Arjo AB (publ)

Thank you very much, and good morning, or good afternoon rather, and welcome to REO's Q1 2024 earnings call. We look forward to give you some details on the Q1 report that we just released. The agenda includes a summary of activities and results from Q1, balance sheet items, an update on Boone Express, and also an outlook for 2024 before we open up for questions. We intend to keep this call to an hour and finish no later than 4 o'clock, as we are then heading to this year's annual shareholders meeting, which is held here in Malmö at 5 o'clock. Next slide, please. Q1 shows a solid start to the year, well aligned with our full year plans. We continue to see good growth in most markets, well supported by both order intake and pipeline buildup. Our capital sales develops favorably in North America and the rest of the world, and we continue to see good growth in both service and rental globally. Our outcome programs in patient handling and pressure injury prevention are still not up to the speed we want, but especially in pressure injury prevention, we see a gradual improvement month by month with new products being implemented and customers ordering patterns stabilized. This results in a 4.3% organic growth for the quarter, well aligned with our plans for the start of the year. Our gross margin came in at 43.5%, an improvement versus Q1 2023, and well aligned with plans to continue to improve gross margins for the full year of 2024. We see good development in both patient handling and service volumes, both adding to the gross margin expansion The good development in our rental business, as you know from previous reports, have a dampening effect on gross margin for the group, as rental has a lower gross margin than capital sales, but an equally good effect on EBIT. This has a large effect on gross margin isolated compared, for example, to Q4, where the percentage of capital sales is always higher. It should also be stated, however, that we continue to improve the isolated gross margin year over year, also this well aligned with PLAS. Activities around price adjustments, internal efficiency and product mix are generating the forecasted results, and our focused work in these areas continue. On the OPEC side and in comparable currencies, the increase is mainly related to higher salary costs, but also increased activity levels and some higher net R&D. We continue to invest where we drive profitable growth for the future, while making sure to safeguard our short-term commitments. Adjusted EBTA for the quarter increased to 502 million SEK versus 475 in Q1 2023, well aligned with our plans for the full year. And Niklas will come back on this subject in his part of the presentation. Adjusted EBIT improved with 13% from 219 restated from Q1 2023 to 248 million. And we continue to have good stability in our earnings progress. We continue to perform as planned on operational cash flow with 256 million from Q1, leading to a cash conversion of 54% for the quarter, which is the same level as last year. And also here, Niklas will take you through further details But from my perspective, another solid quarter with good actions to develop further and meet our full year target of 80% cash conversion. As in Q4, we continue to work and see our efforts to contribute to more sustainable healthcare. One important aspect is to reduce our climate impact. And during Q1, our climate targets were approved by the science-based target initiative, which is a significant milestone in our sustainability work. It confirms our targets as scientifically approved and that they are in line with the Paris Agreement. Based on this, we will now continue our work in this area as a part of building a winning and sustainable area. In summary, we put a solid Q1 behind us, well aligned with our plans for the full year. The organization have done a good job in navigating different market conditions, and we have set ourselves up for good continuous improvement in 2024. Service and rental continues the positive trend from 2023. Capital sales in North America develops well, and we continue to gain step-by-step traction on our outcome progress. Next slide, please. And over to North America, where North America grew with almost 10% organically in the quarter, marking a solid start to 2024. Following the positive trend from 2023, Q1 continued to see good net sales development in Canada, where both rental, service, and capital all developed well, and it continues to be the long-term care business that drives most of the growth based on good investment levels in that market space. Overall market conditions in the U.S. continue to improve, and we are well positioned to capitalize from that. In the quarter, we have had a good development of service, rental, and our patient handling capital sales. Our outcome programs in caregiver injury and pressure injury prevention continues to activate high interest with customers, but with both segments, traction from pipeline to order continues to be slower than wanted. Reasons are, as before, mainly due to staffing problems and short-term focus in healthcare, but the light in the tunnel continues to improve. There is currently better traction in our pressure injury prevention side as new contracts start to activate a monthly inflow of orders, a development that we believe will continue to gain traction throughout the year, given the size of the existing and realistic pipeline. In the more transactional capital sales business in the U.S., we see that continue to improve, especially in patient handling, and we believe that that traction in this area will continue also in the coming quarters. Both service and rental sees mid single digit growth in the quarter. And especially in rental, this is leading to increased profitability through operational leverage on a now well adjusted cost base. In the quarter, decision has also been made to have dedicated leadership in both US and Canada put in place to ensure that we drive the development on these two very important markets with full focus. The two country heads are reporting directly to myself, and as a consequence, the position as president North America has been eliminated. In Canada, we have a new managing director in place, and in the US, our interim management with strong direct support from my side on site has created a positive momentum towards target set. Overall, a good and solid start to the new year in North America with both US and Canada with good traction towards full year targets. Next slide, please. Our global sales region grew with 2.4% organically in Q1 with good performance in many of the larger markets. In Western Europe overall, we see the same trends as from Q4 2023 with a continued healthy demand of our products and solutions together with a good development in both service and rental. With that said, we saw a slight decline of 