Good afternoon, everybody. Welcome for about 30 people in front of me. For the one online, we have 30 people here in the beautiful Beam Factory. For the one, together with us, we have about 30 people online. It is going to be a bit of navigation between both. Welcome to IBA Capital Market Day. As I said, in the beautiful Beam Factory, as you can see, it is full, full of cyclotron for proton therapy. All of them, or almost all of them, are due to be shipped in Spain, starting late 2025. We speak a lot about backlog conversion. Unfortunately, we have a bit of a noise of a backlog conversion for the presentation, but I kind of like it because, as you know, it helps with our financials. Together with me today, I have the pleasure to have my dear co-CEO, Henri. Hello, Henri.
Hello, everyone. It's a pleasure to have you.
This Capital Market Day has been prepared with many people, but a special thanks to Thomas Pevenage, our new investor relation. Thomas will join us on the stage a bit later, so you'll get the opportunity to meet with him. I'd like to start with the end. I would like you to leave this Beam Factory with three main takeaways. The first one is we have a very strong competitive positioning in growing markets. The second one is we have a governance and a team which is fit for purpose. And fit for purpose, in my mind, means accountable, engaged, and best in class. The third takeaway, in my mind, is we have a very clear path to meet our guidance. This is what we are going to talk about over the next two hours.
For the first 25 minutes, Henri and I will walk you through our purpose, our vision, our strategy in a kind of elevator pitch. We'll then dig into the different business units, together with the people in charge of the business unit for an hour and a half. Don't worry, we'll take a 15-minute break in the middle so we can have a drink. We'll finalize with about half an hour where the team will dig into the financials and the outlook of the company for the next years to come. Of course, at the end of the presentation, we'll have time for Q&A. For the one in the room, you will get a mic. For the one on the webcast, don't hesitate to ask your question on the chat box of the Teams.
Without further ado, let's jump into the purpose, the vision, and the strategy of IBA. We wanted to start with the picture of where we stand today. As you know, IBA will celebrate a 40-year anniversary next year in March. We have shown over the years resilience, robustness, capacity, a very good track record in achieving a lot of value creation for our customers, our investors, and, in general, for our teammates. We are about 2,100 + around the world. Half of them are actually here in Louvain-la-Neuve. The other half are around the world. We'll come to the different jurisdictions in a minute. We are about innovation, so we have a lot of patents. We invest a lot in R&D. It will be commented during the presentation as well.
It gives us a competitive edge, but we're also very well protected with more than 500 patents on our application. If we look at proton therapy, we have treated more than 150,000 patients, which is a great pride for us. We have 44 proton therapy centers around the world treating patients day in, day out. It will double over the next years. We'll come to that as well during the presentation. If we de-zoom a bit and look at the overall IBA business, we have almost 700 or 700 + accelerators installed all over the world. As you have seen in our financial 2024, we were very close to reach the EUR 500 million mark, half a billion, as we would say if we were in America.
Importantly as well, EUR 160 million about our recurring revenue, service revenue, and it will be a bit the spinal cord of where we're going as a company, much less volatile, going forward as we can count on this very recurring business. We have a fairly good visibility on where we're going. As you know, we have EUR 1.5 billion backlog, and we have achieved 33% gross margin, which will improve over the next few years. We'll explain to you how. If I move to the different businesses or business line of IBA, we have reorganized the group recently around two entities, as we call it, IBA Technologies, basically delivering accelerators to different applications, to industrial applications. We'll talk to that in detail in a few minutes. Radiopharma Solutions and IBA Clinical, being proton therapy and dosimetry. We have also a strategy. We call it, low capital or low capital investment.
Capital Light.
Capital Light investments into what we believe are the market of the future for us, which we enable through our application. We'll talk to that, as well today. You know about Pantera, but Christophe Malice, one of the Pantera members, is with us today and will give us more insight on Pantera. MI2, a new application for us in the semiconductor, for EVs. We'll talk about that as well, as well as Normandie Hadron Therapy, our initiative in France for heavier ions than proton therapy, in the field of radiation therapy. We have a lot of key innovations going on. We have a lot of initiatives that will support our existing business, but potentially transform them as well. I will not go through it. We will go through it in the different presentation. Maybe one thing I'd like to highlight, we're a very innovation-driven company.
More than 500 of our employees are in research and development, and almost 80% of our staff is, you know, has been trained as scientists in science, technology, computer technology, or mathematical background, which is our firepower as a company. This is our footprint. We are here in Louvain-la-Neuve, which is our group headquarters, as well as one of our R&D powerhouses. We have a dosimetry in Schwarzenberg in Germany, and we have a very strong presence in the U.S. and in China. If we look at our business, we're pretty well balanced. About 1/3 of our activity is in Americas. 1/3 of our activities are in EMEA, and about 1/3 of our activities are in APAC. We're heavy, located, let's say, in terms of employees in Europe, but we are developing as well in Americas and in Asia.
We have a fairly balanced presence in proton therapy as well if you look at the number of sites per continent. Once again, we'll come back to that later and give you some flavor on the development that we are going to actually witness over the next few years. Henri?
As the relatively new joiner, I can, for sure, comment on the purpose, which is not a gimmick at IBA. Actually, IBA was a pioneer in business as a force for good. It's a business as a force for good native company. There are really three elements that stand out. For me, the first element is the mission: protect and end sensitive life. It's amazing to see a company where you can say that more of that business in the world is good for the world and not the contrary. That is, without question. Another element that clearly stands out for IBA in the way we work is we do it with the people, for the people. It's really a human at the center type of company.
The third element that I find matters is the commitment to adopt smarter standards and inspire others to do so. It's notably encompassed in our B Corp certification.
If we look at our vision, actually, if IBA has a superpower, it is to take applied physics and transform it into a medical accelerator. You have many of them here in the assembly hall to serve unmet needs around the world and solve humanity's deepest challenges: cancer, oncology in general, cardiology, neurology, but also some industrial challenges such as medical device sterilization. We do it with our Rhodotron in a much safer and, let's say, cleaner way. We have also potential applications in the space of environment. We'll talk about that as well. Some other industrial applications such as improving polymer durability. We do it as a company, but we do it also in sync with an innovation ecosystem made of customers. I think we don't shed enough light on what our customers are doing together with us.
but we do it together with partners or fully owned by ourselves. Once again, to accelerate innovation and implementation of our solution. We are also very focused on strong execution so we can do it while developing the company in a profitable manner. If we look at our different strategic market focus, Henri, can you drive us through IBA Technologies?
We believe that it was important for you to understand where we wanted to focus. Strategy is deciding where you want to compete. Of course, as we expand, we see three possible moves. One is further penetration of existing core markets, mostly equipment. The second one is making sure we cover the high potential geographies. And very importantly for us, the third one is expanding along the value chain, moving beyond equipment, but entering tactically into new applications. If I sum up a bit what this means for technologies, and if I start with industrial, and we'll talk more about it with Thomas later today, definitely we need to win the technology competition for accelerator-based sterilization. That's one key element. China is going to be a key component of our strategy going forward for sterilization.
We are exploring how we can tactically move into service to clients and end user, a bit inspired by what other businesses are doing at IBA. We have selected, we will talk more about it, three new applications among a portfolio of 30, which are polymers, phytosanitary, which means food, and PFAS, the forever chemicals. These are really the three we are going to talk about today as part of our core strategic focus. For Radiopharma solutions, we have talked about it in the past. There are some white spaces in terms of application, neurology, cardiology, that we can continue to investigate to further expand in diagnostic. We can for sure tap into the different market dynamics in the U.S., in China, in lower-income markets. We have certain nice opportunities in Africa.
and then as we want to expand in the value chain, two elements, the theranostics, we'll talk about today, in an extensive way, and then chemistry, radiochemistry, where there is more that can be done in equipment and consumable.
If we look at proton therapy, we believe we are entering into a new era for the adoption of proton therapy, and we will explain to you why. We believe the clinical evidence of proton therapy is becoming more clear, and we will explain to you why we believe so and how we plan to leverage on it. It means also that we will continue to innovate into the product to continue to make it more clinical, clinically relevant. Proton therapy, I very often hear proton therapy is expensive. Proton therapy is not expensive. It is cost-effective. We will show you why we believe it's the right time to push. From a geographical standpoint, as I showed, we are pretty well balanced, but Asia is very dynamic, especially China. We will talk about that as well.
Our technology, we can leverage our technology in other similar applications such as heavy ion. I already mentioned, Normandie Hadron Therapy as a way for us in a capital light manner to actually leverage our technology to create value together with partners. If we look at dosimetry, we believe that the product portfolio is the right one. We have done a few acquisitions over the last 24 months. Jean-Marc will explain to us how it does position us to play a bigger role in the space, and especially in the U.S., where we have, you know, initiatives to regain leadership, in the near future. In terms of extending along the value chain, we believe there's a bigger role to play, especially with a new technology now, AI-driven, kind of, technology here as well, potentially through acquisition, and/or, partnership. If we move to our financial target.
Yeah, and we all know that you are expecting us to improve our profitability. We will talk about profitability quite a lot today, but I just wanted to anchor the key concept a bit as an introduction. We have for ourselves set a robust and balanced target of around 10% EBIT margin. That is composed by being close to 40% gross margin and operate at a below 30% OPEX. We have a clear path towards that, and we will explain to you the different levers, and I will give you a few details on the next page. Before we move to next, I want to highlight as well that below EBIT dynamic will be important for us in the coming years as we are going to account for the progress and the movements on the new ventures on the below EBIT.
I would follow that carefully. Of course, I wanted to highlight as well that, contrary sometimes to what is being perceived, we are extremely cash efficient, and we have a cash-generating model, which we will again explain in more details later. Nearing 40% gross margin, below 30% OPEX, around 10% EBIT is our red thread, is our core focus as a management team.
Exactly. Maybe just as, again, an introduction for what will be discussed later, we have, of course, several levers in our toolbox that we can deploy or that we will deploy to be able to get there, taking into account as well evolving market circumstances, starting with gross margin. On the equipment side, of course, as we convert backlog post-Ortega, you can expect that there will be a gross margin proton therapy equipment normalization. We as well, and Emmanuel will talk about it later today, work continuously on our direct cost optimization in our operation, tight installation project management, continuous improvement in the way we assemble and work with our machines, continued effort on sourcing, and further leverage of our indirect cost base as we continue to grow.
On the service side, and Isabelle will tell you more, but as we grow our install base significantly in the coming years, moving from 44 to up to 70, we will have the opportunity to optimize staff, inventory allocation. We will have the opportunity to deploy digital tools for, for instance, remote maintenance, and we will gain operating leverage on our service base. All those elements will help us support significant gross margin improvement in the coming years. We've talked about OPEX as well. We said below 30%. We always try to strike a balance between doing the right things, but at the same time keeping cost under control. We have selected investments in sales and marketing that we are able to pace. We see it as trigger-based depending on how markets are evolving. We can pace ourselves with regards to those spending.
Of course, in G&A, as you should expect, we will continue to work on productivity. Careful workforce planning, demand management, strategic sourcing are the things we are continuing to reinforce. In R&D, we'll show you what are the specific projects, but we believe there are a few things in which we need to spend. Of course, each time we balance the overall cost of the R&D investment versus the opportunity at hand. This is something we can regulate, modulate as time goes by. You see that we have our motto 40, 30, 10, and we have, we believe, the right toolbox to get there soon. In terms of what makes us confident that we are going to be able to deliver, I wanted to highlight a few elements. The first one is that we have a strong organization.
You know, we have worked on that last year. The segment reporting, the PNNs, and the management team now perfectly aligned. That is creating very strong sense of ownership and accountability. We are working. Some people ask the question, how do you track your leaders and your talents? All leaders are incentivized on profit before tax as targeted, on order intake, on B Corp score evolution. All leaders, top 70, are followed on a yearly basis on their development and their performance. That is for the strong organization side. Olivier will talk in a second about the fact that most of our leaders are shareholders of the company as well. We intend to make employees shareholders as well soon. We have an engaged team, I must say, coming from outside. I was really surprised by the level of engagement. I know some investors are following that closely.
We have 77% of our employees considered as engaged, only 6% disengaged, which is to my standards, extremely high. You feel it when you work at IBA. We have a very low attrition rate, and most of the attrition is rather caused by us than people leaving because they are not happy. Olivier will comment in a second on entrepreneurship and governance, but from the execution angle, I want to remind everyone that as management, we have skin in the game, true management encourage and sustainable encourage. At the same time, we have a best practice governance for listed companies that protects well the minority interest. We have a best-in-class board that is challenging management on a very regular basis. We are well followed and well supervised.
We like to say, Olivier likes to say and repeat that sustainability is not just to look nice or have nice posters in the kitchen. It's as well something that pushes us to be more performing. It creates huge standards for the use of energy, use of material, negotiation with suppliers. All those elements of sustainability are as well an element that pushes us in terms of performance and delivery.
