Good morning. My name is Michelle, and I will be your conference operator today. At this time, I would like to welcome everyone to the Khiron Life Sciences year-end and fourth quarter 2021 earnings conference call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question and answer session. At that time, if you would like to ask a question, simply press star one on your touch tone phone. Before we begin, please note the following caution respecting forward-looking statements, which is made on behalf of Khiron Life Sciences and all of its representatives on this call. The statements made on this call will contain forward-looking information that involves risks and uncertainties, including those introduced by the COVID pandemic. Actual results could differ materially from a conclusion, forecast, or projection in the forward-looking information.
Certain material factors or assumptions were applied in drawing a conclusion or making a forecast or projection as reflected in the forward-looking information. Additional information about the material factors that could cause actual results to differ materially from the conclusions, forecasts, or projections in the forward-looking information and the material factors or assumptions that were applied in drawing a conclusion or making a forecast or projection as reflected in the forward-looking information are contained in Khiron Life Sciences filings with the Canadian and Provincial Securities Regulators, which are available on the SEDAR website at sedar.com. To provide a brief agenda, we'll start with the discussion of the quarter financial results. After that, we'll dive into the key catalysts in each market that will drive growth. We'll wrap the call up with a question and answer session. I would now like to turn the conference over to Mr. Alvaro Torres, Khiron CEO. You may begin your conference, sir.
Operator, can you please see that Mr. Torres is on the line?
Ladies and gentlemen, please stand by. We are having some technical difficulties. We appreciate your patience and apologize for the inconvenience. Ladies and gentlemen, I do apologize for the inconvenience. Thank you for your patience. Mr. Torres has joined us. I will now turn the call over to him for his presentation. Please go ahead, sir.
Thank you so much. Apologies for the technical malfunction. My name is Alvaro Torres, and thank you everybody for joining us today, in this call as we will be discussing our financial results for 2021. I think the overall takeaway for us is that, you know, the 2021 results start to completely show how unique, how strong our patient-focused strategy is in Latin America and Europe. We are a real growth company. We are growing in every market that we are selling. We have a very unique way of capturing and retaining patients in Latin America and Europe. We're enjoying very high gross margins that are gonna take this company as one of the leaders in the international markets of Latin America and Europe. I think this year we broke significant revenue and gross profit milestones.
Overall, we exceeded more than almost CAD 30 million, including CAD 4.6 million in cannabis revenues, which represents a 1,200% increase year-over-year, with a 79% quarterly growth rate in the last five quarters, with very high and sustainable gross margins of over 73% for the year, with a very strong presence in Europe, which now accounts for more than 30% of our medical cannabis sales. Which is very impressive for us, particularly since we started in Europe a very short while ago. While we continue to maintain a very clear leadership position in Latin America, particularly here in Colombia. I think we are very proud of the team who has accomplished all of these milestones under very difficult circumstances.
We are certainly now placing Khiron at the top of this amazing industry in Latin America and Europe. As we are talking now in the beginning of May, we're already seeing a beginning of this 2022 with a very strong growth. We're forecasting revenues of for the first quarter of almost $45 million in Q1, which takes us, you know, to a very positive optimism about how much we can more achieve in 2022 and how we can exceed the result that we have in 2021. Particularly since in the March of this year, we've already exceeded the $1 million in sales of medical cannabis worldwide.
We are now in a position where the company is generating real growth, where our patients are growing, where our doctors are prescribing a lot more, where we're taking all of this real-world evidence that has taken us some time to build, to be able to educate doctors across the world and be able to position a very high quality product and create a real brand, which is all about creating a sustainable relationship with patients and doctors. Be able to produce something at very high quality with very good gross margins. We're just really getting started in every country that we're targeting. With this, I will ask Swapan, our CFO, to provide more details on 2021 year-end financials.
I will ask Franziska Katterbach, our president for Khiron Europe, to talk about Europe, and then myself on Latin America, and then provide a little bit more color on what we're looking at for 2022. With that, thank you. Swapan, please. Swapan? I think Swapan may be having difficulties, technical difficulties with the call, so I will proceed and then we're waiting to come back. Revenue and gross profit overall in 2021, the overall revenues increased by 60% from CAD 8 million to CAD 12.8 million, driven by medical cannabis products, which accounted for 36% of the corporation's overall revenues compared to 4.6% in 2020.
In the last quarter of 2021, our medical cannabis revenues represented over 55% of the company's overall revenues for Q4 2021. As the company continues to increase patient demand, patient acquisition, patient conversion and retention, medical cannabis products will continue to represent the majority of Khiron's revenue stream. The entire company's medical cannabis sales in 2021 increased to $4.6 million, representing almost 26% of the total revenue of the company. The gross profit increased over 230% year-over-year to $4.9 million. This is driven by the continuous growth of the highly profitable medical cannabis segment.
