Medartis Holding AG ($MED)
Earnings Call Transcript · March 17, 2026
Earnings Call Speaker Segments
Operator
OperatorSo we'll start. Good morning, ladies and gentlemen, whether you made it to [ strictly ] to Basel here by train or by car or if you're watching us behind the screen, thank you for being here to listen to our Medartis 2025 Full Year Results story. A few practical questions before we get started. The presentation slide deck is our compass for today's meeting that was published this morning as alongside the annual report, the integrated annual report as well as the press release on 6:30 this morning. I encourage you, especially for the annual report to explore them if you have the time. Now a brief important legal disclaimer on Slide 2, you see the forward-looking statements that I'd also like you to take note of it. For today's program, we have 2 speakers lined up. You see them here on your right-hand side, Matthias Schupp, our CEO, who will open the strategic highlights of the year, what has been, in my opinion, a transformational year for the Medartis Group. And then we have Peter Hackel, a very familiar face to many of you. He will then take us through the numbers behind the story. Once both have finished, the floor is yours. We very welcome your questions for an interactive session simply by requesting the microphone here in the room. The ones who are listening through Microsoft teams, I would like you to raise your hand by clicking on the hand symbol. But first things first, Matthias, the stage is yours.
Matthias Schupp
ExecutivesThank you very much. Yes, good morning to everybody here in Basel and also dialing in from outside and listening via video conference. It's every time nice to see you face-to-face. I prefer this much time more than having a video conference. And also welcome to our brand-new auditorium. I'm happy that we have the white chart gone. It's becoming very hot with white chart. 2025 was not only my first year as the CEO of Medartis, it was also a real transformational year. And I'm very happy, but also proud of my team. This is not a one-man show. This is a team behind the results. And what this team worldwide has achieved in 2025 was yes, in my view, outstanding. We had 2 acquisitions, the NeoOrtho acquisition back in March last year and then the full KeriMedical acquisition in August, the 100% takeover. We had leadership changes. So throughout the year, I built the team for the future, also for the future growth of Medartis, and we had a substantial change in our strategy, especially in the U.S. If we look back to the U.S. from 2024 to 2025 -- and I told it 2 weeks ago in a town hall in the U.S., this is like day and night. We have not only changed 50% of our distributors in the U.S., we are focusing now on upper extremities, especially in hand and wrist. We have now exclusive distribution partners in the U.S. for hand and wrist, which we never had before. We prepared the TOUCH launch in the U.S. throughout 2025 because we were never sure which month it will kick in. Finally, we achieved the FDA regulation in August, and we were ready. And the team also managed an unforeseen -- yes, it's like a roller coaster distributor change in Florida, and I will come back to this later, which was a really heavy impact for us to manage, but it was agility and quick decision-taking to make this possible. And very important for me, and I mentioned it to you in March when we met for the first time last year, and I repeated it in August, we deliver what we promised. And I think with our 2025 results, we delivered on our promises. The culture, and you will see it again and again and again throughout my presentations in the upcoming years. This is so essential. This is the basis of everything. And the culture is driven by myself, together with my EMB and then with the EMG through the whole organization. We did important inroads. We have done more than 25 cultural workshops with our teams. And if you ask me, if I compare Medartis today, when I'm coming also here in Basel to the office and I see our employees and I see this communication, I call it this vibe and this happiness and this fun that people have to work for Medartis, this is quite a change. And then in the middle of everything, it is our customer centricity. Whatever we do, we need to focus on our customers. And our customers, our hospitals, our surgeons, our insurance companies, but a lot of departments, they have internal customers, also an internal customer, if you work, for example, in the IT or in the finance department. In 2025, Medartis became the Medartis Group. We have now 3 group brands, the Medartis brand, the KeriMedical brand and the NeoOrtho brand. And I'm asked every time in interviews or in meetings, Matthias, why you are maintaining those brands within a group and not just integrating? And I'm repeating every time the same. We are maintaining the entrepreneurial mindset of those companies. We are maintaining the innovation power and the innovation stream of those companies. We maintain also this cultural top spin. The underlying culture is the same, but the top spin is different, in Keri it's different, in NeoOrtho. And we have also a kind of challenge between the brands. So one brand is pushing the other and nobody would like to stand behind. And for me, my personal opinion is it would be too easy to think that only because we are sitting in Basel that the Eiffel Tower is in Basel, and we know the best what to do. We see it, and we have seen it throughout 2025 that this is the right setup. With this setup, we are now 1,360 employees, and we are growing not only because of the acquisitions, but also because we are expanding production. We are hiring new talents. We also started a talent program with our HR department. So Medartis, not only from a group perspective, but also worldwide is on a growth path. The group revenues, you have seen it in the press release today in the morning. We achieved CHF 269.3 million total revenue with organic revenue growth of 15.7%. This means we are at the upper end of our guidance when I say we deliver what we promise. And we know we had some headwinds, only speaking about tariffs or FX exchange rates, we delivered an EBITDA margin of 18.4% in 2025. If you look to the Medartis world, this is a mixed picture, but a very positive picture. There is not one single region not growing at least double digit. Let's start on the right side with the APAC region. The APAC region is coming from a negative growth, single-digit negative growth in 2024, and we are back to growth with 13.3%. This is mainly driven by Australia and Japan and some distributors in the APAC region. We then move to another region, which was double-digit negative in 2024 and 2023. Now coming back with 10.4% growth is our Latin American region with our Latin America regional office in Brazil, but also with our subsidiary in Mexico and some distributors in the other countries, and I will come later back to Latin America when we speak about the value segment. Then in the U.S., I will touch it later. We have achieved a 13.4% growth. We would have achieved 18% growth if you would not have had the impact in the second half with our Florida distributors. Quite happy with the performance of the U.S. and the floor is prepared for the future. And an outstanding result of EMEA, our leading region. And what it shows is that also when you have in markets in big markets like Germany, above 35% or 40% market share, that is not a stop signal. And what I said also last year, even if you have 50% market share, you can gain additional market share. And our fantastic EMEA team is showing this month by month. As I said, in the U.S., we had this impact starting June. We had to exchange our distributor in Florida. And let me explain, this was one distributor covering the whole Florida region. And therefore, so important for our business, around 10% of our annual business in the U.S. done by them and also a long-standing distributor with over 17 years. Located in West Palm Beach near Miami, I'm telling you this because this means that the focus was really on the southern part of Florida. The team in the U.S. reacted very quickly. we identified very soon additional distributors, and we decided strategically to not leave it in one hand to divide it into 5 different distributors throughout the region of Florida, especially focusing also on the northern part. If you ask me, we have an analysis and gap analysis month by month, and we are closing this gap, and we are closing this gap, especially very quickly in the northern part. As I said, Orlando, Tampa, the northern part of Florida, there are some states where we -- some cities where we are already better than before, but we are still suffering on the southern part. And I expect that by mid of this year, this transition is done, and we are full on speed. The other news, and I announced this already in March last year is that we -- out of 57 distributors, we changed 