Integrum AB (publ) (INTEGB) Earnings Call Transcript & Summary

Hello, and welcome to today's webcast with Integrum, where acting CEO, Scott Flora; and CFO, Jorgen Svanstrom, will present the Q3 report of 2024. [Operator Instructions] And with that said, I hand over the word to you guys.

Thank you, Ludwig, very much, and good morning, everybody, and good afternoon, and really happy to be here and share our Q3 results and then talk about our path forward and answer a few questions that everybody may have. So with that, should we start the presentation?

I don't think we can see the presentation yet.

No. Great. Sorry, everybody. Okay. So just a reminder, Integrum is a leading medical technology company. We've been a pioneer in bone-anchored prosthetic solutions for patients with amputations, amputees for -- within Europe and the U.S. We've built a nice company. We are -- we've got results. We're over -- as we've updated our numbers now, 1,000 implants now. And we think we're in a really good position to accelerate growth in the U.S. market and then continue to grow nicely within the EU. But we're going to be very focused in those markets as we'll talk about in a little bit. Next slide. Just a reminder that we are -- our market positions within the U.S. and Europe. In the U.S., we have a PMA since 2020. And we do operate a wholly-owned subsidiary there. We have an internal sales force that focuses on the processes and then we use distribution independent orthopedic reps to call on the surgeons and the hospitals, and we figured the U.S. is worth about $5.6 billion to us in the TAM given the number of patients that could use a bone-anchored prosthetic solution. In the EU, we have CE marking since '99. We have an internal sales force there. We've got several distribution partners throughout Europe, and we figure that market is worth about [ $2.2 ] billion. The difference between the 2 markets is we have more product approvals in Europe, with digits and the humeral implant are available in Europe. Those products are only available in the U.S. through a compassionate use prescription from a surgeon. Okay. So let's talk about the OPRA device. You can go ahead and advance. So if you break this down, you look at the results of the amputations, it is a global phenomenon. But let's -- there's 3.1 million individuals living with mobility challenges in the U.S. and targeted EU markets. And the targeted EU markets are the ones where we could get good data against this, and they're listed below. We have 1.3 million patients that have had amputations because of cancer or trauma, severe car rec, motorcycle acid or something like that. So that's where we come up with our OPRA population of 260,000 patients that could use that procedure today, which -- that's how we drive the [ $7.8 ] billion TAM. So if you think about why this is such a life and earth shattering solution for patients, it's just -- when I show this to some of my business associates from the orthopedic implant market, they just -- they instantly go, oh, I get it, because now you have an implant in the patient's bone and you restored that natural mobility for a patient where you're actually -- you're anchored in bone and now all of your weight distribution is where it has traditionally been on the skeleton versus on soft tissue. So it eliminates a lot of socket-related problems of soft issue wounds, pain, recurrent infections. And this allows for also very easy on/off attachment with the device for the patient. And then also there's a number of lifestyle things that happened to a patient with sockets that sometimes the prosthetic device will fall off. If there's any -- if they've been out and they have perspiration, it can fall off. It's very difficult to change if they're buying clothes in a store and they want to try something on. So this is a much better lifestyle for a patient as well. Okay. Go back. Okay. Yes. We missed it. Yes, that's fine. So the OPRA implant, as I said, fundamentally restores mobility in prosthetic users. Now we use a 2-step insertion and it's an efficient standardized treatment, but it is 2 surgeries. And we're going to talk more about that as we unwrap the revenue model. But there are other companies out there that don't have an FDA approval that do a one-step procedure. But part of our safety profile was the second step in convincing FDA was part of the second procedure, which is restoring the vascularity in the skin and doing appropriate skin closure around the aperture device. Then we have the Axor II release system, which is the safety device that allows, let's say, if a patient has a fall, the prosthetic device comes off similar to what happens when you're skiing and your ski boot binding releases, so that's an extra level of safety that allows the patient -- that allows -- that allowed the FDA to feel more comfortable with approving the device and allows the patient a safer option in living with the device. Our BioHelix surface is our proprietary bone in growth surface that is on the femoral implant that goes into the femur or if it's a humeral, it goes into the shoulder, and that's where you get the very good Osseointegration interface in the patient. And as we've said, we now have 1,000 patients treated globally. We have a nice proven clinical outcome, 92% clinical success rate, and we continue to see new studies, and we continue to follow up with clinical studies to continue to show the benefits of this procedure. Okay. Yes, here's -- this is the total offering that is in the system. Again, in the U.S., we're FDA premarket approved for above the knee. We do have an upper arm solution that we're negotiating, trying to bring to market in the U.S., and we have thumbs and digits that are only available on an emergency basis through compassionate use in the U.S. Within Europe, the upper arm, thumb and above the knee are approved. The below-the-knee is an option that would -- it's a very big market that needs additional work and time. It's also going to need some updates on the Axor