Good morning, good evening, and welcome to this Medartis 2026 half-year results conference. We appreciate you taking the time this morning to dial in. Our reference document that you see also on the screen is the presentation slide deck, which was alongside the press release and also the half-year report published this morning at 6:45 on our website. With me today on the left-hand side is Peter Hackel, the CFO, and in the middle, Matthias Schupp, the CEO. One brief note before we start, housekeeping question, please refer to the disclaimer, which you see on the screen on slide two, concerning forward-looking statements. We will take your questions at the end and welcome your active participation as always. With that, I would like to hand over to Matthias for his opening remarks and the highlights of the first half on slide three. Matthias, over to you.
Fabian, thank you very much and also a good morning, good afternoon from my side. Thank you for joining this call. You all know I prefer face-to-face. We did it during our media and investor day in June, during the FESSH Congress. Now again, video conference, and in March next year, we see each other hopefully here in Basel. Let me start with a thank you to my team. I think we are very pleased with the results of the first half year. I told you already in our first conference beginning of 2025 that we deliver on what we promise, and we continue to do so. When I say promises, it is twofold, and we will hear it throughout the presentation today. It is the top line, but also the profitability we have in our focus. We are on track with our organic sales.
In the first half year, 17% growth, and this is also very important, we could increase our EBITDA margin to 18%. The TOUCH rollout in the U.S., but also in Australia, is fully underway, is fully on track. Let me add, this is also a continuous rollout, very successful rollout in some European markets like Germany, Austria, and the U.K., because the TOUCH rollout is during some years and not from one month to the other. Most of you were here at FESSH. The biggest hand congress in the world came home this year to our hometown, to Basel, and we were very pleased with over 4,000 visitors and more of the half of them we welcomed here in our headquarters in Basel. They could see the production facilities, but also share some impressions when it comes to education.
As well this year, we had in the south of France, the second TOUCH congress. It was a worldwide congress for CMC1 prosthesis. It was a record attendance. It was fully packed beginning of May, a wonderful organization by our KeriMedical team. NeoOrtho's cold fusion project completed. We moved into the new offices beginning of the year in Q2, and also we opened in June together with our board, the new facilities in Curitiba, Brazil, where will be the home for Medartis and NeoOrtho in the future. We are now starting to move the machines also into the new production facility. I will come back to Latin America, but Latin America, 2026 is a transformation year. A lot of things are happening, and we are also preparing international launch for NeoOrtho. Under this remark, the Latin America figures are really strong.
Based on business performance to date, we are very confident that we can, Peter, elevate the promises, elevate the guidance for the full year to 17%-19% top-line growth. Therefore, you see our cultural triangle on this chart. I think this is a reflection. The results are a clear reflection that our culture is progressing. Our culture is getting speed, and not only here in Basel, in the headquarter worldwide, and I feel this when I am visiting our subsidiaries. The customer centricity is clearly a remark in the center of everything, and we are gaining with our core behaviors, with the attitude, with the agility, with the psychological safety. This is increasing. It is a different culture, and you see this in the results, and this was also confirmed with a very successful clean survey we ran during the month of May worldwide. CHF 160.8 million group revenue.
This is 30.7% up, including contributions of CHF 24.3 million from NeoOrtho and KeriMedical. Our organic revenue growth, 17%, driven by the dynamic growth in the U.S., but also further share gains in EMEA. The European is a region where we already have over 35% market share. Said this, nothing is impossible, and we will continue this momentum in Europe also in the future. Very happy with our EBITDA margin of 18%. The financials you will get explained in a moment from Peter in detail. As I said, we are raising our 2026 guidance. When we look into the regional picture, EMEA, I mentioned it already, I am normally not speaking about markets, but I know that also our countries are listening, our country managers are listening. A special compliment to Germany, the U.K., Spain, and Austria for a very strong H1.
Everybody had strong growth, but growing with nearly 20%, this is outstanding. Congratulations to these countries. The U.S. with 27.4%. Let me tell you, it is not all about KeriMedical TOUCH. Yes, KeriMedical TOUCH is a contribution driver, but we are also doing progress with our legacy business. We are closing the gap in Florida. We will come back to this later. Then 9.6% in LATAM. Here, only Brazil is growing 16%. Remember, softer were the distribution markets in Latin America, where we are changing distributors as we are preparing to launch for NeoOrtho. But the biggest market in Latin America, Brazil, growing solid double-digit, teens 16%. Very good. Shows the momentum we have with Medartis and NeoOrtho because we are also growing in our premium segment. APAC, I am happy with the APAC region, even if you see only 5.5%, but this is a one-time effect in New Zealand.
Not very material. With this, I would like to hand over for the financial review to our CFO, Peter.
