Good morning and welcome to the Tristel PLC Interim Results Investor Presentation. Throughout the recorded presentation, investors will be in listen-only mode. Questions are encouraged, and they can be submitted at any time just by using the Q&A tab that's situated on the right corner of your screen. Simply type in your questions and press send. The company may not be in a position to answer every question it received in the meeting itself. However, the company can review all the questions submitted today and publish responses where it is appropriate to do so. Before we begin, I'd like to submit the following poll, and now I'd like to hand you over to Chief Executive Matt Sassone. Good morning to you, sir.
Good morning and good morning to everyone that is joining us online today. Thank you ever so much for taking the time to listen to our 2024 Interim Results. I appreciate many of the people that are joining us this morning are aware of the Tristel story and what we do, but for those that are new to Tristel, I'm just going to take the first couple of slides to explain who we are, what we're about, and what we do. Our company is an infection prevention company. Our purpose is to prevent the transmission of microbes from one object or person to another. How we achieve this is by applying our very powerful chemistry, which is chlorine dioxide, to the target environment, surface, or medical device. Our products fall into sort of two categories, really.
We have our Tristel range, which is focused on the decontamination of medical devices, and we have our Cache range, which is focused on the disinfection of hospital surfaces. You can see there we have an ambition to be a leader on the Tristel leader in the point-of-care decontamination of medical devices. With regards to Cache, our ambition is to be the global market leader in the niche of sporicidal surface disinfection, not the entire hospital surface disinfection market. When you look at the split of our two businesses, you can see that Tristel represented 87% of the H1 sales, and you can see which kind of target medical devices that we apply our chemistry to. We are mainly focused on non-lumen or single-lumen medical devices that are heat-sensitive, that cannot be sterilized or decontaminated by normal means.
In the last 12 months, our chemistry has been used over 23 million times for the medical device decontamination. Our sort of newer portfolio, the Cache portfolio, represents 8% of our H1 sales, and we are focused on sort of the more general market and surface disinfection. You can also see there we have put for the first time the number of kind of cleaning events or disinfection events with our Cache range, which is 20 million. It is a large number, but obviously generating much smaller revenues. How do we win? On the Tristel, it is always our value adds and our value proposition, which customers really appreciate, is the convenience. We have the ability to provide disinfection at the point of care. We do it in a very fast and efficacious manner with contact times between 30 seconds or 2 minutes, depending on the product.
Our chemistry is safe and presents no risks to the users. Really, sort of things that set us apart is our compatibility. Over the years, we have been tested and approved to be used with thousands of different medical devices. We have a very compelling offering. We do have competitors, and these are a variety of forms. Some are manual, like soaking, and others are automated, like vaporized hydrogen peroxide. On the Cache portfolio, we win again through the unique qualities of our chemistry, demonstrating higher efficacy than the products they use today, faster speed of action compared to what they're using today. We are addressing some of the needs that our users have.
If we take antimicrobial resistance, for example, some of the cleaning products that they're using today are actually sort of adding to the problem, whereas this is something that we do not contribute to. Also, some of the chemistries they use today are quite toxic and damaging to the environment. Again, this is something that we're able to differentiate ourselves with regards. We have some great products and an exciting market. I myself have been with the business now for five months, so I thought it'd be worthwhile for me just to spend a little bit of time to tell you my impressions after the first five months of being with the business.
First of all, it's an exceptional company, not just with regards to our people and our products, who are talented and outstanding, but also the value that we're able to deliver to our customers. Operationally, we're excellent. We have a robust supply chain. We have first-class manufacturing and a great R&D team and a team that supports us on our day-to-day operations. We have been a business that's created the market for ourselves. We've been tremendously successful, and with that come competitors. We see that these competitive pressures are increasing. It means that we need to sort of sharpen our needle and to maintain our success. What we're doing there is focusing on our execution. I don't want people to get too concerned about the competitive pressures. There's always been competitors for our Tristel offering.