device and then the lower arm would be after we approve the upper arm. Jorgen? So that's kind of historical view of the company and most investors and followers are pretty familiar with that story. I think what was interesting in our press release and what we want to talk about now is how we're going forward. And this is part of our commitment on enhanced transparency and is to lay out a path forward and then report against that path forward every quarter. So if you look at -- we know that we have a technology leadership and market validation. The OPRA implant system, we're very comfortable that it restores mobility for amputees. We were able to get an FDA approval for that in the U.S., and we have CE mark in Europe. We've treated 1,000 patients globally. I know this says 700, but it's 1,000 patients globally, that has been updated. And it's the only FDA-approved bone-anchored system. So if you look at the revenue model, one of the things we wanted to do was to disaggregate it. So investors and analysts could better understand how we drive the business. So there's a 2-stage surgical procedure. And in the past, I've talked about the importance of S1s. S1 is when we capture a new surgical patient, and that's 50% of our total revenue. So if a patient decides that they're going to have the OPRA system, they first have an S1. And then on top of that, then they'll rehab and they'll go to the second stage surgery, and that's when they have the S2 plus the Axor. So the S2 is where they do the skin flap and then they put an abutment in. The abutment is a device that connects to the Axor. So the abutment goes into the femoral implant and then the aperture sticks out of the skin, but that eventually connects into the Axor device. So when thinking about Axor, Axor II is where we have aftermarket revenue. Axor II is covered by a 3-year warranty. So there is a recurring sales and service model with that. We do service the Axor II for the patient in 3 years free. Afterwards, generally a patient will retire that Axor and they could get a new one and then they could file for insurance against the new one. There's been over 1,000 Axor II units sold since FDA approval, and Axor II units are 20% of U.S. revenue in our recent quarters. So as we think about our commercial strategy and our focused growth, as I said, we're going to focus on 2 markets. In the U.S., we're going to be very focused on a few centers, and we have a breakdown of those centers. There's -- there are several centers where we're figuring out how do we drive market penetration more aggressively, and we're partnering with those centers. There's a second group of centers where we have partnered with Hanger around where they have strong prosthetists that are interested in Osseointegration, and we've identified what hospitals those patients can be sent to. And then there's a third set of centers where we have trained surgeons that patients could get referred there. We will make sure we service the case and take care of them. But we're really going to be focused with our SG&A dollars on a fewer number of centers and making sure we find a way to drive those to market to a higher level of market adoption. And then we're going to strengthen the aftermarket business through CPO engagement and Axor II sales. So we announced last quarter that we did do a training with Hanger's SPS unit, which is their independent distribution arm that goes out and calls on non-Hanger facilities. And we've laid out a calendar of training programs in combination with them to train prosthetists on Osseointegration and how to take care of those patients and the benefits of doing the surgery. Finally, we will continue to look, and we will -- we're going to -- we want to appoint a CEO with market expertise, especially one that understands how to drive market adoption and also understands how to grow a U.S. business. So we think that's sort of the very near-term focus that we're driving towards. Also, we sat down, and I commented on this last quarter. And in our Board strategy process, we prioritized all the R&D projects in the company. And we said, look, we've got to drive near-term revenue in the U.S. because we have a clear path. Because we have a clear path with the FDA to drive market adoption, we really need to focus in that area. So we decided that maybe we should curtail some of the longer-term projects that were more in the research level and focusing on things that were more in development that would help drive market adoption in the U.S. And the goal of that is to optimize our resource and the allocation of value. And everybody gets tied up in a project, how do we reduce the number of projects so we get really critical focus from all the teams within the company. It's not a big company. So we got to be focused on the vital few that drive results. Jorgen? So we also said, look, what kind of KPI could we launch into the market so people can understand how we're doing. So we came up with this KPI of the S1. And every quarter, we're going to talk to you about S1 and how we're doing with S1, good, bad or indifferent. We'll let you know how we're doing with that metric, and that should be a trigger for is the company driving adoption. Now there are other sales that the company does. There's Axor sales, there's instrument sales. There's S2s. S2s come along. And we'll certainly continue to show you the aggregate sales number, but we're going to highlight S1s. Also with this strategic shift, it's allowed us to take some cost out of the business so we can extend our cash runway. We think that, combined with the raise that we did can allow us some market time to get U.S. sales back and rebounded nicely and also allow us to attract a CEO to the company. And to do some -- there's some couple of critical key marketing programs that have been missing. We're actually going to do a trade-off on some of the science programs to do some of the key marketing programs, and we'll invest there to drive U.S. growth. Jorgen? Just take it away with financials.

