Start from the top.
Okay. Are we live? Good afternoon, everybody. Appreciate they say you should never work with technology or children. We were not aware that you could actually not see or hear us, so I do apologize for any time that we have wasted. We are going to start again from the top. If anybody would like to stay with us, we'd be very grateful. If anybody would like a call or a follow-up after today, we'll happily facilitate that. So-
Without further ado, again, apologies, everyone. Let me accelerate you through to catch up with a bit of time. Ryan Keeling here, CEO of Diaceutics. I'm joined by Nick Roberts, my CFO, who'll come in in a moment. The investment case here, I'm aware, is not new to some of you. Maybe new to some others on the call. If you would allow me five or 10 minutes just to bring you up to date with what we feel is a new and evolving and exciting evolution of our business. We continue to refine this business case to make it somewhat more coherent, but also really pull out the key facets of the business.
When you look at the headline on this slide, you'll see that it's very simplified down to "We help pharma find patients." When you think about what a pharmaceutical company, big or small, is trying to do, they are effectively either trying to develop a new therapy by which they're running clinical trials, and recruiting patients onto that trial is a key part of what they're trying to do. The more we can accelerate that, the more that we can enable the right patients with the right profile to be recruited, the better, and it's very well documented, the opportunity that exists there. Similarly, where a drug is approved and on market, trying to identify patients who are eligible for that treatment, particularly if this is a more complex disease, maybe a rarer disease or more complex diagnosis.
Being able to get to those patients and importantly, being able to identify the physician who is treating that patient, is something that's a very valuable asset. When we talk about assets, we believe we have three unique parts of our business that really help us be differentiated in the market. The first is our lab network. We spent the last 11 years building a network of partner labs. These are routine clinical diagnostic laboratories. These are the labs that if your physician decides to get some blood work done or even a complex biopsy or molecular testing on a cancer, these are the labs that will perform that testing. We partner with 900 plus labs globally.
That number continues to grow, but at this point, we're at a point where we're focused more on maintenance and retention of that network. The days of growing the lab network at 50, 100 labs a year are behind us. We've reached somewhat of a critical mass there. In the model, we have these laboratories, for the most part, we have what we call a value-for-value proposition, whereby we provide them with a set of services. We provide them with data analytics, some cloud infrastructure, and we provide them with data back from our network that they can use for trending, competitive analysis, et cetera. And in return, we have the commercial rights to an anonymized patient-level daily feed.
Not every lab provides us with daily data, but most do, and that's automated, and at this stage, very stable and very reliable. I should note that for some labs that are particularly strategically important to us or other data providers, we do have a financial contract with those labs. Nick will talk to some of that later. Data coming from the lab network is unstructured. It's challenging to use. We have invested significantly in our data infrastructure as we move to the right on this slide. Let me give you an example of what that means. When you're bringing in data from over 900 laboratories, all of which have different standards, different approaches, different labeling, and I'd say a lot of it is unstructured data. You know, so we're not pulling in nice clean data sets.
We have to do a lot of that work to make sure that the end product that we send to our customer is standardized and, and has some additional value added to it that we can bring to the table. One of the advances we made through 2023 is evolving how we process that data. It used to be largely a manual process driven by a team of clinical experts in our headquarters in Belfast. Now, for the most part, that data standardization, data value add, and, and data cleanup is done through AI using natural language processing.
That same team that was previously doing it manually, for the most part, are now presiding over an automated service that is running effectively in line that can get us to close to real-time data. Our platform is our scaled layer here, and this is how we deliver the data to our customers. You must remember or be reminded that our platform effectively exists in two layers. One is the web layer, where you'll, as you'd expect, that platform, you can log in, you can see all your data assets, you can see all your engagement with Diaceutics, you can see trends from your data, you can drill right down into the physician level and patient level beyond.
That is used by our customers, particular types of customer use the data in that way. What is a more common model, and goes hand in hand with that, is where our data is plugged directly into the data infrastructure of our clients. And that means that we can provide an automated feed that's scalable, that is, very manageable in terms of the delivery, and it's sticky. Okay? We have to have an integration phase with the IT and data engineering side on our customer base. We build our data into theirs so that that feed is automated, and it also means that our data can be leveraged in the tools that are already in existence with our pharma clients.
