Senzime AB (publ)

Welcome to this Sensime Q1 2025 results interview. With me in the studio to discuss the outcome in the first quarter, I have Sensime CEO Philip Sieber. Welcome. Thank you. Nice to be here. And this morning you reported really nice numbers with really strong and impressively strong sales growth. I wonder if you just could start off with just give us the highlights of the quarter.

Yeah, thank you. Yeah, it's been a good start of the year. Good momentum. I think we're pretty much on the plans that we have set for the year. If we look at kind of the summary slide here, what you can see is that our net sales grew 94%, strongly boosted by our next generation, our new TetraGraph system that we launched in the fourth quarter of last year. The important deliveries of single-use sensors or TetraSense grew very nicely, above 100% in units as well. So we're really delivering to our installed base of units. Our gross margin improved versus last year. I think we're getting better paid and reducing manufacturing costs. Our operating expenses were pretty much flat versus last year's first quarter. And this is despite significant commercial investments that we're doing specifically in the US. So our EBITDA remains negative, but we're making major improvements and moving towards profitability within the plan that we're on.

Perfect. Let's get back to each of these points. We could start with the sales development. Really strong sales and this follows as a rather weaker Q4 last year. How much of your sales improvement is driven by a backlog going into the year?

Yeah, good question. If we look at the next slide, then we can just see we had a little bit of a bump in the curve in Q4 of last year. And that was, as I was very clear with in our Q4 report, we launched the next generation TetraGraph. It also is in the midst of the fourth quarter, so it postponed a lot of the ordering and the sales processes we were in. So people said, OK, we want to reevaluate. We want to look at your new system. So we came into 2025 with a bit of a backlog, which was good. So a part of the deliveries now in Q1 are a little bit of backlog from last year, but also a very nice underlying run rate of the business. I think we had roughly... About 2 million SEK in backlog as we went into Q1. So it's a relatively small number.

But maybe there was some customers that waited for it.

There was definitely. And we did our first shipments of the next generation TetraGraph just in the end of Q4. So we started shipping and now everything is smoothly working towards it.

And your current shipments, particularly in the US, is it primarily the new version of the Tetrograph or is it a mix of them?

It's actually a mix. So we're now really promoting more like a classic entry level or classic Tetrograph, but also promoting then the... The next generation, which is more state of the art, very advanced, yet simple to use, slightly higher price point, but a much broader kind of configuration, making it more acceptable for the mass audience.

You see any difference between the customers that's chosen the older version between the newer version?

Yeah, I would say that the older version is more for price sensitive. You want the legacy technology, something that's already out there. You don't want to take any kind of new product opportunity and upside and risk. While the new system is more and more chosen by the users, by the nurses, by the people in the operating room who really love kind of the graphical interface and the ease of use and really understanding the level of block in a very intuitive way.

You showed quite nice sales growth in all markets this quarter, but let's stay particularly the US market, which is the largest market for you still. It's a bit, a little bit, I mean, a lot of political volatility, let's say, in the US market during the first quarter. Do you see any, I mean, how is the underlying market demand changing?

Yeah, I wouldn't say that the underlying market demand is in any way affected by the political climate or tariffs or trade, etc. There's still a strong underlying growth for surgical procedures. Patients need anesthesia and they need the type of technology that we offer. so i'm not seeing any of that as of yet at least um the u.s did not have triple digit growth but but it was also we had a number of major deals that we have in the pipeline that simply didn't close in in q1 as planned but but we continue to strengthen our market position um i don't see that we're losing any deals in q1 to competition of a major kind and uh So all in all, very positive about the pipeline and the outlook for the rest of the year.

You have not noticed any changes to the selling processes, getting more lengthy or something like that?

I wouldn't say so. I don't see anything around that. I mean, contracting, we're selling to large hospital systems. These processes always take time. So that's a little bit of my challenge. This is mediating the time and the effort of getting to closing.

You were out with a press release mentioning some of your thoughts about the tariffs and how it might impact your business. But maybe we could repeat this. What kind of effect do you see from the proposed and implemented tariffs?

Yeah, so Senzyme is in a pretty unique position where we have the majority of our production done in our head office in Uppsala. We source the vast amount of our components from European suppliers. So we are not affected by any new tariffs in terms of supply. And then we ship the majority of our products to the U.S. So there is definitely an exposure on the tariff value as we shipped it into the U.S. On the other hand, my industry peers in the U.S. all have, many of them have major production sites in China and are reliant on importing from there. So we're seeing companies who are now kind of addressing and flagging for we're going to need to increase the prices to meet this. So there may be an underlying increase that we can kind of hang on to. So I'm seeing a little bit of a balance here. Yes, we need to pay some tariffs. On the other hand, there may be some price increases that we can adjust to as well. So the balance is there is hard to say, but we think that the effects on this, which will be on our gross profit margin, is single digit percentage plus minus.