Thank you very much. Yes, good morning from my side. Starting with the core sales. In the first half 2026, we reported CHF 160 million core sales or an increase in Swiss francs of CHF 38 million. That corresponds then to a growth rate of 31% in Swiss franc. You see on the left side, we also have a slight negative FX headwind of almost CHF 4 million, mainly driven by the U.S. dollar and by the euro. If currency rates stays at the current level, I expect that to be stable in the second half, maybe even to decline a little bit in absolute figures. M&A and inorganic growth contribution mainly from KeriMedical and NeoOrtho. CADskills, the acquisition we did in the first quarter this year contributed insignificantly to the M&A impact. Total M&A impact, almost CHF 19 million. Organic growth 17%, as Matthias has already highlighted.
EMEA once again posted the highest growth in absolute terms, CHF 40 million. U.S. posted the highest growth in relative terms, 27% growth. All the countries in EMEA were growing double-digit rate, and also the distributor business was growing double-digit despite a softness in the Middle East area that only contributes around 2% to total sales. U.S., we see a significant acceleration versus the full year growth rate 2025 of 13%. That was lifted by a very good start of the KeriMedical TOUCH launch, and KeriMedical TOUCH launch was also one of the reasons why we increased our guidance a bit. We increased full year outlook from 1,200 cases to 1,800 cases, contributing an additional CHF 3 million to top line.
In Florida, where we suffered from the distributor change, especially in the second half last year, we have regained the business in the northern part of Florida, whereas the southern part, which is the home turf of the former distributors, we still need some more time for recovery. We expect that to be at the same run rate as previously at the end of the year. Matthias also mentioned APAC, a bit the slower growth rate. That is caused by a one-time positive impact in the comparative base in the first half 2025, where we recognized a bigger sale from set and instruments to our New Zealand distributors due to the change of the distribution model there, and we pulled out from direct sales in New Zealand. Excluding that one-time impact, growth would have been in the high single digit for the Asia Pacific region.
Japan posted very solid double-digit growth. The Latin America region contributing CHF 17 million double-digit growth for the Brazilian market, also for the Medartis business in Brazil, which was lifted and supported there by the launch of the MODUS 2 set for craniomaxillofacial, but also very solid visit in Mexico, and Mexico will also be the first country where we sell NeoOrtho direct via our own sales subsidiary in the second half of this year.
Looking at the sales development a little bit from a different perspective, from the product portfolio perspective, it shows our strong foothold in upper extremity that posted the highest growth with 21%, increasing the share of upper extremities to 71% of total sales, an increase of four percentage points. That was driven by a very strong performance of the hand and wrist portfolio, and lifted also by the expansion of the KeriMedical TOUCH sales around the globe.
Lower extremities, a bit lower growth, but double-digit growth of 10%, and CMF has only a single-digit growth. As said, that was impacted by the distributor sales to the New Zealand distributor in the first half. Excluding that, CMF would have posted also a high single-digit growth rate. Before we dive into the P&L, let me comment a bit on the tariff situation with the U.S. tariffs. In the first half 2025, we basically did not recognize a substantial U.S. tariff impact. However, in the second half, we imported our products to the U.S. with a 39% tariff rate. Already at the press conference in March, I said I expect a significant impact of these high tariffs in the first half 2026, because these products were still on inventory and only with selling the products to the hospitals, to the surgeons, we will recognize the 39% tariff.
However, at the beginning of the year, we applied for a refund of this excessive tariff rate of 39%, and we got refunded by CHF 4.4 million in the first half 2026 of this year. We have recognized that fully in the P&L. However, in the cash flow, it is not recognized yet, and we expect to get the respective cash in the coming weeks. The majority of that refund of CHF 4.4 million was used to normalize the tax rate in the first half with a rate of 12.5%, roughly. That is also the rate that I expect going forward. That leads to a charge of $800,000 U.S. tariff expenses in the first half in the core results. The remaining part that was not reused to normalize the tax rate to 12% was posted in the IFRS result, lifting the IFRS result by CHF 900,000.
That means in the second half of 2026, I expect a similar tax rate based on current knowledge of 12% as in the first half. Our project to shift production to the U.S. for the U.S. domestic market is fully on track, and we expect to produce around 70% of local U.S. sales in the plant in Warsaw by the end of the year, and we expect that this share is going slightly up in 2027 to around 80%. Coming now to the alternative performance measures and the reconciliation between the IFRS result and the core result. You see our usual reconciliation. The left side, the one for M&A impacts, which is mainly the amortization of the acquired intangibles of historical acquisitions. Then you see the normalization for the non-core business, the third-party business that we are producing for third parties in our Warsaw plant.
That is expected to phase out once we use the capacity, and we need the capacity for our own production. On the right side, you see the column, others, with basically two postings. On the one hand, a gain of CHF 1.7 million of the refund of the excessive tariffs that was not used to normalize the tariff rate of 12%. On the other hand, the second posting, a charge of CHF 1.9 million in OpEx, which was caused by a litigation that was initiated by a supplier without cause. This litigation is fully settled out of court, and we didn't pay anything, but we posted the cost for the litigation here in the other columns of the non-core results. Coming to the gross margin. The black columns represent the core gross margin and the increase on a constant exchange rate of very strong 140 basis points.
