Hello, ladies and gentlemen, and welcome to the conference call of Medios AG. At our customer's request, this conference will be recorded. As a reminder, all participants will be in listen-only mode. After the presentation, there will be an opportunity to ask questions via the telephone conference. If any participant has difficulties hearing the conference, please press zero, followed by the hash key, for operator assistance. May I now hand over to Claudia Nickolaus, Head of Investor and Public Relations and ESG Communications at Medios.
Welcome, everybody, to our earnings call for the first quarter, 2024. As always, all relevant documents can also be downloaded from our investor relations website. Additionally, this presentation can be followed in parallel via the internet link provided to you in the invitation. Today, with me is our CEO, Matthias Gärtner, and our CFO, Falk Neukirch. Matthias will start with an executive summary, followed by Falk, who will then provide details on the financials for the first quarter, 2024, the guidance for 2024, and the outlook for 2025. Finally, Matthias will comment on Medios' growth story. After the presentations, we will begin with a Q&A session. I would now like to hand over to Matthias.
Thank you, Claudia. Ladies and gentlemen, welcome to our conference call for the first quarter of 2024. Overall, we started with a solid business performance into the year, with a strong operating cash flow. The main highlights of the first quarter, 2024, are shown on slide three. Let's start with the financials on group level. We recorded an almost 6% rise of revenue to EUR 456 million, with a slightly increased EBITDA pre of EUR 15 million. We posted a very strong operating cash flow of EUR 43 million, compared to -EUR 25 million last year. On the basis of these solid figures, we confirm our guidance, 2024. Falk will provide more insight on the financials later.
Our main highlight of Q1 2024 is the acquisition of Ceban, an outstanding event for Medios, a milestone on our mission to create a European specialty pharma platform. This brings me to the news published yesterday. We are proud and very blessed to have Constantijn van Rietschoten on board since about a year now, and on May first, he was appointed as further member to the executive board. Our new Chief International Markets, in short, CIM, will drive the international activities of Medios and develop them further as a renowned expert for the various international markets. Furthermore, in Q1, the executive board contracts of Chief Operating Officer Mi-Young Miehler and Chief Innovation Officer Christoph Prusseit were extended ahead of schedule. Regarding our ESG activities, we continue to work on the implementation of the CSRD and EU Taxonomy requirements.
Consequently, our non-financial reporting 2024 will be fully in line with these new standards. Finally, a few words on our most recent and first acquisition outside of Germany. Ceban Pharmaceuticals is the Dutch market leader and also has activities in Belgium and Spain. We see this as an outstanding milestone in implementing the Medios internationalization and growth strategy. On slide four, you can see an executive summary of this transformative and value-enhancing acquisition. This acquisition is the first milestone in our journey and vision to build the leading European specialty pharma platform. In addition, we get immediate market access to three European countries: the Netherlands, Belgium, and Spain. The new Medios Group will have a leading position in compounding of specialty pharma in Northwestern Europe. With this acquisition, we will significantly diversify our product portfolio and value chain in specialty pharma.
We will run a network of 23 owned pharmacies in the Netherlands, and we'll be adding the API business. API stands for Active Pharmaceutical Ingredients, and the high-margin, non-sterile business as well. The good cultural fit of the two groups strongly supports the cross-selling of potential and synergies. I would like to stress that the transaction is immediately EBITDA accretive and will increase our earnings margin from the very beginning. We expect the closing of the transaction to take place during May. Now, let's move to slide five . Our German-wide network of around 800 specialized pharmacies will be enlarged by Ceban's network of around 3,300 pharmacies and more than 200 hospitals, as well as the 23 owned pharmacies. This is an excellent basis for our further European expansion and the realization of synergies and cross-selling opportunities.
