I would now like to hand the conference over to Ms. Parmjot Bains, CEO and MD. Please go ahead.
Thank you. Good morning, and thank you for joining us to discuss the Quarter Four FY 2025 results. I'm pleased to be here with McGregor Grant, our CFO. We will be referencing the 4C Quarterly Activity Report and presentation that we launched this morning with the ASX. The presentation is a summary of the more detailed 4C. After our remarks, we'll be taking questions. It's been another busy and encouraging quarter, with clear signs that the strategy we've been working hard on is starting to pay off. We recorded the highest ever Total Contract value this quarter, which is a fantastic achievement. On top of that, a major commercial payor began coverage, something we believe will have a significant impact going forward.
We also achieved the key goals that we set for ourselves, including exceeding our sales targets to trigger access to the next tranche of our debt facility and exceeding the cost reduction targets we put in place. The American Society of Breast Surgeons conference was another highlight last quarter. It was led by our new VP of Sales, Scott Long, and gave us a great opportunity to connect with both current and potential customers. What really stood out was the importance of survivorship in cancer care, and more and more clinicians turning to SOZO to lower the lymphedema risk for their patients. This quarter, we also initiated a measured expansion into two new clinical areas, both of which represent major opportunities for the business.
I'm really looking forward to giving you an update on what we've achieved this quarter and where we're headed as we move into the new financial year. Let's move into the presentation, and we'll begin on page three with an overview of the agenda. Looking at page three, we'll start with the key highlights for Quarter Four. We'll take you through an overview of the business and give an update on the strategy, including the expansion of body composition and heart failure. McGregor will present the financials, and to finish off, we'll cover the outlook for the balance of the year before commencing the Q&A session. Now, turning to page five, we have delivered on our plan. We've been consistently messaging about building a strong opportunity pipeline and focusing on conversion. This quarter, we started to see the results, and we delivered a significant increase in U.S.
sales and a record TCV. Today, we're going to walk you through why we had this confidence going into the quarter, and importantly, why we believe that this is just the beginning. To succeed in the U.S. healthcare market, there are a few key pieces that need to be in place, and one of the biggest is reimbursement. We're pleased to announce the news that another major commercial payer is now providing coverage. It's a significant milestone and a real credit to our VP of Market Access and the hard work that she has put in. I'm also presenting this morning from my new corporate office in Sydney, and it's great to have a core part of the management team based in Australia. This setup aligns with how other successful Australian medtech companies are run: the governance, product development, finance, operations, and business development lead out of Australia, with U.S.
sales, marketing, and medical affairs staying focused in the U.S., close to our customers. It's also been positive from a cost point of view as we rationalize our facilities. It's a fantastic team across two geographies that really complement each other, and I'm genuinely looking forward to what we can achieve together. Now, turning to page six, we will touch on the key highlights for Q4. As I mentioned at the start, this was a very pleasing result, and I want to leave you with three key takeaways. First, record TCV, clearly a standout highlight. It wasn't just about new sales. It also reflects the strength and quality of our renewal.
When I meet with customers from some of the world's leading institutions and hear firsthand about how much they value SOZO and how it has become a game changer in their clinical practice, it really reinforces that we are on the right track. Secondly, sales momentum, 44 units this quarter. That's a 100% increase in quarter three, and it sets a new base for the balance of the year. It also means we qualified for tranche two of the debt facility. This gives us added flexibility to fund the business as we continue executing on our path to profitability. Thirdly, reimbursement, a major step forward. The additional coverage we secured will make a big difference. It's great to see that the number of states with coverage above 80% increased from 25 to 36 states.
It's not just about the number of states, but the depth of the coverage within those states. The number of states now with over 90% coverage jumped from 7 to 21. As a result, some states that were difficult to access with low reimbursement moved to very high levels of reimbursement. In one example, a state moved from around the mid-30s to the mid-90s with this range and coverage increase. At the top 15% by population, we think harder to cross the year before. It's home to four major IDNs, with potential for 80 devices- 120 devices. That's meaningful. These improvements in coverage will help us move faster and lift us to the next level. Now, on to page eight. As we mentioned last quarter, we have very strong foundations that have taken a lot of work.
