Almirall Aktie

Good day, and thank you for standing by. Welcome to the 2026 First Half Earnings Call of Almirall. [Operator Instructions] Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Pablo Divasson, Head of Investor Relations. Please go ahead.

Thank you very much, Sharon, and good morning, everyone. Thank you for joining us for today's quarterly earnings update and review of Almirall's First Half Year Financial Results of 2026. As always, the slides we are using today are shared in the Investors section of our website at almirall.com.

Please move to Slide #2. Let me remind you that the information presented in this call contains forward-looking statements which involve known and unknown risks, uncertainties and other factors that may cause actual results to materially differ from what we are sharing today.

Please move to Slide #3. Presenting today are Carlos Gallardo, Chairman and Chief Executive Officer; Jon Garay, Chief Financial Officer; and Karl Ziegelbauer, Chief Scientific Officer. Karl will start with the business highlights of the first half of 2026, followed by an update on biologics and the key growth drivers of our medical dermatology portfolio.

Karl will provide you with an update on the pipeline and R&D programs. And then Jon will go through the financials before Carlos concludes the presentation, and we open for questions. I will hand over to Carlos Gallardo, our Chairman and CEO. Please move to Slide #5.

Thank you, Pablo, and good morning to everyone in the call. Almirall delivered a steady first half of 2026, broadly in line with our expectations and the trajectory set out at the beginning of the year, with performance expected to build progressively through the remainder of the year. Net sales reached EUR 603 million, with European dermatology once again acting as a primary growth engine.

These results remain broadly consistent with recent trends and our full year guidance. This is why we are reiterating our full year 2026 guidance with growth expected to pick up towards the second half of the year.

Turning to products. Ilumetri delivered steady double-digit growth around EUR 125 million 125 million in the first half and remains firmly on track towards peak sales of over EUR 300 million. Ebglyss generated EUR 84.5 million in the first half, close to doubling year-on-year. I will provide a bit more context on Ebglyss on the following slides.

Among other products, Wynzora continues to lead market share across key regions, while Klisyri delivered stable growth overall. We remain closely connected to the dermatology community, strengthening our partnership with physicians through ongoing engagement at key platforms such as the 2026 American Academy, Skin Academy and European Academy of Dermatology and Venereology Symposium.

On the innovation side, we continue to make progress. We have several proof-of-concept and Phase II programs advancing, most of which are first or potentially best-in-class. The initiation of Phase II of our anti-IL-21 monoclonal antibody monoclonal antibody marks a key step in our Hidradenitis Suppurativa strategy.

Combined with the IL-1RAP, now we have 2 differentiated assets targeting a disease with significant unmet need. We also signed a strategic research collaboration and licensing agreement with Certest Biotec, adding further depth to our innovation efforts. Karl will revisit our pipeline updates in greater detail.

Please move on to the next slide for an update on our biologics portfolio. Ilumetri net sales reached EUR 125 million in the first half of the year, marking a steady 10.5% year-on-year increase. Ilumetri continues to demonstrate a solid position in the psoriasis market, maintaining its share within the leading anti-IL-23 class, supported by real-world evidence such as the positive study data presented at the latest AAD and EADV congresses, which continue to highlight meaningful long-term benefits in patients' well-being and disease control.

Moreover, we see additional opportunity to further strengthen the profile of Ilumetri. For that reason, we plan to initiate the EVOLVE study in psoriasis to study the effect of the 200 milligrams dose in biologic-naive patients diagnosed for less than 2 years, further reinforcing Ilumetri's strong and growing long-term clinical evidence base. Karl will provide additional details on the EVOLVE study.

Performance remains consistent, and we, therefore, continue to be firmly on track to deliver over EUR 300 million in peak net sales, even as both the product and the class enter a more mature phase of the growth cycle.

Please move to the next slide for Ebglyss highlights. Since its approval in Germany in December 2023, Ebglyss has rapidly scaled to become our second largest product, underscoring one of the most successful atopic dermatitis launches in recent years.

Second quarter sales reached EUR 43 million, up from around EUR 26 million a year earlier, bringing first half sales to approximately EUR 85 million, close to double the level of the first half of 2025. Despite the positive trajectory of the launch, the performance in the second quarter reflects 2 factors.

First, we must recall that we had a strong performance in the first quarter, which sets a higher base for comparison. Secondly, we experienced some softness in the countries like Germany, where a relatively modest pricing adjustment created a short-term uncertainty, and we may have resulted in some sales shifting from June to July.

In addition, we also experienced temporary minor volatility in certain other countries. Overall, we have not changed our mid- and long-term view on Ebglyss, and we expect the strong clinical profile and continued healthy growth in the AD market to support Ebglyss sales.

While we do not typically like to comment on individual product sales for the year, we are aware that where the consensus is for Ebglyss, and we remain comfortable around that figure. On the clinical side, our collaboration with Lilly continues to support Ebglyss' positioning with extensive lebrikizumab data, including the long 4-year results and the ADorable-1 pediatric data presented at recent scientific meetings.

This week, the EMA admitted the submission of the pediatric indication of Ebglyss. In June, the FDA approved the every 8-week maintenance dosing regimen for Ebglyss in the U.S. This approval further strengthens Ebglyss profile in atopic dermatitis and supports its long-term competitiveness in the market. We are also conducting the ADhope 2 trial in Europe, which has the potential to support an extension of the dosing interval to every 12 weeks.

I will now hand over to Karl to walk you through our pipeline developments in more detail.

Thank you, Carlos, and good morning to everyone on the call. On this slide, I would like to focus on the early and mid-stage pipeline as a source of future value creation and upcoming clinical inflection points.

Today, we have 4 proof-of-concept or Phase II studies ongoing with 2 additional studies planned to start towards the end of this year. During 2025, we advanced 2 important programs into Phase II. Our anti-IL-1RAP antibody in hidradenitis suppurativa and the IL-2 mutant Fc in alopecia areata. In addition, our partner, Simcere, initiated a Phase II study of IL-2 mutant Fc in atopic dermatitis. We also recently started a proof-of-concept study for our anti-IL-21 antibody in hidradenitis suppurativa.

Looking ahead, we plan to initiate 2 further proof-of-concept studies, IL-2 mutant Fc in SLE with cutaneous manifestation and the anti-IL-1REP antibody in an inflammatory skin disease.

Taken together, this gives us 6 proof-of-concept of Phase II studies with data readouts expected over the next couple of years beginning at the end of 2026. These programs remain early, but they are anchored in well-defined biology and give us a diversified set of potential first or best-in-class opportunities in area of high unmet need.

Next slide. While we advance the clinical pipeline, we're also building the next wave of innovation in dermatology. Our approach is to focus Almirall's internal capabilities on deep disease understanding and to partner selectively where external technology can provide the most appropriate modality of a -- for a novel therapeutic hypothesis.

A recent example is our strategic research collaboration with Certest Biotec, a Spanish biotechnology company with mRNA and lipid nanoparticle discovery and development expertise. Together, we aim to discover novel treatments for rare dermatological diseases and recurrent cutaneous conditions. The important point is that this is a partner-enabled model.

We access differentiated technology while Almirall retains global rights and leads future development and commercialization. This allows us to broaden our innovation reach while maintaining strategic control over asset that fits our dermatology focus.

Next slide. This slide summarizes our life cycle management activity for products already on the market. The objective is to support the long-term relevance of our key brands through label expansion, additional clinical evidence and disciplined prioritization of investment.

For tirbanibulin, the regulatory process for the larger 100 square centimeter treatment area is ongoing, and we now expect the European approval towards the end of this year. Together with our partners, Sun Pharma and Eli Lilly, we continue to advance label expansion opportunities and generate additional clinical data for Ilumetri and Ebglyss, respectively.

For lebrikizumab, we have filed with the EMA for pediatric label extension to include children from 6 months to 17 years of age and a waiting below 40 kilo with moderate to severe atopic dermatitis with approval expected around mid-2027. We are also running a Phase III of lebrikizumab in nummular eczema with readout expected in 2029. Additional ongoing clinical studies are summarized in the appendix.

Turning to tildrakizumab. The INSPIRE-I and II studies showed benefit in psoriatic arthritis. Both trials met the primary endpoint at week 24 and continue to show benefit through week 52. After evaluating the access dynamics and investment required, we have decided not to pursue commercialization of tildrakizumab in psoriatic arthritis in Europe.

We believe that further investment in generating additional data in psoriasis can generate more value for tildrakizumab, and we, therefore, plan to study tildrakizumab in psoriasis patients with short disease duration and high disease burden. Details are shown on the next slide.

EVOLVE PSO is designed to explore the potential benefit of tildrakizumab 200 milligram in biologic-naive adults with moderate to severe plaque psoriasis and short disease duration defined as less than 2 years. In addition, the study will evaluate the potential to maintain high levels of disease control using a dose spacing approach.

We plan to initiate the study around year-end with first readouts are expected in 2029. Strategically, EVOLVE PSO is intended to support a more flexible and patient-centric treatment paradigm. If successful, it could help reinforce the value proposition of tildrakizumab in psoriasis by maintaining outcomes while potentially reducing treatment burden. With that, I will hand over to Jon for the financial review.

Thank you, Karl, for the pipeline updates, and good morning, everyone. Net sales for the first half reached EUR 603 million, a 7.5% growth year-on-year and a 10% growth in the last 12 months, which is in line with provided net sales guidance range.

Please note that the second quarter of 2026 included the recently announced divestment of Actithiol, comprising of a EUR 13 million upfront and an additional EUR 1 million revenue recognition out of the remaining payments. As noted, the year is progressing positively with increasing performance expected during the remaining part of the year as indicated in February earnings call.

European Dermatology keeps delivering solid double-digit growth, reinforcing Almirall's path towards leadership in medical dermatology. We will review the details in the coming slides. EBITDA for the first half came in at EUR 151 million, resulting in a ratio of 25% of our net sales versus 21.7% prior year, representing an improvement by 330 basis points.

Gross margin benefited from Actithiol divestment and is expected to normalize in upcoming quarters amid ongoing pressure from higher royalty tiers associated with Ilumetri net sales growth. Regarding SG&A, investment reflects the timing of our promotional activities during the year, and there will be some pickup in the coming quarters. On R&D expenses, our half year phasing reflects the progress of our trials into Phase II with 4 already ongoing and another 2 set to start shortly.

We closed the first half with a net cash-to-EBITDA ratio of around 0.1 with a strong cash generation in the first half of the year, leaving us with significant financial flexibility. Overall, these results lead us to reiterate our 2026 guidance. Let's move to the details of our sales breakdown on the next slide.

European Dermatology continued to perform positively in the first 6 months with double-digit year-on-year net sales growth. We will go into more details on the next slide. In General Medicine and OTC, European sales reflect the divestment of Actithiol completed in the second quarter. Excluding these portfolio moves, the segment remained broadly stable with lower sales in some legacy products largely offset by contributions from products such as Ebastel and Airtal.

In the United States, performance declined year-on-year, reflecting continued pressure on the legacy portfolio, which we will discuss on the next slide. In the rest of the world, overall sales grew strongly, driven by solid dermatology demand. Let me take you through the dermatology performance in more detail on the next slide.

Our European Dermatology business continued to perform well in the first half. Ilumetri delivered robust double-digit growth versus prior year, reaching EUR 125 million. Ebglyss further increased its contribution to approximately EUR 85 million in the first 6 months of the year. We remain focused on unlocking the full value of the franchise from both the commercial and the R&D side.

Wynzora continued to build market share across core European countries and Klisyri demonstrated stable growth in Europe year-on-year. In the United States, overall performance declined, reflecting continued pressure on the legacy portfolio. Dollar-euro FX evolution represented a negative impact of minus 6% in our performance year-to-date. Seysara and Klisyri improved the price volume dynamics in the second quarter, while still declining and Axon remain impacted by generic competition. In the rest of the world, dermatology sales were driven primarily by Finjuve demand in China. Overall, our dermatology franchise continues to show solid underlying performance.

Let's briefly review the remaining elements of the P&L in the next slide. Gross margin reached 64.6% in the first half with the second quarter divestment offsetting royalty impact associated with Ilumetri's growth. SG&A in the second quarter following an incremental quarter-on-quarter trend as previously announced. We expect that trend to continue in the remaining quarters of 2026 while supporting margin expansion on an annual basis.

R&D percentage of net sales was somewhat lower than our target of 12.5%. Our half year phasing reflects the progress of our trials into Phase II with 4 already ongoing and another 2 set to start shortly. A full year ratio of approximately 12.5% remains a good proxy, subject to the normal quarterly variability. EBITDA margin reached 25% of net sales, a level aligned with our 2028 ambition, but approximately 2.5 years ahead of schedule.

While this performance benefited from the divestment of a minor non-derma product, portfolio optimization is an integral part of our ongoing business strategy and value creation. This milestone demonstrates the strong position we are building. Financial expenses continue to reflect the valuation impact of the equity swap in line with the share price evolution during the period.

Our effective tax rate continues to normalize, and we continue delivering on this positive trend, driven by the strong increase in the group's overall profitability, which materially reduces the related impact of our U.S. business at consolidated level. Please move to the next slide to take a look at the balance sheet.

Our balance sheet remained stable throughout the first half of the year. Intangible assets reflect Ebglyss-related R&D capitalization, the development milestone to Simcere for advancing IL-2 mutant fusion protein into Phase II and the access fee linked to the Huaota collaboration, broadly offset by higher amortization.

Our net cash-to-EBITDA ratio stood at around 0.1, providing us with a strong financial flexibility for licensing opportunities and selective bolt-on acquisitions. During the quarter, Moody's upgraded our credit rating to Ba1, validating the strength of our balance sheet and financial performance.

Let's now turn to the cash flow statement. Company generated EUR 17 million cash in the first 6 months of the year compared to a dilution of minus EUR 54 million in the same period last year, representing an improvement by EUR 71 million. Free cash flow raised to EUR 33 million compared to minus EUR 20 million in the first half of 2025.

