KRMD November 12, 2025

KORU Medical Systems Q3 2025 Earnings Call - Accelerated 27% Revenue Growth Driven by SCIG Market Expansion and Oncology Infusion Advances

Summary

KORU Medical Systems reported a strong Q3 2025 with 27% year-over-year revenue growth, fueled primarily by a 30% surge in their core subcutaneous immunoglobulin (SCIG) business fueled by international expansions and share gains. While domestic revenue faced some inventory-driven softness and cross-geography distributor shifts, international revenue soared 230%, led by successful prefilled syringe conversions in Europe that simplify administration and boost adoption. The company advanced its pipeline with nine new pharmaceutical collaborations including oncology, highlighted by a U.S. pilot showing workflow efficiency gains and high nurse satisfaction with the Freedom Edge Infusion System. KORU raised its 2025 revenue guidance to $40.5-$41 million (up 20%-22%) and reaffirmed gross margin and cash flow targets, confidently pointing towards sustained double-digit growth and pipeline-driven acceleration in 2026 and beyond. Despite margin pressures from manufacturing costs and tariffs, the firm maintains a disciplined financial approach and anticipates margin improvement as international scale and operational efficiencies grow.

Key Takeaways

  • KORU delivered 27% year-over-year revenue growth in Q3 2025, hitting over $10 million for the second straight quarter.
  • Core U.S. subcutaneous immunoglobulin (SCIG) business grew 30%, outpacing market growth due to international expansion and global share gains.
  • International revenue surged 230%, driven by successful prefilled syringe (PFS) conversions in Europe simplifying patient and healthcare professional usage.
  • Two new pharmaceutical flow technologies (PFT) collaborations announced, expanding KORU's drug pipeline and market reach.
  • U.S. oncology pilot study achieved 100% administration success, with 70% of nurses able to multitask thanks to Freedom Edge Infusion System, boosting clinic efficiency.
  • Oncology infusion market entry on track for FDA 510(k) submission by end of 2025 or early 2026, with commercial entry expected in H2 2026.
  • Seven active collaborations with all major immunoglobulin manufacturers support pipeline growth; four additional new drugs expected on label by end of 2026.
  • Gross margins held above 60% despite increased manufacturing costs, tariff impacts, and international mix; full-year margin guidance reaffirmed at 61%-63%.
  • KORU generated positive adjusted EBITDA and $400,000 cash flow in Q3, reducing net losses by more than half year-to-date.
  • 2025 revenue guidance raised to $40.5-$41 million (20%-22% growth); early 2026 outlook suggests sustained 20%+ growth driven by pipeline and international expansion.
  • International expansion targets 40% market share from mid-teens currently, representing $10-20 million incremental opportunity primarily from PFS shifts.
  • U.S. SCIG market is expanding above 8%-9% expected annual growth, helped by increased primary and secondary immunodeficiency diagnoses influenced by aging and cancer treatments.
  • Japan market entry progressing with modest current sales; international PFS market opportunity is prioritized as top growth driver.
  • Stocking order and distributor dynamics temporarily skewed revenue split between domestic and international but resolved promptly with controls in place.
  • Reimbursement for oncology infusion already in place, removing a typical barrier to adoption in new infusion markets.
  • Long-term margin improvement goal remains 65%+ supported by operational excellence and volume growth.

Full Transcript

Operator: Greetings, and welcome to KORU Medical Systems’ Q3 2025 earnings conference call. At this time, all participants are in a listen-only mode. A question-and-answer session will follow the formal presentation. If anyone should require operator assistance during the conference, please press star zero on your telephone keypad. Please note this conference is being recorded. I will now turn the conference over to Luisa Smith, Head of Investor Relations. Thank you. You may begin.

Luisa Smith, Head of Investor Relations, KORU Medical Systems: Thank you, Operator, and good afternoon, everyone. Joining me on the call today are Linda Tharby, President and CEO of KORU Medical Systems, and Tom Adams, Chief Financial Officer. Earlier today, KORU released financial results for Q3, ended September 30, 2025. A copy of the press release is available on the company’s website. I encourage listeners to have our press release in front of them, which includes our financial results and commentary on the quarter. Additionally, we will use slides to support further commentary in today’s call, which are also available on the Investor Relations section of our website. During this call, we will make certain forward-looking statements regarding our business plans and other matters. These comments are based on our predictions and expectations as of today.

