Nightingale Health Oyj (HEL:HEALTH)
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Earnings Call: H2 2023

Sep 28, 2023

Teemu Suna
CEO, Nightingale Health

Good afternoon, and welcome to Nightingale Health's Financial Year Webcast. Today, I will be first talking about Nightingale Health, then we go to the targets of the last financial year. Then we will talk about key achievements. We go to financial review. We talk about the updated strategy that we announced some weeks ago. We will be looking at the targets for the ongoing financial year. Finally, we look at the financial calendar, and we have the Q&A in the end. In case you have any questions, please post the questions to the online tool, and we will be covering as many of them as we can.

My name is Teemu Suna, I'm CEO and one of the founders of Nightingale Health, and later on, also our CFO, Tuukka Paavola, will join me on stage. Let's start. Nightingale Health in brief, we are a preventative health company. Our mission is to solve, to help solving the crisis of chronic diseases. What is the solution? What is our technology? We have created a novel way to find the health risks from healthy individuals. And I will be talking about this quite a lot in the presentation later on. This technology is very broadly validated by medical science. We are also validated by the regulation, so the company is well positioned to reach towards different projects in healthcare.

We are running laboratories in Finland, Japan, the U.K., and the U.S. So, we are also internationally, t he technology is internationally quite broadly available. So, what's the whole point of this company? Why are we doing what we are doing? Well, the preventative healthcare makes sense because when we look at the healthcare costs, many times we talk about, when we talk about healthcare, we talk about that, oh, it's so expensive, and the costs are unsustainable level. But when we look behind this narrative, we can actually see that the major part of these costs are coming from the chronic diseases. So diseases we all know, cardiovascular disease, type 2 diabetes, et cetera. The cost level, as I said, is at unsustainable level.

In many countries, it's around 10% of the gross domestic product, and then, for example, in the U.S., it's in the ballpark of 20%. Maybe to give this a bit of context, the military spending in the U.S. is less than 4% of gross domestic product. In Finland, the military is spending around 2% of gross domestic product, healthcare, 10%. So it's at an unsustainable level. The positive thing here, however, is that this is a problem that can be solved. So there is a lot of evidence, and I think it's pretty clear that the chronic diseases respond very well to early interventions.

So what this means is that if we treat the chronic diseases before the disease onset with the known medical interventions, and it's important to note that these are known medical interventions, we can actually reduce the risk of developing the disease and avoid the disease potentially altogether. So why are we in this situation? We know where the costs are coming, we know what is the problem. We know that there are interventions, so it's not about that we don't know what to do with the health risks. We are in this situation because the healthcare systems do not have a tool to find the people at risk. And I'm not talking about now, like, individual people. I'm talking about population level. For example, what would be a tool to figure out the health risks for everyone in Finland, for the entire population?

That tool does not exist in the health system at the moment. So we cannot call everyone in and say, come to see a nurse, come to see a doctor. It's impossible. So the real problem in prevention, and this is very important, we need to understand what is the problem. The real problem in preventative health, why it is not happening is that we are lacking the tool to find the people at risk in population level. This has been the situation so far, but what we have created at Nightingale, we have created that tool. So we have created the tool that can be used to find the risks population level. Running the test for everyone in a country is completely feasible. This is made possible by the low price point of the technology and very strong scalability.

So we will be talking more about this today, but I think it's quite important to understand what is the problem and then how to solve it. So how have we built the capability to find people at risk? So the first step, we have created a new way, a novel way of testing blood samples. So instead of the current model, where just like many separate tests are required for each result, the Nightingale way takes a single test, and then we capture the biology, we capture the metabolism of the body very broadly. And because we can catch the metabolism broadly, we can catch the biology more comprehensively, we also understand the underlying biology better. Now, this is just the first step. So the second step here, and the first step is shown here.

So the second step is to connect the blood test results into the health outcomes. I mean, there are many companies in this field that are just testing a lot of biomarkers and or are testing, like collecting a lot of data. But the value for this data is only created when you connect the test results into the actual health outcomes. Because let's remember what we are trying to do here. We are trying to detect the health risks, health risk for different diseases. So that's why we need both number one and number two in the slide, and then with that combination, we have created the exceptional ability to detect the health risks. So I said that we capture the biology more comprehensively, how we find the health risks, what kind of risks we can find?

