ImpediMed Limited (IPD) Earnings Call Transcript & Summary

I respectfully acknowledge the traditional owners of the land on which we meet, the Gadigal people of the Eora Nation. I pay my respects to their elders, past and present and also to any Aboriginal and Torres Strait Islander people here today. Good morning, ladies and gentlemen. My name is Christine Emmanuel-Donnelly, and it's my pleasure as Chair of ImpediMed Limited to welcome everyone joining us today for our Annual General Meeting. I wish to advise that the AGM is being recorded and the recording will be made available on our website after the meeting. It's now just past 11:00 a.m., the nominated time for the meeting, and I've been informed that a quorum is present. I note that the meeting has been validly constituted, and I'm pleased to declare the meeting open. So let's start with some introductions to our directors here today with Andrew Grant, Nonexecutive Director; Janelle Delaney, Executive Director; Fiona Bones, Nonexecutive Director and Chair of our Audit and Risk Management Committee; Dr. Parmjot Bains, Managing Director and CEO, currently in the U.S., actually in New York in a meeting with some cardiologists and customers, and had fully intended on being here today, but we took the opportunity to progress our heart failure business opportunity and to drive, obviously, the BCRL opportunities as well. And also here is McGregor Grant, our Executive Director, CFO and COO. We also have our Company Secretary, Leanne Ralph, and representatives from the company's share register, Link Market Services. From EY, we have the independent partner on the ImpediMed audit, Susie Hill, here in the room to respond to comments and questions in relation to the audit. There are 4 components to today's meeting. And firstly, I'll provide you with an update in the Chair's address. This will be followed by a very detailed overview from our CEO and Managing Director, Dr. Parmjot Bains. And we'll then open the meeting for general business questions after my address and Parmjot's presentation. And following the general business Q&A, we'll then move to the formal business of the meeting, where the items set out in the notice of meeting will be put to shareholders. We'll also allocate time for questions on each of the items of business when they are considered. Thank you to those shareholders who've submitted questions prior to the meeting, and we've endeavored to address those during the upcoming presentations. So I'll begin with the address. So welcome to the 2025 Annual General Meeting of ImpediMed Limited. It's a privilege to address you as Chair. First, I'd like to acknowledge and thank the shareholders for trusting in us as a Board and as a management team to navigate and drive the long-term success of ImpediMed and continue to serve and improve the lives of patients from preventable pain in the BCRL category, as well as work towards further improved patient outcomes in the categories of cardiac health, wellness and medical weight management. We've reinforced our position as a leader in the diagnosis and management of lymphedema and see increasing use of the SOZO device in assisting workflow management for surgeons and clinicians. As a Board, we take very seriously our role in setting the strategic direction of the company, governance of the company's risk, and of choosing and overseeing the excellent management team to drive the success of the company. On Board practice, I'd like to point out that Andrew Grant has now completed a year back on the Board following on from his 6-month role in the business back in the '24 financial year, and we see him as a full Nonexecutive Director for the 26th year ahead and are confident in the majority independence of the Board. The 2025 year saw payer coverage increase significantly in the second half of the 2025 financial year with 26 states greater than 90% coverage. We expect to see more momentum in BCRL sales as a result. We saw a steady 23% revenue growth in 2025, and with pivoting investments towards our sales capability, we're confident in the commercial execution of the BCRL opportunity. This is continuing to grow and the management team has made good decisions about recruitment and sales capability and continue to refine the sales process with a number of staff also supporting the post-sales process for increased SOZO utilization. The value proposition for the long-term success of this business lies in the digital health platform. And as much as we are excited about the increased momentum in BCRL and be rest assured, we remain committed towards accelerating the success of this opportunity, also buoyed by the opportunity to leverage the multiple technologies across the SOZO Digital Health platform, taking advantage of the commercial opportunities and progressing better patient outcomes across these categories. So the team has been working across these various categories, preparing the path to commercial execution. As we've reiterated previously, the SOZO device has multiple FDA-cleared applications, including FDA clearance for lymphedema, body composition, heart failure and protein calorie malnutrition. The heart failure category has a $1.1 billion opportunity with the body composition category at around $600 million. The team is open to opportunities to expand into these categories in the most efficient way and are working on various options. As a Board, we support exploring any opportunities which may become available to us, including new collaborations, mergers, distributors, acquisitions in certain categories in order to ensure we realize the full value of the SOZO Digital Health platform. Dr. Bains will describe these categories and the opportunities in more detail in her presentation. So for now, I'd like to thank my colleagues on the Board. Not only do you bring your executive experience, but also your keen questioning and challenge to the Board and to management. I also thank our staff for their continuing passion, dedication and hard work. It has been difficult for the Board and management while we resize our costs, and we're confident these steps will contribute to the future success of the company. Finally, and to reiterate our thanks to you, our shareholders, for your continuing trust and support. We do not take this lightly and share your passion to make ImpediMed a success. I will now pass to Dr. Parmjot Bains for her presentation, and we will take questions after that. Before we hear from Parmjot, we will play a video. [Presentation]

