Align Technology, Inc. (ALGN) Earnings Call Transcript & Summary

June 11, 2020

NASDAQ US Health Care conference_presentation 41 min

Earnings Call Speaker Segments

Nathan Rich

analyst
#1

Good afternoon, everyone. My name is Nathan Rich, and I cover the dental space here at Goldman. Thanks so much for joining us this afternoon. We're very pleased to welcome Align Technology to our conference today. I'm joined for this session by the company's CFO, John Morici; as well as Madelyn Homick from Investor Relations. [Operator Instructions]

Nathan Rich

analyst
#2

So with that, John, thanks so much for being here today. Maybe to start, could you just kind of give us an update on your business since you kind of last spoke to us on the first quarter call?

John Morici

executive
#3

Yes. Thanks, Nate, and welcome and happy to be here to speak with you and everybody today. When you look at our business, pre COVID and now post COVID, we're in a vastly underpenetrated market. On the orthodontic side, through all these years of the 12 million plus orthodontic case starts that we do -- that we have in a year. The vast majority are still done with wires and brackets on a pre-COVID basis. And we have a huge opportunity outside of that kind of the expansive market, where there's a 300 million plus potential patients that want to get some teeth straightening and have the economics to afford that. We saw this pre COVID. That demand is still there post COVID. Now it turns into how do offices open up, what restrictions that are lifted on a country-by-country basis and then within country, on a region-by-region basis. We talked a lot about at earnings about how, to use China as an example, that as China starts to open up, you see regional differences. Areas that were more impacted, maybe open slower and have different restrictions versus other areas. And that plays out in every place that we operate in. We're doing everything we can during the crisis and now post crisis to be able to enable our doctors to be able to treat their patients in the most safe and effective way. So a lot of tools around visualization, helping them with kind of the remote monitoring, making sure that they can treat their patients in a safe way that meets their needs as a patient meets the needs and safety that you need in the office. It meets the needs so that as offices open up, they might not be able to see 100% of the patients. They might be limited in terms of who they can see and when. And we want to provide as many tools and opportunities to our doctors to enable them to succeed in this changed world that we're in. So areas are opening up. We're excited about that. We want to be able to provide as much as we can to our doctors to enable that recovery. And we get into specific questions that you have and what we're trying to do.

Nathan Rich

analyst
#4

Sure. No, that's a great intro. Maybe starting with the U.S. business. Obviously, a lot of practices are now opening back up, like you mentioned. I think the other thing that we've heard at this conference so far has been that there seems to be demand for patient -- from patients to come back in and see their dentists. I guess, could you maybe comment on what you're seeing specifically in the orthodontic community? Have they seen the same type of pace of reopening and return of patient traffic that we seem to be seeing in dentistry more broadly?

John Morici

executive
#5

Yes, you're right. And again, it varies region-by-region in terms of how things open up and what's allowed and in terms of a capability standpoint for those offices. The general dentists, obviously, they're dealing a lot with -- during this time period where they couldn't see patients. They're doing a lot of catch-up in terms of hygiene and fillings and other more restorative type work that they're doing as well as straightening teeth, but maybe the priority has been to catch up on some of that. Whereas in the ortho side, especially on the teen side, from a seasonality standpoint, this becomes more of a demand from a teenage standpoint to get into treatment based on their age and kind of in between school years and so on. So there's a large opportunity. And we see ortho clinics, maybe as ortho practices coming back a little bit faster as a result of that.

Nathan Rich

analyst
#6

Great. And in the markets where you do have a little bit more of a history to look at, whether it be China that's been opened a little bit longer. Has there been a difference between how quickly comprehensive cases have come back versus the simpler, maybe more aesthetic cases? Are you seeing any difference there?

John Morici

executive
#7

It varies. You're going to -- again, if you have teens kind of based on that seasonality, you're going to have those just kind of by definition, or comprehensive cases. So you see those as teenagers come in. But it varies. I think what we see is just in general, as those offices open and as those doctors are open for business, we see volume coming through. And we're trying to do everything we can to provide tools and productivity improvements and safety so that those patients could come in, see their doctor and do it in a safe and effective way.

