Welcome to the Bactiguard Q1 conference call. For the first part of the conference call, the participants will be in listen- only mode. During the questions and answer session, participants are able to ask questions by dialing star five on their telephone keypad. Now I will hand the conference over to the speakers, CEO Anders Göransson and CFO Carin Jakobson. Please go ahead.
Welcome everyone joining in today's call, where we will share our Q1 2023 results. I hope you had a chance to browse through the report as I now will give you the verbal presentation commenting on the quarterly figures and the strategic focus ahead. As usual, Carin Jakobson, our CFO, and I are available for questions after the presentation. Looking at Q1, it was a continuation of a very transformative 2022. We continue to invest in the organization, as well as positioning Bactiguard to capitalize on the vast opportunities behind the global healthcare trends. We see positive effects of the transformation and remain focused on ensuring we have an organization truly equipped and geared for future growth. Go to slide two.
Before we dig into the stats and figures of today's presentation, I want to put Bactiguard and our business into broader context from an issue to market opportunity perspective. We see globally an increased interest in and awareness of the importance of prevention, both in terms of healthcare associated infections and antimicrobial resistance. Let me give you a couple of examples of reporting and conversations over the last quarter. One is in early March here in Stockholm, a high level conference took place with a focus on combating the threat of antimicrobial resistance. It was hosted by the Swedish government as part of the ongoing Swedish presidency of the Council of the European Union. One of the key themes of this was prevention, and of course, Bactiguard was represented as a part of the interactive presentation materials on what you can do with our technology.
Second example is that much of the debate around antimicrobial resistance includes the need for new antibiotics to treat infections, but there's less buzz around how to actually avoid using antibiotics. Again, we're happy to see that the WHO in the recent published draft of people-centered framework for addressing AMR in the human health sector puts prevention as one of the four key pillars. On prime time Friday night a few weeks ago, the importance of preventing hospital- acquired infections made it to the major evening news program here in Sweden, Rapport, which reported on a hospital in southern Sweden that had invested significant amounts to achieve cleaner air in their operation rooms with the aim to decrease infections. A great initiative that shows the importance of reducing hospital- acquired infections.
There is more one need to do, as up to 60% of the healthcare associated infections is due to bacteria adhering to medical devices such as catheters and implants. This is of course if you're using uncoated devices. Go to slide three, please. You may recognize this page from previous quarters, but the global macro trends remain the same and are as pressing as always. I know I've repeated this many times, but one out of 10 patients globally are affected by healthcare associated infections, which means you enter a hospital for treatment and acquire a new infection while under care, often caused by bacteria adhering to medical devices that are part of the treatment. An interesting fact is that this relation is roughly one in 25 patients in the U.S. because it's a market where infections, and more importantly, prevention of them, are taken much more seriously.
I will come back to the importance of the U.S. later in the presentation. These trends are clearly gaining momentum on the agenda of decision makers across the globe, which makes the potential for Bactiguard even brighter. On the right-hand side, you see the market opportunity for Bactiguard. Firstly, we target the market with our technology and solutions, which has a market size of $80 billion. Secondly, our key therapeutic areas are at the core of our growth strategy and where we focus our efforts, such as deepening current partnerships, for instance, like we did with Zimmer Biomet within orthopedics, and gaining new, like our development agreement with Dentsply Sirona, our first inroad into the dental field. At the center of all lies preventing infections.
Being an important part of solving global healthcare issues, clearly the potential for our technology and solutions to make a real positive impact is huge for patients, for healthcare institutions, their budgets, and for a healthier world. If we go to slide five and dig into the financial of the Q1 of 2023. As I began today's call, looking at Q1, it was basically a continuation of a very transformative 2022. We focus on strengthening the license business further. This is where our strongest potential lies, and have a strong sense of urgency for transforming while also appreciating the longer-term character of our business model and how revenues evolve over time. I will revert to that in a few minutes.
Revenue in the quarter was SEK 61 million, which was an increase of 11% compared to Q1 2022, though when adjusted for currency effects, it was down 4%. EBITDA for the quarter was SEK -6.6 million compared to SEK -4 million last year. Operating cash flow amounted to SEK -8.8 million for Q1, compared to SEK -12.9 million in Q1 2022. Finally, the key events in the quarter, which I'll come back to later as well. First, we appointed Mikael Sander as Head of Bactiguard Product Portfolio, and he joins Bactiguard management team. Zimmer Biomet achieved regulatory approval for the trauma orthopedic implant, ZNN Bactiguard in Japan, which is an important step towards the commercial launch in Japan. That also means we now have two Bactiguard coded products approved in Japan.