Exactly. In my mind, sustainability brings four things: better product, cost reduction, capability to attract the right talent, and risk management. If we zoom into entrepreneurship and governance, indeed, I think there's a few things I'd like to highlight here to support what Henri just said. One is indeed it's part of who we want to be as IBA is to have a referring shareholder to align the entrepreneurship spirit that we want to, to, fire in the belly of our management with shareholders anchoring long-lasting value creation into the company. That's why we have sustainable anchorage with 20% of the shares and 30% of the voting right. It allows, as Henri has already highlighted, to have a full alignment between shareholder and management as management has significant skin in the game and are fully aligned with long-term value creation such as, our, shareholder.
On the other side of the equation, we also want to have the best-in-class governance. This is why we have a very diverse Board. As you can see here, you have the details of it. We have actually more independent directors than what we are, you know, suggested or as the law is suggesting we are doing. We have six independent Board members with a lot of track record bringing two things. One is the supervision power, challenging the management to achieve the best possible result and expertise to help us and guide us into a strategic exercise. I think you know the name, Christine Dubus. She's bringing a lot of experience in the financial sector, and she's chairing our audit committee. Edvik Rischak brings a lot of knowledge from the clinical experience. She's working as a chair, radiology chair in MSK in New York.
Richard Hofmann has a long-lasting experience in radiation therapy. He has been a CEO of Elekta. Marcel Miller brings a lot of industrial experience coming from Alstom Benelux. Sibyl Vandenborre gives a sustainability angle to everything we do. Muriel Dolatower is a very experienced Board member in a different industry around the world. Yeah. Moving on to the new organization. Before I jump into the details, I have an announcement to make. It is good that you came. You will leave with some news. We have just hired our new CFO, our new group CFO. Catherine Vandenborre brings a lot of experience. She has been CFO, group CFO for ELIA for about 15 years, I believe.
She's a very experienced Group CFO, and she will help to go from where we are now, EUR 500 million to, you know, she has the experience of a much bigger organization. She will help us to continue to grow in a profitable manner. If we look at the way we are organized, I have already highlighted that we have regrouped our business unit in two entities, IBA Technology and IBA Clinical. Catherine will actually lead what we call IBA Corporate. Of course, the Group CFO, you know, usual responsibilities, but she will also challenge, support the business to grow, taking care of the capital allocation and also dealing with a new venture and the Discolor Very Lab we have launched a few months ago.
The group is managed by four people: myself as a group CEO, Henri as deputy CEO, the CFO, and the founder. I said five, but it's actually, also part of, the management team, let's say at the group level. We have also Christian Matton, our Chief Legal Officer.
Yes.
Sometimes we have the question why two CEOs is not very clear. You know, over the years, because of the growth and because of the potential, I became a bit of a bottleneck. While I need to focus on IBA Clinical, it's very important that we continue to develop IBA technologies. That's why I have the pleasure to share the duty of being the CEO or the co-CEO of this company with Henri for about a year and a half now, or almost a year and a half. Moving on, before we look at the future, I just wanted to have a quick look back at our journey over the last 10 years. Basically, I would split the last 10 years in three chapters.
Chapter one was 2014, even 2013 to 2016, where we had a fantastic journey, driven by the potential and the growth in proton therapy. We were right on track delivering growth, delivering results. Unfortunately, one big player decided to play, and to adopt, let's say, an irrational behavior. That is why we have seen that the second chapter of the history, let's say from 2017 to 2021, has been a bit more hectic. We can see that suddenly the proton equipment revenue part of IBA became very volatile with lower margin. We did three things during this period. One, we have managed the cost very smartly, I believe. We were not losing money. We were not making a lot of money, but we were not losing money while our competitor was losing a lot of money. We have smartly played the price war.
We did not lose too much market share. We were able to develop what will become a very significant install base to build the future of a profitable business. The third thing we did was to actually focus on the IBA technology part of the business so we could grow the business faster than the challenge we had in proton therapy. This is how we are fit for purpose and fit for growth as we are entering this new era, which has started in my mind in 2022 when the irrational competitor decided to exit the market, leaving the space available for us where we are now very competitive. We are gaining market share in proton therapy. We will come back to that with a very competitive product at a time where the market has become more rational and when there is some potential to grow. We can count on top of that on a very significant business on the IBA technology side.
Yep.
This is why we're going to talk today about the from two. It's a new era, a new inflection point where we will go from double-digit revenue growth to low single-digit revenue growth, but on a much higher basis, from a margin erosion led by aggressive competitive forces, pandemic and supply chain crisis driving to a low-digit rebate margin to margin improvement nearing, as Henri has already showed to you, to 10% rebate margin. From scaling in mature fully owned business to completing this nice portfolio of fully owned business with high growth opportunities in new venture, from proton therapy-centric organization to a more balanced portfolio diversified, activities from a low uncertainty as a margin from adjustment to a higher uncertainty considered in the prospect and the guidance.
Today you really have to look at IBA from an investment case standpoint, based on, I would say, two things. You buy a robust base with a strong upside. The robust base is based on two pillars, mature, profitable, and cash-generating IBA technologies businesses and scaling and profitable proton therapy services. While the upside is based on three pillars, the proton therapy equipment activities, which will improve and potentially grow again, a capital-light investment strategy allowing IBA to create value through partnership like we did with Pantera based on our technology advantages. Last but not least, a fantastic platform of technology which can be leveraged in a different market going forward. Ladies and gentlemen, this is what we are going to talk about for the next hour and a half.
I would like now to move to the next section, which is about going deeper into our different businesses. I would like to invite, or you do it maybe.
I can invite, so Thomas and Jeremy, we are going to deep dive into technologies, cover industrial solutions as well as Radiopharma. A lot of you ask questions about market dynamics, competitive dynamics, how we are going to win. This is the moment. This is the moment for those who were curious about those deeper business dynamics. Welcome, Tom.
Hello, Thomas. Hello, Jeremy.
Hello, everybody.
Hello.
My name is Thomas Servais. It's 17 years now that I'm with IBA, and I'm the President of IBA Industrial Solutions, which means I represent about a bit more than EUR 100 million revenues by now. If we talk about industrial solutions, we for the moment talk about basically four different markets. I will talk about the first one, which is our core market, our intrinsic market, which is the medical device sterilization. You see that we have three additional markets that Jeremy will cover later on in the presentation, which we have chosen amongst many different applications we could have targeted, thanks to e-beam usage and the capacity of e-beam. It's true that all the markets we address, we basically address them based on our competitive advantage.
We are the only one to provide an electron accelerator, which is so much powerful, and it's very useful in many applications. The only one which is so clean, so scalable, so sustainable. We combine our efforts with the rest of IBA in our understanding of how the beam interacts with matter. You see how we can fine-tune applications of Orbeam. This is Ion Beam Applications. Coming back to the market, the core market of IBA Industrial, which is the medical device sterilization, you see that we address an underlying market of about EUR 5 billion. The market of the people using our equipment is about EUR 5 billion, which is significant growth. This is a steady and kind of predictable market because it's directly linked to the number of medical, you know, prescriptions that are used in the world and that are increasing by this level, basically.
We have a very good fit between our catalog and the market needs that is demonstrated, let's say, daily. On the other markets that Jeremy will cover, I will just say that, okay, we re-enter the market of the polymer. We were there in the past, more and more commodities, wire and cable industry. Now we re-enter on more advanced applications. Jeremy will explain. On the food irradiation, we see more and more that to allow the food to be, let's say, shipped everywhere in the world and to address the needs of the different consumers, you need to address some technological barrier like the phytosanitary and the shelf life. You will see that our technology addresses that with a good potential. Last but not least, environmental applications are numerous and more and more we see the benefit of Ion Beam.
We selected today one main application we should target for, which is the PFAS remediation. Those three other applications are also on the north of $1 billion in terms of underlying market. Now we'll focus more on the medical device sterilization. When we talk about medical device sterilization, basically we talk about two types of players. You have the in-house players, the big names you see there, J&J, Abbott. Okay. They sterilize their product themselves and/or they subcontract it to sterilization contract providers. Okay. You see the names there also. All those people, they use four different technologies to sterilize the product. Three are irradiation-based. You use electron beam, then you can treat single product or boxes. You use X-ray beams, then you can treat entire pallets of product, sterilize entire pallets of product. Those are the two technologies that IBA master.
You can use gamma irradiation, which is basically to use a radioisotope and you pass the product in front of this radioisotope and you sterilize thanks to the irradiation. You have a gas-based alternative, which is the ethylene oxide usage. Basically, you put all the product in a big chamber, you absorb this gas, it kills the microorganism, and then it dissolves and you can reuse the product. It is a batch production taking a long time. Thanks to those technologies, you address more than 1,000 different products, which are single-use, disposables, implants, but also pharmaceuticals. The drugs are treated like that. Even the manufacturing process lines, the bioprocessors have to be sterilized, and we can use our technologies to do so.
Accelerator, the activities we are on this market and we provide are designing, installing, and maintaining particle accelerators that we integrate into a system using interface in terms of software conveying system. A full solution to sterilize. Of course, we, after, we maintain that product, that product, sorry, and that installation up and running the best we can. We have a lot of development on that. Still on the market, you see here the composition of the market. Again, you see the three technologies, ETO, gamma, X-ray. You see that there is a difference in between developed countries and emerging countries where you have China and where you see that ETO, gas-based technology, is prevalent.
What we do here and what we can share with you is that ETO will lose market share because they really face huge concerns in terms of health and safety. Gamma irradiation will also decrease because they really have some problem in terms of supply chain. They are not able to follow the market demand because this radioisotope is basically a byproduct of a few of the nuclear power plants you have in the world. All the transition from ETO and gamma towards E-Beam and X-ray machine-driven technologies, we are there to support it and to facilitate that.
When you look at the breakdown of the future volume being traded in sterilization of medical devices, you can see that from the 10% we address today, the green part of the left bar, we will have an addressable market after some efforts, of course, of about 30%. Being the market leader by far in this segment, we expect to grow significantly from the 10% we have today to at minimum 15% in the end of the decade. Doing so, we'll need to pursue a much more proactive marketing. We'll have to reduce the barrier to enter into our technology, which means give objective evidence of the superiority of the performance of our product and also work on the cost efficiency, cost reduction of our systems, basically. Last but not least, unlocking the Chinese potential.
You have seen on the previous slide that China uses a lot of ETO, and so the potential to transfer to machine-driven systems in China is even bigger. That is what you see here. If you look at this graph under sailing condition, basically we will double the application of our system in China within 10 years. Working together with a partner which is able to influence the regulation, unlocking the usage of machine-driven systems instead of ETO, like it is done everywhere else in the world, and developing a specific product together with Chinese to address their market reality, we could expect a much higher multiple in terms of volume being treated with our technology. Last but not least, we have a growing install base. End of this year, we will have about 70 systems up and running using our Rhodotrons. Those systems in the past, we maintained them.
90% of the install base is under IBA contract, but more a kind of case-by-case approach. Today, because we have a growing install base, we have a much more industrialized product and we have a connected product. We develop a digital, you know, platform. We are able to provide proactive upgrades. We are able to provide AI-based predictive maintenance. Basically, we are able to go like they do in proton therapy from a case-by-case kind of, we give you a bit of support and spare part to something which is more an uptime business model on the service where we can get paid on basically the usage of our machine. This is the next step, which is factored into our strategic plan. I give the mic to Jeremy.
Thank you, Thomas. Hi everyone. My name is Jeremy Brison. I'm in charge of innovation in the industrial business unit. As Thomas explained, we have this very strong and robust sterilization market where we are the market leader. My job is to create and streamline the new markets which will grow tomorrow. That is what we do. We have selected specific markets which have a strong growth dynamic and where we have a strong competitive advantage. I will present three of those today. The first one is what we call polymer modification or polymer enhancement. We have all observed that there is an increasing need in the world for more sustainable polymers. It is true for automotive, electrification, construction, medical device, and finally for food packaging. Every day we buy food and we need to have good packaging.
We have demonstrated the last decade that electron beam is one of the most sustainable solutions to modify and improve those plastics. What we have done here that you can see is that we have, with experts in the field, sized the market, and that's what you see there. We have assessed which part of this market is addressable by our technology. You see that 20% of it will be the most used polymers today is the polypropylene, and the second one will be polyethylene and elastomers. Actually, what is great is that what we bring, the value we bring with the electron beam to those polymers is that we make them lighter, more resistant, more mechanically resistant and thermally as well. Finally, we make them greener to manufacture. This is a great value proposal that we have on the polymer market.
What you see on the right side is that we have mapped all the players in the world who are today manufacturing polymers. Two years ago, we sold a machine for cross-linking of ethylene, polyethylene to the number one player in the U.S. Last year, we sold two systems to one of the top players for polypropylene. We really think that this market will be strongly growing in the few years. The second exciting perspective that we have is on, as we said, phytosanitary applications. It is food treatment. As you know, millions of tons of fresh produce are shipped every day. For mangoes, grapes, you see, for example, that 7 million tons of fruits are shipped from South America to the U.S. every year. That means that technically all those products need to be treated.
This is the control that you have at airports when you travel, where you cannot bring banana or meat. All those, this food must be controlled for pest control and also to improve their shelf life extension. What you see in the middle is that the market share of X-ray on that market is growing faster than the market, which is growing a few percent every year. This is because X-ray is becoming proven to be the most efficient way to do this pest control and shelf life extension. Why? Because it's faster, it's cleaner, it's a lot simpler to deploy and to scale, and it's much safer than the use of chemicals like bromide. Okay. What you see on the right is a confirmation of that. We have sold a few years ago a small system in Asia, Vietnam and Taiwan.
