Asker Healthcare Q1 Earnings Call 2025. For the first part of the conference call, the participants will be in listen-only mode. During the Q&A session, participants are able to ask questions by dialing *5 on their telephone keypad. Now I will hand the conference over to CEO Johan Falk and CFO Thomas Moss. Please go ahead.
Yes, hello everyone, this is Johan Falk. Thank you so much for taking the time listening in to our first Q1 report. It is an exciting day for us, of course. This is the first time after the IPO being out with a quarterly report. I have been here 13 years, so I have many, many quarterly reports behind me, but this is the first in the public environment, so it is a bit exciting. I am happy to convey that we have a good Q1 behind us. We have a solid momentum in the business, and overall we feel good about both the organic growth and the M&A growth. Our net sales increased with 16%, and more importantly, the organic growth, which is the kind of honest truth of what the customer thinks of us, is we are going faster than the market, which is very much appreciated.
We have an EBITDA that has been increasing 17%, so a bit faster than the top line, which also is good. Our EBITDA margin, most of you know that we have put a target of 10% in the mid to long-term future, about 10% EBITDA margin, and we now have 9.1%, so it's increasing slowly but stable towards that. That's also a good sign. We had two new acquisitions this quarter. We had a little bit of other things to focus on also. This IPO has taken a bit of time, as you can imagine, but we're happy to see two acquisitions in the quarter, and as you maybe follow, we did one more just the other day here, so that also feels good. I'm coming back to that in a little while.
The IPO was, of course, a mega event for us as a company and also personally for the management team. It was a successful event. We have a lot of advisors doing a good job, and 20,000 new shareholders is fantastic news that people are interested in taking part of Asker and seeing the same vision as us. I mean, we want to improve the healthcare system in Europe, and we know we're playing an essential part to make that happen. For other people to think the same way and also see that this could be a good investment at the same time is the same view as we have, so we're very grateful for that. Our net debt over EBITDA has been reducing from our 2.2 level to 1.7 thanks to capital injection when we IPOed.
We have a strong balance sheet, which means that we can have a high pace of acquisition in the future as well. Our cash flow, as you know, is high and stable, but having a bit of extra firepower is very good. The opportunities out there are not endless, but there are a lot of good companies out in Europe. I mean, as you might know, this market is fantastic. It is SEK 1,300 billion in turnover each year, and we have listed 800 companies in Europe, so that means that we have a lot of interesting deals. What differs in good and bad players in this market is finding the right people, finding the right entrepreneurs that are market leaders in their niche. That is where we excel, I would say. We have a good list of companies that we could acquire going forward.
We have the cash, and we have the people out there, so it feels really good. I mean, what we call the twin end, organic and M&A growth, is going; it's doing what it should. If we turn to page three then and look at our financial targets, I hope that most of the shareholders that are part of this and showing interest in Asker are looking at this over a longer period of time. As I mentioned, I've been here a long time, and I see this smooth, stable, soft development in the future. I mean, I think you should look at this over time, and we have a market that is growing with 3%. We should grow faster than the market, which we show.
Our most important matrix is the adjusted EBITDA growth, and if you look at the last 12 months, it's 22%, which I'm very proud to present. We have a target of over 15%. That's the promise to the market, and being able to do that both in the quarter of 17%, but over the last 12 months of 22%, feels really good. The R over RK, or the EBITDA over net working capital, is a key matrix for us internally. Every new entrepreneurial company that comes into the Asker family is working hard to please the customer and have a good EBITDA margin, but at the same time, having an efficient working capital. 67% and seeing a little bit increase in the quarter as well feels really good. I touched upon the EBITDA margin, which is slowly going upwards to 10%.
If we turn to page four, looking at the list of acquisitions here, you should expect us to do between 10 and 20 acquisitions per year. I mean, it's both the number of acquisitions, but as importantly, the total addition of EBITDA. Our list of companies that we potentially could buy is roughly 800 companies in Europe, and we have active dialogues with quite a few in the process as well. We have an aim to have at least 10% acquired growth each year, so that's 10% of our EBITDA each year. It's both the number of companies but also the absolute amount. We're trying to stay out of the larger acquisitions. As you can see on this list, our aim is to buy companies between SEK 100 million-SEK 300 million in revenue.
