Alphatec Holdings, Inc. (ATEC) 10-Year Financial Performance & Capital Metrics

ATEC • • Industrial / General

HealthcareMedical DevicesOrthopedic & Musculoskeletal DevicesSpinal Implants & Fusion Systems

AboutAlphatec Holdings, Inc., a medical technology company, designs, develops, and advances technologies for the surgical treatment of spinal disorders. The company offers SafeOp Neural InformatiX System, an Alpha InformatiX product platform designed to reduce the risk of intraoperative nerve injury; Sigma transforaminal lumbar interbody fusion pedicle-based access system that provides direct visualization of anatomical landmarks; Sigma PTP Access and Patient Positioning System; squadron lateral retractor designed to maximize patient outcomes; Invictus Spinal Fixation System, a thoracolumbar fixation system to treat a range of pathologies; and Invictus MIS SingleStep System that provides minimally invasive pedicle screw placement. It also provides Invictus Modular Fixation Systems designed to increase adaptability with the power of screw modularity; OsseoScrew system to restore the integrity of the spinal column; Arsenal spinal fixation system, a comprehensive thoracolumbar fixation platform to fix a range of degenerative to deformity pathologies and surgical procedures; Aspida Anterior Lumbar Plating System, a fixation system for anterior lumbar interbody fusion; AMP Anti-Migration Plate; OCT Spinal Fixation System; trestle luxe anterior cervical plate system; and Insignia Anterior Cervical Plate System. In addition, the company offers IdentiTi Porous Ti, Transcend Lateral, and Battalion Posterior Interbody Implants; and biologics consisting of Cervical Structural Allograft Spacers, 3D ProFuse Demineralized Bone Scaffold, Neocore Osteoconductive Matrix, Alphagraft Demineralized and Cellular Bone Matrix, and Amnioshield Amniotic Tissue Barrier, as well as EOS imaging products. It sells its products through a network of independent distributors and direct sales representatives in the United States. The company was founded in 1990 and is headquartered in Carlsbad, California.Show more

Revenue $612M +26.8%
EBITDA -$53M +53.5%
Net Income -$162M +13.1%
EPS (Diluted) -1.13 +26.6%
Gross Margin 69.37% +7.9%
EBITDA Margin -8.64% +63.4%
Operating Margin -22.27% +38.1%
Net Margin -26.51% +31.5%
ROE -291.71% +47.6%
ROIC -22.62% +39.2%
Debt/Equity 64.65 +1114.1%
Interest Coverage -5.47 +47.5%

Technical Analysis

Key Insights

Based on financial data analysis

✓Strengths

✓Strong 5Y sales CAGR of 40.1%

✗Weaknesses

✗High debt to equity ratio of 64.7x
✗Negative free cash flow
✗Low quality earnings: Net income not backed by cash flow
✗Shares diluted 17.9% in last year
✗Expensive at 264.6x book value

Price & Volume

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Growth Metrics

Revenue CAGR

10Y11.44%

5Y40.07%

3Y35.98%

TTM27.11%

Profit (Net Income) CAGR

10Y-

5Y-

3Y-

TTM12.88%

EPS CAGR

10Y-

5Y-

3Y-

TTM18.75%

ROCE

10Y Avg-40.2%

5Y Avg-32.29%

3Y Avg-29.86%

Latest-21.44%

Peer Comparison

Spinal Implants & Fusion Systems

Name	Market Cap	Current Price	P/E Ratio	Revenue Growth 1Y	Net Margin	ROE	FCF Yield	Debt/Equity
GMEDGlobus Medical, Inc.	10.46B	93.89	125.19	60.62%	15.3%	9.63%	3.87%	0.13
TNONTenon Medical, Inc.	10.6M	0.95	-0.08	11.92%	-396.26%	-267.01%		0.07
BBLGBone Biologics Corporation	3M	1.67	-0.35			-65.59%
OFIXOrthofix Medical Inc.	570.24M	14.40	-4.36	7.08%	-14.56%	-26.92%		0.36
XTNTXtant Medical Holdings, Inc.	91M	0.65	-5.42	28.44%	1.32%	3.48%		0.82
ATECAlphatec Holdings, Inc.	2.59B	17.46	-15.45	26.81%	-21.29%	-13.47%		64.65
SIBNSI-BONE, Inc.	762.82M	17.58	-23.44	20.37%	-11.24%	-12.64%		0.22

