Integrum AB (publ)

Hello and welcome to today's webcast with Integrum. We're acting CEO Scott Flora and CFO Jørgen Svalenström will present the Q3 report of 2024. After the presentation, there will be a Q&A. So if you have any questions to the company, you can send them in via the form to the right. And with that said, I hand over the word to you guys.

Thank you, Ludvig, very much. And good morning, everybody. Good afternoon and real happy to be here and share our Q3 results and then talk about our path forward and answer a few questions that everybody may have. So with that, should we start the presentation?

Sure. I don't think we can see the presentation yet.

No.

Great. Sorry, everybody. Okay. So just a reminder, uh, Integrum is a leading medical technology company. We've been, uh, we've been a pioneer in a bone anchored, um, prosthetic solutions for patients with amputations, uh, amputees for, uh, within Europe and the U S we, uh, uh, We've built a nice company. We've got results. We've updated our numbers now, 1,000 implants now. And we think we're in a really good position to accelerate growth in the U.S. market and then continue to grow nicely within the EU. But we're going to be very focused in those markets, as we'll talk about in a little bit. Next slide. Just a reminder that we are market positions within the U.S. and Europe. In the U.S., we have a PMA since 2020. We do operate a wholly owned subsidiary there. We have an internal sales force that focuses on the prosthetist. And then we use distribution independent orthopedic reps to call on the surgeons and the hospitals. And we figure the U.S. is worth about $5.6 billion to us in that TAM, given the number of patients that could use a bone anchor prosthetic solution. In the EU, we have CE marking since 1999. We have an internal sales force there. We've got several distribution partners throughout Europe. And we figure that market's worth about $2.2 billion. The difference between the two markets is we have more product approvals in Europe with digits and the humoral implant are available in Europe. Those, those products are only available in the U S through a compassionate use prescription from a surgeon. Okay. So let's talk about the upper device. You can go ahead and advance. So if you break this down, you look at the, the result of amputations, it is a global phenomenon. But there's 3.1 million individuals living with mobility challenges in the U.S. and targeted EU markets. And the targeted EU markets are the ones where we could get good data against this, and they're listed below. We have 1.3 million patients that have had amputations because of cancer or trauma, severe car wreck, motorcycle accident, or something like that. So that's where we come up with our Oprah population of 260,000 patients that could use that procedure today. That's how we drive the 7.8 billion TAM. So if you think about why this is such a life and earth shattering solution for patients, it's just, you know, when I show this to some of my business associates from the orthopedic implant market, they just, they instantly go, oh, I get it. Because now you have an implant in the patient's bone And you've restored that natural mobility for a patient where you're anchored in bone. And now all of your weight distribution is where it has traditionally be on the skeleton versus on soft tissue. So it eliminates a lot of socket-related problems of soft tissue wounds, pain, recurrent infections. And this allows for also very easy on-off attachment with the device for the patient. And it also, there's a number of... lifestyle things that happen to a patient with sockets that sometimes the prosthetic device will fall off. If there's any, if they've been out and they had perspiration, it can fall off. It's very difficult to change if they're buying clothes in a store and they want to try something on. So this is a much better lifestyle for a patient as well. Okay. Oops. Go back. Two. Okay. Yeah. I missed it. Yeah, that's fine. So the Oprah implant, as I said, fundamentally restores mobility and prosthetic users. Now we, we use a two-step insertion and it's an efficient standardized treatment, but it is two surgeries. And we're going to talk more about that as we unwrap the revenue model. But there are other companies out there that don't have an FDA approval that do a one-step procedure. But part of our safety profile was the second step in convincing FDA was part of the second procedure, which is restoring the vascularity in the skin and doing appropriate skin closure around the aperture device. Then we have the AXR2 release system, which is the safety device that allows, let's say a patient has a fall, the prosthetic device comes off similar to what happens when you're skiing and you have ski boot binding, it releases. So that's an extra level of safety that allows the patient, that allowed FDA to feel more comfortable with approving the device. and allows the patient a safer option in living with the device. Our BioHelix surface is our proprietary bone ingrowth surface that is on the femoral implant that goes into the femur, or if it's a humeral, you know, it goes into the shoulder, and that's where you get the very good osseointegration interface in the patient. And as we've said, we now have 1,000 patients treated globally. We have a nice proven clinical outcome, 92% clinical success rate. And we continue to see new studies and we continue to follow up with clinical studies to continue to show the benefits of this procedure. Okay. Yeah, here's, this is the total offering that is in the system. Again, in the U.S. we're FDA pre-market approved for above the knee. We do have an upper arm solution that we're negotiating, trying to bring to market in the U.S., and we have thumbs and digits that are only available on an emergency basis through compassionate use in the U.S. Within Europe, the upper arm, thumb, and above the knee are approved. The below the knee is an option that would – it's a very big market but needs additional work and time. It's also going to need some – some updates on