Hello, and welcome to interim report Q2 2023. My name is Ben, and I will be the coordinator for today's event. Please note, this call is being recorded, and for the duration of the call, your lines will be on listen only. However, you will have the opportunity to ask questions at the end of the call. This can be done by pressing star one on your telephone keypad to register your question. If you require assistance at any point, please press star zero, and you will be connected to an operator. I will now hand you over to your host, Mr. Jón Sigurdsson, CEO, to begin today's conference. Thank you.
Thank you. Good morning, and welcome to the conference call for the interim report second quarter, 2023 for Vitrolife Group. Today, July 14, and the time now is 10:00 A.M. My name is, as I said before, Jón Sigurdsson, and I am the interim CEO here. I am here together with our CFO, Patrik Tolf, and we will talk you through the investor presentation, and thereafter open up for questions. You will find the presentation on our new website, vitrolifegroup.com. Let's go to page number two. The APAC has been exceptionally good for this quarter, as well as for the whole 2023. For the Vitrolife Group, we increased our sales with 9% to SEK 905 million, excluding discontinued business.
Our sales growth was 10% in SEK and 4% in local currencies. The growth in the market regions, as well as our business areas, different a bit during this quarter. With the exception of the COVID recovery in China, we see that the number of IVF cycles is returning to more normalized level, although there is still a big, differences between and within regions. We also see that several countries have introduced or about to introduce reimbursement programs. This will increase the underlying growth in the future, both the medium and long term. During the quarter, we had a moderate growth in EMEA, a decrease in Americas, and a solid growth in APAC. Our business area level, Technologies, and Genetic Services declined slightly, while our growth in Consumables was particularly strong during the quarter.
We believe that the cycle, the high cycle growth, has put a damping effect on Technologies investment, as many of our customers delay their investment to keep an interrupted workflow, in the post-COVID period. Now, let's move into performance. Net of non-recurring warranty provisions, the gross margin run rate was 56.5%. The margin was driven and impacted by growth and the product and the market mix. EBITDA, adjusted for the non-recurring cost, increased to SEK 299 million, or 33% EBITDA margin. Vitrolife continued to generate a very healthy operating cash flow, and we increased the operating cash flow to SEK 211 million for the quarter, and for the year, SEK 372 million for the first half year.
Patrik, over to you.
Thank you, Jón, and let's move on then to page number three. As Jón said, I mean, the growth in the market regions differed a bit throughout the quarter, and also to repeat that the IB markets and IVF in terms of IVF cycles are returning to some kind of more normalized level, with the exception of China, that also has a big impact on APAC. There are still differences between the regions, as we see, and also within the regions. Looking then on our sales performance per market region, in local currencies, the growth was then summarized to 4%, and that is excluding the discontinued business for the quarter. I will start then with Americas, where we decreased our sales with 6% for this quarter.
We continue then to grow our Consumables business and declined in Technologies. Technologies in Americas is from a small base and has normal quarterly fluctuations. Genetic Services was impacted both on customer and product mix. Americas, then market-wise, we continue to grow in South America, although again, from a lower base, and during the quarter, we also then was impacted by new customer gains that we have in U.S. That was offsetted then by a large clinic chain that decided to in-source the basic PGT-A testing. Throughout the year, we have seen several changes in the genetic testing market in the U.S., where some players within Genetics now focus on other genetic testing areas.
This gives opportunities for us, which we have taken, and we grew in specific areas like carrier screening testing, as one example. We will continue to strengthen our capabilities in U.S. Is the growth in EMEA was 3%, that again, shifts a bit within the region as well. The growth, regional wise, is driven then from North and Central Europe, as well as Middle East. Strong and robust growth of our Consumables products across the line. Genetics Services grew, continued to grow strongly in Middle East. This quarter offset it a bit by a decline in the northern part of Europe.
Technologies made major gains, some major accounts in the North and Central Europe during the quarter, also offsetted them by large installations that was done during the last year. Growth in APAC, 19%, we grew within all business areas. Growth was strong in several markets, particularly Japan, Southeast Asia, and also China. We have seen that the activities in China has continued to increase during this quarter, but is still impacted by COVID. Moving on to the next slide, page number four, where we look a bit more into business area Consumables.