Profit & Loss

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Sales/Revenue+	185.28M	120.25M	101.74M	91.69M	113.43M	144.86M	243.21M	350.87M	482.26M	611.56M
Revenue Growth %	-0.1%	-0.35%	-0.15%	-0.1%	0.24%	0.28%	0.68%	0.44%	0.37%	0.27%
Cost of Goods Sold+	63.74M	44.11M	39.41M	28.46M	35.83M	42.36M	85.45M	117.81M	172.06M	187.3M
COGS % of Revenue	0.34%	0.37%	0.39%	0.31%	0.32%	0.29%	0.35%	0.34%	0.36%	0.31%
Gross Profit+	121.54M	76.13M	62.33M	63.24M	77.59M	102.5M	157.76M	233.06M	310.2M	424.26M
Gross Margin %	0.66%	0.63%	0.61%	0.69%	0.68%	0.71%	0.65%	0.66%	0.64%	0.69%
Gross Profit Growth %	-0.16%	-0.37%	-0.18%	0.01%	0.23%	0.32%	0.54%	0.48%	0.33%	0.37%
Operating Expenses+	127.62M	87.48M	69.99M	83.23M	124.87M	161.36M	285.82M	380.03M	483.6M	560.43M
OpEx % of Revenue	0.69%	0.73%	0.69%	0.91%	1.1%	1.11%	1.18%	1.08%	1%	0.92%
Selling, General & Admin	105.72M	77.3M	64.38M	72.51M	101.71M	129.16M	229.27M	300.01M	374.08M	450.2M
SG&A % of Revenue	0.57%	0.64%	0.63%	0.79%	0.9%	0.89%	0.94%	0.86%	0.78%	0.74%
Research & Development	18.04M	9.25M	4.92M	9.98M	13.85M	18.75M	32.02M	44.03M	70.11M	80.72M
R&D % of Revenue	0.1%	0.08%	0.05%	0.11%	0.12%	0.13%	0.13%	0.13%	0.15%	0.13%
Other Operating Expenses	6.98M	-715K	0	738K	9.31M	13.46M	24.53M	35.99M	39.4M	29.51M
Operating Income+	-172.44M	-15.38M	-9M	-22.44M	-47.28M	-58.86M	-128.06M	-146.97M	-173.4M	-136.17M
Operating Margin %	-0.93%	-0.13%	-0.09%	-0.24%	-0.42%	-0.41%	-0.53%	-0.42%	-0.36%	-0.22%
Operating Income Growth %	-94.51%	0.91%	0.41%	-1.49%	-1.11%	-0.25%	-1.18%	-0.15%	-0.18%	0.21%
EBITDA+	-168.59M	-3.01M	-1.52M	-15.65M	-38.77M	-47.23M	-97.88M	-103.05M	-113.71M	-52.85M
EBITDA Margin %	-0.91%	-0.03%	-0.01%	-0.17%	-0.34%	-0.33%	-0.4%	-0.29%	-0.24%	-0.09%
EBITDA Growth %	-26.72%	0.98%	0.49%	-9.28%	-1.48%	-0.22%	-1.07%	-0.05%	-0.1%	0.54%
D&A (Non-Cash Add-back)	3.85M	12.36M	7.48M	6.79M	8.51M	11.63M	30.17M	43.93M	59.68M	83.32M
EBIT	-168.4M	-25.57M	3.04M	-23.03M	-47.28M	-66.47M	-137.05M	-146.5M	-170.27M	-137.19M
Net Interest Income+	-3.99M	-5.37M	-7.62M	-7.14M	-9.87M	-12.37M	-7.11M	-5.5M	-16.64M	-24.88M
Interest Income	11K	0	0	0	9.87M	0	0	0	0	0
Interest Expense	4M	5.37M	7.62M	7.14M	0	12.37M	7.11M	5.5M	16.64M	24.88M
Other Income/Expense	3.46M	-15.56M	4.43M	-7.73M	-9.87M	-19.99M	-16.11M	-5.03M	-13.52M	-25.9M
Pretax Income+	-178M	-30.93M	-4.57M	-30.17M	-57.14M	-78.85M	-144.16M	-152.01M	-186.91M	-162.07M
Pretax Margin %	-0.96%	-0.26%	-0.04%	-0.33%	-0.5%	-0.54%	-0.59%	-0.43%	-0.39%	-0.27%
Income Tax+	681K	-4.49M	-34K	-1.36M	-239K	145K	-1.13M	-716K	-277K	50K
Effective Tax Rate %	1%	0.98%	0.5%	0.96%	1%	1%	0.99%	1%	1%	1%
Net Income+	-178.68M	-30.32M	-2.29M	-28.98M	-57M	-78.99M	-143.03M	-151.29M	-186.64M	-162.12M
Net Margin %	-0.96%	-0.25%	-0.02%	-0.32%	-0.5%	-0.55%	-0.59%	-0.43%	-0.39%	-0.27%
Net Income Growth %	-12.87%	0.83%	0.92%	-11.63%	-0.97%	-0.39%	-0.81%	-0.06%	-0.23%	0.13%
Net Income (Continuing)	-171.25M	-26.3M	-4.54M	-28.81M	-56.9M	-78.99M	-143.03M	-151.29M	-186.64M	-162.12M
Discontinued Operations	0	0	2.25M	0	-100K	0	0	0	0	0
Minority Interest	0	0	0	0	0	0	0	0	0	0
EPS (Diluted)+	-21.53	-3.53	-0.17	-0.82	-1.09	-1.18	-1.50	-1.47	-1.54	-1.13
EPS Growth %	-12.63%	0.84%	0.95%	-3.82%	-0.33%	-0.08%	-0.27%	0.02%	-0.05%	0.27%
EPS (Basic)	-21.53	-3.53	-0.18	-0.82	-1.09	-1.18	-1.50	-1.47	-1.54	-1.13
Diluted Shares Outstanding	8.3M	8.58M	13.28M	35.31M	52.23M	67.02M	96.2M	103.37M	121.24M	142.95M
Basic Shares Outstanding	8.3M	8.58M	12.79M	35.31M	52.23M	67.02M	96.2M	103.37M	121.24M	142.95M
Dividend Payout Ratio	-	-	-	-	-	-	-	-	-	-