Nathan Rich

analyst
#8

And for the adult market, can you remind us what the typical selling cycle looks like that from when the patient first comes in and maybe ask about treatment or first sees their dentist to when they decide to move forward with getting aligner treatment done. What does that process typically look like?

John Morici

executive
#9

It will vary, Nate, over different locations and kind of the type of treatment that's needed. But just in general, you'd have some type of scan to be able to show the dentition as is many times a doctor and through some simulation and other ways, we can look at the picture of their teeth as they are now. Be able to provide a simulation as to what their teeth are going to look like with treatment. Very powerful to help sell the case as a doctor talking to the patient right when they're there. If you can get that commitment that they want to go forward, then there's some back and forth work that goes on with the doctor and our technicians to make sure the final positioning, the way the treatment is going to proceed, maybe with attachments or without attachments or certain ways that doctors want to treat. There's some back and forth work that goes on. But when you factor all that together, it varies 2 to 4 weeks in terms of kind of the -- from the initial scan to when that patient, if they do accept, goes into treatment.

Nathan Rich

analyst
#10

And then from there, once you get the finalized treatment plan, is that like the 3 to 4 weeks that you've talked about, I guess, between like order receipt and when the case would be fulfilled and sent to the doc?

John Morici

executive
#11

Yes, I would look at it more of 3 to 4 weeks kind of from that initial scan and kind of that initial point of it and then because some doctors move very quickly, and they know how the protocols are to be able to treat their patients. They do a lot of volume. They know quickly on how to get things to completion with the technicians that they use. Things can move quickly. And once it gets into our manufacturing center, it's a matter of queuing that up and manufacturing then shipping. So it'll vary based on the time of the month and the kind of the quarter in terms of our volumes, but we've got that process down pretty close.

Nathan Rich

analyst
#12

Got it. So that like 3 to 4 week lag is kind of what -- that's the right range to think about when we think about when the patient could show up in the dentist office between when you would potentially recognize revenue for our case?

John Morici

executive
#13

That's correct.

Nathan Rich

analyst
#14

Okay. And then, John, how are you thinking about your marketing plans as practices open back up? Are you planning anything different than what you would do in a normal year as you kind of think about helping the doctors to kind of help jump-start demand?

John Morici

executive
#15

Yes. I think, Nate, when you look at it broadly, we're a company that, as I started in my opening that we're in a vastly underpenetrated market. There's a huge opportunity on the traditional side of these orthodontic case starts and on the expansive market that we see on some of the minor lower stage cases that we can sell. And when we look at the investments that we're making, of course, during this crisis, you make trade-offs in terms of some of the -- how you market, the frequency, the manner that you do things to be able to market. But let's face it. At this time, we've got a lot of people at home, a lot of people on social, on their phones or computer or even watching TV. And we want to be able to make sure that we are capturing them, capturing those -- that interest in the right way and be able to make sure that it's top of mind, let them understand the benefits, what it could offer to them, give them that understanding now such that when the offices open up, and they have the opportunity to come back. We're a product that they want to use, and they ask for it by name. And then we're also doing things with our doctors during this time, the crisis. The training, online training. We kept our sales team and that sales team is able to reach out to doctors and spend time with them during this crisis and now during the recovery. And we think that's important to be able to help bring the businesses back to where they were.

Nathan Rich

analyst
#16

And it sounds like you're still seeing teens kind of show up at the orthodontist. Can you maybe just talk about what you're expecting for this upcoming teen season? We're kind of getting into the few months kind of the typically most important for the teen market. Assuming kind of orthodontists are able to keep their practices open, do you expect this to be a relatively normal teen season this year?