the XR device and then the lower arm would be after we prove the upper arm. Jorgen. So that's kind of a historical view of the company and most investors and followers are pretty familiar with that story. I think what, What was interesting in our press release and what we want to talk about now is how we're going forward. And this is part of our commitment on enhanced transparency and is to lay out a path forward and then report against that path forward every quarter. So if you look at, we know that we have a technology leadership and market validation. The Oprah implant system, we're very comfortable that it restores mobility for amputees. We were able to get FDA approval for that in the U.S., and we have CE Mark in Europe. We've treated 1,000 patients globally. I know this says 700, but it's 1,000 patients globally that's been updated. And it's the only FDA-approved bone anchor system. So if you look at the revenue model, one of the things we wanted to do was to disaggregate it so investors and analysts could better understand how we how we drive the business. So there's a two-stage surgical procedure. And, you know, in the past, I've talked about the importance of S1s. S1 is when we capture a new surgical patient and that's 50% of our total revenue. So if a patient decides that they're going to have the Oprah system, they first have an S1. And then on top of that, then they'll rehab and they'll go to the second stage surgery. And that's when they have the S2. plus the axor. So the S2 is where they do the skin flap, and then they put an abutment in. The abutment is the device that connects to the axor. So the abutment goes into the femoral implant, and then the aperture sticks out of the skin, but that eventually connects into the axor device. So in thinking about axor, axor 2 is where we have aftermarket revenue. Axor 2 is covered by a three-year warranty. So there is a recurring sales and service model with that. We do service the Axor II for the patient in three years free. Afterwards, generally a patient will retire that Axor and then they could get a new one and then they could file for insurance against the new one. There's been over a thousand Axor II units sold since FDA approval and Axor II units are 20% of US revenue in our recent quarters. So as we think about our commercial strategy and our focus growth, as I said, we're going to focus on two markets. In the US, we're going to be very focused on a few centers. And we have a breakdown of those centers. There are several centers where we're figuring out How do we drive market penetration more aggressively? And we're partnering with those centers. There's a second group of centers where we have partnered with Hanger around where they have strong prosthetists that are interested in osseointegration. And we've identified what hospitals those patients can be sent to. And then there's a third set of centers where we have trained surgeons that patients could get referred there. We will make sure we service the case and take care of them. But we're really going to be focused with our SG&A dollars on a fewer number of centers and making sure we find a way to drive those to a higher level of market adoption. Excuse me. And then we're going to strengthen the aftermarket business through CPO engagement and XR2 sales. So we announced last quarter that we did do a training with Hanger's SPS unit, which is their independent distribution arm that goes out and calls on non-Hanger facilities. And we've laid out a calendar of training programs in combination with them to train prosthetists on training on osseointegration and how to take care of those patients and the benefits of doing the surgery. Finally, we will continue to look and we want to appoint a CEO with market expertise, especially one that understands how to drive market adoption and also understands how to grow a US business. So we think that's sort of the very near-term focus that we're driving towards. Um, also we sat down and I, I commented on this last quarter and, um, in our board strategy, uh, process, we, we prioritized all the R and D projects in the company. And we said, look, uh, we've got to drive near term, um, revenue in the U S because we have a clear path because we have a, uh, uh, a clear path with the FDA, uh, to drive market adoption, we really need to focus in that area. So we decided that maybe we should curtail some of the longer term projects that were more in the research level and focus on things that were more in development that would help drive market adoption in the US. And the goal of that is to optimize our resource and the allocation of value and, you know, Everybody gets tied up in a project. How do we reduce the number of projects? So we get really critical focus from all the, all the teams within the company. It's not a big company. So we gotta be focused on the, the vital few that drive results. So we also said, look, what kind of KPI could we, uh, launch into the market so people can understand how we're doing. So, um, We came up with this KPI of the S1, and every quarter we're going to talk to you about S1 and how we're doing with S1, good, bad, or indifferent. We'll let you know how we're doing with that metric, and that should be a trigger for is the company driving adoptions. Now, there are other sales that the company does. There's Axor sales. There's instrument sales. There's S2s. S2s come along. And we'll certainly continue to show you the aggregate sales number, but we're going to highlight S1s. Also, with this strategic shift, it's allowed us to take some costs out of the business so we can extend our cash runway. We think that combined with the The raise that we did can allow us some market time to get U.S. sales back and rebounded nicely and also allow us to attract a CEO to the company. And there's a couple of critical key marketing programs that have been missing. We're actually going to do a trade-off on some of the science programs to do some of the key marketing programs, and we'll invest there to drive U.S. growth. Jorgen? to take it away with financials.

