To present the Q1 figures for AddLife. I will first try to take off the voice from all of you, so hopefully you can hear me. Let's see if that. If I managed. I hope so. Otherwise, if you hear, please make sure that you are unmuted. My name is Kristina Willgård, and I'm very happy to present to you the interim report for the first quarter of 2022. I hear that it's somebody who's actually not unmuted. I will try to do that before. Yeah, now it looks perfect. Great. Well, I'm, as I said, very happy to present this report. I think it's a very strong report for the first quarter.
If we look on the highlights for this quarter, we did write it was a successful quarter because still I think we do a very good both sales growth but also a profit growth in this quarter. You see when you look into the report that the acquisitions are driving the sales in Medtech, which is actually exactly what we expected. You know that we have done a lot of acquisitions during the last two years within our Medtech business area. If we exclude the sales in COVID, with COVID-19 products, we actually had an underlying organic growth of 5% in this quarter, which I think also is very strong. Both business areas actually had a positive growth excluding COVID sales. We have completed two acquisitions in the quarter. That was of MBA and Telia.
Another two was finalized after the quarter, and that was O'Flynn and BioCat. Summarizing this quarter, we had sales of close to SEK 2.6 billion, which is +49%. EBITA ended up at SEK 435 million, which is 34% growth. Our margin ended on 16.9% compared to 18.8%. The EBITA margin actually increased in both business areas, which I think is very strong. Just to understand how come that the total margin decreases somewhat, that is actually because our Medtech business is a big portion of the total group compared to one year. This year, the Medtech profit is 33% of total EBITA. Last year, it was 15%. The EBITA margin in our Medtech business is a bit lower than the rest of the Labtech.
In this quarter, I also want to emphasize that we actually put out and do a big donation of medical devices for surgeries to the awful war in Ukraine. I really would like to thank all our companies and people at AddLife who made it possible for us to ship. I think it was six or seven trucks filled with difficult, different devices. And the value of that was SEK 7 million. I also want to say, which I think you all are aware about, is that we have now appointed my successor, and Fredrik Dalborg will join as the new CEO of the AddLife Group, and he will start in the fourth quarter. A few words still about the COVID pandemic, we feel it's really going down and which is obvious also in our figures.
I think we are all aware about that this wintertime it was still a lot of Omicron. In the beginning of the quarter, actually January or February, it was high, a high part of PCR testing for the Omicron, mainly in the Nordic countries. It was obviously much, much weaker in the month of March, which actually is exactly how we see that the infection rates are changing over time. We foresee that the COVID testing, as we said before, will slow down throughout the year if a new mutation doesn't come, that will prove that it's actually more aggressive. During the last two years, I think all of us have learned that when we thought this was over, it has actually restarted many, many times. Right now it looks rather promising.
Restrictions are taken out in most countries in Europe. I think we all follow how the situation is in China, especially in Shanghai, where all people are locked in their homes. That actually affects our people who work in China because they are now just located in their homes, which makes their business life a little bit more complicated. The effect of this Omicron is still that the elective surgery was slow in the quarter. In March, of course, it started up much more again. The main problem is that the healthcare professionals are infected. I would say there's not a financial constraint in healthcare.
It's actually lack of personnel which makes this difficult. Our COVID sales decreased 25% in the quarter to SEK 459, compared to SEK 620. We didn't have any sales of COVID-related products in our business area, Medtech. In this picture, you see the bridges of the net sales between the years. As I said, 49% growth. Acquisitions added close to SEK 900 million. We also had the non-COVID organic sales growth. Then we have a loss, of course, in the COVID sales. EBITA is actually the same bridge. You see that the Labtech, we got a little bit of growth. We strengthened the margins in our Labtech business, which I think was very positive.
The main part of the profit growth comes from the acquisitions within our Medtech business. Summing up that to SEK 435 million. Looking into Medtech, Labtech, sorry, it's a really strong start of the year. I talked about the decreased COVID sales, but the organic growth was actually 8%, which I think is very strong. It was strengthening both in our diagnostics area, but also in the research field. We did one acquisition after the end of the quarter. It was a smaller company named BioCat. That was for us actually the first acquisition in the German market in the field of research. Summarizing this quarter, sales up 4% to SEK 1,280 million, and EBITA margin strengthened to 23.2%.
