Bonesupport Q3 2025 slides: Strong sales growth and margin expansion despite stock pressure

Introduction & Market Context

Bonesupport Holding AB (STO:BONEX) presented its third-quarter 2025 results on October 23, showcasing strong sales growth despite currency headwinds. The Swedish medical technology company, specializing in injectable bone void fillers, reported significant growth in the U.S. market while facing challenges in certain European regions. Despite the positive operational performance, Bonesupport’s stock declined 7.67% to SEK 236 following the presentation, approaching its 52-week low of SEK 233.4.

The company’s core product, CERAMENT G (gentamicin-eluting bone void filler), continues to gain traction in the U.S. market, while the company prepares to expand into new segments including spine and revision arthroplasty. These developments come amid a shifting landscape in orthopedic infection management, with increasing adoption of local antibiotic delivery systems over traditional systemic approaches.

Quarterly Performance Highlights

Bonesupport reported net sales of SEK 294.1 million for Q3 2025, representing a 24% increase compared to the same period last year (SEK 237.5 million). When adjusted for currency effects, the growth rate reached 34%, highlighting the impact of USD/SEK depreciation on reported figures.

As shown in the following breakdown of Q3 net sales growth components:

The U.S. market remained the primary growth driver, with sales reaching SEK 246.3 million, a 28% increase (40% in constant currency). Meanwhile, the EUROW region (Europe and Rest of World) delivered more modest growth of 5% (7% in constant currency), with sales of SEK 47.8 million. The company noted that strong performance in Southern Europe, Australia, and Canada helped offset austerity measures affecting the German market.

The adjusted operating result reached SEK 78.6 million with a margin of 27%, demonstrating continued profitability improvement. Operating cash flow remained strong at SEK 71.1 million, contributing to a solid net cash position of SEK 379.0 million at quarter-end.

Detailed Financial Analysis

A closer examination of Bonesupport’s financial performance reveals divergent trends between product segments. The antibiotic-eluting CERAMENT products (CERAMENT G and CERAMENT V) showed robust growth of 59% on a last-twelve-months basis in constant currency. In contrast, the non-antibiotic CERAMENT BVF product experienced a slight decline of 1.7% in the U.S. market.

The following chart illustrates the long-term sales trend by segment, highlighting the growing importance of antibiotic-eluting products:

The company’s adjusted operating result has shown consistent improvement, reaching an all-time high operating margin of 28.6% before foreign exchange effects. This trend is visualized in the chart below, which also illustrates the impact of USD/SEK exchange rate fluctuations:

Regional performance analysis shows the U.S. segment delivering both higher growth rates and superior margins compared to EUROW. The U.S. business contributed 84% of total sales in Q3, with gross margins remaining stable at approximately 92%.

Strategic Initiatives

Bonesupport highlighted several strategic developments that could drive future growth. Most notably, the company presented results from the CeraHip study, which demonstrated 0% infection recurrence in patients undergoing cementless one-stage hip revision with CERAMENT G. This compares favorably to literature references showing reinfection rates of 5.7% to 30%.

The CeraHip study results are illustrated in the following image, showing improvements in Harris Hip Score and Quality of Life metrics:

This clinical validation is expected to facilitate Bonesupport’s entry into the revision arthroplasty and periprosthetic joint infection markets, representing significant growth opportunities. Additionally, the company received New Technology Add-on Payment (NTAP) approval for CERAMENT G in open trauma cases, providing up to $5,687.50 per case in additional reimbursement.

Other strategic initiatives include:

• Preparation for spine market entry in Q4 2025
• CERAMENT V supplementary file submission planned for November
• Ongoing R&D focused on next-generation CERAMENT products

Forward-Looking Statements

Bonesupport maintained its full-year 2025 guidance of sales growth above 40% in constant currency. The company announced plans for a Capital Markets Day in spring 2026, suggesting confidence in its long-term growth trajectory.

CEO Torbjörn Sköld emphasized the company’s strong position, stating that the most exciting part of Bonesupport’s journey still lies ahead. The company’s focus on expanding into new market segments, particularly revision arthroplasty and spine, indicates a clear growth strategy beyond its current core business.

However, investors should note potential challenges not extensively addressed in the presentation, including market saturation in key segments, regulatory hurdles for new product approvals, and ongoing currency headwinds. The stock’s decline following the earnings presentation suggests the market may be concerned about these factors despite the strong operational performance.

With a solid cash position and improving profitability metrics, Bonesupport appears well-positioned to execute its growth strategy, though the gap between operational performance and stock price movement warrants attention from investors.

Full presentation:

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