Shield Therapeutics (LSE:STX) — Q4 2025 Trading Update

0:01 Good afternoon, and welcome to the SHIELD THERAPEUTICS PLC Investor Presentation. Throughout this recorded presentation, investors will be in listen only mode. Questions are encouraged, and they can be submitted at any time using the Q and A tab situated on the right hand corner of your screen. Simply type in your questions and press send. The company may not be in a position to answer every question received during the meeting itself. However, company can review your questions submitted today and publish responses where it is appropriate to do so. Before we begin, I would like to submit the following poll. And I would now like to hand you over to Anders Lundstrom, CEO. Good afternoon to you, sir. Thank you so much, and good afternoon, good morning, depending where you are in the world. So welcome to SHIELD THERAPEUTICS trading update covering the fourth quarter and the full year of 2025.

0:48 My name is, Anders Lustrom. I'm the CEO. And together with me this afternoon is also Santoshanberg, our CFO, and we will take you through the presentation, and then answer a lot of, of course, your questions when we come to the end. So this is our disclaimer. I leave it up for a little bit. And just so know, this presentation that we will be shared with you today will be available on our website, corporate website, in the next coming days. So SHIELD THERAPEUTICS, we are a specialty pharmaceutical company. We are focusing on the iron deficiency and iron deficiency anemia market. It's a very, very big global market. And in The US alone, there's about fourteen million iron deficient, patient diagnosed.

1:43 Our product is called Aquifer or Feracru depending on where in the world you are. And what we offer these patients is a better tolerated product because the the the, problem sometimes with traditional oral irons is that they lead to gastrointestinal side effects and thereby the patient cannot continue their treatment. We are today the number one branded prescription oral iron in The US market. And I will go into more details on on these things a little bit later in in the presentation. The big news for us for the quarter is that we turned cash flow positive. And that, of course, gives us a good flexibility going into this year where we can then more easily invest behind our strategic priorities and have a much more room than we have have ever had previously.

2:45 So this is our executive team. We are a very experienced executive team with extensive US commercialization. And across us, we are driving the product, CRISPR, ferrocrew in in the global in the global setting. David and Jackie are at our headquarters in in Newcastle, and the rest of us are in the in our Boston office. And in The US, it's the only market where we directly sell and market the product ourselves. So what is the problem we are trying to solve for here with AccroFair? It is that most every other oral iron deficiency, replacement therapy is assault. And what happens with this salt is that they dissociate in the stomach.

3:35 And what then happens is that they cause irritation and damage to the intestinal lining, and the result of that are gastrointestinal side effects. So we know that up to seventy percent of these patients, they can experience these side effects. And what is unfortunate with that is that in quite a few of those, they will discontinue treatment because the side effects are are so bad. In our case, we have a whole different formulation. We're not a salt, first of all. We have a formulation where the actual iron molecule is covered by a maltol complex. That makes the the product, not dissociate in the stomach. Instead, it happens in the upper smaller intestine.

4:23 And thereby, we can avoid many of these gastrointestinal side effects. The product is better tolerated. The patient can stay on the product, and we also have an advantage that we actually can then by doing this formulation, we we have a lower iron dose. This gives us a a very good place in in in the market. So most everybody, as you can see, over ninety percent of a patient or person with iron deficiency or iron deficiency anemia starts on an oral iron salt. And as I just explained, quite a few of those have these gastrointestinal side effects. And before we were available, the only other alternative was for them to go and get an IV iron infusion.

5:12 Now for us, this which is a perfect place in the market for us because there is now an oral alternative for these patients as well. So this is our place in the market. So typically, in The US and then and everywhere else, we are what you could hold second line, but that is really no no disadvantage at all because, most of these patients will have these side effects. And and if we can't tolerate it, they they have this alternative go to aquifer. That's why we continue to see a very good uptake of aquifer in The US, which we will come into more in detail in a few slides. So this is our global footprint. As I mentioned, we market sell and market directly in The US.

5:59 We do that together with Viagris. It's a it's a collaboration we have had with them now for over three years, and we'll come back to the and we've been very successful, and we'll come back to the numbers. In Canada, CHI launched the product in the end of last year. In Europe and in The UK, we have NordGen as our partner. In Korea, we got an approval in last year, and we're looking forward to launch now now in this year. In China, we expect the filing in, you know, in the first half of of this year. So that is where we are active in some instances looking forward to be have the product on the market during during this this year, and then China will file that would probably be on the market in 2027.

6:47 The new thing also, is that we in the end of last year, we got the pediatric indication approved in The US. So for children older than 10, they can use our capsule. For children below 10, we are submitting a new application in The US and in The EU towards the end of of this year. In Europe, we have the same setup. So we have filed for the those above 10, and we are waiting for a decision which would like this come come wanna come to this year as well. Then finally, in Japan, we have a new a new collaboration. They are going for different indications. They're gonna try the product in in PAH, the pulmonary arterial hypertension, and they are about to start a a phase two study in the first half of of this year.