Actual events or results could differ materially due to risks and uncertainties, including those mentioned in the associated press release and our most recent filings with the SEC. We assume no obligation to update any forward-looking statements. During the call, management will also discuss certain non-GAAP financial measures. You will find additional disclosures, including reconciliations of these non-GAAP measures with comparable GAAP measures in our press release, the accompanying investor presentation, and SEC filings. For the benefit of those listening to the replay, this call was held and recorded on Wednesday, November 12, 2025, at approximately 4:30 P.M. Eastern Time. Since then, the company may have made additional comments related to the topics discussed. I’d now like to turn the call over to Linda Tharby, President and CEO. Linda, please go ahead.

Linda Tharby, President and CEO, KORU Medical Systems: Thank you, Luisa. Good afternoon, everyone, and thank you for joining today’s earnings call. I’ll begin with some commentary on our Q3 highlights and strategic progress, and then Tom will review our financial results before we open the call for questions. During Q3, we delivered strong results: accelerating revenue growth, outstanding performance in our core immunoglobulin business, new additions to our PFT pipeline, and continued progress towards sustained profitability. We achieved our second consecutive quarter with more than $10 million in revenue, representing 27% year-over-year growth. The key growth driver was our core subcutaneous immunoglobulin, or SCIG, business, which grew 30%, driven by international expansion, continued global share gains, and strong underlying patient growth. While we saw some quarterly shifts in purchasing patterns between domestic and international markets, both underlying businesses remained robust. Tom will provide additional details on the shift in geographic mix.

From a strategic standpoint, we advanced several important initiatives this quarter. We recently announced two new PFT collaborations, underscoring our commitment to expanding our pipeline, broadening our label, and reaching additional patient populations. I’ll share more detail on those collaborations during our pipeline discussion. We also made meaningful progress toward our goal of expanding into oncology infusion centers, successfully completing a U.S.-based oncology study that validated KORU’s value proposition in this market. We remain on track for a 510(k) filing by the end of 2025. On the financial front, we delivered gross profit growth of 21% year-over-year, achieved positive adjusted EBITDA, and generated positive cash flow. To reflect our confidence in the business and continued execution, we are raising our full-year revenue guidance to $40.5-$41 million, representing growth of approximately 20%-22%, and we are reaffirming our guidance for gross margins and cash flow from operations.

Now turning to our U.S. SCIG business, which represents our largest recurring revenue base. As shown on slide 4, external forecasts project SCIG market growth of approximately 9% annually over the next five years, outpacing the IVIG segment. This growth outlook is supported by several key factors. First, an increasing number of new patients are being diagnosed and treated with SCIG as their first-line therapy. With approximately 20% market penetration today, SCIG still has significant headroom for expansion in the broader immunoglobulin therapy market. Second, we’re seeing broader diagnosis of secondary immunodeficiency, or SID, driven by an aging population, higher prevalence of chronic illnesses, and increased use of immunosuppressive treatments such as chemotherapy and CAR T-cell therapy. Importantly, we’re also seeing growing clinical activity in the SID area, which could ultimately support new reimbursement coverage and add further momentum to SCIG adoption.

Finally, pharma partners continue to invest heavily in the SCIG space through device innovations such as prefilled syringes and a strong pipeline of clinical trials and label expansions. Our leadership position in this category remains very strong. U.S. end-user demand and sales to specialty pharmacies are at or above market growth rates, reflecting solid execution and the continued health and momentum of our U.S. SCIG business. Now turning to international, which continues to be one of the most exciting areas for our accelerated growth potential. Over the past year, we’ve grown our international market share from roughly 10% to 15%-20% of the underlying $60 million OUS SCIG market. We see further growth potential in several key areas. First, the shift to prefilled syringes in Europe. This represented the majority of our growth this quarter.

The efforts to convert a market from vials to prefilled syringes using our Freedom Infusion System, including both the pump and consumables, have been very successful. By simplifying administration steps, our system makes it easier for patients to use and for healthcare professionals to train them. Several additional EU countries are planning similar conversions, and our innovation pipeline, combined with strong alignment with pharma partners, positions us well to further penetrate the top European markets. At the same time, we continue to grow infusion set sales in markets that still primarily use vials. Overall, we feel very confident about our international momentum. We are targeting to accelerate our overall market share from the mid-teens into the 40% range, representing a $10-$20 million opportunity over the next several years. This next slide highlights our progress with IG pharma partners.

