Implantica AG

Thank you. My name is Peter Forssell and welcome to Implantica's Q4 2025 presentation. So, for new listeners, I am a surgeon, inventor of Reflagstop and have invested more than 100 million euro in Implantica and also created a successful business with the adjustable gastric band. Here you see the Reflagstop introduction tool with the device at the end. And we have a little bit closer picture here. where you see how the device looks in real life. It's two and a half centimeter in size. And currently we have 50 hospitals performing this procedure in Europe, and we have done more than 1,500 procedures. And existing surgical treatments is plagued with high complications rates. It's actually 30 to 50% complication rate. And that's why this surgery has been heavily compressed compared to the huge market size we talk about here. So everybody in the past has believed you need to compress and support the closing of the sphincter between the stomach and the esophagus. However, it's nothing wrong with this winter. And when you do that, try to compress, you get swallowing difficulties. You can't belch, you can't vomit. You get so-called gas bloating because you can swallow your saliva, but nothing comes up. So with reflux op instead, we have showed that the sphincter is perfect. It's just a question of the anatomical and physiological region, how things are organized here. So what we realized is that in the chest, You have breathings. That means the pressure is coming and going, coming and going. And that is leaking out through the big diaphragm muscle that you have that divides the chest from abdomen. And these pressure variations is affecting the sphincter when that comes close to the diaphragm. And the diaphragm is a muscle that you use for breathing. So it moves up and down. And therefore, it's a hole for esophagus to pass through. And that is where the pressure variation leak out. You can compare to a harbour with a big stone wall to protect the boat from the waves and in the opening where the boat goes in and out. It's always very steamy. So what we are doing, we are free dissecting and moving this winter down five centimetres below the diaphragm. So it's not affected so heavily by these pressure variations anymore. And we place our device on the outside of the stomach wall. And it's a little bit more sophisticated than that. It's actually three components of the anti-reflux barrier that we all correct. And that's why in reality, if you do this operation correctly, we don't know any single patient who's not treated. And why are it now so important to have a new treatment for acid reflux? First of all, the drugs only help 40% of the sufferers. You have drugs that diminish the acid in your stomach. However, the acid has a purpose. It kills off bacteria, it kills off parasites, and we don't have the acid anymore. It comes bacteria into your small intestine, who normally is sterile, region and then you get inflammation, swollen, distended, gas bloating, and it's not so fun to take these drugs. On top of that, they are really dangerous. These drugs should never have been approved if it was known what we know today. And it's a huge study from the United States where they have followed 157,000 US veterans and one out of 20 died during 10 years of PPI use. So extra deaths due to PPI use, also the medication, one out of 20 died. That's just an incredible figure, really, really dangerous drug to take long term. Also, we know that both the drugs and the disease together cause cancer. So it's 48,000 people only in Europe and United States who die from cancer in this region, esophageal adenocarcinoma. And that's absolutely unacceptable. And when they looked at these deaths here in Sweden, they find that all the people that died from esophageal adenocarcinoma, 38% took PPI. And it was increased number, even if you didn't have this disease and took PPI for other reasons, you still had an increased PPI use in the deaths here. Not good for the patients. You can compare with breast cancer. You do anything to save lives. Here just these people let go. It's not acceptable. So the clinical outcomes of this new treatment with reflux stop has now reached more than five years of experience. So we have built a really heavy clinical evidence. And in our pivotal study that has been used for the filing PMA to FDA, we have all patients took drugs before surgery and only one single patient at five years was still taking drugs. And when you look at the objective measurement to measure pH in lower esophagus over 24 hours, then you can see that everybody was normalized. And between six months and five years, It's more or less the same. It's stable for five years and everybody is very successfully treated. If you compare the standard of care, who is fundoplication, where you wrap the top part of the stomach around to compress the sphincter, you can see here in orange color the complications. And in green, you see our study, the pivotal study. And you can then see that inability to belch, for example, 40% of the patients after five years can't vomit, can't belch. None had that problem in our study, as an example. And you see to the left, every single parameter you look at, our outcome is between 93 and 100% successful. You can read yourself because all the FDA data has now been published. They are published in Surgical Endoscopy and American Magazine for Sages. And there you have two articles to read, one about food passageway related events and one overall. And during this time it's like we are building a castle of Lego made for grown-ups and you have several thousand of pieces and we build step by step by step and when the castle finally is ready then people will realize how beautiful it is. and here you can see what we have achieved in terms of clinical evidence we have 33 published or accepted manuscripts it's absolutely incredible number of articles about reflux top center of the center of the center pop up with the results and it's all very very successful clinical evidence produced A little bit further updates. I guess you all are waiting for FDA approval. So are actually we. And I can then tell you that we have fulfilled the pre-approval inspections from FDA. So when you reach the final stage of your PMA, FDA come out and do lots of inspections. They inspect the hospital sites, they inspect the production sites. inspect Implantica, our quality system, how we have acted as a sponsor of this study and so on. So all these six inspections you see here has been finalized without any major findings. And the result has been given