Dynavox Group AB (DYVOX) Q2 2026 Earnings Call Transcript

All right. Good morning. It's nine o'clock. Welcome to this earnings call where we'll cover the second quarter in 2026, summarizing our business in April, May and June. And I am Fredrik Rubin. I'm the CEO of Dynavox Group.

Hello, I'm Linda Teibring and I'm the CEO of Dynavox Group and I will cover the financials in more detail.

Great. So for those of you who have participated in these calls before, you will be familiar that we will start with a quick recap about what Dynavors Group does. Then we will summarize the main takeaways from the quarter. Linda will, as she said, dive deeper into the financials and will thereafter have a Q&A session. And you can submit questions during the Q&A session in the Q&A function here in Teams. Or you can ask them live by raising your hand in Teams and unmute yourself, and then we invite you to speak. And we, of course, always welcome offline questions sent by email to the above email address, which is linda.tybring at dynavoxgroup.com. But let's start with a brief overview of the Dynavox Group. So first and most important is to reiterate our mission and our vision, which I know is very dear not only to our now over 1,000 colleagues around the world, but also to our ecosystem of partners and investors. And our vision is a world where everyone can communicate. And we will contribute to this via focusing on our mission, which reads that we are empowering people with disabilities to do what they once did or never thought possible. And this also summarizes two of our main user stories. The first one, the do what you once did, that may be the person who led a normal life until a diagnosis such as ALS, which rendered her unable to control the body or communicate like before. And the other one, the never thought possible, that can refer to the child diagnosed at a very early age with a condition such as autism or cerebral palsy, where thanks to our solutions, she can do much more than the world around her ever thought possible. And on the picture here to the right, you see Linnea, a 12-year-old girl from Gothenburg in Sweden. She was diagnosed with cerebral palsy, and she's a great example of this. And some may know that Linnea was the keynote speaker at the Women in Tech conference here in Stockholm earlier this spring with our colleague Grit. And thanks to our solutions, she was able to fulfill one of her dreams, was to give a lecture about assistive communication in front of thousands of people. And Linnea has been a user of our products since she was about two years old. The market that we serve is hugely underserved. Some 50 million people have a condition so grave they simply cannot communicate unless they have a solution like ours. And every year about 2 million people are being diagnosed. And yet we estimate that only some 2% of those are actually being held and the rest literally remain silent. And the main reason for this spells lack of awareness, also among the professionals and the prescribers that are tasked to assist these users, combined with a poor healthcare reimbursement system. We operate with a global footprint. Today, almost three quarters of our business stems out of the US, largely because of a reasonably well-functioning funding system established some 20, 30 years ago. Our comprehensive solutions are sold in more than 65 markets around the world, of which 12 are markets where we sell directly, while the others are served by a network of some 100 plus reseller partners. Our own staff is distributed in a similar way as the revenue, meaning some 50 percent of our staff are based in North America with our U.S. headquarters in Pittsburgh in Pennsylvania. and our second largest office is our headquarter here in Stockholm but we have branch offices in several European countries as well as in Suzhou, China, Adelaide, Australia and as of today we are a little bit more than 1,000 employees in total. We provide what we refer to as a comprehensive portfolio of solutions and they range from the content and the language system such as the world's leading library of communication symbols, they're called PCS symbols, and a leading solution for off-the-shelf or custom-made synthetic voices of the highest quality with a large diversity in terms of languages, ages, ethnicities, and so forth. Moving on, we also make highly sophisticated communication software that is then tailored to the type of user which can vary greatly based on the needs of him or her. We develop and design devices, hardware with cutting-edge technology and medically certified durability, including communication aids that can be controlled via eye tracking, but also accessories such as the re-adapt mounts. we have a services portfolio to help our users through the complexity of obtaining and getting funding for the for their solution and last but not least we are there to help our users the therapists the caregivers and everyone through our global teams of support resources we operate this model on globally and it's important to note that each piece in this is critically important and also a significant differentiator for us, making us absolutely unique. Our go-to-market model is predominantly as prescribed aids. That means some 90% of our revenue comes from either public or private insurance providers. But this also means that we have solid paying customers, but also have been resilient towards changes in the overall economic climate. But now we will go back to focusing on the main topic of today, namely our earnings report for the second quarter, 2026. If we look at the highlights, we deliver a solid year-on-year revenue growth in the second quarter. Revenue grew globally by 16% after adjusting for currency effect compared to the same quarter last year. And if we recall, last year's growth was an exceptional 38%. The demand for our solutions remains high, proving the solidity of our underlying business, and we see a robust underlying growth across all markets where we operate. The revenue in North America benefited partly from delayed orders from Q1. However, this positive effect was offset by what we see as overall longer prescription processes compared to before. So the consequence of that is that it leads to longer handing times, but there's not less opportunity out there and there is no deteriorated policies or reimbursement, just longer lead times. And in the light of that, it is reassuring that the operating profit more than doubled compared with the same quarter last year and came in at 105 million sec, a 130% increase to be precise. The global rollout of our new ERP system that has been long in the making is now successfully concluded for all our main legal entities. In Europe, we continue to strengthen our local presence and our commercial execution. And on April 1, we completed the acquisition of our Italian reselling partner SR Labs Healthcare, and we welcome new colleagues to the team. A new health economic study focusing on the U.S. was released and that shows that high-tech assistive communication solutions like ours significantly improves quality of life for people with disabilities while delivering clear economic benefits to society. In summary, quality of life for users improves by 65% and pays for itself more than three times over. And this study confirms what previous has also been seen in similar studies conducted in Sweden and in Germany. During the quarter, we filed a lawsuit in the US against AbleNet. Our objective here is to protect our intellectual property and to address alleged practices that, in our view, risks confusion around delivery, support, and reimbursement of assistive communication technology. And then last but not least, we announced in the quarter that Jakob Thordenberg has been appointed the new CFO for Dynavox Group, and Jakob will join in September this year. Linda, who you will meet soon, will remain in her role until Jakob joins and will then be available until January 2027 the latest to ensure smooth handover and support his onboarding. So now I hand over to Linda to take us deeper into the financials. Thank you, Fredrik.