Well, we can find the health risks very comprehensively. So, from this one blood sample, with this one test, we detect the risk basically for almost all key chronic diseases. And you can do this only by having blood sample, knowing the age of the individual, and sex. With this combination, we have the scalability. So you don't have to actually take the people first to like how the current model is working, that there are a lot of steps that are required to evaluate the risk, for example, for cardiovascular disease. So you call the patient in, you measure blood pressure, you do blood test. Also, you ask the family history, and there is nothing wrong with that, but the problem is, what is the scalability?

We don't have the resources to call every citizen in a country, call them in, and do all this. Instead, taking just the blood sample, because you only need age and sex in addition as a clinical parameters, you have massive scalability. And then for every blood sample, it's not only cardiovascular disease risk that you find out, you get all the other key chronic disease risks as well. This is quite important, and I would say even quite groundbreaking when you put this in the context of what we are aiming to do here. We are aiming to solve the chronic disease crisis by introducing a possibility to do preventative health. And this is enabled by the capability that we can find the people at risk. This technology is completely production ready.

I will be talking more about the journey that we have had so far, but the technology is validated by regulation and by medical science very comprehensively. We are also operating around the world already, so this technology is basically, I would say that in medical science, this is basically the gold standard when it comes to big epidemiological sample collections in chronic disease area. Going to the business targets of the past fiscal year. We set the targets. So the whole point with these targets is that what we are doing here is that we are building the company through these flagship deals.

So these kind of reference deals that are helping us to move the big mission and the big purpose forward. So the number one target, we didn't reach that one. However, there is very strong traction also in the public healthcare sector. The fact just is that these projects, when you talk about nationwide use, they are very complex projects, and it is very difficult to evaluate the exact timelines. But I think we are making good progress in that field also. The target number two, winning business-to-business contract. So we announced in August that we made a significant deal with Terveystalo. Terveystalo is the largest private healthcare provider here in Finland. I will be talking more about that shortly.

And then the target number three, we expanded our business in medical research, and that target we reached. I will also come back to that later on. Then we made a strategy update. More details also to follow regarding that. So the one of the targets is not relevant in this context anymore. And then the regulatory approval in the United States, that is still in progress. And it's something that is very long-term effort, but we are also making good steps forward with that. All right. Moving forward, I will next talk about the key achievements for the financial year, for the past financial year.

Before going into these key achievements, I wanted to talk a bit about what will follow in the next three slides. So, when we started this company, and when you are trying to build something new, and now building something new is in the context of making the primary healthcare system better, solving one of the most significant problems in the world, it's quite difficult. So, 10 years ago, when we started, we knew it will be, it will be very hard. But of course, it is very, very hard. But we also set kind of a strategy, like a very long-term strategy, how we believe that this very ambitious target or a vision can be achieved. What do you need to build first?

You need to build first an innovation machine. You need to build a machine that creates innovations that are taking, taking the company, taking the mission forward. Then, step number two, you need to show that your innovation machine is working. So it is creating breakthroughs, it is creating results that are actually demonstrating that the vision can be made reality. And step number three, you need to show that you can also translate the innovations into the commercial applications. When you do these three things, then you take a significant step towards building a better world, in this case, building a healthier world. Let's have a look these three steps. Step number one, build innovation machine. Here is the Nightingale innovation machine that we started to build 10 years ago. What do you see in the graph?

You see, the amount of analyzed samples, blood samples that we have run through this platform, and you see the amount of publications. Now, we have calculated here in the slide what has been the annualized growth. So let's have a look at the number of analyzed samples. So the number of analyzed samples has been increasing steadily over the past 10 years with, I think, substantially good growth rate. We have to put this in the context of medicine, in the context of medical innovations. It takes time. And the problem we are trying to solve, it's still one of the hardest problem you can solve in this entire field. So, but what we have managed to do is to grow all the time the number of samples we have analyzed.

Does it matter what we have been doing? So has it been like a hobby just to run the samples? Not at all. So now, if you look at the number of publications, the number of publications demonstrate, is there value in medicine, the medical value with the data, with the samples, with the sample analysis we have done? And yes, there is. There's a very substantial value what we have, have done. There are more than 500 peer-reviewed publications done around the world using this technology. And now to give some context to these numbers, the number of publications, the number of samples, we are not aware that there is any other company in the world who is in the same-even in the same ballpark where we are. And we have this advantage because we took the vision.