Balance Sheet

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Total Current Assets+	101.86M	72.82M	66.48M	75.54M	108.32M	184.16M	331.16M	255.63M	451.09M	417.4M
Cash & Short-Term Investments	11.23M	19.59M	22.47M	29.05M	47.11M	107.77M	187.25M	84.7M	220.97M	138.84M
Cash Only	11.23M	19.59M	22.47M	29.05M	47.11M	107.77M	187.25M	84.7M	220.97M	138.84M
Short-Term Investments	0	0	0	0	0	0	0	0	0	0
Accounts Receivable	26.87M	18.51M	14.82M	15.45M	16.15M	24.6M	41.89M	60.06M	72.61M	82.99M
Days Sales Outstanding	52.93	56.19	53.18	61.48	51.97	61.99	62.87	62.48	54.96	49.53
Inventory	44.91M	30.09M	27.29M	28.77M	34.85M	46M	91.7M	101.52M	136.84M	175.26M
Days Inventory Outstanding	257.15	248.99	252.79	368.95	355.03	396.37	391.71	314.54	290.29	341.54
Other Current Assets	32.56M	364K	131K	242K	10.2M	5.79M	0	9.36M	20.67M	20.31M
Total Non-Current Assets+	44.85M	21.36M	18.18M	53.94M	66.63M	81.06M	240.9M	265.33M	354.12M	358.31M
Property, Plant & Equipment	21.95M	15.08M	12.67M	13.23M	21.58M	37.85M	112.68M	130.31M	176.25M	191.09M
Fixed Asset Turnover	8.44x	7.98x	8.03x	6.93x	5.26x	3.83x	2.16x	2.69x	2.74x	3.20x
Goodwill	0	0	0	13.9M	13.9M	13.9M	39.69M	47.37M	73M	70.98M
Intangible Assets	21.62M	5.71M	5.25M	26.41M	25.61M	24.72M	85.27M	82.78M	102.45M	93.52M
Long-Term Investments	5M	5M	5M	5M	5M	4M	0	0	0	0
Other Non-Current Assets	1.28M	577K	264K	401K	546K	599K	3.25M	4.87M	2.42M	2.72M
Total Assets+	146.7M	94.19M	84.66M	129.48M	174.95M	265.22M	572.05M	520.97M	805.21M	775.71M
Asset Turnover	1.26x	1.28x	1.20x	0.71x	0.65x	0.55x	0.43x	0.67x	0.60x	0.79x
Asset Growth %	-0.57%	-0.36%	-0.1%	0.53%	0.35%	0.52%	1.16%	-0.09%	0.55%	-0.04%
Total Current Liabilities+	125.4M	40.53M	29.74M	30.61M	36.39M	58.31M	101.09M	138.87M	157.57M	153.03M
Accounts Payable	13.54M	8.7M	3.88M	4.4M	7.77M	17.6M	25.74M	34.74M	48.98M	52.98M
Days Payables Outstanding	77.54	71.99	35.92	56.42	79.17	151.64	109.94	107.64	103.92	103.25
Short-Term Debt	79.74M	3.11M	3.31M	3.28M	1.8M	5.08M	342K	14.95M	1.81M	1.66M
Deferred Revenue (Current)	648K	1000K	1000K	-3K	0	0	1000K	1000K	1000K	1000K
Other Current Liabilities	27.16M	23.71M	15.11M	19.71M	18.78M	23.38M	4.29M	5.64M	56.52M	6.82M
Current Ratio	0.81x	1.80x	2.24x	2.47x	2.98x	3.16x	3.28x	1.84x	2.86x	2.73x
Quick Ratio	0.45x	1.05x	1.32x	1.53x	2.02x	2.37x	2.37x	1.11x	1.99x	1.58x
Cash Conversion Cycle	232.54	233.19	270.05	374.01	327.83	306.72	344.64	269.38	241.33	287.82
Total Non-Current Liabilities+	57.88M	95.56M	81.58M	81.29M	66.32M	49.43M	391.54M	416.76M	545.91M	613.25M
Long-Term Debt	480K	43.09M	37.77M	42.3M	53.38M	38M	326.49M	349.51M	511.04M	574.52M
Capital Lease Obligations	0	0	0	92K	989K	78K	24.38M	26.56M	23.68M	27.3M
Deferred Tax Liabilities	0	0	0	0	0	0	0	0	0	0
Other Non-Current Liabilities	57.4M	52.47M	43.81M	38.9M	11.95M	11.35M	37.77M	37.65M	8.64M	8.29M
Total Liabilities	183.28M	136.08M	111.32M	111.9M	102.71M	107.74M	492.63M	555.63M	703.49M	766.28M
Total Debt+	80.11M	3.11M	41.07M	3.28M	56.18M	43.16M	355.43M	395.86M	541.68M	609.94M
Net Debt	68.88M	-16.48M	18.61M	-25.78M	9.06M	-64.61M	168.18M	311.17M	320.71M	471.1M
Debt / Equity	-	-	-	0.19x	0.78x	0.27x	4.48x	-	5.33x	64.65x
Debt / EBITDA	-	-	-	-	-	-	-	-	-	-
Net Debt / EBITDA	-	-	-	-	-	-	-	-	-	-
Interest Coverage	-43.10x	-2.87x	-1.18x	-3.14x	-	-4.76x	-18.02x	-26.70x	-10.42x	-5.47x
Total Equity+	-36.58M	-41.9M	-26.66M	17.57M	72.23M	157.48M	79.42M	-34.67M	101.72M	9.43M
Equity Growth %	-1.25%	-0.15%	0.36%	1.66%	3.11%	1.18%	-0.5%	-1.44%	3.93%	-0.91%
Book Value per Share	-4.41	-4.88	-2.01	0.50	1.38	2.35	0.83	-0.34	0.84	0.07
Total Shareholders' Equity	-36.58M	-41.9M	-26.66M	17.57M	72.23M	157.48M	79.42M	-34.67M	101.72M	9.43M
Common Stock	10K	1K	2K	4K	6K	8K	10K	11K	14K	14K
Retained Earnings	-427.24M	-457.17M	-459.46M	-501.92M	-558.92M	-638M	-782.33M	-932.32M	-1.12B	-1.28B
Treasury Stock	-97K	-97K	-97K	-97K	-97K	-97K	-25.1M	-25.1M	-25.1M	-25.1M
Accumulated OCI	-21.19M	970K	1.09M	1.06M	1.09M	1.2M	-5.99M	-10.79M	-8.32M	-13.68M
Minority Interest	0	0	0	0	0	0	0	0	0	0

