A very good morning from a sunny Oslo, and welcome to Medistim's presentation of our first quarter 2026 financial results. My name is Kari Krogstad, and together with CFO Thomas Jakobsen, we will together take you through the results.

Before getting into the highlights, we like to start these presentations just reminding ourselves on Medistim's track record, and also just highlighting that our growth over the past 10 years in sales has been close to 11%, and on our EBIT, we have been growing close to 15% over the past 10 years in a CAGR way. That's a reminder of our promise to continue to deliver profitable growth.

Let's now dive into the first quarter. I'm very happy to being able to present another record sales quarter from Medistim.

For the first time, we are exceeding 200 million NOK in revenues. That means 11.1% growth in NOK.

We can see that we have some negative currency effects here, if we adjust for this, we will see that the currency-neutral sales development is actually up at 18.5%. Further, looking at sales of our own products, which is, of course, the strategic product portfolio and the most important part of our business, we see that this is up a solid 28.8%.

All regions are contributing to this result. Americas is up 30.9% currency-neutral this quarter, EMEA up 11.5%, and Asia-Pacific have a tremendous 57.5% growth.

We're also noting that our third-party products is down by 30.2%, and we will remember that the beginning of last year was very, very strong due to sales to new hospitals in Norway, and we couldn't expect that to be repeated in this quarter. When we look at the EBIT at 57.1 million, that is also a very, very strong operating result.

It's actually the second-best operating result ever, just beaten by the same quarter last year. If we are adjusting for currency effects here, we would actually see a close to 4% improvement in the EBIT for this quarter.

We know that the US tariffs is making an impact this quarter, impacting our gross margin, and that's also of the EBIT margin. The margin remains strong at 28.3%, a little bit lower than the same quarter last year, but still at a high level that we would like to see, of course, very much driven by strong sales of our own products.

We will note and have some explanation to some higher operating expenses this quarter. Of course, some of that is connected to the establishment of the direct operation in Japan.

We are also seeing higher activity levels throughout our sales organization, which is a very deliberate effect that we want to see, and we're also taking some expenses on an IT infrastructure upgrade. The General Assembly yesterday decided that we will pay out a dividend of 8 NOK per share, so that will be a total of 146.2 million.

With that introduction, I will leave the word to Thomas.

Thank you very much, Kari, and good morning, everyone. I will take us through the first quarter profit and loss, balance sheet, and cash flow.

Going directly to the profit and loss, Kari will take us through total revenue splits per region and per product, I will not go into that detail. However, we do have a weaker gross margin in percent this quarter, and this is explained by our sales channels.

We have communicated before that our margin is very much dependent upon the sales channel we are selling through, either through distributor network or if we're direct in a market, and there's also variances between different regions. For this first quarter, relatively speaking, we have a strong sales through our distributor network, but we also have very strong sales to our APAC region, which affects gross margin and gives us a little bit weaker gross margin as such.

Not much, but it is a little bit lower than our margins in the US market. Also, what Kari mentioned is the tariff.

The US tariff was not implemented in the first quarter 2025. We have full effect of that in 2026, and it amounts to 5.1 million, and that was an expense, obviously, we did not have last year.

Salary and social expenses are at the same level, more or less, as last year, but we do have additional operating expenses this quarter, and that's related to a lot of activities which Kari has touched upon. We do have this IT infrastructure project, which we also spoke about in the fourth quarter, and in this quarter, we expense 1.5 million related to that project.

We also have the establishment of our direct operation in Japan, and that has added another 1.5 expenses to our P&L. We also had recruitment expenses.

We recruit and grow the business continually, and the recruitment expenses for this quarter was 1 million higher compared to last year. Last but not least, we do have a high level of commercial activities, which was 3 million higher this quarter compared to last year, and it's very much travel and face time with customers we're then talking about.

Last but not least, we also have an agent commission for this quarter. This is not very normal in Medistim because we either sell through distributor or our direct sales network.

However, some hospitals require that they have a contract directly with Medistim, and that's happened this quarter. These contracts are then controlled through letter of credits, then which controls the cash flow from the hospital to the manufacturer, and also controls that the hospital are actually getting the delivery and secure the delivery that they've been promised.

This happened in the first quarter, and then we have an agent commission then of 2.1 million, which are then the return commission to our distributor for the services that they provide. Given all this, our EBITDA ends at 63.3 million, a little bit weaker than first quarter last year that ended at 64.7.