Gross margin in absolute terms amounts to CHF 130 million or an increase in Swiss francs of CHF 32 million. On the very left side, you see the FX headwind of 60 basis points, once again, mainly driven by the US dollar and the euro. Adjusted for FX gross margin in Swiss francs did increase 80 basis points. The main drivers of the gross margin increase was, on the one hand, a favorable product and price and regional country mix, contributing 70 basis points to the increase. Then further, very strong efficiency increases in all the plants around the world, another 70 basis points increase. Then you see the consolidation impact of 50 basis points increase, which is basically the internalization of the gross margin of KeriMedical, which was still a distributor in the first half of last year and is fully consolidated since 1st of July this year.
You see the charge of the U.S. tariffs of CHF 800,000, leading to a reduction in gross margin of 60 basis points, and the overall gross margin of 81.5% for the core business. Moving on to the EBITDA reconciliation. Also here, you see an increase of EBITDA of 90 basis points on a currency-adjusted basis. In Swiss francs, the increase was 20 basis points and once again, a negative FX headwind of roughly 70 basis points. Absolute core EBITDA amounts to CHF 28.8 million or an increase in Swiss francs of CHF 7 million. The biggest contributor in EBITDA increase is the gross margin impact of 140 basis points. You see a favorable development of our OpEx ratio despite significant investments into the expansion of the business into the launch of KeriMedical TOUCH in the U.S., but also in building up the KeriMedical organization in the European markets.
You see a decline of the associate result. In 2025, we recognized the contribution from KeriMedical, and that obviously declined to zero after the consolidation of KeriMedical. You need to net that decline basically with the profit gains in gross margin and reduced OpEx ratio that we recognized through the consolidation of KeriMedical last year. Coming now to the net result. Last year, we posted a net loss of CHF 400,000, a significant increase in core net profit to almost CHF 7 million. CHF 7 million increase. You see CHF 5 million increase driven by the operational result, the decline of CHF 1 million from the associate result, and you see a very favorable contribution of CHF 7 million from the finance result.
That is mainly caused by a favorable development of the Swiss francs versus especially the Brazilian real and the Australian dollar, and led to a FX gain on intercompany outstandings and intercompany loans up to CHF 7 million. You see a higher tax charge of CHF 3.6 million, bringing net result to roughly CHF 7 million in the first half of this year. Let's discuss now the final chart from the financial overview, the development of the cash, and the development of the free cash flow. You see the operating result contributed positively CHF 8 million to the cash flow development, and you see very high CapEx investments of almost CHF 18 million in the first half of this year as expected and as already announced at the full-year press conference together with our guidance.
About 10 million of these 18 million CapEx were invested into machines in the KeriMedical production sites in Basel and in Archamps, as well as in the expansion of the production site and the new building for NeoOrtho in Curitiba. We had another 4 million investments in sets in the first half of this year, and then another 4 million ordinary CapEx, bringing that figure up to 8 million, resulting in a negative free cash flow of CHF 10 million. If you take out the extraordinary investment of CHF 10 million that I have mentioned right at the beginning, you see free cash flow is around breakeven. In M&A and other investing category, that is the second milestone for the KeriMedical investment, as well as a smaller investment into the acquisition of the CADskills.
Financing contributed positive CHF 17 million in cash generation, and that is basically an increase of the bank loans by CHF 26 million. You see a marginal FX result bringing the cash balance at the end of the first half to a comfortable CHF 26 million. With that, I hand back to Matthias for the strategic outlook.
Yeah. Thank you very much, Peter. It is good, and I am happy to have you and such a strong finance team on board. Peter has also other qualities we will come later to this on the commercial area. Let us speak a little bit about the strategy update. Our strategic house has not changed. Everything is based on our high-performance culture with a high-performance team. I spoke already about this. I think accelerate the U.S., we have this on our plan since last year. We are doing this, and I think you see it in the figures. This gives me also the opportunity to inform you that our U.S. president, beginning of this year, for personal and private reasons, decided to leave. No impact because I was already very close to the U.S. team. We have a totally different U.S. team than in the past.
We have this in good hands currently. I think the results we see since this happened for the first half year are very positive. Nevertheless, also would like to use the opportunity to thank him because strong contributions also from him during 2025. KeriMedical, this became one team. KeriMedical standalone within the Medartis Group as a group company like NeoOrtho as well. Fantastic performance, fantastic management. Very happy having KeriMedical and also showing now when we have international congresses, when we have international events, KeriMedical and the Medartis Group team on one stage together. The value strategy, I have to say, fully on track. Still a lot to do. Our Cold fusion project is finished in Curitiba. We move together now. We are preparing, like Peter said, the launch now in Mexico towards end of this year.