0.5% on organic growth, mainly because of lower capital sales in markets like Germany and Netherlands. Especially for Germany, this slight decline is more a timing issue, as we expect to see recovery for the full year. Also in France, we had a decline in overall net sales, but this is mostly due to very strong comps from Q1 2023. And we continue to have a really good momentum in all parts of the French business, especially when we now have renewed the rental contract with UGA and put that into full swing from Q2 and onwards. Our UK business continued to develop well despite the continued turbulence market situation, and we see good performance also in countries like Belgium, Italy and Ireland. Our service and rental business in Western Europe develops well in the quarter, both on volume and on price. Especially pricing has continued with traction across segments, and we have full focus on securing needed increases to compensate for salary increase. As we've indicated in the latter parts of 2023, the uncertainties around capital spend levels in European healthcare is there, but based on our current performance and the information at hand and the pipeline, obviously, We are positive around our possibilities to continue to see growth and continued improvements on profitability in Western Europe also in 2024, mainly driven by service, rental, and the solid work around pricing. In addition to this, I would like to mention our performance in our diagnostics business, which is not included in what I just went through and reported. And the diagnostics business is then reported externally under our segment others. Q1 and Q2 of 2023 were, as you probably remember from these reports, heavily positively affected by the clearance of backlog from 2022, making the comparison with Q1 this year difficult. And hence, we saw an organic net sales decline of almost 20% in the quarter for that business. This is, however, in line with our plans as we're now back to normal backlog levels in this part of our business and should see growth returning in this area by Q3 and onwards. Next slide, please. Then to the rest of the world that continued on the good trend from Q4 with an organic growth of more than 11%. We continue to see good performance in countries like Australia, New Zealand, and India in the quarter, and our capital sales continue to develop well together with good service development in more mature countries in the region. We had rather large medical beds orders invoiced in the quarter with unfavorable product specifications in APEC. This led to lower than expected margins in this area. And here we will need to be very mindful of our approach going forward to ensure both market development and profitability at the same time. Our sales in Japan developed favorably in the quarter. After a thorough analysis, however, it has become clear that we will need to change our go-to-market model in Japan. to create better momentum on this large market. We are therefore implementing this new go-to-market approach where we will, to a larger extent than today, use solid and experienced dealers to execute sales. The changes have been implemented in the end of Q1 and are expected to secure our net sales plan for 2024 and build better momentum for 2025 and onwards. We have continued to implement the plans that we talked about in the Q4 report around strengthening our activities on the markets in Eastern Europe, where especially Poland and Czech Republic are markets where we believe that significant net sales development is possible based on inflow of investments financed by, for example, the European Union over the coming years. Next slide, please. gross margin that came in at 43.5% for the quarter, which is a slight improvement from 43.1% in Q1 of 2023. We have, as expected, seen an increase in salary cost in supply chain, service and rental, which we during the year will offset in a good way through continued efficiency work and continued price increase. Salary increases seen are within the limits forecasted, and we expect additional price increases from beginning of the year to start mitigating even better from the second half of this year, with the same pattern for gross margin development that we saw in 2023, especially in Q4. We have had lower than expected gross margins in our medical beds category, which is mainly driven by larger low margin projects in APAC, as mentioned under the rest of the world sector. We believe that these products long-term can lead to good market development with the possibility to introduce other more profitable business on the back of this investment. But for Q1, it has a negative gross margin effect. On the positive side, we continue to deliver service on good gross margin levels, and we're improving our profitability in our patient handling category, despite the lower sales than expected with our outcome programs in this area. We also continue to see good efficiency gain based on our supply chain strategy, and we can conclude that external transportation and material cost is following the expected positive trends. I discussed pricing shortly a few seconds ago, and I would just like to emphasize that we are trending according to plan in this area and continue to focus that we will see pricing add in between one to one and a half percent organic growth on top line for the full year. where Q1 achievements have been well aligned with that. Next slide, please. Our OPEX level continues to be well managed, and we make sure to invest in activities that secure both short-term targets and solid profitable development for the future. The increase in OPEX for the quarter versus last year's Q4 is, as expected, more or less isolated to salary cost in selling and admin. The increase are aligned with expectations coming into the year, and we expect remaining increases to affect Q2 and onwards. R&D investments is at 2.8% for the quarter, and net R&D is approximately 6 million higher than in Q1 of 2023. This reflects well the development in our R&D pipeline, and we are looking forward to some interesting launches in existing main categories by the end of the year. We continue to improve our profitability levels for the group according to plan, and our adjusted EBIT grew with 13% from 219 million in Q1 2023 to 248 million for this quarter. Restructuring came in at 29 million for the quarter, which was higher than what we previously estimated. The reason for this is the decisions I mentioned earlier in North America and Japan, respectively. The rest is, as planned and previously communicated, related mainly to our strategic alignment in our West European sales setup. And given the additional activities now in North America and Japan, we expect that destruction will be around 40 to 45 million for the full year, up from expected 30 to 35 at our last telco. And with that, next slide and over to you, Niklas.