in a meeting after each of these in a successful manner for Implantica. So as you know, we have made a modular PMA. That means we have filed in three different modules. And all modules have been reviewed by FDA. FDA has provided feedback to Implantica on these. Two of the three modules, we have also answered on the feedback, which from our perspective means they are closed. Of course, FDA may have another opinion. And regarding Module 3, FDA required some additional tests. And we got the information in writing how long time this test should take at the test lab. But of course, they didn't fulfill their promises and we have been a little bit delayed. However, this in the long run is very marginal and we are very, very close now to finalize and also get our FDA approval in the near term. We are preparing for the US launch, of course now pending FDA approval and we have done lots of work preparing a very extensive plan and we have made efforts that you could make so far. You're not allowed to start the business and visit hospitals for business but the scientific part we are allowed. And there we have done a big effort. We have been at all the Congresses and all the important meetings in the United States. And 20 surgeons has already been flown over to Europe. They have seen the procedure at two different hospitals and they have been operated at cadaver in the United States. And we are targeting the first initial launch, 25 to 50 centers. And the key here is the training part. We have also made a production tool so we can produce products in the United States. We have a new tool where you put silicone in one end and out comes butcha, butcha, butcha products. We can make many, many products in a short period of time. And this allows us to produce these 10,000 products we are doing right now. So for the launch, we expect to do a really splash in the market. That's our target for this launch. And the good thing here is that it already exists, existing codes that we are targeting. So both the surgeons and the hospitals will get paid with high likelihood based on these existing codes. And for the product, we are targeting something called Medicare transitional pass-through payments, which is a program where you get paid for three years. Meanwhile, you finalize your permanent code for the implant. Also, to explain a little bit more about the market for reflux stop, we have two markets. One is the existing market. In the US, it's like 30,000 procedures done every year, and that's where you have most of the medical treatment, the surgeries and so on today. However, this is only half of the sufferers. The other half of the sufferers is those with very severe disease, very long-term disease, where they have developed a damaged esophagus. So the food transportation is damaged because the nerve ends and the muscles have got this acid over and over and over again. So these patients, you can't operate. Imagine that you have a very weak food transportation and then you put the swinter or try to close the swinter down. It doesn't work. They have not power enough to get the food down. So it's only reflux stop who works for these patients. And because they are all the severe, really bad long-term sufferers, the need for surgery is maybe 10 times larger. So instead of 30,000, here we have a need of 300,000 and still a very compressed market we talk about here. So as an endorsement for this, NHS, who runs all the public health care in UK, they have an organization called NICE who create guidelines and evaluate new treatment. And they, for nine months, have looked into reflux stop. And their conclusion was, we recommend reflux stop for use for IEM subjects in the public healthcare in the UK. And that's a fantastic reinforcement, endorsement maybe. And that means that this is something really real here. And if you then look at our main device competitor, and suddenly they are withdrawing from the whole market outside U.S. So from end of March, this product will no longer exist except in U.S. And in U.S., this product, MSA, it's called LINX, is a trademark from China. J&J, Thorax Medical, they developed the business very, very quickly up to, let's say, 350 hospitals. However, you also need good results. And that has not come, sorry to say, so they have failed in the outcome. And that's why they have like 10% of the sales left only in United States today. And also these links, they could not be used for IEM sufferers. They could not be used for large hernia sufferers like reflux stop. So reflux stop has like 10 times larger market size than links, approximately. So if we then look at the US market, this is now play with figures. You have to take it. This is not any prognostic figure or anything. It's just the play with figures. But in the United States, 22.9% has acid reflux. That's 78 million people. And if we just look at those who is not treated by drugs, it's 31 million people, 40% of the sufferers. This represents a potential market size of 290 billion US dollars. And if we just play with the figures and say, okay, 1%, we take 1% of this market for surgeries, that becomes around 300,000 surgeries. 330,000 maybe surgeries. And this is approximately the message you get when you talk to US surgeons. What is now realistic if it suddenly pops up a method that actually works for treating acid reflux, then it's approximately the figure you get if you talk to 10 surgeons. So I wanted to show you this figure because that's a product that could be used for some similarities with our product. This is actually a product from Inspire Medical. And this is a device who is used for snoring. It's a surgical procedure with a little stimulator for snoring. And when they come out to the market, they had one year of clinical evidence. They do one year study in US, they get your FDA approval. But they had a completely new market. They need to build a new market. No one wants to start to use something without first having more evidence, long term evidence to show. And it took them four years to do around 1000 cases and create this clinical evidence, the five year evidence that people want to see. After that, they took off and they reached in their peak $8 billion valuation. And you see it just continuing to increase. A very nice success story here. This is a little bit similarity to our IEM group because this group has no surgery today, no treatment today, and we are building a new group of patients for treatment. The difference between Inspire Medical and us is that we already have five-year data. We have a massive clinical evidence and five-year