Good morning and good afternoon. Thank you, everyone, for joining us today. Welcome to Sisram Medical Full-Year 2023 Earnings Call. This is Qianli, Vice President of Investor Relations of Sisram Medical. Please note, this event is being recorded. Before we begin, I would like to remind all of our listeners that certain information provided in this call may contain forward-looking statements, and changes in business, competitive, technological, regulatory, and other factors could cause actual results to differ materially from the forward-looking statements made today. Our historical results are not necessarily indicative of future performance. As such, we can give no assurance as to the accuracy of our forward-looking statements and assume no obligation to update them, except as required by law. This safe harbor statement applies to the call. If you haven't received a copy of the release, please go to the Investor Relations section of the company's website.
Now, I would like to introduce our speakers on the call today. With us on the line today we have Mr. Lior Dayan, Sisram's Chief Executive Officer, and Mr. Doron Yannai, Alma Lasers CFO. So today management will begin with an overview of the business development for the full year of 2023, and then following the prepared remarks we will open the call for the Q&A section. With that, I'd like to turn the call over to Mr. Liu Yi, Sisram's Chairman. Please go ahead.
Thank you, Qianli. Can you hear me?
Yes, Mr. Liu.
Okay, thank you. Good day, everyone. Thank you for joining us today. It's our pleasure to share in the business status of Sisram for 2023 and discuss the business for 2024. In the past few years, I think we have witnessed the development of the medical aesthetic world, mirroring a shift in consumer behavior from reactive, simple-focused approaches to more proactive and personalized engagement. Consumers now prioritize trustworthy, medical-grade solutions tailored to their individual needs, reflecting a growing demand for personalized wellness experience. As a global consumer wellness group deeply rooted in the medical aesthetic industry for many years, Sisram Group has established a clear strategy with two key focuses: business diversification and direct sales expansion. Over the past few years, the company has evolved from a singular focus on energy-based devices to a diverse portfolio and building a global wellness ecosystem.
Since the company clarified its growing direct sales strategy from 2016, the revenue generated from direct sales has increased obviously, which brings the company closer with the doctors and the end consumers. So take the opportunity I want to say thanks to our great team, partners, and investors, so expecting we have productive communication today. Thank you.
Thank you, Mr. Lior. So, next let's welcome our CEO Lior Dayan to give us more updates about the year of 2023. Lior, please.
Thank you, Qianli. Thank you very much, Chairman Liu Yi, and thank you all for joining our call today. I'm happy to provide an update on the ongoing success of our wellness ecosystem in the year of 2023. This year was a milestone period for Sisram as we significantly advanced our wellness ecosystem, expanded our direct reach, and achieved market breakthrough across our key business lines. The group's performance for the year of 2023 includes revenues of $359.3 million, which is an increase of 1.4% compared to the revenue of the previous year. Our gross profit margin rose by more than 4% to the level of 61.1% for the reporting period, as compared to the 57% during the corresponding period in 2022. The gross profit is with the amount of $219.5 million, which represents an 8.6% increase comparing to the last year.
The gross profit trends attributed to higher revenue driven from the direct operation, channels and more profitable product mix not only showcase our ability to adapt and thrive amidst macroeconomic fluctuations, but also represent our market dominance in strategic countries. The net cash flows from the operating activities were close to $44 million, which is an increase of almost 100% year-over-year. Sisram maintains healthy fundamentals with sufficient funds to meet its future business needs and sustain its operational resilience. I'm also proud to report to you today on the significant progress made in expanding our direct sales presence in key markets, which serve as key contributors to Sisram's profitable future growth. During the reporting period, revenues in North America and in Asia Pacific were $157 million and $110 million, which is an increase by 9.2% and almost 12% respectively.