Let's now go through the different components of our cash flow. Cash flow from operating activities raised to EUR 132 million, representing more than 2x improvement versus prior year, driven by working capital management alongside higher profitability levels.

Cash flow from investing activities reflects the 2025 Ilumetri sales milestone paid in the first quarter, the highest milestone expected this year with the remaining investment-related payments for the year being marginal and the total outflow within the usual limits in absence of new acquisitions.

Cash flow from financing activities reflects the change in the bond interest payment schedule following the recent bond issuance and cancellation of the previous one as well as the dividend paid in the period.

With that, thank you very much for your attention, and I hand it over to Carlos for his closing remarks.

Thank you, Jon. To summarize, the first half of 2026 confirms that the business remains solid and on track. We know where the consensus sits today, and we are comfortable with these figures.

Turning to the key drivers. First, our biologics portfolio continues to give us real momentum in the dermatology market that keeps expanding with Ebglyss scaling across Europe and Ilumetri still growing steadily as it moves through a more mature phase of growth. In parallel, we continue to generate robust life cycle management data that further supports the strong profile of our biologics.

Second, our growing and exciting pipeline now spans immune-mediated skin diseases, rare dermatology and non-melanoma skin cancer with 6 proof-of-concept Phase II programs moving forward and most assets being with potential for best or first-in-class, providing a solid base for sustainable growth without concentration on any single asset.

Third, we remain disciplined but active on capital deployment with a strong balance sheet supporting bolt-on M&A and early-stage licensing. We continue to work towards delivering on our mid- and long-term ambitions, supported by a well-positioned portfolio, a strong and targeted pipeline and strategic positioning in the right dermatology indications. This combination of pipeline depth, financial discipline and execution gives us confidence as we continue to advance Almirall towards leadership in medical dermatology. With that, we conclude the presentation and turn to Pablo for the Q&A.

Thank you very much, Carlos. Sharon, back to you for the Q&A, please.

[Operator Instructions] And your first question comes from the line of Hen Boeg from DB.

I've just got a couple. The first one, you mentioned there's a Germany pricing adjustment from July. It would be good to know a bit of clarity about what effect that's having into H2 and also how this fits into maybe the German drug pricing reform that's taking effect in '27 and how you think that will impact Ebglyss and Ilumetri and maybe whether that's included in your '28 EBITDA margin target of 25%.

And then my second question, please, is you didn't reiterate your peak guidance for Ebglyss. Is there a reason for this? Yes, just a bit more clarity.

I'm not sure about the second question. You're asking us to confirm the peak sales estimate for Ebglyss?

Yes, yes.

Okay. Sure. Thanks for the question, Hen. So the German pricing reform is certainly not good news for the industry in Europe. However, there's still a number of clarifications as there are deductions and modifications that now need to be clarified by the German government between now and the end of the year.

Once we have clarity on this reform, we will be able to provide further clarity on how we see this impacting the business. In terms of the peak sales guidance for Elis, yes, we remain very confident on the outlook that we have provided. And so we are very happy to reiterate peak sales above EUR 450 million.

Your next question today comes from the line of Shan Hama from Jefferies.

Just 2 from me, please. Are you able to quantify the extent of the planned price decrease for Ebglyss in Germany in July or from July?

And then secondly, can you tell us about some early ordering patterns you're seeing in 3Q for Ebglyss and whether you're expecting a return to acceleration from 3Q despite the typical slowdown during the summer season?

Thank you, Shan, for the questions. If I understood well, you're asking about the price decrease in Germany and Ebglyss this year, it will be from January 1, 2027. No, is that the question or not?

No. Your question, Shan, if I understood well, you are asking the price reduction for Ebglyss in July, right?

Yes, exactly.

Yes. So it has been a low single-digit one that it was agreed with the German government at the point of launch of the product. It has -- is minor, but it has had an impact on the phasing of orders between quarters. So we expect an acceleration in the Q3. So this is the answer of your first question.

Thank you for -- so sorry, I misunderstood the question. Thank you Jon for your help. You want to take the number 2 as well?

Yes. Your second question, Shan, was about order pattern in the second half of the year and return to accelerate. Yes, I mean, we remain confident in the long-term profile of the product. We continue receiving very positive feedback from our key opinion leaders in the market, and we continue having long-term life cycle management.

The market consensus for the products shown at this point in time is in the range of EUR 190 million to EUR 193 million, and we remain comfortable in this ballpark for this year. Just to reiterate that our focus remains firmly on the long-term opportunity. And as usual, we would encourage all the analysts to have a view on short months more than on quarter-on-quarter phasing. I hope this addresses the answer to your question, Shan.

Your next question today comes from the line of Juan Ros Padilla from ODDO BHF.

Two, if I may. First one regarding the PCS guidance. So after the H1 EBITDA, how should we interpret the guidance of EUR 270 million to EUR 290 million for the year? Are you now maybe more comfortable with the upper half of the range?

And secondly, regarding Ilumetri, we've seen some moderation of the growth in Ilumetri in Q2. Are you still expecting double-digit growth for this year? And what contribution are you seeing from the 200-milligram presentation?

Juan, thank you very much for your questions. So at this stage, we are confirming our full year guidance. Yes, we had a very nice EBITDA in the first half. Not only that, we have already reached the 25% EBITDA ambition that we had set for ourselves in the midterm guidance that we set up and we had set this target for 2028. So we are very happy to see that we have been able to accelerate our operational leverage agenda. So that's great news. At this time, we are happy to confirm the full year guidance that we have provided.

Ilumetri, perhaps for the details, I'll pass it to John, but let me reiterate that we remain very, very confident with the performance of Ilumetri, both in terms of how the market is growing, IL-23 is firmly established as the winning class. And within this class, we are able to either to keep or to grow market share. So the underlying dynamics remain extremely positive for Ilumetri. Jon, do you want to add some more color on Ilumetri?

Just to complement, Juan, that if I remember well, the market consensus is in the ballpark of EUR 260 million, EUR 262 million, similar level as of February earnings call, and the company feels comfortable with that ballpark, although we do not provide guidance per product.

On long term, the guidance for the product is to reach peak sales beyond EUR 300 million, and we also reiterate we are comfortable with that peak sales. But more importantly, Karl has been sharing with us exciting aspects of Ilumetri life cycle management and products. So if it is okay, Juan, I would like to pass the word to Karl to complement our answer.

Thank you. I mean just to remind everyone, Ilumetri is the only anti-IL-23 with dose flexibility. And we're seeing, especially on the 200migram where we receive very positive feedback, especially in patients that are overweight or with a high disease burden. And that's why we now start the EVOLVE PSO study to further explore this 200-milligram option in patients with a short disease duration and a high disease burden. And we will -- we are confident that this adds to the already very solid clinical evidence on Ilumetri will further drive the product.

And your next question comes from the line of Guilherme Sampaio from Caixa Bank.

So 2, if I may. I'm sorry to insist on the Germany reform, but taking into consideration the accelerated operating leverage that you have been achieving, is there a scenario in your preliminary analysis in which you would not reiterate the 25% margin in 2028 that you've been targeting?

And the second question, you've been guiding for an underlying EBITDA growth acceleration across 2026, and you've been delivering upon it. But you mentioned that you're comfortable with current consensus, which implies a major slowdown in the second half of the year. So I wanted to confirm both statements. So if you still think that you should have some acceleration or if there's going to be a slowdown and if you could provide some more details regarding this.

Thanks for your question, Guilherme. Yes, as I mentioned, we're very happy to see our acceleration on the operational leverage agenda that we have established for ourselves. In addition, we've seen very good progress, and I would say I would as excellent progress in our pipeline with the 6 POCs by end of '26.

And that means that we'll have all the data, the data readouts in the next 18 months. This -- and you were talking about -- asking about the scenario, right? So this opens many scenarios depending on the data, depending on the readouts. And we will be, of course, first, solving with value maximization for shareholders in mind and secondly, monitoring very closely what this means. And your question on EBITDA for the second half of this year, maybe, John, you want to take it?

Yes. Thank you very much, Carlos. Thanks a lot, Guilherme, for your question. When you are doing the comparison, first of all, any potential scenario we have had in the first half of the year, including the divestment of a minor derma product was already included in the scenarios we provided for our full year guidance in both net sales and EBITDA, 9% to 12% and EBITDA amount EUR 270 million to EUR 290 million.

Having said that, in the second half of the year, we expect certain acceleration in our R&D investment as our trials progresses, and we expect certain pickup in our SG&A investment following the phasing of our promotional activities.

If you remember, what we have always said is that SG&A will be a component -- a key component to the operational leverage that you already see in the P&L as of today but the growth will be materially lower than the growth we are showing in net sales.

In this scenario, in the second half of the year, of course, in order to continue accelerating in the same ratio, we should have a similar divestment to the one we have executed for Actithiol.

But from an operational point of view, excluding the divestiture, we continue expecting EBITDA acceleration. This would be our ambition. And still, we think we are in the ranges we have provided for the full year guidance range for 2026.

Your next question today comes from the line of Jaime Escribano from Banco Santander.

So a couple of questions from my side. The first one more on the competitive landscape in AD. So today, we heard Sanofi discontinuing amlitelimab. I would like to know your opinion and maybe to summarize which ones do you think are going to be the main competitors going forward?

And the second one for Karl would be how excited you are with the new anti-IL-21 candidate that is passing to Phase II for hidradenitis suppurativa. Maybe if you can elaborate on this candidate versus, for example, the anti-IL-1RAP?

Thank you, Jaime, for the questions. So the competitive landscape in AD. We've always said that the AD market is largely underpenetrated. So only around for probably less than 20% of patients that are eligible for this type of advanced treatments are treated with modern medicines. So for us, the new entrants, new mechanism of actions coming into this market continue to expand the market, right?

Having said so, within the community, it remains firmly convinced that the anti-IL-13 remains the mainstay treatment for first-line in patients, right? So overall, we believe that IL-13 will continue for the future to become the mainstay and market progression and feedback of physicians, these patients make us very -- continue to deliver very positive signals for us in this market. Karl, do you want to comment maybe on amlitelimab and the IL-21?

Yes. I think, yes, we saw the news on amlitelimab this morning. When these decisions are always based on benefit risk. And we need now to analyze what this could mean on our bispecific antibody where this is only one component. The other component is an anti-IL-13 mechanism that, as Carlos said, is the key pathogenic driver in AD.

Now coming to your second question, we are very excited about the anti-IL-21 antibody. HS is an indication with very high unmet medical need, but it's also a very complex disease. And that's why we have been searching for mechanism that can address multiple pathways.

The anti-IL-1RAP addresses multiple path more towards to the innate immune system, so the IL-1 alpha beta, the IL-33 and the IL-36 alpha, beta and gamma. And both the anti-IL-1 beta independently as well as an antibody against the IL-36 receptor have shown benefits addressing different aspects of the pathophysiology. So we believe this combination of those activities when inhibiting the anti-IL-1RAP has a chance for an increased efficacy.

IL-21 is a cytokine that is involved both in B and T-cell biology. So addressing more the adaptive immune system. And again, there is evidence that addressing T-cells and addressing B-cells has impact on the pathophysiology of HS.

And our hypothesis is again that by combining those activity, this may lead to an increased efficacy. We have just started a Phase II kind of proof-of-concept study and expect first results during next year.

We have one further question in the queue. And the question comes from the line of Joaquin Garcia-Quiros from JB Capital.

Just regarding the investments, if I remember correctly, you said that you should expect around EUR 70 million for the year. Is that still a good target?

And then what can we expect for next year? And then if you could remind us what could be the potential target markets for hidradenitis suppurativa and alopecia areata and talk a bit on the competition right now that you could have on those fields?

Joaquin , thank you much for the questions. John, do you want to take the first one on investments and then Karl the ones on HS and EA.

Thanks a lot, Carlos, and thanks for your question. Joaquin, I understand you refer to investment CapEx. Should this not be the case, please feel free to speak up, and we also cover ordinary CapEx. In terms of investment CapEx, yes, our guidance for the full year was EUR 70 million to EUR 80 million in absence of new acquisitions.

Our year-to-date basically reflects the payment of our 2025 [indiscernible] sales milestone that is the highest we are going to experience this year. And right now, Joaquin, we confirm that range, probably ending to the high to EUR 75 million to EUR 80 million. It is what we will be finalizing in our investment CapEx.

Happy to say that the results we are presenting today, where we are discussing CapEx, they also show the strong cash generation the company has achieved in the first 6 months of the year. So I am confident we have the enough muscle and power to fund those CapEx and potential new licensing opportunities that may come up in the near future. Hopefully, I have addressed your question. Otherwise, let me know. Back to Carlos for the other.

And then to Karl.

Yes. Thanks for the question. As I mentioned, HS is an indication with a still very high unmet need and experts we have talked to mention that the currently available treatments are still suboptimal in addressing all the different aspects, specifically the efficacy.

The high unmet need is also reflected in the interest and in the pipeline. We believe we have 2 very differentiated assets that have, as I just mentioned, a chance for an increased efficacy by addressing not a single but multiple other mechanisms.

When it comes to the potential commercial opportunities, Evaluate estimate the HS market to be in the range of EUR 5.3 billion in 2030. And the second, the AA market, alopecia areata is estimated to be in the range of about USD 1.4 billion again from Evaluate Pharma 2030 estimates. This shows that both are significant commercial opportunities.

I will now hand the call back to Pablo as there are no further questions.

Thank you very much, Sharon. If there are no further questions, ladies and gentlemen, this concludes our today's conference call. Thank you for your participation. You may now disconnect.

Good day, and thank you for standing by. Welcome to the Almirall's First Quarter 202 Results Conference Call. [Operator Instructions] Please be advised that today's conference is being recorded.

I would now like to hand the conference over to your speaker today, Pablo Divasson, Head of Investor Relations. Please go ahead.