data, which means that we will start and much faster get to this stage here than they did. Here you see the 2025 AWS meeting. Actually, this was in September, not the last quarter, but I can't avoid to show this because the interest was so incredible. We talk about hundreds of surgeons. They looked here at our five-year data. They looked at our symposium to the left, and the interest was enormous. We are the absolutely hottest topic among surgeons in this treatment field in the United States. Here you see a very respected center in Florence in Italy who operates with robotic surgery. And it's more and more centers who try to use and successfully use reflex stop with robotic surgery. So if we then look at Europe and other countries, we of course have our 50 centers approximately in Europe, but we still have not any full reimbursement. We are still struggling, but we are coming closer and closer. And I will show you that very soon here, how we are in different markets. So you get a bit updated. Regarding Canada, they have said, if you get the US approval, we accept that for approval in Canada. Also in Japan, it's high likelihood that they will accept the US approval. So we are preparing. We have all of the network surgeons. We have been at the meetings down there. So we are prepared to get going also in Japan. And the nice thing with Japan is that when you get approved, you also get reimbursed. That is, of course, a very nice feature. So if we then look at reimbursement, what is happening in Europe? Why don't we sell tens of thousands of units instead of what we are doing today? And the answer comes here. So first of all, if you take Italy and Spain, they have so-called budget systems. That means that every year you need to apply. I want to do reflux stop. I want to do this and this. The first year they say, okay, you can do 10 reflux stop. Next year they say, okay, you do 30 reflux stop and so on and so on. You negotiate and you increase step by step in the budget system. And in December this year, we actually had two tender wins for two centers. For over 1.2 million euro for reflux top surgeries. So we are getting there step by step. Also in Spain, we have these wins, tender wins. And we are not so far away from in a few years time, it will increase more and more and more basically. If we look in UK, as you already heard, they have endorsed NICE for NHS public hospitals that reflux stop is used, which of course is a fantastic step when we now should also get paid. There is already an existing code that gives us part paid, but we are trying now to get fully paid here in UK as well and to increase the market. And that also looks quite promising. In Germany, again, a completely different system. We already have achieved our own OPS code. So we have a code in the system to operate D-Flagstop, and that's fantastic, big achievement. However, they didn't apply any money to that code. So we are getting the same pay as the fundification procedure, although we also need to pay for the implant. So in this case, they instead have a system with so-called INEC hospitals. That's hospitals, a small selected group of hospitals that report cost. Every cost for a procedure is reported. And based on that cost, you then finally will get your pay to your code. And the problem we have had is that it has been very few INEC hospitals that all do this type of surgery. They don't do anti-reflux surgery. And finally, we have now managed, so we have seven hospitals, INEC reporting hospitals. So we finally can get around, we need around 200 surgeries in a year from these hospitals to finally get us registered and also get paid. And that's we are targeting now. so we will file actually both this year and next year but we don't expect approval until after the next year's filing which is this month next month i think yeah next month So on top of that, we have the cost effectiveness, which we have presented at ISPOR, which show that also in United States, society save money by operating with reflux. It's more cost effective than taking drugs. It's more cost effective than the way for duplication than doing links. And that's because there is so few complications and the treatment effect is better. just to remind new listeners implantica is not only about reflexo that's of course the highest priority and the blockbuster potential product however we also have two platform technologies that we have developed an e-health platform and a wireless energizing platform and these platforms are actually so unique. So we think we have the potential to license this to all implant manufacturers, these platforms. So we are step by step coming forward and this will save lots of costs for society and you will be able to do much more advanced treatment and you can do treatment on distance. This will actually be a complete revolution at healthcare. It will be like AI coming to your computer This is a new world for healthcare. And we have done not less than 25,000 pages of patent on this platform technology. You can imagine 25,000 pages of patents. It's an incredible effort. And this is something that is enormous. It's just that for the moment, it's reflux stop and reflux stop. But this will come in a later stage. Two pipeline products, repeated for those who listen to me often, but I just want to take those before we go to the finance part. So people have a stoma bag. They are maybe taking away the large intestine for some reason, and they collect the fecal matter in a plastic bag. The business just for the plastic bags is $3 billion. It's an enormous business just for plastic bags. Here we get the most emails from patients. And they don't need this plastic bag anymore because we have reservoir, emptying function, open, close, everything designed. And when I was a young surgeon, we actually started with this type of experimental surgery. So I have a big experience of that part. And we have another very humanitarian issue. product that probably can go into the humanitarian program in the United States if we are lucky. And that's Uridestor. And that's for people who can't urinate. It's 1.7% of the US population can't urinate. And that's because either they have spinal cord injury or a multiple sclerosis disease or some other reasons. They put in a catheter in their own bladder five times per day. And I can tell you, if you manage to put the catheter in your own bladder once, you have done a real achievement. They don't need this anymore. They need a remote control and implant device. Thereby, I will give the word to Andreas to talk about the finance update.

