Good morning and welcome all. I hope you are all well and that you are also staying safe as the pandemic has unfortunately started accelerating again across the world. We go to the next slide, please. The third quarter was the weakest in several years for Bactiguard, and I am not satisfied. External factors have clearly had an impact on development, as COVID-19 has led to a reduction in general healthcare and elective surgery, and this has affected both us and our licensing partners. The demand for medical devices, including our catheters, has been very low. At the same time, the global backlog in healthcare is accelerating, and the need for infection prevention is greater than ever. Bactiguard products save lives, and we can do better than we did in the third quarter. We should have shifted gear much faster, and therefore, we are focusing on our sales strategy.
During a transition period, the sales organization will report directly to me. We now go to slide three, please. Let's look at the numbers. Sales declined by 49% and 46% if we adjust for currency to just over SEK 30 million. The third quarter of 2019 is, of course, a tough benchmark as we signed the biggest licensing deal since 1995 with Zimmer Biomet in September of last year. Having said that, license revenues from Becton, Dickinson and Company, BD, have been stable for many years, but their sales are not immune to COVID-19 either, which has resulted in lower license revenues for Bactiguard. Based on a stronger order intake at the end of the third and the beginning of the fourth quarter, we expect that BD revenues will return to more normal levels in the fourth quarter.
BIP sales increased somewhat in the quarter. Not at all in line with our ambition. The consumption of consumable medical devices, like our catheters, has been very low in all regions as a result of the focus on COVID-19 patients. The broader portfolio acquired from Vigilenz contributed to a small increase in sales. Our EBITDA was also affected by the decrease in revenues and a weaker SEK than last year. Let's now turn to the picture number 4 and focus on licensing. The collaboration with Zimmer Biomet continues with very high intensity. This is very encouraging. We are using the fast track to the European market that opened when the new European regulatory framework, which some of you know is called MDR, was postponed by a year until May 2021.
This means that we can use our existing CE mark for orthopedic trauma implants to reach the European market already at the beginning of next year. The milestone payments that are in the agreement with Zimmer are linked to the U.S. registration process, and that is also ongoing at full speed. It's a little behind Europe, as we are determined to use the current window of opportunity to start generating recurring sales. From the beginning of next year, we will have two recurring revenue streams in our licensing business, and that is the one from BD and from Zimmer Biomet. Our agreement with Well Lead is also moving ahead, and the fact that trade barriers are increasing supports our decision of localizing production in China. We are confident in the strength of the Bactiguard technology for various types of medical devices, both for short-term and long-term use.
We have several interesting license projects in the pipeline and see new existing business opportunities. The strategy of establishing one to two new licensing deals per year remains unchanged, with focus on orthopedic and dental implants and different types of products for the bloodstream. For example, dialysis catheters in the near term. vascular stents is another interesting area, and animal studies are currently ongoing at the Karolinska Institute. The purpose of this study is to verify that Bactiguard's technology not only reduces the risk of infection, but also prevents thrombosis, which reduces the need for taking blood-thinning drugs. The commercial negotiations in current projects are a bit slower than usual due to budget constraints caused by COVID-19, but we are convinced that the products and studies we are involved in will pave the way for new licensing deals. Let's turn to page five, please.
Media reports that the number of planned interventions in the U.S. decreased by 60%-80% during the summer months. In Stockholm, a 50% drop has been reported. Add to that 25% fewer cancer cases were diagnosed in the Stockholm region, this doesn't mean that we have become healthier, simply that we are pushing an accelerating healthcare backlog ahead of us. Let's turn to slide six. Many countries continue to have far-reaching restrictions and some are introducing new restrictions, the U.K. most recently today, making access to hospitals and day-to-day sales difficult. The fact that physical meetings can't take place as normal means that we and our distributors must develop our digital presence and communication at a much faster pace. One example of new opportunities is that the Indian government has established an e-commerce platform for medical devices.
We have already registered Bactiguard's central venous catheters and are now waiting for the urinary catheters and endotracheal tubes to be listed and more accessible to the healthcare provider. Another example is that we are conducting training of healthcare professionals and participate in panel discussions with key opinion leaders digitally to strengthen our brand and awareness. You can see that our Chief Medical Officer, Dr. Stefan Grass, can travel across the globe without getting on an aircraft. Let's turn to slide seven, please. The global launch of HYDROCYN aqua is well underway, but tender processes and local regulations means that it will take some time before sales seriously take off. The strength of HYDROCYN is that it's proven effective against the virus that causes COVID-19. It's also effective against most bacteria, viruses, and fungi that lead to infection.
At the same time, it is tissue-friendly and contributes to faster wound healing, making it useful for wound care, dental, baby, and animal care, to name a few potential line extensions. HYDROCYN doesn't sting, nor is it flammable. That makes it superior to alcohol-based alternatives. Let's turn to the next slide, please. We increased the pressure in our own sales organization to make Bactiguard more visible and influential. Our product should be the obvious choice for infection prevention and established as a standard of care like it is in the U.S. To strengthen our communication and marketing, we are expanding our management team with Petra Kaur Ljungman, who has successfully developed several companies, brands, and digital strategies. At the same time, we have initiated the recruitment of the new global sales director. We are adapting the regional sales team to local conditions.