Thank you very much, Matalena. Good morning, everyone. Thank you for joining us for today's quarterly earnings update and review of Almirall's first quarter financial results for 2026. As always, we are sharing the slides we are using today in the Investors section of almirall.com.

Please move to Slide #2. Let me remind you that information presented in this call contains forward-looking statements, which involve known and unknown risks, uncertainties and other factors that may cause actual results to materially differ from what we are sharing today.

Please move to Slide 3. Presenting today, we have Carlos Gallardo, Chairman and Chief Executive Officer; Jon Garay, Chief Financial Officer; and Karl Ziegelbauer, Chief Scientific Officer. Carlos will start with the business highlights of the first quarter, followed by an update on biologics as the key growth drivers of our medical dermatology portfolio. Karl will provide you with an update on the pipeline and R&D programs. Jon will then walk you through the financials before Carlos concludes the presentation, and we open for questions.

I will hand over to Carlos Gallardo, our Chairman and CEO. Please move to Slide #5.

Thank you, Pablo, and good morning to everyone in the call. Almirall delivered steady performance in line with our expectations and market consensus in the first quarter of 2026. The results reflect the high comparative base in the first quarter of 2025, which was boosted by divestments alongside minor revenue phasing effects across quarters. This was anticipated and flagged at the 2025 full year results presentation.

Excluding the different effects, growth remains in line with the guidance and with the recent trends, being last 12 months net sales growth of 9% as of Q1 2026, consistent with our 2026 guidance, which is why we remain comfortable reiterating our guidance with growth expected to be driven by our Biologics as well as the strength in our core Medical Dermatology business.

Growth this quarter is underpinned by effective commercial and operational execution, led by solid biologics performance in Medical Dermatology across Europe. We also continue to advance innovation, broaden patient access and support the physician community.

Turning to products. Ilumetri delivered steady double-digit growth, reaching EUR 62 million in sales and remains on track to peak sales of over EUR 300 million. With EUR 42 million in net sales, Ebglyss momentum picked up in the last quarter following completion of the rollout across key regions with launches in key European markets continuing to scale.

With 2026 now providing a clear reflection of the product's potential, this strong performance reinforces our confidence in its positioning and long-term growth prospects. Among other products, Wynzora continues to lead market share across key regions, while Klisyri delivered stable sales growth overall. We remain highly active within the Medical Dermatology community, continuing to strengthen our presence in the field.

At the 2026 American Academy of Dermatology Annual Meeting, we presented more than 15 posters featuring new data across atopic dermatitis, actinic keratosis and acne. Earlier in the year, Almirall hosted the 17th edition of Skin Academy, bringing together leading global experts in Medical Dermatology, focusing on the latest advances in atopic dermatitis and the importance of individualized treatment in psoriasis.

We are encouraged by our pipeline developments with 3 proof-of-concept studies currently in Phase II and a further 3 more POC studies on track to begin Phase II over the coming quarters. Most of these assets are either first or best-in-class. Our bispecific antibody targeting atopic dermatitis has progressed into Phase I. And we recently entered a new collaboration with Huaota to advance the development of a monoclonal antibody with potential applications across multiple indications within Medical Dermatology. Karl will revisit our pipeline in greater detail.

Please move on to the next slide for an update on our biologics portfolio. In the first quarter, Ilumetri net sales reached EUR 62 million, marking a steady 12% year-on-year increase. The 2-year positive study results were presented at both the 2026 American Academy of Dermatology Annual Meeting and 2025 European Academy of Dermatology and Venereology Congress. The data continue to highlight Ilumetri's long-term value, demonstrating meaningful real-world benefits in patients' well-being and reinforcing the product's clinical and commercial relevance.

Ilumetri continues to demonstrate a solid position in the psoriasis market, maintaining market share in the leading anti-IL-23 class. Performance remains consistent, and we, therefore, continue to be firmly on track to deliver over EUR 300 million in peak sales -- in peak net sales, even as both the product and the class enter a more mature phase of the growth cycle.

Please move to the next slide on Ebglyss highlights. Since its approval in Germany in December 2023, Ebglyss has rapidly scaled to become our second largest product, underscoring one of the most successful atopic dermatitis launches in recent years. This outcome reflects strong patient and physician adoption, supported by solid commercial and operational execution.

At the same time, the advanced therapy segment in atopic dermatitis across the EU5 continues to expand at around 30% annually. First quarter sales more than doubled to EUR 42 million from EUR 19 million a year earlier, driven by the successful European rollout and continued scaling across key markets. Ebglyss has already achieved double-digit market shares in several strategic regions, alongside encouraging early traction in new country launches. This underpins our confidence in Ebglyss as a major growth driver in the years ahead.

We aim to become a first-line treatment and capture increasing market share. We are confident in the product's potential targeting the IL-13 as it is the predominant Interleukin in AD patients, and there is a broad number of clinical studies validating the product's good efficacy, which is the main factor in picking the most adequate treatment. Our clinical collaboration with Lilly continues to support Ebglyss positioning through a growing body of evidence.

At the 2026 American Academy of Dermatology Annual Meeting, Almirall presented extensive lebrikizumab data, including AD long results showing durable disease control for up to 4 years. Prior to that, Lilly published their ADorable-1 pediatric study data, demonstrating significant skin clearance and improved disease severity and improved disease severity in children with moderate to severe atopic dermatitis.

Please turn over to the next section for Karl to explain our pipeline developments in more detail.

Thank you, Carlos, and good morning to everyone in the call from my side. This slide shows you the status of our early and mid-stage pipeline. To date, we have 3 proof-of-concept Phase II studies ongoing with 3 additional studies planned to start within this year.

In 2025, we progressed our anti-IL-1RAP antibody into Phase II for hidradenitis suppurativa and our IL-2 mutant Fc for alopecia areata. In addition, our partner, Simcere, initiated a Phase II study on the IL-2 mutant Fc in atopic dermatitis. As a reminder, we retain global rights for this asset outside Greater China.

Looking ahead, we plan to initiate additional proof-of-concept study each for the IL-2 mutant Fc and the anti-IL-RAP antibody in an inflammatory skin disease. For the anti-IL-21 antibody, we will start a proof-of-concept study in hepenitis suppurativa in the coming weeks. The Phase I study of our bispecific antibody targeting IL-13 and the OX40 ligand has just started.

From those 6 proof-of-concept Phase II studies, we anticipate data readouts over the next couple of years, starting end of 2026, beginning of 2027. While these programs remain at an early stage, they address well-defined biological pathways and represent a range of first or best-in-class opportunities.

Next slide, please. In March this year, we inaugurated our business development office in Shanghai, China to advance innovation in medical dermatology through partnerships. This team is dedicated to life science innovation with a focus on programs and technologies that are complementary to our in-house R&D activities. A good example of what we intend to do is our collaboration with Huaota we announced recently for the development of a novel monoclonal antibody in Medical Dermatology.

For this collaboration, we proposed a target for an attractive skin disease and Huaota will conduct early research and initial development to deliver clinical proof of concept, while Almirall holds global rights outside China and leads further global development and commercialization.

Next slide, please. This slide gives an overview of our life cycle management activity for products that are on the market, and I would like to highlight a few new developments. For tirbanibulin applied to a larger treatment area of 100 square centimeters, the regulatory process is ongoing, and we expect launch in Europe late 2026. Together with our partners, Sun Pharma and Eli Lilly, we continue advancing label expansion opportunities and generate additional clinical data for Ilumetri and Ebglyss, respectively.

Let me share some recent data on the next slide. At the AAD 2026 in March this year, we presented clinical data that showed that lebrikizumab delivers long-term disease controls for up to 4 years in patients with moderate to severe atopic dermatitis. In the lebrikizumab Phase IIb study, 94% of patients maintained EASI-75, 75% maintained EASI-90 and 68% kept clear or almost clear skin defined as an investigator's global assessment score of 0 or 1 with up to 4 years of lebrikizumab treatment, reinforcing the sustained response achieved over time in patients with moderate to severe atopic dermatitis.

Importantly, itch relief was also sustained over the long term with 78% of patients achieving a 4-point or greater improvement on the pruritus numeric rating scale with measures itch intensency on a scale from 0 to 10. Overall, these results further reinforce the long-term disease control potential of lebrikizumab in a chronic condition requiring sustained and consistent treatment.

Next slide, please. The ADorable-1 Phase III study met co-primary efficacy endpoints with 63% of pediatric patients achieving meaningful skin improvement, EASI-75. 44% of patients reached clear or almost clear skin, IGA-001 at week 16. ADorable-1 is a multicenter, randomized, double-blind, placebo-controlled Phase III trial in 363 children and adolescents with a moderate to severe atopic dermatitis that evaluates lebrikizumab versus placebo on top of standardized low to medium potency topical corticosteroids.

Given the substantial physical and emotional burden of atopic dermatitis, particularly when disease onset occurs early in childhood, these findings further strengthen the role of lebrikizumab across the full patient journey. Detailed data will be presented at an upcoming scientific meeting.

We plan to use this data together with the forthcoming results of the ADorable-2, which is the open-label 52-week extension trial of ADorable-1 to file for an extension of the label of lebrikizumab to the pediatric population aged 6 months to 18 years. Finally, we initiated our Phase III study to explore lebrikizumab in patients with nummular eczema. The readout is expected in 2029.

With that, I will hand over to Jon for the financial review.

Thank you, Karl, for the exciting pipeline update, and good morning, everyone. Net sales increased by 2.2% year-on-year in the first quarter of 2026, reaching EUR 291 million, which is in line with our expectations and consensus. Last 12 months net sales growth of 9% as of Q1 2026 is equally consistent with our 2026 guidance.

As Carlos mentioned earlier and anticipated in our full year 2025 earnings call, the first quarter of 2026 needs to be viewed against the divestment of Algidol and out-licensing of Sekisan in Q1 2025. In addition, we also had some minor phasing of sales amongst our products in derma and non-derma between quarters. Excluding these effects, growth is in line with our expectations and provided guidance, allowing us to remain on track for the full year 2026 guidance.

Performance remains solid and European dermatology portfolio continued to deliver solid growth, further reinforcing Almirall's path towards leadership in Medical Dermatology. Gross margin landed at 64.2%, slightly above the performance that you may have seen in the prior quarters. There is still a minor recurring pressure that you should take into account, primarily due to the higher royalty tiers associated with Ilumetri's net sales growth.

EBITDA came in at EUR 67.5 million, reaching 23.2% of our net sales versus 21% ratio reported at year-end 2025. SG&A declined by 1% versus prior year and is expected to pick up in the coming quarters, driven by phasing of our marketing and promotional activities. R&D investment reached 12% of net sales, driven by phasing of our R&D activities as our POC trials progress gradually. In this sense, 12.5% remains a good proxy for the full year.

We closed March 2026 with a net debt-to-EBITDA ratio of 0.1 after successfully completing the issuance of a new high yield bond at 3.75% interest rate back in December 2025. Overall, the results lead us to reiterate our 2026 guidance.

Let's move to the details of our sales breakdown on the next slide. European dermatology portfolio continued to perform strongly, delivering 19.3% year-on-year net sales growth in the first quarter. We will go into more detail on this performance on the next slide. The comparison impact was concentrated in Europe, where general medicine and OTC sales reflected a stronger prior year base due to the Algidol divestment and out-licensing of Sekisan alongside the mentioned phasing effect from smaller portfolio areas.

Lower sales in legacy products such as Crestor, Sativex and Eklira were largely offset by contributions from [ Ebastel and Alta. ] In the United States, performance declined year-on-year, which we will discuss on the following slide. In the rest of the world, overall sales were slightly higher with solid dermatology growth more than compensating for a modest decline in General Medicine.

Let me take you through dermatology performance in more detail on the next slide. Our European dermatology business continued to perform well in the first quarter. Ilumetri delivered sustained year-on-year growth, while Ebglyss further increased its contribution now with launches across all key European countries being completed. Ebglyss generated EUR 42 million in the first quarter, reflecting continued scaling and reinforcing our confidence in its long-term growth potential.

We continue to work hard to unlock the full value of the franchise from both the commercial and the R&D side. Wynzora continued to build market share, gaining traction across core European countries. Klisyri demonstrated a stable growth in Europe year-on-year in spite of some phasing in sales against prior quarter. Cyclosporine sales were slightly soft following a strong Q4 2025.

In the United States, overall performance declined, reflecting continued pressure on the legacy portfolio. Products such as Cordran Tape, Tazorac and Aczone remain impacted by ongoing generic competition. Seysara saw lower sales amid intensifying competition and exchange rate evolution. In the case of Klisyri, the exchange rate evolution impacted growth negatively by 10 points in the quarter.

Additionally, our market strategy to broaden coverage and increase volume has put some year-on-year price pressure, expecting sequential quarterly improvement during the year. In the rest of the world, dermatology sales increased year-on-year, driven primarily by Finjuve demand in China.

Overall, our dermatology franchise continues to show solid underlying performance. Let's briefly review the remaining elements of the P&L. Gross margin reached 64.2% in the first quarter. Last year, gross margin benefited from the already mentioned divestment and out-licensing. Aside from this impact, we see continued slight margin pressure, primarily from higher royalty tiers associated with Ilumetri continued growth.

SG&A expenses accounted for 41.8% of net sales compared to 43.1% for the same period last year, which is in line with our expectations and pacing throughout the year. As highlighted earlier, SG&A is expected to increase in the coming quarters, driven by phasing of our marketing and promotional activities. We continue to anticipate SG&A full year growth to be slower than sales growth, becoming an important contributor to our EBITDA margin expansion guidance.

R&D investment represented 12% of net sales, a full year ratio of around 12.5% remains a good proxy with the normal quarterly variability expected. Financial expenses increased versus last year, driven by the valuation impact of the equity swap in 2026 following the share price evolution.

Finally, our effective tax rate came in at 34.6%, which represents an improvement of 5.1 percentage points year-on-year. We continue delivering on this positive trend, driven by the strong increase in the group's overall profitability, which materially reduces the relative impact of our U.S. business at the consolidated level.

