Xtant Medical at Canaccord Conference: Biologics Drive Growth

On Tuesday, 12 August 2025, Xtant Medical (NYSE:XTNT) presented at Canaccord Genuity’s 45th Annual Growth Conference, highlighting its strategic focus on regenerative biologics. CEO Sean Brown discussed the company’s impressive 18% year-over-year revenue growth and the impact of divesting non-core assets. While the company is strengthening its balance sheet, it also faces challenges in penetrating existing networks more effectively.

Key Takeaways

• Xtant Medical reported an 18% increase in Q2 revenue year-over-year.
• The company divested non-core assets, improving profitability by reducing sales team workload.
• Focus on biologics, diversification, and profitability, with a strong cash position expected to exceed $20 million.
• Plans to expand into wound care and surgical repair markets, reducing reliance on spine-related revenues.

Financial Results

• Q2 revenue increased by 18% compared to the previous year.
• Revised annual revenue guidance to $131-135 million, up from $127-131 million.
• Cash balance expected to exceed $20 million, boosted by $9 million from asset divestitures.
• Shift in revenue mix with spine revenue decreasing to the mid-70s percent range, indicating successful diversification.

Operational Updates

• Recent product rollouts include Amneal products, Viable Bone Matrix, Trivium, OsteoFactor Pro, and Fibrex.
• The company is vertically integrated, manufacturing its own products for better supply chain control and margin expansion.
• Over 450 IDN agreements and 650 independent agent agreements, demonstrating broad commercial reach.

Future Outlook

• Guidance to be reissued in Q3 following asset divestitures.
• Plans to launch collagen-based products in 2025 and develop a new synthetic with enhanced bioactivity.
• Focus on increasing penetration within existing distributor and IDN contracts.
• Monetizing excess capacity through OEM and contract manufacturing opportunities.

Q&A Highlights

• Emphasis on increasing mindshare among independent agents for biologics sales.
• Remaining hardware business expected to generate $23 million in revenue.

For a more detailed understanding, readers are encouraged to refer to the full transcript below.

Full transcript - Canaccord Genuity’s 45th Annual Growth Conference:

Caitlin Cronin, Med Tech Team, Canaccord Genuity: Good afternoon, everyone. Thank you for joining us at this year’s Canaccord Genuity Global Growth Conference. My name is Caitlin Cronin, and I’m on the med tech team here at Canaccord Genuity. I’m joined today by Xtant, a medical device company developing regenerative products for orthopedic and spine procedures. With me today is Sean Brown, CEO.

And before we begin, I want to remind everyone of any relevant disclosures which can be found on our conference inter firm website. And with that, I’m going to hand it over to Sean.

Sean Brown, CEO, Xtant Medical: Thank you, Caitlin. And I will go through the okay, here we go. Extant Medical, who are we? So Extant Medical is a global technology company focused on the design, manufacture and commercialization of regenerative biologics and spinal implant systems. And quite frankly, in that order.

More importantly, when you think about who we are as a compelling investment, there’s kind of six big areas that I look to. First and foremost, we serve a large market opportunity. Just the orthobiologics business alone, we estimate to be about $2,500,000,000 When you look at some of the adjacent markets that we touch on such as advanced wound care, surgical repair, these things get over into the $10,000,000,000 market cap or at least addressable market out there. When you look at the business itself, we’re a high growth and profitable business. This morning, we announced our second quarter results.

We’re up 18% year over year, very profitable, cash flowing, all the arrows going in the direction that we really wanted to go, especially given where we’ve been in the years past. The balance sheet for us has gotten significantly more strengthened not just because of what we’ve been doing from an operating perspective, but also when you look at we announced earlier this year or earlier this month, should say, or I should say early July, we announced the divestiture of some non core assets. By doing that, those non core businesses will be adding significant dollars onto our balance sheet in way of cash, but also at the same time significantly reducing our long term debt. We’re vertically integrated. So one of the things that we’ve been working on is trying to make sure that we sell everything we or we make everything we sell.

This has helped us in a number of different ways. One, in way of helping us at least be able to make sure that we’ve got the supply that we need. And then secondarily, the margin that comes along with making your own products. Not to mention the fact that we get to put our own twist on the different products. We get to make sure we add our quality to it.

