Brainsway (TASE:BWAY) Q1 2021 Earnings Call

0:00 Greetings and welcome to the BrainsWay first quarter 2021 earnings conference call. At this time, all participants are in a listen-only mode. A question and answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. As a reminder, this conference is being recorded. It is now my pleasure to introduce Bob Yedit of Lifestyle Advisors. Thank you. You may begin. Thank you, Daryl, and thank you all, and welcome to BrainsWay's first quarter 2021 earnings conference call. With us today are BrainsWay's President and Chief Executive Officer, Chris Fagnacco, and the new Chief Financial Officer, Scott Arreglato.

0:50 The format for today's call will be a discussion of the first quarter trends and business updates from Chris, followed by a detailed discussion of the financials from Scott. Then we will open up the call for your questions. Earlier this morning, BrandsWay released results for the first quarter ended March 31st, 2021. A copy of the press release is available on the company's investor relations website. Before I turn the call over to Chris and Scott, I'd like to remind you that this conference call, including both management's prepared remarks and the question and answer session, may contain projections or other forward-looking statements regarding future events or future performance of BrandsWay, including but not limited to any statements relating to commercial plans or activities, financial projections, clinical studies, R&D plans, and or anticipated timelines.

1:46 These statements are only predictions and BrandsWay cannot guarantee that they will in fact occur. BrandsWay does not assume any obligation to update that information. Investors are cautioned that all forward booking statements involve risks and uncertainties. such as reliance on third parties and shifting market conditions, particularly due to the COVID-19 pandemic, which may cause actual results to differ from those anticipated by BrandsWay at this time. Additional risks concerning factors that can cause actual results, actual event, results or achievement to materially differ from those contained in the forward-looking statements can be found in the company's registration statement on Form 20-F, and Southern Filings, Securities, and Exchange Commission. For those remarks, it's my pleasure to turn the call over to the CEO, Fritz Vaniaco.

2:40 Fritz? Thank you, Bob, and welcome, everyone, and thank you for joining us today. We're extremely pleased with the current operating trends in our business and expect some of our recent achievements to drive further growth in our business. I'll discuss all of this further shortly, But first, I will provide a brief overview of our key first quarter financial results. We achieved $6.1 million in revenue for the first quarter of 2021, which represented a significant 47% increase over our first quarter of 2020, demonstrating the resiliency of our business following the impacts of the COVID-19 pandemic. Importantly, we believe that the momentum we began generating in our business late last year which continued into our first quarter of 2021 is expected to be sustained throughout the year. Key to the current and continued strong performance of our business is that the operating environment has improved, a trend that we expect to further progress as additional stability returns to the marketplace in everyday life.

3:49 As evidence of this, patient treatments with DTMS have continued to increase Since the fourth quarter. I would like to highlight that we recently completed the 100,000 patient treatment with DTMS, which we view as a major milestone and a testament to the innovative, non-invasive mental health technologies we have developed. Looking ahead with approximately 40% of the US population currently fully vaccinated and another 10% that have received at least one dose of the vaccine, We anticipate that these positive patient trends will continue. Moreover, mental health issues continue to rise dramatically as we emerge from COVID-19.

4:36 In fact, a recent study published in the Lancet Psychiatry indicated that 34% of about 235,000 primarily US patients studied who suffered and recovered from COVID-19 were diagnosed with a brain or psychiatric disorder within six months. With over 100 million people that have recovered from COVID-19 worldwide and with the United States ranking first among nations in number of cases, it is cause for concern that we may face a secondary epidemic of mental illness. In a separate recent study of about 4,000 recovered COVID-19 patients published in the Journal of American Medical Association, Over 52% met the criteria for symptoms for major depressive disorder.

