C-Rad AB (publ) (CRADB) Earnings Call Transcript & Summary

Good morning, everyone. Today's webcast is presented to you by Henrik Bergentoft, our CFO; and me, Tim Thurn, the CEO. In the first part, I will give a short introduction and comment on the financial highlights in Q4 and for the full year 2020. Let's look into our assessment of the sales development before I finish commenting on the key events. Henrik will guide you through the financial review before I conclude with a short presentation to give a market overview. At the end of the presentation, there will be a Q&A session. You can post your questions through the chat function, and we are happy to answer them before we close this webcast. And like always, we will put a recorded version of this webcast on our website after the meeting. Let's get started with an introduction in the financial highlights. C-RAD is active in the field of cancer treatment. Our customers are hospitals that fight cancer with radiation. A modern, high-precision radiation therapy, accurate tumor alignment is crucial for a safe and successful treatment. C-RAD positioning products are supporting this process and are fully integrated in the clinical workflow. Over the past years, C-RAD has been growing significantly and generated, last year, a profit of SEK 17 million at about SEK 220 million in revenue. Our mission summarizes our overall goal. C-RAD's cutting-edge solutions ensure exceptional high precision, safety and efficiency in advanced radiation therapy, helping to cure more cancer patient and improve the quality of life. Sorry for interrupting here, but we realized that there was a technical hiccup with flipping the slides. I think that should work now. C-RAD has sold about 580 systems, whereas approximately 415 are installed within what we call the advanced markets of radiation therapy. Those countries are marked in orange in this map. There's offices in Sweden, Germany, France, Belgium, Florida and China, we are serving our customers through our sales and service organization. To start with the financial highlights for the fourth quarter and the full year. We are closing the year with a record order intake of close to SEK 313 million and SEK 122 million in the fourth quarter. This is reflecting a growth of 16% and 39%, respectively. As COVID-related restrictions eased up in the fourth quarter, we were able to ship systems for SEK 74 million, which is reflecting a growth of impressive 46%. This leads to an 8% revenue growth over the full year. With a well-controlled cost structure, we succeeded to generate an operating profit of SEK 9.8 million, which reflects a profit margin of 13.2% in the fourth quarter and on the full year side, an operating profit of SEK 17 million or 7.7%. Let's take a closer look at our sales performance. A large part of our customers in EU and APAC are hospitals financed by their respective governments. We have reported in earlier quarters the implications of COVID-19 on the purchasing behavior of our customer. The situation improved somewhat from quarter-to-quarter and creating a strong momentum towards the end of the year. Order intake grew with 39%. All our segments show strong growth. Sales of our positioning products is the core of our business, and it is encouraging to see its strong development both in Q4 and for the fiscal year 2020. The service team is winning the race with an impressive growth of 64% over last year's Q4. We have reported similar growth rates in earlier quarters. This is a very good sign. Two factors are driving the development, a growing installed base, but also the attachment rate is improving, which means more systems out there in the field are covered with service contracts. Despite the challenging market situation in earlier quarter, we are closing the year with a remarkable growth of 16%, especially China and North America contributed to success in order intake. In both regions, C-RAD succeeded to secure large orders related to prestigious proton therapy projects. The business in North America started to recover only during the third quarter. And in the fourth quarter, we could see the results of our sales efforts that we did during the year. Also, our partnership with Elekta North America contributed to the strong order intake in the fourth quarter. Looking at this, it shows again the volatility that we are exposed to. Volatility can be positive, like, for example, in APAC and the U.S., but also in the other direction, like what we see now in EIMEA. However, most important is that continuously increasing demand for cancer care and the overall trend within radiation therapy towards high-precision treatment is creating an underlying growth for technology like ours. In 2020, we experienced an extraordinary situation due to COVID-19, no doubt. However, also in other years, C-RAD's business is exposed to a