Let's take a closer look at Q2 financials. Revenue for the second quarter came in at 670 million sec, a 16% year-on-year growth after adjusting for currency effects. Recent acquisition contributed with four percent and the organic growth was 13 percent. Currency fluctuations had five percent negative impact on revenue. Sales continued to grow across all markets. In North America, as Fredrick already mentioned, we recovered part of the delay orders from the first quarter. However, the positive effect was offset by overall more drawn out prescription processes compared to before. This is partly driven by a higher number of users changing insurance provider at the beginning of the year, resulting in additional administration, and we continue to navigate the complexity and bureaucracy of reimbursement processes, which remain a recurring feature of our markets and a headwind during the quarter. The gross margin ended up at 70%, an increase of 2.6 percentage points. Gross margin benefited from favorable currency effect of close to 1 percentage point and lower freight costs. This was partly offset by higher component costs. EBIT increased by 137% to 105 million SEC, corresponding to an operating margin of 15.7%. Currency adjusted EBIT growth was 145%, our OPEX increased by 5% organically. The OPEX increase relates mainly to continued investments in sales and marketing staff, but also within our IT organization. During the quarter, we continue to invest in our systems and tools, including our new ERP platform to strengthen scalability. And now we've successfully rolled out the new ERP in all our main legal entities. These non-recurring investments totaled to 6 million SEC, a decrease of 12 million SEC year-on-year. Acquisitions contributed with 17 million SEC increase over operating expenses versus prior year. We saw a decline of our long-term incentive program cost of 12 million SEC year-on-year, driven by the shared price development. Costs for research and development after capitalization and amortization decreased by 17 million SEC compared to the same quarter last year, mainly driven by higher costs in prior year related to the organizational restructuring. Higher capitalization related to launch of new product and lower amortization contributed further. If we look at the basic earnings per share, it totaled to 0.7 SEC per share to be compared to last year's 0.27 SEC per share, which is a 150% improvement. For the quarter, cash flow after continuous investment was positive with 67 million SEC. It's encouraging to see that our work on improving processes and operations have had a positive impact on cash flow compared to last year. We also paid a dividend of 53 million seck during the quarters to our shareholders. Cash at hand by the end of the quarter was 223 million seck and net debt was 882 million seck. The total unused credit facility at the end of the quarter was 300 million seck. The net debt over the last 12 months EBITDA was 1.6 times. So, Fredrik, back to you to conclude today's earnings call.

