We're very pleased you joined us for the European Growth Conference. Our first presentation today is from Senzime. Please note you may submit questions for the presenter in the box to the left of the slides, and you may view a company's availability for one-on-one meetings by clicking "Book a Meeting" in the top toolbar. At this point, I'm very pleased to welcome Philip Siberg. He's the Chief Executive Officer of Senzime, which trades in the OTCQX Best Market under the symbol SNZZF, and on Nasdaq Stockholm under the symbol SEZI. Welcome, Philip.
Thank you. Good to be here. Okay, I'll get started. Welcome to this event, and an introduction and presentation of Senzime. Senzime is a very fast-growing medical device company. We're in the field of personalized anesthesia. We're here to enable safer recoveries and make sure that every patient leaves the operating room without the risk of postoperative complications. We're headquartered in Sweden, but we're originally spun out of Mayo Clinic in the United States. Let's start in the jungle. Curare, many of you are familiar with this. This is one of the most deadly molecules on the planet. It's been used for hundreds of years in hunting, where this molecule is put on the arrow. What it does is that it paralyzes the prey in a couple of seconds. It kills the prey really by suffocating it.
This same type of substance, yet in a more synthetic form, has been used in humans as part of anesthesia during surgery for the last 70 years. There's about 100 million patients every year that get what's called paralytic agents. It's an essential part of anesthesia. You get it in combination with drugs and equipment that make you sleep and avoid pain. What happens when you get these drugs is that you get paralyzed in about 45 seconds, and you lose the ability to breathe. You get intubated, and you need to be closely monitored to make sure that you're breathing enough during surgery. The complication with these very toxic drugs is that it's difficult to determine the right dose. In a recent study shown, 87% of the patients actually were overdosed by these types of drugs, and equally, 13% of the patients were underdosed.
Essentially, in that study, 100% of the patients had the wrong dose. Also, a lot of patients leave the operating room still being partly paralyzed. That's because of inadequate monitoring and really understanding the effects of these drugs. It's very important to really thoroughly monitor these patients to avoid any type of postoperative complications, which are very common in the world today. What we've done is kind of beaten this challenge by developing a system that we call the TetraGraph system. This is a portable neuromuscular monitoring system that's used in the operating room. It's used by the anesthesiologist to follow in real time the level of paralysis or the level of block the patient is in. How it works is that you stick on this single-use disposable sensor that is stimulated by the monitor with small currents during the procedure.
These currents then travel through the muscle and the nerves, and you can monitor the actual effects. What is the actual potential? How well is the nervous system and the muscles working? Which is the level of the degree of block that the patient is in? This is very important to assess that you get the right dose, that you also are extubated at the right time, and you can leave the operating room without the drugs in your body. We have delivered about 4,000 of these units to operating rooms around the world. We've now monitored over 750,000 patients. We are a strong pioneer and innovation leader in this field with over 100 patents, and we're active in more than 40 markets. What we are addressing is a technology and clinical shift.
As I said, these drugs have been on the market for over 70 years, and for about the last 30, 40 years, there's been various types of technology to monitor the effects of these drugs. Traditionally, what's been used predominantly in Europe and Asia is an analog technique where you measure the muscle response. The same way you give small little impulses, and then you measure what are the effects. How does the thumb actually twist? It's a very simple technology that's done. The drawback of it is the variability, and studies have shown that variability can be up to plus minus 50%. The beauty of the TetraGraph system is that it monitors the direct effects of the paralytic drugs, and it does it by electromyography. By this, we've shown that the variability is 0.3% or an accuracy of 99.7%.
Very simple to use, very easy to put on, and you get a very safe number from the patient. Further on, studies have shown that if you use this type of technology, you can actually eliminate complications because you will know that the patient has all these drugs out of the body, no risk of residual paralysis, and can leave the operating room safely. It's also shown in studies that if you use this type of technology, you can reduce costs of drugs because you're not overdosing anymore. Studies have shown up to 70% reduction of these pretty expensive drugs. In a typical setup, this is how it can look like in an operating room. You have the robotic surgeon in the back. Very often, our systems are used in combination with Da Vinci and other types of robots.
