Welcome to the Q-linea 2023 Q4 report. 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 pound key five on their telephone keypad. Now, I will hand the conference over to CEO Jonas Jarvius and CFO Christer Samuelsson. Please go ahead.
Thank you very much for that introduction. So, happy to have you join our Q4 report for 2023. As you can see also on this first slide, we also have Stuart Gander, our president, coming in from March first, and he will have the opportunity to present himself to all of you during this call. Having said that, I'll suggest we move on to our disclaimer slide in case me, Christer, Stuart could make any forward-looking statements during this call. But, after you read that, let's focus on the main topic for this conference. So when we look at the highlights, really, for this call and for this year, I would say overall, I think we have seen a lot of activities happening throughout this time.
I will actually use the opportunity to look back on 2023, which was a very important year for us as a company, and talk a little bit about it from basically January first up until the last quarter, and also into the first part of this year. I think the key message here was that during last year, we started off basically in Sweden. We have built a strong partnership network in key geographies within Europe. We have really also started commercial-focused companies in U.S. and in Italy, and we have really been active in performing ASTar evaluations, both in Europe, primarily Europe, but also in the United States.
As we see today, we can see that these results are coming in very strong, and we also see that they are now moving and triggering an increase in tender activity early this year. Another important priority for us last year was to start our health economic study. That was started in Italy beginning last summer. We are going to present the interim results on this at AMCLI, which is the big Italian infectious disease conference on March ninth. If we look at the period end, I think the most promising part was that we could announce our first tender win in Italy, and we could see that ASTar was really technically superior to other competing offers into that tender.
But of course, although that we have seen in these evaluations that ASTar has been a very strong and very competitive product, we're not standing still. So we can also announce just off the period end, that we could extend our offering in the Gram-negative panel with adding of meropenem/vaborbactam, which is a very important combination antibiotic for patients with severe resistant infections. We've also talked about FDA review and clearance of ASTar in the U.S., and I will come back to that, but we clearly see that we're coming closer to sort of the final line in that race.
Another part that we think might also be of importance for the U.S. market is that we have submitted for New Technology Add-on Payment, so dedicated reimbursement for the U.S. market and ASTar, and we plan to submit that during the first quarter. We'll come back to that during the call as well. Another very important part, of course, is that as we have moved through our development path, we have made ASTar competitive product. We have completed our clinical studies in Europe and U.S. for the Gram-negative Panel, and we see that we are refocusing, repurposing the company towards, of course, a more commercial-oriented operation.
That is, of course, one reason that Stuart is coming in, and he's going to tell you a little bit more about his background and why we think that that's a very good handover from me to Stuart. But it also means, of course, that we are looking at the funds available, and with this restructuring program, we can see quite a significant cost savings of around SEK 50 million on an annual basis, coming into full effect, second half of this year. So with that, I will present Stuart Gander to you and give the word to you. So welcome, Stuart.
Thank you, Jonas, and appreciate the chance to introduce myself to everyone on the call. So few words about my background, and a little bit how I think about it, stepping in now at this very important stage to Q-linea. So I'm Canadian by birth and upbringing, was educated in business administration and finance, Queen's University in Canada, and moved to the Nordics more or less directly afterwards in the year 2000, where I started working with Sonera at that time in Helsinki, in the ecosystem around the telecom boom that was ongoing, obviously, at that time. And then moved over to Stockholm in the year 2003, when Telia and Sonera merged.
So I at that time was focused on launching new mobile web products and working with mobile internet, and getting immersed in the telecom space. It was around that time also that I got to know some of the folks at BCG, the Boston Consulting Group, was invited to join the team there in Stockholm in the year 2006. Initially to help grow the telecom practice out of the Stockholm office, but was pretty early on in my career there at BCG, when I got a chance to meet some of the global thought leaders in healthcare practice area, who were working on a concept that was, at that time, unnamed, but would later become known as value-based healthcare, which is really, you know, centered around the notion of driving-...
value in healthcare by putting, you know, patient outcomes delivered at, at the same or improved cost at the center of the strategic thinking around how to move forward in healthcare, and, and building strategies for our clients around that. So I spent nearly 15 years working at BCG across the healthcare sector, across pharma, payers and providers, and most importantly, MedTech sector, where I worked most of the MedTech's segments over time, especially within the diagnostic space, where I've spent the better part of the last 5-7 years focusing a lot of my time on, on diagnostics across all modalities and elements of the value chain, and, and getting immersed in that, in that space.