The strengthened margins, I would say, comes from that the companies within this group has been very active when it comes to price adjustments. We have a very favorable product mix. We don't have so much instruments, but we have more parts of of reagents. Actually, it is the strong research March figures that actually adds on to the total margin in the group in this first quarter.
I would also like to say that all the Labtech companies are very good on the strong cost control because we all know that markets are opening up, but still we're really controlling the cost to make sure that we don't sort of do a boost in the cost structure now when we sort of see that we can come out to the customers and get back a little bit more to the normal pace in our business. A few details in the Labtech business. It's very high activity in the market in the diagnostic field. Our big product, blood gas analysis, and that is our Radiometer business, has had high activity, which proves that normal sort of medical surgeries, et cetera, is restarting in the hospitals. Pathology and other microbiology tests are really growing for the diagnostics companies.
As I said, in the research and laboratory, we saw really a good end of the quarter, which means that March was very strong. Actually, for one of our oldest lab companies, they had the all-time high order intake in March, which was very positive. We would say it's picking up, and we are looking forward to see what we can do with the companies in the research field. We had very robust sales for our own advanced instruments, and it was. We were pleased to see that we got good sales in China in this quarter. Of course, we have a question marks now when most of our employees in China are locked into their homes. It's a little bit more complicated in the second quarter.
Coming into the Medtech business, as expected, the strong sales growth came through the acquisitions. The main acquisitions, you know, Healthcare 21, AddVision, and in this quarter, MBA as well. The market situation, still very volatile. We expect it to continue to be a little bit volatile because even though we hear a lot of political focus on reducing the long queues, it takes a little bit time to reorganize in the hospitals. There's no lack of financial resources, as I said, but it's lack of healthcare professionals. We actually saw that when we're looking forward, for example, in the Finnish market, 25,000 healthcare professional started a strike first of April because they want higher wages, which I think we all understand, but that gives the sort of restarting in the Finnish market a little bit more a bumpy ride.
We completed two acquisitions in the first quarter, and we did an add-on acquisition to Healthcare 21, which was O'Flynn. I would say all the acquisitions that we have done has realized or have been able to improve the margins in the Medtech areas. Summarizing Medtech first quarter, we have a growth of 154% to SEK 1.3 billion. The EBITA margin was strengthened from 9.7% to 11.1%. A few words, sorry, about our health services. The acquired companies are according to our expectation delivering the results. We all knew that Healthcare 21 would have a good and strong first quarter, which they had. U.K. NHS are closing their books in March. This year, exactly as last year, their first quarter was really strong and good.
Even though they had less sales in the surgery side, they could compensate that in other areas. If we look at another big acquisition, AddVision or Vision Ophthalmology Group, we see that they have sales according to last year, and that is from the market expectation again exactly what we foresee. For both these big acquisition, of course, we hope that the market now will open up a little bit more so we really get the effect on the improvements that we saw was possible for a more long-term perspective. Looking into the home care, we actually saw again that it was opening up, especially in March, and we saw a strong interest for the digital solutions that we now have on board.
We're really pleased to see that the new company, Camanio, who now integrated Telia, they really did the first pilot in their platform in one Swedish municipality in the quarter. As soon as that proves to be really good, we know that we will implement in more and more municipalities throughout the year. I think the digital solutions we now have on board and the opportunities for digital solution in the home care taking care of the elderly people will be a very important part of AddLife's offering to the market going forward. As I said, you all know that we did with acquisitions completed in April, totally four acquisitions, adding full-year sales of SEK 830 million and 350 employees.
The plan, as I said, in previous meeting, is actually that if we look at 2022 going forward, this is a year for consolidation. It's a year for integration because we really need to get the possibilities we now have with all the new acquisitions on board. We really have to take a big grasp on those and make sure that we can see the fantastic networking opportunities and the sales opportunities inside this group to happen during this year. Actually, we have just finalized the first MD meeting in years. We have had two days with 80 people together discussing how we can work more together, how we can really get out the best of all these companies we now have in the European market and make sure that we collaborate and find business opportunities together.
This is a really big focus from the AddLife team right now to make sure we get our arms around everything now when we can meet and that we really can use the knowledge together in the group. It was very positive, I would say, from all new companies also because they haven't been able to meet all of us before. Two days with a lot of spirit and discussion about our growth journey going forward. Hopefully, we will see now that we have a lot of internal collaborations opportunities coming up during the year. This is the graph for the long-term financial goals. If you look at the profit growth, it really looks a bit awkward. We had last year fantastic rolling twelve EBITA growth of more close to 200%.
