Today we have this presentation for you that will mainly be presented by Scott, and we will have a short business update, a short financial update, and open up for questions after that. With that said, welcome everyone, and I hand over to you, Scott.
Thank you, Jörgen. Good afternoon, everybody, and it's a real pleasure to be here today and to be talking about this great company that has a fabulous product offering and a fabulous history in taking care of patients. So where are we coming from as a company? You know, Integrum, you know, I'm from the US, and Integrum has an amazing opportunity in the US. I mean, you're looking at a lot of companies that can't get their products approved, they're struggling with cost of capital. Whereas we have a PMA for our OPRA and Axor products, and we have a long history in this company of leadership in science, leadership in clinical research, leadership in providing the right surgical training so the outcomes of the product are delivered accurately and with compassion.
And so we have a great platform to build upon, and we wanna talk to you, you know, we wanna continue to talk about that, but we also wanna give you a hint on what we are focusing on right now. So, Jörgen? So, you know, these are some of the highlights that we shared with our quarter, and you know, we remain a pioneer in innovative solutions for bone-anchored implants. Our OPRA system and our OPRA implant system is the only FDA-approved PMA for osseointegration. We've had good top-line growth, and we have a very robust pipeline.
And we have such a robust pipeline. We need to do some prioritization, but we think we're well-capitalized, and we have a proven track record of, again, clinical excellence and scientific innovation. So let's talk about walking the talks, as I like to say. What are we gonna do in the interim here to rally the troops and get this company focused? So on the left part of this slide, there was a tremendous set of vision and values that this company put together, and I will tell you that when you go and you meet with the people in this company, they are tremendously passionate about delivering this product to those amputees who wanna have an improved life. And there's a common theme here of purposeful leadership, and that's what you know.
And they really are very excited about this, and they're all in. They are all in on delivering this technology to patients. What we needed to help the team here is get a little more focused on delivering results and prioritizing where we play so we can win. So the first thing is, if you look at what objectives am I gonna start leading around? We wanna build an empowered and performance-driven culture. We wanna make sure that people understand what and when they need to deliver, and give them the tools to deliver that. We wanna drive to profitability. We wanna grow sales. We definitely wanna grow sales, but all sales are not good sales, and we wanna make sure that we have the right sales, and we put profitability into those sales, so they return margins, and we do it in an efficient manner.
Sales force productivity. It's very important that we drive a top-quartile sales results, but yet we leverage selling expenses every year. Now, we have a direct sales team, and they're all good people, and we just need to work very diligently with them to make sure they have the toolkit to succeed, they have the roadmap on how to sell the product. We just got to put some basic tools in place, and we've got to measure productivity and drive it. Finally, on the bottom of objectives is quality. Quality is overarching in everything we do. We have to have a quality systems, we have to have quality product, because we're putting these products in patients, and we're changing their lives, and we have to be dedicated to quality. So let's talk about financial goals.
We must demonstrate consistent top-line growth, sequentially and annually, and we've got to be that kind of a company that consistently delivers to expectations. Operationally, focus on invested capital. We must — you know, we got to be more return on invested focused. If it's a R&D project, if it's hiring a sales rep, if it's deciding to go into a country, we need to have a game plan and make sure that we are focused on what's this gonna return to us, and is the investment worth it? One of my favorite things is focused growth. I come from a culture of, if we go in a market, how do we win the market? And don't enter the market unless you have a way to grow it and become a leader in it.
So we're gonna get very focused about what countries we grow in and what products we launch to grow into those countries. So finally, the critical thing — three things that I'm gonna be focused on are sales force productivity, leadership, and product launch and portfolio. We have a lot of good ideas here, and my business professor in France always reminded me, "A great strategy allows you to say no to good ideas." So we have to be very focused on making sure we have a portfolio approach to launching products, and then launch with execution and excellence. Finally, if we do those two things in the near term, we're gonna return shareholder value, and we're gonna be focused on returning shareholder value and making sure that we're running the business profitably.
I wanna make one comment on the US because I had a number of questions on the US. This company has always done a great job of growing the US through orthopedic surgeon partnerships, and the resulting patients that they were able to pull in for implantation. Now, a number of things in the US that we have to do better at are, first, we have to do better at the prosthetists. To really grow top quartile growth, we're gonna have to get referrals from prosthetists, and we're employing some new strategies starting today to effectively. We've done some market research on prosthetists, and we're understanding what are the levers to driving their attention towards us, and we're gonna start working that aggressively. And we have good strategic partners in the prosthetic market, and that's important, too.