You'll hear me talk a lot today about our Signal product, and it's really leading the way for us as part of our land and expand go-to market. And Signal is ostensibly a service we provide whereby we enable our pharma sales colleagues to understand which physicians are in the last 24, 48 hours seeing a patient who has been diagnosed with a particular disease. And that data is primarily provided out to a pharma sales team. They're using their own existing CRM tool, like a Salesforce or Veeva. Rather than us ask them, those field people, to log into our platform, we basically have an API call between DXRX and the tools that they're already using.
So they can log into their existing tool with all their existing compliance, business rules, all that set up, but it's our data, Diaceutics data, that they're viewing every day in terms of the, the call plans, physicians that they should go visit. And we can identify who are the likelihood of success, all those other key metrics, which helps guide the sales team in their day-to-day operations. Next slide, please. I will go through this very quickly, just getting we're slightly behind on time. Precision medicine for us, it isn't. There isn't a standard definition. What we're really getting to here is therapies that we can understand in advance of prescribing the likelihood of response.
Long gone are the days that we practice medicine by starting a patient on one drug, seeing if they respond, if not, swapping it out for another one until you run out of drugs. Precision medicine is no doubt the future, whereby we understand the diagnosis so well, and hopefully, we have a drug which has been designed for that very specific diagnosis, that you can match a patient diagnosis with a drug that's designed for that specific sub-diagnosis. And therefore, the response rate is typically much, much higher. That's where Diaceutics is strongest.
There's a very strong patient story here, strong purpose and mission, and it is absolutely hand in hand with what our pharmaceutical clients are trying to do, which is avail of the science, avail of the opportunity to bring drugs to market, which are potentially transformational for patients, given the response rates that typically we see with from precision medicine versus non-precision medicine. Next slide, please. One of the things that's very evident is that there are still significant challenges in the marketplace. We call these practice gaps. We are in a fortunate position in that, given the data we have and the understanding of the market and patient journeys, we can identify where the gaps are. This is a great framework for us to be able to engage with our customer.
They may have already bought Signal, for instance, but we can go and help them identify where else in the market they may be losing patients because they aren't, they aren't coming through the funnel. They aren't being diagnosed, they aren't getting the right tests. There's, there's other challenges that might exist. We can convey that in terms of patient lives. We can also convey it in terms of potential lost revenue for the therapeutic. And those two go hand in hand comfortably. This defines our roadmap and is very much driven by customer and where the customers agree with us around the gaps and opportunity to close. And, and we've built a lot of product around these gaps, and we'll continue to do so. Next slide. Very quickly on this.
We, at this stage, have been involved in the launch of almost every single precision medicine that's on market. And we have since, founded by our, our founder, Peter Keeling, back in 2005, we have lived and breathed this space. We stayed very devoted to precision medicine. We continue to do that. Our business is changing, and you're observing a change, from, from IPO in 2019. A lot of the investment has been building the platform, building the lab network, building the data, understanding those practice gaps, and really focusing on being more embedded with our customer. That means better quality revenue, building a backlog and order of position with a customer, building recurring revenues, all of which Nick will talk to, as we get down to the KPI and financial metrics. Next slide.
I just want to pull out one KPI on this slide that is referred to frequently by us, and you'll see us tracking it frequently. 69 therapeutic brands. So we usually use the word brand along with therapy or drug interchangeably. I'm sorry about that. We tried trying to standardize, but 69 is where we were at the end of 2023. Today, our understanding of the market is that there are 250 therapy brands that are eligible or highly eligible for Diaceutics. A lot of these brands exist in the current customers that we work with, so it's about investing in our sales and marketing and our ability to move sideways. And that 250 number is growing by around 15 new brands a year, net.
Some will drop off, some will come in, but that's the opportunity. We see all of that through the clinical trials that are onboarding at the moment and what might come through to market. Remember, our offering exists both in the pre- and post-launch phase, so even a drug in clinical trial is still an opportunity for us to sell Signal or other services to them. Next slide. Again, not going to labor too much of this, but I'm just gonna talk the salient points as we go across this slide. Hopefully, we're starting to convey that there's a significantly growing market opportunity here. We talked about the number of brands growing, the roadmap will deliver an opportunity for us to increase the revenue per brand.
Currently, that revenue per brand is GBP 380,000 per year. That's our average. The roadmap will allow us to grow that, through country expansion. You'll, you'll have seen an RNS earlier this year about, a return to strong position in Europe. As I said, 88% of our revenue last year was in the U.S.. But historically, we have had more of a balance with Europe, and, and we want to bring some of that back online in, in 2024. Last few years, we've very focused on the U.S. market, but there's opportunity in Europe. That, that's part of the roadmap. A bigger part of the roadmap is to continue to bring new, offerings, which are very complimentary to Signal, and again, back to that land and expand model.
