Welcome to Nexstim's webinar for investors, analysts, and media. Nexstim's CEO, Mikko Karvinen, and CFO, Joonas Juokslahti, will be giving a presentation that will take a little over half an hour. After that, they are available to answer any questions you might have. You can send questions at any time through the Q&A chat, but they will be replied to only after the presentation. As you send a question, it will first be visible to us organizers only. The webinar will be recorded, and the recording can be accessed on this page after the event ends. You'll be able to access the recording also on the events page of the Nexstim website. Now, let's move on to the presentation. First presenting is Nexstim's CEO, Mikko Karvinen. Go ahead, Mikko.
Thank you, Essi, and welcome everyone. My name is Mikko Karvinen. I'm the CEO of Nexstim, and I will be joined in this webinar with our CFO, Joonas Juokslahti. We are happy to go through our first half, 2025 financial results in this webinar. We will begin this webinar by I will be going through a bit about the general story and Nexstim business, continued by, of course, the H1 as a summary. Joonas will be going through some of the financials in more detail. At the end of the webinar, I'll come back with some of our 2025 key strategic objectives and then finalize with some information on our new NBS 6 product. We can go forward with starting off a bit about our strategy. We started off a new strategy period in the beginning of 2025. Our strategy period here at Nexstim continues until 2028.
I want to explain a bit about this picture. We're in the middle. We have our key focuses and our businesses for this strategy period. Beginning with the top mega trends. Nexstim is an international medical device growth company, and we are headquartered here in Helsinki, Finland, where our system is developed, where our system is also manufactured in Finland, or where we export it around the world. The mega trends that are affecting the medical device business and our brain disease and disorders businesses are the ones in the top: aging population, technological development in healthcare, and healthcare cost pressures. Those set up some of the key things that are happening in this business environment of ours. On the below part of this graph, we have our important mission, our vision, and our values.
These, without going into exact detail of each one of those, those are the ones that have the foundation, the platform where we can build our strategy and our business on top. We've been very stable. It's been a stable, good, growing platform where we can have successful business growth. Now coming back to the center and to the focus of our strategy, we have taken, we have four areas of focus, four businesses and the interests that we want to serve in particular during our strategy period. If we start with the first one on top, the diagnostics business. This is the business where we've been the longest. It's brain mapping. We are with our navigated transcranial magnetic stimulation technology in our system. We can map the brain, motor, and speech functions in a very accurate manner. This helps neurosurgeons perform more safe procedures and safe surgeries.
In particular, for example, in tumor surgeries, epilepsy, and then somewhat also in radiotherapy. We announced a large partnership with a German-based company, Brainlab AG, at the end of 2024, at the end of November. This partnership is going to be a very key element for our growth during this strategy period in the diagnostics business. Through systems and service sales volume increase, through a successful Brainlab partnership, we seek to bridge neurosurgery, neurophysiology, and neuroscience in a way that ensures growth, growth, and profitable growth for Nexstim. This is an exciting area. I will be going through a bit more detail about the Brainlab partnerships too. Exciting development. On the therapy business, this is an area where Nexstim currently already has two approved indications in Europe. It's major depressive disorder and chronic neuropathic pain treatment.
With our therapy system, which is the newest generation NBS 6, we can help patients that suffer from major depressive disorder or chronic neuropathic pain. We want to continue the development of this part of the business through, of course, these mentioned approved indications, but also want to expand into possible new indications and market opportunities. There's a lot to do in the area of therapy. In the new indications path, of course, there are multiple exciting areas that have been researched, but there are also areas where new research information might be available even during the strategic period itself. We have also built some interesting partnerships and starts in that area.
If we go into the research and neuroscience, which is the third platform here, we try to help the leading research and neuroscience hospitals or clinics around the world in getting forefront technological and clinical development with the Nexstim system. As a very, very new partner in this area, we have Sinaptica Therapeutics to mention. Sinaptica is researching, doing further research, has researched and will be doing further research in the area of Alzheimer's disease with TMS- EEG. We have now signed an exclusivity agreement with Sinaptica that would enable us to be an exclusive provider of Nexstim TMS and third-party EEG integrated system with their cloud-based software engine. This is something unique, and it could help first research, do more research in the area of Alzheimer's treatment, but also possibly in the future have a commercial partnership around this.