We're just having to sort of deal with more sort of local players that occasionally pop up. The team is well-versed in what we need to do and ensuring that it does not distract us too much from our day-to-day activities. When we look ahead, it's a very exciting future for the business. I can see a significant runway for growth ahead. In markets, we are taking share. We're seeing customers use high-level disinfection more and more, so the adoption is increasing. We also recognize that we are penetrated in a few markets across the globe, but there are many other new markets waiting for us to open up and for us to start selling our chemistry in those. The near-term opportunities are very exciting. Over the last few years, we've invested significantly in our surface disinfection market, and this represents a significant opportunity for us.
We have to take some care as we go forward for this market. Our secret success over the years has been focusing and being very targeted on profitable niches, and we need to apply that same rigor to a surface disinfection market. I'll talk a bit more about this in some of the slides coming up. The near-term opportunity to drive global penetration. Yeah, basically what I'm trying to say here is our greatest opportunity for growth is going to be within our existing markets with our existing portfolio. We are far from being penetrated, and we have the U.K. market as our core home market. When we look across the globe, we see great opportunities to drive greater growth and also drive greater growth in the U.K. too.
In the mid to long term, we see the potential to unlock major new markets, and everyone is very much focused on the USA. I will provide an opportunity on the USA, but the headline is we feel very bullish about our success that we've had so far and the future, and we believe that we can win and win big in the USA market.
Morning everyone, this is Liz Dixon here. I'll run through the financial highlights with you here. We're looking at a set of results here where we've delivered strong performance in this first half. It's in line with both the market expectations, but also with our own internal forecasts, our internal targets. Running down the highlights themselves, revenue increased by 8%, up to GBP 22.6 million. That's 9% at constant currency, which is, of course, slightly behind the growth rates that we have achieved in recent times. We know where the issues are that have reduced our revenue growth percentage, and they are all fixable problems. We feel that returning to double-digit growth is definitely achievable for us. Running down the P&L, then we can see that adjusted profit before tax increased by 19%, which we're delighted with, up to GBP 4.9 million in the half.
Adjusted EBITDA was up by 14% to GBP 6.3 million, and we achieved an EBITDA margin of 28%. Adjusted EPS sat at 8.17 pence per share. It was negatively impacted by an increase in the effective tax rate, which increased from 10% up to 25% as a result of Patent Box relief ending in this financial year. Nevertheless, our interim dividend has increased up from 5.24 pence to 5.68 pence per share, payable on the 11th of April, with an ex-dividend date of the 20th of March and record date 21st of March. That leaves us with cash and deposits, which increased up to GBP 11.7 million, up from GBP 10.8 million in the comparable period. Just a reminder, the company has no debt. Over on the next page, operational highlights.
Matt joined us in September last year, and I think we can state very confidently that it's been a successful transition, and he shared with you his first impressions. During the period, we made our application, our submission for a second U.S. product clearance under a 510(k). This is for Tristel OPH. It's a high-level disinfecting foam for the decontamination of ophthalmic devices. We received a request back from the FDA for additional information, and we're in the process of compiling that test data. It's not a surprise to be asked to provide additional information, but we're going through the process of collating that, and we will submit that back to the FDA shortly and still expect clearance by the summer of this year. A couple of other operational highlights refer to the regulatory landscape that we're working within.
The first is that we have been included in the revised American National Standard for our Tristel ULT technology. That is an update which now makes clear to users of the product that they can use a foam or a wipe that contains chlorine dioxide. Of course, we are the only supplier of those types of products, of that technology, and they can happily use those products within the U.S. The second regulatory point relates to Germany. We have had much slower growth in Germany over the course of the last couple of years as a consequence of a question mark hanging over whether wiping a medical device is a validatable methodology for decontaminating it in between patient use.
Now the regulators in Germany have agreed that wiping is a validatable methodology, and so they've issued a new guideline, which means that customers can now validly use it without any concern. Moving over onto the next slide, looking at sales growth by geography. You can see we've got a couple of areas that we have had some issues with, namely Australia, also within the Western Europe line, France, and Hong Kong. There are three areas that we need to pay a little bit of attention to. I'll run through them one by one. In Australia, we have invested in our sales force to build it out, having had a few individuals leave the company over the course of the last year. It does take a little while to get new salespeople up to speed.