Specifically, when robotic surgery is done, the patient needs to be very deeply blocked to lie absolutely still. Again, you're not relying on the absolute touch of the surgeon. You're relying on the robot and the surgeon's hands. This is a setup where it's very important that you have a deep blockade, and you can monitor that very accurately throughout the procedure. What we did is we launched our TetraGraph system back in February of 2020. Conveniently, just as COVID hit, we tried to innovate and bring out new technology in the market. It was not easy, but we won quickly traction in the market. Just over a year, just under a year ago, we launched our next-generation TetraGraph. We made a big buzz, and this is really a game changer in the industry because now we made very advanced, very complicated monitoring extremely simple.
We introduced a number of features, including adaptive intelligence. We included a sixth-generation algorithm and a number of features to make intelligent monitoring very simple and easily accessible for everybody. The exciting part of the field we are in are the guidelines. Summing up to about 10,000 studies in the field and over 40 years of research, two years ago, the American Society of Anesthesiologists, as well as the European Society of Anaesthesiology and Intensive Care, issued practice recommendations or guidelines. They think that every patient that receives paralytic agents needs to be adequately monitored. You need to use a quantitative technique to really make sure that you get the right value. It was really shifting from where previously a lot of subjective monitoring was done to now saying that everybody has done this. This has been a key driver of our business.
To summarize our case, what we're in here is a very interesting paradigm shift. We're backed by guidelines. We have a technology, electromyography, that's shown in study to be significantly more accurate than the legacy technology. We've shown that our type of technology can reduce complications and cost of drugs, and we've shown that our system has the highest accuracy and is the only system on the market that is clinically validated at all levels of block. If you look at our business, it's a classic selling and placing monitors and then using disposable electrodes on patients. The install base of our TetraGraph systems continues to grow very quickly. Just during Q2, we delivered out over 700 units and now have over 4,000 TetraGraphs in the field. If we equally look at the sensors, they are growing at triple-digit speeds.
The more monitors we get out there, the more disposable sensors we will sell. If we summarize our latest report, which was the first six months, we grew 90% in local currencies. The drive is, as you can see to the right, the pink part is the U.S., which is about 70% of our business. The remaining is Europe and Asia. Sensors is the big driver. The gross margin was a little bit affected during the first half of the year due to the new tariffs, but also because of the U.S. dollar currency versus the Swedish krona. The ambition here is to grow this company at hyperspeed while keeping our operating expenses as fixed as possible. We're seeing strong effects of that, and our EBITDA level is moving at a rapid pace to reach profitability by the end of next year in 2027.
We are, in Sweden, the fastest growing medical device company on the Nasdaq main market. We're in this classic hockey stick phase where one of the main triggers was, of course, the guidelines that came out early 2023. This is also just showing where we were after six months. I think the excitement here is that we're growing at very high speeds in all our active markets. We have a commercial team in the U.S. and in Germany, and then we have 30-plus distributors and a number of licensing partners covering other regions. A little snapshot on the U.S. market. We made a significant push about two years ago and said, "Okay, we're going to really focus on the U.S. market opportunity." Since then, we've quadrupled the business. We have over 200 highly prominent U.S. hospital systems as customers.
We have a very strong and competitive commercial team that will really help these hospitals to move from interest in this field to be guideline compliant and to be really standard of care in this field. We've had nice growth, and this is just a number of the many releases that we've done this year in terms of big system wins. I'm not going to mention them all, but typically what we win is large university hospital systems or VA or other types of systems who are now transforming and moving to be guideline compliant and moving to our technology. I'd also like to mention our collaboration with Fukuda Denshi, which is a billion-dollar Japanese company, very strong in patient monitoring. With Fukuda, we have a licensing agreement where they have used our technology, and they've built an integrated module with our system. Here we have the TetraGraph inside technology.