seasonality pattern, whereas we usually see a stronger order intake in the second half of the year and especially in the fourth quarter compared to Q1 and Q2. Revenue grew significantly in the fourth quarter with 46%, as many countries more -- were more selective in applying lockdown measures, more customers were willing to take deliveries as installations of our systems resumed. APAC and China, in particular, is the main contributor to the revenue growth, both in the quarter and for the full year, which is a result of a strong order intake during the year. With the regions APAC and Americas becoming stronger, we are less exposed to volatility in individual regions. Looking at the revenue by segment. Measurable growth in both our main segments, which is positioning products and the Life Cycle Business. Very encouraging to see the growth in our service business. I believe this slide is displaying our growth journey with our surface tracking technology becoming standard of care in radiation therapy very well. Let's come to the key events. We have been reporting 2 larger orders from our Catalyst -- for our Catalyst PT solution. Catalyst PT is based on the C-RAD Catalyst platform with a dedicated software to support workflows and interfaces with important therapy. The U.S. market has a very dynamic proton therapy scene. C-RAD secured an order with multiple cancer centers across the country. The first system is on its way to be installed with an expected go-live yet in this quarter. Another large order has been secured together with the Belgian company, IBA, for a customer in China. To sum up, we are proud of what we have achieved during the last year, and I want to extend my appreciation to all C-RAD employees for great contributions during this very challenging but still successful year. We can continue to expect volatility in individual quarters, and I want to be firm that the pandemic will continue to bring short-term uncertainty. But I'm convinced that we will continue to see the growing demand for our solutions in high-precision radiation therapy. I'm very much forward -- looking forward to the new year. And therewith, I hand over to Henrik, who will guide you through the financial review.

Thank you, Tim. So starting off with a more detailed look at our P&L statement. So total revenue for the quarter amounted to SEK 74 million, an increase compared to last year of 46%. In constant currencies, the increase was 49%. As said, significant deliveries in Asia and China, in particular, were the main drivers behind the growth. In North America, revenue grew slightly, but with a significant uptick compared to the beginning of the year. Revenue in the EIMEA region grew with 2% in the quarter with notable variations between the various parts of the region. This quarter's revenue includes SEK 3.1 million that will be paid as commission to sales channels partners, equally recognized as cost of goods sold in the quarter. Revenue for the full year increased by 8% or 9% in constant currencies and amounted to SEK 221.6 million. The reported gross margin was at 58% during the fourth quarter compared to 60% during the same period 2019. Fluctuations in gross profit margin can be expected between periods as it is dependent on the product mix and sales channels. And as mentioned, cost of goods sold in the quarter includes commission to sales channel partners of SEK 3.1 million. Hence, the underlying gross margin is 60% for the quarter and also for the full year. Full year 2019 gross margin was at 59%. Going forward, if and when sales channels are used that affects the reported gross margin materially, we will comment on this in our reporting and also disclose what the underlying gross margin is. Looking at our external expenses that amounted to SEK 44.3 million for the full year compared to SEK 52.6 million last year. The reduced cost for the full year is a consequence of active and natural cost reductions during the pandemic. Less spending on marketing and travel are the main drivers behind this cost decrease. Now the company will continue to carefully monitor its cost depending on how market conditions develops in the light of the pandemic. Still important to note that the cost level for this year, i.e., 2020, certainly is lower due to the pandemic. Personnel expenses for the full year amounted to SEK 64.8 million as compared to SEK 63.9 million last year. C-RAD has taken various measures to lower personnel expenses during the year in order to mitigate the negative consequences due to the pandemic. Among other measures, the company has taken benefit from different short-time allowance programs and other state contributions, available in countries where the company operates. Personnel expense for the fourth quarter 2020 amounted to SEK 15.8 million compared to SEK 16.9 million last year. The average number of employees during