BONESUPPORT Earnings Call Highlights Strong Growth Momentum

BONESUPPORT HOLDING AB ((SE:BONEX)) has held its Q1 earnings call. Read on for the main highlights of the call.

BONESUPPORT’s latest earnings call struck an upbeat tone, underscoring strong underlying demand, accelerating constant-currency growth and expanding profitability despite notable FX and cost headwinds. Management emphasized powerful U.S. momentum, exceptional margins and cash generation, plus emerging regulatory and reimbursement catalysts that could further strengthen the company’s competitive position.

Accelerating top-line growth despite currency drag

Net sales reached SEK 324 million in Q1 2026, up 31% at constant exchange rates versus Q1 2025, though reported growth was 14% as a stronger krona masked the operational performance. On a last‑12‑months basis, sales rose 35% in constant currency and 22% reported, highlighting a growth trajectory that continues to run well ahead of headline figures.

U.S. CERAMENT G drives record momentum

The U.S. market remained the key growth engine, with sales climbing to SEK 267 million and CERAMENT G contributing SEK 222 million, up roughly 25% year on year. Management highlighted a record sequential increase of USD 2.6 million for CERAMENT G, the strongest quarterly step‑up to date and a clear sign of deepening surgeon adoption.

Antibiotic-eluting portfolio outperforms

Across the portfolio, antibiotic‑eluting CERAMENT products expanded 48% over the last 12 months at constant exchange rates, underscoring strong clinical and commercial traction. In contrast, U.S. CERAMENT BVF volumes were flat over the same period, with some near‑term softness as traditional BVF users convert to CERAMENT G and the new spine indication remains in its infancy.

Margins and profitability remain a standout

Profitability stayed a core strength, with an adjusted operating result of about SEK 85 million translating to a roughly 26% margin in Q1. The company maintained an exceptional 94.5% gross margin, while FX‑adjusted operating margin improved to 25.5% from 22.6% a year earlier, demonstrating operating leverage even as investments increase.

Cash flow and balance sheet underpin flexibility

Operating cash flow came in at SEK 75 million for the quarter, supporting a cash balance of SEK 455 million at period end and giving the company ample investment capacity. Management noted that average cash conversion since Q3 2024 stands at 81% and that Q1 performance exceeded this benchmark, reinforcing the quality of earnings and balance sheet strength.

Regulatory and reimbursement tailwinds build

On the regulatory front, BONESUPPORT is advancing the De Novo submission for CERAMENT V, actively addressing FDA questions across preclinical, clinical and biocompatibility areas. In parallel, a proposed U.S. CMS IPPS ruling for FY 2027 points to improved payments, more precise procedure coding and a proposed NTAP for CERAMENT V, signaling institutional recognition of clinical and economic value.

Geographic expansion and clinical data support adoption

Outside the U.S., EUROW sales reached SEK 57 million, up 16% at constant exchange rates versus a strong prior‑year quarter, though profitability from the region dipped. The company also recorded its first CERAMENT sales in India and published two U.S. clinical papers in trauma and open fractures, which management expects will further support real‑world uptake.

Currency headwinds cloud reported figures

Management stressed that headline numbers understate operational momentum because of pronounced FX movements, particularly the Swedish krona’s strength versus the dollar. The gap between reported growth of 14% and constant‑currency growth of 31% illustrates how translation effects obscure end‑market performance while leaving underlying demand intact.

Tariffs and higher commercial spend pressure margins

Newly announced U.S. tariffs of 15% are expected to gradually hit costs, with a fully phased‑in impact reducing U.S. gross margins by about 0.8 percentage points later in 2026. At the same time, selling and marketing expenses, commissions and long‑term incentive costs increased at mid‑ to high‑single‑digit rates, creating near‑term pressure on operating margins as the company invests for growth.

BVF softness and regional challenges

The company acknowledged softer U.S. BVF sales in Q1 as some users transition from traditional BVF to CERAMENT G, creating short‑term cannibalization but potentially higher value over time. In Europe and the rest of the world, profit contribution slipped to SEK 12.7 million from SEK 15.4 million, with management citing geopolitical unrest in the Middle East as a source of temporary market and logistics disruption.

Guidance and outlook: investing through strength

Management reiterated its strategy of gradual commercial expansion, including about 10 new U.S. hires and the EUROW Booster program, which adds roughly SEK 10 million of cost but is expected to pay back in around 18 months. While these moves and looming tariffs will weigh on near‑term margins, the company expects continued sales growth, gradual margin improvement over time and key regulatory and reimbursement decisions for CERAMENT V over the next 18–24 months.

BONESUPPORT’s earnings call painted a picture of a high‑growth, high‑margin medtech player leaning into its momentum with targeted investments despite FX, tariff and regulatory‑timing risks. For investors, the combination of strong U.S. CERAMENT G traction, robust cash generation and emerging reimbursement and geographic catalysts positions the company as a compelling growth story with manageable headwinds.