Welcome everyone to this information meeting. My name is Synnøve Jacobsen, and I am the CEO of Induct. The agenda for today's meeting is to look at the estimated potential that lies in our exciting collaboration with AstraZeneca and Portsmouth Hospitals University . AstraZeneca is a renowned pharma company, of course, with a global presence, but we will also be talking about what we have achieved in NHS England to date and provide more information about our three-party collaboration to accelerate growth. We wanted to start by giving you a short business update.
We have shared in our quarterly reports that we have delivered a number of cost-reducing initiatives that directly impact the bottom line. These initiatives have resulted in an annual cost reduction of NOK 15 million . We have also reviewed the profitability of our product portfolio and investment areas. We're no longer allocating time or resources to products that do not provide a sufficient return on investment. Moving forward, we are dedicating our time and our effort on our healthcare solutions and Tilskuddsbetaling, our core product offerings.
This has resulted in a slight reduction in revenues, but this is outweighed by the associated reduction in cost. As a result of our strategy and actions, we forecast an operationally cash-positive result of between six and eight million NOK in 2025, and this result has been achieved without taking into consideration the scale of revenues from the collaboration with AstraZeneca and Portsmouth University Hospital. All revenues from the NHS initiative will therefore directly increase the operational cash result. Let's have a look at the potential of scaling up the asthma care pathway in England.
Together with our partners, our goal is to implement the asthma care pathway across NHS England using a rapid implementation model. This model, or blueprint, as you can call it, is developed as part of the implementation at the Portsmouth Severe Asthma Network together with AstraZeneca. In terms of market need, there are eight million people, adults and children, in the U.K. that receive asthma treatment and approximately 930 public hospitals providing treatment.
There is a waiting list for treatment at specialist centers, and we know that there are patients that need biologic medication that are not currently receiving it. We also know that there is a lack of software solutions in the market, which creates a higher demand, and the opportunity for us to deliver or achieve a higher market share. To provide you with an idea of the monetary potential in our subscription-based business model, we estimate between NOK 70-80 million in annual recurring revenue from the asthma pathway in England alone, with a gross margin at current levels of 95%.
A nd to highlight the importance of a high gross margin, if we were to secure annual revenues from subscriptions at NOK 100 million , NOK 95 million would go straight on the bottom line every year. Our goal is to expand the asthma pathway to a global market together with AstraZeneca and Portsmouth, and to give you an idea of the global market potential, we have looked at the current market for biologic medication. This is a type of medication that is different from steroid-based inhaler medication, and treatment with this type of medication is a key aspect of the asthma pathway.
The current global market for biologics is valued at $6.5 billion, with an expected annual growth of 12.5%. So there's no doubt that there is a high value and high potential market for big pharma within this area. We have a long-term vision of being a key player in innovative healthcare solutions. This means that we are also looking at developing pathways for other diseases, including diabetes and cardiovascular disease and others. And our technical platform has been designed in a way that allows us to build several pathways using the same architecture.
This means that we have a shorter go-to-market timeline and a low investment cost for developing new pathways. Our market research shows that the potential in each of these diseases that we've mentioned, like diabetes, is equal to or perhaps even higher than at the asthma pathway that we've been working on so far. I will now hand over to Alf Martin Johansen. Alf is responsible for our healthcare projects, and he will tell you more about what we have achieved so far.
Thank you so much, Synnøve. As Synnøve said, I'm the lead for driving the patient management initiative within Induct, and I'm very passionate about it because I've worked on this since 2017, where we worked on a joint project together with AstraZeneca and Portsmouth and others, where they actually received the research project of the year for this project in NHS. So the result was really, really well documented already back then.
So we got our solution approved for managing live patient data in October 2023, and Portsmouth started using our solution and went live in December 2023. This means that the solution has been live, holding real patient data, and is being used in clinical use every day. So I would like to introduce our collaborative partner and severe asthma specialist at Portsmouth. Mr. Tom Brown.
Thank you, and good morning, everybody. Thank you for the introduction. So I'm going to talk a little bit about some of the clinical aspects of asthma first, just to explain why this pathway is important, and then come on to talk about how we've utilized the pathway thus far in Portsmouth and across our network, and think a little bit about how this will work and why this is such an important solution for the NHS.
So just focusing initially on asthma, we have about eight million patients in the U.K. who have a diagnosis of asthma, and of those, quite a significant proportion will have severe asthma, and that's across adults and children. We see about 200-250,000 patients are likely to have severe asthma. Severe asthma is a type of asthma which we can't control with steroid medication alone, and they need very high doses of medicines. They often suffer the side effects of those, but it's also a very serious and life-threatening type of asthma that does require treatment in a specialist service.