To reinforce the company leadership across the Asia Pacific markets, the company established new strategic subsidiaries in Japan, the world's third-largest economy, and in China, following by the acquisition of the aesthetic device distributor PhotonMed International. The setup of our direct operation channels in pivotal strategic territories not only streamlined our supply chain, but also led to higher average selling prices, enhanced brand visibility, and fortified relationships with partners and clients. In the current reporting period, revenue from the direct sales comprised a record high of 78% of our total revenue, with sales through distributors making up the remaining 22%. This shift towards direct sales highlights the effectiveness of our long-term strategy and increases companies' profitability. At the heart of our success has been our dedication to expanding Sisram's unique wellness ecosystem, with a synergistic product line.
This year marked successful launches and regulation progress, including the flagship hair removal device, the Soprano Titanium, in North America following the FDA approval. Opus, a transformative skin treatment, gained traction in the international markets, and the DermaV, a dual-wavelength vascular laser workstation, made its debut in the United States. Meanwhile, the NMPA, the Chinese FDA, has accepted registration application of the biostimulator Profhilo and the long-lasting neurotoxin DAXXIFY. We have also launched LMNT.O2, the second generation of our home-use device. As a main pillar of our business strategy, we have placed significant emphasis on strengthening the Alma's global brand recognition. The Alma commercial brand stands as a beacon of trust and reliability in the aesthetic industry, serving as a strong vehicle to drive demand and business for our partners' clinics.
Elevating Alma's global brand and bolstering B2C recognition, the company has announced a 2-year collaboration with Hollywood superstar and iconic figure Ms. Kate Hudson, which will serve as the global brand ambassador. This partnership showcases Sisram's brand value to end consumers, fostering bottom-up demand and enabling effective promotion and sales of our solutions. Looking to 2024, Sisram will continue to execute our strategy by evaluating and implementing near-future technologies and extending the company's global footprint according to the direct sales approach. The group's efforts throughout 2024 will strategically focus on corporate leadership in strategic markets such as Asia Pacific and North America. Based on the current global footprint, looking ahead, as the company continues to expand its global operation, Sisram will refine and enhance its direct sales strategy.
We will intensify the efforts in penetrating direct channels, ensuring closer engagement with clients, while maintaining a customer-centric approach to drive growth. We will also continue expanding our offering through our unique wellness ecosystem, with strategic focus on utilizing the building blocks of injectables, skin care, and personal care, especially to prepare for the launches of DAXXIFY and Profhilo in China. Furthermore, we will enhance brand awareness among end user consumers, strengthen global brand recognition, and create bottom-up demand for the company's solutions that will eventually drive business to its partners, our customers, impacting their growth. In the ever-evolving era of medical aesthetics, we understand that prioritizing long-term relationships between clinics and patients is not just a strategic maneuver, but a crucial paradigm shift driving force behind sustainable business growth.
Sisram continues establishing unique supportive operations that empower clinics to anticipate and meet patient needs and deliver personalized experiences that resonate deeply with their patients, enhancing patient retention. This not only contributes to the sustainable business growth, but also solidifies our competitive advantage in the market. As always, I would like to thank all of our employees for their efforts to build Sisram into a global leader in wellness and extend our deep appreciation to our shareholders as we continue our journey together. Thank you very much, Qianli.
Thank you. Thank you, Lior. So, we are ready for the Q&A section. To ask a question, you can raise your hand or leave a message in the Q&A box. I would like to remind our listeners, when you ask the question, please state your name and organization before asking a question. Thank you. I see we already have a few attendees raise their hands. Let's see our first question. Let's go with Chuanqi. The operator, please help to unmute. Chuanqi, please go ahead. Yeah.
Hello, Ms. Fang. Can you hear me?
Yes, we can hear you.
Okay. Thank you for this opportunity. This is Chuanqi Ma from Sealand Securities. I've got a couple of questions here. The first one is, as we can see, Europe H2 revenue is up 29% compared to H1. Is there any sign of Europe economy recovering and any plan in 2024?
Specifically for Europe?
Yes.
