Welcome everybody to our conference call on our results for the third quarter and first nine months of this year. 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 for the first time, our new CFO, Falk Neukirch. Matthias will start with an executive summary, followed by Falk, who will then explain the financials. Finally, Matthias will comment on the outlook for the full year. Both gentlemen will then be available to answer your questions. I would now like to hand over to Matthias.
Okay. Thank you, Claudia, and also a warm welcome from my side. Thank you for attending this call and for your interest in Medios. Once again, I'm proud to present excellent results to you today. Medios' best nine months ever. Not only in our M&A strategy paying off, we also have delivered strong organic growth. Even more important, our margins are continuing to improve. This positive development goes along with strong operating and free cash flows. I will start with a short summary of the achievements and highlights for the third quarter of this year. Today and in the future, we will outline only the highlights for the respective quarter and no longer the events of the entire reporting period. That should make this call more efficient. As usual, I will be referring to the slides of the presentation. Let's go directly to slide three.
How can the third quarter be best summarized? Again, record sales and EBITDA numbers. We continued the growth and success story. We have set ambitious targets and confirmed our guidance. I would like to point out one thing in particular. From a corporate perspective, we have left the corona pandemic behind us and do not expect any material effects on our business development in the future. We are now in a position to fully cope with the situation, and we are no longer burdened by negative influences. Our growth continues, as the figures impressively show. We delivered strong inorganic and organic growth in the first nine months of the current fiscal year. What are the reasons for the excellent 9-month results with profitable and sustainable growth? Strong inorganic growth, to a huge extent driven by the ongoing and successful integration of Cranach Pharma.
Strong organic growth, also adjusted for M&A effects. We grew at a rate of around 22% in the first nine months of 2021 as well as in the third quarter 2021. Focus on higher margin products. This was again impressively illustrated for our compounding business. Falk will give you the detailed figures later on. Addition of further specialized pharmacies to our network of now 550 partner pharmacies. New partners were also gained through our innovative platform, mediosconnect, as we rolled out the platform in an additional fourth federal state in Germany and included an additional indication as well. Ongoing improved working capital management and free cash flow. The good results as well as the cash flow, cash inflow from the consolidation of Cranach Pharma led to an excellent free cash flow of over EUR 60 million.
Ongoing expansion of our market position in indications like hemophilia. Successful further integration of our acquisition with cross-selling already picking up. Finally, no more corona effects, as just mentioned. In a nutshell, we are showing dynamic and profitable growth and are excellently positioned for the future. The new authorized capital and our strong cash position ensure the financing of further potential acquisitions and organic growth. Our new labs in Berlin currently being set up, new partner pharmacies, cross-selling opportunities, and the digitalization of the healthcare system offer ongoing attractive growth potentials. Slide four illustrates the impressive continuous growth of revenue and EBITDA pre, reflecting the de facto end of the corona impact on our business. Also, compared to the first nine months of last year and the second quarter of this year, most of the KPIs have improved. The same picture on slide five.
Again, substantial growth year-over-year. Revenue more than doubled and EBITDA pre even more than tripled. Both slides show the very impressive development since the beginning of 2020. Strong sales growth, significant expansion of our market leadership with the integration of Cranach Pharma acquisition, and an increase in profitability. Let's switch to slide six, providing a revenue and EBITDA pre breakdown per segment. For the first nine months of this year, which is more or less unchanged compared to the split for the first half of 2021. Pharmaceutical supply generated 95% of revenues and 80% of EBITDA pre. Our target remains to grow the share of the higher margin segment, patient-specific therapies, in line with the strategy to focus on higher margin, but usually lower revenue indications in this segment. I will now provide a short update on our ESG strategy, illustrated on slide seven.
