Okay. Most welcome, everybody. Nice to see that so many of you are interested to hear today about the acquisition that we did send a press release yesterday evening, very, very late. But we are very happy to announce that we have acquired Vision Ophthalmology Group. And here today, you will meet me, Kristina Willgård. I'm the CEO of AddLife. And with me, I have.
Dario Aganovic, CEO of Vision Ophthalmology Group.
We thought we would give you just a short update about a very short AddLife and the reason why we acquired VOG. Then Dario will walk you through some more details about what VOG actually is, what kind of company, what they sell, their offering, etc., etc. Then we end with some financials and, of course, some questions. I think most of you actually know AddLife, but this is a very brief summary of us. You know that we own and acquire companies within life science. We are always looking for strong leaders in niches. That's one of the reasons why we today have acquired Vision Ophthalmology Group. We have subsidiaries working from research to medical care. Today, some 70% of our business is distribution of other players' products in the market where we have access. We also sell our own brands in the market.
That's mainly in the Medtech division. We have today two business areas. We have Labtech and Medtech. Labtech is 60%, Medtech 40%. But there will be some changes, of course, after this acquisition because Vision Ophthalmology Group will be part of the Medtech business area. Before the acquisition, we had 55 subsidiaries with some 1,100 employees in the AddLife Group. Last year, we had net sales of 5.3 billion SEK and a good EBITDA margin of 15.2%. I just want to sort of come back to the strategy we have in AddLife that is going market-leading position in niches, exactly as I said. VOG is really a niche company.
And we always like to find great companies in niches because that's one big opportunity to increase profitability in this group and really to add a lot of knowledge to our customer and be a little bit closer to the customer, which gives us better added value and a stronger relationship both with partners on the supplier side and with the customers. We continue to work with operational mobility, which means that we continue with this centralized model, keeping the brands in the companies that we acquired. We want the companies to be more agile, closer to the market, to adapt to the technology changes or any other changes. And those of you following us have probably, hopefully, realized that during the COVID pandemic, I think this has been one of the best things with AddLife.
We have really been able to adapt to the new normal situation in the pandemic and offer the customers great products from a lot of good suppliers. And the third strategy and the reason why we're here is that we love to add acquisitions to build this company because we get stronger growth and we add new knowledge to the group. So why did we go for Vision Ophthalmology Group? Well, ophthalmic surgery, it's a difficult word if you're Swedish. Eye surgery is something I would prefer to say. I'm not sure if you can say that, but.
Yes, you can.
Yeah. For us, that is actually a new niche, but we have been looking into this niche for a very long time because we think that the trend in this niche is very interesting for us going forward. And we haven't been in this niche before. It's a strong growth potential. And Dario will come back to that. VOG is quite a large player. They have subsidiaries in four different countries. They have today net sales around EUR 70 million. And they have very strong margins in their operations. They drive the business in a very decentralized business model, exactly the way that we think in AddLife, with the subsidiaries close to the customer and then with a common sort of platform where we can use resources in a good way.
What we have seen and when we have reviewed Vision Ophthalmology Group is really, it's a solid customer and supplier relationship because this is really a relationship sales. Selling is done directly to surgeons in many cases, and the importance of being very close to the market is really what we see that VOG has in their group. The platform that has been built during, I would say, the last two years, actually, in VOG is a good platform that we can continue to grow both organically, but also to add more acquisitions, either in the geographies where VOG are today or actually add new geographies to the same platform in this niche segment, but that is something for the future, but for us, this is very important that we have a strong company with a good platform to grow because we know that the market is growing.
What we have seen with VOG is that it's a very experienced management, both Dario and his central team, but also the managers in the subsidiaries. They've been really working in this business for many, many years and are well-known in the market. And we will keep the management, of course. You know that is very important for us when we do acquisition. And we are looking forward to continuously grow this business. Oh, you're surprised now. So it is. Okay. I will hand over to Dario, and he will explain a little bit more details about VOG.
