Kari Krogstad
Good morning, and welcome to this presentation of Medistim's third quarter and year-to-date September 2026 financial results. My name is Kari Krogstad, and together with CFO Thomas Jakobsen, we are here to take you through the results.
As always, we like to start with a little reflection on Medistim's track record. We've had the goal and ambition over time to deliver profitable growth, and as these nice graphs are showing, this is exactly what we have been doing.
An update to this slide this quarter is actually on the dividend side, which we can also see has been pretty consistent over the years. This quarter, we're introducing a quarterly dividend for the first time, we're adding 2.
2.50 NOK per share in addition to the 8 NOK per share that we paid out earlier this year, and we'll get back to this. Let's get into this quarter's presentations.
I will start with going through the highlights, Thomas will take us through the detailed financial statements, and then I will get back to commenting on the various business segments, and today I will talk a little bit about the PATENt study as a part of our implementing the strategy section. I'm very happy to being able to present a new sales record for a quarter for Medistim, this quarter delivering 210 million sales revenues, which is a 25.9% increase over this quarter last year.
As we can see from this table, we do see a negative currency effect here, when we are adjusting for this currency effect, we see that the currency-neutral sales development under total sales is actually showing growth of 31.5%. Our own products sales is up 34.6% currency-neutral, and we can see strong contributions from all our sales regions.
Americas growing 51.7% this quarter, Asia-Pacific growing 44.6%, EMEA also growing 5.5%. In addition, we're seeing a normalized growth from the third-party products this quarter at 5.3%.
Then looking at the profitability at the EBIT level, we are delivering 63.1 million, which is 55.7% growth over the same quarter last year. This means that we are delivering an EBIT margin on the high side at 30.1%, of course driven by the strong sales of our own products.
We're seeing that this quarter we have a net tariff payment effect of 2.7 million, and this is based on both the tariffs that is applicable to this quarter and this period, but also the refund that we have received of 2.7 million. I'm sure that Thomas will comment further on this.
As alluded to, the board of directors resolved yesterday to pay a quarterly dividend of 2.50 NOK per share, totaling 45.8 million, under the authorization granted by the general assembly. Then moving on to the highlights for the year-to-date period.
Again, of course, with three sales record quarters behind us, that also gives us a new record for this period, surpassing 600 million for the first time. So, 613.7 million NOK in revenues, 18.6% growth.
Again, a negative currency effect here, and when we are adjusting for that, we are seeing that the total sales for Medistim is up 23.6% so far this year. The own product sales growth is very strong at 30.1%.
Again, all the regions are contributing strongly. Americas growing 35.1%, Asia-Pacific 45%, and EMEA 12.5%.
The third-party product portfolio is down 13% in the period, which is of course related to the very strong sales we had in the beginning of 2025. Then looking at profitability at the EBIT level, 185.5 million in operating profits, that means a 20.6% growth so far this year.
That also gives us a strong EBIT margin at 30.2%. If we dive into the operating expenses, we see that of course growing the business also comes with needs for further investments, and we're seeing higher commercial activity, we're seeing the effect of having added a new direct operating team in Japan, and also ongoing IT system migrations to the cloud, a project that has been ongoing for some while, is increasing the operating expenses.
With that as highlights, I will leave it to Thomas to take us through the financial statements. Thank you.
Thomas Jakobsen
I will take us through the P&L and financials for the third quarter and year-to-date September, and and we start with the P&L. I will not go in detail into the sales the revenue line.
Kari will take us through that in more detail related to both product and split of geography. What we do notice for this quarter is the improvement in gross margin, going from 81.5% to 84.5%.
That despite the fact that we now are booking tariff expenses for all transactions that we import to the US. As Kari mentioned, we have received a refund of the first tariff that was that was set into place in 2025, which was deemed unlawful, and of of of those some of those have been refunded in in the third quarter, and around 2.7 million was refunded and is booked as a reduction in cost of good goods cost of material in the third quarter.
Having said that, we've also booked an expense of 5 million Norwegian kroner with the existing valid tariffs, so that means that the net tariff expense for this quarter is 2.7 around 2.7 million Norwegian kroner. That is also a part of why we have somewhat improved gross margin, but the main reason is the strong sales we experience and the continued growth in Norwegian kroner of sales in the US.