So all the elements of being vertically integrated have come to bear here. The other piece that we offer as an investment vehicle is we have a very broad commercial reach, especially for a relatively small company. We have over four fifty IDN agreements. We’ve got every major GPO as well as over six fifty or six seventy independent agent agreements. And then last but not least, the innovative part of what we do.

So So if you looked at our long term pipeline, we got a very, very diverse product profile or product pipeline that we’ll talk a little bit in the slides ahead, but it’s something we’re really, really excited about as time progresses. So first and foremost, the sale of the noncore assets. Selling the Paradigm and Coflex businesses really backed the Scoliosis brothers. They’re the ones who originally sold these things as Paradigm Spine, quite frankly, to RTI back in 2019. As we were working with these businesses, these businesses made up about 16% of our sales over the course of time, but they took up about 50% to 60 of our sales guys’ times, never mind finance, never mind other parts within the organization.

And at the end of it, they didn’t necessarily contribute a lot from a profitability perspective. Actually, by spinning these off, we are slightly more positive. So in general, really, really great technologies just in better they’re now going to be in better hands than with us. So talking more about our Furlough service offering. So today, we do both the fixation and the biologics offering.

Clearly, you know, biologics is what we lean on. Biologics is our future. And it’s not to say that our hardware business isn’t have, you know, some really wonderful pieces to it. It’s just that over the course of time, this is something that at least from our end, you’ll hear more and more about what we’re doing on the biologics side than necessarily what you’ll hear on the hardware side. So the market opportunity, as I mentioned before, is about a $2,500,000,000 opportunity in the orthobiologic space, another $5,600,000,000 in the hardware space.

But in particular, one of the things that we’re really excited about is that we’re able to touch all five of these markets. And more importantly, we’re now manufacturing products for all five of these categories. And so this is something at least from our side, it was a real goal for where we wanted to be. I’ll talk a little bit more about that in the following slides. From a robust revenue growth over the course of the last four years, we’ve seen some really nice growth year over year.

Some of this back in 2023 was through an acquisition. But then as we start looking at what we’ve been able to do since then and with our new guidance that we laid out this morning from 127 to 131, we’ve now gone to 131 to 135. Now, this is assuming the Paradigm and Coflex businesses are still within our business. Once those businesses are officially sold which we expect to happen in the third quarter here, we’re going to reissue our guidance from there. So when you think about our focus, really our focus comes down to these three things.

First and foremost, biologics two, diversification and three, profitability. When you think about number one, biologics, it’s who we are. It’s our knitting. This is the stuff that we do. Trying to do as best as we can and I think we’ve been successful at vertically integrating these businesses.

But then also trying to emphasize that next generation of the biologics that we’re working on. And then last but not least, one of the things we’ll be working on over the course of time is creating both a clinical and a regulatory mode. We’re blessed with being a ISO thirteen thousand four and eighty five facility. As matter of fact, one of the products we sell as a biologic is a five ten product. This is an area for us that we think that we can start driving not only higher clinical outcomes, but also with a five ten regulatory pathway for some of our biologics.

We hope to actually also increase our ASPs. Secondly, from a diversification perspective, one of the things that when I first got to Xtant, over 90% of our revenues were coming from just the spine space. Today, that number is somewhere in the mid-70s. So it’s still very big, but it’s not as reliant on the spine world. And so especially when you start looking at the product lines such as our Amneal product line and soon to be released collagen based product lines, these are things that get us into the wound care and the surgical repair side.

So areas that again help us at least as a shareholder know that we’re not completely dependent upon just one specialty for where our dollars are coming. And then the other piece of this too is that when you think about leveraging our strengths, this is really the stuff that when you think about a biologics business over the course of time, from a shareholder, greater shareholder value, this kind of diversification is going to be important, especially when you think about regenerative biologics. And then last but not least from a profitability perspective, recognizing operating leverage as the business scales. So one of the things that we’ve been very, very in tune or really been focused on over the course of the last year and you’ll see it in our results this past quarter is how much we’ve been able to take drive out cost. And as we’ve been growing, we’re getting greater leverage.

