Nightingale Health Oyj

Good afternoon and welcome to the Nightingale Health Financial Year 25-26 webcast. My name is Teemu Suna. I'm CEO and founder of Nightingale Health. I'm currently also CFO of the company. Today, our agenda is I will first talk about Nightingale Health. Then we will go to the business targets of the past fiscal year. Then we look into the business targets of the current fiscal year. Then we'll have a business update. I go through the different business areas. Then we will have the financial review. Then we look at the AGM and financial calendar. Then we have some significant events after the end of the period and then in the end we have Q&A and you can post your questions. We will go them through in the Q&A in the end. So let's start. So Nightingale Health, we are a global health technology company. We've been building the company for more than 10 years. We have a global footprint. We run our own laboratories in the US, UK, Finland, Japan, Singapore. We work in B2B and B2G markets, and the main focus is preventive healthcare. So what Nightingale is all about, we have created a preventive healthcare platform. And this is a preventive healthcare platform that enables various AI-powered applications. So the problem with basically all healthcare applications today is that there is no globally standardized clinical grade way to measure health trajectories and intervention impact. So we actually take actions in healthcare, but we don't know what is the impact of those actions. We operate many times blindly. This is particularly true when it comes to lifestyle interventions. The solution is that we take a single blood sample, we run one test, and we detect the risk of developing diseases in the future. So we detect if a healthy individual is at risk of developing many cardiometabolic diseases, type 2 diabetes, cardiovascular diseases, kidney disease, fatty liver disease. This platform has been built, as I said, over the past 10 years. It has very, very strong validation. We have run more than three million samples. There are more than a thousand peer-reviewed publications of the technology and the footprint is global and the technology is already in national use in Finland. The opportunity here is that we enable the standardized global measurement layer to power all the healthcare applications, particularly when they are AI native. And then this problem, preventive healthcare problem, is applicable across all the fields of healthcare, payers, providers, population scale programs. So the solution in a more detailed way is that we take a single blood sample. This is a standard blood sample. It's venous or it can be a finger prick. We have our own proprietary device how we can collect the sample. Then we take that sample, we run our own biotechnology platform based on NMR metabolomics. And in that test, we detect a very broad biological information from the blood. And because we can detect very broad biological information, more than 40 clinical biomarkers, we have then developed validated risk models that goes beyond the biomarkers. So we detect the risks of developing diseases, heart attack, stroke, type 2 diabetes, chronic kidney disease and liver disease in one go. So we are not a traditional diagnostics company focused on single biomarkers. We quantify disease risk. And this is important because if you really think about it, I mean, nobody is interested what is your LDL cholesterol. And matter of fact, people who have a heart attack, 70% of them have normal LDL. So if nobody is interested about the biomarkers or the biomarkers really don't tell the story, So then the whole industry is kind of working around the biomarkers. So we have created something better. This goes beyond the biomarkers. This quantifies the risk. So instead of knowing what is your LDL, you should know what is your risk of developing a heart attack. And then when you take actions, lifestyle actions, medication, It can be anything, exercise, sleep, diet. Then we measure you again, and we can quantify if your actual risk is going down. And this is important, because why would you measure your blood if you cannot measure if your risk is going down, your risk of developing the actual disease? So that's why we are not a traditional diagnostic company. We actually quantify the disease risk. And this is what other diagnostic companies cannot do. Why the risk detection is Very important now. First of all, the chronic disease burden, the diseases that I mentioned, it's all around the world. If you take all of the healthcare costs, depending how you calculate this, someone may say this is like 60% of all the costs. You can also argument it's closer to 90% of all the costs. chronic diseases and the reason is that chronic diseases by nature are long-standing diseases that need attention all the time. So this creates a huge cost pressure and it accelerates around the world. Then the second point, prevention is going mainstream in population scale programs. So it's not something that The market is not there. The market is there, and it's expanding rapidly. When we started this company, I remember like 10, almost 15 years ago, when I was talking about preventive healthcare. It was something that was mostly in your keynote speech, you talk about preventive healthcare and nobody does anything. Today, the situation is very different. So we have a lot of preventive health care programs going around the world. They are in the early days, but it's very clear that this will be the new prevention, will