The last piece of this is we've had some. Because we work with the best surgeons in the US, we've had some of these top surgeons move to bigger positions, move from being chief of the cancer surgery unit to the chief of the total orthopedic unit. So we've had some churn in surgeon location, which was part of the offset in some of the cases we saw. And we also are experiencing, and this is actually a good thing, we have some insurance pushback, and we're putting some tools in place right now to deal with the insurance pushback. We're not having a challenge with Medicare or with Medicaid in the US, but it's the private payers that are pushing back.
Now, what we need to do with the private payers, it's just like, any other sales or marketing activity, we have to educate them on why this is such a game-changing technology for patients. And we have to get in there and make sure they understand that for those patients that are intolerant of socket prosthesis, that this is the best alternative for them, and it gets them ambulating again, and it gets them ambulating in the correct way, bone versus on soft tissue. Jörgen?
Thanks. Yeah, so a little bit of a — thank you, Scott, and a little bit of a financial summary. Of course, we're two-thirds into Q2 , so the most recent figures we have is from Q1. And as you may know, our Q1 ended up at SEK 18.5 million for net sales, in comparison to SEK 20.4 million for the corresponding quarter last year. And that meant a negative growth of 9.5% year on year. And the last quarter last year — last Q1 last year, we had an 18% positive growth. The operating profit, or the EBIT, was minus SEK 12 million, in comparison to last year's corresponding quarter, where it was minus SEK 2.9 million. Obviously, for both years, this leads to negative EBIT margins.
These are some of the highlights from Q1 this year. I guess now we turn to our Q&A.
Thank you so much for the presentation here. Let's start with the first question: Are you in a position to disclose why you're an acting CEO rather than a permanent one, Scott?
Yes, definitely. So we came together as a board, we made a decision, and I guess I'm the most relevant person with orthopedic experience on the board and was asked to step in. And I'm happy to do that because for three reasons. One, I want to make sure that this technology reaches more patients. There are more patients... We are just at the beginning of penetrating the TAM in the U.S. and other markets, and this technology needs to continue to move on. The employees of this company are great employees, so I want to make sure that we help them and give them guidance and continue that way.
But I also felt that for shareholders we needed to do some things to dramatically change what was happening in performance, and so I was happy to step in. Ten years ago, I would've jumped all over this. I don't know if I'd have moved to Sweden, but ten years ago, I would've jumped all over this 'cause it's such an exciting company and product line. But my number one remit from Bengt and the board is to find a world-class CEO to step in here and take over, and that's what I plan on doing.
Thank you. Would you consider becoming a permanent CEO?
I think I answered that.
But how does it work to build a team as an acting CEO while simultaneously looking for a permanent one? Could you give us some insight to that?
Yeah
Yeah. So, I have a really good friend of mine in the biotech business, and he always says, "Scott, you know, don't be the last man in the boardroom." But, you know, I've done this three times, and you ask a really good question 'cause it's not easy. Because, you got a group of people, you know, that's gone through change, and it's a sudden change, and you've had a dynamic leader, a leader that's brought true innovation to the orthopedic market. You know, when I talk to people about Integrum, the only thing that's been innovative in orthopedics for the last few years, outside of 3D printing, is robots, and this is true innovation.
So we have to step in now and spend time with them, help them get focused, help them understand that everything that they're doing is important. But we have to get them focused on the important activities and the important markets. So it's been done. We can do it. They also will understand that we'll deliver the type of leader that believes in the same things, and that's important.
... Thank you. You say that you're experiencing pushback from private payers. Is this related to implant, Axor II, or both of them?
Ah, great question. It's related to OPRA and the patient files for his insurance to cover it, and then they're pushing back, and in some cases, denying or asking for more, and we have to cancel surgery. So, that's a work in progress, and I've got the team on a solution on that right now, and we'll be able to report out how we're executing to that later.
Thank you. What's the three most important things Integrum will focus on in the upcoming six months?
Yeah, so, I'll revisit that again, so sales force productivity, and we have direct sales reps in the company, we have independent sales reps that call on orthopedic surgeons, and we have direct reps that call on prosthetists. We need to make sure that they have the toolkit they need to succeed. We need to make sure that they are focused on the right targets and the right geography, and they're carrying the right message to the surgeons, and it's. You know, sales productivity is like managing a factory. You've just got to make sure that you're putting the, you're getting the outputs you want, but you're putting the right inputs in, and then you're measuring it, and you're inspecting what you expect. Leadership, portfolio, and product launch.
We have some really good products to follow on OPRA. We just need to get focused about delivering those products and getting the clinical and regulatory work done and getting the products done. And taking that leadership in this market, we have physicians that want our products, and we need to deliver those. And if we do those two things, there's a dramatic margin hit and a dramatic sales expansion that's going to return shareholder value. It also gives us a place in the market where we continue to lead.