The gross margins before fair value adjustments of 73%, on its medical cannabis revenue stream in 2021, compared to 49% for the previous year of 2020. The company continues to prudently manage expenses, with 2021 general administrative expenses declining over 15% year over year. I think when we're looking at the revenue growth and how medical cannabis starts becoming such an important part of our business and our top line, what we're seeing already in 2022 and beyond is how medical cannabis revenues will exceed our health services revenues.
In medical cannabis, in 2021, the company's medical cannabis revenues increased by more than 1,200% from CAD 370,000 in 2020 to CAD 4.6 million, with gross profitability of 73%. Just in Q4 2021, the company sold over CAD 2 million in medical cannabis, representing 43% of the entire year's medical cannabis product sales, mostly driven by Colombia and by Europe, Germany and the UK. This is, of course, attributable to the continuous growth in patient demand for the company's products in Europe and Colombia, as evidenced by growth in patient acquisition, patient conversion, and patient retention.
In 2021, the entire year, the company generated revenues of almost $1.5 million in Europe, particularly Germany and the U.K., representing more than 32% of the company's medical cannabis products, compared to $40,000 in 2020. As we continue to grow in Q1 2022, our European cannabis sales are representing now a bigger portion of our total medical cannabis sales. We're looking for Europe to become a very big driver for growth and revenues in the entire year 2022 and beyond.
When we look at health services, which include the revenues and costs from our ILANS and Zerenia health centers, the company continues to grow the number of annual consults by 42% from 99,000 patient interactions to 140,000 patient interactions per year, driven mostly by the growth in our Colombian operations, which represent the majority of the revenues of health services. In 2021, the company recorded revenues of CAD 8.1 million, up 9% from 2020. Furthermore, the company increased the gross margins of its health services division from 13.6% in 2020 to 20.5% in 2021.
For expenses for the year ended December 31, 2021, total general administrative expenses decreased by CAD 12.1 million compared to 2020, as a result of the decrease in personnel costs and lower share-based payments being partially offset by higher expenses in other areas. Corporate and governance increased by CAD 1.6 million in 2021 due to higher insurance costs. However, for the year 2022, the company has been able to make a significant reduction on that insurance cost from an approximate amount of CAD 2.2 million that we paid in 2021 to almost CAD 350,000 that we will pay in 2022.
This is attributable to the growth in revenues, the less perception of risk on the recognition of revenues from insurance companies, and the position where the company is right now, compared to where it was in 2021, as well as the belief of the insurance market about our business model and our ability to collect more revenues. In terms of EBITDA and net loss, adjusted EBITDA loss decreased to CAD 13.4 million in 2021 versus a loss of CAD 18.8 million in 2020, primarily due to an increase in revenues. The corporation's comprehensive loss increased to CAD 29.1 million in 2021 compared to CAD 25.3 million in 2020.
The increased loss that we experienced in 2021 is due to $50 million of impairments and a $3 million decrease in the gain of fair value biological assets, partially offset by a $2.3 million dollar gain in the non-cash fair value of the corporation's outstanding warrants, and having $2.5 million less amortization of signing bonuses compared to 2020. When we look at the impairment loss that the company took in 2021, this is due to the suspension of the cultivation license that the company had in Uruguay.
We believe as a company that now that we're exporting products to Brazil from Colombia and our overall belief that we are not in the cultivation business necessarily, we have decided to take this asset off our balance sheet, take the appropriate write-off of goodwill non-cash impairments, and be able to have a balance sheet that really reflects the business of the company and the business that we want to be in, which is medical cannabis sales from a B2C perspective in Latin America and Europe.
The same decision was made this year to stop selling our Kuida cosmeceutical line in Colombia and across the world, and we have taken the appropriate inventory write-ups to further reflect that the company is fully focused on its high growth, high profitability medical cannabis business and be able to focus our efforts and our expenses in the markets where we are becoming leaders and where the company is certainly seeing a lot of growth and results. With this in mind then, I will provide some operational highlights and catalysts. With that, I will ask Franziska Katterbach, our President, Europe, to give you some light on what's happening in Europe and what we're looking to do.
As I said before, the results that we have continued to showcase the unique leadership position that we are building as in the medical cannabis market in Latin America and in Europe. Currently, our company is generating sales in medical cannabis in Colombia and Peru and Brazil, UK and Germany, and we have very high expectations to enter the Mexican market very soon. We began sales of medical cannabis in March 2020 at the beginning of the pandemic. Even though the pandemic has not ended, our company has shown that we can grow under very difficult circumstances. Not only that we can grow and that we can generate sustainable profits, and that we can build a brand which is now one of the leading brands in Latin America and in the UK.