Please move to the next slide to take a look at the balance sheet. Our balance sheet remained stable as of March 2026 compared to December 2025. Intangible assets grew in the quarter, driven mainly by Ebglyss-related life cycle management activities, the development milestone payment to Simcere as IL-2 fusion mutant protein progresses into Phase II and a small upfront access fee linked to the new Huaota collaboration Karl has just mentioned. This increase was more than offset by higher amortization, resulting in a modest decline in goodwill and intangible assets during the quarter.

Also, the payment this quarter of the 2025 Ilumetri milestones is driving the reflected decrease in current liabilities. Our net debt ratio stood at 0.1, continuing to provide us with a strong financial flexibility. The increase in net debt primarily reflects higher cash outflows related to investing activities. Let's now turn to the cash flow statement.

Cash flow from operating activities reached EUR 47.9 million, an increase of EUR 21 million compared to the first quarter of 2025, driven by working capital improvement. Cash flow from investing activities amounted to minus EUR 72 million, an increase of EUR 52 million versus the same period last year. This increase largely reflects the payment of the 2025 $55 million Ilumetri sales milestone, which has slipped into the first quarter of 2026.

I would like to highlight that this is the highest milestone payment expected during the year in the absence of new transactions. Projected investment-related payments in the remaining quarters are marginal and the total estimated outflow related to investing activities for the whole year remains within the usual limits.

Cash flow from financing activities was minus EUR 3 million, representing an improvement compared with the minus EUR 9 million in the first quarter of last year. The year-on-year difference mainly reflects the change in the new bond structure issued at the end of last year.

With that, I would like to hand the word over to Carlos for his closing remarks. Thanks a lot, everyone, for your attention.

Thank you, Jon. To reiterate, the business remains solid despite the optically lower growth first quarter figure. We also remain very confident in the 2026 outlook and our ability to deliver on our targets. We know where consensus sits today, and we can confirm we are comfortable with these figures.

Turning to the key drivers of the business. First, our biologics portfolio is giving us real momentum. We are operating in a dermatology market that continues to expand, and we are doing so with a portfolio that is both diversified and as well aligned with where unmet needs remain highest. This is reflected in a pipeline that spans immune-mediated skin diseases, rare dermatology and non-melanoma skin cancer.

From a development standpoint, we currently have 3 programs in proof of concept of Phase II with a further 3 expected to enter in the next 9 to 12 months. Taken together, this provides a solid base to support sustainable growth over the coming years without concentration on any single asset. In parallel, we remain disciplined but active on capital deployment.

We continue to assess selective bolt-on opportunities in commercialized assets while screening early-stage licensing opportunities where we see differentiated science and a clear strategic fit. Most importantly, execution remains the angle. We are translating strategy into delivery, staying on track to achieve our midterm ambitions for double-digit net sales growth through 2030 and a circa 25% EBITDA margin by 2028.

EPL continues to scale across Europe, while Ilumetri is being managed pragmatically as it moves to a more mature phase of growth. Overall, this combination of pipeline depth, financial discipline and execution give us confidence as we continue to advance Almirall towards leadership in medical dermatology.

With that, we'll conclude the presentation and turn to Pablo for the Q&A.

Thank you very much, Carlos. Matalena, back to you for the Q&A, please.

[Operator Instructions] And our first question comes from the line of Shan Hama from Jefferies.

Just 2 from me, please. So as we acknowledge there's quite a notable acceleration in Ebglyss in 1Q versus the prior quarter. Is this the sort of level of growth we should be anticipating throughout 2026? So that's my first question. And then my second is, which countries have really driven this acceleration? And where do you see a more pronounced prescribing behavior for Ebglyss?

Thank you, Shan, for the question. So yes, Ebglyss is showing a very, very strong momentum. When you look at the recently published ADlong studies, you realize you're not that surprise as we -- the product achieves near complete skin clearance and its relief in up to 4 years. So that translates into what that physicians and dermatologists are achieving treatment goals in most of the patients. And that's what's driving the success of Ebglyss.

The vast majority of dermatologists go to an IL-13 inhibitor to treat moderate to severe atopic dermatitis patients. So very pleased with the results as well, and we expect -- so confident with the consensus, and we're very happy to confirm the guidance of exceeding more than EUR 450 million peak sales. In terms of which countries are driving, of course, we have launched in the vast majority of the countries where we wanted to launch. So all countries are performing well.

We have double-digit market share in most of them. But also importantly, we have the recently launched countries, Italy and France that now are contributing. So they are adding to the sales of Ebglyss. So the recent performance and the recent acceleration has been driven for the inclusion of these 2 new important markets to the countries where we have launched Ebglyss.

Our next question comes from the line of Damien Choplain from Stifel.

Congrats on the results. First one on the IL-2 mutant Fc. So what level of clinical efficacy and differentiation would you need to see in Phase II to trigger a Phase III programming [indiscernible]? And would you plan to run and finance a global study? Or would you consider limiting it to Europe? This is my first question. And maybe a quick one on Ebglyss. Is the pediatric population included in your peak sales guidance?

Thank you, Damien, for the questions. I will take the latter. Yes, the pediatric indication is included in our pixel estimate. And I will defer to Karl on our very exciting IL-2 program.

Yes. Thanks a lot, Damien, for the question. As you know, the IL-2 mutant Fc targets regulatory T cell and with that trying to restore immune hemostasis. And we believe this mechanism has potential across different skin diseases, including alopecia areata as well as atopic dermatitis.

Now in terms of future strategy, we, of course, need to wait for the data and the readouts and how they look like. But I see a lot of different options that we have given the mechanism. Also in terms of more global versus a European study, certainly, our goal is to maximize the value of this asset. And once data are available, we will look at all different options.

Our next question comes from the line of Jaime Escribano Mais from Banco Santander.

So my first question regarding Ebglyss positioning and performance, which is being very good. But we also see other peers doing very well, like [indiscernible], for example. My question would be, how do you see the competitive landscape? Is it that the overall market is expanding and that's why all the peers seems to be doing good. And so this would be my first question.

The second one regarding Ilumetri, which we saw a decline quarter-on-quarter, but it's true that in Q1 '25, we saw something similar. So maybe you can confirm how the product is doing or what's the outlook in Q2? And a final question, if I may, regarding SG&A, so minus 2% year-on-year in Q1. which looks quite content. What should we expect in terms of SG&A? Should we extrapolate this? Or do you expect the growth rate to be slightly higher because it's quite low?

Thank you, Jaime, for the question. for the question. So let me take the first question about Ebglys and competitive dynamics. And Jon, will take the Ilumetri and the SG&A questions. So competitive dynamics in AD, I think it's important to remind what we've been saying in the last quarterly calls that this is a market that remains severly underpenetrated.

Only around 15% to 20% of patients that are eligible for advanced therapeutics are prescribed. So we've always said that new classes will make more noise, of course, for promotion and will expand this penetration, and that's what's driving the growth of the market. So on that regard, new entrants are beneficial towards this growth.

In terms of positioning, there's very strong consensus within the dermatology community that IL-13 is a key cytokine and therefore, the go-to product is an IL-13 inhibitor. And why? Because they achieved the treatment goals, right?

IL-31s, they are good at dealing with itch relief, but not good at dealing with skin clearance. And that's why they are more -- we're seeing higher use in prurigo vulgaris. And in atopic dermatitis, they are used more as a second line or third line patients as let me remind you that this is a highly heterogeneous patient population and not all the patients always respond to a first-line treatment.

Ilumetri, Jon, can you take Ilumetri and SG&A, please?

Thanks a lot, Carlos, and thanks for the question, Jaime. If we start with Ilumetri, yes, Ilumetri grew around 12% in the quarter, which is aligned with the full year growth of 2025. It's true, as you mentioned, that in Q4 2025 isolated, Ilumetri grow a bit higher. But so far, on a full year basis, we think Ilumetri will be continuing solidly in the range of the double digit. And as we estimated and we shared in February earnings call.

At the moment, we are quite comfortable with the ballpark of the market consensus for Ilumetri, which is in the range of EUR 260 million. Ilumetri is competing in the IL-23 segment, which is the leading class for psoriasis, moderate to severe. And basically, the product recently, we launched the Ilumetri 200 presentation -- media presentation that is performing well and is providing flexibility to the health care professional to individualize care, and we think it's one of the strengths we are bringing to the market.

Switching to the third question you raised, Jaime, which is SG&A. Yes, SG&A in the quarter declined 1% versus prior year, reaching around 21% of our net sales is mainly driven by the phasing of our marketing and promotional activities. It's true this year that in some of our jurisdictions, the main campaigns are going to take place in Q2, and this is the phasing you see. you may expect a certain pickup in the upcoming quarters.

And on a full year basis, as we disclosed in our full year 2025 earnings call in February, you can expect a lower growth of our SG&A than our net sales growth, and this will become a key contributor to the margin expansion at EBITDA level.

Our next question comes from the line Guilherme Sampaio from CaixaBank.

So 3, if I may. The first one, if you could provide a bit more details regarding your change in strategy for Klisyri in the U.S. market. And the second related to -- the second and the third related to readouts from competition and your position in the market. So the first, there was a specific readout on the 3 specific antibody from Pfizer in atopic dermatitis to [ Rkimig ] this quarter. Just wanted to check how are you seeing this data?

And the second question on competition regarding your products in the [indiscernible] market. Considering the profile, how you are in the positioning and regarding competition, okay? So how are you seeing that?

Thank you very much for the question, Guilherme. I will take the question on the U.S. Klisyri and Karl will take the questions on the readout of competitive products.

So in terms of Klisyri U.S., the U.S. represents 3% of our sales. And in terms of -- and again, this quarter has been impacted by exchange rate. So also something to take into consideration. In terms of the strategy for Klisyri, has not changed. Of course, one of the things that we are trying to do is to broaden coverage to increase volume, right? This always comes at the expense of a little bit of a price reduction.

So what we're seeing here is first comes the price reduction and then comes the expanded coverage. So you should expect to see increased volumes in the next quarter if we are successful with this change in -- or with this push in expanded coverage in the U.S.

Karl, back to you.

Yes. Thanks a lot for the question on the competition. I mean, first of all, what Pfizer calls a trispecific antibody covers IL-13 and IL-4, and we all know that maybe the IL-13 component is the more important. So we rather think of this of more bispecific antibody.

There are a number of bispecific antibody now in early development, and this is due to the still high unmet medical need in AD and the heterogeneous nature of the disease, as Carlos mentioned. We have to see how this early data translate into later-stage data we remain very confident on our data that we see with Ebglyss.

Carlos mentioned, for example, the very strong maintenance of response for up to 4 years or the recent data that we have seen in the pediatric population. And also then finally, in our bispecific antibody where we combine the anti-IL-13 approach together with an anti-IL-40 ligand approach 2 validated mode of actions in atopic dermatitis that are highly complementary.

Your second question was about HS and the competitive environment. HS is a disease, again, of a very high unmet medical need. And the currently approved therapy, which are either anti-TNFs or anti-IL-17 according to experts only provide a limited benefit for patients, and we believe there is a lot of room for improvement. Based on, again, discussions with experts, we have chosen approaches and targets that cover more than one pathomechanism as this is a very complex disease potentially driven by multiple and different pathomechanism.

On the one side, the anti-IL-1 covers 6 different cytokines of the IL-1 superfamily, IL-1 alpha beta, IL-33 and IL-36 alpha, beta and gamma. And based on data that were achieved or shown with antibody target in [indiscernible], the anti-IL-1 beta or the IL-36 component, we remain confident in this mode of action.

On the other side, the anti-IL-21, where we are about to start the proof-of-concept study is a mechanism that covers both B and T cell pathophysiology, again, covering more than one pathomechanism. With that, we remain very confident in the 2 assets and the mechanisms we have chosen.

Okay. Just a follow-up. There's a similar or at least also targeting anti-IL-1 RAP from Cantargia that was recently acquired by Otsuka. How is your positioning relative to this product?

Thank you. Yes, there is a number of assets targeting IL-1 RAP one from Sanofi and also one from Cantargia. The Sanofi has started the Phase II. We are not aware that Cantargia has already started, and we will continue with our study. I believe with our Phase IIa/IIb seamless design, we will have a very good approach and we'll be able to be first with this mechanism in HS.

We have one more question, and this question comes from Natalia Webster from RBC.

I have 2, please. Firstly, on your pipeline, Phase I for the anti-IL-13 OX40 bispecific. I appreciate it's early days, but are you able to talk more on the opportunity you see here, particularly following data from competitor OX40 programs and how you expect this program to sit relative to your current Ebglyss franchise? Secondly, just curious to hear a bit more on the scope of your collaboration with Huaota and the expected financial impact from this.

Thank you, Natalia, for the questions. I think both of them are for you, Karl.

Yes. Thanks a lot for the question. Our bispecific antibody targeting IL-13 and the OX40 ligand combines 2 validated -- 2 clinically validated mechanism for the treatment of AD. For example, it is known that the innate immune system leads to IL-13 release that is not covered by the OX40, OX40 ligand pathway.

And on the other side, while Th2 cells that secrete IL-13 are the main driver of AD in a lot of patients, there is also other T cell population involved that then can be covered by the anti-OX40 OX40 ligand blockage. So we believe this combination has a chance for a broader and deeper response in AD.

As Carlos has mentioned that AD is still an underdeserved indication, only 10% to 15% of patients who are eligible to advanced therapy actually get them, we believe there is a lot of room for novel therapy like this bispecific antibody.

I think on Huaota, that is a collaboration where we, based on our activities here in Barcelona, came across a very interesting target and another approach for an important skin disease. We haven't disclosed details because of competitive reasons.

And we have identified Huaota as a partner with very significant experience in monoclonal antibody discovery and early development. Actually, the CEO of Huaota was one of the inventors of Skyrizi, which, as you know, is a very big product in the dermatology market. We haven't disclosed detailed financials. But as you can see in our press release, cumulative payments would sum up to USD 340 million, including upfront and milestone payments that are linked to the development and commercialization success as well as tiered royalties.