Depreciation increases. We do have additional lease obligations, which is the reason for the increased depreciation, and our operating profit ends at 57.1 million and an EBIT margin of 28.3%.

That's weaker than the first quarter last year, but I think, look at the big picture, that the fiscal year 2025, our EBIT margin was 28%, we are well in line with what we've communicated earlier that our EBIT margin should be in the high-20 area. Net finance is negative.

We have experienced a strengthening of Norwegian krone, especially towards US dollars, but also towards euro, the net effect of finance is negative by 5.5 million. Profit before tax then ends at 51.5 million, and profit after tax ends at 40.3 million.

Looking at our balance sheet, our intangible assets increases. We have two major development projects ongoing, which are recognized as an asset in our balance sheet, but we also have this IT infrastructure project, which I mention in the P&L.

Basically, what we're doing with the IT infrastructure project is that mainstream code and setup are expensed, and Medistim unique code and setup is recognized as asset, it's a combination of those two. Inventory level, same level as at the end of the year, the increase in our working capital is related to accounts receivables that increases from 86 million to 104 million.

Cash position is solid, ends at just under 210 million, a little bit below the cash position by the end of the year, and I will comment that a little bit further later on in the cash flow statement. Equity strong, ends at 70 over 74%, and we have no interest-bearing bank debt, haven't had that for many years.

Our long-term liabilities are related to two things: we have lease obligations of a total of 46.2 million, where 11.6 million is short term, and the deferred revenues is extended warranty contracts, 2 to 3-year contracts, which then revenue are then recognized over that time period. All in all, we do have now decided that we are going to pay out a dividend, and that will be paid, I think, estimated 18th of May.

That will obviously affect our equity when we are then closing the second quarter, 146 million, will then reduce our total equity and equity percent, but it's still a solid equity as such. Earnings per share, still solid, more than 2 kroner, Norwegian kroner, per share this quarter, and we do have also a strong equity position, as you can see, 70.9% by the end of the year increased now to 74.3.

Cash flow: we do experience that our cash flow from operation is relatively weak this quarter, and there are reasons for that. We have prepayments of income tax of 14.1 million.

We do have the increase in working capital related to increase in our accounts receivables, but we also have what is called here other, which are accrued expenses in 2025 that we now have paid out in the first quarter. A lot of this is related to commissions and also yearly bonuses that has been achieved based upon the results that Medistim delivered in 2025.

Net cash flow operation is then 7.2 million. In addition to that, we have investments related to our development project and the IT infrastructure project, and also we have paid lease obligations of 2.9 million, net negative cash flow is then 2.3 million, which then leaves us with a cash position pretty much the same as we entered the year into with, 210 million.

With that, I leave the word to Kari. Thank you.

Yes, and let's then dive into our business segments update, starting with the flow and imaging systems sold in units. This is obviously our most important part of the product portfolio, since it's our absolute unique product offering.

We are the only company out there providing a combined flow measurements and high-frequency ultrasound technology in the same system, which is providing really high value both to cardiac surgeons and to vascular surgeons. As we are selling this product as about double the price of a flow-only system, this is very important for us to see a continued uptake and adoption of this technology.

For the quarter, we see it's a good quarter for us. We sold 28 systems this quarter.

EMEA and Asia-Pacific sold more than the same quarter last year. Americas down by four units this quarter.

These typically vary from quarter to quarter, but all in all, a strong quarter for flow and imaging unit sales. When we are selling these systems, the imaging probe sales tend to follow, and we've also seen, therefore, strong imaging probe unit sales this quarter.

Here, Americas is up by two units, EMEA up by seven, and Asia-Pacific down by one unit. When we look at the flow-only systems, it's also very reassuring to see that this is also growing.

Strong flow system unit sales this quarter, up eight units quarter-over-quarter. Americas is up, EMEA is a bit down here—we recognize that they had higher flow and imaging sales, this tend to sort of level out a little bit—and then we're seeing that Asia-Pacific grows by 10 units this quarter, and this is very much driven by growth in our sales to China.

When it comes to flow probes in units, we see that this is a very strong continuation of growth here, up 27% this quarter, and really strong contribution from all the territories. As we know, that the strong capital system sales are driving the probe sales across all of these regions.