Many thanks, Peter. I will walk you through our financial performance for the fourth quarter of 2025. Net sales for the fourth quarter amounted to €530,000, representing an increase of 20% compared to the same period last year. As discussed on earlier calls, Implantica is currently solely commercializing its lead product, Reflex Top, to selected European key opinion leaders. As Peter has discussed, US market approval and European reimbursement coverage represent the key milestones to unlock the vast reflux stock revenue opportunity. The business consistently achieves exceptional gross margins. Adjusted gross margin for the fourth quarter amounted to 92%, up from 90% the same period last year. Operating laws for the fourth quarter amounted to €7.4 million, representing an increase of 3% compared to the same period last year. R&D expenses increased by 12% year-on-year, driven by FDA inspections and data collection. During the fourth quarter, €1.3 million of capitalized development costs were impaired. This non-cash expense reflects a realignment of the product portfolio. For the full year, operating loss decreased to €20.5 million, representing an improvement of 19% compared to the prior year. Let's turn to cash. Operating cash outflow amounted to €4.9 million for the quarter, 2% lower than the same period last year. For the full year, operating cash outflow decreased by 27% to €16.6 million, underpinned by disciplined cost management. At the end of December 2025, we held 48.9 million euro cash and short-term investments. The short-term investments are simple fixed deposits with a leading A-plus rate in Swiss Bank. There is no interest-bearing debt in our capital structure. So let me sum up this slide by saying we have a solid financial position. Moving to the next slide. In addition to management, including our founder and principal shareholder, Dr. Peter Vestal, our shareholder base is primarily composed of high quality Swedish and Swiss institutions. We value the continued trust and long-term support we're receiving to ensure that GERD sufferers globally are getting access to the best available treatment at scale. Let me hand it back to you, Peter.