50% more or less to get exclusivity in upper extremities. We have a new North Star in the U.S. It's not any longer lower extremities, this old NSI portfolio, which Medartis had after the acquisition. It is now the upper portfolio, and this fits exactly with KeriMedical TOUCH because this goes also into the hand. This was a very smooth transition, I have to say, and also a big effort again from my U.S. team. TOUCH, let's touch TOUCH. And TOUCH is the overwhelming story whenever I'm on roadshow, whenever I'm meeting you, whenever I'm meeting journalists, and I have to be very careful to not only speak about TOUCH because you can expect an acceleration of Medartis as well. So we have a Medartis-based portfolio, which we are tracking totally in separate. And then we have our growth accelerator, TOUCH. TOUCH finally was launched in the U.S. We got the first products in September 2025 in the market. And as you know, we had already 45 key opinion leaders trained in Europe before we launched TOUCH. I explained to you this, that we used the European facilities of KeriMedical, but also together with some clinics like the Schulthess clinic in Zurich, for example, to train 45 surgeons coming to Europe throughout '25. So they were ready. And you can imagine, the first TOUCH prosthesis' arrived end of September into the market of the U.S. And there were some surgeons like Jonathan Tueting on this photo who could not wait to place the first TOUCH because everybody of this 45 wanted to be the first to place TOUCH in the U.S. It was Jonathan, who placed in Chicago the first TOUCH in this lady, she has her own bakery. So she is very active with her hands, with both hands. She's doing beautiful cakes, delicious. She is only 40 years, 48 years of age. So a TOUCH prosthesis is not only for patients of 60, 70 or 80 years. She felt arthritis in her thumb. She had difficulties to prepare the cakes and she visited Jonathan. And Jonathan reserved her since mid of the year only waiting for TOUCH. Believe me or not, this month, she got the second TOUCH on the right hand. This is, of course, a unique case. But she was so happy, and you can also see it and maybe Fabian, you can share, we have some CBN interviews on the U.S. news TV channels where she got interviewed, and therefore, we are also allowed to show her picture because normally, we cannot show patients. She speaks highly about TOUCH. So the rollout started already in October. This was not planned. So we had the first surgeons like Jonathan placing some TOUCH in October, but the official launch was in January. Throughout the last year, we had already built up our initial launch team for KeriMedical with 10 exclusive field experts. Those field experts, let me explain. When we train surgeons, then the surgeons throughout the first 10 cases, they are together with the field expert. We are very close to the surgeons. This is not only to support and help the surgeons, but this is also to make sure that we have no complications in the first TOUCH surgeries. We know from our international clinical data that after 10 surgeries, they are fine, they can go alone. We plan to train this year another 300 surgeons in the U.S. So we are doing a careful approach. We are not training 500 or 600. We are training another 300. And we have more or less 3,000 hand surgeons interested. So at the moment, we have this unique situation that we can select which surgeons we invite for trainings. And we are not depending that surgeons are registering by themselves. We did also our first U.S. training already end of December, just before Christmas last year, which was also not planned, but the vibe was so big in the U.S. that we had to start. And I'm also very happy that we are now in the construction phase. And by end of the year, it will be ready of our own education center in Orlando. Orlando, Florida, Sunshine State, a lot of future patients also for TOUCH, and we use the Orlando location also in the future to train international surgeons. Maybe interesting for you that in the moment, those trainings in the U.S. are still held by our European surgeons. But starting with the second half of the year, these trainings will be taken over by our U.S. surgeons, and Jonathan will be one of them doing TOUCH in the future. This is my EMB. This is my dream team. And I've learned one thing. Each leader deserves the team she or he has. And I think I'm a very happy guy that I have this team working with me. What is new on this chart. On the upper left part from your view that Dougal and Bernard, the 2 founders of KeriMedical are connected to the company. They are forming together with me an advisory board. They are still very active, very motivated. Bernard is running the whole innovation and R&D side, and we are working on new innovations outside TOUCH, but also on the next generation of TOUCH. And Dougal is, yes, our face to the market also in the U.S., but also still leading the direct countries of KeriMedical, which held in France and Belgium, for example, and handing this over throughout this year to our commercial head, Loic, who is taking care of KeriMedical commercial in the future. And another new phase, but not really new to you, but a new phase in my EMB is Peter Hackel. And I think about Peter, I don't need to speak a lot or not need to explain a lot. We know each other for 18 years. We never lost the contact, thanks God, when he left Straumann. And this was maybe one of the reasons why I got the jackpot to bring him back, and I'm very happy that he joined the team now 1st of January, but actually, he already onboarded throughout December last year. And with this, Peter, the financial review, the figures are yours.
Peter Hackel
ExecutivesThank you very much, Matthias, and a warm good morning also from my side. When I'm looking to the audience, I see quite some familiar faces from previous time, and I'm very happy and excited to be back in Basel to be back in medtech as well and especially also excited to be back in such a great company as Medartis with such a great future ahead of us. So let's deep dive a little bit into the financials, and you see that some time has passed by. That's a sign I need to remove my glasses. Otherwise, I can't see the figures anymore here on the chart. Let's dive into the financial figures. Matthias has already elaborated on the growth of the regions, all the regions, double-digit organic growth, group organic growth at 15.7%. And let me shortly explain the definition of the organic growth. On the one hand, it's a growth rate based on current exchange rates, on stable exchange rates and constant exchange rates. On the other hand, we have also included the organic part of the acquired business, the organic growth of the 2 acquired business on a pro rata basis throughout '25. So that lifted the organic growth rate a little bit. And if you would exclude that, organic growth would be at the same level as in the first half for the second half as well. You see on the right side, total sales stand at CHF 269 million, a difference of CHF 3 million to core sales. And this CHF 3 million are basically caused by 2 business activities. On the one hand, in the first months after the acquisition of NeoOrtho, we still had the hip business in our books. We divested that business. So that is contributing a little bit. And the other contributor is the contract manufacturing business that we still have in Warsaw in our U.S. plant to better utilize our fixed cost and capacity that we have there. That is scheduled to be phased out once we need that capacity for the production of our own products. Then moving in the chart to the left side, you see the M&A sales impact of CHF 18 million. That is caused by NeoOrtho that we consolidate since May '25 for 8 months and is contributing about 1/3 to the CHF 18 million and the other 2/3 are coming from KeriMedical that we are consolidating since July '25 in our books. And on the very left side, you see the headwind from the FX side, mainly caused by the U.S. dollar, you see a negative impact of almost CHF 8 million versus previous year. And that's also a theme that you see throughout the whole presentation, that FX headwind also on the margin side. So let's move on one chart and look at the product sales from a different perspective from the product perspective. The larger upper extremities are contributing almost 70% of the shares with a growth of 16%. And there are basically 3 main product groups really driving that growth. On the one hand, TOUCH sales, not in the U.S. because we launched TOUCH in the U.S. only this year, but mainly in the European regions where we have been acting as a distributor already before the increase and full acquisition of KeriMedical during last year. The second driving factor are 2 product launches in the dorsal olecranon area and the clavicle portfolio that we also launched partly in '25. The third growth factor is the hand nail portfolio that is used to treat finger fractures contributing very