Right. And thanks, Scott. As you probably have seen in the report already, the net sales for the quarter was 23.7 million SEC. And this is in comparison to same quarter last year where we had 30.1 million SEC. Now, this is a negative growth of 21.2%. But if we look at the US, the same quarter and the same comparison, we had 20.1 million SEC this quarter and 20.3 million SEC in the corresponding quarter for last year. So the big difference is in EMEA APAC, which had 3.6 million as revenue for this quarter and 9.9 almost for the CARS comparable quarter last year. And the explanation for the difference is that last year's Q3 was heavily influenced by activities in the Ukraine. I don't know if you remember, but let me remind you that that's when we really started training that center in the Ukraine. So Richard went down in December 2023, did a lot of surgeries. And then at the end of the quarter, we sold them an inventory set of implants. And I think those activities explain almost all of the difference in revenue. Looking at the gross margin, it's 81%, which is fairly consistent with what we've had historically. And also within what we think now is a normal range. Now, as Scott alluded to before, of course, the gross margin will vary both with the customer mix, of course, but also with the product mix. We don't have the exact same margins for all of our products if we sort of think of our product as implants for S1s, S2s, and Axors. So depending on how the relationship is between those activities, the gross margin and the revenue will vary, of course. And I think, I mean, jumping ahead a little bit, this is also a reason why we wanna show you the number of surgeries that we've done in the quarter. because S1s will show you, I mean, nobody does an S1 without doing an S2 and buying at least an XOR. So S1s will show you which way we're going in market penetration, but it doesn't necessarily mean that an increasing number in S1s means an increasing revenue. That is also a function of how many S2s and XRs we've sold in the period. Looking at the EBIT, we're now at a negative 7.4 million SEC in comparison to a slightly positive 340,000 SEC for last quarter. And a lot of the reason for that is also, of course, the same activities as I talked to you about previously. Now, the cash flow. for the quarter was a negative 19.5 million SEC in comparison to negative 5 million last quarter, leaving us with a cash balance going out of the quarter of 14.7 million SEC almost. Of course, this has been considerably strengthened after the share issue we did in February. And as I said, the number of S1 surgeries we did in the quarter was 44. And I want, I mean, we have chosen to not show the historic numbers. I mean, we started, we're starting from now and we want you to sort of think of the number 44 in relation to what Scott mentioned earlier about our total TAM and the number of opera patients we have. in total, which was 260,000. So 44 means that we still have a lot of market to go for. Thanks, and over to you again, Scott.

