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Medistim — Earnings Release 2021
Apr 28, 2021
3662_rns_2021-04-28_073940c6-4ed7-465a-9c40-1a65c288e57b.pdf
Earnings Release
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Welcome to Medistim ASA's Interim report 1st quarter 2021
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Medistim ASA First quarter 2021
April 28th 2021

Kari E. Krogstad Thomas Jakobsen
PRESIDENT & CEO CFO

Disclaimer
The information included in this Presentation contains certain forward-looking statements that address activities, events or developments that Medistim ASA ("the Company") expects, projects, believes or anticipates will or may occur in the future. These statements are based on various assumptions made by the Company, which are beyond its control and are subject to certain additional risks and uncertainties. The Company is subject to a large number of risk factors including but not limited to economic and market conditions in the geographic areas and markets where Medistim is or will be operating, IP risks, clinical development risks, regulatory risks, fluctuations in currency exchange rates, and changes in governmental regulations. For a further description of other relevant risk factors we refer to Medistim's Annual Report for 2020. As a result of these and other risk factors, actual events and our actual results may differ materially from those indicated in or implied by such forward-looking statements. The reservation is also made that inaccuracies or mistakes may occur in this information given above about current status of the Company or its business. Any reliance on the information above is at the risk of the reader, and Medistim disclaims any an all liability in this respect.
Table of Contents


01 Highlights
Highlights 1st quarter
| Q1 2021 | % Q o Q | Q1 sales close to last year's record | |
|---|---|---|---|
| Revenue | MNOK 102.6 (103.1) | -0.5% | |
| EBIT | MNOK 29.1 (24.8) | +17.2% | |
| Currency | -4.9% | Currency neutral sales growth of own products: In the USA with 2%, while decreasing 8.6% in NOK o |
|
| No of units sold: |
In Asia with 3.4% o |
||
| Flow systems |
39 | -7.1% | While ROW were down 26.8% currency neutral |
| Imaging systems |
22 | -15.4% | |
| Flow probes |
1 774 | +6.0% | Vascularsales down 19.6% in NOK o |
| Imaging probes |
31 | -20.5% | Strong 3. party sales with 20% growth o |
Sales down by 0.5% in NOK, but currency neutral growth was 4.4%
o Improvement from Q2, Q3 and Q4 2020 which showed 19.3%, 9.7% and 7.2 % currency neutral decline, respectively
Currency neutral sales growth of own products:
- o In the USA with 2%, while decreasing 8.6% in NOK
- o In Europe (own products) with 4.8 % driven by strong sale in UK
- o In Asia with 3.4%
- While ROW were down 26.8% currency neutral
- o Vascularsales down 19.6% in NOK
- o Strong 3. party sales with 20% growth
Procedures (USA) 16 671 +10.8% Second best EBIT ever, margin up from 24.0% to 28.3%
LivaNova is new distributor in India as of January 1st
The General Assembly resolved to pay a dividend of NOK 3.00 per share

02 Financial Statements
Profit and loss Q1 2021
| Profit & loss | Q1 2021 | Q1 2020 |
|---|---|---|
| All numbers in NOK 1000 | ||
| Sales | 102 630 | 103 106 |
| Cost of goods sold | 22 801 | 23 075 |
| Salary and sosial expenses | 32 403 | 33 290 |
| Other operating expenses | 12 508 | 16 464 |
| Total operating expenses | 67 711 | 72 829 |
| Op. profit before depr. and write-offs (EBITDA) | 34 919 | 30 277 |
| EBITDA% | 34,0 % | 29,4 % |
| Depreciation | 5 853 | 5 493 |
| Operating profit (EBIT) | 29 066 | 24 785 |
| EBIT% | 28,3 % | 24,0 % |
| Financial income | 2 001 | 6 638 |
| Financial expenses | 3 216 | 3 930 |
| Net finance | (1 215) | 2 709 |
| Pre tax profit | 27 851 | 27 493 |
| Tax | 6 029 | 6 386 - |
| Profit after tax | 21 821 | 21 107 |
Sales per Quarter (TNOK)


