All right. Good afternoon, everyone. My name is Matthew, and I work on our U.S. MedTech research team, and I'm joined by the management team of Everless. So maybe get us started. So today, Everless looks very different than it did two years ago. So maybe talk us through how you think about the company's evolution from a neurotoxin company to a more broader aesthetic company. How should investors think about you over the next two to three years? And I guess we'll use that as a chopping-off point.
Great. Well, thanks for having us. It's our first time attending the Jefferies Conference, and it's great to be here. You're right. The company looks very different over the last 24 months. As you may know, we started as a single-product-focused toxin company with a brand name Juveau, which over five years was the fastest-growing brand in the U.S. and as a single-product company, captured mid-teens market share. And during that time, we spent a lot of time scrutinizing the market and looking to enter the second biggest category in aesthetics, which is the HA injectable space. And we signed an agreement several years ago with an R&D partner named Cimitase, and we led the development of our new product, Evelisse, both in the U.S. and internationally, and ultimately led to approval and launch last year of the Evelisse injectable hyaluronic acid, first two products. and we expect the third which is the flagship product to be approved by the end of this year called sculpt which is unique because it'll be indicated in the midface area it's a really coveted area to gain an indication in a difficult area to engineer a product for and that we're excited to introduce what we consider the sculpt flagship product our line and then lastly we expect to file our lip product by year-end as well so we have a lot of pipeline assets in the US that'll play out but beyond diversification of our portfolio in the US and continued execution we've also expanded geographically in our footprint started with the direct presence in the UK and now we have a presence in all the major markets in Europe in addition to that we're in Australia and Canada and we're really proud of the fact that our international team has really grown at a healthy clip and continues to be an important growth driver for us last year, it represented about 8% of our revenue and nearly doubled year on year. So it's a lot of exciting opportunity going forward. We're a company that's now capitalized and we expect to be profitable on the full year. Great. Thank you. So maybe diving in a little
bit deeper, you've continued to take share over what some would consider to be a little bit of a softer aesthetic environment. So what do you think you've done differently, whether clinically or commercially, and then maybe any specific call-outs in terms of how we can think about quantifying that or understanding the share gains?
Well, we designed the company differently from the outset. There's a trend that's been playing out for the last seven or eight years, which is this younger demographic, the millennial who's no longer the young. She's now approaching her mid-40s on the upper end of the spectrum, believe it or not. And that consumer really viewed this category differently than her parents. and viewed it more as a beauty type of treatment rather than a traditional medical procedure. And so when we developed Avalis, we focused on this shifting dynamic towards beauty. And we positioned the company as a performance beauty company, meaning performance-driven products, drugs, devices that are FDA-approved, but marketed and commercialized through a beauty lens. And that led us to develop our digital platform that's proprietary, where today the majority of orders for our product, our customers, which there's 17,000 in the U.S., they go through our digital platform. They purchase through our app. They pay their bills through the same application. And our consumer loyalty program, which now has about over a million and a half consumers in it, when they go in and get treated, that consumer through our SMS-based platform earns $40 off each treatment. And that credit goes right back to the account through the same digital app. And that platform has been incredibly powerful, and it's robust because it also introduced our latest product, Evelisse. So now the whole portfolio benefits run through that same digital platform as well. And we think the efficiency that we can scale is reflected. If you look at our operating expenses, they're relatively flat year on year. That's only possible because we just have so much potential here through this digital platform to be able to support our customers, enabling our reps to be more productive and spend their time where they're driving meaningful revenue rather than doing some of the other tasks that others do in the industry.
Great. So I wanted to touch on what you mentioned there and maybe on your digital platform in terms of building a more entrenched relationship with your clients. And one of the things that stands out is how durable your customer metrics have been and obviously with the overall macro environment. So maybe you can help us better understand the reorder behaviors and kind of customer engagement that gives you confidence that your demand specifically remains stable and actually could be poised for more growth?