7:42 So this is, both how we describe The US market. So I what I mentioned initially is that about fourteen million patients are diagnosed with iron deficiency or iron iron deficiency anemia. The target market for us is a subset of that, about half of that, the 6,700,000 patients, and these are patients that are actively taking iron replacement therapy. But those we focus on is a smaller subset of less about four million patients that we are doing direct direct to consumer marketing. And I'll come back in a couple of slides later to show you the effect of that. And we know these four million patients are actively seeking an oral iron treatment online, and that's how we can target them. We can also target them then with our DTC marketing.

8:34 The the smallest circle, which is where we focus our sales and marketing to the towards the physician or the the prescribers. And our focus is on primary care and women's health primarily. This this this group we focus on, which is around 25,000 prescribers, they treat around one and a half million patients. So as you can see, there are large numbers. And if you compare that to the number of prescriptions we had dispensed last year, which was closer to 200,000, you can see there's still a lot of growth to be had for us in The US market. This is how we have directed our customer market sort of direct to cuss direct to consumer marketing efforts.

9:26 So this basically why I you know, we can see three different ways we're doing. We have social media influencers. For instance, on Instagram, we have eight of them. They were all launched during the course of of last year. And as you can reach as you can see, they've reached a significant number of patients via their different posts, about a million. Our top channels are, as I said, Instagram. It's Facebook, which is called Anita. It's Google, and it's Bing, so different search search engines as well. We also do digital advertising, and then you can see we reach them around 4,000,000 patients as as well. Then on the physician side, we also do we do marketing, of course, to towards, you know, physicians or they are not all big and and our prescribers.

10:15 And if you then look to the left, this this is where our sales effort is concentrated. As I said, women's health and primary care is this majority of where we focus our sales efforts. On the marketing side, on the other hand, we go broader. And the reason we do that, we know that other specialties like nephrologists, gastroenterologists, hematologists also have large patient populations. So and and they are outside women's health and primary care. We know these specialists are harder to get to. So what marketing can do for us, it's to create leads that then can be transferred to our salespeople, and that is what why we go broader for our with our marketing efforts.

11:01 So just to show you, what this could look like. So what I'm sharing here is the growth in the number of prescribers. And these are the number of prescribers that that we then detail also. And the reason we're showing new prescriptions is that you have to remember that when you treat iron deficiency or iron deficiency anemia, typically, patients take that for three to four months. Of course, there are those who have a more chronic disease, but most of them take it for for for, you know, three to four months as I said. Thereby, the new what we call new prescriptions is something we follow very, very clearly. It's an existing customer that writes a new prescription. And and to the left, you can see the development and all the number of of writers we have in the field, and we're up to about, you know, seven and a half thousand ish prescriptions.

11:58 To the right is where we see the impact on marketing, and these are the number of new writers we see where we never made a sales call. So that marketing works, we know. So and this is these are the way we can measure this. We also know then, of course, how much they have prescribed these writers. And thereby, we we know that investing in marketing alone, has an impact and has a positive return on investment for us. So in summary, what what we are focusing on, as you can see from a marketing point of view, is to increase awareness. Among those four million patients that we know are taking, an an OTC product or have had the product prescribed.

12:45 So that's that's the awareness piece. Then we also are, this year, enhancing our Salesforce output. We are targeting other specialists. And the reason we're doing that, is that we know they have larger patient population. But there is a little bug with that. It's not that they typically with these specialists like nephrologists, oncologists, and gastroenterologists, it takes longer to get to them. But now when since we are where we are, we have a very strong platform, we have the luxury of time to also target them. We continue to drive demand in our six top states, and and what we have there is, we have more salespeople in those states than we have in any other states or more territories.

13:32 And the last piece, which is also very, very, very important, is that when we have a prescription, we work very hard on the back end, first of all, to make sure that the physicians are submitting what we call a prior authorization. And that is a a justification why a patient should get our product. And that's where we it comes in that they would typically have failed on an other oral iron before getting to our product. So that we work really hard on that that they submit the PA. So we contracted pharmacies that has a PA approval support for the offices so that this is also very important because then they can in turn help the prescriber putting together the PA so the prescriber or the physician doesn't have to spend time on that. And in the end, we also leverage case managers to contact patients to pick up unfilled prescriptions.

