Welcome to the Q-linea Q4 report 2024. For the first part of the conference call, the participants will be in listen-only mode. During the Q&A session, participants are able to ask questions by dialing pound key five on their telephone keypad. Now I will hand the conference over to CEO Stuart Gander and CFO Christer Samuelsson. Please go ahead.
Welcome, everyone. Thank you for joining this presentation of Q-linea's 2024 year-end report. This is Stuart Gander speaking here, CEO of Q-linea, and I have beside me Christer, our CFO. Just a quick note, obviously, regarding the forward-looking statements for this presentation, and we'll move straight into the agenda. We wanted to do a few things today. Firstly, just reflect a little bit on what has been a year of great excitement, I would say, for the industry and certainly for our sector, with a lot of developments. We will reflect a little bit on that and those who have been involved in moving things forward, and then give a little bit of the status of the race, so to speak, now that we see the rapid AST sector moving forward, and what you U.S. investors can expect for 2025 and beyond.
Try to give a little bit of flavor of that. I will then hand it over to Christer, who will walk through a financial update, and then we will have an open forum for questions. A few things to make sure you take away if you log off after this slide. I would like to land basically on four key messages. The first is that there is clear evidence that the global rapid AST race is now on in earnest. We see that commercial activity is ramping up across the key geographies. We'll give some more flavor there. Let's say the next generation rapid AST instruments, of which the ASTAR is, we would say, the leader in the field, we are now seeing placements of those instruments into clinical environments.
I would also add to that that we see evidence that Q-linea is the clear track leader, both in terms of placements of instruments and the coverage of patients so far associated with those instruments, and also crucially on the thought leadership side, with more clinical evidence emerging through the year, and we can expect some more going forward as Q-linea continues to establish itself as the leader for this segment. I would characterize 2024 overall as the year in which we completed many of the critical elements of building our growth platform. Obviously, we've mentioned it several times, but it goes without missing again that we made the FDA clearance in the spring, which gave us access to the world's most crucial diagnostics market. We've been building our commercial sales team, both in the U.S. and across our EMEA region as well, throughout the year.
We've also completed some key development projects, and that has enabled us to, on the one hand, reallocate resources from development into commercial, as well as reducing cost, more on that later, and has also made sure that we have the continuous leadership in the field from a technical perspective. We've been doing a ton of work within the team, reallocating resources and people, bringing in new capabilities, and just new manpower, so to speak, in areas that we needed to beef up, and then reweighting away from other areas that we need less. That's been a busy year of transition, but now that we've come through that, the bulk of the major pieces is complete and we're racing forward. I would expect that 2025, looking forward, is really going to be acceleration on progress across the three key dimensions.
On the clinical side, we will see further evidence from our clinical studies coming out, but most crucial, we will start to see real-world evidence from ASTARs in practice treating real patients in the field. That is where the rubber hits the road, so to speak. That will continue to translate into commercial results and progress, and those will in turn contribute to our financial progress. That is where we will add some color to those. Those are the four key pieces to take away from today's discussion. To start off, I think it is really worthwhile just taking a moment to reflect a little bit and provide some thank-yous for all those many individuals and institutions who have helped to make this happen and bring us to this stage.
I would start with our lab partners, our many research partners out in the field, working in the lab, who've been both part of getting the ASTAR in development and all the way through development and so on, and now on the market, giving it testing and feedback. That has been an absolutely crucial element to making sure that we have the best system to offer to customers that works best in the real-world environment. These are particularly in Italy, Belgium, U.K., France, and the U.S., but we have collaborations in many places. I think also really worth recognizing the early adopters, those who've made the decisions now to move ahead with ASTAR. We should recognize that they are taking risk in a couple of areas, both personally and professionally.
They are standing out on the front line and saying, "Dear colleagues, physicians, lab managers, we need to change our standards of practice." That's not easy to stand out and try to move the needle. They're also taking risk whenever they go to their institution and say, "We need money here allocated to buy this new technology," even though in this institution, we know we have unlimited priorities for cancer, for cardiac treatments. There is in healthcare, unlimited demand for resources. These people are sticking their heads out and saying, "This is an area where we can deliver very tangible outcomes for our patients, and this is the technology to bet on now." We need to recognize that these early adopters are really paving the way for us to open this segment.
I would say just a thank-you to our lab and clinical champions who are making that happen and work with our team every day. Of course, in many cases, we are interacting directly with these individuals, but we're also working with our channel partners, notably Prolab in the U.K., Eurobio in France, our BMD Eurobio affiliate in the Benelux region, Mekro in Romania, Labema in Finland, Montebello in Norway, and now, most recently, Amico, who's covering the GCC, call it broader Middle East markets. These teams and the individuals who make up those teams have been selected because they are leaders in our field in microbiology. They have proven results in selling products and supporting customers in this. We want to also recognize that they have those businesses in this. Therefore, they must take time away from those topics and put them into rapid AST.
They must also believe in ASTAR and that it will deliver for their customers because they are putting their reputation on the line and so on. I just want to recognize that and that they are still here indicates their belief and their commitment to making this happen. Of course, everyone recognizes we would love to be further with more instruments already. Everyone always does, but they remain committed to making this happen and understand that it takes time in our industry to do so. Of course, our Q-linea team goes without saying was absolutely vital to getting us to where we are. There are a few dimensions to this. I think, firstly, to recognize and thank all of those who left during 2024.
Obviously, many individuals on their own accord have found other great things to do, and we celebrate them and those things that they will go on to do. We also recognize that there were those who were impacted from the changes that we needed to make due to the change of our phase in our journey, moving from technical to commercial. Not everyone can make that transition, unfortunately. We really want to recognize that everyone has contributed to making it successful to get here, and they will share and enjoy the legacy that Q-linea will deliver over the coming years.
Obviously, those who joined in 2024, to thank them for, again, taking that risk and jumping on the boat with their passion, bringing their experience and capabilities from their past, and also the new ideas and connections and relationships that they bring to the game on day one, which we are already enjoying the benefits of. Crucially as well, all of those who have stayed through 2024, clearly a year of change, a year of some uncertainty for our team, and those who stayed through it did so because of their belief in our mission, the passion for our cause, and also their commitments to delivering on the results ultimately for us and for our patients. Thank you for them.
Finally, I would round up by thanking certainly everyone here on this call for your close attention and broadly all of our investors who have had the patience and resolve through what I could only best describe as would have been a pretty wild year. We have had individual days of some pretty crazy increases and unfortunately decreases in our stock price. Many of you have had questions to us throughout the year that have been much appreciated in terms of what is happening with this sector, with the markets and our business. I think through that, we get a chance to hear from you as well about your commitment to this and why, in many cases, of course, everyone is looking for solid returns, and we are absolutely dedicated to delivering that.