Yeah, when we started Evolus, the whole idea was we want to develop deep partnerships with these clinics. You have 30,000 aesthetic clinics around the U.S., and they're all small business owners. Some of them are now acquired and they're part of chains, but even the chains, they measure productivity at the individual practice level as well. And so when we designed our model, it was about bringing value to these clinics so they can become more productive when they partner with us. And it starts with a high-quality product that's consistent in how it performs. And we're proud of the fact that Geveau and Evelisse are two products where we put them head-to-head against market leaders in Phase III studies. And that's been a key part of our story is telling the science and clinical differentiation of our brands. And that's an important part of the share we've gained. But it's also our go-to-market support for these clinics. These clinics advertise in their local community. They want to retain these patients. And we provide the full offering to help them do just that. As they purchase more from us, they earn what we call co-branded media, advertising their clinic with our brand within a radius of their office. And we do thousands of campaigns around the U.S. at any given time. Several investors commented that they took the subway here and they see our ads on the subway. with local clinics that are using our brands and that's unique to our cash pay business model and i talked about our consumer loyalty program where once they're treated with our product we want to keep them loyal to our brands and we give them benefits as consumers to go back to the same clinic that originally treated them and that builds trust and long-term partnership with these practices which is why evalice now we've seen the majority of our top customers have brought in Evelisse and they're in their adoption cycle as we continue to educate them on how to use the product and that has a lot to do with the trust that we've built with these customers over time and that'll continue to drive continued success for that product and ultimately that manifests itself on a slide where you see the reorder rates in our accounts are over 70 percent of accounts to place initial order reorder with us and you also see in our consumer loyalty where it continues to grow at a very healthy clip i talked about one and a half million consumers but that program crossed a million threshold less than 24 months ago. So you could see how quickly that we start scaling in terms of clinic support as well as the consumer side. And I think that's what makes us unique is we're the only dedicated cash pay company doing these types of things to help practices grow. And in return, I think we're rewarded for that in market share.
Great. Maybe now transitioning more to the product side and wanted to dig a little bit more into Evelisse. So that seems to be appearing, that appears to be resonating quite well with practices and wanted to get a little bit more feedback on what you're hearing kind of more consistently and like would like to dig more into that to get like a better idea of the clinician feedback. So the fundamental principle
behind Evelisse is just trying to do a good job preserving the natural HA chain and you know on paper you would think well if that happens you should have something that's pretty biocompatible And, you know, maybe if you preserve those structures, they'll last longer, and maybe you'll have a more efficient gel. When we started doing our checks during diligence and we spoke to the investigators in the clinical trials, that's exactly what we were told. And then ultimately when it went into the real world is when you start getting the real feedback, and it's been really consistent. The first thing that we hear almost consistently is we get a disproportionate amount of correction. In other words, we almost have to take our foot off the gas pedal. You know, the amount of improvement you get with a little gel is a differentiator. The second thing we're seeing is it's durable. We saw that in the clinical trials. And the other interesting thing is they're saying, you know, with a product with this specific rheology, we're surprised at how forgiving it is, meaning you can go into various tissue layers, not pay an inflammatory price, maybe, again, because we're anchored in trying to keep that as a more natural structure. And the final comment that we get is the tissue integration is something that people really have spelled out, meaning you inject it, you can integrate it, you can massage it in, and then as you animate or talk or speak, the material actually integrates really nicely and naturally into the tissues. So for us, it was really nice when you hear these kind of reports in the setting of a clinical trial, and then in the real world, consistent messaging. That was really encouraging for us.
Okay, great. I think, like, a lot of the focus may be on the science behind the CODEX technology, and I guess I think you've covered a lot in terms of why Evelisse is differentiated in terms of the hyaluronic acid category. Like, is there anything else that maybe you want investors to kind of really focus on and understand and, like, the key selling points that you give to clinicians and even patients?
Well, ultimately it starts with the technology. Clinicians in particular ask, well, what is the technology? What is the differentiation? Maybe if I could just spend a minute there. If I make, you know, just some obvious statements, the magic behind HA gels is the fact that they're made of hyaluronic acid. And then the reason why these hyaluronic acids work so well is because Mother Nature engineered hyaluronic acid muscles to be really long and really complex. And so that entanglement is what gives it those dynamic properties and why it lasts. and why you get these magical principles behind that. And CIMITES, our partner in this, what they did was they figured out how to do a really good job of preserving the HA during the manufacturing process. When you're manufacturing, you have to cross-link the HA. That's cross-linking is how you get the various properties. And typically, industry has used heat, be it room temperature, about 70 degrees, or more traditionally, much higher temperatures, 90, 100 degrees. That introduces kind of kinetics, thermal energy, into the system, and that will help break up and fragment HA. So CIMITES took the exact opposite approach. They figured, well, maybe we can try and make this stuff using coal technology, meaning what if we took out the thermal energy out of the system? Would that help us preserve the HA? And that's exactly what we found. In some of the studies, we found up to a four-fold difference in terms of preserving HA. So basically, they figured out how to do that reaction and create these gels in near-freezing temperatures.