All in all, a growth of 24% in SEK, and 17% in organic growth in local currencies, with a solid growth in all product areas, media, disposable devices, and also the genomic kits that we sell through the business area Consumables. Our focus is on scalability and the investments that we have done previously to increase the production capacity of disposable devices has enabled growth in all market regions. We have, of course, very high quality standards, and during this quarter, we have scaled and ramped up our production on media, particularly to meet the increased demand, particularly that comes from APAC and China, more specifically. Moving on to slide number five, on business area Technologies.
As we know, there are continuously some volatility over the quarter for our installations, depending on the clinic's ability to take on the installations of our systems. The growth within Technologies is continuously driven by standardization within the consolidation of the clinic chains, focus on improving the workflow, in addition then to use the EmbryoScope as an embryo selection tool. We have strong pipeline and strong interest from customers to use our EmbryoScope, supported then by our iDA capabilities, AI capabilities of iDAScore. That becomes continuously more standard of care in several markets in APAC and EMEA. For the quarter, we declined the sales of 2% in SEK, 7% in local currencies. Americas drops 38%, but is impacted by some installations to customers in South America, primarily last year.
In U.S., we continuously see opportunity for the EmbryoScope as we are focusing on workflow and efficiency gain for clinics using biopsy that can gain additional workflow improvements on using our equipment. In EMEA, we did some major installations to customers this year, but also last year, and hence we see a decrease on that side. APAC continued to grow, and we see it continue to grow in primarily Japan. As we have seen in other markets, when it comes to recovery from COVID, we see that the Consumables products normally comes first, and thereafter, investment into Technologies. That is what we now expect in China going forward as well, where the recovery has started then on the Consumable products.
Investments into Technologies is another budget, and will probably come later on during this year and into next year. Moving on to page number six on Genetic Services. Starting then, where we then declined 1% in Swedish crown and 4% in local currencies for the quarter. That is, of course, then excluding the discontinued business on that side. Starting then with the largest market for genetic testing, which is Americas, where we, during this quarter, declined with 10%. We increased by 10% during the first quarter. We continue to grow solidly then in South America, but the base is lower than compared to North America. A couple of things have impacted during this quarter.
Firstly, if we then starting with the customers, we have done some changes there as well. We have a strong position continuously amongst large clinic chains. One of them has decided to insource their basic testing, and we have also been able to gain new customers that offset the majority of that lost sales, which is really good. As I said initially, we have also now started to strengthen our products and services portfolio, and will now also then start to sell the newly launched Smart PGT-A Plus. That will continues to be competitive when it comes to the embryo testing on that side. Secondly, there has been some changes then within the genetic testing market.
Some players working within Genetics has decided to focus on other things, which is an opportunity that we have taken and grown into areas like carrier screening testing as one example. We have also then seen a bit of a change when it comes to the product mix, where we are gaining again on the embryo testing, not only in PGT-A, but also on PGT-M, but we have declined the medium endometrium testing, ERA on that side. That is one of the big drivers for the decline that we've had in Americas throughout the quarter.
Moving on to EMEA, where we had a moderate growth, continuously then a strong position on an EMEA, but has been in Middle East, but it has been a bit offset by moderate growth in northern part of Europe. In APAC, we continue to grow, we grew with 9%, and that is driven then by growth in key markets like Japan, Taiwan, with the endometrium testing and embryo testing, PGT-A and ERA, on that side. Moving on to page number seven, where we then summarize the financial highlights. And let me repeat then, we have done a growth of 9% in Swedish krona for the quarter, and that is then equivalent to 10% in Swedish krona for if we then exclude the discontinued business.
The growth in local currencies organically is then 4% if we then exclude the discontinued business. Gross margin for the quarter was impacted by a non-recurring cost that excluding that one, gives us then a run rate of 56.5%. Margin was impacted positively then by the growth that we have, particularly Consumables, but negatively impacted by the market and product mix that we have, particularly then in Americas, but with a lower recurring cost base that we have for Genetic Services, that is also continuing to be a positive driver for the cost profits.
