Xvivo Perfusion AB (publ) (XVIVO) Earnings Call Transcript & Summary

July 13, 2021

Nasdaq Stockholm SE Health Care Health Care Equipment and Supplies earnings 45 min

Earnings Call Speaker Segments

Operator

operator
#1

Ladies and gentlemen, welcome to the XVIVO Group Interim Report Q2 2021. I will now hand over to Dag Andersson, CEO. Sir, please begin.

Dag Andersson

executive
#2

Yes. good morning, good afternoon and good evening anywhere in the world you are right now and welcome to the second quarterly telephone conference 2021. I am happy to present with my CEO -- CFO, Kristoffer Nordstrom. And as mentioned in the quarterly report, which was released this morning, we had a strong second quarter from many aspects. Sales, margins and EBITDA showed very positive performance. Sales in local currencies increased by 116% in the quarter. Gross margin of nondurable goods, 76% and EBITDA margin adjusted of 14%. These are very strong numbers. And on top of that, an organic growth of 82% for the thoracic business area also worth mentioning since this is actually an exceptionally strong number. The level of recovery within organ transplantation varies from country to country. In the U.S., the number of transplants increased for all major organs compared with 2019. Interesting to note regarding lung transplants is a very strong second quarter number. During the second quarter, 712 lungs transplants were performed in the U.S. versus 675 in 2019 and 587 last year. In Europe, the recovery is slower and more fragmented. Central Europe recovering at a quicker pace, Nordic countries and Southern Europe at slower pace. This is, of course, strongly correlated with how much, today, capacity there is in intensive care units for non-COVID patients. As travel restrictions are now -- or at least are on their way to disappear, the commercial team within XVIVO is now able to meet with existing and potential customers and discuss EVLP programs, liver perfusion, kidney perfusion, et cetera. Consequently, we have also increased the number of customer training events and held very successful webinars on different topics such as starting how to start a machine perfusion programs, kidney perfusion, et cetera. We have also continued to invest in our commercial team, as earlier mentioned, particular focus on preparing the U.S. organization for the launch of the abdominal product range with initial focus on our highly claimed Kidney Assist Transport, which was featured in a publication in The Lancet, November last year. We are also investing in Europe as we see reimbursement initiatives open up business opportunities in different countries. Coming back to Q2 highlights. It is worth mentioning the submission of the 510(k) application with FDA for the Kidney Assist Transport and we expect regulatory approval end of this quarter. NICE in the U.K. is supporting EVLP, and we are actually starting an EVLP program this quarter in a leading lung transplant center in United Kingdom. More clinics included in our European trials for heart preservation and also PrimECC. And we have started something very exciting, a digital transformation journey together with the University Medical Center in Groningen, 1 of the leading medical centers in the Netherlands. I will talk about these highlights in greater detail after the Kristoffer as presented in the numbers. But as regards financials, before I hand over to Kristoffer, I have already mentioned sales, margins and EBITDA performance. Another important number is the machine perfusion percentage of net sales, which in quarter 2 amounted to 52% versus 39% last year. This is very important, and it shows that customers are interested in profusing organs. And this is actually the only way to ensure that organs are in optimal condition ahead of the transplantation. We had SEK 10 million in onetime costs, 1/3 of this amount refers to an M&A process, which was terminated. So Kristoffer, are you ready to talk through the numbers in greater detail?