It was also in the year 2017 that, in conversation with the healthcare leadership at BCG, I agreed to move over to the U.S., based out of Boston, to help grow the MedTech practice, in the U.S. as well. So I continued to work with BCG in healthcare in the U.S. for a few more years. Then 2021, was asked to join the management team of a company called StatLab, a leader in histology consumables based out of Texas. So I spent a few years in various roles there. It's a high growth, private equity-owned, MedTech company. So I spent a year as the chief operating officer there before taking on some commercial roles, including leading U.S. distribution, international sales, marketing, product management, R&D.
As that company's strategy was also driven by organic growth and M&A, I was given the opportunity to lead our UK acquisitions that we had made during the last part of my tenure there at StatLab. So it was at the end of last year that I was reacquainted with this space. I had followed the AST space with some interest over time. I looked at it early on in my BCG career, and when I had a chance to discuss with some of the board members of Q-linea, after having heard that they were looking for a new CEO for the next phase, I was really impressed to see how far Q-linea had come.
So, a real credit to Jonas' leadership and the whole of the Q-linea team for bringing the company to this point. Extremely impressed by the product and how they've stepped out into the market here, as Jonas just spoke to, and we'll speak to in a little bit more detail. I'm very excited to lead the company as we go into the next phase of commercialization. So with that, I'll turn it back to you, Jonas.
Thank you very much, Stuart, and I really look forward to see the next transition and journey of Q-linea. So but we'll go back to the presentation, talk a little bit about what we've seen during the year, with a focus, of course, on the last quarter. But before I do that, I really just want to emphasize what's our purpose, what's our goal in this world, and it's really focusing on improving infectious disease diagnostics. It has been presented as the largest threat to mankind when we look at it overall, and you know, we have had antibiotics more or less in day practice since the fifties. But we see antimicrobial resistance is increasing, and we really need to think about how we use antibiotics in the future.
But of course, that's a big problem to tackle, and we will be a small piece of that puzzle. Our first application is really focused towards sepsis, bloodstream infections, where we can see that there's an urgent need to have more rapid, evidence-based therapy prescriptions. So the highlights of sepsis is the mortality is high. We start treating these patients empirically, meaning that we in around 50% of the cases, are not having the patient on the best therapy available. And unfortunately, a high number of these patients will die before you get the traditional diagnostic answer. It simply takes too long.
It's, of course, a very big problem, the most common cause of death in our hospitals, and also in the progression of sepsis, when you move into septic shock, into the intensive care unit, it also is the main cost driver in the U.S. healthcare system. So this is a big problem that we and others are trying to address, and I will focus a little bit more about how Q-linea and ASTar will fit into that picture. If you look at this slide, of course, you have seen it many times before, if you have followed Q-linea. And of course, if you look at the traditional workflow, it's many steps over many days, and you start therapy without knowing if the patient, will develop sepsis, what bacteria is causing the infection, and most importantly, how to treat that infection.
That today can take three or four days with a lot of work from the staff in the microbiology lab. So of course, this is what we want to change with Q-linea, to make it much easier for the persons in the lab, and then provide a very complete and broad answer fast to guide therapy, and of course, for the purpose of a better outcome for patients. Just a very high-level market triangulation. I mean, we see at least four companies that we think are providing semi-automated or automated products to this space. When we look at the market with a focus or a weighting of U.S. and Europe, we see around 20 million blood cultures annually.
If we say that, initially, around 20% of them will be eligible for testing in a rapid AST, although I think over time, that number will increase, the value is high. If we then say that just for a pure math exercise, that we will divide the market equally among us, that will, equate to around 1 million tests per year. This is just the numbers. So it is a large market, and it's a high value. What's important here also in this picture is that, of course, we didn't only design ASTar to work with blood. We have tested and also, presented data on complicated urinary tract infections or urine in general, but also isolate testing. So that is something for us to grow into the future, and I think with Stuart's leadership-...