We are now down in this quarter rolling 12, 35%, which is still a lot more than the 15% target that we have. We look at the profitability, it goes down a little bit, of course, both due to the EBITA figures are going down a little bit. But also actually, we have increased stock in a few companies during this quarter because we had to make sure that we could manage the complexity in the global sourcing and supply chain. It is, as you all know, quite complicated with freight, raw material price increases, et cetera. We have just to make sure that we could deliver to the customer. In a number of companies, we decided to increase a little bit of stock in the quarter. Summarizing the income statement, I'm not sure if it's so much to say.
We increased sales 49%, EBITDA 34%. Of course, depreciation of intangibles have increased quite substantially, and that is, of course, due to all the acquisitions the last year. All these acquisitions has also meant, as you know, that we have taken on much more debt, which means that our financial cost has increased, also during this quarter. Going to the balance sheet, I would mostly like to mention that, the financial net liabilities are now close to SEK 5 billion. The ratio which we measure a lot in the board and think is very important for us is net debt to equity, and it's still 1.0. For us, that is a ratio we don't want to be long term more than 1.0.
Right now, if we also look at financial net liabilities compared to EBITDA, it's 3.2. We all realize it's a bit too high. The rest of this year, we will use the cash flow we get out of the business to reduce liabilities, to strengthen the balance sheet a little bit before we take the next step in our growth journey with acquisitions. The equity ratio still very good on 37%. Cash flow this quarter was good, SEK 332 million from operating activities. As we showed specifically in this slide, the adjustment for non-cash item is really the increased amortization that we have in the group. I think I will open up for a lot of Q&As if you have any.
I would like to summarize this as a very good quarter. As we see also, our total margin decreases somewhat just as expected. Before COVID, AddLife had a margin of 8.8% actually in 2019. We are right now running on 16.9%. I think we foresee that the margin with all the acquisitions will be somewhere around 13+, where we have the existing product mix right now. Let's see how it ends up. Now I will try to open for questions. If I manage. Now I show how bad I am on fixing this. I see that Karl, you have your hand up, but I cannot take out.
I think now.
Now.
Can you hear me?
Now you're here. Yeah, I can hear you.
Yeah. Great.
Sorry.
Good morning. No problem. So I have a couple of questions, but maybe if we start with the boring COVID one, just so we get some kind of information regarding the exit rate, I guess, in the quarter and maybe how April has looked. Because I think all the companies are basically saying that, and we can see it in the infection rates, that it's going down quite dramatically now in Q2 and probably also going into the summer and spring. What can you say? I guess it's fair to assume a very dramatic drop in the COVID testing or what are you seeing right now?
Yeah. Yeah, that's exactly what we assume as well. I would say Q2, it will be a big drop. Exactly what the sales figure will be is too early to say. We haven't got that full. Of course, we see a few days of April, it has gone down quite a lot, which is expected. You should foresee a big drop in the second quarter, yes.
Okay. Yeah. The COVID sales, is that mainly, as in Q4, been mostly in the Nordics?
Yes.
Not as much in Central Europe?
Yes, mainly in the Nordics. Actually, with the awful war that happens in Ukraine, we have a lot of refugees coming into some countries close by. In those countries, we have some more infection spreads, and actually they have opened up a little bit for more testing, but it's too early to say where that ends.
Yeah. I see. Maybe if we look more in the Medtech segment.
Mm-hmm.
It seems like organic growth has accelerated throughout the quarter when you're speaking, but you also highlight this, the strike in Finland among nurses, and I guess a lot of surgeries has been postponed. We can read in the newspaper.
Mm.
What is it possible to give any kind of indication of how it will impact the growth? I mean, it still sounds like, you know, home care is accelerating in the end of the quarter. I guess we should expect organic growth underlying to accelerate from 1% organically in the upcoming quarters. Is that fair to assume?