That is the main explanation of why we go from 81.5 million to 84.5. Just as a reminder, in 2025, in the third quarter, we had no tariff expense since we had shipped goods to US before the tariff was valid, and was selling from inventory, which was not affected by the tariff.
Going further, salary and social expenses increases from 60.3 million to 67.8 million. Two major things to mention here, one is the direct direct organization in Japan, we did not have that in place in the third quarter last year, and we also had exceptionally good quarter sales-wise, especially in the US, and this affects obviously the the commission and bonus schemes for the sales team in the US in a very positive way, and therefore the expenses increases.
Other operating expenses also increases with 10 million. There are a lot of activities going on at the moment.
I can mention the the PATENt study, which is speeding up compared to where we were last year. We also have the IT infrastructure project, which has been expensed in this quarter.
Having said that, we are now about to go live, or in October we went live on on on parts of this project, we do expect that going into 2027 that these type of expenses will no no longer be there, but we still have this these expenses going into the fourth quarter. Also, the direct operation in Japan was not present in the third quarter last year and has given us additional expenses.
In addition to that, two other things: high activities related to commercial to the to our commercial operation, but also a higher agent commission. We do have agents in in the US and also at times agent commissions in Asia-Pacific.
Those are the main explanation for why we have a higher other operating expenses for this quarter. Even so, with higher expenses, and we we do experience an solid improvement in EBITDA percentage from just under 28% to 33.6%, and EBITDA ends at 70.6 million.
Depreciation increases, and this is because of our Intui Cardiac software, which now are being depreciated. Having said that, we are still doing a lot of development work on the Intui software, but that's related to Vascular.
EBIT ends at a solid 30.1%, up from 24.3% last same period last year, and ends at 63.1 million. Net finance is negative.
This is currency-related. Last year, that was very positive, also currency-related in the net 5.4.
Profit before tax for this quarter ends at 61.8, profit after tax ends at 47.8, 37 37 38% increase compared to same period last year, a solid quarter. Year-to year-to-date numbers: first time after three quarters that we are over 600 million NOK in revenue.
Also, when it comes to the gross margin, we are maintaining gross margin at the same level as we had last year at 82.1%, despite the tariff that we have in the US. In total, we have expensed 12.5 million of tariff expenses year-to-date September, and as we communicated earlier, the price increases in US would compensate for the additional expense that the tariff would would give us.
Salary and social expenses, we have the same type of explanation as for the quarter, only higher numbers. This is also the case for other operating expenses, it's the same type of activity that drives the expenses to a higher level compared to last year.
EBITDA ends at 33.4%, that's more or less in line with the accumulated numbers last year, which ended at 33.2%. EBIT ends at 30.2% versus last year 29.7%, and the operating profits increases from 150 just under 154 million to 185.5 million, this is also a record operating profit-wise after three quarters.
Net finance is negative. Norwegian krone is strengthening towards US dollars and euro, and that's why we get a negative effect of 3.2 million.
Profit before tax ends at 82.2 million, and profit after tax ends at 140.3 million, up from 121 million last year. Going further to balance sheet, intangible assets increases.
We have three major projects that contributes to that. It is the Adapt project, it's the Intui project, and also our IT infrastructure project.
Inventory levels are still high, although lower than what it was at the same time same period last year, but again we are securing critical components, and we expect going forward to have high inventory level levels as well. Accounts receivable are increasing due to higher sales, but at the same time we are improving our cash position quite positively, going from 100 million by the end of Q2 to 175 million 175.6 million in by the end of the third quarter.
As Kari mentioned, the board has authori- authorization to now decide quarterly dividends, and they did so at the board meeting yesterday, and the dividend of NOK 2.5 per share, which is totaling a total payment of just under 46 million, will then be paid out to our shareholders, and that payment will be in early November. Looking at equity, liability, we have as always a solid balance balance sheet with equity more than 71%.
Our obligations or long-term liabilities is related to lease contracts and extended warranties, we have no interest-bearing bank debt as such, and therefore we we we we have a very solid balance sheet in total with a very high level of equity. Earnings per share, some key figures: these earnings per share numbers obviously develop in line with the the profit and the positive development in profit.