Right. And thanks, Scott. As you probably have seen in the report already, the net sales for the quarter was SEK 23.7 million. And this is in comparison to same quarter last year, where we had SEK 30.1 million. Now this is a negative growth of 21.2%. But if we look at the U.S., the same quarter and the same comparison, we had SEK 20.1 million this quarter and SEK 20.3 million in the corresponding quarter for last year. So the big difference is in EMEA, APAC, which had SEK 3.6 million as revenue for this quarter and SEK 9.9 million almost for the comparable quarter last year. And the explanation for the difference is that last year's Q3 was heavily influenced by activities in the Ukraine. I don't know if you remember, but let me remind you that, that's when we really started training that center in the Ukraine. So Rickard went down in December 2023, did a lot of surgeries and then at the end of the quarter, we sold them an inventory set of implants. And I think those activities explain almost all of the difference in revenue. Looking at the gross margin, it's 81%, which is fairly consistent with what we've had historically and also within what we think now is a normal range. Now as Scott alluded to before, of course, the gross margin will vary both with customer mix, of course, but also with the product mix. We don't have the exact same margins for all of our products if we sort of think of our product as implants for S1s, S2s and Axors. So depending on how the relationship is between those activities, the gross margin and the revenue will vary, of course. And I think -- I mean, jumping ahead a little bit, this is also a reason why we want to show you the number of surgeries that we've done in the quarter because S1s will show you -- I mean nobody does an S1 without doing an S2 and buying at least an Axor. So S1s will show you which way we're going in market penetration, but it doesn't necessarily mean that an increasing number in S1s means an increasing revenue. That is also a function of how many S2s and Axors we've sold in the period. Looking at the EBIT, we're now at a negative SEK 7.4 million in comparison to a slightly positive SEK 340,000 for last quarter. And a lot of the reason for that is also, of course, the same activities as I talked to you about previously. Now the cash flow for the quarter was a negative SEK 19.5 million in comparison to a negative SEK 5 million last quarter, leaving us with a cash balance going out of the quarter of SEK 14.7 million almost. Of course, this has been considerably strengthened after the share issue we did in February. And as I said, the number of S1 surgeries we did in the quarter was 44. And I want -- I mean, we have chosen to not show the historic numbers. I mean we started -- we're starting from now, and we want you to sort of think of the number of 44 in relation to what Scott mentioned earlier about our total TAM and the number of OPRA patients we have in total, which was 260,000. So 44 means that we still have a lot of market to go for. Thanks, and over to you again, Scott.