Cash Flow

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Cash from Operations+	10.12M	-9.96M	-8.73M	-25.61M	-33.12M	-46.41M	-73.32M	-75.13M	-78.48M	-44.65M
Operating CF Margin %	0.05%	-0.08%	-0.09%	-0.28%	-0.29%	-0.32%	-0.3%	-0.21%	-0.16%	-0.07%
Operating CF Growth %	1.5%	-1.98%	0.12%	-1.93%	-0.29%	-0.4%	-0.58%	-0.02%	-0.04%	0.43%
Net Income	-178.68M	-29.93M	-2.29M	-28.98M	-57M	-78.99M	-143.03M	-151.29M	-186.64M	0
Depreciation & Amortization	19.03M	12.36M	7.48M	6.79M	8.51M	11.63M	30.17M	43.93M	59.68M	0
Stock-Based Compensation	2.64M	1.63M	3.9M	5.3M	10.96M	17.66M	36.45M	40.56M	81.24M	0
Deferred Taxes	-333K	10K	-36K	-1.41M	-438K	9K	0	0	0	0
Other Non-Cash Items	168.34M	8.46M	-7.48M	2.39M	13.23M	19.23M	28.15M	15.61M	21.41M	22.62M
Working Capital Changes	-882K	-2.49M	-10.3M	-9.71M	-8.38M	-15.95M	-25.05M	-23.94M	-54.18M	-67.27M
Change in Receivables	1.2M	8M	4.15M	-396K	-1.3M	-7.48M	-10.14M	-18.83M	-12.79M	-14.59M
Change in Inventory	-5.46M	-5.74M	258K	-6.02M	-14.71M	-18.19M	-27.75M	-20.7M	-45.56M	-54.66M
Change in Payables	3.21M	-4.87M	-2.59M	16K	6M	7.13M	757K	9.8M	6.99M	9.67M
Cash from Investing+	-12.25M	61.96M	-6.5M	-21.67M	-13.03M	-23.86M	-157.76M	-58.28M	-141.97M	-93.14M
Capital Expenditures	-12.25M	-9.15M	-7.6M	-6.91M	-13.03M	-23.13M	-68.54M	-49.45M	-80.51M	-93.14M
CapEx % of Revenue	0.07%	0.08%	0.07%	0.08%	0.11%	0.16%	0.28%	0.14%	0.17%	0.15%
Acquisitions	-	-	-	-	-	-	-	-	-	-
Investments	-	-	-	-	-	-	-	-	-	-
Other Investing	0	1.32M	1.1M	348K	0	-728K	0	-8.83M	-6.47M	0
Cash from Financing+	-6.53M	-43.39M	17.82M	53.88M	64.18M	130.83M	311.97M	31.23M	356.92M	56.21M
Debt Issued (Net)	-	-	-	-	-	-	-	-	-	-
Equity Issued (Net)	-	-	-	-	-	-	-	-	-	-
Dividends Paid	0	0	0	0	0	0	0	0	0	0
Share Repurchases	-	-	-	-	-	-	-	-	-	-
Other Financing	0	-114K	24.39M	0	0	-58K	-60.15M	-3.77M	-4.86M	-2.03M
Net Change in Cash	-	-	-	-	-	-	-	-	-	-
Free Cash Flow+	-2.12M	-19.11M	-16.32M	-32.52M	-46.15M	-70.3M	-141.86M	-133.41M	-165.46M	-137.79M
FCF Margin %	-0.01%	-0.16%	-0.16%	-0.35%	-0.41%	-0.49%	-0.58%	-0.38%	-0.34%	-0.23%
FCF Growth %	0.93%	-8%	0.15%	-0.99%	-0.42%	-0.52%	-1.02%	0.06%	-0.24%	0.17%
FCF per Share	-0.26	-2.23	-1.23	-0.92	-0.88	-1.05	-1.47	-1.29	-1.36	-0.96
FCF Conversion (FCF/Net Income)	-0.06x	0.33x	3.81x	0.88x	0.58x	0.59x	0.51x	0.50x	0.42x	0.28x
Interest Paid	7.63M	7.37M	4.7M	5.14M	5.97M	6.33M	5.03M	3.86M	17.27M	20.32M
Taxes Paid	621K	920K	107K	134K	161K	190K	223K	272K	333K	275K

Key Ratios

Metric	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Return on Equity (ROE)	-317.99%	-	-	-164.87%	-126.94%	-68.78%	-120.75%	-676.09%	-556.7%	-291.71%
Return on Invested Capital (ROIC)	-152.52%	-	-	-	-97.02%	-50.69%	-56.42%	-42.07%	-37.21%	-22.62%
Gross Margin	65.6%	63.31%	61.27%	68.97%	68.41%	70.76%	64.87%	66.42%	64.32%	69.37%
Net Margin	-96.44%	-25.21%	-2.25%	-31.6%	-50.25%	-54.53%	-58.81%	-43.12%	-38.7%	-26.51%
Debt / Equity	-	-	-	0.19x	0.78x	0.27x	4.48x	-	5.33x	64.65x
Interest Coverage	-43.10x	-2.87x	-1.18x	-3.14x	-	-4.76x	-18.02x	-26.70x	-10.42x	-5.47x
FCF Conversion	-0.06x	0.33x	3.81x	0.88x	0.58x	0.59x	0.51x	0.50x	0.42x	0.28x
Revenue Growth	-10.48%	-35.1%	-15.39%	-9.87%	23.7%	27.71%	67.89%	44.26%	37.45%	26.81%

Revenue by Segment

	2013	2014	2015	2018	2019	2020	2021	2022	2023	2024
Products And Services	-	-	-	-	-	-	242.26M	350.85M	482.26M	611.56M
Products And Services Growth	-	-	-	-	-	-	-	44.83%	37.45%	26.81%
International Supply Agreement	-	-	-	8.04M	5.18M	3.78M	954K	15K	-	-
International Supply Agreement Growth	-	-	-	-	-35.49%	-27.06%	-74.78%	-98.43%	-	-
United States Product	-	-	-	83.66M	108.24M	141.08M	-	-	-	-
United States Product Growth	-	-	-	-	29.39%	30.34%	-	-	-	-

Revenue by Geography

	2013	2014	2015	2018	2019	2020	2021	2022	2023	2024
UNITED STATES	-	-	114.58M	-	-	-	223.91M	326.7M	445.35M	571.27M
UNITED STATES Growth	-	-	-	-	-	-	-	45.90%	36.32%	28.27%
Non-US	-	-	70.7M	-	-	-	-	24.17M	36.91M	40.3M
Non-US Growth	-	-	-	-	-	-	-	-	52.71%	9.17%
Non Us	-	-	-	-	-	-	19.3M	-	-	-
Non Us Growth	-	-	-	-	-	-	-	-	-	-
JAPAN	28M	31.9M	-	-	-	-	-	-	-	-
JAPAN Growth	-	13.93%	-	-	-	-	-	-	-	-

Frequently Asked Questions

Growth & Financials

Alphatec Holdings, Inc. (ATEC) reported $728.0M in revenue for fiscal year 2024. This represents a 268% increase from $197.7M in 2011.

