Hello everyone, and welcome to today's conference call with Ambu, where we are going to announce and talk about our results from Q2 and the first half of our fiscal year 2024-2025. My name is Britt Meelby Jensen. I'm the CEO of Ambu, and with me today, I have the pleasure of introducing Henrik Skak Bender, our CFO. We will start with the presentation of the results, and then we will open up the floor for questions. Let me start with the highlights and the key messages that we have. If we look at the first half of our fiscal year, we delivered a solid organic revenue growth, bringing our first half of the year up to a total organic revenue growth of 15.4%. This is in line with our own expectations and in line with our adjusted guidance from January.
Also, we had a strong start on our very important launch, Ambu SureSight Connect, and we continue good momentum on our urology launches when it comes to our aScope 5 Cysto HD and our ureteroscope. I will come back later and talk about these launches. We continue a strong EBIT margin, where we have 15.2% EBIT growth in the first half of the year. Last but not least, today we confirm our guidance that we came with, an upgraded guidance in January this year, sorry, with 11%-14% organic revenue growth and 13%-15% EBIT margin before special items. Let me look at some of the results that we have for the quarter. In this quarter, we delivered—just go one back—in this quarter, we delivered 11.7% organic revenue growth.
If we break that down into our two business areas, its Endoscopy Solutions growth grew by 13.1%, and we had 9.8% growth in Anesthesia & Patient Monitoring . These results come on the back of very strong results from our first quarter in this fiscal year and also strong results in our second quarter last year, which is the year we used to compare. Also, when we look at our EBIT margin, we delivered before special items an EBIT margin of 14.4%, and we had a positive free cash flow of DKK 80 million. Let's look at some of the progress on our strategy because we do remain ahead of our plan when it comes to our strategy. There were a number of highlights in the quarter from all categories.
When we look at our solutions, the two key highlights and the two key news was, first of all, the SureSight Connect launch, both in the U.S. and the U.K., our video laryngoscope solution that I will come back and talk more about. Then we also strengthened our urology portfolio in Europe with the CE mark expansion, where we can now also use our aScope 5 Cysto HD to function in cystoneuropathy. These are procedures that are used either when you diagnose or when you treat the full urinary tract. When we look at operational excellence, we continue to progress with our transformation program, where we are looking and completing different areas of improvement across the company. These are continuing to deliver in alignment with our long-term EBIT guidance.
We are also continuing to invest in growth as we optimize and bring the organization to a scalable setup that allows for the future growth targets that we have. Specifically on Mexico, I want to highlight that this is a factory that we opened two and a half years ago now and where we have ramped up quite a lot. Now we have a very high efficiency level in our manufacturing, which is comparable to the other sites and specifically to Malaysia, where we have our endoscopy manufacturing. On sustainability, we kicked off in the quarter our Recircle Program. It is a program that we are, as a start, rolling out in four markets: Germany, France, U.K., and U.S., where we across all four countries have hospitals signed up, where the idea is that we collect and recycle our endoscopes.
On the culture, we continue to be very focused on the people and culture. Under this headline, I'm particularly happy and proud that we last week welcomed Jesper Johnsen Steen as our new Chief Marketing Officer, and who's also part of our executive leadership team. Let's look at some of the business results in the different areas, starting with Anesthesia & Patient Monitoring . Here we delivered an organic revenue growth of 9.8%, as mentioned earlier, and on a reported growth taking into account FX, it's 11.6%. This brings our—when we look at our rolling 12 months, we are still above 10% with 10.9% growth versus our long-term target, which is slightly lower. What we have seen is both an increase in price levels, but actually also an increase in volumes in the quarter. We continue to focus on pricing governance as a key lever in this segment.
I also have to say, as we have previously communicated, that some of the above-normal price increases that we have taken were primarily in effect in Q2 last year. That means that this quarter was the last quarter where you should expect an abnormally high effect from prices. I also have to say that what happened was that we basically did not lose any significant amount of contracts as we had as a plausible scenario. However, what happened was that in some of the contracts, we did lose exclusivity, which means that we are still closely monitoring whether we will lose some of the volume in some of these contracts because they are starting to test competitive products. So far, we have only seen a very minor effect of this, but it also typically can take a couple of quarters before this kicks in.
Now let me turn to pulmonology. In pulmonology, we had an organic revenue growth of 8.5% reported, including FX, 9.8%. If we look at the trend, which is what we are very focused on, we still see an above 10% growth when we look at rolling 12 months. If we look at some of the growth drivers in the quarter, I would like to highlight the aScope 5 Broncho, where we in particular in the U.S.A. continue to see that being a strong growth driver. I would also like to comment on the flu season because that did have a small impact on our overall growth. However, when we go back and analyze with our customers, it looks like the 18% growth that we had in the previous quarter was also impacted by customers buying in expectation of a high flu season.
You should look at the impact on the flu season being distributed both on Q1 and this quarter, Q2. Also, I think it's worth noting that the impact of the flu continues to have a lower impact on our pulmonology business because the mix of sites of care that we have is getting more balanced. It is to a larger extent being used for procedures that are not relating to the flu. However, when we then look ahead on this pulmonology segment, I'm extremely excited and confident about future growth. This is not least fueled by our SureSight launch, which is a launch that is so far in the U.S. and U.K. and which will both open up to a new market, and it should also have a positive impact on our bronchoscope revenue in these markets. Let's take a closer look at this launch.
We launched, as I said, in the U.S. and the U.K., and we did that after a shorter period for what we call our controlled market release than usual. What many of you will know is that we typically, when a product is approved, test it with a number of customers for a certain period to confirm that there are no quality problems or challenges with the product. It is also part of ramping up our manufacturing. We had overwhelmingly strong feedback and did not see any hiccups. That also means that we quickly moved into what we call our commercial launch of this solution.
