Thomas M. Prescott
Analyst · Roth Capital Partners
Thanks, Shirley. Good afternoon, everyone. On the call today, I'll provide an overview of our first quarter results and discuss the performance of our 2 operating segments, Invisalign clear aligners and scanner and CAD/CAM services. In our release, I'm sure you noticed a charge we took against our scanner business. Roger will cover our Q1 financial results, including the discussion of that charge, as well as our outlook for Q2, and then I'll come back for a few closing comments and some questions. Q1 was a solid quarter across the board. We started the year out with better-than-expected revenue and earnings, driven primarily by record Invisalign case volume. Strong Invisalign case shipments in North America, especially among orthodontists, reflect stable patient traffic in our customers' offices as well as continued sales and marketing activity to encourage doctor engagement. During the quarter, we launched SmartTrack, our next-generation aligner material, which is now the standard for Invisalign clear aligners worldwide. We have received consistently positive feedback from our customers and their patients as they move beyond initial usage. We're excited about the potential for SmartTrack to help build even greater clinical confidence so our doctors who will utilize Invisalign more often and on more complex cases due to the improved control of tooth movements and the added benefit of increased patient comfort. Let's get started with an overview of key highlights for Invisalign. For Q1, total Invisalign case shipments grew across all customer channels to a total of 98,200 cases, an increase of 15.1% year-over-year and an 8.5% increase sequentially. Year-over-year growth was driven by increased Invisalign utilization, especially among North American orthodontists, as well as customer base expansion for North American GPs. The sequential increase in Q1 primarily reflects strong growth among North American orthodontists as well as good growth from both North American GPs and international doctors. The uptick in North American Invisalign case volume we saw as we ended the year continued throughout Q1, reflecting steady patient traffic in our customers' offices as well as traction from customer engagement and practice development activities. Switching briefly to our performance among the teenage patient segment. We continue to make progress here as more teams are being treated with Invisalign. This quarter, teenagers treated with Invisalign increased to 23,100, a year-over-year increase of 29% and a sequential increase of 13%, a positive direction as we head into this year's summer season. From a product perspective, the Invisalign Teen product increased 27% year-over-year and 12% sequentially, primarily driven by North American orthodontists. From an Invisalign product mix standpoint, growth was primarily driven by utilization of Invisalign Full and Invisalign Express products. This quarter, we saw positive uptake of Invisalign Express in North America and, to a lesser extent, Invisalign i7 in our direct European countries. These products to treat minor malocclusion grew a combined 47% year-over-year and 19% sequentially. Adoption of our newest offering, Invisalign Express 5, was driven by both our ortho and GP dentists in North America as many took advantage of a $200 off promotion we ran during the past quarter to spur increased trial and repeat usage. For North American orthodontists, Q1 case volume -- Q1 Invisalign case volume of 38,000 cases increased nearly 18% year-over-year, reflecting increased utilization of Invisalign as well as cases from some newly trained doctors. Sequential growth of 13% was driven by increased usage of Invisalign, especially among higher-volume orthos. We believe the interest in SmartTrack may also have played a role in this improving level of engagement among orthodontists. For North American GP dentists, Q1 case volume of 36,700 cases increased 11% year-over-year and 6% sequentially, reflecting continued expansion of our GP customer base and slightly lower utilization due to this larger customer base on a sequential basis. Q1 Invisalign case shipments outside of North America increased 17% year-over-year, reflecting growth across direct and distributor geographies. On a sequential basis, Q1 Invisalign case shipments increased 5%, a bit better than expected, with good growth from our direct countries in Europe and Asia, offset somewhat by our distributors. In Europe, we continue to make good progress in our core direct countries. Year-over-year growth was led by the Central European countries of Germany, Switzerland and Austria, as well as solid progress in both France and Spain. On a sequential basis, Spain and Italy were up nicely despite the widespread economic challenges there. Across Europe, we continue to focus on clinical education programs as a key lever to help expand our customer base and increase utilization of Invisalign. In Q1, we trained a large number of new customers and have been working to reengage doctors who had previously been trained but did not submit any cases. We've also seen good uptake from the launch of Invisalign i7, our minor tooth movement solution, which is now available in all direct markets in Europe. Early results from our pilot in the U.K. suggest that many of our existing customers adopted i7 for minor correction cases instead of using competitive products. New customers have also reported they are adopting