Photocure ASA ($PHO)

All right. Well, great. Welcome, everyone, to Photocure ASA's First Quarter '26 Results. I'm Dan Schneider, President and CEO. Today, with me will be Dick Peters. He's Controller for Photocure. Erik Dahl, our CFO, is out ill today. And also Priyam Shah, Vice President Investor Relations. Just a reminder, the usual disclaimers are in effect for today's presentation. So Photocure's corporate strategy is built on 3 priorities: guiding execution and capital allocation. The first pillar is strengthening the core Hexvix and Cysview business, driving disciplined revenue and EBITDA growth while expanding operating leverage. U.S., we want to scale the Blue Light Cystoscopy Mobile ForTec along with the tower installations and upgrades with the goal of increasing BLC inactive and upgraded accounts, so increasing that throughput. And in the EU, we want to increase penetration in the key EU markets through BLC expansion, image upgrades and broader distribution reach, and we'll talk more about these today. We also want to be a lead in the standard, establishing BLC as the primary precision diagnostic across detection, surveillance and the treatment monitoring of non-muscle invasive bladder cancer. We also support next-generation high-def BLC adoption via the OEM upgrades and new OEM entrants. As we mentioned in today's presentation, Stryker has now entered the blue light cystoscopy market in Europe, and that is extremely exciting, if you know anything about the Stryker organization. And then partner with Richard Wolf to grow flexible BLC in Europe while advancing our co-development of the 4K global Flex system for a proprietary launch in 2027 on a global scale. And the third pillar, expanding our platform. We want to build a broader uro-oncology and precision diagnostic platform, be it biomarkers, artificial intelligence, technologies like Flex, et cetera. We also want to leverage our partnerships to scale mobile and 4K solutions, and we want to advance innovation and pursue M&A to accelerate our corporate growth. The result, near-term growth and strengthen long-term competitive positioning. Q1 highlights. Extremely excited about this quarter's results, very, very strong. Overall, we had 18% product revenue growth ex-FX. It's 11% including FX. In North America, we delivered 26% unit growth and an equivalent 26% product revenue growth ex-FX. It's 11% including FX with those headwinds. The installed base of Saphira upgraded blue light equipment continued to increase with 4 new tower placements and 7 tower upgrades in the U.S. in Q1, reminding you, upgrades in every situation have produced double-digit growth impacts for those accounts. So this is an extremely important part of our strategy, is to keep the technology as cutting edge. We had a fantastic 26% unit growth in the rigid surgical market, inclusive of ForTec Mobile solution. As a reminder, ForTec has 24 towers in their national fleet of rentals, underscoring the growing demand for BLC. As you recall, 6 were added towards the end of third quarter into fourth quarter of last year, fully operational now in 2026. The number of active accounts increased by 21% year-over-year to 413, setting the stage for continued momentum into the future. In Europe, revenue was up 11%, units up 8%. We continue to execute the EU with strong growth across all key markets, driven by continued execution focus and tower upgrades, which now account for over 15% of all EU accounts generating double-digit growth. The launch early last year of the Olympus Visera III BLC state-of-the-art equipment continues to gain momentum now with 75 Visera installs in the field and growing. Upgrades throughout the world have proven to increase the usage of BLC with Hexvix/Cysview, and encouraging accounts to upgrade means -- remains a priority for the organization. We generated positive adjusted EBITDA of NOK 15.3 million. That's NOK 128.3 million of reported EBITDA, inclusive of the milestone. We now report the adjusted EBITDA as our key profitability metric, in line with conventional practice, to better reflect the underlying operational performance and scalability of the organization. Q1 marks the 12th quarter or the third year in a row of positive EBITDA as we continue building organizational operating leverage. We had approximately NOK 10.4 million in business development expenses in Q1 on various strategic initiatives. And during the quarter, we also made a minority investment of NOK 28.7 million or USD 3 million in Vesica Health, who is developing and launching a precision diagnostic multi-omic urine biomarker test called AssureMDx for early detection of bladder cancer with a best-in-class performance. This investment is consistent with our long-term priorities, and as you recall from the slide prior, the third pillar, of making precision diagnostics a key strategic move, which I will elaborate on further in today's call. At the end of Q1, we have a strong balance sheet with NOK 192.7 million in cash. This is before the Asieris payment. And post Q1, we received that NOK 82.3 million or USD 8.6 million in milestone payments from Asieris on the NMPA approval of Cevira in China and the acceptance by EMA in Europe, which will be reflected in the cash balance in Q2 when we deliver it later in July. And lastly, the organization carries no debt. On the news flow, as a very important regulatory and strategic update, the FDA has finally provided clarity on reclassification pathway for the OAY-related equipment or it's the internal product code for BLC. And this is super exciting, because as everyone knows who's been involved with Photocure, we have been highly active, highly engaged trying to move this process forward. This unlocks a tremendous opportunity for Photocure. And following the response to Karl Storz's Citizen Petition, they have now confirmed that they will initiate a proposed reclassification process in the second half of this year. This marks an important step towards a more structured and predictable regulatory framework for BLC equipment in the U.S. market. For Photocure, reclassification has the potential to be a major step change driver for the business, unlocking a significant larger commercial opportunity as we move towards double-digit penetration across an expanded market, much more today. We will talk about the magnitude of this decision later