We launched our wound care product in the U.K. and Ireland. As announced in January, we achieved a key regulatory milestone with our first MDR approval. MDR, which stands for Medical Device Regulation, sets new higher standards for medical devices in Europe. If you go to page six, please, and look at the financial overview in a little bit more detail, there's a couple of things to highlight. Total licensing business was up 8%, reaching SEK 39.4 million, and our own Bactiguard Product Portfolio was up 6% to SEK 16.3 million. When adjusted for currency, both were slightly negative or flat. EBITDA for Q1 2023 was SEK -6.6 million, corresponding to an EBITDA margin of - 11% compared to our last year's EBITDA of SEK -4 million.
This is mainly impacted by lower gross margins and higher cost for personnel. We're in an investment phase, which we started last year when we kicked off our growth strategy and started our transformation journey. This work continued in quarter one, 2023 with increased focus on the license business related to technology development and regulatory, also within the BPP. Our depreciation costs are stable and mainly related to depreciation of our technology, leading to a net result in Q1, 2023 of SEK - 22.1 million , compared to SEK -6.5 million last year. If you go to slide seven and look at our rolling twelve-month revenue. You can see that over the last year, we have had a strong momentum in revenue growth, rolling twelve-month revenues are at an all-time high. Obviously, supported by positive currency effects.
Look at the blue bar, which is our recurring license revenues from commercialized license products. You also have some initial contributions from Zimmer Biomet in the form of royalty on sales on their ZNN Bactiguard trauma implants in Europe, as well as the contract manufacturing we do for them. The yellow bar in the chart is new license revenue and shows the non-recurring revenue streams that we receive from our license partners, most often prior to commercialized product. We do significant development work before they launch a product. It's not until commercial launch we start receiving royalties. The development projects are different depending on the scope and complexity of the materials to be coded. These revenue streams also include exclusivity fields, milestone payments, and development or other type of product-related fees.
As you see in the yellow bar, the revenues from development products are showing good momentum over the last year, both with Zimmer Biomet related to their broader portfolio beyond trauma and Dentsply Sirona. It is important to bear in mind that the nature of our business is long-term. Development products and technology development take time, and revenues are generated and increased over time. Revenue also changes character over time, from development and milestones revenues, the yellow bar, to royalties, et cetera, in the blue bar once products are commercially launched. Resilience is obviously key. I will come to the revenues from our own Bactiguard Product Portfolio, BPP, the green bar on this page, in a few minutes. Go to next slide, please. In Q1, BD revenue was up 16% compared to last quarter one, including positive impact by the strong dollar.
Revenues from our partnership with BD have been strong for five consecutive quarters. They comprise of two parts. First, concentrate for the manufacturing of coated catheters. Two, royalties based on the sold volumes. This is the fifth quarter in a row with very high concentrate shipments to BD. They have now built a significant stock in-house. We expect concentrate volumes to be lower in the coming one to two quarters. While royalty revenue is expected to be relatively stable. BD remains one of our biggest and most important strategic partners. Looking at the Zimmer Biomet trauma partnership with ZNN Bactiguard, all is progressing well. The regulatory approval of ZNN Bactiguard in Japan was an important milestone, being a 1st step towards a commercial launch in a market where preventing infections is a high priority.
The development product with Zimmer Biomet on the broader orthopedics portfolio is progressing according to plan and generated some development revenues in Q1. Compared to last year, it was significantly higher then as we received sign-on and initial development fees, which will not appear to the same extent in 2023, as the development phase is now moving from coding development to evidence generation phase, which Zimmer Biomet drives themselves to a larger extent. Development fees from Dentsply Sirona were about SEK 1 million in the quarter compared to zero last year, as the agreement was only initiated in Q2 last year. The development product with Dentsply Sirona is progressing, the initial development phase will take longer than both parties anticipated at announcement in April last year. Part of the reason is that the coding development for some of the materials are taking longer than initially planned.
The new license business is the key building block, and together with the recurring businesses, the foundation to continue the growth to meet our long-term goal. If we go to slide nine and deep dive into our own Product Portfolio. Firstly, it's great to be able to announce, Mikael Sander has been appointed Head of Bactiguard Product Portfolio and a member of Bactiguard's management team as of April. His focus will be on operational excellence within BPP and look at areas such as supply chain optimization, distributor and sales excellence, just to mention a few. Mikael brings to Bactiguard a multitude of experience from the global MedTech industry. Most recent, before joining Bactiguard, he worked at Dentsply Sirona, where he was responsible for Dentsply's global digital implants business.
Previously, he held other roles at Dentsply as VP Sales, General Manager in North America based in Boston, and VP of Business Development. In addition, he has experience for both commercial, supply chain, and management roles in operations, finance, and business developments at AstraZeneca and Astra Tech. If we look at the revenues from BPP, we have a modest growth of 11% in Q1. With continued good momentum in India and the Nordics, where we have invested, but it's not enough to offset lower performance in other markets. Clearly, we have not yet achieved the acceleration we wanted globally, but we remain focused on strengthening our sales team structure and offering. Another highlight of the quarter was the launch of Bactiguard Wound Care in the U.K. and Ireland. U.K. is one of the leading wound care markets in the world.