That's gonna be some interesting announcement over the next coming years, of course. Where I think, we are a little bit different, I mean, when we look at the market today, we see the fully automatic system, which basically means very little hands-on time for the lab user. Then we have the semi-automatic that do require some more hands-on time before you load it. So we, we see this market in basically in two categories. And what we see as a strong point of ASTar is that we include a lot of the, the good features, the features that we feel that customer value in one complete package. So we are full automatic, it takes less than two minutes to load the system, around 50 minutes of training, for a person to be able to run an ASTar.
It is a truly random access-based system, and that really means that if there is free available capacity in the system, you can load a sample at any given time point. You don't have to wait for the completion of, say, a batch, initiated run. Large throughput, 12 patient samples in parallel is the maximum capacity in ASTar, and we do, in Europe now also include fastidious and non-fastidious bacteria. So we have a very, very broad coverage in an ease-of-use platform.
And I think what we have seen after all these evaluations we performed last year, and of course continue to do, is that the breadth of the panel, meaning the number of antibiotics, but also the concentration range, is where you can determine the concentration that would kill or inhibit bacterial growth, meaning the MIC value, can really be assessed over a large range with ASTar. So if we look at that compared to our colleagues or you may say, competitors in the field, we have a very, very broad product, and I think that is something that we have seen in this evaluation being highly appreciated by our customers. But this is also to look back a little bit over last year.
As you may remember, we started the year in January having a sales force in Sweden, only because we had done recently decided jointly to separate from Thermo Fisher. We had a very competitive product, in our opinion, at that time point. And then over this year, we have progressed to what we see are the main markets in Europe, the high priority markets, and find good distribution partnerships that we now, of course, want to extend and, and refine to, to be truly successful in, in the geographies in Europe. In Italy and in the United States, we have set up two companies. In Italy the reason being that, first of all, it's a very different sales model in Italy with sales ADMs.
We also had a very good person that worked with ASTar during the Thermo Fisher era, Franco Pellegrini, and he was then willing to join in the Q-linea journey and continue with ASTar, and has done so very successfully. The same in the U.S., the team led by Jim Kathrein, and of course, now Stuart is initially based in the U.S., where we have a very complete but small team, and there we're now doing basically the same thing as we did last year in Europe. Meaning presenting ASTar to customer, enable them to test the system, see the benefits. So I think that retrospectively we have come a long way in our journey.
Of course, in Europe, we want every region to be orange, so that will be a continued extension of our partnership or sales in Europe as well. This is really a summary or just partly summary of some of the many customer evaluation studies we performed last year. I'm really proud to see that in all of these studies, and I can truly say all of them, ASTar has been received very positively, and they have seen the effects that rapid AST can actually bring to the patient population. But it extends beyond that. It's not just finding the right therapy, meaning that you can reduce antibiotics or you can escalate if you need to, to save money and of course aim for a better outcome for the patients.
We have also seen perhaps unexpected effects, that rapid AST early on can really also help reduce outbreak in the hospital, because you can much, much faster identify what type of bacteria you have and what resistance patterns it has. And that means that you can then go beyond just rapid AST for one particular patient and look at it more from the hospital population. That was unexpected, but very, very positive, and we saw that in Basingstoke in one of the evaluations. But if we look at ASTar and what we bring to our customer, I would say that there are two main areas that I would like to highlight. The first one is that it really fits into their processes. It's super simple to use, and it really requires no change in the lab practice. This is very positive.
The second part is that the breadth of the panel has now come to demonstrate that in a very high degree of patients or samples that you load in ASTar, you can act upon that. So around about 95%, you will actually have an actionable result, and this is a very high number, and of course, means that it provides a large value for each test. The ease of use, very schematically, you load the sample, you put the barcode on, you walk up to ASTar, and you are guided through a graphical user interface. You can start the run. So all this is less than two minutes, and as soon as you start the run, you know exactly when that sample will be completed.