As everybody probably understands in this call that our revenue stream is comprised of two businesses. One is our health services business, in which we focus on offering integrated medical services to patients with chronic pain, mental health, sleep disorders, and neurological conditions. This business allows us to generate a unique real-world evidence to convince doctors to prescribe medical cannabis. Allows us to convince insurance companies of the pharmacoeconomic benefits of cannabis and to increase conversion and retention rates for patients. Our second business is medical cannabis business, where we focus on educating doctors using our proprietary real-world evidence, produce and source high-quality medical cannabis products that patients need, and create brand loyalty across our markets. For the past three years, we have stated that our health services business is a funnel.
This funnel allows us to capture demand, increase patient retention, and generate real-world evidence that translates into great sales of our high profit medical cannabis products. In 2020, medical cannabis revenues represented only 4.6% of our total revenues of CAD 8 million and 12% of our total gross profits of CAD 1.5 million. In 2021, medical cannabis revenues presented 36% of our total revenues of almost CAD 30 million and 68% of our total gross profits of CAD 4.9 million. In the last quarter, our medical cannabis revenues exceeded revenues from our health services business and represented almost 55% of the entire company revenues.
All these trends give us a lot of optimism because we have a very unique model, and we're certainly showing that our business concept works, and we're just really in the very early stages of our growth. In looking at Q1 of 2022, as I said before, our company has already exceeded the $1 million revenue milestone in March, and we believe that we're just really getting started in our target markets. We are focused on improving the quality of life of patients through the use of medical cannabis, and we will keep growing quarter after quarter. I think our expectations for Europe and the way that we have been growing in a market like the UK. has been tremendous and fantastic because of our ability to educate doctors and source a very high quality product.
In 2022, we expect our largest markets to be Colombia, Germany, and the UK., and we expect that our medical cannabis revenues will surpass our health revenues overall. With the already expected results of almost CAD 4.5 million for Q1 of 2022, I believe we are well on our way to surpass last year's top line and certainly the bottom line results. In Colombia, our main sources of revenue are health services and medical cannabis. In 2022 and 2020, the government of Colombia mandated that all insurance companies must cover medical cannabis to all patients. This is a tremendous milestone because it makes Colombia and Germany some of the few markets in the world where medical cannabis has got to be covered by insurance companies.
This milestone has brought on great growth opportunities for the company, and some of which we already started to see in Q1 and before. In 2021, we increased our total interactions from 99,000 to 140,000, 40,000 patient interactions. In the last few months, the company opened two new health centers that are located in high traffic shopping centers in Bogotá, and we have already begun to show the great impact in our total patient interactions. Just in the first quarter of 2022, the total interactions in the clinic were already at 41,000, which gives us great optimism about growing our patient base. The more patients that come to our clinic, the more cannabis we're prescribing, the more retention we're having, and the more profitability we're making.
In 2021, our clinic revenue grew by 90%. Our top and bottom line, the health services segment, depend on our ability to be able to bring in a lot more patients. Insurance coverage has had a tremendous impact on our medical cannabis business. In 2021, we sold more than 52,000 oil-based cannabis units, which is up from 5,600 in 2020, and over 68% of those were covered by insurance. Today, over 80% of all the units sold are sold through insurance coverage. This insurance coverage has had a tremendous positive impact in our growth because it helps to increase patient retention. In 2021, 60% of all patients with medical cannabis were returning patients.
In the last month, three out of four patients that come to our clinic are all returning patients, which is the key towards building a sustainable growth, towards building a brand. The more we keep having repeat customers because they see the value of the Khiron products, the more revenue, the more profitability, and the less expensive it will be for us to be able to grow to the numbers that we want. Overall, in Colombia, Khiron has the top selling brand in medical cannabis. We provide our patients with great service. We have a very high patient conversion and patient retention metrics. We're just really getting started, considering there's almost 6 million people in Colombia that probably need with the conditions that can be applicable to medical cannabis.
We're selling a very high profit margin product, and we're improving the quality of life of people of many patients. We're generating tremendous amount of data, which now we're taking to other countries and other regions, as we are seeing in Europe, which Franziska will talk about. We're taking all these learnings, all of this data, and be able to convince doctors that medical cannabis is not a fad, that this is not a trend, that it's a real medication. With the right data, and with the right product mix, this is gonna be one of the biggest disruptors in the healthcare industry in the next 15 years. Now, we, with this growth and this focus, we also have to think efficient of where the company should put its resources.