Looking a little bit more into the regions, starting with Americas, Americas this quarter delivered sales revenues of 84.8 million NOK, and if we adjust to the same currency as we had last year, we look at an underlying growth of 30.9 for the quarter. As we know, the US is the majority of Americas, and looking at US in isolation, the currency-neutral growth was 33%, and we have increased our prices significantly in the US, and the growth this quarter, we see that about 50% of the 33% is coming from price increases.

It's then very reassuring to see that we have good system volume sales as capital, although not as high as the same record quarter last year, and also very strong flow probe volume growth at 46%. Canada has a little bit weaker quarter in the beginning of this year, while the Latin American distributors delivered a strong quarter, but of course from a much lower base.

Diving a little bit further into the US, we can see here in the table system sales and also the placements on PPP or lease contracts, and the total number of units that we have then sold or outplaced this quarter is 14 versus 18 last quarter last year. We're seeing this fewer number of systems sold, but we also see strong sales of consumables to the capital customers.

If we look in the second table, the number of procedures from flow probes to capital customers, we see that that is growing by the high 35%. We're also seeing very high growth of imaging probes to capital customers of 15%.

New customers are increasingly coming in as capital accounts, and we also see that some of the current PPP or lease customers tend to convert to capital. This is a trend that is continuing.

To the right in this slide, we have split out the flow procedures, splitting out the cardiac part of these procedures and the vascular part. Now we can follow the development of flow procedures to cardiac, here highlighted in orange, either by year or by quarter.

This means that it's very easy to calculate the penetration or the adoption of our technology in the US in CABG. The cardiac number for 2025 is about 80,000 procedures, and then considering a market of around 200,000 procedures, that leads us to a share of 40% covered by Medistim in the US CABG market.

Hopefully this will be useful to follow going forward. Moving on to Asia-Pacific, here we're delivering 42.7 million in sales.

Making this currency-neutral, the increase is actually 57.5%, and we see that the sales to China is making up the majority of this and growing as high as 74.6% for the quarter. We have continued to explain that we have to expect quarterly variations in our sales to China, because we do have, of course, sales office with our own staff, but we still rely on local distributors and agents, and that will inevitably result in some quarterly variability.

Japan, it is a new era for us in Japan, and Q1 was the final quarter where we're selling through a distributor there. It was on the low side at 2.7 million, much lower than the same quarter last year, but this also means that there will be no inventory build-up in the distribution channel, as we saw in China when we went direct there.

We know that when we are starting to sell from the second quarter onwards, that will be through our own team, and there should be no unexpected inventory issues going forward. We also see this quarter quite strong contribution from the other Asia-Pacific distributors, up 105% and contributing then in total with 14.7 million.

In Europe and Middle East, the region delivers 52.1 million NOK in sales in the first quarter. Currency-neutral, this corresponds to an increase of 11.5%.

We note that our direct markets delivered sales in line with the prior year, no big change there, while the distributor sales is actually providing the growth contribution this quarter, going up 26% currency-neutral. Just thinking back at the EMEA performance also through 2025, varying quite a lot, direct markets from time to time contributing very strongly and in other quarters a bit weaker.

I expect to see a bit variation going forward here as well, but really good news that we in the first quarter are already growing by 11.5% currency-neutral. That's very encouraging.

The third-party products, as mentioned in the introduction here, the revenue is down 30%, and we are reminded that the first quarter last year represented an exceptionally strong comparable because we sold a lot of ophthalmology products to two new hospitals in Norway, we could not plan for or expect to repeat that sales in this quarter. Other than that, we have a highly diversified product portfolio, and it's Mentor, Care, and AMI, which are the biggest contributors in the whole portfolio.

This table is just summarizing the growth in NOK from the direct markets and also from the distributor parts and regions, I will not go through the details here. Of course, we are following closely the development of the vascular sales, since this is the new market that we are establishing a position in.

In this specific market, we see that growth is, yeah, missing in the vascular segment. It's just 1% up from the same quarter last year.

We see that the cardiac sales growth was 24.5, really at the high side, and is then, of course, responsible for being the driver of the total growth this quarter. Still, vascular sales is accounting for 17% of our own product sales, it's not a bad proportion.

It was a little bit higher than when we looked at the 2025 numbers. Here we are just expecting the vascular growth to continue and, yeah, going forward will be in line with what we've seen in previous years.

