Axogen, Inc. · NASDAQ:AXGN
Axogen — Investor Day (March 2025)
73 slides from Axogen's investor day presentation, Mar 4, 2025
Slide 1: The Standard of Nerve Care
The Standard of Nerve Care Investor Presentation March 4th, 2025 1
Slide 2: Forward-looking statements
Forward-looking statements This presentation contains “forward-looking” statements as defined in the Private Securities Litigation Reform Act of 1995. These statements are based on management's current expectations or predictions of future conditions, events, or results based on various assumptions
Slide 3: Objectives for the Day
Objectives for the Day 1 Understand our 2025 – 2028 strategic plan priorities and assumptions and our rationale for success 2 Understand common nerve injuries and causes 3 Make clear the clinical significance and incidence of the nerve problems that comprise our market opportunities Understand the b
Slide 4: Management Team with a Track Record of Success
Management Team with a Track Record of Success Michael Dale Marc Began Nir Naor Erick DeVinney Jens Schroeder Kemp Ivica Ducic, M.D. Chief Executive Officer Executive Vice President Chief Financial Officer Chief Innovation Officer Chief Marketing Officer Chief Medical Officer and Board Director and
Slide 5: Our Mission
Our Mission To restore health and improve quality of life by making restoration of peripheral nerve function an expected standard of care 5
Slide 6: Patient testimonials
Patient testimonials reflect personal experiences and are not reflective of all possible outcomes. Individual results may vary. 6
Slide 7: Uniquely positioned to lead in nerve repair
Uniquely positioned to lead in nerve repair Partnership Expertise Access Evidence A valued educational 15 years of experience Nerve care access Supported by 300+ partner appreciated for and more than 100,000 established in more than clinical and scientific our commitment to patients treated in all 2
Slide 8: The US Nerve Care Opportunity is Large and Underserved
The US Nerve Care Opportunity is Large and Underserved; Similar Potential Internationally Extremities Breast OMF / H&N Prostate $2.9B $677M $1.2B $754M 2% Penetration 8% Penetration 1% Penetration 0% Penetration More than 1.5 million peripheral nerve injuries requiring treatment in Axogen focus mark
Slide 9: Updated TAM Based on Mix, Volume, ASP, and Additional Targeted Procedures
Updated TAM Based on Mix, Volume, ASP, and Additional Targeted Surgical Procedures and New Markets PRIOR TAM ESTIMATE NEW TAM ESTIMATE Total estimated TAM Total estimated TAM $2.7B $5.6B TAM Adjustments Extremities Extremities Updated mix, volume and ASP update $2.2B $2.9B Addition of neuroma manage
Slide 10: Market Priorities Based on Advantage 2025 – 2028
Market Priorities Based on Advantage 2025 – 2028 Extremities Breast OMF / H&N Prostate Our largest business and the Our fastest growing business. Growing OMF market with Highly attractive market with market closest to achieving Procedures are elective and strong data and societal well defined clinic
Slide 11: 2025 – 2028 Strategic Plan Priorities
2025 – 2028 Strategic Plan Priorities Growth Markets New Markets Standard of Care CAGR 15 - 20% Elective and planned Prostate market development Drive the evidence and procedure focus societal advocacy required to Significant commercial establish Avance as a infrastructure expansion standard of care
Slide 12: Industry Trends and Best Practices in Nerve Repair
Industry Trends and Best Practices in Nerve Repair: The Axogen Nerve Repair Algorithm Erick DeVinney, Chief Innovation Officer 12
Slide 13: Peripheral is Pivotal
Peripheral is Pivotal Nerves span from head to When damaged, they lead to toe – managed by multiple numbness, paralysis, loss of specialties our senses, and pain Everything we experience If a surgeon can identify the involves the proper function damage, it is possible to of peripheral nerves restore