5:27 Of course, these studies do not include individuals with mental health issues who may not have necessarily been diagnosed with COVID-19, but nonetheless suffer from the ill effects of isolation, lack of support from family, friends, and colleagues, and other impacts from COVID-19 to their daily lives over the last 15 months. The importance of mental health, especially in light of COVID-19, has taken on a greater sense of urgency. As such, we continue to ramp up our patient awareness initiatives. To highlight May as Mental Health Awareness Month, we were honored to ring the NASDAQ closing bell earlier this month. We also launched a robust social media influencer campaign about mental health awareness. In addition, we recently initiated a significant patient awareness campaign with the goal of reaching any patient seeking an alternative to medical management of their mental health.

6:26 We also continue to expand our efforts to educate prospective patients on the benefit of BrainsWay's deep TMS. This includes, for example, content on our new website clearly explains the important differences between deep TMS and traditional TMS, as well as our hosting of numerous well-attended webinars. including 10 in the first quarter alone aimed at informing patients and providers alike about the benefit of BrainsWay's unique approach to mental health treatment. In our continuation of recent trends, we are pleased to report that our organic website traffic has again increased significantly, up over 33% from Q4 2020 to Q1 2021. I would now like to turn to DTMS for the treatment of OCD, as well as our continued efforts to obtain reimbursement in this key indication.

7:24 As of the end of the first quarter, we had shipped 225 OCD coils as add-on helmets to certain of our BrainWay's new and existing systems. As a reminder, we fully launched this innovative treatment in the first quarter of 2019, and already about one-third of our total installed base have opted to offer our OCD treatment, which is a clear-cut reflection that our customers strongly believe in the benefit of DTMS for OCD. We note that a number of these providers have been requesting coverage from healthcare plans for specific OCD patients and are also now advocating coverage for DTMS generally for this indication. During the first quarter, we dramatically improved both our depression and OCD resources.

8:10 including features on our website and customer portal to guide our providers in navigating the sometimes complex coverage landscape. We also continue to reach out to payers with new clinical evidence, including eight additional studies published in 2020, highlighted by our real-world evidence study that analyzed 219 patients from 22 medical centers to support deep TMS treatment for patients with OCD. During the first quarter, we held 13 meetings, including with all seven Medicare administrative contractors and six large commercial payers. During these meetings, many of which included behavioral health medical directors, we presented our DTMS OCD clinical evidence, as well as information on appropriate patient selection criteria, proper placement of DTMS within the treatment continuum, and associated health economics.

9:07 We continue to reach out to additional commercial payers to present this information. I would add that the Clinical TMS Society, a leading TMS medical association, recently published its 2021 recommended OCD coverage policy with guidance on patient selection criteria and treatment protocols, which we also shared with payers to demonstrate the medical society's support. Based on this collective work, we are awaiting current evidence reviews and coverage policy decisions from multiple payers. With that, I would now like to highlight two recent achievements that have the potential to drive meaningful further growth in our business. First, we recently successfully initiated our controlled market release of DTMS for smoking addiction. This new commercial offering, the first of its kind, was distributed to 10 customers. The initial patients at these sites have been treated or still undergoing treatment, and we have received excellent feedback from our customers in regard to the impact the therapy is having on their patients.

10:11 As previously discussed, we received FDA clearance based on the data from our double-blind multi-center trial with 262 smokers. These smokers were highly addicted to cigarettes with a long history of smoking, and with 70% of them having failed three or more attempts to quit. Of the participants who received a full course of DTMS treatment, 28% achieved four consecutive weeks of abstinence from smoking. We have a significant opportunity to leverage this large target market with 34 million adult smokers in the U.S. Over time, we expect that DTMS with smoking addiction could have a significant impact on our business, and we look forward to providing you with further updates on this exciting commercial launch over the coming months.

10:59 We were also pleased to have recently received FDA clearance for our Thetaverse three-minute protocol utilizing the deep TMS system for depression. This new FDA-cleared protocol, which is immediately available on our systems, provides patients with shorter duration of treatment option to manage their depression. The availability of a shorter treatment protocol has the potential to expand access to care by providing clinicians with added flexibility in selecting courses of treatment that may be better for certain patients. In support of our successful application to the FDA, BrainsWay's seventh clearance to date, we submitted safety and efficacy data from 146 subjects who had received either the standard deep TMS protocol or Thetaverse deep TMS protocol.