So thanks, Christine, and my apologies for not being able to be there in person. I have some important customer visits and just felt that with the urgency of moving this business forward, it was important to take those, particularly in the heart failure and cardiology space. So good morning to everybody, and thank you for joining us today, and thank you to those that have joined on the webinar as well. Slide 8 just looks at the forward-looking statements and the obligatory and important disclaimer slide. So going on to Slide 9. This is my agenda for my presentation this morning. I'll provide an overview of the SOZO proposition and market opportunity, followed by an update on the BCRL market. Then I'll share some more in-depth details on our offering and launch activities into the very exciting and rapidly growing cardiac, wellness, and weight loss market. I'll then cover off how we're going with a look at key metrics, and to finish off, I'll go through our strategy for the year ahead and IPD's value proposition. Going to Slide 10. Over the years, we've been reinforcing how SOZO is a platform with multiple applications and clearances with 3 clearances that are now in commercial focus actively, lymphedema, body composition and heart failure. So today, I'm pleased to share more detail on how we are commercializing these 3 applications. So going on to Slide 11. I just want to just stop and just check for a moment that online and everyone can hear okay.

Yes.

Thank you. Slide 11 just really goes through the title expanding SOZO to growing U.S. patient population. I'm actually going to spend a bit of time on this page to give you a perspective on why we believe SOZO is so uniquely positioned to capture what is a large and rapidly growing market. So SOZO fluid and body composition outputs are applicable to large patient populations and are now an active commercial launch in the U.S. market. The FDA clearances for healthy and unhealthy patient populations, the removal of contraindications for cardiac pacemakers and ICDs, the strength of this and the use of the device already in many cancer centers and hospitals in the United States gives us an incredibly strong and unique selling proposition. And we are hearing that in person as we attend conferences like this week's Lifestyle Medicine Conference as well as direct connection with cardiologists and other specialties. We are in BCRL, which is an addressable market of $600 million, driven by our guidelines, clinical data and increasing reimbursement. We're also capitalizing on that increasing interest in cancer survivorship, and you heard Dr. Deepika Wali talking about how she's looking at the whole patient care as they go along their journey. So she has now incorporated body composition into her measurements and patient workflow. With our existing platform, FDA clearances, clinical data and the new SOZO Pro device, we have moved into that cardiometabolic space, more specifically weight management and heart failure. Now what's driving this? The increasing growth of GLP-1. And as you can see, within the United States, 13 million patients alone are on GLP-1. That weight management and wellness market is rapidly expanding, and along with it, the need to manage fat and muscle mass. And that is now indicated and requested by guidelines. Within this space, we're targeting the emerging and rapidly growing Lifestyle Medicine market and med spa market. I just want to take a moment just to kind of explain what those categories are, because we don't see those in Australia yet, but we are definitely seeing those in the United States. So a Lifestyle Medicine doctor is a physician who uses therapeutic lifestyle intervention as a primary treatment to prevent cardiovascular disease, chronic conditions like diabetes, cardiovascular disease and obesity. In 2024, the American College of Lifestyle Medicine reported over 3,000 physicians and over 1,000 other health care related professionals certified in Lifestyle Medicine, a new but rapidly expanding specialty. The market is projected to reach $15 billion by 2028, driven by the rise of lifestyle-related chronic disease and employer interest in preventative care. And our team is this week at the American College of Lifestyle Medicine Conference and reporting extremely high levels of interest. The second category is the med spa market. So what's the med spa? A health care facility that combines spa environment with medically prescribed treatment. Historically, that's been cosmetic procedures, but we are now seeing increasing GLP-1 usage. And I've seen that in person as I've gone around and visited these clinics and sites of care. According to multiple industry sources, this market is expected to grow to $70 billion to $85 billion in the early 2030s. So it is growing very, very fast. The lifestyle medicine and med spa market significantly expand the use case for SOZO across weight loss, lifestyle, heart failure and beyond. At the other end of the spectrum are the 6 million heart patients in the United States with heart failure, projected to grow to 8.7 million by 2030. As Christine noted, our internal calculation on the outpatient TAM market alone based on an existing CPT code indicates a $1.1 billion market. If we go to Slide 12. This just really demonstrates the value of the SOZO device. So in lymphedema, we've talked to the market about how the SOZO and early prevention replace the tape measure, while ultimately, we can actually replace the scale. The workflow is