We got today at the PHC Holdings Corporation Third Quarter, Fiscal Year Ending March 31, 2024, Earnings Call. My name is Makise from IR and Public Relations Department. I would be your moderator today. I would like to explain a few points about how to participate in this meeting. Simultaneous Japanese-English interpretation is provided for this briefing. For audio, click on the う symbol at the bottom of the screen to open the menu. Please select Japanese, English, or Off. Off is the original radio without interpreter. For the language of presentation, you can select either Japanese or English from the View options pull-down menu on the top bar of the window. Please note that our presenters have their personal microphones muted due to the audio equipment setting. Please note that the audio will come from a different account than the presenter.
[Foreign Language]
Let me introduce today's presenters: Mr. Shoji Miyazaki, President and CEO, Chief Executive Officer, and Mr. Frederick J. Reidenbach, CFO, Chief Financial Officer. After their presentations, we will have time for questions and answers. Mr. Miyazaki, the floor is yours.
[Foreign Language]
With regard to the third quarter results of FY23 and forecast, I myself and Frederick J. Reidenbach, our CFO, will provide explanation, and this is the content today. For the first nine months of the year, revenue decreased by 3.2% year-on-year to JPY 256.7 billion, despite the positive impact of foreign exchange rates, mainly due to lower sales of BGM, lower sales of PCR testing, and lower special demand for ULT freezers. Operating profit-wise, due to revenue decline, increased investment in the CGM business, increased one-off costs such as structural reforms in diabetes management and other areas, and business structure-related costs mainly in Japan, and impairment losses recorded in the LSIM business in the third quarter, in addition to Epredia in the second quarter, we recorded a net loss of JPY 5.1 billion. Profit attributable to the owners of the parent on the cash basis was JPY 9.9 billion.
In terms of a comparison between the result of the first nine months and the plan, both sales and profits were down. Next, I'd like to explain about the impairment loss in the LSIM business recorded in the third quarter. Impairment losses totaling approximately JPY 14 billion were recorded in the cash-generating units of clinical testing and the LSIM IVD. In clinical testing, the plan was based on the assumption that the number of tests would recover to pre-COVID level. However, the gap between the actual performance and the plan led to the conclusion that there were signs of impairment. We also took into account, to a certain extent, the impact expected from the next financial year onwards of the impropriety at LSI Medience.
In LSIM IVD, we also saw indication of impairment mainly due to the expected increase in the discount rate applied to the LSIM business as a result of discrepancy between the actual and the plan in the clinical testing cash-generating unit. Impairment tests were conducted, respectively, which resulted in impairment losses being recorded in goodwill and intangible assets. Next, I would like to explain our full-year forecast for this fiscal year. Although we have not changed our FX assumptions, we have taken into account the results of the first nine months and the respective risks and have lowered our full-year forecast for this year. Revenue is forecast at JPY 351.5 billion.
This is due to the impact of market contraction in the BGM business, risk of lower-than-expected growth in the CGM business, delay in the recovery of demand for clinical testing business, and delay in the induction of electronic prescriptions in the healthcare IT solutions business, as well as the impact of a deteriorating market environment mainly in Europe and the US in the IVD life science segment. The forecast has been revised, therefore downward by JPY 4 billion from the previous forecast. Operating profit is expected to be JPY 2.6 billion. The forecast includes gains and losses, such as impairment losses, up to the third quarter. By quarter, profitability is expected to improve in the fourth quarter compared with the third quarter due to the effects of structural reforms and cost reductions, but profits are expected to decline significantly for the full year.
Cash-based profit attributable to the owners of the parent is expected to decrease by JPY 8.1 billion to JPY 15.3 billion, taking into account a future increase in the interest expenses of JPY 2.1 billion. With regard to the dividend forecast, we recognize the importance of stable dividend and will, for now, plan the same year-end dividend of JPY 36 per share, which makes a total amount of dividend annually JPY 72 per share. The details of the figures will be explained later by our CFO. This is a slide that I presented at the earnings call in May. I will explain the update of each policy. This slide shows the measure of BGM and CGM in diabetes management. First, let me talk about BGM.
Revenue for the first nine months of the year was -8% in Europe and -10% in America compared to the previous year, while revenue in emerging markets increased by 3.5%. In Europe, revenue declined in some countries due to inventory adjustments, the impact of new insurance reimbursement for CGM, and a market shift to the low-cost bidding channel. While in America, revenue in Canada increased, but revenue in the United States declined due to the termination of sales collaboration. In the emerging markets, China and India drove growth and increased sales. The streamlining of the organization, which has been ongoing, was temporarily completed in the third quarter. Next, let me talk about CGM.