11:52 Subjects in both groups demonstrated a statistically and clinically meaningful reduction in depression scores. Switching gears, our recent equity raise, which generated over $45.2 million of gross proceeds, favorably positions the company to invest more aggressively to increase the revenue growth rate and shareholder value. As previously mentioned, we are continuing to expand our sales coverage as well as accelerate our marketing and reimbursement initiatives. Finally, we're extremely proud of our R&D and clinical leadership position in the non-invasive neurostimulation space, and we will continue to invest to maintain this position. Turning to investor relations, we remain dedicated to sharing BrainsWay's compelling growth story with both institutional and retail investors.

12:42 In the first quarter, both during and following our recent successfully completed equity offering, we met with a number of high-quality healthcare-focused U.S.-based institutional investors. We also presented at the annual Oppenheimer Healthcare Conference, as well as held meetings with a number of high network retail investors. We will be presenting at a number of additional healthcare investment conferences during the remainder of 2021. And later this year, we intend to host a KOL event for investors and analysts similar to the meeting we held last November. I would like to take the opportunity now to welcome Scott to the BrainsWay team. He joined us as Senior Vice President and CFO earlier this month. Scott brings more than 25 years of leadership experience across finance and accounting positions within the high-tech medical device industry.

13:33 Most recently, he was the CFO of ICAD, a NASDAQ listed global med tech company that focuses on early detection and treatment of cancer. We are thrilled to have Scott on the BrainsWay team, as he is extraordinarily qualified to assist in our mission of Boldly Advancing Neuroscience to Improve Health and Transform Lives. I look forward to his interactions with many of you over the coming weeks. Finally, as always, I'd like to express my gratitude to our hardworking customers on the front line of this mental health crisis and to the entire BrainsWay team for their continued support and dedication to our mission. These extraordinary efforts by our customers and employees continue to generate significant achievements for BrainsWay positioning us well to leverage the many key catalysts ahead of us. Thank you again for joining us today.

14:26 With that, I will now pass the call to Scott for his review on our first quarter 2021 financial results. Scott. Thank you, Chris. I am pleased to be joining my first BringsWay earning call, and I am thrilled to be a part of this dynamic growing company. Now I will jump right in with a discussion of our financial results. For the first quarter of 2021, we generated revenue of $6.1 million, a 47% increase compared to the first quarter 2020 revenue of $4.2 million. This year-over-year revenue growth was driven by the increase in our direct sales. Our recurring revenues, primarily derived from leases, were $3.5 million, consistent with the first quarter of 2020.

15:14 These lease revenues represented 56% of our total revenue which underscores the recurring nature and predictability of BrainsWay's growing revenues. As of March 31st, 2021, BrainsWay's installed base totaled 652 deep TMS systems, which reflects a quarter over quarter increase of 23 systems and 19% growth year over year. Gross profit for the first quarter of 2021 was $4.6 million compared to $3.1 million during the prior year period. Gross margin for the quarter was 75% as compared to 76% in the first quarter of 2020. Moving on to operating expenses. For the first quarter of 2021, research and development expenses were $1.2 million as compared to $1.8 million in the first quarter of 2020.

16:10 and primarily consisted of costs associated with the continued development of our patented deep TMS technology. SG&A expenses for the first quarter of 2021 were $3.6 million compared to $3.7 million for the first quarter of 2020. Total operating expenses were $6.8 million for both the first quarter of 2021 and 2020. It is important to note that operating expenses for the first quarter of 2021 included a one-time non-cash charge of approximately $2 million for stock compensation expense, which was related to the repricing of options in the first quarter of 2021.