As I said before, what is important to keep in mind when you look at this product is that it's a video laryngoscope, which is a market that is very well established, in particular in the U.S. and U.K. when it comes to the OR. It is also a market that is getting more and more established in ICU and emergency care. The benefits of using a video laryngoscope over a direct laryngoscope is that it improves the visualization, so the success rate when the doctors are using a laryngoscope because of the visualization, and then it also improves the patient safety.
For us, because we have designed it in a way that it works on the Ambu systems platform, it means, as you can see on the picture here, that you can use it together with our bronchoscope and actually have a dual view on the screen, and you plug it in and use it separately if that's what you prefer. That means that that whole solution is really helping both advance our bronchoscopy revenue, but also to open up to this video laryngoscope market. We are very excited about the feedback that we see and the uptake that we have seen in the very early phases of the launch, although I should say that it still has a very minimal impact on the revenue in Q2 that we are reporting on today. Let me turn to the remaining part of our endoscopy revenue, urology, ENT, and GI.
Here we posted an organic revenue growth of 18.3%. This is slightly lower than the last 12 months' rolling revenue growth of 23.4%. When we look at what is driving growth, it's primarily the aScope 4 Cysto, it's our rhinolaryngoscope , and it's both new customers buying and existing customers buying more. This growth is lower than what we have in the last 12 months. The lower growth we believe is to some extent temporary or to a large extent temporary. What is mainly driving it is if we look into the U.S., where we have seen new competition primarily coming from Chinese players. Remember that we were the first to come out with an aScope 4 Cysto, and we have been alone in that market until recently. These competitors are coming in, and they do exactly as our sales cycle.
They do tests and use the product in procedures before they are open to sign up to a product. That whole testing period does mean that we are temporarily extending our sales cycles. We are, of course, taking this competition serious, but we are also reminding ourselves that these solutions, we don't perceive them to be better than our solutions. Also, I mean, for these, and it's primarily only Chinese companies that are entering, we don't see them having a manufacturing cost comparable to ours. We, of course, expect that we should remain very competitive in this segment. It is also a way for us to continue to see an expansion of the segment where there's still a lot to gain from customers using reusable today.
I also want to highlight for this segment our new product launches because we launched in Q1 of this year, we had the ureteroscope, and we had the aScope 5 Cysto HD launched. These are products that we believe over time will contribute to an accelerated growth in this segment. However, due to our sales cycle, this is not yet producing meaningful revenue. To illustrate these dynamics in our sales cycle, let's stay with this segment and look at what is driving our revenue because what we actually do see is that our endoscope solutions that we are bringing to the market, they in general have long life cycles.
What you see on the graph here, where we have taken, I mean, the urology, ENT, and GI last 12 months' rolling revenue, you can see that when we look at the Q2 last year, we had over 90% of the revenue coming from existing solutions. This is aScope 4 Cysto and aScope 4 RhinoLaryngo . That means that our new products are generating less than 3% of the revenue. If we then look at this one year later, and new solutions being defined as solutions that have been launched within the last two years, we actually see that still over 90% of the revenue is coming from our existing solutions.
This just underlines the message that I just had before around that the sales cycles are long, which means that the launch uptake curve that you see for our endoscope solutions is in general not very steep in the beginning. This is in particular true, as we have seen, for new solutions that address more advanced procedures, which is the case with, for example, our ureteroscope, which, as you are well aware, is for kidney stone management, which is typically a procedure that is longer. We, of course, as we should do, continue to see how we can learn and optimize our launch process. We take customer feedback and learn from that.
In the case of our ureteroscope, we have also deliberately had a slightly lower manufacturing ramp-up in order to make sure that we were able to manage the right quality because this is a product that is characterized with very specific features that are both for the reusable and for the single-use can be difficult to get right. Before handing over to Henrik, let me finish with an overview of the four business areas that we are in because we are actually excited as the pioneers and first movers into single-use endoscopy. We are still the leading single-use endoscopy player globally across all these segments.
Also, as you see on the bars here, we continue to have a lot of white space in all of the segments, less in the pulmonology segment where we entered first, and white space meaning customers that are using reusable endoscopes today that can convert and are converting to single-use. Also, what you see on this is that what we see as growth drivers when we look ahead is both for pulmonology and urology. It's very much the mix of the existing products that we believe will continue to grow and then some of the new launches, new solutions that I've talked about in this presentation. When we look at ENT, I mean, we have a next generation in development, but we continue to see solid growth coming from the first version that we launched around six years ago.
In GI, it's an area that we are newer into where we see growth coming from some of the new solutions, mainly being our gastroscope and Gastro Large. All of this, last but not least, we have a benefit with our leadership position that we can leverage the digital, our endoscope systems platform, our digital system that also includes an increasing amount of software. We have the benefits of also having a cost-efficient setup and the flexibility for the customers that they can plug any of our scopes into that system and then start working immediately. With this, I'll hand over to you, Henrik, to go through the financials.
Thank you very much, Britt.
Before I dive into the financials, I just want to reiterate what Britt also started out with saying, being we are very satisfied with what we feel is a good Q2 in line with our own expectations and also in line with the increased financial guidance that we upgraded back in January. If we start looking at revenue, as Britt explained, we reported a revenue of 11.7% organic revenue and in reported currency, 13.7%, mainly driven up by positive effects in the U.S. dollar/ DKK currency. If we look at how that splits beyond the product split, also geographically, we were happy to see continued solid growth both in North America and in Europe, driving our overall base up and also driving up across all categories of products.