nicely also to the growth of the upper extremities. Lower extremities, posting the highest growth with 18%, but at a low share of 15% contribution overall. And CMF and others craniomaxillofacial and others is posting a 17% share with 15% growth driving basically by 3 different factors. On the one hand, mid-phase solutions were lifting growth there. The orthognathics area contributed to growth and especially the cannulated compression screws, which are used as an alternative bone fixation method also contributed nicely to growth. That's -- and CMX digital and customized solutions were expanded to cover all the different product ranges, upper and lower extremities as well as craniomaxillofacial. And that's also an area that we strengthened significantly with the CADskills acquisition that Matthias will elaborate a little bit later in the presentation. So let's move on one chart coming to U.S. tariffs and the impact of the U.S. tariffs. But before we go into the details, let me reflect a little bit how these are recorded in our financial books. When we import a product to the U.S. or to any other country with tariffs, the tariffs are added to the product costs. Then we put the product on the inventory in the local stock, and it stays there for a couple of months. And only when we ship that product from our local stock to the customer, tariffs will impact our P&L. So there's a certain delay of something like 6 to 10 months between importing a product in the U.S. and seeing the impact of the tariffs in our P&L. So in '25, we faced a burden of about 90 basis points on the gross margin or an absolute impact of around CHF 3 million. In '26, I expect a slightly higher impact of around CHF 4 million, especially in the first half year because of that delay that I just mentioned. You see that from August to November, we imported products with a 39% tariff. Currently, we import around 10% tariffs impact on a blended rate. But you see that 39% burden from last year will impact also especially the first month of this year with the tariffs. However, what are we doing to mitigate that impact? We already decided late in '24 to shift part of the production for the U.S. market from Basel to our Warsaw manufacturing plant. Obviously, the tariff discussion did accelerate that shift. And we plan now to produce about 70% of our U.S. volume by the end of this year in the Warsaw manufacturing site and by the end of next year, around 80% of the U.S. domestic sold volume. That is not only mitigating the U.S. tariff impact, that is also diversifying our production footprint and easing or helping us to better naturally hedge the impact of the U.S. dollars and the continuous weakening of the U.S. dollars that we have seen over the last couple of years. Moving on now to a reconciliation from the IFRS figures to the core figures. It's a little bit busy and number heavy chart. You see the impacts of the different noncore and alternative performance measurements on the right side in the comments. But let's start with the table on the left side. You see there the IFRS reported figures. And then we have 3 columns where we took out either onetime exceptionals or M&A accounting effects to come from IFRS and reported to the core figures. Let me go through the different columns. M&A impact, overall, we reversed a gain of CHF 13.6 million at the EBITDA level coming from 3 effects. The amortization of the fair value step-up from the KeriMedical acquisition of the inventory, adding a charge of CHF 8.8 million. Then in the operating expenses, we have 2 impacts there. On the one hand, a revaluation gain of the initial KeriMedical stake at the point of the acquisition -- time point of the acquisition. On the other hand, we also have a reversal of a contingent liability from the former NSI transaction adding to the CHF 13.6 million reversal of gain. In the middle, we have taken out the noncore businesses that I have already explained on the top line. And on the right side, in the column other, we have eliminated costs of CHF 10.2 million coming from -- mainly from 2 different effects. On the one hand, scrapping costs for the former NSI inventory of around CHF 3 million. And on the other hand, from past service pension costs because we changed our pension model in Switzerland from an insurance-based model to a collective foundation, which led to some past service costs that we eliminated in core. And on the right side, you see the core results '25 and the comparative base for '24 as well. In the following charts, I'm going only into the details of the core results and not the reported results. So let's start with the gross margin. Overall, core gross margin, we posted 81%. You see the negative burden of 90 basis points from the U.S. tariffs and eliminating or excluding that headwind from the U.S. tariffs, core margin -- gross margin almost stayed stable around 82%, posting 81.9%, a slight decline of 20 basis points. We were facing a certain negative product and country mix effect. However, with efficiency increases in the production sites that was more than overcompensated KeriMedical, the full consolidation of the margin of KeriMedical since the acquisition lifted gross margin as well. And we saw an unfavorable impact from the NeoOrtho acquisition as expected. NeoOrtho is coming in with a lower gross margin. However, on the EBITDA line, it is margin and absolute EBITDA accretive as expected. And NeoOrtho shows the typical P&L structure of a Latin American value player. On the left side, you also see the FX impact on the gross margin, 60 basis points unfavorable FX impact. If we move on to the EBITDA margin, we were able to increase despite several headwinds and despite also significant investments in growth opportunities, such as, for example, also the preparation of the TOUCH launch this year in the U.S. to increase the EBITDA margin by 60 basis points to 18.4%. We see gross margin negative impact of 110 basis points. That was overcompensated by a strict cost management and a reduced OpEx ratio with 140 -- 150 basis points associates results and others slightly also lifted gross margin. On the left side, you see the FX impact of minus 120 basis points on the EBITDA margin. So coming to the bottom line of the P&L to the net result. And despite the increase in absolute core EBIT of CHF 4 million, net result from -- in an absolute point of view, decreased by roughly CHF 5 million, on the one hand, driven by unrealized FX losses and on the other hand, also by slightly higher financing costs. So let me start with the FX result. Financial result was negative CHF 13 million or CHF 8 million more negative than in the previous year. FX results was negative of CHF 5.6 million, mainly driven by the weakening of the U.S. dollars versus the Swiss francs and hence, respective unrealized FX losses in our intergroup financing structure. However, these FX losses are noncash relevant. Interest result stands at CHF 8 million, including a noncash accretive interest charge on debt -- I'm sorry for that -- on -- so interest result stands at almost CHF 8 million, including a noncash accretive interest charge on debt components of the convertible bond as well as contingent liabilities, mainly milestone payments from the former acquisitions of roughly together CHF 3 million. And please bear also in mind that the convertible bond was issued in April '24, and we have recorded in '25 for the first year full 12-month interest charge for that loan. In summary, roughly CHF 4 million of the finance result are cash relevant. The other part is not cash relevant. You also see other operating result positive contribution of CHF 2 million on net result that is mainly coming from an innovation grant that we received from the Canton here in Basel. Now let's move on to the free cash flow overview and the development of the cash balance in '25. Obviously, the debt development of the cash balance reflects the acquisitions of NeoOrtho and KeriMedical that I have already commented. Operating cash flow contributes CHF 35 million. CapEx increased to CHF 25 million, significantly higher than last year, around CHF 30 million higher than last year. And going forward, I also expected the CapEx level at that level, mainly because of investment in production expansion sites. We have expanded the production for KeriMedical in [ Ars-sur ] near Geneva. We will invest this year and next year also in the expansion of KeriMedical in [ Tuchbresis ] in Burson. We have -- are just moving into a new manufacturing site in Curitiba for NeoOrtho, and we are shifting the production from -- part of the production from Basel to Warsaw for the U.S. domestic market. So these are all investments in this year and next year in growth expansion and growth strategies. That brings free cash flow to CHF 9 million for the full year and the cash balance at the end of the year to CHF 33 million. And with these comments on the cash, I will hand back to Matthias for the strategic outlook and update.