That's something interesting in developing in that area, just to mention one. On the final one, the fourth platform, the clinic partnerships, we have invested into a few clinics in the United States through this management services organization. Our investment is into these management services organizations that help the clinic partners focus into their business fully, which is helping the patients, treating them with, in this case, Nexstim devices, but also other leading technology and pharma approaches to helping patients who suffer from brain disease and disorders. It's mostly now clinics in the beginning that are treating depression because in the United States, our therapy system is approved for major depressive disorder treatment. It might evolve in the future also clinics that operate around different brain disease and disorders.
This is an exciting strategic focus area where we continue to expand the existing partnerships and also actively monitoring effective new treatment methods, including new indications, but also other treatment supports. That's in a nutshell where our strategy is focusing on during the upcoming years. I will next want to remind about the diagnostic business major partnership agreement that we did with Brainlab AG at the very end of last year. This is an exciting new opportunity for Nexstim because Brainlab AG is an innovative and a leading company in the area in the neurosurgical field, providing the leading neurosurgical hospitals around the world with their technology, their systems, and software. This is something that is extremely new to us. At the same time, we have been working with Brainlab AG with multiple customers already in the past. The new news in this area is the partnership form.
If we look at the next slide, we've started now a collaboration by signing a development and distribution cooperation agreement. This helps us first now in the beginning to sell the Nexstim NBS 5 and in the future, the Nexstim NBS 6 diagnostic system once regulatory approved to, of course, a wide customer base that Brainlab AG already has and then new customers for possibilities through this partnership. At the same time, we are looking, we are doing some development activities already to deepen the integration between Nexstim and Brainlab AG. We are also looking forward to doing even more in the future in developing the next versions of the Nexstim device and future integration of the Brainlab AG offering and Nexstim's current offer. We start off with our NBS 5 as we've started already in the distributorship and then continue with the new NBS 6.
Here we can look at a quick look at this before moving on. Again, in the area of diagnostics business, here's a very, very simplified non-emballistic brain motor mapping in 20 minutes slide, which I'll go through because some of the listeners might be unused to how we perform a brain motor mapping. This is the area which is key also in the Brainlab AG partnership. As basic material for our system, every patient undergoes an MRI scan. Their brain is scanned with an MRI. In this first step in the slide, we upload their MRI into our Nexstim NBS 5 system or NBS 6 system. This creates a 3D model of the brain. That's the patient's own brain in a 3D model within our Nexstim system. In the second phase, we register the patient's head to this MRI that's a 3D model in the Nexstim system.
We tell our system where the patient's physical head is in relationship to this 3D model. In phase number three, 3D mapping of the brain where we stimulate the brain, we can stimulate any place in the brain's cortex. We navigate the actual electric field, we visualize that on the cortex, and then you can stimulate that area. We will be starting forming these pinpoints after that, and multiple pinpoints will form a map of where a certain motor function is located. We have an EMG and electrodes that measure whatever muscle, for example, the hand or the legs or the facial muscles you want to be mapping. In phase four, we review the areas eliciting responses to avoid during surgery.
This is a phase where looking at the map and deciding which areas are important in the map, which areas are such that we should be focusing so that the patient can be treated or have surgery in the safest possible manner with minimal possibilities of focusing on any deficits of any sort. In the final phase five, we can export this data that we've done, the brain map, into surgical planning and navigation tools. In the Brainlab AG partnership, this, of course, focuses on integrating this data done with the Nexstim system seamlessly flowing into the Brainlab AG system, their surgical planning and navigation tools. We are also compatible with other leading surgical planning and navigation tools.