EBITDA level, we increased that one, and 299 is then the like for like, then giving us an EBITDA margin of 33%. Moving to the next slide, on operating expenses. That increased with 7% to SEK 317 million for the quarter, and that was driven then by investments into sales and marketing activities, such as ESHRE, the big conference here that was done in the end of the quarter, and also relating to personnel cost on that side. We have, since the majority of our operations and staff are located outside of Sweden, of course, we have a negative impact on currencies, which is approximately half of the increase on that side.
Exploratory research focus, R&D cost is then slightly lower compared to last year, and that is primarily dependent on that we have done the agreement on the foundation that was signed in the beginning of the third quarter last year. That is an impact that you see on the positive side throughout this quarter. Moving on to the next slide, which is then again, a summary on the key financials to highlight a few things here. Sales, SEK 905, and then we have the adjusted gross margin, which is 58.1%, and that's where we adjust then for the amortization of acquisition-related intangible assets. EBITDA margin, 33%, and we continue then to strengthen the operating cash flow on that side.
That increased by 17% for the quarter, giving us then a strong cash flow, both for the quarter, and then obviously for the first six months of this year. This gives us then a lower net debt to EBITDA on a rolling 12-month basis, that now is 1.3 x compared to last year, 2.4x. I leave it back to you, Jón, for some final comments.
Yeah. Thank you, Patrik. The takeaway for this quarter is that the fertility market is returning to pre-COVID conditions with some post, admittedly, some post-COVID challenges for both us and our customers. Cycle growth are returning to the normal, reflecting our solid growth in our Consumable business and our ability to leverage on our new global sales and marketing setup, where, which we have previously communicated, and makes us able to extend our market reach both geographically and with the extended product reach. This gives us excellent possibility to benefit from healthy underlying cycle growth and structural changes in the market, where we will benefit from our extended product portfolio on our broad product/services range.
That was very apparent of ESHRE, as Patrik mentioned, the main trade show for the industry that was held in the last of the quarter, the last quarter, in Copenhagen two weeks ago, where we introduced a host of new products and services, cementing our position in the forefront of the development of the IVF industry. This includes new and better genetic testing, upgrade of our media, you know, product range and devices that will not only promote clinical outcome, but also help with workflow in the clinics. All our technological platforms are well suited for the new AI development, and is integrated part of our development going forward. All we are well positioned to benefit from a healthy underlying market growth, expanded product and portfolio, and long and well as this position in the market.
Thank you. Now we open up for questions.
Ladies and gentlemen, as a reminder, if you'd like to ask a question or make a contribution on today's call, please press star one now on your telephone keypad. To redraw your question, please press star two. The first question comes from the line of Jakob Lembke, calling from SEB. Please go ahead.
Hi, and good morning. I have a few questions, and I'll take them, one by one. If we start with the Genetic Services, I would like to hear your assessment of the balance of lost and gained customers here, and also when we look into the second half of the year.
I can start here. The Genetic Services, I mean, those are mixed bags. Of course, as you see, we have a growth in APAC. We have a considerable decline in U.S. The reason for the decline there is kind of, let's call it a very critical article that was published on our ERA testing, claiming that the ERA testing was not beneficial for the patient of IVF, our patients. Partly this is true, as we have never promoted ERA testing for the general patient group. It's very valuable for the recurrent patient coming in, and couples having problems with conceiving.
We have about 15% of couples, recurring couples, we have a very solid proof that this is very beneficial for them. It has to be said that some of our customers have been very aggressive, you know, describing it to the general public, that is the backlash we're facing now. We believe that in the future, this will stabilize, it will be used in the recurrent couples, which is about 15%. Only 2% of those are being helped by ERA testing, there's a lot to gain there. In our view, this is the main reason why this development is happening in U.S. Do you have anything to add, Patrik?
No, I think you covered it well. Going back then to the mix of PGT-A, as we see, I mean, there are some clinic chains that have decided to insource their basic PGT-A on that side, and Genetic Services has, in U.S. particularly, been focusing on big IVF clinic chains. Of course, there are more clinic chain, clinic chains and more clinics that we are also working with now as well. I mean, we've been managing to offset the loss, call it, from some clinic chain to new customers on that side as well. That we have an opportunity to do, which we have captured during the second quarter as well.