be the new standard of primary care. Number three, AI is driving the transformation in health care everywhere. And AI is, like many times when we talk about AI, we talk about data centers, we talk about algorithms. If you look now, what is the kind of the most advanced conversation around AI? It's all around data. Because data is the fuel for the AI. If you don't have good data, like, you cannot... generate biological data of people. You have to measure it, you have to get the data. And then on the other hand, when AI applications get the data, if you think about the big health platforms, if they have high quality, objective, standardized molecular data, it will transform what these applications can do. and this is what Nightingale will enable and we have a very very unique platform to enable it. Building the company, this kind of a company is a long journey, very long journey. The reason for this is that you have various very complicated elements. So we started from creating the biotechnology. And building a biotechnology platform, the amount of scientific work, engineering work, and particularly the validation work and regulatory work, it's immense. And you have to build all of that first before you can do any applications. In our case, it had like two different parts. The first part was to validate the platform to detect the biomarkers. And then the second part was to validate the risk models. And the risk models we have today are something that the level of validation, there is nothing like that in the market worldwide. So we are a global leader in this, but it has taken a decade to build it up. Then building even that is not enough because then you have to build the capability to deliver the product. So you have to You have to build the laboratory network because we are not using the standard laboratories because the equipment and technologies they are using, they are not good for what we want to do. They are not good for what the market actually wants to happen. They are built for single biomarker detection. The market, the future of healthcare in primary care is holistic health profiling. So we could not go to the existing labs and say, oh, we're going to do this with these technologies. And this is very, very heavily validated by many scientific publications where we've been compared against the standard clinical chemistry measurements. And the results are very clear that our risk detection performance goes beyond the standard routine protocols in biomarker detection. So how does this journey If you put it in a timeline how this journey looks like, so we started from Finland, we built our laboratory in our headquarter starting 2015. First you do the pilots without the local lab, then you build the local lab, then you get the regulatory approvals, then you win the local pilots, then you try to win the local reference deals, and then you try to get the volumes up. Then after Finland, we started to build Japan, then Singapore, UK, US. And now you can see that the timeline accelerates heavily. So Finland was 2015 and now in two years, Singapore, UK, US. And this is because The expansion model and how we have standardized the lab rollout, we have it completed. So when we expand to more countries, we can basically take this technology anywhere in the world. And now after these five locations, which we needed to invest heavily upfront ourselves, now when going to new regions, we do it with a very commercial model. The business model, as I mentioned, we work with the B2B customers. They embed Nightingale's data in their preventive health applications. we have basically you can think this less like a tiered structure so depending on the volume because this is heavily a volume business so the more you have volumes the better you can kind of manage the process do it more affordable manner having lower unit prices This technology is not built for the longevity, high-end longevity field where the richest one person in the world can use this technology. I feel good about it. This is built to build a healthier world. What it means, it means that we need to integrate into the health care systems. But I think more importantly, we need to deliver health information that is built for the humans. And this is what we do. So, as I mentioned earlier, instead of telling what is your LDL, what is your ApoB, ApoA1, what is your... Yes, we tell also that information, but if you think about, if you take the population, if you really think about healthcare globally, the real problems and challenges that we need to solve, They are not this kind of distinct group of people who are very familiar with all the biomarkers and metabolic pathways, etc. That's not the point. The point is to deliver information that anyone can use to live a healthier life. And that's what we do. That's the focus. That's why we also aim to high volume applications. We aim to push the price down, not up. It's a hard thing to do. It's actually much harder thing to do than going into these high end luxury markets. But that's why we started the company and that's what we are going to do. And when we get it done, there is also immense global business opportunity that we aim to capture. To that end, the market is there. It's huge. I think the main point in this slide is that if we look at the global wellness economy, I said that this is what we built. We built this for the people. We are not directly going to direct to consumer and sell this to people, but the world is full of these major scale health platforms that will