Detailed narrative
HYDROS vs. AQUABEAM Performance Dynamics
The company observed a significant contrast in performance between its HYDROS and legacy AQUABEAM accounts. While HYDROS accounts continued to perform well with procedures per account significantly exceeding AQUABEAM, the overall procedure growth shortfall was concentrated in legacy AQUABEAM sites. Management noted that HYDROS's enhanced imaging, workflow, and clinical capabilities are helping physicians adopt Aquablation more quickly and utilize the system more consistently, driving the strategic focus on upgrading legacy systems.
Accelerated Replacement Strategy
PROCEPT is accelerating efforts to upgrade legacy AQUABEAM systems to HYDROS, selling 14 replacement systems in Q2. This activity is expected to remain an important commercial strategy, with approximately 40 replacement sales anticipated for the full year. While these upgrades may cause modest near-term disruption, the company believes they will improve account productivity and support stronger, more durable procedure growth over time⏳, leveraging the higher utilization seen in HYDROS accounts.
Commercial Reorganization and Launch Team Scaling
The U.S. sales force realignment and optimization of account coverage are substantially complete. The dedicated launch team model is scaling, with 40% of HYDROS systems launched through this team in Q2, up from 20% in Q1. The company expects a meaningful increase in Q3 and aims to have the capability to support 100% of new HYDROS system launches by year-end, which is expected to drive shorter time to first case and stronger early utilization.
Patient Activation Pilots
Direct-to-patient pilots have been launched across 18 U.S. markets, utilizing television, radio, digital, and social media campaigns. The company is actively gathering data to assess channel effectiveness and is encouraged by leading indicators such as increased website traffic, stronger digital engagement, and greater interaction with patient education resources, aiming to motivate patients to seek care.
Clinical and Regulatory Milestones
The American Urology Association strengthened its recommendation for Aquablation therapy in its updated BPH treatment guidelines. The company completed enrollment in WATER IV, its first randomized clinical trial evaluating Aquablation versus radical prostatectomy, with primary endpoint results expected at the AUA Annual Meeting in Spring 2027. FDA IDE approval was also received for WATER IV AF, a second randomized protocol.
Pricing Discipline and Capital Sales Strength
Pricing discipline remains fundamental, with Q2 greenfield HYDROS ASP reaching its highest to date at approximately $495,000, up from $485,000 in Q1 and $435,000 for FY25. This reinforces the perceived value of Aquablation therapy and validates hospital commitment, contributing to strong system demand and confidence in the platform's outlook.