14:27 You'd be surprised how many patients we, in this way, can actually get to get the product to because people sometimes do not pick up their prescriptions. So that is an a third lever we use a lot. And all of this to to get more pay to get our product dispensed to more patients. And by that, I leave this this stage to Santosh. Thank you, Anders. Appreciate it. Hello, everyone. Let me give you a quick update on our 2025 business priorities. As we had laid out our priorities at the start of the year, we have three key big ones, growing Acrefor net revenues, specifically in The United States, turning cash flow positive by the end of twenty twenty five, and launching can in Canada and executing the regulatory strategy in Korea, China, and the pediatric population for Acrefor.

15:19 I'm excited to report that we have made significant progress and, and exiting 2025 on a high note across all three priorities. Total revenues for 2025 was nearly $50,000,000. This includes $46,000,000 from Aquifer revenues in The United States That represents a 56% growth over the prior year. This came through nearly 200,000 prescriptions in 2025, representing a 33% growth over the prior year and a set net selling price of approximately $223, representing a 21% growth over the prior year. Clearly, all of this led to Acrefer now being the number one branded prescription oral line in The US ID IDA market. Really exciting times for Acrefer.

16:09 From a balance sheet perspective, we reported that we turned cash flow positive in q four twenty twenty five. This is a significant milestone for the company, as Anders mentioned at the start of the call. This is the first time in the history of the company that the company has turned cash flow positive. We've reported 11,600,000 in cash and cash equivalents at the end of the quarter. This represents a $1,000,000 in net cash generated, excluding the 2,000,000 debt financing that we put in place through refinancing into q four. The refinancing was done at significantly improved terms on the senior debt, and we were also able to expand the size of the senior debt available to us to up up to $50,000,000. That includes $15,000,000 earmarked for m and a.

16:56 Last but not least, from a global expansion perspective, we launched Aquifer in Canada in q one twenty twenty five through our partner, Kai Pharmaceuticals. We also got an approval by the FDA for children greater than 10 years old for Acrefor here in The United States. The Korean Ministry of Food and Drug Safety also approved Acrefor in South Korea. And as Anders mentioned at the start, we also initiated a Japanese phase two trial for Aquifer in pulmonary arterial hypertension or PAH in Japan. This is an exciting time for the company. And, as you can clearly see, we have executed against our priorities in 2025 and sets the stage really nicely to execute against our strategy in 2026. Let me dig a little bit deeper into some of the details and the trends that we saw in 2025 across the business.

17:48 We have shared this slide with you before. This represents the weekly prescriptions in The United States for AcreFur. Clearly, the direction of travel is positive since we fully staffed the sales team in The United States along with our collaborate collaboration partner, Weatrice. We are right now exiting 2025 with nearly 5,000 prescriptions a week. We continue to see that trend in the first couple of weeks in January as well. As you can see on this slide, there is a seasonality to AccraFer in the seen in the prior years. Specifically in q one, in 2024, as well as 2025, there's typically a softness in the market, primarily driven by the fact that patient insurances typically reset at the start of the year.

18:37 Q one twenty twenty five had an additional impact of extreme weather as well as, if you remember, the reorganization of our sales force. We expect to continue to see some level of softness in q one and a similar seasonality in along 2026 as well. We have continued to grow Aquifer in The US across the key three metrics, net revenues, price per script, and total prescriptions. We reported in q four twenty twenty five $13,500,000 in The United States. This came through some significant growth in prescriptions of 61,000 prescriptions, of which 13,000 prescriptions or 21% were dispensed as consignment prescriptions that are dispensed at a significantly subsidized price to patients who are not yet reimbursed by payers.

19:30 The net price in q four twenty twenty five was $222 that was impacted by an increase in coverage but rebated prescriptions. Let me give you a little bit more color on the channel mix of Acrefer in, in q three twenty twenty five and q four twenty twenty five that has an impact on pricing. You can see on in both the charts, consignment was moved in the right direction. Consignment, again, prescriptions that were dispensed at a subsidized price while pay patients are still waiting for payers to provide coverage. That number dropped from 22% to 21%, and we like that trend, and we continue to see that trend. We are seeing more prescriptions come covered by, whether it's Medicaid or commercial, and moving in the right direction. However, as you can see on this slide, the commercial covered prescriptions that were rebated were 18% in q three twenty twenty five, and that increased to 21% in q four twenty twenty five.

20:34 As we have said before, the pricing of AccraFair will continue to fluctuate as we go through the year. However, we expect the pricing to lie between between the 02/22 and about $2.40, $2.45 through the course of the year in 2026. Coming to the balance sheet. We reported that we are cash flow positive in q four twenty twenty five. This was primarily driven by the continued growth of AcreFire in The United States and effective cost and working capital management. We reported in q four twenty twenty five a million dollars in cash generated, and this excludes the new financing that was put in play place through the refinancing in q four twenty twenty five. We expect to generate cash in the first half of twenty twenty six, including the anticipated seasonality of AccraFord that we have seen in q in the first quarter of the year in prior years as well.

