Kamada, and thank you for joining us today. I will give you an overview of Kamada. Our ticker is KMDA, and you are, of course, invited to follow our progress. Kamada is a global biopharmaceutical company. We are focused on a very interesting niche, a very sophisticated, interesting niche called specialty plasma therapies or specialty plasma immunoglobulins. We are growing significantly double-digit on an annual basis. We have six FDA-approved products. We guided the market this year will be selling between $200 million- $205 million, with an EBITDA of between $50 million- $53 million, and we finished the first six months, which were our strongest six months since basically the company was founded, exactly kind of midway to meet our annual guidance. I will show the results in a minute.
We have been growing on average 14% per year over the last few years, and we had $70 million at the end of the quarter. We have paid a dividend recently both on our 2025 results and also on our first six months 2026 results. We have a clear strategy how to continue growing the business, growing profitability, growing top line, through what we call the four growth pillars or growth pillars of growth, through increasing our specialty plasma therapy sales, in-licensing partnership, plasma sales, and new M&A opportunities. I will talk about it through my presentation. As I mentioned, we continue to execute on our plan, and we have been delivering excellent results over the last few years, and we have a projection to continue growing in a similar pace moving forward. This chart shows our progress over the last five years. In 2021, we were selling $100 million.
This year will be more than double, over $200 million. As mentioned, we finished the first six months of the year at $100 million, so exactly the midpoint. On the EBITDA chart, you see that from $6 million EBITDA in 2021, this year we have projected between $50 million- $53 million. We finished the first six months at $26 million, so we are running at 26% of EBITDA from top line. You see, we are not just growing, but we are growing in a highly profitable way. This is a comparison of the first six months of the year to the previous year to 2025. Revenue grew by 13%, adjusted EBITDA 14%, earning per share 21%, and our operating cash flow has grown significantly. We generated close to $18 million from operation in the first six months of the year.
As mentioned, we paid a dividend of $0.25 per share on April 7th, and last week we paid additional $0.17 per share. A total of $0.42 per share were paid this year as dividend to our shareholders. These are our six FDA-approved products, which are, as I mentioned, focused on plasma-derived specialty products, plasma-derived therapeutics. The production process, the supply chain of plasma, specialty plasma product starts with plasma collection. We have our own three plasma collection centers in Texas, and we source plasma from additional suppliers. We are able to collect plasma to quantify the potency of the plasma from specific donors, specific individuals, identify the ones that have high titer, high potency against specific virus. Then it goes into production, where we purify the plasma into the specific antibodies.
We make sure the plasma is safe and clean through multiple viral inactivation steps. The final steps are formulation, fill and finish, and packaging. Then you have a ready-to-use liquid, concentrated antibodies, immunoglobulins for specific viruses, which are used in a variety of acute life-threatening situations. We are active in over 40 countries. We have our own commercial team in the U.S., in the Middle East, in Israel. In the other countries, we work through a network of experienced distributors and partners that are working hard to expand Kamada reach and our products in the various markets. The management team has been working together for quite some time. I have been with the company for over 12 years. We have assembled a team of experts in the field of plasma commercialization, plasma manufacturing. We work a lot around business development, finding new opportunities, and expanding our business.
As mentioned, four pillars of growth, starting with expanding our portfolio to additional territories and deepening our strengths in those markets, deepening our market share. We are also working on in-licensing products from other parties, primarily for Israel and the MENA region, where we act as a distributor for other companies. This is a significantly growing business for us. We are starting to sell plasma through third-party clients. We just secured a $50 million plasma sales agreement with a leading biopharmaceutical company. Those sales are to start before the end of this year, and at a rate of around $17 million a year. As mentioned earlier, we are also highly focused on accelerating the growth beyond our organic growth through additional M&As and acquisitions that we are currently screening. The lead product is anti-rabies immunoglobulin called Kedrab.