The number of CGM users increased more than 50% year-on-year in the United States, mainly due to the marketing campaign launched last October, but the number of users both in and outside the US remained below expectations. The number of leads has tripled as a result of the S. marketing campaign, and though the number of current users is higher than before, we recognize the urgent need to improve the conversion rate from leads in order to achieve further growth. This month, Tandem's former Chief Commercial Officer joined the company as a global CGM business manager, and we will continue to further strengthen our sales and marketing efforts.
Regarding the CGM product pipeline, Senseonics has announced that it has completed data analysis of the Enhanced Clinical Trial and plans to file an FDA application by the end of March for a new product, the 365-day sensor, which will enable the use of product with weekly calibration. Next, I will explain the progress of Epredia's earnings improvement. Revenue for the first nine months of the fiscal year was up 3% year-over-year on US dollar basis, but was affected by restricted capital investment, particularly in the United States, resulting in a decline in the revenue in the third quarter. In addition to the streamlining of the organization implemented at the end of the second quarter, we are continuing to reduce costs through operational improvements.
Regarding the risk of additional impairment losses at Epredia, although there were no signs of impairment in the third quarter, we expect the current restraint on capital expenditures to continue for some time, and we will closely monitor the fourth quarter results and interest rate trends when testing for impairment for the full year. Next, I will explain the progress of major measures to achieve the goals of the midterm plan. First, in healthcare solutions, Wemex launched Medicom-CK II, an Electronic Medical Record system for small and medium-sized general and nursing care hospitals, and Finance Cross, a system for insurance pharmacies. We will continue to contribute to medical DX through sales of new products. In telemedicine, we are promoting initiatives using Teladoc Health in Yamaguchi Prefecture and Toba City, Mie Prefecture, and we will continue to contribute to improving access to local medical care.
Next, in Diagnostics and Life Sciences, we have launched a new slide printer in the United States as Epredia. This is a state-of-the-art slide printer that improves the efficiency of tissue sample retrieval and allows for the inclusion of more identifying information on slides. Next, Biomedical established and began operating a life science equipment sales company in Indonesia. This will enable us to strengthen our market-oriented marketing function and capture customer needs, as well as new business opportunities in Indonesia. Next, in January, we issued the PHC Group's first integrated report. This is one of the important initiatives in our sustainability management following the materiality announced in August last year, and it introduces our value creation process and sustainability initiatives along with new key graphics of the PHC Group. I hope you enjoy reading it. This concludes my presentation on executive summary. Fred, the floor is yours.
Thank you, Miyazaki-san.
In the next few slides, I will cover the same key areas I normally review. First, I'll walk you through the keys to our performance with an emphasis on the year-to-date results, and then I will review our forecast for this fiscal year, which we are updating from our latest Q2 forecast. First, on slide 14, we have included on the left side our year-to-date results through Q3, and on the right side our results for the third quarter. Both are compared to the same period of the prior year. Up until the end of Q3, our revenue was JPY 256.7 billion. This is a decrease of JPY 8.4 billion from the JPY 265.1 billion reported in the prior year. The year-to-date average exchange rates were about JPY 155 to the Euro and JPY 143 to the US dollar.
This is up from JPY 141 to the Euro and JPY 136 to the US dollar in the same period of the prior year. The weakening of the yen resulted in a favorable foreign exchange revenue impact of about JPY 8.2 billion. However, this benefit was offset by revenue decreases seen in several key business units, which I will go over later in the presentation. Our operating profit decreased by JPY 26.6 billion to a loss of JPY 5.1 billion. The drop is mainly due to the impairment losses recorded in Epredia in Q2 and LSIM Medience in Q3, which Miyazaki-san just spoke about. In addition to the impairment, our year-to-date operating profit was affected by lower revenues in BGM, increased investments into CGM, and higher one-time costs, mostly related to the organizational restructuring, which took place in the first half in diabetes management.
Our profit before tax and our profit attributable to owners of the parent company both came in negative at JPY 13.8 billion and JPY 11.2 billion, respectively. The gap between operating profit and profit before tax is due to two reasons. First, we reported in financing costs a JPY 3.8 billion FX valuation loss, mostly on intercompany loans. This was principally due to the strengthening of the euro against the yen, with most of the charge recorded in Q1. S econdly, we recorded interest expense of about JPY 5.1 billion. After adding back one-time charges, our adjusted EBITDA decreased by JPY 15.6 billion to JPY 33.7 billion. Lastly, our cash-based net profit came in at JPY 9.9 billion, a decrease of JPY 5.8 billion relative to prior year. Slide 15 shows a quarterly trend of our revenue and operating profit.