To Fukuda Denshi, we not only supply portable monitors for the Japanese market, but also our technology per se, where they can integrate it directly into the patient monitoring system. We now have over 200 hospitals as well in Japan. We recently announced expanded guidelines in Japan, and I'm very bullish about the opportunities in that market. As a company, we are backed by a very strong investor base. We have a market cap of roughly $120 million. Our shareholder base is about 85% Swedish, and the remaining is U.S. and German. Our key and main shareholder is the Crawford family. The Crawford family was part of, were early entrepreneurs, part of starting Tetra Pak and ultimately Gambro that was sold to Baxter. They have a strong long-term view of developing global medical device companies.
We have a number of Swedish pension funds and long-term institutions, as well as one of our latest investors, ShapeQ, a venture capital company from Germany. What is the goal of all this? I mean, our mission is to be the undisputed global market leader in this field. We're really seeing a paradigm shift, and the beauty of the business is, again, the recurring business out of this. We're trying to drive usage to be about five patients per monitor per week. If we do that, we have about roughly $5,000 in revenues per monitor and year. If you look at a typical U.S. hospital, they may have 30 ORs. That's about $150,000 in recurring revenue. If you multiply that by, there's 16,000 hospitals and about 160,000 operating rooms in our target market, we have an opportunity which is way in excess of $2 billion.
The paradigm shift is truly happening of the decade. I just wanted to give you a reflection. What's happening during the last 40 years in the operating room? In the 1980s, you had capnography came out, an early technology that is now standard of care. In the 1990s, pulse oximetry came out. It's now standard of care. In the early 2000s, people started monitoring depth of anesthesia to understand the level of sleep. That is now pretty much standard of care. In the 2010s, it was salivary oximetry. I would say that the main talk of town, one of the key areas of discussions at large anesthesia conferences today, is neuromuscular monitoring, and specifically, people are seeing it as the new gold standard, which is electromyography and our technology. To wrap up, as key takeaways, we are a hyper-growth company. It's an amazing journey to be in this commercial phase.
Past all the regulatory challenges, we have very good control of our OpEx, and it's about growing just like crazy. We are winning big. There's a very strong demand for our product, and we're winning hospital after hospital. The building blocks are there. We have the guidelines. We have an enormous amount of science, key opinion leaders, and we have strong long-term funding to make all this happen. To wrap up, join us on our mission. We're here to safeguard every patient's journey from anesthesia to recovery. Thank you. All right, let's see what happens now. I'll take a couple of questions that have come in here through the chat box. One of the questions is, can I discuss a little bit more about our sales resources, channels, and how I've expanded the U.S. market? We took the strategy of going direct and setting up a U.S.
commercial team quite early in our process. The team is split with what we call market development managers, a number of very experienced developers who know and can help hospitals to take the shift to our type of technology. The other part of our team are clinical product specialists. They have a history of working in the ICU or working in the operating room, so they can be clinically supported to help with evaluations and, more importantly, help with installs, training, and really getting utilization and get this standardized. That's how we've conquered the U.S. market. If you look at the plans outside of the U.S., we are working with partners, as I mentioned. We have a small sales team covering direct the German market, but we will probably continue in the same type of path we are on.
In a question of what regions and product categories accounted for the strongest revenue growth, we are in a phase where it's been growing in all regions. The Asian markets are growing very quickly, partly because of local reimbursement, but also because of long-term work. We've been there in about five, six years in the market, and that is really now taking off. I have another question here. Exciting to say this, looking at this at the latest. Looking at your quarters, when do you see the company becoming cash flow positive? What we have guided to the market is that we're looking at a revenue range of this year to about SEK 110 million to SEK 140 million. Divide that by 9.5, and you have it in U.S. dollars. If you look at where we were in the first six months, we were just under 50 million Swedish krona.
We were about nicely halfway during the first six months. Further on, we've guided for next year to reach 250 to 350 million Swedish krona. Quite a broad range, which is the result of working with big hospital systems and sometimes hard for us to control the timing of these big installations. We've also guided to the market that we intend to be cash flow positive during the year of 2026. I anticipate during 2027, us starting to make actual money. Let's see if I have some more questions here. For how long will we be able to grow with such high pace every quarter? That's a very valid question. The beauty of the business of selling capital and having a consumable tick in a recurring business.