Earnings per share ends at 2. 2.61 for the quarter and 7.
7.67 year-to-date. Cash flow: very positive cash flow for this quarter, and cash flow operation ends at positively at 91.5 million.
In addition to strong profit, we also have a change in working capital from going from the second quarter into the third quarter, which gives a positive contribution. Although, if we look at the year-to-date number, we we do have a an increase in working capital, which then af- affects cash flow from operation negatively, and cash from operation year-to-date ends at 146.5 million.
Investments are related to the projects I just talked about, and after after payment of dividend in May, net cash year-to-date is negative with 36.4 million, and going then going down from 112 to 175.6 million in cash by the end of September. Looking at the change from the second quarter to the third quarter, it's a very positive cash development in where net cash increases 75.5 million, going from 100 million to 175.6 million.
With that, I give the word further on to Kari. Thank you.
Kari Krogstad
Yes. Let's go through the various business segments here, and starting with the unit sales of our flow and imaging systems.
The flow and imaging systems is our flagship product, definitely, and it's a very unique product. We have no competition on this type of product out in the market.
It's the highest value, and therefore also highest priced product that we're selling. Of course, success in growing utilization and also new customers for this technology is vital for Medistim.
This quarter, we're seeing 27% increase in the number of flow and imaging systems compared to this quarter last year, and we're seeing that Americas is really taking the lead here with significant growth in number of units for the quarter. We also see that Europe, Middle East, Africa is showing growth here, while Asia-Pacific in this quarter is down by 4 units.
Of course, when we see continued high-volume sale of this high-value product, this drives revenue, especially when the growth comes from the Americas, where we are getting the best prices. This is something we are very happy to see.
Imaging probes, the probe that works together with this flow and imaging systems: this quarter, we are seeing strong quarterly sales in Americas, which is increasing 30% in units. In the same quarter, Asia-Pacific and EMEA is down with some units.
This points to quarterly variation that we're seeing, I would say, in all product categories and in all regions from quarter to quarter, and something that we need to keep in mind. If we move then further on to the flow-only systems in unit sales, here we're also looking at a healthy 22% increase in number of flow systems sold.
Americas is down by 3 units, of course directly related to the very strong growth in the flow and imaging units that we just talked about. Asia-Pacific, at the same level as last year, while EMEA is showing a good quarter with growth of 8 units.
Flow probes in unit sales growing 8.7% this quarter. This quarter Americas is seeing a slower quarter after several quarters of growth.
Asia-Pacific on the other hand showing very strong uptake on the probe sales, reminding that this sales is going through the distributor network in China, and not necessarily directly out to the end users. EMEA is at the same level as last year, but overall 8.7% growth.
Look at the business from the geographical side, starting with Americas, delivering 116.9 million NOK in revenues for the quarter. Then looking at the currency-neutral growth, that is 51.7%, extremely solid.
We saw that we have shown very strong sales in flow and imaging systems, also with very high following sales of imaging probe. This is of course the main reason and explanation why we're seeing this tremendous development for the quarter.
We also pointed to weaker unit sales on flow probes systems and PPP lease procedure sales, but this is also partly compensated by price increases. USA is accounting for about 95% of revenues from Americas, Canada is accounting for 4.5%, and was increasing 65% in the quarter.
Latin America is a very, very small region here. Diving a little bit further into the unit sales development in the USA, first starting with the system volumes, we saw that we had growth in units, especially on the capital sales, and for the quarter we have then sold 19 units, a solid growth over the same quarter last year, and we're pretty flat for year-to-date.
Year-to-date, we're seeing the effect of the increased flow and imaging unit sales, not only good for the quarter, but also very positive year-to-date. When it comes to total flow procedures, we're seeing negative development for the quarter, already alluded to the former quarters where we've seen very solid growth, and year-to-date we are looking at a 14.1% growth in number of flow procedures.
Also when it comes to imaging procedures, seeing solid growth for the quarter and also for the year-to-date. There is a lot of quarterly variations, and I think it's very important that we are always keeping the longer time periods in mind, and as these graphs are showing, the number of cardiac and vascular flow procedures sold per year in the USA has been growing very nicely, both on the cardiac side and on the vascular side, a little bit stagnation there on the vascular side, which is related to well, the dynamics around the Intui on cardiac and not being available for vascular and Ultimate systems so far.