the fourth quarter of 2020 amounted to 56 compared to 59, the corresponding period in 2019. At the end of 2020, the number of employees in the group amounted to 55 compared to 59 last year. In total, operating income for the quarter amounted to SEK 9.8 million compared to minus SEK 0.5 million last year, producing a margin this year of 13.2% in the quarter. Last year included a write-down of capitalized development cost of SEK 11.6 million, whereas reported operating income last year was minus SEK 9.6 million. The increased operating income is a function of a strong development in revenue during the fourth quarter, combined with operating expenses, more or less on the same level as last year. Net results of the tax in the quarter amounted to SEK 12.5 million compared to minus SEK 12.5 million last year. Tax income of SEK 2.7 million refers to an adjustment of the deferred tax assets for the Swedish entities and does not affect cash flow. Next slide displays revenue and gross margin over a longer period of time. And as said, reported gross profit margin was 58% during the fourth quarter 2020. But the underlying margin was 60% compared to 59% during the same period 2019. To repeat myself, fluctuations in the gross margin can be expected between periods as it's dependent on the one hand side, on the product mix, and the other hand, what kind of different sales channel partners we use, but where an underlying margin of approximately 60% is what can be expected going forward. Next slide is putting our total operating expenses in relation to revenue for the past years. And the purpose of this slide is to put C-RAD's growth journey into a context where investments have been made in the organization to support this growth, hence, generating an increase in total operating expenses. The graph outlines operating expenses and revenue for the last 4 years, where we can see that these investments are, in fact, paying off in the sense that the revenue trend line has a steeper upward leaning curve as compared to operating expenses. Equally, meaning that the average yearly operating expenses in relation to sales is going down. The next coming slide shows our operating profit and revenue over a longer period of time. As seen, the business of C-RAD is volatile between the quarters and also expected to be so going forward since larger single orders has an effect in the quarter when they are delivered. However, the trend line clearly shows that C-RAD is on a growth journey with the company also since mid-2018 has reached a very important milestone in the sense that the company is delivering profitable revenue growth. Despite the challenges that the pandemic has presented, C-RAD has still managed to deliver a record operating income for both the quarter and the full year 2020. Next slide displays our cash flow for the fourth quarter and the full year. The sum of that is that liquid funds at the end of the quarter or end of the year amounted to SEK 108 million. In addition, the company has an unused credit facility of SEK 20 million. Operating cash flow for the quarter contributed with SEK 17.5 million and for the full year with SEK 18.4 million. In February, a directed rights issue was undertaken with an issue of 2.5 million B shares, fueling the company with SEK 102 million, net of issue-related costs. Following the rights issue, a bank loan of SEK 20 million was fully amortized, and the company ceased to use factoring. Next slide displays our balance sheet at the end of 2020 with a couple of comments to be made. On the asset side, 2 things. One is that inventory is on a relatively high level, which is a deliberate decision that during the pandemic have a buffer in our inventory to maintain delivery capacity. And secondly, and again, is the cash position of SEK 108 million, which is at a very solid level from a historical perspective. On the debt and equity side, I want to highlight that the solidity is at a historically high level of 74%. And also that the company, after the repayment of the SEK 20 million loan in quarter 1 and the ceasing of factoring now is completely debt-free. Next slide displays our order backlog at the end of 2020. Now the order backlog represents orders that have been received but not delivered nor invoiced, meaning future revenue. The backlog in total amounted to SEK 350 million compared to SEK 267 million last year, meaning a growth of 31%. From the total order backlog, SEK 172 million relates to product and SEK 178 million relates to service contracts. And out of these service contracts, SEK 28.7 million is programmed to be recognized as revenue in the coming 12 months as the service contracts are recognized as revenue over the contract period. The service contracts, as such, can be up to 8 years, while the most common contract period is 3 to 5 years. Thank you, and now over to you again, Tim.