These include, one, the strength of the ARR business model that builds on itself with every contract, and the quality of our customers. Reflecting on our customers, the list is of new and renewing institutions over who's who of world-renowned hospitals. This quarter, our U.S. sales included a standout nine-unit lead contract with Legacy Health, a leading healthcare system serving Oregon and Washington. Legacy is committed to delivering comprehensive cancer survivorship programs that meet the NAPBC standards. That commitment played a key role in the decision to adopt SOZO as the foundation for their lymphedema prevention strategy. The new and customers continue to validate the value of our offering. Not only are they renewing, but renewing with price increases. Overall, there was a 13% rise in TCV for these renewals, the churn remains at less than 3%. Now to page nine.
We now have a strong foundation in place to drive the level of sales required: expanded reimbursement, a strong and growing pipeline, and a well-connected, high-performing sales team. That foundation gave us the confidence we'd see year-end results, which wasn't just incremental. It was a series of stepwise changes. It was clear from the start we needed to invest in systems and processes to support a more robust pipeline. Quite simply, the volume of leads being generated when we came on board wasn't enough to support the sales needed. We addressed that by rolling out tools like the Acuity MD and Siemens AI, implementing tools for productivity measures, and ramping up targeted lead generation activity. That investment has paid off, creating a major uplift in the quantity and quality of leads. As a result, the pipeline is now in excellent shape.
It includes multiple multi-unit sales opportunities, 27 master service agreements with healthcare providers that represent hundreds of potential service sites, and with more than enough qualified leads to support our initial goal of being profitable. Now, turning to page 10. We have confidence that sales will continue to grow. We have a product that addresses a real clinical need, strong clinical validation, a solid pipeline, and a very positive reimbursement environment. The final piece of the puzzle is conversion, turning those leads into sales. Another area we knew we needed a boost was sales team experience, specifically in breast cancer devices. That’s why we were really very pleased to bring on Scott Long as our new VP of Sales. Scott brings over 30 years of experience with breast cancer medical devices, and with that, a deep understanding of that space.
He has spent his career building strong relationships with breast surgeons, and he's used to working with sales teams in smaller companies. That means he not only knows how to get the results, but he has a great network of top-tier sales talent. Scott has already hit the ground running. He's assessed the current team, led our presence at the ASBS conference, and has been out in the field with the reps, coaching them and making key introductions from his own network. As part of that, we've recently hired two new key account execs, both with very solid breast cancer experience and both who are now on board. It is great to have them on board, and we're very excited about the opportunity.
It will take a quarter for them to fully hit this drive, but based on their track records, we are very confident that they'll start to deliver and patch them. One factor people often underestimate is the network effect in hospital systems. Getting a device approved at a hospital isn't quick. There are legal contracts, budgets, and IT approvals. It can take months. Once these items are completed, adding a few devices in a hospital system is a much faster process because those hurdles are already cleared. That is a big advantage that we will continue to build on. Currently, in one state, we're finalizing two-year contracts that unlock the potential for up to 75 more units, which lines up with improved reimbursement in that state.
A lot of these changes are just now taking effect, but the tailwind is strong, and as we move through the financial year, we are confident in delivering sustained sales growth. Now, turning to page 11. The start of the new year is always a great time to revisit our strategy and check in on where we're headed. We're not making any major changes. We're continuing to execute on the strategy we've outlined, but there is a natural progression as we move forward. BCRL remains a very core focus for us, along with maintained strong financial discipline, and McGregor will talk about our progress on that front. Over the past couple of quarters, you've also heard us talk about moving into stages four and five of our strategic plan. That is starting to take shape.
We recently shared our updated product roadmap with the board, which highlighted two key focus areas. First, body composition. We have activated and effected active sales in this market with our current product offering. Initially, we talked about oncology as a natural adjacency, and that continues to be a focus. We're also looking at how we can leverage SOZO's unique position within hospitals to support clinically managed weight loss, a space where there is growing and real potential. Secondly, heart failure. We've started to re-engage in that space with some early steps. Beginning with a key investigator-initiated observational cancer trial, which produced promising data that supports the clinical utility of the SOZO device, both for managing fluid levels as well as body composition in heart failure patients.
Building on that, we're now expanding our efforts with additional clinical research partnerships to better define how SOZO can be best utilized within that healthcare pathway. Firstly, over to body composition on page 12. As I mentioned, we are continuing our work in body composition within the oncology space. We believe that there is a clear clinical demand to support body composition management in cancer patients as part of their survivorship journey. At the same time, you're seeing a generational opportunity emerging around the rise of the GLP-1 weight loss drug, like Ozempic and Mounjaro, that is supported by new guidelines. What makes this especially compelling is our unique position in the market. SOZO is currently the only FDA-cleared bioimpedance device.