Okay. Just a short follow-up on the ERA test. Do you have any sense of when this sort of pressure on that test will reverse, or have you seen any changes recently?
I mean, this article came out in the beginning of the year, and it created a lot of kind of disturbance in the market, and it was harshly written, concluding with a far-reach conclusion. Some of the claims there are right. I mean, we have never recommend ERA testing to be used in the general public and or general patient groups. This is one of those things that have to blow over and stabilize. There are some customers that are kind of hesitant to use it now, but there are others that have never wavered, and those, we believe that this will just stabilize.
It'll take some time, but it'll stabilize, and we believe that there's still potential in the ERA testing.
And, and maybe-
Okay
... to add to that one, I mean, we have, we are the pioneers within this area, but we are not alone. I mean, we have one of our big competitors also, offering similar products on this one. That also, of course, gives us a bit comfort on that side, that there are additional opportunities. We, of course, have the biggest market share within this field today, and we'll continue to work together with our customers to get this really successful continuously going forward as well.
It's very important to understand that this is not something that somebody else is taking market share from us.
Mm-hmm.
This is some customers that are wary of describing ERA testing because of this, discussions within the industry.
The next question comes from the line of Ulrik Trattner, calling from Carnegie. Please go ahead.
Great, thank you very much. I have a ton of questions, we can start off with ERA testing and your statement there that 2% out of 15% of patients having more, sort of, being more problematic are currently using ERA tests. Just how big is the current ERA penetration in the U.S. out of the sort of overall population?
I believe it's, isn't it 3% ±? There is a 15% of recurring couples, and, the penetration is, we believe it's, 3% ±.
Okay, if you were to switch the patients that are been overly subscribed to the ones that actually need this, you would still have considerable growth opportunity?
That's correct.
Absolutely so, yes.
And-
We talk about the risk patients and risk stands for Recurring Implantation Failure on that.
Yes.
That is deemed to be something like 15% of the patients.
Perhaps going back to Jakob's questions here earlier on the call, when you're expecting to see this trend abating, I know the article was out earlier this year? Are you doing anything on your own in terms of clinical studies? You also talk about new products being launched, I know, EMBRACE being on the market, PGT-A Plus or PGT Plus, also being on the market. When should we balance this and see that Genetic Services are back on track and actually growing?
I mean, of course, we are doing a lot of things on this side, on the ERA test specifically. I mean, again, we are upgrading, as I say, EMMA and ALICE, who are also testing when it comes to the timing of the implantation on that side, supporting the transfer of the embryo. That is one thing. We are also speeding up a bit on additional clinical studies on this one. Of course, we have a lot of experience. This is one article. There are some several other articles that talks in favor of ERA, so of course, that will continue. We will, of course, work on additional clinical studies to support our conviction that this is really value-adding on that side.
That's what we do on the ERA side. When it comes to other testing that we are improving here as well, is what is rightly said here, it's the Smart PGT-A Plus, as we call it, which is then an upgrade on the existing PGT-A test on that side that contains additional features that will be launched during, well, end of this quarter, beginning of the next quarter, throughout the year as well. That will continuously then strengthen our position within PGT-A. For us, of course, it's important to be competitive on that area. That we are taking a lot of actions on as well.
Okay, great. As well as on genetic testing, looking at the rest of geographies and your comments, it sounds like the price pressure you have experienced throughout the last few years is abating, and the trend from Q1 looks to be consistent here in Q2. Is that what you're currently seeing, as well as I know that you're talking about taking market share in embryo mapping, which is bread and butter type of genetic tests, so you're grabbing market share, I'm guessing, in those areas as well?
We continued, I mean, to well, expand that business, so absolutely so. Also, I mean, when you think about then the next generation of PGT-A, of course, that will, since that increases more features as well, there will be additional activities on the pricing for that one as well. Those kind of things will also be positive for us going forward, as well.
Okay, question on Consumables.
Mm-hmm.