From revenue, then driving into margins, we also delivered a solid EBIT margin in quarter two, mainly driven by continued progress on expanding our gross margin, but also with what we feel was a good result in terms of our OpEx and OpEx leverage. This is a continuation of the journey of expanding our EBIT margin, which is part of our ZOOM IN strategy. I'll come back to how we view the current status and also how we view the journey ahead. On EBIT margin, if we start looking at gross margin, we had a gross margin of 16.6% in quarter two, which is an increase of a bit more than a percentage point versus the same quarter last year. This increase is mainly a combination of one, that we continue to grow more in Endoscopy Solutions than A&PM.
Even despite the price increases in A&PM, that is still a higher gross margin. That said, the price increases in A&PM are still supporting an increasing gross margin also. Last but not least, we also continue to see improvement on production efficiency across all our sites. As Britt also mentioned, particularly now also more efficiency in terms of output from our Mexico site, even though we are still not fully utilized. Therefore, we still see potential for even further production efficiencies ahead of us. If we turn to OpEx, we had an OpEx ratio in the quarter of 46.2%, which is actually higher than the quarter two of last year.
This increase was planned and part of the commercial acceleration, the commercial investments we've been talking about for the last quarters, investments particular in supporting our sales growth within the pulmonology and urology space, whereas Britt said we've had new product launches. Furthermore, we also continue the investments in generally ensuring we have a strong and scalable organization and ensuring that we can continue to deliver and support the organic growth targets that we have ahead of us. That also means that for the rest of the year, we continue to see some further investments, but that said, also see more and more leverage as we look further ahead in the future.
On that note of looking further ahead in the future, if we look back towards when we launched the ZOOM IN strategy and ahead towards the targets we as part of the ZOOM IN strategy communicated for 2027, 2028, we feel very confident on the progress we've made already. As illustrated on the slide, we are now more or less, you could say, halfway through the strategy period. With this quarter delivering more than 15% EBIT margin, which we are very satisfied with.
As communicated in our Q3 and Q4 of last year, we still see more EBIT margin expansion ahead of us, of which, generally speaking, we feel around 1/3 of that expansion should come from gross margin improvements, further price increases, better production efficiencies, and generally better utilization of our manufacturing footprint, and 2/3 of the remaining margin expansion coming from OpEx leverage, making sure that we make the most of the investments we do in new product launches with new innovation, and also making sure we leverage our sales force even further than we do today. Overall, we feel very confident that these are still continuous steps towards the direction of meeting our long-term financial target of approximately 20% EBIT margin. In conjunction, we're talking about EBIT margin, and in conjunction, we're looking at the world.
It's clear for everybody that the first quarter of this calendar year, our second quarter in our financial year, has been a quarter with a lot more geopolitical turmoil. Therefore, we today and with our Q2 message also wanted to reiterate that we remain confident about our guidance, and we feel well-positioned to manage the potential impacts on tariffs on our business. Our main priority remains to support our customers around the world. That also means that our focus is very much on ensuring that we can deliver products despite tariffs and despite challenges in parts of the supply chain or potential challenges in distribution. If we double down on our manufacturing footprint, we feel that our setup with manufacturing sites in the U.S., in Mexico, in Penang, in Malaysia, and in China enables us to be flexible around where we produce.
Now, with an even stronger output efficiency, particularly in our Mexican site, it enables us to also move across production where we see fit, both for short-term optimization and for long-term strategic opportunities. Generally, therefore, we feel confident that we can deliver on our guidance. We can continue to support our customers on every basis of what we know today on the tariff situation. Turning from margin and growth to cash flow, we also had a solid cash flow in Q2, we feel, with a free cash flow of DKK 80 million. That said, it's also clear that in our cash flow, we still continue to have a higher networking capital ratio, which I'll come back to in a second, than we've had in previous quarters, and particularly than we had in the last financial year.
This is in part due to preparations for the product launches, particularly both the VL and the ureteral solution, but also in part us making sure that we, as I said before, can continue to supply products to our customers around the world. Therefore, we are accepting slightly higher inventory levels across our supply chain. If we double-click on the key drivers of this, we feel, generally speaking, that a cash flow of about DKK 150 million, just short of DKK 150 million for the first two quarters, is a good start. Also, we can still deliver on our soft guidance of delivering around or + DKK 500 million free cash flow for the year. The cash flow continues to be positively impacted by our increasing EBITDA margin, but then again, as I said before, negatively impacted by a higher networking capital ratio, in particular, higher inventory levels.
Last but not least, ending where Britt started and where I started, we remain confident in maintaining our guidance, financial guidance for the full year, the financial guidance that we upgraded in January, both on organic revenue, where we remain confident guiding 11%-14% growth based on where we are year to date and based on the continued momentum we see both in the market and with new product launches, both within Endoscopy Solutions and within Anesthesia & Patient Monitoring . Secondly, we also feel confident about our EBIT margin guidance of 13%-15%. Obviously, that means that we are still expecting a slightly lower EBIT margin for the second half of the year, given that we are just above 15% year to date, mainly driven by continued investments in the commercial organization and also continued investments in our product launches.
Last but not least, we also remain confident on our guidance on cash flow, + DKK 500 million, despite the slightly lower cash flow for the first half year. That ends our presentation. Again, we feel confident and now ready also to answer any questions you may have. Thank you for your attention.
Star and one on the telephone. If you wish to remove yourself from the question queue, you may press star and two. Questioners on the phone are requested to disable the loudspeaker mode while asking a question. Our first question comes from Anchal Verma with JPMorgan. Please go ahead.
Hi. Good morning, Britt and Henrik. I have two questions, please. The first one is on endoscopy. You have mentioned that you expect to return to 20%+ growth rates. Are you able to put a timeframe on that?