Thank you very much, Kristina. Hi, everybody. Dario Aganovic, CEO of VOG. I'm super excited to be here today. And we at VOG are very happy to become a part of AddLife family. I've been with the company since 2019. And my previous experience, I've been doing similar jobs in the pharmaceutical business. I've been in facility services before. So I'm a kind of generalist. But fortunately, then the people in our subsidiaries who are running the business have, as Kristina said, quite a long experience within the ophthalmology industry that, as Kristina said, here is very much relationship-driven. So who is VOG? VOG, we like to say that we are a leading European distributor of surgical products for ophthalmologists. Now, ophthalmology, difficult to pronounce, even more difficult to spell, as you can see here.
this is the right spelling with lots of Hs and so on, is a niche within the medical industry, and ophthalmic surgery, you can say, is a niche within a niche, so we are very specialized at what we do. We distribute all the products that the ophthalmic surgeon needs, really, to perform his or her job. Typically, what we work with, the most common kind of treatment is treatment of cataract, and what is cataract is really clouding of the lens that all of us get at some point in life. If you live long enough, you'll get the cataract. Clouding of lens, age-related, and the only way to treat that is basically through removal of the lens and putting in an implant, basically, surgically.
So whatever a surgeon needs to perform that treatment, the lens itself, the disposables, consumables, equipment for both diagnosing and doing surgery, all of that we provide to the surgeons. We provide branded goods from well-known manufacturers, but we also have a portfolio of our own private label products. We are active in several European markets. So you can see here on the map behind me, these dark areas here are our direct markets, where we have our own sales force on the ground. It's in Germany, Austria, Switzerland, Poland, United Kingdom, and Ireland. We have sales offices in these countries here. We're also covering these a bit light blue areas as well through two ways. We have some sub-distribution deals with the distributors in these countries, but we also sell our surgical kits, custom surgical kits to these markets.
These custom surgical kits, now, when you perform a surgery, for instance, cataract surgery, typically, you can use lots of disposables, pull them together and perform a surgery, or you can buy a kit. For each surgical treatment, you open one kit, you take out all disposables you need, you perform a surgery, dispose them off, and then in the next surgery, you open a new kit. These kits, they are custom-made for different clinics. We are making these kits, and we are manufacturing these kits in our plant in Germany, in Karlstein, in Germany. It's in northern Bavaria here. This red dot, I'm not really sure if you can see the corners there.
These kits, we sell to our own distributors in these dark blue areas, and we sell them also through our distribution partners in markets where we do not have a direct presence. We are operating our business through five business units. It is our four geographic distribution units that I just mentioned: Germany, Austria, Switzerland, Ukraine, and Poland. Then we have these custom packs. We are covering, as we said, seven service areas. With service areas, we mean treatment areas. I mentioned cataract. It's a big one. Refractive, glaucoma, vitrectomy, intravitreal injections, diagnostics, and practice services. We are serving about 4,500 customers in our direct markets. These customers are everything from a single surgeon in a privately owned clinic to a large university clinic. In between, there are larger clinics. There are chains of clinics.
And in most of the cases, the vast, vast majority of these places, these customers are local. There are some international chains that are growing now, but the markets are very much local. We have a set of suppliers that are supplying these products to us. You see here approximately 50 suppliers. They are actually much more than 50 suppliers because the tail is very, very long. But we have 50 major suppliers. And they are providing to us approximately 15,000 items that we are delivering to our customers. Our workforce is currently about 190 people working in our organization, majority of them, obviously, in commercial roles since we see ourselves very much as a commercial sales-oriented company. But we also have product management functions. We have operations and logistics. As Kristina mentioned here, the turnover that we had last year was about 70 million EUR.