Yeah. It will accelerate, absolutely. That's what we foresee, that even though it's a strike in Finland, I just wanted to mention that because, yeah, I fully understand that healthcare professionals after these two years want some extra wages. Still, I mean, there's a lot of different things happening in the world, but it is a big focus to restart all the surgeries. I would say in the U.K. especially, they have opened up specific clinics just to take down a few different illnesses, where they really focus to do so many surgeries a day as possible. There is a lot of new opportunities to sell actually. It takes some time to make this change in more of the administration in the hospitals. Of course, it will accelerate from this point.
Yeah. Okay. Have you seen in, for example, if you take U.K and Spain, I guess two now large markets for your elective surgery business-
Mm-hmm.
Have you seen that the, what to say, the challenges, the operational challenges in hospitals, are they improving or what's your view there?
I mean, the situation from our side is improving a lot. Actually, Spain, I would say, is the country where we see the largest progress. They have really been able to change faster than, for example, the Nordic countries. In Spain, we have seen a higher activity compared to what MBA had for the last year. Just in Spain, it is a really good and strong start.
Okay. That sounds good.
Mm-hmm.
Maybe just a few more on the supply chain constraints and the price increases. Is it possible to say if you've had any material, you know, let's say, impact on your deliveries in the quarter? Approximately how much are you impacted by the higher costs for freight and material, et cetera?
I would say so far we have managed very well. I said that, I mean, we have strengthened our margins, so our companies have been very good at really taking care of the price adjustment so far. so far I think we have managed very good, and we didn't see any push right now on the margins, but for sure after the war in Ukraine.
Yeah
The situation changes a little bit more in the world. It's too early to say where it ends. I mean, now you have everything with gas and oil and all that stuff. It is a complicated market situation for us as well as for everybody else. But I think we have managed so far very good. You know, from our perspective, I think also the agility we have with our subsidiaries is quite unique here. Just looking back what our subsidiaries managed throughout the COVID pandemic, they are very fast in the market, finding solutions on differences and difficulties in the market, and I would say they are continuously doing that. I'm not that worried, but of course it could be a little complicated.
Yeah. Because that was also my, maybe my last question on the gross margin, because it seems to be up around 200 basis points year-over-year.
Mm-hmm.
I guess that also has to do a lot with acquisitions that maybe have higher gross margin. Is it possible to say, like, what the gross margin was year-over-year on a like-for-like basis, or is that hard?
No, I actually don't have that figure, but yes, you are right. Our new acquisitions have higher margin, and that is actually in, you know, the acquisition we did in the Medtech area. They have higher margins because they are really niched focused in the elective surgery side where we have this really add-on value to the customer. That's why we get higher margins. That is the anticipation we all had with the acquisition, that it should be companies with higher margins that we add to the group. I would say a big takeoff for many of our companies after these two days with all the MDs is actually to discuss with these new companies, okay, how do you manage to have these high margins?
I think it will be interesting to see how the colleagues within the AddLife family starts to work even harder with the margins.
That sounds promising. Thank you, Kristina, for taking my questions.
Thank you. Thank you. I see somebody else, and if you have raised your hand, please, if you can change just so you can talk so we can hear you.
Hi, Kristina. It's Anna from Handelsbanken.
Hello, Anna.
Just three follow-up questions from my side. Since you've in the quarter seen the trend to, you know, going closer to new normal selling in the Labtech business, would you still think that the annual boost of around SEK 300 million would be reasonable to assume ahead, you know, compared to the pre-pandemic levels? Or have you shifted your estimates in this matter?
No, we haven't shifted any estimates.
Could you maybe talk a bit on how the experience of the first add-on acquisition in Healthcare 21 has been?
Oh, you know, they've been on board for two weeks, so it's a bit difficult to say. Yeah, I mean, this add-on was just sort of to talk about the doing this, it was fantastic. I mean, O'Flynn is a company that Healthcare 21 have known for many, many years, and it was actually on the list when we acquired Healthcare 21 because it was a fantastic match for them in the Irish market. Their business model is a lot about actually renting out products to the healthcare. I would say if you look at the healthcare, we will probably see some change of the business model because instead of them always buying all the products they need, they perhaps would like to rent.
What I like with that model with O'Flynn, that is actually more a sustainable model. That means actually that they rent out instruments or beds or other stuff. When a new user should have it, they take it out, take it back, they decontaminate it, and then send it out to the customer again. The sustainability focus is really good in the business with O'Flynn. I think that adds another angle to our business to see opportunities with this rent, take in, get out again. Long term, I think it's very positive. They, I mean, actually it's the people in Healthcare 21 who have done all of the work with this acquisition.