significantly benefit of Nightingale's data when they integrate it in their applications. This is how we can reach the global wellness economy. And now the global wellness economy is 6.3 trillion. But that's kind of reflection of the market that we want to be in. That is the future of healthcare. The primary healthcare will not happen as a part of the healthcare system that we have currently. It's not hospitals. That's the sick care system. The healthcare system is where you meet the people. To connect with people you need to show them data that they can understand, they can use and they can improve their health. Which is the ability to detect the risks and follow the change of the risk when people take actions, change their lifestyle etc. So building the globally standardized clinical grade measurement layer, that is the key that powers the whole world of preventive health care as well as the global wellness economy. And this is the opportunity also with Nightingale and this being able to detect the risks, the capability of detecting the risks. This is where we are a world leading company. So why Nightingale and what makes us unique? Validation is next to none. We are global. This is an asset that is not regional. If you think about the current diagnostics industry, you can take the biggest player in the United States, you take West Diagnostics, LabCorp of America, They are not global. You take the biggest player in Europe, you look at Synlab. They are not global. But we are. And then we are independent. We are not dependent on any of the existing laboratory networks. We have built our own. This is only available from Nightingale, what we do in terms of the risk detection and importantly validated, clinically validated risk detection. Only available from Nightingale. I mean any engineer can build this kind of a model you just take some biomarkers and you take some some data and then you build some kind of a risk model and you say oh here is my risk model but it's not a validated model it's completely different thing and then when you start building global health applications it's better for all of us if the technologies that the health platforms use are validated with the highest possible standard. And this is what we have. The data that this is based on, we are running this on top of the world's largest metabolomics database. We have transparent operations as we are a public company. We have excellent scalability, excellent efficiency. In a global comparison, how efficiently we operate in terms of the use of funds, for example, is exceptional. And then this technology is already adopted by nationwide healthcare here in Finland. So that's it. So I think it's a very important moment in our journey as a company, because what we have been building for a long time now, we very strongly feel that the market is also very clear indications that this prevention, holistic health profiling, ability to detect the outcome risks, objective measurements, repeatability, global footprint, remote sampling. If you take this and you take any of the big health platforms in the world, these are the things that are on top of their priority lists. And these are also things that building these is immensely difficult. Takes a decade and we have it and I'm not aware that there is anyone else who is even close what we have built. I would call that a moat, which is very, very important now in this situation when the market is taking steps towards prevention and holistic health profiling. All right, let's go to the business targets of the past fiscal year. Our target was to increase revenue by at least 50%. We landed only 17% increase, didn't achieve the target. This is, of course, disappointing. We had the pipeline, we had the deals, we had everything set up in a way that we would reach the target. Unfortunately there was about 2 million euro in revenue that got postponed in a single large project and this was due to third parties so we could not do anything about the situation. Now this 2 million moved to the current fiscal year but of course it was disappointing that we didn't achieve the target. Now when we look at the current fiscal year, so last year the aim was to increase the revenues by 50%. Now it's approximately double, so approximately 100%. So we aim to achieve revenues of at least 10 million euro. We have only this single target and the reason for this is that now the most important thing is to increase the adoption of the technology. And this is to... Revenue is a very efficient way to measure it and we have full focus in building up the revenue streams across all of our businesses, in our research business, in our healthcare business, all across the board. The mid-term and long-term business targets are unchanged. We strongly believe that these are still very relevant. And as I said, the problem we are solving here is a global problem, and this is the level what we want to achieve with this technology. Then we have next the business update by geographical areas. So in summary, what we've been very focused on is the commercial activities. I mean, the point here is that now it's time to increase the adoption. So it's to win deals. and it's only to win deals. That's what matters now and we have very strong focus towards that. We have made many changes in the company to enable more time and energy to the commercial activities. So what we have already last fiscal year, we managed to increase the value of the sales pipeline. We signed a new significant agreement and then we had a lot