Tandem Diabetes Care, Inc.
Q4 2019 Earnings Call Transcript

Published: 25 Feb 2020

[Operator:]

Ladies and gentlemen, thank you for standing by and welcome to Tandem’s Fourth Quarter and Year-End 2019 Earnings Call. [Operator Instructions] Please be advised that today's conference may be recorded. [Operator Instructions]I would now like to hand the conference over to your speaker today, Ms. Susan Morrison, EVP and Chief Administrative Officer. Ma'am, you may begin.

[Susan Morrison:]

Thank you. And welcome, everyone, to Tandem's fourth quarter and year-end 2019 earnings call. Today's discussion will include forward-looking statements. These statements reflect management's expectations about future events, product development timelines, and financial performance and operating plans and speak only as of today's date.There are risks and uncertainties that could cause actual results to differ materially from those anticipated or projected in our forward-looking statements. A list of factors that could cause actual results to be materially different from those expressed or implied by any of these forward-looking statements is highlighted in our press release issued earlier today and under the Risk Factors’ portion and elsewhere in our most recent Annual Report on Form 10-K and in our other SEC filings. We assume no obligation to publicly update any forward-looking statements whether as a result of new information, future events or other factors.In addition, today’s discussion will include references to adjusted EBITDA, which is a non-GAAP financial measure. Adjusted EBITDA is a key measure used by us to evaluate operating performance, generate future operating plans and make strategic decisions for the allocation of capital. Please refer to our press release issued earlier today for further information.Today's call participants include Kim Blickenstaff, our Executive Chairman; John Sheridan, President and CEO; and Leigh Vosseller, Executive Vice President and Chief Financial Officer. Following our prepared remarks, we’ll open up the call for questions. We appreciate everyone limiting themselves to two questions before getting back into the queue.I’d now like to turn the call over to John.

[John Sheridan:]

Thanks, Susan, and welcome, everyone, to today’s call.Before we discuss our results and plans for the year, I'd like to take a moment to express our sincere thanks to Kim. Kim became our Executive Chairman this past year after serving as President and CEO of Tandem for more than 12 years, and after March 6 will transition to a role of Chairman. Kim has been an incredible metric to me and the executive management team and Tandem stories is a success because of his leadership and unwavering personal and financial support. We appreciate your guidance through the years and look forward to continuing to work closely with you in your new role as Chairman.

[Kim Blickenstaff:]

Thank you, John, and thanks to all of our employees who have helped build Tandem into a company that lives by its mission to improve the lives of people with diabetes. It's a hardworking group that is very passionate about our customers and building our company for long-term success.Five years ago, we offered a fantastic insulin pump in the United States and had less than 5% market share. Since that time, we estimate that the U.S. insulin pump market has grown by 40% to 600,000 pumpers of which we have nearly 20% market share. We believe this strong trajectory is largely due to our focus on innovation and technology advancements such as our Basal-IQ and Control-IQ automated insulin delivery technology which are designed to be easy to use and help to reduce the burden of diabetes and improve clinical outcomes.With 2019 being a strong first full year of sales outside the United States, we believe there's a similar opportunity to drive pump adoption in international markets. If we look at five years from now, that's our goal for 0.5 million customers to use our products worldwide. To achieve this, we'll be working to lead an insulin therapy management by building a robust ecosystem and portfolio of data-driven products and services around our flagship insulin pumps. We'll also be continuing to invest more customer service and support to live up to our world-class standard we've set for ourselves.I believe John and the team have the talent and the passion to accomplish this goal. As Chairman, I look forward to staying active with the company and helping Tandem along the path to achieving its longer term objectives. I’ll remain meaningful shareholder and also look forward to continuing to build long-term value of our company.With that, I'll turn back to John.

[John Sheridan:]

Thanks Kim.We've spent a lot of time refining our plans to achieve the vision Kim described. Some of which I'll touch on today. It really starts with our tremendous accomplishments in 2019. During this past year, we set records throughout our business that well positioned us for longer term success. These include shipping more pumps in 2019 than the past four years combined, nearly doubling our year-over-year sales, a 5-point year-over-year gross margin improvement and crossing a meaningful profitability measure by generating nearly $50 million in cash this year.We also added to our growing list of company and industry first. The t

[Leigh Vosseller:]

Thank you, John, and good afternoon everyone.We entered 2019 with an optimistic expectation of at least 40% sales growth and closed the year at $362 million in worldwide sales which is nearly double our 2018 sales and the highest annual growth rate in our history. Strong demand for our t

[Operator:]

[Operator Instructions] And our first comes from Brooks O’Neil Lake Street Capital. Your line is open.