In the U.K., we still see poor outcomes for asthma patients. We, every 10 seconds, know that somebody's suffering a severe, potentially life-threatening asthma attack, and sadly, we still see a number of asthma deaths, and on average, we still have three asthma-related deaths a day in the U.K., and that makes it really clear why access to specialist treatment in a timely way to make sure that patients can get the right medication for their condition at the right time is so important.
Of course, I'm emphasizing that for asthma, but this is so true for many other conditions as well. Our severe asthma service in Portsmouth is one of the 14 specialist centers in England. The model in England is that we have a number of specialist centers where people will come for their care, and we work managing severe asthma across seven hospitals in our region, and we cover a population of over two million patients to support that pathway. Together with the team at Induct, we've developed a digital pathway for treating these patients with severe asthma.
In that pathway, patients coming through our service are examined, evaluated, provided with that right treatment, and then that also looks after the follow-up arrangements for those patients as well. And what that means is, as a specialist center, we can offer biologic medications, and you have to remember these are high-cost drugs, so there is a huge amount of gatekeeping that needs to be done. You have to find the right patient to give the drug. They're incredibly effective, but you do need to find the right patient for the right drug.
And also, we've therefore been working with AstraZeneca, who are a key supplier of biologic therapies in the U.K. Biologics are a specialized type of treatment for asthma that work. They're essentially antibodies that are produced in a laboratory, but what they do is they bind specific parts of the inflammation pathway that cause asthma. Incredibly effective if given to the right patient, which is why the pathway is so, so important. But what's the importance of working in a digital pathway? We know that if we want to improve patient care, we need to focus on how we deliver that care pathway.
The pathway is central to what we do, and that's really involved us working at how we can deliver it effectively. We need to make sure that every patient, no matter where they come into our service, gets the same standard of care, and you can only do that with a digital pathway solution. Because we're delivering services across quite a wide range of hospitals, working with lots and lots of different partners in that pathway, with lots of different stakeholders, we have to make sure that our pathway works on a regional basis. It can't just work in our organization.
The pathway we've now got with Induct brings all of those things together and allows us to support really a really important and efficient service that allows us to effectively get the right treatment to the right patient, but across a really large population of patients, so hugely important in terms of the care that we can deliver.
We've also really focused on using this kind of customized IT solution to simplify the complexity of healthcare services, so the healthcare system is a really complex system, and nowhere more so than in the NHS, and it gets more complex when you start adding layers on, so not only the care pathway you're delivering, but also how you're going to monitor that care pathway. How are you going to look at what the best way to deliver care is? How are you going to generate the data?
And people don't want dashboard data delivered a year after your service has been delivering. People want to know day by day what's happening in the service, how is it delivering, what's the quality, are there any things that we can change? But we want that information as well, because that's the only way you can truly innovate within your pathway. So the challenge for us is then, how do you start pulling all of this together and give people that real-time information about the quality of care that they need in order for this service to be overseen, but also to be delivered as well as possible?
And how do we do that in a way that means we don't have to go out and employ 20 different asthma coordinators at each different location? What we see as complexity grows in the NHS is more people are generally employed to try and cope with that complexity in the pathway, but actually that's not an efficient system. Actually, the more people you bring in, the more complex the system becomes, as I'm sure everybody knows. We see it as a clear problem in our clinical services, and we do need to resolve that, but the way we need to resolve that is with simple IT solutions.
We're also not good at implementing simple IT solutions often in the NHS. Instead, what we do is take a system that may have worked somewhere else for some other problem, and we try and retrofit that or work out how we can adapt that so that we can use it within our system and try and hope that that might work. But actually, what we find is that very often doesn't quite meet the needs of what we were trying to achieve because it was never really designed to fix the problem that we actually have. So therefore, it never quite gives us the solution we need.
Our relationship and partnership with Induct has been pivotal for us because what it's allowed us to do is work really collaboratively to create a solution that's actually specifically designed for the problems that we face and what we need to fix, and allowed us to implement a solution that really genuinely allows us to fix the problem and make our pathway better. What we want to do is make our pathway better for our patients, and that's what we're seeing, and that's why we're so supportive, encouraged, and keen to persevere and to make this useful across the much wider regional basis.
So what about the interest from other severe asthma specialist centers and other networks? We're one network. There are other networks across the U.K. Because we now have a system that's designed to deliver exactly what we need for the pathway that we need to deliver, what we see from our colleagues is envy because they want this solution. They want something that's going to work for them because they're working in a different system. We see people still working with Access databases. We see people working on Excel spreadsheets, all of the problems that come with that.
But in honesty, every day I see people working out of paper diaries and off loose sheet bits of paper, and that can't be the right way forward, and it's not a sustainable way to work. So we really want to scale the system that we now have across to other networks as well. We know it's a real solution. We know it works, and we're really proud of what we've achieved, and we want to see that work for the benefit of patients in a much wider basis. And so we want to scale it rapidly. We want to make sure that this is brought to people quickly so that they can actually start using it. We've spoken to other teams.