Yes, thank you Joakim, and good afternoon from me as well. The positive trend in operational cash flow continues with a slight year-over-year improvement in the quarter. This is despite the difficult comparison due to low level of bonus payments last year in quarter one and also we have a later than normal invoicing peak this year, which means of course late build-up of accounts receivables. Worth mentioning is also that Q1 is from a seasonality perspective normally lower than other quarters. Working capital increased in the quarter, mainly due to increase in accounts receivable coming from the late invoicing peak. And this is a timing effect. The payments will come in quarter two. Our long term improvement activities regarding working capital is continuing in full speed, and this focus will continue throughout this year. Working capital days sees a significant decline year over year in the quarter, down to 82 days compared to quarter one, 23, with the 96 days. But it's sequentially up from quarter four with the historically low 77 days. The improved profitability offset by the working capital increase gives a stable operating cash flow of 256 million sex for the quarter versus 250 million in quarter one last year. Cash conversion was stable versus quarter one, 23, and we report 54% cash conversion for the quarter, which is in line with historical levels in quarter one, considering the normal seasonality I mentioned before. We are well on track towards our target of 80% cash conversion for the year. For your information, cash flow from investing activities was minus 141 million SEC versus the 190 million SEC in quarter one last year. And this is mainly containing the investments in our rental fleets, R&D and fixed assets. Next slide, please. Our net debt is significantly down year over year from 5.2 billion in quarter one last year to 4.4 billion in this quarter. Sequentially, the 4.4 billion net debt is slightly up versus the 4.3 billion in quarter four. Our financial net has improved compared to the same period last year, and it's mainly connected to currency effects, while the interest rates are higher than last year. The interest net was sequentially stable from quarter four, based on the stable debt level. We expect our reduction journey on net debt to continue in the coming quarters, and together with potentially lower interest rates during second half of this year, we anticipate decreased financial costs during the year. Our cash position remains strong. Our leveraged net debt to adjusted EBITDA improved significantly year over year and came in at 2.3 in this quarter versus the 2.8 in quarter one last year. And this is a consequence of the last year activities regarding improved profitability, working capital and cash flow. The equity ratio came in at fifty point seven percent, which is an increase from forty nine point one percent last quarter. And this is mainly due to positive effects. One final note I would like to make is to remind everyone about our statement in quarter four and the implementation of our new internal elimination model. And one is that we're lowering our run rate on depreciation with about twenty five million per quarter. So when adding back depreciation to build EBITDA, consider this new lower level of depreciation. For example, if we take quarter one specifically and applying the treatment of the depreciation according to the old internal profit elimination model, everything else unchanged, EBITDA would have been 525 million instead of the reported 502 million, just as an example. When it comes to EBIT comparing quarter 1.24 to quarter 1.23 restated EBIT shows the correct underlying profitability improvement. Quarter 1.24 EBIT has not been impacted by the new internal profit model since we are stable on our inventory. And I think I leave it over to you there.