Alphatec Holdings, Inc. (ATEC) grew revenue by 26.8% over the past year. This is strong growth.

Alphatec Holdings, Inc. (ATEC) reported a net loss of $155.0M for fiscal year 2024.

Dividend & Returns

Alphatec Holdings, Inc. (ATEC) has a return on equity (ROE) of -291.7%. Negative ROE indicates the company is unprofitable.

Alphatec Holdings, Inc. (ATEC) had negative free cash flow of $0.0M in fiscal year 2024, likely due to heavy capital investments.

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Alphatec Holdings, Inc. (ATEC) 10-Year Financial Performance & Capital Metrics

ATEC • • Industrial / General

HealthcareMedical DevicesOrthopedic & Musculoskeletal DevicesSpinal Implants & Fusion Systems

Revenue $612M +26.8%
EBITDA -$53M +53.5%
Net Income -$162M +13.1%
EPS (Diluted) -1.13 +26.6%
Gross Margin 69.37% +7.9%
EBITDA Margin -8.64% +63.4%
Operating Margin -22.27% +38.1%
Net Margin -26.51% +31.5%
ROE -291.71% +47.6%
ROIC -22.62% +39.2%
Debt/Equity 64.65 +1114.1%
Interest Coverage -5.47 +47.5%

Technical Analysis

Key Insights

Based on financial data analysis

✓Strengths

✓Strong 5Y sales CAGR of 40.1%

✗Weaknesses

✗High debt to equity ratio of 64.7x
✗Negative free cash flow
✗Low quality earnings: Net income not backed by cash flow
✗Shares diluted 17.9% in last year
✗Expensive at 264.6x book value

Price & Volume

Loading chart...

Growth Metrics

Revenue CAGR

10Y11.44%

5Y40.07%

3Y35.98%

TTM27.11%

Profit (Net Income) CAGR

10Y-

5Y-

3Y-

TTM12.88%

EPS CAGR

10Y-

5Y-

3Y-

TTM18.75%

ROCE

10Y Avg-40.2%

5Y Avg-32.29%

3Y Avg-29.86%

Latest-21.44%

Peer Comparison

Spinal Implants & Fusion Systems

Name	Market Cap	Current Price	P/E Ratio	Revenue Growth 1Y	Net Margin	ROE	FCF Yield	Debt/Equity
GMEDGlobus Medical, Inc.	10.46B	93.89	125.19	60.62%	15.3%	9.63%	3.87%	0.13
TNONTenon Medical, Inc.	10.6M	0.95	-0.08	11.92%	-396.26%	-267.01%		0.07
BBLGBone Biologics Corporation	3M	1.67	-0.35			-65.59%
OFIXOrthofix Medical Inc.	570.24M	14.40	-4.36	7.08%	-14.56%	-26.92%		0.36
XTNTXtant Medical Holdings, Inc.	91M	0.65	-5.42	28.44%	1.32%	3.48%		0.82
ATECAlphatec Holdings, Inc.	2.59B	17.46	-15.45	26.81%	-21.29%	-13.47%		64.65
SIBNSI-BONE, Inc.	762.82M	17.58	-23.44	20.37%	-11.24%	-12.64%		0.22