Get the client on a Signal, use Practice Gaps and other mechanisms to help them understand what else they could and should be doing, and they will ultimately increase the flow of patients to their drug. And that increases that revenue, average revenue per brand. We have a strong competitive advantage through our network of labs. 11 years now into the build of that, the labs are very happy. We have very high retention rates, very little churn in that network. It's all automated, it's contracted, it's clean and tight in terms of that supply of data coming into us. Hard to break into and very unique for us. We have our platform, and what's not on this slide, of course, is the team that we're building. And I think we talk about that over on the right-hand side.
These are experts in what we do. The track record we have is unique for this industry, and there are people in this organization who have launched more precision medicines than anyone else in the world. And that is very valuable as we go and engage with our client base. Our financial strength is there. Nick will talk to the balance sheet. Our customers are blue- chip. I couldn't ask for a better customer list than we have. These are some of the largest businesses in the world. We have a three-year revenue CAGR now of 23%. We're funded well in terms of our current growth plans. And you'll see recently we've announced some additional enterprise-wide deals. There are more coming, and I'm comfortable to talk to that, but that's a key part for us.
When you see an enterprise-wide deal, your main interpretation of that should be that we've gotten very heavily embedded with a new customer or an existing customer where we've tipped them over into enterprise. And that means that we are expecting to be there for the long run. We have multi-year engagement with a significant recurring revenue. Next slide. We talk a lot about our Signal solution, and it would be remiss not to talk about the other things that we have built or are building. And the reason I talk so much about Signal is because we found that it's a really good lead-in product for us, whether it's pre-launch, post-launch. But we do have, obviously, other offerings. One thing that's very exciting about our business and where we're going is what we call our engagement solution.
So on the left, you'll see a mixture of data, like Signal and lab and physician segmentation. But you'll also see what we call Lab Engage, Physician Engage. And this is where we can leverage our Signal, leverage our lab network and growing physician network to engage with those stakeholders directly, maybe as well as a pharma-led engagement through a sales or field team. We can engage, and we're doing more and more there in terms of connecting this with a Signal to offer more of an end-to-end solution or a complete solution to our customer. All of these are designed to be added on to a subscription.
Typically, that's starting with a Signal, and then these are upsells or additionals that we can add on to our subscription, again, pushing that revenue up, pushing the order book for visibility and ultimately our recurring revenue. For this reporting period, Nick has been working on some new metrics. Most of them will be ARR, which he'll talk to you in a moment. The right-hand side of our business is absolutely critical. A lot of the practice gaps work, a lot of the knowledge of where our customers need to go and what we're doing is in here. This represents part of the business that we've always had, our more traditional strategy and planning. But again, that evolves and looks very different to what it did even a year ago.
A strong team there who are industry experts and are critical to our business, both in terms of delivery, but also on our business development side, and have significant and deep relationships with our customers. Next slide. A bit on our IP and I'm talking to one example of it here, there are others. We have. This really represents that process I talked to earlier, where we're bringing in ostensibly raw data from our lab network. We're doing a lot of expert labeling through the platform. We've built our large language model on these Diagnostic Deductive Pathways, which are effectively enable us to label the data so that then you can standard query it, rather than having to do some regex searching or other more complex and less reliable ways to engage with the data.
All of that then is wrapped up in a nice model, which we deliver through our DXRX platform. And ultimately, this is all to enable us to develop and innovate new products. So our lab segmentation, physician segmentation, Signal, patient rate tracker, et cetera, et cetera, are all things that are coming out of our ability to better leverage the data we have and get it to market quicker and with less overhead than we would have historically. I'm going to present this slide, and then I'm gonna pass over to Nick. Again, in the interest of time, I just want to make sure we get to the financials. I want you to focus on the right-hand side of this slide, and I'll preface this slide with, this is our best-case example. So of course, we will select that one.
So this is where our offerings made the biggest impact, but you should not interpret that as, you know, we haven't had a very significant impact elsewhere. We have. It's just this one really shines brightly. And it's quite stark because they only switched on our data halfway through the year. So this was a new drug that launched at the start of last year, 2023, with an existing client of ours in lung cancer. For the first six months, so if you look at the chart on the right, you'll see the first six months are only represented by the dark blue bar. That represents the number of new starts that the company had on drug each week. So they were averaging somewhere between five and 10 new patients onto the drug each week.