We have seen flat growth in Australasia, but we expect that to rectify itself as we move into the end of the second half and into the first half of next financial year. In France, similarly, we have had a change of leadership in the sales team. In both markets, we also have competitive pressures, which Matt touched upon. None of these things are permanent problems. They are all fixable issues, and we have confidence that in both of those markets, we can return to growth in the short term. In Hong Kong, we have seen, again, zero growth in the period, and that is predominantly because of our surface products, where what we see is where there is an outbreak or an epidemic, particularly in Hong Kong, then there is very swift take-up of highly efficacious products to decontaminate surfaces such as our Cache range.
Over time, when cost pressures rise again, we see the use of the products slowly dissipate. That is a pattern that we are quite used to now in Hong Kong, but we are looking to roll out our newer Cache products in Hong Kong to address that. Looking at the more positive side of things, Central Europe, on the back of that guideline change, we see 13% growth driven by Germany. In Southern Europe, 14% growth. That is predominantly Italy. We are going direct, having set up our own operation in Spain with effect from the 1st of January. We expect strong growth in Spain as we go through the rest of the financial year. Malaysia and Singapore, also good growth.
The Americas, of course, we are showing flat growth, but that is because of the mix there of royalties, product sales into the U.S., and also Latin and Central America are playing an important part in that growth. All looking good in the U.S., and Matt will tell you more about that as we go through the presentation. The U.K. is the big one here, 7% growth, which we are very pleased with because last year we had a high level of growth as a consequence of price increasing. Now growth comes almost exclusively from volume increases in the U.K., which just goes to show that even in very well-established markets, there are always new opportunities for our products.
I just want to jump in here, quickly, before we move off this slide, just to sort of say, look, we appreciate the 8% year-on-year growth. We are pushing hard to get us back into the double-digit top-line growth. We feel that's very important. That's something about Tristel that we've been able to do over the years. I say we need to get back to. When you look at this breakdown by geography, you can see it's not a million miles away, and it's not very difficult to identify what needs to happen in order to get us back up to that level. If we talk also about some other actions, more tactical actions that we're putting in place with regards to sort of our markets and addressing some of the challenges we have with regards to Australia and France, for example, it's also changing incentives.
Over the past, the incentives have been focused on local profitability. Now they're focused on local revenue. Some other sort of actions we have taken in order to sort of get ourselves back up and motoring again in those markets. As we look over the 10-year sales record, we've had a tremendous track record of strong growth. That continues. Over the last few years, pricing has been sort of price increases have been exceptional and have been a big driver of our growth. We've now sort of that's been normalized, and we've returned to more standard levels of price increases. We remain on track to deliver our three-year financial targets. Looking towards the second half and looking towards the future, how are we going to drive greater growth in our business?
For the Tristel range, I've listed down here sort of four key levers for the business. The first is geographical expansion. We all recognise the opportunities that we have in the U.S. This is a very exciting market where we've just got our clearance, and we'll talk a lot more about that in some of the forthcoming slides. With regards to sort of expanding our reach, we continue to invest in direct operations. Liz made reference to Spain, but we're also going direct in Austria, and I'll mention a bit about India as well. We're also looking at new markets, so exploring what are sort of currently untapped markets such as Japan and Latin America. It's about our existing markets and how do we expand our application and our product application and extract more from what we're doing.
We have a great opportunity with our existing portfolio and existing markets, and we're far from done. We have a large runway, but we're also looking to get existing users to spend more with Tristel and sort of create more value by adding more products that they can use, whether that be cleaning products. Some of the new products we're working on are digital traceability and broaden the adoption beyond our core ultrasound into other markets. We've got good penetration already into ENT, but there are other sort of heat-sensitive products that would benefit from using our chemistry and benefit from being high-level disinfected, and we continue to invest in that expansion. What we need to do, though, is maintain our clinical differentiation and continue to invest in that area. We're all consumers, and sort of physicians, healthcare practitioners are no different to us.