The last one here, or the one at the top of the list, HSL in Northern Ireland, is a little bit of a platform acquisition. It is less than 5% of our turnover, but it is a good, solid company in Northern Ireland that could be used as an acquisition platform for the future. They already now have a list of small bolt-ons that they could do, so that is really, really, really good, and they have had a good start as well. Twelve acquisitions in the last 12 months amounting to SEK 1.8 billion is also where it should be. Looking into the HSL, I mean, we are doing quite a lot of acquisitions, and we are not presenting everyone in detail, but this is a little bit larger, so I could take maybe one or two minutes. As you know, we are a provider of medical supplies, devices, and equipment.
HSL is leaning a little bit more towards equipment and devices, and also have a higher part of their revenue comes from services. So the value add is quite high in HSL, where we also see a higher bottom line margin of EBITDA over 10%, which is good, and it's adding to our journey towards 10% for the group. SEK 800 million in revenue, 150 FTEs, and they have a strong track record in many markets in Great Britain and Ireland. With those words, I leave the word to Tom.
Great. Thanks, Johan. I will just take a few minutes to go into some of the numbers in a little bit more detail and just step through the different regions. Here on page six, the summary very much is steady growth in sales and EBITDA, really continuing the trends that we as a business have seen over the last few years. On the top left here, you see the net sales grew by 16%, the adjusted EBITDA 17%, up to SEK 364 million. The slightly faster growth in EBITDA versus sales is just nudging the margin upwards, which is very much in line with what we want to do and what we want to achieve going forwards. The R over RK, as Johan mentioned, also moving in the right direction.
I'll come back a little bit more to that later on, given the importance of that as a steering metric in our model. The main contributors to the growth in the quarter have really been the regions west and central. Again, I'll say a little bit more about that in a second. When we look across the 50 companies in the group, we do see product mix improvements coming both from the acquisitions that we've done, but also the ongoing operational efforts across the business area. A little bit of an FX effect we should just mention, not huge during Q1, but potentially larger in the later parts of the year. We will all obviously keep an eye on that. If you turn to the right-hand side of this page, we just tried to break out the different elements of the growth.
As Johan mentioned earlier, 6% organic growth in EBITDA through the quarter, which we're very happy with, and then the acquired growth coming on top of that at 12%, a small negative impact from the FX effects, primarily translation effect of euro into SEK, and the total growth in EBITDA, adjusted EBITDA growth in the quarter of 17%. If I just flip forward, we can have a brief look at the different regions. If we start with business area north, a very stable quarter for business area north. Actually, when we lift the lid and look into the individual countries and the individual companies, we see lots of areas to be pleased with, solid performance, continuing to develop the mix across our countries and finding those operational efficiencies.
There is overall a slight decline in EBITDA, as you see there, 2% down to SEK 177 million EBITDA for the quarter. This is mainly due to project-based activities that we have beginning to come into business area north, and in this quarter, largely in the government events and equipment area, which was extremely strong during Q1 last year, so in the comparable period. It is a relatively small part of the region's performance, as many of you will know. The region north is very stable by servicing the regions and the commune, but we have introduced, which we are happy about, a slight lumpiness with some of this project-based activity, and that explains that slight dip in EBITDA in the quarter.
I think it's also important to note that we feel very strongly that this is an important, growing, and interesting area going forward, so we have no doubts that it'll be an important part of the business in the future. Final note, just to mention, we have a new distribution center, state-of-the-art distribution center, being built in Gothenburg, and the build and progress on that construction is going entirely as planned. We look forward to getting the benefits of that in future years as well. If you look over to the right-hand side of things, you can see the summary. Organic growth down 3% in the quarter on EBITDA level, acquired growth contributing a little, so minus 2% overall adjusted EBITDA growth, net sales growing at 2% in the quarter.