The U.S. market for this type of product is around $200 million. There are only two products in the market, us and a competitor. We finished 2025 with $54 million sales. We sell it to our partner, Kedrion, and they sell it in the U.S. market. The market is around 50/50 right now, so we have around 50% market share. I think the big news here that just last week the CDC has highlighted, there has been a significant increase in U.S. rabies exposure and AAT utilization. We, Kamada, are equipped to supply this expansion, this increased demand for our product. The second product I would like to mention is GLASSIA. It is alpha-1 antitrypsin for a disease called alpha-1 deficiency, which is a chronic genetic disorder. People that their body does not produce sufficient levels of the protein. Usually, the complications manifest as a severe lung disease, COPD-like.
We have licensed the product in the U.S. and Canada to Takeda, and Takeda is paying us royalties. In 2025, this amounts to $16 million. Outside of the U.S. and Canada, outside of North America, we work directly with a network of distributors, primarily in LATAM, CIS, Israel, and Switzerland. This has been a $19 million business in 2025, a 27% growth compared to 2024. We expect continued double-digit growth in the year to come. We are working with our distributors on better diagnosis, identifying new patients. In many of those countries, we are the sole supplier of an AAT product, and we are growing significantly. Last but not least, a product called CYTOGAM, which is a CMV immunoglobulin, CMV antibodies. This is used as part of solid organ transplantation. CMV is the leading cause for organ rejection post-transplant. We sold $17 million of the product in 2025.
We are doing significant clinical work post-marketing. The product is already in the market. In order to strengthen the medical and clinical data to support product utilization, the main study is called the SHIELD Study, conducted by leading experts in [uncertain] in CMV and organ transplantation, focusing on investigating the benefits of CYTOGAM in reducing the risk of late CMV flare after a few months in kidney transplant recipients. The data is supposed to be available late 2028, and we expect that with strong data from that study, we can grow the product sales significantly in the U.S. market. As mentioned, in addition to our own portfolio, we are also a partner distributor for international companies that are basically licensing the products to us primarily for Israel and the MENA region. This is over a $30 million business for us.
It's growing significantly, primarily through our licensing and launch of biosimilar products. We've already launched two in 2024 and 2025. Two additional products are being launched this quarter. An additional two to three products are expected to be launched next year. We expect this business to generate incremental sales between $15 million- $20 million within the next four to five years in those markets. Plasma sales, as mentioned, three plasma collection centers in Texas, Houston, San Antonio, and Beaumont. We're collecting specialty plasma for our own production, anti-rabies, anti-D, hepatitis. In July, just two months ago, we announced that we've signed a three-year, $50 million sales agreement to supply plasma to a leading biopharmaceutical company that is focused on plasma-derived products. On the M&A side and BD side, we are screening for opportunities to acquire or license additional products.
We are focused on our areas of activity, either transplantation, plasma-derived, distribution, infectious disease, and we are expecting to be able to close on this type of deal within the next few months. To summarize, a global biopharmaceutical company in a highly regulated niche biopharmaceutical market where there are significant entry barriers for newcomers. We are leading in most markets with our products, growing significantly, guided the market for over $200 million this year, and between $50 million- $53 million EBITDA, cash positive, $18 million cash from operation generated in the first six months of the year, paying dividends to our shareholders, and expecting to continue growing in a similar double-digit pace moving forward in the years to come. Thank you very much for your attention.
Thank you, Amir. We do have some time for Q&A. If you do have a question, you can type it into the Q&A box at the bottom of your screen, and I'll read them to Amir. Can we start with Kedrab and the situation with rabies in the U.S.? You noted that we've seen an increase in the incidence of rabies here. Is it just in the U.S., or is there a worldwide increase in incidence of rabies?
We've experienced a greater demand for our product in other markets where we sell Kedrab. It's called Kedrab in the U.S. and Kamrab in other countries. This is true for Australia, Canada, Israel, some Latin American countries, some European countries. I think it's beyond the U.S. There is data which has been published, so this supports the high utilization and demand for the product that we have seen over the last few months.
Do you have the capacity to meet that demand, or are you going to have to ramp up at your facility?