One being on China, We can perhaps start off with Europe and U.S. They are growing fast, looking at your organic growth here in Q2. Is it that you're taking market share, or are you experiencing that Europe and U.S. are accelerating in terms of its underlying cycle growth?
We believe that there is underlying cycle growth. We, at this stage, we are not prepared to tell you... I mean, we don't know whether we are taking market share or not, but it's and when that happens, it's probably a mixture of both. It is a very favorable situation, and we believe that there is a, as Patrik mentioned, there is a time lap, the time lag in the investment decision on time-lapse specifically that, I mean, because of the cycle growth, the capital investment have been delayed in some customers. We see that in both the U.S. and Europe, and maybe specifically in China, where we have a two different budgets.
They are refraining for making investment decisions while there is such a demand on the IVF clinics.
Okay, good. On China, can you give us some more granularity on the current development and trend in China?
I mean, again, it's recovering. I mean, we saw the call it start of the big recovery then at the end of the first quarter on that side, then it was just a month on that side, but of course it continues. COVID is still not over, right? I mean, it's underlying growth is there, but, I mean, there comes the additional COVID waves in China, as we all know, on that side, that has an impact or has had an impact as well. Going forward, I mean.
It has to be said as well, that, Ulrik, that, I mean, all suppliers are scrambling to meet the demand from China, and we could probably have sold more if we had been able to deliver. The word we are getting from others, that's the case as well for them. This is a post-COVID headache. It's still lingering.
It's almost likely to linger for beyond 2023 as well, I'm guessing?
Yeah, it's probably true.
Yeah.
Yeah.
A question on the margin side. Are you happy with the development? I'm seeing, sure, some minor improvement on the adjusted EBITDA margin, but I recall you had GPDx in the portfolio back in the second half of 2022, which had a negative impact. You were quite confident in gaining margins in Genetic Services, and also when I look at the Q2 isolated, Consumable was the outperforming part here, and it's a margin driver of your business. Are you happy with the margin development currently, and what should we expect going forward, and what should drive margins higher than we're seeing currently?
Well, it's probably not appropriate to say whether we are happy or unhappy about the margins. Of course, I mean, the margins are going sideways, and of course we shouldn't be happy about it. On the other hand, I mean, we have a tremendous price pressure out there. We believe that we've been able to keep the gross profit margin and EBITDA margin. That's something. We believe very strongly that there are synergies still in the piece. There are some scalability, and that's the most important thing. I think that I believe there is a underlying scalability in the business, and the margins, like-for-like margins should improve going forward.
I would, of course, no CFO and CEO should be happy for constant margins. They should improve, and there should be a scalability. I know that is not a very concise answer, but that's how far we can go.
Fair enough. Last question on my end. Cooper and Cook merger, they look to be terminating that. I know that you don't want to talk specifics about that specific event, but do you see opportunities here? Unlike looking at your balance sheets, looking at your cash flow, are you seeing opportunities to buy products from Cook, from sort of that situation? Would it be any product in specific that you would be more interested in?
Well, I mean, you can read the balance sheet as well as we can.
Mm.
We have the financial ability to do it, but I don't think we should, we are prepared to speculate anything on it at the moment. There is no question that we will benefit from this, and just from the industrial dynamics, we are one of the major players. We are a very stable player. We have been able to deliver products where a lot of others have not. I think long term, all this will benefit the bigger ones, and we are in that enviable position. Other than that, I think, I don't think it's appropriate to speculate on it, and inappropriate to comment on what the competition is doing.
Okay, thanks. That's fair enough. Thanks, Jón and Patrik. I'll get back into the queue.
Thank you.
Thank you.
The next question comes from the line of Patrik Ling, calling from DNB. Please go ahead.
Yes, good morning. I also have a few questions. Maybe we can start in the U.S. with the genetic service business. I mean, we've talked a lot about the ERA now. Could you just give us a sense for how much the net impact was of losing a large client and gaining a few new? I got the sense that it was still a few percentage points negative on growth.
Not much. It was basically, I mean, the gains that we have with new customers, has more or less offset the drop that we've had throughout the quarter, on that side. It's more or less flat on that side. Slightly negative, but not material.