This also means that the number of the currently around 400,000 individualized preparations in 2023 will substantially increase. More information on the Ceban transaction is provided in the appendix of this presentation. We expect to significantly exceed the EUR 100 million mark in EBITDA pre already in 2025, with an EBITDA pre-margin of over 5%. Falk will provide more insight on the financing later. Now, some comments on the financials for the first quarter of 2024, as illustrated on slides 6 and 7. Slide six shows the quarter-on-quarter development of our two KPIs, revenue and EBITDA pre. Revenue, EBITDA pre, and their respective margin for the first quarter were above the level of Q4 2023, despite the already described regulatory price adjustments still impacting our PST business. Moreover, Q1 2023 revenue included EUR 3 million coming from Kölsche Blister that was sold in June 2023.
Revenue in Q1 2024 increased by around 6%, and EBITDA pre was slightly ahead of the first quarter of 2023, as shown on slide seven. All of this growth was attributable to organic growth. This is all from my side for the moment. I now hand over to Falk to provide more details on the financials for the first quarter 2024, the guidance 2024, as well as our targets for 2025.
Thank you, Matthias. Also welcome from my side. I will give you an overview on the financials for the first quarter of 2024. A full financial statement can be found on our website. Let's start with slide 9. As already mentioned, we had a solid first quarter 2024. Revenues increased by 5.8% to EUR 456.2 million, driven by the operational segment, Pharmaceutical Supply. Gross profit was almost flat, amounting to EUR 27.6 million, with a lower gross profit margin of 6.1%, compared to 6.5% in the previous year. The growth of the PS segment was absorbed by the lower gross profit of PST, due to the already mentioned deconsolidation of Kölsche Blister, regulatory headwinds, and higher performance-based payments for additional compounding orders.
The decrease of personnel costs by 4.2% to EUR 8.6 million results from deconsolidation of Kölsche Blister end of May 2023. Mainly due to increased legal and consulting costs, largely attributable to the acquisition process of Ceban, other operating expenses increased by EUR 1.7 million to EUR 7.3 million. Thank you. An almost flat EBITDA pre of EUR 15.1 million compared to EUR 50 million, resulted in a slightly lower EBITDA pre-margin of 3.3%, compared to 3.5% last year. As previously stated, the margin was burdened by regulatory price adjustments, as well as increased contribution of the PS segment, resulting in lower EBITDA margins. The EBITDA pre was adjusted by extraordinary expenses in the amount of EUR 3.3 million, compared to EUR 1.7 million last year.
This consists of EUR 4.3 million expenses for stock options, EUR 1.6 million for M&A transaction costs, EUR 1.4 million for performance-based payments for the acquisition of compounding volumes, and EUR 4.04 million for ERP system implementation. Depreciation and amortization amounted to EUR 5.2 million and remained almost unchanged compared to first quarter 2023. The financial result of -0.7 million euro is slightly below previous year level of -0.4 million euro, and mainly includes interest payments for the utilization of the RCF and provision fees for the secured bridge financing relating to the Ceban acquisition. We generated a strong operating cash flow of EUR 43.4 million, compared to -25.4 million euro in the first quarter 2023.
This development mainly resulted from the positive operating result and actively managed working capital at the reporting date. As highlighted already in our last earnings call, end of March, in future, Medios will focus even stronger on cash flow by pursuing an active working capital management, especially in the PS segment. The goal is to generate quarterly a perpetual positive operating cash flow in the group, and thus increase the annual operating cash flow compared to the previous year significantly. For the first quarter, we delivered on what we were, we were aiming for, even so, supported by a few cash flow tailwinds on the reporting date. Investing cash flow of -EUR 0.4 million reflects primarily investments in equipment, whereas Q1 2023 was dominated by the cash component for the BBW acquisition of EUR 19.2 million, less acquired funds.
Financing cash flow of -EUR 1.3 million reflects interest payments, repayments of financial liabilities, as well as, as payments for long-term finance lease contracts. Free cash flow before M&A amounted to almost EUR 43 million, following the operating cash flow in the first quarter of 2024. Cash and cash equivalents amount to roughly EUR 113 million, compared to EUR 71 million at year's end 2023. The equity ratio decreased from 78.8% by end of 2023, to 75% by the end of the first quarter 2024.