We are preparing then, beginning 2028, the other Latin American markets like Colombia, like Argentina, like Chile, where we have no opportunity to further gain shares over the next years. As I said before, in EMEA, with the team of Mareike, we are showing this very successfully. When it comes to innovation and digitalization, we are working on the future. I believe I stated this during one of our meetings last year, that we clearly know that innovation cannot come only through acquisition or M&A. We have strong teams in our R&D department. We have strong teams worldwide. We are working on our own innovation. When it comes to innovation and digitalization, it is not the next year. It is 2030 and beyond, where we are looking now, and great things are prepared and the team is working on.
Last but least, Peter, this is your strategic responsibility to improve the cash flow. Let me tell you one thing. We have a clear plan. I am very confident with this plan, and I am, as I said, very confident also with Peter and our finance team, this will happen. On top of everything is our customer. Our customer insurance company, surgeons, hospitals, distribution partners. We have also internal customers, and they are in the center of everything what we do. This is the big change if you compare Medartis today and Medartis maybe five years ago. We are firmly on track to meet our full-year TOUCH projection. KeriMedical continues to grow dynamically. We are growing 45% in the Medartis direct markets, and we are growing by 30% the business with external distribution partners.
We are even growing, and I mentioned this at the beginning, in the mature markets like France and Belgium on a run rate of around 20%. We sold last year a little bit more than 40,000 TOUCH. TOUCH cases were performed. I am speaking about volume, and we will grow to around 60,000 cases this year. Peter mentioned it, and I will come back to this. This is one of the reasons why we are increasing our production facilities in Archamps, in Besançon. We are preparing for the future. We are preparing for the TOUCH future because this is just the start. Yes, we are very happy with the initial start in the U.S. We only launched in January. We see a very good acceptance of the TOUCH prosthesis. We see a vibe in the U.S. market. We are on track with everything we have planned.
Therefore, we feel comfortable to raise from 1,200 to 1,800 our TOUCH units in 2026 for the U.S. Let me say, on the reimbursement price, on the ASP, with $6,500 US dollar, nothing has changed. The Medartis Group had a strong presence in Nice during the CMC1 conference, congress, and also the FESSH. Education is everything, and those congresses are a lot about education. Education is one of our clear, strong pillars beside innovation for the future. Therefore, those congresses are important. Therefore, it is also important to have such a strong scientific and education partner like IBRA and such a modern IBRA Institute here in Basel. As I said to you, news will come. We are still coming this year with our education center in Florida. The one team, and here is my one team.
Most of the players, you know, and let me touch it. I said that Peter has more talents than only finance. He has also commercial talents, and he is currently heading at interim also the U.S. I did this immediately beginning of the year when our former U.S. president left, and we had such a wonderful transition. We have such a strong team today in the U.S. We are on plan. We are executing on plan in whatever area we are active. We have the TITAN Nail launch just in execution. I will come back to this currently in August. We have now in September in Boston, the biggest U.S. congress, the ASSH, where we have a fantastic representation.
In order to not disrupt his team and to give them a home and to achieve our goals, we decided that Peter will lead this team at interim at least until the end of this year, because currently it could not be better. I have learned during my professional career, never change a winning team. Also, I would like to announce that we have decided together with my board that Julie Moyet, the CEO of KeriMedical, will join our EMB by January 1, 2027. This is a clear message also how important KeriMedical is and how important this one team approach is for KeriMedical with my Medartis Group team, and therefore, they need a voice also in the EMB. We will announce it at a later stage, but in January, our new CEO for NeoOrtho and EVP LATAM will start.
This position, and this is not new, I already announced it, will be part of the EMB as well. We have no other changes here. As I said, Julie joining us. She has a long, long background with KeriMedical. She was really growing under the leadership of Dougal and Bernard, the founders, in this role. She is coming from R&D. She is coming from quality and regulatory. She knows the whole organization. Nobody better than Julie to represent in the Medartis Group EMB, KeriMedical. When we speak about KeriMedical, we need to speak about our production facilities. You see it on this picture. We are growing. We have now six. Peter mentioned it already, premium implants in Warsaw, U.S., we are ramping up by end of this year to around 70% of our volume we need for the U.S. produced in the U.S.
Next year it will be 80%. We call this project Flash, and it is faster than a flash. Then we have our value implants new production facility, which we just officially opened in June this year in Curitiba, where we are now moving the machines in from the old production facility, but also new machines we are expanding. This is in progress throughout the second half and in Q1 2027, and therefore I said for Latin America and not only NeoOrtho, it is a transformation year 2026. Then we have two production facilities, one in Besançon, where we will build a new production facility starting this year, and one production facility in Archamps, which is close to Geneva, where we just a few weeks ago had the opening of the expansion.
We are really looking ahead the next three, four, five years to have the volume for KeriMedical assured to be produced. Then we have in Ghent, our CADskills production facility and offices in Belgium. Very happy with the start of CADskills. Very happy with the acceptance of CADskills, especially in our European markets. Then last but least, we should not forget it is where we are sitting today, our headquarter, our premium production, our main production facility in Basel, Switzerland. Premium is Swiss production and will be Swiss production also in the future. We have expansion plans also for this plant here at Stücki Business Park in Basel. As I said, we opened, these are some impressions of the KeriMedical plant in Archamps with a lot of politicians, but also a lot of customers.