Okay. And last slide, and then we'll go to questions. Just a reminder of the team board of directors. We did add two new board of directors, Annette Lindquist and Christopher Westergren have joined the board and it's been, those have been very positive and they've both been very helpful as we've gone through this strategic realignment. And then this is a reminder of the management team. Some of them are headquartered in the U.S. and some of them are in Sweden, but we are one company and that's how we're operating the company. It's all about focusing on key markets. So, Jörgen? Thank you. And I look like we can go to questions now.

Thank you so much for the presentation here. And as you mentioned, now we will carry on with the Q&A. And the first question here is, can you please elaborate on why you see a return of U.S. sales growth? The Q3 U.S. sales were still reliant in line with the volatility we have seen in previous quarters.

Sorry. The first part of that question?

Yes. Can you please elaborate on why you see a return of U.S. sales growth?

Okay. Yeah. I think it's a heightened focus on making, you know, like any function in a business, you've got to manage and inspect the details of what's happening. And I think it's two things within the U.S. I think it's a heightened inspection of okay, what are we forecasting? How are we going to make that forecast? And what are the drivers? And then you inspect those and you make sure that they happen. I think the second thing is we brought a U.S. Director of Sales on who comes from the prosthetic, both the orthopedic and prosthetic market. And I think he's been a great help in breaking down how to sell to prosthetists and how to explain the Oprah device. And that's That's been very important. But I just think, you know, executing in sales is as much of a science as anything. And I think you've got to be very focused on it, make sure that it's happening. There's also some critical things within marketing that we needed to make sure that we were getting the right tools out. And we're just actually in the process of launching those tools this quarter.

Thank you. You're now more transparent on the number of S1 surgeries, but will you consider giving more information on how many surgeons are OPRA surgeons? Are we seeing the same small group of surgeons using OPRA or a large group using it very scarcely?

That is a great question. Let me break down how we're thinking about things right now. We have... two accounts, as I've talked about, um, that we are focused on partnering with around understanding how do you drive deeper adoption within a facility, um, that could go from pricing to, um, creating a center of excellence to helping the hospital market, uh, you know, to where, where are the prosthetists located that, um, can refer those patients. Then, as I said, we've got five centers that we've, we've partnered, we've, uh, uh, identified with hanger. And then we've got 11 other centers where patients get referred to. We have 18 surgeons overall that are highly trained. Underneath that, there are surgeons waiting to be trained. But if you look at our ability and our size, we have two sales reps out there to call on prosthetists. We as a company think it's not the best use of cash to open up a whole bunch of accounts, spend the money on training, and then have one patient dribble. We think it's more important how do we figure out to get five to six to 10 patients going into highly trained accounts. Then when we have that recipe, then we can go out and unlock the market faster. And at that point in time, then we'll start talking to you about centers of penetration and number of surgeons.

Thank you. Can you elaborate on the terms and conditions for your trade term financing, such as how much, what interest rate and what payback period?

I have an excellent person to answer that question, Jorgen.

Yeah. It's the sort of facility itself is 24 million SEK. so we can at once have 24 million SEC finance. This is why it's not a factoring deal, it's because it's more like trade finance, meaning that we can actually set the payment terms or credit terms for each sort of time we use an invoice as collateral. So the strategy will be to use our credit terms to our customer as the credit term we have towards the bank. So that's a match. So if the customer has 30 days, we will set up 30 days with the financing. And then it's more of a fee-based setup than an interest-based setup, of course. But I think in the long run, it's better for us, given the industry standards in terms of payment terms, It's going to be a better deal for us to use this for customers and to finance sort of the increases in our working capital coming from the accounts receivable through this and get the money right away. So yeah, I think it's a good structure. And for us, it's a little bit better than having a straight factoring deal because we can use this facility for all sort of both companies. So we don't have to have separate agreements for each company. So both Inc, our US market and European market can be financed under the same agreement. So from an administrative point of view, It's a very good arrangement. In a factoring deal, you would have to have a separate deal for the US, for each country, more or less. So yeah, overall, a good deal. I can talk a lot about this. So if you have any more questions, just email me and I'll answer when I can and what I can answer.