As I've explained in previous quarters, Q1 tends to be our slowest quarter, and the numbers tend to increase from the second quarter to the end of the year. Spending from US and European customers typically gains momentum starting in July, reaching its peak during the October to December quarter, with Japan-based customer spending accelerating from our third quarter, with the most significant growth occurring in our fourth quarter. This trend from our global customers resulted in revenue rising in Q3 by 5.1% when compared to Q2. Unfortunately, we did not see a similar trend in operating profit this year, mainly due to margin drops in our diabetes management and healthcare solutions segment. Slide 16 shows the results by segment. Our diabetes management segment reported revenue down 4% year-over-year to JPY 80.3 billion.
Our healthcare solutions segment reported a 4% year-on-year decrease in revenue to JPY 95.2 billion. Within the segment, our healthcare IT solutions business reported an 11.2% year-on-year increase in revenue to JPY 30 billion, but this was offset by a 9.7% decrease in LSI Medience's revenue to JPY 65.2 billion. A portion, though, of the change within the segment was due to the transfer of LSI Medience health checkup support business to Wemex. Lastly, our diagnostics and life sciences segment's revenue decreased 1.3% year-on-year to JPY 79.4 billion. Within the segment, our Epredia business reported revenues up 8.4% year-on-year to JPY 39.6 billion, but this growth was offset by a 9.3% year-on-year decrease in our biomedical business's revenue, which came in at JPY 39.8 billion. This drop was mainly due to lower COVID-related ULTs this year relative to last year.
I will go over each segment in more detail a little later in my presentation. First, on slide 17, we have provided bridge charts to explain the year-to-date change in our revenue and operating profit relative to prior year. In the top chart, you can see that our revenue, excluding a net positive COVID headwind of JPY 6.9 billion, was down 3.8% year-on-year. The underlying growth seen in our healthcare IT solutions business was not enough to offset the weakness that we saw in our other business units. In the bottom chart, you can see that our operating profit, excluding a net positive COVID impact of JPY 2.7 billion, decreased from a profit of JPY 8.7 billion to a loss of JPY 5.1 billion. This result was due to a combination of factors.
First, we did see savings of about JPY 5.1 billion in our headquarters costs, most of which relates to the early retirement program offered in Japan, the downsizing of the US during Q1 of the previous fiscal year. Secondly, our diagnostics and life sciences segments operating profit was mostly flat, but included in the results was a profit on the sale of an investment, but most of that profit was offset by impairment taken out of Epredia. Both of these items occurred in the first half of the year.
These items, though, were offset by a JPY 18 billion drop in our healthcare solutions segment, most of which is from the impact of the impairment loss recorded in Q3 on LSIM, and a JPY 11.1 billion drop in our diabetes management segment, most of which is due to an acceleration of the decline we have been seeing in our BGM business in the US and Europe, plus planned investments into CGM and increases in one-time costs of about JPY 2.8 billion relative to prior year. From here, I will explain the breakdown of our Q3 year-to-date revenue and operating profit by segment. First, diabetes management. Revenues in our diabetes management segment came in at JPY 80.3 billion. This is a decrease of 4% year-on-year despite positive FX impacts of JPY 3.7 billion.
On the BGM side, we continue to see declines in sales in developed markets in Europe and in the US due to termination of the sales collaboration, which we have been reporting on during the current and previous fiscal year. Sales of CGM product continue to trail behind plan. These drops, though, were partially offset by our IVD business, which continued to report growth in sales of both POCT and motorized drug delivery devices. The 50.2% decline in operating profit year-over-year from JPY 19.7 billion in the prior year to JPY 8.8 billion in the current year is what drove the segment's operating profit margin down to 11%. This drop continues to be due to the same four factors we reported on last quarter. First, investments continue to be made to reinforce the sales force and marketing of our CGM product.
Second, the business continues to see a change in the BGM sensor channel mix from developed to developing markets. Thirdly, there continues to be a change in product mix as we continue to see increased sales of lower margin IVD and CGM product and reduced sales of higher margin BGM product. And lastly, one-time expenses of JPY 3 billion were incurred to further restructure and streamline the BGM business, almost all of which was reported in the first half of this year. And for your reference, as you can see in the bottom of the slide, the segment's year-to-date adjusted EBITDA was JPY 17.3 billion. This is down from JPY 27.8 billion reported in the prior year. Our healthcare solutions segment's revenue decrease of 4% was driven by LSI Medience, which saw a drop of 9.7% year-on-year, with most of the drop due to decreasing COVID test counts.