Turning now to business area west on page eight, some good attractive growth numbers we see in business area west. We see the net sales growing 19%, adjusted EBITDA growing 35%, and the effect of that is to lift the margin by 1 percentage point versus the same period last year. The high organic growth levels in region west are largely driven by the strong growth in patient numbers. For those of you that followed the details through the IPO process, you'll know that we managed to acquire some additional customer databases last year, and we are now running those through our system, and as you see, they are contributing well to business area west. We also see continued improvement from the closer cooperation between our different companies in the region, and particularly in the home care area of business, which is delivering some nice results across the area.
Two acquisitions that Johan mentioned earlier, HSL in the U.K. and Ireland, and Myomana in the Netherlands. To the right-hand side of the page, you can just see the summary again. Organic growth was strong, 24% acquired growth, 12%, and a small negative effect, as I mentioned earlier, the translation effect of euro reporting into SEK as the group currency. The final region, business area central, our youngest and newest and fastest growing region, very much driven by the active M&A agenda. You see the overall net sales growth at 37%, EBITDA growth even stronger at 75%, and as you look over onto the right-hand side of the chart here, you also see the strong contribution of the M&A growth through that period at 62% acquired growth in EBITDA and 33% acquired growth in net sales.
I think also worth noting that we're pleased to see that the activities that we're doing to get margins up, both the mix effect of the new M&As, but also the operational effects on businesses that we already own, are nudging the margin nicely in the right direction in region central. A quick word from me on page 10 on R over RK, or EBITDA over net working capital, when translated into English, it's a metric that we will keep coming back to, extremely important to us given the diversity of the group, 50 companies in different areas of business and different operating models, and to have a single metric that we can look at all of those companies on that focuses us and focuses them on the operational efficient usage of capital is very powerful and something we believe in strongly.
I will keep coming back to this, and in the quarter, we are happy to see again a small positive move continuing in the right direction. I can just note, as we've had the question in the past, the Asker target about 50% means that we want every single individual one of our companies to be about 50% rather than managing the group total to 50%. Yep. Just a final page from me, just to mention a little bit on the debt, the cash, the leverage picture on page 11. I maybe start on the right-hand side of this chart. You will see our net debt to EBITDA has dropped primarily as a result of the capital injection we got during the IPO. We took in SEK 1.5 billion of new equity during that period.
The leverage is now down at 1.7, which, as Johan mentioned earlier on in the presentation, is giving us a little bit of firepower in the short and medium term to do some more M&As, which we're happy about. One final note, cash flow was a little bit lower in the comparison period to Q1 2024. The vast majority of that effect comes from HSL, the acquisition that we just did. They have customers who have year-end at the 31st of March, which means actually we build up quite a large chunk of accounts receivable in March, which is a phasing and a dynamic that we've not had in the group historically, but obviously will even out going forward as HSL rolls into the group in full. I think that's it from me. I hand back to you, Johan, for a few summary words.
Yes, thanks, Tom. All right, so before we leave the word to you for Q&A, just to summarize, I mean, I feel good about this Q1, as I mentioned. We have a solid performance, and we are where we should be. It means over 15% EBITDA growth coming from both organic and M&A, which we are delivering of 17%. And showing the organic growth in markets, I mean, it's partly due to this very stable market. The underlying market in healthcare is growing with 3-4%, and us delivering more than that. We see, as you saw now and explained by Tom, it could, of course, be quarter by quarter in some regions by project-based. We can see some lumpiness in the cash flow as we saw in some.
I've been here now many, many years, and over time, looking at this rolling 12, this is just normal business, so to speak. I'm very, very pleased to see this. M&A, where we drive very hard to be in the forefront. We are today market leaders in Europe, and we see very little aggressive competition. I would say it's healthy competition, very few times where we want to buy a company that they do not sell to us to good multiples. I feel good about the M&A part of our agenda, which is very, very important. Also the strong balance sheet giving us firepower for the future. All in all, we're a happy team, and we hope we have happy shareholders as well. Thank you so much. Now over to questions.
To ask a question, please dial pound key five on your telephone keypad to enter the queue. If you wish to withdraw your question, please dial pound key six on your telephone keypad. The next question comes from Carl Ragnar Stam from Nordea. Please go ahead.