Thank you so much. The next question here, you have a target to educate more than 200 certified CPLs during the year. How many are educated on OPRA today?

I tell you what, I don't have an exact number of that. I would suspect it's probably, if you look at the new program that we've identified, and we've actually taken one of our prosthetist employees that's been involved in the company for a long time and moved him out of sales and into, he now drives professional relations for prosthetists. You know, I would say it's less than 75 that are really trained. And I, you know, I could be wrong on that, but we'll get that number and I'll find a way to get it to you.

Thank you. How does Oprah fit into the reimbursement structure today from private insurance companies? And do you assume that it will always be on a case-by-case situation?

Within the U.S., Oprah, we have trouble with one insurance company, and that's UnitedHealth. We are being reimbursed at all the other insurance companies. The first quarter I was here, I talked about We had some cases canceled and that was with Blue Cross in St. Louis and they've now started reimbursing for Oprah. So what we are doing and need to do is we've taken some of the marketing team, which is a small marketing team, but we've taken some of them and partnered them with an external consultant around how to get our arms around marketing to insurance companies. And so we've been organizing our data and we're putting together a package to go forward. But I think that critical for the company, and there's a number of things that we need in the company on the commercial side of the business, and we should have someone that is in the company that drives insurance and reimbursement. So as we put our budget together for our strategy meeting that's coming up next, end of March with the board. We're going to put some things in the budget that we think drive that. So I think we're making progress. We still got some work to do with UnitedHealthcare. They are the toughest one in the U.S., but that's the only one today that we're having challenges with.

Thank you. How is the work going forward finding a permanent CFO and permanent CEO?

So the work going forward on the permanent CFO is... I and the board decided that we really want to not go after the CFO until we hire a CEO. I think that's an important partnership. I work very well with Jorgen, and we've gotten to know each other, and there's always a relationship there that the CEO has with the CFO, and it's really important that that's there. I think hiring the CFO ahead of the CEO really didn't make sense. We are moving forward with the CEO. We've hired a good firm. We've got... people that are interested and we're in the process and we're trying to bring that to a conclusion. And then even with that, there's always the timing considerations to think about as well as how fast they can join. So when that's able to really concretely talk about, we'll let you know.

Thank you. What are the company's financial objectives? Is it sales growth? Can you please elaborate on any goals related to net profitability and or positive free cash flow?

Yeah. So right now, the company is very focused on sales growth. And then we're also focused on the cost reduction target that we gave you. Anything outside of that, I think will come out of our strategy meeting. But in the past, we've been trying to drive sales in the US and do it as close to break even as possible. So you know, until there's a different strategic change, I think that's what we can communicate to you is that we're going to continue to try to do that.

Thank you. How should we view the Hanger partnership after the announcement of the partnership with SPS? Aren't they being considered as competitors?

Oh, no. So let me explain. Thanks for that question. That's a good question. So Hanger, there's two pieces of Hanger. Hanger owns Clinics. And then Hanger has a group called SPS. SPS calls on the clinics that are not owned by Hanger, and they sell and market to them all of the devices, powered knees, prosthetic devices, limbs, and then they sell Axor to non-Hanger clinics. So the SPS team, as a value added, wanted to offer... a training program for those clinics. And that's what we decided. We agreed to partner with them and do that. Made a lot of sense to us. So they're not a competitor with the hanger. They're a very important part of hanger and hanger appreciates any work that we do with them that helps drive an increase in sales.

Thank you for the clarification there. Sales reached 20.1 million SEK this year compared to 20.3 million SEK for the same period last year in the US during this time. You have signed a new partnership with Hangar and reshaped the company's strategy with a strong focus on CPOs. How do the targeted initiatives between these periods differ and how should analysts interpret the numbers in this context?