This was really a highlight also for Archamps and for the industrial zone to have in such a short time the first expansion of KeriMedical. Here you see how the new plant will look like in Besançon. This will be really a big plant, where mainly the implants will be produced and the land is already purchased, and the building will start in Q4 this year. As you know, we are fast in construction plants. We have shown this also in Curitiba. Coming to Curitiba now, you see it on the Viver em Movimento, so living in movement. This is the slogan from NeoOrtho, and this picture shows also our entire board in Curitiba, visiting and opening the new plant in June this year. We are in a new home now.
This brings me. This is so important because I think it was a little bit a wrong assumption over the past that we do not know exactly how to tackle the U.S. or what is Medartis doing in the U.S. I think we are showing now for the second time after the successful KeriMedical TOUCH launch, that we know how to tackle the U.S., that we know how to prepare a launch. TITAN Nail is replacing the NX Nail, a product which we had since nearly five years in distribution from an external partner. We decided to develop our own nail to improve the existing nail. The launch shows us how fast the acceptance is on one hand. We have still the Field Orthopaedics NX Nail in distribution, exclusive distribution in parallel until February next year.
This gives us the momentum to introduce our TITAN Nail parallel to this. But it shows me as well how fast our R&D teams are, how focused they were. This is the first product in the Medartis history where we have disposable instruments. It is a new step into the future, not working with sets, but with disposable top-notch instruments. We will gradually now phase out the NX Nail and transition to our own technology. This will bring us not only more credibility in the market with an innovative product, but also our normally used operational margins because it is our own by-us-produced product and not something we have in distribution, which is never, I think, long-term standing good. The new Proximal Humerus system in limited release, we know that we have to improve shoulder.
We know that this is addressing a top three indication where we were not present. This is, again, one of the innovations of our team. This is not just bringing a product. This is changing the mindset, and this is a result of working very closely with our design surgeons. It has a new PentaLock locking system for selected indications, which is complementing the APTUS portfolio and anatomical plated design. This is a specialty, that the plates are not just plates. The plates are anatomical plated design and a huge advantage for bone and soft tissue management. With all this in mind, as I said, we are raising our guidance to 17%-19% core sales for the full year. We remain positive with our core EBITDA margin, as Peter stated, in the high teens. We are really now accelerating the momentum.
You this graph, where is our organic growth coming from, looking back the last six, seven years. I don't like to look back. I'd like to look into the future and how this is now accelerating. We are feeling very confident from what will come in the future. This was it from our side. Thank you very much. I will hand over to Fabian now for the Q&A.
Yes, excellent. We move seamlessly to the Q&A session. As this is an online call, we would appreciate that you use the question button, which is this, I guess you use from other companies, the Raise Your Hand button, and then we will call you up. The first question is from Sandra Deplazes from Octavian. Please unmute yourself and ask your question.
Yes. Good morning, gentlemen. I have two questions. The first one is on the U.S. In the U.S., excluding KeriMedical TOUCH, how is the underlying momentum doing? Is it fair to assume some low double-digit growth in this underlying business? It would also be helpful if you could share some more color on the is there an expected headwind from this TITAN Nail transition, so the phase out, or is this even accretive, this transition? Just to better kind of understand what to expect from the underlying business in the second half of this year. That would be my first question.
Yeah, Sandra, good morning. Thank you very much for your questions. Spot on. The KeriMedical TOUCH, I would like to give you some idea. You know that the reimbursement price, the ASP is $6,500. We did around 700 KeriMedical TOUCH in the first half-year. This gives you a heads-up that we are also with our legacy or base business underway. We still have an impact, as Peter said, in South Florida, in the home turf of our former distributor, where we are still reducing the gap. I think this will happen until end of the year because we are now driving the second half, where we had really seen the impact last year. So well underway in North Florida and well underway in the rest of the U.S. It's not all about KeriMedical TOUCH. TITAN Nail.
The TITAN Nail is really interesting, because we have a chance to launch it in parallel, having still the distribution for the NX Nail. We normally would have increased the volume, but we are now phasing in one on one in. We expect to come in in line with what we have done with our NX Nail. Why not faster? Why not more aggressive? Because although for the TITAN Nail, as I explained it many times for KeriMedical TOUCH, you need contracts. We are doing this currently, changing contracts. We are very positive with the change. We will not see an impact.
Okay, fair. Perfect. My second question is on LatAm. Could you there split the growth from the premium Medartis franchise and the one from NeoOrtho? There was a break in the call, so maybe you elaborated on it, but I couldn't hear it. What is the trend in the premium segment? Is there still some pressure on that, or how do you see that also going forward?