Last year, we have sold the biggest and the first largest facility, which will be installed in Mexico to treat most of the mango, which will go to the United States. Again, great potential for this second market. Last but not least, and this is very important, as you can see when you look at the values of IBA and the mission, we have realized last year that our electron beams can be a very efficient way to destroy the PFAS. You have all heard of the PFAS problem, right? It's a major increasing concern for the population, for health, but also for the economy because all the PFAS that is human-made that you can see here in the clothes that we have, the shoes, the pesticides, the consumer goods, all those PFAS are there and they will be there for a very long time.
In the end, they will end up in the waste, in the soil, and in the water that we drink. Okay. The only thing that you can do today to remediate those PFAS is to capture them. You have to filter them with resins or activated carbon, and then you have to manage this carbon. In 2028, there will be a new regulation that makes that the number of the quantity of carbon needed to capture these PFAS will be multiplied by five. The only way you have today to get rid of this PFAS is to incinerate it with a lot of limitation. It's very gas-intensive, which is also a problem for the price. It's a pollution for the atmosphere, and it's also creating a lot of loss in the carbon because technically a big part of the carbon is burnt.
We are introducing with the Discovery Lab this year the electron beam as the most permissible and the most sustainable alternative to incineration. Why? Because as you can see, it's very efficient at destroying PFAS. It can allow, it doesn't destroy at all because it's a cold process, the matrix, so we can reuse the carbon as much as you want. It's very easy to decarbonize because it's fully electric. It's also very scalable. You see that a machine can treat 30,000 tons of carbon. Finally, it has a very long time, a very long lifetime. We strongly believe that this technology will be emerging in the next few years for PFAS remediation. To conclude, we have those four very strongly growing markets at IBA Industrial. We have a strong value proposition with our electron beam accelerator, the Rhodotron, which is very unique.
This is why we are very confident about our plan for the next five years. Thank you very much.
Thank you, Jeremy. Thank you, Thomas. We are going to welcome Emmanuel and Charles.
They did it on time, by the way. Fantastic.
Right on time. Thank you.
Great. Great job.
Hi, guys. Charles and Emmanuel . Welcome.
Thank you. Hello. My name is Charles Kumps. I've been with IBA for eight years now, and I'm currently responsible for our Radiopharma business. What is Radiopharma? Radiopharma, the market that we're talking about, is the market of manufacturing of the tracers that are injected to patients either for imaging or for treatment. Typically, three types of players manufacture those tracers. On one side, we have Radiopharmacies who produce them to sell them to hospitals. Hospitals sometimes do it themselves. Sometimes you also have research institutes who manufacture some tracers for experiments or for drug development. Two technologies are used to manufacture those isotopes. The first one, which is the one in which IBA is active, is accelerator-based isotopes. The other one is using nuclear reactors to be able to manufacture those isotopes as well, either from energy manufacturing or from research reactors.
Currently, there are more than 70 diagnostics and treatment molecules available on the market and that are routinely produced on a daily basis. What we do in there today is manufacture equipment and then have service activities related to the equipment that we manufacture. If we take a deeper look in that broader market that we're active in, there are two things that we need to differentiate. The first part of the market is a mature one. It's the diagnostic radiotracer market. The other one is an emerging one. It's the theranostics market. If we look at the first one, it's approximately EUR 7.5 billion in 2025, and it's expected to grow to EUR 10 billion at approximately 7% per year from now to 2030.
It's mainly driven by an increase in volume, and that volume stems from new tracers being injected, as Henri alluded to before, to new diagnostic tools in neurology, in cardiology. All of that progressively develops into additional tracers or additional doses being produced. Next to that, there is that emerging theranostics market where in 2024, they were just above $2 billion sales. It's expected to be $3 billion this year, to grow to $20 billion by 2030. This is much more of a low volume, very high value type of market in the sense that these tracers treat and not just diagnose. The value chain starts by, the value chain in this industry starts by the formulation or the creation of the drug, the ligand that will be injected.
There is the link in which IBA has been historically active, which is the manufacturing of the equipment and the servicing of that equipment. Then that equipment is used to manufacture the isotope. Then the isotope is linked to the drug and then injected to the patient. Something interesting to observe is that recently, driven by this emergence of theranostics, among others, a lot of players have been starting to change their position in the market, divesting some of the areas, investing in some other areas, and not always in a very replicable way. Some have gone left, some have gone right. It's interesting to see that this market is extremely active.
When we look at the different value pools of this market, what we see is that the one that IBA is historically active in, which is manufacturing of equipment and service, represents a bit less than a billion or is expected to represent a bit less than a billion in 2030, approximately $700 million. Next to that, the emergence of theranostics has created two enormous pools of value in radioisotope production and in radio labeling of these drugs that were much smaller before, but that due to the introduction of those theranostics suddenly became very large. At Radiopharma, we have or we are pursuing two focuses. The first one is to grow our leadership in our historical market of equipment. That's very clear. We've always been present there. We want to maximize our footprint in there.
The second one is to expand into those larger value pools that the theranostics development offered to us. Looking now for a minute at the equipment market, the equipment market is expected to grow at the same pace as the PET diagnostics tracers market. Driven by the demand of additional doses, there will be, in this case, additional cyclotron sales. We expect that market to grow approximately to the same tune of 6% per annum, which means that, roughly speaking, we expect between 45 and 55 cyclotrons being sold from now to 2030. We expect them to be sold with a very specific geographic split. Half of them would go to China. 25% of them would be split between Europe and the U.S. equally, and then 25% towards the rest of the world, approximately.
This being said, the type of machines that would be sold in China or the product mix in China would differ significantly from the product mix in Europe and the U.S. in the sense that China is starting to equip itself completely, whereas Europe and the U.S. are much more mature markets, more looking for more sophisticated equipment or with higher output. To that effect, we have a product range that can produce absolutely any type of isotope that can be accelerator-produced for nuclear medicine, ranging from very small Cyclone Cube to the biggest football pitch-sized Cyclone 70. We can produce it all. We have developed recently or invested over the last few years in injecting all modern technologies and the latest developments in all of those products so that they're really top of the range, everyone in their market segment.
Today, we have more than 380 cyclotrons producing on a daily basis tracers that are injected to patients. The technology platform that we've developed allows us to actually translate our customers' business case, or at least accelerate our customers' business case. It's not technology for technology, but it's really technology with an impact for our customers. The example here is the one of our workhorse, the Cyclone Cube, where when you look at the most powerful competitor, by being more powerful with the same footprint, we can produce more activity, almost twice as more, by requiring less maintenance and having a higher reliability.
When you look at a year's operations, you can produce twice as much activity, which means that for a standard product, typically with the same investment, you could have 2.5x , so 2.5x more EBIT generated for each site, which typically helps our customers to grow faster, but also to de-risk and then to diversify into other types of production. Next to that best-in-kind equipment catalog, we also have a complete service offering and the ability to scale up our supply chain. We've gone from approximately 10 to approximately 25 cyclotrons produced every year at RPS. We're now able to really go and grow that leadership in each and every one of these markets. If you look at the second market that we discussed, which is the theranostics, there is a bit of a race between different theranostics.
Recently, they were introduced around 2017, the second-generation, the beta-emitters radiotheranostics are taking a bit of a head start. Nowadays, only two molecules are approved, and they generate by themselves more than EUR 2 billion sales every year, coming from nothing in 2017. They really are priced at a very different price point than diagnostic tracers. Typically, there is between one and two orders of magnitude of a difference between the two. We also see that next to those beta-emitters second-generation, there is progressively emerging in research the third-generation, the alpha-emitters, which typically have a much higher impact, but on a much smaller part of the tissue, so that have the potential to be more accurate as well. We do not believe that one will replace the other or will win, but we believe that those will combine into a portfolio of therapeutics.
The move towards alpha therapy or the third generations is undeniable when you look at both the number of assets in the pipeline and the typical transactions that are done nowadays by big pharma. At IBA, as we've briefly discussed, and you will soon hear, we've put, let's say, a bet on Actinium-225, but we've also put a bet on Astatine-211 because we believe that in that portfolio of future isotopes, it's another promising candidate for targeted alpha therapy. That's for multiple reasons. First of all, it has interesting properties from a chemical and from a physical standpoint that would allow to target neurologic diseases as well. Second of all, due to a very short half-life, you can have a very simple patient workflow where the patient comes in and gets out the same day.
Third of all, due to an abundant supply and the fact that it can be created using an accelerator, you can de-risk it in a small and scalable way by implanting nodes of networks progressively as the drug's demand increases. How do we activate that? To make sure that we actually create the virtuous ecosystem around Astatine, first of all, we've coordinated an EU-funded consortium where EUR 30 million of R&D budget, not only IBA money, but really R&D budget globally around the 24 partners, will be dedicated towards developing the equipment, making or standardizing the production process, and also validating the clinical case of Astatine. Next to that, we're investing into a partnership with Framatome, the large French conglomerate, where we will create production centers of Astatine so that progressively, as the drug demand increases, we're able to meet it with the radioisotope supply.
Of course, that's the bet that we do on Astatine-211. IBA will continue betting on other promising isotopes as time passes and will enrich its portfolio with other promising isotopes. If I just take a minute to synthesize, one, grow the leadership in our historical market of equipment and make sure that we maximize our footprint in there using and leveraging our unique technology platform. Two, continue tapping into that pool of radioisotope production and labeling so that we can maximize also the value for IBA.
Thank you, Charles. Emmanuel, the floor is yours.
Good afternoon, everyone. My name is Emmanuel Terrasse. I'm with IBA since eight months, joining from the space sector, which is actually a sector that has some similarities with our particle accelerator industry. It's not a high-tech, not a low-volume, high-reliability industry. I'm very glad to have joined this new journey. The organization I'm in charge of has as its mission to develop and to provide accelerators like the ones we can see behind us and other large hardware for the three accelerator-based business units of IBA. Radiopharma and Industrial, which we've heard about a minute ago, but also Proton Therapy, which we'll come to after the break. What I would like to do today is to present to you how our industrial roadmap supports the achievement of the key objectives of IBA's strategy. Before we do that, let's start with an overview of our industrial model.
Over the past few years, the model that we've put in place is a balanced one between our in-house activities and the subcontracting to a network of trusted long-term partners. What we reach with this balanced model is, on the one hand, being able to capture agility, in particular when we bring new products to the market, and also to remain capital efficient and being able to implement our strategy with a limited capital expenditure.
If we start with the upstream, which is the supply of parts and assemblies, very often involving critical technologies like coils, supraconductive coils, or radiofrequency amplifiers, we typically rely on partners to provide us with this technology, which allows us to leverage on their own expertise and also on their investments, both in terms of R&D and capital expenditure, and therefore access this technology for lower overall costs than it would have entailed our own investment. When we then move to the assembly of our products, here we have a hybrid strategy. We have our own assembly capability and capacity, but we also tend to partner with external subcontractors. We use our internal capacity, on the one hand, for agile prototyping and the first models of new products. This gives us agility, shortening the lead time of developing new products.
On the other hand, when we go to larger series, and I'm thinking in particular to the Cyclone Cube accelerator, for which we now manufacture more than 20 models a year, we partner with a subcontractor who gives us economies of scale and access to larger industrial facilities. Finally, in the value chain, the ultimate step, which is very important to us, is the testing of our products. This is critical for ensuring the product quality. To ensure that quality, an important step is the test of the accelerators in real conditions involving the emission of a beam. For that, we need specific infrastructure, so-called vaults, which are basically concrete bunkers that protect the external environment from the radiation emitted by the cyclotron. Actually, we are sitting right now on top of one of those vaults.
We have in total seven vaults here in Louvain-la-Neuve, and we rely on this critical infrastructure to test and demonstrate the quality of our product before shipping them to our customers. Now, how do we use this agile and capital-efficient industrial model to support IBA's strategy? We've devised over the past few months, and we continue to implement a double-front strategy. First, we build and develop the resilience of our supply chain to secure the delivery of our different business units and ensure the execution of the growth plans that we've talked about and will continue to talk about. Two examples of actions that we've implemented to achieve this more resilient supply chain is, on the one hand, the development of double and, in some cases, triple sources for the critical parts of our machines.
You can see on the left-hand side of the chart here the example of the Rhodotron accelerator, which is the key accelerator of the industrial business line. As you can see on that graph, we have for all the critical parts two or three different sources that allow us first to guarantee the capacity that is needed to deliver that growth, and second, ensures backups in case of failings of one of the sources of that particular item. In parallel to this action on the supply chain, we've also worked on our internal production capacity to remove the bottlenecks. In particular, what we've done is that we've now dedicated each assembly hall, like the one you see here, to a single product family. For instance, the beam factor here is dedicated to the ProteusONE accelerator, one of the key products of the Proton Therapy business unit.