This was the year that was impacted by COVID pandemics. Now, this surgery, ophthalmic surgery, is in most of the cases an elective procedure. So basically, it is not that you can elect if you're going to do it or not, but you can control the time points to a certain extent. And this meant that many of the surgeries got postponed. It impacted our sales in 2020 by approximately 10%, which is, if you look at the market in general, if you look at our other listed competitors, they've been performing at average about 14%-15% lower than they did the year before. So our performance was quite good in comparison with them. But still, we suffered, obviously, from the COVID pandemic that is still ongoing to a certain extent. Pro forma EBITDA, 13 million last year. Now, why is this so interesting market?
As Kristina Willgård really, really believed, this is super interesting and with a huge potential, and the reason for that, it is driven by the underlying demographic factors that are playing in our favor, so the eye diseases, they are age-related to a large extent. Specifically, those that are treated with the surgical treatment, they are age-related. Here behind me, you can see the prevalence curve, so prevalence on the Y-axis is percentage of prevalence, and on the X-axis is the age, and you can see here that with the increasing age, the prevalence of different diseases increases. The dotted line one is presbyopia, and presbyopia, that's the thickening of the lens that results in a loss of focus, and then you lose some visual acuity here. It's typically people in their 40s that start to get. You can treat it in many different ways.
One of the ways is a surgical treatment. Most of the people treat it with glasses, some with laser, but you can treat it also with the surgical treatment, remove need for glasses altogether, and then you have the cataract that I talked about, and cataract is kicking in when you're about 70. It is lifting up, and the prevalence is increasing drastically, and you can imagine what happens now when we have a growing population of people that are in this age span, like we have in EU 28 countries, so basically, the market for cataract is increasing drastically. Glaucoma as well is increasing related with age, and then this disease here is called AMD, age-related macular degeneration that is increasing, especially in the higher age span, which is a chronic illness that can be treated only through injections that you need to take frequently.
So this is not basically surgical treatment. You do one time and fix it. You need to continuously give these injections. So these factors here are actually driving the growth of the market. And the market is growing with a CAGR of about 6% going forward. So a very, very interesting market indeed.
I think it's perhaps difficult to see the market size in Europe are somewhat 700 million EUR of size.
Yes. And these are the markets, our core markets in Germany, Switzerland, and the U.K. here. So now the market in Europe, if you look at other countries, where we have expansion opportunity, basically, it's even more than that. So our setup here, as Kristina mentioned, we are operating in a highly decentralized way. We have a very small.
Head office.
Head office. Head office is very, very small, so here it's myself, and we have a corporate affairs function that is covering regulatory affairs, HR, and some support functions to the group. We have a group finance, and then we have these four geographic units that are all operating under their own brands, so this structure has grown during the last six years through acquisitions, and then we have MED, which is our production unit that is manufacturing the sets, and what we have done here last year, we have introduced this function here, product management and sourcing, where we are consolidating the product portfolio decisions and strategic sourcing within the group, thereby creating an integrated platform. However, what is important to mention here is that the commercial interface towards the market is local because the markets are local, customers are local.
So we are very keen on keeping decentralization on the commercial side and then supporting these commercial units here with the economies of scale and scope that come from operating this common product management and sourcing structure. And this is the change that we basically introduced during the last year. Yeah.
Thank you, Dario. That was a very short, quick overview of VOG. I will give you some financial updates on the deal on the whole. Today, we have closing. We have signing yesterday evening, very, very late, as you probably saw out of the press release. The price today, SEK 165 million cash, debt-free. 50% of that is cash, 50% in shares. We are using 1,500,000 owned repurchased share that we already had in AddLife. And then we do issue share to the sales side with 3.8 million new shares. This totally means that it will be a dilution of approximately 3.8% of total shares in the group. It is an opportunity for the seller to get an additional cash consideration 23/24 of EUR 18 million extra if financial results, as we have agreed upon, will be met.