[Brooks O’Neil:]

With all the amazing things you guys discussed in your prepared remarks, it’s very difficult to limit myself two questions, but I’m going try hard so?

[John Sheridan:]

Thanks.

[Brooks O’Neil:]

I’m curious, I hear that the FDA is particularly sensitive about the issues related to phone control and I was particularly intrigued by the work you’re doing in that area. Can you just share with us any sort of sense from the conversation you’ve had with the FDA. And what are the key issues they want you to demonstrate to give you approval for phone control and for t

[John Sheridan:]

Sure, good question. I would say that a couple of years ago the way you describe the FDA’s feeling is about phone control is true. But as time has gone on they have become more open to phone control. And in fact in the last year or year and a half the conversations we've had with them actually have encouraged us to move forward with control from unrestricted phone because it's what everybody uses in their lives today.They just want - a kind of as a matter of reducing the burden. So I think it's something that they want us to achieve. We're moving forward in that direction. You heard that not only will we have full phone control for t

[Brooks O’Neil:]

Yes okay. So my second question, I'm just curious not whether you had discussions with your friends at UnitedHealth Care, but have you detected any change in the relationship in the discussion and the tone from them related to the success you’ve had with Control-IQ. And obviously the - what appears to be a significant problem for Medtronic with their recall?

[John Sheridan:]

Well, we don't provide specific updates on particularly payer situations. But I would say that in general we're very pleased with all the conversations we're having with payers and longer term our goal is to increase our direct presence and seek additional reimbursement for these algorithms.You do know now that the New England Journal article is huge. I think that's exactly what they asked us to do and now that Control-IQ is in the market. And I think we're in a position to have meaningful conversations with them.

[Operator:]

Our next question comes from Alex Nowak from Craig-Hallum Capital Group. Your line is open.

[Alex Nowak:]

I just want to start on what happened in the quarter here with international that was trending around 4,000 pumps a quarter. So it did come in about half of that so, just curious what happened there in the quarter. And then just what gives you confidence in the rebound as you included in the guide?

[Leigh Vosseller:]

Sure, thanks Alex nice to talk to you. When it comes to international where we ended up for the year there were a number of moving parts I would say in the third and the fourth quarter. As we had talked about before the Animas conversion opportunity was almost fully complete by the end of second quarter. Some of it fell into the third quarter so third quarter is slightly benefited from a little bit more Animas opportunity.But also what happened was that we began to rollout Basal-IQ and even more importantly the Tandem Device Updater. That product didn’t become available until the very end of the third quarter and what happened in many cases was that distributors did not want to begin sending out new pumps of Basal-IQ until they’re existing patients could update, which impacted the launches a little bit. So that’s really what was going in the fourth quarter.And I would say as we think about the baseline as we go into next year, it’s really an average of what we saw in the third quarter and the fourth quarter. It’s a good launching point as you think about our existing markets, but we’re also excited that we’re launching into the new geographies which are doubling our opportunity next year.

[Alex Nowak:]

Okay, understood. And then we saw the Medtronic is recently trialing the 670G pump and the accessories by the PBM channel. So similar to what insulin is doing there. So I'm curious is PBM channel ever an option here for Tandem or the DME remain the preferred pathway for you?

[Leigh Vosseller:]

I don't see that the pharmacy channel is not off the table for us. More importantly right now we're working on building the relationships with the payers and increasing our direct presence. And we think that's the right avenue to work closely with the payers to determine the right channel for our product.Our is being very highly specialized, I think one different center standard to note between us and Medtronic today is that they're not only selling durable pump, they're selling a pump combined with sensors. So what impact that has on which channel they go through, I can't really comment too. But it is different from our position.

[Operator:]

Our next question comes from Chris Pasquale from Guggenheim. Your line is open.

[Chris Pasquale:]

I want to start with the Control-IQ launch. You mentioned you trained I think about 7,000 healthcare providers today. Just want to get a sense of how far along you are in that process? How much more work do you have to do on that front to really make it broadly available to the patients and all those providers are managing?

[John Sheridan:]

Thanks, Chris. I would say that we're - well, we're approaching you know our plans and I think that we've trained nearly all the people we have to train. I think that as time goes on, there is going to be a continued - this requirements for this. But I think the majority of what we planned on doing has now been accomplished.