This is quite good actually, because it also means that you can alert your physician to tell him or her when to expect the result of this coming out. So you can sort of be ready already when you start the test. Of course, ASTar is an LIS bi-directional unit, so it will be reported if it's decided to be connected to the hospital network, but you can actually plan in advance. And this is something that we've also received very positive feedback from a number of customers.... The second part of the panel, I will, of course, not go through this. This is just our European panel, and I think the reason we can provide the breadth of this panel is our technology that's built into our AST consumable.
It's based on a compact disk platform that has really been pioneered here in Uppsala, and in one disk, we can have 336 reaction wells. While we see many others choose the more traditional 96-well plate format, and that, of course, means that we can cover more ground, so to speak, more antibiotics, more concentration ranges in a unique consumable, and we see that this truly adds value to our customers as well. If we then look what this turns out, this was our first tender, the first tender that we submitted to last summer. We can see that all companies submitted to this tender. Of course, we all want to shape and move this field.
Typically, in these tenders, you have a financial score and a technical score, and they weight it differently, with more weight on the technical side. So just on a very objective view, we can see that the price in this case we actually came in close to the limit of this specific tender of EUR 600,000, meaning an instrument of consumable over a period of time. That, of course, are reflected in a fairly low financial score in this case. But I think the key part here was the technical score, where ASTar really performed well, and because of the technical benefits of the platform, we were ranked one in this particular tender.
This is, of course, just one tender, but it perhaps give an idea that ASTar is truly a competitive system in this environment. I think what might be more interesting is that we now start to see that the overall market is slowly moving. I mean, when we were here a year ago, for the same report, about 12 months ago, we didn't see any tender activity in Europe. Now, I would say because of us and the rest of the companies in this field have been active in the market, have been performing a lot of evaluations, we can today see that more than 15 rapid AST system tenders are either announced or very close to be announced. Most of them, I would say, are in Italy. This is also the country where we started to work earlier.
We started in Italy, and then we signed a distribution partnership in the other geographies in Europe. So Italy is a bit ahead, compared to the other geographies. But this, to me, indicates a very clear shift in the trend of rapid AST, and that's why I also think that the shift from me now to Stuart is to really continue to grow this market, the market awareness, the competitiveness of the system, and then, of course, continue to do that in U.S. as well. So if we move over to the U.S. market, we have talked about our FDA discussion, and we have said that we are coming closer and closer to clearance or approval, but clearance is the word FDA would use for it.
I would say that where we are today, if you compare this work with a marathon, we are coming closer to the last leg of that race. So fine details in discussions, no major questions or concerns, so hopefully, this is something that we can bring to you in the very near future. The reason we say that U.S. is the most important market is not just because of size, it is also because U.S. have been seeing or been aware of rapid AST for a longer time than Europe, I would say. So it's more mature, in our opinion, compared to Europe. We do see Europe being a very interesting market. The message here is not that Europe is less important, just that U.S. is more mature for this.
We have started. We announced that in December of last quarter that we are now putting ASTar in hands of, hopefully, a future customer, but today evaluation hospitals. Of course, we have started with two. We have several in the pipeline, and we would, of course, adjust the volume and speed with that coming into the spring here. But so far, the feedback has been very, very positive. Again, what we see is the ease of use, how ASTar presents the data, and at what timeline. So the strategy of U.S. is gonna be similar than the than Europe: first anchor ASTar performance in key labs with key opinion leaders and then go broader, so we get the right feedback first.
And of course, Stuart, with his background and, of course, being on ground in the U.S., I think will be instrumental together with already in place U.S. team to bring this market forward. This is not the message to understand that as soon as we have clearance, the market will explode. That's not the way the market works, but we clearly see that if we see the same type of messaging from customers in U.S. as we have seen in Europe, I think this could be a very interesting journey when we come into end of 2024 and 2025. Another part of U.S. is, of course, it's a very large country. As I say, we have a very complete and competent sales and commercial force in the U.S., but we're now discussing on how do we broaden that reach in the U.S. market.
There are ongoing discussions with distribution partnership. Some might cover a very large region of U.S., some smaller, but we're also looking into how we can use our team at the best during this year. We think we can be very efficient, even with a smaller team, actually. The reason for that is that, as you may remember, ASTar is built for the medium-size and up hospitals, and we don't think we need to address all hospitals in the U.S. We have a very clear list of what's on our priority list, what would make the biggest difference before we take the next step?