If we have a colleague or a friend that recommends something, we immediately look to go and purchase that. That is the same that happens in healthcare. Having that influence and having our users sell a product for us is a key sort of growth creation and something that we need to continue to invest in. That is something that we will be spending more money in order to push that as a strategic lever. Our fourth strategic lever is working with the original equipment manufacturers, the OEMs. What do we mean by that? We are very proud about our level of compatibility, but what I have seen in the first months with the company is some real examples of best practice.
I can think of many countries around the globe where we work hand in hand with these equipment manufacturers, and they are essentially an extension of our sales force. How does that happen? We are present at their sales meetings. We are training them with regards to the Tristel offering. When those equipment manufacturers are going in and talking to the customers about their technology and they get faced with the question, "How can we disinfect this?" they immediately think of Tristel and are promoting us at that point. In the same way, actually, in some countries, we are providing their staff with Tristel products because whether it be the sales staff or the engineering staff, they are going in and touching their products in the healthcare arena, and we are providing them with our Tristel products so they can go in and decontaminate the devices and use it there.
It's great to see when I go to exhibitions around the world, trade shows around the world, the equipment manufacturers' booths and their stands actually have Tristel products on it. It's great to learn of examples where the sales reps and the engineers actually have the Tristel products in their bags to protect themselves. It's even better to learn and hear and say we need to do more of have those salespeople talking about Tristel at the point of sale when they're selling the equipment in the first place. That's a good growth lever for us as we look to the future. On our Cache range, it's interesting. We talked about Hong Kong, and we talk about sort of there being periods of time when infection control is more at the forefront, and we've all lived through COVID.
When it's not sort of immediately front and center, this market tends to revert back to much more sort of commoditized offering. That being said, it is a large and a significant opportunity for us. Why do we say that? There are areas of the customer base which are always focused on infection prevention. It's always front of mind. These tend to be more of the high-impact areas like the operating room, intensive care units, neonatal units, dialysis centers, oncology units, where infection prevention is at its most critical. Those sites are prepared to invest more in infection prevention. They value what we're able to bring a lot more, and they are prepared to pay our premium pricing. That's something that we need to really focus on and keep.
The secret to Tristel's success over the years has been identifying profitable niches, being very focused on those profitable niches with our very differentiated offering, and then targeting upon that. That is exactly what we intend to do with our Cache portfolio. What we have seen in the first half of the year, and it is something for us to be cautious about, is we have this full portfolio now. We have this wide range, and we have this proposition that is very attractive. Naturally, you want to do a whole-house conversion. You want to go into a hospital, into a trust, and get every possible department using our Cache technology. On the face value, that sounds very exciting, and it seems like the obvious thing to do. You are knocking out the competition.
What we have found, though, is that this tends to be very resource-intensive, and this is where we must ensure that we have the right balance. Why is it so resource-intensive? When you start to do the whole hospital and you're trying to take on all of the staff and all the areas, there are not hundreds, but there are thousands of individuals that need to be trained. There are some very ingrained practices that are hard to give up. We have experienced essentially huge percentages of our sales team being tied up for weeks upon time trying to reach the different parts of the hospital and without a great amount of return on it. When we assess the opportunity, we're excited by it.
What we're doing is just sharpening our approach to ensure that we're getting the best return on investment with our Cache portfolio. Let's focus a bit more on some of the geographical opportunities we have. If I start you on the right-hand side of this slide and just talk a little bit more about Spain as an example. Over the years, Tristel has been very successful at using distributors to build up our business. When they reach a meaningful size, we then go direct ourselves. Spain is another example of this where we've been working with a distributor very successfully. We've got to a point where we believe that it would be beneficial for us to go direct.
That's a process that we've been undertaking, and we've been recruiting and getting our own infrastructure in place so that when we went live in January, everything was ready and set. We are a few weeks in, but it's all going very well. We're very excited by it. We can really focus on transitioning that business across before we then focus on some of the sales opportunities that we see and start to grow our presence there greater. We're looking to do that in other European markets, and Austria is the next market that's been identified for us. We continue to look at other opportunities we've got. There are large untapped markets that are open to us that we're also looking at. Japan is an example of this. Tristel's never been present in Japan.