LSIM did continue to see increases in revenue from COVID-19 antigen test kits and IVD-related product. However, these revenue streams were not enough to cover revenue lost on COVID test volumes. Part of the shortfall in LSIM revenue drop was offset by growth seen in our healthcare IT solutions business, which grew year-on-year by 11.2%. Our healthcare IT business did continue to benefit in the first half of this year from the continued pressure on the industry by the Japanese government to complete the rollout of the online eligibility check system. And in Q3, the business did begin to see demand resulting from the start of E-Prescription Operations, but this was much weaker than what was planned. The business also reported inorganic revenue growth from the Fujifilm Healthcare Systems Electronic Medical Records and Medical-receipt systems related business, which was acquired in October of this fiscal year.
The drop in the segment's operating profit from JPY 8.5 billion to a loss of JPY 11.6 billion was mostly due to the impairment loss of JPY 14 billion reported in Q3 at LSIM, as well as from impacts due to decreases in the volume and profitability of PCR, general, and esoteric testing in LSIM. Unlike in prior periods, these drops were not offset by growth in the healthcare IT solutions business as we continue to increase SG&A expense in this business to accelerate investments into new products such as cloud services. Again, for your reference, you can see at the bottom of the slide, the segment's year-to-date Adjusted EBITDA was JPY 11.3 billion. This is down from JPY 17.4 billion reported in the prior year. Finally, our diagnostics and life science segments reported revenue of JPY 79.4 billion.
This decreased 1.3% year-on-year despite a positive FX benefit of JPY 4.3 billion. Excluding this benefit, the segment's revenue came in at JPY 75.1 billion. Within the segment, our biomedical business continued to see increasing sales for products unrelated to COVID from its life science research clients, and they continued to be successful in raising prices. However, these positives were not enough to offset lower demand for COVID-19-related ULT shipments relative to prior year or the impact of restrained capital investment and inventory adjustments made by the business's customers due to concerns over inflation and a potential global economic slowdown. Our Epredia business within this segment faced the same impacts from restrained capital investments and inventory adjustments on its capital equipment side, but this weakness was offset by continued growth in sales of consumable products.
The business also saw a rebound from lost sales due to the factory lockdown in Shanghai in the previous year, benefits from positive FX impacts and price increases, and inorganic revenue from M&A transactions. The segment's year-to-date operating profit came in at JPY 4.9 billion. This is down 21.3% from prior year. During the year, both the biomedical and Epredia businesses continued to work to pass on increased costs to the product selling prices, but not all cost increases could be offset with higher prices. This increase in cost, coupled with lower COVID demand for higher margin (ULT) freezers as compared to prior year, were the main factors driving down the segment's operating profit, excluding one-time profits and losses.
I do again want to point out that included in the segment's year-to-date results is a net JPY 2.5 billion one-time profit recorded on the sale of an investment, against which we recorded an impairment loss of JPY 2.1 billion on the Epredia business, both of which, again, were reported in the first half of the year. Again, finally, for your reference, you can see at the bottom of the slide, the segment's year-to-date Adjusted EBITDA came in at JPY 11.3 billion. This is a decrease from the JPY 12.1 billion reported in the prior year. Slide 21 shows a revenue breakdown by region. Japan reported revenue of JPY 107.5 billion. This was down 2.4% versus prior year, with the shortfall mainly due to the decline in PCR testing and LSI Medience. The EU region reported revenue of JPY 62.3 billion, a year-on-year decrease of 9.4%.
The drop in sales was mostly due to weaker sales in diabetes management's mature markets in the EU region and in our biomedical business, which delivered fewer ULTs this year relative to prior year due to special demand. The North America region reported revenue of JPY 55.7 billion, down 1.5% year-on-year. Like in the EU, the drop was mostly due to the same two factors. First, weaker diabetes management sales in the US due to determination I'm sorry, due to the termination of the collaboration agreement we have been reporting on. And secondly, from lower biomedical sales due to restrained CapEx spend by our customers. Lastly, sales in other regions, which included APAC, the Middle East, and Africa, rose to JPY 31.2 billion, an increase of 5.1% year-on-year.
In this region, we saw strength in diabetes management emerging markets such as China and a rebound in our Epredia business from lost sales due to the factory lockdown in Shanghai in the previous year. Slide 22 provides a reconciliation between operating profit and Adjusted EBITDA and a conversion of IFRS-related profit attributable to owners of the parent to a cash basis. As shown at the top of this slide, the only material items between operating profit and EBITDA continue to be depreciation and impairment. Depreciation continues to decrease year-on-year as capitalized intangible assets in our diabetes management segment continue to become fully amortized. The JPY 16.1 billion impairment is made up of the JPY 2.1 billion impairment recorded in Q2 at Epredia and the JPY 14 billion impairment recorded in Q3 at LSI Medience, which Miyazaki-san discussed earlier.