As I mentioned before, we decided to discontinue sales of our Kuida portfolio, which is our CBD-based cosmeceutical line and is the first product Khiron ever launched. I'll say that prior to the pandemic, our Kuida line was growing double digits quarter after quarter. With pandemic and the difficulties we faced, it was very difficult for us to generate sales impact and our sales channels, and we reduced the major marketing and sales activities. Starting last year, we see our medical cannabis business grow. We decided to continue to focus on this high growth, high gross margin business, which is really what the company was founded. We have discontinued sales in the short term of our Kuida product line.
We are taking all the appropriate inventory measures, and even though we will keep that product and those brands to ourselves, the company is now being focused on medical cannabis. In Peru accounted for almost 5% of our total medical cannabis sales. The country offers tremendous opportunities for growth, because this is the first country where the company has been able to register a finished product. We registered a product called Alixen with CBD, and very soon we will have our first THC branded product registered as a final medication. This provides tremendous opportunities for us to explore other types of sales channels, making access to patients in Peru a lot easier and providing us a lot of opportunities to export those type of products that are already registered in a country like Peru into other countries of Latin America in the future.
We see the opportunity to build brands into other countries, and I think that these new products that we are now registering will grow our revenue base substantially in Peru. In Brazil, we began sales of CBD-based products late last year. We're currently building our clinic in Rio de Janeiro and are working towards importing high-THC products to the country, which will be a very significant milestone, a very big differentiator, and a good revenue generation for our company. We expect Brazil revenues to become significant in the second half of this year and 2022 and 2023 and beyond. When we look at Mexico, it's always been a top priority for the company. We believe we have the right business model to become a leader in that market, just as we are the clear leaders in the Colombian market.
For the past years, we have been working on several avenues, and we have recently begun to announce some initiatives that we believe will make Khiron very well positioned in this market. First, we have been educating doctors and physicians and closing partnerships with large hospitals so that we can build more willingness to prescribe, which is really the way that you have to build the demand in these markets. We have partnered with the Tec de Monterrey to educate doctors, and we recently announced a partnership with Teletón, which is one of Mexico's most renowned hospital networks, with 24 clinic centers and rehabilitation centers all across the country. It's going to create a powerful foot in for the company that's truly unparalleled.
As we recently announced a couple of weeks ago, we are working on the regulatory aspect of importations and commercialization, and some of these processes are not in our control. We have achieved significant steps towards being able to commercialize very soon, and we are expecting to begin sales in Mexico as soon as possible this year. With that in Latin America, Franziska, perhaps you can give an introduction of what we're doing in Europe. Europe has been a tremendous market for us. It's gonna be a tremendous revenue generator and gross profitability market for the company 2020 and 2023 and beyond.
We couldn't be prouder of the work that the team has done there, building a brand, becoming one of the top leading brands in the region and, you know, in very early stages of growth. Franzi, if you could please, let's talk a little about Europe.
Yes. Thanks a lot, Alvaro. Hello, buenos tardes, and guten tag to everyone from Europe. Let's talk about Europe now. Khiron has historically entered the European medical cannabis market in 2019, with our conviction that leveraging the real-world evidence generated by our clinics, combined with a high quality and agile supply chain strategy, will allow Khiron to make an impact on the European medical cannabis market and also diversify our revenue base and provide more growth opportunities. In 2021, I'm very proud that Europe represented a significant share of our medical cannabis business, and in 2022 and beyond, this region will grow in importance.
The success we've had experienced in Europe in such a short amount of time is due to our ability, on the one hand, leveraging our unique understanding of medical cannabis, coming from Latam, but also our incredible evidence that we build in our clinics every day, combined with an amazing local team that we have in this region. Due to the pandemic, 2021 was also a very challenging year for all of us, and not only on a personal level, during all the lockdowns. Nevertheless, we have established and strengthened our operational presence in both Germany and the UK., which are two of the largest markets in medical cannabis in Europe. Of course, from a European perspective, I'm very pleased that the European contribution to Khiron's total medical cannabis sales finally exceeded more than 40% in Q4 2021.
What has emerged in Germany and the UK. under really challenging conditions makes me proud and happy on the one hand, and on the other hand, reinforces our patient-oriented approach. Patients come first for us. Of course, this development would have not been possible without our experienced European team, which is constantly and rapidly growing. Besides our team and our patients, we also have a huge focus on our products, that enjoy great popularity in the relevant patient forums in both Germany and UK. For example, our THC-dominant Khiron 20:1 flower is today the most prescribed, medical cannabis flower in the UK. On the other hand, our Khiron 1:14 is still the most popular CBD-dominant cannabis flower on the German market.
We are very thrilled to take advantage of this momentum and further develop the market, build out our market share, and expand our medical portfolio with more flower varieties and extracts. Let's now have a closer look at Germany. Germany, with its progressive medical cannabis law that includes the possibility of reimbursement by statutory health insurers, is undoubtedly the largest and most mature market for medical cannabis in Europe. Although Germany is currently the largest market, the true potential for cannabis patients has not yet been reached. That is good news, because that means that there is still a huge untapped potential which we, as Khiron, continue to tap. In particular with our CBD dominant cannabis flower product, Khiron 1:14, we have launched an important niche product in Germany in 2021, which enjoys great popularity among prescribers and patients.
