Neuronetics Inc
For the period ended Sep 30, 2024. Filed Nov 12, 2024.
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Sep 30, 2024 · Filed Nov 12, 2024
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Notes to Interim Financial Statements
- DESCRIPTION OF BUSINESS
Neuronetics, Inc. (the “Company”) is a commercial stage medical technology company focused on designing, developing and marketing products that improve the quality of life for patients who suffer from neurohealth disorders. The Company’s first commercial product, the NeuroStar Advanced Therapy System, is a non-invasive and non-systemic office-based treatment that uses transcranial magnetic stimulation (“TMS”) to create a pulsed, MRI-strength magnetic field that induces electrical currents designed to stimulate specific areas of the brain associated with mood. The NeuroStar Advanced Therapy System was cleared in 2008 by the United States (“U.S.”) Food and Drug Administration (the “FDA”) to treat adult patients with major depressive disorder (“MDD”) who have failed to achieve satisfactory improvement from prior antidepressant medication in the current MDD episode. It is also cleared by the FDA as an adjunct for adults with obsessive-compulsive disorder (“OCD”), and to decrease anxiety symptoms in adult patients with MDD that may exhibit comorbid anxiety symptoms (anxious depression), and as an adjunct for the treatment of MDD in adolescent patients aged 15-21. The NeuroStar Advanced Therapy System is also available in other parts of the world, including Japan, where it is listed under Japan’s national health insurance. The Company intends to continue to pursue development of its NeuroStar Advanced Therapy System for additional indications.
Liquidity
As of September 30, 2024, the Company had cash and cash equivalents of $20.9 million and an accumulated deficit of $407.1 million. The Company incurred negative cash flows from operating activities of $22.4 million for the nine months ended September 30, 2024 and $32.0 million for the year ended December 31, 2023. The Company has incurred operating losses since its inception, and management anticipates that its operating losses will continue in the near term as the Company continues to invest in sales, marketing and product development activities. The Company’s primary sources of capital to date have been proceeds from its initial public offering (“IPO”), private placements of its convertible preferred securities, borrowings under its credit facility, proceeds from its secondary public offering of common stock and revenues from sales of its products. On July 25, 2024, the Company entered into a Credit Agreement and Guaranty with Perceptive Credit Holdings IV, LP (“Perceptive”) as collateral agent and other lenders defined in the agreement (the “Perceptive Facility”). As of September 30, 2024, the Company had $50.0 million of borrowings outstanding under its credit facility, which has a final maturity on July 25, 2029. The Perceptive Facility is subject to certain financial covenants including a minimum net revenue covenant that escalates over the term of the Perceptive Facility and a minimum liquidity covenant. Our future ability to comply with these financial covenants is subject to risks, including our ability to continue to generate sufficient revenue growth and operating efficiencies to achieve cash flow breakeven. Management believes that the Company’s cash and cash equivalents as of September 30, 2024, anticipated revenues from sales of its products, and operational cash savings from the actions described in “Note 21. Subsequent Events” are sufficient to fund the Company’s operations for at least the next 12 months from the issuance of these financial statements.
- BASIS OF PRESENTATION
The accompanying financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“GAAP”). Any reference in these notes to applicable guidance is meant to refer to U.S. GAAP as found in the Accounting Standards Codification and Accounting Standards Updates (“ASUs”) promulgated by the Financial Accounting Standards Board (the “FASB”).
Interim Financial Statements
The accompanying unaudited interim financial statements have been prepared from the books and records of the Company in accordance with U.S. GAAP for interim financial information and Rule 10-01 of Regulation S-X promulgated by the U.S. Securities and Exchange Commission (the “SEC”), which permit reduced disclosures for interim periods. All adjustments, consisting only of normal recurring adjustments, necessary
for a fair presentation of the accompanying balance sheets and statements of operations and stockholders’ equity and cash flows have been made. Although these interim financial statements do not include all of the information and footnotes required for complete annual financial statements, management believes the disclosures are adequate to make the information presented not misleading. Unaudited interim results of operations and cash flows for the three and nine months ended September 30, 2024 are not necessarily indicative of the results that may be expected for the full year. Unaudited interim financial statements and footnotes should be read in conjunction with the audited financial statements and footnotes included in the Company’s Annual Report on Form 10-K filed with the SEC on March 8, 2024, wherein a more complete discussion of significant accounting policies and certain other information can be found.
Use of Estimates
The preparation of financial statements in accordance with U.S. GAAP and the rules and regulations of the SEC, requires the use of estimates and assumptions, based on judgments considered reasonable, which affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. The Company bases its estimates and assumptions on historical experience, known trends and events and various other factors that management believes to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Although management believes its estimates and assumptions are reasonable when made, they are based upon information available at the time they are made. Management evaluates the estimates and assumptions on an ongoing basis and, if necessary, makes adjustments. Due to the risks and uncertainties involved in the Company’s business and evolving market conditions, and given the subjective element of the estimates and assumptions made, actual results may differ materially from estimated results.
- SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
The Company’s complete summary of significant accounting policies can be found in “Note 3. Summary of Significant Accounting Policies” in the audited financial statements included in the Company’s Annual Report on Form 10-K filed with the SEC on March 8, 2024.
- RECENT ACCOUNTING PRONOUNCEMENTS
New Accounting Standards Adopted by the Company
In November 2023, the FASB issued ASU 2023-07,Improvements to Reportable Segment Disclosures (“ASU 2023-07”), which requires public companies to disclose for each reportable segment the significant expense categories and amounts for such expenses. ASU 2023-07 is effective for annual periods beginning December 15, 2023, and for interim periods within fiscal years beginning after December 15, 2024. This ASU will be effective for our annual period ended December 31, 2024. The Company believes that the adoption of ASU 2023-07 will not have a material effect on the Company’s financial statements and related disclosures.
In December 2023, the FASB issued ASU 2023-09*, Improvements to Income Tax Disclosures*(“ASU 2023-09”), which requires public business entities to disclose specific categories in the rate reconciliation and provide additional information for reconciling items that meet a quantitative threshold. ASU 2023-09 is effective for annual periods beginning after December 15, 2024. This ASU will be effective for our annual period ended December 31, 2025. The Company is currently evaluating the impacts of ASU 2023-09 on its disclosures.