We started to build this 10 years ago. Now it's becoming a reality. I would say that if you look almost any of the today's super companies, super technology companies, they have a similar story. So to build something new for the world, you start from the beginning. No one will believe you in the beginning. You just start building it, and then if you're successful, the numbers in this case, the numbers show that the innovation machine we have built is working, and it is accelerating. Okay, this is all great. The next question, number two. The first is, build the innovation machine. The number two is show the value of the innovation. Show that it demonstrates, really, the innovation machine creates breakthroughs, in this context, medical breakthroughs that can help to solve the world's largest healthcare problem. So here is number two.

Approximately a year ago, there was a landmark publication in Nature Medicine, one of the world-leading scientific publications, showing that the Nightingale's technology, and this is completely independent science, showing that the Nightingale test is very applicable and can be used to find the health risks better than the current clinical solutions. And better now in the context, it's better because it finds all the risks from one sample, one test. The performance in individual diseases is equal or better than the current clinical tests. But the real breakthrough is that simple blood sample, age, and sex, you get all this. That is a breakthrough, how we can use this tool to build a better health system. So number two, checked.

Number three, show that this, the innovation machine creates the, breakthrough results, and you can use these breakthrough results in commercial applications. So next slide. So we announced in, August that the, largest private healthcare provider in Finland takes the Nightingale technology in regular health checkups in occupational health. What makes this quite significant is that, Terveystalo is offering their occupational health service for around 30% of the, of the, workforce, in, in Finland. So all the working population, 30%. That is something that, I think, ticks the box of being nationally significant. So how Terveystalo is using this technology or will use this technology? Well, they will use the technology to find out people, the health risks of people in a new way.

How this changes. There are now many ways how we can take a deep dive into this, and we will be talking about this in our later presentations, but I will now just give one example. So, when you think about the technology, the Nightingale technology, that allows you to figure out the risks from one sample, one test, in a very scalable fashion. Now, what this enables is that you can actually do this test before there is a meeting with a GP or a clinician. So the clinician can actually have the data of the health risks in the first meeting with the patient. And let's explore this a bit further.

So the current process, you go to see a healthcare professional, whether it's a nurse or GP, that's the first step. In this first meeting, there is typically a list of tests that are being prescribed. So in the first meeting. In the second meeting, so the patient goes to have these tests. In the meanwhile, blood work and whatever is being prescribed. In the second meeting, there is feedback of the results, and there is intervention also. And then there is a third meeting, which is to give to see how the interventions have worked out. So one, two, three. Now, with the Nightingale's technology, you can actually we remove one step. We remove one step. It's substantial. I've been in healthcare, in healthcare IT, and looking at these different healthcare systems for 15 years.

I'm not aware of anything else that takes one step away. Even if it doesn't take all the steps, it doesn't always work like that. Of course, I'm not saying that it takes 1/3 of the, i t takes 1/3 away, but let's say it takes 1/4 away. That's massive. And now, let's get back, let's get back to the idea when I said that in how can we screen, how can we apply, how we can bring preventative health in national scale? So you need technologies, you need something that you can run for people in a very simple and scalable fashion, and this is it. So this is not actually then changing the way how the clinicians, then all the kind of the interventions and everything goes according to the medical guidelines.

So once the risks are detected by the Nightingale technology, if the risks are high, then the interventions will be done according to the guideline interventions. So it doesn't like burden the current system, it's actually bringing more, more value. So, I think this is like, something, something very important. And then when we look forward, these health checks and these routine blood testing, it's, it's truly a massive market around the world, and the need and the problem is pretty similar everywhere, everywhere we go. All right, let's move forward. In the U.K., we are moving forward with the laboratory, so we are establishing the Nightingale laboratory in the U.K. That is moving forward according to the plan.

I will not go into the details at this time. We discussed about this already in the previous webcast. In Japan, also same story, we discussed about this previously. We are still continuing to build the distribution network, and it is moving forward in a nice way. I think it's still very important to note that building the distribution network is we need to make that happen first before we can move into the commercial, into the more commercial steps. But that work is still going on rather rapidly.

Then, the remote blood collection capability, and this now comes to the strategy update we announced. So we will be discontinuing the direct-to-consumer business, and utilizing the resources and the assets, and the capabilities to actually bring this into the white label business model. And the nice thing about the white label business model is that this will allow us to scale this quicker. We are at the moment in the process that we are already selling the white label solution to our customers internationally, and we will then follow up with that feedback later on. All right, so that's it for the achievements.