Today, we have seven active collaborations across all four major IG manufacturers, which continue to drive KORU growth alongside their new drug, device, and indication expansions. Commenting on changes from last quarter, we saw two previously announced collaborations push their launch dates into 2027, so we have updated our pipeline accordingly. Importantly, we do not see this as having any material impact on current projected revenue. Highlighted in green on the bottom row is our most recent collaboration, which we announced last week. This is particularly exciting because the relationship with this drug manufacturer expands our potential into the broader patient populations for an IG drug where we currently hold a lower global share position. Overall, these IG collaborations are a key driver of both share gains and geographic expansion in the subcutaneous market, reinforcing our strategy of partnering with pharma companies to accelerate adoption and growth.

Turning now to new drugs outside of IG, we currently have nine active collaborations with four potential new drugs expected to be added to our system by the end of 2026. Recent updates to this pipeline are highlighted in green on the slide. First, a rare disease candidate has been pushed by one quarter to Q1 2026, following FDA request for additional testing data. We do not expect this to materially impact our timeline or 2026 revenue opportunity. Second, we are seeing expanded commercial potential for an additional Empoveli indication, a prior clear drug, which we are currently supporting in phase three trials. Finally, we recently announced our collaboration with Forecast Ortho supporting their clinical trials for treatments that address complications from joint replacement surgeries. This marks our first opportunity in the orthopedic space and adds approximately 140,000 potential infusions.

We estimate that the non-IG drugs in our pipeline, with an anticipated launch date between now and 2027, have a commercial potential for KORU of up to $10 million by the end of 2028. With a clinical pipeline of more than 95 drugs exceeding 10 mL across the pharma landscape, we continue to actively pursue additional assets to expand and strengthen our pipeline. This quarter, we also continue to advance our entry into the oncology infusion space. Currently, there are seven subcutaneous oncology drugs administered in infusion clinics using manual syringe push, which requires nurses to stand over patients and inject highly viscous drugs over a period of 5-10 minutes. Following our successful EU study, where 97% of nurses preferred the Freedom Edge Infusion System over manual syringe administration, we launched a U.S. pilot study in Q2, which concluded in Q3.

In total, five oncology infusion clinics participated, administering two leading oncology drugs. The results were very encouraging. We achieved a 100% success rate in administration and met all safety requirements. We also observed high satisfaction among nurses and patients with improvements in physical strain and patient comfort using the Freedom Infusion System compared to manual syringe push. Importantly, 70% of nurses reported the ability to multitask, including treating other patients, adding the potential for improved clinic workflow efficiency. Our value proposition continues to resonate across all sites studied. We are progressing in collaboration with one of the seven oncology drugs and remain on track for a 510(k) submission to the FDA, either in Q4 of this year, subject to federal timing, or in Q1 2026, with anticipated commercial market entry in the second half of 2026.

The total addressable market for oncology infusion consumables is significant, projected to grow from approximately $60 million in 2025 to $138 million by 2030. We are being very diligent about our market entry and regulatory strategy, ensuring that when we enter oncology, we do so in a way that supports patients, providers, and long-term growth. Overall, I’m extremely proud of the team’s execution and the strong momentum we built across our business during the first three quarters. With robust growth in our U.S. and international markets, meaningful pipeline progress, and strategic advances across both IG and non-IG opportunities, we’re well positioned. With that, I’ll turn the call over to Tom to review our financial results and share our updated guidance for 2025. Thanks, Wanda.

Starting with revenue, we are pleased to report our second consecutive quarter of revenue above $10 million, with 27% year-over-year growth, which is a record high for KORU. We delivered 30% growth in our overall KORU business, reflecting the fundamental strength of the underlying demand for our products and KORU’s growing market position. The geographic mix this quarter does require some context, for which I’ll provide some additional commentary. Our reported domestic revenue declined 5%, while international revenue grew by 230%. There were three specific factors that drove this geographic shift in revenue imbalance across our businesses. First, in the domestic KORU business, as we discussed and anticipated on our previous call, one of our U.S. distributors reduced their on-hand inventory levels this quarter, which temporarily impacted their order volume and moderated our domestic growth.