In fact, none of our competition really has been present in Japan, but there's still a need out there. Japan is the third-largest healthcare market in the world. They tend to be able to pay a premium price for medical devices. On face value, this looks very attractive. It's always been scary from a regulatory perspective, but we've been investigating that market and creating a path forward where we feel that actually now is the right time to start to look for commercial partners in Japan and exploit the opportunity that is there. India, another large market that on face value offers a lot of opportunity. Tristel has tried over the last few years with distributors to get traction in that market. We're now deciding to take a slightly different tact, and that's by recruiting directly with our own people there.
We all know India is a very large market, and I don't want to scare investors to think that we're going to try and cover the whole of the Indian market. In fact, we're taking a very small and targeted approach. We're focusing on the cardiology ultrasound market. These are transesophageal echo ultrasounds that are used in cardiac surgery. This is the premium part of the market. Currently, in India, they are using soaking technology. We've recruited two individuals from one of the largest equipment manufacturers of cardiac ultrasound probes in India. Therefore, they come with extremely strong customer relationships, deep knowledge of the market. Geographically, we're being very targeted. From a product segment, we're very targeted, and we feel that we can build and get some traction in the Indian market in the near term using them.
The Middle East continues to be an area of the world where we're getting great growth and great success, and the team there are doing a great job. In fact, in the second half of this year, we had great wins in that region, primarily in Kuwait, where we've won two very large tenders for the Ministry of Health now. That's a part of the world that we continue to see greater adoption of our chemistry, and we'll continue to invest in to get greater growth from. Latin America is a bit like Japan, an area of the world that we've never been present in, and we feel that we have got some opportunities here. We've been investing a lot in creating local clinical evidence.
That's something that takes time, but we believe that now is the right time to sort of explore the commercial partners and to sort of drive our market entry. Finally, we get to North America, which is our largest opportunity, and I'll now talk about that in a bit more depth. Over the years, ultrasound has always been the prize that we've strived towards. It's taken us a long time to get there. We finally got our approval after a lengthy De Novo process, and now it's about commercial execution. On the face of it, royalties of GBP 37,000 do not seem to be something that we can really sort of claim to be a great success. We are encouraged by the traction we're getting in that market. It's a very large market, as I said, but that GBP 37,000 actually translates through to 50,000 procedures.
What that shows is we're getting a presence there. We're getting repeat use. We're getting a number of customers where the adoption is spreading, and that's where I really want to focus the investors' thoughts and talk more about. As Liz mentioned earlier, normally, it takes us years to get guidelines to endorse our technology. We spoke about Germany, where those guidelines up until now, and we've been present in the German market for a long period of time, well over a decade. We've been present in the U.S. market for 12 months now, and to already see the guidelines come out and recognize Tristel and actually have it as a recommended means of performing high-level disinfection is a real feather in our cap and a real strong lever for us to drive greater growth.
Everything we're seeing about the activity we're doing is really giving us a lot of confidence about the U.S. market. Our partner, Parker Labs, has invested significantly. They're keeping up with that level of investment. They believe in the opportunity too, and we're seeing the actions that we're putting into place now accelerate the sales cycle. Our local team is working with them side by side, supporting them with regards to the sales calls, but also supporting them with regards to the sales management, being present in the sales meetings, being present on regular calls to share best practice and drive our success in that market. Where are we at? I made reference to the fact that we're present in 200 health systems. Quite frankly, the leads coming to us and opportunities is not our challenge. We've got more opportunities than we can deal with.
What we need to do is really focus down on our land and expand strategy. And what do we mean by that? We've been getting penetration into these healthcare systems, but rather than skim the market, we want them to fully adopt Tristel. Rather than Tristel be used on sort of a niche area of a few intracavity probes, we want to be used on all of their intracavity probes. We want to be used on their vascular access ultrasound probes as well. That's what we've been focused on. What we're hearing from those users is, "We are easier. We are faster. We are more user-friendly." They love the fact that they don't have to leave the patient room. Some of the feedback has also been about the fact that ergonomically, we're easier for the users. We're seeing that now.