Is that potentially a target for next year when you start seeing the benefits come through from the new product launches? The second question is on tariffs. We understand you're relatively well protected this year given the September year-end delay in implementation and supplying USMCA products from Mexico. How should we be thinking of next year? Are you able to provide any quantification in terms of sales or EBIT impact for FY 2026? How quickly can you move the facility to Mexico? What products do you think are potentially not, you wouldn't be able to move from the Malaysia facility into Mexico? Any numbers around this would be really helpful. Thanks.
Thank you.
Yeah, thank you. Maybe I can start. I think when we look at the segment and our statement around, we will return to 20% +.
We deliberately did not put a timeframe because the way that we look at this is that, I mean, this was an illustration of this is the level that we believe we should be at. We also feel quite confident that this is, I mean, where we will get to. I think that is how you should look at it. I think we talk about some of the, I mean, that it was lower than the 23% that we have in the rolling LCM is really something that we see as temporary. We still see on the aScope 4 Cysto and RhinoLaryngo that we continue to see a solid progression with new customers and with also existing customers buying more.
We will gradually, as we also explained, see our new customers have our new launches, sorry, have an increasing impact. That is not going to be big in this quarter or the coming quarter, but this will be a gradual uptake as we have tried to explain our launch curve. I think that is how to think about it. Maybe a few comments from my side on the tariffs, and then Henrik can add. What we feel very confident about is the Mexico factory that we opened two and a half years ago. As we also talked about, we actually have both an efficiency level that is on par with what we have elsewhere. That has been as it does when you open a new factory. It takes a little bit before you get to that efficiency level.
Secondly, where we also have a lot of spare capacity. That actually means that we are able to, and we have had in our long-term plans that we gradually will move more manufacturing to Mexico in order to also have a fully global setup where we manufacture our products close to the customers. Right now, I mean, the majority of our products that we are or solutions that we are selling in the U.S. are actually produced either, I mean, some of it in the U.S., but actually also a large part of this in Mexico. That is also where, I mean, we see no reason, and it was in our plans, tariffs aside, to continue to ramp that up so we can also be more flexible and produce close to the customers, reducing freight costs. That is very much in line with our plans.
We are not, we, of course, have different scenarios, not knowing where the tariffs will end, but we do feel that with that flexibility, we are actually able to manage some of the different scenarios that we have. The good thing is that we do have a lot of very recent experience in moving production lines because this is what we have done as we have ramped up in Mexico. That also enables us to act quickly to some of how the dynamics are changing.
Yeah, I think you, I think, already provided a good answer.
I think the only thing I would close off with saying, if we obviously do not comment on what this could mean for our financial performance next year, but building on what Britt said, I think we feel quite confident that if, because I think it is important to underline that if tariffs, as we at least know them today, are actually implemented, then we have a lot of measures to mitigate impact from those tariffs. Therefore, it is not a concern for us that this will have a major business impact.
Yeah. Maybe the last thing, I think this is pretty clear for most of you, but the products that we are manufacturing in Mexico, they are under the free trade agreement, USMCA, between U.S., Mexico, and Canada. We do not have any tariffs on these products, just to make that statement super clear.
Absolutely. Thank you.
Thanks.
Thanks, Anchal.
Maybe just a follow-up on that. I'll ask it a different way. Can you tell us how much of your U.S. products are currently produced in Malaysia? Out of that, how quickly do you think you can move those products into Mexico? Are there any specific lines that you think will take a little bit longer to ramp up in Mexico?
I can perhaps take that. We do not comment on the volume split for many reasons. One, because we do not go to that level of detail externally, but two, because the volumes are actually already moving as we speak. I think the comment I will give is that we are, as Britt said, moving more and more towards Mexico or Noblesville where we can. Most of our high runner products now, particularly obviously within Broncho and urology, are now mainly produced in Mexico.
Perfect. Thank you.
The next question comes from Niels Granholm-Leth DNB Carnegie, please go ahead.
Thank you for taking my questions. First question on your gross margin. What kind of gross margin progression have you built in for the next few quarters? Should we still expect a headwind from the launch of the video laryngoscope going into quarter three and quarter four? I guess there will be an effect from the U.S. dollar and potentially from tariffs as well if you book tariff cost under cost of goods sold. My second question would be around your tax. You did not pay or your effective tax rate was unusually low in this quarter. Can you just comment on that and give us some kind of guideline for the full year? Thank you.
Absolutely. Thank you, Niels, for the good and detailed questions, as always. Much appreciated.
I think in terms of gross margin, first, we do not comment on all the details, but I will give you a couple of hints also building on what we communicated before. If we start with VL and our product launches in general, you are right, as we communicated also in connection with Q1, we are expecting partly in Q3 and in Q4 that there might be extraordinary investments to support the launch of these products, mainly investments in capital equipment, so monitors that at the initial sale will come at a slightly lower gross margin. That is also built into our forecasts for this financial year to allow for some of these investments that obviously are investments to secure future growth as they are part of converting customers into our solutions.
Secondly, also, as you correctly note on gross margin, obviously here we are still also in the quarter we are talking about now positively affected by the U.S. dollar. That helps on our margin, both gross margin and EBIT margin. In terms of the future with a depreciating U.S. dollar, that could have a negative impact on our business and both on gross margin, but also EBIT margin. That is also why in our Q2 report, you will see we comment on the currency risks also as we look ahead in the full year financial guidance. Given that we guide on reported EBIT margin, then of course, that is something we are observant towards. With what we know today, we also feel confident that even despite or even with, sorry, potential negative currency effects, we can still stay within our EBIT guidance of 13%-15%.