So last year, uh, last year in this quarter, we had a number of one-offs also in the U S um, and we, we had some surgeons that were leaving institutions that did, that did the, um, uh, I'm looking for the right word. They, there were some patients wanting to be done at those facilities and they did those surgeries and then they, they moved on to other facilities, you know, to accompany our size with, with our thin, um, penetration into the market that's you know you're always at risk on that and that's why you want that's why we want to solve this adoption problem and grow it faster um and then we also had um a large a couple of large axor orders last year um so with the focus um with the with the realignment and the focus going forward it's going to be on driving new surgeries it's going to be on um an increase of, um, we, we have a deeper understanding of Axor and that patients have multiple Axors. And we also, um, will continue to partner with, um, Hanger and Autobach and other prosthetic suppliers for Axor. Um, but I, uh, you know, things like, uh, big instrument sets into hospitals and stuff like that, that that's kind of going away in the U S market. So, um, The real growth of the company going forward is going to be S1s, S2s, and Axers, and that's how we're going to drive the market.

Thank you. You have capitalized R&D expenses of 10.3 million SEK year-to-date. What progress has been made in R&D, and when can we expect this investment to translate into commercial products?

Great question. That's a great question. Jörg, do you want to talk about capitalization, and then I can talk about projects? Sure, yeah, yeah.

I mean, of course, there are things that we haven't really communicated to you that are changes to existing products that we have capitalized. And those make up a part of the capitalizations we've done this year as well. So, of course, they will reach the market, but it's also a question of certifications and getting the regulatory work in place before we can talk about and market them, of course. But then there are also some bigger things that we have started that are more longer term, but I think the strategic shift We'll also see sort of has already started a shift in how we think about what projects to run. So with that, I guess I should hand over to you, Scott.

Yeah. We need to be focused on projects where there's a clear business case and a clear ROI on how we're going to how that's gonna be successful in the market. And a lot of that is thinking through the route, the regulatory pathway, the reimbursement pathway, those things need to be thought of the day the product is actually started. So within R&D, it's gonna be much more of let's actually think about why are we doing this project? And then how do we do it? And then we execute to it. And so, as I said earlier, we've looked at everything We've prioritized everything. Some of those longer-term projects, they're going to be delayed because we just don't have the resources to apply against them. For a company of our size to try to do some very hefty To try to do more than one PMA at a time is really tricky. Those are big investments. And then at the same time, shareholders want penetration and growth in the US. And I just think it makes a lot of sense right now. to take our market position in the U S and if we can drive success there, it throws out, we have tremendous margins, which we can throw off cash. And then we can continue to invest in that. It becomes a vicious cycle of success and we can throw off cash. And then that cash can be used for projects can be used for sales growth. And so if we could get, you know, once we get over that $20 million revenue hump, um, this starts to be a different discussion. So for now we're going to be a little more, um, We're going to be very focused on R&D projects, on the ones that we're doing, and they've got to be critically important to driving adoption in the U.S.

Thank you. How do you view regulatory challenges and approval for OPERA on other extremities? The latest data from the DoD is very promising for above-elbow application. Is this something you could soon use as a basis for a PMA application? And if so, when do you plan to submit it?

So as was, as was talked about a while ago, FDA has said, Hey, we're open to looking at different paths on getting this approved. And one of the paths was doing a chart poll around the world of all the humoral projects that had been implanted. That's proven to be very difficult and it's also very costly because we have to sign a contract with every clinic and we have to hire, buy an insurance policy for every clinic. So that's been slower and it's been more cumbersome. So we are actually in a very deep focus right now on how do we, what's the right path to get humoral to market? Because we do have an interest in that in the U.S. and we're seeing an increase in surgeons asking about when can they have it and is there another path for them to get it? So We're focused on that. I think that is our first focus is how do we bring Humeral to the US market. PMAs are big projects and they're costly and they also need an internal staff in the company. You know, we're still, you know, we have a femoral PMA, and then we also have to do a post-market surveillance study with the femoral. So there's a lot of stresses on the clinical department. So that's where you get into this proper allocation of resources planning when you think about all of these projects, because you can only stretch one person so many ways. So we will, but again, we will be focused on the humorous project next.