So and then of course, as the great driving the greater penetration, you know, today we have all of these IDN agreements and independent agent agreements. And so today, we don’t do as good a job as we need to in way of driving the kind of penetration that we should. And so this is going be a real focus for us in the months and years ahead. The other big thing too is that when you look at our Xtant branded products, when we sell an Xtant branded product that we manufacture, we do very, very well. And so the actual gross profit dollars are significantly higher.

So I’m telling you something I guess you should probably already know. But it also there’s an opportunity for us and we’ve been able to take advantage of that, especially on our higher margin products is monetizing our excess capacity through OEM opportunities. And so this is something that again helps drive nice contribution dollars to the bottom line, not so much on the gross profit side. So vertical integration, what does it mean to us? So over the course of time, we were a business that only did demineralized bones and basically allograft.

And that made about a little over 60% of our total biologics business. And our goal over the course of what would be about eighteen months was to be able to start making our own viable bone matrix, growth factor, amnion and synthetics. And so I’m happy to say that now we’re at a point today where all of these products today are being manufactured internally. But more importantly, here we had 60% of our business tied into demineralized bone. Now if we could make something that again could drive higher average well, first of all, a better product that’s sold at a higher price that gets higher margins and from a production perspective is really, really extraordinarily efficient for us to make, that’s what we’ve been able to do with our enhanced DBM.

And that’s this new product that we just started called Trivium. And Trivium is something I’m really, really excited about because even if we are able to never even grow anything on Trivium by itself, but even start just converting 20%, 30%, 40% of our DBN business, that would be something that would be extraordinarily profitable and very accretive from a top line perspective too. Last but not least is getting into the recent innovations that we’ve had and then I’ll talk a little bit about what we’re doing from a longer term perspective. So from the recent innovations, if you look at the things that we are aiming for is that first and foremost, we want to develop best in class products, expand margins through vertical integration where possible, also make sure that we can control the supply chain because this again is something that at least from our side, we had some of our fastest growing products being held back because we were just third or fourth or fifth in line. And then last but not least, selectively expand distribution network where possible.

So if you look at over the course of the last year and a half from 2024 to where we are today, in Q1 twenty twenty four, we rolled out our first Amneal products. Second, in Q3, we rolled out our Available Bone Matrix product. In Q1 and Q2 of this year, we rolled out Trivium, OsteoFactor Pro and Fibrex. Now Fibrex was a product that we used to get made. It’s a product of about a $2,000,000 product line for us and it was a product line that was already done for or sold by the old surge line business.

We’ve taken it on, been able to increase the margins. So it’s a nice product but not new. It’s really replacing something old. So when we look at Tribune, as I mentioned before, this great new product line in our OsteoFactor Pro, which is a growth factor product. We’re really, really excited about how we’ve positioned and quite frankly, building the muscle within our organization to be an organization that’s knocking out new product quarter after quarter after quarter.

And so and again, expanding our footprint within the regenerative biologics world. So when we think about our pipeline, we laid out before you what we’ve been able to do over the course of time. But then as we start to look at some of the other things, when we get into things like the collagen based products, which we will be rolling out here in the 2025. And then getting into even greater eMatrix wound care. EMatrix is a technology that we acquired in the Surgeline acquisition.

It was actually the base collagen that had its own five ten by the way that’s tied to nanos. And so this product by itself has already done a fair amount of the regulatory work to become a surgical repair wound care product. And then the other part about this thing too is it’s also the core, as I mentioned, the Nanos. And so we are looking to be rolling out a new synthetic that’s going to have more bioactive activity. So therefore, we’ll be able to get higher reimbursement over the course of time.

So anyhow, here’s a list of some of the things. There’s a number of other things over the course of the next few years that we’ll be working on as well, but here are the big ones. Then when we think about diversifying and what diversification means to me is that there are opportunities and there are things that we make today. For instance, our Amneal product line today, there are things that we sell with our own Xtant branded product that’s sold into our spine procedures, things that are basically created as a barrier for tricky cases. But our Amnion is also sold into Wound Care which is a big part of the success we had this past these past two quarters.