Second, in the international KORU business, we had some outsized stocking orders to support the exceptionally strong demand we’re seeing with prefilled conversions in Europe. We’re encouraged by this momentum in PFS and believe that it will continue to be a meaningful driver of international growth moving forward. Third, one of our international distributors sold product to a U.S. distributor, and that transaction had a dual effect. It inflated our international revenue figures while simultaneously reducing our domestic revenue growth. We have since corrected for this dynamic and do not anticipate it occurring again. Altogether, we estimate that these three factors had an underlying impact of approximately $1.2 million between the two businesses. The bar chart on the right provides a visual to normalize for the imbalance we saw from these factors in the quarter.

The bottom line here is that our KORU business is solid, and market demand is robust. We continue to grow our market position, and we are really pleased to have posted 30% overall KORU growth, which underscores the strength of our business on a global scale. Our pharma services and clinical trials businesses fluctuated slightly year-over-year due to the inherent nature of revenue recognition timing associated with the staging of work and milestones. Moving on to gross margin, we continue to consistently deliver margins greater than 60%. This quarter, we reported a gross margin of 60.2%, a decrease of 320 basis points from the prior year, driven primarily by a combination of higher manufacturing costs and lower yields, geographical customer mix from the strength of our international business, and tariff impacts of approximately 50 basis points.

Looking ahead to the fourth quarter, we expect the cost of manufacturing to improve, and as we have indicated throughout the year, we will continue to see a higher mix of growth in our international markets with lower ASPs and a modest tariff impact from our suppliers. We reiterate and expect our full-year margin to stay in line with our guidance of 61-63% as we have laid out since the start of the year. We finished this quarter with $8.5 million in cash, representing cash generation of $400,000, which was driven by lower net losses from higher revenues and disciplined operating expense spending. Additionally, our working capital was balanced, and we saw lighter investments in manufacturing equipment. Our non-cash items were primarily driven by stock comp expenses and depreciation. We continue to see the benefits of our discipline in our cash flow results.

Our year-to-date financial highlights show that we are progressing towards profitability. Revenue grew 22% to $30.2 million compared to $24.8 million in the prior year’s first three quarters, with a corresponding operating expense increase of 3%, demonstrating our ability to run a disciplined capital allocation process. Gross margin remains over 60% at 62.1%, despite some Q3 headwinds with manufacturing costs and tariff impacts. We cut net losses in half from $4.5 million to $2.2 million, and we have delivered positive adjusted EBITDA this year, showing a 109% improvement. As it relates to the balance sheet, our cash usage has dropped to $1.1 million year-to-date, representing a 60% decrease from last year. Looking ahead for the full year 2025, we are raising our revenue guidance to $40.5-$41 million, representing 20%-22% growth, an increase from our prior range of $39.5-$40.5 million.

This is driven by opportunities for further growth internationally and a strong SCIG market in which we will continue to gain new patient starts. We are reiterating our gross margins in the range of 61-63%, as well as reiterating our positive cash flow from operations. We expect to end the year with at least $8.2 million in cash. I’ll now turn the call over to Linda for some closing commentary on future milestones and our vision for continued growth. Thank you, Tom. We are making strong strides across our strategic priorities, setting the stage for accelerated revenue growth. In our efforts to expand the number of drugs on our Freedom Infusion System, this year to date, we have advanced four new pharmaceutical collaborations and submitted a 510(k) for our rare disease infusion drug.

Upcoming 510(k) filings in early 2026, including opportunities in oncology, position us for meaningful pipeline and commercial growth. In our international expansion efforts, we launched commercial sales in Japan and rolled out our phase one flow controller. Growth in our top 10 markets will be further driven by prefilled conversions, expanding our global footprint and patient reach. Our KORU domestic SCIG franchise continues to outpace the market’s 8-10% growth. With key submissions ahead, including the phase two flow controller and next-gen IG pump, we are poised to expand our SCIG leadership. Overall, these achievements, combined with upcoming milestones, reinforce our confidence in meeting 2025 financial targets and sustaining long-term momentum. In summary, I’ll leave you with some of the core elements we believe make KORU an attractive opportunity not only now, but also in the future.