in the deck, but safe to say this provides Photocure with tremendous opportunity to go after a market opportunity that is more than 10x today's current business. Taking into account multiple manufacturers, peak penetrations of at least 40% of rigid alone, this unlocks a tremendous opportunity for the organization, and we're super excited about it. Our partner Asieris and Richard Wolf have had several updates this quarter as well. The System Blue BLC equipment developed by Richard Wolf received market approval in China to work in synergy with Hexvix, which was approved back in late 2024. This marks the moment where Asieris and Richard Wolf will begin the commercialization in China in the coming months. Also, Cevira was approved in China by the NMPA as a first-in-class non-invasive therapy for cervical precancerous lesions. This was on the heels of Asieris announcing that the EMA has also accepted market authorization application for Cevira in Europe. And finally, staying on the subject of Cevira, Cevira was included in the joint consensus of 4 prestigious medical societies in China that recommend Cevira with Class IA evidence, establishing a new benchmark for non-invasive treatment of cervical precancerous lesions. In events and publications, on January 8, a key publication of LASER III examined 12 months recurrence-free following photocoagulation of bladder tumor versus TURBT. Photocure has supported this program and the specific study in Denmark since 2016. The study was published in the Journal of Urology in January, and the authors concluded that office-based laser photocoagulation of bladder tumor is noninferior, or said another way, is as good as a TURBT performed with blue light -- TURBT performed in the hospital under general anesthesia and is safe, efficient treatment of recurrent low-grade bladder tumors. So basically, combining the 2 in the office gets them the same results as if they did a TURBT in the operating room under general anesthesia. On March 13 through 16, the European Association of Urology held its Congress. There were 2 trials in progress that were presented, the CUT-less randomized clinical trial, which is investigating whether second look TURBT can be safely omitted by combining perioperative stage accuracy of MRI using BLC and VI-RADS as the mechanism to avoid that second unnecessary TURBT. And the second study was -- or the second trial in progress was the evaluation of urinary minimal residual disease and outcomes in high-risk non-muscle invasive bladder cancer with blue light compared to white light cystoscopy. The urinary biomarker UroAmp from Convergent Genomics, which we had announced several quarters ago, detects minimal residual disease in the bladder. By enhancing tumor margin visualization, BLC may improve TURBT completeness. This randomized controlled trial enrolls high-risk non-muscle invasive bladder cancer patients receiving either the standard of care of white light or blue light and UroAmp, and this will be evaluated for the completeness of resection in each modality. So we're super excited about where that particular study can go. Let's move on to segment trends. So we had strong unit sales in both regions. Both North America and Europe delivered continued growth. In North America, the rigid surgical market had 29% unit growth in Q1 to an all-time high with the addition of ForTec Mobile Solution. There are 11 Saphira towers installed, 7 upgrades, 4 new, adding active BLC account growth of roughly 21% year-over-year. And I'll remind you that this growth account has been consistent over quarters, consecutive quarters. So it bodes extremely well as we look into the future. ForTec Mobile Solution now covers 187 accounts as of the start of the service and over 300 different, or let's call it, new physicians are now trained since launch, demonstrating the growing momentum and demand from an otherwise inaccessible market segment. Said another way, this -- the business we're getting from ForTec is inaccessible because of capital budgeting constraints, et cetera. But these physicians are demanding it and ForTec is delivering this service and patients are benefiting from it. The ForTec Mobile Solution and Saphira upgrades are the key drivers to the U.S. business. Access to BLC in the U.S. remains a top priority, demonstrated by our ongoing efforts with the FDA reclassification and reimbursement initiatives, which we'll talk about some more today. Supporting this growth are many discussions and presentations at U.S. congresses, such as the upcoming AUA next week, where there is a growing belief that BLC's ability to see more assures physicians of their ability to perform a more complete TURBT, which then leads to more accurate pathology, staging and risk stratification, and ultimately, helps urologists make an informed precision medicine decision. And I think we're seeing that in the business. There is wind catching into the sails with BLC and just it's got its own momentum going. We're super stoked about that. In Europe, the Q1 units hit an all-time high of 8% growth. Europe is beginning to see the impact of the Olympus Visera III upgrades, rolled out particularly in DACH, Germany, Austria, France and the Nordics. There are 75 Visera III installs so far through Q1 with more in the pipeline for 2026. Upgraded accounts now represent over 15% of the installed base, delivering positive double-digit impacts. 40% of the EU is dominated by Olympus, and that primarily is concentrated in the Nordics, Austria, Germany and France. Europe growth also remains strong with a solid 10% growth in the DACH countries, which make up a majority of the revenue and the priority markets of France, U.K. and Italy, where we see in all markets double-digit growth and continued momentum. Taking a look at the U.S. specifically in active accounts, there was a significant growth of 21% in active accounts in the U.S., which are accounts that have ordered in the past 12 months. Over the past 6 quarters, we have consistently seen accelerating year-over-year growth in accounts as an ongoing trend fueled by ForTec and the increased interest and importance of blue light cystoscopy, along with the upgrades of the Saphira system and new implementations and installations. The ForTec program continues to exceed everyone's expectations. The reactivated accounts with BLC upgrades along with