Matthias Schupp
ExecutivesThank you very much, Peter. Yes, our strategic update, the future looks bright. And I think it is important we have, since last year, a clear North Star and our teams around the world, they know it. They know where the strategy is going, and we are really focusing also on transparent communication with the teams. From head to toe is our strategy, literally from head to toe, and we have 6 strategic priorities, and those are also not changing year-by-year. They remain the same. And we have one EMB member at least responsible directly for each priority. And of course, for our team, we have those broken down in action steps. We still continue to accelerate the U.S. When I speak about our Medartis-based portfolio, we are getting some inroads now. I said 2025 was a transformation year, but with a market share in upper extremities of around about 2%, you are nowhere. So we have huge, huge focus on growing the volume, but also gaining market share in the U.S. And on the other side, the TOUCH launch will accelerate this growth. But again, we should not forget about the Medartis-based business. And we have also made sure for our sales agents that they have an incentive to focus on the Medartis business and separate on the TOUCH business so that you cannot go with your commission only based on TOUCH. The second topic, the second priority is KeriMedical. The KeriMedical further expansion. We are speaking about the U.S. We are registering KeriMedical currently in other big markets around the world. We have still huge opportunities also in some of our European countries where we are in the process for only 4 to 5 layers like Germany, like the U.K., Austria. We have also in Asia Pacific opportunities for Keri, TOUCH, and this is one of the reasons what Peter managed that we are really expanding the production. The third pillar is our value strategy. I think we are the first global orthopedic player stepping into the value segment. And we are doing this very clear that there is an increasing value market, not only in Latin America. I will come back to this, but also in other regions of the world. So expanding NeoOrtho internationally is one of those strategic priorities. Regional share gains. And here, I have all my regional heads as leaders of this pillar. This is clear and valid for all regions. I mentioned the example of EMEA, where we have already very good market shares, but still continuing to gain additional market share. Innovation, digitalization, CADskills, I will come back later to this is one of those transformational acquisitions we did, we are announcing today, which is really technology going into innovation and digitalization, but also a new technology when it comes to manufacturing. But also a big focus for the team of Merck to focus on our innovation stream for Medartis products. You see a few, which we will launch this year, but we have some other very interesting products in the pipeline for the upcoming years. And last but not least, Peter, this is your pillar, improving the cash flow because nothing has changed. It is a focus growing top line, but as well profitability of this company. Where we are operating. The total orthopedic worldwide market, you see it on the left side is a CHF 50 billion market. This is dominated. You see this on the right side, by the big knee, hip, spine business where we are not active. So if we address this down, what is our serviceable addressable market, we are speaking about a CHF 4 billion to CHF 5 billion market worldwide we can address at Medartis. And there are some very nice and not small niches like the CMF part, the blue ones here, like extremities, when I speak about upper extremities, hand, wrist, elbow, shoulder, but also trauma. But -- and I said this last year as well, -- it cannot be our goal to be just the number in this market. The number X. We need to focus where we can really become a world market leader. And I said it, and after 1 year in the company, I repeat it. In hand and wrist, we have everything to become the #1 in the world in the future. And this is something we are focusing, and this is also the reason why we are not playing with the sharks in these hips, knee and spine area. Again, the TOUCH. Here a little bit the growth momentum over the last years. And I'm including this chart because I was asked several times from a few of you, why we are so confident with TOUCH. TOUCH is a prosthesis, some prosthesis which is already over 9 years in the market, especially in the French and Belgium market. So we have clinical data over 9 years. We know how successful TOUCH is. And what is the interesting part is that even in a market where TOUCH in the meanwhile has over 80% market share, we are growing 18% still. And we continue to grow double digit in France and Belgium, where you would say, but this is already overpenetrated. But why we are growing. Because this is the first product in our portfolio where we can do patient awareness activities, patient campaigns. It's not a typical B2C business because we are not speaking openly about TOUCH. We are not mentioning Medartis, we are not mentioning KeriMedical. This is really educating the patients in sport events, in their daily activities that pain in the thumb is something normal that this is something you can treat. You can back -- you can gain back the strength of your hand. And I also learned that opening a bottle of water, it depends on your thumb, the whole strength in your hand or playing golf keeping the golf club fixed in your hands. It's all about the sum. So when you lose the strength in your thumb, you will feel a direct impact in your daily life. And then knowing that there is a solution, guiding interested patients to an Internet page where they can find doctors. And of course, those doctors are working with TOUCH in their region, in their country. And we started these campaigns now in other countries of Europe, and we are preparing after the launch phase to do this as well in the U.S. Now Cold Fusion. We call this project Cold Fusion. Cold Fusion was bringing the Medartis Sao Paulo organization of Brazil into the NeoOrtho organization of Curitiba moving into our new production facilities, gaining synergies, starting producing in the new facility, but having also one back-office functions together and only have a differentiated marketing and sales approach. And I would say that this was really in record time. In 12 months, this new production facility is ready. The people started to move in last week. And next week, we will celebrate the internal opening. The teams are now together. This Cold Fusion project for us started only in March, and it was finished in only 10 months. The teams are now together. The synergies are getting in and NeoOrtho is ready for the new stage. But also Medartis in Latin America is now ready for the new stage. And with this, in 2025, when I spoke about a transformational year, we also are coming from 1 production facility to 5. This is quite a big step, and I promise you it will not happen each year. But we have now on one hand side, our -- we are sitting here our Swiss-based main production facility for Medartis, and nothing will change. Our home is Basel, and we will stay in Basel. And by the way, we just renovated for another 12 years, our contract here in Stucki Park. So we stay also here at this location, and we are expanding here with our production. But as Peter mentioned, and not only because of the tariffs because we had a wonderful production acquired in 2022 in Warsaw, Indiana, with capable people, we are translating now. And this project is called Flash. And it's running and our COO is sitting here. Mario, it's running like flash. I would say it's running faster than flash. This production transfer to the U.S. producing 70% of our needs for the U.S. already this year in the U.S. Then we have 2 production facilities for KeriMedical, the one in [ Archon ], which is just 2 kilometers behind the border after Geneva, where we are in an expansion phase now. And the second production facility, which was actually the first one where KeriMedical started in [ Besson ], where we will invest this year in a new facility as well. We are focusing on to the next 10 years or 7 years, and we are doubling our production volume for KeriMedical. And last but not least, on the lower part of this chart, our new beautiful production facility in Curitiba, Brazil. The value segment is fully underway. As I said, we have now the back-office functions consolidated. We are in the process of doing this. The move started a week ago. We are addressing now an additional value market segment of around CHF 450 million only in Latin America. We know that only in Brazil, 85% of the market is value where you have absolutely no chance with the premium product. If you're going to the public hospitals in Brazil, you even do not need to knock the door with Medartis because you are totally outpriced. This is opening now new access, and this is the same in Argentina. This is the same in Colombia, and this is the same in Chile and in Mexico. In Mexico, we started to launch NeoOrtho through our Medartis subsidiary already beginning of March. We are in the process of rolling it out. Colombia, Argentina and Chile are following this year for the rollout. At the same time, we already started a project with the expansion committee of NeoOrtho, both in Curitiba, but also here in the headquarter to analyze some interesting European markets where we would like to launch in 2028. And you know for this, we need MDR. So we started now the process of getting registration of the NeoOrtho portfolio also