All right. Great. Thank you, Linda. So, to summarize, before opening up for questions, I'd like to iterate some of the main takeaways and bring further nuance to our performance and our outlook. We continue our strong growth trajectory, a trend that started early spring of 2022, so almost four years ago. We grew revenue by 16% adjusted for currency, and that should be seen in the light of a 38% growth in the comparable quarter last year, making the comps quite challenging, and yet we beat that with quite a margin. Sales continue to grow in the quarter across all our markets. In North America, we benefited from deferred orders from Q1, but that was countered by overall longer prescription lead times. This slows down handling times and delays revenue, but it does not deteriorate reimbursement or long-term opportunity. And these types of complexities are quite well-known characteristics of the market in which we operate. Our profitability improved notably, reflecting strong operating leverage while the prior investment-related costs continued to taper off. And all in all, our EBIT improved by 137%. Not only was the reported earnings encouraging, we deliver a strong cash flow, further underscoring the improved operational efficiency, which we have put a lot of energy into, and cash flow after continuous investment increased by 167%. We continue to expand our direct market presence by closing the acquisition of our Italian reseller partner SR Labs Healthcare. We continue to monitor all macroeconomic and policy changes development closely but as of today there have been no changes or alternations to reimbursement or governing laws but we of course see increasing administration and prescription timelines. And while currency effects and the broader macroeconomic environment can create volatility we are well positioned to continue to deliver on long-term sustainable growth in what we see as a severely under-penetrated market while advancing our mission to provide life-changing solutions to those who need them the most. We reiterate our long-term financial targets when it comes to growth to, on average, grow revenue by 20% per year, adjusted for currency effects, including contributions from acquisitions. In local currencies, the second quarter this year's growth was 16%, which means we continue on the growth trajectory, but also in the light of last year's exceptional growth. And the market that we serve remains hugely underserved, but also quite immature. And with the example of growth levers such as sales team expansion, adding direct markets, and operational excellence, we continue to build on our growth journey and remain confident in our ability to continue delivering on our ambitious plans. If we move over to profitability, where the goal is to deliver an annual EBIT margin that reaches and exceeds 15%, We feel that we have proven to build strong growth with incremental improvement in profitability. We need to continue to invest in future growth with improvements in scale, which we have. And the recipe is rather simple. Continue revenue growth, high and stable growth margins, and total operating expenses that increases at a lower pace than revenue growth. And as a consequence, we see good opportunity to further leverage how revenue growth translates to reaching and exceeding a full year EBIT margin of 15%. And this quarter is a clear evidence of our ability to deliver on this. And then on dividends, we have an attractive cash flow profile. and given the growth opportunities we of course need to maintain a capital structure that enables strategic flexibility to pursue growth investment and that of course includes acquisitions but in it's still expected to over time generate excess cash and our policy is therefore to distribute at least 40 percent of the available net profits to our shareholders via dividends or share repurchases or similar programs when so allows and when we deem that it's the right prioritization. And 2026 was the first year where we started to pay dividends and given our ability to translate revenue into cash flow, as was also proven in this quarter, we remain confident in our ability to deliver on this target too going forward. Okie dokie.

With that said, we are inviting our corporate communications director, elizabeth manzi who will help to moderate and enable us to take questions from you yes thank you so much frörik and we do have a couple of people who have raised their hands so if you would like to speak you will raise your hand and we will call your name so first one out is daniel jurberg so please unmute and ask your question and if you would like you can also turn on your camera daniel okay now it's unmuted hi hi there hi daniel actually you can see me as well

i guess yeah hi nice to see you uh congrats to solid numbers good cash flow and gross margin etc uh first my first question would be a little bit on this comment on the reimbursement you know longer times and so on uh and linda you talked about you know but should we expect this to ease of anything or get worse or is it like Linda said that it's mostly when they are changing financing that this occur just some more I can give some more practical flavor of what this actually means in practice so now we're we're more or less only talking about the US so at

at the beginning of every new year that's when people change insurance providers and we see that there is a slight increase for whichever reason this year when you change insurance providers it's quite often so that you also have to change therapist because the your former therapist was maybe associated with a different payer and now you're since your shift shifted payer you will have a new therapist and as you can then maybe understand the the the lead times increase you i'm not saying that you start from scratch but there is there's a little bit of a rework This is one explaining factor of why we see that it's not like the reimbursement is taking longer. It's the entire prescription timeline that we notably see is longer this year than before. I would say that the trend or this function is not new to us. We're quite used to handling this, but it is longer. to say, to give some sort of outlook on when this will taper off or how fast things will go, I cannot tell. We hear anecdotally that waiting times to get an appointment with a new prescriber or therapist, speech language pathologists, for example, in the US are quite long. So it's, you know, we hear, you know, 30 or 90 days wait until you can get an appointment. And of course, if you start from zero, that will take longer time. But that is the practical consequence. But it's hard to tell exactly when or if it will taper off. But there is no fundamental change to neither number of users or reimbursement.