Other than the items noted above, there have been no new accounting pronouncements not yet effective or adopted in the current year that we believe have a significant impact, or potential significant impact, to our unaudited interim financial statements.
- FAIR VALUE MEASUREMENT AND FINANCIAL INSTRUMENTS
The carrying values of cash equivalents, accounts receivable, prepaids and other current assets, and accounts payable on the Company’s balance sheets approximated their fair values as of September 30, 2024 and December 31, 2023 due to their short-term nature. The carrying values of the Company’s credit facility approximated its fair value as of September 30, 2024 and December 31, 2023 due to its variable interest rate. The carrying value of the Company’s notes receivable approximated its fair value as of September 30, 2024 and December 31, 2023 due to their variable interest rates.
Certain of the Company’s financial instruments are measured at fair value using a three-level hierarchy that prioritizes the inputs used to measure fair value. This hierarchy maximizes the use of observable inputs and minimizes the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows:
| Level 1: | Inputs are quoted prices for identical instruments in active markets. |
|---|
| Level 2: | Inputs are quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; or model-derived valuations whose inputs are observable or whose significant value drivers are observable. |
|---|
| Level 3: | Inputs are unobservable and reflect the Company’s own assumptions, based on the best information available, including the Company’s own data. |
|---|
The following tables set forth the carrying amounts and fair values of the Company’s financial instruments as of September 30, 2024 and December 31, 2023 (in thousands):
| · · · · · · · · · · · · · · · | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| | September 30, 2024 | |||||||||
| · · · · · · · · Fair Value Measurement Based on | ||||||||||
| · · · · · · · · Quoted · · Significant · · · | ||||||||||
| · · · · · · · · Prices In · · other · · Significant | ||||||||||
| · · · · · · · · Active · · Observable · · Unobservable | ||||||||||
| · · Carrying · · · · · Markets · · Inputs · · Inputs | ||||||||||
| · Amount · Fair Value · (Level 1) · (Level 2) · (Level 3) | ||||||||||
| Assets · · · · · · · · · · · · · · · | ||||||||||
| Money market funds (cash equivalents) | | $13,488 | | $13,488 | | $13,488 | | $— | | $— |
| · · · · · · · · · · · · · · · | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| | December 31, 2023 | |||||||||
| · · · · · · · · Fair Value Measurement Based on | ||||||||||
| · · · · · · · · Quoted · · Significant · · · | ||||||||||
| · · · · · · · · Prices In · · other · · Significant | ||||||||||
| · · · · · · · · Active · · Observable · · Unobservable | ||||||||||
| · · Carrying · · · · · Markets · · Inputs · · Inputs | ||||||||||
| | | Amount | | Fair Value | | (Level 1) | | (Level 2) | | (Level 3) |
| Assets · · · · · | ||||||||||
| Money market funds (cash equivalents) | | $27,507 | | $27,507 | | $27,507 | | $— | | $— |
- ACCOUNTS RECEIVABLE
The following table presents the composition of accounts receivable, net, as of September 30, 2024 and December 31, 2023 (in thousands):
| · · · · · · · | |||||
|---|---|---|---|---|---|
| | | September 30, | | December 31, | |
| · 2024 · 2023 · | |||||
| Gross accounts receivable - trade | | $18,825 | | $16,577 | |
| Less: Allowances for credit losses | | (2,000) | | (795) | |
| Accounts receivable, net | | $16,825 | | $15,782 | |
- INVENTORY
Inventory is stated at the lower of cost and net realizable value, with cost being determined on a first in, first out basis. The Company’s inventory is primarily comprised of finished goods and work-in-process.
- PROPERTY AND EQUIPMENT AND CAPITALIZED SOFTWARE
The following table presents the composition of property and equipment, net, as of September 30, 2024 and December 31, 2023 (in thousands):
| | | | | | | | |
|---|---|---|---|---|---|---|---|
| · · September 30, · · December 31, · | |||||||
| · 2024 · 2023 · | |||||||
| Laboratory equipment | | $705 | | $702 | | ||
| Office equipment | | 495 | | 495 | | ||
| Auto | | | 23 | | | 23 | |
| Computer equipment and software | | 1,136 | | 1,082 | | ||
| Manufacturing equipment | | 575 | | 551 | | ||
| Leasehold improvements | | 1,463 | | 1,436 | | ||
| Rental equipment | | 598 | | 542 | | ||
| Property and equipment, gross | | 4,995 | | 4,831 | | ||
| Less: Accumulated depreciation | | (3,356) | | (2,822) | | ||
| Property and equipment, net | | $1,639 | | $2,009 | | ||
As of September 30, 2024 and December 31, 2023, the Company had capitalized software costs, net, of $4.5 million and $4.2 million, respectively, which are included in “Prepaid expenses and other current assets” and “Other assets” on the balance sheet.
Depreciation and amortization expense was $0.5 million for the three months ended September 30, 2024 and 2023, respectively, and $1.6 million and $1.5 million for the nine months ended September 30, 2024 and 2023, respectively.
9. NOTES RECEIVABLE
Greenbrook TMS Inc.
On March 31, 2023, the Company entered into a Secured Promissory Note and Guaranty Agreement (the “Promissory Note”) with TMS Neurohealth Centers Inc. (the “Maker”) and Greenbrook TMS Inc. (“Greenbrook”) and its subsidiaries, excluding the Maker (the “Guarantors”), in the principal amount of $6.0 million for a period offour years.
Notes receivable outstanding from Greenbrook was $4.0 million and $5.2 million as of September 30, 2024 and December 31, 2023, respectively.
The Promissory Note bears interest at a rate equal to the sum of (a) the floating interest rate of daily secured overnight financing rate as administered by the Federal Reserve Bank of New York on its website (“SOFR”) plus (b)7.65%.