You can also see here that we have recruited a new general manager for the Nordic market who will focus on the healthcare providers, home care providers, pharmacies, B2B, and B2C segments, and he has had a flying start in the months that he has been with us. Following the acquisition of Vigilenz, we have also recruited a new general manager for Southeast Asia to lead our sales team in Malaysia and also to manage our distributors in the region. During the period that we're recruiting a new global sales director, I have temporarily taken over the responsibility for leading the global sales team to increase the sense of urgency. With that, I would like to hand over to Gabriella for a financial review.
Thank you, Cecilia. Next slide, please. Good morning, everyone. This is our business model. The strength of Bactiguard is our technology, which can be used for a variety of medical applications. We have two business areas, the licensing business and our own Bactiguard Infection Protection Products, also called the BIP portfolio. To the left, you can see the licensed business. We license our unique technology to other medical device manufacturers. This business generates upfront revenues at signing. This is what we call new license revenue. Then we receive royalty on the sales going forward. To the right, we have the BIP portfolio with our own products of medical consumables for infection control. With the acquisition of Vigilenz in the second quarter, we have added two new product lines, advanced disinfection and advanced wound care.
Our product portfolio is sold mainly through distributors. Now in the new sales strategy, we are further strengthening sales with our own sales force. Next slide, please. To summarize the third quarter, we have a negative EBITDA of SEK 3.1 million. This is driven by the low revenue of SEK 34.1 million compared to previous year, SEK 67.2 million. We are monitoring the cost closely, and we have good cost control. As Cecilia has already mentioned, the underlying reason for the low revenue is that the healthcare has focused on COVID and other activities are postponed, and the number of canceled elective surgeries is increasing, and thus also the healthcare debt. This is not only impacting our own sales, but also sales for other distributors and licensing partners.
The difference comparing the Q3 with Q3 2019 is that we had new license revenue from Zimmer Biomet regarding the orthopedic trauma implants, which was not repeated in Q3 2020. This is the yellow part of the bar in the diagram. The strategy of establishing one or two new licensing deals a year remains the same. Even though COVID-19 has had a negative effect on revenues during the second and third quarters, we have a stable revenue stream from BD, our licensing partner of 25 years. That is visualized in the blue part of the bars. The revenue from BD varies slightly between the quarters, and due to COVID, this quarter we see a 20% decrease compared with Q3 2019. On a yearly basis, the revenues from BD are about SEK 100 million.
Sales of our own products, that is the BIP portfolio, have been approximately at the same level between 2018 and 2019. As a result of the Vigilenz acquisition earlier this year, the extended product portfolio contributes with a more stable revenue flow in the rolling 12-month analysis. Looking forward, we see opportunities in the product development area. Next page, please. For the third quarter, the revenue totals SEK 34 million and EBITDA negative SEK 3.1 million. Looking at year-to-date, the revenues total SEK 130 million, which is slightly lower than the actual from previous year, and this is without any new license revenue. It shows that with the acquisition of Vigilenz, we have a more stable underlying business, and we are reducing our dependency on individual customers and markets. EBITDA year-to-date landed on SEK 21.8 million despite of the negative third quarter.
Following the EBITDA margin year-to-date was 17%, and for the third quarter isolated - 9%. The net results year-to-date of -SEK 27.6 million is related to depreciation of the technology by SEK 6 million per quarter according to plan. Furthermore, the value of our technology increases as we sign new license agreements and also when we have increased sales of our own product portfolio. In addition, we have a technical accounting effect of negative SEK 10.9 million linked to the acquisition of Vigilenz, where the setoff is reported as a forward contract in the first quarter. Neither the depreciations nor the setoff impact the cash flow. Next slide, please. As you can see, this is an overview of our cash flow. I should start by mentioning that in Q2, new shares were issued as part of the payment for the acquisition of Vigilenz.
For the third quarter, we had a negative cash flow of 3.3 million SEK caused by the weak revenue development. At the end of the third quarter, we had utilized 13.9 million SEK. The available liquidity, including credit facility, amounted to 35.5 million SEK compared to 36.6 million SEK same time last year. To summarize, looking forward, we are confident that our technology will play an important role in addressing the postponed demand of medical consumables for infection prevention, a situation due to the COVID pandemic. Over to you, Cecilia.
Thank you, Gabriella. Let's now turn to the next page. COVID-19 affects all of us, and we unfortunately see a second wave of the pandemic around us, which makes near-term development difficult to assess. What is becoming increasingly clear is that the need for infection prevention has never been greater. Although the current situation is tough, the pandemic has made Bactiguard even more relevant. Our job is to convince the market that Bactiguard's product and technology can help reduce the risk of infections and serious complications for patients, shorten the treatment period, and reduce the use of antibiotics. The antibiotic resistance is often referred to as the silent tsunami, and I think that gives a very good image of what it is. It lurks in the background. It is very serious, but we don't give it enough attention. Bactiguard's technology is effective and safe in reducing infection.