I think many are also here because they believe in the mission underlying it and the impact we will have. That is tremendous. I think also just thank you for the continued support. We were very pleased to see more than 90% subscription to the rights issue, which is a real testament to, yes, we're in it for the next stages of the journey here. Of course, we have the warm program upcoming. Christer will touch on that later. It is my personal goal to see that that commitment rate is at 100%, of course, because we are passionate about being successful through the next stages. Thank you very, very much for staying with us through the year. For those who are new to this call and a little newer to Q-linea, just a quick reminder on what we're about.
We are revolutionizing antimicrobial susceptibility testing, which in short is basically aiming to reduce the impact from sepsis or bloodstream infection. There are three big numbers to remember. Six hours is when we deliver our test instead of the 48-hour plus that it typically takes today. This saves lives, it saves money, and it massively reduces the amount of clinical effort to address patients, which is, as you can imagine, a major burden on our healthcare systems. The other number, two, is the number of minutes that we expect lab technicians to spend running our test. That includes all of the activities needed to get the sample into it and to read off the test in the end. It is an extremely highly automated platform that requires essentially no manual steps, completely load and go.
It also is very intuitively designed and requires minimal training, which means a lab tech at all levels of technical capability can run it. That makes it significantly easier to do so on the third shift, for example, when in night shifts, you don't always have all of the capabilities in the lab. The final number, number one, of course, we are the leaders in the space with the only fully automated, fully random access platform with a broad comprehensive menu and very high performance track record on reproducibility. That is what we're about in short. That ties, I think, nicely to this message, which is kind of a metaphor here. We shared it with our company meeting, just reflecting on the year, but I think it's very apt to just kind of describe the feeling that we have as we come into 2025.
Really, the race is on. I would characterize that the grid really got going in the spring of last year, 2024, when there were four FDA clearances really back to back in the spring. Of course, in addition to that, there are other options on the market as well. We are all in full motion. I think it's worth relating the metaphor here. Maybe just a note for those wondering. Of course, in the picture here, we are the red car. No specific preference for myself, as a matter of fact, but as this was a company meeting, I figured if I did not choose the Ferrari team, I would have to deal with a bunch of resignations from our Italian team on Monday. I'll leave it to you guys to assess the other car. We would see ourselves, obviously, in the lead here.
It's worth noting that this is a very engineered segment, diagnostics in total, and certainly our space. It's a very technical field. The cars are now ready. They're designed. Just like with F1, you do all the work before the season starts, and then you launch it. You can fine-tune the car and the instrument as we go. You can make minor changes. You can make improvements, but you can't do major engineering, radical engineering adjustments without redoing all of the clinical work. All of the systems on the market have been designed making real engineering trade-offs for different technical and clinical functionalities that were made. Now we will see how those engineering trade-offs play out in real life.
We are very encouraged to note that so far, we can, with a lot of confidence, state that we strongly believe we are the leader of the pack, both in terms of the number of evaluations in the field. We have confidence. We have eyes on all of the major institutions considering rapid AST. We'll talk more about that in a second and are in the most important discussions. Of course, there may be a few labs we don't see, certainly smaller ones that may not be considering something like the ASTAR. In terms of our sector, our space, we feel like we have very good visibility. I can say we've announced some wins in the field based on what we have in our pipeline. Our win rate is well above 50%, but with very good confidence. That's across all of the other competitors.
Therefore, with some certainty unless someone shows me some facts otherwise, we have the most active commercial placements of the next generation rapid AST platforms in the market. We will try to give some more numbers on that in a second for why we believe this. At the end of the day, we are still just a few laps into this race. There will be a long one. The most important thing is now we, and ultimately, by extension, you, will start to see the visibility on those outcomes. We will measure ourselves, and everyone will ultimately measure the results in terms of the actual in-clinic results. That is the true lap time here. It is one thing to do an internal study and to set that up for the FDA and for regulators to run a study to prove that it works.
Those barriers are high, and we have full respect that everyone has gotten through those barriers with sufficient performance. It is also one thing to do an evaluation with a customer, again, where a customer wants to put the machine through its paces and typically hands it over to the best techs in the lab. They do it in a controlled fashion, obviously, because they pull the tests aside from patients to run those things. Often, we and our other competitors are along for those journeys to answer questions and help out. That is one environment. Another environment entirely is the real day-to-day of a lab where thousands and thousands of tests are coming in every hour of the day onto multiple systems, and techs are running back and forth, tremendously busy.
The more variation you have in terms of manual steps, complexity of the system, variation in results at the end, the less understanding and clarity and actionability there is ultimately for physicians to act on it. If physicians do not believe in those results over time, they simply will not use them. That is what we mean by clinic results is the lap time. We are very confident that the engineering of the ASTAR instrument is going to put us in high stead. Why do I say that? Obviously, the specs are one thing, but we know the labs, the many ASTAR instruments running in our own development labs have run tens of thousands of cycles. We know what the customers can expect when they get an ASTAR in their lab. The real life will show the truth in the end.
We will update you on the progress. What's the track? This is a bit of a recap. It's a simplified version of the slide that I showed for our last session, but this is the track in our metaphor here for the F1. It's basically all of those tests that are moving from the current standard of care, the 48-hour plus, over into this rapid AST. That's what we're trying to capture. There were something in the order of 25 million of those patients inpatient, which means they're in the hospital. In our addressable markets, it's SEK 1.5 billion or so rounding market. Typically, a customer would pay $20 - $50 for the AST component. That ranges by volume, by market, of course, many reasons to vary, but you get the point.
They may pay another SEK 100 - SEK 200 for a rapid ID, the molecular tests that can give you a quick answer on what type of bacteria. What are we about? We are offering the rapid AST component of that, and we are saying, "Look, that should be worth another $120 - $200, and you should do it for your high-risk patient populations." Obviously, sepsis, bloodstream infection, that is number one that will kill you if you do not treat it and you do not treat it quickly. Those go without saying, and there are roughly six million of those patients. There are other sets of patients. It is hard to estimate how many because criticality varies by patient and clinical context, but obviously, spinal infection, absolutely critical, kidney, some respiratory, and obviously, wound/surgical patients. Some might be at high risk or have complex situations, and those would all be deemed critical.
There are just simply high-risk patient populations. We made a press release noting our evaluation ongoing with a major cancer institution in the U.S., which we hope to share those results shortly. Obviously, oncology treatments and those patients are highly susceptible to infection, therefore, almost by definition, a high-risk population. There are others, right? Just to give you a sense, this is what we're focused on. There are also, of course, this future potential idea of direct from whole blood, right? This is the Holy Grail, as I mentioned before, for our space, just to go immediately from the patient into test. We would love to do it. We, in fact, have lots of IP around this and a proof of concept platform called ASTRID that we're eagerly waiting to develop. The market's not ready there for that.