Getting back to that later on. Asia-Pacific, 33.6 million in sales, currency-neutral growth of 44.6%, it's definitely China that is driving this growth.
Very strong quarter, 59.5% growth for the quarter, reaching 17.8 million. The sales are going through the local Chinese distributors, and we have to expect quarterly variations, I will not commit to this level of growth every quarter.
Very positive to see that Japan is starting to deliver, as we said in the former quarter, we are busy developing the pipeline, and have now started to sell the first systems into the customers in the Japan market. So, 35.7% growth to 9 million this quarter, and we are building momentum into the next quarters.
We see a weaker quarter sales from the other Asian distributors, down 8.4% this quarter, but looking at year-to-date figures, we're up 41.6%. Again, very important to always keep in mind longer periods development.
Europe, Middle East, and Africa delivers 36.9 million in sales, currency-neutral growth of 5.5%. A good quarter for our direct markets: Spain, Germany, UK, Scandinavia together delivers 14.8% in NOK for the quarter.
Sales through distributor decrease 17.5% for the quarter, but year-to-date, it's a similar growth actually. Again, always keep that in mind.
Third-party products, as already mentioned, 5.3% growth for the quarter, so that is taking this part of our business back to a more normalized growth rate. The third-party product portfolio sales is now making up around 11% of the total Medistim revenues.
Summarizing, we're seeing that the total Americas region grew 40.6%, this is then in NOK, it's not currency-neutral, this is in Norwegian currency, 40.6% for the quarter. We see that USA is definitely the driver here, but Canada is also contributing, and we're also seeing very positive development for the year-to-date period.
Asia-Pacific, 33% growth, we see that China is the driver, Japan is now coming as a great contributor for the third quarter, the year-to-date figures has not caught up yet, and then we see that the rest of Asia-Pacific, the distributors, have a bad quarter, but are delivering very well for the year-to-date period. EMEA in total flat for the quarter in Norwegian currency, showing 7.9% year-to-date.
Here we see that it's Europe that is really driving the development this year, while Middle East Africa is a little bit behind. This in total brings the total sales to the 25.9% growth for the quarter and 18.6% growth for year-to-date September.
Taking a look into the split of our cardiac versus vascular product portfolios, we see that we have very strong cardiac segment sales in this quarter, 35% growth in the cardiac product portfolio, also 31.4% year-to-date, definitely driving this. We're now starting to see that more and more of the systems that we're selling is with the Intui software inside on the cardiac side.
So 39% of all the MiraQ Cardiac systems sold this quarter was with Intui inside. If we look at the USA in isolation, as much as 80% of the systems were with Intui inside.
This will of course only continue to grow until all of our new sales of MiraQ Cardiac systems is with Intui inside. We're seeing the flat development on the vascular surgery side, and as also explained in the second quarter presentation, this is reflecting a temporary product mix effect, not a shift in underlying demand.
We are counting this to that customers, some of them who would otherwise have gone for an Ultimate system, now have been choosing a cardiac system with the Intui software, and that impacts the sales recognition, since a sale of a Ultimate system is divided 50% to cardiac and 50% to vascular. This is a temporary effect.
If we look at the total sales of our own products, split into the flow portfolio and the imaging portfolio, we see that the flow products is growing 15.4%, 22.2% year-to-date, but we are seeing that the imaging product portfolio is really coming back as the big growth driver for us, which is something that we really like to see, 57.9% for the quarter and 28.6% for the year-to-date period. While we have pointed to that it's really USA who's driving this growth, we are seeing growth of the imaging products in all the regions.
Closing off now with just looking at the split between recurring and capital revenue, and we're defining recurring revenues as revenues from sales of flow and imaging probes, PPP smartcards, and also lease contracts. We see that for the last 12 months period, the recurring revenues makes up 68% of the total.
Then, I would take the opportunity to this time talk about vascular surgery and our strategy to build a position within vascular surgery. Let me start by emphasizing how important engagement with surgeons and key opinion leaders is to build awareness, generating interest, and ultimately driving adoption of our technology.