as simple as replacing the clinical scale with a financially sustainable digital health offering that positively impacts patient outcomes. That data from the SOZO device is relevant for breast cancer surgeons, rehabilitation teams, cardiologists, lifestyle medicine specialists, obesity specialists, and plastic surgeons, to name a few. And in fact, one of the reasons I'm here this week is I'm meeting breast cancer specialists who actually have got very small facilities and workspace. And so we're looking at how we can put the new SOZO Pro into these workflow and work plans where they're already taking away. And so we can add in the SOZO Pro and we can actually help expedite that workflow. As we grow into these new markets, we're leveraging referrals from our advisers, existing customer referrals to colleagues and other departments, and also leveraging the contracts and IT approvals already in place within these hospitals. And just as a note, I was in Austin working with some cardiologists last week. And one of the key questions they asked is, do you already have approval within our health care system for this IT and risk assessment? And fortunately, we can say yes. So this expedites the process very, very quickly. If I go to Slide 13, this slide is about cancer survivorship and the prevention of breast cancer-related lymphedema. BCRL execution has been the main priority of my first 18 months, and we've built a lot of momentum over the past year. It is still a key priority for our business. One of the crucial elements is reimbursement, and we are seeing significant increases both in terms of breadth of payer coverage from 73% to 87%, as well as depth, which is critical, with 26 states now with more than 90% coverage. A lot of this momentum coverage came at the beginning of this current financial year, and the sales team is now working very hard on converting these leads to sales. We have 10 sales reps and a CPS team focused on the BCRL opportunity, where execution with urgency is a priority. And we had all the team together in Dallas last week, really reinforcing that message and making sure that we are acting to convert our lead conversion. We produced a record contract value in the last quarter of the financial year. Last quarter was a little slower than we expected with hospital budgets under some pressure. It's a little early in the quarter to know where we will finish, but we remain confident of the continued improvement of the balance of 2026, as our new sales team matures, recent improvements in reimbursement come through and start to flow back through into hospitals, relieving some of the short-term budgetary pressure. So go to Slide 14. Now looking at these new areas of cardiometabolic health. And specifically looking at heart failure. So the unmet need across heart failure is significant. So ImpediMed has the new SOZO Pro device, which is now in the market, uniquely cleared by the FDA for use in fluid and body composition and heart failure patients, including patients with cardiac implantable devices or CIED. That makes us unique and compelling. We've validated with U.S. clinicians that we have a compelling clinical offer to help improve outcomes. And we have initiated a controlled launch with focus on a small number of key states, which have high coverage, that will enable us to refine the messaging to clinicians and our go-to-market model. In the U.S. alone, there's 13,000 cardiologists, so we need a very clear model to roll out into this market space. So Slide 15 gives you the proposition of what is HF-Dex and what is our proposition within the heart failure space. So this is the new SOZO Pro device, which when you stand on, it gets an automatic weight calculation, which when done can put it into the scale, but it also provides that 30 second test, which provides detailed data and analysis on the patient. So SOZO has a measure that's called HF-Dex, a trademarked FDA tape measure that measures the extracellular fluid over total body water. Heart study conducted by ImpediMed, where clinical data already exists in an 89 patient population followed from discharge, show that this HF-Dex measure is twice as sensitive as weight, which is the current standard for monitoring fluid change. Patients discharged with an HF-Dex over 51 had a fourfold higher risk of readmission, and readmission within 30 days is a significant driver of health care costs and metrics within the U.S. health care system as well as Australia. The current measure HF-Dex has an 80% sensitivity and specificity for patients with heart failure. The beauty of the device is that we also measure body composition, and with over 50% of heart failure patients obese or overweight, the body composition measures support management of patient outcomes. GLP-1s or more specifically Ozempic is now indicated in cardiology patients to reduce long-term cardiovascular risk. Fats are also recommended by guidelines to be monitored through devices, including bioimpedance. As I noted, cardiologists rely on weight as a surrogate for fluid changes and decompensation, i.e., when the fluid starts to build up as the heart fails. With the introduction of GLP-1s, weight is now not a reliable surrogate and SOZO can provide an alternative measure for fluid change. Finally, really importantly, the SOZO fits into existing heart failure nurse-led workflow, replacing the scale for the financially sustainable digital offering. I've been in New York and Texas in the last couple of weeks, meeting with