Through this partnership and integration, we look forward to developing the Nexstim Brainlab AG integration work to help the surgical planning and navigation in that form to be the very best in the world. That was a quick look into this and a bit of extra information outside of the mostly financial data we will be listening to today. The final slide before I go into the H1 events is just a reminder about our business and products. The two businesses that require regulatory approvals from our side, of course, are the diagnostics business and the therapy business. We have two businesses, and they are served currently by two systems, also mainly two, actually three if we take the MVT, but NBS 5 is currently the system that we use for the pre-surgical mapping of the brain. This is the business we've been doing the longest, over 250 systems sold.
We are the only navigated TMS provider in the world, system manufacturer that has both the FDA approval and European CE marking for activating motor and speech functions of the brain. This is unique technology, unique offering, and approvals to support it. This is the business we are partnered together with Brainlab AG. In the therapy side of our business, the current, the newest version NBS 6 and the earlier version of our therapy product MVT, we have over 110 systems sold, including the therapy software. The two applications are depression, so major depressive disorder, and chronic pain, chronic neuropathic pain. Both are CE marked in Europe, so we have the marketing approval for both of those, depression and chronic pain, here in the EU.
Depression, major depressive disorder is also FDA approved in the U.S., and they have a fairly good existing reimbursement also for treating patients with treatment-resistant depression with TMS. The efficacy is really good. For patients that suffer from major depressive disorder and have not, didn't get relief from other treatments such as drugs, we have a patient registry of over 400 patients treated in the U.S., and we see that we have about 50-55% remission rates in this patient category and over 70% in response rates. This is highly effective for treatment-resistant depression. For chronic pain, we have a CE marking. We do not have FDA approvals yet. We are evaluating and have been for quite some time evaluating additional clinical trials for this area. We are doing some work to facilitate certain research in this area, but we don't have the approvals yet.
We do have multiple systems in the EU, especially in Finland where the university hospitals are treating already very successfully pain patients with Nexstim systems. We hear about 40%- 50% of the patients get a clinically meaningful pain relief. For treatment-resistant pain, chronic pain, these are excellent results. That is also something that we want to be aware of when our commercial path moves forward. Outside of this slide, there is the neuroscience research and neuroscience business. We don't require as such regulatory approvals for those systems, but most of the systems that we sell for research and neuroscience purposes are usually based on these FDA or CE marked systems. We add elements that, of course, are added in a safe way, but they require different ethical approvals from the researching parties, but they don't require the approvals as such. That is part of our business also.
This is the main volume of business that comes from diagnostics and therapy. Now we can move on into the Nexstim business and financial summary for H1. If we look at 2025 and how did the year start, the first six months, happy to say that Nexstim accelerated growth and improved profitability. It was over 40% revenue growth, which is excellent for H1. It is very much in line with our main strategic objective, which is focusing on profitable revenue growth. Our sales forecast also for full year 2025, I can tell you, looks promising. Especially happy I am about the fact that the EBITDA was $0.2 million positive. We have now two consecutive half years where we have a positive EBITDA. H2 2024 and H1 2025 produce a positive EBITDA. This has never happened in the history of Nexstim.
We see this also as one key milestone of showing the progress in how we have successfully executed a profitable revenue growth. I'm very thankful for our teamwork, for the whole Nexstim team in managing, first of all, such growth in such a profitable manner, but also that we have been at the same time developing and training our partner network within the diagnostic business in close collaboration with Brainlab AG. A lot of our team effort has also been going during H1 into participating in helping our partners, including Brainlab AG, deliver our sales and marketing message to as many markets as possible. Brainlab AG has thousands of customers, and they have a couple of hundred people in their commercial team. We've been helping their commercial team in Europe and also U.S. especially, to understand the technology that we have, integrate our technology into their marketing message.
As you've probably noticed and can notice from both companies' social media or websites, there's a lot of work that has been put, positive work that has been put there so that the customer understands. First, we need to understand both teams, Nexstim and Brainlab AG, the full offering and the full potential of what it could mean for the customer. For the customer to get this marketing message and the sales opportunities are opened. This is a big effort that is there. This is a very big strategic investment, but we can see that there's a lot of positive things happening right there. Aside from the Brainlab AG partnership, which we've worked on a lot during the first half, we've also worked on another partnership, which is the Sinaptica Therapeutics that I mentioned earlier, part of a client collaboration in the treatment of Alzheimer's disease.