Kristoffer Nordstrom

executive
#3

Yes. So thank you, Dag. Starting with a P&L overview and the key ratios. First of all, as he said, we are pleased with the overall net sales for the quarter, given the fact that there is still a COVID-19 effect on health care, especially in Europe. Net sales amounted to SEK 59 million, corresponding to growth of 95% compared to last year and 116% in local currencies. Overall, strong sales in America within lung transplantation compensated weaker sales in Europe for all organs. Regarding gross margin, we are very pleased with the margins also for this quarter. Total gross margin, including both nondurable goods and durable goods was 75%. EBITDA adjusted for onetime costs was SEK 8 million corresponding to an EBITDA margin of 14%. Same thing here. We are satisfied with this level especially since we have invested quite a lot in the organization during the last 12 months here, and I will comment more on the onetime costs, my last slide here. Year-to-date, we present net sales of SEK 118 million, total gross margin of 74% and an adjusted EBITDA margin of 12%. If we deep dive a bit into the thoracic business area, net sales amounted to SEK 50 million, corresponding to a local currency growth of 82%, very strong against 2020. And this was, as I said, mainly driven by a strong recovery in the U.S. in both static preservation and machine perfusion such as EVLP. Non-durable goods accounted for 98% of sales. That means no expert sales in this quarter. However, outlook is promising. And for example, we have increased our stock in the quarter to meet the future demand for our machines. In terms of regions, Americas accounted for 65% of sales Europe, 30% and APAC 5%. U.S. strong, as we have said, for example, all our top 10 U.S. clients are returning growth on year-on-year terms. And in terms of EVLP, the most important U.S. clinics are now more or less returning to normal levels, which is very satisfying. In Europe, the recovery varies country by country, and overall, it does not come as far as in the U.S.. Gross margin on nondurable goods was strong, 80% in the quarter, which is in line with last year. So next slide. If we look at the abdominal business area and the Q2 highlights, sales came in on SEK 9 million, compared to figures in our report are missing since the acquisition took place in Q4 last year. However, organic growth for abdominal and former organ sales was 126% compared to 2020 and sales came in, in line with the comparable quarter 2019. Year-to-date, 64% organic growth compared to 2020 and 56% organic growth compared to 2019. Nondurable goods was 77% of sales and durable goods, meaning machines, was 23%. And as you know, abdominal more or less only operate in the Europe still, so 98% of sales came from Europe. Gross margin, 52% was in line with Q1. Let's move over to the EBITDA. Perfect. One back, exactly. So some comments on the EBITDA. Adjusted for onetime costs, EBITDA was SEK 8 million, corresponding to a margin of 14%, as we said. The onetime costs, as we like to present them, amounted to SEK 10 million in the quarter and consists of the following items. So cost of an M&A process, costs from business integration with Organ Assist. We expect that type of cost to cease in the third quarter. And finally, cost from cash-based incentive programs for employees outside of Sweden. The rolling 12 months adjusted EBITDA is SEK 31 million positive and also 14%. This could be compared with SEK 19 million and 10% last year. And so to my final slide, cash flow, financial position. So the cash flow in the quarter, cash flow from operating activities was negative, minus SEK 13 million, and that was mainly due to our onetime costs of SEK 10 million. And furthermore, as I said, we increased our inventory during the quarter, which impacted on our cash flow. So both machines and disposable sets were manufactured in order to meet the future demand and to secure transition into new manufacturers. So except from these costs, based on strategic decisions, I would say that cash flow from our core business was positive for the quarter. Cash flow from investing activities was minus SEK 23 million, mainly attributable to investments in our R&D projects, such as our heart preservation trials. And we ended on a cash position of SEK 311 million in the end of Q2 and that is in line with our year-to-date expectations. Finally, we continue to have a healthy balance sheet, equity assets ratio of 88% and no external debt basis. And now I will hand over to you again, Dag.