Last but not least, tariffs is a little bit of a mixed story. Actually, a significant part of the tariffs cost would impact our OpEx and a little bit less our gross margin. Simply put, if we import a subcomponent, so a not finally assembled product, it will mainly hit our gross margin. If we import a finally assembled product into the U.S., it will mainly impact our OpEx. Actually, the potential impacts of tariffs will, to a larger extent, impact our OpEx cost and to a lesser extent impact our COGS and therefore our gross margin. Tax, also thank you for asking that question. It is correct that we had a lower tax ratio in quarter two, mainly because we have had an old tax case with the Danish tax authorities.
You'll find it in the note where we now got confirmation from the tax authorities that we were right in our position. Therefore, we actually reversed an accrual that we had put aside for a tax upside in the quarter and also had a payment from the tax authorities that just came in just after the quarter, actually. This will not impact, it has not impacted, the Q2 numbers as you've seen it for now, but it's more impacting cash flow-wise, the Q3 numbers. This is an extraordinary case. Otherwise, besides this, it's normal business and the effective tax rate, therefore also going forward, you should expect to be as you've seen in the past.
You're still expecting the effective tax rate for the full year to arrive at around 23%?
It will be a little bit lower because of this one-off effect that will still impact this financial year. I'm more talking Q3 and Q4, you will see effective tax rates that are more similar to what you've seen in normal quarters. For the full year, the effective tax rate will be a little bit lower, to your point, because it is lower here in Q2.
Just to understand the tariffs that you have built into your guidance, you have assumed that you will start paying tariffs from quarter three or quarter four this year?
Yeah. As also based on the question from JPMorgan, I think the point here is that we only pay the tariffs really when, or you see the tariff cost when we start selling the products that have been impacted or imported, sorry, with tariffs.
The real impact you will only really see partially in Q3 and then secondary in Q4, again, depending on where the final tariffs end. Back to Britt's point, obviously everything produced in the U.S. and everything produced in Mexico under the USMCA compliance free trade agreement is completely tax, or sorry, tariff-free. It is only the products that we produce either from China and, of course, mainly the products in volume at least, because that is the biggest relative split coming from Penang in Malaysia. There you will see some of these tariff costs impacting partly Q3, mainly Q4, based on what we know today.
I think as Henrik also said earlier, we are not providing any details on how much is coming from where, but I think we can say that from the tariff-free area, so U.S., Mexico, it is more than half of the revenue in the U.S. that is from these areas. That is also part of the mix. I do not think we can be more specific on that.
I think also on the question of how fast can we move production lines, it is a six- to nine-month period. I think in that sense, also coming back to the question previously from JPMorgan, we feel comfortable that there are a lot of mitigating actions we can take also going into next financial year if the tariff situation plays out as what we know today.
Obviously, we are in preparation mode for whatever might come, but really focused also on making sure we follow through with a longer-term strategic plan, which is to rebalance our production footprint, to bring it closer to our customers, to add agility and lower distribution costs and cost of goods towards the customer in the end.
Thank you.
Our next question comes from Martin Brenøe, Nordea. Please go ahead.
Hi Henrik and Britt. Thank you for taking my questions here. I have three questions if I may. First question would be on what you're seeing in particularly in the U.S., but in general also what you're seeing as a consequence of the tariff announcements. Have you seen any change in behavior shortly before the tariff announcements, particularly from Chinese competition?
Maybe if you can also comment a little bit what you have seen after the tariff announcements and whether you have seen any change in behavior. For example, have the Chinese manufacturers stopped shipping to the U.S. in the time afterwards? Has there been any stocking impact if you have seen any flushing of the market during the last quarter? That's the first question. The second question is, and I really hope that this is the last quarter I will have to formulate this question in this way, but you have now seen a slowdown six quarters in a row in ENT, urology, and GI. When do you expect Ambu to trough out on this particular segment? I can see you've got easier comps going forward. I can see you have a lot of interesting product launches that are seeing encouraging trajectory.
If you can specify that a little bit, it would be very helpful. Lastly, just on net interest-bearing debt, it continues to be more and more negative. I guess that it must be nice to have a big war chest, but I am keen to also hear how you plan to make use of this strong balance sheet as it continues to grow.
Yeah. I think I can start on some of the first questions. First on the tariffs, what we see, I mean, in the actual marketplace. I think it's, I mean, we are of course trying to stay very close, and it's a little bit difficult to separate facts from rumors.
I think overall, what we did see also before the tariff was that we saw, as I talked about specific for the urology segment, we did see some Chinese companies increasing their activity level in the U.S. and also coming in with fairly, in selected cases, we saw fairly aggressive price competition, which we can assume is below, I mean, their ability to make profits on it. We have seen, and this is again very early stages, but we have seen that, I mean, that we are that's becoming much more silent on that front is one thing. The other thing in terms of stocking of their products in the U.S., it's really hard to fully understand because I think we hear contradicting rumors from different places.
I think also, I mean, I think it's broadly known also outside our industry that there's a lot of products that are, I mean, not able to get into the country because you have to pay the tariffs upfront and that in many cases, it has been limited how much you have been able to both produce and then also get into the U.S. market in time. I think if we just look at our own, as Henrik talked about, relatively flexible setup, I would say even with a flexible setup, I also think it has to be limited how much they've been able to get into the country, in particular because a lot of these companies, and it's only a few that we see in the U.S. market, it's relatively smaller companies. There is also a limit here.
We are of course monitoring this closely, but we do see net-net that the Chinese competition that we started to see in the U.S., I mean, that being much less aggressive and that they will have a much harder time given all of that is coming from China. Of course, you could say until they may, if they do find other ways, but it changes the dynamics for sure. Your comment on ENT, GI, and urology. I mean, I think we tried again with the + 20% also to share some of our expectations on the business and how we see this segment, which is of, and that is also why we tried to show the picture of new versus existing products to try to, in a transparent way without revealing too much to competition, to show how is it that we see the dynamics.