There are numerous reasons for that, not least to which the economic challenge of you would need to stratify the 90% of patients who don't need that out before you run tests on those that do. There aren't really solutions for that right now. We're really focused on the green space, and this is where the race is at. How do we think about it, and how is that developing? Again, reprising some of the graphics I've used previously and framing it with some additional information. The pacing of this race on our track here is really down to the commercial funnel, right? I shared some views last time on how we see the funnel and the timing across those stages here.
Of course, crucially for us, over the last 12 months and plus, we have been focused on growing the front end of the funnel, so to speak, right? The great part of this. I'm very encouraged to update that we now very confidently have engaged more than 200 of the top U.S. customers. I shared last time that of the 3,000 - 4,000 labs addressable, there's around 1,200, maybe 1,600, depending on how you define them, that are really in our core focus area. We've stratified them to focus on the top 250, and then, of course, we will keep going. We've reached all the ones that we focused on really first, and we're now looking to expand that aperture to the next 400, next 500 after that, which is the journey for 2025. We've now engaged those.
Of those first 200 - 250, there's half of them, roughly, roundly speaking, that have said yes to rapid AST already. That is to say they've been persuaded on the merits of it. They've seen the clinical evidence from our studies, from other studies in the field. Sepsis is a priority for them, and they've been directed or have selected themselves because they're decision makers to look into the solutions for this. Of those that are moving forward rapid AST, we would say another half of them, 25% total, have said rapid to AST now. By that, we mean they've either got the budget or they're actively asking for budget to be deployed for this. They are actively exploring with the vendors in the field for the solution, and they're looking to set up, crucially, time with us for an evaluation or demo and whatnot to move forward.
For those customers, that's obviously where we're focused now on driving the pipeline. The conversation we're having is now getting them to yes to ASTAR for rapid AST. They've now persuaded of the first two questions. We still work with all the other customers, the next 500, on the first two questions, and we will keep filling up the pipeline there. The dynamics are similar in Europe. The pipeline is expanding. Obviously, in Italy, where we have our team, we have very sort of direct control over the funnel and the funnel dynamics. In the other markets, we're working with our partners. I would say that it's my view, at least, that the U.K. and France are probably the next to move behind Italy in EMEA, and we hope to have good news through the year from those markets.
Also, we've expanded our footprint with Amico, and our team has spent a lot of time in there, not least of which being down there for MedLab and for the Saudi Sepsis Day this month, both of which were very encouraging events in terms of both the level of sophistication and interest of that market. There is adoption already ongoing, both for older legacy AST solutions and high interest in the next generation platforms like the ASTAR. There are therefore active tender processes and purchasing processes ongoing that we're able to jump into. We're actually expecting the pacing there will look more like the U.S. market than Europe, not to pick on Europe all the time, but we know it is a different type of market dynamic that tends to move a little more steadily, let's say, with tenders and things like that. That's the pipeline.
It's growing, and things are moving forward. What is absolutely crucial here, and we wanted to emphasize kind of going forward in our discussion now for today, is that we're moving into the other stages of the funnel through, and now, as we've been very happy to announce, are having them fall out the funnel at the end, right, as they go live. A couple of data points for you here. During 2024, we placed 15 ASTAR evaluation installations, right? We have announced from that four commercial contracts already. That isn't to say you can calculate that as a 25% win rate. Obviously, the evaluations are ongoing. We're still in tendering or we're still in negotiation on the contracting, things like that. We still have to do installs and blah, blah, blah, blah. They're still ongoing, right? Just wanted to highlight that one.
We can expect more from those 15. We obviously are continuing to place more, excuse me, in evaluations. We see several multiple regional tenders and multi-site evaluations that are ongoing on both sides of the Atlantic. Why is that exciting? The good thing about these is they may take more effort, but if they are multiple instruments, they do not take a linear amount of time and effort for the number of instruments that you get. They tend to generate longer-term rollout type plans that make it much more predictable for our business. These are tremendous. We are extremely committed to winning these ones. These, by the way, are also where ASTAR, not only ASTAR is most effective, but also because these are typically regional or networked institutions, it is also, by the way, where Podlet is perfectly suited.
With these customers, we will naturally also be talking about solutions like that down the road that help them with the overall workflow. I think the other thing worth noting here is we see our first walk-in customers. What do I mean by that? Those are customers who, they may have encountered us at a booth in a conference or something like that, but we have not, they may have not been on our top priority to go at first. We've not sort of spent a lot of time cultivating them in the gray phase. They basically jump from a pipeline phase straight into that yellow-orange bucket, right, as a walk-in customer. They may still want an evaluation. They're more likely to not need an evaluation. I would call them a direct-to-validation customer. We will expect to see some of those as we go forward.
We have already seen our first walk-ins here straight to demo evaluation, which is great to see. That means there is pull starting to generate in the market. Where do these come from? They come from a couple of sources right now, primarily, honestly. They just come from the buzz in the market, and they can tend to be maybe more proximate to where we have already launched something. So they have probably seen it physically or at least know the people who are putting the ASTAR in place and are calling us therefore as a result.
The other source of these that I would expect going forward as we think about funnel is that as the leader in the field, and again, I'm very confident in saying that, it would be very unusual for any customer who's going to make a five- to seven-year infrastructure bet on rapid AST, putting down, we know, sizable amounts of funding and relying on it for their clinical testing for five to seven years. It would be remarkable for them to do that without considering at least several of the alternatives. We have competitors who, of course, go out in the market, and they will reach customers, some of them before we do.
We will expect that those customers will call us because they want to hear from us, having talked to the other guys, and that we will expect to see more walk-in customers as our competitors also spend time growing this segment. As a consequence, we have expanded and continue to plan to expand the evaluation pool of ASTAR instruments. Christer will touch on that, how that means financially here for us, but that is a consequence, obviously, of an expanding pipeline. We are very happy to note, as you have seen in press releases, that we have converted. We have got four commercial platforms up and running. Italy is clearly in the lead, as we indicated. Now, in the first couple of months of this year, we have announced three more contracts, two of those in the U.S.
As we try to guide, we do see the U.S. very much keeping pace with Europe through this year. Ultimately, it is going to be the bigger market and faster moving over time, right? I would see 2025 as really firing on both sides of the Atlantic, so to speak. What does that mean, and what should you be looking for, right? We are very conscious that many of you have asked us and are thinking and asking for guidance and how things should look forward. Obviously, a company in our situation has challenges in providing precision on things for natural reasons which you do not understand.