Good morning. It's Carl here from Nordea. A couple of questions from my side. Firstly, starting in north, you grew organically, but as you said, EBITDA had a slight organic contraction year over year. You mentioned defense in the comparisons, but I'm a bit curious to know more of the nature of the defense business or GDE, as you call it. Is it typically one big order a year or delivery, or is it twice, or how does it work? Is it also possible to sort of quantify how big deliveries were last year versus sort of a normalized year? And then finally, if you on this topic expect a similar boost to come at some point during 2025 as well.
Yes, thanks, Carl. Johan here to start. I think the absolute majority of our business, the thousands and thousands of customers and institutions, are healthy, steady healthcare institutions. On top of this, we have project-based. We saw during the pandemic, if you go a few years back, that it could be deliveries on more project-based nature that comes on top of the business. Nowadays, the pandemic has ended a couple of years ago, but now we have uncertainty in the world due to the civil defense and Ukraine situation with wars, and all European countries are trying to strengthen their social defense, which partly means also healthcare articles and machinery. Different countries, especially in the north where we are strongest in this, are buying products from us. Sometimes it goes to Ukraine. Sometimes it goes to building our own civil defense.
This is not one deal a year, but it's not 50 deals a year either. That's kind of one part of the defense thing. It's also, as you know, we have public customers, which sometimes you win a tender and sometimes you lose a tender. For a region and for a country, if you have lost a tender one quarter and you have won another, that can also differ. Usually we see very smooth development, but as you saw in north right now, it could happen occasionally, but it's not normal for us to swing up and down this much. It's nothing to be worried about. I would say that maybe I'll leave the word to Tom to quantify this in some way, but it's a smaller part of our business that comes on top of the normal healthcare supplies.
What would you say, Tom?
No, I 100% agree with that. I think that it's important to emphasize that it is a relatively small part of the business. When you look at the numbers, a $1 million move moves the growth rate by 1%. We're not talking big effects here.
I hope that's.
Okay. That is, yeah, that's very clear. Thank you. Also, looking at some disclosures in the report, seemingly your most recent big acquisition, HSL, did 13% margin when I look at it. Is that correct, firstly? Also, what seasonal variations do you see in that business between the quarter, i.e., should we continue to expect it to deliver the Q1 level, or do you see seasonality in the remainder of 2025?
Yep. Do you want me to start that one, Johan? I can do that. Yes, so you're right. The margins are certainly above the group average, nudging up into those sort of low mid-teens levels. I think HSL does have slightly more seasonality than our typical businesses. I think when you look across the other 49 companies in the portfolio, everyone has some degree of seasonality, but evened out across the patch, the group as a whole does not have significant seasonality. I think March in particular tends to be a strong month for HSL because, as I say, the year-end of some of their major customers also coincides with March. Otherwise, their performance also is relatively stable through the rest of the year. We would expect, yeah, strong March, slightly slower in April, and then back to normal again through the rest of the year.
Maybe what you could add to the HSL and seasonality is the cash flow. As you saw, the cash flow for the quarter is lower than normal, and that's also due to HSL coming into the group. They have a fiscal year that ends in March, meaning that they usually tie up more capital in that quarter. That's part of the answer to that change.
Do they release working capital in Q2 instead, or is it Q3, or how does it work?
Yes, that's right.
With seasonality and cash flow?
Yeah, that's exactly right.
Q2.
Yeah.
Okay. The final one from my side is, you touched a little bit upon it or quite a bit. The M&A pipeline. You closed quite a few acquisitions during the second half of 2024, now three years to date. Is the pipeline somewhat drained due to it, and do you need to rebuild it, or should we see it as you also, on the other hand, you did the IPO, you maybe postponed some projects or processes during it, where we could see a catch-up effect? How should we look at it?
Yeah. I mean, it's definitely not drained. I mean, the market is very attractive and will be so for many, many years. I mean, there is, as you know, 37,000 medtech companies. We have listed 4,000, and we have a shortlist of 800. Over the next years to come, we will find good and attractive companies. That's something I'm very, very sure about. Of course, I mean, it's a matter of when you're picking the best entrepreneurs, as we do, we want to be quite picky, and we want to have a stable, nice growth of 10% EBITDA from M&A. Sometimes a bit more. It could be a little bit less, but most of the time, it's becoming a bit more. I mean, as you can see right now, we have bought three companies already during this year.