Market dynamics continue to support a shift towards subcutaneous delivery, and our technology is well positioned to capture the benefits of that shift. Each quarter, we make great strides in executing against our plan. We achieved another excellent quarter with revenue expansion exceeding 25%, driven by steady recurring revenue from our KORU IG franchise, ongoing patient-based expansion, with a compelling opportunity for growth acceleration internationally with prefilled conversions. Additionally, we have a robust and growing pipeline, including 11 new opportunities to bring new drugs outside of IG onto our label in the coming years. Finally, our updated guidance underscores our confidence in continuing to accelerate revenue growth in 2025 and beyond, while maintaining a healthy P&L and improving balance sheet to optimize flexibility and support with our growth strategies moving forward.

Before closing, I’d like to thank the entire KORU team for their continued efforts and passionate work to further our mission and treat even more patients worldwide. Operator, please open the line for questions. Thank you. We will now be conducting the question-and-answer session with selected analysts. The format will be for one question and one follow-up. If you would like to ask a question, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two if you would like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. Our first question comes from Frank Takkinen with Lake Street Capital Markets. You may proceed with your question. Great. Thanks for taking the questions. Congrats on all the progress.

I was hoping to start with the oncology setting. Happy to hear the pilot’s done, and you had some great outcomes there. I think I heard you comment on the nurse feedback has been particularly positive, with the ability to service a few patients at once. Maybe a little bit deeper into that would be helpful to understand how that feedback has been. As a second part in the oncology setting, can you maybe talk about the reimbursement model, any work that needs to be done there, or is there currently a structure in place that’d be conducive to adoption in that setting? Thanks, Frank. Obviously, we’re very excited about oncology being a major expansion into a new market for KORU. The clinical study that we did was really based in five clinics in the U.S.

We had very large centers and much smaller regional centers, so we had good diversity in terms of that. The outcomes across all the clinics were fairly synonymous. I’ll glide quickly past nursing and patient satisfaction, very, very high in the 90+% range, obviously the safe dosing of all of those drugs. Your specific question on workflow efficiency was the one that we were really excited about, where 70% of nurses reported the ability to multitask. Right now, they are completely wed to that patient with the manual syringe push administration. What we were hoping to validate was that by using our pump, the clinic could see improved throughput of patients. Indeed, what we saw was that many nurses were comfortable being able to leave that patient and attend to other patients, do administrative duties, etc. Really huge opportunities for these clinics.

On your last part around reimbursement, the great news is we do not have anything to do on the reimbursement front. The reimbursement codes that exist today cover for the administration of these drugs in infusion clinics using a pump. That reimbursement coverage exists for the products. We are very excited about the opportunity. Charging ahead now, we have been doing the work to get the submission completed. Provided that everything gets passed, we hope that the FDA will be receiving that submission. We are confident by the end of this year, and we are looking forward to what is ahead for us in the oncology market. That is great. Thanks for that color. Maybe a clarifier on guidance for Q4. Any color you can provide on kind of breakout of revenues per line item would be helpful, just given the volatility from the different stocking dynamics and distributor dynamics.

Maybe if I can squeak one more, any initial thoughts on 2026 would be helpful for us as we’re building out our models for that year. Okay. Maybe I’ll start with the remainder of the year this year, and then I’ll turn it over to Tom to give you some more specifics. Overall, if you look at our front half performance for the business, we grew 19% overall for the business, with back half growth implied at the midpoint of our guidance at 23%. The first thing is everybody should feel comfortable about the acceleration in revenues between the front and the back half. As for the splits between business and what you can expect, given the dynamics of the Q3, I’ll let Tom go ahead. Yeah. Thanks, Frank, for the question.

If you look at our first half of the year and you look at that split, we split around 70% or so for the U.S. business and around 23-24% for the international business. You can assume that’s that sort of split for the Q4 expectation on revenue, with the remainder of that obviously being the PFT business. Thanks. Then regarding 2026 guidance, first thing I want to say is obviously when you post two 20%+ quarters in a row, we feel great and excited about the position that we’re in. If you look back over what we’ve been talking about for pretty much the course of the last year, it’s taken the company to this new level of sustainable 20%+ growth.

So while I’m not comfortable giving exact guidance for 2026, what I can say is that a number that starts with a two is something we’re feeling good about at this moment in time. Obviously, we’re looking for those accelerations, which opportunities from prefills, more international expansion, oncology, those new drugs, all of those things, the 20+% you’re seeing today is being done without those things. Obviously, acceleration, whether that comes in 2026, later in 2026, early in 2027. That’s what I would say, that the number starting in a two is what we’re comfortable with today, given what we know today. That’s helpful. Yep. Got it. Makes a lot of sense. Thank you. Our next question comes from Caitlin Roberts with Canaccord Genuity. You may proceed with your question. Hi. Thanks for taking the question and congrats on a great quarter.