And finally, for the U.S. market, because we were awarded breakthrough device designation by the FDA, we're now continuing to sort of use that stamp that acknowledgement, I would say, from the FDA, to apply for NTAP. An NTAP is an add-on payment to promote new technology that they find of value to U.S. hospitals and the patients, which could enable you to have a dedicated reimbursement outside the DRG reimbursement that's already in place, for three consecutive years. We do not know if we are gonna be awarded NTAP, but we are continuing that submission at least. I don't think that it will make or break the U.S. market, but of course, it will be an added value to be able to do that, and would provide some cost coverage for the labs.
What we also had, as an announcement after the period end, was that the board of directors had decided to place Podler in a separate company. So today, it's a fully owned subsidiary, and we're just in the preparation of completing that transformation. The purpose is very simple. A, Q-linea needs to focus on ASTar. We see we have a strong product, and we need to really focus efforts on that. But it also enables us to, perhaps in a parallel track, continue the ongoing business discussions, and really have focus for Podler and ASTar, but separately. And of course, the underlying thinking here is to maximize the value for Q-linea shareholders going forward. And if we see that we can't develop Podler at Q-linea, of course, we can bring some value of that back into Q-linea.
It will be of very much interest to both the company and hopefully its shareholders. Sort of, the last slide I have here is also a bit of an announcement. We are gonna present at AMCLI in Italy on March 9th. That's gonna be a workshop here. And I just wanna highlight two prominent speakers in that workshop. Professor Alexia Verroken from Brussels will participate in our workshop. Professor Verecken, she was responsible for the largest comparative study of rapid AST system performed in Europe during last year. I do not know what she will present, to be fair and honest, but I'm very happy that she decided to participate in our workshop during that conference.
The other very important part is, of course, Professor Saverio Mennini , who is participating in the health economic study that we are performing in Italy. He will present interim data from where we are today in that HEOR study. And of course, hopefully, that will be very positive for us and for all of you that will listen into this. And then, of course, the rest of the study, we aim to complete that during later part of this year. But at least an indication of where we are right now, so interesting and quite important. So with that, I will just sort of end on the highlight of how we look at it. The clear focus today is ASTar, the Gram-negative product. But of course, our goal is not to end there.
We will, over the next several years, continue to increase expansion. Also, we have products and value, I would say, in the company that we think could be worthwhile in the long run. Of course, the focus is ASTar, and I would say only ASTar, in the short term. With that, I would like to hand over to Christer, who will run you through the financial statements for the fourth quarter. Go ahead, Christer.
Thank you, Jonas. I will, as Jonas said, take you through the more financial part of the presentation, and I will start with some P&L highlights from the fourth quarter. Starting on the top line, we can see somewhat lower sales than anticipated, due to lower, slower conversion of the sales funnel, and longer lead times. That's something obviously that we are focusing on to shorten this lead time. It's a key focus of us going forward, obviously. Going a bit deeper in the P&L, and looking at the operating result, we can see somewhat improved, although negative, improved result, a -SEK 55.4 million, as compared to last year's -SEK 59.6 million. And you translate current or the fourth quarter operating result amounts to -SEK 18.5 million negative per month.
Looking at the first nine months of this year, the same operating result was - SEK 19.5. It says the full year, but it should say the first nine months there. Obviously, we are looking at this very carefully, and last year, we had a cost-saving plan that we initiated last spring, and that explains the improvement we can see in the fourth quarter. Stepping down a little further down in the P&L, looking at the financial net, we can see an improvement there, thanks to excess cash that we have invested and the higher interest rates on the market. That's the explanation on that one. We have the same story as on the operating result when looking at the earnings before tax and earnings after tax.
It's also improved as compared to last year, both for the quarter and then, and for the full year. And looking at the earnings per share, it's a fairly dramatic change. It's negative, - SEK 0.46 per share, before and after dilution. And it's explained, obviously, by somewhat better result, but mostly because of the increased number of shares coming from the rights issue last summer. Yeah, I can switch page. Stepping ahead now and looking at the cash or the consolidated statement of financial position, and starting with the cash. At the end of the year, we have cash and cash equivalents of SEK 81.9 million.