Next step, we will move to the financial review, and I would like to ask Tuukka to join me on stage and talk a bit about the numbers.

Tuukka Paavola
CFO, Nightingale Health

Thank you, Teemu, and hello, all, watching this webcast. Great to be here talking about the numbers from the second half and the full financial year. And of course, it's great to see that the great things we are doing are slowly starting to translate into real numbers. So, looking at the revenue from the second half, it was at EUR 1.9 million, compared to roughly EUR 1 million the year before. And roughly EUR 4.2 million for the full financial year, which indicates a healthy 81% growth year-over-year. Our EBITDA for the full year was at around minus EUR 11.8 million, and the operating profit at minus EUR 18.5 million.

We continued having a strong focus on operational efficiency. So the increase in expenses comes mostly from targeted investments in commercial growth and international expansion. We are still in a really good financial position to continue the execution of the updated strategy. Our net debt to equity is at - 78%, and at the end of the financial year, we had roughly EUR 8 million cash. The net cash change for the last financial year was roughly EUR 50 million, and we are planning to keep the net cash change in short term below EUR 20 million. That provides us with all we need to fully execute on the updated strategy and build the business towards the positive EBITDA target in midterm.

That is, briefly about the numbers, and then I'll hand it over back to you, Teemu.

Teemu Suna
CEO, Nightingale Health

Thank you, Tuukka. Yeah, so I think, like, when reflecting this cash position with this innovation machine we've been building the past 10 years, I think the position is quite good because that has been the biggest investment in the end of the day. And because that we are very confident that we can, we have very nice runway. All right, moving forward. One of the big things that we just announced recently was the Nightingale Health strategy update. I wanted to give, like, a brief update regarding that as well, or more like a recap of the strategy. Then many of the new initiatives and projects are, of course, announced later on.

But maybe coming back to the key elements and talk a bit, provide a bit more clarity about the background. So the first point here is that the focus on B2B and B2G markets. The overall strategy of the company has been for a long time that when you are building this kind of platform technology, you are in new markets, you have something new, you have something that the markets you are entering are not used to have. It's a great improvement, but it's also a new thing. So one very good way to address this challenge is to run in parallel several different business initiatives, and you try to see where you get the traction. Then when you get the traction, you go there, you focus there.

Now we are in this, we have reached this step. Based on the announced deals and based on the market insights we are getting all the time when we talk with our customers, we are confident that now is a very good time to focus on B2B and B2G markets. And this is pretty much the, s o the commercial traction, I was already mentioning this, and this is kind of the backstory there, that when, if we think about the deal with Terveystalo, it's not like the value we are creating, it's not country-specific, it's not customer-specific, it's international. So because of this, I think it is absolutely the right timing to go into a more focused business model.

This is of course, there is the commercial side of having better focus, but then there is also the operational side. So the more things company is running in parallel, the more difficult it is to manage that, but then also to make it very efficient. So I think we have managed this like running multiple things in parallel. I think our efficiency is very, very good. When we compare the use of capital, use of cash to build what we have built, we are super efficient. You compare this to some of the American peers, their use of cash is eight to 10 times more.

So I think we have done pretty well when it comes to the efficiency, but now building more focus also helps us to execute even better. One challenge with the D2C is also that when you compare D2C with B2B and B2D, they are by nature very different kind of businesses. So it also helps to have this like more clear mental focus, more clear business model, and that is also one of the reasons why we defocus the D2C side. Then the business growth, we believe that this focus is also allows faster business growth. I think Nightingale is kind of working in pretty exceptional marketplace. We don't have a problem that the addressable market would be too small.

It's that, T hat's, it's not too small. It's like, it's very, very large. So even when we kind of step away from the D2C, there is no problem with the addressable market side, and then our strengths actually work better in B2B, B2G, and then with better focus, we can also grow faster. I think that's like very much aligned all, all, all the steps with the business growth. And then it's also not something that we need to throw away our assets. I talked about the white label business. Basically, the white label, when we are selling the Nightingale solution to our customers in white label fashion, some of those customers are actually working in D2C space.

Now, when we bring our solution, we can, we can show for in marketing purposes, but we can, we can also offer as a white label solution some of the other assets as a part of the package. So, now, Nightingale can actually offer complete end-to-end solution to our B2B partners, and they can utilize it in D2C. We have better focus, we help them to build better business, and then we can also scale the business up faster. So that is the, that is the idea in the, in the background.