new accounts remains an important initiative as upgrades provide double-digit uplift in sales in the accounts that do those upgrades. We continue to see growing momentum and increasing interest in the adoption of BLC with Cysview in the U.S. as the market continues to evolve in bladder cancer. So I want to take a moment on this slide. And what we're representing here or illustrating is the unlocks, the inflections, the opportunities as they unlock throughout the U.S. market. Whether it be the reclassifications, the entrance of OEMs, the Flex launch, the reimbursement changes, these all have tremendous impacts on the business. And despite the accelerating growth today, less than 10% of the market is serviceable by Photocure despite a very large U.S. bladder cancer market. And there's strong clinical validation and demand for BLC. It's just getting to having accessibility to patients, and we'll talk a little bit about some of the things that are taking place. What changes the trajectory are 3 clear expansion drivers. This graph represents the potential addressable market and serviceable market with each unlock. First, additional manufacturing capacity removes historical access constraints, immediately opens up 100% of the rigid market. Said another way, additional OEMs who have a stronghold in the other 65% of the hospitals in the U.S., if they offer blue light cystoscopy, it offers an opportunity, a base for us to build on. We believe the FDA reclassification, which begins in the second half of this year, and -- I won't remind everyone, and the alternative pathways that certain OEMs are pursuing currently will unlock the rigid market compared to what we service today. And I believe that could happen as soon as the end of this year, certainly into 2027. Second, the Flex reentry will allow us to move into a lucrative and growing important surveillance market, driving broader and repeat usage. The Richard Wolf has an interim solution that is already launched in the EU, combining a white light scope with a System Blue system. Combining that -- if they have those materials in the hospital, they're able to perform a flexible blue light solution. But that is not the long-term solution. We have, as you know, have entered into a global -- or into a development program to launch a global state-of-the-art solution we are co-developing with Richard Wolf. It's expected to be -- ready to be approved and launched in 2027. And we believe the reclass, which the FDA has announced, will also facilitate BLC Flex relaunch, accessing a market vastly larger than what we currently are servicing today, depicted in the graph below. That Flex market is 3x plus the size of the rigid market. And you got to keep that in mind. So if you take a look at the rigid market, we're only getting access to 1/3 of that. If we get the reclass or OEMs enter, we got 100% of that. That 100% market is only 1/3 of the size of the Flex market, and both markets are imminent for us to access. Taken together, these drivers support long-term growth trajectory for the U.S. business that is both scalable and sustainable. We have a proven product, a growing clinical endorsement. You see the constant publications and presentations and discussions that are happening, both in our control and out of our control, quite frankly. We go to AUA and EAU and there's countless presentations where blue light cystoscopy is mentioned as a key element to the study and to the diagnosis and staging of those patients. And it is an enormous underpenetrated market, giving us strong near-term upside as these catalysts materialize. And then the final one is the reimbursement. And I will mention this, we've worked with Congressman Dunn and Soto. They're both bipartisan. Dunn is Republican, Soto is Democrat. They submitted a bipartisan bill to Congress called the FAIC Act, or F-A-I-C Act. That is a bill that the Congress is currently debating. It's got growing momentum. The essence of that bill, and you could find it online, is basically to say that patients need access to things like Cysview. And I say that broadly because the bill when you read it, we are in it, but there's several companies that we brought together that have -- that are also facing the same challenges, where they're not -- we would like them to decouple the product from the procedure. So currently, when you reimburse in white light cystoscopy or blue light cystoscopy, you get a certain reimbursement. The difference is a margin, right? The cost of Hexvix has to be taken out of the blue light procedure, so that margin gets squeezed a little bit. We are asking them through the FAIC Act with the support of Congress to turn it into a law that will force CMS to make this decision, and that is to decouple it like they did in the radiopharma business. This is a bold move by Photocure. I'm super excited about the progress we made. It took a lot of work to get it there, and we're super excited. We're looking forward to seeing how that progresses through Congress. If that happens, they will force CMS to decouple it. Meaning whether you do white light or blue light, you get the same amount. And if you do a blue light procedure with Hexvix, you get a special reimbursement for Hexvix on top of it. And that immediately changes the economics for blue light cystoscopy, and most importantly, opens up access to patients. So bladder cancer remains a major unmet need in the U.S. Each year, there are over 85,000 new cases and 730,000 patients living with the disease. There are over 350,000 to 400,000 TRUBTs and 800,000 surveillance cystoscopies performed each year. And the total addressable market for flexible cystoscopy alone exceeds USD 1.3 billion globally. Blue light cystoscopy is uniquely positioned to capture a meaningful portion of that opportunity, particularly as there are 5 precision medicines out there that are looking for patients that blue light is uniquely positioned to find, CIS, high-grade, high-risk patients. That is exactly what blue light cystoscopy does, and we're super excited about this market and its evolution. I want to take an opportunity to provide some additional color on the FDA reclassification because I know everyone has a lot of questions around that. There is no statutory time line per se. However, there is a process they go through. The basic reclassification under 513(e) paragraph