Let's now switch to slide 10. The 5.8% increase of group revenue is solely driven by the PS segment. The external revenue of the PS segment rose by 8.9% to around EUR 401 million e xternal revenue generated by the PST segment decreased by 12.5% to EUR 55 million, a decline of almost EUR 8 million. Around EUR 3.5 million of this decline are attributable to the sale of Kölsche Blister.
In addition, as already mentioned, regulatory price adjustment, as well as higher performance related payments for the acquisition of compounding volumes, had also negative impact on revenue in the first quarter. EBITDA pre for PS segment amounted to EUR 11 million, a plus of EUR 0.9 million or 9%. The EBITDA pre for the PST segment declined by EUR 0.7 million to EUR 5.9 million, nine point four percent below previous year, mainly due to the already described regulatory headwind. The sale of Kölsche Blister had no significant impact on EBITDA pre year-over-year.
The margin in relation to external revenue in PS was stable at 2.8%, whereas the PST margin increased from 10.4% to 10.8%. On group level, the EBITDA pre-margin of 3.3% is slightly below the margin of the previous year. Let's now go to slide 12, providing our guidance for the full year 2024 for the Medios group, including Ceban, and an outlook for 2025. We confirm our guidance for 2024. We expect revenues to reach the range of EUR 1.9 billion-EUR 2.1 billion, reflecting a growth of 11.1%, considering the middle of the corridor. EBITDA pre is expected to be in the range of EUR 82 million-EUR 91 million, a disproportionate rise of 43% at the middle of the guidance corridor.
The guidance of 2024 is subject to the assumption that Ceban acquisition will be closed still in May, and we are able to fully consolidate Ceban as of beginning of May 2024. The EBITDA pre-guidance includes integration costs, but it is adjusted for extraordinary expenses like M&A transaction costs, expenses for stock option programs, performance-based payments for compounding volumes, and implementation costs for an ERP system. As our ambition for 2025, not as a guidance, the further integration of Ceban is expected to lead to revenues of approximately EUR 2.15 billion. The reason for the slightly lower revenue increase is a focus on increasing margins and cash flow, which to a certain extent also means that we would accept waiving revenues with lower profitability.
Also, as an ambition, but not to be understood as a guidance, we expect in 2025 for the first time to cross the EUR 100 million mark in EBITDA pre, by a targeted EBITDA pre of around EUR 110 million, and the corresponding EBITDA pre-margin of around 5.1%. This shows very clearly that the acquisition of Ceban is EBITDA pre-margin accretive. We will significantly increase our profitability with a potential EBITDA pre-margin above 5%. A summary of our strategic priorities is outlined on slide 13. For this, I hand back to Matthias.
Thank you, Falk. Our growth strategy is strongly advanced with Ceban. Its three pillars are outlined on this slide. In addition to strengthening our core business in Germany, Ceban will enable us to expand our operations into other European countries. And we plan to further diversify our business model by entering the production of advanced therapies, meaning medicines based on genes, tissues or cells, all expensive and complex therapies. This is also a very good fit for Medios, as we are already a trusted partner for high-value drugs in Germany, and we will be one in our new European markets as well. As said at our last call in March, the vice president, being responsible for the new field advanced therapies, started on April 2. We are very blessed to have Dr. Andreas Schmiede on board.
Andreas holds a PhD in biochemistry and has more than 25 years of professional experience in the field of diagnostics at QIAGEN, biotechnology and biopharma, among others, at Baxter, Shire and Lonza. Andreas has held various senior leadership positions in R&D, strategic and technical operations, business development, M&A, and sales, and has several years of experience abroad, e.g., USA, Brazil and Switzerland. In his last position, Andreas worked for more than 7 years in the field of cell and gene therapy in several companies. Before he joined Medios, he was Senior Director, Strategic Business Development and Account Management at Lonza. I'm sure we will report regularly on progress in the area of advanced therapies in the future. As a result of Ceban's integration and the implementation of our growth story, we defined financial targets for 2025, replacing and exceeding our previously mentioned midterm targets, as just presented by Falk.
We remain excited and confident that we will achieve these targets. In a nutshell, our growth story is well on track. Thank you very much for your attention. Falk and I am now available to answer-.