Invisalign into practice based partly on the potential offered by i7 in their practices to treat those minor malocclusions. Turning to Asia Pacific, I'll spend a little more time in this geography than I typically do, given some significant recent developments, one being the addition of our new Vice President for the region; two, the transition of our Asia Pacific distributor into a direct sales region starting May 1; and three, with all that in hand, the formation of a Pan Asia Pacific organization. Starting with results for the region, during Q1, our direct Asian country markets of Japan and China continued to make great progress, albeit off a small base. In China, our strategy of leveraging key opinion leaders and focusing on top providers is contributing to continued strong growth in the targeted major cities of Beijing, Shanghai, Shenzhen and Guangzhou. We continue to see growth from our most experienced providers, driven by evolution in product and technology with Invisalign G3, G4 and now SmartTrack, as well as by word-of-mouth and increasing interest in Invisalign among GPs and orthodontists. In Japan, Q1 was a strong quarter for Invisalign case shipments, and I'm very pleased to see real progress in this market. The strength in case growth is driven primarily by mid- to high-volume orthodontists as well as from the cumulative impact of training more doctors over the past few quarters and then getting these practices started with Invisalign. It's good to see this growing interest and a positive response to our continued cycle of innovation, which is essential to treat these more complex cases. Shifting now to geographies covered by our Invisalign distributors in the APAC, EMEA and Latin America regions. Q1 was up nicely year-over-year and yet down slightly from Q4. On May 1, our Asia Pacific distributor will transition back into a direct region for Align, and we are excited about becoming more directly involved and engaged in this tremendous growth opportunity. We recently announced the hiring of Julie Tay, an experienced global medical device executive from both J&J and Bayer, to run our Asia Pacific operation. Julia has already spent time pulling our teams together in the field and is focused on ensuring great execution for all aligned products and services in this Pan Asia Pacific region. This widespread set of countries represents one of the best global growth opportunities for Align Technology over the next 3 to 5 years. Now let's turn to utilization and training. We continue to focus on expanding our customer base, primarily among North American GPs and international doctors, as well as increasing utilization among new and existing practices. For Q1, total Invisalign utilization was 4.3 cases per doctor, an increase from 4.1 in both Q1 of 2012 and Q4 of 2012, driven primarily by North American orthodontists, followed by international doctors and North American GPs. During Q1 of 2013, we trained a total of 1,660 new Invisalign doctors, adding 65 North American orthos, 690 North American GPs and 905 international doctors. Pivoting to the topic of product innovation. On January 21, we announced that our next-generation aligner material, SmartTrack, is now the standard of aligner material for Invisalign in North America and most international markets. The commercialization for SmartTrack was initiated in North America, as it was announced during our Ortho Summit in Las Vegas last November, followed by -- shortly thereafter by the official launch in January. Now, with SmartTrack in use for almost a full quarter in North America, we continue to receive positive customer feedback from doctors and their patients. In a recent customer survey, 80% of respondents cited SmartTrack product improvements as the reason why satisfaction was up for Invisalign. When asked, "What new orthodontic product or trend excites you?" SmartTrack was top for both orthos and GPs. Based upon detailed data and clinical evidence demonstrating superior performance, doctors report SmartTrack gives them more confidence to use Invisalign more often and on more difficult cases. During Q1, SmartTrack was also launched outside of North America, and we're now starting to get some initial feedback from the international customers. In Europe, our doctors welcomed the SmartTrack launch, with over 870 doctors attending high-impact clinical education events across 11 major cities in February alone. Feedback from our customers confirms the benefits of delivering consistent moderate force and ensuring precise aligner fit. They also love hearing from their patients about better comfort. As a result, many customers are considering expanding the range of applicability and trying Invisalign on even more complex cases. In March, we held an Invisalign SmartTrack clinical seminar in Tokyo, with more than 150 Invisalign providers attending the event. This is the largest number of Invisalign doctors to ever participate in an Invisalign event in Japan. Our integrated consumer marketing platform has historically been focused on the North American market and combines paid media like print, broadcast and digital along with a mix of traditional PR and event marketing, all surrounded by social media outreach. The goals of this platform are to generate awareness of and preference for Invisalign and Invisalign Teen as the best options for a healthy beautiful smile among women, especially moms, and teens. Increasingly, as our business evolves in key markets like Europe, we are