21:31 We talked about the refinancing. I wanted to spend a little bit more time on our balance sheet. We refinanced the senior debt with SWK with significantly improved terms. We were able to push out the principal payment terms principal payments from, January 2026, to by about a year. We were also able to lower our interest rates, and we were also able to expand our available loan to 50,000,000, including allocating 15,000,000 towards any m and a, specifically to support the, expansion of our portfolio beyond the aquifer. We have now drawn 22,000,000 off the 50,000,000, from SWK. The maturity still stays at September 2028.

22:18 As you can as you remember, we put an, accounts receivable factoring program in place of 15,000,000. We continue to maintain that, and we still have the milestone monetization with AOP of 5,700,000 in place. We believe that this provides us enough flexibility to allow us to execute against our strategy in, 2026, including expanding our portfolio beyond AcreFirth. That brings us to the 2026 business priorities. We have three key business priorities in 2026. Continue to grow Acrefor net revenues, which we plan to achieve profitability in 2026, and we we wanna diversify our revenue stream beyond adult IDA in The United States.

23:03 From an Aquifer perspective, there are three key areas that we are focused on. And has already alluded to this in a previous slide, increasing awareness of Aquifer, continue to drive the demand in the top big states in the top six states, New York, California, Texas, Florida, Georgia, and North Carolina. These are the key states that really truly drive the prescription growth of Aquifer and continue to improve patient access to Aquifer. We plan to achieve profitability in 2026. We plan to do this by driving top line growth while improving our overall margins. We would like to continue to streamline the balance sheet. We have strategies in place to help streamline and make our balance sheet much more efficient and deliver on an operating profit in 2026.

23:50 From a diversification perspective, we expect to have two aquifer launches, one in South Korea and one in The United States for kids 10. We expect to have a regulatory process two regulatory processes executed in China and and children in Europe. And we are looking, feverishly to add a second product into our sales portfolio. Today, our sales our sales team carries one product in the bag. They can easily carry two, if not three, in the bag. We are we are actively seeking additional products that can be added to the bag, specifically products that may be in a late stage phase three or an FDA approved product. With this, I would like to hand it back to Anders to close close our prepared remarks.

24:40 Thank you, Santos. So what you've seen, during this presentation is you we described to you, we it's a big market opportunity we have with significant revenue potential. We because you you have seen the continued growth in AccraFire prescriptions, net revenue, net selling price. And as Santos explained, unfortunately, there's not a straight line between the number of prescriptions we see and the net revenue due to that there as the the channel mix vary from quarter over quarter. And but what we're really happy about is the prescription number because these are dispensed prescriptions, so they are read prescriptions. So that continues to grow, very, very nicely. Our global partnerships continue to develop, at a steady pace.

25:28 And we never said this initially, but we have milestones coming, and and and we have doubled typically doubled the the royalty from those partnerships. The goal is to be a profitable company by the end of this year. And very importantly, and and actually for the first time ever, as as an corporate objective is to find a second product. So or or product or partnership with with and to give us a second product to expand the portfolio, which it would be very, very important step for us as a company as well. So that concludes the formal presentation. And by that, we can move on to the Q and A. Fantastic. Anders, Santosh, thank you very much indeed for your presentation. Ladies and gentlemen, please do continue to submit your questions using the Q and A tab situated on the top right corner of your screen. While the company take a few moments to read those questions submitted today, I would like to remind you that a recording of this presentation, along with a copy of the slides and the published Q and A can be accessed by our investor dashboard. Stephanie, if I may now hand back to you to take us through the Q and A session, read out the questions where appropriate to do so, and I'll pick up from you at the end. Thank you.

26:36 Thank you. Anders, I think you touched on this early on in the presentation, but for anybody who's missed it, we've got a question. Will the company be attempting to patent the new delivery system for the oral liquid suspension? And and, also, will the company be submitting the new drug application to the US FDA for the oral liquid suspension? So so yes and yes. So the reason we divided the, pediatric data up in in age cohorts is that for the oral suspension, which we then will be will apply for a label for those below 10 years of age, we need a a whole new manufacturing process to be set up. Of course, we have manufactured the oral suspension because it was used in the study, but when we move to commercial production, we need stability data. That and that's the reason why we will submit that during this year when we have the stability data we need from from the new manufacturing side. So that is the reason why it's been divided up in in in two cores, and and that's the reason also behind that that that it will be at at some point during this year.

27:49 IP protection on I see the question here. There there is not an extension in IP, for the new formulation by itself. So the so it still goes to 2,035. Thank you. Another one here. So, hi, Anders and Santosh. Clearly, high growth never comes in a straight line, but finishing with the full year '25 with q four twenty five positive on operating cash flow is impressive. You've guided for this to be the case as well for field year '26. How do you expect the phasing of that to be? Are there any quarters which are harder than others? And how would the second half weighted do you expect the growth to be? I think, Santos, you touched on that earlier with q one. I I did. I did. Maybe I can maybe I can take the samples, and you can add color.

