First of all, we apologize for the technical problems we have seen today on the platform.
We were hoping to be able to host it on time, and I'm glad we managed to recover still today.
I'm here today with Corrado Farsetta and Gianluca Olgiati.
We can go through the very good and strong results we reported in H1 2022. We can see the highlights of the semester. Starting with 19% growth in terms of revenues reported, which is 14.6% at constant currency.
This growth was driven by a significant new customer acquisition, sales force expansion and new product introduction, especially in the first months of the year.
In Australia and in U.S., we still had some headwind coming from the pandemic restrictions and hospital staffing shortages.
We wanted to highlight here as well that Medacta is truly generating significant growth. Compared to pre-pandemic level H1 2019, Medacta grew 36.5% at constant currency, which is a CAGR of almost 11%.
A very important milestone this semester was the achievement of 100 NextAR platforms in the market. We had the success in the launch of the first full market release application, the NextAR Shoulder, while the knee and the spine are still in the limited market release.
We have been able to continue our expansion in terms of marketing and medical education programs with the network of reference centers active worldwide, which is now more than 500 centers helping us.
The expansion of our sales force, which is one of the key pillars of our growth continued, and this happened across all the geographies and all our business lines. The contribution of each product line was quite interesting, with a very strong performance of our core hip and knee portfolio.
The hip grew 11.1%, the knee 16%. Both hip and knees are still following our core strategy in terms of product strategy, AMIS for the hip and kinematic alignment, single-use instrumentation and GMK Sphere for the knee.
On the extremity, so both shoulder and sports medicine, the growth was very strong, 35%, and on the spine, around 16%. If we move to the geographical area, we can see that Europe did perform extremely well with a growth of around 22%.
While, as I was saying before, North America and APAC were both impacted by, especially quarter one, headwind linked to pandemic restrictions, especially in Australia.
The first three months were really heavily impacted, which resulted in a growth for Asia Pacific of 3.7%, while North America was around 11%. The rest of the world did perform very well with almost 32% growth.
This has changed slightly our geographic mix, moving from North America and Asia Pacific more in to the European regions. Again, we wanted to highlight how the different lines did perform in the last three years, so pre-pandemic and current growth, showing that we are really delivering significant growth well beyond mere recovery. It's now two years in a row that we are surpassing a pre-pandemic level in a very significant way.
A quick update on the NextAR surgical platform, which is part of our MySolutions Personalized Ecosystem. We have reached almost 1,000. Actually, we passed the 1,000 NextAR surgeries across all the application we have in knees, in spine and in shoulder.
We felt comfortable in fully releasing the shoulder application in the later months of the H1. We expect to have other application in full market release phase in the second part of this year. In June 2022, we reached an important regulatory milestone with the full approval in Japan of all the current applications.
Both knee, shoulder and spine. Just as a reminder for those not familiar with the platform, the NextAR is really a very flexible platform technology covering knee, shoulder, and spine, down the road, hip and unis, with a very limited capital investment and single-use instrumentation. It really provides a different angle when it comes to technology.
In terms of outlook, we see a very positive development of our top line. That's why we wanted to confirm our guidance and actually guide on the higher end of our guidance, which is at the moment between EUR 400 million and EUR 414 million at constant currency.
At the same time, linked to the faster growth to the current macroeconomic situation with inflation, with the geopolitical impacting energy, et cetera, we feel that our profitability should be in the lower end of our guidance at constant currency. This, I believe, was my last slide, and I'm not sure, Gianluca, if we are going to be able to handle question from our guests.
Yes, we can. Please, raise your hand to ask questions.
We have already the first questions from Tando Ntosona . Please, Tando, go ahead.
Hello, can you hear me?
Yes.
Fantastic. Hi, guys, Tando here from UBS. I just had two questions, please.
Just on the FY 2022 guidance, obviously you've delivered exceptional growth in H1. Also on top of that, you've got some tailwinds coming for you guys in H2. You've got a weaker comp.
Just looking at your revenues, you're more weighted to the second half. I'm just curious, why, you know, I'm just curious on the cautionary statement around your guidance. My second question is just on margins.
I do understand, this is a revenue update call, but I was just curious, how should we think about gross profit margins and also EBITDA margins in the first and second half, just given the growth you've seen now?
Thank you, Tando.
As you might know, there are some markets that just recently introduced a price review. One is Australia, where we were expecting a significant recovery from the H1. Now, this will come in volume as a slightly lower price. We do have some, let's say, cautious approach to other aspects of the business. We are all listening to the potential negative impact of a global recession, which might impact some of our U.S. recovery.
There are some elements in the current world that are not all positive, and we prefer, especially at this point in time, to remain cautious. We believe we are already delivering the top end of our guidance.
It is already a very, very strong performance, especially because, as we wanted to point out, Medacta is not recovering. It's really grabbing market share in a very aggressive way and is not a given that we continue month after month after month to do that.
We just wanted to be cautious. On the margins, as you correctly said, we will have an additional call beginning of September, when we will go into the details of how the margins have been impacted and how potentially will evolve. I might ask, if you don't mind, Corrado, to give you a little bit of a color on what we see and how you should see as well the impact of revenues on our profitability. Corrado?
Yes, sure. Thank you, Francesco. Hi, Tando. Good afternoon.