If I talk you through some of these examples, we just pulled out a handful here. In Boston, we got initial penetration at one account, and they adopted us for their vascular access probes. Now that's started to spread. We're now being used in urology. We've been used in the ICU. We've gone from being present in one hospital to now being present in four hospitals. We're seeing that penetration in that system not only come as a result of Parker's sales efforts, but also organically as well. The physicians are talking to each other. They're praising our products and our chemistry, and that's spreading to wider use. In Orlando, we're seeing the same, where we in a large healthcare system in Florida, Orlando. After a lengthy sales process, we're now spreading adoption in their outpatient clinics and are now going into their hospitals as well.
At the same time as trying to get this deep penetration within the healthcare system, we recognize that we want to drive revenues as fast as we possibly can. We have been working on some of the private practices. Why have we been doing that? Well, when you're going into the hospitals, you have a very lengthy sales cycle. It's typically 12-18 months. When we're going to these private practices, that sales cycle could be much shorter. It can be three-six months. We are trying to get that good blend, but we are getting some good success in these private practices, and it's providing us with those quick wins. That's encouraging. As we focus on our success in the ultrasound, what I want to leave you with is this.
Whilst GBP 37,000 sounds like a small number, when you translate that through to the actual number of procedures, that's GBP 50,000. We are getting a lot of traction, and this is a flywheel. We will start off small. We will start off slowly, but it is picking up pace. We can see on a monthly basis the sales are increasing, and we are very encouraged and also very bullish about our ability to get success and the opportunity in the U.S. ultrasound market. Switching gears, but staying within the U.S., let's talk about ophthalmology, which is another area that is open to us. This is a slightly smaller market. It's got 16 million procedures on an annual basis that we believe would require high-level disinfection. That compares to the 50 million in ultrasound.
This is a market that is more of a greenfield compared to the ultrasound market, where you've got an established player. The ophthalmology market is more greenfield, where they're typically using soaking technology or a very low-level disinfection wipe to sort of solve their needs. It is an unmet need today. We applied for our 510(k) clearance from the FDA during H1. We got a request for some additional information. That is not out of the usual standard practice for the FDA. Typically, when they come back and ask questions, you hope that you already have the data they want on file. In this case, it did require us to do a little bit more of a clinical study in the U.S., so an in-use clinical study. That is underway.
We have been working with the FDA to ensure that what we are doing will satisfy their request for information. Therefore, we feel confident that once we have completed that clinical work and presented the data back to the FDA, they will grant us with clearance sometime. Our expectation is that that will be summer 2025. What is our route to market? How are we going to get success? You will notice in the presentation deck, and if you download it and look at it after my speech, on the last slide, we do show a time study that was performed in the U.S. comparing standard practice to our offering. You can see there the efficiency that we bring and the reason why a customer will want to be swapping to our OPH product. With regards to the route to market, we are looking at a mixed sales model.
What do we mean by that? For ultrasound, we use Parker Labs, and we chose them because they seem they are a perfect partner for the ultrasound market. Parker is synonymous in ultrasound. It's very well known. They've got a very high presence. They have existing relationships, and working with them meant that we weren't an unknown going to the market. Parker is not focused on the ophthalmology market. This would be new ground for them. We will continue to work with Parker from a manufacturing perspective. We may utilize them in some means as a non-exclusive distributor to enable us for logistics and invoicing. We will work with some ophthalmology-focused distributors, people that already have a presence in this market. They will also be on a non-exclusive perspective.
We want to retain a lot more control as we go forward in the U.S. with ophthalmology. We have identified eight large hospital users who are very keen to move forward with our products, which we will manage directly with our own resources that are already present in the U.S. market. They will be our people on the ground. As we get success, we will invest further and create our own direct presence. I do not want people to misunderstand me on the call. We are not going to go out and recruit a sales force from day one. We are going to be using distributors and our own presence we have, and then build upon it as we get success and have a very targeted approach. We look forward to getting the approvals in the summer. We have learned from what happened with the ultrasound approval.