of pilot projects launched. So the work we are doing, I think we have done many important and right actions. If I look at the volume of commercial activities, it has increased significantly. We will continue increasing that, but it's also important to remember that in this business, Sales cycles are long and then even when you win some new contracts they typically ramp up step by step. It's not like overnight that someone like adopts the technology in large scale use. We have also that kind of deals but it's important to to realize that there are like the market dynamics are pretty slow in this industry. We go through country by country in Finland. I think we have a very strong market position here. We are in nationwide use. We have run more than 250 000 samples for for people here in Finland already, which is given the population of five million, it's pretty significant. We are also going to public healthcare use here in Finland. I think that's also very important because this is, as I mentioned earlier, this is a technology that is built to be part of the health system. It's a technology that enables a new kind of a health system. And I'm thrilled to see that in Finland the government also has a very progressive thinking to start building the prevention. I said earlier that the current healthcare system will not build the prevention, I still think this is true in the big picture but then we have countries and we have programs that actually aim to transform the healthcare system into the direction of prevention and of course this is very good to see this happening. In the UK, we have done a lot of market exploration work in the clinical side. We are very strong in the UK in the research business side of things. But now we have also put a lot of effort in the clinical side. Market exploration going, first pilot project loans. I expect more results from the UK already in the current year half. In EMEA, a lot of commercial activities over the past fiscal year. We opened discussions in more than 20 countries. We started from a very market exploration style of activities, aiming to close as much pilot programs as we can. and we have the pipeline for the pilots. It's very, very strong. We have announced some of the pilots already and there is more to come. And next with these pilots, there's a lot of conversations to go into production stage negotiations. The market is building well in EMEA. As I said, it takes time and it's important to note that last fiscal year was the first one that we had a strong commercial effort starting to build this up. So it takes some time, but when looking at the pipeline and the funnel, it looks very good and it grows all the time. Singapore. Maybe the most important thing we did in Singapore was that we introduced a new version of the product based on the customer feedback. Now there are customers who have been using the product and the feedback is very good. So we are very happy about it. The volumes are initially modest, but we expect the volumes also to increase increased steadily. It's also the health screening market that we work in Singapore. It's very kind of... It's not the same around the year. So there are certain time periods in a year when there is more demand. And we will now see how the demand develops when we move into the high season of the health screenings in Singapore. In Japan, we have also done a lot of work with the customer feedback that we have got from the recurring customers. There are improvements to the business model and the report over the coming months. Initial conversations have already taken place with the customers and the feedback about the improvements is very good. Having a good product market fit is essential and that's why we are taking these actions to help to build the business up. But the first commercial results of the new products in Singapore and in Japan are expected also in the current fiscal year. In the United States, I think a very important step was that we managed to receive the CLEP permit from the state of New York. And we have a clear roadmap to enter the US healthcare market now because of this. We also hired a chief commercial officer located in the US and we have several new sales activities initiated. There are a lot of pilot negotiations ongoing that would utilize the New York lab. Medical research market, which is still our biggest business area, We took strong actions to increase sales activities in this business area. We introduced the multiomics offering. We announced a strategic partnership with Alamar Biosciences. So there are a lot of very strong commercial actions that we have taken. The pipeline has increased substantially. I'm expecting to see more wins also in this segment in the future. And in the past fiscal year we closed, here we have a couple of important projects that we closed in the past fiscal year. All right, that was the business update. I would summarize it in a way that one of the key strengths of Nightingale is that we are, I said it in the beginning, I say it again, we are a global company. And the global company structure, even though it's very challenging to build, we have now built it, we have it going. The benefit of that structure is that we We can execute in parallel in several markets. We can learn from different markets at the same time. We can get those learnings to build a better product, and then we can deploy the products in these markets. Then if there are some disruptions, as we have seen, there may be disruptions around the world, politics may