28:39 Yeah. I mean, I I think we expect to continue to remain cash flow positive, in the foreseeable future. We're trying to manage this on a half yearly basis. There are certain quarters where, there is more investment compared to the revenue, and there are certain quarters where there's more revenue compared to the investment. But overall, we are we have transitioned to be a cash generating business, and we will manage that on a half yearly basis and on a full year yearly basis. In addition to turning cash flow positive, we have also indicated and provided guidance that we will turn EBIT positive. So on a p and l perspective, we expect to turn EBIT positive as well. That will be, for 2026 for the full year 2026. So we're excited about that as well. Not a lot of companies in in our in our world today are EBIT positive, and we would love to be one of those few, who stand out and are profitable, in 2026.

29:31 Yeah. And we should just rate it what you said as well, Santos. Yes. That there is seasonality there's seasonality of January, as well. And, also, I mean, the month of July is is is a month. We see that. We continue to see that, but we continue to see if we compare year over year, we still have growth in the in those, periods as well. So so that is what we will be looking to as well. So how are we growing compared to the previous year rather than to the previous quarter all that time? So so so there is a seasonality. We have some to accept. There's not much we can do about it. That's right. Yeah. Thank you. The rate of growth in The US seems to be slowing. Is this a concern for the executive team? No. No. This is a great question, and and you see that. You see, it is a yes. It's slowing if you look at, the quarters, but the reason really is the price that so the the average selling price. So what we're looking at is also what are the prescription numbers because that is the Salesforce drives in the prescriptions, and and then on the back end, as we we said, we work on them getting them dispensed approved and dispensed. So we have a very nice growth in prescriptions.

30:45 But the centers also mentioned earlier, there there will be variability in the net selling price. Not much we can do about that, to be perfectly honest, because we have the number of plans that that cover the product. There is different pricing. It's just a a very complex complex situation. And for us as a company, we cannot nitpick and say we would only go to those physicians with that certain plans. It doesn't work like that at all. I mean, we we also have Medicare where where we have very bad coverage, but we don't exclude that either. No. We we couldn't we are very optimistic with with our prescription numbers. And with that growth, we will see revenue growth as well. It might flat fluctuate, and it won't as I said, it won't be straight line, you know, between the prescription growth and and the revenues you see.

31:37 And that's just how it is. It it's there's so many different prices from the different channels, and that's just so if we did not see prescription growth, we would be really worried. This doesn't worry us worry worry us at all when when we see this this type of growth, in the prescriptions. Yeah. And maybe maybe just to add to that, I think it's a fine balance between getting coverage and, hence, increasing volume, but then those volumes sometimes need to be covered by payers who have rebates. And so you're gonna this is very normal. This is very common. This you see this across all medicines in the in The United States. As long as Anders said, we see that increase in prescriptions and they are covered. You know, we do not wanna see prescriptions increase, through consignment.

32:31 We wanna see prescriptions increase through covered prescriptions, and there will be fluctuations in pricing. And like I said on in my prepared remarks, we think it's somewhere between $2.20 to to $2.40 is ex the expected range, plus or minus in any given quarter. And and to add to that to that, I mean, there there's a lot of numbers we threw around there. But if you look at the the percentage of consignment, it constantly goes down. We lose one well, it goes down one to 2% per quarter during the all of 2025. So that's a very positive trend because then again, those are heavily subsidized. So so that is another sign for us that this is going absolutely in the right direction. Thank you.

33:17 Given the expansion of the addressable market, is $450,000,000 still the correct target for peak sales in The US? Yeah. It it it is. I mean, if we look at the you know, how we grow, if you think about that, that we have quite a few years until we reach 20, you know, 35, which is the end of the IP, but even before that. Right? So, absolutely, that is absolutely achievable. And and now when we are cash flow positive and we start to expand further, into other specialties, that again can give us another growth first, because we've been pretty static in in focusing on on on detailing to women's health and primary care.

34:04 And as as we show, thanks to the marketing efforts, we which we in all fairness, we've we've really been investing in over the last six, seven quarters, that really starts to take off. And there, we have even more potential. And thanks then to the leads we get into other specialties, we will continue to, be able to get to patient populations we haven't been able to touch before. So so that is what also being in the situation where we're at when we are cash flow positive, we have the luxury of time with our sales force to start going after. Those decisions are a little bit harder to see, but we we are making the in role with marketing, and then they they per prescriber has a larger patient population. So that is why we're also optimistic about the growth. And in addition, we're launching the pediatric indication this year, which potentially adds another million patients. That's about the number of patients between 10 and up to 18 that are treated for for different forms of iron deficiency and iron deficiency anemia in The United States.