Profit & Loss

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Sales/Revenue+	185.28M	120.25M	101.74M	91.69M	113.43M	144.86M	243.21M	350.87M	482.26M	611.56M
Revenue Growth %	-0.1%	-0.35%	-0.15%	-0.1%	0.24%	0.28%	0.68%	0.44%	0.37%	0.27%
Cost of Goods Sold+	63.74M	44.11M	39.41M	28.46M	35.83M	42.36M	85.45M	117.81M	172.06M	187.3M
COGS % of Revenue	0.34%	0.37%	0.39%	0.31%	0.32%	0.29%	0.35%	0.34%	0.36%	0.31%
Gross Profit+	121.54M	76.13M	62.33M	63.24M	77.59M	102.5M	157.76M	233.06M	310.2M	424.26M
Gross Margin %	0.66%	0.63%	0.61%	0.69%	0.68%	0.71%	0.65%	0.66%	0.64%	0.69%
Gross Profit Growth %	-0.16%	-0.37%	-0.18%	0.01%	0.23%	0.32%	0.54%	0.48%	0.33%	0.37%
Operating Expenses+	127.62M	87.48M	69.99M	83.23M	124.87M	161.36M	285.82M	380.03M	483.6M	560.43M
OpEx % of Revenue	0.69%	0.73%	0.69%	0.91%	1.1%	1.11%	1.18%	1.08%	1%	0.92%
Selling, General & Admin	105.72M	77.3M	64.38M	72.51M	101.71M	129.16M	229.27M	300.01M	374.08M	450.2M
SG&A % of Revenue	0.57%	0.64%	0.63%	0.79%	0.9%	0.89%	0.94%	0.86%	0.78%	0.74%
Research & Development	18.04M	9.25M	4.92M	9.98M	13.85M	18.75M	32.02M	44.03M	70.11M	80.72M
R&D % of Revenue	0.1%	0.08%	0.05%	0.11%	0.12%	0.13%	0.13%	0.13%	0.15%	0.13%
Other Operating Expenses	6.98M	-715K	0	738K	9.31M	13.46M	24.53M	35.99M	39.4M	29.51M
Operating Income+	-172.44M	-15.38M	-9M	-22.44M	-47.28M	-58.86M	-128.06M	-146.97M	-173.4M	-136.17M
Operating Margin %	-0.93%	-0.13%	-0.09%	-0.24%	-0.42%	-0.41%	-0.53%	-0.42%	-0.36%	-0.22%
Operating Income Growth %	-94.51%	0.91%	0.41%	-1.49%	-1.11%	-0.25%	-1.18%	-0.15%	-0.18%	0.21%
EBITDA+	-168.59M	-3.01M	-1.52M	-15.65M	-38.77M	-47.23M	-97.88M	-103.05M	-113.71M	-52.85M
EBITDA Margin %	-0.91%	-0.03%	-0.01%	-0.17%	-0.34%	-0.33%	-0.4%	-0.29%	-0.24%	-0.09%
EBITDA Growth %	-26.72%	0.98%	0.49%	-9.28%	-1.48%	-0.22%	-1.07%	-0.05%	-0.1%	0.54%
D&A (Non-Cash Add-back)	3.85M	12.36M	7.48M	6.79M	8.51M	11.63M	30.17M	43.93M	59.68M	83.32M
EBIT	-168.4M	-25.57M	3.04M	-23.03M	-47.28M	-66.47M	-137.05M	-146.5M	-170.27M	-137.19M
Net Interest Income+	-3.99M	-5.37M	-7.62M	-7.14M	-9.87M	-12.37M	-7.11M	-5.5M	-16.64M	-24.88M
Interest Income	11K	0	0	0	9.87M	0	0	0	0	0
Interest Expense	4M	5.37M	7.62M	7.14M	0	12.37M	7.11M	5.5M	16.64M	24.88M
Other Income/Expense	3.46M	-15.56M	4.43M	-7.73M	-9.87M	-19.99M	-16.11M	-5.03M	-13.52M	-25.9M
Pretax Income+	-178M	-30.93M	-4.57M	-30.17M	-57.14M	-78.85M	-144.16M	-152.01M	-186.91M	-162.07M
Pretax Margin %	-0.96%	-0.26%	-0.04%	-0.33%	-0.5%	-0.54%	-0.59%	-0.43%	-0.39%	-0.27%
Income Tax+	681K	-4.49M	-34K	-1.36M	-239K	145K	-1.13M	-716K	-277K	50K
Effective Tax Rate %	1%	0.98%	0.5%	0.96%	1%	1%	0.99%	1%	1%	1%
Net Income+	-178.68M	-30.32M	-2.29M	-28.98M	-57M	-78.99M	-143.03M	-151.29M	-186.64M	-162.12M
Net Margin %	-0.96%	-0.25%	-0.02%	-0.32%	-0.5%	-0.55%	-0.59%	-0.43%	-0.39%	-0.27%
Net Income Growth %	-12.87%	0.83%	0.92%	-11.63%	-0.97%	-0.39%	-0.81%	-0.06%	-0.23%	0.13%
Net Income (Continuing)	-171.25M	-26.3M	-4.54M	-28.81M	-56.9M	-78.99M	-143.03M	-151.29M	-186.64M	-162.12M
Discontinued Operations	0	0	2.25M	0	-100K	0	0	0	0	0
Minority Interest	0	0	0	0	0	0	0	0	0	0
EPS (Diluted)+	-21.53	-3.53	-0.17	-0.82	-1.09	-1.18	-1.50	-1.47	-1.54	-1.13
EPS Growth %	-12.63%	0.84%	0.95%	-3.82%	-0.33%	-0.08%	-0.27%	0.02%	-0.05%	0.27%
EPS (Basic)	-21.53	-3.53	-0.18	-0.82	-1.09	-1.18	-1.50	-1.47	-1.54	-1.13
Diluted Shares Outstanding	8.3M	8.58M	13.28M	35.31M	52.23M	67.02M	96.2M	103.37M	121.24M	142.95M
Basic Shares Outstanding	8.3M	8.58M	12.79M	35.31M	52.23M	67.02M	96.2M	103.37M	121.24M	142.95M
Dividend Payout Ratio	-	-	-	-	-	-	-	-	-	-