Okay. I have made a little summary slide here, which I thought could be on view. Meanwhile, we see if we have any questions.

I think we take the callers first, if anyone's called in.

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 Philip Wyberg from Pareto Securities. Please go ahead.

Hi, I've lost my voice a little bit, so please excuse me for that. But I've got some questions today. I'll try to take them one by one. So perhaps I'll start with the FDA process here. So I would like to just get a better sense of the current status here. So where exactly you are at the moment? So have you done the testing yet and submitted it again, or is that still underway, so to say?

So the testing part were delayed due to third party. Nothing we can do. And the testing is now ongoing and we expect it in the very near term to be finished.

OK, so after that is done, you compile that data basically and send it back to the FDA and that's where the clock starts. Is that accurate or?

That's accurate. And, you know, FDA has their own timeline. We cannot affect that, so to say. But on the other hand, we know that FDA has already reviewed all our three modules and they have presented feedback and got answered on all the feedback. So, of course, they have a more slim-lined process than they would have had if they had the whole PMA in hand.

Yeah, yeah, good. But then it sounds like a delay of just a few months, you know, based on the like compared to prior communication. Would you say that's accurate as well? That's accurate. Yes. Okay, good. Perhaps I'll follow up with you talked about it during the presentation. I also wrote in the report that you had 20 US surgeons that have completed hands-on training. some observational procedures at the European centers and cadaver-based surgical training in the US. So does this refer to the cadaver training you did some time ago or was this now also done in Q4?

No, this is referred to earlier training.

But since you're not allowed to do any such activities now before the approval in the US, for instance.

No, we can only do basically activities related to the scientific world. So, you know, by presenting our data, all the different congresses and meetings in US and European surgeons flying over and talking and presenting and also US surgeons. that is increased awareness you know so we we have more than 100 surgeons who has lined up so to say and want to start here so we are well prepared in in a sales process but it's not called sales it's called scientific awareness yeah okay thanks thanks for that

And then just a question on the production of the 10,000 units. We talked about it in a couple of reports now, so I'm just curious how far you've come. I've looked at the inventories in the balance sheet and seen it increase somewhat during the year, so I was wondering if that's an effect of this increased production.

So the tool, of course, is not something cheap, you know, that something so you can produce very quickly large amount of quantities of products. And this has been produced, finished, validated in Europe, finished. So everything is controlled that the production is correct. with this tool and then it's moved to us and then you need to do another line of so to say validation in the machine they will use in us and then we are ready to produce in us but we are already now producing these units in europe so we will send them over to us

Okay. So these 10,000 units, those will be produced in Europe now prior to the launch? They will be produced prior to the launch, yes. Okay. And how many have you done so far?

Oh, that was a difficult question. I can't say exactly, but maybe it can take six weeks to produce these units, something like that. I can't say exactly.

Okay. And then maybe just a few questions on Europe here also. So you had the tenders that you want in Italy now. So I was just curious if you could share any more details around that. So how many years it is for and if you've gotten the price that you want and the one that we've always talked about for reflux stop device.

So we only sell reflux top to full price. We do not give any kind of discount. It does happen in some exceptional situation that we have given products for free for studies. And that's why you see the gross margin is 92%. Actually, the gross margin is 98%. So our device is cheaper to produce than a drug, basically. But in Italy now it was two centers and I think it is a two year program for these two centers. But it's a step. It's like open the door, so to say. It will follow more and more of these and more and more centers. That's how it works in the budget system. You need sort of to get accepted and take the first steps. And this we have done both in Italy and Spain. We have won quite a bit of tenders and This is a process that will take a couple of years. You get every year more centers, more products per center. So it's, as you heard during the presentation, it's extremely different in different countries. So I selected Italy, Spain as one who's the budget system. I selected Germany, which is completely based on this INEC reporting hospitals who report all the costs of a procedure. And in UK, you know, where they have this evaluation by NICE. So a completely different system for every country, basically.