35:17 Thank you. Have IV sales in The US been impacted by aquifer at all? The the honest answer is we haven't checked, to be perfectly honest. Quite you have to put the numbers into perspective, and I tried to do that. We we had about almost 200,000 dispense prescriptions last year. In the target market for us, which is around four million patients. So if if IV slows down or or not, I honestly don't know. What we measure ourselves against is the other oral that can be prescribed. Prescribed. And here we are the market leader in the market today. So coming very close to to 50% of that segment of the market. So that is where we compare ourselves. There's so many patients available, and and we actually don't even look at the IV part of the market. The reason we mention IVs is that they are costly, way more costly than any oral iron.

36:22 And and sometimes it's not so practical for a patient unless there's a chronic, you know, chronic kidney disease or something. Other other disease where they really, really need, of course, an IV, that's a whole different situation. The the majority of patients, thankfully, do not need an IV, but they can do really well on an oral preparation like Acrofor. Thank you. How do you expect to the average net selling price to change in 2026? Yeah. I think we just may have just answered this, Steph. Mhmm. Yeah. I think we can continue to see the fluctuations in price really driven by the channel mix. We continue to see increase in coverage of our prescriptions.

37:08 Sometimes they come at rebates. We continue to see a a decrease in the consignment channel like what Anders was saying. And so I I I think the sum of all these pieces are going to land the price somewhere between the $2.22 and the $2.40 unless we unless we, you know, get some some something significant from a policy change in the in in the in the industry. But we we expect somewhere in the $2.22 to $2.40 price point. Thank you. You described potentially adding another asset into the portfolio. What might this look like? It may look like, ideally, a product that is a specialty product that is within one of the specialties that we cover today, to some extent, women's health, nephrology, gastroenterology, hematology.

38:04 If that product as well has a a prescription base among primary care, which some some of the specialty products do, yeah, that would be good too. So we're looking very, very broadly, actually. So that it could be a a range of different products. So that that would be that, which is very broad, would still be a very good fit for us. And and it would be a late stage phase three Yeah. Yeah. Thank you. Or an FDA approved product. You know, we we're not we're not looking to, invest money behind an r and d program that that will deliver a product to us in three years from now. We we're looking for a product yesterday.

38:49 We need something quick. Right. Thanks. Please, can you clarify what you mentioned about increasing the Salesforce in The US? Do you have any plans to expand beyond the six current states? So yeah. Well, sorry if I wasn't clear. What we are expanding with the Salesforce that is currently 80, we have 40, and we are just at 40, is to expand the targets. So what I tried to explain was that today, we typically focused on primary care and women's health. We're expanding the target to other specialties that also treat iron deficiency or deficiency anemia. We are active in in many more states than that. We are not active in in all 50 states, but we are active in in a great number of states. Those six states are the biggest states for us, where California and New York are the two biggest states.

39:44 So that's where we have the biggest potential as a company. And what I tried to explain was that we, in those states, have more sales territories than we, for instance, have in in Arizona where we have one. So in in in in the in California and New York, there's around I think I was making an average now. It's about 10 to 15 territories. That that is what I mean. Thank you. Do you have any plans to launch in any other parts of the world such as Australasia and Latin America? We we do. We constantly look at that, actually, and it it all depends on, what interest we get from from other parties because we would partner in all of those markets.

40:33 Australia is already with Nord Stream, so that that's up to them to decide if they would go to Australia. In in Asia, well, we we are in Korea now, and we we're looking at other parts of the world as well, like The Middle East and and Latin America as well. Some of those markets are easier, and some of those markets are harder to go to, but we we constantly looking to see if there are other companies who will be willing to launch the product in those. Will you be using the financing facility to expand the sales team in The US? We we don't plan, I mean, I I think there were a few questions about our balance sheet, about about the debt. I I think I'm I I'm aligned with the view that, we do we should not be taking more debt right now. I I think we are in a good we are in a in a strong position from a balance sheet. We don't want to take on more debt. I don't think that would be ideal for the company. And so I I I think what we have right now is the availability of 50,000,000 of debt. We don't plan to take that unless there is a unique opportunity for us from a m and a perspective or an in licensing perspective or a partnership perspective to expand our portfolio and, and make sure that that new product that comes into our portfolio is accretive to the business, we may look at we may look at debt as an option.

42:03 We just we just have that in place so that we have dry powder in case we need need to do something. But we do not plan to use that to support the operations of our current business. I I think we are we are well funded, right now from, from generating cash, on our own to support our business needs for growing Aquifer. Yeah. And and let me just add to that. We're constantly looking, if we for instance, if we have territories that are very successful but a little bit little bit on the larger side, we're constantly looking if we can make, you know, one territory into two territories, for instance. So we we so the the we are looking at expansions like that and which where where we could add one or two or salespeople.