Balance sheet – Assets
Cash position by end of quarter was MNOK 86,7
Securing end -of -life components, security stocks of components and lower sales due to COVID 19 resulted in increased inventory level
The General Assembly on April 27th decided to pay a dividend of NOK 3.00 per share based upon 2020 results
| Balance sheet | 31.03.2021 | 31.12.2020 |
|---|---|---|
| All numbers in NOK 1000 | ||
| Assets | ||
| Intangible assets | 32 045 | 33 464 |
| Fixed assets | 63 372 | 66 570 |
| Total intangible and fixed assets | 95 417 | 100 034 |
| Inventory | 114 128 | 112 667 |
| Customers receivables | 58 298 | 57 485 |
| Other receivables | 10 591 | 3 744 |
| Cash | 86 657 | 71 891 |
| Total current assets | 269 673 | 245 786 |
| Total assets | 365 090 | 345 820 |

| Balance sheet | 31.03.2021 | 31.12.2020 | |
|---|---|---|---|
| All numbers in NOK 1000 | |||
| Share capital | 4 585 | 4 585 | |
| Premium fund | 44 172 | 44 172 | |
| Other equity | 232 546 | 208 089 | |
| Total equity | 281 303 | 256 846 | |
| Total long term debt | 27 312 | 29 497 | |
| Total short term debt | 56 475 | 59 477 | |
| Total equity and liability | 365 090 | 345 820 |

Balance sheet – Equity and Liability
9.8 MNOK in interest-bearing debt, of which 6 MNOK is a U.S. Covid-related loan ('Paycheck Protection Program')
26.7 MNOK in obligations
related to lease contracts where 19.9 MNOK is long term
Strong balance sheet with 77 % equity ratio

03 Business segments update


Imaging probes and systems in units
Sales of imaging systems and probes show recovery from previous 3 quarters
Imaging probes in units

Imaging probes US imaging probes

Flow probes and systems in units
Number of flow systems down 7% from Q1 last year, but signs of recovery compared to the previous 3 quarters
6% growth in flow probes indicates that the surgical activity level is getting back to normal levels
Flow systems in units (MiraQ capital sales)


Flow probes in units (excl USA)


Q1 revenue performance by region
| Mill NOK | Q1 '21 | Q1 '20 | Q / Q | 2020 | 2019 | Y / Y |
|---|---|---|---|---|---|---|
| Europe | 44,7 | 40,8 | 9,5 % | 173,3 | 163,9 | 5,7 % |
| USA | 35,1 | 38,4 | -8,6 % | 126,4 | 136,1 | -7,1 % |
| Asia | 19,5 | 19,2 | 1,5 % | 46,8 | 41,8 | 12,0 % |
| ROW (MEA, CAN, SA, AUS) |
3,4 | 4,8 | -28,2 % | 16,7 | 22,0 | -24,2 % |
| Total | 102,6 | 103,1 | -0,5 % | 363,1 | 363,7 | -0,2 % |
- In Europe, Q1 sales of own products increased with 2.8% in NOK and 4.8% currency neutral. 3. party increased with 20.4% for the quarter.
- In the USA, currency neutral sales increased with 2.0% for the quarter.
- In Asia, currency neutral growth of 3,4 %.
- ROW continues to be a small sales territory for Medistim, with significant quarter to quarter variation.
Q1 2021 revenue performance by product
| Mill NOK | Q1 '21 | Q1 '20 | Q / Q | 2020 | 2019 | Y / Y |
|---|---|---|---|---|---|---|
| Procedures (USA) | 25,9 | 28,3 | -8,4 % | 99,4 | 106,7 | -6,9 % |
| Flow probes | 26,2 | 24,7 | 6,0 % | 92,6 | 95,0 | -2,5 % |
| Flow systems (MiraQ) | 13,1 | 14,1 | -7,3 % | 47,2 | 32,9 | 43,6 % |
| Imaging systems (MiraQ) | 15,5 | 17,4 | -11,2 % | 44,2 | 49,2 | -10,3 % |
| Imaging probes | 1,6 | 2,1 | -24,8 % | 5,2 | 5,0 | 4,4 % |
| 3rd party | 18,7 | 15,5 | 20,4 % | 67,5 | 68,1 | -0,8 % |
| Other | 1,7 | 1,0 | 74,9 % | 6,9 | 6,8 | 1,7 % |
| Total revenues | 102,6 | 103,1 | -0,5 % | 363,1 | 363,7 | -0,2 % |
- Procedure sale in the USA: The total number of procedures increased with 10.8%. Lower sales in NOK is explained by product mix and unfavorable currency.
- Flow probes: 6.0% increase in both units and NOK.
- Flow systems: About 7% decrease in both units and NOK, compared to our strongest quarter ever, and before COVID 19 affected the business.
- Imaging systems: 15.4% decrease in units, again, compared to a record quarter last year.
- 3rd party products: Strong start to the year with 20 % growth 16