And what's your expectation when it comes to price increases, the magnitude and sort of a... It's hard to say.

I mean, we've seen other companies in the industry go out and say, okay, we're going to increase prices by 20%. I think we all have some contracts, so it's new customers. I think we're talking a couple of percentage points that we can increase. And at the same time, the tariffs will hit a couple of percentage points. Then there are strong advocates ongoing out there to try to exclude medical devices from the tariffs. And this is driven by AdvaMed and big industry kind of consortium, specifically in the US. So I'm hoping that we can hang on to that. There might be an exclusion.

And just to follow up, the tariffs, I mean, do you see the same effect on the monitor production costs as well as the sensors? Or is this difference how they play out?

So far, it's the same. What we are evaluating now is still, should we potentially move parts of our production to our U.S. facility or use U.S. sub-suppliers? We are quite competitive in Sweden, actually, in terms of... cost of a manufacturer believe it or not so we'll continue to monitor this and we will move and do the changes as needed and let's suggesting there will be 20% tariffs would that affect you in a greater way than you're mentioning now or is it in the same yeah so remember the tariffs is something which is paid by the US importer it's not taxed of Sweden AB And the tariffs are applied to the actual value of the product, which is shipped through customs. And in life science space, where you typically have... quite high gross margins meaning that the export value is relatively low and then you apply a higher price in the end. So the value that we are shipping things into the US is in relation to our big cost a very marginal part. So you're only hitting a tariff on the actual export import pricing.

Okay, perfect. And going back to the customers, looking at your press releases, there have not been that many press releases in the past months, but you seem to have a very good, strong underlying business. Do you have any comments?

Yeah, let me show you a slide on that as well here. So just summarizing some of our key wins, I would say, in the Q1. We started by announcing kind of a major win down in the southeast of US, which was over 60 units delivered to a large university hospital systems. We announced a win up in the mountain region of the US. We also announced that we supply the leading, the most highly prestigious, highly ranked hospital in the system in the US with next gen monitors. We announced in the end of March that we won a large evaluation up in the northeast part of U.S. And that was evaluation versus legacy technology as well as EMG technology, which is a pretty big win for us. And then in Europe, we've had wins specifically in Switzerland that has proven to be an early adopter. And we also installed the first university hospital in Germany. All in all, you know, these together amounted to about 440 tetragraphs that we delivered during the quarter. We didn't do press releases of all of them. We did the ones we felt had a material effect and that were important to disclose to market.

Okay, so we should not expect the same intensity of best releases?

I mean, we will. Whenever we think it's an important win, we will definitely always disclose it.

Okay, great. And then let's stay in the European market. That's quite strong numbers. And you mentioned in the report that you did the launch of the new tattograph in mid-March, and it will be well-received.

Yes. So Europe last year, 2024, had a little bit of a slower year, tougher for capital. And then perfectly on time, we launched the next gen mid-March. So now it's all CEMDR approved and ready for sale. And in just two weeks, we shipped out... a higher volume that we did in the full year of last year classics so it's a very good start of the year very strong positive momentum in in europe we have distributors that we work with and very positive response from them so so i'm i'm actually very bullish for for the european market this year versus like and when you say bullish what time frame are we talking about I mean, of course, some of these that we shipped were to direct to hospitals and some were demo units, which kind of, you know, affects a little bit of the average price point. But I mean, the feedback we're seeing from our European partners, the opportunities out there, the ease of use, the ease of sale, and that we're coming out with something that market really wants, I think has encouraging for the year of this year.

So you see a sort of growing acceptance of your technology, the AMG technology. I would say so.

I mean, AMG, the legacy technology, has a very strong foothold in the European market. But we're winning robotic surgery, laparoscopic surgery. We're winning these niche areas. And pediatric market is also important. And we know guidelines are to come in Europe and abroad. So I think we're strengthening and we're kind of winning after winning.

And just describe the competition. Is it different compared to the US market?

I mean, the same players are here as they are in the US, but I would say European market is more integrated, more big tender based. The type of technology that we are promoting is more offered as a package offering. So if it's easier to buy a big integrated system and you check the box for an old legacy technology, that sometimes wins.