cardiologists and the key points to note is, one, interest from cardiologists, cardiometabolic clinics and heart failure nursing teams is high due to our ability to measure fluid and body composition in heart failure patients, particularly those with obesity and on GLP-1s. We have a unique proposition that fits easily into existing nurse workflows, and we've already started on quotes and program builds within cardiology sites, including multi-device offers across different sites of care. Going to Slide 16. This goes through some of the marketing material that we've developed in collaboration with cardiology advisers and are now using within the market. Going to Slide 17. Within the cardiometabolic space is wellness, lifestyle management, and weight management space. They're all very interlinked. Similar problems, similar issues. A lot of this has been driven by that growth of GLP-1 being prescribed in a large number of platforms. We've initiated active sales into this space with 2 dedicated body conference in the U.S. led by one of our key account specialists. The team has recently attended MedSpa Pro in Florida and was now currently at the American College of Lifestyle Medicine Conference, where as I noted, there is significant interest from clinicians. We go to Slide 18. I just want to give you a bit of overview of the marketing material. So we keep reinforcing the FDA clearance for healthy and unhealthy patients, the regular contraindications, the strength of this, the use in hospitals across the United States gives us an extremely strong unique selling proposition against the competition. We are raising the bar. We know we can just do it better for more patients. If we go to Slide 19, I'm going to cover some of the financials, which are really from the last financial year. For the previous year, the focus for the business was on execution of BCRL and cost reduction. Looking at our key metrics, the SOZO Core business revenue rose 23% to $12.7 million, and the SOZO Core business annual recurring revenue rose 27% to $14 million. The profit margin remained healthy at 86% and patient testing continued to grow. Cash balance at the close of FY '25 was $22.2 million. The next, Slide 20, shows SOZO Core business revenue and ARR. The U.S. business still represents 91% of our revenue for our BCRL business, and our FY '24 Core SOZO business revenues were up 25% versus FY '24. The next chart demonstrates the growth in ARR. Solid growth at a 3-year compound rate of 24% and a 27% growth in FY '25 over '24. The growth in reimbursement and building program health with customers is supporting a low churn rate and customer adoption. Slide 21 looks at the momentum and pipeline growth continues through trade show attendance and direct promotion by our field force. We have invested a lot in developing the depth of our sales team in the last financial year and are really working hard with them to see the fruits of this work. Slide 22 goes lastly to patient testing. Again, solid growth of 21% compounded over 3 years and a 15% growth for FY '25 over FY '24. Healthy programs and healthy accounts are key to renewal increase and are the prime focus of our clinical team, which supports our customers once they have implemented devices. Going to Slide 23 is the focus for the next financial year. We remain ever cognizant of our cash burn and the need to rapidly drive sales, hence, my presence in the United States. To do this, we are focused on lead conversion of BCRL with our existing reps, providing our customers with a best-in-class experience, which includes leveraging AI. We continue to reduce our cost base through efficiencies and process automation. And importantly, this is a year of growth where we are actively launching into the new cardiometabolic spaces. So to take an opportunity to go through what we're doing in AI. We have a new Chief Product Officer, turn to Slide 24, Scott Savage, who comes to ImpediMed from Google and other health platforms. Scott is leading our use of AI to drive operational efficiencies and improve our customer experience in a cost-efficient manner. As a HIPAA compliant entity, we need to be very considerate about our AI use and have refocused these activities on the back office support functions, where we can improve efficiency. Slide 25 just wraps up with the value proposition that ImpediMed represents. ImpediMed has a market cap of around $55 million with $23 million in cash. We're now in 2 key health areas, cancer survivorship and cardiometabolic health, with all of the critical elements in place. Clinical data is there, regulatory clearances are done, guideline inclusion is there. They've all taken time, and it can be easy to overlook what we've achieved and to lose sight of how uniquely placed ImpediMed is. We have a digital platform technology that's applicable to multiple indications, providing significant growth options. We have FDA approvals, not just in lymphedema, but also in heart failure and body composition. We have positive clinical results, both in terms of the Level 1 evidence for the randomized clinical trial for lymphedema, and we've also got existing clinical data for heart failure. We have multiple guidelines and industry standards that advocate for this use. And reimbursement in BCRL and heart failure creates a financially sustainable breakthrough clinical digital platform for our customers. And that's what makes me very excited about the future for ImpediMed. And with that, I'll pass it back to Christine.