And this question comes from the line of Jaime Escribano Mais from Banco Santander.

Just a follow-up question on the pipeline for Karl. Building on one of the products you just explained. So UCB has acquired Candid Therapeutics, mainly a platform, which is a bispecific antibody directed to B cells and CD3 on T cells. The first question is if you have a view on this approach? Second, does this -- is this similar or has something to do with the one you just explained that was targeting also B cells and T cells?

And just a reflection for the management or for Carlos. So UCB is willing to pay EUR 2 billion, which is like 2/3 of the market cap of Almirall while -- for a platform that is in Phase I, while you have several products, what do you think is missing for the market to put a higher valuation on your pipeline, which look much more advanced to biotech like this one?

Thank you, Jaime, for the question. So before I pass the word to Karl to discuss the program you have mentioned, Again, we are a specialty company focused on medical dermatology. We're probably the only company in the Western Hemisphere that has capabilities from early research to commercialization. And that's only thing that we do. And why? Because there's tremendous unmet need.

So when we look at it, we see plenty of places, plenty of opportunity in diseases that don't have adequate treatment. And we have also the ability to come with plenty of novel scientific hypothesis and develop either programs internally or externally. And so far, our strategy is working. You can see it in our pipeline that we've been able to either secure through licensing or through generating internal hypothesis and doing our products from scratch, right?

So we do see other companies paying a lot of money for licensing opportunities for acquisitions. I can only speculate about the reasons and the market prices. But what I can confirm is that our strategy is working. We are being able to spot opportunities. We are being able to capture opportunities through licensing agreements or through generating of internal programs, and we are very comfortable with that strategy.

And now back to you, Karl, about the program that Jaime mentioned.

Yes. Thanks a lot, Jaime, for the question. This program is a so-called T cell engager that targets CD19 so pathogenic T cells. And this kind of approach is targeting with CD19 B cell in either an oncology, so malignant B cells or in an autoimmune setting. So pathogenic B cells, either through CAR-T or T cell engager have recently gained quite a lot of attention, and we are very closely following that space.

Now to explore such a space and such an asset, this might be important and that might be a driver for UCB to go beyond dermatology. As you know, we are focusing on dermatology. That is one angle to that. And I think another angle to it is that a lot of indications are not only driven by pathogenic B cells, by pathogenic T cells as well.

So this is an approach that is potentially not universally applied across all of the dermatological diseases we remain interested in.

There are no further questions for today. I will now hand the call back to Pablo Divasson for closing remarks.

Thank you very much, Matalena. If there are no further questions, ladies and gentlemen, this concludes our today's conference call. Thank you for your participation. You may now disconnect.

Good day, and thank you for standing by. Welcome to the Almirall Full Year 2025 Earnings Call. [Operator Instructions] Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Pablo Divasson, Head of Investor Relations. Please go ahead.

Thank you very much, Sandra, and good morning, everyone. Thank you for joining us for today's quarterly earnings update and review of Almirall's full year financial results of 2025. As always, we are sharing the slides we are using today in the Investors section of our website at almirall.com.

Please move to Slide #2. Let me remind you that the information presented in this call contains forward-looking statements, which involve known and unknown risks, uncertainties and other factors that may cause actual results to materially differ from what we are sharing today.

Please move to Slide #3. Presenting today Carlos Gallardo, Chairman and Chief Executive Officer; Jon Garay, Chief Financial Officer; and Karl Ziegelbauer, Chief Scientific Officer. Carlos will start with the guidance and business highlights of 2025, followed by an update specifically on biologics and the key growth drivers of our Medical Dermatology portfolio. Karl will provide you with an update on the pipeline and R&D programs. Jon will then walk through the financials before Carlos concludes the presentation, and we open for questions.

I will hand over to Carlos Gallardo, our Chairman and CEO. Please move to Slide #5.

Good morning to everyone in the call. Before turning to the highlights of the year, I'm pleased to report that we met our 2025 guidance in line with our midterm outlook. For 2025, we guided for net sales growth of 10% to 13% and delivered closer to the upper end with 12.4%, bringing net sales to EUR 1,108 million. On profitability, we expected EBITDA in the range of EUR 220 million to EUR 240 million and we closed the year at nearly EUR 233 million, comfortably within the range. Turning now to 2026. I'd like to share our guidance, which remains aligned with our medium-term targets. We expect net sales growth of 9% to 12% and EBITDA in the range of EUR 270 million to EUR 290 million.

With that, let's revisit our midterm guidance on the next slide. We are pleased to reiterate our midterm guidance, which remains unchanged. Between '23 and 2030, we expect to deliver a double-digit compound annual growth rate in net sales and reached an EBITDA margin of around 25% by 2028. Together with the new 2026 guidance, this confirms our confidence in both short and medium term.

Please turn to the next slide on the 2025 highlights. Almirall delivered solid performance in 2025, in line with our expectations, exceeding for the first time EUR 1 billion in net sales. Growth is supported by successful commercial and operational execution, particularly in the sales of biologics. We continue to deliver innovative treatments, broaden access for patients and support our physician community. Ilumetri continues to deliver steady growth, reaching EUR 234 million in sales and is on track to achieve peak sales of over EUR 300 million. Ebglyss maintained a strong momentum during 2025 as the rollout is now complete in all key European geographies and these markets begin to scale. The good performance reinforces our confidence in the product's positioning and growth potential.

Regarding our products, Wynzora keeps its leading market share in key countries, while Klisyri maintains a strong performance across Europe. During 2025, we have focused on continuing the development of our strong presence in the Medical Dermatology field. We presented at major events such as the 2025 Annual AAD Meeting, and we reinforced our presence at the 2025 European Academy of Dermatology and Venereology Congress in Paris.

On the clinical side, we are excited about the new developments in our pipeline. We have initiated 3 Phase II proof-of-concept studies and 3 other PoC studies are on track to enter Phase II in the upcoming quarters. Most of these assets are either first or best-in-class. Karl will soon provide a full update on the recent developments in our pipeline.

Please move on to Slide 9 for our -- for an update on our biologics portfolio. In 2025, Ilumetri net sales reached EUR 234 million, representing a steady 12% year-on-year increase. The brand continues to perform consistently, and we remain firmly on track to deliver the more than EUR 300 million peak sales in net sales, even as both the product and the IL-23 class move into a more mature phase of their growth cycle. Ilumetri remains well positioned within the psoriasis market, maintaining its market share and remains one of the leading therapies within the class. The successful launch of the 200-milligram formulation provides enhanced dosing flexibility for patients, thereby strengthening the product's competitive profile and supporting long-term growth. Additionally, the 2-year positive study results presented at EADV 2025 further demonstrate Ilumetri's long-term value, highlighting meaningful real-word benefits in patient's wellbeing and reinforcing the product's clinical and commercial relevance.

Please move to the next slide on Ebglyss highlights. Ebglyss continues to be the most successful atopic dermatitis launch in recent years. Since its approval in Germany in December 2023, it has quickly become our second best-selling product. The advanced therapy segment in AD across the EU5 nations continues to expand rapidly at around 30% growth annually. Full year sales more than tripled to EUR 111 million, up from EUR 33 million in 2024, reflecting the successful European rollout with healthy scaling across all key markets and encouragingly early traction in new country launches. This gives us a strong confidence in Ebglyss as a major growth driver in the coming years. Patient and physician acceptance along with good commercial and operational execution have been key elements to achieve this result.

Clinically, our collaboration with Lilly remains highly productive. At EADV in 2025, we presented a wide set of Lebrikizumab data, including real-world evidence, long-term results up to 3 years, patient-reported outcomes and safety data, all showing rapid and sustained efficacy and reinforcing its differentiated profile.

Please turn over to the next slide. We are working closely with our partner, Lilly, to build a growing data set for Ebglyss through a series of synergistic post Phase III studies on lebri. The objective is to strengthen the evidence base through life cycle management, supporting broader patient access, expanding our market presence and exploring additional indications for these advanced treatment. As part of this effort, Almirall recently initiated a new Phase III study in nummular eczema. Karl will provide you with additional details in the following section. Additionally, we will be conducting a face and neck study on lebrikizumab to further strengthen the profile of the product.

Let me turn it over to Karl for the pipeline update.

Thank you, Carlos, and good morning to everyone on the call. This slide gives an overview of our life cycle management activity for products that are already commercialized. And I would like to highlight the progress we made in recent months. Seysara was approved in China end of last year. We have also signed a partnership agreement with Sinomune to commercialize Seysara in China, strengthening our presence in this important market. Together with our partners, Sun Pharma and Eli Lilly, we continue to advancing label expansion opportunities for Ilumetri and Ebglyss respectively.

Carlos has already shown what we expect in terms of clinical data flow for lebrikizumab. The next readout will be the week 16 data of the ADorable-1 study, which we expect to share in the coming weeks. ADorable-1 explores the safety and efficacy of lebrikizumab in pediatric patients with moderate to severe atopic dermatitis. As mentioned earlier, Almirall will also explore lebrikizumab in ADorable-1 nummular eczema.

Next slide, please. Nummular eczema is a chronic inflammatory disease with a high unmet medical need. Today, treatment is largely limited to topical therapies, which often fail to provide adequate disease control, and there are currently no approved systemic treatment options. IL-13 is hypothesized to be a central cytokine, not only for atopic dermatitis, but also for nummular eczema. Given the proven efficacy of lebrikizumab in atopic dermatitis, we believe there is a strong rationale for meaningful symptom relief and quality of life improvement in patients with nummular eczema. We expect to start enrolling patients in Q2 2026.

Next slide, please. This slide shows you the status of our early and mid-stage pipeline. Today, we have 3 proof-of-concept Phase II studies ongoing with 3 additional studies planned over the next 12 months. In 2025, we progressed our anti-IL-1RAP antibody into Phase II for hidradenitis suppurativa and our IL-2 mutant fusion protein for alopecia areata. In addition, our partner, Simcere, initiated a Phase II study of the IL-2 mutant fusion protein in atopic dermatitis. As a reminder, we retain global rights for this asset outside Greater China.

Looking ahead, we plan to initiate 1 additional proof-of-concept study each for the IL-2 mutant fusion protein anti-IL-1RAP antibody in an inflammatory skin disease. The anti-IL-21 antibody we plan to explore in hidradenitis suppurativa. We also expect our bispecific antibody for atopic dermatitis to move into Phase I in the coming months. Furthermore, we have started preclinical development for an oral small molecule targeting Th2 diseases and a new approach using mRNA/LNP technology for non-melanoma skin cancer.

Let me show some more details on the most advanced projects on the next slide. For hidradenitis suppurativa, we have 2 programs. The anti-IL-1RAP antibody has recently entered Phase II and the anti-IL-21 antibody is expected to start proof of concept in the coming months. The anti-L1-RAP antibody blocks anti-IL-1RAP inhibit signaling across the IL-1, IL-13 and IL-36 pathway. Inhibiting these pathways concurrently is intended to support deeper suppression of the inflammation and the relevance of the IL-1 and the IL-36 pathways in hidradenitis suppurativa is supported by existing clinical evidence. The second program targets IL-21 and is designed to modulate both B and T cell activity. We believe that this dual strategy targeting 2 distinct inflammatory pathways has the potential to provide meaningful differentiation compared to current treatment.

Please change to the next slide. The IL-2 mutant fusion protein has entered Phase II development in alopecia areata. Alopecia areata remains an area of high unmet medical need with fewer than 30% of patients achieving a satisfactory symptom response with currently approved therapy. The disease has a prevalence of approximately 0.1% to 0.2%, a lifetime incidence of around 2% and 44% of cases are moderate to severe. It is also the third most common dermatosis in children. IL-2 mutant fusion protein is designed to selectively expand regulatory T cells with the aim of rebalancing the immune system. This mechanism is intended to support immune tolerance, addressing the underlying autoimmune component of the disease rather than only its symptoms.

From those 6 proof-of-concept Phase II studies, we anticipate data readouts over the next couple of years, starting end of 2026, beginning of 2027. While these programs remain at an early stage, they address well-defined biological pathways and represent a range of first or best-in-class approaches. In summary, our investment over the past few years is beginning to translate into tangible progress in our pipeline.

With that, I will hand over to Jon for the financial review.

Thank you, Karl, for the update on our R&D programs and pipeline, and good morning, everyone. As Carlos mentioned earlier, company's consistent execution continues to translate into solid tangible results. In 2025, Almirall delivered a strong performance with net sales growing over 12% year-on-year, achieving our 2025 guidance. Our European dermatology portfolio remained the key growth engine, further reinforcing Almirall's path towards leadership in Medical Dermatology. Gross margin for the year reached 64.4%, reflecting continued royalty pressure from Ilumetri royalties, partially offset by the Q1 2025 divestment. EBITDA came in at EUR 233 million, up 21% year-on-year, driven largely by strong top line growth that outpaced SG&A increase.

As expected, SG&A increased 7.9% to EUR 501 million with Q4 reflecting the previously announced uptick. R&D investment grew by roughly 11%, representing 12.5% of net sales, fully aligned with our annual targets and guidance. We closed December with a net debt-to-EBITDA ratio of 0. During the final quarter, we successfully completed the issuance of a new high yield bond at a 3.75% interest rate, a level that reflects the strong trust Almirall has built among financial markets. Company long-term credit rating by Standard & Poor's was improved to BB+, very close to investment grade. Our strong balance sheet gives us meaningful flexibility to pursue licensing opportunities and targeted bolt-on acquisitions as and when attractive opportunities arise. Overall, these results strengthen our confidence in delivering full year 2026 guidance and the midterm outlook we shared earlier.