At a time when leading medical societies are specifically calling for muscle mass monitoring during pharmacological weight loss, they are recommending validated tools like a bioimpedance as part of best practice care. We already have a body composition application. We have now begun a major expansion into that space, assigning sales resources to build up the market and gather early feedback from customers to optimize our offering. It is still early days, but the initial signals are very encouraging, and we're genuinely excited about where this opportunity will lead. Now to page 13. Heart failure was something that the company identified as a major opportunity quite some time ago.
ImpediMed has invested in a clinical trial, developed the heart failure software, explored reimbursement, and secured FDA clearance, not just for heart fluid status monitoring in heart failure patients, but also for body composition assessment to support cardiac rehab and prehab. ImpediMed has invested in developing SOZO with scales to improve workflow and invent the contraindications for implantable cardiac devices. Heart failure is one of the most serious and growing health challenges we face today. It affects over 54 million adults globally and is one of the top causes of hospitalization, especially in older adults. It is not just a clinical issue.
It places a significant burden on healthcare systems because of the complexity of care, high readmission rate, and the sheer volume of patients involved. That is why we've now started to rebuild our focus on heart failure, and we're doing it in a very smart, needed way, leveraging our investment to date and utilizing investigator-led trials to build the clinical utility needed for adoption, which includes leveraging guidance from two previous ImpediMed run heart failure advisory boards. Professor Sindone , a leading cardiologist based in Sydney, has just completed a 116-patient observational study on heart failure using SOZO. From that work, abstracts are being presented at the Cardiology Society in Australia at the Australian New Zealand Conference in Brisbane next month.
We also have two more investigator-initiated studies underway in the U.S., both exploring key cardiac failure markers alongside SOZO measurements. It is still early days, but importantly, we have a plan, and we do not expect it to require a major investment going forward. Most of the groundwork has already been done, and it is about leveraging that early investment to shape a clear and practical path forward. Now, I'll turn the presentation over to our CFO, McGregor Grant, to go through the financials.
Thanks, Parmjot. Starting on page 15, as Parmjot mentioned, it was a positive quarter from a financial perspective. A significant achievement for the year was meeting our commitment of reducing the cash cost base in FY 2025 by 10% versus FY 2024. We recorded a 16% reduction, which mostly came from a 22% reduction in staff remuneration, with the most significant part from senior management costs. Financial discipline continues to be a core goal of the business as we head into the new financial year. Operating cash outflow came in on budget at $3.5 million, in line with last quarter's results. Last quarter, we flagged that we expected a one-off $1.2 million payment for key electronic components in Quarter Four. This will now occur in Quarter One, FY 2026. Cash receipts were at $3.8 million, slightly down on the $4.1 million last quarter due to the timing of customer receipts.
The cash balance of $22.2 million for the third of June equates to 6.3 quarters of operating cash flow. If we adjust for the additional $5 million drawdown of the debt facility that occurred in July, there are 8.4 quarters of operating cash flow remaining. The strengthening Australian dollar relative to the US dollar resulted in an unrealized FX loss of around $1 million. Moving on to page 16, clearly the standout financial result was the record TCV of $6.3 million, up 86% year-on-year and 29% versus the prior quarter. As well as a strong contribution from new sales, there was also a large number of contracts renewed in the quarter, with solid price increases adding to the record result.
We continue to be very pleased with the quality of accounts either initiated or renewed in the quarter, together with continued solid price increases on renewed contracts, averaging 13% for the quarter. Churn remains low, below 3%. The upward trajectory in TCV translates to an increase in annual recurring revenue, or ARR. TCV contracts in place as of 30 June 2025 are expected to generate core business ARR of $14 million for the 12 months to 30 June 2026. That equates to a 27% rise year-on-year and a 3% increase on the prior quarter. The strong Australian dollar reduced the increase in ARR as the FX effect is applied to the whole balance. Turning to page 17, revenue for the quarter remains close to record levels at $3.4 million, up 15% year-on-year, but down 1% on Quarter Three. US revenue was flat as a result of the stronger Australian dollar.
The rest of world revenue was down 19%. No units were sold to the rest of the world compared with 14 units sold in Quarter Three, FY 2024. The reduction is a result of timing of distributor inventory restocking. I noted in July that the company received an 18-unit order from its Australian distributor. Cash receipts of $3.8 million were up 27% year-on-year, but down 8% against the prior quarter. The reduction from Q3 was largely due to timing of customer receipts. On to page 18. We've already mentioned the significant lift in U.S. unit sales, and I've commented on the lack of rest of the world sales. We've been investigating several rest of the world options. In BCRL, the work we've done to date suggests that many of the European markets are more focused on treatment than prevention.
