MM, +6.3%. vs. 4Q17, with 2018 full-year revenue of $1,101.7MM, +7.3% vs. 2017. Against the backdrop of a stable U.S. spine market, the company provided 2019 guidance in the range of $1.14BB to $1.16BB.

Growth in the spine segment was driven by new product introductions such as TLIF and XLIF Modulus, increased adoption of expandable titanium and Porous PEEK implants and strong sales in international markets like Japan, Italy and Spain. RELINE products achieved double-digit growth year-over-year due to an accelerating surgeon adoption rate.

To bolster its growing trauma segment, NuVasive will add the Precice Bone Transport System, a minimally invasive treatment for segmental bone defects up to 10cm in the femur and tibia, to its portfolio in 3Q19.

Biologics exited 2018 down -6.4%, but leadership remains encouraged about the segment which grew sequentially +4% vs. 3Q18. NuVasive CFO Raj Asarpota said, “The sales force continues to make strides selling Biologics in the majority of spine cases, along with expanded use in other orthopedic areas. Additionally, in the fourth quarter we added three new product lines which are gaining traction in the field and placing NuVasive in a much stronger position competitively.” With a broad portfolio driving pull-through, leadership believes that this segment is well-positioned for future growth.

NuVasive CEO Chris Barry outlined four areas of technological focus for the company in 2019: lateral single-position surgery, surgical intelligence, advanced materials science and complex spinal deformity.

The company’s effort to expand its lateral procedure portfolio with lateral single-position surgery, termed LSPS, met with greater adoption by traditional NuVasive lateral surgeons and recently converted surgeons in 2018. Leadership believes that the procedure has validated clinical and economical value propositions by reducing OR time and hospital stay costs.

NuVasive has gathered robotics expertise at the executive and board levels, and is now ready to leverage that experience by announcing the Pulse Robotics platform. The company will debut its prototype at NASS 2019, but gave no further details about FDA clearance or market launch. The robot is viewed as the mechanical automation aspect of the broader enabling technology of the Pulse system, and is aimed at being applicable in 100% of spine cases.

Underlying the Pulse platform is NuVasive’s Surgical Intelligence modular operating system that combines monitoring, planning, imaging, 2D and 3D navigation, automation and insight to deliver a connected O.R. The company is also planning to integrate mobile 3D imaging called Cios Spin, developed in collaboration with Siemens Healthineers. The combination of so many disparate technologies into a single platform is an example of NuVasive’s strategy of creating a connected ecosystem of tools that drive product pull-through and increase the cost of disruption from switching to another provider.

The company’s focus on advanced material science is aimed at continuing to expand its portfolio of spine interbodies and increasing the adoption of porous PEEK and third-generation porous interbody titanium implants. To address complex spinal deformities, the company plans to add several products to its fixation portfolio. NuVasive will leverage its partnership with Biedermann Technologies to advance the development of the next generation of RELINE products.

ORTHOWORLD estimates 4Q18 and full year segment sales and growth on an as-reported basis, as follows.

  4Q18 4Q17 $ Change % Change
Spine $251.4 $237.4 $14.0 5.9%
Trauma $9.9 $6.3 $3.6 57.7%
Orthobiologics $27.0 $27.5 -$0.5 -1.8%
Total  $288.3 $271.2 $17.1 6.3%
  FY18 FY17 $ Change % Change
Spine $959.8 $880.8 $79.0 9.0%
Trauma $38.1 $34.9 $3.2 9.1%
Orthobiologics $103.8 $110.9 -$7.1 -6.4%
Total  $1,101.7 $1,026.7 $75.0 7.3%

ORTHOWORLD estimates NuVasive’s orthopaedic revenue by geographic region as follows.

Geographic Region 4Q18 4Q17 $ Change % Change
US $234.6 $220.2 $14.3 6.5%
Ex-US $53.7 $51.0 $2.8 5.4%
   EMEA $43.80 $40.79 $3.0 7.4%
   Asia Pacific $5.51 $5.10 $0.4 8.0%
   Rest of World $4.43 $5.10 -$0.7 -13.0%
Total  $288.3 $271.2 $17.1 6.3%

Net earnings for 4Q18 are as follows.

4Q18 Amount ($MM) % of Sales
Sales $288.3  
   Cost of Sales -$86.1 29.9%
   R & D -$17.1 5.9%
   Selling and Admin -$142.2 49.3%
   Other -$30.7 10.7%
Net Earnings  $12.2 4.2%


Sources: NuVasive; ORTHOWORLD estimates.

Mike Evers is ORTHOWORLD’s Market Analyst. He can be reached by email.

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