16:55 Absent this one-time charge, operating expenses would have been approximately $4.8 million for the first quarter of 2021. Going forward, we expect to invest in initiatives to drive commercial adoption of our primary indications in major depressive disorder and OCD, as well as further clinical evidence for our smoking addiction indication. Operating loss for the first quarter was $2.2 million compared with a loss of $3.6 million for the same period in 2020. For the first quarter ended 2021, we incurred a net loss of $2.7 million compared to a net loss of $3.4 million in the first quarter of 2020, a year-over-year improvement of $1 million.

17:44 Again, the net loss in 2021 included the $2 million stock compensation charge that I just referenced. Moving on to the balance sheet, we ended the quarter with cash, cash equivalents, and short-term deposits of $58.5 million compared to $17.2 million as of December 31, 2020. The significantly increased cash position reflects the completion of the company's public offering, which was closed in March 2021 and generated gross proceeds of approximately $45.2 million. We believe that our strong balance sheet allows us to expand our sales and marketing efforts to drive additional adoption of our DTMS system to continue to invest in R&D in order to explore new potential indications for our differentiated innovative technology.

18:35 As Chris mentioned, we believe these initiatives and investments will help drive top-line growth and improve the company's strategic position. This concludes our prepared remarks, and I will now ask the operator to open up the call for questions. Operator? Thank you. We will now be conducting a question and answer session. If you would like to ask a question, please press star 1 on your telephone keypad. The confirmation tone will indicate your line is in the question queue. You may press star 2 if you would like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. One moment, please, while we poll for your questions.

19:24 Our first questions come from the line of Steven Litman with Oppenheimer. Please proceed with your questions. Thank you. Good morning, guys. Chris, you mentioned some of the digital marketing activities in one queue. I was wondering, can you talk about what other sales and marketing initiatives we should look for from you guys now with the four to five balance sheet, including maybe where you are in terms of Salesforce expansion? Yeah, sure. Thanks, Steve. I'll take the Salesforce expansion first. So I think, as we may have mentioned in the last call, we ended with 13 Sales professionals at the end of last year, and our goal is to get up to 18 in the short term.

20:11 At the present moment, we have 14. I think as Hadar may have mentioned on the last call, our plan was to get up to 18 by the end of the third quarter. As far as other marketing initiatives that we're doing, we're doing quite a bit. Our real focus is on pushing towards You know, the digital marketing campaigns around patient and patient awareness. And as I mentioned in the prepared remarks, we are doing quite a bit in this month. We actually launched the largest campaign on direct-to-consumer around DTMS, you know, highlighting obviously Mental Health Awareness Month.

20:58 Okay, great, great. I was wondering also if you could, Give us a sense of any feedback from the Salesforce on the addition of Data Burst. Any early comments on how that has impacted commercial interactions with customers? Yeah, I think the initial indication from our Salesforce was extremely positive. And as I mentioned, the prepared remarks, I think also in our press release, it's immediately available to our customers. and just taking a first look, I think that our current customers roughly around 30% or maybe a little bit more have already started taking utilization of the Thetaverse protocol.

21:43 So it's pretty good excitement around it and we're looking to continue to leverage that. Great. And then maybe lastly, you mentioned a lot of activity in the first quarter with payers on OCD. What if you could sort of characterize the meetings generally? Any surprises in just how you're feeling overall, you know, coming out of those meetings? Yeah, that's a great question. Thanks, Steve, for asking. I think one of the biggest things that we have encountered with the payers is really going through our evidence and describing the difference in our clinical data as compared to traditional PMS.

22:33 That has sort of muddied the waters for us to a certain extent because I think the payers just felt all PMS technology is the same. So we've had to really educate them on the difference of the technology and also the benefits of our technology because They were looking at OCD and fatality with all TMS. And so we've had to do a much better job of educating the payers. I think that was really the biggest hurdle for us going into it and sort of an eye opening for us. But I say, beyond that, it's been it's been really positive. Again, it's really hard to characterize, you know, where it's going to go. But as I mentioned, I think on the last call, I was, I did pretty positive about the response thus far.