We have been kind of forecasting this increased demand already the beginning of the year based on projections and numbers that we got from our U.S. partner and from the Israeli Ministry of Health. We've already expanded our production in order to meet this high demand. It's already embedded into most of our 2026 production plan and guidance.
Okay. On the distribution business, you mentioned that you've added a couple products already this year. You plan to add a couple more and then some more in 2027. Are those all into the same regions, or are you expanding regions as well as products?
Our originally distribution business was in Israel. As of around a year ago, two years ago, we decided to expand and copy this business model also to the MENA region, based from our sales office in Dubai, in the Emirates. That is our main focus currently, Israel and the entire Middle East, to grow this distribution business.
Okay. We had a question from the audience on M&A. You said your priorities for free cash flow is to grow, but you also mentioned that you are paying a dividend. Can you kind of [crosstalk].
Right.
Just make sense of that?
Yes. Our board declared and announced a dividend policy at the beginning of this year, and we paid it for the first time last year. This was a special dividend. Starting this year, we have declared a policy that we will be paying at least 50% of our net profit. Of course, if we are to execute a significant M&A, we will need the cash, the money for that. This might come, for a period of time, on account of a dividend payment. But in general, we believe that we can do both. We have the cash, we have the profitable business. We are generating cash quarter after quarter, so we believe we can execute our BD strategy, BD plan, in parallel to paying dividends to our shareholders.
All right. Another question from the audience regarding the second quarter, which was up 23% on a revenue basis, the strongest quarter you've ever had. Was that largely due to the demand for Kedrab? Do you think that they're going to exceed their minimum commitments by a significant amount?
Second quarter or first six months of the year was strong, but that was not a surprise. That is exactly per our guidance. A company which is growing year after year should expect that we'll continue showing improved results year after year, quarter after quarter, and that's exactly what we have demonstrated. The growth is coming not only from Kedrab U.S., it's coming from Kamrab, other territories, Varizig, GLASSIA, distribution business, biosimilars starting soon, plasma sales. We have a highly diverse business with a wide portfolio of different products and activities that each one of them is growing year after year. So that's a very healthy situation. We are not relying on one product, one territory, but we have a wide enough portfolio that even if in one specific quarter, one product is underperforming, we have the other products to compensate for that.
We expect to continue growing, as I mentioned, and we believe that it's the current strength of Kamada.
As we stick on that first half, which has been a good first half for you, it's about exactly half of what your full year guidance midpoint is. What would it take for you to move the guidance for the year-end?
Currently, we've reiterated the guidance. When we get closer to the end of the year, based primarily if the Kedrab increase or if the number of rabies exposure in the U.S. continues to increase beyond what is already included in our annual guidance, that might move the guidance. Right now, we are sticking to the guidance, which is already a significant increase compared to last year. I think more interesting will be our 2027 guidance once we publish it, that will most likely show another year of double-digit growth.
Can you talk about the geopolitical situation and how that's impacted your business? Do you think that you're past the challenges you faced in the first quarter, and that your supply chain's back intact?
Supply chain is intact. We've been operating in this geopolitical situation for 36 years, since Kamada was founded in Israel, and definitely since October 7th, 2023. Kamada is extremely experienced, and our employees have shown a resilience to continue working throughout the three years. We basically, I think, shut down the plant for one day, October 8th, right after the war and the attack. We have strong confidence in our ability to continue operating, and also from Israel. We are not relying on the Israeli market. We are basically a global company with activities, sales, manufacturing, plasma collection, also in North America, U.S., and Canada. This is a global company headquartered from dual offices in New Jersey, Hoboken, and in Israel. The first quarter, that was a glitch of one shipment. I always tell investors and analysts, "Don't judge us based on one quarter.
Look at our performance, look at our guidance, and look at the six months, nine months, 12 months performance." We haven't missed even a single annual guidance since I remember the company. I've been with the company for 12 years. We haven't missed a single guidance. I don't think we've missed even before I joined the company. We have very strong capabilities in forecasting and in executing to the plan.
The area where you compete, the plasma market, there's some big names in that space, CSL and Grifols. What can Kamada do to compete against these companies, and what do you provide that they don't provide?