42:48 We're not looking to add, like, 10 or 20 or something like that at this stage. And it all comes to I mean, that, with where where we see the opportunity. So we do we do things like that. Thank you. When do you expect the China phase three trials to complete? The actual study is completed in China. It it was complete. I think we must have announced that last year at some point, I I believe. Or if we didn't, now you know it. It it is complete anyway. The the the the the reason why this has taken longer on the regulatory side is that in China, we had a very large number of sites. And what they've been doing in China in the end of of last year is to make sure that every site is up to the quality standards that they would need to present when they do their when they file to the Chinese authorities, and that has taken longer. So the data is in place and and and so forth. So we now estimate that they should be able to file. We we don't I mean, sometimes during the first half of of this year.

44:13 Thank you. What would the profile of revenues be outside of The US? Can we start forecasting revenues and royalties? Sorry. Can you ask the question again? I missed that question. Outside The US, what might the profile of revenues be? Yeah. We are you are seeing what our, revenues are. We had 50,000,000 in 2025. 46 came from The US. We anticipate we anticipate that ratio to remain consistent, at least in the near term. Once once we start to see countries like China coming on live, the population there is significant, probably comparable to The US in terms of opportunity. And so that's, I think, when you start to see a true shift in in the split.

45:05 We we are anticipating South Korea to launch, like I said, this year. The contribution of that is going to be useful, but I I I would not call it extremely large compared to what The US revenues are in the near term. There are a few milestones that we are expecting to see through these deals that will contribute in terms of revenues and cash as well. Again, compared to The US revenues, those will be relatively small. Thank you. Sorry. And last question. What does streamlining the balance sheet mean?

45:55 That's a that must have been me. I was using a consulting term, I guess. It it it it it says a lot, but doesn't mean anything. No. So so we are, you know, we are constantly constantly looking at how do we make our balance sheet more efficient. You you saw what we announced in q four. We refinanced the debt. We like our partners. We really like our partners. They have been extremely flexible, and and have been working with us as we continue to grow the company and and grow the and grow Acrefer. So we like our partners, but these these, debt instruments were put in place when SHIELD was in a very different position as a company. We were not profitable. We were not generating cash. We were burning cash, and we we had a higher risk profile in the eyes of these debtors.

46:43 Today, they are different. We we are not generating cash. We expect to be profitable this year. We are growing revenues. Acrefer is making a a dent in the market, and our profile as a company is way different from a risk perspective. And so we continue to have conversations with our partners to make sure that the debt instruments we have in place reflect the nature of who who we are as a business today. And that's what we mean by country reevaluate our balance sheet and and strengthen it. At some point, we would love to get rid of some of the debt instruments that we have on our books, and we'll continue to evaluate those options as well. Thanks, Santosh. Thanks, Anders. Anders, if I could pass back to you some closing comments. No, Kim. Hold on. Kim, there is a few other questions I think we can address as well Okay. Instead of them putting it in writing. If especially if you try to sell out a product, would that affect AccraFire and so forth? No. Actually, it will. It will be affected positively because if we do have a second product where you can actually visit the same target as we have for Aquifer, it typically actually increases the the the revenue for your first product as well because you have a second chance to go back to that that physician or prescriber.

47:55 So, typically and that's why we're looking for a product that would overlap with with partly, the targets we have for aquifer. So that is why we so you know, really looking for to to get a second product. And somebody asked if that would we will make money immediately on a second product. It depends on the product, of course. There will always be an investment about behind the second product, but we will not wouldn't take anything on unless we thought we would sort of be able to generate more revenue for both products. That is basically what I'm trying to say. So having a second product in in the bag of our salespeople typically helps the first product as well. And I think there's a question, Santos, on the debt facilities to repay AUP and so forth. I think there's a big missing I miss this is a little question 36.

48:44 It's a little bit of a misunderstanding. I think we should address that as well. Let me, yeah, let me read the question. Is the debt facility available to repay AOP for the milestone financing if that milestone isn't hit by end of year? Also, can you clarify that you can repay the 5,700,000 plus interest? You don't need to give AOP 11,400,000 milestone. Yeah. That's a good question. So the structure of the milestone monetization was we received 5,700,000 from AOP last year. And in return, we paid them the $11,400,000 milestone that we get from ASK upon approval in China. And so that is the current plan. The plan is that we would repay them the 11,400,000.