You're planning to launch the new TetraGraph version in Asian markets as well?

We are, yeah. So we did a little bit of a pre-launch here in Q1 in Japan with extremely positive response. The formal launch will be happening in June. And then South Korea, an important market for us, is on track to follow. It's a little bit of timing on regulatory processes, but hoping for about Q3 time period.

And we saw really good sensor sales growth in the rest of the world.

I can jump to that picture here. The rest of the world region for us is Japan and South Korea. That's where we do the business predominantly. South Korea has, with the boost of local reimbursement for this and a very strong market penetration with our systems in Seoul and the big hospitals, it's really started to take off. In Japan, we have, as reported before, about 200 hospitals as customers and the integrated system that Fukuda markets is now doing very well. So there we're simply supplying sensors and then invoicing them for the sensors as well as a royalty for their integrated modules.

And then maybe the monitor launch now that you're about to do, we should expect perhaps to see a better footprint in the South Korean market than compared to the Japanese market.

I think the footprint will probably start faster in Japan. They are more into this kind of this type of niche technology, where in South Korea we have a strong penetration already with many, many hundreds of monitors. So I think both markets will accept this very well, but Japan will be first.

Okay. And let's then jump to the cost side and the gross margin, at least. You reported some improvements year over year. But if you could comment, you have already mentioned that the tariffs might affect the gross margin, but you also have an exchange rate effect in the US market.

Yeah, so the dollar, which is an important currency for us, is hard to predict and hard to follow. But I mean, the dollar affects us on the top line, definitely, but it also affects us positively on the expense level. About half of our operating expenses are in U.S. dollars. So there is an effect happening all the time. And I don't want to speculate what's going to happen to the dollar the remaining of the year, but I mean, as is right now, we were able to keep our operating expenses in line with last year. There is a large currency effect. So we did a little bit of a new, we introduced new bookkeeping principles. So we moved a lot of the intercompany currency effects, which are non-cash flow related. We moved them. down the P&L and this makes it a lot easier to follow our expenses but there is quite a hit on how when the currencies change there are bookings that change into company wise but we moved it to the financial level of the P&L

That's good. I think it's easier to understand how your OPEX develops. But you mentioned also that you might increase the sales force a bit more in the US. But you're sticking to your previous guidance that you're with single digit.

Yes, the guidance remains both on top line and also on expense level. So we said expense is going to potentially increase with a single digit, lower single digit over the year. And again, this is despite, like I said before, major investments in our team. And I'll show you a slide here on this. So what we did during the first quarter is that we increased our production capacity in Uppsala. So brought in more skilled operators. I expanded the US commercial team, so brought in more salespeople, divided into new regions. And then we created a new team, which is the medical affairs team, which is working to work with KOLs and drive studies. We're going to win this race by science. And we're already well on that path.

And the new manufacturing capacity, how many instruments are you able to produce?

I mean, we have the ability to produce according to our five-year plan. But I'm scaling it carefully in steps, and we don't want to tie too much capital. I mean, a little bit of a negative effect on the Q1 report was we had a higher cash burn. And that cash burn was because we built up some more inventory. So we were just being ahead of the curve for U.S. changes. And since we had a lot of big sales to U.S. large hospital systems, they are not as good as paying as they should. They always pay, but it could take up to 85, 90 days before they do. So there's a pretty high increase in receivables during Q1. And then the last portion was we're continuing to drive innovation work and we have some very exciting things in the pipeline and we are capitalizing those as part of our development efforts.

Yeah. And then staying with the financing, you mentioned in the report that you have been looking at the 75 million credit facility and you have on the balance sheet today about 62 million cash. Yeah.

So we did a directed shares issue Q3 last year and I was pretty clear in the press release that this is not enough money but we want to take this in steps and we were looking at various kind of non-dilutive financing options. And then as time has progressed, terms have become a little bit more favorable and we have offers on the table. And this is looking at right now a credit facility of around 75 million SEK. And by bringing this in, this would give us enough capital to take the company to the business plan and the cash flow profitability that we've announced.

And how important is it for you to have a credit facility over a sort of a rights issue?

I think I want to be, I mean, the share price has taken definitely a hit in these kind of uncertain times. And we think this is the best deal for the shareholders. We think the terms that are now being offered are getting more and more attractive. And we think this is the best offer right now.

Okay and we will get a little bit more information during Q2 then perhaps.