Pursuant to the terms of the Promissory Note, in the event of an event of default thereunder, the Maker will be required to issue common share purchase warrants to the Company equal to (i)200% of the unpaid amount of any delinquent amount or payment due and payable under the Promissory Note, together with all outstanding and unpaid accrued interest, fees, charges and costs, divided by (ii) the exercise price of the warrants, which will represent (i) if the Maker’s common shares are traded on the Nasdaq Stock Market (“Nasdaq”), a 20% discount to the 30-day volume-weighted average closing price of Greenbrook’s common shares traded on the Nasdaq prior to the date of issuance (subject to any limitations that may be required by Nasdaq), (ii) if the Maker’s common shares are not then traded on Nasdaq, but are traded on the Toronto Stock Exchange (“TSX”) or another nationally recognized U.S. or Canadian securities exchange, inter-dealer quotation system or over-the-counter market (an “Other Market”), a 20% discount to the 30-day volume-weighted average closing of Greenbrook’s common shares traded on the TSX or Other Market, as elected by the Company, or (iii) if the Maker’s common shares are not traded on any of the above trading markets, a 20% discount to the fair market value of a common share as determined pursuant to the Promissory Note.
Under the Promissory Note and related loan documents, the Maker and the Guarantors have granted to the Company a security interest in substantially all of the Maker’s and the Guarantors’ assets and the Guarantors have guaranteed the Maker’s obligations under the Promissory Note. The Company’s security interest pursuant to the Promissory Note and related loan documents rankspari passu with the Maker’s senior lender, Madryn Fund Administration, LLC, and is subject to an intercreditor agreement.
Interest income recognized by the Company related to notes receivable was $0.1 million and $0.2 million for the three months ended September 30, 2024 and 2023. Interest income recognized by the Company related to notes receivable was $0.5 million and $0.4 million for the nine months ended September 30, 2024 and 2023, respectively, and is included within “Other income, net” on the statements of operations.
10. LEASES
Lessee:
The Company has operating leases for its corporate headquarters, a training facility and office equipment, including copiers. The Company leases an approximately 32,000 square foot facility in Malvern, Pennsylvania for its corporate headquarters, which includes office and warehouse space. The Company leases an approximately 9,600 square foot facility in Charlotte, North Carolina as a training facility for its NeuroStar Advanced Therapy Systems. The Company does not currently have any finance leases or executed leases that have not yet commenced.
Operating lease rent expense was $0.2 million for the three months ended September 30, 2024 and 2023, and $0.6 million for the nine months ended September 30, 2024 and 2023. As of September 30, 2024, the weighted-average remaining lease term of operating leases was 3.3 years and the weighted-average discount rate was 7.2%.
The following table presents the supplemental cash flow information as a lessee related to leases (in thousands):
| · · · · · · · | |||||
|---|---|---|---|---|---|
| · Nine Months Ended · | |||||
| · · September 30, 2024 · September 30, 2023 · | |||||
| Cash paid for amounts included in the measurement of lease liabilities: · · · | |||||
| Operating cash flows from operating leases | | $827 | | $807 | |
The following table sets forth by year the required future payments of operating lease liabilities (in thousands):
| | | | | |
|---|---|---|---|---|
| · · September 30, 2024 · | ||||
| Remainder of 2024 | | $221 | | |
| 2025 | | | 898 | |
| 2026 | | 921 | | |
| 2027 | | 882 | | |
| 2028 | | 116 | | |
| Total lease payments | | 3,038 | | |
| Less imputed interest | | (343) | | |
| Present value of operating lease liabilities | | $2,695 | | |
Lessor sales-type leases:
Certain customers have purchased NeuroStar Advanced Therapy Systems on a rent-to-own basis. The lease term isthree orfour years with a customer option to purchase the NeuroStar Advanced Therapy System at the end of the lease or automatic transfer of ownership of the NeuroStar Advanced Therapy System at the end of the lease.
The following table sets forth the profit recognized on sales-type leases (in thousands):
| · · · · · · · · · · · · · | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| · · Three Months Ended September 30, · · Nine Months Ended September 30, · | |||||||||
| · 2024 · 2023 · 2024 · 2023 · | |||||||||
| Profit recognized at commencement, net | | $21 | | $13 | | $45 | | $60 | |
| Interest income | | — | | — | | — | | — | |
| Total sales-type lease income | | $21 | | $13 | | $45 | | $60 | |
The following table sets forth a maturity analysis of the undiscounted lease receivables related to sales-type leases (in thousands):
| | | | | |
|---|---|---|---|---|
| · September 30, 2024 · | ||||
| Remainder of 2024 | | $232 | | |
| 2025 | | | 402 | |
| 2026 | | 78 | | |
| Total sales-type lease receivables | | $712 | | |
As of September 30, 2024, the carrying amount of the lease receivables is $0.7 million. The Company doesnot have any unguaranteed residual assets.
Lessor operating leases:
NeuroStar Advanced Therapy Systems sold for which collection is not probable are accounted for as operating leases. For the three months ended September 30, 2024 and 2023, the Company recognized operating lease income of $0.04 million and $0.02 million, respectively. For the nine months ended September 30, 2024 and 2023, the Company recognized operating lease income of $0.1 million.
The Company maintained rental equipment, net, of $0.3 million as of September 30, 2024 and December 31, 2023, which are included in “Property and equipment, net” on the balance sheet. Rental equipment depreciation expense was $0.02 million for the three months ended September 30, 2024 and 2023, and $0.07 million and $0.07 million for the nine months ended September 30, 2024 and 2023, respectively.
- PREPAID COMMISSION EXPENSE
The Company pays a commission on both NeuroStar Advanced Therapy System sales and treatment session sales. Since the commission paid for system sales is not commensurate with the commission paid for treatment sessions, the Company capitalizes commission expense associated with NeuroStar Advanced Therapy System sales commissions paid that is incremental to specifically anticipated future treatment session orders. In developing this estimate, the Company considered its historical treatment session sales and customer retention rates, as well as technology development life cycles and other industry factors. These costs are periodically reviewed for impairment.
NeuroStar Advanced Therapy System commissions are deferred and amortized on a straight-line basis over aseven year period equal to the average customer term, which the Company deems to be the expected period of benefit for these costs.
On the Company’s balance sheets, the current portion of capitalized contract costs is represented by the “Current portion of prepaid commission expense”, while the long-term portion is included in “Prepaid commission expense”. Amortization expense was $0.7 million and $0.6 million for the three months ended September 30, 2024 and 2023, respectively, and $2.1 million and $1.7 million for the nine months ended September 30, 2024 and 2023, respectively.