Slide 14: Common Types and Causes of Peripheral Nerve Injury
Common Types and Causes of Peripheral Nerve Injury Cut or Laceration Compression Stretching Neuroma Trauma Surgery Amputation Trauma that leads to damaged nerves Nerves that have been cut, compressed or stretched Stump pain associated with nerve damage has been Severe Cuts, Falling Though Glass, Com
Slide 15: Science Applied
Science Applied Inflammation Controlled Bioactive Extracellular Tissue and Tissue Neurite Damage/ Scaffolding Matrix Regeneration Response Outgrowth Zone of Injury 15
Slide 16: The Axogen Nerve Repair Algorithm
The Axogen Nerve Repair Algorithm Cut or Laceration Compression Stretching Neuroma 16
Slide 17: The Axogen Nerve Repair Algorithm
The Axogen Nerve Repair Algorithm Connection Protection Termination Cut or Laceration Compression Stretching Neuroma 17
Slide 18: Elevating Nerve IQ
Elevating Nerve IQ 9 Society Programs >30 head and >75% neck surgeons trained percent of hand fellows trained >45 9 breast National teams Programs trained Programs conducted in 2024 18
Slide 19: Secondary Site Morbidities Results Without Sacrifice
Secondary Site Morbidities Results Without Sacrifice Traditional Autograft Avance® Nerve Graft* Secondary surgery can lead to pain, Biologically active regenerative scaffold 2 numbness, functional impairment 3 Readily available in multiple diameters Increased OR time Favorable Benefit-to-Risk Profil
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Slide 21: A Clinically Proven, Standard of Care Option
A Clinically Proven, Standard of Care Option 200+ publications Meaningful recovery in sensory and mixed-motor nerve gap repair6 M3 or better S3 or better 87.1% 81.6% 70.4% 69.9% 72.6% 57.2% >82% 80% 52.6% 50.5% Avance Nerve Graft Avance Nerve Graft >5 to ≤30 mm gaps 30 to ≤70 mm gaps >5 to ≤30 mm ga
Slide 22: Evidence Base Across Market Development Priorities
Evidence Base Across Market Development Priorities Extremities: Extremities: Nerve Cap: Avance Breast OMF/H&N Protection Termination Nerve Graft Level 1 3 0 0 0 1 STRENGTH OF EVIDENCE Meta- Analysis/ 12 1 9 19 0 Review Comparative/ Cohort 1 3 9 1 0 Case Study/ Series 58 20 10 35 3 Focus on building
Slide 23: Trends: Expansion in the Nerve Space
Trends: Expansion in the Nerve Space Awareness Specialization Education Interest Nerve viewed as next Growth in number of Identified as the top area >70% increase in the frontier in functional practices that specialize of interest for incoming number of nerve repair reconstructions in Peripheral Ner
Slide 24: Extremities and Oral Maxillofacial and Head & Neck
Extremities and Oral Maxillofacial and Head & Neck Jens Kemp, Chief Marketing Officer 24
Slide 25: Extremities
Extremities Extremities 25
Slide 26: Extremities
Extremities Extremities Multiple specialties treat both extremities trauma and chronic nerve conditions Axogen is focused on driving algorithm adoption at high potential accounts that perform 80% of nerve repair procedures in hospitals CALL POINT EXTREMITIES TRAUMA CHRONIC NERVE CONDITIONS Plastic H
Slide 27: See Avance Nerve Graft instructions for use here
See Avance Nerve Graft instructions for use here 27
Slide 28: Extremities $2.9B
Extremities Our largest market where Avance is closest to becoming a standard of care option Why we are here 75% High incidence of traumatic nerve injuries in the extremities Hand surgeons are trained in microsurgery to manage nerves – $2.9B of microsurgical trained TAM hand fellows attend an many h
Slide 29: Extremities
Extremities THE MARKET DRIVERS Injury Prevalence Market Penetration 700,000 traumatic nerve injuries per year and 370,000 chronic nerve injuries creating a sizable patient population Complex customer creation process and patient journey 98% UNTAPPED Societal Engagement & Improved Coverage 62% The ma
Slide 30: Extremities