on the FDA's website indicates that the proposed new class had sufficient regulatory controls to provide a reasonable assurance of safety and effectiveness of the device. In order to reclassify, the FDA must do the following. They must publish a proposed order in the federal register. That's the first step. That's what we talk about when we say the FDA will begin the process in the second half of this year. Second half of this year could be anywhere from July to December. So we're particularly optimistic that it will be sooner than later. This is followed by a comment period, which the FDA must consider any comments received, leading to an issuance of a final rule with an effective date, and there's some other potential steps. What's really interesting about this in our exchanges with the FDA and what I took particular note in was when they closed the citizen's petition with Karl Storz, they were really explicit in what they were looking for, which led us to believe that they have done more than just think about this. They have carried this a little bit further down the track. And that's why we're particularly optimistic in the time line on this. It seems as if they've already got an idea of what they want to do. I believe those special controls will look very much like the paper PMA route of linking up clinicals with the device and making sure it's a nice tight package. But we'll wait and see, but I am excited about that. And I think that the way they wrote that closure on the citizen's petition and then responded to us reopening it was quite eye-opening and very, very good for us to hear. The FDA may convene a device classification panel. To reclassify a device from 3 to 2, the available scientific evidence must show general and special controls are sufficient to provide a reasonable assurance of safety and effectiveness of the new device. And the FDA has communicated to Photocure that they plan on initiating this, as I said, in the second half of this year. Let's take a moment and talk about growth initiatives because I think in this space, we've got a lot of really good stuff going on, and these are things that are adding to the momentum of blue light cystoscopy adoption. And let me reemphasize our organic growth initiatives, and then we'll talk about the inorganic. For ForTec, we have 187 ForTec accounts with over 300 different new users gaining experience. It's growing to roughly 15% of our business and continues momentum. Whose patients -- these are patients who would otherwise not benefit from blue light cystoscopy. ForTec has proven to be a key driver for the U.S. business growth, and particularly as Flex -- the old Flex system has deteriorated, until we bring out the new Wolf system. This has actually overperformed, and it was able to cover off on that leakage, so to speak, of the old Flex business that washed out, that was 15% to 20% of our total business. 90% of ForTec accounts would not be using blue light cystoscopy if it were not for ForTec. That is 15% of our business versus last year. I think it was approaching 10%, and it continues growth and momentum. Richard Wolf -- our development partnership with Richard Wolf is progressing well. A Flexible BLC interim solution has been made available in the EU, and it has received positive feedback and physicians are currently using it, but they're super excited for the new system when we come out with it. The System blue is a BLC -- this interim solution is a BLC light source, which is then connected to an already approved flexible scope to perform the procedures. The interim solution is intended to keep the excitement, build the data, build the experience behind the launch of the high-def MAMBA blue light system that we intend to launch next year with Richard Wolf in 2027. The Claritas ISC AI partnership is progressing well. Our partnership with Intelligent Scopes Corporation, is a U.S. based subsidiary of Claritas HealthTech, is to develop AI software for real-time tumor detection using blue light cystoscopy. This collaboration will result in an intelligent diagnostic platform designed to improve the accuracy and consistency in tumor detection. Look no further than the GI space with GI Genius and what AI has done to colonoscopies. We believe we can do the same in the bladder cancer space. The joint development work is underway since Q4 of '25 and the ENAiBLE clinical study, which we announced, has been initiated in both the U.S. and Europe with patients already beginning enrollment. Post development, the FDA and CE submissions are planned with Photocure holding the exclusive global commercialization rights once the software receives its clearance. This initiative extends Photocure's technology moat around data-driven precision care, paving the way for future AI-enabled diagnostics in uro-oncology. And importantly, it adds a high-margin, scalable software subscription component to our business model, creating durable value beyond our high gross margin recurrent Cysview/Hexvix consumable. And why do we feel so strong about BLC adoption? The environment and the organic growth under this is getting stronger and stronger. The guidelines from AUA and EAU in various individual countries now recommend BLC, and the newer updated guidelines keep getting stronger in the use of BLC. We recently had upgrades into the Italian guidelines, super strong. We're expecting updates on the U.K. guidelines, again, continued strengthening the use of BLC, which was extremely encouraging as physicians turn to guidelines to guide their daily decisions. The science itself from over 300 publications in multiple well-powered randomized studies provides a wealth of clinical evidence. There are over 40 independent studies confirming the improved detection and reduced recurrence. We now have the U.S.'s largest bladder cancer patient registry with over 4,000 patients, and that is producing tremendous treasure trove of real-world evidence that continues to generate and reinforce the importance, and not only the clinical importance, but the economic advantage of using blue light cystoscopy. Our OEM partners are investing in anticipated volume growth, rising tides in bladder cancer diagnostics by upgrading their systems with rollouts of 4K and high-def systems. And new OEMs are increasingly wanting to enter the market to offer BLC as a new -- as such. And