- ACCRUED EXPENSES
The following table presents the composition of accrued expenses as of September 30, 2024 and December 31, 2023 (in thousands):
| | | | | | | |
|---|---|---|---|---|---|---|
| · September 30, · December 31, | ||||||
| · · 2024 · · 2023 | ||||||
| Compensation and related benefits | | $6,769 | | $8,003 | ||
| Consulting and professional fees | | 1,702 | | 488 | ||
| Research and development expenses | | 556 | | 260 | ||
| Sales and marketing expenses | | | 397 | | | 1,760 |
| Warranty | | 237 | | 213 | ||
| Sales and other taxes payable | | 714 | | 818 | ||
| Other | | 1,054 | | 1,053 | ||
| Accrued expenses | | $11,429 | | $12,595 | ||
- REVENUE AND DEFERRED REVENUE
Payment terms typically require payment upon shipment or installation of the NeuroStar Advanced Therapy System and additional payments as access codes for treatment sessions are delivered, which can span several years after the NeuroStar Advanced Therapy System is first delivered and installed. The timing of revenue recognition compared to billings and cash collections typically results in accounts receivable.
However, sometimes customer advances and deposits may be required for certain customers and are recorded as contract liabilities (deferred revenue). For multi-year agreements, the Company generally invoices customers annually at the beginning of each annual coverage period and recognizes revenue over the term of the coverage period.
As of September 30, 2024, the Company expects to recognize approximately the following percentages of deferred revenue by year:
| · · · | ||
|---|---|---|
| · Revenue | ||
| Year: | | Recognition |
| Remainder of 2024 | | 43% |
| 2025 | 54% | |
| 2026 | 2% | |
| 2027 | 1% | |
| Total | 100% | |
Revenue recognized for the three months ended September 30, 2024 and 2023 that was included in the contract liability balance at the beginning of the year was $0.3 million and $0.4 million, respectively. Revenue recognized for the nine months ended September 30, 2024 and 2023 that was included in the contract liability balance at the beginning of the year was $1.4 million and $1.7 million, respectively, and primarily represented revenue earned from separately priced extended warranties, customer deposits, milestone revenue, and clinical training.
Customers
Significant customers are those that represent more than 10% of the Company’s total revenue. For the three months ended September 30, 2024 and 2023, one customer accounted for 13% and 15% of the Company’s revenue, respectively. For the nine months ended September 30, 2024 and 2023, one customer accounted for 14% and 17% of the Company’s revenue, respectively.
Accounts receivable outstanding related to that customer was $1.9 million as of September 30, 2024 and December 31, 2023.
Notes receivable outstanding related to that customer was $4.0 million and $5.2 million as of September 30, 2024 and December 31, 2023, respectively.
Geographical information
The following geographic data includes revenue generated from the Company’s third-party distributors. The Company’s revenue was generated in the following geographic regions and by product line for the periods indicated (in thousands):
| · · · · · · · · · · · | |||||
|---|---|---|---|---|---|
| · · Revenues by Geography | |||||
| · · Three Months Ended September 30, | |||||
| · · 2024 · · 2023 | |||||
| · · · · · % of · · · · · % of | |||||
| · · Amount · · Revenues · · Amount · · Revenues | |||||
| · · (in thousands, except percentages) · | |||||
| U.S. | $17,922 | 97% | $17,211 | 96% | |
| International | | 608 | 3% | 673 | 4% |
| Total revenues | | $18,530 | 100% | $17,884 | 100% |
| · · · · · · · · · · · | |||||||
|---|---|---|---|---|---|---|---|
| · · U.S. Revenues by Product Category | |||||||
| · · Three Months Ended September 30, | |||||||
| · · 2024 · · 2023 | |||||||
| · · · · · % of · · · · % of | |||||||
| · Amount · Revenues · Amount · Revenues | |||||||
| · (in thousands, except percentages) · | |||||||
| NeuroStar Advanced Therapy System | | $4,108 | | 23% | $3,597 | | 21% |
| Treatment sessions | | 13,326 | 74% | 13,060 | 76% | ||
| Other | | 488 | 3% | 554 | 3% | ||
| Total U.S. revenues | | $17,922 | 100% | $17,211 | 100% | ||
| · · · · · · · · · · · | |||||
|---|---|---|---|---|---|
| · · International Revenues by Product Category | |||||
| · · Three Months Ended September 30, | |||||
| · · 2024 · · 2023 | |||||
| · · · · · % of · · · · · % of | |||||
| · Amount · Revenues · Amount · Revenues | |||||
| · (in thousands, except percentages) · | |||||
| NeuroStar Advanced Therapy System | | $244 | 40% | $258 | 38% |
| Treatment sessions | | 90 | 15% | 280 | 42% |
| Other | | 274 | 45% | 135 | 20% |
| Total international revenues | | $608 | 100% | $673 | 100% |
| · · · · · · · · · · · | |||||
|---|---|---|---|---|---|
| · · Revenues by Geography | |||||
| · · Nine Months Ended September 30, | |||||
| · · 2024 · · 2023 | |||||
| · · · · · % of · · · · · % of | |||||
| · · Amount · · Revenues · · Amount · · Revenues | |||||
| · · (in thousands, except percentages) · | |||||
| U.S. | $50,845 | 97% | $49,464 | 97% | |
| International | | 1,552 | 3% | 1,570 | 3% |
| Total revenues | | $52,397 | 100% | $51,034 | 100% |
| · · · · · · · · · · · | |||||||
|---|---|---|---|---|---|---|---|
| · · U.S. Revenues by Product Category | |||||||
| · · Nine Months Ended September 30, | |||||||
| · · 2024 · · 2023 | |||||||
| · · · · · % of · · · · % of | |||||||
| · Amount · Revenues · Amount · Revenues | |||||||
| · (in thousands, except percentages) · | |||||||
| NeuroStar Advanced Therapy System | | $11,418 | | 22% | $11,936 | | 24% |
| Treatment sessions | | 37,974 | 75% | 36,018 | 73% | ||
| Other | | 1,453 | 3% | 1,510 | 3% | ||
| Total U.S. revenues | | $50,845 | 100% | $49,464 | 100% | ||
| · · · · · · · · · · · | |||||
|---|---|---|---|---|---|
| · · International Revenues by Product Category | |||||
| · · Nine Months Ended September 30, | |||||
| · · 2024 · · 2023 | |||||
| · · · · · % of · · · · · % of | |||||
| · Amount · Revenues · Amount · Revenues | |||||
| · (in thousands, except percentages) · | |||||
| NeuroStar Advanced Therapy System | | $502 | 32% | $573 | 36% |
| Treatment sessions | | 400 | 26% | 589 | 38% |
| Other | | 650 | 42% | 408 | 26% |
| Total International revenues | | $1,552 | 100% | $1,570 | 100% |
- DEBT
The following table presents the composition of debt as of September 30, 2024 and December 31, 2023 (in thousands):
| · · · · · · · | |||||
|---|---|---|---|---|---|
| | | September 30, | | December 31, | |
| · 2024 · 2023 · | |||||
| Outstanding principal | | $50,000 | | $60,000 | |
| Accrued final payment fees | | — | | 1,856 | |
| Less debt discounts | | (3,998) | | (2,573) | |
| Total debt, net | | 46,002 | | 59,283 | |
| Less current portion | | — | | — | |
| Long-term debt, net | | $46,002 | | $59,283 | |
For the three months ended September 30, 2024, the Company recognized interest expense of $1.7 million, of which $1.6 million was cash and $0.1 million was non-cash interest expense related to the amortization of deferred debt issuance costs and accrual of final payment fees. For the three months ended September 30, 2023, the Company recognized interest expense of $1.2 million, of which $1.1 million was cash and $0.1 million was non-cash interest expense related to the amortization of deferred debt issuance costs and accrual of final payment fees.