Extremities Our objective is to extend leadership in the extremities “ nerve repair market and establish Axogen’s nerve repair algorithm as a standard of care I’m out of pain and I’m able Drive Societal Support & Clinical Guidelines to walk, stand and run with my grandkids.” Partner with surgeon adv
Slide 31: Extremities
Extremities POSITIONED TO WIN Proven Clinical & Health Economic Value Preference for allograft Allograft and Autograft are Avance is backed by level 1 clinical evidence and health economic increasing for all gap Acceptable Standards of Care8 value proposition versus autograft lengths8 2% Comprehensi
Slide 32: Extremities
Extremities Extremities 2025 STRATEGIC INITIATIVES 1 Standard of Care & Guidelines 3 Expand Coverage & Payment Drive advocacy for Avance as a standard of care option Leverage evidence and expected Biologic designation to engage with major hand societies and develop consensus for commercial payers an
Slide 33: Head & Neck
Head & Neck 33
Slide 34: Oral Maxillofacial and Head & Neck
Oral Maxillofacial and Head & Neck High procedural concentration (90%) in about 900 hospitals CALL POINT SURGICAL PROCEDURES Oral Maxillofacial Surgeons Mandible Reconstruction Iatrogenic (ex: 3rd molar removal) H&N/ENT Surgeons Parotidectomy Plastic Reconstructive Surgeons Radical Neck Dissection T
Slide 35: Nerve reconstruction after mandibular tumor removal
HEAD & NECK Nerve reconstruction after mandibular tumor removal 35
Slide 36: Dr. Patrick Garvey
Dr. Patrick Garvey Professor of Plastic Surgery MD Anderson Cancer Center, Houston, Texas — COU ¥
Slide 37: Oral Maxillofacial and Head & Neck
Oral Maxillofacial and Head & Neck OMF and H&N represents a large and attractive market development opportunity Why we are here Large procedural volume and high incidence of peripheral nerve injuries impacting function and quality-of-life $1.2B ~300K H&N surgeons are microsurgically trained TAM Annu
Slide 38: Oral Maxillofacial and Head & Neck
Oral Maxillofacial and Head & Neck THE MARKET DRIVERS Low Market Penetration High Incidence of Iatrogenic Nerve Injuries 300,000+ OMF and H&N procedures are performed annually in 99% the US, with potential for nerve injury 28% UNTAPPED Reduction in patient life Societal Support & Clinical Evidence s
Slide 39: Oral Maxillofacial and Head & Neck
Oral Maxillofacial and Head & Neck Establish Axogen products as the Standard of “ Care for peripheral nerve repair for the OMF and H&N market segments After my wisdom teeth were removed, I Drive Societal Support & Clinical Guidelines couldn’t feel my tongue. After surgery, as the feeling came back m
Slide 40: Oral Maxillofacial and Head & Neck
Oral Maxillofacial and Head & Neck POSITIONED TO WIN Societal Support OMF societal support for nerve repair and included in AAOMS ParCare Guidelines can be leveraged to influence H&N societies Opportunity to build patient Physician payment Clinical Evidence and surgeon awareness of available for sur
Slide 41: Oral Maxillofacial and Head & Neck
Oral Maxillofacial and Head & Neck 2025 STRATEGIC INITIATIVES 1 High Potential Account Focus 4 Clinical Development Focused market development and sales efforts in high Work with KOLs to develop algorithm for malignant mandible potential accounts reconstruction as well as other H&N procedures includ
Slide 42: Breast
Breast Emily Hansen, Senior Director, Breast Market Development 42
Slide 43: Patient testimonials
Patient testimonials reflect personal experiences and are not reflective of all possible outcomes. Individual results may vary. 43
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Slide 45: Breast
Breast Breast is our fastest growing business with immediate and significant market opportunity Why we are here $677M ~150k Numbness after a mastectomy is a problem – restoring sensation TAM Annual Procedures matters and is the next frontier of breast reconstruction How the problem is being addresse
Slide 46: Breast