When we switched on our data in the middle of the year, that number typically doubled. So the pale blue is now with the DXRX Signal engaged, and these are the additional patients that we're able to find through our network. And remember, what we're providing them with here is a feed of physicians who in the very recent past had a patient who matched the diagnostic criteria for this drug. In this instance, it was lung cancer. It was a particular biomarker test that was being performed. And the interesting story here is, this client was a little bit dubious as to the power of the data, and was actually a bit concerned that we had more data than they thought we should, i.e., didn't believe that we had this much data.
Three weeks into this, which was initially just a pilot, we renegotiated a 3-year deal with an auto- renewal. We were able to do some up-pricing at that point as well. We switched them later in the year from what was initially a weekly service to daily, because we switched on our NLP and AI on the data processing side. So now we can process that data in flow, basically, and provide it to them every day. And this has represented a very successful relationship for them and us. They blew their initial forecast in the first year of drug out of the water, and it was a great story for them. You can see on the left here, significant ROI. For every $1 they spent with us, this was a $350 return.
The average is closer to 200 for every one. Still, obviously, very significant, and we'll talk later about the work that we're doing to evolve the model so that that balance of investment versus return is maybe improved for us. Even though this one client represents, this one data feed is close to $1 million a year in terms of data, it's still a very significant ROI, and therefore, some headroom for us in that contract. Nick, I'm gonna pass to you.
Thanks, Ryan.
Do you want to move on to-
Yep.
- your slides?
Yep. Thank you. Thanks, Ryan, and just very conscious of time, we kind of capped ourselves a little bit at the beginning. Just to quickly say, this is in the deck, a really interesting slide. It shows the physicians that we are flagging to our pharma customers with Signal throughout 2023, and you can see the blue dots are all of the population hubs and the sort of coverage we have in the U.S. The bottom left number, the 461,000, as at the end of 2023, we signaled to our pharma customers over 500 potentially eligible patients for them to go on drug. A significant number, and obviously looking to grow that as we grow the number of signals we have with customers.
Again, I won't spend too long on this slide. You might have seen in RNSs during 2023 and the beginning of 2024, really added to the strength and depth of our management team, supplementing our already wonderful and very experienced workforce. And that's really helping us, as a business, speak to pharma, talk pharma's language, grow, and meet their expectations. So thank you to everyone on this slide and everyone who's not on the slide and part of the company. I'll, I won't spend too long on this slide. Again, I'm very keen to get to the finances. No surprise there. We did update in the RNS on our strategy.
We set out at the beginning of 2023, our accelerated investment in our strategy, the key areas highlighted here, so enriching data platform products, accelerating the growth, engagement in the lab network, investing in scale and capability, and transforming the customer experience. I think Ryan has talked really well earlier in this presentation about how we are achieving against each of those, and some of the key areas are highlighted, tokenization, daily Signal launch, the AI, recruiting and embedding our customer account teams. All really key for us continuing to grow and succeed as a business. Onto the financials, just at a very high level, and Ryan touched on our financial strength.
I think some of the key areas, the high margins that we are able to achieve, so an average of 83% gross margin in 2023. Our three-year revenue CAGR of 23%, that 52% of our revenues are now recurring. I'll talk to the ARR metric in a little bit. We continue to embed ourselves with our blue-chip pharma customers through our enterprise-wide engagements, now up to 6. And I think we're in a very fortunate position to have a strong balance sheet, not least underpinned by the fact we have no debt and cash of GBP 16.7 million, as at the end of 2023. So some of the key finance areas, and I know that we pre-trialed some of these as part of our detailed trading update in January.
So revenue, very pleasing to see that up 22% to $23.7 million at 19% constant currency growth against a difficult macroeconomic background. Hopefully, we're seeing the inflation, the general inflation felt worldwide come down. That's both cost and wage inflation, and certainly, we saw and observed and felt some pharma headwinds during 2023. I think the biotech industry was particularly hard hit, and something which is very pleasing to see, has come back online strong in 2024, particularly those later stage, those clinical stage biotechs in the U.S., who have got sort of phase 3 clinical trials and are looking to commercialize their assets. Recurring revenue, up to 52%.
Just to remind everyone here, as a business, we started off recurring revenues in 2021 of just 3%, so a significant change in the underlying business, both in terms of recurring revenue, and I'll talk about what that's gonna look like in the future, but also our ARR, which we've introduced, so annual recurring revenue as a metric for the first time this year. Just on KPIs, we'll look to introduce newer KPIs to help supplement the understanding of the business as time goes on. I think this is a very relevant one, given where we are. So the ARR is GBP 13.7 million as at the end of December 2023. Nine million of that relating to enterprise engagements across six customers, so again, highlighting the importance of those enterprise-wide customers and engagements we have.