We've demonstrated the platform. We've demonstrated the value as well, not just to clinical teams, but also to those that pay for it in NHS England and also our Integrated Care Boards. And actually, what we see is just a genuine enthusiasm to make this work, scale it so that we can start implementing. There's also a huge amount of enthusiasm about doing this as quickly as possible because actually, if we fix these problems within our pathway, that's where the money saving comes.
Actually getting the right treatment to the right patient is the right thing to do, and we know that that will save money to the system as well. This is a huge win-win scenario for a healthcare system. The biggest challenges with expanding the system to other networks and hospitals that we see is really around information governance and IT.
But because we've now been able to get that through in our system and in our hospital, and we've used the time that we've had so far to road test it, make sure it works, make sure that we know how to communicate that with other people, but also working as part of this partnership with AstraZeneca and Induct to make sure we know how to essentially embed this into other systems as well. That's absolutely critical. So we're in a really good position to start looking at how we can embed this now in other locations.
Of course, you need the buy-in from other specialist centers, but I don't think that's going to be an issue here because actually there isn't anything else that does this. So they don't have another solution that they can use. But also, it's really important to think about who's going to pay for it. And we've been working really carefully to make sure that we're aligned with NHS England and our Integrated Care Systems to make sure that they are getting what they want so that actually the barrier of payment isn't going to be there at the other end. And what are the key benefits that we found of working with Induct?
Well, actually, this has been a really unique collaboration for us. Actually, we're working together to come up with a solution that is fit for purpose, does what we want it to do. And actually, what we've been able to do is when things don't quite work, we're able to adapt and evolve. And that's not something that we see in our other IT projects. We see that it can be tremendously difficult to actually make any changes once something has been signed off.
S o actually, that's been really, really important for us, and Induct have provided us with a really fresh and innovative perspective on how we can actually meet the demands of our care pathway, but I'll be honest, it's not met our expectations. It's far exceeded any expectations we have, so what about the future? So looking forward to two or three years ahead, well, in two or three years, I really think genuinely that Induct is going to be implemented across our healthcare system, across our country, across the U.K.
I can't see how any severe asthma network wouldn't benefit from this, but it's not just severe asthma networks. It's also so many other conditions, but to help us achieve that, we've now entered into this collaboration with AstraZeneca. Unfortunately, they're not able to attend this live stream, but Louise Goswell, who's our AstraZeneca Project Manager, has recorded a short video where she's going to tell us a little bit more about why AstraZeneca wanted to be part of the collaboration and what she's been working, what we're working together to achieve. Sorry. With that, I'll pass over to Louise.
We understand that we're having some problem with the sound. What we'll do is, if you just keep on, keep the meeting going, we will fix the issue and be back shortly.
Thank you, Tom, and good morning to all of you. My name is Louise Goswell, and I'm a Pathways Manager here at AstraZeneca UK and also delighted to be the project manager for this piece of work. AstraZeneca is an established leader in respiratory care, which includes asthma and severe asthma.
As you've just heard from Tom, there is a huge unmet need in this disease space. And here at AstraZeneca, we're committed to transforming care for patients through strong NHS partnerships such as this one. A streamlined and standardized digital pathway that offers a better quality service to a huge number of patients is, of course, completely in line with our vision and medical missions and the reason that we're delighted to be partnering and contributing.
The benefits of embedding such a pathway enables the full harnessing of the clinical expertise that sits in this network and therefore delivers a better clinical quality and improved health outcomes for patients equitably. In addition to project budget resources, we're also committed to working side by side with the team to help implement the pathway solution to the other hospital sites at pace.
As part of my role as project manager, I will also be capturing both the local and network benefits from the implementation and, as an output, be delivering a final report that can act as an implementation blueprint for other networks. In addition to the pathways team, there is a much broader cross-functional team internally from medical affairs at AstraZeneca that are involved in this project and meet as part of the monthly steering group. We're really excited to be part of this project and have high hopes in terms of the benefits that can be achieved through the project and the pathway solution. Thank you.
So sorry about the technical issues. Fortunately, we have a really technical CEO, so he can help us here. Thank you, Synnøve. So thank you, Louise, for your words. I know you've had to go through several layers of approvals within AstraZeneca to share this with us, and I really appreciate the commitment to the collaboration. As a summary, I would like to highlight who the collaboration partner, what, or how the collaboration partners will contribute. The Portsmouth team will contribute with clinical expertise and research and also help to pave the way for the IT approvals within NHS.