Here, we can see the growth in publications featuring Medistim's technologies over the years across cardiac, vascular, and transplant surgery, steadily growing. The surgical community is truly global, with surgeons collaborating, sharing experience across borders, and this is reflected in the geographical distribution of the publications, and we see that Japan, the United States, Germany, and China is leading the clinical research.
When we compare the annual number of publications with our sales revenues, yeah, it seems to be some kind of correlation here. This is just to stress how important these clinical projects and collaborations is for developing our business, is really our key marketing investments.
I'd also like to highlight the REQUEST study, a registry study published in 2020 that demonstrated the clinical value of combining flow measurement with high-frequency ultrasound for graft assessment during CABG surgery. This study showed how our technologies provide real-time guidance, prompting surgeons to change their planned surgical approach in as much as 25% of the patients.
The REQUEST study also reported a very low rate of adverse events, and this study has played a pivotal role in driving the adoption of imaging. It's a similar transformation we aim to drive in vascular surgery through the PATENt study on peripheral bypass.
Peripheral bypass is our number-one target segment within vascular surgery, because it's a sizeable market segment, and it's a market segment where both the flow measurement and the high-frequency ultrasound are really really important technologies and tools to help in this surgery. Peripheral bypass is a revascularization treatment for patients with critical limb-threatening ischemia, CLTI, and the purpose here is really to reduce the risk of having to amputate a limb.
The timing for the onset of the PATENt study was really great, because there was a recent clinical trial that was finalized and published, really showing that while endovascular treatment has been the first choice for this patients, a recent study has shown that open surgery is a better alternative in certain patients. It really fits very well with an interest and a sentiment in this field right now where the surgeons are more open to also consider open surgical alternatives.
What is the PATENt study and why is it important? The situation today is that the clinical need for improved completion control is really there, because about 20% of peripheral bypasses fail within the first year.
There is no standard completion control existing today, while we know and experience that hospitals in the Nordic countries as well as Germany, they use both flow and imaging, but there's very little published clinical documentation on this. The purpose of this study was to document the clinical benefits of the combined use of flow and imaging, and then recommend a standardized protocol for completion control.
Objectives: the primary endpoint is graft patency rate at 1 year, of course we want to have a higher success rate than the current clinical practice is showing with the 20% of failing bypasses. The design of this study is it's a prospective, non-randomized, international, multicenter trial in 450 patients suffering from CLTI, which is an advanced stage of peripheral artery disease.
We're extremely proud of the investigator team for this study, and to also to have Professor Michael Conte as the lead investigator, who was the first author of the 2019 global guidelines on CLTI management. We couldn't have gathered, I think, a stronger investigator team for such a study.
Today, 14 sites are now actively enrolling patients, 5 more sites are in process. After a slow start, patient enrollment is now progressing very well, and is expected to be completed by the end of 2027.
Then there will be a 1-year follow-up, and this period will then run through the end of 2028, and then analysis and publication is expected to come in 2029. While we are waiting for the final results, we expect investigators to begin presenting and publishing clinical cases, sharing their experience with peers, and building awareness, interest, and desire among more surgeons to try our technologies, just as we saw during the REQUEST study.
This is a short update on where we are with the PATENt study right now, and I think with that, we can open up for questions.
Operator
We have a few today, too. The overall revenue from USA is showing impressive growth, but sales of flow probes and flow procedure sale were down for the quarter.
Can you comment on this development, and how do you see this developing in the future?
Thomas Jakobsen
Third quarter last year was a very strong quarter for probe sales, it's a very strong comparable, point one. The other thing is that we have a shift towards PPP customers towards capital, and the capital customers have a more random variation quarter by quarter, because when you buy a set of probes that includes more procedures than buying a stack of cards.
If you buy a probe, it's 50 times use; if you buy a card, it's one-time use. Therefore, you will see more fluctuation as such from quarter to quarter when it comes to the capital customers.
I think that in order to sort of have a good opinion about this, you can't just look at one quarter, we need to look at the trend as Kari was elaborating to throughout in her presentation in a longer-term picture, and I would look at year by year on how these things develop, and not just quarter by quarter. Having said that, for the third quarter, the good thing is that when it comes to the imaging products, we had a tremendous good quarter with strong growth in imaging and flow system sales, and actually of the 19 systems sold, 17 was imaging, the majority was imaging.
