엘루티아(ELUT) 2026년 3분기 실적 발표 컨퍼런스콜: NXT 41X FDA 승인 신청 순항
엘루티아는 2026년 3분기 계속영업 순매출이 심혈관 사업 호조로 전년 동기 대비 20% 증가한 110만 달러를 기록했다고 밝혔다. 조정 매출총이익률은 85.5%로 상승했으며, 3분기 말 기준 현금 및 현금성 자산은 2,910만 달러다. 당사는 주식 발행 없이 대출, 사업 매각, 정산금 수령을 통해 2,600만 달러를 확보했으며, 이 자금이 NXT 41X 허가 및 상용 출시 첫해까지의 운영을 뒷받침할 것으로 보고 있다. NXT 41X는 핵심 GLP 연구의 평가변수를 충족해 2026년 4분기 FDA 허가 신청이 예상되며, 심사 결과에 따라 2027년 2분기 허가 및 하반기 소프트 론칭이 전망된다.
핵심 요약
- 2026년 3분기 계속영업 순매출은 심혈관 사업 호조에 힘입어 전년 동기 대비 20% 증가한 110만 달러를 기록했다. 조정 매출총이익률은 81.3%에서 85.5%로 상승했다.
- 엘루티아는 2026년 10월 1일에 수령한 보스턴 사이언티픽 유보금 800만 달러를 제외하고 2,910만 달러의 현금 및 현금성 자산으로 이번 분기를 마감했다.
- 당사는 애비뉴 캐피털 대출, 심플리더름 매각 및 보스턴 사이언티픽 정산금 지급을 통해 주식 발행 없이 2,600만 달러를 확보했다. 경영진은 이 자금이 예상되는 NXT 41X 허가 및 상용 출시 첫해까지의 운영을 뒷받침할 것으로 보고 있다.
- NXT 41X의 핵심 GLP 연구가 사전 설정된 평가변수를 충족했다. 엘루티아는 2026년 4분기에 해당 제품의 허가를 FDA에 신청할 계획이며, 규제 당국의 심사에 따라 2027년 2분기에 허가 결정이 내려질 것으로 예상하고 있다.
- 경영진은 2027년 하반기 NXT 41X의 소프트 론칭과 2028년 본격적인 상용 출시를 목표로 하고 있다. 생산 역량은 본격 양산 시 최소 3억 달러의 매출과 80%를 웃도는 매출총이익률을 뒷받침할 수 있도록 설계되었다.
- 엘루티아는 심혈관 사업부 매각을 지속적으로 검토하고 있으나, 수용 가능한 수준의 재무적·전략적 가치를 제공하는 거래일 경우에만 진행할 것이라고 밝혔다.
주요 재무 데이터
| 지표 | 2026년 3분기 | 2025년 3분기 | 변동 또는 배경 |
|---|---|---|---|
| 순매출 | 110만 달러 | 90만 달러 | 전년 동기 대비 20% 증가 |
| GAAP 기준 매출총이익률 | 61.7% | 52.8% | 8.9%포인트 개선 |
| 조정 매출총이익률 | 85.5% | 81.3% | 비현금성 무형자산 상각비 제외 |
| 영업비용 | 760만 달러 | 640만 달러 | NXT 41 및 NXT 41X 관련 R&D 지출이 190만 달러 늘어난 점이 증가세에 주로 반영됨 |
| 영업손실 | 690만 달러 | 590만 달러 | 전년 동기 대비 손실 확대 |
| 계속영업 순손실 | 650만 달러 | 100만 달러 | 전년도 실적에는 510만 달러의 비현금성 워런트 부채 재평가 이익이 포함됨 |
| 조정 EBITDA | -560만 달러 | -340만 달러 | 손실폭 220만 달러 확대 |
| 현금 및 현금성 자산 | 2,910만 달러 | — | 2026년 9월 30일 기준; 10월 1일 수령한 800만 달러 제외 |
사업 및 영업 실적
NXT 41X 개발 현황
엘루티아는 NXT 41X의 핵심 GLP 토끼 이식 연구가 사전 설정된 모든 성능 평가변수를 충족했다고 밝혔다. 해당 연구는 MRSA(메티실린 내성 황색포도상구균) 및 대장균의 높은 박테리아 부하 환경에서 제품을 시험했다. 7일 후 NXT 41X 검체 및 주변 조직에서 생존 박테리아가 전혀 검출되지 않은 반면, 항생제가 포함되지 않은 매트릭스를 이식받은 모든 동물군에서는 균 집락이 형성되었다.