Even if it's too early to talk about P&L, as you said, we don't have the numbers yet, but I can add some qualitative comments about the marginality. I would say the first one is about the geographic mix. From an average selling price perspective, the growth mix in this semester was less favorable than in previous periods, given the strong acceleration in Europe, 22%, compared to APAC, which was only 4% for the reason that
We've already explained. We know that Australia is one of the highest price market, and, say, with the limited growth in that country, the key offsetting factor against price erosion, which is still in a market, will not show the positive effect that we normally see when the growth rate in those countries like Australia and US are stronger.
That's the first comment I would say. The second comment regards the inflationary costs. We are not an exception in the market, and we are already registering significant increases in transport costs. Sooner or later, we will also see the effects on price increases in raw materials and services. Third, the strong revaluation of the US dollars and Swiss francs on euro generated a positive effect on the top line.
We have seen that more than 4%, but also a negative effect on the cost side, of course.
We expect that this pure translation, because it's just a translational effect into balance sheet, which is in euro, will be a negative effect as well. In general, what I can say, Tando, is that it is not unreasonable to expect these three elements to offset, at least in part, the positive effect from the big jump in revenue that we have just discussed, and to move toward the lower end of the guidance in terms of EBITDA margin, as we said. Of course, we'll be more precise when the numbers will be ready and available to be discussed.
Great. Thank you.
We have now Christoph Gretler from Credit Suisse. Please, Chris, go ahead. Chris, can you hear me? Chris, you can go ahead. Otherwise, we have questions from David Adlington from J.P. Morgan. Please, David.
Hey, guys. Can you hear me?
Yeah. Thank you.
Perfect. Yeah, just two questions, please. I just wondered if you had any particular idea who you were taking most share from, particularly in hips and knees, and what's driving that. And secondly, just a technical one. In terms of the FX impact on margin for the full year, that would be useful. Thank you.
Thank you, David.
In terms of market share, it varies quite a bit from region to region. I would say out of the four big guys, probably the only one where we take a little bit less is Stryker, especially on the knee side. We are getting some customers on the hip side.
On the shoulder side, they're still dealing with Tornier, Wright Medical integration, so there are always bits and pieces they might lose. In terms of hip and knees, I would say everybody, Zimmer Biomet, Smith+Nephew, probably more than J&J and Stryker. It varies a little bit. In terms of effects, I might again ask Corrado to comment. Yeah, sure. Hi, David.
Again, we don't have the numbers today, so it's difficult to say what would be the precise effect. Basically that is driven by an increase in top line euro, US dollars and Swiss francs.
The balance sheet in Swiss franc is less, say, big in the top line and more in the cost side. Basically, that's why I would expect to have a limited effect on the gross margin and a bigger effect on the fixed cost side. I would be surprised to see an effect which is more than 1%, but of course, now it's still difficult to be more precise than that.
That's useful. Thank you.
Yeah.
Let's try again with Chris.
Yes, I think now it should be better.
Yes. Thank you.
Thank you. Yes, my first question was also on EBITDA, you know, whether there is, you know, possibility to quantify at this stage, you know, the margin effect, you know. But I heard you.
I think, you know, probably kind of that's as good as it gets, you know. The second, you know, question was on Europe, you know. That was a very remarkable performance.
Could you maybe elaborate a bit more in which countries, you know, you managed to achieve such a strong growth and what were the driver also maybe by product franchises?
Yes, thank you, Chris. Thank you for the question. I was very impressed with the European performance as well. I think this is directly correlated with our ability to continue to generate sales leads during the pandemic.
We know in orthopedics there is always a ramp and customers take many months before they really trust the product. The effect we see now is probably coming from the very good level of activity we maintained during the pandemic and the reorganization of the marketing medical education in 2020, 2021. We did see it across all the regions. Germany did grow extremely well in the core market, hip and knees, and shoulder in particular.
All the major markets are Germany, Italy, France and Spain growing very rapidly. U.K. is still a relatively small market, but we are growing there significantly as well, starting from a very small base.
In Switzerland as well in the new lines, we've performed pretty well. I was extremely pleased to see that in the core products of hip and knees in Europe, where in certain markets we do have already a, let's say, a significant market share, we're able to deliver double-digit growth. This is very good, and we expect this to continue for a bit. That's even more positive.
Yeah, that's great to hear. Maybe, you know, the last question on NextAR. I mean, these 100 systems that you mentioned to have placed in the market, could you maybe specify in what indication they are?
Yeah. I would say just to give you a qualitative idea, the number of units we had in shoulders, in knees and in spine did not change because they are still in limited market release.
We have just increased significantly the shoulder and there will be more in the second half on the shoulder and hopefully as planned and as announced we will start to see the release on spine and knees. I would say probably roughly today is 50% of those are shoulder and more to come.
Geographically, could you also maybe comment where you know have most of these systems placed?
It's at the moment the system is cleared basically just in Europe and U.S. with more or less the same geographic split that sales have. We have just received clearance in Japan.
As you might know, we still don't sell shoulder in Australia because the implant per se still is under a regulatory approval process. The APAC is not contributing at the moment on the NextAR at all, I would say.
Okay, thanks. Very helpful and enjoy the weekend later on. Thanks.
Thank you.
If you have further questions, please raise your hand. There are no more questions, Francesco.
Thank you. Thank you, Gianluca.
Once again, thank you all for readjusting your busy schedule to participate to this call. We really appreciate. Once again, we apologize for the inconvenience, which was completely out of our control.
I wish a good weekend to everybody, and I look forward to the next call early in September to update you on the full P&L.
Thank you very much, and enjoy the weekend.