with MDR registrations, and this is coming around in 2 years from now. And in parallel, we are also analyzing some countries in Asia Pacific or in Saudi Arabia. This is running in parallel, but this is a process step by step. And before you ask me afterwards, the U.S. is not a focus at the moment. First of all, we have a lot on the plate to do in the U.S. And the other side, the U.S. market is still a premium dominated market. CADskills. Very happy with the team. They made it through. This is a truly innovative technology acquisition, but also a production acquisition with a new technology of titanium printing. This is a step into personalized implants. Personalized implants in orthopedics are becoming more and more important. It started in the phase with reconstruction for 2 more patients. Those are surgeries you can plan. Those are surgeries you can digitally plan. And then the products, the plates are produced individually for each patient. We have more and more also extremity cases, for example, in hand and wrist, where you have patient-specific products. One thing is the planning. So we are getting now with CADskills, a high talented team of planners who are doing the cases for the surgeons, but we are also getting a team who is then producing it in Belgium on their own titanium printing device, a huge machine. And this is Class III approved. Just to give you an idea, Class III means that you are also allowed to sterilize and to deliver directly to the OR. So basically, in Europe, we are ready to deliver in 48 to 72 hours, the plates now to the OR. This is a technology we were looking in for quite a while because I mentioned to you that this is high on our innovation list looking to digitalization and innovation. And we also analyzed this in -- with the partnership of the University Hospital in Basel, where they are doing this already in the hospital, but only for this specific hospital. So it was quite a learning process for us. And if you see what these products can do for the patients in the face, this is really mind walking. And yes, you see teeth again on this chart. There is a connection with our sister company on the other side. And of course, where we will produce those products to replace upper and lower jaws, you have the implant abutments already connected and those might be in the future, Straumann or Neodent is clear. But you see what's possible also on the mandibular with these joints, printed joints from CADskills. So very happy that we have them on board, and this is a technology we can scale. This is a technology we are analyzing now to bring to Latin America because NeoOrtho is printing the personalized products currently in Argentina, but now we can source this in-house because you need those planning and those services in each region in the future. You cannot do it in Europe for the world, for the U.S. or for example, for Latin America. So -- and this brings me to the outlook. As I told you, we have interesting launches in our pipeline for 2026. We are continuing to launch. We have the fibula nail, which is a lower extremity product going a little bit into lower extremity trauma. We have custom-made plate for the CMX service, but this time also with our TriLock locking connection. So we are able not only to personalize, to produce those plates in the future, but also with our patented locking system. We have, when it comes to the shoulder, our clavicle hook plates, a little bit the hook plates, which we also launched this system in hand, and now it's becoming bigger and also going to the clavicle hook. We are launching our Titan nail system from Medartis this year. very unique, very modern system. And for the Humerus system, we are coming now with the PentaLock 3.5, which is a bigger locking, a bigger screw to give even more stability. And the PentaLock system is something we will further expand also in our portfolio for our surgeons in the future. And this was really a wish from many of the surgeons where we are listening to and where we are executing. This brings me to our outlook 2026. We expect the organic growth from 16% to 18% on core sales. And our core EBITDA margin will improve, will continue to improve, and we expect to be in the high teens for 2026. And now Fabian, I'm handing over to you for the Q&A.
Fabian Hildbrand
ExecutivesSo we will start with the Q&A session. We try to juggle different channels at a time, but we will start with the room participants, go around. And please, if you could state your name and maybe the company you represent so that people will not see you on the screen are able to identify who's asking the smart question.
Unknown Analyst
AnalystsCongratulations on today's results. I'm [ Tanja hanslik ] from UBS. So I have 2 questions, if I may. First one for the 2026 guidance of 16% to 18% sales growth, it's a slight acceleration from the, I think, 15.7% in 2025. Can you tell us what your assumptions are for the U.S. launch of Keri that are baked into the guide. And I understand Florida will also have an impact. Is there an upside case as well. That was the first question. Should I go one by one or...
Matthias Schupp
ExecutivesYes, it's okay. Yes, should I answer the first question. Okay. Yes, thank you very much. Interesting question. I was expecting this question. But as I said earlier, we promised what we can deliver, and I'm very confident to deliver on this guidance again. The U.S., the TOUCH launch is an ongoing process. This is not just kicking in, in 1 month. This is starting slowly because more and more surgeons are starting to work now with TOUCH. I told you that we had trained 45 surgeons in the U.S., 33 of them already use TOUCH in the meantime. So there are still from this group, 12 missing to start, and this depends also on the contracts for the hospitals because the surgeons normally like to immediately place the TOUCH, but they need also clearance from their administration in the hospital to get the contract. This is a process with a 3 months delay, depends on the impact of the surgeon. So slowly start. In the U.S., I clearly expect that our Medartis-based business is moving towards a 20% growth. And then, of course, as I said, for 2026, the TOUCH business will slowly kick in. And you know I was open with this that we plan for this year, 1,200 TOUCH cases in the U.S., and I'm very confident that we will reach this.
Unknown Analyst
AnalystsOkay. And then for my second question, maybe more for Peter. How will you finance the growth strategy. You have a net cash position of CHF 33 million and CapEx, I think you mentioned similar to this year, plus I think you have an earn-out for Keri and obviously, the investments for the U.S. launch.
Peter Hackel
ExecutivesYes. Thank you very much for that question. I expected that as well. Obviously, we have a comfortable cash balance of CHF 33 million at the end of year. We have only used about 1/4 of our existing credit lines. And based on discussions with the different banks, we are very comfortable and sure we can increase further our credit lines. So that will be increased by increasing -- financed by increasing the credit lines.
Fabian Hildbrand
ExecutivesThe next question from Sandra.
Sandra Dietschy
AnalystsThis is Sandra Dietschy from Octavian. I have a quick follow-up to the previous question on the U.S. You mentioned that you would expect the base business to accelerate to 20% growth. Now is it fair to assume that in 2025, like a high single-digit percentage point was coming -- of the growth was coming from price increases. So what is -- the 20% seems like a significant acceleration on volume growth compared to last year. So what gives you that confidence that you can really accelerate the base business that significantly?
Matthias Schupp
ExecutivesGood question, Sandra. Look, I said close to 20% for our Medartis-based business. Of course, we see now the acceleration to close the gap in Florida. And when I say that we would have grown 18% last year without the impact of Florida, this is not calculating any growth into Florida. It was just flat. So I expect that especially we will see this only in the second half because we had still some rest sales of the former distributor in June and July. So the impact really happened end of July, beginning of August. So that will also help us to grow with a lower baseline. And the other thing is that we are now getting new contracts. I explained last year in August that getting new contracts in hospital, this is really a hard work, and it depends sometimes up to 6, 9 months to get a new contract. So we started with our distributor change in the U.S. moving to upper extremities to hand and wrist. We had to open new hospitals, new contracts. We were focused mainly on lower extremities. And having a contract with lower doesn't mean that you go in with your upper extremity portfolio. The other thing is, Sandra, and I think we also spoke about it last year that Keri throughout this year will open new doors as a TOUCH. There will be surgeons interested to place TOUCH who are maybe today working with another hand system of a U.S. competitor of us, and then we have now opportunities to really become more prominent in those hospitals. But again, we need contracts. So this will kick in. So I see the growth more kicking in, in the second half of this year.
Sandra Dietschy
AnalystsOkay. Great. Fair enough. And then a second one on the lower extremities segment. So what is there the long-term ambition? Is it kind of simply grow in line with the underlying market, which I would assume is some high single-digit growth? Or do you see scope for an outperformance also in that segment?