We continue to work to identify the best way to approach these markets. The Australian distributor continues to make lymphedema sales, and with over 400 units deployed across Australia and New Zealand, we are working closely with the distributors to explore other applications, and we plan to extend SOZO sales into the body composition and cardiology markets in FY 2026. Testing continues to trend upward, up 3% on the prior quarter. We continue to monitor testing numbers closely because the health of the lymphedema prevention programs for our customers is essential to patient outcomes and essential for renewals. Accordingly, monitoring utilization remains a priority for our company. I'll now pass it back to Parmjot to wrap up before going on to Q&A.
Thanks, Ms. Williams. Over to the outlook for H1, onto page 20. Our goal has remained consistent for breast cancer-related lymphedema, but we're adding Body Comp and heart failure into the mix. We have a very clear focus on growing U.S. sales in BCRL by leveraging the changes in our sales team and the expansion of payer coverage. We continue to invest to grow that pipeline and drive improvements in our sales metrics. That is our core focus. We are expanding into body comp and heart failure, and we will do all of this while maintaining our financial discipline. Thank you. We'll open the call now for questions.
Thank you. If you wish to ask a question, please press star one on your telephone and wait for your name to be announced. If you wish to cancel your request, please press star two. If you're on a speakerphone, please pick up the handset to ask your question. Your first question comes from Tom Godfrey from Ord Minnett. Please go ahead.
Good morning, Parmjot and McGregor. Thanks for taking my questions. Can you hear me okay?
Yes.
Great. Maybe if I can just start with the major commercial payer that I'm on from 1 July, and noting it gives you 11 additional states, so over 80%. Is there any color you can sort of give around whether there are any material states in that mix or which states they are, and then just whether it unlocks any of your near-term pipeline in terms of bigger sort of IDN deals?
Yeah. No, there is, I think the shift of those state numbers is material, and we've kind of outlined that already. It is a major U.S. payer with a material number of states that have jumped across. We aren't sharing the name of the payer in a specific state, but we do look at our customers within those states to help convert the sales across. As you know, it's 20 stuff in 25 states with 80% coverage for 36 states. There are a large number of IDNs in hospital systems that are over the 20 states and other states with coverage. The 90% coverage growth in 2021 has made a major impact within our payer mix and the market.
Okay. I understood. It's a little bit hard to hear you, but I think I followed all of that. Maybe just the follow-up to that was, were you expecting to have this major payer come through in terms of when you said, you know, first quarter 2026 should be a similar sort of 40 number and then incremental growth through FY2026, or does that sort of help give you more conviction in that view?
I'm not sure the question, Tom, but I think the market active team has been working very hard with all of the kind of major payers. The timing is very dependent on them. We'll just continue to grow, as I mentioned. Having this payer coverage come on board gives us more confidence that our sales will continue to grow. Sorry, I'm not sure. I was just having a bit of more—can you repeat the question? I forgot what you were asking.
Yeah. No, it was just when you gave the trading update a couple of weeks ago, sort of that guidance around, you know, the following quarters in U.S. sales. You've answered it, Parmjot, so thanks for that. Maybe just changing tacks slightly, I mean, around the body comp sort of go-to-market strategy. Can you, in terms of the oncology side of that, can you leverage your BCRL installed base? Does that work from a workflows perspective at those customers, or do you need to be looking at a new installed base for that strategy?
No. No, no. The Body Comp for the oncology first is very much about the BCRL installed base, and it would, as part of that, extend healthcare and use leveraging Body Comp to extend down into that cancer survivorship pathway, into the radiation oncologist, the medical oncologist. Probably medical oncologists are the key ones that would be monitoring body composition so that it can impact chemotherapy compliance, medication compliance, and long-term survivorship outcomes. There has also been some very interesting recent data and literature that shows the value of exercise in improving cancer outcomes. It was headed with the major news articles in the ASCO back in June. It showed the value of exercise on improving colorectal cancer outcomes is significantly better than most drugs. There is an increasing awareness around needing to put in intervention programs that can be supported by body composition management and medical oncology.
Got it. I mean, the medical weight loss and GLP-1 opportunity, does that sort of come off the back of oncology? How do we sort of think about that incrementally?