With that, we were able to positively influence the discussion in the medical German public around the topic of medical cannabis. In addition to the high quality of our products, we have a strong focus on constantly educating prescribers on our products and their indication specific application possibilities with our in-house sales force. A path that we continuously continue to push further in 2022, whereby we will also constantly expand our product portfolio to German cannabis patients and prescribers. Let's now move north to the UK. In the UK, Khiron has a comparatively long history with Khiron Europe, as we had our first market entry in 2019. Our pioneering status in the UK has reached a peak in 2021 with the opening of Zerenia Clinics UK in November 2021.
Our presence in the UK started back in 2019, when we became a founding member and also the exclusive Latin American supplier for Project 2021, which offers a subsidized pricing model for patients to access treatment in the UK market. As in Germany, we have a very strong focus on doctor education and continue to build out our medical training for healthcare professionals with our fully accredited digital education platform, Khiron Academy. As said, the opening of Zerenia Clinics UK was without a doubt a huge milestone in 2021 for Khiron in the UK. It was the milestone that changed Khiron's European presence the most, as it brought a new facet to our pan-European team with the clinic.
Today, our THC-dominant Khiron 20:1 is one of the most prescribed cannabis flower products in 2021 in the UK, and our local team of experts is constantly growing. That's it from Europe for now. Operator, wanna go to questions?
Thank you, sir. Ladies and gentlemen, we will now begin the question and answer session. If you would like to ask a question, please press star followed by one on your touch tone phone. If you would like to withdraw your question, please press star followed by the two. Please stand by for your first question. Your first question comes from Aaron Gray of Alliance Global Partners. Please go ahead. Mr. Gray, please proceed with your question.
Sorry. Yeah. Hi. Yeah, I was on mute. Apologies. Hi, thank you for the questions. First question for me, I just want to talk a little about the gross margin profile. So for the fourth quarter, it looks like, you know, gross margins were down a little bit in 4Q, but, you know, now it's a different world than historically. The bigger difference seems to be in the medical, you know, cannabis products. So I just wanna ask if you could provide maybe some more color in terms of, you know, where you see that margin profile, you know, kind of going forward. Obviously, historically, you know, first two quarters have been, you know, high 80%.
You know, how you see the margin profile rebounding into 2022, I think, would be really helpful, because obviously, that would be key to kind of improving the EBITDA profile as well. Thank you.
Hi, Aaron. Thank you. Good morning. While we did in Q4 of 2021, after looking at our auditors regarding our revenue recognition as principals and our costs in Europe particularly, we updated the costs of the entire year in Q4 2021. What you're seeing there of $1 million of gross profit for medical cannabis for the quarter includes already the recognition of all the costs throughout the year after we discussed with our auditors our revenue recognition strategies for 2021 and beyond. To give you some color, before the end of this year, we were recognizing our revenue as agents and not as principals, meaning that we were taking the net revenue from our European sales.
After discussion with the auditors, we're now recognizing the gross revenue and recognizing the entire cost of our products. To give you some light of what that means in Q1 moving onwards, Latin America is having 85% gross profitability. In Europe, we will be showing
Ongoing gross margins between 65%-65%. That will increase as we have different types of product mix and product sales, and we are negotiating with our suppliers for better prices. It's still very, very strong for us. It also shows that our top line has increased as we did in the Q4 2021. To summarize, our overall revenue, gross margins for the year with all the accounting for our principal and COGS was about 33%. I think that is an appropriate measure to take on the future as we're not seeing any price decrease in our top line in Europe or Latin America.
Okay. Thanks for that color. That's really helpful. Then in talking about the returning customer retention, this talks about, I think, 2021, 60% in your prepared remarks. Talked about last month being 75%, so really good retention rates. I just wanna get some color in terms of, you know, kind of the new kind of patients also coming on board. Retention appears to be very strong. Wanna get some color on the new patients especially. Just looking at the number of patient interactions, looks like it was down a little bit sequentially for Q4. Obviously, that can kind of be a leading indicator, I would believe, for kind of new patients for cannabis as they come into health service for other ailments.
Just any kind of color in terms of new, you know, patients for the medical cannabis products, that are coming, both for the first quarter and going forward. Thanks.
When we look at patient interactions, Aaron, we always have to look at it cyclical, right? Because the end of the year is usually, particularly December, a month that most patients are either on holiday or not taking their consult. Every December or every Q4, it's always gonna be a little slightly lower than Q1 of the next year because of these particularities of holidays and vacations and things like that. In Q1 of 2022, we already grew to 40,000 patient interactions, which is almost 25% more than Q1 of 2021.