Interesting.
Wow, thank you for that. Probably switching gears a little bit now, going to more of like a topic du jour is, and a demand driver potentially is, maybe some of the discussions around GLP-1s and how that's changing patient preference and bringing more patients into the funnel. Do you see GLIPS kind of bringing patients, seeking more aesthetic treatments? And if so, are there any new categories there? Like what are the difference of trends? And I'll kind of let you start and then we can dive in.
Yeah, it's the area that I will tell you, whether it's clinicians that we have in our training programs or meeting with investors, it's the number one topic that we get is the tailwind of these GLP-1 patients. And there was a great article recently published by McKinsey around those patients that are on GLPs and the areas that could potentially benefit from that downstream benefit of the weight loss. And aesthetics is one of the top areas that they start thinking about once they lose weight. And as you know, once you lose weight, you lose facial volume. And a lot of the lines and wrinkles really start to show in a more meaningful way. And as that patient gains confidence, they're looking at her aesthetics. And this is a qualitative comment, but a year ago, you went into aesthetic clinics and you asked them, are you seeing GLP-1 patients? They'd say, yeah, I see some patients coming in. If you ask clinics today consistently, they'll tell you, I'm starting to see them coming in more often. But I don't think we're anywhere near the levels where, you know, we have a constant flow of patients. Because when you look at the GLP user base and you compare it to the injectable user base, it's three times larger. And so once those consumers start coming in and the majority of them, when they achieve their desired weight, have an interest in aesthetics, we will see an inflection point from that. But we're not quite there yet, but we've continued to see an increase. And a lot of what you're seeing right now in the macro environment is consumer sentiment has softened a bit, yet the aesthetic market continues to be growing. And I think we're seeing a healthy market this year in aesthetics. We're really confident in what we're seeing in the trends, not just in the first quarter, but what we're seeing here in the second quarter. And I do believe a portion of that is driven by this benefit of new consumers entering the space because of GLP-1s. And, of course, fillers are the number one area they go to first for that volume loss. And once a consumer comes into a clinic for a filler, the majority of them will leave with a toxin as well because clinicians know the complementary benefits of injecting the two together, and that should bode very well for the category as a whole, not just this year but over
time. Great. Interesting. And in terms of patients actually coming into the funnel, do you think it's organic or is it a lot of DTC marketing driven by clinics or a mix of the both? Yeah, you'd be
hard-pressed as a younger consumer not to open your social media or the news and not see a full integrated view of health, wellness, and beauty together. And our category of injectables sits right there in the middle of it. I mean, if you're doing your hair, your nails, you're thinking of injectables in the same context. So it used to be a manufacturer-driven advertising to create awareness. And now it's just fully integrated, whether it's a 30,000 aesthetic facilities that do a lot of advertising and a lot of social media in their local markets. It's the broader media that captures it, celebrities that use it. Of course, in our case, we have a unique co-branded media program where we partner with our clinicians and advertise them. And that's an important part of building our brand awareness in the category so we can continue to grow share. And we're proud of the fact that even in its seventh year on the market for Jouveau, we've continued to gain share every single year. And last year, despite a new entrant entering the category, we continue to do that. And we believe investing around the consumer plays a part in why the brand will continue to grow. And we plan to do the same with Evelisse. What's unique about Evelisse beyond the properties of the gel that Rui talked about is that we do have a mention of weight loss in our label. And we're the only hyaluronic acid that has that mention of weight loss. And so we're incorporating that now into our co-branded media because we do know that obviously targeting those GLP-1 patients, if we can be the beneficiary of that branded advantage that we have that could, you know, yield significant results for us over time.
Maybe one more quick one on Evelisse and GLP-1s. Is there anything clinically that you would like to point out that differentiate in terms of treating facial volume loss?
I mean, my opening point is the one that David said. We were lucky enough to be able to negotiate weight loss into the patient labeling, so that's one thing. The other thing is, you know, Sculpt is a mid-face product, and that's what it's going through. The thing that we're learning about with GLP-1 patients is they come in all shapes and forms, different skin qualities and different genetic codes. And what that means is it's not just one product that is the magic bullet for that GLP-1 patient. Sometimes you'll need something. This will be off-label, but that form product has different properties. The smooth product has different properties. And depending on that patient, their skin thickness, their BMIs, just the quality of that patient, you don't necessarily just lean on one product. You actually need a broader portfolio. So I think the portfolio they have fits really well into that.