particularly, the now CE-marked Stryker blue light compatible system in Europe, the 1788, is now launching in Europe after a little bit of a test phase. And that is super exciting as Stryker is a very strong medtech player, and we look forward to more development with Stryker. Taking a look at the therapeutic landscape and the rapidly evolving conditions of it, there provides other opportunities for Photocure. Another major source of tailwinds behind the interest in bladder cancer diagnostics is the rapidly evolving therapeutic landscape in bladder cancer. Bladder cancer remains a prevalent malignancy and high recurrence rates despite standard therapies. BCG is the cornerstone of treatment for many decades. However, nearly half the patients experience a relapse or develop a resistance, highlighting the need for alternative strategies and therapies. There are now 5 recently approved novel drugs and over 40 total active non-muscle invasive bladder cancer pipeline programs with clinical trial reviews and a wide variety of novel agents across multiple modalities. Why is this important? Well, as these therapies are becoming more advanced, they're also becoming more expensive and missing a disease becomes even more costly. Every non-muscle invasive bladder cancer case will become more complex with the new personalized treatments with combo immunotherapies and bladder-sparing options. Improving the outcomes and guiding the future management of bladder cancer will depend on precision pathways, starting with a precision diagnostic like blue light cystoscopy with Cysview and Hexvix to offer a more comprehensive approach to detection, risk assessment, surveillance and treatment planning. And that is the underpinnings of the market itself and the swell up in the interest in blue light cystoscopy. Looking at the inorganic opportunities are things that we're working on, investments we've made, and we announced one today as well in a minority investment in Vesica Health. The future of bladder cancer is precision diagnostics and expansion into biomarkers, AI and surveillance will be critical in the bladder cancer patient care continuum. Blue light cystoscopy is the foundation of that ecosystem and Photocure is building towards an integrated future of molecular digital framework. We have spent significant time and effort in evaluating the right areas to focus on to expand our portfolio of offerings, and we believe these targeted areas will truly allow us to advance in the continuum of bladder cancer diagnostics and management. We have disclosed this quarter a $3 million investment in Vesica Health, as mentioned earlier, who is developing and launching a multi-omic biomarker called AssureMDx in hematuria. Hematuria is a $6.8 billion opportunity as a market. And shifting the paradigm, similar to what we've seen across other cancers such as colon cancer, the upstream opportunity is very large in bladder cancer. Patient flow into cystoscopy is determined upstream by non-invasive modalities, our products such as Vesica Health's AssureMDx, and which may provide the appropriate risk stratification. And this is tied to the physician's confidence on who should get scoped, when they should scope. And obviously, this leads to blue light cystoscopy. So this is why -- this is how it all ties together. Vesica Health's AssureMDx test for hematuria, in other words, it's blood in the urine, can identify more high-risk patients, which blue light cystoscopy is very important for, and increase the appropriate referrals to cystoscopy. It helps more patients enter the BLC TURBT pathway. This may result in a higher yield per procedure and per patient and can improve clinical efficiency for the provider. Simply, more patients will be identified with more targeted cystoscopies, more BLC usage, better risk stratification. There will be a higher conversion to BLC versus white light because these patients will be identified sooner and identified as high risk. And it also builds clinical stickiness with urologists. We have more granular -- we will have more granular updates in the future on our developing partnership with Vesica. We continue to see further opportunities to gain access and optionality. It fits into our broader precision diagnostic strategy. This approach is a stepping approach. It's a step towards it. We're investing in them. We're interacting with them. Part of it is we have a very strong presence in bladder cancer, as everyone knows. And so this partnership with Vesica Health is a win-win for both companies. The approach aligns more with where we are strategically and where the external landscape is evolving. The commercial opportunity in operating and commercial leverage potential remains our top focus for the organization. And let me just kind of move off to Cevira. Our partnership with Asieris also continues to make progress. We have taken in over USD 26 million in milestones, both across Hexvix and the Cevira programs to-date from Asieris with the potential for additional milestones -- regulatory milestones for like such things as EU approval, if it comes or when it comes, and royalties on sales in China, and eventually, hopefully, Europe as well and looking towards the U.S. as these programs advance through regulatory and commercial goalposts. Last month, Richard Wolf Blue Light System received its approval in China after a lot of work with the Chinese authorities. They will be launching with Asieris Hexvix in China. Both companies will begin that process in the coming months. Cevira was approved in China by the NMPA and the MAA accepted by EMA. So it's been approved in China and the package has been -- and is under review in Europe. Both events triggered milestones to Photocure in the amounts of $11 million for the Chinese approval and $2 million for the European acceptance of the package to begin the review. Asieris has also engaged the FDA and disclosed interest in pursuing additional indications. We announced a few weeks ago, we have a dispute with Asieris on the milestone owed to Photocure over the Chinese approval of Cevira, in which Asieris paid us $6.6 million of the $11 million owed. We believe we have a strong legal standing and we'll aim to resolve this dispute as swiftly as possible. I'd like now to turn it over to Dick Peters, our Corporate Controller, to review the financials. Dick, over to you.