Thank you. Thank you, Parmjot. It is a very detailed presentation. We enjoyed that. Thank you. I'd like now to open the meeting to general business questions. You'll have the opportunity to ask questions pertaining to each resolution when we get to the formal business of the meeting. Before we begin, visitors are reminded that this is a shareholder meeting, and therefore, only shareholders, proxy holders, body corp representatives or attorneys are able to ask questions or make comments at this meeting.

[Operator Instructions] The order in which we will address questions for each item of business will be first, questions from the shareholders present in the room and then questions received via the online meeting. So now I invite questions or comments from shareholders or proxy holders present in the room. I ask that you please state your name and then ask your question.

My name is Peter Gregory. I'd like to ask a question that relates to the utilization of SOZO and just focus only on BCRL. Every day, there are thousands of decisions made by caregivers as they review breast cancer survivors. The decision is whether they make a decision as to whether to test or not. It is each of these daily decisions that will determine whether or not our company is a success it should be. Therefore, for shareholders needing to understand how well our company can do, it is the sum of the baseline tests completed and the sum of the follow-up tests completed is probably one of the most important indicators that we have. And particularly given the guidance that's out there of a baseline test in 1 to 3 years, a test every 3 months; and then 4 to 5 years, a test every 6 months. We would expect to see, over time, a significantly increasing rate of follow-up tests as compared to baseline tests. The company used to show us that breakdown previously. And I think it's really important that we see that as well as the total progress of the test. So I'd ask if you could share those numbers with us for the last year and also commit to giving us that detailed kind of breakdown going forward.

Thank you, Peter. I will take that as a request, and the actual comment you've made is very clear. So unless we have Parmjot on the line, I'm not sure whether you heard the entire question, but if you want to make a comment...

Peter, we hear you. Can you hear me all right?

Yes.

Yes. Absolutely, we are seeing a good divergence in that baseline up to the incremental testing, which is what we expect, and that's a core part of that return on investment for our sites and our clinicians as well as we sell and promote the device. So it's not just for the benefit of shareholders, it's also for the benefit of our customers. So we do take that, and we'll take that as noted that you would like to see more information around that.

You're saying you don't have the results available for the last quarter or last year?

Sorry. We said, yes, we see it, and we're seeing good divergence of that. So you would expect those repeat tests to be increasing. And so we do have that, we do track it, and we do see it. And so I think we noted we will look to share going forward.

Stephen Atkinson. I was just wondering if the company could share their view on what a normalized sales cycle looks like for new SOZO customer?