We signed an exclusivity agreement during late summer or early summer. We've agreed on conditional payments of up to EUR 1.5 million, of which EUR 0.2 million was recognized as revenue during H1. This exclusive arrangement, exclusivity agreement means that Nexstim will exclusively be providing Sinaptica with navigated TMS devices, including a third-party EEG, to be integrated with their Sinaptim Precision Neuromodulation System, cloud-based engine, and to get these systems into the future research that they do. We've delivered already multiple systems during H1. We're getting ready to help them in this research agenda as much as possible. We still need some, of course, the payments to happen, but also the final agreements to be approved before end of 2025 before this long-term exclusive rights are so-called finalized for a longer period. We are right now already with the agreement signed and the payments made.
We are exclusive pending the final payments and also then the agreement signing, which was already we've published some information in the form of a letter of intent. There is a lot of positive development in the growth, in the partnerships. Now, focusing to a couple of numbers before I give also the possibility to Joonas to go through some financials. System sales were EUR 2.2 million. There was an increase of almost 80%. A huge growth during the first half. Recurring sales was EUR 2.1 million with an increase of 7.7%. Increased, but a lot lower than on the system sales side. System sales drove the growth in the first half. Net sales EUR 4.5 million. That's almost 42% growth. EBITDA positive, as I mentioned. Second consecutive half positive, EUR 0.2 million in this first half 2025. Operating results and results for the period were still negative.
There is a big step forward also in there, 70% less loss that we made in the first half compared to H1 2024. Cash flow was positive EUR 0.3 million. The main message here is the cash flow from operating activities is positive. Finally, when we split it into the businesses, diagnostic business sales was EUR 2.5 million. Huge increase of 65.3%. Therapy business net sales was EUR 1.4 million. There was a slight decrease of 8.4% in that area. This was due mainly because of the fact that we sold less therapy devices, but we still have a recurring revenue base. The therapy revenue decrease is because of the fact that we delivered a lower amount of therapy systems than in the first half of 2024. There are systems in the backlog that will be also delivered during the second half. The largest increase percentage-wise was in the research and neuroscience business.
This includes also the Sinaptica Therapeutics part of our business. EUR 0.6 million. There is an increase of over 565% in that area. Of course, this is the smallest business area right now, but still the one that is growing, has grown in this report the fastest. It is good to have these different areas of business. In comparison, for example, the therapy business grew the fastest percentage-wise in the second half of 2024. Now the diagnostic business grew the fastest. There is always a bit of change in the half-yearly mix of business that we do. That's also a strength so that different business areas can experience different types of growth percentages for a certain half-year period. Finally, one graph before I let Joonas explain a bit more detail to the financials.
If we look at the first halves of the recent three first halves, in two years' time period, if we look at the first half 2023, first half 2024, and first half 2025, this is a graph that shows the progress, the very positive progress we've made. First on the net sales side, there's 27% and 42% increases in net sales between these periods. The gross margin is positively developing. Percentage-wise, we've been above 80 or 80% during all these, which is an incredibly good result following the COVID inflation and the components, also including the tariffs that we've experienced recently in 2025, things like this. We have been able to keep our prices and also our purchases in the level that we can show these types of gross margin levels, which are in this industry, they are among the very best gross margin percentages, excellent ones.
The increased net sales and the increased gross margin, followed by our good expense control, had brought the EBITDA from over a million negative two years ago to now slightly positive EBITDA already in 2025. Very good, solid progress in all of these areas and showing the, I would say, the important strategic objective of profitable growth and managing that through a long, long, long period. With that, I thank you for this part. Now it's Joonas. Sorry, please.
Thank you, Mikko, and good afternoon, everybody. My name is Joonas Juokslahti, and I'm the CFO of Nexstim. Yeah, thanks. Let's look at the key figures of the group for the reading period. This morning, we had the opportunity to report the first half year of our updated strategy period. Looking back at the previous strategy period, which ended last year in 2024, our compound annual growth rate was approximately 21%.