Breast THE MARKET DRIVERS High Disease Prevalence 150,000+ reconstruction procedures are performed annually in the US creating a sizable patient population14 Market Penetration Substantiation of the Clinical Problem 1 in 8 Robust clinical data supports the prevalence and patient impact women will be
Slide 47: Breast
Following the construct of Strategy Statement: 1. Objective Breast 2. Market Drivers 3. Strengths 4. Strategy Establish leadership in the breast neurotization market, creating a future where Resensation is the standard of care in breast reconstruction “ What is most important to you for the rest of
Slide 48: Breast
Breast POSITIONED TO WIN Proven Patient Activation Strategy 100K+ monthly Axogen’s marketing team excels at translating complex medical website visitors information into patient-friendly content, raising awareness and 1K+ monthly visitors driving demand for Resensation to surgeon locator Specialized
Slide 49: Breast
Breast 2025 STRATEGIC INITIATIVES 1 Advancing Clinical Evidence 3 Enhancing Surgeon Education & Training Initiate the development of a comprehensive study to As a primary lever to increase surgeon activation and demonstrate the clinical efficacy and long-term outcomes procedure adoption, a robust ed
Slide 50: Prostate
Prostate Jens Kemp, Chief Marketing Officer 50
Slide 51: Prostate
Prostate Oral Maxillofacial and Head & Neck Growing prostate cancer incidence16 and nerve related complications from surgery makes prostate an attractive expansion opportunity Why we are here TAM Important unsolved clinical need that can be addressed by Axogen’s nerve repair algorithm $784M Post rob
Slide 52: Prostate
Prostate THE MARKET DRIVERS 1 in 8 men High Disease Prevalence Prostate cancer incidence is increasing 3% per year and affects millions of men (1 in 8)16 110,000 robotic-assisted radical prostatectomy procedures are performed annually in the US, creating a sizable patient population will be diagnose
Slide 53: Prostate
Prostate Our objective is to establish cavernous nerve protection and reconstruction as an expected standard of care for robotic radical prostatectomy Surgical Technique Development Establish a standardized scalable surgical technique for cavernous nerve reconstruction in robotic prostatectomies by
Slide 54: Prostate
Prostate POSITIONED TO WIN Nerve Repair Portfolio Axogen’s nerve repair portfolio is ideally suited to address the nerve protection and reconstruction needs in robotic assisted radical prostatectomy Avance Nerve Graft provides better size matching than a sural nerve autograft and Axogen has the broa
Slide 55: Prostate
Prostate 2025 STRATEGIC INITIATIVES Surgical Technique Development Clinical Development Pilot 1 4 Partner with influential high-volume institutions and Recruit and engage target centers to incorporate nerve surgeons to standardize surgical technique and establish care into their robotic prostatectom
Slide 56: Reimbursement
Reimbursement Jens Kemp, Chief Marketing Officer 56
Slide 57: Positive Avance Medicare/Medicaid Reimbursement but ~50% of Commercial Lives Not Covered
Positive Avance Medicare/Medicaid Reimbursement but ~50% of Commercial Lives Still not Covered Avance Medicare & Avance Commercial Keys to expand coverage Medicaid Lives Covered Lives Covered Strong clinical evidence 94% 52% Expected Biologic in 2025 Societal support for Standard of Care designation
Slide 58: Significant Improvement in Medicare/Medicaid Facility Payment for Allograft Nerve
Significant Improvement in Medicare/Medicaid Facility Payment for Allograft Nerve in the Last 6 Years 2025 FACILITY PAYMENT National Average National Average Reimbursement Reimbursement Ambulatory CPT Code Descriptor C-APC Hospital Outpatient Surgery Center Allograft 64912 nerve repair 5432 $6,404 $
Slide 59: Trends for Surgeon Payments Show an Increase for Allograft Procedures