Hello, everyone. My name is Dick Peters, and I'll be presenting the first quarter 2026 financial results to you today. First off, we start with the consolidated income statement. We started the year strong with NOK 139 million in Hexvix and Cysview product revenue. That's an increase of 11%, including the FX headwinds we faced in the U.S. or 18% excluding those FX impacts. During the quarter, we have also invoiced Asieris for milestone achievements related to the approval of Cevira in China and the market authorization submission acceptance in the EU. Total milestone revenues came in at NOK 125.6 million. With that, total revenues came in at NOK 264.4 million for the quarter compared to NOK 116.2 million in Q1 2025. Gross profit ended at NOK 254.3 million in total, and the gross profit margin of Hexvix/Cysview revenue remained stable at 93% of sales. That's the same as last year. Operating expenses at BD were NOK 115.6 million. That's a 3% increase versus prior year. But excluding the favorable impact of FX on expenses, the increase was higher than that. This expense increase was mainly driven by an increase in bonus accrual in line with the higher sales versus prior year and, of course, the usual merit and inflation. Beyond that, operating expenses remained relatively flat versus prior year. Business development expenses were roughly NOK 10 million in the quarter, and they relate to our strategic efforts to diversify our business. Overall, reported EBITDA was then NOK 128.3 million, a significant increase versus Q1 2025, and that is, of course, driven by the increase in sales, but also by the milestone revenue recognized in the quarter. Therefore, we have introduced a new adjusted EBITDA metric that excludes milestone revenues, business development expenses and certain other ad hoc and noncash expenses. All details about this new metric can be found later in this presentation and, of course, in the earnings release report. We will continue reporting on this adjusted EBITDA metric going forward. And in Q1 2026, the adjusted EBITDA was NOK 15.3 million, up from NOK 9.7 million versus Q1 2025. And the consolidated impact of FX on this adjusted EBITDA is less than NOK 1 million because we have a natural hedge on FX. Further down the P&L, we report a net financial loss of NOK 11.3 million, which is mainly driven by the payment of Ipsen earn-outs and FX impacts on intercompany loans. Then you'll see tax expense of NOK 26 million, an increase due to the increase in total revenues, and therefore, net earnings before tax. And earnings after tax then come in at NOK 83.4 million for Q1 2026. And with that, we have reviewed the P&L. We can go over to the next slide. On this slide, we will look deeper into the segments. In the North American market, we grew revenues by 26% ex-FX, but we faced significant headwind from the weakening of the American dollar versus the Norwegian kroner. The revenue growth, including the impact of FX is therefore 11%. Gross profit was NOK 50.9 million or 94% of revenue, and that's pretty much in line with prior years. In North America, direct costs increased by 4% or a total of -- to a total of NOK 46.3 million. As explained earlier, this increase is mainly driven by the increase in sales bonus accruals in line with the increase in sales, and the increase was partially offset by the tailwind of FX on AI expenses. Then the resulting contribution margin in North America is NOK 4.6 million versus NOK 2 million in prior year. That's 9% of revenue versus 4% last year. And lastly, EBITDA, which includes allocations of non-direct overhead expenses, ended at negative NOK 7.9 million, still an increase versus the negative NOK 10.6 million last year. In Europe, revenues were NOK 83.4 million in the quarter. That's an increase of 9%, including FX impacts or excluding FX impacts, which were smaller in Europe, that was 11% growth. The growth was mainly driven by sales increases in the DACH region, that's Germany, Austria, Switzerland, by 10%, and 13% in the high priority growth markets, France, U.K. and Italy combined. Direct costs in Europe increased by about 5% to a total of NOK 33.1 million, and that's just mainly due to merit and inflation. Contribution margins ended at NOK 43.5 million or 52% of revenue. And also there, that's an increase from the NOK 38.2 million or 50% of revenue last year. Finally, EBITDA in Europe increased from NOK 19 million in Q1 2025 to NOK 28.4 million in Q1 2026. And that concludes the presentation of the segment reports. And then we go to the next slide, where we look at the cash flow statement and the balance sheet. Firstly, about the cash flow statement. During Q1, we delivered operational cash flow of NOK 0.8 million. That's mostly driven by the EBITDA adjusted for noncash expenses and working capital changes. The large change in working capital is the result of the timing of the invoice of the milestone payments to Asieris during Q1 and the partial payments received during Q2. The cash flow from investments in the quarter was a negative NOK 34.4 million, and that's mainly driven by the investment in Vesica Health, Inc., as Dan explained. The cash flow from financing was NOK 12.6 million negative, and that's mainly due to the payments to Ipsen during the quarter of NOK 9.9 million. And with that, the total cash flow in Q1 was a negative NOK 46.2 million, and the cash balance at the end of the quarter was NOK 192.7 million. But as explained, this does not yet include the paid milestones during Q2. And when we look at the balance sheet, we see a total of noncurrent assets of NOK 325.6 million. That mainly includes intangibles and goodwill related to the Ipsen transaction. We also have inventory and receivables of NOK 267.7 million, and that includes invoiced, but by the end of Q1 not yet paid milestones from Asieris. And as mentioned, cash and cash deposits at the end of the quarter were NOK 192.7 million. Shareholder equity was NOK 577.9 million or 74% of assets. And long-term liabilities, which include a liability for the future Ipsen payouts of about NOK 95 million were included in those long-term liabilities. Current liabilities were NOK 96.6 million. And that includes the financial section of the presentation today. We can go back to Dan for the rest of the earnings call.