We also will read it that as a small company, particularly one that is relative to some of our self-funded or incumbent competitors, we are vulnerable to the more we communicate to the market when everyone can count or at least has a decent idea of who are the first movers. The more information we provide, the more signal we give to those guys to spend their resources dragging things out. We will still win the fight, but it will take us longer and more energy. We know it's kind of frustrating, but bear with us. We will give as much information as we can, and we will continue to give more and more as we're going to try to do today and build on that going forward.
We also will get more predictability in our business as we understand the funnel dynamics, pricing, and contracting will start to normalize across the field, these sorts of things, which will be developments through this year. Progress in three areas I would really like you guys to pay attention to, right? Firstly, commercially, obviously, we expect to see the increased pace around the track, right? We shared 2024 with the four commercial instruments. I would say comfortably Q1 will be equal to or greater than 2024 as a whole, and that we would expect to see that improving quarter after quarter, right? That is number one. You can hold us to it, and we will keep you as updated on that day-to-day as possible.
The second thing we communicated last time, and I still stand by, wanted to give an update on the multi-site contract in the press releases. One of them, the key one that we have tried to give some visibility so you can track timing, is the large U.S. reference lab. That's still very much in progress. We got it to completing that in Q1. I still have a very strong belief that we will complete that during Q1. That will be exciting. The other things to look forward to as we look during this year, the first regional tender signed, of course. I mentioned there's multiple of these, in fact, that we're working with, but we will expect at least to deliver on one of those. The first walk-in customers that I mentioned will have been signed, and we will see the first direct-to-validation customers.
This is tremendous because now we skip, as I said, that evaluation phase. That changes the economics of our sales process pretty significantly. This will be an exciting milestone, and we will provide it if we can because, again, we cannot announce every contract because customers do not always sort of let us give specifics. We will try to guide you when these major milestones happen. The other things to look for, right, we will expect to see a rising average tests per instrument. This is driven by two factors. Number one, of course, as we launch in the U.S., and the U.S. does have the mega labs that Europe, for various reasons, lacks. They have the integrated network IDNs that tend to share resources in the center cores and so on. They have some labs with some really big volumes, and we are obviously focused on those.
That will pull up the average, but that's one thing. The other crucial thing we are really paying attention to is kind of like the same store sales over time, right? We would expect to see that we launch in, and we typically have minimum, certainly if it's a reagent rental contract, we have minimums that are required. We have a kind of, let's say, minimum base case expectation based on the number of patients that a customer sees. We track that by site, and we want to work with the sites to make sure that they're testing on all patients. In many cases, especially in the beginning, they're very open to us.
They say, "Yes, we will stratify our patients." They might not be happy with it, but either because they do not have the budget yet or they need to prove it internally that it works, or often just that they have many, many doctors, and they can only sort of train a few of them initially, and that they will roll that out, right, and that will increase over time. They will also find utility for more patient groups, right? We will talk about that in a second with the clinical impact. They will start with one set of high-priority patients, and they will expand it as they see the results and learn themselves where they can use the results. We have actively tracked this number, and to the extent we can, we will share with you where we are at.
Just to let you know, our goal for each ASTAR going out the door is 1,000 sort of on average. This is a kind of rule of thumb that we will apply here as a full-year equivalent. Obviously, we placed the instrument in October this year. It's not going to get 1,000 tests in 2025. You get the logic here. The other thing to keep track of, we'll certainly communicate these because it's very exciting, is when we get those geography first, like we did in Belgium now with the first placements. Those are important, not least of which it's another country and set of patients that we're saving. Also those tend to be the networks, right, that people really look to.
Once you get an early mover in the country, in the region, from my earlier comments, those people are breaking the ice, so to speak, for many around them, and they tend to be the types who are the key opinion leaders in their area. It makes the next ones easier and easier and easier. Watch for those things. We'll give updates as and when we can, of course. Secondary progress, we very much expect on the clinical side. We've talked a lot about our lifetime study. We are tremendously proud of this. To my knowledge, it's the only multi-site study of at least this scale done in our space. We've already been able to announce some very positive results from that study. We will expect to see the completion of that. Now all of the patients have been recruited. The study is closed.
We're now doing the publication and all of that. That will come out. We will expect to see real numbers demonstrating the health economic impact on it, certainly length of stay, but also the dollars and so on saved in the patients and in the drugs when you de-escalate. All of this is like the questions we and customers have all the time. We are extremely confident we have a very good idea what these numbers will show and can show because we know this when we see it in our size. This study will provide peer-reviewed evidence that can be shared and will really help move the needle forward. Of course, in the U.S., we will have completed during this year all of the early access programs. Several of them have already presented.
You may have seen the webinars that were there shared with our colleagues, very robust evidence again coming in. On the one hand, the numbers point to the same messages over and over and over again, like lifetimes and everything. Crucially, those are American-based in American context and big American labs. That is what the American customers are looking for. Boom, that is there. I will come back to the main point here that this year we will see the real clinical truth, real-world evidence, the actual patients in all of their messiness and all of the day-to-day craziness in the labs and hospitals and real clinicians that need to make real decisions. That is what is going to come out during this year, and we are very excited about that. With those, we will obviously be mapping as much as we can.
We'll be having podiums, poster presentations at all the major events. We will be present. We will work with our research partners, and they are very excited to be present and to represent. In some cases, they will be open there that it's us involved. In many cases, they are passionate about the research and will just move the space forward because they believe in rapid AST, right? Watch for those. The other area, of course, we continue development. This is not a sector that stops in its innovation. We remain highly committed to being at the absolute forefront, being the leaders in the space. We have a U.S. clinical trial ongoing to expand our U.S. menu, which is very exciting. We expect that FDA submission to come. We will, of course, communicate that. Our EU menu will also expand.
We are doing some things also regionally in terms of breakpoints and more of the technicalities to allow us to operate cross-regionally even easier. For example, in the Middle East and whatnot. Some of these developments that we'll deliver through the year will allow us to be really fit for purpose in every geography. I think the other really interesting space to watch, which we will excitedly share updates as and when we can, is around isolates, right? We've talked a lot about blood cultures, and that's the priority. That's the six million patients. The other 20+ m illion patients are what we call isolates, right? We know there's applications for those. Our customers are very keen to use the ASTAR for those patients with high clinical need.
We are, of course, working with our research partners on those, and we'll give you updates on that as we can. The consequences of that, of course, as we think about Q-linea down the road for the business case are tremendous because they double, triple the available volumes, right? This should all translate into financial progress that we'll continue to give you updates on, obviously, the rights issue from a funding perspective, and we'll be closely watching the warrant program that we very much hope that you will join as well. We are actively exploring grant applications that will help with funding, both sort of for the scale-up for Q-linea and also for those new developments, right? There are many stakeholders who want to see these developments come faster. Again, as a leader in the space, we now have a tracker here.