John Morici

executive
#17

Look, it's tough to say, Nate, because on top of this, you have the virus, that it could have an impact, an unknown impact as things open up or if there's other concerns and relapse or other things. But then you have the underlying unemployment and economic uncertainties that this has brought. So in the end, we're -- just like many companies and many products, it becomes discretionary in the end. And we think less so with teens. I think for the reasons I've mentioned earlier, you get to a certain age, you have crowding and space requirements. You need to expand things out or you need your jaw aligned as your teeth are being straightened with mandibular advancement that can provide that. So there's some windows of opportunities that you have to be able to provide that care and provide that benefit to those patients. And then there's a window of opportunity from a timing standpoint from the fact that it's better to do in the summer as you go from maybe one school year to the next. So there's various reasons for it, but it depends on the overall economy and kind of how things progress. But we're working everything we can to try to increase our volume as much as possible, but it's very dependent on those offices opening up and the ability for patients to want to come in for treatment.

Nathan Rich

analyst
#18

Yes. And one of the questions we get a lot is how sensitive the consumer is to the economy and to unemployment and when they're thinking about getting orthodontic treatment. Do you feel like -- we can obviously look back at the last recession and kind of see how the business trended. I guess I'd be curious just to get your view. Do you feel like that's an appropriate reference point or comparison to make when thinking about the impact of a potentially prolonged period of unemployment post COVID?

John Morici

executive
#19

Well, look at it from the standpoint, there's two viewpoints that you can have, kind of one from a macro standpoint, kind of economy standpoint and one maybe as our company is different from 2008. Obviously, 2008 it was nothing to do with a virus or anything that was happening kind of in the marketplace like this. It was bank driven, in many cases, debt and other financial instruments that caused some of this problem, housing market concerns and so on. And a lot of concerns on whether banks were going to even make it and survive. And many didn't, as we know. And that caused a lot of instability during this time period and took us a number of quarters to recover. We, as a business -- even though it is discretionary, we as a business, were impacted, but maybe not as much as some other industries and some other impacts. I think when you look at our business back then compared to where it is now, back in 2008, we were mostly a U.S. North American company, 80-plus percent of our revenue would have been a kind of U.S.-based. We didn't have iTero. We didn't even have a scanner business. So that was pretty cadent acquisition. It was back at a time where we were trying to grow in teens, but we didn't have mandibular advancement, Invisalign First, some of the new technologies and how to move teeth with SmartForce and SmartStaging and SmartTrack material and 1 week wear and all the different innovations that we've been able to come up with, dramatically different business. So you look at, the products were different, we're much more diverse now. As we sell into the world, much more diverse where now just over 50% is from North America. And we have just under 50%, that is OUS. So a product being different and just the technology that we bring to market being different. So we think that as things evolve, we've been able to provide a lot of tools and virtual technology, giving our doctors an opportunity to be able to navigate in this new world. Obviously, there's still virus concerns, and that affects the market. It affects how doctors are practicing and doing things to accommodate to those changes. But we'll provide tools to our doctors to make it as safe and effective as possible.

Nathan Rich

analyst
#20

And how much of the business today from like a volume standpoint, is there some sort of insurance coverage involved? And if you could maybe kind of break it apart between the teen market and the adult market?

John Morici

executive
#21

Well, many employers in the U.S. and in certain countries, not all countries, by far, have some type of insurance plan that they'll pay for a certain amount of coverage. In the U.S. maybe it's $1,500, $2,000 that they'll pay for coverage. Whether you're -- if you've never used it, whether you're a teen or an adult, though, many times to give that from a reimbursement standpoint. Other countries, some don't do it. Places like China, there's no reimbursement. So it varies kind of country by country. It doesn't necessarily matter between ortho and GP in the U.S. It just depends on the plan that you're in, in terms of what that reimbursement is.

Nathan Rich

analyst
#22

Okay. Okay. And then maybe looking at the international markets for a minute. I guess, starting with China because you gave the stat on your last call that case receipts were, I think about 80% of the mid-January kind of pre-COVID levels at the time you reported. Were you surprised by how quickly you saw China bounce back to that level? And can you kind of maybe just give us a sense of what drove that type of, what we think is kind of a relatively quick recovery in that market?