04 Implementing the strategy
Medistim growth strategy
| Emerging high-growth economies (e.g. BRIC) |
3 | ||
|---|---|---|---|
| Developing Medistim markets (e.g. USA, UK, France) |
2 | ||
| Strong Medistim markets (e.g. Jp, Nordic, Germany) >50% CABG share |
1 | 4 | |
| CABG surgery (2 BNOK) |
Vascular surgery (>1 BNOK) |
Other open heartsurgery (1BNOK) |
GEOGRAPHIES
-
- Convert the routine Flow market to a Flow-and-Imaging market by establishing Surgical Guidance and Quality Assessment as the new standard of care through
- → Early adopter & KOL support
- → REQUEST study
- → Ease conversion from flow to imaging with MiraQ
-
- Achieve routine use of both Flow and Imaging by fighting ignorance, indifference and ease-of-use objections through
- → Clinical marketing, guidelines and educational programs
- → Product innovation for ease of use
- → Increased sales force capacity
-
- Offer an entry-level solution to reach emerging, price-sensitive, high-growth markets
-
- Build and strengthen position in vascular surgery
- → Dedicated system (MiraQ Vascular) & probes
- → Build position with societies and KOLs
-
- Expand our direct market coverage
APPLICATION AREAS
18

Sales expansion in the USA
Performance US sales
Revenues in USD increased 2.0% in Q1
- o Signs of recovery as COVID vaccination program is starting to show effects
- Total number of procedures was up 10.8% in Q1, a good indicator of higher activity level
- o Flow procedures up 11.3%
- o Imaging procedures up 8.5%
- Recovery of capital systems sales
- o 9 units for Q1 compared to 10 last year
- Continued growth in new customers
- o 10 vs 6 in Q1 last year

Number of procedures per year

Number of procedures per quarter 20
Medistim growth strategy
| Emerging high-growth economies (e.g. BRIC) |
3 | ||
|---|---|---|---|
| Developing Medistim markets (e.g. USA, UK, France) |
2 | ||
| Strong Medistim markets (e.g. Jp, Nordic, Germany) >50% CABG share |
1 | 4 | |
| CABG surgery (2 BNOK) |
Vascular surgery (>1 BNOK) |
Other open heartsurgery (1BNOK) |
-
- Convert the routine Flow market to a Flow-and-Imaging market by establishing Surgical Guidance and Quality Assessment as the new standard of care through
- → Early adopter & KOL support
- → REQUEST study
- → Ease conversion from flow to imaging with MiraQ
-
- Achieve routine use of both Flow and Imaging by fighting ignorance, indifference and ease-of-use objections through
- → Clinical marketing, guidelines and educational programs
- → Product innovation for ease of use
- → Increased sales force capacity
-
- Offer an entry-level solution to reach emerging, price-sensitive, high-growth markets
-
- Build and strengthen position in vascular surgery
- → Dedicated system (MiraQ Vascular) & probes
- → Build position with societies and KOLs
-
- Expand our direct market coverage
GEOGRAPHIES
APPLICATION AREAS

Distributor Agreement for India signed with LivaNova
India as a longer term growth opportunity
Distribution agreement signed with LivaNova