We have double-digit growth in premium and value. We see this premium is accelerated, especially in Brazil, because we did some reorganization also on the commercial side. I see no pressure. I see possibilities. You know that only 15% of the market is premium, but we had room for improvement in this premium segment. It looks a little bit different and you see overall we are only growing 9.6% or 9.7%. The impact is distributor markets in Latin America. Distributors where we are not directly represented, where we put a stop a little bit and restructured now because we need new partners to distribute NeoOrtho and Medartis in the future. We are preparing this. But the direct market, Mexico and Brazil, we are well underway and this is the indication for the future. We can grow in premium, but over the years, the acceleration with value will be faster.
But also here, Sandra, we should be a little bit patient. I am very happy. It is fantastic. But we are already jumping into conclusions what will come. We are still in a ramp-up phase for NeoOrtho. We just moved to production. We just moved to people. We are at the moment transferring the machines. So everything will come together next year.
Fair. Thank you very much.
Good.
Good. Thank you, Sandra. We move on, and we take the questions else by order as they come in. So the next one is Tanya Hansalik from UBS. Please go ahead.
Tanya.
Tanya. Mm-hmm.
Yes.
You-
Hello, can you hear me?
We can hear you well.
Yeah. Good morning. Thank you. My first question is on the higher sales guidance upgrade. Can you maybe talk about the reasons for the upgrade and what proportion is attributable to the higher KeriMedical TOUCH target of 1,800 units? That is my first question, please.
Tanya, good morning. The upgrade from KeriMedical TOUCH 1,200 to 1,800 is a momentum we see in the U.S. I said it before, answering to Sandra, we did around 700 KeriMedical TOUCH cases the first six months. Imagine we started in January with 20 KeriMedical TOUCH cases. I mentioned to you in May, when you were here, we did 150, so it is ramping up slowly. This gives us the confidence. August will be a softer month because it is elective surgery, and elective surgeries in August in the U.S. are a little bit slower, so we will end up the year on 1,800 KeriMedical TOUCH.
Yeah, the question was, how much of the raise in the guidance was attributable to KeriMedical TOUCH and maybe to other businesses?
Oh, no. I think this mix is not only KeriMedical TOUCH. We have also a good base business growth, especially in the U.S., where we said it, the second half of the year has a lower base or higher growth now because of the Florida impact, which really started to kick in end of July last year.
Good.
Okay.
Tanya, you have a follow-up question or-
Yeah. Well, yeah, maybe on the U.S.-based business, do you see any evidence of cross-selling from KeriMedical, or is this a bit too early for this? When should we expect this to kick in? Yep.
It's really a little bit early, but we see it. It's too early. We have now around 20 surgeons, which are already using Medartis products they had not used before because they are onboarded on KeriMedical TOUCH. This is really something we see. But, I cannot quantify it now. It's really too early. Let us tackle it in March when we have the full year. We have a little bit more meat on the bone.
Okay, thank you. KeriMedical TOUCH was also very strong, as you mentioned, in Europe. You had, I think, 60% growth with your own sales force. Can you talk about what are the main drivers for the high growth? Can we expect this to continue? Is it increasing penetration in existing markets? Is it new markets? Is it EMEA? What
Yeah.
Will help it continue?
I have to correct you. It was not 60%, it was 40%. We had in our markets in Europe in the first half year with KeriMedical TOUCH, and it was 30% in the distribution markets. Our markets are relatively new. The Medartis markets we had before the acquisition already like Germany, Austria, and the U.K., we are now coming from the third to the fourth year, which really accelerates a lot. So, huge momentum and very strong opportunities, 30% growing in Germany, for example. But also, and this is important, in mature markets like France and Belgium or France, where the KeriMedical TOUCH prosthesis is already nine years in the market, where they have 80%, 85% market share. It's becoming more and more patient elective and patient marketing driven. We are growing 20% as well.
The Europe growth is not over, and this shows as well that KeriMedical TOUCH is not only the U.S., and the U.S. is not only KeriMedical TOUCH. KeriMedical TOUCH is also Europe, and Europe also will benefit from KeriMedical TOUCH in the next years.
Good. Thank you.
Thank you.
Then we move on to the next gentleman, that is Errol from Stifel. Can you please also unmute yourself?
Perfect. Can you hear me?
We can hear you well.
Yes. Perfect. Good morning, guys. Thanks for taking my question. I think the first one would just be back on the upgraded guidance. I think on my numbers, it is around 1% for the new KeriMedical TOUCH procedures that you have added. I think you have mentioned also that there is other facets to why this growth has been upgraded. Is there maybe perhaps anything on the negative side that sort of only, let us say, moved guidance up by 1%? That would be my first question.
I can answer it. Peter, you can answer it?