From a financial point, we do not need to buy anything more to kind of have that growth, but we have a very attractive pipeline ahead of us. I would say that we will manage this to pick good companies, high quality, and add this so we do not buy much more than our cash flow. Now we have a strong balance sheet, so you could, I mean, we could add a little bit more than our cash flow if we like, which could be maybe a good idea. I would see this as a smooth growth, both on organic and M&A. Quarter by quarter, it can differ because it can be pushed. Usually, if we buy a little bit larger company like HSL, maybe we focus a little bit harder on that, and you could see the quarter previous and after maybe a bit slower.
For the rolling 12, you should expect us to do 10-20 deals and roughly 10% of our EBITDA on a group level.
Okay, very clear. That's all for me. Thank you.
Thank you.
The next question comes from Eric Castle from Danske Bank. Please go ahead.
Hello, good morning, everyone. First question on West. I appreciate that a lot of the strength came from the customers that you acquired. You talked about that. I was wondering if that is something that you can continue to ramp on, meaning can you continue to grow sequentially from this level based on those sort of customers? Also, do you think that the margin level that we're seeing in West is sustainable going forward?
Yes. I think, I mean, always when you dig down into a region or a country or a company or a niche, I mean, you need to have a special discussion around that medical discipline in that country and that circumstance. It is always hard in these kind of calls to draw drastic conclusions. What you should do is kind of lift yourself to see, I mean, all countries that we are present in, 17 markets, have the same need. We have, as human beings, identical needs, and that translates into the same need of products as well. For me, the market is growing with 3-4%. We are growing now with 6%, so we should grow twice the speed of the market is my ambition. That is spread across.
If you go down the level, you have, of course, more attractive companies, segments that are growing faster sometimes, and some are growing a bit slower. You could also see that the scale effects in the Netherlands, we have bought quite a lot of companies. We now have roughly SEK 7 billion sales and a lot of scale effects in the Netherlands, also adding to organic growth, the gross margin, and the net profit. If anything, I think we have a strong possibility to kind of continue growing, seeing scale effects, and also positive margin movements over time. That is kind of how I view it. It is very hard to analyze on a country, company, or market segment basis. You should always kind of move up and look at the bigger numbers and over time.
I'm thinking sort of specifically on the customers that you acquired a couple of months ago. I guess there were thousands of them, and that's you sort of ramp and process each and every one, but over time. I was just more wondering if you can still gain more volumes from just that sort of customer acquisition that you did back then.
Right. Sorry, maybe I misunderstood your question. It's a good question. I mean, part of our growth comes from M&A. That's pretty straightforward. Part of it comes from, yes, winning tenders or customer deals, pretty straightforward. Part of it is also what you saw now in the Netherlands where we have taking over customer databases or customer agreements that can add to our organic revenue. That is something that is a very positive part of the organic growth. Exactly what that translates into numbers, it's very hard to say. It is something on the positive side, absolutely.
Eric, I would maybe also say that.
Oh, sorry.
No, go ahead.
Yeah, Thomas.
No, I was just going to say, obviously, we have a one-off step up as we take over a large injection of new customers. There is underlying growth on top of that as well. It's not just that growth only comes from adding a single new customer. If you add all of those customers in one go, somehow there is no growth in the future. You continue to work with those customers. You continue to find new areas of developing the business, improving how you service those customers to get the margins up. There is an element of a one-off step up, but it's not a one-off step up that precludes growth in the future.
No, exactly. I understand it's a step up. I'm more willing to understand if the step has been fully taken, so to say, if you're at the new level already, if you continue to ramp in Q2. That was more the question.
Yeah, yeah, okay. Sorry, we can get to that some other time maybe.
I was also interested in the sort of pricing adjustments that you can make for 2025. I saw that the December print, which seems to be pretty important for a lot of one-med contracts, was fairly strong. Of course, that isn't all of your business. I was more now interested in the customary pricing adjustments that you tend to make in the end of Q1, how those have come out, and what sort of pricing, let's call it, tailoring that you can see for 2025.