Now, in the H1 of 2025, we have managed to double our growth rate. The total net sales increased by 42% to EUR 4.5 million. The main driver for this rapid growth was the system sales. System sales amounted to EUR 2.2 million with an impressive growth of 80%. This represents just under half of our total net sales. Recurring revenue grew by 8% to EUR 2.1 million, accounting for 45% of total net sales. Recurring revenue has become this significant and important revenue item for us over the years. Additionally, some EUR 200,000 in revenue was recognized in the first half as licensing income related to the exclusivity agreement with Sinaptica . Previously, we have reported our revenue split into two business areas, the diagnostic and the therapy business. This period, we have separated a third business area, research and neuroscience.
There has been activity in this field already in small amounts before, but it was previously reported under either diagnostic or therapy based on the nature of the sales. Diagnostic revenue was EUR 2.5 million with 65% growth. Most of the system sales growth fell on this side of the business. Therapy revenue was EUR 1.4 million with 8% decrease. This was mainly due to our timing of system deliveries. Several therapy system deals were recognized in the comparison period. We now have those orders in our order backlog, and those will be recognized upon delivery of the systems. The new research and neuroscience business revenue was approximately EUR 0.6 million with a relative growth of 566%. That is due to both increased demand in the field, but also lower activity in the field in the comparison period. Gross margin amounted to EUR 3.6 million with an increase of 40%.
The gross margin ratio remained at the usual high level, over 80%, being 81% for the review period. We have been focusing on this so-called profitable growth for the recent years. Internally, we monitor this, for example, by comparing the growth rate of the gross margin to the growth rate of the operating expenses. In the review period, gross margin grew by approximately 40% and the operating expenses by 11%. That is indicating a healthy development in this metric. By function, operating expenses were distributed as follows. We invested the most in sales and marketing, which increased by some 15% from the comparison period, totaling EUR 2 million. Daily lease expenses were EUR 1.1 million, up 12% in comparison to last year. The admin expenses, which include also regulatory and political matters, grew very moderately at about the rate of inflation at about 3%, totaling EUR 1.2 million.
Our business is traditionally very cyclical. For example, last year, we delivered roughly half of the year's systems in the last three weeks of December. In this context, it's great that already in H1, our EBITDA was positive at EUR 0.2 million. The operating loss decreased by 72% to approximately EUR 0.2 million, which is nearly at a break-even level. Net result improved by 64% to minus EUR 0.3 million. The cash flow from operating activities was positive at about EUR 0.3 million. The cash balance at the end of the review period was EUR 2.7 million. In addition to that, we had account receivables that amounted to EUR 2.4 million with an increase of 25%. The group equity also improved by 7% to EUR 3.2 million with an equity ratio of 32%. In addition to the sales recognized in H1 and reported here, we have received system orders at a record pace during the year.
Those systems are being delivered as we get them from the factory. Our standard delivery time is approximately 12 weeks. Based on the strong first half, the outlook for the full year of 2025 will remain unchanged. The company estimates it's necessary to grow and operating results to improve. On the next slide, I also wanted to show this trailing 12-month performance graph in this webinar. This is based on our published report. Each bar represents a 12-month period, which is calculated by adding up two consecutive half years. From this, we can see that on a half-year basis, we have continuously improved our 12-month key figures. The net sales have grown, for example, by 92% over the two-year period shown in the graph, which corresponds to a compound annual growth rate of 39%.
As the gross margin ratio has remained at a high level, the gross margin itself has also grown proportionally. The graph shows that three consecutive trailing 12-month periods already are showing positive EBITDA. That's been growing steadily. This has been supported by our strong net sales growth and continuous cost awareness in all of our business operations. This graph concludes my part of the presentation. I'll now hand over the floor to Mikko for a moment, and then we'll go to the Q&A. Thanks.
Thank you. Thank you, Joonas, for presenting those financial highlights. We're getting towards the end of this presentation. I have a few things that I want to still share with you. The first one is the Nexstim key strategic objectives for this year 2025. We have three of them. The first one is profitable growth, which we've executed very nicely during the first half.