Okay. Last slide, and then we'll go to questions. Just a reminder of the team, Board of Directors. We did add 2 new Board of Directors. Anette Lindqvist and Kristofer Westergren have joined the Board and it's been -- as those who have been very positive, and they've both been very helpful as we've gone through this strategic realignment. And then this is a reminder of the management team. Some of them are headquartered in the U.S. and some of them are in Sweden, but we are one company, and that's how we're operating the company. It's all about focusing on key markets. So Jorgen? Thank you. And I think we can go to questions now.

Thank you so much for the presentation. As you mentioned, now we will carry on with the Q&A. And the first question here is, can you please elaborate on why you see a return of U.S. sales growth? The Q3 U.S. sales were still reliably in line with the volatility we have seen in previous quarters.

Sorry, the first part of that question?

Yes. Can you please elaborate on why you see a return of U.S. sales growth?

Okay. Yes. I think it's a heightened focus on making -- like any function of the business, you've got to manage and inspect the details of what's happening. And I think it's 2 things within the U.S. I think it's a heightened inspection of, okay, what are we forecasting? How are we going to make that forecast? And what are the drivers? And then you inspect those and you make sure that they happen. I think the second thing is we brought a U.S. Director of Sales on who comes from the prosthetic -- both the orthopedic and prosthetic market. And I think he's been a great help in breaking down how to sell to prosthetists and how to explain the OPRA device, and that's been very important. But I just think executing in sales is as much of a science as anything, and I think you've got to be very focused on it and make sure that it's happening. There's also some critical things within marketing that we got -- we needed to make sure that we were getting the right tools out, and we're just -- and actually in the process of launching those tools this quarter.

You're now more transparent on the number of S1 surgeries, but will you consider giving more information how many surgeons are OPRA surgeons? Are we seeing the same small group of surgeons using OPRA or a large group using it very scarcely?

That is a great question. And I think -- so let me break down how we're thinking about things right now. We have 2 accounts, as I've talked about, that we are focused on partnering with around understanding how do you drive deeper adoption within a facility. That could go from pricing to creating a center of excellence to helping the hospital market to where are the prosthetists located that can refer those patients. And then as I said, we've got 5 centers that we've partnered -- we've identified with Hanger. And then we've got 11 other centers where patients get referred to. We have 18 surgeons overall that are highly trained. Underneath that, there are surgeons waiting to be trained. But if you look at our ability and our size, we have 2 sales reps out there to call on prosthetists. We, as a company, think it's not the best use of cash to open up a whole bunch of accounts, spend the money on training and then have one patient dribble. We think it's more important how do we figure out to get 5 to 6 to 10 patients going into highly trained accounts. Then when we have that recipe, then we can go out and unlock the market faster. And that -- at that point in time, then we'll start talking to you about centers and penetration and number of surgeons.

Can you elaborate on the terms and conditions for your trade term financing, such as how much, what interest rate and what payback period?

I have an excellent person to answer that question. Jorgen?

Yes. It's -- the sort of facility itself is SEK 24 million. So we can, at once, have SEK 24 million finance. And yes, so this is why it's not a factoring deal, it's because it's more like trade finance meaning that we can actually set the payment terms or credit terms for each sort of time we use an invoice as collateral. So the strategy will be to use our credit terms to our customer as the credit term we have towards the bank. So that's a match. So if the customer has 30 days, we will set up 30 days with the financing. And then it's more of a fee-based setup than an interest-based setup, of course. But I think in the long run, it's better for us given the industry standards in terms of payment terms, it's going to be a better deal for us to use this for customers to finance sort of the increases in our working capital coming from the accounts receivable through this and get the money right away. So yes, I think it's a good structure. And it's -- for us, it's a little bit better than having a straight factoring deal because we can use this facility for all sort of both companies. So we don't have to have separate agreements for each company. So both Inc., our U.S. market and European market can be financed under the same agreement. So from an administrative point of view, it's a very good arrangement. In a factoring deal, you would have to have a separate deal for the U.S. -- for each country, more or less. So yes, overall, a good deal. I can talk a lot about this. So if you have any more questions, just e-mail me, and I'll answer when I can and what I can answer.