We hope, of course, that will be met because then we have both done a fantastic deal. Looking to the multiples, because you very often ask me about the multiples, you know that normally we buy smaller companies, and they are in the range of 7, 7.5 times multiple EBITDA to EBITDA multiple. This time, a larger company in this group, we came to an EBITDA multiple of 12. We will give you more detailed pro forma accounts in our Q1 report that will be released on April 28. But in the orange spot here, you can see that if we just take the sales we had in AddLife last year and add the VOG sales, we end up with a company of around SEK 6 billion. It's a growth of 13% of top line. And EBITDA is then expected to grow with 16% to SEK 930 million.
But this is just for an illustrative point of view. This is not actually sort of the pro forma accounts. But this was just to give you a hint about what size do we get into AddLife in the group. And now I would like to open for questions, please.
Hello. Florent Boutier from Amiral Gestion. Thank you for this very clear presentation. I wanted to come back on your 2020 year where you did only -10% compared to your competitors' -40%-50%. So how did you manage to do such strong results? Did you compensate the lost sales elsewhere or?
The competition performed 14% on average less than the year before.
Not 40.
Not 40.
14.
14.14.
Yeah.
Yes. Yeah. So we have performed 10% less. They performed on average 14% less. We have had the surgical volumes we have seen have dropped more than 10%. Obviously, they have dropped close to 14%, actually, the surgical volumes. We have had quite good sales on the equipment side. So since this is a very strong market, many of our customers utilized the pandemic also to refurbish their clinics, to acquire some equipment. So we had some lift there as well.
Which is good for the future.
Yes.
Because then we have connected the customer even more.
Yeah. Yeah. Thank you. And what kind of growth did you have in the past, let's say, five years before the pandemic?
I think the growth has been close, I mean, since it's acquisition-driven. But if you look at the companies itself, it is around 5-6% on average CAGR. But then we have added the VOG have added acquisition. So I don't actually have in my head these total numbers. We will have to come back to that in the pro forma accounts.
Thank you very much. Can you tell me what is the percentage of consumables in the revenue mix versus equipment?
Yeah. Roughly.
I would say 80%?
Yeah. It is. I'm thinking here, consumables, what do we mean with consumables? You have implantables, the implants, and you have consumables themselves. So I would say about approximately 70% together. Yeah.
When you talk about implants, it's lenses.
It's lenses.
Intraocular lenses, very often.
Yes. Exactly. Exactly.
Why are you talking about the pro forma EBITDA and not just about EBITDA?
Because when we acquired this company, they have been owned by a PE company, and they have had depreciations that we will not have for the future. So it will look somewhat different when they are managed by us. So that's why we want to come back to you in the pro forma accounts with more details on how it will look after the acquisition. I think that's more fair than the figures that we have shown you here right now.
Okay. And revenues were down 10%, and that was organic, if I understand correctly, last year. So there was no acquisition effect in there. And EBITDA, how did that develop or EBITDA margin in the last year? You were talking about cost savings. So how does that compare to the previous year? And suppose revenues would go up, let's say, 10% again this year, I'm just calling out a number. What kind of upside would you have in your margin?
If I look on the company, it's obviously so that 2019, when Dario and his team sort of came in as management here, they came in to do a big change in the company. 2019, you see really bad results, I would say, because there are high one-time costs for reducing personnel. I think you reduced with some 50 people, close to 50 people in 2019. Some of that cost goes also into the 2020 figures. We have to sort of take away this one-time big cost to see it. But if you deduct for that cost, we see that the gross margins or the margins before these one-times have been very stable at around an EBITDA margin of around 18%. That's what we have seen in the business, taking away these one-time big ones. Does it give you the answer?
Yes. If that's kind of the run rate going forward, regardless of, let's say, revenue growth that you could expect this year versus last year, then that is the answer.
If we have, I mean, if we are a bit cautious, I would say if we could continue to run this business at least 18% EBITDA margin, I think we do a great job. That's quite high to be a distribution business.
Yes. Yeah. And that's driven by the private label business, the own manufacturing, I would assume?