And adding the remaining loan facility from our main owner Nexttobe, SEK 41.5 million, which adds up to SEK 123.4 million available funds at December 31. And also, if you look back, we have a spending last quarter in Q4 of SEK 18.5 million, just to give you that number in connection to this amount of funds. Looking at some other parts of our balance sheet, we have inventories of SEK 46.5 million, a slight increase as compared to last year. But here, you also shall be aware of a large part of this amount constituted by instruments, sellable instruments. Looking at the equity, we have SEK 189.6 million, an increase as compared to last year.
Obviously, that is a result of last summer rights issue. And although it's good that that is fairly solid as of December 31. Let's switch to last page. An important part is obviously, given the fact where we are in our phase of development, is the future financing. And as you have seen, and you're probably aware of, we do not yet generate a positive cash from our operations. And also in Q4, in this year-end report, we have reported that we do not have going concern. In this section, there's a section in the report that says future financing, where you can read basically what is written on this page. But I would like to summarize it like this and also give some extra comments on this one.
As I have previously informed, we have a total of SEK 123.4 million available funds at year-end. As I said, an average operating result in Q4 of - SEK 80.5 million. Also, as previously announced, we have a large restructuring cost savings plan ongoing and implemented with a full effect as from Q3 this year, which obviously positively will impact the spending. Also, as you are aware of, as Jonas has said, we are in an early co-commercialization phase, and for this reason, we are engaged in pursuing alternative financing options. That includes licensing of distribution rights and sales rights, strategic partnerships, capitalization of existing assets within Q-linea, and of course, negotiations with new or existing investors, financiers, and lenders.
Given this summary of future financing, it is the board of directors' assessment that the group successfully will be able to finance company operations going forward. I think this is the summary of the financial part.
Thank you very much, Christer. That actually concludes our presentation part of this meeting. I will now hand back to the operators to open for the Q&A section. Thank you, everyone.
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We have a question from an anonymous caller. Can you please state your name and company and then ask your question? You are unmuted now.
Thank you. It's Johan Nerhus from Redeye. I think there was something, well, odd with the registration. Anyway, thanks for taking my questions. The first one, you mentioned that you are working on speeding up the sales conversions. The activity has improved, and you refer to some 15 tenders in process or preparing, including some that you are preparing for. Most of them seems to be related to Italy. What can be done to improve the conversion?
Right. First of all, thank you, Johan, for your question. Well, I think the conversion is more or less, basically, to be frank and honest, respond to the tenders and have a competitive product. So that is just for the tender process. For the conversion overall, I think it's important to understand that revenue is still a young field. And today, we see in the market that customers really want to try and test the product in their lab, understanding the value for the lab and the patient. I think this will continue throughout this year, to be fair and honest. But on the other hand, we also see that the previous evaluations are now turning out to publications, and some, I think, will be proven to be very strong in the value for the lab and the patients.
I think that when more of these publications become available, maybe this, we're looking at next year or so, I think there will be a little bit different, structure in, say, a sales funnel. Today, it's, basically testing and trying the instrument. Then you have to, to motivate it, of course, for the finance department of the hospital, and then you can raise a tender. So I mean, approximately, that process could be 12-15 months long. So it's a fairly long process from A to Z. But I think that when more evidence becomes clear, and when we see more key opinion leaders talking about the system in their hospital, their environment, I do hope, and I, I foresee that many customers can then bypass the evaluation step. The evidence is strong, and you can more into tender.
I also think that what could be sped up in the overall process is that, I mean, it's easy to forget, but we're still recovering from a large pandemic. Of course, the pandemic as such is over, but during last year, we saw that had very much strain in hospital budgets, and that is still the case for basically all countries, but it's starting to be more positive. And then I think also could be a change that with increased value and more funds available, that could be an important step. So maybe a very long answer to your question, Johan, but I see it's many facets on this process overall. I do hope it answered your question, maybe a bit long.
Thank you. Yeah. Yes, and could we expect some publications of the testings and tender testings already in 2024?