[Chris Pasquale:]

And then on gross margin Leigh, I just wanted to go back to the different factors that are impacting that. I think I heard 1 to 2 points headwind from the Control-IQ royalty. Are there other sort of specific items there that are holding you back this year and that you know keeping you from making steady progress?

[Leigh Vosseller:]

Sure, I would point to a couple of factors so first and foremost that we’re extending our manufacturing capacity again. And as you can imagine, when you expand, you have to get to a point then where you can leverage. So, we're doubling the cartridge capacity which means we won't be fully utilizing that in 2020. Add to that then the onset of the royalty, but the one that you point was really a combination of a number of smaller factors that an individually weren't significant.But when added together, it was royalty - a little bit of uncertainty around tariffs and where that my head in 2020. Those were the two primary items that were new to the story, I think for next year.

[Operator:]

Our next question comes from Travis Steed from Bank of America. Your line is open.

[Travis Steed:]

I just wanted to touch on the 2,000 patients that you think delayed. Just curious - I guess I thought the number would be a little higher than that given the impact on the revenues in Q3 and Q4. So, I don't know if you're being conservative there or if you're maybe seeing a small impact from the Medtronic 780G upgrade program. Just curious on how you came up with that 2,000 number?

[Leigh Vosseller:]

Yes as you can imagine, it's a little bit typical to the number - to ascertain, but - a couple of factors we looked at the anecdotal information that we had from physicians and from our field in particular as they were interacting in the physician’s offices. There were some offices that were prescribing some that were waiting or some patients that were waiting.And then add to that our own expectations for the year. But the 2,000 pumps represents roughly a little more than 10% of what we did in the fourth quarter. And so, that's where we are today.

[Travis Steed:]

And it looks like for the full year 2020, you're assuming more patients in the U.S. then you did - in 2019? So, just curious what your thoughts are on driving that acceleration shift or gains versus MDI conversions. And in Q4, did Animas contribute any patients or was 50% from share gains?

[Leigh Vosseller:]

Yes, so I'll start with 2020. If we look ahead, we actually are expecting more patients to come to us in the year than we did in 2019. And what we think from an MDI perspective, we're looking at - least as many who will come to market next year as this year if not more. And we also expect that competitor conversions will keep pace that we will - we kept that nice healthy balance of about 50/50 between MDI patient and competitor conversion.From an analyst’s perspective though, it did start to decline in the fourth quarter just as we had anticipated prior to fourth quarter they had been averaging about 80% of our new comp shipment. Whereas in the fourth quarter it went down just under 10%, and we think that will continue to dwindle. And - there may be some folks who took advantage of Medtronic’s upgrade program that would come to us appearing that they're Medtronic customers, but we don't really anticipate much from them in 2020.

[Operator:]

Our next question comes from Matthew Blackman from Stifel. Your line is open.

[Matthew Blackman:]

Leigh, maybe to start I think in the past you've characterized your guidance philosophy as a goal post that you would hope to exceed. I'm assuming that philosophy is still unchanged as we think about 2020?

[Leigh Vosseller:]

Yes so just to frame up our philosophy is, we try to capture what we think is more within our control. So, for example renewals are one area that we have better visibility into what's available to us and better relationships with those patients. And in fact I should have mentioned that's one of our main growth drivers for next year as well.But then we're typically cautious around things when it comes to FDA approval or even timing of competitor launches. And so, those are the things until we see demonstrated evidence. We are reluctant to build - to factor that in.

[Matthew Blackman:]

Okay, understood. And so with that in mind and in a sort of reflect on your comments about the shape of the year. And so the first quarter in particular having I guess a similar mix as it has in prior years. If I just do the raw math on that and granted there are some moving parts there, but it would imply a number there would be roughly in line maybe a little bit below consensus. So that - is that math right. And the second, is there something we should be sensitive to or again does this just go back to the initial point you made which is - hey, let’s start off conservative and see how this all plays out?

[Leigh Vosseller:]

Right. So yes I agree that we would still think about the traditional seasonality curve for pump shipments in the U.S. which are typically about 16% to 17% in the first quarter. One thing that I want to be - have been thoughtful about is what the impact of Control-IQ has on the year. And so we're just getting going with that and that's one of the areas where while we're very enthusiastic about the opportunity to come, we're still cautious about it. And so until we start to demonstrate that inflection where John would say definitely there's going to be an inflection.

[John Sheridan:]

There's got to be an inflection.

[Leigh Vosseller:]

So we’re actually comfortable with the Q1 numbers.