Dag Andersson

executive
#4

Thank you very much, Kristoffer, for this. I will then talk a little bit about some of the significant bets, which I earlier mentioned, but I would talk them through in more detail. If we start with one of the most important ones, the Kidney Assist Transport, nearly 2/3 of all transplants in the world are kidney transplants. And therefore, our new Kidney Assist Transport will play an important role in preserving kidneys in optimal condition ahead of the transplants. An article published in the scientific journey of The Lancet in November last year proved that oxygenated perfusion of kidneys before transplantation has a significant impact on the first year result after transplantation, less graft failure, better function and lower rejection of the kidney when compared to the cold perfusion alone. The plan to receive market clearance for the U.S. launch by end Q3 is still valid and U.S. go-to-market strategy prelaunch activities, education, supply chain optimization are all ongoing activities. We have already received questions on our filing in FDA, which is good, and we are well prepared to provide them now with the answers. As mentioned earlier, we will start an EVLP program in the U.K. during this quarter. One leading hospital will perform EVLP, not only for the hospital itself, but also smaller land transplant centers. This model is very exciting and a true breakthrough for us in the U.K. And one important aim of this initiative is to collect EVLP data in order to support the reimbursement process in the U.K. As regards our clinical trials, notably the European heart preservation study and PrimECC. We are now including 5 centers in the heart drive in Europe, and we expect 3 more centers joining the study during the third quarter. We have also decided to include additional centers in France and Germany to speed up the trial as much as possible and conclude the trial by end of 2022 as earlier communicated. The same logic applies to PrimECC, where we intend to include the leading hospitals in Oslo and Copenhagen and we are also in discussions with 2 leading German centers. I'm also very excited about the digital transformation journey we have initiated the University Medical Center, Groningen in advanced analytics. The projects named XCEPT aims at extracting liver perfusion data from our Liver Assist machine. And the objective is to help surgeons make more data-driven decisions, and increase the number of successful liver transplants. We are also planning to initiate a similar pilot project for lungs within U.S. transplant center in the near future. So what is key for us for the remainder of 2021? Well, we are in the process of preparing the 2022 to 2026 strategic plan and we'll have a meeting with our leadership in Gothenburg in August to finalize the plan. We are -- we will become the global leader in machine perfusion for all major organs. And our strategy will tell us what we need to do to achieve this. Of course, the launch of the kidneys is transport in the U.S. is key to start our dominant journey in the U.S. We are also planning FDA submission for the Liver Assist machine. We are, as I told you as well, speeding up heart and PrimECC trials and continue preparing for the launch of U.S. trials. We are also focusing on continued price increases in the U.S. and Europe and work with reimbursement authorities in Europe. So final comment. We will have our first Capital Markets Day on September 23 in GoCo Health Innovation City in Gothenburg. There will also be an online webcast, of course. But we have a great agenda and hope to see as many of you there as possible. And as a company involved in preserving and evaluating organs, it is important never to forget the purpose of XVIVO, which is that we believe in an extended life of organs. No one should die waiting for a new organ. And this is what I and my colleagues around the world strive for every single day, Wishing you all a great summer vacation. Thank you very much for listening. Thank you and goodbye.

Operator

operator
#5

[Operator Instructions] And our first question comes from Trattner from Carnegie.

Ulrik Trattner

analyst
#6

Both Dag and Kristoffer, and I'll start off with the strong development in the thoracic segment and essentially for lungs, seeing nondurable sales up 75% year-over-year, putting that into context of the increased number of transplantation. And I'm not sure if I got this right, but it -- was it up 21% year-over-year, 712 transplant versus 587 last year? And if so, are you gaining market share? Is this just purely an effect of your price increases?

Dag Andersson

executive
#7

No, I mean you remember the number correct. I mean, it was 587 in quarter 2 last year. It was 675 in 2019 and 712 this year. We believe that we are actually gaining some market share as well in the U.S.. I mean, if we look at the large customers we have, we are doing more lung transplants with those customers than ever before. So it's a combination of gaining market share. It's also -- of course, price increase plays a role here as well and the general sort of market growth. You have the organic growth. You have gained market share and you have price increases, which all lead to this fantastic development.

Ulrik Trattner

analyst
#8

And if you could help shed some light on the price increases. So how much are we now currently on sort of year-on-year basis for both...

Dag Andersson

executive
#9

Kristoffer, I think you'll have to...

Kristoffer Nordstrom

executive
#10

Yes. No, but we made a price increase in Q4 last year of 15% in U.S. on warm perfusion and 10% on cold. And we have been -- there have been really not been any objections from the customers here. So I would say that we have had a full impact of that -- of those increases on the thoracic sales in the U.S.

Ulrik Trattner

analyst
#11

Perfect. And on to the gross margin. And as for the abdominal segment noted that it was affected by a change in supplier.

Dag Andersson

executive
#12

Yes.