23:21 Great. Thanks so much. I'll jump back in here. Thanks. Thanks, Steve. Thank you. Our next questions come from the line of Jeffrey Cohen with Lattenburg-Dahlman. Please proceed with your question. Hi, Chris and Scott. How are you? Hi, Jeff. Great. Great, Jeff. Thanks. Two areas I wanted to ask about. So, firstly, just on the depression front, are you seeing an increase in utilization as far as an influx of of new patients that are out there, and what do you see coming from PharmaLand and failures in PharmaLand? I guess, you know, what is the psychiatry market saying, and what are you hearing from the docs? Yeah, so we definitely saw an increase from Q4 to Q1. I think those are all positive.

24:10 Obviously, we're continuing to exit COVID, and I think we'll see – we'll continue to see increase as the year goes along. As you know, and I think we've mentioned on previous calls, just sort of the effects of COVID, the patients and the effects of those patients, we may not see them jumping into the fray, so probably, you know, H2 of this year, and then going also into 2022. Just because it's, you know, most of the reimbursement companies are still at four filled medications that are needed, even though there has been a trend going from four to two. So to come up and down, you know, for medications, you're talking about at least a year minimum, if not two years. And I think, yes, does that answer your question, Jeff?

25:02 Yep, that's helpful. And secondly, could you talk about, not that you have your hands full with three large indications, but could you talk a little bit about some of the studies and any progress in Parkinson's and MS as far as neurodegeneration and Thanks. Yeah, great. Thanks. Thanks for that question, Jeff. So, you know, we have obviously three clear indications here in the United States, depression, OCD, and smoking addiction, which we've talked about. In Europe, we have a number of other indications that are cleared. You mentioned Parkinson's disease. We also have some other neurologic disease that we have there as well. I think as I mentioned on our last call, we are looking to start at least one clinical trial later this year, a pivotal trial later this year.

25:55 And one of those probably be in the neurological area, specifically around MS, which I think I mentioned on the last call. Yep. Okay. Thanks for taking my questions. Nice readout. Appreciate it. Thanks, Jeff. Thank you. Our next questions come from the line of Kyle Mixon with Cantor Fitzgerald. Please proceed with your questions. Hi, guys. Thanks for taking the questions. Welcome to hear your voice again. Yeah, thanks. Well, question on, of course, the question on the revenue beat our estimate and was above street expectations by close to March. It's actually closer to the CQ estimate. So I was wondering if there was any, like, one time where non-recurring items didn't kind of call out. You know, I'm thinking, like, Blade orders from 2020 or maybe some multi-DTMS system orders as well. I'm just trying to understand that $6.1 billion number, that could be like a run rate going forward.

26:50 Thank you. So Kyle, thanks for the question. You know, we were excited to actually, obviously our direct sales came in probably a little bit higher than we expected. But again, if we have one or two direct sales, that's going to tip the number higher. So it's nice. I don't know if it actually trickled over from Q4 or not. We obviously, you saw we had a really great close to Q4. But again, you know, one-time sale at direct sale can really tip us in one direction or the other. All right, got it. Makes sense. And kind of like on a similar note, OCD coils came in lower than they were a year ago by just a bit. They're actually kind of like in the same level.

27:35 Anything you can kind of share there, why that could have been a little bit weaker or Could that kind of pick back up as you go along here? I know there's a seasonality, but wondering if there's anything you can share there, maybe reimbursements kind of more of a headwind than you were expecting. Yeah, so when it comes to OCD, not every clinic that we end up selling actually takes an OCD because they may not be focused on OCD in that clinical practice itself. So, you know, I think it's usually less than a 50-50. in some case. And then, you know, some of our business is to existing customers. And if an existing customer is expanding, and they already have an OCD coil, they may not require one at this time. And again, I think obviously, we're pretty proud of what we have already with, you know, one third of the install base, having the OCD coil. And that's even again, without reimbursement.