This is the opposite of what we've seen earlier in other quarters, where the majority is flow, and now we see gradually in the US a shift that most of the customers actually go for the flow and imaging systems. We're gradually building up our portfolio with the premium product.
Also what's nice to see in the third quarter is the good growth in imaging probes, which are the additional recurring revenue related to the flow and imaging product. Looking at year-to-date numbers, we have a growth in the US, underlying growth in volumes of around, I would estimate, around 10%, and that is based upon the probe sales of flow probes and also imaging probes in combination with the strong capital sales.
Operator
Another one on Americas. What is the growth in Americas and the group if adjusting for price increases in the quarter?
Thomas Jakobsen
When it comes to growth for the quarter and what's price and what's volume, it's a bit tricky one. On one side, on the procedures sale and flow probe sales, we have a decrease, but in revenue, it's an increase, so that's compensated by price increase.
When we look at capital sales, this has increased a lot for the imaging part, which when we sell imaging products gives us twice as much revenue compared to flow system sales, and when we shift from flow sales to almost being 100% imaging product sales, it gives us a good uptake in revenue, and when we, in addition to that, have 80% of that on the Intui software, which we also charge additional amounts for, this drives the growth. For capital sales, it's a nice growth, but on the utilization based upon procedure sales and flow probe sales, it's actually a decline in this quarter, but compensated by price.
Operator
Thank you. How much cost did you take related to ERP implementation and potential other nonrecurring items in Q3?
Thomas Jakobsen
ERP was, or the IT infrastructure project, was 2 million for the quarter, year-to-date it's been 6 million. Then when it comes to other nonrecurring, well, I can mention PATENt study.
The PATENt study will still go on in 2027, but it will have an end when the study is completed. As of year- year-to-date numbers, the additional expense for that project is 4.5 million, and around 1.5 million for the third quarter isolated.
Operator
Thank you. The next one is on deferred income.
Is deferred income item related to the software sales, or something else?
Thomas Jakobsen
It's related to system sales, and that's an extended warranty or guarantee on uptime on the system. If anything happens with the system, it's kind of like an insurance premium that we will either come out and fix it or replace it.
Operator
Thank you. Could you explain how you achieved such a great shift from 50/50 split in flow and flow and imaging systems sold in US a few years back to now mainly flow and imaging device sales?
Do you expect this to continue?
Kari Krogstad
Yes. The current growth that we're seeing from the imaging portfolio, first of all, it's coming, I would say, primarily from winning new accounts for the imaging technology, especially in the USA, but also in Europe, to lesser extent in Asia-Pacific so far.
We're also seeing that in the markets where we are direct, we tend to have higher success with winning with the imaging component as well. As we now establish ourselves in Japan, we are hoping to see and expecting to see also very positive development in an Asian country like that.
I think the major growth is really winning new accounts, but of course we're also working hard to grow utilization at our current accounts. We are seeing an opportunity to perhaps increase our engagement with the users that have sort of bought the technology and spend more time with education, provide more hands-on support at these current accounts.
We think that is going to be critical in order to see real uptake in utilization. We've actually launched just recently a sales campaign where we are providing more support to our customers, we have developed some new tools for sales reps to help them achieve this, among them a new Medistim app that I hope everybody will take notice of, we are very proud of it and we think it's going to be very useful for our customers, we're receiving very nice feedback already.
We're seeing also already that some sales rep seems to be successful in selling more probes into their accounts due to this sort of strengthening of both the messaging and the tools that we are providing to help the sales force. We will see more of this in the periods to come.
Operator
The next one is on China. China shows strong growth at more than 50% growth from 2025.
The report states that sales are still going through distributors and agents. As you have a local team in China, do you have plans of doing more direct business, or are you satisfied with the structure you have established?
Kari Krogstad
Yes. I think we are expecting to continue with the current setup, and we will continue to rely on the distributors and agents in China for various reasons.
We're also exploring the use of a digital purchasing platform in China to see whether this can really be meaningful as a transaction tool and enable Medistim to sell then directly to the hospitals. We already have a few sort of success stories from using this platform, but it's very early days, I cannot say to what extent this will be really impactful for us, but we are committed to investigate further and do more with that platform, and hopefully it will help us drive both the business and of course the margins if this is really taking off.