Ulrik Trattner

analyst
#13

If you could help us with just how much that was in Q2. And you mentioned that will not be a sort of any major effect into Q3 as well as will the new supplier provide you with sort of cheaper options that would have positive effects on these nondurable goods for the abdominal segment?

Dag Andersson

executive
#14

Do you want to answer that, Kristoffer?

Kristoffer Nordstrom

executive
#15

Exactly. So there -- we are in the middle of a transition to new suppliers. In that process with the old supplier, we have received higher prices on the present kits that we sell, and we need to live with that for a couple of months here. The new kits that will be manufactured will have a lower -- a bit lower manufacturing price, which is good. But the -- but as you can see, the gross margin was more or less in line with Q1. And that has also to do with the fact that the amount of distributor sales in Q2 was lower than in Q1. So there, we had a positive effect isolated to this quarter that offset the higher price, so to say, on the kits on the purchasing prices.

Dag Andersson

executive
#16

And we look in the future. We believe that -- and the target, I mean, for European sales until we go over to the new kits, the level of gross margin that we present now is reasonable, so to say. Our U.S. launch, of course, will give us possibilities to increase that margin.

Ulrik Trattner

analyst
#17

Perfect. And just on the one-off costs in the quarter. Obviously, interesting to see that the M&A activity remained high. And I'm guessing you won't go into detail on what type of acquisition that was related to. But if we were to focus on the one-off related to the cash-based incentive programs, when will that start to abate? And are we to expect or similar effects going into Q3 and Q4?

Dag Andersson

executive
#18

I totally understand the question because it is a onetime cost that is a bit odd since it has nothing to do with our operations, and it is only an effect of the increase or decrease of our share price. So the history is that we have historically launched incentive programs such as subscription warrants for Swedish employees, and we have not offered that to our employees outside of Sweden. And instead, we have offered them a bonus model that more or less mirrors the potential outcome of the Swedish programs. So we -- there will not be a cash effect in future quarters until potentially the Q2 in next year because that -- because we have 2-year programs that are running. So there's 1 program left with -- associated with this type of cost, an incentive program that ends in May 2022. Then potentially, there will be a cash effect, but all quarters until May 2022 could have a P&L effect based on the share price development.

Ulrik Trattner

analyst
#19

Okay. Fully understood. And then on to exciting times ahead for the abdominal segment. Obviously, it looks like that the kidney transport device is ready to be launch on the U.S. market fairly soon. But what about Liver Assist? What is left before filing for U.S. approval for that product? As well as, if I remember correctly, there were earn-outs related to the acquisition of Organ Assist related to these -- some milestones. Are these earn-outs we are to expect to be paid out during the next 6 months?

Dag Andersson

executive
#20

I mean to answer the last question first. I mean, of course, I would like to see the earn-out paid -- earn-out paid out because that also shows things are being delivered. And then there are 2 components in the earn out. One is the Kidney Assist Transport registration completed by end 2021. And the other component is the sales value of dominant product range globally in 2021. And as it looks now, the way we plan things, we are -- they expect or it's expected that the earn-out will be paid out. So that's where we are right now. But it is also very much linked to the timing of the launch of Kidney Assist Transport, because part of the budget for the abdominal range is linked to U.S. sales in the fourth quarter of this year of the Kidney Assist Transport. So hopefully, if everything moves forward the way it's doing now and we get the FDA registration completed by the end of September and we can launch the source setting in October, then, of course, it should sort of be fine. So that's on earn-out and kidney. When it comes to liver, we are in the process of filing for the registration, FDA registration. The challenge with the Liver Assist is that there isn't really a similar machine on the market. So we are trying to see here also what categories we fall in under and there is something called or De Novo category, which we hope would be the case with liver system and so on. So we are in the process of communicating with FDA and trying to assess what kind of registration process is the correct one for this device. I mean the work has started, and we expect to have it done by next year. But the big focus now is, of course, the Kidney Assist Transport. We have to sort of focus and do things also one at the time. So we can't just do everything simultaneously that -- so there's nothing in the budget for this year relating to Liver Assist in the U.S. It's only sold in Europe. And then we see how we plan the budget for April 2022. Did that answer your question?