Well, that's the European economy in general, and we're talking about the more conservative part of Europe that is still facing some challenges regarding the, you know, the war that is in Europe between Russia and Ukraine. This has repercussions in other countries. And again, GDP wasn't growing at the pace that one may have wished, nor the consumer consumption. I believe that on our side, what we did have a change with the second half was the fact that we, as you know, established our U.K. operation at the beginning of somewhere in the middle around May of 2023, and the team was up and starting to be up and running towards the second half of the year. And so that's, I guess, one of the reasons why you see a change. This isn't a general comment. This might come in other questions.
Wherever we have, I mean, in general, where we have our new offices coming up, and we have 11 of those today, 10 of them are new - sorry, 7 of them are new - are basically driving strong growth and really positive control in the markets, even when there are some financial challenges. And that's the unique of working direct. Now, in addition to that, we introduced new services around, again, in the direct operation, around the customers, driving more attention, helping the accounts to be able to exercise better the units that they have in their clinics, or to expand to new ones. This is part of the new operation of the customer success teams, which we are implementing in our direct operation.
Okay. Thank you, sir. Very clear. And I've got another question in terms of North America. Could you please explain the main reasons for the slowdown in growth of North America? And what do we expect for 2024? Thank you.
So, North America, actually, we haven't faced a slowdown. The growth was with about 9%. And—but what we may have seen is a very strong demand that was during 2022, and we had a lot of backlog coming up, I think, with remaining. But in general, the growth in North America is really related to the high level of interest rate that is still delaying the process, especially on deals of EBD, energy-based devices. A lot of the deals in North America, specifically in the United States, are based on leasing. And so if the process of approval takes a longer time, this is, I guess, part of the difference of the growth rate, which wasn't in 2023 as strong as we faced in 2022.
Thank you, sir. Very informational. Thank you.
Thank you. Let's see the next question. Let's, Carson? The operator, can you help? Yeah, thank you. Carson, you may start. Yeah. Thank you.
Hi, management. This is Carson from J.P. Morgan. Thank you for taking my questions, and thank you for sharing the resilient results. I've got two questions. The first one is regarding the guidance or outlook for 2024, the sales growth and the earnings growth, and corresponding drivers for the growth or some underlying assumptions for such guidance, like by region or by product line, something like that. My second question is regarding the overall consumer demands. In China, there is a consumption downgrade trend. In North America, you've mentioned that the interest rate is very high, and in Europe, the inflation. So what's our observation on the consumer demands for the aesthetics or beauty service, and how would we respond to the consumption trend? Thank you.
Carson, thank you very much for your questions. I'll try to address it as much with details as possible as I can. So in general, we're not giving an exact forecast number for 2024, but I would like to try to color for you where we're heading. So in general, looking at 2024, and we're from a time frame point of view, we're very close to the end of Q1. And you can see there is the momentum that we could see, in general, of the second half of 2023. The pace is picking up, and we definitely expect growth in 2024. Now, there are, other than the macroeconomic figures that we don't know to predict, of course, but we all hope the interest rate will come down, and tensions of war in different places in the world will tune down, hopefully. This would definitely drive more growth for business.
In general, it's true, it's not clear regarding financials of macroeconomics, inflation, unemployment rates, and so on. But what really stands for us is a few things. First of all, Alma, the EBD level, really beefed the pipeline of our products over the last few years. And just this year, we launched earlier this year in North America the new version of the Harmony. It's a long project, which was worked out in the last three years. And we already had a large event in New York, Business of Beauty, introducing the product with having first sales from the product. Also, we introduced the special edition of the Soprano Titanium, the leading hair removal platform on a global level, the strongest brand of hair removal existing today. And we introduced this at the IMCAS event in Paris earlier this year.