That 13.7 million is from the subscription revenue, expected. That's on an annualized basis, and at this stage, assumes a 100% renewal rate. And again, we'll refine that as a metric as time goes on, but I think what we are experiencing in the business is mid- to late-90%s in terms of renewal of our contracts. Couple other key points on this slide, the order book up to GBP 26.5 million. Really important growth there, giving us future visibility. I mentioned the cash there on the right, obviously really important for funding our accelerated investment plan, which is in line with where we guided the market, and I'll speak about that in a bit more detail on the slide in a moment.
Couple of KPIs, finance KPIs not on this slide. Gross margin at 83%, down a couple of percentage points on last year, but within what we believe to be the range of our gross margin, so 1-2 percentage points either side of 85%, depending on the mix of revenue, and also some of the fixed costs within cost of sales, such as our platform stack cost. Our adjusted EBITDA for 2023 was GBP 2.4 million. That's an EBITDA margin of 9% and down on last year, but again, in line with the accelerated investment in the strategy.
Part of that investment is growing the cost base, at least in line with the top line growth, and that means that, just through 2023 and 2024, we have a greater cost burden to shoulder, but the plan being that we'll see the growth and the growth continue and the scale come through in 2025 and onwards. And just to finish off by saying the cash flow from operations for 2023 was $600,000. Our free cash outflow for the full year was $3.7 million, and a lot of that free cash outflow coming from our continued investment in our, both our technology stack, but also our data. Some key operational KPIs here on the dashboard, and again, I won't talk to every single one.
Ryan already talked to the 69 customer therapy brands, brands, really important for us. We work with 17 of the top 20 global pharma, and they're our customers and have been for a long time. We'll obviously look to add the additional three to get all the top 20, but are looking to add increasingly more, more biotechs and, and other large pharma. We have six enterprise-wide engagements as of today. That was four, as at the end of 2023, and again, I talked to the importance of that, contributing towards our ARR. I think just to highlight, and we haven't talked about earlier, is the strategic partnership with KPMG. That's a really important partnership for us. They are a precision medicine thought leader, like us.
Very little overlap in our services. The partnership with them allows us to approach our joint customers with a comprehensive and jointly pitched sales proposition. Obviously, KPMG were a very strong brand and reputation, and us, in terms of our specialty, focus on pharmaceutical commercialization of precision medicine. So still in the early stages of that partnership, but beginning to bear fruit and really pleased to hopefully give some updates later on the year on that. I'll just finish off by summarizing the outlook in terms of the finances and then maybe let Ryan speak about what that looks like, and we can open up to some questions.
So we are continuing to see revenue growth, particularly in Q1 of this year, at that 25%, which is where our consensus guidance is in the market. We continue our strong transition to recurring revenue, so it's 52% in 2023, and will be up to 70%, by the end of 2025. We are on track to return to both profitability and a free cash inflow in 2025. That's after the years of investment in 2023 and 2024. And just to remind everyone, that was a $7 million free cash outflow across those two years, but not going below a minimum cash holding of $12 million.
We are looking to continue to grow and scale, and where possible, are assessing acquisition and partnership opportunities to help augment that growth.
Okay, so we'll now move to the Q&A portion of today's presentation. I would ask any of the analysts, if you'd like to ask a question, please raise your hand, and we'll take the first question from Christian Glennie at Stifel.
Yep. Good afternoon, guys.
Hi, Christian.
Hi. So, three questions, please. I guess we'll start with... I was just interested in a couple of comments around, you know, this, this, in terms of your customers, maybe a potential shift in the customers or whether maybe we're overinterpreting it, this idea that you are potentially moving slightly earlier, I guess, in terms of the typical development cycle of these products. Talked about getting involved maybe more in the sort of helping with diagnostics and the and identifying certain patients in clinical trials.
Yeah.
Is that a material shift, or is that still, you know, just to get a better sense of the balance of your business still between pre-commercial and then commercial, post, post-launch? And then, as it relates to the, you know, the talk flagging the fact that you're seeing opportunities beyond pharma, I assume that means, you know, you're seeing more interest on the, on the biotech side of things. Is that, is that, is that still largely dependent on how sort of positive generally biotech funding is, for example? Thanks.