Okay, okay. But have I understood it correctly then? So you're expecting revenue from Italy quite soon, but it's tender and it goes on for basically two years at a time.

Yes. And, you know, we have today quite many centers in Italy and Spain, many centers, and they have done not so many because, you know, they are not allowed to, but maybe 10 procedures or something like that, but quite many centers. I don't know exactly how many centers we have in Italy and Spain, but it's many.

Okay. That's a very good answer. Thanks. And then just perhaps in the UK as well. I was wondering, you know, after this nice recommendation, if you've been able to onboard any new hospitals since then or and if you're expecting any sales ramp here in 26 or if you have to wait for that full reimbursement that you talked about during the presentation.

There is more and more centers coming on board in terms of NHS hospitals, but all this process is a bit slow. It's lots of administration people involved and you make agreements that takes many months. It's not like it's popping up like this and suddenly you have another 20 hospitals operating. it's a process so to say you need to take it step by step um but it's clear that having you know recommendation that we should be used in nhs hospitals that's of course very very powerful and that that will create a change of course

And then my last question is just on links here. There have now been a few months since they announced that they will withdraw from the European market. So I guess they're still on the market and will withdraw in the spring, as I understand it. But have you seen any changes so far in terms of the market dynamics or if you've gotten even higher interest for reflux from surgeons that have used links in the past, for instance?

Absolutely, from many different areas. For example, LIGS was targeted to do a study that GBA, the big healthcare organization governmental in Germany, they have got 4 million to do a study and now they can't do this study, for example. these many centers who do links who contacts us and because they realize that after end of march it will be no more products so that's of course very positive for us and But still, you know, most of our surgeries has done in a study format so far in in Europe and it's starting to take off step by step. But it will be a process, I would say, over a couple of years more before we really can get going. in a good way in Europe. Then, of course, it's much different in the United States where you saw we had the two codes already. So, you know, to produce these 10,000 products cost us one million, which is not so much. And we are in a much, much better situation in the US. And you can see that from the few examples. I showed you one example from another product in the US that The US market is very different. They sort of give priority to new technology and they take care of new technology in a completely different way. So to start in Europe or to start in the United States is like night and day. And that's why it's so fantastic to get going in the United States, as we hope in the near term. Then, of course, Europe will also come. And I think they could add on in a fantastic way. But that's because we have done all this groundwork for all these years. But it's more complicated in Europe and you basically expect a company to run a business for five years without getting paid before you come into the normal healthcare system, which is only Janssen & Janssen and Medtronic can afford. It's sort of a non-functional system, basically. It kills off all new technology, all new treatment. So, yeah, it's different.

Okay. Thank you very much. That was all the questions that I had.

As a reminder, if you wish to ask a question, please dial pound key five on your telephone keypad. There are no more phone questions at this time, so I hand the conference back to the speakers for any written questions and closing comments.

OK, thank you very much. I will address the questions. We have many repeat questions, so I'll try to condense them. One question is, do you expect to maintain such a high gross margin percentage in the US or do you foresee price pressure there?

So in the US, we target a little price premium compared to the European market because you have a little bit more. legal cost but we will follow the same principle we hope to try to keep the gross margin up so we have no intention to start to sell with lots of discount if it's not during any special circumstance and that is not affecting the price at the end because at the end we need to keep our price yep

You've mentioned a price of approximately $8,000 for reflux stop in the US. Is that still the target?

I mean, I think our target price is $8,800, but that's completely undefined. It needs to be adapted depending on the situation.

Can you describe the status and plans regarding information activities towards insurance companies in the U.S. in order to build knowledge about refund stuff?