change, various things may happen. But because we are operating globally, we are also in a position to kind of continue growing the business even if a country faces some challenges. And that's something that we are going to continue building this as a global company, building it parallel. And with that, we can also ensure that the business growth will take place. Then let's have a look at the financial review for the past fiscal year. We had the best half year, half ever. the last half of the past fiscal year. The second half revenue increased by 30% compared to the second half of the previous fiscal year. And then the revenue of the whole year was 5.5 million. Largest part still came from the research business. This is something that when I look at the kind of forward-looking pipeline, this balance is shifting step by step. So the healthcare part is taking bigger and bigger part of the revenues. It takes some time to build it up and I'm very excited to see also the research revenues growing because it's not that these two businesses that we have, they're completely isolated. They are not. So when we win in research, it helps us to win in healthcare. When we win in healthcare, it helps us to win in research. It's the same technology, these are interlinked. It's the same company, these are interlinked. And one of the unique abilities we have and what we have demonstrated, we have the ability to translate scientific findings to clinical products. You can make a review and see how successful companies are in this in general. It's very difficult and we have done it with a very difficult market when we look at the primary care market. Now, when there are more scientific findings, we can now translate these findings to clinical products very, very rapidly. And I think this is important to remember when evaluating the business between research and health care. They are both very important. Here are the financials. So the revenue growth was 17% compared to the last fiscal year. Change in liquid funds was more or less the same as in the previous year. So we can run the company without increasing the The cost burden, which is important also when we're looking to increase the revenues, we have strong confidence that We can actually hold this cash position and with the revenue increase, even starting to improve it. So I think we have the, and this is because we have the structures in place. Many times if you look at the numbers in technology growth companies, when the revenue starts going up, The amount of money going out increases. In our case, we expect this number to decrease, which tells a lot about the business structure that we have in place and the ability to grow. We are still in a solid financial position. We have debt-free balance sheet. When looking at the business transformation that we are building, I'm not worried about the financial position. I strongly believe that it's strong enough to take the company commercially to a very different position, and our focus is entirely to build that commercial position to show that our technology is being adapted all around the world Revenues increase and the business increase with that. And I think with that increase we will be in a very good position financially to take any actions that are then appropriate. And that's something that we will see when we move forward. The annual general meeting and the financial calendar is here. So the annual general meeting will be held on 5th of November. And the calendar is there. There were a couple of significant events after the end of the period. So I mentioned that We are now putting a lot of effort in the deals. So it's deals, deals, deals. And here you can get some reflection of these deals. So here we have four deals that were announced after the end of the fiscal year. They are all pilot. in the first piloting stages, some of them already moving also to the more production stage, for example with Genome. So kind of the The strategy and the commercial implementation is taking place all the time and there are also results coming all the time. And the current fiscal year, I believe, will be the transformation in terms of the financial results as well for Nightingale. We have set the target to double the revenue. Reaching that will already take the company make the company financially very, very different. And we strongly believe that we are in a very good position to reach that target. And I think investors should Follow our releases regarding the deals. The more we can win deals, the more there will be business, the more there will be adoption for the technology. And I think that is the most important thing to follow right now. All right, so that was the review of the agenda, except one point left, which is the Q&A. So let's go to the Q&A and as usual, Janna Ranta will join me on stage.

Good afternoon, Teemu, and good afternoon, viewers online. We have received a lot of questions, so I would say we jump right into it. Let's start with an easy one. So summarize the fiscal year in one word. How would you describe it?

One word. Well, I think that word would be commercial. It's this kind of a company that, as I showed, more than 10 years of being a technology company. and now becoming a commercial enterprise. It's a very difficult challenge and that has been the focus. We have done tons of things internally to make this transformation happen and I think there are a lot of... We have been very successful in many of these things. and then I think the word for this fiscal year is deals.