Balance Sheet

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Total Current Assets+	101.86M	72.82M	66.48M	75.54M	108.32M	184.16M	331.16M	255.63M	451.09M	417.4M
Cash & Short-Term Investments	11.23M	19.59M	22.47M	29.05M	47.11M	107.77M	187.25M	84.7M	220.97M	138.84M
Cash Only	11.23M	19.59M	22.47M	29.05M	47.11M	107.77M	187.25M	84.7M	220.97M	138.84M
Short-Term Investments	0	0	0	0	0	0	0	0	0	0
Accounts Receivable	26.87M	18.51M	14.82M	15.45M	16.15M	24.6M	41.89M	60.06M	72.61M	82.99M
Days Sales Outstanding	52.93	56.19	53.18	61.48	51.97	61.99	62.87	62.48	54.96	49.53
Inventory	44.91M	30.09M	27.29M	28.77M	34.85M	46M	91.7M	101.52M	136.84M	175.26M
Days Inventory Outstanding	257.15	248.99	252.79	368.95	355.03	396.37	391.71	314.54	290.29	341.54
Other Current Assets	32.56M	364K	131K	242K	10.2M	5.79M	0	9.36M	20.67M	20.31M
Total Non-Current Assets+	44.85M	21.36M	18.18M	53.94M	66.63M	81.06M	240.9M	265.33M	354.12M	358.31M
Property, Plant & Equipment	21.95M	15.08M	12.67M	13.23M	21.58M	37.85M	112.68M	130.31M	176.25M	191.09M
Fixed Asset Turnover	8.44x	7.98x	8.03x	6.93x	5.26x	3.83x	2.16x	2.69x	2.74x	3.20x
Goodwill	0	0	0	13.9M	13.9M	13.9M	39.69M	47.37M	73M	70.98M
Intangible Assets	21.62M	5.71M	5.25M	26.41M	25.61M	24.72M	85.27M	82.78M	102.45M	93.52M
Long-Term Investments	5M	5M	5M	5M	5M	4M	0	0	0	0
Other Non-Current Assets	1.28M	577K	264K	401K	546K	599K	3.25M	4.87M	2.42M	2.72M
Total Assets+	146.7M	94.19M	84.66M	129.48M	174.95M	265.22M	572.05M	520.97M	805.21M	775.71M
Asset Turnover	1.26x	1.28x	1.20x	0.71x	0.65x	0.55x	0.43x	0.67x	0.60x	0.79x
Asset Growth %	-0.57%	-0.36%	-0.1%	0.53%	0.35%	0.52%	1.16%	-0.09%	0.55%	-0.04%
Total Current Liabilities+	125.4M	40.53M	29.74M	30.61M	36.39M	58.31M	101.09M	138.87M	157.57M	153.03M
Accounts Payable	13.54M	8.7M	3.88M	4.4M	7.77M	17.6M	25.74M	34.74M	48.98M	52.98M
Days Payables Outstanding	77.54	71.99	35.92	56.42	79.17	151.64	109.94	107.64	103.92	103.25
Short-Term Debt	79.74M	3.11M	3.31M	3.28M	1.8M	5.08M	342K	14.95M	1.81M	1.66M
Deferred Revenue (Current)	648K	1000K	1000K	-3K	0	0	1000K	1000K	1000K	1000K
Other Current Liabilities	27.16M	23.71M	15.11M	19.71M	18.78M	23.38M	4.29M	5.64M	56.52M	6.82M
Current Ratio	0.81x	1.80x	2.24x	2.47x	2.98x	3.16x	3.28x	1.84x	2.86x	2.73x
Quick Ratio	0.45x	1.05x	1.32x	1.53x	2.02x	2.37x	2.37x	1.11x	1.99x	1.58x
Cash Conversion Cycle	232.54	233.19	270.05	374.01	327.83	306.72	344.64	269.38	241.33	287.82
Total Non-Current Liabilities+	57.88M	95.56M	81.58M	81.29M	66.32M	49.43M	391.54M	416.76M	545.91M	613.25M
Long-Term Debt	480K	43.09M	37.77M	42.3M	53.38M	38M	326.49M	349.51M	511.04M	574.52M
Capital Lease Obligations	0	0	0	92K	989K	78K	24.38M	26.56M	23.68M	27.3M
Deferred Tax Liabilities	0	0	0	0	0	0	0	0	0	0
Other Non-Current Liabilities	57.4M	52.47M	43.81M	38.9M	11.95M	11.35M	37.77M	37.65M	8.64M	8.29M
Total Liabilities	183.28M	136.08M	111.32M	111.9M	102.71M	107.74M	492.63M	555.63M	703.49M	766.28M
Total Debt+	80.11M	3.11M	41.07M	3.28M	56.18M	43.16M	355.43M	395.86M	541.68M	609.94M
Net Debt	68.88M	-16.48M	18.61M	-25.78M	9.06M	-64.61M	168.18M	311.17M	320.71M	471.1M
Debt / Equity	-	-	-	0.19x	0.78x	0.27x	4.48x	-	5.33x	64.65x
Debt / EBITDA	-	-	-	-	-	-	-	-	-	-
Net Debt / EBITDA	-	-	-	-	-	-	-	-	-	-
Interest Coverage	-43.10x	-2.87x	-1.18x	-3.14x	-	-4.76x	-18.02x	-26.70x	-10.42x	-5.47x
Total Equity+	-36.58M	-41.9M	-26.66M	17.57M	72.23M	157.48M	79.42M	-34.67M	101.72M	9.43M
Equity Growth %	-1.25%	-0.15%	0.36%	1.66%	3.11%	1.18%	-0.5%	-1.44%	3.93%	-0.91%
Book Value per Share	-4.41	-4.88	-2.01	0.50	1.38	2.35	0.83	-0.34	0.84	0.07
Total Shareholders' Equity	-36.58M	-41.9M	-26.66M	17.57M	72.23M	157.48M	79.42M	-34.67M	101.72M	9.43M
Common Stock	10K	1K	2K	4K	6K	8K	10K	11K	14K	14K
Retained Earnings	-427.24M	-457.17M	-459.46M	-501.92M	-558.92M	-638M	-782.33M	-932.32M	-1.12B	-1.28B
Treasury Stock	-97K	-97K	-97K	-97K	-97K	-97K	-25.1M	-25.1M	-25.1M	-25.1M
Accumulated OCI	-21.19M	970K	1.09M	1.06M	1.09M	1.2M	-5.99M	-10.79M	-8.32M	-13.68M
Minority Interest	0	0	0	0	0	0	0	0	0	0