Once I get this to work, and we have the evidence now in the business that you get a very nice exponential growth curve because I'm just adding hospital after hospital, and they are just ticking consumables. If you look at what I just said in terms of our outlook, I foresee that we will continue to grow at very high speeds. As we've now matured the business, our pipeline is much more transparent, and we are working very closely with large hospital systems, and it's easier to forecast this. If I look at, okay, so what is the, if I look at the question was how much of the guideline of the estimated revenue range for next year can I pull out of the current base of hospitals? That's a good question. Now I have far over 500 hospitals as customers.
My target has always been to have at least four sensors used per monitor and week. If I have that number, I multiply it by an average of 30 TetraGraph systems per hospital. That translates to about $30 million in sales in consumables only. I have the building blocks in place. I have the utilization rate. I have the number of accounts. I'm just working hard to get our technology to every single operating room. I have another question here. Can you help me understand where the revenue growth to 2028 is coming from? Can you give us some idea of the revenue for equipment and how much market share would that be? The market here is large. As I mentioned, we're targeting about 6,000 hospitals equal to 160,000 operating rooms. The technology that we are pioneering has only touched the market opportunity.
There are a lot of hospitals and operating rooms left to convert. Looking at the feedback we're getting, the guidelines coming, we know and have also disclosed that there are pediatric guidelines soon to be announced where the belief is that electromyography, our technology, will be the preferred choice. There are a number of triggers that will create the ability for us to meet the long-term targets. I think I have responded to all the questions. Okay, let's see here. A question of, do you have any discussions about integrating with similar systems like Fukuda, for example, with Philips? We have a number of partnerships already in place. We have a long-term partnership with Philips that we signed far beyond 2020. We have a partnership with Masimo. We have connectivity to Fukuda Denshi, connectivity to GE's system, and to Getinge's system. We have a very broad connectivity base.
Those are very important prerequisites because bringing in a new technology in the operating room today requires that data can stream instantly from a system like ours into patient monitors and then into electronic health records like Epic and Cerner. They need to be there. We have the building blocks in place to make that. A question on IP portfolio. As I mentioned initially, we have now 107 patents. On top of that, we have thousands and thousands and thousands of patient data that we use to constantly work to improve our algorithms. The IP portfolio is really a mix of know-how, algorithm competence, and core IP patent filing. Question came up here, a little bit of what the competition is like. Competition here is split into different buckets.
One big competitor is subjective or no monitoring at all, which has been a big dominator in certain markets where subjectively you assess that the patient looks fine. Let's turn off the ventilator and move them out of the operating room, which is proven not to be the right thing to do. The other competitor is a number of companies who are still marketing the AMG technology that I mentioned early, acceleromyography, which is measuring the indirect effects of the drug and looking more at muscle movement. We are two or three companies that are spearheading the electromyography technique, all with a little bit different focus and types of offerings. I'm proud to say that, you know, we are really winning this race, and I believe we are on route to be the industry leader. One question came up here.
I understand that Senzime has a strong product, but it's not clear to me why hospitals would go with Senzime instead of competitors. Is it compatibility, price, simplicity, what hospitals are looking for, or is it word of mouth? I would say we are winning for a couple of reasons. One is we're winning because of science. We are the scientific pioneer and leader, sprung out of Mayo Clinic with enormous amounts of data. We have the most amount of published studies in the field. Two, we are winning because we have an extremely competent commercial team. We are in there to help hospitals win this race. We're in them all the way with clinical competence, helping them to guide, to do everything they need to succeed. Number three, I believe we're winning because we are a transparent, publicly traded company with a very long-term owner approach.
We tick all the boxes in sustainability, and we've proven that our products are superior in the market. I think I will wrap it up there. Let's see here, I have one more. A question came up. What is the win rate? A very valid question. To answer that, I think it's hard to say because we are active in so many different markets, but we are by far winning more than the majority of deals that we are active in. Most of the deals that we are active in are typically competitively evaluated. There are trials and evaluations. There's a value committee discussion, and a lot of people engage to really understand what is the choice. If I revert back to the slide where I showed our big wins, I'm proud to say that I believe we are winning by far the most deals in the market right now.
I would like to wrap it up there. Thank you, and good questions, and thank you for the audience.