Let's move now to the details of our sales breakdown on the next slide. The European dermatology business delivered a strong performance with net sales up 25.6% year-on-year in 2025. Additional details will be shared on the next slide. In general medicine and OTC, European sales included the divestment of Algidol and the out-licensing of Sekisan. A softer allergy season for Ebastel and lower sales of cardiovascular products such as Crestor, were largely offset by a solid contribution from Eklira Performance in the U.S. declined and further details will be shared on the next slide. In the rest of the world, overall sales were broadly stable with rapid growth in dermatology offsetting a decline in general medicine.

Let's take a closer look at the dermatology business on the next slide. Our European dermatology business continued to prosper positively. Ilumetri maintained its healthy year-on-year growth, while Ebglyss further strengthened its role as our primary growth engine. At the same time, we continued to build relevant market share for Klisyri and Wynzora with bought products continuing to gain traction across key European markets. Ebglyss delivered EUR 111 million in 2025, beating slightly consensus as European markets continue to scale up following launches in all key countries. This performance reinforces our confidence in its robust long-term growth potential.

Across the rest of the portfolio, Ciclopoli sales remained broadly stable and Skilarence posted a solid improvement versus 2024. In the U.S., performance declined year-on-year. While Klisyri's large field launch continued to deliver some growth, these gains were offset by ongoing pressure on the legacy portfolio. Products such as Cordran, Tazorac and Aczone remain affected by persistent generic competition. In addition, Seysara sales declined, driven mainly by intensifying competition in the oral antibiotic segment for acne. In the rest of the world, dermatology sales increased year-on-year, supported by portfolio momentum and a minor contribution related to the recent Seysara partnership agreement in China. Overall, the performance of our dermatology franchise remained strong.

Let's now review the remaining elements of the P&L, starting with some of the ones mentioned earlier. Gross margin came in at 64.4% in 2025, 30 basis points lower than prior year, reflecting margin pressure mainly due to higher royalty tiers associated with Ilumetri's growth. R&D spending represented 12.5% of net sales, broadly in line with last year and guidance. SG&A expenses increased 8% year-on-year, driven by ongoing support for Ebglyss launch across new markets and continued investment behind our key brands. As we highlighted previously, SG&A picked up in the final quarter due to some seasonality in the second half and ended align with expectations. Financial expenses improved versus last year, supported by a EUR 12 million positive impact from the equity swap valuation, reflecting share price gains year-to-date. Finally, our effective tax rate ended at 38%, an improvement by 24 basis points versus prior year, driven by the strong increase in the group's overall profitability, which materially reduces the relative impact of our U.S. business at the consolidated level.

Please move to the next slide to take a look at the balance sheet. Our balance sheet remained very stable in 2025 compared with previous year. Capital expenditure were elevated in the final quarter, mainly reflecting the Ilumetri sales milestone of nearly EUR 50 million recently extended collaboration agreement with Simcere, capitalization of Ebglyss R&D programs and pipeline progress achieved in prior quarters. This increase was more than offset by higher depreciation, which resulted in a decline in goodwill and intangible assets. Our net debt ratio remains close to 0, providing us with a strong financial flexibility to pursue inorganic growth opportunities. The reduction in net debt primarily reflects solid cash flow generation in the third quarter.

Let's take a look at the cash flow statement next. Company's free cash flow more than doubled in 2025 compared to last year. Cash flow from operating activities reached EUR 174.5 million, an increase of EUR 17 million versus prior year. It was mainly driven by a more than twofold increase in profit before taxes, partially offset by higher working capital needs linked to the growth in biologics volumes with the rollout of Ebglyss in Europe. Cash flow from investing activities was minus EUR 127 million, an improvement by EUR 13 million compared to the previous year. It reflects lower investment outflows versus prior year, which included the EUR 45 million Ilumetri sales milestone as well as milestone payments related to Ebglyss, Wynzora and pipeline progress.

Cash flow from financing activities amounted to minus EUR 87 million, representing higher outflows versus the minus EUR 31 million recorded in 2024. The difference is mainly explained by the refinancing of the senior notes where the variance in nominal amounts combined with issuance costs had an impact of roughly EUR 55 million. In addition, we recorded a higher cash dividend selected by shareholders, which was partially offset by the positive EUR 12 million equity swap impact supported by the increase in our share price.

I will now give some more color on our 2026 guidance. We anticipate quarterly performance to strengthen progressively as the year advances. In the first quarter, in particular, while being positive about the underlying growth of our business, we are going to face a tough comparison considering the divestment of Algidol and out licensing of Sekisan during the first quarter last year. Regarding the details of the 2026 guidance, I would like to outline some assumptions used regarding the rationale behind provided ranges. As in every other year, we have 4 main elements that may impact both net sales and EBITDA.

Firstly, the speed and level of penetration of biologics in the overall market; secondly, underlying market growth and competitive dynamics; thirdly, performance of the legacy portfolio; and lastly, potential opportunities that may arise through portfolio management strategy. Any changes in these elements may influence the performance within the reasonable range we have announced this morning with 10.5% as a midpoint of net sales growth at EUR 280 million as midpoint of EBITDA level for 2026.

Other than that, we are positive about ongoing performance of the business and confident in delivering a good set of results for 2026, driven mostly by our newer products and biologicals. We feel comfortable with market expectations for our biologics in 2026. Checking Bloomberg or Visible Alpha sources, Ilumetri seems to be in the range of EUR 260 million and Ebglyss seems to be in the range of EUR 180 million to EUR 190 million. At the same time, we reiterate our midterm guidance of double-digit CAGR growth in the period 2023 to 2030.

In 2026, we will continue to experience a slight gross margin pressure given increasing royalty rates, particularly for Ilumetri. R&D investment is expected to stay at the level of 12% to 12.5% relative to net sales. And in 2026 and going forward, we continue expecting net sales to grow faster than the SG&A as we have seen in 2025, now Ebglyss has already been launched across Europe. Regarding the tax rate in 2026, it should continue going down towards the mid-20s target by 2028 as a strong increase in the group's overall profitability materially reduces the relative impact of our U.S. business at consolidated level.

With this, I would like to thank you all for your attention this morning. I will pass the word to Carlos for his closing remarks.

Thank you, Jon. Building on the strong achievements of 2025, let me highlight the momentum we are now carrying into 2026 across our biologics pipeline. We are well positioned to lead in an expanding dermatology market, supported by a broad and highly relevant portfolio. Our pipeline includes disruptive potential programs across immune-mediated skin diseases, rare dermatology and non melanoma skin cancer. Today, we already have 3 studies advancing through proof of concept and Phase II with 3 additional programs expected to start in the coming quarters. That gives us strong scientific foundation and a clear path to sustainable value creation.

At the same time, we continue to evaluate opportunistic bolt-on acquisitions in commercialized assets and remain active in pursuing early-stage licensing opportunities in promising advanced therapies. Importantly, we are turning strategy into results through rigorous execution. Having delivered fully on our 2025 guidance, we remain firmly on track to achieve our midterm targets of double-digit sales growth and a 25% EBITDA margin. The Ebglyss launch continues to scale strongly across Europe, while we effectively manage Ilumetri's transition into its more mature growth phase. We are committed to shaping leadership in Medical Dermatology in Europe, turning innovation into growth and delivering lasting value for patients and shareholders.

With this, we conclude the presentation, and I hand it back to Pablo for the Q&A session.

Thank you very much, Carlos. Sandra, back to you for the Q&A, please.

[Operator Instructions] And the first question comes from the line of Shan Hama from Jefferies.

Two from me, please. So firstly, what is factored into the top and bottom end of the net sales guidance for 2026? And then secondly, if I can push you a little bit, why is the bottom end of the guide 9% when the midterm guide is double digit? Is there any way you can reconcile that?

Thank you, Shan, for the question. Let me for this color, I think Jon can take this question.

Absolutely. Thanks a lot, Carlos, and thanks a lot Shan, for your question. I think both questions can be replied basically into one for the low range. As you know, usually, the management portfolio strategy is part of our guidance. But as I have said during my script, in Q1 2025, we had the opportunity to execute 2 transactions. One was the divestment of Algidol and the other one was the out licensing of Sekisan computing for around EUR 12 million in Q1 2025 and around EUR 15 million on a full year basis. In order to be able to overcome the double-digit growth, we also need to replicate these 2 transactions or even more to compensate that amount of volume. So this is what it makes the lower range guidance that perhaps we are not able to close this year 2 transactions in the same way.

Moving to the higher range, basically means a the other way that we are able to close 2 or even one, but basically that we are able to accelerate Ilumetri and Ebglyss further in the high range of provided guidance. These are basically the main levers for the low and the range, Shan.

We will now take the next question from the line of Francisco Ruiz from BNP Paribas.

I have 3 questions, very quick ones. The first one is, if you could give us an update on your peak sales that you expect on Klisyri and Wynzora, now they are gaining some weight on your P&L. The second one is, if you could give us some detail on Seysara's partnership in China and how much will contribute in the future for you? And then there are some question on modeling. I mean you commented on reducing the tax rate towards the 20% target. Could you give us some more detail for next year and also the milestone payment that you're expecting in '26 and '27?

Francisco, thanks for your questions. So we are not providing a review on peak sales projections for Klisyri and Wynzora at that stage. I think both brands are progressing extremely well. We're happy with the progress, particularly in Europe. Seysara partnership, we are pleased of the approval. We're pleased of the partnership. The contribution at that stage, we prefer to be prudent, and we think it's going to be modest. And the modeling part, I'll pass it to Jon. I'm sure he will be -- he will do a much better job than me.

Yes. Can you please repeat the question about the modeling part, Francisco?

Yes. I mean -- so one is about the tax rate for next year, although you say that we should see 20% or mid-20% in the medium term, but for next year more specifically. And also on the milestones cash out as we should expect in '26 and '27?

Yes. Thanks. So regarding the effective tax rate, yes, during my script, I have said the expression that by 2028, we expect to be in the range of mid-20s, and we will continue going into that direction. Guidance for 2026, we should expect a reduction at least I would say, mid-double digits is our intention to go in that path as we increase the group overall profitability. Regarding the other aspect about the CapEx payouts, reasonable investment CapEx, excluding recurring CapEx, will average around EUR 70 million to EUR 75 million in the upcoming years, excluding potential additional in-licensing deals. Basically, this covers milestones for in-licensed assets. When we talk about ordinary CapEx, ordinary CapEx are expected to be in the range of around EUR 70 million to EUR 80 million in 2026 and then go down in the upcoming years as we have some ongoing post Phase III studies that are capitalized, as Carlos has mentioned during his script, together with IT projects, industrial CapEx and other minor tax.

Thank you. We will now take the next question from the line of Jaime Escribano from Banco Santander.

A couple of questions from my side. In terms of gross margin, what should we expect based on the product mix? I guess, Ebglyss and Ilumetri licensed products are putting a little bit of pressure there. And my second question would be on Almirall legacy. So there is a EUR 12 million one-off in 2025. So in 2026, what should we expect from the rest of the portfolio? If you can give us a little bit of color on the different moving parts there?

So let me take the second question, and then I'll pass it to Jon for the gross margin question. So as we have shared with you on a number of occasions, we have a big product portfolio on the legacy bid. Our goal is always to keep an optimization strategy. That meaning if we see an opportunity to acquire something where we can add value, we do so, as we did 2 years ago. But also if we think that we are not the best owners of a certain asset because we are not promoting it and someone comes in and offers us a superior value than the value that it has in our hands, then also we divested it. And this is the case that we've done in Q1 last year.

So it's difficult to make projections on this because this is business development. But our strategy will be to keep optimizing this portfolio, and it might entail some maybe small minor acquisitions or might entail some, again, divestitures. But it's difficult to anticipate any specific transaction at this point. Jon, do you want to take the gross margin question?

Thank you very much, Carlos, and thanks for your question, Jaime. So regarding the gross margin expectation for next year, please let me start saying that the gross margin, you may appreciate in Q4 has been lower than expected, and it doesn't represent what you should be expecting. The margin in Q4 came in at 62.8% as a consequence of an accrual to cover potential inventory write-off related to quality observation in some time batches for minor products. Having said this, that this is a one-off, we should expect certain pressure taking the margin down for next year.

We don't disclose guidance, but in my earnings call of Q3, I said that the Q3 margin we disclosed could be a good proxy for next year, something in the high 63% could be used as a base. And then coming back to the point of the EUR 12 million milestone you have commented, I linked to this in the reply to Shan, that we need to overcome it to be able to deliver double-digit CAGR growth this year as well. And that's why we have provided the range. But having said that, let me reiterate that we are fully convinced about the 10.5% midpoint of guidance on net sales we have provided this year. We feel comfortable with the market expectation for 2026 is for our biologics, Ebglyss and Ilumetri, and we reiterate the midterm guidance of double-digit CAGR growth between the period 2023 to 2050.

Thank you. We will now take the next question from the line of Guilherme Sampaio from CaixaBank.

Guilherme, this is Pablo. We cannot hear you. We cannot hear you very well.

Hello? Yes, is this better?

Yes, no better.

Okay. Sorry. So the first one is for Karl. If you can comment on the relevance of IL-13 in the cascade of nummular eczema versus atopic dermatitis? And then 2 ones related to financials. The first one in terms of phasing of the growth for next year, I already mentioned that Q1 is going to be below the average. Just wanted to understand how do you expect this to evolve in the remaining quarters? And the third one, if you could provide a bit more details in terms of Klisyri. So there was some step-up in terms of sales in this quarter. Just wanted to understand how this should unfold over the coming quarters.

Karl, you can go straight to question.

Thank you, nummular Guilherme, for the question. I think that nummular eczema is a disease that is different from AD, sometimes there is certain comorbidities or certain coherence and it's characterized by pruritic discoid shape, well-demarcated, you know, some of the most lesions that are frequently occur both on the arms and the legs. IL-13 is hypothesized to be a key cytokine in both indications. And therefore, we believe that we have a good chance to see with lebrikizumab a meaningful treatment effect in this patient population. It is a disease where the prevalence is estimated between 0.1% and 9%. So there is a lot of variability reported. We believe it's at the lower end. And we think addressing this high medical need indication is a good opportunity both to help these patients, but also to expand the use of lebrikizumab.