So in a full, it would be annualized at least Q2 is 27, given that the longer the impact you saw.

Your guess is as good as mine here.

Yeah, I will see. May I ask you about the cost for the AbleNet lawsuit in Q2 and also go ahead if we should expect this to be a substantial amount in the OPEX side here and if you will comment on it as an NRI or not?

It's not substantial at all. It will be a small part of our OPEX.

That's good to know. I think what we said in some prior calls, this should not influence our long-term guidance. This is within, like Linda said, within our financial envelope. Super.

And now when you see net depth coming down here to 1.6 times rolling EBITDA, any comments on M&A and what you have thinking there? Because the 20% growth target is, I guess, with some minor M&A as well included.

Yeah, I still think it should be seen that our play is largely organic. We sometimes use the word that M&A is sprinkle on the cake. If you look historically, it's been low single digit percentage points of our growth that has been related to M&A. also when you make the types of acquisitions that we have made more recently meaning that we buy our own resellers or distributors the the addition is actually quite small because in in actual in currency or in money the only difference when you buy a reseller is the difference from what we sold to that reseller and what that reseller sold to the market so it mna is not a fundamental part of our kind of overall growth story it is organic perfect thank you and finally i just want to to

thank you linda so much for a great work done and good collaboration and the best wishes ahead and have a great time with both of you yeah thank you so much thank you it's been a pleasure thank you daniel and we will now invite philip betterquist to ask questions Yes, Philip, if you're there, you can unmute, and if you'd like to, you can also turn on your camera.

I think we can see you now, almost. Philip, you might want to turn on your sound.

Hello?

Yes.

Hey, there we go. Yes, thank you. There we go, and there we have the camera as well. All right, good morning. Just coming back on the prescription lead times, I assume this was an effect you saw in Q1 as well. I mean, you talked a lot about the weather being a big effect in Q1, but I would assume this is an effect as well, looking back at that quarter.

Correct. And not to kind of say an excuse, it is sometimes difficult for us to understand why a certain therapist's meeting with a user was delayed or deferred, whether it was weather, whether it was a new therapist, since we are not part of that, you know, part of the journey. but you're absolutely right there could have been some effects that being said when we interviewed both our own reps and and prescribers in the market the weather effect that we experienced in q1 was quite extraordinary and was definitely a big contributing factor but should we view this as more like revenue as being deferred and not lost these like longer lead times yes yeah but but but it's it's it wouldn't be right of us to kind of try to quantify the timeline for that but since there are again if you just look objectively there's no changes to reimbursement the laws haven't changed the there is obviously no less prescribers and no less users this should be you know caught up eventually yeah and then you talked in the in the q1 presentation about march being back to historic growth levels which i assume is 20 to 30 percent and then we see a slower growth than that here in q2 so can we then assume that march was just like it picked up because of the lost revenue in january and february so you got that in march so it was an effect of that or i don't have an exact number but you're probably right there's there's an element of what was lost due to weather or what was lost due to changes in insurance coverage also in march because as you noted we we did see a strong momentum in march and kind of that comfort i mean we do have a slight increase in in growth q2 versus q1 even though it's merely one percentage point but there are such fluctuations we have i mean if you recall we have a fairly clear seasonality pattern q1 is our weakest q2 slightly better q3 slightly better and q4 slightly better interestingly enough we have within each quarter also a similar trend where the first month of a quarter is typically more shaky or weaker and then you have a little bit more of a push through at the end of the quarter.

And then you reiterated in the report your growth, 20% FX adjusted growth target. Do you see that as still possible for 26, given that we are some five percentage points below in H1, or do you more view it as a long-term target?

I think we should read it exactly how it's spelled out, that it's a long term and that it's on average per year. We didn't say that every year or every quarter or shorter periods. that being said we remain confident because if you if you go up in the helicopter a little bit looking at the market what we offer how we do it to be able to deliver a an annual growth of 20 percent is something we we feel that we both have the capability and and the demand is out there and then just uh one last quarter one last questions uh a question uh the number of employees increased quite a lot uh this quarter about five percent quarter of a quarter or 50 people do you expect to keep this hiring pace throughout the year or should we expect it to slow or how should we uh and linda may want to answer that yeah i think you should remember that we also acquired a company in the quarter as well so that kind of brings additional people into it and so i think that's the explanation other than that the main focus areas where we add headcount is within our market facing roles so reps out in the field etc we we expect that specifically given the investment in organization and back-end system that the rest of the organization if you will should scale much better.