Ulrik Trattner

analyst
#21

Yes. Perfect. Two last questions on my side before I'll get back into the queue. NICE is obviously, it's up. The track towards reimbursement in the U.K. is interesting. And you mentioned that you're expecting reimbursement to be in place in Q1 2023. But what are we to expect in terms of costs to be seen, like, for reimbursement in the U.K. up until 2023? Will it be a sort of cost coverage from NICE during that point in time?

Dag Andersson

executive
#22

Yes, yes. I mean we are going -- we will sell in quarter 3. We will start selling to 1 very large center in the U.K. who also will work with land from other centers. So we are in the process to prove our case. NICE is giving -- well, it's giving us this what we call, Kristoffer, it's like a temporary financing of EVLP, also for us to be able to prove our case so that it counts nationwide reimbursement. But we expect good sales will be placed in the center during quarter 3. So that's already decided. So we will start selling officially in the U.K. this quarter. But it's not full reimbursement for throughout U.K., sorry.

Ulrik Trattner

analyst
#23

So what is the current limitation from a budget perspective for EVLP in under the NICE sort of agreement that you currently have?

Dag Andersson

executive
#24

I don't know exactly how the agreement is formulated, but we know that we will be -- there is a certain quantity of EVLP that will be performed, which we are -- which we have already discussed and negotiated, prices already decided. So everything is ready, but it's not a full national reimbursement yet. It's a selective reimbursement because there is a great belief in EVLP. And we are well starting to sell in the U.K. as if there was reimbursement, but only for this center with some smaller centers attached to this very big center in the U.K.. I don't really have more details than that right now, but you will see sales during quarter 3 in the U.K. Yes.

Ulrik Trattner

analyst
#25

Okay. Perfect. And just last question and I don't want to sort of infringe on the Capital Markets Day, where I'm guessing you will talk more about this. But if you can give us some more insight on to the digital efforts that you're currently doing in the press release from last week, what that entails in terms of how that would imply in terms of adoption of both in the abdominal and thoracic segments as well as is this a new segment where you're seeing transplantation moving towards?

Dag Andersson

executive
#26

I mean, there are many reasons to work with digital transformation in the area of lung and liver and also kidney and heart transplantation. And we have started this initiative in Netherlands. We are also starting in the U.S.. We are not allowed yet to mention the sites for legal reasons. But we believe that there is a lot to be done when it comes to average risks in terms of predicting the functionality and suitability of organs. And we will talk much more about that at the Capital Markets Day. So I would -- if you don't mind, I would prefer not to say more than this right now. Since in September, we would be able to reveal the U.S. center and what we expect to get out of it. So would it be fine if I then go through this talk through in more detail right now?

Ulrik Trattner

analyst
#27

That is perfect. We'll have something to look forward to at the Capital Markets Day.

Dag Andersson

executive
#28

Absolutely.

Ulrik Trattner

analyst
#29

Congratulations on a great quarter.

Dag Andersson

executive
#30

Thank you for very good questions.

Operator

operator
#31

Our next question comes from Dylan van Haaften from Bryan Garnier & Co..

Dylan van Haaften

analyst
#32

Dag and Kristoffer, congrats on nice sprint. Perhaps unsurprisingly, most of my questions have been answered. But just 2, I understand you might not be able to exactly give me a range, but could you give me sort of a rough estimate of the transplant capacity versus last year for U.S. and Europe? I know U.S. is ahead of last year, not being as disrupted, but in Europe, I understand, it can be very wide. But anything here helps. And my second question would be, I also noticed you had some more capital spending or it appears this way, at least, on the side of the centers buying more machines. Could you perhaps tell me a bit about the placements and what kind of devices you placed? And if this is a leading indicator for nondurable sales third quarter, what kind of rate do you expect that to be relevant?