Great. Thank you. Maybe shifting gears a little bit, and you mentioned it, just wanted to dive into how strategically important it is for your Chauveau customer base, well, how you're integrating that when you're launching adjacent products like Evelisse. Maybe you can talk us about some of your current and, like, future portfolio additions.
So right now we obviously have an injectable toxin, and the next add-on that was a priority for us was hyaluronic acid. It just makes sense if you're going to build an aesthetic company. Then we look at our company, and what we do really well is we work well with the clinics, with the doctors. We can train them. We have a relationship with them. And if we think about the efficiency of our sales force, the next things that would work really well and be complementary to our portfolio, biostimulators. So we're very active on the BD side looking at biostimulators. This is a natural product to add on to the portfolio we have. Another big piece of interest for us is skin quality. Right now there isn't very much in the United States. We're aware of one product that has an indication for skin quality. And then if you start thinking more blue sky and more different opportunities, hair becomes a really interesting thing for us. In particular, 90% of the patients that we deal with are female. And females have a different need. They don't like systemic drugs. And they're going to be very sensitive to a drug that, for instance, a pill that may actually grow hair everywhere, not just on the head. So when we look at the opportunity of hair, we're really trying to consider our patient, which is a female quite often, and our customer. So we're trying to look at something that would be procedure-based and not have that systemic exposure.
Great. Thank you. Maybe one more on the products and kind of diving a little bit deeper into Sculpt. We touched a little bit upon it for, obviously, GOP-1s, but is there anything else you want to maybe focus on in terms of why you think it's such an important catalyst within your portfolio?
Well, what's interesting when you look at the various companies in the space, they all have a flagship product in their filler brands. And the reason why flagship products are important is because they become anchor brands that bring the rest of the products along. And for us, it was interesting. Rui and I were both in Italy for the launch of all four of our hyaluronic acid gels in Europe just two weeks ago. And when the KOL injected the Sculpt product into the mid-face area for the 100 doctors that were at that training session, it was very clear that the product was different. It performs in a different way from current products that are approved. And as I mentioned earlier, the engineering is what makes it unique in that mid-face area where you're trying to replace bone structure, but you want it to be natural. You don't want it to be too firm. and you want it to move with the facial movements you don't want to appear unnatural when you smile and sculpt is designed for both creating that lift but also integrating into the tissue so it also works in a dynamic way and I could tell you that many of the clinicians pulled me aside and said this product is very different from anything that they're using and in Europe that's a high bar because there's over a hundred competitors in that market so we're We're really excited to bring what we believe is our flagship product with Sculpt. And as we're now focusing on selling a portfolio, this is the first six-month window of us introducing our new portfolio value proposition. It starts in January. It ends in June. It's very typical in our industry to have these sort of six-month programs. We're really excited to see this play out. We've had a lot of interest from clinicians to partner more closely with us. Our two Evelisse products give us the opportunity to do that with these customers, but introducing Sculpt gives us another opportunity, and the lip product the following year gives us another one as well. So we think we're on the right track in terms of how we're partnering with these clinics. Our pipeline gives us a lot of runway over the next couple years to introduce what's new, and this market's turned the corner, and it is growing, and we're excited about that all coming together with the tailwinds of the GLP ones.
Great. You mentioned a little bit about your launch in Italy. So I wanted to dive into how you view international as a strategy and potentially how that's increasingly underpenetrated in the story today. So can you please help us kind of understand your confidence in the international business and why we think that can be a larger contributor over
time? Yeah, we've been very measured with our expansion internationally. It started about four years ago when we first invested to have a direct presence in the UK with Nuceva, which is the brand of our toxin in Europe. And what we observed over the first 18 months was a trajectory that looked very similar to Jiveau in the U.S. And from there, that gave us a lot more confidence that if we go in with the Everless brand and we give the clinics the services we provide here, that we can build something unique there as well. And UK is now approaching double digit market share with NuSeva. And we have a presence where they're now launching the entire Steam, which is the brand name of our Evelisse fillers in Europe. And that gave us confidence to make investments to launch direct in Spain and then Australia. Those markets are now approaching two years and their trajectory is actually a bit steeper than what we saw out of the UK. So really impressed with the performance there. That gave us more confidence last year to take back the distributorship in Italy and Germany and go direct there. And we're in the early stages now of having our direct presence in Germany. We almost have a full team, but we're starting to see the results of that investment. And Italy, we are in the early stages of building the team to have a full direct presence. So we're seeing really healthy overall growth rates. But importantly, as we look by market, it's a very efficient spend base for what appears to be a very strong trajectory with NuSeva. And it's very early days. We're only weeks out on esteem. But judging by the launch meeting, I think that team is off to a very good start.