For the nine months ended September 30, 2024, the Company recognized interest expense of $5.5 million, of which $4.9 million was cash and $0.6 million was non-cash interest expense related to the amortization of deferred debt issuance costs and accrual of final payment fees. For the nine months ended September 30, 2023, the Company recognized interest expense of $3.6 million, of which $3.1 million was cash and $0.5 million was non-cash interest expense related to the amortization of deferred debt issuance costs and accrual of final payment fees.
Loss on extinguishment of debt amounting to $4.4 million was recorded during the three months ended September 30, 2024, related to the SLR Facility. This included $1.2 million of early prepayment fees and $3.2 million of deferred financing expense related to extinguishment of debt.
Perceptive Credit Facility
On July 25, 2024, the Company entered into the Perceptive Facility which was used to partially repay the Company’s previous$60.0 million credit facility with SLR Investment Corp.
The Perceptive Facility permits the Company to borrow up to an aggregate amount of $90.0 million inthree tranches of term loans, a “Tranche 1 Loan”, a “Tranche 2 Loan” and a “Tranche 3 Loan.” On July 25, 2024, the Company borrowed an aggregate amount of $50.0 million, which was the aggregate amount available under the Tranche 1 Loan portion of the Perceptive Facility. Under the Tranche 2 Loan portion of the Perceptive Facility, the Company is permitted to borrow, at its election, up to an aggregate amount of $15.0 million, (i) upon the Company achieving a specified amount of trailing twelve months net revenue, and (ii) assuming there has been no event of default under the Perceptive Facility prior to such election. The Tranche 2 Loan portion of the Perceptive Facility must be borrowed on or before December 31, 2025. Under the Tranche 3 Loan portion of the Perceptive Facility, the Company may request to borrow, at the consent of the Majority Lenders (as defined in the Perceptive Facility), up to an aggregate amount of $25.0 million. The Tranche 3 Loan portion of the Perceptive Facility must be borrowed on or before June 30, 2026. There will be no scheduled repayments of the principal on the Tranche 1 Loan, Tranche 2 Loan and Tranche 3 Loan prior to the maturity date. All amounts borrowed under the Perceptive Facility are due on July 25, 2029.
Each of the Tranche 1 Loan, Tranche 2 Loan and Tranche 3 Loan accrues interest from the date of borrowing through the date of repayment at a floating per annum rate of interest equal to the sum of 7.00% plus the greater of (a)4.50% and (b) One-Month Term SOFR (as defined in the Perceptive Facility).
If the Company prepays either the Tranche 1 Loan, Tranche 2 Loan or Tranche 3 Loan prior to their scheduled maturity date, the Company will also be required to pay prepayment fees to Perceptive equal to 6% of the principal amount of such term loan then-prepaid if prepaid on or before the first anniversary of the closing date,5% of the principal amount of such term loan then-prepaid if prepaid after the first anniversary and on or before the second anniversary of the closing date,4% of the principal amount of such term loan then-prepaid if prepaid after the second anniversary and on or before the third anniversary of the closing date, and 3% of the principal amount of such term loan then-prepaid if prepaid after the third anniversary and on or before the fourth anniversary of the closing date.
The Company’s obligations under the Perceptive Facility are secured by a first priority security interest in substantially all of the Company’s assets, including its intellectual property. The Perceptive Facility requires the Company to comply with a quarterly minimum trailing revenue covenant commencing December 2024 and a minimum liquidity covenant as well as affirmative and negative covenants.
The Perceptive Facility contains events of default, including, without limitation, events of default upon: (i) failure to make payment pursuant to the terms of the agreement; (ii) violation of covenants; (iii) material adverse changes to the Company’s business; (iv) insolvency; (v) material cross-defaults; (vi) significant judgments, orders or decrees for payments by the Company; (vii) incorrectness of representations and warranties; (viii) significant adverse ERISA events; (ix) failure by the Company to be registered with the United States Securities and Exchange Commission in good standing; and (x) failure by the Company to maintain a valid and perfected lien on the collateral securing the borrowing.
As consideration for the Perceptive Facility, the Company agreed to issue to Perceptive warrants to purchase up to 1,462,500 shares of the Company’s common stock, with a warrant exercisable into 1,125,000 shares of the Company’s common stock issued on the closing date (the “Initial Warrant”). The per share exercise price for the Initial Warrant is equal to the lower of (x) the 10-day volume weighted average price of the Company’s common stock on the business day immediately prior to the closing date and (y) the 10-day volume weighted average price of the common stock ended on August 31, 2024. In addition to the Initial Warrant, an additional warrant will be issued for 337,500 shares of common stock concurrently with the borrowing of the Tranche 2 Loan. The per share exercise price for the additional warrant will be equal to the exercise price of the Initial Warrant. Each warrant will be exercisable, in whole or in part, until the tenth anniversary of the applicable date of issuance.