Through these actions, what we've been able to achieve is a progressive increase of the capacity and the delivery in terms of numbers of machines delivered per year, which you can see on the right-hand side of the graph. In particular, it's interesting to note the significant increase that we captured that we achieved last year, bringing the overall increase over the past few years to around a doubling of our production capacity. You can also see on the graph the production plan, which is the result of the strategic plans of the different business units. As you can see, this production plan is well in line with our current capacity, with the delivered production that we had last year, which gives us a high level of confidence in our ability to deliver that production plan.
The second important aspect of our industrial roadmap is the improvement of industrialization that targets the optimization of costs and therefore contributes to the increase of profitability that is at the core of our overall strategy. Here we are able to rely on the increased volumes that we have on our different products to step by step continue to optimize our products and industrialize them more. If I can quote three examples of such actions, we are working on redesigning our key components with a view to manufacture them better and in a simpler way. This is what we've done with the amplifiers of the Rhodotron product with good success.
We're also working with our suppliers upstream to ensure a reduction of the variability of the products, therefore ensuring that when these products are delivered to us, we can integrate them with a lower risk and therefore a shorter lead time. We use our better knowledge of these recurring products to streamline our test plans, focusing on the key steps where we know we need to have this testing approach to guarantee the quality. This streamlining allows us to reduce our cost and our lead times in this critical test phase. All this leads to regular and significant reductions of our production costs for our recurring products.
As an example of that approach, you can see on the right-hand side of the graph the inflation-adjusted production costs of the ProteusONE accelerator, again for our Proton Therapy business unit, where you can see that over 10 years, with the gradual delivery of overall 28 machines, we've been able to capture a significant reduction of 23% of the production costs. I hope to have given you a view on how our industrial roadmap contributes to the two key objectives of our strategy: growth delivery on the one hand and profitability on the other. Before concluding this section, I wanted to come to a topic which I guess many of us have on their minds in these days, which is what is the impact on our overall activity of the new tariff policy that the U.S. administration has announced a few days ago.
Obviously, as you can imagine, this is an analysis that we are doing right now and that we have not completely consolidated. It's also quite a fluid topic where we expect new developments which may come in the coming weeks. Nevertheless, we wanted to share with you the preliminary view we have of this important topic. What you can see on the left-hand side of the slide is the breakdown of our revenues. We consider our overall IBA revenue of close to EUR 500 million. Out of this revenue, roughly 30% of our revenues is coming from U.S. sources.
Now, what is interesting to note is that out of this 30%, actually almost half of it comes from services, and in particular, Proton Therapy services, with the specific characteristics that a significant largest part of the cost behind those revenues is actually linked to local labor costs, therefore limiting our exposure to tariffs and leading us to the conclusion that on that side, the half of this 30%, we consider that the impact of the tariffs announced by the U.S. administration, 10% as of now, 20% in the coming days, will be quite low. The other half of the 30% of U.S. revenues relates to the sale of equipment. This half is again shared more or less equally between non-medical equipment for industrial and Radiopharma business units and medical equipment, Proton Therapy and dosimetry.
Here, clearly, the sale of equipment involves the import of some hardware from our larger European supply chain to the U.S. Therefore, these imports will be hit by tariffs. Nevertheless, we know we can rely on two important mitigation factors that will limit the impact for that side of the business. One, the backlog is composed of contracts which are mostly forcing a liability on the customer side for the duty. On the other hand, for new orders, competition, as we face it coming from suppliers manufacturing locally in the U.S., is, depending on the business unit, either non-existent or limited. We believe that these two factors will mitigate the impact of the increased tariffs on that side of the business. Having said that, we continue to work and to build a plan that will allow us to mitigate further that impact.
One, we will continue to explore which exemptions some of our products may benefit from, in particular on the medical side. Second, we're working on devising a plan that would increase the local content of our activities, be it on the procurement side or on the manufacturing side. Obviously, we'll continue to monitor that issue to consolidate that plan going forward in the coming weeks.
Thank you very much, Emmanuel. This is closing the IBA technology part of the presentation. We are going to take a 10-minute break, if I may ask the people on site to be seated again at 3:27 P.M., as we are going to resume the live webcast at 3:30 precise. Thank you very much. 10-minute break. Thank you.
Okay, welcome back. If you're online, once again, after the presentation, we'll go through Q&A. Don't hesitate to input your question on the chat box. We're now going to talk about clinical. Clinical is about EUR 300 million out of the EUR 500 million of revenues, EUR 214 million in proton therapy in 2024, and about EUR 60 million in dosimetry. Together with me to present proton therapy, they will introduce themselves. Luk is our Chief Market Officer, and Isabelle is in charge of our proton service business. Before we jump into it, I think everybody knows, but as a quick reminder, why proton therapy? Everything, the magic behind it, it is the so-called Bragg peak. It basically gives the opportunity or the chance to the radiation therapist to put more therapeutic dose in the tumor while sparing healthy tissue, having a dramatic impact on the reduction of the side effect, improving local control of the tumor, providing chances for re-radiation in the future.
There are many, many advantages for proton therapy for a number of indications, which actually we are going to talk about because if we want to summarize where we are in proton therapy, the adoption is going up. There is a wave of clinical evidence coming to it. Luk will discuss about that. The competitive environment is quite favorable to IBA. We will talk about that as well. Last but not least, our install base will grow significantly over the next few years, allowing us both to grow but also to improve our financials. As we are growing, we have more density, we can change our operating model, and we can have a lot of productivity gain. I will not spoil Isabelle's presentation. She will come into that in a minute. Without further ado, Luk, walk us through the proton therapy market.
Thank you, Olivier, and good afternoon, everyone. My name is Luk Herremans, and I'm indeed leading all market-related activities in proton therapy. I stick for one second on this slide because it really shows the true power of proton therapy. Everything which is above the blue line or in between the blue line and the orange line is basically excess dose, which is not given with proton therapy, but dose that would be given with conventional therapy to healthy tissue. That's really the true power of proton therapy. If I look at where this treatment modality stands today, it's really still very early stage as a treatment modality. If we look at all patients worldwide that are being treated with radiation oncology, less than 1% of all those patients are being treated with proton therapy. It's about 2% in the U.S., about a half percent in Europe, and less than half percent in Asia-Pacific.
Whereas there is a stronger growing consensus from experts that about 13%, maybe even up to 20% of all those radiation oncology patients should or could be treated with proton therapy because they would really benefit from it. There are two important drivers that will help us bring proton therapy from that 1% or less than 1% up to 13%, and that's clinical evidence generation and improvement of cost-effectiveness. We will talk about that furthermore. Talking about clinical evidence in healthcare, the most important or the strongest evidence that you have is called level one evidence. Level one evidence is being created or being generated by phase III randomized controlled trials. As we speak, there are 17 of such phase III randomized controlled trials ongoing for proton therapy.
As you can see on the graph, until last year, there has been zero level one evidence for proton therapy available. Over all those years that proton therapy is available, there has been no level one evidence available. Last year, for the first time, there was a level one evidence being published. As you can see, in the five years to come, we really see a wave of that evidence coming towards us. On top of that, there are 130 other trials, phase II and phase I trials, which are generating evidence for proton therapy as well. We have never had that before, so much evidence is being generated on proton therapy. There is one in particular that I would like to highlight. It's the one you see there, the 440 patients.
It's basically a phase III trial that was conducted as a principal investigator by MD Anderson, the number one oncology center in the world, on head and neck patients. The preliminary results that they have shown last year have shown that there is a strong reduction in side effects for those head and neck patients. On top of that, there is a significant overall survival effect in favor of proton therapy. This is the first time ever that this is being demonstrated. The trial will also further look at cost-effectiveness of proton therapy, and we have high expectations on that as well. Me personally, being heading the market activities, this really excites me if I see what a wave of evidence that's coming towards us and that will really help drive the adoption of proton therapy.
Now, if I look at the market and I take a bit of a step back retrospectively, if I would show this market year by year, you would see a lot of volatility. However, as we group it in blocks of five years, you can see that there is a steady growth of more than 5%. In the last five years, for example, the market on average, 30 new centers have acquired a proton therapy system spread out all over the world. We believe that this trend will continue. We see that this trend will continue. In the next five years, we expect another growth in the market. In 2024, the total market revenue was well over EUR 500 million, which is composed by equipment production and sales and also service and maintenance sales.
On IBA side, our installed base today is 44 active centers, which are treating patients on a daily basis. We have sold altogether 77 centers. All those are still under installation or under construction. By the way, on those centers sold, there is a few that I would like to highlight. In the last week of 2024, we have announced a sale in India. AIG is the name of the hospital. About a month ago, we have announced again in India, two more centers to be installed with Apollo Hospitals. Last week, I believe, we announced a center in Taiwan that bought from us ProteusONE as well. There is one more in particular that I would like to highlight. I mentioned on the previous slide, MD Anderson, the number one oncology center in the world.
As we speak, they are running a public purchase RFP in the U.S. to double their treatment capacity for proton therapy. If the number one oncology center in the world is doubling their treatment capacity for proton therapy, again, that's something that excites me as a market-driven person. Our position in that is about 60% market share. Our key competitors right now are Hitachi and Mevion, and our strategic partners, CGN in China, but we will talk more about that, I think, in the next slides. Then Elekta and Research, two well-established radiation oncology companies which we are partnering with mainly on the software side.
Maybe one thing on the two competitors, Hitachi is from Japan and Mevion is from China. When we speak about U.S. dynamic, I just wanted to highlight that. Moving on to China, all jurisdictions are very important to us, U.S., Europe, but maybe a quick zoom on China, a very important market for us as a planified economy. We can actually see the dynamic of the market. As you know, they allocate licenses in their five-year plan. Today, China still has more than 20 proton therapy licenses to be taken by hospitals and vendors. It constitutes quite a significant market opportunity for us. We believe this will continue. New evidence will become a reality, as Luk just alluded to, and it will stimulate for sure the market in China as the demand will only grow as, unfortunately, China is touched by cancer occurrence as well. As you know, we're going to market in China in two ways.
One is through our partnership with CGN for multi-rooms, but IBA will go direct when it comes to ProteusONE. It is my pleasure today, actually, to disclose to you that we have reinforced our management capabilities in China. Jay Liang joined us in February. Jay is in the room. If you want to stand up, Jay is bringing a long experience in, let's say, the medical sector in China and a lot of knowledge. Jay is bringing a lot of firepower to make sure that IBA is as successful in China as we are in the rest of the world. There is a lot of upside potential for us in China, both from market growth, but also from, let's say, a very nice hunting reserve in the short term.
We believe ProteusONE has a lot to bring, and we are about to launch the product in China in 2025. Luk, back to you or actually to Isabelle.
Good afternoon, everyone. My name is Isabelle Hennen, 20 years at IBA, and I have the pleasure to be in charge of the exciting roles in the service in proton therapy. As you can see here, the figures are quite exciting because in 25 years, we had, or I should say even in 30 years, if I take into account the contract signature of Boston, our first proton therapy center, and we were able to achieve 44 centers in 25 years. Now, in less than five years, we will double the size of the install base. This is really an extraordinary journey that we have in front of us.
We have a fully engaged team because we will be able to improve our profitability thanks to three big opportunities. The first one is really we have finally achieved the critical mass that we were expecting for so long that will bring a lot of scale effects. The first one I wanted to highlight to all of you is the smart scale-up in the way we will grow for our install base. We won't grow the same way that we have did the last 25 years. We will do it in a fully different way with a fully engaged team that are on board, and we will use a new creation of areas.
We won't talk anymore about centers, but areas, so countries where they will work all together and that we will build some hubs of flyings and people that have an extensive knowledge and experience because we have people for our ProteusPLUS community with more than 20 or 15-20 years of experience. We will use them in a way that we will grow in a smarter way and in an agile way. We'll also make sure that we innovate and we will deploy everything over our install base in a smarter way. As Luk mentioned, thanks to this growth, we will have more clinical evidence, and they will generate more and more cases that will allow to have proton therapy as real evidence. The second axis, because we will grow in a smart way, we'll make sure that we use the artificial intelligence.
We will have condition-based maintenance to make sure that we automate the way we do our maintenance in a smart way, making sure that we do it at the right time with the right people. We will also automate all our workflows that we are using on our install base. We did not wait for the growth with Ortega in Spain. We have already put in place in Italy the first area that has just been created a few weeks ago. We are already in that journey all together with our team.
Last but not least, the third axis, which is quite important, our install base is also aging, and we will capture the replacement and a kind of new market for the revamp and making sure that for our first institutions that are in the proton therapy business for a long time, they will have the opportunity to have the access to the latest technologies. As you can see on the next slide, the growth is worldwide. Across all geographies in the Americas, EMEA, APAC, we have growth in a balancing way. We will do plus six centers in the Americas, +14 in the EMEA thanks to Ortega in Spain because we had the 10 addition in that country, in Spain, and APAC +6 . It is quite exciting news, a well-balanced growth. We will see that we will achieve 70+ centers in proton therapy in less than five years.
Thank you, Isabelle. Now, if I go back to the market for a second, I showed you before that the continuous growth exceeds 5%, which is great, but what is even more contributing in our order intake is that we have really strengthened our competitive position. If on the left side, you can see that in 2016 to 2019, our market share in terms of order intake was about 1/3. In the last four years, we have systematically had a market share above 50%, which is, of course, contributing nicely to that scale effect. On the right side, you can see that we also have a gross margin increase effect, and that is driven by the scale that I just mentioned.