Yes, so what we have done is to prepare the dossier to present this for the insurance companies and of course we have quite fantastic presentation with all these clinical evidence we have built with all these more than 30 articles and Yeah, we are in a good shape. We have cost-benefit analysis that show it's more cost-benefit. They save money, basically, to operate in a leaf-like stop. So we have a good situation, but we are not allowed to start the actual process until we have FDA approval.

Do you plan to set up a production facility in the US or via a CMO? Is this in process?

We are producing in the US, yes.

Are you looking also at the Middle East and North Africa region and Latin America, I assume then via partners?

So, of course, for example, Middle East is a very good market that is not so dependent on reimbursement. So that, of course, will be a good market for us. For the moment, we are focusing on the FDA approval and we are not doing anything else until we have that.

What is the commercial structure or organization planned for the U.S. by partners or your own setup?

Our own setup.

How much will Lynx withdrawal in Europe boost revenue and uptake in Europe?

I guess it will be very valuable for us, but please remember that because it's not reimbursed fully yet, it still, it will not take off in a fantastic way in Europe. It will be a process over a couple of years.

You've shared in your presentation that the other procedures had around 30 to 50% of complication rates. What, could you share this figure for ReluxStop as well?

Yeah, so if I compare 40% rate for not able to belch and vomit after five years, in the reflux top group, it was 0% good belch and vomit. If you take swallowing difficulties, it was 28.9% in the fundoplication group. And in the Nissen group, we had 2.3%, one patient. What else should we take? We have gas bloating. I think it's 52% who has gas bloating in the fund application group. And I think we had the magnitude of 4.3 or something in the reflux stop group. Yeah, that was, I remember spontaneously, but it has caused many more data.

How can robotic surgeries help you scale the business?

So in United States, nearly 60% of all surgeries today is done with robotic surgery. So it's of course very, very important that reflux top fits so well for robotic surgery. So we are developing parallel operating instructions for this type of surgery. So this is a new development and we are joining.

Some questions, ENIC. How are you going to reach the 200 surgeries necessary to report of the ENIC cost reporting surgeries? And what will happen once you reach the number of 200?

So as I said, we have seven INEC reporting hospitals and we have been negotiating with them that they together try to do these surgeries. So everybody has agreed to focus really a lot on this. And we are also performing a little registry study for this group. and we are really trying and people have actually committed to this so we hope we really should reach our goal of course without any guarantees but that's our target um do you when do you plan to relaunch the rct with dr shopman yeah so Our idea is to launch when we have the FDA approval because our advice has told us we should not fool around with any study before we have FDA approval. And that's the advice we are following. So we just have, I would say, a final kind of question a couple of people have touched on is how do you intend to monetize ReflexStop in Europe, which you've addressed through the reimbursement, but maybe you can... Yeah, I mean, you know, Europe will be nearly as good as US if we just come into the healthcare systems and, you know, we get paid for the device, then, you know, so surgeons can operate. That's what it's all about. It's not about the technology. We are clearly a superior treatment and it's just sad for the patients that they need to wait. In some countries like Sweden, it's only administrative people today who decide which treatment should be given. which is very sad and it's all about costs. It doesn't matter if your treatment are good or bad, cost is the first priority. And that's really, really sad if you compare to 1980s when I was a young surgeon And Sweden was the best healthcare in Europe. It was fantastic. So for me as a surgeon, I think this influence from only administrative people, that's not good for the patients.

And a final question, any comment on Japan and Canada?

Yeah, so I think I answered that, but I can repeat it. So Canada has committed to approve us when we come with the US approval. In Japan, it's high likelihood that they will approve us when we come with the US approval, but it's not as clear and there's no commitment made. And all the FDA data need to be prepared in a format that is, every of these organization, they have a specific requirement for the format when you file. And that's what we are doing right now. We are preparing and organizing all the information we have in our FDA submission to also be able to file in Japan, which is actually 11% of the world market for devices like us. Okay, I think that was all the questions. We tried to answer them all in the best possible way. And yeah, we thank you very much for listening. Sorry it took some time, but we appreciate the time you spent and good luck. Have a nice evening.