Thank you. And over to the next slide and some updates on ROCT. And for once in this area, some positive news. And that is that the randomized control, and as you know from before, our latest statement around that would have been that we would have the actual trial part completed by the end of Q2 of 2024. where the recruitment of patients given the current situation in healthcare on taking on trials like this has been the main uncertainty. I am happy to inform you that we will be able to meet that time schedule and have our last patient out by the turn of 4-2 this year. Based on this, we believe that with third-party writing and normal timelines for publishing scientific papers, that we could see the official results published in mid 2025. This time limit is very difficult for us to influence given the third party responsibilities and we obviously hope to have readings before that. But this will now allow us to in detail start planning for the launch in major markets like US, UK, Canada and France and make sure that we hit the ground running as soon as we have both publications of this study and hopefully early readings. This also allows us to stand by our forecast on sales ramping up from H2 of 2025 and onwards, which is a clear step forward for our own forecast. Next slide, please. Just as a short word on our outlook for 2024, that given the solid start to the year remains as before. In other words, that the organic net sales growth will be within the group's target interval of 3 to 5%. Next slide, please. And to a short summary, we closed a solid Q1 with 4.3% organic growth, improved gross margin, and a 13% increase on adjusted EBITDA. We continue to see stable and good development in both US and Canada, and we are navigating market conditions well across Europe. Our rest of the world business continues to grow with good pipeline going forward. We continue to face challenges in moving from a very attractive pipeline to orders in our outcome programs, both in patient handling and in pressure injury prevention, but are seeing good trends in the right direction here. Our more transactional capital equipment sales, especially in the US, developed well, and we continue to drive a healthy development in both service and rental globally. Our focus on working capital continues, and we are looking forward to continue to reduce net debt and decrease our leverage further. With our performance in Q1, we have set a good base for further development on net sales and profitability for 2024 and onwards, well aligned with our plans for the full year. With that, I would like to open up for questions, so moderator, please go ahead.

If you wish to ask a question, please dial pound key five on your telephone keypad to enter the queue. If you wish to withdraw your question, please dial pound key six on your telephone keypad. The next question comes from Ricard Anderkrans from Handelsbanken. Please go ahead.

Good afternoon and thank you for taking my questions. So first one, could you comment on what the organic growth was in U.S. in the quarter? And maybe if you could also comment on the book book to build development coming out of the quarter, that would be so helpful. Thank you.

Now, the development in the U.S. is almost 10 percent in the quarter and we are not eating from backlog.

All right thank you that's clear and maybe if you could elaborate or quantify the gross margin impact from the medical beds in APAC in Q1 and should we expect sequential gross margin improvement into the second quarter? Thank you.

With our internal calculations it is approximately half a percentage point on gross margin that the medical beds project in APAC led to. Obviously not good, but as I said during my presentation, I believe that this is an investment to build bridgeheads in our markets out in APAC, and I strongly feel that we have a possibility to continue to build something positive out of that. When it comes to gross margin development for coming quarters and also for the full year, we feel confident that we will, for the isolated Q2, continue to see good traction in that area and also, as we have said before, for the full year of 2024.

All right, thank you for taking my questions.

The next question comes from Matthias Vadsten from SEB. Please go ahead.

Hi, thanks for taking my questions. First one, would you say is performing a bit better than you thought after the fourth quarter? And then maybe looking at the demand picture for the group, how it has developed sequentially and the order book, what do you foresee here for Q2 and the remainder of the year? Do you see a higher organic growth than in the first quarter or rather more descent? That's my first one.