Also, historically, we have had a few or several low-margin projects in the order intake driven by competitiveness, also the geopolitical and supply chain situation that we were dealing with at the time. The proportion of those projects is going down now. That will contribute as well to GM increase. Also, we have really strengthened our go-to-market position in America, in Asia-Pacific, and as already mentioned by Olivier, in China. Now, if I want to talk for a second about product, ProteusONE is really the market-leading and versatile solution. We are approaching 50 sales of ProteusONE now. I think the runner-up product in the market is, I would say, about 50% of that or not even 50%. The reason for that, it's really a versatile solution. All indications can be treated with this system. It has high efficiency and throughput.
Up to 45 patients per day can be treated on this system. That is very comparable to a conventional radiation therapy machine. The scalability and upgradability of this system is also important. It is a way longer investment than for a conventional radiation oncology machine. It is more like a platform that can grow as innovation evolves, and that is very unique as well. We have an open vendor situation or position towards software integration. We have a one-stop shop with our colleagues of dosimetry, who will present just after us. We have the largest and most experienced community in proton therapy. I think that is very relevant. On the right side, you see, I would say, a selection of luminary accounts there. There are a few that I would like to highlight. It is MGH, our number one customer in Boston, which is an affiliate of Harvard University.
UPenn, our number one collaborator for research and development. Here in Belgium, Partikel, which is embedded on the site of UZ Leuven in collaboration with KU Leuven and UCLouvain. Other important names in Europe, EAO, Institut Curie, which definitely resonates strongly in radiation oncology. In China, worthwhile mentioning as well, is the Chinese Academy of Sciences, which is the highest reputed academic institution there. Why is it so important? Because having these luminary accounts as IBA accounts influences other buyers, they are excellent contributors for more evidence generation. Thirdly, for IBA, they are excellent collaborators as well for research and development. We are very pleased with this customer portfolio. It's not because we have the leading product in the market that we are sitting still on the innovation side. We are innovating strongly.
Three things that I would like to highlight on the left side is we are really putting a lot of focus on improving our quality of imaging. That's an important driver to go to hypofractionation. Hypofractionation, what means that instead of treating the patient 35 times, 35 different days with two greater fractions, the idea is to treat these patients 15 times with a higher dose or 12 times with a higher dose. It's also very important for adaptive workflow. What that means is when the patient is on the table for treatment, the patient is being imaged, and on the spot, the plan is being fine-tuned. Your treatment becomes much more accurate. Now, if I go to the middle section, this is our innovation on dynamic arc.
Dynamic arc is basically, instead of treating the patient from two or three different angles, the treatment is being delivered while the proton therapy system is continuously rotating around the patient and basically treating from all these different angles. The advantage there is that it goes faster, it's simpler, and it has a sharper treatment. Again, an increased quality in terms of treatment. Why is it important, those innovations? The ones which are boxed there, they contribute strongly to cost-effectiveness. This is one of the two drivers I mentioned in the beginning for proton therapy adoption. The second one will allow us to treat more patients because the quality goes above the treatment. More indications will be prone for proton therapy. The last innovation that I would like to mention is on the right side. It's called conformal flash.
What is conformal Flash? A typical radiation dose of this 2 Gy that I was mentioning, 35 fractions of 2 Gy. A typical 2 Gy delivery takes about a minute and a half, two minutes, depending on the volume of the tumor. With Flash, the entire idea is not to deliver 2 Gy, but substantially more, 10 Gy in less than a second. Very high ultra-dose delivery. What we have seen there as an effect is that it has the same impact on tumor destruction, tumor treatment, same curative treatment, but a way lower effect or way lower toxic effect on healthy tissue. This potentially could be very disruptive in radiation oncology. This is relative early research. A lot is still to be demonstrated, and a lot of evidence generation is ongoing. This could be very disruptive.
Our target is by the end of this year or by the beginning of next year to have a first patient trial starting with this together with Penn University. Again, research, way more of a gamble than the two others, but potential to be very disruptive in the market.
Thank you very much, Luk. Thank you, Isabelle. In conclusion, while Jean-Marc is joining us to present dosimetry, three things I would like to highlight again. One, we are going to witness a massive growth in service, which will contribute thanks to productivity, density, to significantly to both the growth and the profitability of IBA. The overall competitive landscape has improved for us thanks to a very strong positioning of our product. We expect to see significant market share with improved deal condition going forward. We have started to see that over the last couple of years.
Last but not least, proton therapy is a super cost-effective way to treat a number of indications. With the wave of level one clinical evidence that is due to be published in the next few years, we believe the adoption of proton therapy could accelerate. Thank you very much. Without further ado, Jean-Marc, the floor is yours.
Thank you, Olivier. It's Jean-Marc Bothy, in charge of the dosimetry business unit with IBA for more than 20 years in different roles. I have had the pleasure to meet some of you during these years. Now in charge of the dosimetry business, the dosimetry business represents north of EUR 60 million for the group. Three components into our business: the quality assurance for conventional radiotherapy, representing about 70% of the business; the quality assurance for proton therapy.
Luk has mentioned this collaboration with, of course, the proton business unit: 10% of the business. Also the quality assurance for medical imaging equipment, representing about 20% and on the rise in the business unit. It is an overall market of about $400 million. It is always a bit difficult to assess exactly what you put into it, but we assess it to $400 million, sustained in conventional radiotherapy by the sale of 15,000 LINACs that are the equipment allowing the delivery of the radiotherapy, the conventional one, equivalent to the ProteusONE and the system of IBA for proton therapy. In proton therapy, it has been mentioned already, 350 rooms globally. In the huge market of medical imaging, we are essentially providing solutions for X-ray systems and also, to a large extent, to MRI and CT systems. It is a booming market nowadays.
In this, the growth potential for us is in line with this market, and it represents about 5%-7%, depending on the studies. We are both, of course, selling small capital equipment together with the LINACs, together with the PT systems, and also providing service that represents about 15% of our revenues: service to the equipment, also recalibration of the equipment, and so on. The key players that are sustaining this business in conventional radiotherapy are the two main providers of LINAC equipment. We are working hand in hand with these people to provide the quality assurance solution. Variant, number one in the market, and also Elekta, of course.
It used to be almost a duopoly, but by now we have also Chinese equipment manufacturers that are really starting to make a difference, like United Imaging, by example, but more Shinva and these people are also taking a market share by now. In proton therapy, of course, we have already discussed the subject, Mevion, Hitachi, but the lion's share for IBA. Of course, we've been developing all our products hand in hand with the engineers from IBA. In medical imaging, it's the usual suspects, of course, Siemens, and they are our neighbors to our factory in Germany. We are working a lot with them for OEM products. Our detectors are embedded into the Siemens X-ray imaging systems, but also we work for Philips, GE, and Canon. This is a strong focus for us to work even more with these OEM manufacturers.
In terms of technology trends and medical trends sustaining our growth, there is for proton therapy and radiotherapy, it has also been mentioned by Luk, the adaptive treatments. It's the same in the conventional radiotherapy. It is the big thing for the moment. Also in conventional radiotherapy, talking about hypofractionation, while the name commonly, it's stereotactic radiosurgery or stereotactic body radiotherapy that is also on the rise and requiring more and more quality assurance tools. AI is everywhere in RT, but even more in medical imaging. The flash treatment that has been explained is also applicable to conventional radiotherapy. We are already working with some hospitals, and we have already qualified a number of our equipments for flash treatment. We are ready for the startup of this methodology of treatment, modality of treatment. In terms of generally, our applicative solutions are in, it's the quality assurance.
It allows safe treatment, faster treatment, implementation of new technology, cost efficiency for the hospitals. We try to come from a burden for the hospital, the obligation to do quality assurance into something that provides a real advantage to the hospital using our equipment. This is really applicable for the entire portfolio that we have. We need to mention also in medical imaging that there is the strong emergence of photon counting CT, where it is very low dose, very high quality images that require even much more sensitivity to the detector. We are, of course, on it. The artificial intelligence, the help for diagnostic through artificial intelligence, is also offering us possibilities for more solutions in quality assurance. Currently, we are operating at an operating profit between 6%-9%. We have plans, of course, to grow this profitability.
We are banking on four elements. On one side, growing the share of our recurring business. For the moment, we are still depending quite a lot on tenders or large orders for proton centers, by example. Going into more recurring business is one of our focuses. Medical imaging is offering, of course, much more possibility of having a more leveled business due to the size of the market and the procurement processes. We have operational leverage thanks to the acquisition that we have made recently in North America. This offers us a possibility to optimize our production. We have created a global supply chain where we are really taking advantage of the different setups that we have in North America, but also in China. We have a factory. Of course, our main production center is still here in Europe.
Knowing the new constraints with the Buy Made in China Act on one side, having the tariff on the other side, of course, it's a little bit juggling with all these constraints. We have an appropriate setup to optimize in that direction. We are also diversifying our portfolio. First of all, through R&D, through internal development. We have a unique combination of portfolio thanks to the recent acquisition that we have made and also the development we have made. We are now truly unique with this combination of imaging quality assurance and radiotherapy quality assurance. This becomes extremely important for things like adaptive treatment. More and more, the LINACs and the proton system have a lot of imaging embarked and therefore require an integrated quality assurance system. This has been really one of the reasons for our recent acquisitions. Not the only reason.
It was also completing our portfolio, by example, with Quasar, a product that are solid phantoms based in Canada. With Radcal, it was expanding the portfolio. It was also increasing our presence in North America. It will probably be an advantage to be producing over there and also increasing our firepower in R&D, of course. That's it for.
Thank you very much, Jean-Marc.
Maybe I can just conclude on this that it's a growing business with all the elements in place for growth. We are following the technology. We are hand in hand with the OEM. We have the right combination of portfolio, and we have the operating leverage.
Thank you very much, Jean-Marc. Joining us to talk about the corporate initiative, I have the pleasure to welcome Christophe from Pantera and Eric from IBA taking care of MI2.
Good afternoon. I think it's important to position this because this is a new entity, IBA Corporate, in which we are going to place and report on all our new ventures. In that context, we thought it would be good to give you a spotlight on two of those key initiatives in very different fields. Christophe, tell us about Pantera.
Great. Thanks. Very happy to share more insights about Pantera. My name is Christophe Malice. I worked for 17 years at IBA. Once Pantera was incorporated in 2022, quite naturally, I joined Pantera to continue this journey. Before moving to the next slide, this building that you see in front of you is basically the construction will start this October, 2025. This building will enable the production of 50,000-70,000 patient doses of treatment for patients by 2029, 2030. It's really happening.
Next to this building, basically, we have already started the construction of another building, so-called industrial building, where Pantera is going to move in June of this year. It is over the last, I would say, six years that basically IBA and SCK CEN are preparing all the building blocks to get where we are today. In 2019, the collaboration agreement between SCK CEN and IBA to produce Actinium-225, I do not need to come back on the Actinium-225. I think that Charles has already explained and presented a little bit the market, but there is a huge momentum. It is still there more than ever. Last year, there was for more than $10 billion M&A acquisition by four pharma companies over some biotechs. This is more than ever still the case, and the desirability for Actinium is still over there.
In 2021, this collaboration agreement was further materialized with an R&D agreement, which basically enabled to accelerate the development of the IP. In 2022, the incorporation of Pantera, which was a very important milestone, basically to enable in 2023 the in-kind contributions of the Radium-226, absolutely unique stock of pure Radium-226, the Rhodotron from IBA, but as well all the IP. The second important milestone in 2023 was a partnership with TerraPower IsoTop, which enabled Pantera to access some Thorium-229, which is basically a starting material which decays into Actinium-225 and will enable Pantera to produce Actinium-225 as from 2025. Extremely important as well for the equity story, basically, that we pitched in 2024 to finalize a very nice Series A of over EUR 95 million, combined with a senior debt of EUR 34 million.
Today, I think that more than ever, we can say that Pantera is extremely well equipped, I would say, thanks to this unique access to the Radium-226, unique access to the Rhodotron, a very strong technology with eight patents, but as well extremely well funded with a very nice syndicate of investors led by EQT. Also, we have Paladin, Coris, Eurazeo, Kurma, PMV, Wallonie Entreprise, and SFPI-FIM in this syndicate, with a new governance led by Luc Daucher as an independent chairman of the Board. All those building blocks are extremely important, put Pantera in a good position. Regarding the strategy by itself that we are executing right now, there are two pillars. The first one is this early supply, and the second one is the commercial supply. We have to play on those two timelines.
First, the early supply is extremely important to bring more material, more Actinium-225 on the market as from today. Important because the clinical trials need more materials to continue, basically, but also to generate some revenue for Pantera to invest into the commercial supply. The production will start somewhere in May, June of this year. We are as well very well connected with pharma and biotech, basically already 70% of the activity is sold. We have a demand for another 70%. That shows as well the desirability for the Actinium-225. On the other hand, the commercial supply, the construction of the building, as I mentioned, should start in October of this year. The nuclear permit, the environmental permit as well, are almost there.