We're now out on the market. It's sort of a safer bet now to work with Q-linea to make sure we get innovation out earlier. We're, of course, working with many institutions on those things. Of course, finally, as we get revenues in, our gross profit will start to contribute increasingly to our funding over time. On that note, we work very conscientiously with our cost of goods. We have multiple projects underway that will deliver through the year that will improve our like-for-like, let's say, kit cost, the consumables cost. We also will benefit more and more from the scale effects we've shared before. We have the luxury of having our own production facilities here in Uppsala. That, of course, generates some fixed cost.
The benefit, if you will, of that is now that we really should see the scale effect as we move volume through. As we do get to those volume thresholds, which we've mapped out, we understand them very, very well. We will implement different automation steps throughout the way to de-model NEC, but also each of those should generate varying degrees of sometimes impressive cost reduction. Finally, we remain committed to sort of maintaining our OpEx outlook. Christer will speak to that more in a second. That means also repurposing costs, either from personnel, from team to team, or moving people around. It's sometimes the same people, different activities, and so on, but also just from different types of cost. We will, at the same time, look for every possible avenue for cost efficiencies to keep OpEx as low as possible for this.
Obviously, as a company, we are maturing, getting better and better at various aspects of the business all the time. I will take that and hand it to Christer, and then we will come back for questions.
Perfect. Thank you, Stuart. I will just start by saying that we have seen a number of questions in the activity feed, and we will address those after my presentation. Be with us. It is good questions. I have seen them as good questions. Hopefully, you will get some good answers. What can you expect from me? I will share some highlights on past year. That is one thing. Also, highlights on where we are financially and also what we can see ahead of us. Starting off with the top line, fourth quarter and full year. Obviously, not too impressive in the fourth quarter. Why is that?
Yeah, we haven't seen any capital sales of ASTAR in the fourth quarter. We have signed over the year reagent rental contracts, but there are no capital sales on those. In the fourth quarter, we're very low. Looking at the year, though, it's basically in line or on par with 2023. Here you can have it split sort of by ASTAR is 50% or slightly less, and other income is 50%, both in 2023 and 2024. The next thing I would like to look at is the OpEx and inform you that we are in good control, I would say, on the OpEx side. I will show you the development from 2023 - 2024. I think the cost-cutting programs, restructuring programs in place in both 2023 and in 2024 has paid off and are in line with our own expectations, which is good.
More details on next slide, so I'll get back on that one. On the financing side, I just wanted to tell you how we did it in Q4 and where we were at the 31st of December this year. Our main contributor, Next2B, they borrowed us another SEK 21 million in Q4. At the end of the year, we had a total of SEK 99.5 million from Next2B. Those have been used, and I will get back to that. I'll tell you that SEK 50 million of these have been netted in the rights issue, invested in Q-linea, to say. SEK 9 million has been repaid according to agreement. That means that SEK 40.5 million remains until at least 30th of June 2026, according to the agreement. We also have received a bridge loan in these rights issue transactions to take us through this transaction of SEK 40 million.
That loan has been repaid 21st of February, recently repaid. That is gone now. At end of year, we had SEK 40 million in bridge loan. Looking at just high level on the rights issue that was announced on 5th of November, at the time it was announced, we had an 80% guaranteed. Now we know that it was at 90.5% subscribed. Also, in addition to that rights issue, we made a directed issue, but more of that later. Digging a little bit deeper on the OpEx and the OpEx development, just to show you that not only are we in control, we are also delivering what we have said, what we have said on the OpEx development. One way of showing that is to look at the expenses in the first half year of this year and compare it to the second half year.
If you do that and you look at the personnel expenses and the other external costs and put these together in this graph, that's our main expenses and actually linked mostly to the OpEx. We also have some expenses with material in our development and things, but I've excluded those for this is a better picture of our development. If you do that and look at the monthly reduction on average between H1 and H2, it amounts to around SEK 5 million, which means that there is a SEK 60 million cost saving on an annual basis. Right. We can divide that in two different parts, as you see here on the presentation, that the cost program implemented in the Q2 amounts to around SEK 50 million.
We have made some additional savings in the second half year, not linked to the cost saving program, but we are always keen on looking at how to spend our funds wisely. One way of showing that we are decreasing the expenses is to look at the number of employees. Beginning of the year, we were at 127, ended up now with 94 employees. Obviously, the big drop was when we made the restructuring in Q1 and Q2. End of Q2, most of the people in that restructuring program were out of Q-linea. That is why you see the number 99 there end of Q2. Going to the next part, just to go through the funding, there has been a lot of activities with press releases. For some, it might be technical, financially technical.
I just wanted to try to summarize this rights issue and the directed issue and the still to come warrants, T01, that will come in May. Hopefully, that will shed some light on this. Obviously, this funding activity will both bring in equity and liquidity. In our case, and what we have done, the increase in equity, as you can see, is much higher than the increase in liquidity. Why is that? I think we have said it before, but part of this funding rights issue is paid by netting of loan. That was on Next2B. We netted SEK 50 million. That is a big, big part of the difference between SEK 205 million and the SEK 93 million. As I said before, we have received a bridge loan of SEK 40 million. That has been, as I said, repaid now in February.
That is the main part or the main differences between the SEK 205 million increase in equity and the SEK 93 million increase in liquidity. This is a big transaction. When we started off, we did not know at what price. I mean, the market controls the pricing, obviously. The terms in this transaction were done so that we ended up with going from 117 million shares before the transaction, now having 4.4 billion shares. A big increase and a big dilution, obviously, recognized by the market. Now, still to come, and we are very anxious and very keen on looking at and having this as a success for Q-linea, is the warrants. That could bring an additional maximum of 2.1 billion new shares, which is sort of 50% of the increase in number of shares already.
We could end up maximum with 6.6 billion shares after this completion. This transaction will take place in May with a subscription period between 5th and 19th of May, where the price is set with a 30% discount or the volume-weighted average price for the period between 14th and 29th of April. These are the mechanics for the pricing. We obviously do not control the subscription rate, but we are feeling confident that if we deliver, continue to deliver, this will also be a success. Great. Looking a little bit at our financial position end of fourth quarter to show where we are, what kind of assets, liquid assets we have, and how our working capital is developing. Started with the cash and cash equivalents of SEK 25.7 million.