As said, this new strategy has been just announced, and the results of this better focus will follow, but I will not be talking more about this at this time, but we, of course, will come back to this when we start really implementing the strategy. Then moving to business targets for the ongoing financial year. So we are still continuing, and we are still in the stage that the most important thing is to win commercial contracts that have significant reference and contract value. And I would even say that the reference value here is the more important one at this point.

Why I'm saying this is that if you look back the, the presentation today, it's still the problem we are aiming to solve is such a major problem that these references are the ones that help us to demonstrate the, the value in different commercial setups. Healthcare is also very different when you go, you go to different countries, there is different systems, etc. The problem is the same for everyone, but to really kind of implement the solution as a part of that system, I think that is, that is the, that is the main target that creates the reference value, and then, of course, there is, there is contract, contract value because we are also looking, looking real commercial, deals. This is for the target one, target two, same, same, background, background story.

So winning the reference case demonstrate the value that we can provide to our, white label customers. It's a new business area, but then on the other hand, we have very complete set of assets, as I already mentioned, through the D2C. Now we repurpose it as a part of the white label, and we are going after, reference and, deals with significant reference and, and contract value. Then finally, target number three, this is our medical research business. The, you saw the figure with the, with the sample number growth. You saw there the publications. There is a very important role of this business area to continue building the innovation machine, making it stronger, scaling it up.

It's all part of the same narrative where the evidence, where the breakthrough studies will translate into the commercial deals, as we have now already shown. There is a contract value target, and the intention there is to, it's just to reflect that there is a strong business model also in addition to the substance points that I mentioned. Then finally, the FDA. So as I have said many times, this is a long-term process. There is a lot of complexity in this, but there are also very good solutions how to move this forward. So we are at the moment also examining different options to do the CLIA route in parallel.

The whole point here is that we can be quite flexible how we make this happen, and then it goes like step by step. Even with the CLIA route, I believe that commercially we are in a sufficient position when looking at the United States market. But we will come back to this also when there is more progress in this area. Some small updates to the midterm and long-term business targets. I think the most significant is the midterm business target to achieve positive EBITDA. Tuukka already talked about this.

I think when looking at the commercial traction, when looking at the recent breakthroughs, when looking at our current spending, the need for new investments, and putting all this together, I think we are well positioned to achieve the positive EBITDA as a midterm business target. In the long-term business target, we basically, s o the numbers are the same. And this is simply because the addressable market in the B2B and B2D is completely sufficient to reach towards these targets. And we have done some also evaluations when it comes when we look at the addressable market, market side, and then re, reflected those back to these numbers. And I think these targets are completely reasonable to move forward to reaching them.

Here is the financial calendar for the ongoing fiscal year. Annual general meeting will be held on 16th November. And then there is the timeline for financial reports as well. All right, I think that's it with the presentation. Next step is to move to the Q&A, and as usual, I would like to ask our Chief Operating Officer, Satu Saksman, to join us on stage. And let's have a look at the questions and have some answers.

Satu Saksman
COO, Nightingale Health

All right. Thank you, Teemu, and great to be here as well. So, actually, there's a lot of questions, and you try to listen to you at the same time and kind of like what, what have you already covered and what not? So probably there will be some repetition as well. But let's go still back to Terveystalo deal. That's a significant one. Can you share, I mean, operationally, yes, you discussed about it, but can you share any sort of commercial details? What it's what, what is it about, and what is the schedule, and when we can show, like, commercial results, and what to follow, sort of what are the key indicators, what to follow from that deal?

Teemu Suna
CEO, Nightingale Health

Yeah. So, yeah, I think it's a very good, good, good question, and, the easiest one to answer is that, the service will start rolling out early next year, so in January. Then when it comes to the numbers, we have not announced these exact numbers, but maybe if we look it in a way that, as I already mentioned, Terveystalo is running the occupational health service for around 30% of the Finnish workforce. And then the health checkups are being done. It's kind of a routine test that is being implemented from time to time. And in this routine health check test, it's the Nightingale technology that is actually replacing the current solution.

And, and then I think you can make your own evaluations, but we have agreed not to announce any of the more detailed numbers.

Satu Saksman
COO, Nightingale Health

Okay, but then if thinking about, like, now having this situation in, in Finland, so thinking about the total addressable market, you also touched that a little bit, but is there something that you can, you could maybe open up a little bit and then, w ell, let's take that, that first, kind of like, can you, can you give any concrete numbers?