We also follow the split of flow portfolio versus the imaging product portfolio closely, and we can see this quarter that both the flow products and the imaging products are contributing nicely to the total growth, 23% from the flow products and 12.6% from the imaging products. That is a solid performance as well.

Closing up here now, taking a look at the recurring versus capital revenues, and we can see that this quarter we are seeing 20% growth in our recurring revenues, which is quite in line with also how the capital revenues are growing. The last 12 months takes us to a 70% share of recurring revenues of the total, which is quite in line with the historic levels.

Then a few comments on our strategy. Just to go through this really quickly, we have a strong position in the coronary bypass segment, the cardiac segment, and we have some markets with really high market share with our Medistim technology: Japan, China, the Nordic countries, the German-speaking countries, and other European countries as well, with really high share, up to 80 to 90% of the procedures covered.

Here it is important for us to continue to convert the dominant flow-only installed base to a flow and imaging installed base. This is gradually increasing and ongoing.

We are also working to grow our adoption in what we regard as underpenetrated markets, including the US at 40%. Of course, it's growing, but still regarded as underpenetrated in our view.

Clinical marketing, the studies that we are doing, really critically important in order to get that traction. Flexible pricing and business models are important in some particular areas.

We've mentioned India before. There are other areas also where we are finding different business models and ways of making our products available and affordable to the customers.

That's part of our strategy. As I mentioned, building a position in vascular has been a focus for quite some time already, and we are getting traction there.

Last but not least, to expand our direct market coverage and getting closer to customers, that leads us into the change that we announced the 2nd of February this year, that we're opening our direct sales office in Japan. As of 16th of March, we are direct.

We have now a very solid team in place. We have 10 employees there and a very experienced leader with background from the vascular area, which is really very important and provides optimism in terms of breaking into a vascular market also in Japan.

We know that Japan is the strongest market for us in terms of market penetration. 90% of the CABG surgery procedures are already supported with our technology, and the question is then how to continue this growth.

By getting closer to the end users, we want to get higher traction of the conversion from flow-only systems to flow and imaging systems. Of course, we get the, let's say, the one-off effect of capturing the distributor margin, so that's also important, and then we will then seek to untap this potential from vascular procedures as well.

Last year, we had sales through our Japanese distributor of about, yeah, 21 million NOK, and that gives some idea about what we could expect for this year, taking into account that the distributor margin would be now going to Medistim. As also mentioned in the previous quarterly presentation, but related to the first quarter, I want just to remind that we are now sponsoring a new randomized clinical trial in CABG surgery, the so-called SMART-FLOW trial.

Being a large randomized clinical trial comparing the use of flow technology versus no use of flow technology, this could be a breakthrough into providing the evidence to make our technology being eligible for guideline inclusions in the United States, which is the country where we are lacking that kind of support. The lead investigator of the trial, Professor Mario Gaudino, well-known, really one of the, well, I would say, the stars on the CABG heaven at this time.

He was also the first author of the Circulation paper that we have been referring to many, many times, which is a absolutely critical consensus paper stating that this group of highly renowned surgeons are saying that TTFM should be used in every CABG case. This paper is also concluding that there is a lack of randomized clinical data, and this is now the project that they want to go through.

We know that the first patients have been enrolled in this trial. It is going to be 1,242 patients enrolled, and there will only be MiraQ flow measurement system that will be used, that will be mandatory, and then we will, of course, also encourage the surgeons to use the imaging component, while this is not mandatory.

It will be a, yeah, a relatively big trial with 20 centers in US, Canada, Europe, and Asia, good coverage there. The goals of the study, to begin with, is to determine whether TTFM reduces the rate of graft failure.

This will be checked within one to three months of the surgery, and it's going to be documented by coronary CT angiography. Then the idea is that this provides a platform to continue the study and evaluate the impact of TTFM on the longer-term clinical outcomes.

Then we're talking about myocardial infarction, repeat revascularizations, survival, and quality of life. These are the outcomes that are relevant for guidelines consideration.

We really believe and hope that the whole platform study will be prolonged into this long-term clinical outcomes study. Exciting days.

Our involvement here, of course, it's a scientifically independent trial, but we are making a limited financial contribution of US dollar 500,000, which will be supporting the study over the course of the trial. At the side of, of course, the main objective, which is to provide this evidence, is also providing us with an opportunity to facilitate upgrade of the imaging at the sites that are currently not imaging users.