With that said, we also have a total, had a total of SEK 99.5 million loan from Nexttobe and a bridge loan, another bridge loan of SEK 40 million. As I said, a big part of this bridge loan and the other loan has been repaid. This is where we were 31st of December 2024. Looking from the cash side and asset side on the liquidity side, go to the inventories and working capital, you can see a fairly big decrease from SEK 46.5 million last year to SEK 33 million. This is good. Obviously, it's always good to minimize the inventories, although you need security levels. How you can read this one is linked to what Stuart said before, that our commercial activities are increasing. We are placing instruments in Europe and in the U.S. for evals, early access programs or clinical evaluations.
Hopefully, that will then lead into contracts later on. We still have them, many of these, in our books, but not in the inventories. They are working for us now in a good way. The group equity, as some of you might have noted, is on the negative side. It obviously does not look perfect, but what is more important is the parent company equity, which is very strong. Why is that strong? There are mainly two reasons behind the parent company equity being stronger than the group equity. One is we have the Podlet technology that we are working with. We have put a reasonable value of SEK 70 million on that one. That will obviously boost the parent company equity. In addition to that, we have a value of our shares in subsidiaries, and that is linked to our American company, Q-linea Inc .
Both of these things are not included in the group equity and constitute the main difference between the two numbers. Now, looking ahead a little bit for the future financing and what we will end up with later in the bottom of this page is, do we have going concern or do not we have going concern? That is obviously important for you. It is important for us and for new investors. I tried to shed some light on how the situation is. Starting off with the secured financing, some of this is mentioned before. If you take the combination of the cash at hand in the beginning of the year together with the net proceeds from the rights issue and the directed issue, which has now been completed, then we have SEK 119 million.
That said, we are still waiting for SEK 15.9 million cash on that transaction because it's linked to the ISP. It's a process when someone passes the 10% level of ownership, it takes a couple of months to conclude that one. It will come end of March, the SEK 15.9 million. Those SEK 15.9 million are included in the SEK 119 million. The additional financing required, as we see it, the board sees it, is that we need another SEK 80 million. If we get that, then we can state we have going concern. At this point in time, we can say that we believe we will get it, but we don't have it for sure. We cannot state the going concern. Going into the next step of our financing process, which is the T01, the warrants.
If you assume that it would be 100% subscribed at a price equal to the rights issue, that is SEK 5. With full subscription, you will get SEK 105 million net of transaction costs, which obviously then is above the SEK 80 million. Just for you to get a picture of what that second part looks like. Where will we spend it? As Stuart says, we are constantly looking at our OpEx, where to spend it, and also how to shift it from where it has been to where it makes better sense to have. We will continue to look at this and have a cap, which is in line with the SEK 14 million - SEK 15 milion spending per month. Looking at other parts of the use of funds is obviously working capital. When you increase, when you grow, this will increase. We need more inventories.
There will be more trade receivables and things like that. At where we are right now, as you have seen, we have quite a few instruments in stock. For this year, we are pretty good off, actually. We will use these instruments, and that will offset a big part of the anticipated working capital growth. Looking at investments and fixed assets, it will come when the volume comes. We will do some more investments. This year, we anticipate very low amounts. Again, going concern, no, we haven't got it, but we believe we will have it. I'll hand over to Stuart.
Great. Thank you very, very much. As you mentioned, Chris, I guess we got a bunch of questions on the line.
Yes, we have.
Do we start from the group call, though, if there's any? Why don't we start with any verbal questions?
Let's do that.
If you wish to ask a question, please dial pound key five on your telephone keypad to enter the queue. If you wish to withdraw your question, please dial pound key six on your telephone keypad.
We're waiting for someone to jump in on the line.
The next question comes from Johan Unnérus from Redeye . Please go ahead. Go ahead,
Jon. Yes. Thank you. Let's see. I got some questions here. Start off with the U.S. contract, the latest one you had. As often as the case, it's on a no-name basis. Can you say something from the recent experience? What sort of customers, and contracts, and type of accounts we can expect from the U.S. market?
Yes. Great question. Yeah, just a note on that.
I mean, especially in the U.S., but it's not limited to the U.S., customers can be very sensitive on being announced in press releases because it may be seen as endorsement of a company, right? Just so you guys understand the concept. I can say there that we are focused on the top institutions, the largest labs, the earliest movers. They very much are overweighted into the IDNs, integrated networks that tend to be multi-hospital type institutions, often with major labs at each hospital or central core labs that are serving multiple hospitals. Our U.S. contracts thus far would fall into that group. I would expect the next one mainly to also be that. That will be the trend for the U.S. Yeah.
Yeah. There are differences compared with Europe, I suspect. Pricing is one area, isn't it?
Yeah.
The main differences are Europe. In terms of structure, there are fewer of these true integrated networks, right, with some exceptions. They tend to be more like the regional tenders, which we've seen some of them that I mentioned. Those are multi-site. As hospitals, they're not typically as much part of one buying entity or a large corporate entity like the U.S. hospital structure. It is a little bit more like individual deals in Europe. We will see that. In terms of pricing, I think there's some sense that Europe is lower price. I'm not sure that that's truly the case. I think a couple of things. Obviously, with volume, the U.S. guys are aware that they have volume power. That is one factor. The Europeans will disproportionately want reagent rental contracts.
They will understand that means that we take on more risk and that they are getting capital, right, with the instrument. That generates some higher prices to offset the instrument, but also just ultimately higher returns over time. I would characterize them both as kind of I expect the range to be between $130 - $180 that we land in that range for both markets. I think it would be safe. Yeah.
Okay. In terms of recurring brevities and pricing on the test, at least in the early phase, the foreign established price points in the U.S. market, is that correct? While in Europe, very popular wide awareness.
Yes and no. The end cap funding provides some kind of reference because that is calculated as two-thirds of the amount that is expected for the customer to pay.
That is sort of declared by the CMS when they agree to the reimbursement. Also, given that it's $98.50 per test, that also it's not a cost that will be borne by the customer for all patients. It makes it much easier to clear that hurdle in a way. Nonetheless, the price point discovery is still a function of obviously the clinical utility, but then volumes and risk and all that. I would say the dynamics are similar on both sides, like I said. The end cap funding helps a lot in the U.S., for sure. Particularly since it's unique to ASTAR and Q-linea, it's a major competitive advantage. Yeah.
Yeah. What about volumes, these latest contracts, for example, you do operate with a sort of minimum volume per installation.
Correct. Certainly for reagent contracts, that's explicit that we expect volumes.
We do that also when we sell the instrument. We have a sort of business case with the customer. Clearly, we go through those economics with them, and we know their patient volumes. So we target those minimum volumes, and that translates into our pricing as well. Yeah.
Yeah. You mentioned earlier in the call that on the U.S. market, there are now several alternative suppliers offering rapid AST. That's a bit of a two-sided dynamic, I suspect. It's good that your several suppliers are working together to expand the market, but it's also increased competition.