[Operator:]

Our next question comes from Ryan Blicker from Cowen. Your line is open.

[Ryan Blicker:]

Maybe just following up on the last question. So historically domestic new patient adds have declined 25% to 35% sequentially versus Q4. That historic seasonality doesn’t seemed to make much sense to us given the 2,000 customers pushing Q4 to Q1 plus the Control-IQ launch. I guess can you just talk a bit more about your rationale and why wouldn’t Q1 be much stronger than typical seasonality in the U.S.?

[Leigh Vosseller:]

Great. So one thing to think about that Control-IQ differently if you want to call it is that we don't anticipate that all comes in the first quarter. So these are folks who waited to make their purchase. And in some of them will still have I will call limitations if you will on when their deductibles will reset.So we anticipate that those are spread more evenly across the year. It may play an interesting dynamic from Q4 to Q1 in that Q4 was a little softer than we typically see because of that deferral piece of it. But for now the best way to think about is look at the typical historical trend.

[Ryan Blicker:]

And then it's been awhile since you've updated us on supplies versus pump gross margin. Could you be willing to talk about what overall supplies gross margin has increased to in 2019? How do you think about the pathway there moving forward as you expand capacity with your customers on and make steps to outsource some production? And then do you still expect to achieve a 50% gross margin over the next five years or so? Thank you.

[Leigh Vosseller:]

So, yes. Absolutely, we are still well on track to hit our 60% margin target. Unfortunately, we won't give product margin by product simply for competitive reasons, but I can say that the supply margins have continue to scale since we first broke even back in the third quarter of 2016 and scaled nicely as we continue to leverage our cartridge capacity, as well have the full benefit of the infusion set sails that we were, if you want to call it, missing at that point in time.And so, we're very confident at where we're headed. Some of the other opportunities as you mentioned would be outsourcing to our third-party manufacturer to help reduce costs as well as just again leveraging the capacity that we're building.

[Operator:]

Our next question comes from Danielle Antalffy from SVB Leerink. Your line is open.

[Danielle Antalffy:]

A quick question on this whole dynamic of the pause that you guys saw ahead of the Control-IQ launch. Just curious how you're thinking about you might have two competitive launches coming in 2020. How are you thinking about a potential pause across - within the market ahead of those launches and what's factored into your guidance from a competitive perspective? Do you see the same dynamic coming ahead of the competitive launches and impacting you were ability to add new patients.

[Leigh Vosseller:]

Yes. So, that's one of the areas where when we think about our guidance philosophy. We are thoughtful about what could come later in the year that we don't have control over. As of today, we have much more visibility as to what's happening here in the first and even leading into the second quarter. But the back half is always the most difficult part to predict particularly when we have just the seasonality curve which pushes so much at the back half.So, that's one thing that we're being thoughtful about and we'll keep our eyes on them and we'll continue to update you each quarter as we learn more about those factors and the impact it may or may not be having on us.

[Danielle Antalffy:]

And then my next question for you is on the capture rate for the renewal stream. I'm curious about where you are both from an internal - from a Tandem perspective as well as the competitive perspective. It feels like your guidance probably assumes some acceleration of that capture rate. Curious if that's true. And any color you can give around where you are or where you expect to be exiting 2020. Thanks so much.

[Leigh Vosseller:]

Yes. So we're very excited about the progress that we've made in renewal so far and we have a dedicated effort within the company as you can imagine that's the focus just on that opportunity whether it's from the very beginning when a patient gets a pump, the retention effort, all the way through to the very end to get them to renewed by their next pump.And so, so far we have continued to scale up or I guess I would say accelerate the number of people that are converting. I think what's exciting to me is when we look at our internal figures and we look year by year people whose warrants expired in 2016, 2017 versus 2017 we’re still today seeing increases in people renewing from those subsets. And so that continue to move the needle for us.The other exciting part is that our business grew so rapidly we're adding a significant number of opportunities on the go forward. So whether it's improving the renewal rate on the warranties that have already expired but also adding to that those are the factors that are really going to try drive the renewal business going forward.

[Operator:]

And our next question comes from Matthew O'Brien from Piper Sandler. Your line is open.

[Matthew O'Brien:]

Just I wanted to start a little bit on the new pump side of things. I think you talked about folks that were new to pumping and by our math it looks like about 25% of your pumpers in 2018 were new to pumping and in 2019 it was closer to 33%. Again that's by our math. So love to hear just a little bit about the dynamics that are going on there as far as what you're seeing in terms of capturing market share of people coming in that maybe would have gone elsewhere versus really starting to accelerate the market growth or helping to accelerate the market growth.