Yeah. I would say that our pricing adjustment is a normal part of our business. Given the magnitude of number of customers, I mean, no customer is larger than a percentage, and we have hundreds and hundreds of agreements. We are floating as a cork on the water, I usually say. We are in a very good position of making sure that if there are raw material changes or if there are other effects, we usually adjust in a smooth way towards the customer. There is very little drama for us in our role as a service provider. If the customer is in great need of something, we make sure that it's there. As we have seen during the pandemic and others, if there is a shortage and price points move a little bit up and down, that's also how our price points move.
You should also not expect us to kind of go aggressively and put higher prices up when you see very much higher trading contribution. What you should see is think about this as we have an aim to go toward 10% EBITDA margin over time. That will come from partly operational excellence. We are fine-tuning the business every day, so we lower our cost. We are using our scale of the group. We are pricing and giving the customer a good service. All of that combined will take us from 9% to 10% in the midterm. That is how smooth and slow it will move rather than aggressively pricing one quarter and having an effect. It is kind of evened out over the group.
Okay, okay. You can't quantify what sort of the average pricing effects can be for '25 to sort of help us understand the volume price mix for organic growth?
No. I think it becomes too complicated. When you go down, of course, we can dig out the company and talk about that company and price point, but it will not help you. I think the best way to look at this is kind of from the top-down level. We now have 50 companies. We are going to add 20 companies per year. It will be impossible to follow this on a price point company level. Thinking about this as a smooth ride and focus on the stable organic growth, stable M&A growth, and gradually taking us to 10%. That is kind of the best way to analyze this. A bit boring maybe, but it is also stable, and that is the best way to analyze the future. At least that is what I do when I have been here 13 years. It is hard to do that well.
Okay, okay. I like boring. That's fine. I'll jump back in the Q and come back if there's any more time in the end. Thank you.
Thank you.
The next question comes from Robert Redden from Carnegie. Please go ahead.
Yeah, hi. I'm sorry for asking you about this again, but on those product deliveries in Region North to defense or preparedness, I call it, did you have those deliveries in Q2, Q3 last year? What are the comparisons like in the coming quarters for Region North and that team?
Yeah, I can say last year, I think we had a relatively steady flow of GDE activity through the course of all quarters last year. We definitely are seeing a little bit more lumpiness this year so far. I think it's also important.
It's also important, Robert, again, not to overstate the scale of it. As I say, when you look back at the numbers, the effect from a +2% growth to a -2% growth is SEK 3 million-SEK 4 million in one individual region. Yeah, it's important to keep it in context.
Okay, perfect. Also, on Region West, this patient database is acquired. Was that the deal done in November last year? Should we assume that this is sort of a positive for organic growth in Region West for the period up until October?
That's right. That's right.
Should we think about that?
You should expect to see some positive impacts, certainly through Q2 and Q3, and a little bit less after that.
Okay. Perfect. Yeah, maybe something on FX. I mean, it changed a lot in March. Yeah, we understand that the foreign profits get translated back to SEK, but are there any other effects we need to think about for Q2? Any impacts on, I don't know, margins or FX or net financials?
Yeah, you're absolutely right. The FX effect is mainly a translation effect, mainly a euro into SEK effect. As you say, the big effects actually do not come until Q2, Q3, Q4 this year, a little bit coming right at the end of March, Q1. I think the only other effect to note, but it is an effect that comes much more slow-moving and will come much later on in the year, is we do have a little bit of product sourced in dollars from the Far East. Obviously, the dollar is a little bit weaker as well. There may be some upside there, but much later in the year. Those are the two main FX effects. They also obviously have an effect on the financial net because of our debt position and some of our hedges.
In terms of the P&L, those are the two main effects.
Perfect. Thanks so much.
Thank you.
Reminder, if you wish to ask a question, please dial #5 on your telephone keypad.
All right. I think if there's no more questions, thanks a lot again for participating in this Q1 presentation.
The next question comes from Charles Weston from RBC Europe Limited. Please go ahead.
Please.
Hi. Sorry to ask right at the end there. Apologies, this is something that you talked about already during the IPO. I'm fairly new to the company. Some of your peers talked about med tech manufacturers moving some of their distribution away from direct in some markets to indirect distributors. I was wondering if you could comment on what you've seen in terms of that trend and also whether during that process, med tech manufacturers are consolidating their distributors to deal with multiple countries or even multiple regions rather than dealing with lots of different distributors. Thank you.