utilizing consumer strategies also help drive growth. Q1 was a strong start to the year in terms of traditional media outreach. We secured national broadcast coverage on The TODAY Show and The Doctors, reaching combined audiences of more than 9 million consumers. We also kicked off an exciting new program targeting the important adult female market with the Invisalign wedding campaign. This new campaign will focus on brides-to-be at a time when they're already planning how to look and feel their best on their big day. In Q2, we'll dial up our efforts in traditional media, both TV and radio, along with high-impact satellite media tours, expert spokesperson interviews and other activities designed to leverage Mother's Day media opportunities. In addition, we're continuing to reach moms and teens as we look ahead to prom, graduation and the busy summer teen season. Our social media program, including Twitter, Facebook and our network of influential mom bloggers, continues to be a great way for current and potential patients to learn about the brand and engage with one another. We'll also reach, educate and influence moms specifically this year to our Straight Talk event series, a program that combines the reach of social media with the impact of a live event. We've kicked off a multi-tiered live event program for the Straight Talk series in the top 10 Invisalign Teen markets that will be taking place in April and May. One of the ways we know these and other programs are effective and that we're reaching potential patients is by tracking visitors and activity at Invisalign.com. In Q1, site visits were up almost 30% from Q4, and we doubled our mobile device traffic from the previous quarter. Looking ahead, we are excited about the consumer campaign we're launching in Q2, with new created-for-TV, digital and mobile platforms, all focused on the journey of Invisalign treatment. We're planning to be on TV for most of Q2 to fully leverage our new campaign as we head into the important summer season. Look to see our new ads on air just after Memorial Day weekend. And turning to Europe, our smaller but strategically important consumer marketing investments continue to help facilitate market expansion and adoption growth in our direct country markets. We've seen a significant rise in awareness with increases in web traffic and social media activity across our markets, and we'll continue our investment in consumer awareness campaigns in Q2. Let's now shift to our scanner and CAD/CAM services segment. As Shirley said at the beginning of our call, in Q1, we recorded an impairment charge for a portion of our long-lived assets and all remaining goodwill related to the scanner and CAD/CAM services reporting unit. These are in addition to the charges recorded in Q3 and Q4 of 2012. Although we determined it was appropriate to record the impairment charges related to the scanner and CAD/CAM services unit, our long-term view of this business remains positive, and we will continue to execute plans to be a leader in this business. In addition, we continue to see leverage in the Invisalign business for scanner technology and maintain our belief in the long-term benefits of the scanner and CAD/CAM services business. Invisalign utilization among scanner customers, particularly orthos, continues to grow, and we expect this positive trend to continue. The drivers for this growth come from better customer and patient experience driven by recent scanner innovations, including the new iTero scanner. In addition, the recently launched Invisalign Outcome Simulator brings a valuable patient education tool right to chair-side to help doctors show the benefits of Invisalign treatment to prospective patients. Moving towards operating results of this business. North America continues to perform solidly in the top line. Among our core Invisalign customers, we are leveraging our direct sales force and also taking full advantage of our scheduled customer events like summits, forums or study clubs to help drive sales of iTero scanners. This purchase is especially attractive for our ortho customers, who are looking to differentiate or streamline their practices by integrating intra-oral scanners to completely replace the cost, mess and unpleasant patient experience associated with taking PVS impressions. We continue to see an increase in Invisalign case submissions from a digital impression instead of a PVS impression. The percentage of Invisalign cases submitted with a digital scan rather than a traditional physical impression rose to 19% in Q1 compared to 17% in Q4 and 9% in Q1 of a year ago. This trend is positive for both Align and our customers, as most of them reported faster ClinCheck turnaround case shipments -- reported faster ClinCheck turnarounds to case shipment with less hassle to patients, and all reports to date indicate better aligner fit. Looking ahead, we continue to believe there are potentially a few other high-quality intra-oral scanners that over time can be made to support interoperability with Invisalign. Before we would move ahead with this, Align will need to ensure the quality of the scan as well as the customer experience is up to our high standards. And just like we do with other R&D initiatives, we do not discuss futures. When there's any meaningful news report, we will do so. Until then, iTero is the only scanner with Invisalign interoperability. And I'll now turn the call over to Roger for a review of our Q1 financial results. Roger?