Hello everybody, thanks for joining us here today at the ABG Investor Days. My name is Morten Larsen, I'm an equity analyst here with ABG in Copenhagen, and with us today, very honored to have Embla Medical, the former Össur Icelandic Prosthetics Company. And with us today, we have Klaus Sindahl, the head of IR, and many of you also know him from his former work at Hansa. But Klaus, why don't you take it away and talk us into Embla and where we are?
Thank you so much, Morten. If we can please have the next slide, please. So I'll start introducing Embla Medical for those who may not be too familiar with the story. So we are a global leader in innovative mobility solutions addressing patients with mobility challenges. So we are based out of Iceland, as Morten stated, but we are listed in Copenhagen since 2009 and with global presence in the broader orthopedic space. Today we operate in 36 markets, mainly in the mature Western markets where reimbursement infrastructure has been established. Also, innovation is very key to us, so we launch new products every year and invest around 5% of our sales into R&D and innovation. This year we expect to invest around $40 million. Over the years, we have demonstrated a solid track record of profitable growth with a 17% CAGR since our listing in '09.
Growth has been generated through a healthy combination of organic growth and also through acquisitions. Please turn to the next slide, please. We operate across three business segments, which are illustrated on these slides, which all address the need for patients with mobility challenges. Our legacy business is prosthetics, which makes up roughly half of our revenue today. We develop and produce all components going into prosthetic devices, and prosthetic devices are typically divided into two categories. You have the more simple mechanical solutions, which serve basic needs for an amputee and make up the majority of our business. Then you have the more advanced bionic solutions, which make up 20%-25% of our prosthetic business, but it's growing very strongly these years as reimbursement advances, and you also can justify health economic benefits from bionics, and I'll get back to that.
Bionics are typically digital dynamic solutions with, through sensors, algorithms, and machine learning, help patients to increase their mobility, reduce the risk of falling and hospitalization, and all improve quality of life. This has most recently been validated through U.S. Medicare, who will now allow for less mobile patients to get access to bionic devices. This is very good news. We also have acquired a new business area, the FIOR & GENTZ neuro orthotics area, which is a very exciting area within chronic mobility. This is also what we call neuro orthotics, and these neuro orthotics are sort of shells you build outside of the leg with a bionic component, helping patients with neurological disorder to improve mobility. Often the case is that these patients end up in a wheelchair or with canes or crutches, but these actually are another opportunity for them to regain mobility.
These are typically patients who have been suffering from stroke or multiple sclerosis and a number of other neurological disorders. So this is a very exciting area, which we'll get back to in a moment. Bracing and support is our second segment, which makes up a little less than 20%. Bracing and support covers a range of products meeting more acute need for stabilization following a fracture injury or after surgery. Most of us are probably familiar with these boots or neck collars you get after a skiing accident, and this is sort of meeting a very acute need and not used much more than a few weeks or months. Then finally, we have our clinics business, which makes up a third of our business today.
This is a business we have acquired over 10 years and where we have, through vertical integration, built up a portfolio of 200 clinics in 10 markets. This is a general trend of our industry that consolidation is happening where you vertically integrate into the clinic space. This is to better access patients and also serve them, understand their needs, and develop new innovation. Can I have the next slide, please? If we look at the different markets we operate in, you have the prosthetic market, which makes up $1.5 billion-$1.7 billion. This is a space where you have two leading candidates. You have Ottobock and Embla Medical, who controls more than 60% of the market today. We are known as being the innovators in the space, and then you have a tail of four to five players controlling 3%-5%.
This is a market which grows roughly 4%-6% and especially driven by the functional uptrade as more patients will benefit from bionic devices. And then you have the bracing and support market, which from a value point of view is twice as big as prosthetics, but with completely different dynamics. It's much more fragmented with a lot of smaller players and lower growth and profits in general. Embla has roughly a 5%-7% market share in this space, and we have throughout the years pruned our business and divested a few entities to be much more profitable. Today, the bracing and support business makes up one fifth versus one third a few years back. A more active population and consequently more injuries is driving growth in this segment.