Between EBITDA and Adjusted EBITDA, I would like to point out the two largest items. First, there was a JPY 3 billion charge related to restructuring in the diabetes management segment. Secondly, there was a net profit of JPY 2.5 billion recorded in the diagnostics and life science segment on the sale of one of our investments. Other than these items, there are no other material one-time items to report on in our Q3 year-to-date results. On the bottom of the slide, we have disclosed a profit attributable to owners of the parent company on a cash basis. Adjustments from the IFRS presentation include the amortization expense of M&A-related intangible fixed assets of approximately JPY 8.1 billion and the JPY 16.1 billion impairment charge recorded on Epredia and LSI Medience.
After adjusting for these two items and the related tax benefit, our year-to-date cash-based profit came in at approximately JPY 9.9 billion, lower than the JPY 15.7 billion reported in the same period of the previous fiscal year. The lower cash-based profit is mainly due to increased FX losses and the lower operating result. Let's now move on to the balance sheet on slide 23. On the asset side of the balance sheet, other than the JPY 17 billion decrease in cash, the JPY 43.9 billion, there were no other material changes in our total current or non-current assets. I will go over a bridge explaining the decrease in cash when we get to slide 24. Like on the asset side of the balance sheet, there were next to no changes in our total current or non-current liabilities other than the change seen in our total loans payable.
The change in the long-term portions of loans payable from JPY 262.4 billion to JPY 252.4 billion was due to the refinancing of the US dollar loan to yen in Q1 and repayments of borrowing. But these changes were partially offset by an increase in the carrying value of loans mainly due to currency translation. Lastly, you can see that the decrease in our trailing 12 months Adjusted EBITDA versus prior year's results caused our net leverage ratio to rise from 3.6 times at the end of March 2023 to 4.9 times at the end of Q3 and our gross leverage ratio to rise from 4.5 times to 5.8 times. Slide 24 shows a bridge explaining the JPY 17 billion decrease in cash from JPY 60.9 billion to JPY 43.9 billion. In summary, operations generated cash of about JPY 28.5 billion.
Of this, about JPY 17.1 billion was reinvested in the business, and JPY 31.1 billion was used in financing activities, of which JPY 15 billion was used to repay debt and JPY 8.8 billion to fund our fiscal 2022 year-end and fiscal 2023 interim dividends. In investing activities, CapEx and payments for acquisitions of subsidiaries came in at JPY 10.7 billion yen and JPY 11.4 billion , respectively. But these payments were partially offset in investing activities by proceeds from the sale of an investment. From here, I'd like to explain the updated forecast for fiscal 2023. As Miyazaki-san noted earlier, we are lowering all key metrics in our fiscal 2023 forecast. Despite the takedown, our full-year dividend remains unchanged.
We have also decided to hold our average FX assumptions to our forecast. I'm sorry, in our forecast to JPY 155 to the Euro and JPY 144 to the US dollar, given that the year-to-date average actual rates are almost exactly equal to the forecast rates. On slides 27 and 28, we have provided bridge charts to explain the breakdown of the movement in our revenue and operating profit between our November and our revised forecast. I will go over the operating profit change briefly in a few minutes. But on the revenue side, we are lowering the forecast by JPY 4 billion to JPY 351.5 billion. This takedown reflects the impact of the market decline we are seeing in the BGM business and slower growth in CGM relative to our prior forecast.
In healthcare solutions, we have factored in delays in demand recovery of testing in the clinical testing business in LSI Medience and delays in the installation of our electronic prescription system in Wemex. Lastly, in diagnostics and life sciences, we have factored in the market softness we are seeing in Europe and the US related to CAPEX spend. We are lowering our operating profit by JPY 24.5 billion to JPY 2.6 billion for the year. Compared to prior year, this is down JPY 17.4 billion. The JPY 24.5 billion takedown is comprised of the JPY 14 billion impairment charge taken in LSI Medience and a JPY 10.5 billion revision in operating profit, principally due to additional weakness we are seeing in diabetes management and healthcare solutions. Profit before tax decreased by JPY 26.6 billion to JPY 9.8 billion.
This takedown is made up of JPY 24.5 billion operating profit takedown plus a JPY 2.0 billion increase in interest expense, all of which relates to the accelerated amortization of upfront costs as required under our loan covenants. We are taking down a profit attributable to owners of the parent by JPY 21.3 billion. This takedown is comprised of the above decrease in profit before tax of JPY 26.6 billion, offset by corresponding tax on these adjustments in the amount of JPY 5.3 billion. The effective tax rate on the adjustments is lower than our group average of approximately 30%, as a large portion of the impairment is not deductible for tax purposes.