The Company was in compliance with the covenants under the Perceptive Facility at September 30, 2024.
SLR Credit Facility
On March 2, 2020 the Company entered into a Loan and Security Agreement with Solar Investment Corp. (formerly known as Solar Capital Ltd) (“SLR”) as collateral agent and other lenders as defined in the agreement (such agreement, as amended, the “SLR Facility”).
On March 7, 2024, the Company entered into a sixth amendment (the “SLR Sixth Amendment”) to the SLR Facility. Under the SLR Sixth Amendment, SLR: (a) waived the specified events with respect to the Company’s non-compliance with the required revenue under the net product revenue covenant; and (b) amended the financial covenants and increased the amount of the liquidity covenant and temporarily decreased the net product revenue covenant to reflect current projections.
On September 29, 2023, the Company entered into a fifth amendment (the “SLR Fifth Amendment”) to the SLR Facility. The SLR Fifth Amendment allowed the Company to draw on the$22.5 million Term C Loan portion of the SLR Facility and revised the required testing levels of the net product revenue and minimum liquidity covenants for certain testing periods. On October 3, 2023, the Company borrowed$22.5 million under the Term C Loan portion of the SLR Facility, resulting in total borrowing of$60 million.
On March 29, 2023, the Company entered into a fourth amendment (the “SLR Fourth Amendment”) to the Loan and Security Agreement dated March 2, 2020 with SLR. The SLR Fourth Amendment increased the borrowings by$2.5 million, extended the interest only period from March 2023 to March 2026, and extended the maturity date from February 2025 to March 2028. In addition, the SLR Fourth Amendment changed the basis of the interest expense from LIBOR to SOFR.
The SLR Facility accrued interest from the date of borrowing through the date of repayment at a floating per annum rate of interest, which reset monthly and was equal to the greater of 5.65% plus (a)3.95% or (b) daily simple SOFR for a term of one month. Only interest was required to be paid on the SLR Facility until March 1, 2026. Prior to the effectiveness of the SLR Fourth Amendment, the interest only period with respect to the Term A Loan expired on March 1, 2023. Commencing April 1, 2026, the Company was required to make monthly payments of principal and interest on the SLR Facility.
In addition to the principal and interest payments due under the SLR Facility, the Company was required to pay a final payment fee to SLR upon the earlier of prepayment, acceleration or the maturity date of the SLR Facility equal to 4.95% of the principal amount of the term loans actually funded. If the Company prepaid the SLR Facility prior to their respective scheduled maturities, the Company was also be required to pay prepayment fees to SLR equal to 3% of the principal amount of such term loan then-prepaid if prepaid on or before the first anniversary of the Term C Funding Date (as defined in the SLR Facility),2% of the principal amount of such term loan then-prepaid if prepaid after the first anniversary and on or before the second anniversary of the Term C Funding Date, or 1% of the principal amount of such term loan then-prepaid if prepaid after the second anniversary of the Term C Funding Date.
The Company was also required to pay SLR an exit fee upon the occurrence of (a) any liquidation, dissolution or winding up of the Company, (b) any transaction that results in a person obtaining control over the Company, (c) the Company achieving$100 million in trailing twelve-month net product revenue or (d) the Company achieving$125 million in trailing twelve-month net product revenue. The exit fee for liquidation, dissolution, winding up or change of control of the Company was equal to 2% of the principal amount of the term loans actually funded. The exit fee for achieving either$100 million or$125 million in trailing twelve-month net product revenue was equal to 1% of the principal amount of the term loans actually funded or, if both net product revenue milestones were achieved,2% of the principal amount of the term loans actually funded. The exit fee was capped at 2% of the principal amount of the term loans actually funded.
On January 31, 2024 and February 29, 2024, the Company was not in compliance with its minimum net product revenue covenant under the SLR Facility. The Company was granted a waiver from SLR in the SLR Sixth Amendment for the covenant violations. The amount of borrowings affected by this noncompliance was$60 million.
As of June 30, 2024, the Companywas not in compliance withits minimum net product revenue covenant under the SLR Facility. The amount of borrowing affected by this noncompliancewas$60 million.
As previously disclosed on the Company’s Current Report on Form 8-K filed on July 30, 2024, simultaneously with the Company’s entry into the Perceptive Facility, on July 25, 2024, the Company prepaid in full all outstanding obligations under and terminated the SLR Facility. In connection with this prepayment, the Company paid total consideration of$64.6 million, which consisted of (i)$60.0 million of remaining principal amount outstanding, (ii)$0.5 million of accrued and unpaid interest, (iii)$3.0 million in connection with the
final payment fee, and (iv)$1.2 million in connection with the prepayment fee. The Company funded the prepayment of the SLR Facility using proceeds from the Perceptive Facility and cash on hand.
- COMMON STOCK
Common Stock
The following table summarizes the total number of shares of the Company’s common stock issued and reserved for issuance as of September 30, 2024 and December 31, 2023 (in thousands):
| · · · · · | |||
|---|---|---|---|
| | September 30, 2024 | December 31, 2023 | |
| Shares of common stock issued | 30,317 | 29,092 | |
| Shares of common stock reserved for issuance for: | | ||
| Common stock warrants outstanding | 1,146 | 41 | |
| Stock options outstanding | 1,238 | 1,270 | |
| Restricted stock units outstanding | 3,274 | 3,360 | |
| Shares available for grant under stock incentive plans | 852 | 978 | |
| Shares available for sale under employee stock purchase plan | 1,624 | 1,335 | |
| Total shares of common stock issued and reserved for issuance | 38,451 | 36,076 | |
Common Stock Warrants
During the three and nine months ended September 30, 2024, the Company issued 1,125,000 warrants as stated within “Note 14. Debt”.