AstraZeneca, they will help us with creating a blueprint for the implementation for a rapid and solid and quality implementation across the country. Also, they would like to contribute with a network they built across the globe. Induct, we will contribute with a platform we have already built. We will ensure a 24/7 service, and we will also work on improvements and stay ahead of competition and implement the state-of-the-art technology that is required for such a solution. So for me, this sounds like a win, win, win collaboration. Now it's time for some questions that we have received. Synnøve, are you ready?
Yes, I am. And thank you for all the questions that we have received.
Yes. And the first one is actually not related to this collaboration, but we had to, we felt that we had to answer this as well. So there was someone heard in a podcast that Induct has an interest-bearing debt of NOK 25 million. Is that correct?
No, it is not. So it's, like you said, important to clear that up.
If you look at our last quarterly report, we've reported that we do have an interest-bearing debt of NOK 14 million, just over NOK 14 million, and about NOK 8 million of that is short-term debt that is due within 12 months. So significantly lower than what was communicated at NOK 25 million. Okay. Thank you. And now over to some questions related to this topic that we have today. So how is the care pathway solution implemented at Portsmouth? Is it on local hardware at the hospital, or is it cloud-based service? So what we've delivered is a cloud-based service.
So there is no physical installation locally at the hospitals. And this is obviously the future for all software solutions, especially in healthcare services. And it's an extremely scalable model when wanting to go global. Our cloud-based approach is also why we are able to get such a high gross margin at 95%, which is far higher than what is achievable if you have a traditional or higher cost model with local installations.
Thank you, Synnøve. Next one is about, is the system integrated with other systems in hospitals?
So at the moment, there are no integrations, but as part of the project, we are looking at several integrations, and that's natural now that the system has been in operation for about a year. So what we're looking at together with AstraZeneca is three key integrations. One is with the patient administration system so that we get data fed into Induct, thereby reducing work. We're also looking at integrating with the lung function testing system, whether it be spirometry testing and allergy skin prick testing.
And then we're looking at data export to the National Asthma Registry. And that goes back to what Tom was talking about, this requirement to report on quality data. And we will be providing an integration to support them with this.
Good. So what happens if the patient also has other illnesses? And how is this handled?
So this is a good question. And obviously, I'm not a medical person, but from what we see after working on this, key or it's normal, very normal for asthma patients to have additional illnesses or comorbidities, as they call it. And this is therefore really well taken care of in the pathway that the Portsmouth team has developed and also then incorporated into our solution. And as part of the pathway, they do multidisciplinary team assessments and reviews.
They come together with a number of different specialties to make sure that they cover everything that's needed from a medical perspective. So all of these aspects are incorporated into the solution that we provide, and it's well taken care of.
Okay. Good. So we also got a question here. I guess also Louise has answered a little bit of this, but what is the reason for AstraZeneca getting involved? Is it to increase the sales of medicine? And if so, how does the solution support this?
Yeah. So it's of importance, like Louise said, to AstraZeneca that Portsmouth and the Severe Asthma Network succeed in delivering a high-quality service to their patients. So through the implementation of Induct and the pathway, we've seen already a number of benefits. And we talked about this a little bit before, but it's worth recapping.
We're looking at quality improvements, better data, better documentation of data, standardized data. We see improved patient safety because they get access to the correct medication at the correct time, and we see higher employee satisfaction within the clinical and administrative team because they don't have to spend so much time on tasks that are not productive to the actual pathway.
So when the team is able to work more effectively, efficiently, be more productive, they are able to therefore treat a larger number of patients, so an outcome of what we have delivered is an increase in the volume of medication that is being used, so AstraZeneca is one of, I think, two providers of biologic medicine for asthma in the U.K. And like I said, the treatment with this innovative biologic medication is a key aspect of the pathway that we have developed.
Thank you, Synnøve. I think we got one more question here. Related to the previous question on whether increased sales of medication is the reason AstraZeneca is involved, we have received another question on whether there's a risk of overmedicating.
What we see from data is that there are not enough patients that are actually receiving the medication that they need. There was a section on, I think, Tom's slide stating that they've identified at least almost 50,000 people who are in queue and who should be benefiting from this medication but not receiving it. On the other hand, if you do not get the biologic medication, you probably get a higher dosage of steroids, and there are severe side effects associated with long-term high dosage of steroids. It can cause other diseases like diabetes, for example.
So like I mentioned, all of the treatment that's given with the medication is only given after detailed examination and reviews by this specialist team across a multitude of disciplines. So the risk for overmedicating is very, very low. So basically, if we can sum it up, we are actually helping them reduce the risk of providing too much information or too much medication or the wrong medication, but we're also helping them drastically improve the quality of life for their patients.
So thank you, Synnøve. This was the last question in this Q&A session. So maybe we should say thank you to the listeners.
Yes. Thank you very much for joining today. We are available if there are other questions, of course, as we always are. But thank you for joining today and enjoy the rest of your day. Thank you.
Bye-bye.