But also in the near future, we could be seeing this product being sold into sports medicine and potentially one day in the nerve regeneration world. So when we think about how we diversify where our revenue is coming from, there are these opportunities. Many of them are on OEM type of opportunities, but some of them may be able to even leverage some of the national contracting that we do today. And then last but not least, when we talk about the three parts to our business is the profitability. Like I said earlier, generating operation or at least getting operating leverage as the business scales has always been a high, high, especially for a company that has been capital constrained.

You don’t lose those types of lessons. Second, driving greater penetration of distributor and IDN contracts, big, big focus for us, especially given the fact that over the course of the last year or actually over the course of the last two years, when we basically doubled the number of IDN or I should say, doubled the number of IA or independent agent agreements because of the Surgeline acquisition, we’ve not done a great job of getting greater penetration. So there’s a real, real opportunity for us to get more of their spend than we have today. And then driving sales of Xtamp branded products as I mentioned before, very, very profitable for us. Also something needless to say drives the brand.

And then last but not least, where possible, we want to monetize that excess capacity through this OEM and contract manufacturing. One of the things I should note about this is that even though the Jeep, the gross profit margins when you sell the product isn’t great, our contribution margins, especially on the higher end stuff, gets in the 50% to 60% range. So it’s actually from a contribution margin something very, very good without having to pay a rep’s commission so to speak. So when you look at our improving financial profile, as I mentioned, we just laid these out for this 2025. We’re extraordinarily happy with how we’ve come out, especially when you look at the cash that we’ve been generating, when you look at things such as one of the things that’s not listed here is the fact that at the end of Q2, we had $7,000,000 of cash on our balance sheet but what it didn’t count is the royalty dollars that were coming in.

So that was roughly another 4,000,000 to $5,000,000 And then on top of that, when you throw on the $9 plus million that we’ll be adding from a cash perspective in the near future, you know, we’ll be over $20,000,000 of cash on the balance sheet. So one of the things that was a knock against our business in years past is not having enough cash. I think we’ve been able to answer that. And moreover, I do believe that as we generate more cash from the business because that’s where we are today, that number will continue to grow. And then to summarize things, again, I think this is a very compelling, especially where we are in our business or at least in our company’s history.

We’ve got a large market opportunity. We’ve got a high growth and profitable business. We’ve strengthened our balance sheet with the moves that we’ve made to reduce or at least to refocus the business on our core business. We are fully vertically integrated today, which is again something that’s helping us at least from driving higher margins and really controlling our own destiny. When you look at our broad commercial reach, it’s a great, great, great, great opportunity that we’re just really scratching the surface on what we could be doing there.

And then last but not least, the innovation that we’ve been driving, especially when you start looking at not only the products that we’ve made within our own orthobiologics space, but also as we’ve expanded beyond just the orthobiologics world. So with that said, I will I guess open the floor for any questions. Yes, Ms. Caitlin.

Caitlin Cronin, Med Tech Team, Canaccord Genuity: So

Sean Brown, CEO, Xtant Medical: the commercial as I look at it, it’s kind of twofold, right? When you think about the world of spine, let’s break it out that way. From a spine perspective, so many of the independent agents that we work with think hardware, hardware, hardware, hardware biologics, right? And so and we still carrying hardware, we still have some of that as well within our own business. And so I think over the course of time, as our biologics space or biologics business continues to grow the way it is, I hope that we can get more mindshare of my own guys first and foremost and then be able to therefore get greater mindshare of our independent agents.

And so hardware is a very, very alluring thing because think about it in an average case, it’s probably 75% to 80% of the cost is in the hardware. And so from a reps perspective, they look at it and say, voila, I can meet my quota on one guy here versus having to go out and get the four or five guys that you need to get. So that is what’s going to evolve over time. It’s just that our broader and more no, I shouldn’t say broader, our more focused attention to those biologic cases. Yes, sir?

So with that surgical paradigm divestiture, what’s remaining hardware space? So we have about it will be about $23,000,000 of existing hardware based adult degenerative bread and butter type of product lines. So it still serves a nice role for us. But we’ll the question is how long do we have it, right? And so that’s still out there.

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