- Large market with ~ 100,000 CABG procedures annually (about half the size of USA)
- 7-8 % annual growth
- Price sensitive private hospital market
- o Cost of CABG \$ 2 000 8 000
- Medistim has <1% of the market

- 2-tier product strategy
- o MiraQ Ultimate for high-end
- o Replace SonoQ from 3rd party with MiraQ 'Entry-Level' for low-end
- Bundle deals with hospital chains
- Depending on strong distribution partner

The Indian market Medistim strategy LivaNova partnership
- Global medical device manufacturer
- Strong position in cardiac surgery with their heart-lung machines
- Targeting the same customers
- Good collaborative experience from Australia
- Representing Medistim as of January 1st 2021

05 The COVID-19 pandemic
The COVID-19 pandemic

Gradually decreasing impact of COVID over the quarters; illustrated by the currency neutral total sales:
- → Q2-20: -19.3 % vs LY
- → Q3-20: -9.7 % vs LY
- → Q4-20: -7.2 % vs LY
- → Q1-21: +4.4 % vs LY
No significant negative implications on Medistim
- o Healthy employees
- o Intact supply chain
- o Production running as normal
- o Cost containment
Currency neutral sales in Q1 2021 beat the best sales quarter ever
Not quite back to normal
- o Lock-downs, travel and hospital access restrictions
- o Hospital resources and capacity still treating, and keeping ready for, COVID-19 patients
- o Elective surgeries are still being postponed in some countries
Continued positive development is taking surgical activity back to normal levels
- → Vaccination program accelleraton
- → Improved handling of the COVID situation
- → Increasing pressure to treat patients on waiting lists
- → Increasing confidence from patients to seek medical care

Shareholders list per April 26th 2021
| Rank | Name | Holding | % of total | Country | Type of account |
|---|---|---|---|---|---|
| 1 | AETERNUM CAPITAL AS | 1 862 500 | 10.2% | Norway | Ordinary |
| 2 | VERDIPAPIRFOND ODIN NORDEN | 1 800 000 | 9.8% | Norway | Ordinary |
| 3 | INTERTRADE SHIPPING AS | 1 285 000 | 7.0% | Norway | Ordinary |
| 4 | SEB EUROPAFOND SMABOLAG | 1 032 794 | 5.6% | Sweden | Ordinary |
| 5 | FOLLUM CAPITAL AS | 970 000 | 5.3% | Norway | Ordinary |
| 6 | State Street Bank and Trust Comp | 929 229 | 5.1% | USA | Nominee |
| 7 | SWEDBANK ROBUR SMABOLAGSFOND NORD | 800 000 | 4.4% | USA | Ordinary |
| 8 | Skandinaviska Enskilda Banken AB | 643 905 | 3.5% | Denmark | Nominee |
| 9 | State Street Bank and Trust Comp | 415 227 | 2.3% | USA | Nominee |
| 10 | State Street Bank and Trust Comp | 414 226 | 2.3% | USA | Nominee |
| 11 | SEB NANOCAP | 409 723 | 2.2% | Sweden | Ordinary |
| 12 | SEB European Equity Small Caps | 384 785 | 2.1% | Luxembourg | Ordinary |
| 13 | FD INVT TR: FD SRS INTL SML CP FD | 382 845 | 2.1% | USA | Ordinary |
| 14 | BUANES | 379 936 | 2.1% | Norway | Ordinary |
| 15 | SWEDBANK ROBUR MEDICA | 335 000 | 1.8% | USA | Ordinary |
| 16 | Danske Bank A/S | 258 310 | 1.4% | Denmark | Nominee |
| 17 | MONTANARO EUROPEAN SMALLER COMPANI | 250 000 | 1.4% | UK | Ordinary |
| 18 | TIN NY TEKNIK | 238 314 | 1.3% | Sweden | Ordinary |
| 19 | BNP Paribas Securities Services | 236 210 | 1.3% | Italy | Nominee |
| 20 | Danske Invest Norge Vekst | 228 000 | 1.2% | Norway | Ordinary |