Operator
Thank you. The next one is as following: Congratulations on yet another strong quarter.
Considering the amount of data you collect, is AI useful for creating more value? Can it radically improve your systems over time?
Kari Krogstad
Is the question relating to our products or to our investigating the business? A
Operator
good question. I think it's more if AI can sort of be of help for Medistim.
Kari Krogstad
For the products?
Operator
Yeah.
Kari Krogstad
Of course. As a tool, in programming, coding, it's already one of the tools that we are using in the business in general.
I think we are, as everybody else, exploring what it can do for us, and already proven to provide important tools. We want to do more, and we are in early phase there as well.
When it comes to product development, we have actually done research on various aspects of how AI, machine learning can help us develop maybe even more value to the customers based on the same systems and sort of supporting and strengthening our tools to help our surgeons get answers to the same basic clinical questions. I can say, yes, we are looking into that, and it's a bit early to say when or how solutions based on machine learning will make an impact on the product side.
Operator
Thank you. Thanks for your hard work for the shareholders.
How is the opportunity pipeline looking for the near term for your main markets? Yeah.
Kari Krogstad
The pipeline, we feel our pipelines are always looking great. That's a short question.
I'm pointing to the UK, I'm not trying to joke here, but we have talked about the pipeline in the UK for years, and it has been looking very strong, although it has taken us a long time in the UK to actually materialize business from that pipeline. Now I can even point to UK being developing very nicely, doing very well so far this year, and we have achieved a decent market share even in the UK.
This is a sidetrack. I think when we look at our pipelines in general, especially of course in the direct markets where we have the strongest visibility, we feel we have strong pipelines.
Our problem is always to really assess the closure time for each of the product or projects that we are working on, and that this is proving a challenge always that we can see that some projects are stalling, while other and new projects are maybe speeding up. Exactly, closure time and those type of things, to be very accurate in our forecasting is difficult, but we feel very confident about the pipelines that we're seeing.
Operator
The next question is on the app that you mentioned. Could you elaborate on the app you mentioned?
What problem does it solve?
Kari Krogstad
Yeah. This is an app that takes the users, and when I say users, we're talking both surgeons and nurses, technicians that are helping the surgeons in the operating room to manage the ultrasound device, to introduce them to how to use the flow measurement technology, how to use also the imaging technology, and how to interpret the data.
It's filled with I would say, short videos and examples on how to use things. It's been developed in a very, very user-friendly, very appealing way, and of course it's been developed with the input of leading surgeons, and as I said, the feedback that we have received on that app is very, very positive.
Until now, we've had a web-based educational tool called EduQ, which is also a very important component of the training materials that we're providing, but is a bit more cumbersome to sort of enter into the EduQ system. Now with the app available on the phones, can be brought into the OR, always available to people, this I think can be a game changer for our users in solving simple problems and questions immediately in the operating room.
Operator
Thank you. Let me find...
How do you see the impact of Medicaid cuts in the US that start rolling in January?
Kari Krogstad
Yeah. What can we say?
Far we haven't seen a lot of that, but these are market factors that are imposed on the industry, and will be on Medistim as well. Our job is really to focus on what we have control over, and that is really how we are operating in the market, how our sales force are supporting our customers, what tools we are providing with them, and really continuing to drive the business in every way that we can.
Far, I think we have tremendous speed, and I think we have the opportunity to continue progressing.
Operator
I think we have to round off, but let's do a question on Intui first. When do you expect to release your Intui software for vascular?
Will this be a phased rollout surgery by surgery, or rather all main surgeries at once?
Kari Krogstad
Yes. The Intui software for vascular and then also the Ultimate systems are in sort of final R&D stage, but it will still take some time to get it all the way to the market.
Our aim is as early as possible next year. I don't want to commit to any further than the first half of next year, and our ambition is to launch it as soon as we can.
Yeah.
Operator
Thank you. That was the Q&A session.
Then
Kari Krogstad
we thank everybody for the participation this morning, and we will meet again for the fourth quarter presentation. Thank you.
Thomas Jakobsen
Thank you.
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