We're investing in wound care to build a market position, and there's a lot going on. For example, in April, in the specialist publication Wounds International, there was a deep dive on the Bactiguard Wound Care product line and how it works to improve wound healing. This publication is very timely in light of EWMA, European Wound Management Association's annual congress, which is the biggest wound care event in Europe, which takes place next week. We will have a large presence, which includes hosting two scientific symposia on wound management, as well as gathering our second global wound care advisory board with leading wound care specialists from key markets across the globe. It's really exciting times for our wound care portfolio. Finally, the very important MDR approval of the latex BIP Foley Catheter, which we obtained already in January.
This approval is not only a product approval, it manifests that Bactiguard's quality management system fully complies with the rigorous MDR standards. This is truly competitive advantage for us, both in licensing and for future BIP products regulatory approvals. If we go to slide 10 and look at our financial position. The key point is that we have a strong financial position, which enable us to do the investment necessary to enable growth in our strategic therapeutic areas and focus markets. As you can see in the chart, we have a total cash and overdraft facility of SEK 217 million. The cash flow from operating activities, which is the line in the chart, was SEK -7.7 million in Q1, compared to SEK -11.9 million last year.
The cash flow from operating activities varies quarter -by -quarter, which is a result of large payments, sometimes non-recurring from license partners, as well as seasonal variances and business performance. If we look at our key priority for 2023 on page 11, we have divided them into five areas. First, strengthen our license business, which means both deepen current and initiate new partnerships. We continue our efforts to further strengthen this, the license business, which is where the biggest potential for Bactiguard lies. The pipeline of potential license partnerships is strong, and the goal to sign one to two license agreement per year stays firm. Technology.
This means developing how we apply our unique infection preventing coating technology in existing partnerships, as well as to develop our technology into new license partnerships for new device areas. BPP, as stated earlier in the presentation, we are on this priority, where Mikael Sander joins us to really take next steps towards operational excellence within the BIP product portfolio. Last but not least, the U.S. focus, which we have defined in two areas. First, further develop our go-to-market strategy for our technology in the U.S., either through collaborations with current or future license partner or with distribution partners. Most important for us and our highest priority is to gain FDA approval for more products coated with BIP's infection prevention technology. What we've done to address this is that during the year, we have strengthened our internal expertise within FDA approval procedures.
We have initiated multiple processes for multiple products with different FDA departments. The aim is to define the best pathway and the regulatory package required for each device. Depending on the outcome of those discussions, we will get more clarity on timelines. This combined will be both key drivers and prerequisites for achieving our future growth and profitability. If you go to next slide, you can see that we have three key growth drivers to deliver on our long-term goals. First, the basis for our growth is our existing license contract with BD, and especially Zimmer Biomet, where we anticipate significant growth in the future, triggered by two key events. First was the U.S. approval of trauma implants, and especially if BIP becomes an embedded feature in some key product lines.
We see new license agreements in our focus areas, which will contribute to our future growth, both through initial non-recurring fees, but most importantly, royalties once products are commercialized and launched. Our own product portfolio of infection prevention catheters and wound care product, where the focus is to get our products to more patients in key global healthcare markets, including the U.S. We're not excluding smaller M&As, similar to the acquisition of Vigilenz in 2020, to further accelerate our growth and provide effective and safe infection prevention across the globe. Are our financial goals aggressive? Yes, but the opportunities we're going after are vast. The priority areas have an $80 billion market opportunity, as mentioned in the beginning.
Our bold vision is to champion a healthier world by preventing infections, we generally believe that we, BIP, can make a real difference and be part of solving some of the toughest global healthcare challenges. Before handing over to the operator, I would also like to acknowledge an initiative driven internally in the aftermath of the earthquake in Turkey and Syria in February, where we were able to donate critical products like central venous catheters and endotracheal tubes and our wound care products to help aid the people in need following the disaster. I wanted to thank our staff members that were involved and went above and beyond to make this happen. Thank you. With that, thanks for listening, and I now hand it over to the operator, and Carin and I are ready for questions on the line.
If you wish to ask a question, please dial star five on your telephone keypad to enter the queue. If you wish to withdraw your question, please dial star five again on your telephone keypad. As a reminder, if you wish to ask a question, please dial star five on your telephone keypad.
If we don't have any questions, don't hesitate to reach out to us directly, and we'll take those offline. With that.
There are no more questions at this time, so I hand the conference back to the speakers for any closing comments.
If there are no questions, don't hesitate to reach out to me or Carin, and we'll take those offline. With that, I want to thank you for joining today's call and look forward to staying connected going forward. Thank you, everybody.