We are finalizing, I would say, the detailed engineering of the building, and as well finalizing the selection of the contractor. In a nutshell, I think we can say that Pantera is more than ever in the execution phase. We'll produce Actinium-225 this year and will prepare the future with the commercial facility.
Thank you, Christophe. Eric, back to you for MI2.
Thank you. Hello, everyone. My name is Eric Forton. I've been with IBA for almost 20 years now, mostly on the technical side. This exercise for me today is a world premiere.
It is.
You have seen at this stage of the presentation that IBA has a lot of technologies that allowed it to be market leader or very well present in several markets through four business units. This is very obvious at this stage that these technologies can be used on other applications, as has been shown by Jeremy, for instance, for industrial, but has been shown by Christophe with Pantera right now. These technologies are also very useful, potentially, on markets that are completely different, markets on which we are not present at all.
The IBA corporate organization is now equipped for IBA to tackle and assess these initiatives. I'm going to tell you today about MI2 Factory, which is the first new venture of the IBA corporate entity, a venture that is about silicon carbide market in the power electronic market environment. Silicon carbide is a segment of the power electronics market that is very promising with high growth, but also calls for new technologies on which IBA can be relevant.
On this market, we decided to partner with MI2 Factory. It's a German startup of about 10 people, and it's really active on silicon carbide with a portfolio of IP that we believe has a key asset to high energy implantation system for silicon carbide, which will bring better quality and better yields of the manufacturing process in silicon carbide. It will also leverage on IBA's unique ability to develop and bring to the market accelerators and compact accelerators like cyclotrons. In the short term, for the first phase, we are able to develop an industrial demonstrator, which will bring MI2 Factory from a lab-proven solution towards an industrial-grade solution. At a further stage, we will be able to leverage on IBA's installed base and knowledge distributed worldwide to basically address the needs of future customers of MI2 Factory. Today, it's in the development phase.
What's in it? It's a EUR 5 million investment that gives IBA 15% shareholder shares of MI2 Factory together with other partners. It will unlock the venture and the growth of MI2 for this initial phase of industrial demonstrator. Why? Because actually, the investment of IBA was a key enabler for MI2 to get funding through the IPSAI mechanism granted by the European Union. IPSAI standing for European Projects of Common Interest. Today, we are still in the development phase. It's an early stage, but we do believe we are in the right setup with the right amount of risk because actually, it's fully funded until the demonstration of first phase. We are looking forward for the next phases. We will be able, of course, to tell you more about that during the next meetings with you. Thank you.
Very exciting. Thank you very much.
We said we would close this session with the financial section. Thank you, Chris. Thank you, Eric. I invite our co-host, Thomas, so that we can walk through the financial part together with you. We wanted to start this section with an explanation with regards to how and why we have updated our guidance. Three considerations. The first one is, and I hope you have seen that by now in our presentation, we have reviewed our strategy in quite detail. We needed to integrate those different elements in our outlook. That includes new business opportunities as well as new investments that we believe we need to make. We have transformed the company as well. We have a new organization. As I said, we have now segments, P&L accountability, and management team that align.
We are at another scale, having successfully delivered on the growth momentum up until now. We have renewed leadership in certain functions. The change in organization made us feel that it was indeed, again, the right time to update our guidance. When I say that, I'm fully aware of the irony of what I'm going to say, considering what's happening in the market today. We felt that with growing uncertainties and the demand from our investor to show a clear path without disclaimer, it was about the right time to give a guidance that we see as a solid ground on which we can deliver, incorporating or factoring in those new uncertainties that are emerging quite fast, I must say, and I'm sure you will agree. These were the three reasons.
Speaking about the guidance itself, let me give you a quick reminder, and then we can unpack the different dimensions together page by page. The first thing we felt we needed to do was to give you an in-year guidance, an indication on where we would land for the year in force. We have started with 2025, saying that we expected at least EUR 25 million rebate at group level with proton therapy turning a profit, which we thought was a great and encouraging dynamic or evolution. We have guided on a mid-term outlook, 2024-2028. I'm as well aware of the irony of mid-term when we talk about four years, as you know, that IBA has long cycles. It's not completely a mid-term for us. It's still a bit short term, but yet.
We have given you an indication in terms of overall revenue growth of 5%-7% over the period, but we have said that it would be front-end loaded, which may have been misunderstood. I will clarify what that means exactly. We have as well given you an indication of our cost discipline we want to keep and will keep as from now on, OPEX below 30% of our sales. I will explain what this means concretely for us, which means that by 2028, we will be around 10% rebate. We collectively commit to that margin improvement. We have as well introduced a notion of longer-term elements in our outlook, as just spelled out when we discussed about corporate. We have invested in kind, that means in a capitalized way, in new ventures.
We expect, of course, positive development in those new ventures that are high risk and high opportunities. We see that they have attractive value prospects. That was for the key elements of our guidance. Let me take them one by one. Going back to 2025, we were super happy to deliver EUR 7 million rebate in 2024. We thought it was solid ground in terms of delivery in 2024. We have told you we would deliver at least EUR 25 million rebate with EUR 12 million improvements at least on the proton therapy side. Some of you have highlighted that that would probably imply a small reduction in the overall profit contribution of technologies in 2025, which is completely correct. That is on the back of two things. We are going to have in technologies a slightly less favorable project mix in our backlog for 2025 in technologies.
We are going to invest in some of the initiatives that have been presented today with regards to theranostic and chemistry and a little bit in industrial, which means that we are going to spend a couple of million in those areas impacting our overall profit contribution. On the IBA corporate side, there is nothing to mention. It is going to be roughly stable. That is for the story of 2025. Some of you have asked me, is it at least? Yes, it is truly at least. It is an anchor point. It is a guidance for 2025, not one to meet, but one to beat. Now moving on to the medium-term guidance, let me take all the elements one by one. We have talked about revenue growth.
I remind you that revenue for us is backlog conversion for equipment, and it is mostly backlog conversion for equipment, and it is service. What we have said is that we would grow at 5%-7% between end of 2024 to end of 2028. We've said that it would be front-end loaded. What we meant by that is that we will experience in 2025 a double-digit growth rate like it was guided in the past or even slightly better. That will be on the back of the very strong backlog conversion, notably from the Ortega deal. You see the machines in my back. After that high point in equipment growth, we expect a normalization, and that would mean a top-line growth that is going to be low single-digit around worldwide GDP growth. We've looked at different projections, and I'm sure you will do the same.
I want to remind you that when we say that we exclude from our top-line growth quite normally everything that has to do with our new ventures. Now, before you judge too quickly, I just would love to be able to put that revenue growth into perspective because you know that at IBA, the complexity is that the revenue trajectory, the new sales/order intake trajectory, and cash trajectory are different. Therefore, I would love to explain a bit more how to put that overall top-line evolution into perspective. Just for the pedagogy sake, let me go back to 2024 quickly. You understand that on a given year, we start with a certain backlog. This is revenue to be converted. That is the EUR 720 million you see for equipment. I put service on the side for the moment.
You see that in 2024, we have converted for EUR 317 million revenues. At the same time, we've had commercial activity. We have sold for EUR 290 million new equipment. That has translated. The net effect is a negative effect on our backlog that has shrunk a little bit to EUR 693 million. One indicator to follow is the book-to-bill ratio, which puts in contrast, on the one hand, the order intake in one year, and on the other hand, how much of that backlog is converted. As you follow the performance of IBA, always look at the backlog and always look at the book-to-bill ratio. A side note on cash, you understand as well that cash is a function of order intake because we get down payment, and then we get paid as we convert backlog.
It is some kind of a combination of the order intake trajectory and backlog conversion trajectory. All of that long monologue to explain a little bit the past and the future. What you see on the page is order intake on the top, equipment revenues in the middle, and backlog evolution at the bottom. On the left side, you see the historical value. What you see is that in the last five years or so, if you normalize for exceptional 2022, and I will get back to it, we would be around EUR 250 million order intake on a given year. 2022 was really a peculiar year because Ortega was sold, and we had a very strong order intake in industrial. You remember it was post-pandemic. Everybody was looking for sterilization capacity.
If you look back at the time, you see very strong order intake overall, but a particularly strong order intake in 2022, which, by the way, will translate in an exceptionally high, or I should not say exceptionally, I should say very high equipment revenues to be expected in 2025 as we convert that Ortega backlog. As we will reach such a high point in equipment revenues, and if you look at the order intake of 2023-2024, you can expect indeed a normalization in our equipment revenue. Now, you will say, but where is the commercial ambition? We have heard today a lot about great potential, growth momentum, opportunities. That will translate in new order intake and the perspective we have about the growth of that order intake. That is what you see on the top right of the chart.
We expect that our order intake growth will be a factor or a multiple of our equipment revenue growth, which will in turn translate into rebuilding our backlog. You can expect that as of 2027, 2028, our book-to-bill ratio will turn to higher than one, which means that what we said in a given year in terms of order intake will exceed what is it that we convert in a given year. You see, when you assess the commercial performance of IBA, always important to contrast what is it that we sell versus what is it that we convert in a given year. For me, the message is to say that our commercial ambition does not translate so much into the near-term equipment revenue growth, but it will translate into our order intake and the growth of that order intake over the period.
As we discussed in intro, we are well aware that gross margin, sorry, that EBIT margin is key. We have guided that we will be around 10% EBIT by 2028. We will work on gross margin. We will work on OPEX. I again highlight that there are going to be things happening below EBIT that are quite important as well. In a second, Thomas will talk about capital and will talk about cash. Let me deep dive first on the gross margin component. We've said that we would move from 33.3% delivered in 2024 to nearing 40% by 2028. If I sum up, there will be one key element in that gross margin improvement is really the post-Ortega normalization. Luk, I think, showed it well in the chart. You can go back to it if you want to update your model.
That is a key element as we get out of that specifically priced deal. We will return to improved gross margin in PT equipment just on the back of that. The second element that is going to bring a lot of improvement in our gross margin is everything that Isabelle has presented with regards to our service gross margin. You see that the silver lining here is the fact that with the Ortega deal and other deals, we have our install base that is growing quite fast. You remember from 44 to 70. That brings massive opportunities in terms of operating those centers in a different way as we have a more dense footprint. AI and digital brings as well quite a lot of opportunities for improvement. This is not going to be done in a heartbeat.
It's a lot of work, but it's already ongoing, and you will see improvement coming in quite fast. There is obviously further improvement in terms of smart scaling, everything that Emmanuel has presented in terms of continuous improvement in our operation, which will support our overall gross margin improvement. Dosimetry is already quite high, so it will be stable. IBA Technologies overall is already quite significant and will be stable or marginally improved over the period. These are a bit the acupuncture points for gross margin improvement as we have guided it. We've talked about OPEX. We have said that we would be below 30% of our sales. The overall envelope is going to continue then to increase as we grow.
We are going to tactically invest in sales and marketing, especially everything that has to do with market access, being able to bring the evidence to the clients, to the decision makers with regards to proton therapy, everything that has to do to medical affairs. We are not talking big amounts, but we sense that those sales and marketing investments are needed. We are going to do them trigger-based when we are sure that we are well covered by the development of the business otherwise. For me, G&A, it's all about tight cost control. We are not going to do a revolution there, but careful workforce planning, discipline in demand management, strategic sourcing, especially on the indirect spending, and leveraging the potential of digital and AI. Cost discipline in everything we do will help us keep a tight ship from a G&A point of view.
Therefore, with the lowest to benefit from elements of scale. Then research and development. First, our research and development spending is in OPEX, which is good so that we do not create future liabilities. What is it that we do? We spend in a given year. We have selected a few programs in which we want to invest. Most of them were presented today. You've heard about imaging. You've heard about hypofractionation. You've heard about polymers. You've heard about Astatine. You've heard about PFAS. You've heard about semiconductors. All those elements are included in our OPEX. Some analysts made the remark that indeed sometimes there was more spending, but not always the equivalent from a top-line point of view. It's true that some of the investments we make support our new ventures that are not directly translated in our overall top-line evolution.
I understand that it may blur a little bit the picture, hence the transparency we provide today. Some of you have asked about the governance around those projects. At group level, we review our roadmap. We make decisions on a quarterly basis. By the way, we are quite capped with the people who are able to do those projects. We need to optimize by design how much we spend and on what. Thomas, why don't you say a few words about the new ventures, the balance sheet, and the cash?
Thank you, Henri. My name is Thomas Pevenage. I've been with IBA for 12 great years. Over the last seven years as Group Treasurer, I've been recently appointed for investor relations. I've actually a second hat being co-structuring and managing the IBA investments, so basically what we know as new ventures.
We'll start with that topic. Indeed, you've heard about new ventures being addressed by IBA as capital-light investments driving future value creation for the IBA group. Today we'll speak about Pantera as an illustration, a recent one. Pantera was incorporated in April 2022 together with our partner SCK CEN. Shortly thereafter, we have invested in-kind contributions being equipment NIP, and SCK CEN has done the same. Along the journey, we have contributed some cash to further develop the company and to bring it to basically Series A that took place in September last year. Interestingly, Series A was a mean for the company to get access to the financial means to drive its ambition.