What are the next steps with regard to ESG? We meanwhile established a sustainability committee, and I'm happy to chair this committee. The task of the sustainability committee is in particular to define the key areas of our ESG strategy and to monitor the implementation of the ESG program. Within the next weeks, we will publish our ESG strategy, including concrete measures and targets. This is an important milestone for us in 2021. Furthermore, we will gradually align our ESG reporting with the internationally applied reporting standard GRI, which stands for Global Reporting Initiative. The first report in accordance with GRI is planned for 2023. I cannot repeat this often enough. Sustainability has and will be an integrated part in our corporate strategy. ESG is of top priority for us. This is all from my side for the moment. I now hand over to Falk to explain the financials.
Thank you, Matthias. Warm welcome from my side. I'm very happy to be part of the Medios team now and such a growing company. Before joining Medios, I worked in finance at various companies for roughly 25 years now. Most time there of in the semiconductor industry. Most recently, I've been working as a CFO at Vita 34 AG for about six years. Vita is a Prime Standard-listed company in healthcare segment. I'm looking forward to meeting you all in the near future, hopefully. Now I would like to walk through the numbers. We have planned a Q&A part at the end, so we look forward to your questions after the presentation. Let's start with slide nine, covering the figures for the first nine months of this year.
The full set of financial figures can be found in the quarterly statement as of September 30th, 2021 on our website and in the appendix of the presentation as well. If not explicitly mentioned, I will refer to the first nine months figures of 2021 compared to the same period of last year. Once again, these are the best nine months results ever for Medios. The main KPIs doubled over or even tripled due to inorganic and also organic growth. Revenue increased by 180%, thereof 92% by inorganic growth and 22% organically. The gross margin slightly decreased year-on-year. This is the result of a weighting effect. The over-proportional increase of the Pharmaceutical Supply segment due to the consolidation of Cranach Pharma led to a decrease in the total average gross margin.
At segment level, the gross margin for both operational segments increased year-over-year, not only because of Cranach's good cost structure and higher margin portfolio compared with Medios. Personnel and other expenses have risen mainly due to the inorganic growth that we made beginning 2021 by the acquisition of Cranach plus organic growth projects, for example, the launch of the e-prescription from 2022 onwards and by the expansion of our compounding business, which Matthias had already commented on. The rise in cost was disproportionately low compared to the sales development and led to a disproportionately high development of profitability ratios like EBITDA pre, a plus of 175.6%, and EBT pre, a plus of 203.9% year-over-year.
As you know, EBT pre and EBITDA pre were adjusted by extraordinary expenses for stock options, M&A transaction costs, and for amortization of the customer list, mainly for Cranach. Please keep in mind that the posted higher depreciation and amortization costs are mainly a result of the amortization of Cranach customer lists amounting to EUR 7.5 million for the first nine months of this year. Details can be found in the appendix. The operating cash flow substantially improved to EUR 14.4 million as a consequence of higher earnings and in relation to revenues, lower working capital. After the successful implementation of the new indication hemophilia, inventories have already been reduced significantly, and the cash position has been raised accordingly.
Financing cash flow amounted to only EUR 0.4 million compared to EUR 52 million last year, which included a capital increase as well as a temporary drawing of the syndicated loan. This year, EUR 30 million were drawn from the syndicated loan, and thereof, EUR 24 million were paid in connection with the acquisition of Cranach Pharma. Furthermore, the syndicated loan was reduced by EUR 3 million on June 30 this year as scheduled. All these effects led to a corresponding increase of cash and cash equivalents from just under EUR 20 million at the end of 2020 to around EUR 82 million as of September 30th, 2021.
Free cash flow significantly increased from EUR 2.7 million to now EUR 61.5 million for the first nine months because of the strong operating and low investing cash flow, of which the latter included a one-time effect of EUR 30 million cash inflow from Cranach Pharma as part of the acquisition. Equity ratio has been unchanged high at almost 70%. On slide 10 and 11, we provide a detailed revenue breakdown of our organic and inorganic growth by segment. As you can see, the revenue for the first nine months was driven by almost 97% inorganic growth, mostly in our segment pharmaceutical supply, mainly due to Cranach Pharma acquisition, plus almost 22% organic growth as well.