Trends for Surgeon Payments Show an Increase for Allograft Procedures 2025 PHYSICIAN PAYMENT National Average Physician Fee Relative Value Units CPT Code Descriptor Schedule (PFS) (RVUs) 64912 Allograft $876 27.08 nerve repair +9% Since 2019 64910 Conduit $748 23.14 nerve repair -9% Since 2019 Discl
Slide 60: Future Innovation and Clinical Evidence
Future Innovation and Clinical Evidence Stacy Arnold, Vice President, Product Development & Clinical Research 60
Slide 61: We aim to lead by requiring improved benefit-to-risk profiles
We aim to lead by requiring the solutions we offer provide improved benefit-to-risk profiles versus existing standards of care 1 2 3 Therapeutic Reconstruction Easy Coaptation Protection Expansion Enhancing functional recovery Making nerve repair easier & Addressing issues with with faster regenerat
Slide 62: Our Nerve Care Therapeutic Solutions Roadmap
Our Nerve Care Therapeutic Solutions Roadmap 2022 2023 2024 2025 2026 2027 2028 – Protection Expansion Axoguard Avive+ New Product HA+ Nerve Soft Tissue Easy Coaptation Development Protector Matrix Therapeutic Reconstruction Resensation New Clinical Implant Prostate Additional New Clinical Applicati
Slide 63: We will continue to Invest in Clinical Evidence
We will continue to Invest in Clinical Evidence in Support of our Standard of Care Objectives Completed Underway Planned Establishing the Foundation Strengthening the Evidence Advancing Standard of Care CHANGE Sensation-NOW Implant NAC-N Digital Nerve Pilot Study Autologous Breast Neurotization Regi
Slide 64: EOY Financial Results, Key Metrics, Financial Strategy, and Guidance
EOY Financial Results, Key Metrics, Financial Strategy, and Short and Long-term Guidance Nir Naor, Chief Financial Officer 64
Slide 65: Accelerating Topline and Bottom-line Growth
Accelerating Topline and Bottom-line Growth, while Moving to Positive Cashflow in 2024 $m Revenue EBITDA Operational Cashflow* 5.0 2.5 25.0 19.8 2021 2022 2023 20.0 - 187.3 2024 15.0 (5.0) $159.0 10.0 3.9 (10.0) $138.6 5.0 $127.4 2021 2022 2023 - (15.0) $112.3 2024 (5.0) (1.1) (10.0) (20.0) (18.0) (
Slide 66: 2025 Guidance
2025 Guidance Management expects Full-year revenue growth to be in the range of 15% - 17% Gross Margin to be in the range of 73% - 75%, including one-time costs related to the BLA approval: - Approximately $2m (expected mostly in third quarter) - Impacting full year gross margin by ~1% - ~2/3 of tho
Slide 67: 2025 – 2028 Strategic Plan
2025 – 2028 Strategic Plan Management expects Revenue CAGR of 15% - 20% Gross Margin improvements following process improvements and increase in capacity utilization Cashflow positive for each year Operational Cashflow growth – expect to end 2028 with a run rate > $70m/year Cashflow Priorities: - Se
Slide 68: 2025 Measurements of Success – Reporting Metrics
2025 Measurements of Success – Reporting Metrics Reporting Metric Breast Extremities OMF/H&N Prostate Increase customer facing Add 3-5 sales reps in Add 5 field-based Establish dedicated Commercial footprint from 12 to 22 High Potential account market development market development, Infrastructure s
Slide 69: Thank You
Thank You 69
Slide 70: Our Mission
Our Mission To restore health and improve quality of life by making restoration of peripheral nerve function an expected standard of care 70
Slide 71: References
References 1. Ephraim PL, Wegener ST, MacKenzie EJ, Dillingham TR, Pezzin LE. Phantom pain, residual limb pain, and back pain in amputees: results of a national survey. Arch Phys Med Rehabil. 2005;86(10):1910-1919. doi:10.1016/j.apmr.2005.03.031 2. Bamba R, Loewenstein SN, Adkinson JM. Donor site mo
Slide 72: For indications, intended uses, and contraindications see the following
For indications, intended uses, and contraindications see the following CLICK HERE CLICK HERE CLICK HERE CLICK HERE CLICK HERE CLICK HERE © Axogen Corp. 2025 The “a” logo, Axogen, Avance, Avance Nerve Graft, Axoguard, Axoguard Nerve Protector, Axoguard Nerve Connector, and Axoguard Nerve Cap, Resens
Slide 73: nasdaq: axgn
nasdaq: axgn 73