Ladies and gentlemen, welcome to the conference call of Medios AG. At our customers request, this conference will be recorded. As a reminder, all participants will be on a listen-only mode. After the presentation, there will be an opportunity to ask questions. If any participant has difficulties hearing the conference, please press star followed by zero for operator assistance. May I now hand over to Claudia Nikolaus, Head of Investor and Public Relations at Medios.
Ladies and gentlemen, welcome to our conference call on the results for the first nine months of 2022. As in the past, 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. The call today is hosted by our CEO, Matthias Gärtner, and our CFO, Falk Neukirch. Matthias will start with a summary, followed by Falk, who will then provide details on the financials for the first nine months of 2022, as well as on the outlook for the remainder of the year. Finally, Matthias will comment on Medios growth strategy. Both Matthias and Falk will be available to answer your questions afterwards. I would now like to hand over to Matthias.
Okay. Thank you, Claudia, and also a warm welcome from my side. Thank you for joining this call, and thank you for your interest in Medios. I'm proud to present a further set of excellent results today. The first nine months of 2022 were by far the best for Medios, and Q3 was our seventh consecutive record quarter. Let's go directly to slide three, providing an overview of the achievements and highlights for 2022 so far, whereby my comments refer primarily to the third quarter. What were the highlights of the third quarter? First, we have received the manufacturing permit for our new GMP lab in Berlin. This is a significant step towards increasing our compounding capacity in the higher margin segment, patient-specific therapies, abbreviated PST. Furthermore, we will be able to prepare for compounding for next generation medicines, for example, in the field of personalized therapies.
With this permit, everything is set to begin compounding for our partner network of specialized pharmacies next week. Those attending our capital markets day on November 24th will get a first-hand look at our new cutting-edge labs here in Berlin. Second, the integration of NewCo is progressing very well, and we continue to see good synergy and cross-selling effects. Third, our financials are strong with another record quarter in terms of revenue and EBITDA pre, driven by the integration of NewCo Pharma and to a lower extent, also by organic growth. In a nutshell, we are very well-positioned to achieve our targets for this year. Consequently, we confirm our guidance for 2022. Also, we were impacted by the changed reimbursement scheme in our PST segment for some cytostatic medicines, which became effective on September 1, 2022.
While we expect our revenue to reach the upper range of the guidance, EBITDA pre will presumably come in at the lower half of the range of EUR 52 million-EUR 58 million due to this effect. Falk will provide more details on our outlook later. Our mid and long-term strategy, including internationalization, will help us to mitigate further the potential negative effects of the general economic and regulatory environment. We are working on additional measures which will also help us to offset the potential effects. We are very confident to successfully continue our growth story. Now, a short summary on the financials for the first 9 months of 2022, illustrated on slides 4-6, impressively showing our profitable growth. Slide 4 illustrates the strong continuous quarterly growth of our two KPIs, revenue and EBITDA pre.
Again, reaching new revenue and EBITDA pre records for the 7th record quarter in a row. The 9-month figures on Slide five highlight the disproportionate EBITDA pre-growth of 55% to almost EUR 44 million, also leading to higher margins. We have also made good progress towards our goal of expanding the share of the compounding business within the Medios portfolio, as illustrated on Slide six. This reflects the impact of the consolidation of NewCo Pharma since January, a remarkable increase of the share of PST business. Compared to last year, we increased the revenue share for PST from 5% to 14%, and for EBITDA pre, we doubled the PST share coming from 20% to now 41%. This development is fully in line with our strategy and goal to increase the share of the higher margin PST business.
As the numbers demonstrate, we are successfully integrating the NewCo Pharma Group. We are on track to combine growth with significantly and sustainably increased profit margin of the entire Medios Group. On Slide seven, we can see the strong network that we can build on with the integration of NewCo Pharma Group. Furthermore, the start of the compounding at our new GMP lab in Berlin will help to increase the Medios Group's manufacturing capacity in the higher margin PST segment, up to 600,000 preparations per year. This new GMP lab is one of the most modern, safe, and effective GMP laboratories in Germany. It will enable us to work even more efficiently, make processes safer, and increase profitability at the same time. 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 nine months of 2022, and on the guidance for 2022 as well.
Thanks, Matthias. Welcome from my side also. I will give you now an overview on the numbers and the focus on the first nine months of 2022, unless I refer to a different period. The full set of financials, as always, you can find on our website. Let's start with Slide nine. That the revenue increased by 22.5% thereof 6.7% organic, and 15.8% inorganic, resulting from NewCo Pharma acquisition. We see a disproportionate rise of earnings per season compared to previous years. The gross margin increased from 5% to 6.7% due to the higher share of PST business, also resulting mainly from NewCo Pharma acquisition.
EBITDA pre rose by 55.1%, and the EBITDA pre-margin reached 3.6% compared to 2.9% in the previous year. Personnel costs follow the higher number of headcount with 514 as of September 30. The increase of personnel costs by EUR 10.2 million to EUR 24.3 million is mainly attributable to EUR 7.4 million personnel costs of NewCo Pharma, EUR 1.2 million from stock option programs, and the development of central functions and board remunerations. The increase of other operating expenses by EUR 7.6 million to EUR 16 million was in the amount of EUR 5.1 million, driven by the integration of NewCo Pharma Group, followed by rising rental costs, primarily due to the increase in rented space and the new manufacturing site in Berlin.