49:29 It's it's it's it's more of an in and out. We get 11,400,000 from ASK, and we pay AOP the 11,400,000. So the net impact on our balance sheet on the day of that payment is zero. But in return, we got 5,700,000, you know, two years ahead of of that when it was very valuable to us. The accounting for that is we continue to accrue interest on the 5,700,000 at a certain rate, and it and it hits our p and l as an as an interest payment. If in case there is if in case there is a failure on the milestone, which, you know, you you can you heard from Anders, the study is done and they're looking to file. So, the probability of a failure on the milestone is low. But if that were to happen, then, yes, we would have to pay them, a 5,700,000 plus any accrued interest on on that specific day. Now keep in mind, the accrued interest plus the 5,700,000 could be lower than the 11.4.

50:30 So it's it's not that we would have to pay them 11.4. It would be whatever interest has been accrued on the 5,700,000. Hopefully, that clarifies the question. Good. I was just going through any other questions. Maybe I I don't know, Anders, if you wanna say something about are a few questions about mergers, takeovers, etcetera, if you if you wanna give your thoughts there. Yeah. I can give my thoughts. I mean, mergers take on I mean, in the quest for a second second product, I don't think we're looking we we're not actively looking to do a merger. We active we active we could do other partnerships, of course, like the partnership we have with the artist in in The US.

51:24 If somebody someone else comes with a product, we have a partnership of selling the product for them. I'm not saying we will take out on another partner roles that contributes with with Salesforce. That will be, I think, way too complicated. So that's one way. If somebody would like to buy the company, well, the these are things that's typically outside our, you know, our what we cannot do much about that. If that's if it happens, it happens. And if it doesn't happen, it doesn't happen. I think we're driving the company to grow the company, and that's why we're so proud over that we actually achieved the, you know, the cash flow positivity in the end of of last year and and gonna be profitable this year because that gives us a completely different opportunity to grow the business. Also, the refinancing does that. I mean, it's it's obvious that they believe in that we, you know, can continue to grow the company. That's why we we have those earmarked potential money for a a second product or or a second partnership with with the product. So that's what we are focusing on a 100%.

52:25 It's if somebody comes and gives us an offer, it's up to the board and our shareholders to to make a decision for that. And, of course, it happens in our industry, but but as I said, that's outside what we actually are focusing. On. Thank you, Anders. Can we ask a final question, please, as well? Are there any plans to increase your sales force in the future given your peak revenue target, or do you plan to reach this mostly through marketing? I think there's a combination there to to be had. I think right now, if we can spend an extra dollar or would need to spend an extra dollar, that next dollar will go towards marketing. It's it is very effective to do to do marketing. If we continue to grow, and as I said before, especially in sort of high growth areas, which has a little bit too big geography, we would expand. As I said, we we are we are already looking to do that.

53:25 If we would jump from 40 to 80 each, I don't see that happening in in the short term, to be to be perfectly honest. Because we are targeting those prescribers that have the highest potential. And and many times, this takes time. But when somebody starts to write and continue to write, it's still the one this is the same customer. We are, as I said, expanding into to more specialists, but again and again with the same number of of salespeople. If we are to add a second product, it's a completely different story. If we add a second product, yes, we would have to expand our Salesforce because we couldn't ask the same number of reps to carry two products. So the same that that wouldn't be, that would be a lack of focus, I think, for for both products in that case. We would probably do that. And and, yes, as a rule of thumb, if we would do something like that, you typically increase your sales force, you know, around four thirty, forty, 50% is typically the number you would increase the number of salespeople with to to carry a second product. And then you would you will make territories smaller, but then you have, like, two opportunities to sort of to to to with your with your target prescribers as well. So that is typically how we are thinking about it. But that, of course, would need we we need would need to see what product it is and so forth, but that would be the the the moment in time where we would expand the sales force significantly.

55:00 Perfect. That's great, guys. Anders, just for some closing comments to wrap up. Thank you very much. Well, I think we we covered a lot of ground, so we're happy about that. We got a lot of very good questions, so thank you all for you those who who asked questions. So, you know, thanks again. As I said, I mean, the the big news for us for for the for the fourth quarter and the year is we turned cash flow positive, which actually gives us a lot lot more flexibility than we ever had in the past. And it's thereby we also stress to you a lot that we are looking, you know, very actively to to add a second product. But first and foremost, we are focusing on continue to grow aquifer. So thanks again. And if there are any additional questions, never hesitate to to to contact us and and ask questions and so forth. We're happy to address as many additional questions as as we can.

55:53 So thanks again. Fantastic. Anders, Santosh, thank you very much indeed for updating investors today. Could I please ask investors not to close this session as you'll now be automatically redirected to provide your feedback in order that the board can better understand your views and expectations? This will only take a few moments to complete, and I'm sure will be greatly valued by the company. On behalf of the management team of SHIELD THERAPUITIX PLC, we would like to thank you for attending today's presentation, and good afternoon to you all.