Very good. Thanks, Christian. I'll have a go at those. Firstly, on the mix and the evolution of the specific client we see on our customer side. So historically, Diaceutics has worked both in the pre-launch and post-launch, pre-commercial, post-commercial paradigm, helping them get ready for launch and then following them into market. And with the advent of our Signal product, which, you know, is our number one product now, that's shifted quite dramatically toward favoring the post-marketing, post-launch, because we're very obviously bringing value there. We have... And 90% of Signal revenue in 2023 would have been in that post-launch setting. 10% of it was in pre-launch, supporting clinical trial recruitment.
What we have seen this year, as we've pushed more into that clinical trial opportunity, and remember, we're already working with our customers at that early stage, just with some of our other services.
... And most notably some of our scientific and advisory services and other, other things that we do to help understand the landscape, et cetera. We're getting traction, particularly with those biotechs that are looking for scalable, effective, cost-effective models, and where we can help them recruit faster and in a very efficient way, that's hitting home really well. It's also giving them confidence that they can get to market potentially quicker. And then obviously there's a lot of merit in keeping that signal switched on as we evolve from the pre-launch to post-launch piece.
In terms of our market overall, in terms of new customers, as we look to get the story out there into a broader audience, we have focused so much the last few years, especially on building out the lab network, building the data, building the platform. We feel that we have built scale into this business now, we feel that we have got a very stable model that will grow. Certainly, certainly will rise to the needs of growth over the foreseeable. There's always roadmap, there's always evolution. Anyone who's even dabbling in AI and data technologies at the moment know that it's transformative, what you can do, but it's changing so rapidly, so you need to keep up.
But what that scale has allowed us to do is focus more on our sales and marketing, focus us more on getting to new audiences. And yes, biotech is part of that, pharma is part of that, but there are also some exciting opportunities coming through some of our channel partnerships. Maybe opportunity to white label some of our data and effectively get to a different audience than we would traditionally go after. But all through our increased commercialization and presence in the market, that Nick and I in particular are really focused on driving at this time.
We'll take the next question from Hayley Palmer at Canaccord Genuity.
Hello, can you hear me?
We can hear you.
Perfect. Thank you. Congratulations again. Just two questions from me, please. In terms of the complementary solutions around Signal, I was wondering whether... I appreciate you said that you've got, like, the physician and lab segmentation, but I was wondering if beyond that, you were thinking about more organic development there, or whether M&A would play into it at all? I know you've got a large cash balance, and a lot of that's going towards the internal investment plan, but beyond the forecast period and looking to when we return to growth and profitability, whether M&A might be on the cards.
And then the second one, just in terms of pricing, you're obviously delivering a considerable ROI to your customers, and I just wondered how much flex you had in terms of how you are priced, how you can nudge that up to kind of re-regain, I guess, some of that ROI that you're delivering to the customers, and where you might be priced versus competitors and peers in the market?
Yeah. No, thanks, Hayley, and I'll take those, if you don't mind. So, to the organic and the M&A question, and it dovetails in the one that was submitted earlier around-
Um-
Would mergers be on the card as part of the growth? So just to be clear, I think where we're investing today is to achieve a growth rate of 25% at the top line, and we feel that we can achieve that through organic growth. That said, we have a minimum of $12 million of headroom, if you will, or surplus cash, and we are looking to deploy that. Now, probably less so for a merger, but certainly, acquisitions is something that Ryan and I are assessing more of, so we're seeing those come across our desk. We're obviously got some very tough criteria, but if it meets those criteria, we'd like to try and move that strategy forward, so that could be something we add to.
And I think partnerships like the KPMG strategic alliance could be really important for us. That's in terms of augmenting our already significant engagement solutions for customers. So, we are offering services to help engage physicians or engage labs that maybe we can't offer through our existing networks. Or indeed, like the KPMG one, opening up new sales channels, different customers, that sort of thing. So M&A very much something we're looking at. Yeah, nothing to discuss at this point. On the ROI question, I think you raise a really good point. We showed the case study of Signal there, 350-to-1 return on investment, which is significant for pharma.
I think, the challenge for us is that as a data provider, we are at the premium end of the market when we come up against more standardized and commoditized claims-type data. For us, we need to differentiate ourselves. Part of the way we can do that is by adding these bolt-on engagement solutions. So not just using the data to highlight an issue, but to also help with identifying or engaging physicians and labs. We are also exploring whether, particularly with biotechs and those clinical-stage, well-funded biotechs, whether we can change the contracting model slightly from a pay-for-service model to more of a patient success fee model. That is something we're exploring actively now and hopefully something we can talk about in terms of enterprise later in the year.