We aim to increase net sales and improve operating results for the financial year while minimizing the future capital requirements. This progresses well as what we've told you about H1 and, of course, the HSU and continue this positive progress for the remaining part of 2025 and reach that full year objective also. If we look at the second one, it's focusing on our strategic partnerships. We want to support the long-term collaboration between Nexstim and Brainlab AG. This has already been also performed well during the first half as we've integrated our teams together and we've shared our knowledge of both companies' offerings and met with the teams and strategized about finding the practical solution for the sales and marketing message and how combining our offering is messaged to the broad customer base that Brainlab AG has.
We've been performing together in leading events in the area of neurosurgery and conferences where we present it together and be part of the same stands right there at the actual events with enormous interest. We also want to expand the network of other partners and clinics, primarily in the U.S. Partnerships such as Sinaptica Therapeutics, their treatment of Alzheimer's in this very, very new way of combining TMS and EEG with their cloud-based engine and their protocol, getting excellent results through early research, supporting the research. Our partner clinics through our management services organizations and the operations we have in the U.S. through this private equity Nexstim Investments LLC companies.
Finally, but very important, of course, for any technology company, but as we are leaders in this area of navigated transcranial magnetic stimulation, we, of course, need to develop our product all the time to keep our place as the technology leader. We are launching the new NBS 6 diagnostic system in the key markets. The R&D work is very far already in the very last stages of the R&D project. I'm confirmed. I feel comfortable that the R&D risk is minimal anymore. We are now reaching the phase where the readiness for approvals is the phase that is needed to enable our access to these markets. We're almost there, but we will be, of course, informing the markets more closely when we are there and start our marketing. Also, as a final thing in here, it will enable the ease of use and future add-on modules in the same system.
Being therapy, diagnostics in the same system, NBS 6, and then also future modules that we can use or can be used by our customers. I will also conclude this slide by reading through the future outlook for year 2025. It's similar to what Joonas presented. The company estimates its net sales to grow and operating results to improve. There are no changes from this, what we announced already when we published the 2024 full year and H2 numbers. The future outlook for year 2025 stands as it is. The final slide in my presentation talks about the future, the very near future already, which is that we will have the new NBS 6 product that has both the therapy and diagnostics available very soon. This is the product that our strategy period 2025-2028 we will be basing our commercial focus on. This is a new combined system.
It is built on Nexstim's unique clinical established technology. The modular design allows for expansion of system capabilities over time. If you buy a system that includes therapy or you buy a system that includes diagnostics and therapy and you want to add on new modules that will be arriving in the future, it will be possible through this modular structure to add on modules in the future without doing changes to your hardware necessarily. This is creating long-term value for both Nexstim's customers with the ease of use and the ease of update, and also to our investors see the scalability of the business. Final point that I want to say is that we are responsively responding to customer demands. The NBS 6 software has been developed in close collaboration with some of our customers to ensure the best possible level of usability.
Every time, almost every time I talk to our customers, the NBS 6 customers, the early users of it, I get a lot of positive feedback about how it stands out from anything else in the area of TMS. Of course, as we are the unique technology for navigated TMS and we could do it for ease of use, that is something truly unique. This responds to customer demand for the systems that can do both diagnostics and therapeutic applications and are flexible for the future to help many more patients, whether new indications or current indications. This is a flexible modular system and easy to use. With those words, I end the, I would say, official part of this presentation. You can follow us on social media X or LinkedIn. Thank you for listening. Thank you for your interest in Nexstim.
Let's see if there are any questions that have been submitted. You're free to, of course, ask anything right now through the Q&A tool if you want. We would be happy to answer if there's any questions about H1 or anything else related to our business. We'll take a moment to see. Currently, there aren't any questions right now that have been published. Of course, you can reach out to me anytime also through email or give a call. Happy to answer any questions if needed. It seems like there's no questions right now. First of all, thank you again. I look forward to reporting with our full year numbers in late February of 2026. That's, of course, quite far from now. There will probably be a lot of interesting news flow before that. Thank you and have a great summer day or evening wherever you're listening to this webinar.
Thank you. Bye-bye.