Super, Henrik. Thank you very much for a very good presentation. So let me give you a quick overview about the market and C-RAD's view on the market. So if you look at the opportunity for our products and our solutions, we are very much focusing on what we call the advanced markets. This is North America, East Asia and, of course, the European countries. I think from a clinical perspective, what is really driving the demand, I mentioned earlier in the presentation the trend towards high-precision radiation therapy. But what does it really mean? Conventional treatments, and I want to point your attention to the diagram or the table on the lower right corner of this slide, conventional treatments is still the common practice for most cancer treatments with radiation therapy in the relevant countries. There's, however, a trend towards this high-precision treatment. And what it essentially means is that the patient is getting instead of 30 fractions, significantly less. And if we speak about stereotactic treatments, we are speaking also about 3 fractions, sometimes even single fractions or hypofractionated treatments where we are speaking about 7, 9, perhaps 15 fractions. So it is a trend towards reducing the number of fractions that patients receive during the course of treatment. The positive thing about this new fractionation schemes is certainly a possibility to apply this high-precision treatment technique. However, the concern that comes with this technique is that accuracy plays an even more important role for a successful treatment. However, this is the trend, and especially now in COVID times during this year, it has even accelerated its development as it also generates an opportunity to reduce the number of interactions between patient and visits to their respective hospital, which was obviously from an infection control perspective, very compelling. So there is a clear trend in this direction. And based on this projection here, which -- yes, the base data is from 2016, it is essentially projecting that a large majority of the treatment in 2030 is going to be based on SRS and hypofractionated treatment. So what -- how does C-RAD comes into the play? C-RAD is providing solutions for accurate patient positioning and monitoring in order to deliver treatments for those patients in a secure and efficient way technology like ours is required. I'm coming back to the market opportunity. As I indicated, I mean, our focus are the advanced markets. And I mentioned it earlier in our presentation, we see this technology -- this positioning technology to be on its way to become standard of care. Looking at the current market penetration, which is around 20% across all the vendors, so not only C-RAD but also other vendors in this space, there's still a huge opportunity to equip more machines, and in essence, also provide this safe and good treatment quality to more patients in -- around the world. Then looking at C-RAD's value proposition. There are 2 main aspects why C-RAD products are implemented in the clinical flow. And on the one hand, it's treatment efficiency and accuracy. Now I want to point your attention to the diagram on the lower right corner. There are different ways how patient positioning, and essentially, also monitoring, can be done. And it is always a trade-off between time and accuracy. The laser positioning where C-RAD is also active with the HIT laser systems -- the super HIT laser systems, it is a very time-efficient yet not so accurate way of positioning patients. And it depends very much on the applied treatment techniques, whether or not that is sufficient. However, as I mentioned earlier, that there is a trend towards more high-precision treatment techniques, more accuracy during the patient positioning process is required. There are different technologies and accuracy usually comes at the cost of time. However, the C-RAD solution, which is the SIGRT solution here provides a high accuracy and yet a very fast setup time. And that makes it very compelling to implement C-RAD technology in the clinical workflow. I want to conclude today's webcast with the financial calendar. We have the annual report going to be published on the 15th of April. And the annual meeting as well as the interim report for the first quarter are going to be -- yes, the report is going to be published on May 7, and the annual meeting is going to take place on the very same day. Like always, I want to thank everyone for attending this webcast. As I mentioned, there is an opportunity to ask questions. While you're thinking and typing the questions in the chat function here, I would like to point your attention to our websites. If you are interested to learn more about our products, please take a look at the C-RAD education section where you are able to experience clinical users speaking about their implementation and their experience with C-RAD in day-to-day life. On ESTRO 2020 link, this is our virtual booth that we have developed now during 2020 and used for various exhibitions to give a brief overview about the C-RAD technology and the different products that we are offering. I also want to mention that there is an opportunity to send questions to our investor e-mail address, also because we got the question a couple of times. It's perfectly fine to send these questions in Swedish. It's not only a good opportunity for me to learn, but also Henrik is following this e-mail inbox very well and able to answer most of the questions as well. So okay, that gave us some time to formalize some questions. And let's go through them.