Great. Maybe switching a little bit more to the financial profile, and I know you've consistently emphasized profitability and leverage. can you maybe help characterize for investors how to understand the scalability of the business model maybe the puts and takes there
yeah so what I would highlight there and what I think is important for investors to understand is that over the last several years we have built out this commercial infrastructure and a robust digital platform that David referenced and that is what's highly scalable so it's set up really to sell the portfolio in the US and in international so as we expand the portfolio and grow the revenue it's through Evelisse as we talked about through additional products that will fit right in our portfolio we do not need to step up that investment in OPEX and what we will see and we believe as the revenue grows we'll see this really meaningful margin expansion
great thank you that's helpful um I know we talked a little bit about this before but looking beyond fillers you talked about areas like skin quality biostimulators um how are you thinking about the future of portfolio expansion i know you kind of lined up a number of indication expansions you have but maybe kind of give us a runway to follow
yeah maybe i'll answer from a financial perspective and david can also answer from a strategic perspective so if you think about our current pipeline sculpt looking to get that approved this year and launch next year lips following that then thinking about the biostimulators skin quality and some of these more blue sky ideas that we mentioned coming after that so after 2030 from a capital perspective we are well positioned so a lot of these much like we brought in evelisse in a very capital efficient way we can bring in these additional products that are very much adjacent to our current portfolio but david maybe you can answer just from a strategic perspective
how we think about these products yeah the way we designed our business model is to benefit the clinician who does a procedure, both in supporting them on the patient side with the loyalty program and then on the practice side with our services, whether that's the training where this year we'll train over 14,000 clinicians hands on. It's the way we partner with practices to advertise them or the way we support them locally, whether it's events and things. And that enables us then to introduce more products that are procedure based. And that's where we focus most of our business development efforts is where we think we can add value on a procedure. Rui talked earlier about biostimulatory and skin quality being areas that we're heavily focused on, but we're also spending a lot of time on blue ocean ideas that beyond categories that exist where we do want to participate, we also believe that we can create new categories. Maybe you want to take a minute, Rui, to talk a little bit about some of
the early stage things that we're working on. So one of the things that we're working on is some pretty novel biomaterials. And so again, we don't know if these work out. They're by definition early stage, high risk, but blue ocean if they do. So we're looking at some biomaterials that help with regeneration of tissue. And the idea, and also have a property of reversibility. So the idea, for instance, would be convert a breast enhancement, for instance, like a cup size with a minimally invasive technique. In other words, do a one-cup size enlargement with a 14-gauge or 16-gauge needle, like right in the office. And then the concept of this is cells would then grow within this matrix, and then that biomaterial goes away. So from an advertisement perspective, you would position this as a natural breast enhancement. And you could also look at it for other regions of the body, for body contouring. For instance, the gluteal area, the buttocks. And, again, these are novel biomaterials that don't exist, so we'll have to see how these play out. But that gives you some ideas in terms of how we're thinking about it.
Great. Thank you. And maybe with the time we have left, it's a great time to end on this point. Maybe as you sit here today, what do you think investors still most underappreciate about the story and this market?
I'd say, first, the category itself. Aesthetics is a highly durable space, and it has incredible growth in front of it. Our penetration in the U.S., in comparison to the most developed markets like Brazil and Korea, we're at a fraction of the penetration rate. But as you do research and you talk to the younger demographic, their interest is multifold higher than their parents were in entering the category. So that means there's just a lot of growth to come in this category, and we're starting to see that growth come back this year. That's one. And the second is we operate in the most durable side of the space with both toxins and fillers, which the combination of those two categories represent half of the global value of the aesthetic market. And we now have two competitive products with head-to-head studies against the market leader that really differentiate us in the space. And you see the results in our performance. Last year in a negative growth market, we grew double digits. And we'll continue to do that. Our outlook has us growing in the mid-teens, in a mid-single-digit or below market over the next several years. So we feel confident in our infrastructure to drive that long-term growth. But importantly, I guess the last part is we're going to do that in a profitable way. And we're proud of the fact that we've been profitable now for two consecutive quarters. And we said we'd be profitable in the full year this year. So we're excited to continue to deliver on the metrics that we've set out and build our pipeline for the long term.
Great. Thank you very much for the presentation. Thank you very much for being here. Thank you.