Lastly, we are lowering our cash-based profit by JPY 8.1 billion to JPY 15.3 billion to reflect the business operating profit takedown of JPY 10.5 billion and the interest adjustment of JPY 2.1 billion net of tax at the group's effective tax rate of approximately 30%. Despite the takedown of the cash-based net income, we have decided to keep our full-year dividend forecast at JPY 72 per share. Slide 27 shows a bridge chart, which explains the change in revenue and the interest of time. I will skip detailed explanations for this bridge, but I will be happy to answer questions later. On slide 28, we have provided a bridge for operating profit on the left side and on the right side a bridge for profit attributable to owners of the parent.
We are forecasting a JPY 24.5 billion drop in operating profit from JPY 27.1 billion to JPY 2.6 billion and a drop in profit attributable to owners of the parent from JPY 13.7 billion to a net loss of JPY 7.6 billion. Looking at the operating profit, you can see that in the diabetes management segment, operating profit is now forecast to be lower than our November forecast by JPY 6.3 billion. This takedown is due to an acceleration of the decline in our BGM business in mature European markets, plus lower profitability in our CGM business due to sales coming in lower than planned.
The JPY 17.3 billion drop in operating profits we are forecasting in our healthcare solutions segment is mostly driven by the JPY 14 billion impairment charge we took in Q3 on LSI Medience, but a portion does relate to lower margins in this business unit as general and esoteric testing is now forecast to come in lower than previously planned. Plus, we have also assumed a slower-than-planned rollout of the electronic prescription system in Wemex. I will skip detailed explanations for the right side of the bridge, but I will be happy to answer any questions during the Q&A session. On slide 29, we have provided a forecast by segment. As this is similar to what was just explained on the previous slides, I will also skip this slide in the interest of time. Finally, on slide 30, we have included a summary FX sensitivity guide.
This remains unchanged since the May presentation. But like in the previous quarters, I do want to again point out that this analysis is based on the original budget, which has differed from actual results, especially as it relates to the US operating profit movement. So I will end my presentation here and turn the mic back to Miyazaki-san for the next section. But I do look forward to answering any questions you may have when we get to the Q&A session. Thank you.
Lastly, I would like to explain about the change of representative director of this company. Today, the board resolved that as of 1st of April, Kyoko Deguchi will assume the position of CEO of PHC Holdings. Ms. Deguchi is an independent external director of this company, and she has more than 20 years of experience in the healthcare and chemicals industry.
He has served as representative of the Japanese Company of Global Healthcare and also senior executive positions in finance as well as marketing, and also has been serving as an external board director for many listed and unlisted companies. I will leave the position of CEO at the end of March. Looking back, in November 2022, we announced a value creation plan, a midterm plan defining growth areas, and we have been working on the implementation of value-based healthcare and diagnostics as well as drug development support, reorganization, electronic healthcare, medical accounting. We have made some acquisition and produced some results, but the performance has been underperforming the plan because of the change in the environment. And as we announced last December, we had an impropriety in terms of quality control at LSI Medience, which is one of our subsidiaries.
The external investigation committee is still continuing with the investigation in order to identify the facts and analyze the root cause to put in place plans to stop this from happening again. But as a top-of-the-healthcare company, I feel keenly the responsibility for what has happened because we should be responsible for health and life of people through our products and services. We still need time to achieve the expected result for the growth plan as well. We believe that the partial revision of the numerical targets for the 2025 objective for the midterm plan will have to be revisited. Internally, we are discussing this. After the new president assumes the position, we will explain the specifics through our earnings announcements. I will stay as a director until June AGM, and meanwhile, I'll continue to support Ms.
Deguchi fully in order to help for the growth and expansion of our PHC Group. Under the new management, starting from April, the group will continue to pursue sustainable growth, and we would like to ask for your continued support. That's all from me. Thank you.
We will now move on to a Q&A session. Koichiro Sato, Executive Vice President and COO, Chief Operating Officer, and Kaiju Yamaguchi, CSO, Chief Strategy Officer, will join us as respondents. If you have a question, please click on the "Raise Your Hand" button at the bottom of the screen. When I read your name on the screen, the microphone setting is changed. Once the microphone is turned on, please state your name and your affiliation before asking questions. Each person is limited to one or two questions. Please keep your questions as brief as possible.
If you have a question, please raise your hand. I will call on the participants in the order in which I see them raise their hands. Mr. Shinnosuke Tokumoto, please unmute and ask a question. Yes, I can hear you.