John Morici

executive
#23

Yes. And I would say, and I think we talked about on the call, China is not necessarily an example for every other country in terms of their coverage, because you've got -- I think in China, they were able to quickly stop activity. So you saw a dramatic drop in volume, just by shutting things down and saying, no, you can't go out. There's no movement, and that limited activity dramatically initially. And then as the recovery has happened, they've been able to open up clinics and hospitals and dental practices, to be able to see that improvement. And what we saw at earnings, which was about 3 months after that shutdown, that we're about 80% of where we were pre-COVID, and that was good recovery. But it's a reflection of kind of that -- the government's kind of planning out how things are going to open up and be able to recover. What we did mention and we do see, and it really holds in every region, as the recovery happens, it varies. It's not one country does everything the same way. Even in China, as we've seen the recovery and we talked about at earnings was like Wuhan, where's more of the center of the virus, was slower to recover and Shanghai didn't maybe get as affected and came back faster. I think you see that across the U.S., you see it across other countries where certain regions come back differently. States open up differently, even counties and regions within states to open things differently. But in all cases, when that office is open, people come back. And we want to make sure when they come back, that our doctors have the best tools, capabilities to be able to treat these patients. Because it's a different world. When they come back, maybe they can't -- maybe instead of sitting right next to each other, they have to sit every other chair, can be utilized. Or you can't wait in the waiting room, or you can't have some of the normal ways that you interacted in the past. We think we can help provide a lot of tools and a lot of ways to be able to minimize some of that chair time. We know that we can be, our product with Invisalign, it can make those doctors more productive. We also think that, that productivity can turn into more profitability and being able to sustain the revenue that they have, so that as things change in the world and things become impacted or not impacted, we have that -- the digital platform that allows those doctors to be able to operate in this uncertain world.

Nathan Rich

analyst
#24

And how do you see that treatment model evolving? I mean do you feel like you're at a point today with the tools that you offer to materially reduce the number of visits that a patient would potentially need to make during the course of their treatment to make it easier, I guess, to do treatment in this type of an environment?

John Morici

executive
#25

Yes. And when we look at this, Nate, prior to COVID, we know we have a -- through our digital platform, the -- providing that digital outcomes to -- for our doctors and ultimately to the patients, we knew we were more productive than wires and brackets. It simply comes down to, you don't need as many office visits to be able to provide the treatment. And prior to COVID, we talked a lot about the productivity that we would drive. And many doctors use that productivity to drive more revenue. They would have now the ability to treat more cases and use that productivity to drive profitability. Post COVID, that dynamic still remains. But now it's become even more imperative to have that productivity because patients may be coming into the office, they don't want to spend a lot of time in the chair. They didn't want it before COVID. They certainly don't want to now. When you have the staff that's providing care, like I said, you're going to have maybe every other chair or different ways that they're going to have to spend time treating patients, they're going to be able to see less perhaps. And doctors and the staff don't want the exposure in. So they're going to have to find ways to be more productive, to be able to maintain the revenue that they had, let alone increasing revenue. And we think we can provide through this crisis by keeping our R&D people and salespeople and so on, we've been able to accelerate some of the tools to be able to help those doctors post-crisis or even during the crisis, but now post-crisis to be able to provide remote care monitoring. You started a treatment, and now you're going to be able to have that doctor be able to look at a Skype meeting or some type of visualization to that we have to be able to see is it tracking properly, take a picture, compare this to, are things moving the right way, maybe not, okay, you need to come in and get a scan so that we can course correct that and make that better. Or it's tracking right, go on to your next one, let's talk a month from now. No one has to have exposure. Nobody is using that chair time. It's better for the doctor, it's better for the patients. And I think what it does is it really resonates with a patient from the standpoint that they know that they're going to get the doctor quality care that they want, but in a way that's going to provide that safety for that patient. And it's going to provide peace of mind for that patient that they know once they start treatment, they're going to be able to finish it. You're not going to be stuck in wires and brackets for months or weeks without movement happening. You can move to the next aligner. And through that monitoring, see if things are tracking the right way. And in many ways, a doctor will look at that as well and say, look, my practice, whatever the mix is Invisalign versus wires and brackets. Wires and brackets require people to come in a lot and you're very dependent on; is that office open, is there a relapse, is there more concern from patients, are they going to cut my number of capacity from 50% to 25%. You've got a lot of unknowns that are outside of their control. And by using Invisalign, you can minimize some of those and I think doctors will recognize that, that's maybe a more stable source of revenue.