Dag Andersson

executive
#33

I mean, when it comes to Europe, I mean it is very much varying from country to country, I mean there are certain countries which are relatively strong. I mean Benelux, for example, is performing relatively well. And so with Austria and Switzerland, where Scandinavia and Spain has really not been able to do, for example, anything on the EBITDA side due to the COVID situation. I think Germany, where we don't really have reimbursement yet for lungs, I mean, Germany is also a country where intensive care capacity has been relatively high, and they have also managed the COVID-19 situation much better and been able to perform other surgeries, including sort of organ transplantation. But it's hard to give you exact percentages. I don't know, Kristoffer, if we have anything to share, which gives precise percentage compared to 2019/ '20.

Kristoffer Nordstrom

executive
#34

I mean, yes. No. But as you said, and it applies to both the abdominal area and the thoracic is that, for example, Southern Europe has so far been a struggle and has impact on our sales, Italy, Spain, France, for example. In relation to thoracic, what we see is that, for example, the EVLP programs has not seen such a significant recovery as we see in the U.S. So I think that is the main difference between -- when it comes to lung between the 2 continents. Then I didn't really -- could you please rephrase your second question?

Dylan van Haaften

analyst
#35

Sure. So just on -- I saw that durable sales are actually going well. I was just wondering what kind of devices you placed. And if they're placed in new centers and if these are all EVLP devices or other devices.

Kristoffer Nordstrom

executive
#36

So durable sales in the quarter was, if we talk about XPS machines in lungs were 0, actually. No sales, no placements, but the outlook is good. We're having interesting discussions with centers in -- not new centers in both U.S. and Europe, which is good. When it comes to abdominal, we are looking at different possibilities. If we should sell machines, if we should plate machines with a volume commitment, and that is an ongoing process at the moment. But for lung, normally, we sell the machine.

Dag Andersson

executive
#37

Yes. And for lungs, we have -- we know that there should have been some -- probably 1 or 2 deliveries in Q2 that will now happen in Q3 instead. So we have -- we know, really, 2 customers in the U.S. who will take a lung machine. We have U.K. We also have probably 2 more machines in Europe coming in quarter 3, early quarter 4. So quarter -- 2021 production would be the strongest year ever for XPS machines, if everything goes according to plan.

Operator

operator
#38

Our next question comes from [indiscernible] from Redeye.

Unknown Analyst

analyst
#39

Thank you for taking my questions. Some of them or most have been answered already. Congratulations also to a solid quarter, but I understand a pretty good outlook as well. But yes, a few things. U.K. prices, you have offset and I guess you want to release any price this way, but is there anything we can say about the price level that has been said.

Dag Andersson

executive
#40

You mean for the U.K.?

Unknown Analyst

analyst
#41

Yes, indeed.

Dag Andersson

executive
#42

Yes. I mean I don't have the exact price, but I know it's a good price. That's all I know. I haven't seen the exact price level in pounds. I don't know, if Kristoffer, you have seen it. But it has been agreed and it's a good price level. I mean, definitely not -- I mean Europe average or above. I mean it's a good price. That's all I know.

Unknown Analyst

analyst
#43

Helpful. And is there anything that could be said about -- you were pretty specific that we should expect Q3 sales already from the U.K.. Is there anything we can say about the volumes that it's a big center. There was some satellite or...

Dag Andersson

executive
#44

Yes. I mean. We are not allowed yet to reveal the customer, as I understand it. but it's a very famous and big hospital, and I'm sure you can guess which one it is. And there will be 2 smaller hospitals that will also use this big center and the XPS machine for EVLP. I don't want to give any number when it comes to how many EVLPs will be performed. But it is a good number that makes us -- my commercial team is happy. And if they are happy, it means that it is a good, good number. So we will be able to say more after Q3 and maybe even at the Capital Markets Day. But I would prefer not to say anything that makes this sensitive because we are just sort of about to start up with this program in the U.K.

Unknown Analyst

analyst
#45

That's understandable. And also, you seem to be pretty confident about the U.S. launch, possibly already in October, and that's also related to some earnout. Is that -- is there anything to be said about these volumes?