[Leigh Vosseller:]

Sure. I think I'll start by saying if you first back out the number of patients that were renewal shipments in those years, the difference is about 50/50 for people coming to the new pump therapies versus people from competitor pumps. And that's been very consistent since the beginning of our history.And I think that was one of the most surprising and best elements of 2019. We saw strength everywhere. So even MBI population coming to pump therapy was increasing. We saw similar increases in the competitor conversions to Tandem. And so we're excited about that dynamic and we think with the strength of Control-IQ we have the same opportunity to do that in 2020.

[Matthew O'Brien:]

And then you know shifting over the international business. I guess the number of pumpers this upcoming year is about flat but again our math versus last year. So I know there's a deferral going on as people are waiting for Control-IQ. But can you just talk about some of the dynamics there you know keeping pumpers interested in Tandem. I'm just again, I'm a little surprised it's given that you're doing a pretty big sales force expansion especially in Germany that growth trajectory there wouldn't be a little bit better from a number of pumpers perspective.

[Leigh Vosseller:]

Sure. So one of the important things have known about 2019 was that the majority - a big piece of our business came from that analyst conversion opportunity. So pretty much you can look at the first half of the year as almost all analyst converters and that second half of year is the new market type activities and these.So, now, there was a little bit of the other going on in both parties but I like to draw a line there and say look really more at like Q3 and Q4, the average of what happened there. Those were all new - what I will call new market activities which are the baseline for our existing geographies.And then later on to that what will be coming from Germany, France and the Benelux countries. Keep in mind those might have a smaller slower uptake even though they’re very large geographies because it if starting off at new market we have to go in and become - physicians will become familiar with us and with our products. But I think it's difficult - it’s a difficult comparison to just look at 2019 as a base and you really have to bifurcate between the halves of the year.

[Operator:]

Our next question comes from Matt Taylor from UBS. Your line is open.

[Matthew Taylor:]

And I just wanted to follow up on some of the comments that you made on Q1 especially with regards to the bottleneck that you saw with customers inquiring about Control-IQ. So my question was really did you see actual sales disruption or was it just people looking for feedback? And you had a comment in the prepared comments about the pause kind of lifting with the initial sales that you’d seen so far in Q1? Any color that we could get on the dynamics of the uptake so far in the quarter?

[John Sheridan:]

Sure. So let me just start by saying today we have actually today the majority of the people who have a pump in the United States have updateable pumps. And so that number is in excess of 90,000. And once we made the announcement that Control-IQ was available in mid-January. We were just overwhelmed by people looking for information on how to update their pumps. So, we had 10,000-plus calls just how do I update? How do I get my prescription in? And how do I work with the portal? So we're just overwhelmed by that. It was a surprise to us. We have since gotten past it.We were as I said last year and this year we really been focused on scalability. And I think we scale the organization to a point where we were able to deal with it. And I think we've got it in control now. And I don't think it's had any effect on our ability to ship new pumps. This was entirely about people updating in the marketplace that already had updateable pumps.So we're very enthusiastic. And I'm sure you just - all you have to do really is just look on social media and you'll see that people are really excited about the device. People who are using it today described it as life changing and it’s - been a real excitement for all of us to participate in.

[Matthew Taylor:]

And then just to follow-up on your clinical development, you mentioned some things that you're doing to stay the clinical leader. How can you enhance the core Control-IQ system to make sure that that algorithm and system kind of stays one step ahead of some of these other competitors who are going to come online with comparable sensors and reasonable algorithms?

[John Sheridan:]

That's a good question as well. As you also saw, we just recently completed our pivotal for the team’s groups. And the results were great. We are consistent with the data - or the data we saw from the adults. And we plan on submitting that - the FDA here shortly, and we expect to get approval for the six-plus age category here shortly, which is all great news. And we've mentioned this in the past, but we have been talking to the FDA.And we've been looking carefully about a number of changes that we're interested in making to the device. These changes would improve the clinical outcomes of the device as well as improve personalization and ease of use. So there’s a number of things that we have in mind. And in the conversations we're having with the FDA today.We're trying to understand what is the risk profile of these changes and how much clinical work will be required to support them. Right now, we're not going to - will release any information as to when specifically we expect to see these changes. But I will say, I think the next meaningful update for Control-IQ will be in 2021.