Cash Flow

	Dec 2015	Dec 2016	Dec 2017	Dec 2018	Dec 2019	Dec 2020	Dec 2021	Dec 2022	Dec 2023	Dec 2024
Cash from Operations+	10.12M	-9.96M	-8.73M	-25.61M	-33.12M	-46.41M	-73.32M	-75.13M	-78.48M	-44.65M
Operating CF Margin %	0.05%	-0.08%	-0.09%	-0.28%	-0.29%	-0.32%	-0.3%	-0.21%	-0.16%	-0.07%
Operating CF Growth %	1.5%	-1.98%	0.12%	-1.93%	-0.29%	-0.4%	-0.58%	-0.02%	-0.04%	0.43%
Net Income	-178.68M	-29.93M	-2.29M	-28.98M	-57M	-78.99M	-143.03M	-151.29M	-186.64M	0
Depreciation & Amortization	19.03M	12.36M	7.48M	6.79M	8.51M	11.63M	30.17M	43.93M	59.68M	0
Stock-Based Compensation	2.64M	1.63M	3.9M	5.3M	10.96M	17.66M	36.45M	40.56M	81.24M	0
Deferred Taxes	-333K	10K	-36K	-1.41M	-438K	9K	0	0	0	0
Other Non-Cash Items	168.34M	8.46M	-7.48M	2.39M	13.23M	19.23M	28.15M	15.61M	21.41M	22.62M
Working Capital Changes	-882K	-2.49M	-10.3M	-9.71M	-8.38M	-15.95M	-25.05M	-23.94M	-54.18M	-67.27M
Change in Receivables	1.2M	8M	4.15M	-396K	-1.3M	-7.48M	-10.14M	-18.83M	-12.79M	-14.59M
Change in Inventory	-5.46M	-5.74M	258K	-6.02M	-14.71M	-18.19M	-27.75M	-20.7M	-45.56M	-54.66M
Change in Payables	3.21M	-4.87M	-2.59M	16K	6M	7.13M	757K	9.8M	6.99M	9.67M
Cash from Investing+	-12.25M	61.96M	-6.5M	-21.67M	-13.03M	-23.86M	-157.76M	-58.28M	-141.97M	-93.14M
Capital Expenditures	-12.25M	-9.15M	-7.6M	-6.91M	-13.03M	-23.13M	-68.54M	-49.45M	-80.51M	-93.14M
CapEx % of Revenue	0.07%	0.08%	0.07%	0.08%	0.11%	0.16%	0.28%	0.14%	0.17%	0.15%
Acquisitions	-	-	-	-	-	-	-	-	-	-
Investments	-	-	-	-	-	-	-	-	-	-
Other Investing	0	1.32M	1.1M	348K	0	-728K	0	-8.83M	-6.47M	0
Cash from Financing+	-6.53M	-43.39M	17.82M	53.88M	64.18M	130.83M	311.97M	31.23M	356.92M	56.21M
Debt Issued (Net)	-	-	-	-	-	-	-	-	-	-
Equity Issued (Net)	-	-	-	-	-	-	-	-	-	-
Dividends Paid	0	0	0	0	0	0	0	0	0	0
Share Repurchases	-	-	-	-	-	-	-	-	-	-
Other Financing	0	-114K	24.39M	0	0	-58K	-60.15M	-3.77M	-4.86M	-2.03M
Net Change in Cash	-	-	-	-	-	-	-	-	-	-
Free Cash Flow+	-2.12M	-19.11M	-16.32M	-32.52M	-46.15M	-70.3M	-141.86M	-133.41M	-165.46M	-137.79M
FCF Margin %	-0.01%	-0.16%	-0.16%	-0.35%	-0.41%	-0.49%	-0.58%	-0.38%	-0.34%	-0.23%
FCF Growth %	0.93%	-8%	0.15%	-0.99%	-0.42%	-0.52%	-1.02%	0.06%	-0.24%	0.17%
FCF per Share	-0.26	-2.23	-1.23	-0.92	-0.88	-1.05	-1.47	-1.29	-1.36	-0.96
FCF Conversion (FCF/Net Income)	-0.06x	0.33x	3.81x	0.88x	0.58x	0.59x	0.51x	0.50x	0.42x	0.28x
Interest Paid	7.63M	7.37M	4.7M	5.14M	5.97M	6.33M	5.03M	3.86M	17.27M	20.32M
Taxes Paid	621K	920K	107K	134K	161K	190K	223K	272K	333K	275K

Key Ratios

Metric	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Return on Equity (ROE)	-317.99%	-	-	-164.87%	-126.94%	-68.78%	-120.75%	-676.09%	-556.7%	-291.71%
Return on Invested Capital (ROIC)	-152.52%	-	-	-	-97.02%	-50.69%	-56.42%	-42.07%	-37.21%	-22.62%
Gross Margin	65.6%	63.31%	61.27%	68.97%	68.41%	70.76%	64.87%	66.42%	64.32%	69.37%
Net Margin	-96.44%	-25.21%	-2.25%	-31.6%	-50.25%	-54.53%	-58.81%	-43.12%	-38.7%	-26.51%
Debt / Equity	-	-	-	0.19x	0.78x	0.27x	4.48x	-	5.33x	64.65x
Interest Coverage	-43.10x	-2.87x	-1.18x	-3.14x	-	-4.76x	-18.02x	-26.70x	-10.42x	-5.47x
FCF Conversion	-0.06x	0.33x	3.81x	0.88x	0.58x	0.59x	0.51x	0.50x	0.42x	0.28x
Revenue Growth	-10.48%	-35.1%	-15.39%	-9.87%	23.7%	27.71%	67.89%	44.26%	37.45%	26.81%

Revenue by Segment

	2013	2014	2015	2018	2019	2020	2021	2022	2023	2024
Products And Services	-	-	-	-	-	-	242.26M	350.85M	482.26M	611.56M
Products And Services Growth	-	-	-	-	-	-	-	44.83%	37.45%	26.81%
International Supply Agreement	-	-	-	8.04M	5.18M	3.78M	954K	15K	-	-
International Supply Agreement Growth	-	-	-	-	-35.49%	-27.06%	-74.78%	-98.43%	-	-
United States Product	-	-	-	83.66M	108.24M	141.08M	-	-	-	-
United States Product Growth	-	-	-	-	29.39%	30.34%	-	-	-	-

Revenue by Geography

	2013	2014	2015	2018	2019	2020	2021	2022	2023	2024
UNITED STATES	-	-	114.58M	-	-	-	223.91M	326.7M	445.35M	571.27M
UNITED STATES Growth	-	-	-	-	-	-	-	45.90%	36.32%	28.27%
Non-US	-	-	70.7M	-	-	-	-	24.17M	36.91M	40.3M
Non-US Growth	-	-	-	-	-	-	-	-	52.71%	9.17%
Non Us	-	-	-	-	-	-	19.3M	-	-	-
Non Us Growth	-	-	-	-	-	-	-	-	-	-
JAPAN	28M	31.9M	-	-	-	-	-	-	-	-
JAPAN Growth	-	13.93%	-	-	-	-	-	-	-	-

Frequently Asked Questions

Growth & Financials

Alphatec Holdings, Inc. (ATEC) reported $728.0M in revenue for fiscal year 2024. This represents a 268% increase from $197.7M in 2011.

Alphatec Holdings, Inc. (ATEC) grew revenue by 26.8% over the past year. This is strong growth.

Alphatec Holdings, Inc. (ATEC) reported a net loss of $155.0M for fiscal year 2024.

Dividend & Returns

Alphatec Holdings, Inc. (ATEC) has a return on equity (ROE) of -291.7%. Negative ROE indicates the company is unprofitable.

Alphatec Holdings, Inc. (ATEC) had negative free cash flow of $0.0M in fiscal year 2024, likely due to heavy capital investments.