Yes definitely we'll come back to it. A little bit just comment on the shareholding while we're on that subject. Just an updated shareholding list. So we've had some changes in our kind of top 10 shareholders. I would say that the top three remain strong. And we've had some outflow. Handelsbank and Fonder has been selling. So I think perhaps in a time of uncertainties, since I'm as a high dependence on the U.S. market, and then we've had some movement in the shareholder base, that has probably affected the share price negatively. Yeah.

And you have already mentioned that you're sticking to your financial goals, both the short and the long term. Maybe you can just remind us about the long term financial goals.

I mean, the long term goal of this company is to create a billion Swedish kronor company with attractive profitability. And I think we can do that by a high gross margin, a very fixed and controlled operating expense level, and by that having a nice profit margin. On the way to that goal, we've indicated that we want to get to about 300 million SEK as a kind of a target number by next year. And by this year, we're going to reach 115 to 130. So we need to grow this company in a very aggressive level. We need to pretty much double the business. So that's why I said we open up the year according to plans.

And you feel confident about your financial guidance, even though the dollar has lost almost 15%?

Yeah, I mean, at least right now, if things change and we need to recalculate, we will announce that. But for now, we are anticipating this.

I also have some questions from the investor audience that I received. And one question is about the European market where Brideon, a generic version of Sugarmadex, has been launched. And how, if you see that affecting the demand for your products? I mean, yes and no.

I would say, I mean, in the US, the Sugamidex, Sugamidex is the reversal drug, which is used kind of in the end of part of surgery to help, you know, wake you up and make you spontaneously breathe again. There is a very clear kind of cost benefit case because we can reduce the amount of drugs needed. And hopefully you could drive it to spontaneous wake up so you don't have to have any of these reversal drugs. While in Europe, the price of the drugs are now significantly lower because they're off patent. So that cost case. But the importance here is making sure that you're dosing the patient right. There are numerous studies out there showing that people are getting overdosed because you don't know. You and I will have totally different doses of Sugamidex or Brideon. And who wants to overdose a patient? And so that's why as part of kind of the instructions for use of these drugs is that you carefully monitor the patient to make sure you can have the right dose. And that is irrespective of the price point of the drug.

And also I have a question about your adoption of artificial intelligence and what the new possibilities are.

Yeah, definitely. It's an interesting space. I mean, we introduced what we call adaptive intelligence, which is kind of a series of features to help guide and make the usage of this technology far more simple. We have some exciting things in the pipeline. This is always going to be, we're helping, we're giving guidance. So whatever AI or things that we will bring in is more to help anesthesiologists and clinicians to make better decisions. So we are not attempting to kind of take over or automate things. It's about making more informed decisions.

Perfect. And another question is about your acquisition of Expiron a couple of years ago or the Expiron system at least. And what's going on with this?

I mean, yeah, it was acquired in 2022 in a time of preclinical guidelines, a little bit of post-COVID days. We were looking at that time. The company wanted to kind of broaden the portfolio. And then came the guidelines, full focus on the neuromuscular monitoring side of the business. So it remains a small business. We've had some sales. We're selling to both research and also a few regular routine use clinical accounts in the U.S. So far, I don't really have the resources and the time and the effort to really target this. So it's a little bit on a backburn. We're still defending the value of it. We made an intercompany write down in the Q4 report. So longer term, I see that there are definite, very exciting opportunities in this. There's a lot of IP and there's a lot of interesting technology that we can leverage from at the right time point.

It's not something you're about to sell to?

It's not on the radar. If somebody gave me an attractive offer, I would evaluate it. But that's not the primary focus.

Okay. And then the last question, I think it's quite good to summarize all this, is that given the uncertainty in the U.S. market, what makes Zensan a compelling stock for investment, would you say?

Good question. So let me show a final slide here and try to summarize some key takeaways. I mean, Sensai, we're truly on this mission to make our technology standard of care in every operating room in the world. And behind all this is 40 years of long-term research. There's over 10,000 papers published on the area of neuromuscular block. And we have been pioneering EMG, the new technology for this, and really driving a paradigm shift. So far, we have over 3,500 TetraGraph systems installed in operating rooms, and it's driven by guidelines and very strong key opinion leader support. The total addressable market for this exceeds 20 billion SEK if it's fully penetrated in all operating rooms. We're penetrated right now in about 40 commercial markets and we're growing at a speed of 94%. So we are on the path to really create a difference and join our mission because we're making a difference every day and we're getting closer to closer to a strong profitability and reaching our financial targets.

Perfect. Thank you so much.

Thank you.

Thank you for listening to this presentation.