Dag Andersson

executive
#46

No, I mean we have planned a certain budget for the U.S. for the fourth quarter. We are planning to sell a certain number of Kidney Assist Transport. It's -- we have already -- We are already talking to the centers. We are prioritizing the centers because we believe this will be in high demand. But of course, when you launch something, you have to be a little careful in the beginning because you will always have a buildup of the stock and supplies as well. And so we are talking about a good number. We are not able to talk about the exact number when it comes to the U.S. because it's in the future. But if we get dominant product range, this number is significant, and it's a good margin and so on. So once again, I mean, unfortunately, I will have to pause here and then when things happen, we will be able to talk about the beginning.

Unknown Analyst

analyst
#47

So you are pretty confident that, that amount will come into play?

Dag Andersson

executive
#48

Yes. I mean, I am confident that we are working according to the plan that we communicated since a long time. We have FDA registration, commercial launch. Then of course, something can always happen last minute, you never know. But I mean, we are working with this. We have great project team. People are making sure that things are being delivered according to the timetable that has been established, and we have appointed a product champion for the U.S. We have appointed a marketing manager for the U.S.. So many things are in place for this launch. We are just sort of waiting for the common FDA approval. Once we get that, we can start shipping the device established to the U.S. Absolutely.

Operator

operator
#49

[Operator Instructions] And our next question comes from Caroline Banér from Danske Bank.

Caroline Banér

analyst
#50

Dag, Kristoffer, thank you for taking my questions, which unsurprisingly, most have been answered already. However, I was wondering if you could shed some light on where you see the long-term gross margins going for nondurable goods, obviously, a bit lower due to abdominal being part of it since Q4. So once you see price adjustments and so on in place, where do you see gross margins ending up overall?

Dag Andersson

executive
#51

Kristoffer, do you want to take this?

Kristoffer Nordstrom

executive
#52

Yes, sure. When it comes to abdominal, there is a lot to do on the margin, and we will take this step by step. We have experience from our nondurable goods in lung -- lung transplantation, and we should reach something similar. However, we should know that at the moment, we have a highly profitable solution, the Perfadex for nondurable goods in lung, which we don't have for abdominal. But excluding that, I would say that our midterm goal here would be around 70% should be reasonable for the abdominal nondisposable. We will work with the price increases. But as for other industries, of course, there would also always be increases on the other end as well, MDR costs and raw materials, et cetera.

Dag Andersson

executive
#53

But I mean, U.S. price levels are generally higher than European high-price level. So the more we sell it in the U.S. the better for the gross margin. So I think 7% is good benchmark for the abdominal ranges, as said, Kristoffer, for the disposable products. Did that answer your question?

Caroline Banér

analyst
#54

Oh, for sure. Yes. So most questions have been answered. So I'm just kind of stuck with the more of a sentiment kind of question. So you're not getting much pushback on your price adjustments. I know as you said, Dag, prices are generally higher in the U.S. Would you say that the sentiment is the same when you raise your prices in U.S. versus Europe or...

Dag Andersson

executive
#55

I mean the big difference is, of course, if you have reimbursement in a country, if we have good reimbursement then, of course, it's much easier to talk about price increases. And if you look at the U.S. as an example, if you take one competitor like Transmedic, who is pricing much, much higher than we are and they have, clearly, product to us. So in the U.S., there is competition who is with a very high price. And that makes it, of course, easier for us to raise our prices. In Europe, very strong country to country, standing on where we're -- what kind of reimbursement model is in place. In Europe, we also have certain contracts which have been with long contracts with limited price increase opportunities. But here we are increasing prices in Europe wherever we can, and we will continue to do so, but it's easier to do in the U.S. Because of the reimbursement model in U.S.

Caroline Banér

analyst
#56

Sure. Sure, understood. All right, that's all from me. Congrats on a good and stable quarter guys.

Dag Andersson

executive
#57

Thank you, Caroline. Thank you.

Operator

operator
#58

Thank you. Now there appears to be no more audio questions. I'll turn the conference to the speakers.

Dag Andersson

executive
#59

Perfect. Great. Then we are done. Thank you all for listening, and welcome, hopefully, some of you to the Capital Markets Day and for everyone else, we'll be in touch again after Q3. Thank you.

Kristoffer Nordstrom

executive
#60

Thank you.

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