The following tables summarizes the Company’s outstanding common stock warrants as of September 30, 2024, and December 31, 2023:
| · · · · · | ||||
|---|---|---|---|---|
| September 30, 2024 · | ||||
| Warrants · | ||||
| Outstanding · · · · · | ||||
| (in thousands) | | Exercise Price | | Expiration Date |
| 1,125 | | $0.94 | | July-2034 |
| 21 | | $9.73 | Dec-2024 | |
| 1,146 | | |||
| · · · · · | |||
|---|---|---|---|
| December 31, 2023 · | |||
| Warrants · | |||
| Outstanding · · · · · | |||
| (in thousands) · · Exercise Price · · Expiration Date | |||
| 20 | | $9.73 | Mar-2024 |
| 21 | | $9.73 | Dec-2024 |
| 41 | | ||
The Company valued warrants issued during the three and nine months ended September 30, 2024 using the Black-Scholes option pricing model using the following assumptions:
| · · · · | |||
|---|---|---|---|
| | 2024 | ||
| Estimated fair value of common stock | | $1.61 | |
| Exercise price | | $1.92 | |
| Expected term (in years) | | 9.4 | |
| Risk-free interest rate | | 4.2% | |
| Expected volatility | | 88.0% | |
| Dividend yield | | —% | |
- LOSS PER SHARE
The Company’s basic loss per common share is computed by dividing the net loss by the weighted-average number of shares of common stock outstanding during the period. The Company’s restricted stock awards (non-vested shares) are issued and outstanding at the time of grant but are excluded from the Company’s computation of weighted-average shares outstanding in the determination of basic loss per share until vesting occurs.
A net loss cannot be diluted, so when the Company is in a net loss position, basic and diluted loss per common share are the same. If the Company achieves profitability in the future, the denominator of a diluted earnings per common share calculation will include both the weighted average number of shares outstanding and the number of common stock equivalents, if the inclusion of such common stock equivalents would be dilutive. Dilutive common stock equivalents potentially include warrants, stock options, non-vested restricted stock units and non-vested performance restricted stock units (“PRSUs”) using the treasury stock method, along with the effect, if any, from the potential conversion of outstanding securities, such as convertible preferred stock.
The following potentially dilutive securities outstanding as of September 30, 2024 and 2023 have been excluded from the denominator of the diluted loss per share of common stock outstanding calculation (in thousands):
| | | | | | |
|---|---|---|---|---|---|
| · · September 30, · | |||||
| · 2024 · 2023 · | |||||
| Stock options | | 1,238 | | 1,271 | |
| Non-vested PRSUs | 395 | 395 | | ||
| Non-vested restricted stock units | 2,879 | 3,239 | | ||
| Common stock warrants | 1,146 | 41 | | ||
- SHARE-BASED COMPENSATION
The amount of share-based compensation expense recognized by the Company by location in its statements of operations for the three and nine months ended September 30, 2024 and 2023 is as follows (in thousands):
| · · · · · · · · · · · · · | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| · Three Months Ended September 30, · · Nine Months Ended September 30, · | ||||||||||
| · · 2024 · 2023 · 2024 · 2023 · | ||||||||||
| Cost of revenues | | $35 | | $38 | | $106 | | | 109 | |
| Sales and marketing | | 380 | | 590 | | 1,089 | | | 1,946 | |
| General and administrative | | 807 | | 1,052 | | 2,560 | | | 3,134 | |
| Research and development | | 197 | | 175 | | 565 | | | 504 | |
| Total | | $1,419 | | $1,855 | | $4,320 | | $5,693 | |
|---|
2018 Equity Incentive Plan
In June 2018, the Company adopted the 2018 Equity Incentive Plan, (the “2018 Plan”), which authorized the issuance of up to 1.4 million shares, subject to an annual 4% increase based on the number of shares of common stock outstanding, in the form of restricted stock, stock appreciation rights and stock options to the Company’s directors, employees and consultants. The amount and terms of grants are determined by the Company’s board of directors. All stock options granted to date have had exercise prices equal to the fair value, as determined by the closing price as reported by the Nasdaq Global Market, of the underlying common stock on the date of grant. The contractual term of stock options is up to 10 years, and stock options are exercisable in cash or as otherwise determined by the board of directors. Generally, stock options vest 25% upon the first anniversary of the date of grant and the remainder ratably monthly thereafter for 36 months. Restricted stock units generally vest ratably inthree equal installments on the first, second and third anniversaries of the grant date. PRSUs generally vest based on appreciation of the Company’s common stock to a certain price as determined by the Company’s board of directors measured using a trailing 30-day volume-weighted average price of a share of the Company’s common stock. The fair value of the PRSU awards are determined using a risk neutral Monte Carlo simulation valuation model. As of September 30, 2024, there were 0.7 million shares available for future issuance under the 2018 Plan.
2020 Inducement Incentive Plan
In December 2020, the Company adopted the 2020 Inducement Incentive Plan (the “2020 Plan”), which authorized the issuance of up to 0.4 million shares, subject to increase by approval of the Company’s board of directors, in the form of stock options, stock appreciation rights, restricted stock awards, restricted stock unit awards, performance stock awards and other stock awards to eligible employees who satisfy the standards for inducement grants under Nasdaq Global Market rules. In March 2022, the Company’s board of directors approved an additional 0.5 million shares for the issuance under the 2020 Plan. An individual who previously served as an employee or director of the Company is not eligible to receive awards under the 2020 Plan. The amount and terms of grants are determined by the Company’s board of directors. As of September 30, 2024, there were 0.1 million shares available for future issuance under the 2020 Plan.
Stock Options
The following table summarizes the Company’s stock option activity for the nine months ended September 30, 2024:
| · · · · · · · · · · | ||||||
|---|---|---|---|---|---|---|
| · · Weighted · Aggregate | ||||||
| · · Number of · · Weighted · · average · · average | ||||||
| · · Shares under · · average · · Remaining · · Intrinsic | ||||||
| · · Option · · Exercise Price · · Contractual · · Value | ||||||
| · · (in thousands) · · per Option · · Life (in years) · · (in thousands) | ||||||
| Outstanding at December 31, 2023 | 1,270 | | $3.90 | | | |
| Granted | — | | $— | | ||
| Exercised | (2) | | $0.96 | | | |
| Forfeited and Expired | (30) | | $9.97 | | ||
| Outstanding at September 30, 2024 | 1,238 | | $3.75 | 5.3 | $— | |
| Exercisable at September 30, 2024 | 1,238 | | $3.75 | 5.3 | $— | |
| Vested and expected to vest at September 30, 2024 | 1,238 | | $3.75 | 5.3 | $— | |
The Company recognized share-based compensation expense related to stock options of $0.0 million and $0.1 million for the three months ended September 30, 2024 and 2023, respectively, and $0.1 million and $0.3 million for the nine months ended September 30, 2024 and 2023, respectively. As of September 30, 2024, there wasno remaining unrecognized compensation cost related to non-vested stock options.