Then finally, we have our patient care business, which, as I mentioned before, is undergoing a consolidation this year, similar to what we have seen in the hearing aid industry. So we have acquired 200 clinics over 10 years, and today we hold roughly 3% of the market. Can I have the next slide, please? This picture is rather fundamental to understand in terms of Embla and the industry's growth right now these years in prosthetics. So what you see from this picture is that value-added innovation is critical to our industry. So what has been the standard of care up until 10, 15 years ago are these simple solutions, a wooden leg or mechanical leg, but over the last 10, 15 years, you have seen a gradual trade-off and use of more advanced technical solutions which have emerged.
These solutions are built on sensors, machine learning, and AI, as I mentioned before, and will allow patients to be much more mobile versus the standard of care in most of the emerging markets today. This is an ongoing growth trend and growth paradigm for us to see more patients fitted with bionic devices, as this leads to improved quality of life and reduced hospitalizations and fall accidents, as I mentioned in the beginning. Also, from a price point of view, there is quite a difference between the more simple solutions versus the solutions today. Sometimes you see up to a factor of five to 10. So the more simple devices will probably be sold at around $2,000-$4,000 versus a reimbursed knee would go for $30,000. Can I have the next slide, please? Geographical expansion is also a major theme for Embla Medical.
As I mentioned earlier, the majority of our business today is in the more mature Western markets where we see good infrastructure and reimbursement, but there's still plenty of growth for us to go for in the emerging markets as we see increasing awareness and willingness to pay for good solutions. So what we're trying to illustrate here is that 90% of our business today is in the Western markets covering around 5 million amputees, but 10% of our sales is in the emerging markets, which represents roughly 25 million amputees or 80% of all amputees. So there's plenty of growth to go for if we can get into these markets, and we have a strategy to do so. I mean, we are looking at how we can increase awareness.
There's also private pay opportunities as well as we need to establish some kind of mobile clinics to address some of these markets in remote locations. Can I have the next slide, please? As I mentioned initially, the U.S. Medicare has launched a new expansion reform covering K2 or less mobile patients, which is probably the most significant change to reimbursement seen over the last two decades. And this is a significant change which comes on the back of many research studies who have demonstrated that MPKs, or microprocessor-controlled knees, so-called bionics, provide significant benefits for less mobile patients. So this is a huge validation of the area, and we'll cover on the next slide the addressable market, but this is great news for these patients as it's now accepted by the insurers that less mobile patients will benefit from more advanced technologies such as the bionics.
Also, it's worth to mention that it's not only the bionic knees which is in scope for this, it's also complementary foot solutions which fit to that leg. So there is actually a double-up opportunity in terms of the bionic solutions. Can I have the next slide, please? As we try to depict here on this slide, patients are categorized into four different groups relative to their mobility level. So if you look at the far right-hand side, you see that K3 and K4 patients are considered the more active, and these patients are today eligible for bionic devices. These patients are often younger, they keep in good shape and can walk unlimited, and often be athletes or even kids. These are the categories we have served in the past with the bionics making up 20%-25% of our prosthetic sales.
K2 patients, which is also depicted here, are normally characterized by being seniors, limited community walkers. They can walk outside their home, maybe for stairs and curbs, but it's still challenging for them to, for example, walk and talk at the same time. Lastly, you have the K1 patient populations who are very limited in their mobility today, and often they are staying at home, sitting in a wheelchair, and these patients tend to be patients who got amputated due to cardiovascular diseases and will not be in scope for bionics. So if you try to quantify this option, you can look at the number of claims processed by U.S. Medicare today. So it's roughly similar in terms of number of claims between the K2 and the K3, but looking at the value of these claims, 90% of the value goes to K3.