I can answer it. Yes. Errol, you are saying it is every time the same, but that we are cautious. I think we deliver on our promises. I think, as I said, we have still a way to go. We feel comfortable with the guidance we are giving now with the rise of the guidance. As I said, KeriMedical TOUCH August in the U.S. will be a little bit softer, because it is elective surgery. On the other hand, yes, we have a positive momentum on the base business, with double-digit growth in the second half. We are confident. We have still some things to do. We are speaking only about the U.S. and Europe.
We are now bringing new organization into Japan, so we have still some balls in the air. Therefore, with raising the guidance now from 17% to 19% for the moment, it is fine.
Perfect. I guess just on the surgeons that you have trained, I think you have touched on this in June at FESSH, but maybe just the actual surgeons that have converted into cases and how you would expect this to develop or change throughout the rest of the year.
This is changing. This is also another reason why we raised the expectation of number of cases. Remember that a new surgeon, he starts with one or two cases, then there is a pause. He is waiting for the six weeks, nine weeks results, and then he is doing the next patient, so very slow ramp-up. Currently, only half of the trained surgeons are doing KeriMedical TOUCH, but not because they do not like, but they do not have a contract in their hospital to do it. We have trained a little bit more than 200 surgeons. 180 we have trained this year. We had already trained surgeons in 2025. We have to add a little bit, half of them are doing KeriMedical TOUCH currently. The others are kicking in when the contracts are coming.
When a training and education is older than three months for a surgeon, and he had to wait, or she had to wait for the contract, we have to retrain them. This is now work in progress, and we are continuing to train surgeons, but currently we are focusing training surgeons in hospitals where we already have the contract in place. Contracts are currently delayed by six to eight weeks. It is around six to eight weeks to get the clearance in the hospital for the KeriMedical TOUCH contract.
Very clear. Thank you. Then just finally, just would be on EMEA, and I have to say congrats to your geography team again for a very strong performance. You mentioned the strikes in Spain and U.K., and you are not the only company to call these out. I just want to understand, was this a major impact for you or not, and could you quantify this impact at all?
No, I did not mention strikes. I mentioned congratulations to our team in Spain and the U.K. for a super first half year.
Yeah.
They did a really good job. Yes, it impacts, of course, when there are strikes, but the team is, especially in the U.K., they are already used to it and preparing and urgency cases, patients after an accident, trauma patients are anyway attended. The teams are managing this very well, and they had a strong momentum in the first half year.
Maybe, Errol, I can add to that. You read the press release obviously very carefully. There was some impact on the strikes, yes. But that was not significant. U.K. had an excellent performance. It was actually the best-performing touch country, when you look at the growth rate of that business segment. I would say that without that, we would even have grown a bit stronger.
Yes.
A slight impact, but not something severe. We usually try to list every element that is in the first six months, and that was one element that was brought up also by the business region.
Understood. Perfect. Thank you very much, and congrats again.
Thank you very much.
Thank you, Errol. Let me move on to Michelle Baumgartner from ZKB, Zürcher Kantonalbank. Please also unmute yourself.
Hello, and thank you for taking my questions. I hope you can hear me fine. I have a question for Peter on the free cash flow. I appreciate that the CHF 10 million were extraordinary. How should we think about this going forward for the second half and maybe also midterm? That will be my first question.
Yeah. Thank you very much for that question, Michelle. I would also expect in the second half significant investment into growth and into the expansion of our production. We will start the construction of the new plant in Besançon in the second half of this year. Overall, a similar rate, not at the very high level as in the first half, but roughly a little bit less than in the first half, ramping up to about CHF 35 million total CapEx for the year. Going forward, I expect that the free cash flow, based on our very solid strategic plan that we have, will significantly improve then in 2027, especially in 2028.
Okay. Perfect. Thank you. Maybe also on the EBITDA margin potential, I know you don't really have official midterm guidance, but could you maybe say something about where you see it going?
You mean now in the short or in the midterm? In the short term, I feel comfortable with the EBITDA margin of 18%. That's fully in line with our guidance of high teens. We also left the guidance at high teens. It's always a question how much we invest into the further expansion of the business, especially also in building up structures to push further growth in the U.S. for the TOUCH business. In the midterm, I think an 18% margin is at the lower end for a Medtech company, and if we continue on our growth path, I'm very confident that we can also cross, then, the 20% margin level in the coming years.
Perfect. Thank you. Maybe one last question. Matthias, you mentioned the introduction maybe of single-use instruments in the future. Do you see, in the future, an impact on CapEx? Because sets are a huge part of your CapEx. I guess it is too soon for material impact right now.
Yeah, Michelle, good morning. No, it is a little bit early, but I said it a few times. I clearly see the tendency going to single-use instruments and to smaller instrument sets in the future. I see this because with the old-fashioned sets, and not only from us in the orthopedic industry, you can even sometimes hardly lift them into the sterilization. It is crazy. So I see this. This is a process over time. This would be beneficial, of course, for our CapEx, and much easier logistic and supply chain-wise, but this is a long process. This would become very disruptive in this industry. But in hip and knee, we see this tendency as well, and we started now to go in with our nail, and look, it is well-received, so why not targeting now other portfolios as well? But this is a process.