Correct. There have been news in our sector as well, right, on some of those players. Some are struggling. You said it's a two-sided thing. At this stage with the market opening, honestly, I wouldn't mind if other investors were spending money to educate customers and open the door.
I'm very confident that all the major institutions will give us a call. They'll want to see the ASTAR. I actually am on the side of I'd love everyone to be active here and share the burden on answering those first two questions, why rapid AST and why rapid AST now. I'm super confident we will answer the question, why ASTAR for your rapid AST.
Yeah. Related to that, it's also the prospect of eventually having a U.S. commercial partner at what stage and what is it possible to refer how many reference sites do you need to sort of attract the commercial partner? It's a very open question, I know.
Yeah. I'm not sure attracting a commercial partner is a problem, to be honest. We see deals being made in the sector in very different circumstances.
You can make deals even before you have FDA clearances, we once experimented as well ourselves. I would say it's really a strategic choice. Do we want to do this? We have active and appropriate conversations with players in the field about what it could look like. At this point, it's our determination that when we control our commercial activities, we increase the likelihood of success in the short term, right? The big guys can move a lot if it is the absolute priority of their dozens or often hundreds of salespeople. You cannot guarantee that. I don't have a magic number, Johan, of how we need to get to before I would be confident. I would say certainly once we're breakeven and we are not in mortal danger of anything, then that would be a natural time to scale up. We could do it sooner.
By then, we may not need a commercial partner. This is not vital for our strategic success at this stage.
Yeah. A clarification on the earlier comments that you, as I understood it, are in place to reach commercial progress during Q1 in line with 2024 for the yearly. Is that in terms of contract win or in sales?
Yeah. Contracts and placed instruments, commercially placed instruments. Yes, absolutely. That's how we'll sort of define it going forward for you. We've announced three of those contracts. If you run the numbers, we said we did four in 2024. We should do at least one or more contracts. We are very confident we'll get there by the end of the quarter. Yeah.
Yeah.
Of course, yeah, on the financial side in Q4, the personnel cost, take that compared with the earlier Q3 level, what's the mechanism behind that?
Good spot, Johan. You're right, obviously. You have looked at the numbers. The simple explanation is that in Sweden, we have a summer and summer vacation, and the summer vacation debt that will take most of the cost or a month of the cost sort of in Q3 so that Q3 will be lower. If you look at many companies, that's the way it is. That's the simple explanation.
In terms of what to expect coming quarter, perhaps Q4 is more sort of in line with what the run rate is or somewhere in between?
It will be in line with the Q4, I would say, if you want to compare the coming quarters.
We are looking at both the personnel expenses and other expenses, obviously, in combination. Yeah, that's what it will be.
Of course, you refer to the 12-month run rate, and the first stage of the issue is not sufficient. It is very important to gain contraction from the next stage in May. Related to that, what sort of milestones and value events could we expect over the coming two, three months?
We will aim to provide, of course, insight on those contracts, right, as much as we can, certainly when they occur. If we can summarize at some point in a good way how much, maybe an aggregator, individual, they are worth, we will certainly think about that so we can give you a sense of our pacing, right, around the track. I think I mentioned a number of things, right?
Different types of customers, of course, we will hopefully have coming in here that we can communicate. It will be the qualitative evidence of us moving things forward that we will communicate as we go forward, both within our business, but also partnership developments and whatnot that give you a sense of the type of conversations and activity. We will certainly keep you posted on holding us to those three areas of progress that I laid out in our outlook ahead.
Okay. Thank you. That is all from us.
We had a few questions online.
I can read them out and give a quick answer and I will hand over to you, actually. This is the first question. Thank you for being patient and staying with us. You put a lot of good questions.
First one, we gave notice of a big reference lab being ready, signing in February. What has happened? Stuart,
I think, said, yes, it will be done in Q1 for that one. We said before, you're quite right about that one. We strongly believe it will be in the end of February. There are some administrative things, I would say, that has postponed this. Yes.
Yes. Which market?
Do we have time left in February still?
A couple of hours.
Certainly Q1, yeah. U.S. time.
Which geographic market is the most important and why? I would obviously state the U.S. right now. You can play around that. It is the U.S., right? Not to diminish the huge efforts of our European colleagues and also the urgent clinical need in Europe. The U.S. is just the big one. It is where pace is set.
That is where we will truly step out and prove the leadership, let's say, that will also be the case in Europe, as I would say. Right.
A good question. When will you be breakeven? In our perspectives, we have guided and said during 2027, and that still holds, right? Yes.
Yes. We stand by the perspectives we just published. Exactly. Exactly.
This is an interesting question. Will you be a billion-dollar company? I give that question to you.
I hope so. This is not guidance. Look, I wouldn't characterize it this way. Look, I think I mentioned this on the last one. The rapid AST segment for blood is five to seven million tests. We said six million.
If those are generating $100 a test, which is really at the low end, but let's project this out, it's easily half billion to a billion when you start adding the other next isolates and things like that. It easily gets to a billion-dollar segment, right? Keep in mind, the current business is $1.5 billion for the segment. We are increasing value in the area. It is down to market share for that. You can look up what diagnostics segments split, but it's usually two or three players that split it, often disproportionately with the leader splitting it. That is one way to look at what our long-term could be.
Yeah. Another couple of good questions from Yanis. It's the reference lab question. I think we have covered that and answered that one.
There are still some hours left today, but I think we have already responded to that one, the ref lab question. Obviously, there is a good question. When can shareholders get to see a contract in values, margins, something to calculate? This is something we follow very much in the company, and we will continue to give more and more information when we proceed and get more traction in the market so that we can actually share.
We have shared something from our Italian tender, right? At least one. I mean, the details of those ones are public. I do not know if we have published them, but at least on the top line, basically, those are committed publicly. The question was the most important market is the U.S. The question by extension is probably applying to that. I would stand by, Christer.
We'll try to share, if not specific, maybe an aggregate or some idea on the scoreboard that I outline so you guys can see how it's evolving.
Yeah. It's obviously important for ourselves in the company to know where we are, where we're heading, but also to give the guidance we can give, we will give on this. Now, another question. Will this grow to a billion? That's the same question as we have answered, a billion-dollar company. Another question. H ow many machines in total are discussed regarding the multi-site contract?
G reat question. Very good question. Have to be careful here because a too precise answer would basically define the player. So I would look at it this way.
I mean, obviously, it's a multi-site contract, so it will start with a handful of them that were actively planning the sites, but it will have a rollout plan, right, for going forward over some time. I think I struggled to actually give—it's a great question—I struggled to give a more precise answer at that point, partly because I can't define the rollout plan with the customer at this stage. Yeah. I hope you'll bear with us here till at least we get it signed. There will be more of these as well, so yeah.