The next question here. You have a target to educate more than 200 certified CPOs during the year. How many are educated on OPRA today?

I'll tell you what I don't have an exact number on that. I would suspect it's probably when you -- with -- if you look at the new program that we've identified, and we've actually taken one of our prosthetist employees that's been involved in the company for a long time and moved him out of sales and into -- he now drives professional relations for prosthetists. I would say it's less than 75 that are really trained. And I could be wrong on that, but we'll get that number and find a way to get it to you.

How does OPRA fit into the reimbursement structure today from private insurance companies? And do you assume that it will always be on a case-by-case situation?

There's only -- within the U.S., OPRA, we have trouble with one insurance company and that's UnitedHealth. We are being reimbursed at all the other insurance companies. In the first quarter, I was here, I talked about we had some cases canceled, and that was with Blue Cross in St. Louis, and they've now started reimbursing for OPRA. So what we are doing and need to do is we've taken some of the marketing team, which is a small market where we've taken some of them and partnered them with an external consultant around how to get our arms around marketing to insurance companies. And so we've been organizing our data, and we're putting together a package to go forward. But I think that's critical for the company. And there's a number of things that we need in the company for the -- on the commercial side of the business, and we should have someone that is in the company that drives insurance and reimbursement. So as we put our budget together for our strategy meeting that's coming up end of March with the Board, we're going to put some things in the budget that we think drive that. So I think we're making progress. We still got -- we've got some work to do with UnitedHealthcare. They are the toughest one in the U.S., but that's the only one today that we're having challenges with.

How is the work going towards finding a permanent CFO and permanent CEO?

So the work going forward on the permanent CFO is I and the Board decided that we really want to not go after the CFO until we hire a CEO. I think that's an important partnership. I work very well with Jorgen and we've gotten to know each other, and there's always a relationship there that the CEO has with the CFO, and it's really important that, that's there. I think hiring the CFO ahead of the CEO really didn't make sense. We are moving forward with a CEO. We've hired a good firm. We've got people that are interested, and we're in the process, and we're trying to bring that to a conclusion. So -- and then even with that, we've got -- there's always the timing considerations to think about as well as how fast they can join. So when that's able to really concretely talk about, we'll let you know.

What are the company's financial objectives? Is it sales growth? Can you please elaborate on any goals relating to net profitability and/or positive free cash flow?

Yes. So right now, the company is very focused on sales growth and then we're also focused on the cost reduction target that we gave you. Anything outside of that, I think, will come out of our strategy meeting. But in the past, we've been trying to drive sales in the U.S. and do it as close to breakeven as possible. So until there's a different strategic change, I think that's what we can communicate to you as we're going to continue to try to do that.

How should we view the Hanger partnership after the announcement of the partnership with SPS? Aren't they being considered as competitors?

No. So let me explain -- thanks for that question. That's a good question. So Hanger -- there's 2 pieces of Hanger. Hanger owns clinics, and then Hanger has a group called SPS. SPS calls on the clinics that are not owned by Hanger, and they sell and market to them all of the devices, powered knees, prosthetic devices, limbs, and then they sell Axor to non-Hanger clinics. So the SPS team as a value-added wanted to offer a training program for those clinics. And that's what we agreed to partner with them and do that, made a lot of sense to us. So no, they're not a competitor with the Hanger. They're a very important part of Hanger, and Hanger appreciates any work that we do with them that helps drive an increase in sales.