The way that we've been able now to increase new patients, which in the month of March and April were about almost 1,600 new patients per month, that is happening because of our ability to grow and expand the clinic services because we're talking to insurance companies to be able to get them to send us a lot more patients, particularly after the government mandated insurance coverage. We're always measuring what is the percentage of growth of new patients every month. We're also measuring how many of those patients are returning and how often. The expansion of the clinics is already providing us the great color for 2022. I mean, when we looked at last year, it was about 140,000 patient interactions. This first quarter alone is already 40,000.
We're already seeing a tremendous uptick on that because of the new clinics. I think the challenge and the opportunity for us is that as we keep talking to more insurance companies and we keep expanding those services to be able to be closer to the patients, more and more patients are looking to enter the medical cannabis, become medical cannabis patients. Retention plays a big role because it's much cheaper for us to maintain an existing customer than trying to acquire a new one. But I think the cost of acquisition is also reducing because we're able to get more insurance companies to come to our table. You know, patient interactions need to increase so that we can have a lot more patients coming in.
I think Q2 and Q3 are gonna start showing a tremendous more increase in new patients because more insurance companies are entering this new, medical cannabis, portfolio. You know, just starting the year, I think they'll be all very positive for us. Certainly we're already seeing a tremendous growth, exceeding by far what we did last year in Colombia alone.
All right, great. Thanks for the color and glad to see the momentum continue in the first quarter. I'll jump back into the queue.
Thank you, Aaron.
Your next question comes from Frederico Gomes of ATB Capital. Please go ahead, sir.
Yeah, thanks. Good morning. Thanks for taking my questions. Just on your cost structure, I guess. Your adjusted EBITDA loss this quarter was over CAD 5 million. When you look at your cost structure right now, do you expect, you know, your operating expenses to decline this year? What measures are you taking to achieve that? Thank you.
Hi, Fred. Good morning. One of the big items of expense of last year, and I think that was probably due to the overall thoroughness of the market, was the D&O insurance, for which we paid almost $2.2 million in 2021. That had a huge impact on our finances and cash use. We were able to negotiate much better terms with the insurance companies, particularly, you know, in that D&O insurance, which is gonna be reduced by almost 8% from that. The second thing that we've been doing is, as we focus on medical cannabis, we've already stopped the sales and marketing efforts for the Kuida cosmeceutical line.
I think it's just a recognition of how strong our company is in medical cannabis and how we should continue to focus on that and not spend, you know, our resources in areas like CPG and cosmetics, which take a longer time to build a brand. Since we already started that two years ago, we know how difficult it is, and I think right now our focus is gonna be on medical cannabis. The rest is all also, you know, on reducing our expenses, making sure that we are putting our resources where they have to be. It's all about, you know, Colombia. It's all about making our Colombia operations gross profitable. It's about getting Europe and Germany and UK. into a gross profitability that, you know, offsets all those expenses. We are well on our way there.
I think that the last two months, the company has been making all of these efforts trying to clean up our balance sheet also to make sure that we are reflecting the business that we want to be in. Today, I mean, our focus is all about, you know, improving our cash collection from insurance companies, from our distributors, so that we can get to that EBITDA neutrality by the end of the year.
Thanks, Alvaro. My next question is on Europe. You know, just curious, you expect growth to come more from the UK or Germany this year? Do you have any updated data in terms of your market share in both of those markets? Thank you.
Yes. I think, maybe, Franziska, if you could, take on that question. I think the UK, certainly a market that's been growing the last four months, and the Q1 revenues were mostly driven by the UK. We have several strategies, but maybe, Franziska, you can put some color more into what we think about Europe this year.
Yes, certainly. It's absolutely right what Alvaro was saying. When Germany was the largest portion of our revenues in 2021, we could already see a trend starting in Q4 2021, and it continued to happen in Q1 2022, that the UK is picking up, and we do see more of a 50/50 split in Q4 and in Q1 2022 even more so. What we really see is that the UK is picking up significantly, which is very good. We've been active longer in this market, so we see that our education and the penetration is now starting to happen. In the UK we could really dare say that we have a market dominant position with our high THC flower due to the fact that we had constantly the product on the market and the same quality.
In Germany, we started with a quite good market share, and what we do see in Q1, that the reimbursement of our products is picking up, which is a very good indicator that our sales activities from our in-house sales force is having an effect. Because if we see the doctors and could convince them about the product, he will prescribe it, and it will be covered by the health insurance. This is a trend we could very well see picking up in Q1 2022. I think it's still open, but a revenue split of 50/50 between Germany and UK is very likely.