Further cost increases resulted from higher energy consulting and integration costs. Despite these higher expenses, EBITDA pre outperformed revenue growth considerably, so the NewCo acquisition is already paying off. For your information, the adjusted EBITDA, so-called EBITDA pre, was adjusted by extraordinary expenses in the amount of EUR 2.7 million. On the one hand, for stock options by EUR 2.1 million. On the other hand, for M&A transaction cost of EUR 0.6 million. Depreciation and amortization climbed from EUR 11.6 million to EUR 16.1 million, mainly due to the amortization of customer-related intangible assets attributable to NewCo Pharma. Of the EUR 16.1 million, almost EUR 11.2 million results from former PPAs. Roughly EUR 5 million results from non-PPA acquisitions, and thereof, EUR 2.3 million from IFRS 16 amortizations.
Operating cash flow amounted to roughly EUR 18 million, thereof EUR 8 million in the third quarter of 2022, compared to around EUR 40 million in the first nine months last year. This development is caused by two extraordinary effects in 2022, the tax and social contribution payments for stock option plans of almost EUR 8 million in the first quarter of 2022, and the temporary increase in inventory in the first half of 2022 to prepare for expected price increases. We already started to reduce our stock in the PS segment and would expect continuing reduction with further positive side effects for operational cash flow during the fourth quarter of 2022. Cash flow from investing activities was especially impacted by effects in connection with the acquisition of NewCo Pharma.
The cash component of the purchase price for NewCo Pharma acquisition was EUR 88 million and further operational investments of EUR 3.5 million, mainly in the new manufacturing site in Berlin. The financing cash flow of -EUR 39 million resulted primarily from the repayment of tranche A of the syndicated loan of EUR 25.2 million. Furthermore, the cash flow includes the scheduled repayment of almost EUR 10 million from former shareholder loans of the NewCo Pharma. Currently, Medios has access to a credit facility of EUR 17.5 million, which has not been used yet. Medios currently negotiates a syndicated loan of EUR 75 million to replace the present loan. Cash and cash equivalents amounted to EUR 62.1 million at the end of the reporting period.
The equity ratio increased from 75.2% by end of 2021, to a very solid level of 75.6%. On Slide 10 and 11, we provide a breakdown of the organic and inorganic growth per segment for the nine months of 2022. Sorry. Let's start with Slide 10. Revenue grew organically by EUR 66.8 million or 6.7%. The inorganic growth amounted to 155.9 million euro or +15.8%, driven by the acquisition of NewCo Pharma. Around 74% of the inorganic revenue growth were allocated to our PST segment and the remainder to PS segment. The organic growth of EUR 66.8 million occurred almost entirely in the PS segment. Slide 11 shows the EBITDA pre breakdown by segment for the first nine months 2022.
EBITDA pre grew inorganically by almost EUR 60 million because of the NewCo Pharma integration. Thereof, EUR 12.7 million were allocated to our PST segment and the remainder to PS segment. The increased demand for headquarter function, post-merger integration efforts, and consulting cost increase cost level in the segment services. Let's now switch to Slide 12. As just explained, organic sales growth was 10.5% in the segment patient-specific therapies and overall segment revenue declined because of the NewCo Pharma acquisition. EBITDA pre rose respectively. This is fully in line with our strategy to focus on higher margin products and to increase the share of compounding business. The EBITDA pre-margin decrease is a result of NewCo's PST business with lower margins due to a different product mix and the regulatory price reductions, the so-called Hilfstaxe, effective since September 2022 for compounding of some cytostatic drugs.
As already highlighted by Matthias, the share of the segment PST in EBITDA pre of the group is, as it was for the first half of 2022, above the target level of 40%, while PST revenue is at 14% of group revenue. Let's now switch to Slide 14 and 15. Despite ongoing economic and regulatory uncertainties, Medios confirms the guidance for 2022. We expect revenue to reach the upper end of the range of EUR 1.45 billion-EUR 1.6 billion. However, EBITDA pre is expected to reach the lower half of the range of EUR 52 million-EUR 58 million due to the regulatory changes in the patient-specific therapy segment for the compounding of certain cytostatics.
According to our current projections, the reduced purchase price from September 1, 2022, and the adjusted manufacturing prices for the central compounding of the patient-specific therapies from October 17, will lead to a negative EBITDA pre-effect in the amount of EUR 3.2 million-EUR 3.6 million in 2022. Global uncertainties, as outlined on Slide 15, do still exist, such as rising inflation and supply chain bottlenecks. Our growth course is currently not affected, but we are cautious and are monitoring the situation closely. In addition, we must include the impact from the most recent regulatory change that affects our PST business. Ladies and gentlemen, the numbers demonstrate the sustainable and profitable growth story of Medios. A summary of our growth initiatives, both organic and via M&A, is outlined on slide 16 and will now be presented by Matthias Gärtner.
Thank you, Falk. We are very excited to introduce the new strategy in two weeks from now. Therefore, I will only briefly highlight the key ambition. The general direction of our growth strategy remains unchanged. I would like to emphasize our efforts relating to M&A, in particular in the fields of compounding, which will help leverage our additional compounding capacity. One of our main goals is to increase our EBITDA pre margin. That's why we want to tap further opportunities which will enable us to achieve our objective, in particular by internationalizing our business in the future and by potentially launching new segments, respectively, new services, all within the field of specialty pharma. We are excited to present more information and details on how we plan to achieve these goals at our capital markets day in two weeks. This is all from me now.
We are looking forward to seeing some of you at our capital markets day. Of course, we will publish the presentation on the Medios website as well. Before I conclude the presentation, let's switch to Slide 17. I just want to highlight that the implementation of our ESG software tool is scheduled to be finalized by year-end. Ladies and gentlemen, this concludes our presentation. We hope to see you in person in two weeks here in Berlin. Thank you for attending.