So going a step back, it's a significant expansion opportunity to allow K2 patients now to access bionic devices. We're not saying that all patients will be fitted with bionic devices. They still need to undergo an individual assessment to qualify over the alternative, but this is a great opportunity for these patients. It's, however, also something which needs to fit into the replacement cycle. So this is something which we see contribute to growth over the next three to five years. It's not going to be a catch-up effect. We'll have to see how the pace and the optic will happen over the next few quarters, but we are very, very pleased to see this decision being carried out. Can I have the next slide, please? As also mentioned in the beginning, we have entered into a new space within chronic mobility, so-called neuro orthotics, through the acquisition of FIOR & GENTZ.
So GENTZ develops and manufactures bionic orthopedic devices for chronic patients who, due to stroke, multiple sclerosis, have seen their limbs being paralyzed. These patients could, in principle, regain their mobility through using technical orthosis instead of a wheelchair. Technical orthosis goes outside of the leg and helps the patients on the knees and the ankles through these bionic joints. This is a large untapped market for us, and where we see the same kind of trends with potential for repeat business. Today, the business is mainly German-based, so 70% of the sales of last year, 23 million, were out of Germany. There's huge potential to expand this through Össur Embla's commercial infrastructure. Also, if you look at the customer split, this is very attractive with repeat business and ongoing sales. I think I've covered this slide, yeah.
Let's go to the last slide for a wrap-up of the quarter. The key highlights for the third quarter demonstrated continuous good growth. We had 7% organic growth for the quarter and 11% in local currency, and we had an EBITDA margin showing 22%. We have maintained our guidance for the full year with 6%-8% organic growth guidance, and then on the profitability, we have guided for around 20% as we expect some additional costs in the fourth quarter, but in general, we are in good shape for the year. On the operations, we have seen R&D progress in the third quarter, so continued progress with our newly launched products. We had two bionic devices, two bionic knees launched in the summer, Navi and Icon, which are in limited launch still, but we expect full launch in the beginning of 2025.
Also, we had a new generation of our Naked Prosthetics portfolio launched in the third quarter. The FIOR & GENTZ integration is also moving according to plan and our business plan, so with double-digit growth and profits around 30% EBITDA. And then finally, we had our ForMotion brand rolled out. So this is to unify our patient care network of clinics, and we have actually started to do this in Denmark also now. So we will take them country by country, but it's the intention to get more lean, more operationally aligned across the network of clinics we have. So with that, I'll hand back to Morten to lead the Q&A.
Thanks very much, Klaus. Before diving into, thanks for joining today and giving this presentation. Something stands out to me. If I look at how Embla has developed over time and take a bigger picture view on this, I mean, you have always shown solid organic growth with fairly stable long-term margins over time in the last five, seven years. But as I look at what you're doing now, you seem to be, your quiet FIOR & GENTZ has a higher growth outlook. You have a greater mix of your business in higher growth components, prosthetics, over braces and support, braces becoming a smaller and smaller part of it. You also seem to be able to move some of the margin drivers in a more positive trajectory. How should we think about the longer-term trajectory here in both the growth and the margin outlook for the next mid to longer term for how Embla is looking on this?
Yeah, absolutely. If we start on the growth perspective, I mean, we have a long-term growth ambition or strategy, right, with the Growth 2027 strategy, where we have guided or said that we will grow the business organically by 5%-7%. And then on top, we should see growth to the tune of 2%-3% from acquisitions, right? Acquiring FIOR & GENTZ, I mean, is spot on to that strategy within chronic mobility. So, I mean, that's part of that, right? And then the U.S. Medicare, of course, we need to see a few quarters play out, but in general, this is very, very good news for patients that less mobile patients will be liable for an uptrade here for the bionic devices. Growth looks promising going forward.