Thanks, Stephen. I think we are still -- so for customers that don't have the IP approvals, there are terms and conditions in place, there is a large hospital system, we're still seeing that 5 to 6 months. We did see kind of a bit of a delay on some of these where we thought some sales would come through last quarter, but it just seems to be delaying getting those across. Smaller independent breast cancer clinics or surgeons can actually get it done pretty quickly. We've had some that have turned over in a month. But in terms of normalizing, we're still seeing that 5 to 6 months window and time line for that turnaround.

It's David Robinson. I'd like to get some detail about the state of the U.S. sales force. So what's the total headcount you have now? How many positions are currently open to be filled? And how many people are, say, less than 3 months in their position?

We certainly have 10 sales staff currently in the U.S. There are other staff supporting the team that supports the utilization of sales. And Parmjot, with regard to whether there are any open agencies, I think there may well be some movement.

Yes, let me jump in. We've got 10 BCRL-related sales reps and 2 focused on body composition. To support those, we've got 3 what we call inside sales or BBR positions that basically help go out and drive leads within the team. In terms of the team there, all the positions are now filled, and we've got 2 that are under 3 months in the team. So a couple that are new, but they have been selected with a lot of care and contact them close and they've got solid relationships with breast cancer surgeons and are working hard on accelerating sales.

Just following on from the staffing question. I've read an analyst report and they say that they have a concern about the staffing levels that are currently within the company. If you can provide any information around how you're currently positioned, in particular, relating to the whole of business operations from lead generation to sales through the onboarding, et cetera, all the way through to customer retention and/or renewals?

We've worked a lot in terms of the staffing with Scott Long as our new VP of Sales. Right now, based on the spread and breadth of breast cancer surgeons, which you're looking at BCRL within the United States, we're actually comfortable with the level of staffing that we've got today. And Scott has indicated in some of the previous quarterly calls that we are expecting these reps to deliver significantly more sales on a per rep basis. So we're comfortable with that today, and we're comfortable with the aftersales with just 3 key team members involved. And we're adding in additional reps around the body composition space. I wouldn't -- right now, we feel like we want to get these current reps that we've got up to speed faster. And we've targeted reps that have come out of Scott's previous background with very deep relationships with breast cancer surgeon. So less time taken to get to meet people and they kind of know the existing user base.

Okay. So second question is rest of world, it was on the presentation that you're looking to convert that to a SaaS model. So there was nothing spoken of that. Is there any indication as to when that might occur, or information around what needs to be done to actually do that? Because currently, of the FY '25 report, 49% of the business, which is rest of world, only brought in 7.8% of revenue, which is -- well, it's not functional.

Absolutely. So within the rest of world, the primary focus of the business with breast cancer is actually the Australian market. We did look at the other European markets, but it's very much -- there is not a preventative model of care in place. It's very much about treating lymphedema after the state, particularly up in Europe. So the focus for us has really been about going, as a business of our size and capital structure, going hard in the U.S. market. We did look towards Medicare and think we'd get a reimbursement model in place in Australia. But given the Australian structure of health care with secondary care at the hospital level run by the state, that wasn't a feasible option. So we are continuing to kind of look at what we can do to shift out to the SaaS model and it's part of our kind of conversations as we move to distributors. I can't give you a time line, but it's actively on our radar right now, looking at that model.

Just picking up on that question about the rest of the world. I'd like to ask that you consider in the annual report, including in the segment analysis, U.S. and rest of the world. I think the revenue of the rest of the world last year was about 9%, which is just a touch under the suggested 10%. I have no information about the profit or loss in either segment. But I do note a totally different strategy between the U.S. and the rest of the world. I would expect a totally different cost structure, a totally different approach to the marketplace. And the U.S. is a very high detail, very expert-based approach to the marketplace, whereas in the rest of the world, it's simply through a distributor who has some knowledge, but nowhere near the amount of knowledge that ImpediMed people do. And I'd suggest also that where there is an opportunity in other parts of the world, there perhaps needs to be more focus, particularly from a competitive point of view in that if ImpediMed becomes entrenched in the U.S. and competitors have products that can compete, they'll go to the market where there's some low-hanging fruit, which is likely to be the country we're sitting in right now. So I'll leave that as a comment. Can I also ask how you calculate TAM? Because to me, TAM is one of those how long the piece of string measures.