경영진은 주요 성능 연구가 완료되었다고 밝혔다. 남은 작업은 주로 최종 신청 서류 취합, 실험실 승인 및 진행 중인 안정성 시험 프로그램이다. 당사는 2026년 4분기 중 FDA에 NXT 41X의 승인을 신청할 계획이다.
엘루티아의 자동화 코팅 시스템은 상용 생산 준비를 마쳤다. 경영진에 따르면 이 시스템은 출시 시점에 최소 3억 달러의 매출 생산 능력을 제공하며, 본격 양산 시 80% 이상의 매출총이익률을 달성할 수 있도록 설계되었다.
NXT 41 규제 승인 경로
NXT 41과 NXT 41X 프로그램은 별도의 규제 일정을 따른다. 약물 성분이 없는 생체 외과용 매트릭스인 NXT 41은 이미 FDA 심사가 진행 중이며, 2026년 4분기에 결정이 내려질 것으로 예상된다.
엘루티아는 NXT 41을 상용화할 계획이 없다. 경영진은 이번 신청이 상업적으로 더 중요한 NXT 41X 신청에 앞서 기본 매트릭스에 관한 FDA의 질의 사항에 대응하기 위한 조치라고 설명했다.
심혈관 사업부
심혈관 부문 매출은 3분기에 전년 동기 대비 20% 증가한 110만 달러를 기록했고, 2026년 첫 9개월 동안은 65% 증가했다. 해당 사업부는 이번 분기에 약 85%의 조정 매출총이익률을 기록했다.
엘루티아는 지분 희석 없는 자본을 조달하고 NXT 41X에 역량을 집중하기 위해 잠재적 매각을 추진하고 있다. 경영진은 여러 곳으로부터 관심을 받고 있다고 밝혔으나, 매력적이지 않은 거래는 수용하지 않을 것임을 강조했다.
자금 조달 및 유동성
엘루티아는 주식 발행 없이 51일 동안 2,600만 달러를 확보했다:
- 1,500만 달러 규모의 애비뉴 캐피털 대출 계약 체결 시 1,000만 달러를 수령했으며, NXT 41X의 FDA 허가 후 추가로 500만 달러를 이용할 수 있다.
- 심플리더름 매각을 통해 800만 달러를 수령했으며, 향후 18개월간 최대 300만 달러의 기술 이전 대금을 지급받을 수 있는 자격을 확보했다.
- 2025년 바이오인벨롭 사업 매각과 관련된 유보금 지급이 해제됨에 따라 10월 1일 보스턴 사이언티픽으로부터 800만 달러를 수령했다.
추가적인 잠재적 자금 조달원으로는 조건부 애비뉴 트랜치 500만 달러, 최대 300만 달러의 심플리더름 관련 대금, 심혈관 사업 매각 성사 시 유입될 대금 등이 있다.
경영진 가이던스
경영진은 FDA 심사 및 실행 위험에 따라 달라질 수 있는 다음과 같은 예상 주요 마일스톤을 제시했다:
- 2026년 4분기 NXT 41의 FDA 허가 결정.
- 2026년 4분기 NXT 41X의 FDA 허가 신청.
- 심혈관 사업부의 잠재적 매각 거래(시기는 수용 가능한 조건 성립 여부에 따름).
- 2027년 2분기 NXT 41X의 FDA 허가.
- 2027년 하반기 NXT 41X 소프트 론칭.
- 2028년 본격적인 상용 출시.
엘루티아는 2027년 말까지 미국 내 16개 주요 영업 권역을 담당하여 유방 재건 시장의 약 50%에 접근할 수 있을 것으로 예상한다. 당사는 직판 영업 인력을 주로 활용하고, 일부 지역에서는 독립 대리점을 보완적으로 활용할 계획이다.
경영진은 연간 예산 수립 절차가 진행 중이어서 구체적인 비용 전망치는 제시되지 않았으나, 출시 준비에도 불구하고 2027년 현금 소진 규모에 중대한 변화가 없도록 하는 것이 목표라고 밝혔다.