That's a, let's say, a very interesting business opportunity. Then we will also encourage and help the centers to get hold of the newest INTUITT software, this is also a great opportunity.

Yes. Then, I think we can open up for questions.

Yes, absolutely. I think the moves we made in Asia-Pacific, first by establishing our own team in China, and going through a little bit of a rough patch in the early days there with some, yeah, some distribution channel issues, we now see that we are really getting a return on that initiative and investment.

It was really encouraging us to move forward also with going direct in Japan. Then Asia-Pacific is, of course, many other interesting countries and opportunities, and we've highlighted India as one of the next big growth opportunities in the territories, and that will also be a region where we will be, yeah, be placing, I guess, more resources and give more attention and continue the great collaboration we have with LivaNova in that territory.

Yes, Asia-Pacific is the runners-up for driving growth for Medistim. Americas and US in particular will continue to be the major and foremost growth driver also in the sort of near term or the next few years.

Answer for that, Kari?

Yeah.

Of the increase of just over 10 million, I would say around 5 million are one-off expenses. That is related to the IT infrastructure project that will be a project that we will finalize during the year.

We also have this agent commission, which are unusual, 2.1 million. In addition to that, I would say that the establishing of the Japanese office around 1 million are one-off expenses.

Going forward, we will still have that operations ongoing, but this is kind of like a one-off to establish everything. Those are the one-offs.

The recruitment, Medistim is growing, we will always recruit, so that will be ongoing. It could be timing related to that when the expenses are coming.

Our commercial activities are something that we are actually driving to make sure that our sales force are getting out there and make sure that they have the face time with the customers. Around 5 million, I would say are one-off expenses.

it's actually very simple. We do not speculate in currency.

That means that most of our cash coming in in US dollars and euros are then converted to Norwegian krone as they come into us. However, we do have some hedging contracts that we enter when we do see that the currency is favorable for Medistim.

In that sense, we are a little bit speculative, but in general, it's more like a spot conversion to Norwegian krone. This has been the case for Medistim in many, many years.

We try to make hedging contracts in order to reduce the risk, but we do see that whether you do that or you enter or convert on spot currencies, all in all, you could lose or gain regardless. If we do have a secured cash flow for a large project, it makes sense to have a hedging contract, because you know then you will have an amount of euros or US dollars coming in.

Our cash flow is not like that. It's more a random cash flow stream that comes into Medistim, and therefore, it's a little bit more difficult to plan that in that sense.

I can perhaps say something about that. As we know, we had a tremendous year last year, the first quarter and maybe a bit into second quarter as well, we provided a very strong result and growth for the third-party portfolio last year.

Going back, it has been a lot of variation, but I would say maybe the growth rate has been around 5%, so much more moderate. I think in sort of a normal circumstance, it's probably around there that expectations should be.

There's no real changes that we're seeing. We have a solid portfolio of products.

We are managing those, working closely with the suppliers that we are serving, and we're also seeking new agencies on a regular basis. I'm very happy with the third-party team that we have.

They're operating a lean organization, providing good margins on their work. I'm expecting that to continue sort of in the more historical levels.

What we've seen throughout the years is that our own products are increasing more than third-party products, and as we do that, the gross margins increases in percent and also the EBIT margin. To answer that, we do have in our reports the split of the segments, sales of our own products and sales of third-party products, and based upon that split, you could see what margins are to be expected from sales of our own product and EBIT margin as well.

The thing, though, that could affect it is that if we continue to grow, and that is expected in our direct markets, these margins will actually continue to grow as well as we shift more business from direct operation compared to distributor operation.

Yes, we have mentioned that one of the projects that we're working on has been to, well, redesign our probes, making them possible to automate, and that part of the project has come to, well, almost a conclusion. We are in the phase of sort of looking into various options on how to actually move forward with that automation.

I can't give very specific information about that, but this is a very important and critically project for us. We want to make sure that we have really a future-proof production process that not only provides improved COGS levels for us, but are securing the high volumes that we will be needing to supply the market with when we are fulfilling our growth objectives.

It's moving forward, and we will give more information when it's becoming more concrete. Then

Thank you.

Thank you very much, and we look forward to the next encounter. Thank you.