[Foreign Language]
The representative director will be changed. That's what you just announced. In the past two, yes. Thank you very much for your efforts. About the change, that's my question. Why this timing? Are there any meanings as to the timing of the change? And when we see the past track record, in 2020, John Marotta became CEO, and 2022 April, Mr. Miyazaki, and two years later now, the president will be changed. E very two years, it seems that the management is changed and VCP figures are being repeatedly reviewed.
So what are the issues that the company is faced with, and what is the root cause problem of the company? The timing of the change, that's my first question, as well as the frequent changes of the management in the past years. Thank you for the question.
With regard to the past issues, I refrain from making comments. But regarding myself, of course, I am the representative director and the director, and every year we make a contract. So every year I thought that it was a challenge for me. However, in the past two years, continuously in terms of the numerical results, these were short of the budgets. And based on these results, we have to review the VCP or our Value Creation Plan.
On top of that, personally speaking, as I have mentioned, we have the LSIM quality issue, and I believe that I have the responsibility myself. Amongst that backdrop, the timing of the change. Two years ago, I became the president, and there was an unexpected thing that happened. At that time, I had to do the transition, but the smooth transition was a challenge. This time, I do not want to repeat the mistake. As for the timing, I wanted the new president to be able to begin from the new fiscal year. That is why, in order for the smooth transition and the transfer, at the end of November, we put that issue to the BOD, and then that was put to the NCC committee, and then the successor will determine them. Today, the announcement was made. Did I answer your question?
Yes, I understood it very well. Thank you. One more question about your performance. The management, Europe, I believe that things are worsening in diabetes management, particularly in BGM. In 2024, in Europe, you will focus on CGM, and you will accelerate the CGM sales. But for that, investment is needed. Is there going to be more investment in 2024? Or because in the past, for the fourth quarter in a row, it is a low level of sales, lower profits, so you refrain from investment? What about in 2024, diabetes management, including the advance investment, yes or no, included that, what is your strategy?
Thank you for the question. With regard to CGM, we have the BGM drop, and we want to compensate that drop with CGM. That is why we are focusing on CGM. In 2024, the direction, just as you mentioned, we are making the business plan.
Basically speaking, up until now, we have been focusing on the inside sales and the focus on marketing. This time, we have Brian Hansen to be the CGM head. That is why we are determined and continue to make efforts in the CGM. That continues to be our direction in 2024. On the other hand, the BGM profitability is down, that's for sure. So how to maximally and optimally make the investments to save the cost for better sales, that's a balance, and we will also focus on that. Thank you. This is all I have to say.
Next, Mr. Seiji Wakao, please unmute yourself and ask your question. Mr. Wakao?
Can you hear me?
Yes, we can hear you.
Thank you. I have a question about diabetes management. Looking at the three months, third quarter. Revenue is not that bad, but Adjusted EBITDA is quite low.
It looks like the margin is quite weak. I understand there is shrinkage in Europe. Is this margin deterioration due to SG&A increase? And also, in the fourth quarter, the margin will not improve because you want to add more SG&A. Is that the correct understanding? So revenue versus adjusted EBITDA, I don't understand the relationship between the two. Please explain.
I think the drop is really due to several factors. The first factor that we are seeing is the investment that we are making in CGM. We're not seeing the revenue pull through that we initially had assumed in the forecast. So that is feeding directly into the margin line. Also, in CGM, because we have to order upfront, there was some inventory scrapping that caused the GP margin to drop.
The other area that we are seeing, because of the weakness that was much greater than what we had assumed in the previous forecast in Europe, what we are seeing is that there's pressure on the GP margin due to the manufacturing costs that we have down in Matsuyama. That, coupled with the migration of the sales away from higher-margin markets into lower-margin markets, as Miyazaki-san pointed out upfront, in India and China where the margins are much lower and to a lesser extent in Russia. As a result, all of that came together in Q3 and into Q4 and forecast that because of that, you have a lower margin than what we had initially assumed. I hope that answers the question, Wakao-san.
And also, SG&A is worse because of the FX impact. Yes, that's very clear. Thank you. That's all from me.
Next question, Kazuki Furuyama-san.
Please unmute and ask your question.
The first question. At the end of the presentation, you said that partially you need to overhaul the VCP or value creation plan. When you issued the VCP, you presented things by BU, and you had the numerical target. And so specifically, which target and numerical figures do you think that you need to revise? As far as you can share with us, please explain.
Yes, I will explain and answer your question. With regard to the numerical targets, just as we have explained regarding the progress of the business, that's below the plan. With regard to the figures, I believe that we need to review all of these numerical targets. And at the same time, we need to renew the capital allocation and think anew. We have the shareholder return, and that shareholder return will also be reviewed.