By the way, this was the largest IMCAS event ever, close to 20,000 representatives, which makes kind of a signal about the sentiment out there of customers, doctors, business owners that are really hoping to see the market coming back to the pace, hoping the consumers would be coming back strong into consuming these wellness procedures. So having a deep product line, fresh... And then, by the way, one more product I didn't mention is the hair growth, which is very successful in the United States, the TED. We're also going to launch that in the international markets close to the summer this year. So incorporate this together with the fact we're direct in 11 offices, and more than 80% of our business is with direct control of the markets, which is a growth compared to what we have before.
We are pretty confident regarding 2024 that we'll be able to overbeat the trend in the market like we've done the years before.
That's very clear. Thank you.
Thank you, Carson.
Lior, I think Carson had a second question. How we respond to the consumer trend, you know, just maybe our general opinions in the market.
The consumer trend? Well...
Yeah.
So, as I mentioned, that's just an example of the large event in Paris, which was the largest ever. You can see a very high increase of interest in that area. Also, if we are addressing China, coming out of the Chinese New Year holiday festivals, we see the momentum that we have seen in the second half of 2023 keeping up. And so there is no, you know, no other news which could make us more worried than maybe last year. I think the momentum is, in general, positive right now.
I see. Good. Thank you, Lior. So let's see the next question. The operator, please help to unmute Warren. Warren Dai. Yeah. Thank you. Please, Warren.
Okay. Thank you. Can you hear me?
Yeah.
Yes.
Yeah.
Yeah.
Okay. Thank you, management. This is Warren Dai calling from China Merchants Securities. So I actually have three questions. So the first one is regarding our registration process for the injectable products in China. So have there been any updates from the NMPA regarding Dexify? Since we were hoping kind of, you know, to hear back from the regulators in 2023 year-end, but now we are kind of approaching the second quarter. And also, just curious, you know, any idea when it may get approved and when it will be launched? And just to follow up on Dexify, so I also see the Revance, our Dexify partner. So they just issued their 2024 guidance.
So I'm just curious if their first year's commercial launch and their, you know, the second year guidance will be, you know, a growth trajectory as a, you know, as a proxy for our China launch's sales trajectory in the future. And also, my second question is regarding our Soprano Titanium in South Korea. I'm curious about what's the products, you know, make it so special? And, you know, can you please share more about its core technology and competitive advantages? And since, you know, there's some, you know, there's some domestic, very competitive domestic products in South Korea as well. And what will be the time that the company will introduce to the Chinese market? And my third and last question is regarding the Chinese markets in 2003. I understand you may briefly touch on this topic early on, but I'm just curious if you can share some color.
It will be great to share your thought on how we're going to, you know, ensure a steady growth in the coming years, let's say, maybe 2 years-3 years down the road. Thank you.
Warren, just about the question number three, you speak about global or specifically about China?
Just the China markets, please. Thank you.
Oh, the Chinese market. Sure. Okay. So thank you for the questions. I wrote them down. So first of all, regarding DAXXIFY, we did receive the NMPA feedback. And in general, the approval actually is supposed to be somewhere in the second half of 2024. This is where the approval basically is expected. Normally, it's 12 months-8 months the timeline. And it will be on time, it seems, from the feedback we have from the relevant sites. We haven't had yet the plan of the launch because it's also from the moment we get the approval, that's where we, from a regulation point of view, our partner basically would be able... Revance would be able to start producing the product. And so it's not clear right now whether it's going to be... when it's going to be exactly in 2025. Or right now, we are not committing to that.
Again, the quantities that we're talking about are significant, and we cannot come with small amounts. It's going to be able to create noise in the market. So that's very, very... this is a very sensitive point. But things look very, very positive from that perspective. About titanium, the Soprano Titanium, which you see the strong growth in or heard about the strong growth in Korea, South Korea, the titanium in Korea actually... and there are reports and studies that have been done over the last few years by Korean dermatologists, which are using the most well-known hair removal platform, Soprano, which is using three wavelengths on any given moment when we use the laser. And again, it's based on very high repetition rate. The engine is very strong. We're talking about 10 Hz on the pulse durations, which are very, very short. And eventually, we found...
they found, based on doctors' feedback, a new indication to push with the ability to do that regulated in Korea, which is Titanium Lifting. So it's a lift procedure and with very clear clinical evidence. At the moment, there isn't a head-to-head technology-wise comparison, even though many... because of the high demand, many local competitors have set efforts to go inside the game, but they don't have the spec we're speaking about from a technical point of view. And more than that, they don't have the brand that is very, very strong over there. Following this success in Korea, we also had... during this last IMCAS, I spoke before in Paris, this at the end of last... this January, Korean physicians were on stage and were giving lectures on their studies over the last few years of working with this new indication.