주목해야 할 위험 및 주요 이슈
- NXT 41 및 NXT 41X의 추진 일정은 여전히 FDA 심사 결과에 따라 달라질 수 있다. 경영진은 허가 시점이 현재 추정치보다 앞당겨지거나 늦어질 수 있음을 인정했다.
- NXT 41X는 생체 매트릭스와 국소 약물 전달 기술의 복합 제품으로, 규제 및 제조 실행 측면에서 요구되는 기준이 까다롭다.
- 계획된 상용화 확대는 성공적인 FDA 허가, 병원 가치분석위원회 심사 통과 및 적절한 시점의 영업 인력 채용 여부에 달려 있다.
- 추가적인 자금 조달원에는 지급이 보장되지 않는 마일스톤 기반 또는 거래 연동 대금이 포함되어 있다.
- NXT 41X 신청 및 출시를 앞두고 R&D 지출이 늘어나면서 엘루티아의 영업손실과 조정 EBITDA 손실이 확대되었다.
애널리스트 질의응답(Q&A) 주요 내용
경영진은 지식재산권, 영업비밀, 규제 요건, 제조 노하우를 주요 경쟁 진입 장벽으로 꼽았다. 엘루티아는 NXT 41X 플랫폼이 6년 동안 개발되어 왔으며, 외과의가 수용할 수 있는 형태로 생체 매트릭스에서 항생제가 균일하게 방출되어야 한다고 설명했다.
상용화와 관련해 경영진은 출시에 앞서 영업 총괄 및 영업 담당자를 영입할 계획이나, 2027년 2분기와 3분기 이전에는 대규모 채용을 진행하지 않을 것으로 예상하고 있다. 당사는 병원들이 제품 심사 절차를 완료하기 전에 대규모 영업 조직을 유지하는 부담을 피하고자 한다.
FDA 신청과 관련하여 경영진은 주요 시험 작업이 완료되었다고 밝혔다. 해당 제품은 여전히 안정성 시험을 진행 중이며, 개발팀은 수천 페이지에 달할 것으로 예상되는 신청 서류를 준비하고 필수 GLP 문서를 마무리하고 있다.
실적 발표 컨퍼런스 콜 전문
전체 실적 발표 컨퍼런스 콜 녹취록
경영진 발표
Operator
[Operator Instructions]
Please be advised that today's call is being recorded. I would now like to hand it over to our first speaker, [ Bernadette Eutroniak ]. Please go ahead.
Unknown Speaker
Thank you, Operator, and thank you all for participating in today's call. Earlier today, Elutia released financial results for the third quarter ended September 30, 2026. A copy of their press release is available on the company's website. Before we begin, I would like to remind you that management will make statements during this call that include forward-looking statements within the meaning of the federal securities laws which are pursuant to the safe harbor provision of the Private Securities Litigation Reform Act of 1995.
Any statements contained in this call that do not relate to matters of historical fact or relate to expectations of [ Federal Security Service ] are not subject to [ Federal Security ] predictions of future events, results, or performance are forward-looking statements. All forward-looking statements, including without limitation, those relating to our operating trends and future financial performance, are based upon our current estimates and various assumptions. These statements involve material risks and uncertainties that could cause actual results or events to differ from those anticipated or implied by these forward-looking statements.
Accordingly, you should not place undue reliance on these statements. For lists and descriptions of the risks and uncertainties associated with our business, please refer to the risk factors section of our public filings with the SEC, including Elutia's annual report on Form 10-K for the year ended December 31, 2025, and in our subsequent periodic reports on Form 10-Q and current reports on Form 8-K, accessible on the SEC's website at www.sec.gov. Such factors may be updated from time to time in Elutia's other filings with the SEC.
This conference call contains time-sensitive information and is accurate only as of the live broadcast today, November 5, 2026. Elutia disclaims any intention or obligation except as required by law to update or revise any financial projections or forward-looking statements because of new information, future events or otherwise. Also during this presentation, we refer to gross margin, excluding intangible asset amortization, which is a non-GAAP financial measure.
A reconciliation of this non-GAAP financial measure to the most directly comparable GAAP financial measure is available on the company's financial results release for the third quarter ended September 30, 2026, which is accessible on the SEC's website and posted on the Investors page of the Elutia website at www.elutia.com. And with that, I will turn the call over to Elutia's CEO, Randy Mills.