What happened there was we were going through a De Novo clearance. You're not going to sort of do things at risk whilst you're awaiting a De Novo clearance. This is the first in time in kind clearance. What happened there was we got the clearance in June 2023. We didn't start manufacturing the product until sort of November later that year. Parker made investments in the sales team only post getting that clearance. Because we're going down the 510(k) track, we have a much more defined path and defined visibility to get the approval. Therefore, we can start at risk to get ourselves ready so that once we get that approval, we can hit the ground running, and there isn't a substantial delay between approval and commercial operations. In summary, the fundamentals of the business are very strong.
We are profitable, cash-generative, debt-free, and continue to pay a progressive dividend. The opportunities are very clear in the medical device portfolio. They are significant, and we remain excited about the runway ahead of us in that market. The surface disinfection, as we sort of go forward, we are refining our commercial approach on some of the recent learning. It is a large market. There are areas that really do value our premium offering, and we feel that we can get a very good return on our investment in those markets. Looking ahead, we are continuing to unlock new geographies, and the U.S. being the main one of those. Our growth will come from our existing products in our existing markets, and the U.S. will just augment that as we go forward. Finally, the business is on track to its current market goals, financial goals.
Thank you for your time. That concludes the presentation, and we will now open up for questions.
Matt, Liz, thank you very much for your presentation. Ladies and gentlemen, please do continue to submit your questions, and you can do so just by using the Q&A tab that is situated in the top right corner of your screen. Just while the company takes a few moments to review the questions that have been submitted today, I would like to remind you that the recording of this presentation, along with a copy of the slides and the published Q&A, can be accessed via your investor dashboard. As you can see, we have received a number of questions throughout today's presentation. Liz, at this point, if I could hand over to you to read out the questions, that would be great. Then I will pick up from you at the end.
Okay. Thank you very much. We've had quite a few questions about tariffs in the U.S. What effect will potential U.S. tariffs have on exports? Just a reminder to you that the product is manufactured within the U.S. Predominantly, the revenues that the royalties that we receive will be totally tariff-free. We do not see that as an issue. In fact, it acts as a barrier to the alternatives, which are not manufactured within the U.S. That is a positive for us. How have the Parker USA sales team been deployed, and what is the reporting struct ure for them?
They are deployed throughout the U.S. They are Parker's sales team, and they report into Parker management. We do work very closely alongside them, supporting them, going on sales calls with them. It is very much a joint venture for us out within North America.
Next question. In the October 2024 presentation, specific hospital groups were named as piloting Tristel products. What's the current situation regarding these pilot projects?
Yeah, they continue. As we said, we're sort of being actively used in 200 systems. I think what I would really sort of like to reinforce to the investors is we're being very focused. In fact, we've identified seven healthcare systems that if we were to get full penetration in those seven healthcare systems, the numbers would just sort of blow away everyone's expectations. We continue to manage our pipeline very closely. We're on top of everything that's going on. We're tracking it. Really, our focus is landing and sort of expanding within those markets, those systems where we already have some traction already. Yeah, we're making good success and good progress in all the ones that we mentioned in September, October.
Thank you. Next question. What revenues have been derived from the USA from July to December? There is a table within the interim statement that you can see the exact breakdown of North America and the U.S. itself with respect to royalties. Also, products which we have sold to Parker, which they then distribute out, and also Canada and Latin America. You can find that detail within the RNS itself. Why is reported EPS falling? EPS has been impacted by the tax rate, and this covers another question as well. The company has now, with the expiry of its patent for the use of a chlorine dioxide foam on a wipe, that means that Patent Box has now been removed as a relief for us. As a consequence, our effective tax rate has increased from 10% up to 25%.
Now, having said that, we continue to work on product development, and we do continue to apply for new patents and indeed extend the patent with respect to Trio, which is the wipe system. For now, we do not have that level of patent relief that we had in the past, but it certainly has helped us enormously over the years, and we will work to replicate that with future products. What do you consider a safe level of cash for unexpected events, and what do you intend to do with the surplus? Do you, Matt, have any plans for expansions, either bolt-on or more strategic? I will answer the first part of that, which is to say that with our current cash balance of GBP 11.7 million, we have plenty of comfort there. Certainly, a good half of that can be considered to be excess to our operational requirements.