Thank you. What is developing better is the more transactional, and I pointed that out in the present, the more transactional capital sales in the US. And we also are happy to see the development on service and on rental. Obviously, we would have wished more from the outcome part. It is contributing to growth, but from an absolute perspective, I would like to see that number higher. When it comes to the demand situation, overall I would say it's the same that we saw after Q3. Not much has changed there. We continue to see US healthcare improving their own profitability and that is obviously good for the long run. Still a lot of focus on here and now for US healthcare. In my view, we continue to see those lights in the tunnel and a step-by-step improvement in market conditions in the US. From a more global perspective, again, same messaging as after Q4, we continue to see a healthy demand for our service and rental and in many areas also the capital side. In markets like I alluded to, like Germany, we have seen a slightly slower net sales development of our capital sales this year. in Q1 than what we saw the year before. We believe that that is something based on the pipeline that we have that will reshape in a different direction in the quarters to come. And for the overall guidance of REO, I feel comfortable again, as we have said, and we can repeat what we said after Q4, that we will be well aligned with our three to five percent organic growth interval.

good maybe a follow-up i think we have been impressed by service revenue for the for the past years uh price adjustments of course easier here but you know more structurally could we still expect service to grow faster than are you as a whole and then to this as well on consumables it looks a bit weak when you open up the annual report if you could just provide with some colors here as well and then is there any turnaround where that growth can improve

that's the the next one now the um on the service side we're also obviously happy i mean seeing service growing around eight percent in the in the quarter on top line is something really good and what is even better there is that we have significantly strengthened the gross margin on the service over the over the last couple of years as i've been talking about and 8% might be a little bit too high on service going forward, but we continue to see good possibilities to grow our service business. A, through continued price increases. Two, through a continued better work around our preventive maintenance side. And three, very straightforward sales of the service where we become more and more professional, adding services to what we can already offer our customers. So I have good hopes for continued development in our service business

and um then the last question was what did you repeat that matthias this yeah yeah of course it's on consumables i mean sorry the annual report uh it was a bit soft i i think so just when you expect that to turn around and to grow more in line with the rest of audio that's the thing i think

what is happening is that we we do see as this is this is a value and not volume perspective it is the continued price pressure around dbt that we've been talking about uh since before something that we are mitigating and but it has a short-term effect but the focus on on continuing to drive our consumable side for example in patient handling is very good and we see in q1 a good uptick on consumables as an example in the patient handling side so It's more isolated to one category and the focus on continuing to drive our consumable side is absolutely there.

How big is this segment of the group now? Could you answer that? The DVT segment?

The DVT is, I don't have the exact number, but I would guess around seven, seven and a half percent of overall turnover.

Okay. Thank you very much. That was all from me.

The next question comes from Christopher Liljeberg from Carnegie. Please go ahead.

Thank you. I have two or three questions, maybe. First, on these accounting changes, could you just confirm that the impact on EBIT is much more minor compared with EBITDA, similar to what we saw in the pro forma figures that you provided in Q4 last year? That's my first question.

Yes, we can confirm that, absolutely. That is what I tried to say as well.

Okay, thanks. Then when it comes to the positive gross margin comment you made about Q2, I'm just curious to hear if that's a year-over-year comment or if you also expect to see gross margin improving quarter-over-quarter here in the second quarter. Both.

Obviously, given that we had a low performance in last year, it's going to be bigger versus last year. But in the way I see it, we have the possibility to continue to grow also sequentially.

Okay, good. And then when it comes to operating cost, if you could provide a figure how much that was up adjusted for currencies. and also if you still expect operating costs for the full year to be rather flat as a percentage of sales.

Yeah, I don't have the exact figure in front of me, but I believe that in consistent currencies, we had an uptick of a little bit more than 40 million in the quarter versus Q1 2023. And that is to a large, large majority just salary increases that is happening. And then we have 6 million extra net R&D that I spoke about. And we have some, as we have seen over the last couple of quarters, additional IT costs.

And as a percentage of sales for the full year?

We still remain by our assumption that as a percentage of net sales, it will remain flat versus last year.

Great. Thank you.

As a reminder, if you wish to ask a question, please dial pound key five on your telephone keypad. The next question comes from Sten Gustafsson from ABG Sundal Collier. Please go ahead.