Unknown Speaker
Thank you, Bernadette, and thank you all for joining us today. It is an exceptionally busy and exciting time for us at Elutia, and I'm eager to get you up to speed on our progress. Here's how we'll spend our time. First, the need. It is serious and the lack of attention being paid to it by industry is astonishing. Infection was a major focus at last month's meeting of the American Society of Plastic Surgeons in Houston. It came up in every one of the 11 breast research sessions, yet commercial products addressing it and no company on the exhibit floor was talking about a solution. That market dislocation has created a tremendous opportunity for Elutia.
Second, we'll review the great progress the team is making on NXT 41X. Our key GLP antimicrobial study met its predetermined endpoints. Surgeon feedback on the actual product was very favorable, and NXT 41X is set to head to the FDA this quarter. Then Matt will walk you through how we funded ourselves through launch without an equity offering. He'll also cover our cardiovascular business and its remarkable growth, take you through the third quarter results, and end with the milestones ahead. Then we'll open the line for your questions, including some that were actually brought in by you. Let me start with the need, because that is where everything at Elutia begins.
Infection in plastic and reconstructive surgery is common. It is serious and it remains unsolved. Over the next few slides, I'll show you what surgeons themselves presented on at this year's national meeting because their data and insights make the case better than we ever could. The ASPS meeting in Houston was last month, and to me, one of the most astonishing things that stood out above the rest was infection. There were 11 scientific sessions devoted to breast research. Infection risk and prevention were discussed in every one of them. Of the 135 research presentations, 70, or 52%, addressed infection.
Infection wasn't only covered in the research sessions, however. The conference included an entire course called 28 Years Later: Current Strategies in Salvaging the Infected Implant. Think about that. Surgeons have been fighting implant infection for decades, and it is still one of the biggest problems plastic and reconstructive surgeons face today. The data presented at the meeting were sobering. Investigators from UCSF reported on 1,094 breasts that underwent immediate implant-based surgery. In women who did not receive chemotherapy before surgery, 17.6% developed an infection. In women who did, it was 23%.
That is nearly 1 in 4. A second study from Miami Cancer Institute looked at 419 breasts. Every one of those patients received antibiotics before and after surgery, and 19.3% still developed an infection. These are leading centers following current best practices and infection still approaches 1 in 4, but in most cases, these are women who are already fighting cancer. Think about that. So why not just do what we normally do and give patients more antibiotics? Because it doesn't work. A 20-year multi-center study presented at the meeting answered that question definitively. It looked at 4,647 patients across 170 healthcare organizations. Extending antibiotics past 24 hours did not reduce infection at 30 days, 60 days, or 90 days.
And the biology explains why. Systemic antibiotics travel through the blood. A mastectomy closes off the very blood vessels that would carry those drugs to the surgical site. You can give more drug, but it can't get to where it needs to go. Which brings me back to what struck me most in Houston. In the session rooms, in the hallways, at the receptions, surgeons were focused on infection. 70 presentations across all 11 breast research sessions. I walked onto the exhibit floor and found a sea of commodity surgical matrices. There were literally 25 on the market and none are demonstrably different from the next. But no commercial offering for infection. No one was even talking about it. On one side you have surgeons and their patients living with this problem.
On the other, an industry that hasn't offered them a solution. That gap is the unmet need. It is the reason Elutia exists, and it is exactly what we intend to fix with NXT 41X. Now let me turn to how we intend to close that gap. NXT 41X is our lead drug delivery program. Our key GLP study is complete. Our manufacturing is set for commercial production, and we plan to submit NXT 41X to the FDA this quarter.
Let me walk you through where our programs stand. We currently have 2 product development programs, and both are on track. I want to be clear that they are on separate submissions on independent timelines. First, NXT 41, our biological surgical matrix without drug. The 510(k) is submitted, the review is progressing as expected, and we anticipate a clearance decision this quarter, and we have every reason to believe it will be favorable. However, it is largely academic at this point. NXT 41 has already done its job, which was to discover and answer FDA's questions about the base matrix.