Yeah. But it's also what we see. I mean, actually, the customer isn't that price sensitive because since this is a niche product and you really give added value to the customer, you don't really sell on price. So you sell it with close customer relations, and that is a really new technology. So that's what we have seen. I don't know if you have another comment, Dario.
No, I fully agree with that. If you look at the star of the surgical show when you're doing cataract, is basically getting a lens in the eye, and the cost of lens, the total cost of the surgery is very, very small.
Yeah. So they want exactly the right lens and doesn't really care if that's what percentage growth on that compared to the total cost for the surgeon.
Okay. Great. Thank you.
Hi, Daniel. Here from Danske Bank. Do you hear me?
Yes.
Good. I have two very short questions. The first one is if you could sort of circle back to the challenges you have had in the past and what triggered the management change in 2019 just to have some sort of genesis of the company here. And secondly, could you elaborate a bit more on the competitive environment and if you're seeing increased competition ahead?
Yeah. So when it comes to the challenges that we had in the past, I would say that there are two large events that have impacted. Yeah. One is an event. The second, I don't know. But first of all, is that we have had a regulatory change in one of our major markets, Switzerland, where the reimbursement system changed for cataract operations. And it changed from a, let's say, a full reimbursement model into a fixed cost model, which really made quite a high pressure on the prices for the supplies for cataract. In general, that pushed down the margins in Switzerland, although volumes continued to grow. That's one challenge that we had historically. And the second challenge has been while we were having that push down, the company overhead grew quite significantly.
That we basically in 2019 into 2020, we actually reversed that development when it comes to cost, restructured, took away the corporate overhead and other overheads. At the same time, the price picture fully stabilized in Switzerland. We have got through these challenges, but this is the two major historical things. That's the first question. Second question you had was about the competition. Basically, on the market, there are three types of players, I would say. You have large manufacturers, companies, really, really large multinationals like Johnson & Johnson, for instance, who are striving to be full-set providers. They have their own sales force on the ground, and they do their thing. You have a second type is distributors, small local distributors, very often family-owned businesses in different countries, having a turnover about 10 million EUR and covering a single market.
And then you have us. We are pretty unique here being a pan-European distribution player that is providing distribution platform to all the specialist companies who are not Johnson & Johnson, but who are specialists in their particular areas, doing just the lenses, for instance, or doing certain types of high-quality disposables or reusables. So these guys, they need a distribution partner. Some of them go through the small local players, but many of them, the larger ones, they go to us. And this is giving us access to many innovation pipelines that these companies have. And we are able then to offer to our customers many different alternatives depending on the needs that they have. And we do not rely on one innovation pipeline that, however big the firm is, it's still just one innovation pipeline. So yeah, that's how the market looks like.
Okay. Thank you, and just a follow-up on the first question. Reimbursement changes, is that something to be expected in, say, U.K., Germany, Austria, or sort of if you're looking at this market from here in the next three to five years, will there be a lot of price pressure, or will it sort of stay flat?
We do not see that because the markets that we are operating on currently, they have gone to these types of changes. Switzerland was pretty late on that. There are few European markets that are still facing regulatory change, but not the markets that we are operating on as far as we can see.
Okay. And last question then. On sort of you're mentioning a lot of smaller players in this industry. Do you already have an acquisition target list that you're looking at that maybe AddLife could facilitate?
Well.
Let's say, that is, I know that Dario likes to drink coffee with other companies. So yeah, that is an opportunity for the future. And that's why we think also this is great to have a platform. But if and when we find new companies to add to that platform, I think it's a bit too early to say today. But there are opportunities in different markets.
Okay. Thank you.
Thank you. Okay. No more questions.
Then I suggest if you have further questions, either you contact me, send me a mail, or whatever. I will try to answer as soon as possible. And thank you very much for listening in to us. I hope we give you some more information about this fantastic deal that we are very happy to have announced today. And we're really looking forward to continue working together with these guys. So thank you very much. Bye-bye.
Thank you. Bye.
Bye.