Okay, we'll take our next question from Dr. Julie Simmonds at Panmure Gordon.
... Hello?
Hi.
Hey, a couple of questions. Firstly, just wondering what proportion of revenue Signal makes up, if you can split that out?
Yes. So it's predominantly most of the 52%—Sorry, excuse me—recurring revenue during 2023. It's not quite all of it, there are other data products, albeit a small proportion, which are recurring revenue as well. So, very broadly, it's around about 50% of our revenue is a portion to Signal.
Excellent. Thank you. And then in terms of the accelerated investment plan and the amount you were investing, have you, I know it was over a two-year process, are you broadly halfway through it? And in terms of the balance between the sort of three, four areas of investment that you've got, has it been equal across all of them, or is there, is what's left to do in 2024 more related to one particular area?
No, it's so it hasn't been equal. But that's. It's probably been equal in terms of effort, but not in terms of cost. So for example, Ryan was talking about embedding more technology within the business. We have great people in the business, and it's their time that's really been invested in making that happen and enabling that. And they were with us before, and they're still with us now, and hopefully will continue in the future. But certainly the focus for this year, and we're almost halfway through 2024 now, is around a sales and marketing build for us. I think Ryan articulated around the platform, the data, the technology. We made great progress in 2023, and completely in line with where we wanted to be.
The challenge this year is to build out the sales and marketing function, the coverage we have. Really, turbocharge that and try to reach out to more customers, and embed our solutions across more industry. I think we're broadly in line with that. I think the challenge always is with recruitment around timing. We hope to have everyone we want in place by the end of the year. But, you know, although recruitment is happening and is continuing to happen at a good pace, you know, it can always be really challenging to find the right people, both in terms of culturally, experience, industry, geography, and all that sort of thing.
Lovely. Thanks very much.
Okay. We'll take our next question from Natalia Webster at Royal Bank of Canada.
Hi there, can you hear me okay?
We can hear you.
Yeah.
Great. Thanks. Thanks for taking my questions. I have two, please. The first one's just on the engagement solutions, because I realized some of those have been incorporated up into sort of your new segmentation into the scientific and advisory services.
Mm-hmm.
So I just wanted to kind of get a feel for how much value you're seeing customers attribute to those engagement solutions, particularly the ones that are enabled by the platform, so the Lab Engage and Physician Engage.
Yeah.
If you're seeing those sort of cross-selling opportunities come through here, and also whether those can be incorporated into your subscription contracts as well. Then just my second question on data acquisition. So you spent around GBP 3.6 million in 2023-
Mm-hmm
... and are expecting around GBP 5 million going forward, per year. What's your sort of key focus here in terms of expanding coverage? Is it sort of by indication and geography? And also, what are you seeing in terms of price inflation?
Let me take the first question, maybe you take the second one.
Okay, sure. Yeah.
Thanks, Natalia. The engagement solutions are exciting for us. They are absolutely designed to be added on to a Signal subscription. So they are, you know, they're reliant on us getting that initial patient signal, and then obviously, the engagement piece can be highly targeted and timely. We're seeing good traction from our customers, particularly as we've really started to market and commercialize that through this year. One of the key metrics that we're observing there, and is particularly driving the engagement, is the level of the engagement level we're seeing with physicians when we use those solutions. You typically, as you think about any kind of digital engagement, of which these are effectively leveraging, you know, good is 20% engagement.
We're getting north of 50% engagement on our digital outreach on the back of a Signal. So from an industry perspective, that's groundbreaking and is incredibly exciting, both on the ability to engage with laboratories, and remember there is no current mechanism for our pharma clients to engage with that sector in a very efficient and timely way. So we're bringing a novel solution there that is being leveraged and will increase through this year and beyond. On the physician side, we're seeing similar results.
And again, I keep going back to it sits really nicely with our Signal offering and the solution, the ability to market a solution to the customer, also enables some of the other aspects of the business that we want to evolve, such as the way we price, the way we position. We can be seen to be offering more of a service here than an actual, "Here's data, and you guys figure out for yourselves what you need to do." We can have more skin in the game and ultimately be more of a partner to our customers. That's a key value driver for us, and something you'll see more of through this year, hopefully. Yeah, and thanks, Ryan.
And just on the data side, so just by way of bit of background, so we spent $2.2 million on data in 2022, $3.6 million in 2023, and as Natalia outlined, we'd be increasing that probably near $5 million in 2024 and onwards. In essence, we feel that a $5 million a year data spend would suffice us to grow the business, the top line, significantly past the current level we're at. So it should sustain. It should be a level of data supply that would sustain growth way beyond, say, the $30 million-$40 million a year of revenue. But of course, that's something we'll keep under continual review.