We have no intention of commercializing NXT 41. It broke the regulatory ice for NXT 41X. And everything that we learned from it has been built into the NXT 41X platform. The more material submission is NXT 41X, our lead drug delivery program. Our key GLP study met its predetermined endpoints, and we plan to submit NXT 41X to the FDA this quarter. From there, we anticipate a clearance decision in the second quarter of 2027, a commercial soft launch in the second half of 2027, and a full commercial launch in 2028. That timing reflects our current expectations and is of course subject to FDA review.
All in all, it is a very busy but exciting time in R&D and regulatory. This is the study that supports our submission, and it is pretty cool. In a GLP rabbit implant study, NXT 41X met its pre-specified performance endpoints. We challenged it with MRSA, a drug-resistant gram-positive form of the most common pathogen in breast surgery, Staph aureus. We then challenged it with E. coli, a particularly nasty gram-negative rod that can cause serious infection and lead to sepsis. And we didn't make this easy. We put the bacteria on the uncoated side of the matrix, away from the drug, and we added a lot of them.
The MRSA challenge was 8 logs, that is 100 million bacteria. The E. coli challenge was 6 logs, 1 million bacteria. Both represent far more contamination than would normally be present in the operating room, creating true worst-case conditions. So, the results: after 7 days of implantation, we recovered 0 viable bacteria from the NXT 41X samples and surrounding tissue, 0. Contrast that with the matrix without antibiotics. Every animal implanted with the matrix alone developed fulminant colonization by those same pathogens versus 100%. Pretty cool. Data matter. But the surgeon's opinion matters too, since they are the ultimate decision makers.
While we were in Houston, our NXT 41X Surgeon Steering Committee met in person, and their feedback on the design, handling, and performance of NXT 41X was both informative and very positive. And while we talked about a number of different product attributes, 2 really stood out as the difference makers. And I wanted to share them with you since this is how a surgeon takes a look at a product like 41X. They put it simply, it's about the drug being in the right place at the right time. Right place to them means powerful antibiotics that are uniformly distributed across the entire surgical site. That's exactly where systemic antibiotics fail to reach. The right time means 30 days of coverage. Why? Because that carries them through drain removal, which usually happens somewhere around day 17.
It was simple, and it was a powerful message for us to hear, and it was gratifying for the team since that's what we designed NXT 41X to do. And we're ready to make it. Our automated drug coating system is set for commercial production. It gives us at least $300 million in revenue capacity at launch and is designed to support a gross margin above 80% at scale. That matters for 2 obvious reasons. First, we certainly don't want to be supply constrained as the product is launching. Second, we want to be able to make money with this product, and the margin profile we wanted was built into the manufacturing process from day 1.
So when you take a step back and you look at it, I hope you can see what we're creating here: a product for a true unmet medical need, one that already has been proven with our own technology that our own technology can answer, and one that we can make money with. And we have the capital and team and intellectual property to see it through. And with that, I'll turn it over to Matt to close out and then be back with you for Q&A.
Matthew Ferguson
Okay, thank you, Randy, and good afternoon, everyone. I'll start with our balance sheet because over the last 3 months we did just what we said we would do. We added $26 million without an equity offering. We believe that funds Elutia through the anticipated clearance of NXT 41X and the first year of commercial launch. On our August call, we named 3 near-term funding milestones, and I'm pleased to report that all 3 are now complete. First, on August 11, we closed a $15 million loan facility with Avenue Capital Group. We received $10 million at closing, and an additional $5 million becomes available following NXT 41X FDA clearance.
Second, on August 17, we closed the sale of our SimpliDerm business to Solution Biologics and received $8 million at that closing. We're also eligible to receive up to $3 million in contingent technology transfer payments over the next 18 months. Third, on October 1, Boston Scientific released the full $8 million holdback from the 2025 sale of our bioenvelope business with no claims and no deductions. Together, that's $26 million in just 51 days. That was a busy couple of months. We also have additional sources of capital that we expect will contribute to our runway. There's a $5 million second tranche from Avenue Capital and up to $3 million in SimpliDerm milestones as well as proceeds from a potential cardiovascular transaction should that happen.
As one of our remaining legacy businesses, I'd like now to focus a bit more on our cardiovascular business. Third quarter revenue there grew 20% year over year to $1.1 million. And for the first 9 months of 2026, revenue was up 65%. Third quarter adjusted gross margin was 85%. This business is performing well, but it is ultimately not where we're going as a company. As we've previously discussed, we've been pursuing a divestiture of this product line. We believe the sale makes sense for the company both as an additional source of non-dilutive capital and to provide strategic focus as we get closer to the launch of NXT 41X.