Teemu Suna
CEO, Nightingale Health

Yeah, yeah. It's a very complicated question, actually, this addressable market, and we've been looking this in a quite detailed way. We will be kind of bringing that more visible at some point and talk about that in more detail. But maybe if we put it in a way that, as I mentioned, there is like the healthcare costs, 10% to 20% of the gross domestic product, 90% is connected to the chronic diseases. The best way to manage the problem is to have a system that finds the health risk amongst the healthy individuals as early as possible.

So, it is safe to say that the number, if you look this in terms of number of tests, we take, like, the Western world, it's somewhere beyond 1 billion tests per year. So it's a lot of blood tests that are being done already, but now the value we can bring to the table is, of course, it's completely another planet what we can do in terms of the value. And then we keep the cost parity, and then we make it operationally easier. So I believe that the addressable market is big enough.

Satu Saksman
COO, Nightingale Health

Okay. So touching on the strategy update a little bit. So are you saying that from close perspective, you're not worried about dropping the direct-to-consumer customers?

Teemu Suna
CEO, Nightingale Health

Not at all.

Satu Saksman
COO, Nightingale Health

Okay. Well, then how about thinking about the kind of like now when going targeting the health checks market, so the value chain is a bit different and the level of margins also in health checks. So how would you?

Teemu Suna
CEO, Nightingale Health

Yeah.

Satu Saksman
COO, Nightingale Health

How would you cover that?

Teemu Suna
CEO, Nightingale Health

Yeah. So quite complex, quite complicated question as well, because now when I say that we can offer the health checkups with the price parity, now this price parity means different things in different countries and different regions. This, like, health checkup test is very differently priced around the world. The positive thing is that so far, the countries we have explored, which is quite an extensive list, we can keep this price parity promise and still have a very healthy margin in there. And this is because of the advantages of this technology. Now, if you compare, and now I'm talking only about the cost parity, but now if you combine the value, so value is another story.

So if you then also calculate in, you factor in the value, then the calculation, the return for investment calculation is even better. This comes down to this health economics topic, and we will follow up also in that stream.

Satu Saksman
COO, Nightingale Health

Okay, let's continue with the strategy change. More internal impact. So are you repurposing all the existing internal resources, what has been so far, or can we see, can we expect some cost-cutting and reduction in cash outflow? So this is maybe.

Teemu Suna
CEO, Nightingale Health

Yeah.

Satu Saksman
COO, Nightingale Health

Better, Tuukka.

Tuukka Paavola
CFO, Nightingale Health

Yeah, so like we mentioned, so of course, if you look at the asset side, we believe that we can repurpose most, if not all, of the assets to cater for our updated strategy. When it comes to resources, of course, we can now shift some resources from D2C to work with the B2B and B2G side. Of course, there might be some flexibility. We might be able to reduce costs somewhere, but at the same time, we fully want to focus and invest in growing the B2B and B2G and run the new updated strategy.

Like I mentioned previously, we are not expecting to see any dramatic drop in the cash out, but rather continue roughly on the same level, below EUR 20 million cash out a year anyway.

Satu Saksman
COO, Nightingale Health

Then the runway would be how, I mean, how long will the.

Tuukka Paavola
CFO, Nightingale Health

Well, it's.

Satu Saksman
COO, Nightingale Health

Cash last?

Tuukka Paavola
CFO, Nightingale Health

If you do the math, this runway is four to five years. But of course, if and when we achieve our midterm target of positive EBITDA, that most likely will then actually extend the runway.

Satu Saksman
COO, Nightingale Health

Okay. Let's talk about a bit the U.S. I mean, we didn't cover that much, but that was actually something that has happened after the fiscal year. So, the release that we gave out about Mass General Brigham, so do you have other customers in the U.S. interested about our service? So, any.

Teemu Suna
CEO, Nightingale Health

Yeah, well, there is a lot of conversations ongoing in the U.S. market as well. I think the interesting point to mention about the Mass General Brigham deal is that it seems that there are now, when we are moving forward, when we started, like, if you think about the journey that I was describing, like starting 10 years ago, it was very much, very heavily like in the science, in the medical science side. Now, when we move forward, there seems to be more and more interest with customers that start with this, like, biobank or cohort collection, but they are having within their organization also the clinical practice.