You know, we have OPRA, and then we come up with something else on top of that, and we continue to lead in that space through very precise product rollouts and having a great sales team that is not only out there communicating the right way and providing the right messaging, but really driving our brand and really expanding our brand in the minds of prosthetists and orthopedic surgeons.
Thank you so much. Regarding the strategic overview, when can we expect to hear something regarding this? It's been a year since it's announced. Is acquisition of the company any option?
Great questions that I can't answer. I won't speculate on anything on the second part of that. But on the first part, you know, the board entered into a strategic process. We're looking at a number of things around how we enhance scalability through partnerships, and we'll continue to look at those. And when we have something to report, we'll report it out.
Thank you. What is the biggest challenge going forward? Is it to expand business with existing hospital, finding new hospitals to adapt OI, or finding or identifying patients?
That's a really good question. I think that, I think, and I know that a number of the team believe, and we're working on this now. We've trained 38 centers in the US on how to implant our product, and we have really good orthopedic surgeons. None of those facilities are at capacity, and we think that by working with prosthetists and partnering with prosthetists in the regions around those facilities, we can help get patients into those facilities for surgery. It's identifying patients. Now, I think what we have to be is very thoughtful and smart about how do we identify patients. We need to first partner with prosthetists and hospitals, and then we need to use money smartly on helping them co-market to patients.
But we're not going to go out and do some big, expensive, direct-to-consumer program, and that we can't measure or don't know that's going to work. We're going to be very smart about how we deploy dollars and take the lead with prosthetists because they want to partner with us in getting patients to the right surgeons.
Thank you. The recent underperformance of the company caused a dramatic drop in the share price and market confidence. What are you planning to do in the short and long term to restore shareholder value and market confidence?
We're going to try to do what we say we're going to do, and we're going to show you that we're serious about delivering the kind of results that you would expect in an emerging growth company like this.
Thank you. A lot of questions are about sales here, but what specific initiatives are you driving to improve the sales force productivity?
So let me just answer that this way. We've just done a market research program with prosthetists, and we've uncovered what they want to see more from Integrum and what they need to be more confident in sending patients our way, so we're going to take that data, we're going to put that data into sales activities, and we're going to then look at our organization, and you know, we just recently raised money, and the specific purpose of raising money was to invest in sales and marketing, and we're going to look at our organization and say: Is it organized the right way to take full advantage of selling and marketing to prosthetists? So that, I would first start with a look at the organization.
making sure the organization has the right tools, and making sure that we have the right messages for the prosthetists, so they're educated, and they understand how to partner around OI, and they believe that partnering with Integrum is a good thing for their business.
Thank you. Statistics suggest that July is the most common vacation month for surgeons in the US to be on a vacation. Could the soft Q1 results have also been affected by holidays and fewer surgeries performed in general?
It might have been a piece of it, but I don't think it was the major piece. I think the three things I discussed earlier were more drivers than that piece.
Thank you. A question to you, Scott. Why don't you own any shares in Integrum?
I have a desire to own shares. I'm trying to find the right time opportunistically to do that, and I'm working with my chairman and the remuneration committee around when we do that. I do have some options.
Thank you. Hanger has 40,000 SKUs. How will you become relevant to Hanger when their product range is so extensive, and they likely have a good margins on several products already?
We enjoy a great relationship with our prosthetic partners, and they have lots of products, and one of the things we have to do is educate, educate, educate, how bone-anchored prosthesis, osseointegration, fits into their practice, why it's important.
Mm-hmm.
Why it's interesting. Some of the things we've learned is that prosthetists wanna be. They wanna look to being part of orthopedic surgeons' practices. They wanna be more involved in being better educated. So we're gonna take all of our learnings, and we're gonna put that into a strategy, and we're gonna make sure and come up with a program where we differentiate ourselves.
Thank you. So, is it correct that your sales efforts are mainly directed toward the prosthetists?
Our direct sale. So the direct employees of the company are mainly focused on prosthetists. We do, however, have contracts with a number of independent orthopedic sales reps. They could work for Smith & Nephew, they could work for Onkos, they could work for Zimmer or Stryker. And these independent sales reps will go in and service orthopedic surgeons and hospitals as they do other products, and that is really the most cost-effective way to service the orthopedic side of the business, 'cause these people are very well trained, and they know how to do case coverage.
Thank you. Moving on here to our last question we received there. Are sales ramping up in the US right now?
I can't answer that question right now.
We'll come back to you on that.
Yeah, I understand. That was all the questions we have received, so I wanna thank you for presenting here, and thank you all for tuning in and sending us questions. Have a nice day.
Thank you. Thank you, guys.