We have, however, also now close to the end of the year where we have seen growth being a bit sluggish in the U.S. market, right, compared to the year where we have actually had very, very strong growth, about 13% for the first nine months or for the last quarter, right? So you'll probably see a much more balanced kind of growth going forward, right? I mean, I'm not sure we can keep up with the strong growth we have seen in EMEA going forward. So we will probably be reduced a bit, and then opposite, you should probably see U.S. trade up a bit following the U.S. Medicare reform. When it comes to margins, I mean, we have not provided any long-term guidance for this year.
We have set around 20% EBITDA, but as part of our strategy, we have said that we wanted to improve the margins year- over- year, and this is also what we are executing on. I mean, in the last two quarters, we have improved our EBITDA by three percentage points, which is rather significant, right? We have implemented a number of initiatives. I mean, on the manufacturing side, we have looked at the capacity. We have laid off 100 people, but also we have had a number of measures implemented on the general G&A. But there's plenty of opportunities to go for still. It's a rather conservative, a rather old industry when it comes to the clinic space also. I mean, the way you produce these prosthetics, you still use plasters.
I mean, also you would envision that the handling of patients, I mean, the clinicians are spending way too much time on processing and handling data. I mean, you could probably envision that AI will help a lot on that side. So this is a space which is on the brink of a transformation. So we see good potential. And then on the operational side, I mean, there's probably also much opportunity to optimize our manufacturing footprint.
Excellent. I just want to push a little on the growth, especially in the U.S., because this Medicare opportunity, as you point out in your slides earlier, it's a $100 million market right now in Medicare and Medicare Advantage, but it seems like you're basically looking set to double this market over some years, as it appears. Shouldn't this by itself, and this is against a company that you did little less than $800 million for the group last year. It seems like it should be able to drive a few percentage points of extra growth for the market.
Yeah, I mean, we're not executing that, but I mean, let's see. I mean, this needs to fit into that replacement side, right? So it has to take a few years. I mean, there's also limited capacity at the clinics with the CPOs taking the patients in, etc. I mean, it's not, as I said, it's not a catch-up effect, but it's something which will provide some tailwind for the business over the next three-to-five years, right? It may actually double the business, but we don't know yet.
We probably need to see the effects over a few quarters before we have an informed opinion around where this is going to go, right? It's not all K2 patients will qualify. I mean, it's only when you can justify it from a functional perspective where these patients are better off using Bionics versus the alternative, right? And remember, I mean, this is a gray area. I mean, there are still some K2 patients who are probably not better off with a bionic device, but it's our view that the majority will be better off and benefit from Bionics, and this is very, very positive for the industry, for Embla, and for the patients, not least.
Excellent. Two minutes left, and we also should talk about sort of one of the weak spots that may happen into 2025. We all talk about the Trump tariffs, and you have a Mexican production plant. Can you talk about how you see this playing out into 2025?
Yeah, I will. It's very interesting.
If you can't say anything, what happened here? Yeah.
I mean, assess this impact, right? I mean, it's correct that, I mean, we get some of our production or devices produced out of Mexico. We have components sourced out of China, and we have our Bionics production and some of the mechanical prosthetic devices done in Iceland, right? But in general, I mean, if you look eight years back when he used the same kind of rhetoric, I mean, medical devices were in general exempted, especially prosthetics. I mean, today, the U.S. is not producing advanced prosthetic devices themselves.
So this would put the patients, the reimbursement system under pressure if he really executed on these tariffs, which is not sustainable, right, for the U.S. So let's wait and see, right? But in general, when we talk Mexico, it's mainly our bracing and support business where we manufacture these devices. And then when it comes to Iceland, it's the prosthetic devices, right, including the Bionics. So let's see, I mean, where it all ends.
Excellent. We are unfortunately out of time, Klaus, out of time, Klaus. But thank you very much for joining us here today. It's been a pleasure and good to catch up on the case. And if there's any questions, reach out to Klaus, to me, and we'll sort you out. Klaus, thanks. And thanks for your interest. Good. Thank you.