Perfect. Thank you very much.

Thank you.

Thank you, Philip. And next in line is Jakob Lemke. So Jakob, if you can unmute and turn on your camera, you're welcome.

Yes. Good morning. Hey, Jakob. Hey. My first question is, I guess I'm repeating the other ones but on these drawn out prescription processes just want to be clear and understand that is this something that has increased compared to q1 and also if that means then that the growth for q2 is lower than what you ended q1 within march which you said was strong it's a very good question and if i can dare to answer that question on gut feeling i think you are all right i mean we do see that the reimbursement processes have been drawn out there is definitely so that for the people who

did not change insurance provider that had their processes started say november or december of course there was no change to that but when you have a larger population changing insurance prescriber or provider and then adding to that that you also change a therapist i would say it's likely to say that that it was longer in q2 than it was at least before and whether that was exclusively in q1 or not i don't know i also want to reiterate what i think i answered before is that the funding process the process for once you say once the prescriber says yes this patient

is suitable for one of the products until he or she actually receives it that process hasn't slow down it's more on kind of what happens before that that has been slower which is also slightly more outside of our control to be fair okay um then i'm also wondering if you have any sense of how much of the the weather related the third sales that were recouped in the quarter and how much is left to to recoup no okay uh then i'm moving on to a question on uh yeah your thoughts on, I guess, investments in sales and marketing. I guess last year, you probably took quite a big leap in the sort of sales efficiency in the US, but given the slower growth here in Q1 or in H1, I guess that has taken a step back now. So given this, I'm just wondering on your thoughts in continuing to recruit for sales and marketing. It seems like you're continuing to recruit quite fast.

We are. And then we should also know that it's not like we the hiring process is exactly even across the year if we look back at last year we did add a fairly significant amount of reps during the end of last year and of course that means that those new people are not fully up to speed yet they they're not kind of up and running and we should probably start to see efficiencies from that happening pretty much now if you will but other than that our recipe hasn't changed that the the best way for us to educate and you know build the market is by having more people typically with a clinical background themselves but they represent us work for us out in the market and so far we see that what do you say linda what is the average kind of how long does it take to to have a rep be up and running yeah we said that it's about six months until they're profitable and after 12 months they need to perform according to the set KPIs that we have. But we see no shift in that so but that now we're looking at kind of a global level we're quite detailed on this we we analyze every region every state every market where we see that is there incremental benefit of of splitting territories and adding more reps or should we kind of pause for now and that's something we do on a daily basis okay and just if i may follow up given that you have recruited quite a lot of sort of sales people here in recent quarters do you expect to see a benefit to growth from this in in the second half of the year absolutely otherwise we wouldn't do it okay good then on on the gross margin which is you know

quite strong here in in q2 um well first of all do you think that this is a level you can remain at going forward and also um yeah if you think you will have any material impact from the price increases that apple announced here during the quarter yeah i think i mean first of all we had a positive impact on fx this quarter on almost one percentage point which we cannot count for in the coming quarters.

We are seeing increase both on other components and the iPad or Apple cost. We think from a rolling 12 perspective it's slightly below one percentage point going forward that we might have impact on gross margin.

Okay good and then finally I have a question. I've heard some reports that your competitors or you have a competitor that's being favored because they are able to get their devices out faster to the users. And I guess the question is just if you are agreeing with this and also if you have any plans to mitigate this.

Oh, this is a big topic. And I think this is partly associated with a lawsuit that we issued earlier in the year. And our focus is to A, of course, make sure that the therapist and the prescribers that work with our patients are competent in doing what they do, that the products that we deliver are of the highest possible quality, both in terms of kind of actual quality and also how they function, ensuring that the users are successful. And then, of course, that everything is done with a minimum of delay. We can always become better. I do see, however, that reimbursement systems are very complex material to handle. And making sure that you stay within the boundaries of what is legal what is according to the policies is critically important if you want to maintain a you know a high quality business so we believe that we can probably do things better but when we see that there are players who take shortcuts of course we should see is this something we can improve on or is is there other reasons and i think this is actually related to the lawsuit that was that was announced there is more material and a quite good infographics on a website that you can click on in in the press release related to the and then you can get more flavor on that why why this is not a super simple topic to answer but we want to make sure that we are top notch yeah and and if i may follow up then on the lawsuit just what's the feedback been from from users and also the therapists from the losses I don't know I think it is probably all over the place this is a this is a market with extremely high ethical and moral standards almost everyone that works in this space do it because they want to make difference they want to make an improvement to to the users and the families around them I think doing things right is a fundamental part of how everybody in this space wants to operate. And that is also the majority of the feedback that we're hearing on making sure that we also do things right, also legally and procedurally.