Matthias Schupp
ExecutivesYes. So the lower extremity market is growing between 5% to 6%. It is the fastest-growing segment in the U.S. this is a little bit what we are doing in line. We are getting some portfolio -- additional portfolio products in the future also for lower extremities. It is very clear for me to say that we are not stepping out totally of lower extremities. We are maintaining from head to toe also lower extremities in the U.S. But for the moment, our clear focus is the upper extremities here, hand and wrist. And as I said, we need to focus in the U.S. We are not in a place or in a size of a company where we can do everything together.
Fabian Hildbrand
ExecutivesSibylle Bischofberger?
Sibylle Bischofberger Frick
AnalystsSibylle Bischofberger from Bank Vontobel. I have a follow-up on the outlook. We talked about organic growth in 2026, but obviously, you have also acquisition effects. If you could quantify that with NeoOrtho, Keri and now the new acquisition you made. And maybe also if the currency remains as they are at the moment, how much would be the currency effect? And then I have another question on the EBITDA margin outlook.
Matthias Schupp
ExecutivesSo you mentioned it with the growth without the acquisitions.
Peter Hackel
ExecutivesYes. The organic part of the growth in '25 lift the growth rate a little bit from the first half to the second half, you see that difference. I'm not sure what you mean with the acquisition impact. You mean the M&A impact, the organic impact, what that is. So I think if you take the CHF 18 million and if you divide it by 1/3 comes from NeoOrtho for 8 months and 2/3 are coming from KeriMedical for the remaining 6 months, then you can come back to -- and you adjust that for the pro rata contribution in '26, then you see the M&A impact for '26. On the margin -- and the FX impact on the margins, that's obviously a very difficult question to answer given the current volatile environment and situation that we see. However, if we take the '25 results and recalculate it with current spot rates as of today, then we are facing a margin impact of almost 1 percentage point, 90 to 100 basis points, given current 2-day spot rate basically.
Sibylle Bischofberger Frick
AnalystsAnd your core EBITDA margin outlook for this year, can I understand it that you expect a margin improvement? Or could it also be a margin decrease?
Peter Hackel
ExecutivesWell, the goal, obviously, is always to improve the margins also on a currency or on a constant exchange rate basis, that's important to realize. However, we also need to be aware that we are facing further headwind in '26 on the tariff space. I mentioned it's about CHF 1 million to CHF 2 million more tariffs. I have not assumed any positive impact from a repayment of the tariffs that needs to be seen when and if that will happen. But on the margin side, obviously, especially in the first half year, I see a certain burden on the margin in the second half year with what Matthias also said with the growth and the acceleration of the growth, I see some further tailwind in the second half year compared to the first half year.
Fabian Hildbrand
ExecutivesBefore we move to the next question, I just want to remind people online joining us remotely, you have to click on the hand surgeon -- on the hand symbol in order to indicate that you would like to ask a question, and we continue with Daniel Jelovcan from ZKB.
Daniel Jelovcan
AnalystsThanks, Fabian. So a very quick one, TOUCH plus 60%. You mentioned the growth, 60%. That's the organic -- that's not including Keri markup distribution and so on and so on. That's the pure organic growth of the TOUCH prosthesis you mentioned in the slide.
Matthias Schupp
Executives60%, yes. We mentioned.
Peter Hackel
ExecutivesMaybe I can clarify. That's the Medartis contribution in the 5 channels or 5 markets, that's Germany, the U.K., Austria, Australia has started.
Matthias Schupp
ExecutivesCorrect. Daniel, these were the markets where we had already our TOUCH own distribution before we acquired Keri, correct, our direct markets. And yes, they are all in the ramp-up phase, yes, 60%, correct.
Daniel Jelovcan
AnalystsOrganic unit growth, so to say.
Matthias Schupp
ExecutivesYes. Yes.
Peter Hackel
ExecutivesBut that was always in the numbers also in '25 and '24 and '23.
Daniel Jelovcan
AnalystsAnd then on the CADskills acquisition, how easy is it to leverage this business model, especially in terms of margins because it's -- in the end, it's tailor-made. And on the other hand, it's 3D print. So maybe I lack a bit the skills to figure that out.
Matthias Schupp
ExecutivesThis is tailor-made. This is high reimbursed, especially in Europe, high priced and printed. We have already a CMX division, a patient-specific planning division since a few years in-house. So this division now combined with CADskills is really leveraging the technology. CADskills, just to give you an idea, CADskills had also revenue in the past. CADskills without any commercial activity, without not one single salesperson, they sold for EUR 1 million products last year. but this was not their main focus. This only happened because surgeons, doctors knew the founder, Professor Maurice, and they asked him for products. So of course, through our sales force, through our markets, especially in Europe, we have a huge leverage. But we did not buy CADskills or we did not acquire CADskills because of the commercial performance. We acquired them because of technology and stepping into titanium printing now.
Daniel Jelovcan
AnalystsOkay. Great. And the last question. In the past, you said that the TOUCH on average, a surgeon in Europe uses or makes 30 to 40 treatments per year on average. Is the U.S. higher than that? I mean, I could imagine, but -- or is that a similar number? And then the selling through the increase of share of wallet within the new surgeons you gain in the U.S. when they use other, as you mentioned, plate and screws for the hand. Is that easy to take away from the big guys because the big guys offer plate and screws all over the body, right? So I struggle to see how you can separate that?
Matthias Schupp
Executives2 questions in one, Daniel. So the first one, it's too early to say for the U.S., how many TOUCH each surgeon will do per year. We have to observe -- we may get some hard users who really place it every day. We might have some who are doing 1 per month. On average, for our long-term business case, we calculated an average of 15 to 20 TOUCH per surgeon per year in the U.S., but we have to see this. Your second question is a good one. Yes, those are the big fishes in the U.S. who are attending those surgeons today. I will not name any names, but they are not as specialized and I would say, as good in hand and wrist as we are. This is clearly also seen by the surgeons. What we have now is the situation that those surgeons would like to get trained on TOUCH. And it's at the moment, it's difficult to find a spot for a training this year. So we invite them, and then there is a kind of agreement to say, okay, but we would like to attend you with our whole portfolio and we do TOUCH training with you, and then you get TOUCH, but you get also the Medartis hand portfolio because the agent, the person who takes care is already in the OR. So he will bring in the Medartis products. And honestly, for the company they are working today with, and those are the big ones in the world, this is digestible because their volume is on other products and not necessarily on hand and wrist, even if they are in some hospitals exclusive. And this is also a thing very interesting. We are only getting the door open in those hospitals because we bring a product nobody has. If one of our competitors has a contract with a hospital with a huge hospital in Tampa, for example, you have no chance to negotiate during the running time of the contract. The doors are opening now because they are asking for something which is unique in the market and then you can negotiate with Medartis' hand because the sum is part of the hand and then we are getting in.
Fabian Hildbrand
ExecutivesGood. The next question is from Leon [ Nixian ] from UBS.
Unknown Analyst
AnalystsThree for me, please. I'll start with the first one on current trading. Maybe can you give a bit of color how you've started into the year into the different regions, products in terms of upper and lower, something you want to flag here and also, Keri, is this continuing as strong as in the fourth quarter?