Nathan Rich

analyst
#26

No, makes a lot of sense. Maybe the last one on this topic of COVID. I know we spent a lot of time on it. I did want to get just some big picture questions. How are you guys thinking about the potential for a second wave? And how might that look similar or different to kind of the initial outbreak of what we've just been through.

John Morici

executive
#27

Look, Nate, it's tough to tell and how to forecast this. And I think that's why many companies -- most companies have suspended 2020 guidance because it's difficult to know, as the crisis has happened. And then as the recovery happens, it's difficult to know how that recovery is going to play out. I would say this. I think we, as a country and maybe the globe is a little bit more understanding about the virus than we were 3 months ago in terms of how it's spread, the different dynamics about do you need to shut down everything? Or maybe you can shut down certain parts of the economy to prevent the spread, protect your vulnerable in a way to make sure that they are not impacted, whereas other places can with protection and with social distancing, they can operate more on a more normal basis. So I think we're smarter about what's happened and maybe what we go forward with. I think what you'll find is certain regions will -- you might have an impact where there's an outbreak or some spread that will be impacted. But I don't think you're going to get the countrywide impact that we saw maybe in the past. And I think that it helps with understanding, it helps with testing and some of the other variables that we were lacking in the past. But again, we're going to work with our doctors, with our customers to find ways to help them through this. And really, the more that we can provide them with tools to be able to help them navigate in this new world. We think that's a real positive for the industry.

Nathan Rich

analyst
#28

Okay. Great. So I wanted to take a step back. And first, ask on the kind of 3 to 5-year financial targets that you have, the 20% to 30% revenue growth and the 25% to 30% operating margins. I guess, on top line and maybe kind of putting the current pandemic aside for a second, assuming we get back to a more normalized operating environment. Has the company's growth algorithm changed at all? I think in the past, the way that you got to that 20% to 30% top line growth rate was growing orthodontic utilization of the ortho kind of base and then also growing the international footprint and growing utilization there. I mean is that the same type of general formula that we should expect to see going forward in terms of getting to that 20% to 30% growth level?

John Morici

executive
#29

I think you hit it the right way, Nate. I mean we start with a vastly underpenetrated market. So when you think about the traditional orthodontic cases or the expansive market that we're talking about, where there's minor movement that a potential patient wants. The market opportunity is huge. And when we think that with a qualified doctor, they should be able to do 80-plus percent of the cases out there. And yet, we're 11%, 12% of the market on the traditional orthodontic case starts and even less when you factor in kind of the 300 million potential patients on a worldwide basis. So we start with a vastly underpenetrated market. And we are investing in products and processes to make products better and more productive for our doctors. We're investing in marketing to drive that awareness, be able to reach those consumers where it makes sense and interact with them even during this crisis, where we thought it was very important to keep that interaction to help with the growth when we come out. And our sales force interaction, the training, the explanation of how to take on these cases and things that they can do to help drive productivity within their practice and the use of iTero and creating the digital platform and so on. All of that's very important to continue and so with all those investments and that market opportunity, when we invest and look to growth, we have a view that it should be within the 20% to 30% [ lower ] investments that we're making into this growth opportunity should keep us at this long-term growth opportunity of 20% to 30%.