No, that's the whole new market. We've already got customers within bariatrics and endocrine that have been using the device for body composition management. What is as interesting is, back in February and I think this year, there have been two major societies and guidance that have been put out in the market, which I've put in the deck. One is on The Lancet, and the other one's on The Obesity Society that now recommends that these patients be monitored for muscle mass using a bioimpedance device or Dex, one of the two. It really is an opportunity for us to build out into this new market space. Given I think we all know the growth of those GLP-1 markets is significant. I think it's a generational new opportunity that we think is great for us to capitalize on.
We have an FDA-cleared device for unhealthy patients that have security compliance within hospitals, and we've got contracts already in place within these hospital systems that enable us to catch it a little bit faster.
Great. That's really helpful. Just last one from me, just one for McGregor. I mean, it was great to see you sort of do better than the initial cash cost reduction target in 2025. I just was wondering in the context of, you know, body composition and some changes to the sales team, how you're thinking about cost growth in FY 2026 and whether there's any updated thinking around cash flow breakeven?
The cash flow breakeven is a function of numbers of units sold and the pricing. We've given an indication in the past on that around the 500 units at an average of $2,000. We're certainly progressing towards that. In terms of cash outflows next year, we have invested some more into our sales team, so that will have an impact there. Overall, apart from, for example, the purchase of the inventory we've talked about, we'll see other areas of cash flow being largely maintained consistent year on year.
Great. That's really helpful. Thanks for taking my questions.
Thank you. Once again, if you wish to ask a question, please press star one on your telephone. Your next question comes from Peter Gregory, private investor. Please go ahead. Pardon me, Peter, your line may be on mute. Once again, if you wish to ask a question, please press star one on your telephone. We'll now pause a moment to allow for any final questions to register. Thank you. We have a question from Grant Percy. Please go ahead.
Good morning, team. The 44 SOZO units that were sold in the quarter, are they included in that quarter's revenue, or part included, or will that mostly be reflected in Q1 of 2026?
Some will be included in the quarter. It depends on the timing of the sale. The sales revenue is recorded over the life of the contract. To the extent that purchases were made or sales were made at the latter part of the quarter, there won't be much revenue in the quarter. There will be revenue from all sales in quarter one FY 2026.
Okay. All right. Thank you. Also, with Legacy Health, was that the first purchase they've made, or have they previously trialed something before? Are they part of the NCCN network or the NAPBC network? I suppose, are you able to tell us sort of how they've spread those nine units across their hospital system?
Gotcha. Sorry. I'm going to that Legacy, right?
Yeah.
Yeah. Sorry. Yeah. I said this is our first purchase that Legacy Health has made. They came out and purchased nine systems to really initiate the program across their hospital network. The NAPBC accreditation was a key reason for them, or one of the key drivers for buying the device too. We wanted to help them meet those accreditation standards, led by a very prominent breast surgeon, Dr. Natalie Johnson, who is a strong advocate for survivorship care.
Are you able to give us some bit more color around how they're using those nine units across districts hospitals? Is it like two of them taking the nine units, or is it spread across one each?
No, no. She's building out the program and the kind of locations now just based on the survivorship care. There'll probably be not more additional information. We'll continue to support her to build them out and then see the workflow guides and all the new promotional devices.
Okay, it's sort of like one each at the moment, and then they'll build on that?
I think it varies, it depends on, it'll vary across the network. It depends on surgical loads, kind of rehab pathways, cancer pathways. I've done an assessment of that and got nine devices in there.
Okay. All right. That's all I have for today. Thank you.
Thank you.
Thank you. Once again, if you wish to ask a question, please press star one. Your next question comes from Peter Gregory, private investor. Please go ahead. Pardon me, Peter, your line may be muted.
Hello?
Hi, Peter.
Sorry. Thanks for taking my questions. 44 new U.S. placements I see in the quarter, but the estimate is 40. Can you tell me how many renewals there were and what percentage of a contract up for renewal that was?
I think, was your question a split of TCV between renewals and new sales?
Yeah.
Sorry, we're having trouble hearing you. It's breaking up.
I'm sorry, I've got a phone problem. It's just on the radio.
Okay.
Yep. Peter, we can reconnect. Touch base. Okay. I think that sounds like it's all the questions. Thank you. Many thanks for your questions and your continued support. We're encouraged by our progress and our momentum, and we're really looking forward to catching up with you next quarter. Thank you.
Thank you. That does conclude our conference for today. Thank you for participating. You may now disconnect.