Jon, do you want to take number 2, number 3, there?

Thanks a lot, Carlos. So in terms of phasing, yes, in Q1, we will face a tough comparison. I have already disclosed that we will be competing against a very challenging Q1 2025, where we reported the divestment of Algidol and the out licensing of Sekisan for about EUR 12 million in that specific quarter and EUR 15 million on a full year. Once we pass the Q1, Q2, we will come back to a more normalized comparison, but definitely, the growth will accelerate in Q3 and Q4. So we expect a stronger second half of 2026 versus a softer in half in 2026 due to this divestment.

And then the third question was about Klisyri. Yes, I mean, Klisyri has basically 3 legs, Europe, U.S. and global. In the area of Europe, we have seen a good commercial execution that has driven the good results, nothing to compare. We work with a long-term vision. So some quarters can be better, some quarters can be not so good. We are pleased with the performance of the product in Q4, but nothing specifically to mention. Regarding the rest of the world, we have mentioned during the script that there is a minor contribution in other countries. For example, we signed the agreement with one partner in Asia Pacific during Q4, and it gave us an access. It's a testimony to the strength and scientific value that Klisyri brings to patients, the fact that they are global partners that they want to collaborate with us in territories that we do not operate.

And then in the case of -- in the U.S., the performance in the quarter has been impacted by the FX rate. Well, you see our numbers reported for Q4, they are negative by 9% but the reality is the U.S. team is doing a good job. And in terms of volumes and dollars, we are growing in low single digits. The euro-U.S. dollar FX rate has had an impact in this case in Q4 isolated, where last year, the average was 1.15 to 1.17, while in Q4 2025, we are in the range of 1.05 more or less.

We will now take the next question from the line of Damien Choplain from Stifel.

This is Damien. Congrats on the strong full year results. I have a first question on your midterm guidance. So you have guided to a 25% EBITDA margin by 2028. But given that gross margin will remain under pressure and SG&A piece is already well optimized, what specific sources of operating leverage will support reaching your 2028 target? So this is my first question.

And second one on Ebglyss. Could you provide some colors on what could be the market size for nummular eczema? And when should we expect the Phase III readout?

Thank you, Damien, for the question. In terms of the midterm guidance, yes, there will be operational leverage, and that's where it's going to come this margin expansion. And again, as we've mentioned in previous calls, we've done all the investments that we needed in infrastructure to maximize the value of this asset. So we don't plan to increase or continue to invest in this type of infrastructure. And of course, we're also expecting productivity gains on SG&A. So overall, we are very comfortable with the guidance provided, and we are comfortable that we will deliver on these margins.

On Ebglyss, please can you comment, Karl perhaps can do that.

Happy to comment. So as mentioned, the study will enroll patients in Q2 this year, and we expect readout in the 2029 time frame. So far, this indication has not been included into our peak sales guidance.

Thank you. We will now take the next question from the line of Alvaro Lenze from Alantra Equities.

The first one is on the rate of growth of Ebglyss. You've been adding roughly EUR 5 million of incremental revenue every quarter. I wanted to know how much of this comes from new launches and how much comes from growth in the -- mainly in Germany?

My second question is on working capital. You have invested quite a bit in working capital this year more than in previous years. It doesn't seem to be inventory buildup because I see that your level of inventory is roughly stable. I don't know if this is just a seasonality thing of how some payments ended up in -- at the cutoff date on 31st December or if there is any fundamental reason driving this working capital and if we should see similar investments into working capital in 2026?

And my last question would be on capital allocation. You're generating cash, the payments going forward are likely going to be lower than in the past few years in terms of milestones or capital -- cash flow generation should increase. So we were a bit surprised to see the issuance of an additional bond. So I don't know if you see plentiful investment opportunities or otherwise, why are you not reducing your debt levels?

Thanks for the question, Alvaro. In terms of the rate of growth for Ebglyss, we're seeing strong contribution from all countries. We are in all the countries where we've launched, we've seen double-digit penetration in terms of dynamic market share. And lately, we're seeing also increased acceleration in terms of growth in some of the latest countries where we have launched such as Italy and France. So overall, very pleased with the rate of growth, very confident, very homogeneous across countries. So that gives us total confidence on delivering on our peak sales estimate.

On working capital cash flow, Jon, do you want to take those questions?

Yes. Thanks a lot, Carlos. Thanks a lot, Alvaro, for your question. Regarding your question about working capital, you are spot on. It's basically facing seasonality of collections. It has happened this year is not structural. So we will not see the same increase in the years to come.

And then the third one, which is capital allocation and why we did the bond. First of all, let's start with the transaction that we bought in sale that I think we were able to obtain a very good price in the current environment. And I feel this is a testimony to our prudent financial approach and the good performance of the company. But having said that, I think the bond is very important for us because it represents the commitment to maintain a solid liquidity position to keep investing in early-stage R&D deals and bolt-on acquisitions as and when they come up. It may be in short term, it maybe in midterm, but we want to have this flexibility to execute. That's why we executed the bond, and that's why we reduced it from the prior EUR 300 million to the current EUR 250 million because we also believe we are going to generate positive cash flow in the upcoming years.

We will now take the next question from the line of Joaquin Garcia-Quiros from JB Capital.

It's just on the alopecia areata and you have hidradenitis suppurativa. If you could give us a bit more color on the market that you see for this or maybe number of patients, if you can? And is this -- do you expect this to be -- with a similar size of Ebglyss? Or we should expect this to be significantly lower than Ebglyss in the contribution for Almirall. And lastly, when should we expect the readouts for these studies?

Thank you, Joaquin, for the questions. We are very excited about our alopecia areata and 2 of the HS products that we have in place. Why? Because, one, it's an area of tremendous unmet need, sort of still patients suffering with inadequate treatments for these conditions. And secondly, because we believe that we have our treatments that are now in Phase II have the potential to really transform the standard of care and become first-line for patients.

In terms of how many patients out there, there are prevalence data, maybe Karl can help me here with some data. Here, it is important to note that for all programs in our pipeline, we have global rights. So if you compare it to what we have today, with Ebglyss and Ilumetri, Ilumetri only have European rights. So probably these indications are of lesser prevalence, but we have worldwide rights. So the potential is way higher than what we see with Ebglyss and Ilumetri today. And that's why we are super excited. The opportunity to help patients, but also create a significant opportunity from a financial perspective to the company.

Can you...

Happy to add a bit more color. So alopecia, as Carlos mentioned, is an indication of high unmet medical need. The only available systemic treatment are check inhibitors with not only their known challenges around the side effect profile, but also it is reported that once this treatment is not recurrence rate is very high, which has a very significant impact as once hair fall out again, it takes like 3 months to regrow. The prevalence is 0.1% to 0.2%. As mentioned, it's also an important indication for children. And the market size is estimated to be around, let's say, $1.4 billion by Evaluate Pharma in 2030.

HS, again, another area of high unmet medical need. Currently available treatments are seem to be rather having a modest effect. What experts have told us is due to the complexity of the disease, it's recommended to think about inhibiting multiple pathway, not only a single one. And that's what we're doing with both of our assets. The prevalence is estimated between 0.4% and 2% and with the potential higher prevalence in the U.S. and especially in Afro-American and the estimated market size by Evaluate Pharma is about $5 billion in 2030.

[Operator Instructions] We will now take the next question from the line of Jaime Escribano from Banco Santander.

So 2 follow-up questions from my side. One, if we look to -- regarding the guidance 2026, if we look to the consensus right now, for example, Visible Alpha in Ebglyss is EUR 188 million. And in the case of Ilumetri, around EUR 260 million. I would like to ask how comfortable you feel with these numbers?

And the second question more for Karl. Karl, within the 3 products you guys have in Phase II right now, what is the one you are more excited if you had to pick one in terms of potential efficacy and probability of being successful?

Thank you, Jaime, for the follow-on questions. On the guidance for our biologics, we feel very comfortable with the figures that you have mentioned.

And let's go to Karl for...

That is always a very difficult question. Now we are talking about 2. One is an anti-IL-1RAP antibody and the reasons why we are so excited about this antibody that antibodies that have targeted individual components, for example, one against IL-1 alpha and IL-beta, but also another one against IL-36 has shown some initial efficacy in this disease. And we believe combining those 2 activity has the chance for, let's say, improving the efficacy.

On the IL-2 mutein that is a completely novel mechanism stimulating regulatory T cells. And what makes us optimistic is that there is evidence that this mechanism could work in both diseases, alopecia areata and atopic dermatitis based on initial studies that come from low-dose IL-2, but also from a competitor readout using a PEGylated version of IL-2. So in summary, both are very exciting programs, and we look forward to then having starting readout end of 2026, beginning of 2027.

There are no further questions at this time. I would now like to turn the conference back to Pablo Divasson for closing remarks.

Thank you very much, Sandra. If there are no further questions, ladies and gentlemen, this concludes our today's conference call. Thank you for your participation. You may now disconnect.

Welcome, everyone, to the JPMorgan Healthcare Conference. We are pleased to have with us the Almirall management team here with us today, Carlos Gallardo, Chairman and CEO; Karl Ziegelbauer, CFO; Jon Garay, CFO; and Pablo Divasson, Head of IR.

With that, we'll let Carlos have the stage. For logistics purposes, please reserve your questions until the end of the presentation.

Good evening, everyone, and thanks to JPM for inviting us one more year to present where we are in our journey towards leadership in medical dermatology. Here, I remind you of our disclaimers. I'm just going to spend a few seconds here, but it's in the print out that we have posted on the website. In terms of agenda for today, I would like you to tell you about our growth story in dermatology, and the transformational opportunity that we have ahead of us with our pipeline, and I will close with some closing remarks.

For those of you that don't know Almirall are not familiar with Almirall, let me spend just a few seconds. So it's a European company based in Barcelona. It was founded 80 years ago. And in 2014, we took the strategic decision to focus exclusively on medical dermatology. Today, fast forward, we have already exceeded $1 billion in sales and more than 50% of those sales are already sales in medical dermatology. We have a solid base business and a very exciting dermatology growth engine, mainly driven by our 2 biologics, which is project -- which they are projected to grow double digit from now as a company. We're going to grow double digit from now until the end of the decade.

We have a proven track record in executing commercially. We have 6 successful recent launches, both from internally developed compounds but also from licensed assets. We have what we believe is an extremely exciting pipeline. We have already now 3 POC proof-of-concept studies that are already ongoing and 3 more that will be ongoing before the year finishes. And we have other assets that are already in the clinic, Phase I that we will be updating you about as well. Overall, I think this is a testimony of the strong both commercial capabilities, but also very strong R&D capabilities that cover the whole value chain of the company.

So why dermatology? Well, dermatology is already a very big market that is poised to grow double digit for now at least until the end of the decade. But also there's tremendous opportunity to innovate in dermatology. There are significant diseases that they have with severe unmet need that have no therapies approved. So it's a lot of opportunities for a company like us to innovate, particularly given the new exciting science that allows us to help us to understand better the biology of the diseases and help us to develop novel scientific hypotheses that we can translate into programs and eventually can translate into FDA and EMA approvals.

So extremely exciting therapeutic area to be. We already have commercial assets in some of these categories. Of course, the biggest category being psoriasis, where we have a number of assets, notably Ilumetri, our biologic for moderate to severe patients, Ebglyss in atopic dermatitis, we have Seysara for acne, rosacea. And well, everyone is speaking about hidradenitis suppurativa as the key next indication that will be the next big indication in dermatology. Well, we have -- we don't have a commercial asset, but we have 2 molecules that we are moving into proof-of-concept studies. Already, we have a POC ongoing with our anti-IL-1RAP molecule, monoclonal antibody, and we will soon initiate our POC study with our anti-IL-21 monoclonal antibody.

Talking about Ilumetri and Ebglyss that are our growth drivers. So let me spend a couple of minutes with those 2 products. These products are transforming the life of patients that are being prescribed with this product. But also what is transforming is the size of the company. What we're seeing is tremendous growth since 2 years ago until 2030, which means that the company is going to double in size, thanks to the growth of these 2 products.

Let me start with Ilumetri. Ilumetri was launched 7 years ago. It has delivered tremendous growth to the company. It has the backwinds of an expanding market. Psoriasis you might think that it's a market that is busy, many biologics already launched more than 10 different classes, et cetera. But in Europe, only around 20% of eligible patients are treated with such advanced biologics. So this is still tremendous opportunity for market expansion, and we have the backwind on this market expansion. Moreover, we have the backwind of being in the winning class, the go-to class by dermatologists in Europe that is the anti-IL-23. And within this class, we are competing extremely well. We have more than 20% market share in this class, and we are continuing to increase this market share or sustain it.

And why is that? Well, because in real world, Ilumetri delivers very good efficacy over the long term. And we have now that we have new ammunition to support our commercial organization to continue to increase this market share within the class. That is fantastic real-world data, for example, our POSITIVE study. But also we recently launched the 200-milligram presentation in addition to the 100-milligram presentation that we already had in the market. So now we have the 100, we have the 200 at the same price, by the way, which provides dose flexibility for dermatologists for difficult-to-treat patients. And that's been extremely well received by dermatologists.

So overall, Ilumetri, very nice growth over the past 7 years. We believe we will continue to grow double digit because, again, the market is expanding. We're in the winning class, which is growing faster than the market. And within the growing class, we are competing extremely well, holding market share or increasing market share in a number of countries.

Ebglyss, more recently launched 2 years ago, 2.5 years ago in Germany, and we've been rolling out the launch in the other main markets in Europe. It's an anti-IL-13 monoclonal antibody. IL-13 is a key cytokine in atopic dermatitis, and we have the best anti-IL-13 monoclonal antibody. And not surprisingly, it has been the best launch in recent years in atopic dermatitis. We already have in all markets, double-digit dynamic market share, and our ambition is to be the most prescribed biologic in the treatment of moderate to severe atopic dermatitis patients. And by the way, we have already achieved this being #1 in terms of new prescriptions, at least in one of the markets in Europe.