Nathan Rich

analyst
#30

And you've positioned Invisalign as a premium product in the market. We've seen competitors come into this space sort of across the price spectrum and across channels. How do you maintain that value proposition with the doctor? And how do you make sure that you kind of remain price competitive? Is the Advantage Program that you have, do you feel like that's kind of your best lever to say, hey, if you do more cases, you get the discount, you're more price competitive with maybe the other options that are on the market?

John Morici

executive
#31

Well, Advantage is certainly one. It's not -- we don't have Advantage in all markets, but Advantage is really around providing benefits to doctors as they do more and more cases, they increase their utilization, increase their share of chair of Invisalign. There's added benefits that they get. And some of that -- price benefit is one of them. But we have a lot of opportunities to be able to try to grow utilization. Some of the promotions that we run to really drive those right behaviors, whether you're in teen season or you're a new doctor starting and you really want them to start doing some new cases and get started with this. We've done a lot of things around helping provide financing to our customers, some of the working capital benefits that we've been able to provide where we extend some payment terms and really get that good partnership that we have, doing things externally from an external finance standpoint to be able to provide this external financing to potential patients and have them come in to be able to have this financing in hand and ideally going to treatment so that the doctor gets paid right away, and so do we, and that's a cash benefit. So there's a wide variety of things that we do to be able to help to drive that demand. It starts with having the best product on the market and something that we've developed over time to be able to help doctors treat from the simplest or easier cases all the way to the most comprehensive cases. And everything in between.

Nathan Rich

analyst
#32

And how do you see pricing to the consumer evolving? Obviously, they're kind of -- they have several choices, whether it's wires and brackets, it's clear aligners, the direct-to-consumer model. If we play this 2 or 3 years forward, how do you see pricing to the consumer changing over that period?

John Morici

executive
#33

I think one of the questions you get a lot from the consumers, one of the first questions they ask is how much does it cost? And I think people want -- they want quality, and they want to make sure that what they're getting is what they paid for. And I think when they look at the cost of things, if you can give them the benefit of something that is, maybe it doesn't take a lot of aligners. It's easier movement. You don't have to have as many office visits. If you can price something and where you still see the doctor where you -- upfront and be able to provide that care throughout the process and then finish so that the doctor can understand how things have moved. And did you get the outcome that you want? If you can do that in a cost-competitive way for that consumer, they understand that things might cost a little bit more when you see that doctor. But you get that added benefit from that doctor and -- but you -- they can -- there's a trade-off for that and that you don't want to be too high in terms of what you're charging, but you want charge that right amount. And I think if as a consumer, you recognize that and you pay for some of that added care, and so I think that's where things will be from that kind of that consumer side of things. I think on the orthodontic, more traditional orthodontic care, I think that's one where you're going to see varying prices in certain markets, just based on what that orthodontist would charge in those locations.

Nathan Rich

analyst
#34

And Invisalign Swift is a pilot that you were working on to kind of put a lower price point out there for the consumer, to potentially get them kind of in the door to the dentists. And if they were maybe more price sensitive, encouraging them to kind of go forward with treatment. The pilot like you guys have talked about was sort of interrupted by COVID. I guess, how long would you have that out in the market before you would make a decision whether to -- is that's something that you'd want to roll out more broadly or not?

John Morici

executive
#35

Well, like you said, some of that launch, it was just a test and limited and then COVID hit and so on. Look, we'll evaluate things to try to get the right understanding. Really, our focus now is the recovery and how we let our doctors get into that recovery for a lot of the tools and initiatives that we have. But ultimately, we want to help our doctors be able to drive conversion, being able to access the market, being able to use the best product on the marketplace. So we'll evaluate things and try to get to that right outcome. But right now, we're focused in on the recovery and products like that will be -- could -- as they evolve, will come down the line.