We are pushing this globally in a careful mode because in order to push it, for example, in North America, we need to have a clear indication. And so this would be an off-label, and we always are very conservative with pushing off-label matters. But... and again, every clinic that has the Soprano has the knowledge to learn and how to do the procedure. You don't need special elements in order to execute this. This is clear value to the clinic. Point number three is about, in general, about the China market. The Chinese market, we actually have the two major giant markets which are competing would be North America, the United States, of course, and China. In China, being able to... in China today, we have about 250 employees, very strong operation, which we acquired in the middle of 2023 for the energy-based device, which is ALMA.
And then we have almost the full scale of injectables because we have the biomodeling of Profhilo coming up towards the end of 2025. And then we also have the Daxxify, the neurotoxin, as mentioned before. And we're in discussions for also the volume HA solution, just to finalize the whole scale. Add to that element our home device, which is being sold via D2C, which is really driving a lot of attention to our... to the hospitals, the private entities, which... clinics in China that are using our technologies. China would probably be one of the first places where we can combine all of these technologies that I mentioned into a clinic. So the growth plan for China, again, pending economy scale as much as will allow us, being already the leader in this market, there is a lot of expectation and planned growth for that market.
Oh, okay. Got it. Thank you so much.
Sure. Sure, sure.
Thank you, Lior. So we see we have one more investor raised their hand. Jingpeng, please. Operator, please help to unmute Jingpeng, and then please go ahead, Jingpeng.
Okay. Can you hear me now?
Yeah. Yeah, yeah, yeah.
Yeah. Okay. Thank you, management. I have... I'm Jingpeng from CITIC Securities, and I have one question. So we see the emergence of the exclusive distributor format in China, and this has been finished for over a half year. So what synergy can be seen so far and how it may contribute to the company's financial performance? Just one question. Thank you.
So basically, this acquisition of Faithun on June 30, this happens after almost 20 years that we are working together. So there wasn't an immediate difference between June 30 and July 1 because we are working together. The difference was, of course, is the fact that we could recognize revenue immediately as the top line, and you can see there is also a beneficial regarding... I mean, the gross margin and the operation there is very, very with efficiency parameters, which drives improvement in the operation of the net profit. And of course, the payment terms in China are solid and very strong. So this brings also one of the reasons you can see we have a very high, strong growth in our cash flow of more than $43 million this year. So that's kind of an immediate financials.
Now, taking in consideration our strong brand in China of Faithun, but that's the symbols of Chinese Faithun. Everything in English is Alma. So that kind of step really boosts even further that merger with the doctors. And knowing that soon coming up, the injectable business, they're all waiting for this leading brands such as Profhilo and Daxxify. And so this is really with high attention. So I think everything on that perspective, you know, in more than 10,000 clinics in China, it's a big party. And this year, the company is going to, you know, recognize, celebrate 25 years Alma. And this is a strong message going ahead and growing together.
Okay. Okay. Got it. Thank you.
You're welcome.
Thank you, Lior. Let's see if there are more questions. If not, I think we can conclude the meeting today. Thank you for joining us today. We appreciate your participation. If you have further questions, you can reach out to our investor relations team. You can find the contact on the company's website. We look forward to our continued dialogue. Thank you, Lior. Thank you, Mr. Lior, on the call today. Have a great day, everyone. Thank you.
Thank you.
Thank you. Thank you.