You have to put on top of that that the dynamics are different when you have products for very simple procedures and products for more advanced procedures like kidney stone management with the ureteroscope, where you typically have a longer sales cycle because they do many more trials before they buy. We do see a gradual uptake of this. We do also remain confident in our ENT and cystoscope business that we continue to see white space in the market to capture and also that our customers are continuing to ramp up. Part of our expansion of our indications is also to help and to allow them to be able to fully convert to single use when they can use it for also some of the niche procedures that they can get their equipment out.
This is what resonates, for example, in the U.S. very well because then they get freed up rooms where they had the washing equipment that they can then do more procedures. We do see those dynamics in the market and how we help improve the efficiency for the hospitals. That continues to resonate very well. This makes us confident, but I'm unfortunately, Martin, not able to tell you when we will see that turn because we do not guide on the individual areas.
If I use that as a bridge to the rest, I just want to reiterate a last point on uretero, ENT, and GI. I think we share also your sentiment, Martin, that we look forward to coming out with the quarter again where we are above 20%.
As Britt said, we do not comment on the specific time, but feel very confident that is still the trajectory we are looking towards when we look further out. Just one last comment on the U.S., which we did not mention explicitly, only indirectly, is I think what we are seeing in the U.S. and why we explicitly mentioned this point about higher inventory and ensuring stability in our supply chain is that there are specific areas, ports, where you are starting to see some congestions. We are not concerned with our distribution setup, but again, how that affects the rest of the market is difficult to see.
Particularly in some of the main ports in the U.S. with import from the U.S., I'm sure you've probably seen the news that there are some congestion areas and something we are observing to ensure that we can continue to support our customers and supply products to our customers and why we have slightly higher war chests on inventory also. Speaking of war chests and net interest-bearing debt, then you're right. We still have a building war chest and both in terms of our negative net interest-bearing debt. We also in the Q2 announcement confirm that we've now extended the revolving credit facility amongst others with two Danish banks and one international bank, exactly with the intent to have balance sheet strength in what is to come.
I think the short of a long is that we will keep you waiting until our Capital Markets Day where we will come back on more. We deliberately last year opened the point that we are looking at M&A, but we're not in a hurry. Obviously, I think right now with the geopolitical turmoil, we are certainly not in a hurry to jump into something where uncertainties are even higher, but more ensuring that we are sharper on exactly what is it we want to focus on and also observing and discussing with participants in the market what is coming both on public and more on rumor basis. In that sense, we are getting ready and I think we have more to say at the Capital Markets Day.
I also just want to confirm again to all of you on the call that we are not in a hurry to do a big M&A. We are still mainly an organic growth company and we're running an organic growth strategy. We are more looking at how can M&A support that either with specific products, companies, or capabilities.
Thank you very much for the thorough answers to my questions. If I may be a little bit naughty and just ask one last question here before jumping back in the line. The Recircle Program that you have announced today, I find that highly encouraging and could probably set you apart from most of the competition if you manage to set up such a program.
I don't want to be a party pooper, but could you maybe tell us how much such a program would cost if it were implemented on a global scale? Thank you.
I'm given it's a cost question. I'm happy to take that. I think the short answer is, Martin, it is still unclear exactly what it would mean because obviously there's both a cost side of it, but there's also a revenue side of it. Particularly that revenue side, i.e., the customers paying us for a program like this, is different depending on where you are in the world. In the U.S., it's actually very much a waste management program also where there's a high willingness to pay, even though the sustainability agenda might not have highest focus these days in the U.S., whereas in Europe, it's a slightly different angle.
I think the short of a long is that we are, exactly as you're hinting, seeing this as a distinction versus our competition. We fundamentally believe it is part of us proving that our single-use Endoscopy Solutions are actually more sustainable if you look at the full cycle, we believe. Therefore, it is all about ensuring that we create scale in the program. If we create scale and we have customers supporting like we see right now, then it would not be a margin dilutive program to run something like this. It could more be a revenue contributor in the end, but it's still too early to say. Again, it's today still with a starting point, we feel this as part of the solution rather than a new business unit, if you can call it that.
Perfect. Thank you very much for taking my questions.
Thank you. Thank you.
The next question comes from Yiwei Zhou with SEB. Please go ahead. Your line is open. You may proceed.
Hello. Can you hear me?
We hear you, Yiwei.
Thank you. We hear you.
Okay. Great. Great. Thank you for taking my question. I have three questions here. Firstly, just one follow-up on your comment on new competition from China in the U.S. And you have answered that you're seeing more activity before the tariff and less aggressive now. Could you maybe a bit more specify that if you have lost any customers to the Chinese companies, I guess it's more on the cysto and ENT scopes, or it is only extending the sales cycle for you without any concrete loss?
Yeah. Okay. I can answer that now. Thanks for your question.
I think we are still in the early stages, and that's also why I said I think we are collecting every evidence that we have around some of the specifics. We have not lost a lot of customers. We have one or two accounts that are in the process of being lost, and that's where we see some of the dynamics that I talked about around the whole pricing situation, given also the tariff situation, making this picture a little bit blurred because we cannot have the same guarantees for the pricing. I mean, we do see that a lot of moving pieces right now. We would like to come back when we have a little bit more a clear picture, but it's a bit anecdotal on this point because it's relatively new that they came in.
We have had all these sales processes being ongoing, and now the tariff situation is disrupting some of this.