Thank you for the clarification there. Sales reached SEK 20.1 million this year compared to SEK 20.3 million last -- for the same period last year in the U.S. during this time. You have signed a new partnership with Hanger and reshaped the company's strategy with a strong focus on CPOs. How do the targeted initiatives between these periods differ? And how should analysts interpret the numbers in this context?

So last year in this quarter, we had a number of one-offs also in the U.S., and we had some surgeons that were leaving institutions that did the -- I'm looking for the right word. There were some patients wanting to be done at those facilities and they did those surgeries and then they moved on to other facilities. At a company our size with our thin penetration in the market, that's -- you're always at risk on that. And that's why we want to solve this adoption problem and grow it faster. And then we also had a large -- a couple of large Axor orders last year. So with the focus -- with the realignment and the focus going forward, it's going to be on driving new surgeries. It's going to be on an increase of -- we have a deeper understanding of Axor and that patients have multiple Axors, and we also will continue to partner with Hanger and Ottobock and other prosthetic suppliers for Axor. But things like big instrument sets into hospitals and stuff like that, that's kind of going away in the U.S. market. So the real growth of the company going forward is going to be S1s, S2s and Axors, and that's how we're going to drive the market.

You have capitalized R&D expenses of SEK 10.3 million year-to-date. What progress has been made in R&D? And when can we expect these investments to translate into commercial products?

Great -- that's a great question. Do you want to go? Do you want to talk about capitalization and then I can talk to about projects.

Yes, yes. I mean, of course, I mean there are things that we haven't really communicated to you that are changes to existing products that we have capitalized and that make up -- those make up a part of the capitalizations we've done this year as well. So of course, they will reach the market, but it's also a question of certifications and getting the regulatory work in place before we can talk about and market them, of course. But then there are also some bigger things that we have started that are more longer term. But I think the strategic shift will also see sort of -- has already started a shift in how we think about what projects to run. So with that, I guess I should hand over to you, Scott.

Yes. We need to be focused on projects where there's a clear business case and a clear ROI on how we're going -- how that's going to be successful in the market. And a lot of that is thinking through the route -- the regulatory pathway, the reimbursement pathway. Those things need to be thought of the day the product has actually started. So within R&D, it's going to be much more of let's actually think about why are we doing this project and then how do we do it and then we execute to it. And so as I said earlier, I've looked at -- we've looked at everything. We've prioritized everything. Some of those longer-term projects, they're going to be delayed because we just don't have the resources to apply against them. For a company of our size to try to do some very hefty -- to try to do more than one PMA at a time is really tricky. Those are big investments. And then at the same time, shareholders want penetration and growth in the U.S. And I just think it makes a lot of sense right now to take our market position in the U.S. and if we can drive success there, it throws off -- we have tremendous margins, which we can throw off cash. And then we can continue to invest in that. It becomes a vicious cycle of success, and we can throw off cash, and then that cash can be used for projects, can be used for sales growth. And so if we could get -- once we get over that $20 million revenue hump, this starts to be a different discussion. So for now, we're going to be a little more -- we're going to be very focused on R&D projects on the ones that we're doing, and they've got to be critically important to driving adoption in the U.S.

How do you view regulatory challenges and approval for OPRA on other extremities? The latest data from the DoD is very promising for above elbow application. Is this something you could soon use as a basis for a PMA application? And if so, when do you plan to submit it?

So as was talked about a while ago, FDA has said, hey, we're open to looking at different paths on getting this approved. And one of the paths was doing a chart pull around the world of all the humeral projects that had been implanted. That's proven to be very difficult, and it's also very costly because we have to sign a contract with every clinic, and we have to hire -- buy an insurance policy for every clinic. So that's been slower, and it's been more cumbersome. So we are actually in a very deep focus right now on how do we -- what's the right path to get humeral to market because we do have an interest in that in the U.S., and we're seeing an increase in surgeons asking about when can they have it and is there another path for them to get it. So we're focused on that. I think that is our first focus is how do we bring humeral to the U.S. market. PMAs are big projects, and they're costly, and they need a -- they also need an internal staff in the company. So we're still -- we have a femoral PMA, and then we also have to do a post-market surveillance study with the femoral. So there's a lot of stresses on the clinical department. So that's where you get into this proper allocation of resources planning when you think about all of these projects because you can only stretch one person in so many ways. So we will -- but again, we will be focused on the humerus project next.