Good afternoon. Thank you for taking my questions. If you could go back to the North American market for a second here. You had phenomenal growth in the US and Canada. To what extent is this market driven and and and how much is this is basically easy comms and you catching up on on sort of earlier relatively low growth

However happy I am with the US growth, I would give you rights. It's not super difficult to grow from a low level. Obviously very happy with 10% organic growth, but it comes from something that should have been better, I believe, in Q1 of 2023. I commented on that one as well after Q4, where we at that time had a single digit number of growth, but said that the potential in the US continues to be bigger than that. And I remain by that statement. What I can see, and I've been spending a lot of time in the US now over the last quarter, is that we are starting to get momentum in our sales process. We are significantly tighter on the sales process than what we have been before. And that is why I believe that, especially on the underlying transactional part of our capital sales in the US, that we will continue to see a good trend in that area, which is good to see. When it comes to Canada, I can be nothing else than impressed by the Canadian Also having the opportunity of spending a lot more time with them on a direct basis over the last quarter. This is growing from an already strong start to 2023 in Q1 of 2023. They continue to see a really good growth also in Q1. Pipeline going forward continues to be very stable. And we also see investments in that market coming in, especially into the long term care side. And it is, based on our own information, good to see that it's not only with market that we grow. We grow faster than market in Canada. And I have every belief that we have a potential of continuing to do so in the coming quarters. So well done in Canada.

Okay. But do you think that the underlying market for capital equipment and rental is relatively stronger than... previous years or is that more or less unchanged and you're gaining market share mainly?

I would probably put it like that and put it in the context of the light in the tunnel that I spoke about earlier on is that the US healthcare is in a better financial position than it was in Q4. It is in a better financial position than it was for the complete 2023. And we believe from what we can hear that that trend will continue. And with that trend, we are pretty certain that our products will come in scope again, whether it's on the transactional sales side or if it's on the outcome side. It is more long-term investments, and we are pretty sure that when financials get back to the levels where they should for US healthcare, they will also start looking on more outcome-based programs and they will look at transactional capital sales for products like ours. So I feel confident that the light in the tunnel will help guide us going forward. If we have taken market shares, I would be guessing. I know that we are doing a better job in Q1 than what we did in 2023 in following up on the leads that we have and being very, very detail when it comes to how we're following up on that pipeline. So I feel comfortable that our process at least is well in place and that we continue to drive that with full speed.

All right. Thank you very much.

The next question comes from David Johansen from Nordea. Please go ahead.

Hi, good afternoon. I have two questions, really. First, I'd like to follow up on a question on the gross margin there. Could you speak to the Red Sea impact or costs from possible delays in the quarter? And second, we have heard some negative comments on easter effects in the quarter, particularly relating to consumable volumes. Is this something you have experienced or could speak to for Q1? Thanks.

Starting with the Red Sea coming out, the effects coming out in the way that we expected. We have transportation costs that is four or five million higher than what we expected going into the quarter. Because of this, we have a slightly higher inventory number than what we would have needed to have given that the ships are now going around, but it has not developed in a more negative direction than what we thought after Q4 and what we communicated in that Q report. So we are obviously keeping our eyes on it and making sure that we assess the risks that are there, but for Q1 and what we can see for the future, for the coming quarters, no further effect on that one. We have a good traction on our transportation and logistic costs, and we are taking advantage of our internal activities, but also the fact that we can see a continued pressure on external rates in the right direction for us. When it comes to any Easter effects, there's obviously fewer days, but I don't think that that has a major impact on our development. We are good at having a straightforward discussion with our customers to make sure that they understand what they need in the days that they are that are providing care. So I wouldn't say that we have a negative or positive Easter effect compared to any different year.

Thank you. That was all for me.

There are no more questions at this time, so I hand the conference back to the speakers for any closing comments.

Thank you very much, moderator, and thanks, everyone, for dialing in. As said, we are closing a good and positive solid Q1. Organic growth up 4.3%. We continue to do continuous improvement on our gross margin, and we see our underlying adjusted EBIT growing with 13% year over year. So a good start to the quarter, and we look forward to continue to develop Aureo, both on top line and profitability during 2024.