I think I'm going to give you key performance metrics. You want to make a comment?

You want me to...

Yes, just trend. Yes.

Okay. To Slide 22, please, with the adjusted EBITDA trends. So as I mentioned earlier, we have introduced a new adjusted EBITDA metric, which we believe reflects the underlying business performance in the best way possible. And what we see on this slide is a clear upward trajectory of adjusted EBITDA on a yearly basis. This reflects disciplined cost control and growing operating leverage as the core business scales. Quarterly variations are there, but the yearly trend remains up. We will keep reporting this metric in the future. On the next slide, you can see the adjusted EBITDA historically. We have reconciled this metric for transparency purposes and for our audience to really be able to understand how we get to the adjusted EBITDA metric over a long time. I hope this puts the financials into context and allows everyone to understand our underlying performance. And with that, I give it back to Dan.

Very good. Thank you, Dick. Appreciate it. All right. I'm going to wrap it up here. A summary of '26 Q1 results. Again, a very solid quarter with 18% product revenue growth in Q1. We've now had 12 quarters or 3 years in a row of positive EBITDA. Adjusted EBITDA, as Dick explained, came out at NOK 15.4 million as we continue to invest in key growth initiatives that we believe will, one, position us for long-term success; two, generate future revenue growth; three, increase our operating leverage; and four, protect the business. The North American unit sales were plus 26%. We grew our U.S. accounts by 21%. That's both new and reactivated by upgrades. Again, that is multiple quarters. I think it's 6 quarters in a row something like 20% plus account growth. We continue to work with Karl Storz to grow the installed base of blue light cystoscopy rigid equipment in the U.S., and we expect this to continue to expand. The ForTec national mobile rollout continues to grow traction and continues to contribute to our growth significantly. It's creating a new business by expanding access to otherwise inaccessible accounts with a novel mobile business model. In Europe, revenue was super strong at plus 11%, 8% unit growth with double-digit growth in DACH in the priority growth markets. We continue to facilitate image quality upgrades, and we believe that Olympus Blue Light upgrade will help us strengthen this initiative. As you know, again, upgrades in accounts produce double-digit growth. There are 75 Visera III installed since early '25. That's in Germany, France and the Nordics, which is now kicking in with a strong pipeline and aligned interest in Olympus. Strong momentum for BLC has caught the attention of Stryker, who have now entered into the EU market with -- and meanwhile, Richard Wolf, the blue light system was approved in China. This is new and exciting data, continues to be generated to help position BLC as a leading precision diagnostic in the rapidly evolving non-muscle invasive bladder cancer space. We have a strong cash balance, as Dick mentioned, at NOK 192.7 million, but that does not include the recent additional payments coming in from Asieris in cash. And we have no debt on the balance sheet. Finally, we will continue to advance several business development initiatives in the next -- meeting the next generation of precision diagnostics. Anticipated milestones. We maintain guiding 7% to 11% top line growth, all with the adjusted EBITDA expansion margin, and we realize that further operating leverage on the commercial business. We continue to increase Hexvix and Cysview account utilization through upgrades, installs and mobile solution. We want to advance the development of next-generation state-of-the-art 4K high-def blue light Flex system, which will gain us access to a market that's 3x -- 2 to 3x larger than the current rigid market in the U.S. Our strategic partnership with ICS Claritas developing a BLC AI will be a game changer in bladder cancer precision diagnostics and detection surveillance with a high-margin offering to our customers. The parallel exploration of upstream opportunities such as Vesica Health can further unlock the use and the importance of using blue light cystoscopy in the sooner and more accurate diagnosis. We'll continue the data generation of novel pathways and health economics to help position BLC as the go-to precision diagnostic in bladder cancer. We'll increase access to BLC in the U.S. through FDA reclass and alternative OEM pathways that are currently in route and, of course, support the Asieris progress of both Hexvix and Cysview and resolve our current disagreement. And with that, I think we can go to Q&A.