For the nine months ended September 30, 2024 the Company didnot grant stock options.
Restricted Stock Units and PRSUs
The following table summarizes the Company’s restricted stock unit and PRSU activity for September 30, 2024:
| · · · · · · · · · · | |||||||
|---|---|---|---|---|---|---|---|
| · Non-vested · · Weighted · Non-vested · · Weighted | |||||||
| · · Restricted · · · average · · PRSUs · · · average | |||||||
| · · Stock Units · · · Grant-date · · · · · Grant-date | |||||||
| · · (in thousands) · · · Fair Value · · (in thousands) · · · Fair Value | |||||||
| Non-vested at December 31, 2023 | | 2,965 | | $4.37 | 395 | | $6.77 |
| Granted | 1,593 | | $3.18 | — | | $— | |
| Vested | (1,406) | | $4.35 | — | | $— | |
| Forfeited | (273) | | $4.21 | — | | $— | |
| Non-vested at September 30, 2024 | 2,879 | | $3.74 | 395 | | $6.77 | |
The Company recognized $1.4 million and $1.8 million in share-based compensation expense related to the restricted stock units and PRSUs for the three months ended September 30, 2024 and 2023, respectively, and $4.2 million and $5.3 million for the nine months ended September 30, 2024 and 2023, respectively. As of September 30, 2024, there was $7.4 million of unrecognized compensation cost related to non-vested restricted stock units and PRSUs, which the Company expects to recognize over a weighted-average period of 1.9 years. The total fair value at the vesting date of restricted stock units and PRSUs vested during the nine months ended September 30, 2024 was $4.3 million.
The Company didnot grant PRSUs during the nine months ended September 30, 2024.
- COMMITMENTS AND CONTINGENCIES
Legal Matters
The Company is subject from time to time to various claims and legal actions arising during the ordinary course of its business. Management believes that there are currently no claims or legal actions that would reasonably be expected to have a material adverse effect on the Company’s results of operations, financial condition, or cash flows.
- SEGMENT INFORMATION
Operating segments are defined as components of an enterprise about which separate discrete information is available for evaluation by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. The Company currently operates inone business segment as it is managed and operated as one business. A single management team that reports to the chief operating decision maker comprehensively manages the entire business. The Company does not operate any material separate lines of business or separate business entities with respect to its products or product development.
- GOVERNMENT ASSISTANCE
Employee Retention Credit
The Coronavirus Aid, Relief and Economic Security Act provided an Employee Retention Credit (the “ERC”), which was a refundable tax credit related to certain payroll taxes. The Company applied the grant model and determined that the criteria for recognition of the ERC was met during the year ended December 31, 2023 based on the Company’s determination of eligibility and filing of the ERC claim. As of September 30, 2024, the $2.9 million ERC receivable is reported within “Prepaid expenses and other current assets” on the Company’s balance sheets.
- SUBSEQUENT EVENTS
On October 3, 2024, the Company received a deficiency letter from the Nasdaq Listing Qualifications Department of The Nasdaq Stock Market LLC (the “Staff”) notifying the Company that, for the 30 consecutive business days prior to such letter, the closing bid price for the Company’s common stock had been below the minimum $1.00 per share required for continued listing on The Nasdaq Global Market pursuant to Nasdaq Listing Rule 5450(a)(1) (the “Minimum Bid Price Requirement”).
In accordance with Nasdaq Listing Rule 5810(c)(3)(A), the Company has been given until April 1, 2025 to regain compliance with the Minimum Bid Price Requirement. If at any time before April 1, 2025, the bid price of the Company’s common stock closes at $1.00 per share or more for a minimum of 10 consecutive business days, the Staff will provide written confirmation that the Company has achieved compliance.
If the Company does not regain compliance with the Minimum Bid Price Requirement by April 1, 2025, the Company may be afforded a second 180 calendar day period to regain compliance. To qualify, the Company would be required to transfer to The Nasdaq Capital Market and meet the continued listing requirement for market value of publicly held shares and all other initial listing standards for The Nasdaq Capital Market, except for the Minimum Bid Price Requirement. In addition, the Company would be required to notify Nasdaq of its intent to cure the deficiency during the second compliance period. Following a transfer to The Nasdaq Capital Market, the Company will be afforded a second 180 calendar day period to regain compliance, unless it does not appear to Nasdaq that it is possible for the Company to cure the deficiency. If the Company does not regain compliance with the Minimum Bid Price Requirement by the end of the compliance period (or the second compliance period, if applicable), the Company’s common stock will become subject to delisting. In the event that the Company receives notice that its common stock is being delisted, the Nasdaq listing rules permit the Company to appeal a delisting determination by the Staff to a hearings panel.
The Company intends to monitor the closing bid price of its common stock and may, if appropriate, consider available options to regain compliance with the Minimum Bid Price Requirement, including initiating a reverse stock split. However, there can be no assurance that the Company will be able to regain compliance with the Minimum Bid Price Requirement or will otherwise be in compliance with other Nasdaq listing rules.
On November 8, 2024, Greenbrook Shareholders approved the Greenbrook Arrangement Resolution and Neuronetics Stockholders approved the Neuronetics Charter Amendment Proposal and Neuronetics Share Issuance Proposal (as such terms are defined in the Company’s Definitive Proxy Statement on Schedule 14A filed on October 4, 2024).
On November 8, 2024, the Company implemented a strategic reorganization to sharpen the Company’s focus on growth. This reorganization resulted in a workforce reduction of approximately 10% and will focus the Company’s commercial strategy on the highest growth drivers. The reorganization will also improve operational efficiency, with anticipated post-reorganization annualized cash savings of more than$3.5 million.
The Company expects to recognize approximately$0.4 million in total expenses for severance and related benefits for employees impacted by the reduction in force, consisting primarily of severance payments and related benefits. The Company may also incur other charges or cash expenditures not currently contemplated due to events that may occur as a result of, or associated with, the reduction in force.
The text of this filing, as the company filed it with the SEC, without its images or exhibits. This is not investment advice.