28:32 And we know, as we continue, as we continue our path to gain reimbursement, we know that those numbers will change. All right, that's fair, Chris. And Chris, you actually mentioned it in your prior question, the European indication. So recently, we saw that MagVenture secured some CMARC approvals for indications like addiction, OCD, depression with anxiety. Could you talk about the competitive position of BrainWay in Europe and how you kind of see that evolving over the next couple of years? It's a pretty important market for you, and it grew on the top line over 30% last year, so good luck to hear your thoughts. Yeah, again, our focus has really been on the U.S., the U.S.

29:17 commercial market. We are looking at the international business as a growth opportunity, but right now we're still, I would say, opportunistic in Europe around what we do and the rest of international business. But I think there are unique opportunities that we leveraged. I mean, you mentioned we had greater than 30% sales last year, OUS, which was quite nice. And I think we can continue to leverage some of those. As far as the indications, again, we have a wide, broad range of indications in Europe already, including addiction treatments and things like that. And I think Jeff asked about Parkinson's earlier. So, I think that helps us internationally.

30:02 But where we have challenges internationally is more around reimbursement. Our focus has been primarily internationally in Japan. And Japan, as you know, we have clearance there, but we've been waiting on reimbursement in Japan. And COVID has really set us back there. But we're looking as we exit COVID to hopefully that we will get reimbursement in Japan and we can start our commercial launch there and have an active focus on that. Okay. Makes sense. Thanks, Chris. And if I could just squeeze one last one in here. I know it's very early in the smoking rule out, but have you begun any of the reimbursement work for that indication? And I guess, like, if not, which is probably likely, what is that process really going to be like?

30:48 Is that going to be kind of revolved around generating some clinical data this year? I think you mentioned that in your remarks. Are you talking about smoking or sorry? Yeah, smoking addiction. Thanks. Yeah. Yeah, so it's part of our controlled market release. As I mentioned, we have 10 sites now that are up installed. We put a pretty robust tracking system in there to gain post-marketing data. And we'll be using that, obviously, that post-marketing data in trying to understand the reimbursement landscape. It's a little bit different with smoking than obviously for depression or OCD. And we're continuing to explore that, but it's really Thank you. Our next question comes from the line of Jason Witte with Northland Capital Markets. Please proceed with your questions.

31:57 Hi, thanks for taking the questions. Just to follow up maybe on smoking cessation, obviously it's going to take a while to see, to test the waters on reimbursement from the payers, but do you also anticipate there could be a large out-of-pocket market for this as well? Jason, thanks. Thanks for the question. That's a very important thing, and that's one of the things that we're testing in our control market release. With the 10 systems that we've already installed, we planned out to install it for more systems. Those are specifically the things that we're looking at, how cash pay can be a little bit more robust. We know with OCD, it's been difficult on the cash pay side, but there are some advantages I think we could take with smokers in general if they're really, you know, wanting to quit. And also, it's less treatments, right?

32:45 It's about half the number of treatments that you would do for, say, OCD, so the cost would be a little bit less. But I think To date, we've probably done about a dozen, maybe a dozen patients at those 10 systems, at those 10 sites. And we have some good anecdotal data about how the treatments are going. And there is some excitement there. And we're continuing to learn about it as we kind of expand out and refine our marketing message around it. Okay, great. And related to that, it also seems like it would be pretty – Susceptible, I guess would be the word, to OTC marketing. It's kind of a unique approach.

33:33 There's quite a lot of desperate smokers out there, but there's also quite a few options. Obviously, a lot of them don't work. In this rollout, are you also supporting with some OTC, either local or just internet, or could you explain kind of your thinking there in terms of how the OTC drive might work? Mike Schieffer. Yeah, so great question. So obviously, as part of our big launch this year with the direct-to-consumer market, we have done, as part of our control market release, we're also doing, you know, digital marketing around smoking as well to kind of test what really the, you know, what kind of responses would be viewed, how would they be working We've been working with several of our customers around that as well.