Nathan Rich

analyst
#36

Okay. Makes sense. And going back to the doctor-directed market, a number of the dental manufacturers have kind of launched competing clear aligner products over the last several years. I think they've had varying degrees of success with gaining traction in the market. Have you seen any change from how they're going to market? Or how they're pricing their product relative to 6 or 12 months ago?

John Morici

executive
#37

No real change that we've seen. I mean there's different strategies that they'll use where some use a combo product, where it starts with wires and brackets and goes to a clear aligner. Some will bundle things with maybe implants and others. But from a technology standpoint, the product itself, the treatment planning and so on, there's no technology that we're seeing that is different than what we've seen in the past. It's much more of when there's a comparison, it's, well, we're almost as good as or similar to, and then they'll explain their situation. But from a product standpoint, a process standpoint in terms of what their products look like and how their digital platform is set, there's nothing that's in the marketplace that is out of the ordinary and surprises us in any way.

Nathan Rich

analyst
#38

Okay. In the few minutes that we have left, I wanted to ask a couple of questions on margins. First, just in the near term. Like you said, you guys haven't provided guidance. How should we think about the margin impact on the lower revenue? And can you kind of talk about what percent of the cost base is fixed versus variable as we think about what like the decremental margins might be?

John Morici

executive
#39

Well, I think when you look at, especially in the short term, and you're right, we have not provided guidance. And -- but we've made it clear that we've kept our employees. We're keeping that, it's important to us as the team that we have and how they can really work during this time period to aid in that recovery and how important it is. That has a short-term impact on margins, where you've got salespeople who are still part of the team, but they're not going to offices that are open. Or you have manufacturing where you have a manufacturing capability to manufacture a lot more aligners than you would have during the shutdown. So there's a variable and a fixed component to this, but in the end, there's -- those costs you're going to have regardless of the volume that's going to come through. And I think short term, you'll see some of that impact. But I think as we start to recover and we grow and add to our volume, you see improvements from there. But short term, as any company would have, there's only so much cost that you can adjust in the short-term because you've built capacity for a much bigger business. But as the -- like I said, as the economy improves and as some of the unknowns become known, you can make some of these investments to continue to grow.

Nathan Rich

analyst
#40

And I think your kind of general view has been, you didn't want to cut too much in the short term because you want to be kind of on your front foot for when things start to improve.

John Morici

executive
#41

Yes. I mean what I started with is it's a vastly underpenetrated market. We want to make investments to be able to capture that underpenetrated market. So we had made decisions on how we're going to allocate our resources, but it's really for that goal in mind that we think that we have the best products, best solution to our doctors who can provide the best care to their patients, and we want to be able to keep that momentum going.

Nathan Rich

analyst
#42

Great. And then just the last one before we wrap up. Going back to the longer-term operating margin targets. What -- how do you see the company achieving that? What's the breakdown between gross margin expansion and leverage of expenses? Again, kind of, is it mostly, if you hit the 20% to 30% revenue growth, you get leverage off of that and that's sort of what naturally increases the margin over time?

John Morici

executive
#43

You get leverage from that, definitely. And that shows up in gross margin, it shows up in op margin as well, where you get that investments that we make. We look at the ROIs on those investments. So we want to grow top line above 20%, but we want to grow it in a way that drives that op profit margin of 25-plus percent. And you get it at various phases where sometimes you make the investment, you see that leverage afterwards. Sometimes it's by region where you've already invested. You maybe have a higher op margin, whereas other places, you're just putting in infrastructure and your op margin is impacted there. But when we think about the investments that we make as a business, how we go to market and how we evaluate products and projects that we're doing. It's with that 20-plus percent volume growth and 25% to 30% op margin.

Nathan Rich

analyst
#44

Good. Well, it looks like that's all the time we have. John, thanks a lot for joining us. It was really great to have you on. Everyone on the webcast, thanks a lot for tuning in, and we hope everyone has a great day.

John Morici

executive
#45

Great. Thank you, guys.

Nathan Rich

analyst
#46

Thank you.

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