The first one. Hey, Tim, what is the reason that the order intake in the EIMEA region lost now during the fourth quarter? As we mentioned during the report, I mean, there is still significant volatility that we are exposed to. And I mean, that was kind of dominating the order development very much during this entire year 2020. So we saw that towards the end of the year when the second wave of the pandemic started to have an increased impact. It related directly to our business and had a direct impact on our activities. So there is no structural concern from the market, just the opposite. But I want to highlight again that there is still volatility that we see and can expect or need to be prepared for due to the pandemic. We are not at the point where the business is going as usual. On the other hand, if we look for North America, for example, which was very limited activity essentially up until the third quarter or even including the third quarter, the market eased up and the fourth quarter came in very, very strong for us. The next question is related to the Elekta contribution, how much this has contributed to the result. I can't disclose the exact number here. However, I can just reaffirm based on what I said earlier, that the corporation is developing very well. We have a good working cooperation also from a sales operations perspective. In the field, the teams are working well together and supporting each other. So we are really developing a good setup here with our partners in North America. And there's one question, that we had a development project with Siemens and Elekta, which was running over many years, if I could comment on that. I can't really comment on that. I'm not really where -- which development project this question is referring to. So if you can give more details, please be a bit more precise in the question panel, and I'm happy to answer the question later here during the Q&A session. Then there's a comment on our information policy and how we disclose information to the market. I can -- I understand and hear the comments. We have an information policy in place, which basically defines the level when orders are communicated. I understand that this policy -- applying this policy has not led to many press releases. However, this is not a big concern as also we see now in the fourth quarter, majority of the orders is under this threshold that we have defined there, and that is also for good reasons. I mean we want really to focus on extraordinary, huge orders, large orders, and communicate specifically those. However, I understand the desire to have more information, and we continue to keep an eye on providing relevant information to the market. Can you elaborate on how much the order intake for Catalyst+ is versus Catalyst -- yes, basically the old version of the Catalyst. I can say that the markets where we have regulatory clearance, and that is certainly the entire European Union, it is North America and selective other markets, for example, Australia was also one of the bigger markets where we delivered in the fourth quarter where we have regulatory clearance that we are delivering the Catalyst+ systems. There are other markets, and just to name the bigger ones, it's Japan and China, where we are still working on the regulatory clearance. They continue to receive the Catalyst -- yes, classic, as we say, or the old version, as you mentioned. Can you comment on the gross margin of 58% in the quarter? With that question, I would refer to Henrik, who can reply to...

Yes. Thank you, Tim. So yes, the reported gross margin was at 58%. But as we tried to communicate in the presentation, the underlying gross margin was 60%. And this is a function of how we use different source of sales channels. And in this case, we had a SEK 3 million effect, both on revenue and on cost of goods sold, meaning no effect was ever on the gross profit, but sort of diluting the gross margin. And going forward, from time to time, it might be very well so that we use different kinds of sales channel partners. And when we do that with a material effect on the gross margin, we will communicate that and also communicate what the underlying gross margin is. But going forward, the underlying gross margin in the vicinity of 60% is what you could expect.

So with regards to the proton order, can you say what Linac vendor or which vendor of the main system of the proton system it will be connected to? As a matter of fact, it's different sites, and all the sites are equipped with different proton systems. So it will be really a range of different systems. Then the next question is related to the GEMini system. I can just repeat what we said earlier. I mean the focus for us in the organization is on our positioning products. That is what we see in the short and also in the midterm, be the main driver for the development of the company. At this stage, we are focusing all our resources on these -- on the development of the business around our positioning products and not to the GEMini. So several questions here regarding GEMini. I think glancing through them, they are answered with what I just said. What has happened to the arbitration with the former employee? Is that settled yet? As we mentioned also in the report, if you're interested in more details, please have a look there. But in general, this is still pending at the court in Stockholm. So the case is not settled yet, but nothing changes in our original assessment of the situation. And from that perspective, there is no level of higher concern for C-RAD. Has C-RAD market share in the U.S. increased? Certainly, we have a very good development there. Right now, I think we are in a very good position. And as I mentioned also before, the cooperation with our Elekta partner starts to develop and create results for us. So I think we are in an excellent position to develop further growth there. Also, what I want to mention here in this context is the North American market is a very huge market. It's reflecting roughly 45% of the world market. I think for us, it's very important that we get this momentum now. I think we have a good organization in place. We have great partners there and fantastic products. So I think we are in a good position to further build on this basis. So you mentioned 450 systems, and that was a number that we have mentioned in earlier reports. Yes. I mean this is approximate number and the purpose of giving this is more to give you a picture of -- a gross picture of how C-RAD is positioned. It's not the accurate exact number of systems that we have actually shipped and delivered. Okay. It seems like that was the last question. I don't see any other questions coming in. Okay, then, we'd like to thank everyone for taking the time and attending this webinar. I wish you all a continued great day. And yes, see you again after the Q1 report. Thank you very much. Bye-bye.