I guess to build on what you say, Britt, I think what we can say is that we are more seeing the slower growth as a result of the longer sales cycles than we are seeing it as a result of lost customers. It more or less only relates to our urology portfolio. The cysto products within ENT, we see very, very little competition, if any, single use at all. It is still, as Britt said, anecdotal. We wanted to, of course, then all that said, still be transparent around this because it is a dynamic where we have gotten a lot of questions on what should we expect. It is really a dynamic that we mainly have seen in the U.S. historically.
Great. Very clear.
Maybe also follow up on this. If you're looking at a ureteroscope, does the U.S. tariff now change also the competition landscape in this new product? I know you have not seen a meaningful sales contribution yet, but have you seen that you're getting more requests or it is easier to sell with U.S. customers and hospitals?
That's a super good question. Again, I think it's also very premature because, I mean, as you very well know, the competition that we are up against here is that there's a ureteroscope out there from Boston Scientific that has been out in the market for around seven to eight years. I mean, we are getting in a very strong position against that.
We have also seen some Chinese manufacturers come in with ureteroscopes, which are not better than our solution, but still they are slightly more aggressive on the pricing. I mean, because we are so early in our own state, it's very hard to see what are the drivers for what. In general, we have the same observations and views as when we talk about, and as we just talked about, that there is more reluctance from customers and there is more uncertainty around what does it mean, I mean, when you engage with these companies. In particular, because ureteroscopes are much longer procedure time, so it's a little higher complexity. You want to make sure that when you switch and get used to a different endoscope, that you can also continue to rely on this.
We cannot, I mean, it's too premature to separate these things, but we do have some indications that the competitive picture in this area is changing as well to our favor.
Yeah. Great. Maybe a question to Henrik. You mentioned the currency impact here on OpEx and EBIT, sorry, on the gross margin. I was wondering in Q2, could you maybe quantify the impact on OpEx in absolute value and also on the EBIT margin?
We do not quantify in absolute value on OpEx alone. On the EBIT margin, I do not think we have it specified specifically. Are you talking about the full first half year or just Q2?
Oh, just Q2.
Just Q2.
I think there's still also in Q2 a slight positive, but much smaller positive impact on EBIT margin where, as you might recall in Q1, I was very explicit there was a quite meaningful positive impact in our EBIT margin from the at that time higher U.S. dollar. I would rather go back and say if you compare to where we guided or made our guidance when we started the year where we also had currency estimates around it, we were at that time estimating a U.S. dollar /DKK currency of 6.85. Obviously, now we are below that level. I think if the current U.S. dollar level continues for the rest of the year, then it would go from a positive impact, which is what we communicated without quantifying in Q1, to potentially a negative impact for the full year.
Okay. Great. Thank you.
I'll jump back to the queue.
As a reminder, if you wish to register for a question, you may press star and one. Our next question comes from Cyriaque Blanchet with Bernstein. Please go ahead.
Hi. Thanks for taking my question. Cyriaque Blanchet on behalf of Delphine Le Louët from Bernstein. Three questions, if I may. Just the first one on inventories. If you could give us some precision on how we should see inventories in terms of days of sales for 2025 and when can we expect to see normalized figures. Regarding also your free cash flow guidance, which is above DKK 500 million, I would like to know what you mean by transformation efforts in the presentation and if you can give us more precision on the mitigation plan that you aim to achieve this guidance. Last one regarding tariffs, you specified also different scenarios.
I would like to know more about what would be, for example, your best scenarios, your assumption, and if you could quantify these impacts. Thanks.
Thank you. Good question. Sounds like I have a lot of good things to answer here. If we start with your first two questions on inventories, on free cash flow, those two are connected. We do not inform on days of sales split or inventory days specifically, but if I refer back to the page where you see our networking capital ratio, as our networking capital is a ratio of revenue, you see how that has creeped up for the last now two quarters and we are close to 23%. That is again mainly driven by inventories.
In terms of expectations for how that looks going forward, we do not guide detailed on this, but I think this plays back to my comment about how we have been investing in preparing for product launches, both for the VL, the SureSight solution, and for ureter solution, both products and also display units, monitors to support that. Obviously, the more traction we get, the faster we get that traction, the faster you will also see an inventory decrease. The longer it takes, the slower the inventory decrease. Whether that happens in this financial year or more into next financial year depends a little bit on how fast we gain traction. Therefore, I think overall in terms of mitigating plans for the rest of the year to meet still our guidance, a lot of this is around how we manage networking capital specifically.
Back to the question we got also from Niels from Carnegie, a little bit of a helping hand on tax, which you will only see the positive effects from here in Q3, where our effective tax ratio for this year will be lower because we have a repayment from the tax authorities on an old tax case dating back to 2019-2020. Those are the main effects in terms of how we still feel that we can stay within our guidance of +DKK 500 million free cash flow for the year. In terms of tariffs and assumptions, I think it's important to reiterate that we base our confirmation of our financial guidance on what we know today. I think like you will know, there's been a period here, particularly in April, where it's almost changed by the day.
We feel this is the best basis on which we can do that. Of course, one thing for Canada and for us, most importantly, Mexico and everything produced in the U.S., where we, as Britt said, feel comfortable and we are under the USMCA compliance product registration, which means tariff-free. For the rest of the world, excluding China, there is the basis tariff right now of 10% that, of course, we are observing what happens, but really looking at how do we manage the flow out of Penang, Malaysia, towards Mexico from a short and long-term perspective. There are some mitigating actions, as we said before, we can accelerate or maintain as they were planned already.