Okay. Thank you. Then maybe a last question. Just when you look through 2022 and your capital position right now and your maybe potential cash uses, you know, opening new clinics, et cetera, can you give some color on how are you looking at that? You know, what's your strategy to continue to grow and at the same time manage your capital position? Thank you.
Well, I think that what the company has built so far, in terms of the clinic presence in Colombia, the clinic that we're building, all those CapEx expenditures that were effective in Q4 and the beginning of Q1, that puts us in a position to be able to grow to the number that we're thinking for this year. I mean, we already saw $1.1 million in March. We're not really looking for more CapEx investments as we already built out the infrastructure that we needed. The company right now is focused on generating faster cash inflows into our, let's call it bank account.
As we're selling a lot of cannabis, we sell in Colombia, we sell in Germany, we sell in the UK, and we gotta look for ways to be able to bring those cash flows much faster. I mean, just the month of March or April, where we're selling almost 10,000 units a month in Colombia, it takes us 90 days to be able to collect those after we've been able to reconcile with the insurance company. Sometimes, that process makes us try to figure out ways to working capital so we can fund our operations knowing that we have such a secure revenue base in the future. I mean, our company has always been very clean in its balance sheet. We owe almost only $1 million of a leaseback of our clinic that we got two years ago.
I think we have good opportunities to be able to look for those type of alternatives for working capital. We're actively working and on that. I think the more we're talking to those type of institutions and they see the growth and the high gross profitability of our margins, it starts to become clear that what this company is looking for is to be able to fund that working capital growth. On the other hand, I think that the more we keep selling in the UK, the more we keep selling in Europe, that's also going to diversify our revenue base. This is not anymore a Colombian company. This is a global company with revenue from many different sources with different types of risk profiles.
That's the conversation we're trying to have, institutions to see how we can fund the working capital needs of the company. In terms of the CapEx, you know, we are finishing our two clinics, so we just finished them and we're having a lot of patients coming to those clinics. Brazil is the outstanding item in terms of construction of a real asset. We've taken some time to build that out as, you know, there's been holidays and things like that. We're waiting to be able to get our THC products so we can start matching the revenue contributions it has in with the expense that we've made.
You know, in short, I think right now the company is at a position where it can show real growth and real success and real profitability, and that's a theme that we're looking at how do we expedite our revenue cash flows into the company while we are minimizing our expenses. Our plan to be able to get to EBITDA neutrality by November is well on its track. I think right now we have to focus on finding those working capital needs to be able to fuel the growth. The infrastructure that the company has today, that we have built for the last three years, is gonna take us to that, those levels of revenues that we're waiting for this year.
Okay. Thank you. Thank you, Alvaro. I'll turn it back to you.
Your next question comes from Venkata Velagapudi of Research Capital. Please go ahead.
Thanks, Alvaro and Franziska for taking my questions. I have two questions on your European division. While making remarks on European segment, you said that the true potential for cannabis hasn't been reached yet. Do you have any visibility over when that potential will occur?
Thank you, Venkata. Yeah, Franziska.
Well, while I would like to know that, I think what has been happening in this industry, this market or the potential will only be untapped if we as LPs are untapping it. We have to focus on the doctor education, and this takes a certain amount of time and obviously also some spending. If you don't do it, we don't grow the market. We see it every month. If you look at the patient data and the product that's been dispensed in the pharmacy, there is a constant steady growth. It just takes time, and you have to build the relationship with the prescriber. This is where we at Khiron focus on. We need to, quote-unquote, "own the doctors" while educating them with our data set. This is key.
Once you have that, I think you build a very loyal prescriber base. The reality is a product is not self-selling, and I think this is now coming to all the players in the market. We all have to build this industry, and this only comes with education of doctors, patients, and pharmacists. The growth is there. It's continuously being there. Yeah, I think the potential is huge. If you look at the numbers, we're roughly around 100,000 patients in Germany right now, where we should be in the millions or could be in the millions if we just look at the numbers and the ratio we see in Canada.
Yeah. Makes sense. That's great. One more question is, right now, in the short term, you mentioned that, Germany and U.K. will drive the growth, in Europe. Do you have any visibility over, potential regulatory amendments in other countries, that may impact, Khiron positively?
We already have some further open markets which we pay close attention to, like Poland or Czech. We also have an eye on France. As you might know, France just launched a trial to see over the next couple of years to give out cannabis. We have a close eye on the markets. Italy could also be very interesting. We as Khiron, we only enter these markets when there's already a potential and when it makes sense from the revenue stream side. Right now in France, there's a pilot program where you have to, as LP, dispense cannabis for free. This is certainly not a model where we look at, but we want to see how this market develops, and this could be an interesting market.