It is worth to note, Patrik, that I mean, what, how I look at it is that the big chains are taking the commodity testing in-house, because those are very, very, those are easy, is easy to do. It doesn't require much service around it. It is the lowest profit margin from us. But there are two things there. First of all, there is a huge vote of confidence in genetic testing that they are doing it. That is the first one. I mean, they are not going out of genetic testing at all. They are even investing in it.
That means that our further development in our, the carrier screening, Smart PGT-A, in all the new product, new services are then, and we have a very good chance of getting those which are more profitable and not so easy for our customers to take in-house. Midterm, I don't think it's necessarily a bad development.
If you think about the large chain that you lost now, did you lose everything or did it just in source certain parts of the operation? Can you already see that you're keeping the high tech, high margin products?
Yeah, yeah. Yeah. That's very typical, yeah. They don't take the more specific testing. I mean, what they're doing is that they're taking the, let's call it a commodity testing or more simple ones. Yes, that's the case.
Okay. When you're gaining new clients, are they typically less profitable in the beginning? There is, even if there might not be such a huge impact on growth, might there be a larger impact on profitability from losing a big established customer and, but at the same time gaining some new customers?
Oh, unfortunately, I don't think that. That is a good point. I don't think that's the case. I don't think we are, the, no, I don't think so. I mean, we gain them at the same price. It's a good point. I don't think so.
Okay.
I need to look at it.
Great. Great. I also had a question. I mean, you talked about China and Technologies and indicated that, you know, there's been a big growth in IVF cycles and Technologies investments is held back a little bit, and it's expected to start growing in the second half of this year and the beginning of next year. My question when it comes to that is, I mean, we're moving into the Year of the Dragon, which has historically been a year where cycle activity in China actually picks up, which, I mean, it's a little bit contradictory. I mean, because you should expect the underlying cycle growth in China to actually accelerate during the latter part of this year and into the beginning of next year.
Maybe you can comment a little bit on expectations there.
I mean, Year of the Dragon, yes, of course, as you say, I mean, that's happening next year. That might also potentially continue to boost the growth in IVF cycles in China. Absolutely so on that side. We see, of course, the Consumables product coming out first. Of course, there is a big demand of replacing and make new installments of time-lapse equipment on that side. The point here is that those kind of installations takes a bit longer time. First of all, it's different budgets that it needs to go through on that side, but it also needs to have time then to make those installations as well.
Normally in the recovery phase, those comes a bit later on here as well. Of course, capacity needs to increase in China to meet the increased demand here, as you say.
There's one thing that's very important to come across, and that is we, I mean, APAC is a very successful and the growth in APAC is not only China. It is actually a very positive trend that there are countries in APAC that are coming in very strongly. The very healthy growth in APAC is not only China, it's across the line.
Okay, great. Got it. Okay, thank you very much, guys.
You're welcome.
Thank you.
The next question comes from the line of Johan Unnérus, calling from Redeye. Please go ahead.
Thanks for taking our questions. I only have a few, of course, there are many moving parts, especially in Genetic Services in the U.S., so this is a bit of a follow-up. What should we expect recently short term during this situation? Will you be able or expecting to protect margins or stabilize margins already this year, towards the end of this year, or is this something we should expect more to see next year?
Well, it's, Johan, it's really difficult to tell.
... when we say it's difficult to tell, it's probably that we don't, we don't know. It is the issue is very simple. The issue is that there is an article that cast doubt on the effectiveness of the ERA in RIF patients. We believe that the conclusion is not right. We are countering that. We need to counter it customer by customer, and we believe we have indeed evidence on the contrary. How fast that will that will rectify the true answer is we don't know.
Yeah.
Just to comment, I mean, it's not all about the array as well. That is one important thing as well. I mean, all the other actions that we have done, I mean, we launched, you know, as we call it then the operational excellence program, which is focusing on getting down the cost when it comes to the PGT-A testing, cost the sample and those kind of things. That's continuous.
Mm.
to make progress on that side as well. There were two sides of it as well. I mean, as we know, I mean, the fixed cost portion of Genetic Services compared to Consumables, as an example, is slightly higher on that side as it is today. The margin will be, call it, more dependent on the volume, compared to the other business areas. We are working on both ends, of course, on the cost and the efficiency on that side, and a lot of other activities when it comes to the same side as we mentioned.