Just starting with the EU, I think you noted that several countries are preparing for the change to PFS. I mean, any more color on the size of those opportunities and potentially the timing of those? Thank you, Caitlin, and congratulations on the new last name. Thank you, though, for the quarter. We’re very excited about the international expansion opportunity. As I mentioned on the call, we see international taking our share position, pretty much doubling it over the next little bit, and we see that as a $10 million-$20 million opportunity overall, most of it being driven by prefills. We have converted just one large market. Why this opportunity is such a big lift for KORU is that the standard of care in Europe has been electronic pumps.

Our studies and head-to-head show a 50% reduction in the number of steps required for patients to use our system versus electronic pumps. It is also easier for healthcare professionals to train. I’m not going to give details of what the next countries are, but suffice to say that we’ve only got one down, and we think we have a lot of headroom in front of us with a lot of work to do. It is a major growth opportunity, and we’re putting a lot of effort into that today. That’s great. Obviously, share gains have been a big piece of the SCIG growth for you. Any color on the just market growth dynamics at this point in the year, maybe with early flu season starting and how you feel about that going into the end of the year and into 2026? Yeah.

Just overall, what we’ve seen is the underlying rate of patient diagnosis is going up. I would say we’ve seen definite acceleration quarter to quarter. It’s a little early yet. Usually, the diagnosis lags a couple of months by the infection. While flu season starts, usually these patients require four, five, six infections before their PID may be diagnosed. We’ll wait and see. Fingers crossed on that one. We’ve had a strong year thus far. I would say the second dynamic, which I introduced in the call today, was we’re seeing a lot more SID, secondary immunodeficiency, with general underlying dynamics like aging populations, etc., driving it. The big one is the cancer treatments, the chemotherapy drugs, the CAR T-cell therapies that reduce the immune system by design so that those drugs can work. The patient needs immunotherapy.

We see a lot of the IG manufacturers now starting trials for SID because currently that is not reimbursed in the U.S. We see this as being a potential today that is not built into our numbers. That is probably a story that plays more into 2027 by the time they complete those trials. We are certainly seeing a lot of off-label use of SID today. Great. Thanks for taking the questions. Our next question comes from Joseph Dowling with Piper Sandler. You may proceed with your question. Hey, guys. Thanks for taking the question. I am for Jason today. Just a quick question on gross margin. Looking at the four Q and then the 26 as well.

I know you’re probably not too keen on divulging any specifics here, but just directionally, can you provide any commentary on how we should expect gross margins to develop here over the next 12 to 18 months? I know there’s international mix dynamics, some manufacturing efficiencies, tariffs, some pricing, new launches, things like that. Any color there would be really helpful. Yeah. Hi, Joseph. Thanks for the question. Yeah. As we mentioned, just starting with this year, we have seen that geographic mix change. Obviously, the geographic mix change, when you think about the ASPs and the different markets, as you grow more internationally, you have a lower ASP driven by emerging markets or established markets. When you think about that dynamic and you accelerate that into the next 12 to 18 months, we are doing our best to hold our margins.

We are always working on our cost and manufacturing with our operational excellence programs to identify opportunities driven by volumes, right, because we’re a growing business. We will continue to work on our margin profile. We have long-range plans to get our margins 65-plus. That is our strategy and that we will continue to focus on as we grow internationally. Maybe just to add on to what Tom said, obviously, we started the year with a 61-63% margin range with a couple of manufacturing issues. The growth in international, which we did not anticipate, we knew it was going to be good, but as good as it is, growing through the year, I think Tom, we’re probably double that business through the third quarter already. The fact that we’re able to maintain that original margin gain, also, sorry, I forgot tariffs as well.

Just a huge credit to our operations team. We’ve really done a great job of bringing back some efficiencies, which is why we’re still confident, despite those things, holding on to that 61-63% and continued march towards that 65% range that we’re headed for over the next three to four years. Great. Appreciate that, guys. One quick one on Japan. Can you just give us any color on maybe the cadence of the ramp into next year? That would just be helpful as we look at our models here. Sure. On Japan, I would say the great news is we’re in the market. We’ve got sales. I think I said this year the sales would be somewhere just $300,000-$500,000. I think we’re feeling pretty good about that range. Japan is primarily today an in-hospital system.