I think this would be should be our home market as well, it's Spain. I mean, we're a company from Latin America. We have all our operations. We already have a presence in Spain, and we do see that regulators are looking into legalizing the medical cannabis dispensation. Because what is the kind of weird situation in Spain right now, they allow the production of medical cannabis, but they don't allow the dispensation. It's quite reverse model than all the other markets in Europe. Very interesting market. Could be catalyst. We're paying with our regulatory team and our network close attention to these markets as well.
Okay, that's great. Final question from me. Do you have any guidance on achieving positive adjusted EBITDA?
Alvaro, do you wanna take that?
Hi, Venkata. Yes. So we're looking at a year this year that will get us anywhere from $22 million-$28 million of revenues, mostly driven by medical cannabis sales in Colombia and Germany and the UK. As a plan that we are having, even with the COVID pandemic, we are looking at EBITDA neutrality by November of this year, with the markets that we're in, not including Mexico. Of course, if we start, the sooner we begin those markets, the higher revenues we'll be able to do. Our base plan is to continue to grow in Colombia, Germany, UK, Peru and Brazil in second half of the year. Mexico will be something that will add certainly to our top line. We are looking at that plan, by November.
For us to be able to do that, we need to keep increasing our revenue base. We need to keep increasing our patient focus, patient retention, our U.K. sales, our introduction of new SKUs in Europe, which we are well on our way to do. You know, Colombia continues on a track towards being able to acquire more patients and offer more insurance coverage to patients. But we have our proven business model. I mean, we already broke the $1 million mark in March. We've been growing quite significantly quarter-over-quarter and month-on-month, so we're comfortable with those numbers. You know, we believe that we can make that as we are making all our G&A reductions as well.
Okay. That's great. Thank you very much.
Maybe one, yeah, one addition to, I will answer your question on the growth potential in other markets. Maybe let's not ignore the elephant in the room. If Germany really goes recreational, which the coalition decided to do, we don't know when it will happen, but they said they're going to legalize cannabis in Germany for recreational. This could be a huge growth potential for us because we already have the supply chain to the market. We know what patients want. We know how to bring the product on the market. So this could be a huge potential for us as well and build a second vertical while we keep the medical side, but add on the recreational side.
Okay, thanks for the color. Thank you, Angela.
Ladies and gentlemen, once again, if anyone would like to ask a question, please press star one at this time.
Okay, with that, thank you so much for everybody for your questions. I will just close out with a few closing remarks. Overall, I would say this company was founded over three years ago, four years ago, with the objective of improving the quality of life of people. We focused from the beginning on how to build demand, create access, and create a very big unique moat. 2021 results and the first quarter of this year show that we're growing in every category. We're growing in patient retention, patient acquisition. We're growing our sales in Germany. We're growing in our gross profitability. We're growing sales in Colombia. We're still growing sales in Peru. There's no aspect of this company from an operational level that is not growing.
I think the uniqueness of our model, our B2C model, where we really try to obsess on how we get access for a safe product in the hands of patients now is translated into more than just one country. We have evolved from being a small Colombian company into being a truly international company, where most of our revenues on medical cannabis in Q1 of this year are coming from Europe. I think that diversification of revenue, the diversification of risk, and the ability to collect data and create real-world evidence is what's gonna make this company one of the leaders in the international markets. I think the obsession that we have in creating a sustainable business is starting to show.
We are a growth company that is really showing excellent results, far above the peers in any of our markets, and we are in markets that are just really getting started, where you could relate them to what the United States was 25 years ago. I think that first-mover advantage that we have as a B2C company, creating a real brand, creating real connections, is showing in the way that we are growing our top line and our bottom line, which is gonna get us to EBITDA neutrality by the end of this year.
We believe that if we continue this path, if we continue the discipline and focus of our business in the medical cannabis industry, on patient acquisition, patient retention, and our ability to create a brand, which is really about creating a relationship with the consumer and with the doctors, we're gonna be one of the key players internationally next, in the next years. As we progress through this year, we remain the medical category, the medical cannabis category leader in LatAm, one of the top medical brands in the UK and one of the top-selling CBD predominant cannabis flower in Germany. We've done this in a very short time, in less than two years, in the most difficult of circumstances. These efforts from the team give us a lot of confidence that 2022 and beyond will be a very positive year.
The more that we keep executing, the more we keep selling day after day, more than the day before, we will build a company. We're building a company that's gonna be one of the key players in this market. With that, I appreciate everybody's time today. Thank you to our team, and thank you to everybody who asked the questions. Have a great day, and we'll be looking forward to talking to you about the results of this year, Q1, in the next couple of weeks. Thank you with that, and have a great day.
Ladies and gentlemen, this does conclude your conference call for today. We would like to thank you for participating and ask you to please disconnect your lines.