On China, I think it's difficult to really say what will happen, but the current guidance is based on what we know today and the tariffs that have been communicated. Obviously, if they are implemented in full force, there are several other mitigating actions we are looking at how we speed up. All of that said, I think it also comes back to an earlier question on how fast you will see this impact in the year. A lot of this financial year and the margin impact from tariffs will not really be seen as the products we are selling in the U.S. are products we imported into the U.S. and have in inventory in the U.S. pre-any tariffs. This is mainly a question of what it will mean for next year.
As we do not guide today, next year, and I think really nobody knows where this lands yet. I think we will wait with that discussion until we get further towards the end of the year and talk about guidance for the next year. We are also not quantifying what this would mean in DKK million, but more coming back to confirming our guidance for this year of an EBIT margin of 13%-15%.
Okay. Thanks.
Our next question comes from Tobias Berg Nissen with Danske Bank. Please go ahead.
Hey, Britt. Hello, Henrik. Hope you can hear me.
Yes.
We can. Thank you.
Perfect. I have two questions, if I may. The first one on pulmonology. Pulmonology growth seems to be increasingly getting lumpy. Is this something we should also expect to continue going forward?
How is this new launch of the radar ureteroscope in the U.S. and the U.K. affect this growth going forward? Should we also expect it to be smoothed more out, or should we still expect this lumpy growth? Just on CapEx, it was around this 5% of revenue for the quarter. As you mentioned, Henrik, this was below the expectation of this 7%-9% on long-term projection. When should we expect the CapEx to return to this range? If you give me any insight on that, thanks.
Yeah. Thank you. I can start on the pulmonology, and then you can talk about it. I think what's important to say is that, I mean, we continue to see overall momentum in this segment.
When we look at the LTM growth of + 10%, we believe that that is also, I mean, when you look at the different fluctuations, solid. You have to remember that we had in Q1 around 18% growth, and then the growth was 8.5% in this quarter. If you combine these, you can say we still, which we think is the meaningful way to look at it rather than looking at the quarters isolated. I think we are still at that level, solid level. For the video laryngoscope, it has been important to say this has not really had an impact on the revenue because we did the launch midway into the quarter in the U.S. and later in the U.K. The way that we look at this going forward is that this should be a growth accelerator for the segment.
Again, on two different dimensions. One dimension is on the video laryngoscope market, where we are now getting access to a new market where we already have the customers, many of them using our bronchoscope today. That should be a fairly, you can say, less cumbersome selling process than we have seen in some of our other segments, in particular also because you can use the system that they already have in place and then simply plug the video laryngoscope into that. I think we are, of course, still early days watching the dynamics, but we feel quite encouraged by the positive customer feedback and the early start in that market. The other thing to look at here, because it is, I mean, the same one system that you use, we also believe that it does have an impact and potential to accelerate our bronchoscope sales.
The aScope 4 and aScope 5 Broncho, which we are also seeing some signs of, again, because they like to have the convenience of one system. In particular, that you can look at the screen when you do procedures with both products or solutions at the same time, that you can see them both on the screen. Of course, we have some internal scenarios and plans that we are not sharing externally, but we feel that this should position us very solid for the next couple of years, at least in this segment. We will also continue to be focused on pulmonology and come out with our next generation bronchoscope at a later point. Overall, I mean, this is a segment that has high priority.
It is also a segment, as we have talked about before, where we in the U.S., while we were very focused some years ago on GI, we saw competition coming from Verathon, a company that came from having a video laryngoscope and then also went in with a bronchoscope. We also do see that there is some share that we can gain back now that we have that full solution so that the growth is not only coming from growing the market. I hope that puts a little into perspective how we think about this. I want to highlight that we are super excited to finally have this on the market, and in particular because we have a very solid offering to the customers, and they are also confirming this.
If I build on that, just briefly to follow up on pulmo, very much agree.
I think the only, on your point on lumpy sales, I think what we've said before, and I think we want to reiterate, is that we are not driving specific month-end lumps, to use that terminology. We are more explicitly tracking what is the procedure level we see at the hospitals. I think when we spoke in Q1, we were at the time also indicating the point about timing of orders, where it was a bit unclear for us, had the customers already made more orders in expectation of a higher flu season or not. I think part of what you're seeing in the numbers is that more of the hospitals had done that. Obviously, we are improving our way of tracking that, but certainly not encouraging that inventory stock up, but more trying to balance it through our sales force.
It is something we are continuously monitoring. Last but not least, it's important to say also it is particular in the ICU within pulmonology, where we see some of these swings related to flu. It's not something we see as much in the other sides. Therefore, also we expect that the lumpiness should go down over time. At least that's how we expect to see the order flow when we look forward, even though timing of orders is still a topic you will probably hear us talk about also going forward. On CapEx, we don't guide on the specific CapEx percentage, but to your point, we've been below now for the first two quarters. We probably also for the full year coming in a little bit short. What you did see last year is that we in the last quarter had a number of investments.
I think my point in mentioning that and referring to that is it depends a little bit on the timing of certain investments we're doing, both in relation to launch, but also in relation to some of our manufacturing equipment. Our target remains the same. Our focus is very much one of ensuring we invest enough in innovation in R&D and ensuring we continue to invest in our manufacturing footprint and production optimization and efficiency. There might be swings temporarily, but generally speaking, we still want to continue to invest above normal levels because we believe that's important to support the future growth.
Perfect. Thanks. That's perfectly clear.
Thank you.
Ladies and gentlemen, this was our last question.
Thank you. I would wish everyone a good rest of day and thank all of you for participating in today's call and also for good questions.
I will, before I leave you, just mention one final thing, and that is that we do have our capital market event coming up October 1st that will happen at our premise here in Copenhagen. We hope to see many of you. This is where we will talk a little about some of our focus areas and priorities when we look ahead. Thank you for listening today and have a good day.