Yeah. Two additional on that side, the studies, you are undertaking to support or validate, the core part of the ERA testing, when can that be expected to hit the market?
The Okay, are we referring to the test or the study we are doing now?
Yes, the core 15% support.
Okay.
The, yeah.
Okay, yeah. Do we know?
No, I mean, that, yeah, I mean, it will be, I mean, first of all, to get the whole, call it, market potential penetration up to, from those, say, 2%, 3% where we could possibly be today, up to 15%, that will take some time, of course, for the market to get back to those levels or to get to those levels as well. When it comes to our studies, on that side, we are working on that side, and probably will have something ready by the next year.
Johan, I mean, it's not like we don't have anything. I mean, we have a lot of material already supporting our claim that for RIF patients, ERA is very beneficial. We are, of course, you know, as that, there is an ongoing study now, but focusing only on RIF patients, and I'm not familiar with it. It's not until next year we will have a resource there. I don't know exactly when.
Okay. The support from Smart PGT-A Plus is launch sort of towards the end of this quarter, I suppose. What can we expect on the initial take-up? It's a bit of a, perhaps, at least part of the market is probably on the tougher side to launch in.
I mean, the main focus for the launch of Smart PGT-A will be initially U.S. on that side. That we will launch and start selling here, say, full effect during the fourth quarter for this year as well.
Okay.
Mm.
Yeah, I think that was most on my part. I mean, overall, of course, the ambition is to improve the capital efficiency, but that will come as a result of stabilization and efficiencies and support the volume as well.
That's correct.
Mm.
Yes, yes.
Maybe also finally, in this situation, of course, the support from the Consumables and APAC is, it is obviously very solid, and the good period continues, and what's the outlook on that side? Because that's, of course, very important in this situation.
Yes. Yeah, yes, correct. Yeah, correct. Absolutely.
You, and the outlook, is anything to be said on Consumables and Consumables in APAC?
Well, barring another COVID, you know, another COVID wave, I mean, there is nothing in the cards that should change the trajectory now, but it's. Your guess is as good as ours, of course.
Mm.
That's, it's, yeah. I mean, it's a, it should be a positive trend going forward.
Okay. Thank you.
You're welcome.
The next question call is coming from Suzanna Queckbörner, calling from Handelsbanken. Please go ahead.
Hello, Suzanna Queckbörner.
Suzanna, yeah.
Here. I'm also going to come back to Genetic Services. You mentioned losing a clinic chain in the U.S. due to insourcing. Do you expect this trend to continue into the second half of 2023? If so, is this just the beginning, or have you seen this affect your sales, specifically in the U.S., but also in Europe and APAC already? Also, in terms of these trends and the insourcing of genetic testing, you mentioned PGT-A, but is this trend really just PGT-A, or was it for all genetic testing? That would be question one.
On two, in terms of the ERA, again, we mentioned the impact on the U.S., but there, as far as I understand, the sales have been declining for a while because of this publication you mentioned. Now at ESHRE in June, we actually saw the European Society for Reproductive Health announce that they also released guidelines that were somewhat critical of ERA. In Europe, particularly Spain, you see high use of ERA. Are we to expect that this decline in ERA sales is also going to be seen in the European market? Finally, in 2018, you made this exclusive deal, global deal with Illumina for PGT-A kits, excluding China. We noticed that this is up for review in 2023.
Illumina is the most common sequencing platform, but Igenomix uses Thermo Fisher Scientific. Perhaps you could tell us how we should think about this within your portfolio.
Okay. Will you start with the first one, Jón, on the PGT-A?
Okay. The, yeah, the impact of PGT-A is, I mean, what we've seen is that whether this will continue is that there is a trend that the chains, the consolidation of the business means that there are bigger chains, and there is a trend of those bigger chains to take PGT-A in-house for in-house testing. It, it's a, it's a numbers game, of course, and they in-source what they can, they can do cheaper than outsource it. We've not seen other than PGT-A because of the cost associated with the more specialized testing, and we have not seen those chains take other testing in than PGT-A.