Thank you. The UK is a prioritized market, but according to the latest report, it has not competed significantly to revenue. When is this expected to happen?

Good question. So the group in charge of Europe is actually doing an analysis right now for me on why we're not. We've sold sets into some of these European markets and we're not driving implants yet. And we're doing a very similar study with the distributors in Europe that we're doing with the two hospitals in the U.S. around what's needed to actually start doing some implants. And we're going to actually take that to our board strategy meeting at the end of this month, and we'll discuss that with the board. And then we should have a strategy that we start executing to by April. So to answer your question, I've got some assumptions that I think are issues, but I won't go public until I have data. And then we'll let you know.

Thank you. How do you view potential for partnership or strategic collaborations to enhance the market penetration?

Yeah. So one of the things, those things are always good. I will tell you as being a veteran in the orthopedic industry, a lot of people because of the way these big orthopedic companies work, like doing a distribution deal with somebody isn't really going to help us that much. And they, and a lot of them haven't been that successful in the past. I've been, I was part of a horrible one when I was at Smith and Nephew and had to unwind it. But I think for us, the one thing we've done recently is with our ortho, our independent orthopedic distributors in the U S we're managing them directly. Now we used to have some, we used to have some partnership go through with Oncos and we still work and still are very friendly with Oncos. But what we wanted to do was take that distribution group and have it report directly to us. And so we like that. We think that helps us get more traction. We like the hanger relationship. We like our SPS relationship. If there's something that pops up out there that I think and the board thinks makes sense for the company, either financially from a partnership point of view, we're certainly going to, and we are exploring when those do come up, we explore them, but we really want to just stay focused on executing what we've talked about.

Thank you. Is the strategic overview initiative in 2023 still in play?

So, yeah, we are that is still going on. And that was the result of, um, you know, that, that brought hanger that brought, um, uh, that brought the, um, rethinking of R and D and there's some things that we're continuing to do, but, but we're in the final, we're in the last phases of that. Um, and we'll, um, you know, so that work is being wrapped up and finalized. And as I said, we've got a strategy meeting coming up at the end of March.

Thank you. Um, You mentioned earlier that you're interested in buying stocks in Intergrum. Can you tell us a little about how your thoughts goes there?

I'm sorry, that question again?

Yeah, of course. Buying stocks in Intergrum. You mentioned it earlier that you have an interest in it. How are your plans on doing that going forward, so to speak?

So as soon as somebody can solve that for the Americans, then that will happen. It's very tricky and... very involved. So we're actually working through that. So we'll figure out. We don't have that done yet, I'm sorry to say.

Thank you. Moving on to the last question here. What do you mean when you say the company is entering a transformative period?

You know, the company, like any company that's founded by a brilliant founder, has done a lot of great things and was at an inflection point of being at the 100 million sec mark. And now it's like, how do you put a systemic commercialization process in that takes it to 20 million and beyond? And so if you think about what would transform that, it's attraction of a new commercial leader, somebody that really gets the science of commercial execution and how to grow markets and how to allocate the right products and tools. So it's a transformation process. from a company that really was focused on science and clinical to how do you take that science and clinical and grow revenues and grow your position in the market versus the next science project. So, you know, if you say So you start measuring yourself saying, I've got this great femoral surgery. I've done this good clinical data. Well, how do I then get to 2% to 3% market penetration in the next couple of years? That's the transformation of the company. It's to be much more focused on driving market adoption.

Thank you. That was all the time we had for questions today. But if you have more questions, you can contact Integrum afterwards here. So thank you so much, Juergen and Scott, for the presentation. And thank you all for tuning in. I wish you a pleasant weekend.

Thank you. Thanks, everybody, for tuning in. Thanks. Bye.