It was also an opportunity for us to put a valuation thanks to the entry of new investors, and Christophe named them, a syndicate led by EQT, but also including some long-standing partners of IBA. Basically, it translates already today to an investment valuation that is 3.5 x the value of the initial investments, mostly consisting in in-kind contributions by IBA in 2022 onwards. In the future, there will be additional value creation levers. For instance, revaluation like the event that took place with the first capital increase in 2024. We know Pantera has a strong business model. It is definitely a company having the profile to pay out dividends. Of course, as a shareholder, we may have other opportunities in terms of exits that may present themselves over time given the attractiveness of the actinium markets.
Another interesting topic is cash flow management at IBA. I like this topic because it connects multiple building blocks that we covered during the presentations today. We will go to operating, investing, and financing cash flow profiles. On the operating side, there we have two drivers: the profitability and growing profitability from activities, as the different business units have explained so far. We have another element that is that IBA is a working capital efficient type of company. I will come back to that on the next slide. From the investment side, Emmanuel has explained our manufacturing and supply chain model. That is a hybrid model, as we said, balanced between what we do internally when it makes sense and what we do together with partners, suppliers, when it makes sense as well.
That allows us to have a low CapEx type of activity. Coming back to new ventures, we have, as we said, capital-light investments inside already achieved. Why do we say capital-light? It's a mix of in-kind contributions, for instance, where IBA can provide value through technology or through IP that can be contributed as well to partnerships. It may be financial partners. For instance, we listed Wallonie Entreprise, SFPI-FIM, not only partners of IBA also supporting us in new ventures. It can be also industrial partnerships like with SCK CEN for Pantera, also Framatome. Charles has alluded to the partnership for Astatine-211. We can also further leverage on public funding. For example, we also cited IPSAI European funding for the semiconductor initiative together with Mi2-factory or the IHI funding program for Astatine-211 that we also already covered.
Leading to the financing side of the equation, IBA will be basically debt-free by the end of 2026, save for the building leasing, so basically the building in which we are sitting today, and some IFRS leases. That will indeed provide even more room for use of cash flows by then. If you zoom in a bit more on what we mean by capital-light model, let's just have a look at the balance sheet of IBA at the end of last year. It was more or less EUR 600 million of assets and liabilities. What you see in green color is the amount of tangible fixed assets. These account for more or less EUR 50 million. You see a reduced share of the balance sheet, again, thanks to the manufacturing and supply chain model that we have implemented.
Also, another element is the working capital cycle of which I was speaking of a bit earlier on. There, in the blue color, you can see that our project-related liabilities and excess of project-related assets. On the liability side, for instance, advance payments from customers and payables to suppliers. On the other side of the balance sheet, you have the inventories and the contract assets being executed. It shows that despite, and you know the topic, despite the impact of the Spanish contracts, the Ortega contracts that have rather unfavorable payment terms as compared to our standards, we still managed to have this balance approach towards working capital so far, even over last year. We know.
Thank you very much, Thomas. Thank you very much, Henri. Before we move to Q&A, actually, as we were thinking, Henri and I, on how to conclude this Capital Market Day, I want to bring two slides that you have already seen. One is basically summarizing the way we look at the IBA investment thesis. When you buy an IBA share, you buy a robust-based business with a strong upside. Once again, robust-based coming from IBA technologies, mature, profitable, cash-generating, proton therapy services, scaling and profitable, and upside coming from proton therapy penetration, acceleration, potentially capital-light investment, Thomas, and our other colleague just presented to you. Plus, you know the unknown. We know we have this magic touch, this superpower of converting applied physics into accelerator, and we know there's a lot of unmet needs out there. We'll continue through the discovery lab to actually screen other applications where IBA technology can make a difference and create value.
Ladies and gentlemen, it was a pleasure to share with you why we are positive about the IBA future in a chaotic world. Once again, the way we like to summarize it, Henri and I, is three things. We have a very strong competitive product portfolio in a growing market. We have the right setup with the right governance and the right team to actually deliver value for our stakeholders. We are accountable. We are engaged, and we have the best-in-class governance. Last but not least, and I think we put a lot of effort demonstrating to you today, we have a very clear path to deliver on our new guidance. Thank you very much for listening. Now, it's time for a question. We'll take some questions in the room. By the way, you have the opportunity online to ask questions through the chat box.
Henri and I, we have this beautiful iPad where we will be able to read your question. First into the room, please.
Yes, hello. Can you hear me?
Yes.
Okay. So David Vagman from ING. First question on the proton therapy and the path to improve profitability in proton therapy. As of now, the vast majority of the order book was awarded actually before 2023. What is basically the path of the improvement of profitability? Does it look more like a G curve? Or basically, is it more gradual? That's my first question.
Yeah, I think it's going to be more gradual because I kind of disagree with what you just said. Yes, we have the big order from Ortega that will be delivered over the next 24 months, but it's already quite well rebalanced into the backlog today with order that came after 2022, where we have been able to claim, let's say, a more industrial or a more benchmark margin. Do not expect a hockey stick kind of things, but more of a gradual gross margin improvement. Yeah, all this also fed by our service productivity and growth, as we have already described.
No risk of lumpiness until 2027 or from potentially risky projects? Lumpiness in profit, I mean.
You know, I mean, the only reason why I do not say no is because the world is a bit upside down right now. From what we can see on the execution, let's say, journey that we start to fully understand from our customers, I don't see any dramatic lumpiness, let's say.
Okay, thank you. In the long term, and I mean by that, so the short term for IBA, so 2028, what could be the profitability of PT? I understand it's a bit below average. It would be eventually, even in the best of the world, it would be a bit below, let's say, IBA technology, so IBA, the former order accelerator. Is it a fair comment?
I don't think we are guiding on the different profitability of our entities. Yeah.
Okay. Okay. Last question from my side on the clinical trials. You're talking of helping or I would like to better understand what could be the financing by IBA of clinical trials. I'm not a pharma analyst, but in my mind, a clinical trial is extremely costly. How do you manage to keep your investment in clinical trials to a couple of millions or to a very, let's say, controlled amount?
I will start the answer, and maybe we can give a mic to Luk as well. I think Luk is still in the room. Indeed, I think the role of IBA, as we see it, is mainly on using the clinical data generated by the customer. In our plan, and I don't think it's necessary if you look at what Luk has shown us, these clinical trials are financed by either public money or local funding and so on and so forth.
As a leader in this market, it's the role of IBA to take this data, package it, and claim the right reimbursement in the different, let's say, jurisdictions to actually leverage on this clinical output. I see we speak more about market access than on real clinical trials. Luk, I don't know if you want to add something.
Oh, I think you're—
yeah, go ahead.
No, I think you have been quite complete with your answers. The only clinical trials that we foresee to finance, if they are needed to bring product to market, like for example, with Flash, if that would become products to market, in such a case, then we would have to step in for clinical trial. If it's really indication-based, then it's the market with public funding very often that is running those trials.
You have to understand that the regulatory path for proton therapy is what we call 510K. So it's a comparison with existing product. The point of look is, let's say if tomorrow we go to market with Flash, we might have to conduct clinical trial related to the IBA Flash product, which will completely change the dynamic, of course, because no competitors will be able to claim the same claim, let's say, based on that. But today, in our, let's say, plan, we limit our financial exposure or financial investment to market access.
Olivier, I see that there is a hand raised for those attending online. I just want to remind you that you need to post your question in the chat. That's how we can get your question and answer them. Raising your hand will not help. David, you had another question.
Thank you.
Thank you, David. Laura.
Thank you. Laura Roba from Degroof Petercam . First question is on the timing of these R&D investments. Why now? Could you elaborate on the rationale?
We would need to look at them on a case-by-case, but I'm sure you got by now that we've done a strong review, an in-depth review of our opportunities. Some of the moves are justified by the fact that we want to be able to get a fair share of the overall value we create on our equipment. Therefore, we felt the time was now. The momentum, if I to illustrate on actinium and astatine, is now. The momentum in chemistry is as well really now. One day, I may say that we could have done them before, but the momentum is really now for us. That was the overwhelming evidence we got from the strategic review.
Therefore, they are logged for this year. We can always pace the rest as we see how that unfolds, which we will for sure do. As I said, we review those investments on a quarterly basis to reassess whether we are spending our energy and our money in the right way.
Thank you. What is the strategy on new ventures? Can we expect more investments in other fields there or?
You want to take it or I can?
I can start.
You start.
I think every time we meet an opportunity where IBA can be a game changer for an initiative that we will evaluate as being mature enough, you can expect more investment. Nothing dramatic, very much in the form of a capital light. We have shown we are actually super happy on what happened with Pantera.
That's where you can see that we have a lot of it's almost a duty. If we have such an undervalued asset in the IBA portfolio to bring it forward and go get the value we deserve like we did for Pantera. I don't say we're going to find 20 Pantera, but there's a number of initiatives we believe. We talked about it, MI2, PFAS potentially, where both we can serve a dramatic unmet needs in the market and make the difference with our technology. We will do it. Once again, in a capital light approach like we did for Pantera.
That's what I like about it, you know, because we are then selective. As we do it in kind, only IBA can do it. We are not going to start to put tons of money in crazy things. We only invest in fields where really IBA can make a difference. The collateral is that in most cases, we will invest in kind.
Thank you. One last question. When you mentioned two drivers behind additional proton therapy adoption, clinical evidence and then cost efficiency, which one of those two drivers are the most important in your view?
Yeah, I do not know, Luk. I am not inspired. Maybe you are inspired. Both. I would say both, but it is an easy one.
It is a different lever.
I would like to start with the words that you used before, Olivier, proton therapy today is already very cost-effective. Of course, it is very often being benchmarked against conventional radiation oncology, which is as a therapy only, significantly less costly. Proton therapy is more costly than conventional radiation oncology.
However, if you put it in the big spectrum of oncology care, it's not that expensive. If we look at certain immunotherapy, for example, they are a factor even more expensive than proton therapy, whereas the therapeutic value contribution of proton therapy is very high. That's already one starting point. Evidence generation is very important because it's very often the barrier or the necessity for payers, both public payers in social security-based payment system like here that we know very well, but also with more private-driven payment systems like in the U.S. Level one evidence is the key enabler to reimbursement. I would say if I would have to choose between two, I would first go for medical evidence. However, the more we can do on cost-effectiveness, the more it will contribute to adoption as well.
I would still like to say something about the first question on evidence generation. We are basically an enabler as well for those investments. There are a few good examples. One is a European-funded trial on esophagus cancer where there was a need to have the industry involved. We do contribute, and that enabled unlocking European funding for that trial. We steer, we enable, we steer because we know what is needed, and we enable so that we can unlock money together with our academic partners.
Now, coming back on that, I think I can see two potentially disruptive, let's say, innovations in the proton space that can completely change the dynamic. One is clinical, is the biological effect of proton therapy. We did not talk about that, but in the MD Anderson study, the follow-up is showing an increase of survival rate for proton therapy versus conventional radiation therapy. That is very clinical. If we can show that, I mean, if this becomes a reality, it is super disruptive. Suddenly, it is ethical to treat with proton therapy for the indication where we can show a significant survival rate increase.
The second one is flash. Flash will be both the clinical, but also from a cost-effectiveness. You have understood from what Luk has presented to us, it means basically that you multiply or you divide the cost of proton therapy treatment by the number of fractions that we are using today, which is favorable to proton therapy already. That is the ultimate hyperfractionation, and it is a game changer. One is cost-effectiveness. One is more clinical. I have the luxury to have both.
Thank you.
Thank you, Laura.
Hello, Michiel Declercq , KBC Securities. Thank you for the presentation and also the slide on the tariffs, which is, of course, a hot topic at this moment. Thank you for the visibility on that. I was just wondering if you already had some first thoughts of some of your customers, because I think a big part of the orders currently in the backlog are also U.S. orders. Is there maybe a risk that the customers postpone it or that they ask for a delay in delivery until there is more clarity on the tariff itself? Could this result in some delays for you in terms of the backlog conversion as well? Also, you already gave the numbers on the revenue of 2024 that were U.S.
Can you give a bit of sense of the current equipment backlog? How much of that is the U.S.? Maybe a third follow-up also on the tariff front, looking at new contracts, because you mentioned during the 2024 conference call that you've seen a lot of activity also in the U.S.. What, yeah, the first responses are there? Are they taking a bit more of a prudent approach? Those would be some tariff-related questions.
No, no, of course. Emmanuel, you want to get a crack, and then we can complete or complement?
I can take the customer side. I would say at the scale of a proton therapy project, the tariff on the proton system X works, I would not say it's in the background noise, but almost in the background noise. So many of the backlog supposed to go to the U.S. is already in the U.S.
We still have a number of projects that are due to be delivered. Even though I didn't speak, and maybe Luk, you spoke to a few of them, I think we have had contact maybe even today. I'm not aware of it today, but on Friday, we didn't have any phone call saying, "Let's stop everything. Please, please don't ship." Quite the opposite. I expect, of course, we still need to understand the impact on the demand in the U.S. Once again, at the scale of a proton therapy investment, total cost, building, equipment, everything else, I expect the impact of the tariff to be fairly limited.
Luk?