So, the kind of the distance from the clinical implementation, I think it's getting shorter, and the intention with the research is more and more, okay, let's translate this into the clinical applications. So this is not to imply any of the, like, clinical use, but what has been the change from our point of view is that we are getting all the time, so the science that is being done is closer to the clinical implementation also all the time. And I mean, this makes complete sense. This is like, this is how it usually go. If you are successful in ramping this up, first, it's a scientific thing, then it becomes, like, more interest with the clinicians, and then you are all the time, like, working closer to the kind of the translation and the clinical applications.

Satu Saksman
COO, Nightingale Health

Okay, so maybe that followed by the question, and you said a little bit about this already earlier. So on public sector side, any additional color on the kind of discussions you're having and what kind of reactions you're getting on the public side? I mean, you said it's a long play and complex matter, but, like.

Teemu Suna
CEO, Nightingale Health

Yeah.

Satu Saksman
COO, Nightingale Health

Anything that you could share?

Teemu Suna
CEO, Nightingale Health

Yeah, I think one of the most important things there is this, this price level where we can operate. So we can, well, we can all imagine, and I think it's something that we all care about, is that the spending in the spending to these new technologies needs to be in check. And what it means, it means that we start from the price parity, and we look at the value side as well. And now we are having conversations with several governments, and I think what is very clear is that the value we can bring to the table, it's very, very interesting. This is part of the many government strategies.

It's in the healthcare side, but not only in the healthcare side, it's actually also in this kind of thinking, like, so health should be part of every decision that government makes. This is also a very, very strong topic for the Nightingale test because we are, t his, this data, our health risk prediction, can be also used as a KPI to measure how health policy changes, how different actions in the government can be measured. At the moment, like measuring health policy actions, you wait 10 years to see what happens to people. With the Nightingale test, when you are running this population-level screening, you can actually kind of see, use it as a KPI, and it's very quantitative KPI. It's coming from the molecules.

This is now to say that there is, there is ways that we can make smarter and better decisions that are making healthier societies. And all the data protection and privacy protection, everything can be implemented here with no problem because the data we are measuring, it changes. It's not like genetics that kind of remains the same all the time. So we can also manage the privacy side very, very well. So I think a lot of interest and very like a very kind of appealing initiatives happening in the public side. But as I said, it takes time to build this up. They are complicated, but I think it's completely worth it.

Satu Saksman
COO, Nightingale Health

Okay, let's take the final question. This is a very quantified one, so aiming for positive EBITDA in midterm. So any details or something you would like to describe related to that, and what are the key actions to actually achieve it? And we have, like, two minutes time.

Tuukka Paavola
CFO, Nightingale Health

Yeah. We'll get started. Sure, yeah. Of course, it all starts from growing our business, increasing our revenue, and keeping the same growth as we demonstrated this fiscal year. The good thing about our business and the way we have set up the company operations so far is that it is actually really scalable. So in order to grow our revenue, we don't need to grow operational expenses at the same pace at all. So basically, it comes down to making sure that all the great things Teemu spoke about, building the commercial traction, building international sphere focus, getting those big deals in, all of those are the right steps towards that positive EBITDA target.

Teemu Suna
CEO, Nightingale Health

Yeah, well, I think it's like the financial side, as Tuukka was saying, it strongly supports this target, and then the substance side also strongly supports it. So I think these, like, both sides are very nicely aligned, and it's like, i t's been kind of a long journey to get there, but it's now I think we are in this position to really start building also the commercial side in a different way. And it's been like, also, during our journey as a public company, we've been very careful not to bring, not to give this kind of a target earlier.

So we have, as we have always done, we built the company. We do what is needed to do for the company to make it successful. And now we strongly believe that we have reached a great milestone, and that's why the target is there.

Satu Saksman
COO, Nightingale Health

Okay, I think we, time is out, and time to thank all the audience online. And I also want to thank you, Teemu and Tuukka, for choosing just a great outfit for this. It's really like a team outfit, and we didn't synchronize it at all, so great.

Tuukka Paavola
CFO, Nightingale Health

C oincidence.

Satu Saksman
COO, Nightingale Health

Yes.

Teemu Suna
CEO, Nightingale Health

Yeah.

Tuukka Paavola
CFO, Nightingale Health

Let's see what happens next time.

Exactly.

Teemu Suna
CEO, Nightingale Health

All right. So thank you, thank you, everyone, and have a nice day!

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