Thank you so much, Dan, and thank you to all of you who have submitted questions. We are already on our index time, but we will make room for some questions. The first one is regarding Asieris. Can you provide some clarity on the Asieris milestone payments and if they have been received?

Yes. So on the milestone payments, we received the $6.6 million instead of the $11 million that we believe they owe us, and that was for the approval in China for Cevira. And then the submission of the Cevira -- or the submission and the acceptance by the EMA of the Cevira package for Europe triggered another $2 million. So both of those, the $6.6 million and the $2 million, or a total of USD 8.6 million, has been received. And it's not reflected in Q1 because we received it in Q2. You'll see it in the Q2 results in the cash balance. The disputed $4.4 million, we believe -- and we've had more than one law firm look at the contract between the organizations. We feel we're in a very strong position. And it's not -- the dispute isn't whether they will ever owe us or not owe us. It's really about timing on it a little bit. And so we believe that we have a very strong position, and we will pursue by whatever means we need to secure the remaining $4.4 million.

The second leg of that question was, how is the outlook for the Asieris partnership?

It's good. Honestly, I sent a contingent to China, god, about 2 weeks ago. So in the midst of all this, all the folks within the organizations worked very closely together, whether it's supporting Cevira in China, EU or U.S., Hexvix on a global scale, particularly in China, but also some other initiatives. So our individuals and their individuals, everyone is working good together. It's just a disagreement currently on what they owe us on the approval. And I think we'll resolve it.

Then we do one more question, and that is about Vesica. Why did you make this minority investment in Vesica Health? And what is the strategic rationale?

Yes. So this is a disciplined strategic investment in an adjacent urology diagnostic asset and it expands our understanding of a broader ecosystem through complementary product. And when you look back at the slide that I presented today -- we've shown it before, without the names in there actually, but we had check marks, but still the same mentality, we wanted to be more clear for everyone. We see that patient pathway and all the needs to get a precision diagnostic to get that right so that patient gets the best care possible. Most of that is driven by the fact that you got 5 new therapeutics out there that can cost upwards of $1 million administration in the U.S. They need to make sure those decisions are made soon and they're made accurate and completely. So we saw this as an opportunity. When a patient presents, they see their physician with hematuria, blood and urine, microhematuria or gross hematuria. Vesica Health, in particular, is a very, very good asset with AssureMDx. It has a very good profile in identifying patients. And you can get on their website and look at the specifics around AssureMDx. It's been used in over 8,000 patients in its trials. It's progressing quite well for its reimbursements. And we just see a real opportunity for the 2 companies to work together. It's a win-win for both organizations. We believe in what they're doing, so much so that we extended them a $3 million investment in their organization to further their development, which actually helps us as well. And it aligns strategically and where the external landscape is evolving, representing a commercial opportunity, and we're gaining tremendous insight with this arrangement. So super excited about being involved with them. And again, we're going to continue to look for opportunities. Those patient pathway and the check marks and the products, et cetera, are just demonstrations of this ambition we have to be the leader in precision diagnostics for bladder cancer.

That were the questions we had within our time frame, and I'll leave it to you to wrap it up.

All right. Well, great. Well, listen, thank you, everyone for joining. Super excited. The kickoff of the year was extremely strong. A lot of exciting things going on in the organization. I look forward to seeing everyone at Q2, the end of July. So have a great day. Thank you.