How long will the money last from this latest funding? I think we have given enough guidance on that one. You know what we have gotten so far in the rights issue and the directed issue, and then we have the warrant part still to come.
We have said that the burn rate, we can translate it into a burn rate of SEK 40 million - SEK 50 million a month, I think. You can take and calculate how long it will last. I will not say more than that right now.
We have a question. The warrants.
Yeah, right. What is the main issue you choose? Short time between emission, which is, I guess, the rights issue and the warrants. Good question. I do not have a good answer, but we do not want to drag on for too long with this. We want to focus on our operating activities. I think it is good to have this as close as possible, I would say. Still, I would say there is a couple of months in between. I think it should be enough.
It's up to us to actually deliver progress during this time. A question from Tubion: How close? How does the interest for Q-linea's product look like on the Swedish market? What is the reason for that?
Good question. Very good question. None of us would like more than to be assured if we were to go to the hospital here, we would get an ASTAR test, I can tell you. Why not the Nordics moving fast, given the technology nature here and also that we have multiple players here involved in this space? It comes down to hospital priorities. For the benefit of Swedish patients, antimicrobial resistance is not a major issue. All hospitals have choices on budget on where they put the money on any given budget cycle.
There are other areas I would characterize it as there are other things pulling more urgently on the clinical return on value. That does not mean the clinical impact on a per-patient basis is any less than the Nordics. We have structured our entire go-to-market commercial strategy to chase the patient, follow the patient. That is part of the reason behind our pivot last year to the Middle East because they have very high AMR, as well as a proven track record of adopting technologies in general to treat patients. Where is the AMR and where is the track record for countries to treat urgent medical needs? Sweden scores high on track record, less so on urgency, if that helps. It will come to the Nordics as well. It may even be that we have some breakthroughs during this year. Let's see.
We're watching this space closely. We're working with Labema and Montebello very closely on multiple fronts in the Nordics.
Right. We have a great question on our financing. How can we secure the financing with Nexttobe dropping out of ownership? How can we secure future financing, basically? That is the question going ahead. Obviously, the easy answer to that is to deliver in line with expectation or above. That's basically what it is. We need to deliver progress. If you look at our company, as Stuart sometimes points out to me, we have been in the race for some time. We've spent some, what is it, $150 million altogether already. We can see the light in the tunnel, as we have said. We also have guided in the perspectives and also on this call that there is a breakeven during 2027.
Once you get closer and you see progress, I would say the chance of getting new funds increase. Obviously, this is something we focus on. We need to focus on this as well as the operations. That's how it is. We are not cash positive now. We need to focus on this as well going forward.
Yeah, I can read it. Can you please elaborate on the status of the two negotiations mentioned in the U.K., as well as the status of the contract received from Italy? Both mentioned in press releases during the fall. The U.K. ones, yes. Where they are, we and Prolab are actively involved in multiple discussions in the U.K. We feel confident that those will have live instruments in the U.K. I think I mentioned the U.K. will move next after Italy.
If that helps give a sense of that, we believe there's imminency here in terms of putting clinical patients through. I can't comment on the specifics of any location there, unfortunately, at this stage. The contract received from Italy. If that is referring to Niguarda or Bambinghi. Our contracts in Italy, they've all been installed. They are live. We are treating clinical patients. They are all ordering kits from us for clinical patients, if that's the question behind it. They are active, let's say. Yeah.
Question from Martin. Is there any issue with having Nexabear as a big owner with the problematics with Bank Aughreen? Should shareholders be aware with the hunt for him personally jump over to Nexttobe? Will Skatteverket take Nexabear into the belonging, see all of the shares?
Let me take this one. I'll start from the top.
Nexttobe has been a tremendous supporter and advocate for Q-linea throughout. Erika obviously remains the chair, Q-linea. We work very closely with her and Nexttobe . They have consistently demonstrated their support and backing for the company. I can't comment on any of the other specifics related to Nexttobe or bank and Skatteverket that I simply don't have that. You would need to go there. Insofar as this is material to Q-linea, we have our assurances that this will not impact Q-linea. That's how we operate.
Question from Sebastian.
U.S. placement, can you please share the development terms of number of tests sold so far in February? For the U.S. placements, I can say that they've made orders for the kits. They already placed POs behind that for the consumable kits. If you remember the pipeline, right?
The contract is signed, then there is a period of installation. What the customers do then is they validate. They get the instrument installed. They link it to the LIS, the information system, so lab results can be presented on patient charts to physicians. Then they need to do a little bit of testing just to show that the tests work in their lab. That is usually very minor, let's say, but we line that up. They start running clinical patients. They are very much on track for that. I think this one will move quickly. It will not need longer times to do. I think even the LIS may already be done. Yeah, it is moving at pace, and they have ordered clinical tests.
I think we have another question on the big reference lab contract.
How sure are we that it will happen in March?
Yeah. I have tried to really emphasize I am very confident in it. We have been working with them very closely. They are super keen to work with us. You can imagine something of this size with this many stakeholders, they really want to get things aligned because this is non-trivial. This is clinical stuff, real patients. They are working with us. There are just internal loops that need to run. Look, we are frustrated straight away. We are patient and understanding that they need to do these. They are internally also actively working to speed things along as much as they can. They do sometimes take a little longer than expected, but we are talking it is a short amount of time here. I would put it that way.
Maybe I can add that in the meantime, we continue to work with their clinical team to identify the first sites that will go in. I mentioned that, right? We have line of sight on that. We are starting to work with them on the, call it the rollout plans. They have multiple sites. How will they educate them and make this available and so on? Let's say the operational aspects of that are moving forward within the parameters that they're able to do so without a full contract, if that is helpful.
We have a question on the stock price and when we can expect to see or when we see positive trends and when we expect to see that.
Obviously, the question I cannot answer, I don't know. We shouldn't be too considerate about that one.
We focus on delivering what we should do in the company from an operation point of view, from a sales perspective, and take the right decisions. We cannot affect the stock price. It's out of our hands. It's the market that sets the price. That's basically all I can say.
I think it's the last question for now, I think.
How do the aid budgets affect operations in Africa? I would say this is not relevant for us. I'm assuming this is referring to our EMEA GCC piece. It's unaffected, I would say, from the USAID. I think it's meant to be one word, yeah. That's helpful. For those still on, thank you very, very much for the extra time. I see this as a sign of high interest. We've got a lot of news, lots going on.
We've tried to give a view as much as possible on the outlook and what to expect. We will give you news as soon as it comes and we can on these things. I do look forward to catching up at our next quarterly update. Thank you again. Thank you.