You need to produce them, you need to design them, so this will may come over the next years.
Thank you.
Good.
Thank you, Michelle. Just for your information, if you want to review the growth rates for KeriMedical TOUCH in the distribution market, that was outlined on slide 17, because I got some text message. 17 is the slide. Then we have a follow-up question from Sandra. Sandra, could you also again unmute yourself?
Yes. Thank you for taking my follow-up questions. I have one for Peter on the currencies. You mentioned that you would expect a similar currency impact on the sales in the second half as we have seen in the first half. Is this also true for the EBITDA margin, or is there anything we should be aware of because of changing production side? As I understand, your guidance is in local currency.
Yeah. No. Your assumption is correct, Sandra. If you look at the currency development we saw, especially in appreciation of the Swiss franc after the first quarter 2025, that is basically causing the impact in the first half. But we never know how the currencies will develop. What I said is based on current level, obviously, but I'm sure you're aware of that.
No, sure. Okay, cool. One last question for Matthias on coming back to KeriMedical TOUCH. Now you raise your expectation to 1,800 for this year. You previously mentioned that you have kind of an expectation or an ambition to reach 10% market share by 2030, which would be some 15,000 KeriMedical TOUCH already. Some thoughts on that midterm ambition?
Yeah. 2030 is a long way to go, no? Look, I still believe that when we did our business case for KeriMedical, we did a good analysis. If you see that our budget for the first year was CHF 1,200, it was really a safe budget, it was not a crazy budget. Now we see that things happened in the U.S. which we did not imagine, that the surgeons, on one hand, accept it so well, and on the other hand, that we get so much media. Media-driven through the hospital and surgeons. I showed in June, when you all were here, a video from a TV show. Those are things which are driving this momentum. Yes, you know me, I'm positive, but I cannot give you now a new guidance for 2030. You never know. Let me say one thing.
When they started, and I'm discussing this with KeriMedical, with the management, with Julie. When they started nine years ago in France, nobody ever imagined that they could do in France 80% of the market share and 17,000 cases per year. Then you put this 17,000 after nine years in relation to the 15,000 in the U.S., I think this answers a little bit the message. Let us go this year, let's discuss it next year when we have a bit more information.
That's perfectly fine. Thank you so much.
Okay.
Yes. Then we have a follow-up question from Errol Kenneth, from Stifel.
Hi, thanks for taking my follow-up. I think for me, it is just on the APAC opportunity. I think you talk about the reorganization in Japan, and I am just trying to understand how should we think about Japan, maybe not just for this year, but obviously into the midterm. Then obviously on the Australian KeriMedical TOUCH news as of the 1st of July. How exciting is KeriMedical TOUCH in Australia? Appreciate it is a smaller geography than others, but some initial thoughts there would be interesting. Thanks.
Yeah. Let us start with Australia KeriMedical TOUCH. Everybody is excited. I think we did around 500 cases out of the pocket where the patients had to pay. A little bit, the KeriMedical TOUCH reimbursement price is around CHF 1,300 in Australia. But as you said, it is a limited market. I think in the future, we can double the volume, which we have done when it was out of pocket, but well-accepted as well. Everywhere where KeriMedical TOUCH is launched, it is well accepted. For the APAC region, I think this is very important that I said it, that because of missing headspace, Japan was not the first focus when I started. In the meantime, I was in Tokyo. We had good meetings. We took our decisions. We have a new general manager in Japan starting 1st of September.
He is grown up in Japan, but actually he is German and has a European mindset, but Japanese family and very well established, 30 years in Japan, international background, coming from Medtech. We are moving in a new office location. We are having then also a kind of education center. It is a little bit different in Japan. So we are revamping this business. But as I said, this project starts now in September. Next time when we see each other, I will give you a clear guidance how Japan will move into the future. But we have a big opportunity there, big opportunity in Japan, and this is the reason why we took now the bull by the horns and revamp Japan.
Very clear. Thank you.
Good. I think that's it for today. Let me quickly check. There are no more questions in the line. Thank you very much, everyone, for asking these great questions. Very engaging. It is not the end, because we have, as you can see on slide 32 of the deck, we have in September alone, about seven investor relation events lined up. You have an opportunity to see us with almost every broker that is covering us. I would like to highlight the Octavian Reverse Roadshow, but also the UBS Wolfsberg Conference. Then we're going to travel to Geneva. We're going to be in Paris and obviously also in London. With that, I would like, before I hand it back to Matthias for his closing remarks, one word of gratitude.
People that are behind the scenes that you don't see here in front on the stage, but do an excellent job. I would like to call out Peter Retto and his finance team, Andreas and Robin, for the excellent work. Thank you for making this happening here today. With that, Matthias?
Thank you very much, Fabian, Peter. Thank you to you for showing this interest and being with us and trusting us, and let's continue the journey. It's a lot of fun, and the journey only started. Thank you.