[Operator:]

Our next question comes from Steven Lichtman from Oppenheimer. Your line is open.

[Steven Lichtman:]

Not sure how much this question will latch with your last answer, John. But can you talk a little bit more about the functionality with the new mobile application with t

[John Sheridan:]

Well absolutely. First of all, thanks for asking the question. Right now, we’re in the midst of just the final testing of the mobile app. It's a connected device that means it's connected to all of our systems. It's a lot different than just the pump. That's tethered to a computer for t

[Steven Lichtman:]

Yes, got it. And then just secondly, just given the cash position and the free cash flow generation, just curious as you're looking - as you look to deploy that cash, you talked about making some investments on the customer service side I believe. Would you be looking to accelerate the sales force as this year or how are you looking at the footprint over there - overall?

[Leigh Vosseller:]

Great, so we’ll continue to evaluate closely what we think we need in order to drive the top line. We actually increased the size of our sales force from about 70 territories middle of the year to about 90 territories today. I mean at this point, we feel very comfortable with that number, but again we'll always look at that across the year. If we think we need to add and then we definitely would use our resources to do that.

[Operator:]

Our next question from Jeff Johnson from Robert W. Baird. Your line is open.

[Jeffrey Johnson:]

John, I want to follow-up on the mobile app there. So one, I want to make sure that that's like going to be on an iOS or an Android and it's your personal phone it's not like a separate controller just to confirm that on the t

[John Sheridan:]

Well I mean, I think just to answer your first question yes, we do plan to have capability on unrestricted iOS and Android phones. So, we'll be moving forward in that direction. And I think that the way we look at it is a stepwise process. I think that mobile bolus is probably the most complex issue that we want to deal with. And so, we think dealing with it right away is the right approach. When you look at t

[Jeffrey Johnson:]

And then Leigh, I'd just like confirm on the guidance question on competition. You've said a couple of times now you're very thoughtful on how you think about competition embedded within guidance and I think that makes total sense. But I can't tell from your answer does that mean you've assumed those competitors are coming and so, you've maybe built in a little bit of cushion in the back half of the year?Or you also made a comment about things you can't control you don't really embed in guidance. So does that mean you have not assumed any kind of change in market dynamics in the back half in your guidance? Just trying to understand kind of what's embedded from a competitive perspective in that back half guide? Thanks.

[Leigh Vosseller:]

Sure, you're right. When it comes to competitors and the potential coming to market, even sometime it's not when the products there, but just the discussion around the product coming, that can put pressure on. And so, we have factored in some level of pressure associated with that possibility.

[Operator:]

Our next question comes from Jayson Bedford from Raymond James. Your line is open.

[Jayson Bedford:]

Obviously a lot has been asked here. So just in terms of product enhancements to Control-IQ, appreciate the detail on phone control. Where are you with the ability to share pump data with so-called followers?

[John Sheridan:]

It's something that we have in the works, it’s not something we've actually given specific times on yet, but it's definitely something we're interested in doing.

[Jayson Bedford:]

Any update or progress on your partnership with Abbott?

[John Sheridan:]

We are still working with Abbott on the agreement. I think that when it comes to - it’s just working through the details of the agreement right now. It’s a good team, we have confidence that we're going to get this thing been taken care of in the near future.

[Jayson Bedford:]

Okay. And then just last quick one from me. In terms of the launch in France, do you have reimbursement there? Is that something that will kind of delay revenue recognition in France?

[Leigh Vosseller:]

There is reimbursement for pump there. And we try to launch here in the first half of the year in France and Germany, and the other Benelux countries.

[Operator:]

Thank you. And that does conclude our question-and-answer session for today's conference. I now like to turn the conference back over to John Sheridan for any closing remarks.

[John Sheridan:]

Well, thanks, everybody, for listening in and participating in our call today. We look forward to seeing everyone soon. We are attending a number of conferences and hosting a number of bus tours in the upcoming weeks. We plan to be at the Leerink Global Healthcare Conference in New York tomorrow, on the 25th; the Cowen Annual Healthcare Conference in Boston on March 4; the Barclays Global Healthcare Conference in Miami on March 11; and the Oppenheimer Healthcare Conference on March 8 in New York City.Thanks again for joining us today, and we look forward to keeping you updated on the company and our progress as we go on. Thank you very much.

[Operator:]

Ladies and gentlemen, thank you for participating in today's conference. This does conclude the program. You may all disconnect. Everyone, have a wonderful day.