In terms of the investment, you're absolutely right, Natalia, we are investing to increase the geography of the coverage, and you would've seen recent RNSs on European data sets that we're adding on there. And we're also looking to increase by indication. And just to remind everyone on the call, when we buy data from a lab, the way that we contract with the lab is that we extract all of their data. So we're not just looking for one particular indication or type of test, we take it all, and that's just for ease of their own data supply to us, and then we work with that data to sort it, label it, and ultimately drive insights from it that we sell on to our customers.
We're looking to augment our data. Things like demographic or socioeconomic data is important, and through buying that data, which is quite commoditized and tokenized, so it can be linked to our existing data, we can then use that data for slightly different purposes. So at the moment, we are focused on the commercialization stage of a pharma asset, but it means it can then be used by, say, CROs, for clinical trial recruitment. Or it could be used by labs themselves to look at their market opportunities. So we're looking to add to the data to be able to to exploit it a bit more. And then one thing you mentioned was around pricing.
We are, you know, we continue to observe, I guess, a relatively uneventful market in terms of lab data pricing, but it's something we continue to keep an eye on. Obviously, if that were to shift, we, you know, we can work with that. But, I don't think there's been any particular change from working with labs five years ago, as there has been today.
The next question we'll take is from Chris Glasper at Singer Capital Markets. Go ahead, Chris. Chris, are you there? I think we may have lost Chris. Chris, can you hear me?
Hi. Yeah, hi. Sorry, can you hear me now?
Yeah, we can hear you.
Yeah, sorry about that. Yeah, just a question really on what's going on outside the U.S. Looks like U.S. revenues are about 87% of the total.
Yeah.
Rest of the world, in particular, looks like it went backwards quite materially. Not sure whether that's just the way you've categorized it or whether there's something else going on, but clearly, you know, clearly, I think, a broader base, revenue base outside the U.S. would be, you know, would be welcome in terms of broadening the offering and, and accelerating the, the overall growth of the group. Is there anything you can talk to us about, about those dynamics, please?
Yeah. I'll take that one, Chris. Thank you. You're right. It has gone backwards. Or I think really what's happening is the U.S. piece is growing too rapidly for us. But if you look back previously in the history of the business, there was more parity between particularly the U.S. and Europe. And we will get back to that. We have very much focused on the U.S. in recent years. The data supply, the lab network, the platform maturity, and the opportunity that exists in the U.S. is so significant that we deliberately very much focused on building there. While we felt that the data capability in Europe needed to evolve and grow to be competitive, we did a lot of that work through 2023.
You have seen an announcement midway through Q1, where we announced a significant upgrade to our data and lab capability in Europe. You know, the teams are out promoting that now and selling off the back of it. We're having good traction there. There's a little bit of an accounting and revenue apportioning element to that, where pharma, some of the pharma global activity that we historically would've done a lot with, some of that's shifted to the U.S. away from maybe being based in Switzerland or wherever. It, it's kind of we're selling European data by European markets, but it's a U.S. customer. So there's a little bit of flex in there that we could do a better job, I think, of teasing out.
But I think what you'll see through 2024 is, U.S. still very much leading the way, but a bigger portion of our business through Europe. We have piloted our Signal. We've been piloting Signal in Europe now for almost six months. We'll continue to do that. We're bringing on some more customers, and the broader dataset we have there will enable us to kind of reinvigorate some of the offering, in Europe, through the second half of this year.
I am conscious we've gone over our allotted time. We'll take the next question from Hayley Palmer, and the next three questions, if you could just keep it to one question, please. Go ahead, Hayley.
I had my questions answered earlier.
Yeah.
I didn't-
That's great. Okay, that's fine. Sorry.
Thank you.
I could see your hand up there. Okay, Natalia, did you have a question?
Probably legacy.
Okay. Okay, thank you all for joining us today, and in particular, for your patience during our technical glitch. We look forward to catching up with some of you when we're on the road show in the coming days and weeks. If you have any further questions, please do get in touch via investorrelations@diaceutics.com, or reach out to me directly. And just to reiterate, today's presentation and the results are all downloadable from the website. Again, thanks for staying with us. Thankfully, we didn't lose anybody during the glitch, and we look forward to seeing you soon. Thanks.
Thank you. Thank you, everyone. Talk soon.