I mean it's the addressable market of what we believe we can sell, what revenue we can generate in that market. It's the estimate of the revenue to ImpediMed for the particular market segment we're discussing. So obviously, that varies market by market or indication by indication, but that's how we calculate it. And in different ways, we look at it from the number of procedures that have been done, number of hospitals and so on. So it is a number that we do triangulate. But it depends on the indication.

Okay. So in cardiovascular, for example, the number was, I can't remember, but very big. It's the amount that is addressable to SOZO at SOZO revenue model?

[indiscernible] based on a reimbursed dollar in a subsegment.

Yes. Also with cash flow, in the annual report, there's a reference to a cash flow model that you did that gave us the confidence that you've got sufficient cash flow to get to the end of FY '26. Can you give me an idea of the kind of annual recurring revenue that needs to be in place to get to cash flow positive?

The answer to that is that the way we've described this previously is that in order to bring the annual recurring revenue to the level it needs to be, we do need to sell about another 400 units in the U.S. with monthly billing of around $2,000 a month. So yes, that's kind of the high-level metric that is required to achieve that.

Looks like we are done with questions in the room. So we'll now invite business questions received through the online platform. Leanne, are there any questions?

Yes. There's a question from Elaine Sackett. And her question is, where is your equipment manufactured? And are you subject to U.S. tariffs?

I can take that. SOZO is manufactured by a third-party manufacturer using our design and tooling with components that are sourced from various places, including within and outside the U.S., variously subject to different levels of tariffs. In the last quarterly, we referred to some inventory purchases that we had made. Much of that was inventories acquired prior to being impacted by the tariffs. So at the moment, whilst depending on how the tariff regimes play out, the impact of tariffs on the cost of our product is relatively minor because of the inventory that we've got.

And just -- I couldn't hear properly. Just to confirm, it is manufactured in the U.S.?

That's right. I did say that. Yes. By third-party manufacturer, maybe I didn't say that, in the U.S., yes.

Leanne?

We have no further questions online at this stage.

All right. So thank you for those questions and comments. We'll now progress to the formal business of the meeting. So the notice of meeting was sent to all registered shareholders within the notice period required, and I will take the notice convening this meeting as read. Turning now to voting procedures. I've been advised that all proxies received for the meeting have been checked, and we declare them valid for voting. Voting on all resolutions will be decided by a poll, which I now declare open. The poll will be taken at the end of the meeting, and the final results of the voting will be released to the market as soon as they're available. There are a number of voting exclusions that apply to the resolutions being presented at today's meeting. These were outlined in the Notice of Meeting. We will display on the screen the number of direct and proxy votes received prior to the meeting when each resolution is put to the meeting and prior to asking for questions or comments. The figures shown are as recorded at the closing time for receipt of proxies, which was 11:00 a.m. on Sunday, 16th of November. Where undirected proxies have been given to me as Chair of the meeting, I confirm that as set out in the notice of meeting, I will vote the undirected proxies in favor of all resolutions. I will vote all directed proxies given to me as Chair of the meeting in accordance with the directions provided. If you are eligible to vote, there are 2 ways you can cast your vote, in person or via the online platform. If you're present in the room, you will have a yellow voting card, which you will be asked to complete and hand to the registry staff at the appropriate time. I will advise you when it is time to complete your voting card. If you need assistance, please ask one of the staff members in the room. If you have a yellow voting card and need to leave early, you may, if you wish, hand your completed voting card to the staff as you leave. Online voting. To cast your vote using the online platform, please click the Get a Voting Card button and follow the prompts. You may cast your live vote at any time during the meeting. I will give you a 5-minute warning before we close the online voting platform. You will see a red bar appear along the top of the online platform with a countdown timer of how long you have remaining to cast your vote. Item 1. The first item of notified business is to receive and consider the financial report, the directors' report and the auditor's report for the year ended 30th June 2025. There is no formal resolution required for this item, but I invite shareholders to ask questions or make a comment on the financial report or the reports of the directors and auditors, ask questions or make a comment of the management of the company, or ask any questions of the auditor relevant to the conduct of the audit, the preparation and content of the auditor's report, the accounting policies adopted by the company in relation to the preparation of the financial statements or the independence of the auditor in relation to the conduct of the audit. I will now take questions on this item of business. I invite questions or comments from shareholders or proxy holders present in the room. I'll take questions from any received online, Leanne?