And supporting the customers is very important for us.

Okay, good. That's all for me today. Thank you, Jacob.

Thank you, Jacob. We do have a question from the audience in the chat as well. so uh from someone who hasn't posted the name but education is your bread and butter in many ways can i get an estimate on how many clinicians you train every each year and how many sessions you conduct annually how does i compare historically for example five years ago okay um i cannot give exact numbers but i can i can describe the process and and also how we operate so the the model which which that was a strategy I think we implemented in 2017 or so, so that's more than five years ago, was meant that training is the new selling,

which means that our salespeople, if you will, they are not salespeople in the sense that they go up and kind of close orders. They are typically almost exclusively clinicians themselves who have been operating for many, many years with the patient groups. And now rather than working with individual patients, they work to educate the prescribers who in their turn work with patients this means that the only thing our field reps do is to be out there and educate that's what they they fill five work days a week with along with of course supporting and we have you know the past couple of years increased our field sales staff by what do you say Linda 20 or so annually yeah which of course, means if you have 20% more feet on the ground and they're continuing to train more, that's probably a number. In addition to that, e-learning, all types of new technologies, how we can conduct training without necessarily sitting in a car, driving for hours, et cetera, but getting scale for that has obviously improved.

So in real terms, the number of prescribers touched every year, et cetera, is growing even faster than that but that's what we do yeah i hope that answered to some degree i think it did uh we will bring in someone who has raised their hand so nicola kalnowski if you are still on the call and would like to unmute and turn on your camera please there we go perfect yes hey hey guys hope you're well um just curious on a few things from my end

i thought maybe i would just uh follow up for a clarification on one of the previous questions and i think in particular one on uh component costs and those relating to like memory related price hikes from the likes of apple and so on did i understand correctly that you now expect about a one percentage point impact on the margin rather than the previous you know tens of basis points estimate impact from such hikes or am i mixing it up with the vfx impact on the on the gross margin yeah i think no uh you're right uh the outlook is that we think that slightly below one percentage point will have an impact on the gross margin if we look kind of the coming 12 months perspective it will come gradually over the period i can though maybe add some flavor

as we grow we also continue to scale which means that you know part of the tailwind we had in this quarter is that freight costs are going down so it's not like saying that we automatically all things alike will get a one percentage point kind of headwind from that there are other things how our our operations scale and you know potentially there's also if you look at the slightly longer perspective our aim is of course to make sure that this is also offset by improved increases in reimbursement in markets where we control pricing of course making sure that that is reflected there but in absolute terms if you just kind of look isolated on component costs then of course that that that calculation that was just mentioned is is correct yeah and if

i guess maybe if i follow up on that comment i guess it's relating to the pricing power Or, you know, in which markets do you get the most, maybe, you know, sympathy is the wrong word, but where are you able to get compensated with price increases from your end? When you're being pressured, you know, which kinds of markets are you able to then compensate with price increases?

A good question. We should go back to looking at kind of where our revenue comes from. We have more than 70 or 75 percent of our revenue stemming out of the U.S. The U.S. is not one country. The U.S. is 50 states, several hundreds of various payers. The payer in the U.S. that sets kind of what's referred to as the allowable or the reimbursement amount is Medicare. And Medicare updates their pricing schemes every year, typically December-ish or so. and historically they've always been related to some kpi cost inflation etc and of course similar to gasoline or whatnot component prices is in that too but it's less in our control and we kind of more follow whereas if you look at europe currently representing what 19 of our total revenue there is more of a mixed bag of tender markets where the prices are set for you know one or two years versus markets where we simply we send out the price list yeah okay that's

i think i think in line with some of the market market expectations um and then yeah maybe if we go into europe i think you wrote in the in the ceo commentary here something along the lines of you know there being a full underlying momentum not yet being visible in the in the financials Is that something related to the ERP transition or does it also refer to something else in terms of business momentum?