Whether that will continue, it's fair to assume, I guess, that consolidation mean more insourcing of PGT-A. However, I mean, we've been able to gain customers as fast as we are losing them. The net in U.S. is pretty much similar than last year in PGT-A. I hope that answer my questions. It's really a question of whether the consolidation will continue or not.
On the second note here, Suzanna, on the ERA. I mean, as you say, yes, the biggest impact has been in U.S. But of course, we do some sales of ERA in Europe as well. We haven't seen such an impact in Europe. That might happen, of course, going forward, but of course, then you refer to the guidelines here that comes out of ESHRE, which is, of course, also one thing of the debate, backwards and forwards, that is going on now within the professions as well here. We are discussing and debating that one, backwards and forwards with our customers on that side as well.
There are a lot of opinions on this one, as always, when guidelines comes out from ESHRE, on that side. On the third bullet here-
It is actually worth mentioning, as you know, Suzanna, probably better than us, is that there is a quite a difference of opinion between Europe and U.S., where it come to be genetic testing overall, and there are even, big part of Europe doesn't use it at all.
Exactly.
That is debate that is going on. Part of that debate is, of course, that, I mean, there is no question that ERA has been oversubscribed in U.S. As a typical, I'm not going to clunker our customers, but as a typical U.S. healthcare, it's a profit-driven, and it's probably, where described more, more aggressively than it should. By the way, I mean, our guidelines have never, ever, recommended ERA to be, in the overall population of patients. It is with patients, and that's what we've always said.
Going back to your last question about the kits that we sell, we continue to do that. We have extended the agreement on that side, we continue to do that one. During ESHRE, we also did an upgraded version of the CarrierMap on that side. We will continue to do that one, but again, it's based on the Illumina platform, whilst we within Genetic Services, are also currently using a bit of both on Illumina, but also on Thermo Fisher on that side. That is a question to come back to as time goes on here, going forward as well, on the platform and the various platforms.
Thank you. Can I just quickly follow up on two things here? The first question, when you about, consolidation and insourcing impacting largely PGT-A, would that also EMBRACE?
No, that is not on the scope. No.
For the final question, if you have kits that are suitable for Thermo Scientific, well, with a sequencing, platform for Illumina and Thermo Scientific, do you have any issue marketing them both simultaneously?
No. I mean, today, we, the platforms, that we have then within genomic classical, those are related then to Illumina, on that side. That's what we currently have today.
Okay. Thank you.
Mm-hmm.
The last question is from Jakob Lembke, calling from SEB. Please go ahead.
Hi, I was cut off before, but I have two more questions, if I may. First on Japan, now, it's more than one year since the new reimbursement was implemented. I'm just wondering if you're continuing to see higher growth now also when this sort of one year effect is in the numbers.
The question of the answer is yes.
Okay, very clear. Then just lastly on, just high level on Consumables, it's very strong across the board, in my opinion. I'm just wondering.
Mm.
Is this a reflection of where the market is, or if it's anything in particular?
Well,
I mean, it's both, right? I mean, it's market is recovering here, as we have said, on that side, and obviously in particular parts of Asia, China, then it's also that we are benefiting on competition situation in the media product as well. That certainly helps our position, particularly in media, in China and Asia, Southeast Asia, particularly.
It is probably, as always, there is a mixture of some things, and as Patrik mentioned it, a healthy growth in the market, and our ability to support our customers and a disturbance.
Mm
...with the supply, both from a yeah, probably not, should not comment on it.
Okay, great. Thank you very much.
Thank you, Jakob.
You're welcome.
There are no further questions, so I will hand you back to your host to complete today's conference.
Okay, thank you for your participation and a very lively question- and- answer session here. Thanks for that. I want to thank you for a very short but good cooperation as the interim CEO. We are all looking forward to welcome Bronwyn Brophy in her role as our CEO as of August 1st, 2023, well, I will step back to my role as the Chairman. Thank you very much for a short and good cooperation.
Thank you.
Thank you for joining today's call. You may now disconnect. Host, please stay connected.