34:26 Again, that's to get to hone in our messaging. Okay. I might have just missed this in the release, but did you break out the lease versus sale on the revenues? Related to that, do you think COVID is still having any impact on the direct sales piece of the revenue? Yes. So our lease revenue is about 56% of the mix this quarter. I do think there's still some lingering COVID impact from the end of the year and into the first quarter on our business. And as Chris mentioned in his comments, we see positive trends about that starting to relieve.

35:18 Okay, and then also just, again, maybe in terms of how you're thinking, you just had a successful raise. You have a bit of a war chest now. You're going to 13 to 18, which is certainly a decent increase in terms of sales reps. Still puts you behind some of your competitors. So I guess the question is, when you talk about ramping up on expenses, It sounds like a large percentage of that is going to be for DTC type and internet type advertising. Am I thinking about this right? I'd be curious to know kind of how you think the best way to attack this market since there's so much. It's a good point. I think it's a two-pronged approach here, right?

36:05 We have to just create awareness. I think that's the biggest driver for us. And then we're going to put feet on the street. We have a plan to go to 18 and I would expect, you know, as those ramp up, we'll look opportunistically at where the other territories could be and potentially, you know, add sales where necessary. But at least, you know, our plans are only to go to 18 right now. But, like, I personally, I think, just coming in here, awareness is a huge driver, and everything we can do to create patient awareness in all these geographies is going to help pull through for us to help our sales team. Okay, great. Thanks. I'll jump back in here. Thanks, Jason. Thank you. Our next question comes from the line of Jason Bedford with Raymond James.

36:53 Please proceed with your question. Hi, guys. This is for Jason Bedford. I just wanted to ask about trends exiting the quarter and what the trends look like for the rest of the first half and for the year now that COVID seems to be less of an issue. Yeah, very good question. I think as I remember remarking on last quarter, we'd expect the trends to continue to get improvement. And, you know, our initial thoughts are obviously as we go into the second half of the year, it's going to continue to expand. So we're pretty positive about what we're seeing. I think overall, just, you know, talking to the sales force, and getting their feedback. They're getting more, you know, face-to-face meetings, which I think is quite exciting.

37:49 Great. Thank you. And if you guys could elaborate on the three-minute protocol a little bit more. Does this protocol require a new piece of hardware? And also in terms of like why, what type of patients the shorter protocol is suited for as opposed to the standard protocol? Just a few more details on like what, Thanks for that question. So, our system, our latest and greatest system was actually built with this in mind. So, you know, it is the, I would say, most powerful simulator on the market for any TMS company that's out there. So, it's, in fact, immediately available to all of our customers. There's nothing that's needed at all.

38:39 It's ready to roll. And our customers have been, like I said, they had earlier and said, you know, roughly about 30% or greater of our customers have already started utilizing this. Again, it's more, I would say it's physician dependent. We want the physician to decide what's best for the patient. And we've given some guidelines out. But anecdotally, I've heard from physicians Just that, you know, maybe you have like an elderly patient that's not maybe well suitable to tolerate, you know, the 19-minute treatment. So, in that case, maybe a three-minute treatment is more suitable. Got it. So, other than that patient being older, what is preventing the 30% from, I mean, I would think that most people would want a shorter treatment as opposed to a longer treatment. What's preventing greater adoption of this?

39:38 And in terms of average, like ASP for procedure, is it different than the standard or are you guys still getting reimbursed the same amount for the standard as well as the new protocol? So from a reimbursement percentage, you know, certain insurance companies will obviously reimburse protocol for DTMS for depression. and maybe some of the insurance companies call out Theta Burst or they don't. But I think in general, we will really want to leave it up to the customers and decide, let them have the flexibility of what's more appropriate for their patients. Got it. Thank you very much. Thank you.

40:28 Thank you. There are no further questions at this time. I would like to turn the call back over to management for any closing comments. Thank you. So, in conclusion, I would like to thank all of our investors and other participants for their interest in BrainsWay, and we look forward to keeping you up to date on our progress throughout the remainder of the year. With that, please enjoy the rest of your day. Thank you for your participation. This does conclude today's teleconference. You may disconnect your lines at this time. Have a great day.