The remarkable overall growth of around 180% compares to the relatively weak first nine months of 2020, which were impacted by Corona. As mentioned before, the slight organic sales decline of the compounding business in the third quarter is strategically driven by focusing on high margin but usually lower revenue indications, and consequently led to a significant increase in EBITDA pre and EBT pre. Nevertheless, we expect sales to grow also in this segment in the future. Let's switch to slide 12, outlining revenue and earnings by segment. As just explained, sales developed flat in the segment Patient-Specific Therapies, but EBITDA pre and EBT pre grows disproportionately. Both operational segments show significant ongoing earnings margins improvements year-on-year. Last but not least, because of the Cranach's good cost structure and higher margin portfolio compared to Medios.
Now let's move to slide 13, providing an overview of our currently available funds as of September 30, amounting to around EUR 99 million. They include a syndicated loan of EUR 45.9 million with an original nominal value of EUR 62.5 million signed in March 2020. The decrease results from contractual reductions of facilities as scheduled. Liquidity of around EUR 82 million, reflecting a substantially improved operating cash flow, as well as a lower working capital and a one-time effect from Cranach acquisition of EUR 30 million. In addition, we can use our new authorized capital, approximately the equivalent of 10 million shares at then prevailing stock price. In line with our growth strategy, we will use these funds for organic growth and potential acquisitions as well.
EUR 2.5 million are outstanding to be invested to build up additional labs in Berlin. Overall investment will amount to around EUR 10 million. We will pursue our M&A strategy, looking for attractive targets like in the compounding business. Thank you. This is all from my side. I now hand back to Matthias.
Thank you, Falk. I will now comment on the outlook. Our guidance for the fiscal year 2021 is shown on slide 15, and is unchanged compared to the outlook we presented in August. We expect consolidated revenues of EUR 1.2 billion-EUR 1.3 billion, an EBITDA pre of EUR 38 million-EUR 39 million, and an EBT pre of EUR 31 million-EUR 32 million. Important to know, we would be able to increase sales at an even faster rate, but that would be at the expense of our profit margin. We have opted for profitable and sustainable growth. Our compounding business is a good example of this, stable sales but better margins. This guidance already considers the following two factors.
As said before, we do not expect further Corona-related impacts and additional expenses for future growth, such as hiring new employees, for example, to be prepared for the expansion of our production capacities and start manufacturing with our new labs in Berlin early next year. We are highly confident that all these investments will pay off in 2022 and the years beyond. Ladies and gentlemen, as you can see, the overall growth model of Medios is intact and shows excellent results. We are very well prepared to continue our successful and sustainable growth story. For this, we have a clear strategy. A summary of our growth initiatives, both organic and via M&A, is outlined on slide 16. Our growth strategy remains unchanged, and its implementation will further advance. We are on track and well-positioned to drive future growth, not only in 2021, by expanding our compounding business.
The new building in Berlin gives us the potential to up to triple our production capacities in the future. By exploiting the blistering business with high future potential and synergy effects, focusing mainly on the specialty pharma drugs. By further expanding our partner network of specialized pharmacies and extending business with already existing specialized partner pharmacies. By taking on new business opportunities in relation to the electronic prescription as of January 2022. By further market penetration through the innovative digital platform, mediosconnect. By further expanding and diversifying the indication areas. On top of this, we will drive growth via M&A, in particular in the fields of compounding business, as well as potentially on digitalization.
This is only our short to midterm outlook, not yet reflecting the excellent longer term growth opportunities, which could be additional segments and/or services providing a higher margin potential and international expansion of our activities. We still benefit from the high market potential in Germany with a consolidating market. However, we now also take into account the opportunity to internationalize our business. This is why the management team of Medios is strongly convinced that we are rather at the beginning of our attractive growth story than at the end. Ladies and gentlemen, this completes our presentation. Thank you for your attention. Falk and I am now available to answer your questions. Operator, could you please read out the instructions? Thank you very much.
Thank you very much for joining us for this conference call. If there are any question, and as always, you can just drop us an email or just give us a call. We look forward to hearing you soon at our next conference call. Wish you a nice afternoon and goodbye.
Thank you. Bye-bye.
Thank you. Bye-bye.