We've had significant interest in this asset from multiple parties, and the strategic process remains on track. Now, turning to a brief summary of our financial results. All the figures I'll go through are for continuing operations compared with the third quarter of 2025. Net sales were $1.1 million, up 20% from $0.9 million. Gross margin on a GAAP basis was 61.7% compared with 52.8%. The adjusted gross margin, which excludes non-cash amortization of intangibles, was 85.5% compared with 81.3%. Total operating expenses were $7.6 million compared with $6.4 million.
The increase was driven by $1.9 million of higher research and development spending on NXT 41 and NXT 41X, partially offset by a $0.7 million reduction in net litigation costs. In other words, our spending is shifting toward the programs that are creating value. Loss from operations was $6.9 million compared with $5.9 million. Net loss from continuing operations was $6.5 million compared with $1.0 million. The prior year figure benefited from a $5.1 million non-cash gain on the revaluation of warrant liabilities. Adjusted EBITDA was a loss of $5.6 million compared with a loss of $3.4 million. Reconciliations of our non-GAAP measures are included in today's earnings release.
We ended the quarter with $29.1 million in cash and cash equivalents, and that balance does not include the $8 million Boston Scientific holdback, which we received 1 day following the end of the quarter on October 1. To close, here's what our capital is funding. We had 3 funding catalysts that are now behind us: the Avenue loan, the SimpliDerm sale, and the $8 million Boston Scientific payment. 6 catalysts lie still ahead. This quarter, we expect an FDA clearance decision on NXT 41. We plan to submit NXT 41X to the FDA, and we have the potential to complete a cardiovascular transaction. In the first half of 2027, we anticipate an FDA clearance decision on NXT 41X.
A commercial soft launch follows in the second half of 2027, and our full commercial launch hits in 2028. And in closing, I'd like to mention a couple of investor events that are coming up. The first is a fireside chat with Dr. Al Hassanein, Associate Professor of Plastic Surgery at Indiana University. Dr. Hassanein is a pioneer in local antibiotic delivery for prevention of infection risk and breast reconstruction. He's also very knowledgeable about our development process for NXT 41X and its most salient features. This event is taking place on November 20 and is being hosted by Frank Takkinen of Lake Street Capital Markets. The event is open to Lake Street clients, but please contact Frank if you're interested in attending.
And the second event is the annual J.P. Morgan Healthcare Conference in San Francisco. We'll be hosting meetings there in our own space on January 11 and January 12. If you'll be there and you'd like to meet with us, please email ir@elutia.com. And with that, operator, please open the line for questions.
Operator
[Operator Instructions]
First question from Frank Takkinen from Lake Street.
Unknown Speaker
Hi Randy and Matt, can you hear me?
Unknown Speaker
Hey, how's it going?
Unknown Speaker
This is Sam Knapp on for Frank Takkinen. First, could you talk a little bit more about the barriers to entry and IP that you think will protect your competitive position? It would be interesting to hear where you think the strongest defenses exist, whether that be regulatory, product design, manufacturing know-how, or a combination of all of the above. Any color would be appreciated.
Unknown Speaker
Yes, Sam. So, you know, when you sort of look at the question of, so why can't competitors come in and do this, there's 2 fundamental reasons that prevent that from happening. The first is we have built a very substantial intellectual property platform. Some of that we have chosen quite intentionally to keep as trade secrets. Some of that we have filed patent protection on and actually we continue to file and add patent protection to. And while the idea of a drug delivery matrix is nowadays beyond patentability itself, we think the features that we have designed into 41X, that we have intellectual property for [ Equidi matrix ] around, that we have patent protection around, are actually going to set what's going to be the only acceptable standard going forward and give us some really very meaningful protection in the marketplace. That's one.
Two is the reality of it. It's been 25 years. Infection's been known to every relevant player in this field for the past 25 years, and no one's done anything about it. And the reason they haven't done anything about it is because it's really, really hard to do. Our team here makes what we do look really easy. They are a group of flat out geniuses that have solved some very complex problems with some very sophisticated solutions. And sometimes perhaps I gloss over it a little bit too much, Sam, and almost make it sound too easy. It is not easy. This product platform has taken us 6 years to get to where we are today.