Yeah, thank you. This is a very good question where a lot of my focus is right now. I think this is a very positive addition to our growth story going forward. You all know that we have organic growth faster than the market, and we have this M&A growth. Over time, we're starting to see a clear trend that product companies, OEMs, instead of being direct in the country, go towards a company like ourselves that have a total service offering, know the customer, and can put a complete offering together with both knowledge and products. If we look at the US, which is a bit more consolidated than Europe, we see that a higher proportion of the solution provider sales has moved from a direct to an indirect distribution, which is in favor for Asker. We see that that trend is quite clear.
It's very slow at the moment, but it's very clear the direction. Over the mid to long term, this is a very attractive move, which is kind of release some revenue in the market. You should not expect a dramatic move in this, but it's something to give us a tailwind of this growth. The trend is clear. The pace is low, but it gives us attractive opportunities. As always, being the market leader as Asker is, you tend to be the one who people want to play with. We have a lot of inbound calls from OEMs in Europe right now that want to have a discussion of how the future looks like. Thanks for a very good question. This will be something that will be on the topic for years to come.
Thank you. Can I just clarify? Is that across all types of medical devices and supplies, sort of low-touch supplies versus high-touch, maybe high-end CapEx equipment? Would it be across everything?
Yeah. I mean, there's a clear kind of two-by-two matrix here. If you have a small country in Europe and you have a higher indirect distribution, if you have a large country like Germany, France, and U.K., you have a bit of a lower. There is kind of a sliding scale here that OEMs tend to be present in those markets. Larger market, higher degree of direct, smaller market. The other axis is supplies to very complex installations. I used to work at Getinge before and installed CSSDs in hospitals. I mean, we will not take on a project of installing a new hospital CSSD. That's something for Getinge to do with those large projects over two years of time. Having said that, we have products from the simplest commodities to very complex equipment as well.
There are very few areas of large equipment that we're not present in, but it requires more from a service provider as ourselves when you have a high take HSL as a good example. They are a very complex service provider with a high degree of service level. That's a good example where you successfully have gone with the OEMs to the market, and you are the one that meets the customer, and they're satisfied with it. You will see a gradual shift over time in this. Larger and larger market will come into play and larger and larger equipment. You will see at the end of this, in the end game, you will see this faster exponential growth in this area.
I've been part of this myself when I consolidated industrial supplies for 10 years, and I saw this quite dramatic shift at the end of the journey. Now we are in the beginning of the journey, but I see the tendency is very clear here, which is a positive thing for Asker.
Thank you. My second question, if I can, please, is around multiples on M&A. Again, not sure what you disclosed during the IPO process, but is there a range you've typically paid? What's the trend in that range? What does it depend on in terms of your target?
Yeah. We have a look at our target list, and we have done now 50 acquisitions. We've turned down maybe 100 cases. So we have a big pipeline of statistic data points, and we have paid in absolute mathematical median or average seven times EBITDA for these companies. We have a span of six to eight times EBITDA, what we usually pay. That's healthy levels where we have we will see no reason why this should change. We have been doing a lot of acquisitions previously in my life as well. When you buy companies of this size, of $100 million to $300 million, you play in a category where large private equity and large professional customers is hard to access.
The larger deals that are in process that are coming up to close to SEK 1 billion in revenue, then you see multiples moving because they get access to large capital. For us, we are usually having bilateral discussions. If we buy a small company in Switzerland, they know who the best player is in the neighboring segment, and they maybe know them for 10 years. When they are ready to sell, they want to come to Asker, both because they like Asker and our vision, and they have seen us taking good care of entrepreneurs. I will not foresee that these multiples are going upwards. I think there are counterbalancing factors of having Asker being a stronger and more attractive partner to them that also wants them to come here. It is very seldom that it is only price that is the matter for this.
Six to eight times is something where we see definitely in the midterm where we'll buy companies for.
Thanks very much. Congrats on the IPO.
Thank you. All right. With that, I think maybe we close this session. Once again, thank you so much for taking the time.
Thank you.