We haven't had any customers reaching out to us specifically related to that. On top of that, what Olivier just mentioned, these projects, when they are in backlog with us, the customer is deeply engaged already in building the facility. That is very often far progressed already. A lot of costs have been made already. A delay or a stop on that project is not so easy to put in place.
Maybe if I can ask a short follow-up on that. In general, you have your P1 solution, which is EUR 15 million equipment, which of course includes the building as well. How much revenue of that EUR 15 million is actually from imported goods from the accelerator, and how much is the building? Is there something that you can say on that? Because that would limit your 30% U.S. exposure.
I don't have the number on top of my head, and I don't think we disclose that kind of thing because there's a bit of a competitive, let's say, I would expect it to be a single-digit percent on the total project. We do not mean to be mysterious, but we knew somebody would ask the question, and we have decided not to answer it in a specific way because otherwise we give away business secrets, and that would be stupid. You have seen how we think about impact overall of the tariffs. We are getting ready to cope with it. For me, it should be minimal. Should we not do anything? I think Emmanuel explained to you that we have a lot of ideas and more will come. I don't expect it to be more than a low single-digit impact on the total project.
I think on new projects, what we need to consider is indeed the cost of the building, which is for the customer a significant venture, and also the cost of the installation, which is also some labor. Not the major part, but still also a part that is not directly impacted. That is why overall the impact is just medium for us.
Okay. Thank you for the insights.
Other questions in the room? Yes. Front row. One more.
Sorry. Two questions on the proton therapy part of the business. One on the margins and one on the longer-term growth ambitions. You mentioned with regards to the gross margin of the services part of the proton therapy business that you expect some kind of improvement potential, for example, from predictive maintenance and stuff like this.
My current understanding is that the vast majority of your cost of sales in that bucket is personnel related. You, I think, need four to five people full-time on-site for the normal machines and up to, I do not know, 6-12 people even for the larger machines. In terms of improvement potential, could you maybe describe what you guys are penciling in for kind of predictive maintenance? In terms of the FTEs, you would need less of in future projects. I think that is my first question.
It is a very good question and a very detailed one. Isabelle, give a mic to Isabelle. I will start, but Isabelle will certainly continue. To the point, I think it is, and that is what Isabelle has explained, is the business model will change. It will be possible to change with the density per region, let us say. Take Spain.
Spain, we have one proton therapy system. We will maintain very differently an 11 proton therapy system in Spain versus one system in Spain. We have many instances over the world where the region density of our install base starts to be, we have reached a critical mass where we can really start to change the staffing model, to your point, to actually deliver indeed productivity at scale on our install base. Indeed we have AI. You have to remember, maybe it sounds like a long time, but this product was put in the market, I don't know, Isabelle, maybe 2015, something like that. We start with 10 years, 40 sites. We really start to understand the beast, let's say. That plus AI makes this system, let's say, cheaper to maintain for us today and tomorrow. Isabelle, don't hesitate to add it.
Yes, that's correct. We started with the ProteusONE in Nice, in France, in 2016, so close to 10 years ago. We have learned a lot. Here, thanks to all these areas, for instance, Spain, but we have started with Italy, we create what we call an area. We materialize the resources in terms of management, but also in terms of the people who will do the maintenance. On top of that, thanks to AI, we will do condition-based maintenance. Instead of doing the maintenance as it is planned every six months, we'll make sure that we use the indicators that are collected in our database to trigger the maintenance at the right moment.
On top of that, like for the countries that we will be in an area model, we will have those pools of resources, local resources immediately available. For sure, yes, we will have huge savings.
Thank you, Isabelle. We have a long list of questions on the chat, which we would love to take, Olivier, if that's okay. We can take them in popcorn mode, try to give very short answers, and then we can further complement as needed. Why not contracting debt for leverage at this stage? As explained, we simply don't believe we need it. There is a question on PFAS destruction. Are we considering a partnership with other companies? Yes, we are in discussions with many players, industrial players producing PFAS, water treatment companies. Believe it or not, filtering companies are those companies that provide those carbon filters. It's an industry as well.
We are talking as well with the Walloon region. The idea would be to create a partnership that would allow us to launch an experimental center here in the country, making Wallonia one of the first PFAS-free regions. We are really at the moment where we discuss concrete partnerships. As you can imagine, there is a lot of interest. Matthias is asking whether there is pressure on DNI or other pressures in the context that is affecting us. I think, Matthias, we are for the moment immune to that. There is no visible impact, but of course, we carefully monitor the situation. What would be the cost, Emmanuel, to set up a local U.S. production facility? We get as a question, is that in your plan?
I mean, as mentioned earlier, we're investigating different plans going from local procurement. As we've said, we've been developing double sources for critical parts. This is something we could also do with U.S. suppliers. We could go up to assembly, up to testing. Different scenarios, of course, different levels of cost involved. We have to understand the return of investment of this different scenario.
Another question in the same vein. When we think about doing more stuff in the U.S., what is it that you have in mind? What could that mean concretely in your plans?
We haven't decided yet. We need to investigate on the different items of our portfolio, focusing, of course, on the business units where we believe it would create most value. This is part of the analysis that is ongoing.
Bear in mind that the value we generate, we do it a lot with people, actually. I know it sounds counterintuitive when you see so many machines.
Actually, a lot is happening. Sometimes I compare IBA to a car manufacturer. What we do here is the engine. All the rest is done locally. Actually, a lot of the value added of what we do is already very local today. We have mostly a virtual factory approach with a network of suppliers. We can easily navigate localization of whatever is not done here, which is the engine of the car, let's say.
Olivier, about listing, I know you like that question. About Euronext?
Yeah, I think we, what can I say?
The question is, would IBA consider double listing? Liquidity on Euronext market is questionable.
Yeah, I think we understand we have a bit of an issue on the liquidity of IBA shares. We have the ambition not to stand still on that. One of the reasons why we have hired a very seasoned CFO, let's say. We have not taken any decision, but we will assess whatever makes sense for us in order to improve the liquidity of the IBA shares in the near future.
Again, a question on U.S. How fast can we be set up in the US? Would that be needed?
That depends again on the solution we are targeting. We believe that for some aspects, we have already identified some suppliers that we think could, I mean, be in our supply chain. Now we know that it's not immediate from one day to the next. I mean, given the technicity, the complexity of our products, many of them are not off the shelf. They need some customization at least.
It is not something that would happen overnight. Let's say, given our lead times, we could consider them relatively quickly in our supply chain for new contracts.
One of the questions is, as IBA is moving to a more diversified group, are we moving to a more diversified group thanks to predictable cash flows in the next 5 to 10 years? I hope we convey today that indeed we are doing that, but not in a defocused way. We stay true to our core of accelerator technology. I think the idea is to diversify.
One of the, I do not know if we disclose it to the market, but the project, the new organization project, we called it internally Fit for Growth. Fit for Growth was about giving the right focus to our existing business and IBA Clinical and IBA Technologies, but also to set up the group to be able to seize new opportunities such as Pantera. It is a bit linked to the question already asked here in the room. It is indeed every time IBA, through technology or market access or regulatory knowledge, will be a kind of accelerating shareholder to any venture which we will validate. I think indeed it is our duty to go and get it.
Yes, I think we are structuring ourselves so we can capture these kinds of opportunities going forward and kind of diversify the group without losing focus because the link between everything we do, being in clinical, being in technologies, being in new ventures will be linked to our magic touch or magic power to develop, manufacture, and maintain the best accelerator, industrial accelerator in the world. Every time we can leverage that, we will. The new organization is about that. Fit for Growth.
Olivier, there is a question about how do we go about China for other accelerator, former other accelerator IBA Technologies. We are looking for new joint ventures, sorry. We believe we need a strong local partner to be able to go beyond what is it that we could do or that we are already doing alone. Let me not detail that out right now, but we'll keep you appraised as this is unfolding. I'm actually meeting partners tomorrow. Olivier, what can we do?
Shall we take advantage that Jay is in the room to give him a mic? Yes. Jay, do you want to take a mic and give your perspective on IBA potential in China? Clinical, I mean, proton therapy because you've been involved with proton therapy for the last two months, but in general, Jay?
Yep. I think in the China specific slides, Olivier mentioned about China has a very big potential. Up to now, if we say, if we're combining with the past 13-5 year plan plus the 14-5 year plan, it's more than 60 unit license has been there. China has a big potential on that part.
In China, we have the mission that we want to build IBA, position IBA as kind of the most credible clinical player in that part. To achieve those objectives, we are working on our China specific strategy plan on that part. We will consider our go-to-market strategy and how we can improve our operation efficiency in that to capture those growth opportunities.
I think we have only scratched the surface of what we can do in China. Hence the presence of Jay that will build a team. I think we want to operate IBA China like a fully developed company in China, for China, by China. Once again, I think we have only scratched the surface of what is the potential for China. I forgot to say it before, Jay, welcome to IBA.
Thank you very much. It's my privilege to join this company.
Olivier, we still have a small dozen of questions. Do you want to select a few before we close?
I think there's a lot of questions on proton therapy. We need more questions on technologies.
One of the questions for Isabelle is, is there a competitor in PT service? Can someone do it instead of us? Is that something we can ask?
Maybe Isabelle wants to take the question. There's a lot of proprietary technology linked to that, but Isabelle?
You mean only for the service?
Yeah, for the PT service part.
For the PT service part, yes. That's an excellent question because usually we have that also, that question when we have with our customer, when we do a renewal, they are always, joking with us about, but do you have a competitor? For us, no, we do not. Usually, due to the technology we use, the way we perform the service, the way that we have to maintain our install base, and the knowledge that we have, we do not have a competitor so far who can compete and replace us for the maintenance and the operations.
I have a question here that Luk will love. Luk, you can already give the mic to Luk. Luk, wait for the question. Can you say something about the commercial setup? Do you work with account managers, central CRM, the C-level visit core customers, client roadmaps, etc.?
I can take the last part. I spend about 50% of my time on the road together with Luk and the team to actually visit customers, understand them, show IBA commitment. You have to understand that it's true for proton therapy, but it's true for all our product portfolio. It's more like a wedding than a transaction. When customers are buying a system from us, we are together for at least 30 years. They always want to see the top and the C-level commitment. There is not one single transaction that at some point I need to get involved. It doesn't mean Luk is not doing his job. He's doing his job fantastically. It's a very long-term relationship. Almost it's like a strategic relationship. When we sign a proton therapy contract, it's actually, yeah, a very long-term partnership signature with a customer. Yes, we have a very thorough and detailed go-to-market strategy. Luk, if you can say a few words.
Yeah, thank you, Olivier. I will not comment on the number of miles we have together on the counter, but indeed we visit quite a bit of customers or future customers together. The way we are set up for a go-to-market perspective, we have four main regions. We have the Americas, EMEA, Asia-Pacific, and then China as a separate setup. We act very globally. We do a lot of high-value deals, but very low volume, which is challenging to have a commercial setup for such market dynamic. We have been creating in the last couple of years, we have been growing our critical mass of commercial employees in those regions. Indeed, I heard account management as well has been growing over the last couple of years. These are very often high-profile luminary accounts.
They not only require a lot of attention, but there is a lot of value for us to spend a lot of time with them as well because they are our drivers of innovation. They are our drivers of the market. We do spend a lot of time with them locally.
Maybe you can keep the mic, Luk. There's a question about clinical trials and how come it has taken so many years before there is a clinical study on survivorship versus traditional radiation therapy? Why would you not invest in here if it could triple your market? It would be the best investment ever. Why has it taken so long?
Very good question. I think it really needed a maturing of the market. As you have seen in one of those slides that Isabelle was presenting, for about 10 years, the number of proton therapy centers out there was very, very, very limited. It took a critical mass of centers that had a belief in this therapy, that had a belief that this therapy was more than just research and experimental. For a very, very thin niche population of indications, which were pediatrics mainly, on which there was a decision early on, it is too obvious that for these patients, proton therapy is so advantageous that we cannot run. It is unethical to run a clinical trial. It's only when they started to see potential for proton therapy in other indications on adults. This head and neck trial is a very good example. Specific or a subgroup of breast oncology will be a good example as well.
Esophagus, that center started to join forces and build these types of clinical trials. Once a clinical trial design has been decided, it really takes quite a long time before we reach the first endpoint to give an idea. The MD Anderson trial, which I briefly touched upon, almost initiated the idea, at least the concept almost is 10 years old. It started, I think, eight years ago. That is why it took so long. Why do we not invest in it? We do invest in it, but as I said, more as an enabling party. We have been doing that more significantly in the last couple of years.
We try to steer, we create platforms as well to bring our customers together and to debate about what should we do on the clinical side, where can we get the funding, how can we help by seed funding, for example. It is quite challenging for us to do a full, full clinical trial funding because it's quite expensive and a little bit out of reach. Who knows for the future, for very specific cases, we are not closed to that idea.
Thank you very much, Luk. Thank you very much, everybody. Actually, they told me here that we are at the end of the timing. Thank you very much for joining us. Thank you for your time and commitment to our beautiful company. Thank you, Henri. Thank you, the team, for preparing such a great presentation.
I guess for the one here, we'll have a very exciting tour of the factory. For the others, we'll speak to you at the latest end of August for our first half financial result. Thank you very much. See you soon.