Matthias Schupp
ExecutivesOkay. Thank you. I'm happy with the year, how it started, not only in Germany because of ice and snow. And this is also something I would like to say thank you to the team in our supply chain and logistics. We really ramped up our stocks, and we could serve all those accidents, and I'm never happy when a patient has to go to a hospital. But in January and end of December, it helped us a lot. But this is not the only reason because we are not selling less when summer comes. So very happy, a good team in all regions. And you can imagine that also the regions where we had negative growth in the past in '24, '23, I mentioned APAC and Latin America, that those teams are now motivated. And we have teams that did not get any sales bonus over the last 2 years. And finally, in 2025, it kicked in. So you feel an excitement also on the markets and the team. And yes, this counts also for the U.S. So yes, we are quite okay. The year started, but it's only 2 months. It's a little bit like observing the share price each hour, but we're on a good move.
Unknown Analyst
AnalystsAnd maybe just one follow-up on to this. How many additional surgeons have you trained since the start of the year?
Matthias Schupp
ExecutivesWe have, in the meantime, 100 surgeons trained, yes, nearly 90 something, 93 surgeons trained in the U.S., also including the 45 we trained -- and the rest is already programmed throughout the year. It's not so easy to find education centers with Cadaver Labs in the U.S. who are available for those training. We are training around about 25 to -- we are doing 30 courses this year in the U.S. and therefore, we are also expecting to use more of our own education center in the future.
Unknown Analyst
AnalystsOkay. Then 2 more detailed questions for Peter. Just housekeeping ones on tax rate and net working -- sorry. Net working capital effects and tax rate, just some housekeeping questions for you, Peter. What do you expect? Can we expect tax rate in terms of like between 19%, 20%. And will net working capital effect alleviate the free cash flow trajectory or rather not?
Peter Hackel
ExecutivesYes. Thank you for these 2 questions. Yes, tax rate. Underlying tax rate is around 18% to 19%. So your assumption is maybe a little bit higher than what I expect on the underlying tax rate. Net working capital, we saw a cash inflow from net working capital this year, mainly by managing receivables and bringing down the DSO. So the teams have done a good job there in that respect. Going forward, I see -- and Matthias also mentioned that, especially on the inventory side, it's also somehow supporting growth. And I have not planned to drastically reduce net working capital. I would see it stable or slightly increasing with the sales increase that we are going to push in the next coming years. And focus is definitely on increasing sales, on increasing growth, supporting growth, be it on the net working capital side, but also be it on the margin side with the investments in TOUCH launch in the U.S. for example, as well.
Unknown Analyst
AnalystsOkay. And then last one. Just to clarify the understanding of organic growth. Is it that you assume that the organic growth rate from the second half only refers to the Medartis core business? Or does it also include the Keri and the NeoOrtho organic growth. This was not really clear...
Peter Hackel
ExecutivesOn a pro rata basis, it includes the organic growth of KeriMedical and NeoOrtho for the time where we have consolidated these businesses. And as I said, it lifted the organic growth slightly. If you would exclude that, the growth of the Medartis portfolio will be at the same level as in the first half roughly.
Fabian Hildbrand
ExecutivesAnd Matthias, maybe you can -- you mentioned that in the second half of the year, the U.S. surgeons will take over the train the trainer. What we haven't mentioned is the new training facility in Florida. Can you mention also a word on that, please? On the local training center in the U.S.
Matthias Schupp
ExecutivesI mentioned it when I started that we have in Orlando, our local training center, especially for TOUCH trainings, but also for international trainings in the future. But this will kick in only 2027.
Fabian Hildbrand
ExecutivesOkay. Then we continue with Michel from ZKB.
Unknown Analyst
AnalystsMichel from ZKB. There's a trend in the U.S. towards ambulatory surgery centers. Do you see a trend there as well for your products? Does it make sense for trauma, even I'm not sure if you can treat trauma in ASCs. And also is TOUCH gaining traction in ASCs?
Matthias Schupp
ExecutivesAbsolutely. So we see a trend of the ASCs in the U.S. This is, of course, also for TOUCH the case. You know that touch is an ambulant surgery. The surgeon normally does the surgery in 40 minutes. Patient is then going out. So yes, we see this, but not exclusively in the ASCs. We are also well presented in the big orthopedic hospitals also with TOUCH and the rest of our portfolio.
Fabian Hildbrand
ExecutivesAnd we have a follow-up question by Sandra Dietschy.
Sandra Dietschy
AnalystsSo you mentioned during the presentation, your ambition to become #1 player in the upper extremities. Do you have any time line for that in mind you can share with us? And then also more specifically, is the ambition to become a leader across the whole upper extremity segment or just specifically hand and wrist I would estimate this is a market of CHF 1.5 billion roughly.
Matthias Schupp
ExecutivesCorrect. I think exactly it's hand and wrist. I mentioned hand and wrist where we can become a world market leader. To become a world market leader, you need a significant market share in the U.S. I think we are already showing that market leadership is possible in many of our European countries. This gives us the confidence. What gives us also the confidence is that in the U.S., for example, but also in other markets where surgeons never used hand or wrist portfolio for Medartis, everybody knows it. and it's world-class products and everybody is open to try it and to start to use it. This is quite a way to achieve. So we are not announcing midterm targets, but we have a strategy until 2030 to further expand our market shares in markets outside EMEA. But in 2030, we will not be yet the world market leader. It will take a little bit longer, but we will have a significant market share in hand and wrist in the U.S., definitely.
Sandra Dietschy
AnalystsPerfect. And then another follow-up question on Keri TOUCH, which you also introduced in Australia, and I understand you still don't have reimbursement there. So it's still out of -- fully out of pocket. So maybe you can comment on the commercial and clinical update there so far and lessons learned, which you maybe also can apply to the launch in the U.S.
Matthias Schupp
ExecutivesYes. We are waiting now for the final reimbursement in Australia. But as you said, if you place over nearly 200 TOUCH in Australia over the time and all the patients are paying out of the pocket, this shows how well received this product is when a patient understands that this will improve the quality of life. And I think this is a big learning for us. And it shows us again in the U.S. now. The patient we saw the lady doing the left hand thumb and 2 months later doing the right hand, this is something Dr. Tueting was not speaking her into this surgery. She decided to do it because she was so excited. And this is something which gives us a lot of confidence.
Fabian Hildbrand
ExecutivesSo we have Ed Hall from Stifel. He raised his hand. I don't know if his question was already asked. If not, please raise your hand again, and Leon has a follow-up question.
Unknown Analyst
AnalystsJust one more detailed question on this Keri reevaluation that you did. Can you explain what the context of this was? And was this a positive or negative effect. On the slide, you had those 3 numbers, just to understand which ones were actually supportive or not supportive?
Peter Hackel
ExecutivesThe revaluation impact of the initial Keri stake of 47 was done at the time when we increased to our full ownership. And that was on the reported figure, a gain of CHF 14.5 million that we excluded from the core figures. And obviously, that went into the PPA then the purchase price allocation of the acquisition.
Fabian Hildbrand
ExecutivesThen a question from Sibylle Bischofberger from Vontobel.