And so even if there were somebody that were going to decide to get involved in it, it is a long, hard road to figure out how to get powerful antibiotics to uniformly elute off of a biological matrix in a delivery form that surgeons will accept. And so we feel very, very confident that we have both an intellectual property and a regulatory barrier to entry that are going to keep us pretty much alone in this market for a while.
Unknown Speaker
That makes sense, I appreciate it. And then one other one, once NXT 41X is submitted, how should we think about hiring expectations in advance of approval? I mean, how large of a commercial team will you hope to have in place at the time of the launch? And then maybe for Matt, in light of that, any initial thoughts on how we should think about OPEX going forward without SimpliDerm and the ramp-up investments in front of NXT 41X?
Unknown Speaker
Yes, so I will, you know, I'll do the play-by-play here. Matt will do color commentary on the financial implications for it. But Sam, at the end of 2027, heading into the first full year of launch in 2028, we anticipate having the top 16 territories covered. The top 16 territories in the U.S. give us access to approximately 50% of the breast reconstruction market. We intend to do the vast majority of that through direct representation. We'll use 1099s to fill in some of the spaces in between, but we really want to own the major markets.
You may have seen, I know we have gotten questions about, and our HR department is flooded with applications, we have started the recruitment process for both sales leadership as well as direct sales representation in these markets. The plan is, by the way, not to bring them in too early, but to identify the best candidates in the markets that we need and go through the proper courting and vetting process to make sure that we're onboarding them when the time comes.
So that recruitment process has started, but we don't anticipate bringing on a real heavy recruitment share until really the second and the third quarters. We don't have any need to bring them on too early, since at least the third quarter of next year, if everything's on schedule, the third quarter of next year is going to be an exercise in VAC submissions. And, you know, sometimes VAC submissions are like watching paint dry, and there's no sense in having an elaborate and expensive commercial force sitting around with nothing to sell.
So 16 is where we're going with that, with the appropriate sales leadership, but we're not going to go crazy with it. We're not going to add too early. We think we're going to have great visibility into the 41X regulatory process as we begin to do that. So, if there is an unforeseen change in the timeline, we'll have the ability to adjust, but that's what's the plan for the year, Sam. Oh, you want to talk about money? Sure.
Matthew Ferguson
Sam, yes, I think a lot of what Randy talked about really are the indicators for what spend will look like. And those relate to the concentrated market that we're entering into, the fact that there's no change to the physician workflow, so the sales cycle should not be particularly long, and we're really going to be standing alone in terms of offering a product that there's a great need for in the market right now. So all of that we believe translates to what should be a pretty rapid ramp once we launch with high gross margins and a relatively small commercial organization needed in order to serve that market.
What that ultimately translates to, you know, we're going through our 2027 budgeting process right now, so it's a little bit too early to speak in specifics, but, you know, our goal really is to not have our burn rate change that much if we go through next year and actually start launching the product. So we'll see how that plays out. We'll have a little bit more specificity that we probably can offer on our next call. But we feel good about where we are and the cash that we have in the bank and the ability for that to fund us through the launch of NXT 41X.
Unknown Speaker
Awesome, I appreciate that. And then just one more, on NXT 41X, what is left to be completed prior to the official submission? Is there any outstanding testing that could take a little longer, or are you pretty much just packaging the final submission packet?
Unknown Speaker
Yes, the heavy lifting testing for NXT 41X is now complete. And what I mean by that are the pivotal performance studies, the studies that, you know, are the large animal studies that can go on for 6 months or longer. The product is up on stability testing now. This is when we do the final actual commercial-grade manufacturing of the product, take it through the entire cycle, and then test it over periods of time for shelf life. That will be an ongoing program. And so, you know, that will actually run, that will actually continue to run, we hope, long after approval of the product as we continue to extend the date. But the stability program is just an ongoing study that will continue to happen.
The rest of the data for the product is done or is being packaged. We have no more study. So, Sam, have you ever been sort of around some of these things? We're talking about all GLP studies that are done for every one of these things. Every one of them requires numerous types of sign-offs from the contract testing laboratories that do them in order to meet GLP processes. And so those types of things take a little bit of time. It is a massive submission, so it's, you know, something, it's thousands and thousands of pages. And so it is a big deal for our team to put together. I'll make it sound really easy, but nothing big outstanding at this point. Sam, that's why we're pretty excited about it.