First of all, we do compete with them, and we do it very well. This is true on the alpha-1 product, this is true on CYTOGAM, this is true on Kedrab. I think in every market where we operate, we have developed kind of a competitive edge compared to the competition. In some cases, we are the sole supplier of such a product. CYTOGAM is the only anti-CMV product in North America. Varizig is the only Varicella zoster immunoglobulin in North America. Our technology is one of the best. As an example, we were the first to develop a liquid ready-to-use alpha-1 product. So, when Grifols, Takeda, back then it was Baxter, CSL, had the lyophilized powder that requires reconstitution prior to administration, we launched a liquid ready-to-use product.
Apparently, that was a big advantage, and Takeda acquired that license from us in order to be able to sell the product in North America. Kedrab has advantages related to pediatric study and other kind of improvements that we are implementing in order to maintain this competitive edge. So, we feel very strong about our capabilities. We feel very strong about our competitive advantage. Also, we are highly focused. When Takeda, CSL, Grifols are focused on IVIG, albumin, huge factories, 300 plus plasma collection centers, we are more of a boutique specialty plasma company, which allows us to excel in the specific areas that we operate. We don't compete on standard IVIG. We don't compete on albumin. We focus on specialty immunoglobulins. This is our expertise.
How is the market for source plasma now that you'll be a provider for that, and the pricing volatility? How is that sitting?
We signed an agreement for the next three years. Basically, that agreement covers our entire normal source plasma capacity, so we don't need another agreement right now. In general, it's a relatively soft market currently. There is enough plasma available. So, prices are at the lower range that I remember. There is a constant increase and expansion of the industry, primarily because of IVIG utilization, which drives the overall market to continue growing. In general, there are some ups and downs, but in general, this is a growing market year after year.
You mentioned the SHIELD Study for CYTOGAM. Do you think you'll be able to publish any preliminary results prior to 2028, or is 2028 going to be the first time we'll see any data from that study?
2028 will be the first time you'll see data. We hope it won't glitch into early 2029. We plan on 2028. It really depends on patients' recruitment, and recruitment is based on number of kidney transplanted patients in the centers where the study is being executed. There are good estimations of the pace of patient recruitment. But at the end of the day, the KOLs and the investigators and us depend on actual number of transplant in those centers, and there might be some variability year after year.
Another question from the audience regarding your shareholder base. A leading private equity firm is your largest shareholder. Do you have any sense on what their strategy is?
To make money. I think. FIMI, F-I-M-I, is the largest private equity fund based in Israel. They have been with us since early 2020. They have invested multiple times. A highly successful private equity fund. They just raised, I think, FIMI VIII, which is like $1.75 billion. For the audience that do not know FIMI, I encourage you to go online and to learn about their success. I am sure that at the right time, they will do their thing and be able to, based on continued enhancement of the company value, they will know what to do.
On the acquisition front, how is the pipeline there? Are there multiple companies you are talking to? How has that been historically?
We have been screening for some opportunities. We are at the point that we are currently doing some due diligence. We were close to some transaction over the last 12 months or so, but for various reasons, those transactions have not materialized. It is not necessarily to acquire a company. It could be to acquire an asset, a product or products in our fields of activity. We are looking to do a good transaction, the right transaction for Kamada size, Kamada specialty. It takes time to identify due diligence and transact such an agreement.
All right. We are just about at time. Are there any closing comments you would like to make before we wrap it up today?
I think that this slide basically kind of tells a story. I think that the growth that we have seen over the last few years, we continue seeing moving forward. I believe there's still a lot of value in Kamada as we continue executing on our plan. We expect a strong guidance for 2027, and I'm just inviting the audience investor to join this successful journey moving forward.
Well, thank you. Thank you. It's a very impressive track record that you've put up the past several years. I appreciate that you took the time today to present and also that you took the time this evening today to meet with some of our investors. So, thank you.
Thank you. Thank you, Jim.
Appreciate you being here.
Bye-bye.
Thank you for tuning in, everyone.
Bye-bye.
Bye-bye.