It's much more basic. First of all, if you just look at, you know, we've now had our reseller partner in Italy in our company for three months, the one in Germany for nine months or so. So this is also an integration project and has largely to do with humans. but there is also an element of prior to owning them we sold to their inventory and exactly if they had a good month or a bad month we couldn't tell because we sold to the inventory and then they sold from their inventory now that middle layer that buffer if you will is going away and and hence doing direct comparisons year to year is is not entirely correct hence i don't like gut feeling but our gut feeling currently specifically if i talk for example in germany is that the moment the underlying momentum and demand is very encouraging and we

should we should see that kind of normalize over time and then obviously also shown in our penal i don't know if you want to add something to linda no and i think that when you look at at our revenue you should look at fx adjusted uh revenue and that's 26 in the quarter i think that's important because it's such a mix of how the business has looked historically versus now yeah yeah that makes makes a ton of sense and thank you for clarifying that that's great and then just a final one for me uh this is a very basic one so in the u.s you know one of your key drivers that we talk about is you know how many new solutions consultants are you hiring and that improves your density and so on and the efficacy per per person you know should we think about it

the same way for other markets in europe like germany let's say or should we also consider something else that is unique for for european markets compared to the u.s markets the model is the same but all european markets in germany included is more immature the density is lower it's it's more of a we probably have a even higher task to educate the basic basics etc The US has a longer tradition, more sophisticated, a little bit maybe more clear legal support. But other than that, the model is the same.

Yeah, perfect. Perfect. Wonderful. Well, that's it for me. Thank you very much. Great.

Thank you. Thank you, Nicolai. Thank you. And we will invite Mikael Lassen then to ask your question. We're running a bit long time, so if you can be quite quick on joining, we will have time. Yes, good. I can see you there, Michael.

Go ahead.

We can't hear you, Mikael. There's some mute button somewhere that needs to be clicked. Now? Can you hear me now?

Hello. Okay. I want to follow up on the prescription process. Is it possible to quantify the effect and also where you see the effect? If it's broad based across the US, for example, different types of end users, all types of insurance or funding sources, if you can be a bit more specific how this works.

We can't quantify it on totality. But as you note, there are fairly big discrepancies between different states and different payers. And this is not unusual. So that has almost always been the case. So the discrepancy is quite large between certain states and certain months. So one state that could be slow because of a hiccup or because someone is trying to implement something might actually be reversed the following quarter, etc. But I don't have a bigger number, a more gross number to share. Linda, I don't know if you have any.

No, I don't have anything else. and it's also like i said in the previous question that it's not the reimbursement process per se it's actually what happens before the prescription has all has even been submitted okay so does that mean that you see um the incoming uh requests sort of have slowed a bit and when they come into your process then it takes the same amount of time as before and the rejections are the same.

We don't see that incoming orders are slowing down but the question is since incoming means that our rep has been there we have flagged that specific case that process hasn't slowed down it's what we have seen prior to that so new prescriber new therapist is meeting a new patient they're starting the assessment you know a will you benefit from communication aid b if so which communication aid and so forth it's that part of the process that we believe is is taking longer but once they've actually come to us to your point we don't see that the reimbursement process is taking longer and we don't see that denials or so is percentage-wise going up.

Okay, so the insurance companies, for example, are not rejecting or taking longer time to evaluate and make a decision about the remuneration that you will get?

But not on average.

Okay, okay, good. And just want to double check as well. We've heard that CMS, for example, has in Q1 made some comments about making the reimbursement processes much more, well, thorough and higher quality. has that impacted the market dynamics in any way here short term?

No, but it's actually music to our ears, because we believe that making sure that there are no room for shortcut, there is deep scrutiny, and that there are no attempts to kind of fool the system, that's exactly what we want to stand behind. So there's an element of that that also kind of ensures that there's high-quality players in the game.

Okay. And another thing here, a topic in the market, I think, during the second quarter, the Wall Street Journal had a series of articles about autism and created quite a lot of questions around the entire process. Can you comment on this and what's your view? and how is this maybe changing or not changing the market dynamics? You mentioned that you haven't seen any fundamental changes, but could it delay any processes in the market, have maybe indirect effects in any way?