I'll hand over to Matt to talk to plans for expansions and bolt-ons.
Yeah, absolutely. We're always looking at what's the best deployment of our capital to give the greatest return to our shareholders. That's something we're always focused on. As you can imagine, the business gets presented with opportunities all the time, and we review them and we make our decisions. We won't rule out anything right now, but I would just like to reinforce that we remain committed to investing in the business and generating the best returns for shareholders we can.
Thank you. Okay. Next question. What is R&D spend as a percentage of revenue? It comes in around the 4-5% mark if we're looking at capitalized R&D. Of course, we can capitalize product development. Pure research goes through the income statement.
We do do a little bit of that, but that's not included in that calculation, but would probably be another GBP 100,000 or so. It's sitting at the 4-5% mark. If your emphasis is on moving to direct sales, then how can you incentivize distributors in new markets?
Absolutely. In some markets, it always makes sense to go through the distributor model. Some markets lend themselves to being a distributor model. Over the years, Tristel has worked with distributors and then taken the opportunity to go direct with its rights. This is something that we're not alone in doing. It's a model that's used by many people around the world. When we're working with distributors, they get excited by the opportunity of the Tristel offering, and we work with them to build the business up as best as possible.
When we do decide if we want to go direct, we obviously work with that distributor at that time. It is something that we do hand in hand, but the focus has always been and always will remain on getting traction in those markets and getting success.
Okay. Thank you. We have two questions left. If you want to get any more questions in, do it now. To work through those two, do the competitive pressures mean that you lose greenfield contracts, or are you substituted?
I would not say that we are losing business. It is just a distraction and a frustration. It is a frustration that you can get some small local players that come in and make claims which are quite fictitious, and you have snake oil salespeople out there sort of saying whatever they want to try and get the sale.
We have to work hard to go into those hospitals and provide the evidence and demonstrate that not everything is on face value, and you need to look a bit deeper. I do not want to alarm investors and say that we are losing business. That is not the case. It is just a frustration that we have to deal with companies out there making claims that really they should not be making.
Okay. Last question for today. Will your ultimate goal be to do your own manufacturing in the USA?
No. Partnering with Parker was the best decision for the business. They make—I was trying to think—but the volume that they are making with regards to ultrasound gel, they are extremely efficient. I do not think that is something that we could have replicated with a small manufacturing site in the U.S. Working with them was definitely the right way forward.
We have a sort of contract in place which works very well for us and enables us to make a significant amount of profits in the local market. It ticks all the boxes. Wonderful. I think that concludes our questions.
Perfect. Matt, Liz, thank you very much for answering the questions for investors. Of course, the company can review all the questions submitted today, and we will publish those responses out on the Investor Meet Company platform. Just before redirecting investors to provide you with their feedback, which I know is particularly important to the company. Matt, could I just ask you for a few closing comments?
Absolutely. Thank you ever so much for attending and listening today. Let me leave you with this.
Tristel has delivered a strong financial performance in the first half of the year with adjusted profit before tax increasing 19% to GBP 4.9 million, supporting an 8% increase in our interim dividend. Looking ahead, we see significant growth potential in our core medical device business, using geographic expansion as our primary driver. Our largest opportunity remains the US market, and we are committed to building upon that. We are confident in our ability to maintain and build on our current trajectory, leveraging and expanding our current global footprint and innovative product portfolio, and the business remains stronger than it ever has done. Thank you for your time. As you said, if you have any follow-up questions, please send them in.
Thank you very much.
Matt, Liz, thank you once again for updating investors today. Could I please ask investors not to close the session?
As you know, we automatically redirect it to provide your feedback in order that the management team can better understand your views and expectations. This may take a few moments to complete, but I'm sure it will be greatly valued by the company. On behalf of the management team of Tristel, we'd like to thank you for attending today's presentation, and good afternoon to you all.