It is well documented and clinically proven, which gives us a competitive advantage when the regulatory requirements increase. This morning, we reiterated our growth strategy, which is very clear. Our aim is to convert ongoing license partnerships into recurring sales. The Zimmer Biomet agreement for trauma implants, to take one example, has the long-term potential, which is three times the size of our BD business if all their trauma implants are coated. This will, of course, take time, but it gives you an idea of the potential. In addition, we aim to sign one to two new license agreements a year. The near-term focus is on orthopedic and dental implants, as we already have clinical data and products approved for long-term use, supporting expanded use of our coatings for new applications. We are also targeting different types of products for the urinary tract, bloodstream, and airways for the global market.
Bactiguard's own portfolio for infection prevention continues to grow through the development of new products and new areas of use. In 2020, we have added advanced disinfection and wound care through the acquisition of Vigilenz. We now have a much broader base and better market coverage in Europe, the Middle East, India, Southeast Asia, and China. To accelerate growth, we invest in sales and marketing and take a step forward in the value chain in order to better control activities and priorities. Let's turn to the next page. Based on our growth strategy, which I've just outlined, our unique technology for infection prevention, a scalable business model, broader market portfolio, and market coverage. We reiterate our financial targets for the coming five-year period. Our ambition is to grow sales by 20% per year on average and generate an EBITDA margin of 30%. Let's turn to the finance slide, please.
I am the first one to admit that there are challenges out there, but I can't see a better mission and better business opportunity than infection protection in this time. Thank you, and over to you, operator, for questions.
Thank you. If you do wish to ask a question, please press zero one on your telephone keypad. If you wish to withdraw your question, you may do so by pressing zero two to cancel. There will now be a brief pause while questions are being registered. Our first question comes from the line of Mattias Vadsten of SEB. Please go ahead.
Yes. Hi there. Three questions from my side. I guess we can take them one at a time. Firstly, you comment on proactive measures to bridge this temporary decline. Would it be possible to just elaborate a little bit on this and to what extent this can help?
Yes, of course. Thank you, Mattias. To name one, we are pushing expanded use of HYDROCYN, both in the Swedish market. We had a bit of a low period in Q3. As you all know, we entered into major agreements or signed major deals in Q1 and Q2. We have had a lower level of activity in Q3, which we are now accelerating again with focus on both B2B and B2C clients. We are working on signing up new distributors and pharmacy chains so that our product will be available to more people. We are also signing distribution agreements in other markets and pushing sales in other geographies and introducing the wound care products in the European market.
In Southeast Asia, we are both pushing the Bactiguard portfolio in Malaysia, where we have our own sales force, and we are targeting those distributors across the region who have the best potential of both expanding Vigilenz sales, but also sales of the Bactiguard portfolio. Of course, increasing our digital presence so that we can meet customers even though we are not physically able to meet them face to face.
Thank you very much. My next question, you comment that order intake from BD at the end of Q3 and in the beginning of Q4 improved, and that sales will return to normal levels in Q4. Just elaborate a little bit on under what assumptions this is made, and it would also be interesting to hear what you think one can hope for in terms of sales in other geographies in coming quarters, given what you initially have seen now appearing in Q4.
Yeah. As you know, Mattias, we don't make forecasts, but I'll still try to elaborate a little bit to give you some idea. The BD license revenue is, in a normal year, about SEK 100 million. If you look at the year-to-date numbers, it has been lower than that, although we had a strong first quarter. In the fourth quarter of last year, we made substantial deliveries which were above. Order intake and deliveries vary a bit between quarters. To say that on average about SEK 25 million per quarter is a more normalized level. Then as regards the other business, the BIP portfolio and sales, the acquisition of Vigilenz has added a broader base, which gives us recurring sales of sutures and wound care products in Southeast Asia. We are now seeing increased activity in some regions.
To mention one, the Middle East, where the private hospitals were effectively closed for admissions until September. We are now seeing that they are opening up, which has given us confidence that we will see increased activity. Even if COVID-19 continues for a relatively long period of time and hospitals need to give attention to ICU patients, we cannot see a situation that we continue to put off elective surgeries and cancer treatments. The healthcare system has to return to a somewhat normalized level.
Yes, just on that topic, if we see a pent-up demand coming after when the COVID-19 situation eases a bit, how well is Bactiguard prepared to deliver on a potential stronger demand, a sort of a quick pickup when it eases up a bit?
We are getting into the starting blocks for doing that. We cannot maintain huge inventory, so we stay in very regular contact with our distributors to forecast demand and to prepare our production accordingly.
Thank you very much. Very clear. That was all from me.
Thank you.
Just to remind everyone, if you would like to ask a question, please press zero one on your telephone keypads. We'll now have a further pause while any questions are being registered. There are no further questions at this time. Please go ahead, speakers.
Thank you, operator. Thank you all for listening in this morning. I know that there are a lot of companies reporting today, so I think it's a busy day. I'd like to conclude by saying that our growth strategy is the same. It's to generate recurring license revenues from our current partners, to add new license business, and to grow sales of our own portfolio for infection prevention. We are convinced that we will make that happen. With that, I'd like to conclude today's call. If there are any follow-up questions, please don't hesitate to contact either me or Gabriella. Thank you.