We think it’ll take a little bit longer for Japan to evolve. I would say the overarching comment on international that is more than made up for that is the strength of the prefills. We’re excited still about Japan. I would say it’s still a growth driver, but it’s probably now number three or four on our list versus the broader prefill opportunity is number one by and large. Great. Thanks, Linda. Appreciate it. Our next question comes from Chase Knickerbocker with Craig Hallum. You may proceed with your question. Good afternoon. Congrats on the next quarter here. Thanks for taking the questions. Maybe just to start on U.S. Corps. Just to clarify, I guess, a couple of things. That $1.2 million was basically adjusting for those ordering dynamics from OUS distributor to U.S. distributor. That would make U.S.

Growth, call it 14% kind of year over year if we add that $1.2 million there. Maybe just give us an update on what SCIG growth was from a market perspective in the third quarter. Thank you, Chase. Yes, we’re excited about the quarter and appreciate the well wishes. The order dynamics, I think Tom laid them out well, and you got it perfectly. It’s a combination. The only thing I would correct, yes, it’s the $1.2 million that should have been in the U.S. That was a combination of three things, right? It was the stocking deceleration from one of our major U.S. distributors and then also the order dynamic between the U.S. and OUS. Regarding the broader SCIG market growth, we don’t have the numbers yet for Q3. Those usually lag a couple of months behind for us.

We know that from quarter one and quarter two that number was in that 8-9% range overall, with acceleration between quarters in the growth levels being driven by PID, just really strong demand and patient growth in PID, and then also the SID piece that I mentioned earlier. Got it. Maybe just, you noted some stocking related to the prefilled conversion in Europe as well. Can you just maybe speak to whether or not this is a new geography or the same one that we were talking about last quarter? I know you do not want to give specifics as far as the geographies that you expect kind of these rollouts, prefilled conversions to take in. Can you maybe just give us your overall thoughts as far as how you see the cadence?

Is this going to be something that’s a phase-in kind of country by country? And it happens over the course of the next 18 to 24 months? Or just give us your overall thoughts there on the cadence. Yeah. One thing I should have mentioned on the last call, you said the 14% growth. I think, yes, that’s about right, the number for the U.S. market. Regarding prefilled syringes and the first country, that country was a country that was dominated by electronic pumps. We had very low share positions in that market with our consumables. They converted very quickly. They delisted their vials completely in that market and went 100% to prefills. We were very fortunate they did that pretty rapidly. We still see some upside in that market because the pharma company continues to win new tenders based on their prefills.

That’s great news. Regarding the cadence for prefills, we believe that the manufacturer that we’re working with will complete most of the work in the major markets by the end of 2026. They are being quite aggressive as they see it to be a competitive advantage for them today. What I would say is that the decision-making, though, is done on a country-by-country basis. Reimbursement is different. How the patient receives the product is different. We’ve got a lot of work to do with each of those country leaders to ensure that we work with them on very specific go-to-market plans to make sure that the patient experience and the healthcare professional experience is what we all want it to be. We think most of the opportunity will be over the next 24 months in total for that opportunity. Got it. Makes sense.

Maybe just to sneak one last one in, just to kind of check the box. I mean, this dynamic with the OUS distributor to the U.S. distributor, that kind of cross-geography ordering, how are you able to confirm? I mean, how are you able to make sure it doesn’t happen again? Thanks. I’ll start and then maybe see if Tom wants to add anything. By the way, in my career in this space, it’s not the first time I’ve seen something like this happen. Typically, what we do in all of our contracts is we protect any pricing we provide per the market. We require tracings to say where is that product going to. That’s why we were able to catch it pretty quickly.

We have since worked with both distributors to ensure that we are now ensuring that product goes to the right markets for which the contracts have been written. We are confident that it will not happen again. We had it corrected within the quarter. Thanks for the questions. This now concludes our question and answer session. I would like to turn the floor back over to Linda for closing comments. Thank you all for joining us this afternoon. We look forward to providing updates on our strategic progress. We have several upcoming investor events ahead of our fourth quarter call in March. Have a great rest of your evening. Ladies and gentlemen, thank you for your participation. This does conclude today’s teleconference. Please disconnect your lines and have a wonderful evening.