Unknown Speaker
Fantastic. Well, thank you for answering my questions, Randy and Matt, and congratulations on the progress so far.
Unknown Speaker
Cool. Thank you. Thank you.
Operator
Thank you. And now I'd like to turn it back over to Randy for closing remarks.
Unknown Speaker
Okay, thanks, and we actually are going to try something out here that I really like. We received a number of questions ahead of the call, too many to go through, but I thought I'd take a couple of them and answer them, and this is something we'll do on future calls. So on a future call, as long as you get your question to us ahead of time, we'll be glad to throw it into the queue.
Now a lot of questions we got, basically I'm going to pick a couple of questions here that were the most commonly asked questions, because there seems to be some confusion around those things. That lies with me, that's on me, so I need to do a better job communicating these. So let's start with the first one, which is please clarify the timelines for NXT 41X and how they relate to the NXT 41 regulatory process.
Well, first, I hope that what we had in the presentation helped a little bit there and described that they're both on independent timelines. I think that's the first really important point. NXT 41 and NXT 41X are on 2 separate development pathways. NXT 41X is not dependent on NXT 41. So we will file NXT 41X as soon as that regulatory file that Sam just mentioned is complete and it's ready to go.
Some sort of sub-questions I got: it seems like it's probably going to take like 9 months for NXT 41, and we're anticipating 6 months for NXT 41X. How do you reconcile those? Well, a couple of things. First is, just to clear up some things on the timing of NXT 41, NXT 41 was submitted by us in February, but it actually wasn't accepted into FDA until later in March, believe it or not. And that is when they started their review clock. So just so everyone knows, it isn't taking some unusually long time. The FDA just gave themselves a little bit of time to check our 510(k) submission into their process.
They're our friends. With regards to 510(k), I also think it's important to say that we're anticipating a second quarter submission. Why? Because we don't have any big studies to do. We're not waiting on any data. So we think the second quarter is the most likely time. We think they're going to ask us some questions in the first quarter. We think we'll be able to answer those questions in the second quarter and have our clearance in the second quarter of that year.
But you have to know that's an estimate. It could be earlier. It could be as short as 3 months, you know, and sometime come in April maybe. It could come in sometime in September. So it's our best guess at it, but there is certainly a range around it. We're dealing with a really complicated product and we're dealing with the Food and Drug Administration. So I wouldn't be setting your watch by the exact day, but it is our best guess at this point on what it would be. So thank you for that question of the people who submitted it. And I hope that clarified some of those points.
Okay, 1 more question, and that centers around the cardiovascular process. So where are we on the sale of the cardiovascular business? If it's not sold, what are the plans going forward? This is a great question. We have a great product with our cardiovascular product. In fact, it is the Cadillac of products that are out there for cardiovascular repair. It is a very sticky business. It is one that you've seen in our reporting. It's not just maintaining, but it's actually experiencing some very healthy growth since it returned back to the company from LeMaitre, and it has exceptional gross margins. So this is a product with 80%, 85% gross margins.
We make money with this product. So as you would expect, we have received interest in it, but here's what we're not going to do: we're not going to do a bad deal. If we have a serious acquirer that will complete a transaction that could have value for us, well, will have value for us, obviously, in terms of the cash that would bring in, but also value in terms of strategic focus, then we would do that, and we will do that, you know, as soon as we would be ready to do that deal, right? If that happens this quarter, then we're ready to go.
But we're not going to rush to get a bad deal done. There's a saying a friend of mine taught me: if you want a deal done badly, that's how you get it done. And we're not in a rush to do it because it's a great business and it's a growing business. And frankly, it's not that big of a headache and it's not a distraction for us. And so it is a milestone that we will meet, but only if we end up with the transaction that makes sense for us to do.
So, I hope that clarified it. I encourage you to ask questions, submit questions ahead of time. We'll have information about how to do that in the next press release. It's kind of fun. I like it and lets me know what you're thinking about and what you're worried about and, frankly, what I'm doing a bad job communicating on. But with that, I think we are done, and I will turn it back to the operator to close the call.
Operator
Thank you for your participation in today's conference. This does conclude the program. You may now disconnect. Everyone, have a great day.
This live transcript is auto-generated without human intervention or review.
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