No. And I think what that specific article or whatever is related to therapy of users, which is a different space, a different reimbursement, funding code etc than durable medical equipment that we provide so it's it's more you know i can help your child to get rid of her autism diagnosis whatever through our therapy typically very very costly we even i think in that specific article the cost for a month of therapy was equivalent of the total cost for our device that is prescribed every five years uh but it's it's um it's a different arena if you will it's treatment not

product yeah i i understand that but they are not at all related um those type of okay just want to double check okay because for example those therapies don't include you know using devices it's other things yeah got it um i think organic growth in europe was around five percent um could you break down um the growth rates by region or market or where you see growth in line with your targets is this a temporary slowdown or how should we view that five percent number you should as i said earlier you should look at europe

as effects adjusted so you should include the mna it's also a small part of our revenue so you should look at 26 percent effect adjusted growth just as frederick explained earlier the timing impact when you don't own a partner and when you own a partner becomes a little bit volatile so look at it in total instead all right but i could add that as we write in the report i don't believe that the full potential of what we're seeing in europe is yet being reflected in our pnl and might take some time it is it is encouraging what we hear and see okay can i just

ask one final thing here about seasonality going into the second half is there anything what you see in your processes and pipelines and sales activities that suggest that these things, the delay processes, drawn out processes could improve and we can have maybe a stronger seasonality situation in the second half or should we expect normal seasonality to continue as always?

I think we can expect the normal seasonality patterns, but to your point, but But if we're talking about delays, that eventually means that once the delay is over, then that will have normalized. Whether that takes one or four quarters or whatnot, I actually don't know. But it's important to note that there is no reduction in demand or reimbursement, etc., which of course would have had a, that would have been a different story. Okay, thank you. Thank you, Mikael.

Thank you so much, Mikael. We do have one question that I wanted to read out here from somebody who has been working with students that use Turbo Dynamoqus' devices in Sweden and know that some devices end up in cupboards. I should mention these students are 16 to 18 years old. this person has their theories but what is your understanding as to what amount of devices do end up not getting used as they should and therefore not gaining the benefit that is expected and furthermore if you can comment on the swedish market as an example what is the reason for devices not being used the way they should this is a common dilemma in our industry that people give up.

And I think the reason people give up is largely not related to the device or the technology itself. It's life. You have a condition of your child, which is, you know, technically life-altering, et cetera, making sure that your child stays alive, that the basic fundamentals needs in your life obviously always take precedence over literacy, being able to communicate, etc. So the main reason, and this is universal, is that the infrastructure around the patient, meaning the therapist, the school, everything around it, is not solid enough. So that ends up being that the patient gives up. I think the story I'm talking about now more has to do with people with developmental delays or cognitive disabilities. Then, of course, you have areas where you have degenerative neurological conditions such as als etc then of course unfortunately one of the reasons why you give up is because patients passes away and their own or for other reasons are no longer able to use their products but that's smaller i would say that the giving up feature is is the number one problem that is no different in sweden versus you know some other countries but i would still say that the competence among people tasked with helping our users is tragically low in almost every country in every region where we operate and that's what we are here to change so sweden doesn't stand out there's also in sweden specifically fairly large variations from region to region and that also has to do with competence and resources.

Good. Thank you, Fredrik, for that answer. Jakob, I see that you're back. Do you have a follow-up question before we close? Please make it short.

Yeah, just quickly on the price increases or potential for price increases in the U.S.

I was wondering, are you charging the maximum you can within the reimbursement codes right now, or are there some room that you can increase to those maximums we typically we negotiate with every payer and and mark well we have several hundred i don't know what the latest number that we announced over 700 700 payers or so with those payers we can actually negotiate and basically in exchange for less administration a more smooth prescription or funding process we are actually willing to adjust our price and that's typically a win-win situation because it costs less for us to process and it costs less for them to process so there are fairly large variations i would say um i don't but if you look at kind of the medium median price that we charge for equivalent product they are quite similar across payers Okay, good.

And if I just very quickly may I ask also on Europe, can you elaborate on what the sort of volume growth is in the acquired units in this quarter? Sort of towards the end users or customers or what have you?

I don't even have that number.

I don't have that in front of me, but we are growing faster when it comes to autism, for example, even in Europe.

And that means that the quantity is probably slightly higher than the total revenue growth right because yeah those are products with slightly lower but let's say just the the sales growth out that sort of that's neutral for this acquisition effect and maybe inventory and so on that we don't know because of the fact that there you prior to acquiring a reseller there was a a buffer with their own inventory and whether inventory was high or low we don't know that we should also bear in mind that what did linda say that europe specifically is 19 of our total revenue uh so i we don't have that number in front of us but it's would you say linda that it that it varies greatly within volume growth versus Yeah.

Good. I think we need to close by that. So hopefully everybody got their answers to their questions. So over to you, Fredrik, to close the call.

Okie dokie. I love the fact that there is so much interest. We will continue to work. We will continue to be there. we will go back and make sure that we deliver on our plan and on october 21st that's when we summarize our business for the third quarter and that's when we will have a similar session like today again. Thank you so much.

Thank you. Happy supper.