The U.K. is a prioritized market, but according to the latest report, it has not contributed significantly to revenue. When is this expected to happen?

Good question. So the group in charge of Europe is actually doing an analysis right now for me on why we're not -- we've sold sets into some of these European markets, and we're now driving implants. And we're doing a very similar study with the distributors in Europe that we're doing with the 2 hospitals in the U.S. around what's needed to actually start doing some implants. And we're going to actually take that to our Board strategy meeting at the end of this month, and we'll discuss that with the Board. And then we should have a strategy that we started executing to by April. So to answer your question, I've got some assumptions that I think are issues, but I won't go public until I have data, and then we'll let you know.

How do you view potential for partnership or strategic collaborations to enhance and chance the market penetration?

Yes. So one of the things -- those things are always good. I will tell you as being a veteran in the orthopedic industry, a lot of -- because of the way these big orthopedic companies were like doing a distribution deal with somebody, it's really going to help us that much. And a lot of them haven't been that successful in the past. I've been -- I was part of a horrible one when I was at Smith & Nephew and had to unwind it. But I think for us, the one thing we've done recently is with our independent orthopedic distributors in the U.S., we're managing them directly now. We used to have some partnership go through with Onkos in -- we still work and still are very friendly with Onkos, but what we wanted to do is take that distribution group and have it report directly to us. And so we like that. We think that helps us get more traction. We like the Hanger relationship. We like our SPS relationship. If there's something that pops up out there that I think and the Board thinks makes sense for the company, either financially from a partnership point of view, we're certainly going to -- and we are exploring. When those do come up, we explore them. But we really want to just stay focused on executing what we've talked about.

Is the strategic overview initiative in 2023 is still in play?

So yes, we are -- that is still going on, and that was the result of -- that brought Hanger, that brought the rethinking of R&D. And there's some things that we're continuing to do, but we're in the final -- we're in the last phases of that. And we'll -- so that work is being wrapped up and finalized. And as I said, we've got a strategy meeting coming up the end of March.

You mentioned earlier that you're interested in buying stocks in Integrum. Can you tell us a little about how your thoughts goes there?

I'm sorry -- that question again.

Yes, of course. Buying stocks in Integrum, you mentioned it earlier that you have an interest in it. How are your plans on doing that going forward or so to speak?

So as soon as somebody can solve that for the Americans, then that will happen. It's very tricky and very involved. So we're actually working through that. So we'll figure -- we don't have that done yet, I'm sorry to say.

Moving on to the last question here. What do you mean when you say the company is entering a transformative period?

The company like any company that's founded by a brilliant founder has done a lot of great things. And is it -- was at an inflection point of being at the SEK 100 million mark. And now it's like how do you put a systemic commercialization process in that takes it to SEK 20 million and beyond. And so if you think about what would transform that, it's a traction of a new commercial leader, somebody that really gets the science of commercial execution and how to grow markets and how to allocate the right products and tools. So it's a transformation from a company that really was focused on science and clinical to how do you take that science and clinical and grow revenues and grow your position in the market versus the next science project. So if you say -- so you start measuring yourself saying, I've got this great femoral surgery, I have done this good clinical data. Well, how do I then get to 2% to 3% market penetration in the next couple of years? That's the transformation of the company. It's to be much more focused on driving market adoption.

Thank you. That was all the time we had for questions today. But if you have more questions, you can contact Integrum afterwards here. So thank you so much, Jorgen and Scott, for the presentation, and thank you all for tuning in. I wish you a pleasant weekend.

Thank you. Thanks, everybody, for tuning in. Thanks. Bye.