Sibylle Bischofberger Frick
AnalystsThank you, Fabian. Cranio-maxillofacial is only 16% of total sales. But anyway, it's a historical part of your business. We didn't talk too much about CMF, but what are the goals for 2026 and furthermore?
Matthias Schupp
ExecutivesTo further grow it, we had in 2025, a refocus on CMF, which was a little bit lost throughout the years. But again, we had also a change in our motor system in many countries. So therefore, the growth rate in '25 to '24 is not one-on-one comparable. We had a lot of sell-in also throughout the change in 2024. We have huge opportunities. It's a small market segment, a very specialized market segment, and there are only a few players. There are other big companies stepping out because they do not have this heritage and legacy in this product portfolio, all what we have -- we have a motivated team here. We have engineers working for more than 20 years with Medartis and everything started with CMF. So I see huge opportunities and especially because we are adapting very fast on those patient-specific implants, new design patient-specific design and now CADskills also moves into this. So we are broadening a little bit the opportunities for CMF.
Sibylle Bischofberger Frick
AnalystsSo it remains key in your business.
Matthias Schupp
ExecutivesYes. Yes.
Fabian Hildbrand
ExecutivesSo the person stepped back from his questions. So if there are no further questions, I just look around the room. It was an interactive session. Thank you very much for everybody participating. So before I kick it back to Matthias, just a demonstration of our annual report. So you see a little bit how it looks like. There's a creative team behind it that created this. And of course, you see Jonathan again and other great people from NeoOrtho as well as from KeriMedical. And with that, Matthias, you have still one big thing left for today.
Matthias Schupp
ExecutivesYes, one big thing. FESSH. FESSH is the European biggest hand congress. I would say the world's biggest hand congress. Every time I'm saying FESSH is coming home to Basel, to Switzerland. It was last year in Helsinki, and now we are hosting the FESSH. And we are hosting for you media and investor event on the 3rd and 4th of June, where you can also listen to some very prominent hand surgeons like Daniel Herren, for example, from the Schulthess clinic in Zurich, giving a very nice presentation, what really TOUCH means and how it is placed and how the patients are reacting. You can have the opportunity to visit our booth. It's the first time that we are appearing and in the future, it will be ever like this, KeriMedical and Medartis together and getting a little bit of feeling also about our main competitors. And of course, we will also socialize together. So it would be very happy to welcome you here in Basel again, and it will be summertime. So hopefully, see you.
Fabian Hildbrand
ExecutivesGood. And Ed just came back. So Ed, can we also open the line for Ed Hall from Stifel because he could not attend us today in person. We can hear you well.
Edward Hall
AnalystsVery good. Back on TOUCH, I think you mentioned the 300 surgeons trained in '26 or looking to train these 300 surgeons. I'm curious as to what your assumptions are for the midterm. And then also, if we think about the patients for touch, how many are you assuming are going to be having multiple placements. So obviously, 2 thumb joints?
Matthias Schupp
ExecutivesGood. Look, the 300 surgeons trained per year, this is forward going as well. We believe we should not train more to really have a controlled approach. So it will be next year as well, 300. We will end up the year 2026 with slightly above 300 surgeons trained because we have the one carrying over, which already received training throughout 2025. And then the fact that there is a patient who has done 2 thumbs, I would not generalize this. This would be wonderful. We know that we have estimated our market potential on 15,000 cases in 2030. Out of the 150,000 treated 3 cases in thumb in the U.S. For the moment, I'm sticking to this number. We will see how fast it goes. But also what is very important for the next 3 years, we are alone. There is no other competitor in the market because there is no other competitor with the FDA. And this is a unique opportunity for us. And yes, let's see. Hopefully, I have some more news in August when we have 7.5 months already running into the year, how many TOUCH we placed. For the moment, all fine, all good.
Fabian Hildbrand
ExecutivesEd, do you have a follow-up question or...
Edward Hall
AnalystsYes. Just one quickly on I think it was asked, if we look at other regions, it really has been a headwind for a number of years. Is this still the case?
Matthias Schupp
ExecutivesI didn't understand the last part of the question.
Edward Hall
AnalystsJust on pricing for APAC -- Australia.
Matthias Schupp
ExecutivesPricing for APAC for Australia. Yes. Look, for the moment, we have no further price reductions from the government. We don't know if -- we hope this stays like this. We had still an impact a little bit in the first half year, but this is over for the moment.
Fabian Hildbrand
ExecutivesAnd then as you carefully read in the press release, we also opting for reimbursement in Australia. Today, it's more or less paid out of the pocket. So it always creates a little bit of volatility there, but we also are optimistic that in the second half of the year, we will reach also a greater reimbursement for that more patients can opt for the treatment that are in need for it. There is a question coming electronically. I just read it out. So there is someone asking, so based on the approval by the FDA, we were also asked to submit post-approval study data so that people are safe to get treated by TOUCH. Is there any news flow for the public that they can know what the news flow is, how good the results or how bad the results are. And -- or is this just taken between Medartis or KeriMedical and the FDA?
Matthias Schupp
ExecutivesThe study started immediately. This was one of the obligations from the FDA. The results are very good, but we are not publishing those results yet. They are not different to the results in Europe. So -- and we do not expect to have other results in the U.S. than in Europe. Very successful. We have 9-year clinical data. And this clinical data we are using, but we cannot use the clinical data from Europe in the U.S. So we will use this once we are 1 year into the data, 2 years into the data. I think it makes no sense to use data, which we have only gained over the last 2 to 3 months.
Fabian Hildbrand
ExecutivesGood. I think this is very important that the clinical data are good. That's why we also take a careful approach. We have to train the trainer. Matthias mentioned that 10 surgeons have to be followed by the field specialists in order that we also get great results out that people remain confident in the product.
Matthias Schupp
ExecutivesI think it's fair to say that when you speak also with the specialists and the clinical team of KeriMedical and throughout all the years, we have never seen a big failure in the prosthesis. When there is a problem, it's sometimes because the patient is not careful enough. They are hard working and not waiting at least 3, 4 weeks to get to some movement again. And they are drilling holes into the wall and then it's getting vibration. It really happened or in a very few cases, a wrong positioning throughout the surgery. But everything is not a big damage and it's repairable.
Fabian Hildbrand
ExecutivesOkay. That's one more reason why you should join the June event because Dr. Herren as mentioned by Matthias, he's one of the biggest user, long-term user, and he also has a registrar from his clinic to surgeons that have operated many over -- more than 100 patients. And somewhere, I also invite you to come join us as you're close by our head office here. With that, I would like to close out this session. It was very interactive, 90 minutes. That's probably the longest session we ever had. There was some good news flow, but we don't stop here. There's also a complete IR activity program outlined on Slide 39 of the deck. If we haven't seen you here in person, make sure you sign up for one of these trips, and we're happy to give you the full story and answer all the questions you might have. Otherwise, you can also reach out to us through [email protected] or [email protected]. And we have to -- we are glad to assist in any way. And with that, I hand back to Matthias maybe for some closing remarks you might have.
Matthias Schupp
ExecutivesThank you. No, again, thank you very much for joining. For me, I don't know for you, Peter. For me, this is really a joy seeing you face-to-face and not only listening to a conference call. And yes, and thank you for your interest in Medartis. And see you very soon, hopefully, on the 3rd of June, and let's rock it together. Thank you.
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