We have no online questions from this item.

I will now move on to the next item of business, the remuneration report. I put the resolution to the meeting as displayed on the screen. Direct and proxy votes for this item received prior to the meeting are also shown on the screen. I now open this item up for discussion. Are there any questions or comments from shareholders or proxy holders present in the room, or online?

We have no questions online.

As the next item of business relates to me, I will formally move the mic to Chair of our Audit and Risk Management Committee, Fiona Bones.

Thank you, Christine. This item of business is for the reelection of Ms. Christine Emmanuel Donnelly as a Director. I put the resolution to the meeting as shown on the screen. Before opening this item for discussion, Christine will say a few words about her reelection.

Thanks, Fiona. I'm pleased to stand for reelection to the Board of ImpediMed. My professional background spans over 35 years in IP and commercialization. My background is patent and trademark attorney combined with over 20 years in IP leadership roles, including at Unilever and CSIRO, gives me a unique perspective on how to build value from innovation. Because of this, I'm passionate about helping businesses navigate the complex journey from development to commercial success. My governance experience spans ASX-listed companies focused on innovation. At ImpediMed, I focused on supporting sound governance, creating competitive barriers and value creation. I look forward to continuing to work with the Board and the managing team.

Thank you, Christine. The direct and proxy votes for this item received prior to the meeting are also shown on the screen. I now open this item for discussion. Are there any questions from shareholders or proxy holders present in the room? No? Leanne, are there any online questions?

No online questions either.

Any other questions on this item? Okay. Thank you.

So the next item of business concerns the reelection of Mr. McGregor Grant as a director. I put the resolution to the meeting as shown on the screen. And before opening the item for discussion, McGregor will say a few words about his role at ImpediMed.

Thank you, Christine. I was appointed to the Board following the general meeting held in September 2023, and was reelected as a director at the 2023 AGM. At that time, I expressed my conviction of the commercial opportunity available [ of the product ], particularly since the inclusion of the SOZO technology in the NCCN Guidelines. Since then, U.S. payer coverage, an important enabler for the business, has increased significantly, reaching 87% national coverage. Together with the increasing strength and capability of the team to execute on the opportunity, my enthusiasm for this business has continued to increase. I'm fully committed to creating value for our shareholders, and it's a privilege to be a director of your company. As many of you know, it is a responsibility I take very seriously. And I thank you for your support in reelecting me as a Director.

Thank you, McGregor. So the directed proxy votes for this item received prior to the meeting are also shown on the screen. I now open this item for discussion. Are there any questions from shareholders or proxy holders in the room?

McGregor, referring to the Board skills metric that's in the corporate governance statement, I believe, can you tell me which are the sort of 3 or 4 top skills that you have to bring to the Board?

Sure. [indiscernible]. Prior to joining ImpediMed, I worked for a company called Nanosonics. It was an ASX listed company, which I saw from pretty much its early phase to significant commercial success. My role there was the Chief Financial Officer and Company Secretary. And prior to working for Nanosonics, I was working for another large multinational health care company, which was Abbott Laboratories, located in Australia, U.S., and other [ countries ] as well. So I have international industry experience and [indiscernible] experience, and I would bring all of that experience to ImpediMed and be valuable to the company.

Thanks, McGregor. I certainly appreciate McGregor's in-depth medical device knowledge and expertise and his ability to apply some of the strategic direction also given that it's a similar model, a SaaS model that he's had experience with, particularly in the financial space. So yes, and the growth of the medical device company that he has experience with is also one that we would like to emulate. So we have every confidence in all of the areas of expertise that McGregor brings to the Board. Leanne, any online questions?

No, we have no online questions.

Great. Thank you. Ladies and gentlemen, this concludes the formalities of the meeting. I ask that you now complete your voting card if you've not already done so, and Link will collect these cards. For those attending online, you should now submit their votes. The poll will remain open for a further 5 minutes to allow you to complete your voting on your electronic voting card with the poll closing after that time. As I mentioned earlier, the results of this meeting will be announced to the ASX as soon as they've been counted and verified. I now declare the meeting closed.