Yes, I do believe so. I mean, some have already been actually published on posters. So that's usually the first step where you can see the highlights of the study. And of course, we do know that many clinicians and labs are working to have proper peer-reviewed publications. That, of course, is a longer process before they are approved and reviewed. But yes, we have already seen more. I do also expect that be on ECCMID, which is in Spain this year, the largest infectious disease conference, that we will see many, many more of these posters coming out. So I think the answer is yes to that. And also, just to follow up on your previous question, when we talked about tenders, depending on country, not all countries are as tender-driven.
That's the majority, but we do see more cash-based sales as well, and hopefully, that could be part of the mix to some degree in Europe, maybe to a larger degree compared to Europe in the US.
Good. And, perhaps a little bit more details then on Italy, which seems to be a more dynamic market.
Yes, for sure. First of all, as I said, we started with our presence in Italy, that was the first country that we addressed, basically. It's also the country where we are running our health economic study, so we are running that as a multicenter study in Italy. So I think our story is more known to Italian customers. I think also one key is Franco Pellegrini, who has seen the system over a longer period of time and truly has been very successful in working with the Italian market. So Italy, yes, it's a high need, a high prioritized area. I would say in the past, you would call Italy an early adopter country.
I don't really think there are any early adopter country after the pandemic, but they are earlier, perhaps than the others. But we do anticipate to see traction coming up in UK, France, Benelux, Sweden, also, during this year. But they are a little bit, behind just because they started later, but they're still doing a great job.
Good. And then, of course, growth capital and the finance is very important. You had a rather good illustration of some of the alternatives. It seems like you can be running well into the second half at least, but this suggests that we should expect some sort of clarification fairly soon. Is it something that can be said about that?
Well, I can't give you any sort of details on that, Johan, but I think Christer's slide summarizes very well. And I think what it do provide us is, first of all, we have actually a number of options going forward, both based on the ongoing discussions, but also various options. So the board assessment of us being very, very able to take this on forward is something we stand by. Does it naturally mean finance from the capital market? That could be an option, but there are also alternatives in the mix. And I would not like to be into more details on that, but I'm pretty sure that Christer and Stuart going forward, you will see some of that activity that have started.
I know that it's not a very super clear answer, but I think it provides the best assessment where we are.
Yes, quite understandable. So you can confirm that there are discussions ongoing at some level of, how to say, well, at some level, right now or recently.
Johan, Christer, obviously, I mean, a company of our in our phase, and where we do not generate our own funds from our own operations, these discussions on all options are always ongoing. So that's nothing new, actually. And I think we, as Jonas said, we summarized the various options.
... in a slide, and that's how it is. So it's, yeah, nothing more to add on that one, actually.
Yeah. No, that's very useful. Thank you. That's all from me.
Thank you very much, everyone. Thank you.
There are no more questions at this time, so I hand the conference back to the speakers for any written questions or closing comments.
So thank you very much. We had a couple of written questions in the forum. I think we've actually answered them by answering Johan's questions there. So I think that would be-
I think so, yes.
That would be fine. So with that said, I would like to say thank you. This is my last audio call, so I would thank all investors in your belief in the company. I do hope, and I'm very sure that you will see that the hard work will pay off, and that we are moving into a very interesting 2024. And I'm also super happy to hand over the reins, so to speak, to Stuart. Christer will, of course, continue, but to take the company into the next phase. So I'm very delighted with that. Also would like to invite Stuart, if you have some closing remarks from your view, since you are taking over from basically Friday.
Absolutely. Thank you, Jonas. I think, once again, just to reiterate, I think we're in a fantastic place right now of picking up from the legacy that you built with the team. And now the company is really focused on bringing this fantastic product out to the patients and the market. The transition towards that commercialization has already started, and I think you highlighted a number of the really important foundational elements that have been built up over the last 12-plus months that are putting us in a good place now to really accelerate that growth. So, I would just like to close by saying a big thank you to Jonas for leading thus far.
And that's. I'm very honored and excited to step in now. I look forward to meeting you all over the next coming quarters to update on our progress.
Okay. Thank you, Stuart. And with that, we will thank you for listening in to our last report for 2023, and have a great day, everyone. Thank you.