Us in Stockholm have, of course, talked a lot with them, but they have finalized the full deal themselves, so it's been a great journey, and I think it was very good both for Healthcare 21 and perhaps for you guys as well to see that what we have discussed so much, that we should have a new platforms where we can add on acquisitions. Yeah, this is the first one we did, and I foresee that we, I'm not sure during this year, but later on we will add a few add-on acquisition in this size because it's very good. For those companies like Healthcare 21, they really have the capacity to do that.
Perfect. Thank you. Sort of detailed question. You mentioned that in some companies you have seen an inventory build up.
Mm.
Do you expect this to continue any further, or do you think that from now on you are already at a stable level?
Yeah. I mean, it's from time to time. The problem is actually sometimes we get more or less containers with products from China or somewhere in Asia, and instead of just taking one, perhaps we took three, because we would secure. Because, you know, a few years ago, we knew that the shipment time or the freight time for the product was perhaps six weeks or eight weeks, and now it could be 12, or it could be five, or it could be 15. The freight time has changed dramatically due to the shortage, especially in the sea freight. Therefore we decided in some cases, let's make sure to put in some extras just so we can sort of send the products to the customer. We don't have any ambition to long term, of course, increase our inventory.
Short term, in different cases, I think it's good for the business to do it because then we can. Yeah, coopetition again. If we can deliver, it's better for us.
Okay. Perfect. That's all my questions. Thank you.
Thank you, Anna. Okay, I don't see any more hands out there right now, so there Karl again.
No, yeah, just a question on, I think you announced it in the quarter, but it's not maybe a press release, but I saw it, that AddVision is entering Sweden with a greenfield, let's say, expansion. It would just be interesting if you could maybe explain a bit more on the strategy for AddVision, how you're gonna expand their offering into new markets?
Mm
Maybe both organically but also inorganic growth.
Yeah. The same for AddVision as we had with Healthcare 21. When they came on board, they had a list of interesting companies to add to the group. We of course reviewed that. For the Nordic market, we had a few candidates, but when we reviewed them, we saw that exactly in the segment or the niche where AddVision is strongest, those companies were not so strong as we wanted. We thought it was easier because they actually have European contracts for their suppliers in many cases. Therefore, even though it takes a little bit longer time, we actually employed two very well skilled and experienced salespeople who are now opening up the Swedish market. We've been doing a lot of market research before going in. That was a typical greenfield, which we decided.
We are also looking into some other markets, and especially now when you see with the new acquisitions we have, like the MBA or companies in Italy, et cetera, we're discussing with our AddLife companies in the group to see what to do. They see in these markets either we go for an acquisition there, or perhaps we open up in existing other AddLife companies. This is really a discussion ongoing right now. It's a bit too early to explain to you guys, but we are really going through each and every market and say, "How should we do it?" Because there are for sure ophthalmic surgery with the age explosion is something that is very important for the future. I think what we've seen from the segment and the opportunities, we will find a solution for each and every country.
Yeah. Just maybe a question on you acquired this BioCat in the beginning of Q2.
Mm.
I think it's quite interesting because you're acquiring, let's say maybe, you're entering into segments with, let's say, higher growth rates. I guess genomics, cell biology, et cetera, is growing quite much faster than the, let's say, average med tech or, diagnostic market in Europe.
Yeah, yeah.
I'm just wondering how the prices are looking on these acquisitions like this.
The multiples on these acquisitions are. I mean, it's quite small companies. You know, the average, I would say, is seven, the multiple right now on these smaller acquisitions. BioCat, for example, they have a lot in common with the company Bio-Connect that we bought in Benelux last year. They have a lot in common with our BioNordika companies in the Nordics that we have had for ages, and with EuroClone that we now have since two years in Italy. These companies have actually a lot of common stuff. They all work within these interesting areas, so they are, you know, a new segment where we really together can build much more in more markets. For us, we are not going into any new research segments because we had it.
It's, for us, it was the first time we had that research segment in Germany, for example. The group and the knowledge in the group has been here for many, many years.
Yeah. Thank you.
Thank you. It's five past. Yeah, 10:36. I think we are ending this meeting, but if you have more questions, I'm available for a chat or a mail or whatever. Thank you very much for listening in, and I wish you a great day. Bye-bye.