We have the current business performance and next year's business plan. All of them will be considered to reconsider the capital allocation, including the return to the shareholders.
Thank you. I have the second question. That's regarding LSIM, the quality issue. This time, LSIM Medience, you experienced impairment, and this irregularity is part of the reason. Part of what is in the impairment, what is the degree of the impact of this quality issue? And what would be the irregularity's impact on the company's top sales and bottom sales, as far as you can share with us the information?
Yes. LSIM Medience quality issue, just as Miyazaki mentioned, and the third-party investigation team is investigating. And the impact on the performance, that's still under investigation. In main areas, because of this irregularity and because of the relationships with the customers, we may be barred from joining the bid.
So that's one impact. With regard to that, we need to have further investigation so that that impact can be reflected in BP or business plan. Thank you. This is all I have to say.
Next question, Mr. Hayashi, please unmute yourself and ask your question. Thank you.
I'm Hayashi from Morgan Stanley Securities. I have a question. Can you hear me?
Yes, we can hear you.
Adjusted EBITDA versus EBITDA, structural reform cost is in between those two. And performance until the third quarter is probably according to plan in terms of expense for structural reform. But the fourth quarter and beyond, do we have to expect the same cost? Or what is the estimate of this structural reform cost for this fiscal year and next fiscal year? Do we still need to account for that for the next fiscal year? That's my question.
Thank you, Hayashi.
Let me try to answer that. First, as it relates to this year, if you look through the forecast, you will see in the forecast that we're not planning any really large one-time expenses. Most of these expenses were in Q1 and Q2. So for the rest of this year, there really is nothing large that we're expecting to come through. However, as it relates to next year, we are in the process right now of building the business plan for next year. To the extent that we do see gaps between the targets that we're setting and the actual bill, there is the probability that there may have to be further restructuring within some of the business units. However, it's hard for me at this point to call out a number.
If you can wait until we announce the plan for next year, probably in May timeframe, we'll have a better idea then.
I understand. That's all from me. Thank you.
We have little time left to answer those who already raised them. Akinori Ueda, please unmute and ask your question.
My name is Ueda. Due to the limited time, I would like to ask two questions at the same time. The first question, you said that you are revising the forecast and the sales are down, but the more takedown in Adjusted EBITDA, cost of goods sold or SG&A, what were the reasons for the more takedown for Adjusted EBITDA than the revenue? The second is your thinking on dividend. You said capital allocation policy will be reviewed. Up until now, you presented to us the stable dividend and your policy.
So does that mean that you change your policy of stable dividend? That's question number two.
I'll take the first call, first answer, and then I'll turn it over to Yamaguchi-san. He'll take the dividend question. As it relates, Ueda-san, to the operating profit question, we took the revenue down about JPY 4 billion, and the business operating profit was taken down by roughly JPY 10.5 billion. On the revenue, ordinarily, we would expect to see roughly a 40% flow-through, which would be about a JPY 1.8 billion-JPY 1.9 billion takedown in the operating profit. The difference between the 10.5 and the 1.8 is really made up of three areas. First, in CGM. CGM, we're taking it down by roughly JPY 2.6 billion.
As I mentioned earlier, there was scrapping that we had to take into consideration in the forecast just because we ordered product that has a shelf life and the sales did not come in, so we were stuck with some scrapping. Plus, because sales aren't coming in, the fixed cost was there. So there's probably about a JPY 2.6 billion hit related to CGM. In addition, on the BGM side, BGM, because of the migration of the business into more emerging markets and the weakness in the developed markets, there was a margin hit of about JPY 2.3 billion in the BGM side. The last area really where we saw a hit really was in healthcare solutions. Healthcare solutions really came from two areas. On the clinical, the clinical tests are coming in lower than what we had initially planned. Part of that is due to the compliance issue.
But in addition to that, it really is the overall market in Japan. And I think the other comps are having the same problem. The beds really are just not filling up in the hospital. So as a result, the test count is coming down, but our fixed costs, we can't bring the fixed costs down. So there's a hit on that. And the other area was E-Prescription. The rollout of E-Prescription had 100% flow-through, much higher margin. It's almost 100% margin on that product. That's coming in much lower. So the combination of those two in healthcare solutions was about JPY 3.2 billion. So again, of the JPY 10.5 billion, JPY 1.8 billion is the revenue flow-through. JPY 2.3 billion is really on the BGM side. CGM was about JPY 2.6 billion. And then clinical testing and E-Prescriptions were about JPY 3.2 billion. Let me turn it now over to Yamaguchi-san. You can take the question on the dividend.
We need to do the business plan for 2024, and we need to review the VCP. So considering all of them, including the current performance, we will review things, including stable dividend payment.