Feedback from physicians is excellent. So our job is to get physicians to dermatologists to try the product because once they try it, they like it and they continue to prescribe it in naive patients. Again, fair positioning, naive patients because it's the best treatment in disease. Together, we have guided the market that combined peak sales of more than EUR 100 million in 2030.

Ebglyss, as you know, it's in earlier stages of its life cycle. What it means that together with our partner, Lilly, we plan to have a flow of clinical data readouts to address patient needs, but also to drive growth and value. So let me stop on a few of the studies in this timetable. First, of course, some of them will impact label, such as the pediatric study. So we will get -- hopefully, we'll get a pediatric indication.

Let me perhaps mention the ADlong study that is long-term efficacy and safety, and we'll have 5-year data. We have already announced 4-year data that is -- that provides extremely good results, and we expect the 5-year results will be also very strong. The ADhope-2, which is a study where we are exploring longer dosing intervals. So what we're doing is with 2 injections of 200 milligram, we are dosing patients once every quarter. And again, we get successful results, we might be able to get this new dosing regimen in the label.

Our partner, Lilly is developing Ebglyss in additional indications beyond dermatology, such as perennial allergic rhinitis and also chronic rhinosinusitis with nasal polyps. And I'm very happy to announce today that we have decided also to develop Ebglyss additional indications in dermatology, and we are starting with nummular eczema. So what is nummular eczema? Nummular eczema is idiopathic chronic inflammatory skin disease with significant unmet medical need. The need is so big that there's nothing approved. So there's nothing approved for this patient population, and we plan to be the first product approved to treat indication. The driver of the disease or the key cytokine is also IL-13. So we have confidence that Ebglyss will end up being a good treatment alternative for these patients. We expect to start enrolling patients in the second half of the year.

So overall, we're very pleased to confirm our guidance that we provided for the full year. As a reminder, we're providing the full year results in February in our investor call. But today, we're happy to reiterate our guidance of growth -- sales growth of 10% to 13% versus 2024 and an EBITDA that will be between EUR 220 million and EUR 240 million. And also, we're happy to reiterate our midterm guidance of double-digit net sales between 2023 and the end of the decade, 2030 and an expansion of our EBITDA margin.

Why we are expanding the margin? Because we have already done all the necessary investments in terms of infrastructure, in terms of field force, et cetera. So the top line is going to grow much faster than our OpEx line, and therefore, it's going to show down in profitability. So we expect to have EBITDA margins of 25% by 2028.

So moving into the even more exciting part that is the pipeline. And before going straight to the pipeline, what I would like to say is what I said in my introductory slide, dermatology is a great place to be as a company that develops therapeutics as a scientist because there's still tremendous unmet need. And this slide tries to illustrate this unmet need. These are the key indications or the key diseases in medical dermatology, ranging for immune-mediated inflammatory diseases such as psoriasis, atopic dermatitis, HS, urticaria, alopecia areata, et cetera, non-melanoma skin cancer, where we also have programs and rare disease.

The size of the part reflects a little bit the unmet need. So the challenge of physicians to achieve their treatment goals. Probably the exception is psoriasis where physicians are able to achieve their treatment goals in most of the patients. So it's clear skin or almost clear skin, the famous PASI 100 to PASI 90, thanks to products such as Ilumetri, Wynzora and Skilarence. But even in AD, where we have highly effective treatments such as Ebglyss, given the heterogeneity of the patient population, one size does not fit all. So we still need treatments that cover a wider part of the population and also go deeper in terms of efficacy. So there's still room to go in atopic dermatitis.

But in other indications such as HS or alopecia areata, the unmet need is still tremendous. If you look at the bottom of the blue bar, these are our programs that we have in our pipeline. So we have programs for most of these diseases, right? And in the next slide, you'll see the traditional way to display our pipeline. And what we see here is the 6 proof-of-concept studies that we have already initiated or we are going to initiate in the next few months.

In addition to these 6 POC studies, of course, I will spend some time talking about the read-through inducer and also a very exciting bispecific that we have in our pipeline that is anti-IL-13 and OX40 ligand. I think this slide we're very proud not on the slide, but on the content because for the last 3, 4 years, we have spending a lot of time in building our capabilities in R&D, so we could license and we could internally develop compounds and progress them to the clinic and to patients. And it makes us especially proud to be able to have a number of these programs already in patients. And we expect a flow of news to come starting at the end of this year and into 2027 with the results of the POC studies.

So let me talk a little bit more about some of these programs. First, let me share with you our commitment to hidradenitis suppurativa. Hidradenitis suppurativa, as I said before, is the next big indication according to analysts in dermatology. It's extremely complex disease. It's chronic inflammatory skin disease leading to painful nodules, abscesses and tunnels that significantly impact quality of life, likely recurring targeting multiple diverse pathways for full relief. And again, this is our scientific hypothesis. If you look at what's available now and what's in the late-stage pipeline to treat HS, what we believe is that a majority of patients will not be able to achieve the treatment goals and that the unmet need is going to remain. Why? Because this is a complex disease.

A complex disease requires a medication, a drug that targets multiple diverse pathways. And we have 2 molecules that do precisely that. Our anti-IL-1RAP monoclonal antibody that targets different immunomodulatory pathways. So it inhibits IL-1, IL-33 and IL-36. And there's evidence already in the clinic that IL-1 and IL-36 both have clinical efficacy in hidradenitis suppurativa. So what we are hoping to demonstrate is the additive or synergistic effects of these 2 mechanisms of actions combined in monoclonal antibody. Additionally, and that's already ongoing, and we're already dosing patients with our anti-IL-1 drug.

The other drug that we're going to put into patients very soon is the anti-IL-1 monoclonal antibody and as well is targeting 2 different pathways for dual modulation of T cell and B cell components. And again, we have evidence based on internal experiments, but also in the scientific literature that there's a T cell component in HS and that there's a B cell component in HS. So we hope that IL-21 also we will be able to prove the effect of this medication in HS patients.

Moving to the next slide. Another very exciting program that we are already in Phase II, and we're already dosing patients is our IL-2 mutant fusion protein. This is a regulator of the immune system. So basically, how it works is that it stimulates the expansion of T regulatory cells. We're hoping to restore the balance of the immune system. These mechanisms can work on a number, we believe it can work on a number of dermatology skin diseases. And that's why we're running 2 POC studies and our partner, Simcere is running a third POC study in atopic dermatitis, our partner. And we are going to do it in alopecia areata and in one more undisclosed indication. Again, very exciting scientific hypothesis and we look forward to see the results of this POC study.

We have also another molecule, a small molecule that is a read-through inducer for a devastating disease. That is the junctional and recessive dystrophic epidermolysis bullosa. This is a disease in which because of the lack of collagen VII, skin blisters are caused, mucosal erosion is caused linked to inflammation, pain and scarring. Patients face high risk of death from infections, organ failure and skin cancer with, of course, significant clinical, economical and social burden.

We have this small molecule, but what it does, it helps the protein to code again collagen VII, restoring the functional skin. It's already in Phase I, and we're trying to move it to patients as soon as we can, although we have not yet disclosed time lines for this molecule.

And lastly, let me finish with another very exciting program that we have now in the clinical stage that is a bispecific for atopic dermatitis, our anti-IL-13 OX40 ligand bispecific antibody. As I mentioned before, although they are very -- there are efficacious treatments already approved for AD because of the heterogeneity of the patient population, not all the products work for all the patients. So there's still opportunity due to patient failures, and there's opportunity for treatments that offer broader, deeper efficacy and also potential for disease modification or even maybe partial remission or full remission. So we hope again to show the synergistic or additive effects of these 2 pathways soon with this bispecific.

So overall, as a closing remark, we are a company fully focused and fully committed to medical dermatology, which is a great market because there's tremendous opportunity for unmet need. It's big, it's growing. We have a good commercial portfolio and an exciting pipeline. We have proven execution capabilities, but it is helping us to transform the company and to double the size of the company. And also, of course, we keep looking for additional licensing or bolt-on opportunities from a business development perspective. And of course, all this is translating into results. It's translating into results that we see with a double-digit growth of the organization and the margin expansion. Thank you very much. Time for questions.

Thank you, Carlos, for the presentation. I'll kick it off with a few questions. You touched earlier on the full year 2025 guidance. Could you provide a bit more color on the SG&A and R&D costs as well as the revenue that you have seen in the fourth quarter?

Sure, Carlos. So for the fourth quarter, well, first of all, let us say that we are very confident and very positive about the company performance, and we are fully confident we will deliver the market guidance for this year. For the Q4 in terms of R&D, the R&D expenditure of net sales ratio of 12% that we presented in the Q3 earnings call is a good proxy as we continue investing in our POCs moving to Phase II programs, as Carlos has been explaining. In terms of SG&A, we would expect a certain pickup in Q4, just reflecting the usual timing of activities at year-end as we continue investing in our key products, mainly the commercial rollout of this.

Super. Then just looking forward into 2026, can you share any color on top line growth as well as SG&A, R&D and tax dynamics?

Yes. Sure. It is a bit too early for us to disclose 2026 performance figures because we have not yet disclosed the guidance for next year. But if a bit of context can help, we will be aligned with our midterm guidance. Just to remind you, basically, we have been made public that our revenue will be growing double-digit CAGR growth between 2023 and 2030. So in 2026, we will still be continuing in the double-digit growth area and this guidance does not include any M&A activity beyond the usual portfolio optimization that we make every year.

In terms of gross margin, we can expect certain pressure downwards as some of our in-licensed products are subject to tier royalties and milestones, mainly Ilumetri and Ebglyss. Where the real margin expansion will be taking place in 2026 is at EBITDA level because basically our sales will be growing more rapidly than our expenses once the commercial infrastructure to launch Ebglyss has already fully deployed in the countries in which we operate.

Similarly, following Carlos' presentation today, we have a very exciting pipeline with 6 POC moving into Phase II programs. So a proxy of R&D investment of net sales in the range of 12% is a good proxy for next year. And finally, in the area of tax, we will be contributing to free cash flow generation as well from tax point of view as we will be reducing the effective tax rate as we use the European gains to use the losses we have in the United States. So as a summary, we are accelerating company performance, not only on the R&D pipeline, but also on the operational excellence area.

Great. Do you expect any divestments upcoming in 2026? And would the forward-looking guidance include these contributions?

So we are not looking any -- or we are not pursuing any special divestments. But just to be clear, as part of our market guidance, we usually include our portfolio optimization strategy. And if you look at our financial statements, something in the range 10 million to EUR 20 million is taking place every year, and this is normal portfolio optimization strategy.

Just moving on to some of the key products, starting with Ebglyss. How comfortable are you with the current consensus for 2026?

So right now, with the information we have something in the ballpark that the consensus is showing, which is EUR 180 million to EUR 190 million, we think is a reasonable assumption for next year. So we feel a comfortable space there.

Great. Earlier in the presentation, Carlos mentioned that Ebglyss has approximately 20% market share or maybe that was Ilumetri?

It's Ilumetri.

Ilumetri. So in terms of like the market share between naive versus switches, what does the dynamic look like now for Ebglyss? And do you have an approximate target that you would want to achieve in the next coming years?

Sure. As I mentioned before, Ebglyss has been the best launch in AD recently. From all the products that have been launched, we have already achieved double-digit dynamic market share in most countries. There's one country in Europe where we're already more prescribed than any other product, including Dupixent. And that's our ambition, our ambition because we believe it's the best in disease that eventually there will be more prescriptions, more initiations with Ebglyss that with the need of treatment, and that's what we're working towards.

Just I wanted to also briefly touch on the new Phase III study that you mentioned on nummular eczema. Could you just walk us through maybe what the rationale was to expand the indication? And also where do you see the potential upside and then the approximate market size for this indication?

Maybe I'll take this question. So we are very excited about Ebglyss. We believe this is the best antibody targeting IL-13. And as the pathophysiology is similar in nummular eczema, but the disease is distinct from atopic dermatitis, and there is no effective treatment available, we want to expand in this patient population. This is currently not included into our peak sales guidance as an indication. I think the prevalence of this disease, the reported data, there is big ranges kind of from 0.1% to 9%. We believe the real prevalence is a bit more on the lower end of that range. And we think once the treatment is available and if our study is positive, this would provide significant additional opportunity for Ebglyss.

Great. Just maybe going back to atopic dermatitis. You have a few additional competitors entering the market. So how do you see this market evolving in the next few years?

I mentioned before in my presentation that in psoriasis, only 20% of eligible patients were prescribed with advanced therapeutics. In the atopic dermatitis market, because it's less developed, it's even less than that. It's around 10%. So what we saw -- what we've seen in psoriasis market is the more entrants, the quicker is the market expansion. So we believe that more players is good in the sense of market expansion. And of course, because we believe that we have the best product out there to treat moderate to severe patients that we will be able to capture a majority of the market share of these new patients.

So what we see is a dynamic market, of course, more noise, more market expansion, more competitive. And we believe that IL-13 is a key cytokine for the treatment of AD, which means that there are products that are not targeting IL-13. And so we believe that IL-13 and IL-13 monoclonal antibodies will be the ones that will be the winning class. And within this class, we believe we will have a majority of the dynamic market share.

Okay. Great. Moving on to Ilumetri. You mentioned you have a very good market share already. Do you have any growth expectations for 2026?

Yes. And the market continues to expand as well in psoriasis. And within this market expansion, the anti-IL-23 remains the go-to class or the favorite class for dermatologists in Europe, and we are competing very well. So overall, when you take the market expansion, you take the IL-23 winning class and how well we are competing within the class, we believe that we will continue to grow double digit in the near future.

Great. So in terms of the $300 million peak sales, does that also include the psoriatic arthritis indication?

We believe that psoriatic arthritis will be a small opportunity. We are going to see the full readout of the data up to week 52 before making a final decision. It's not included. So it's only upside. It can only add to the $300 million. But again, I want to manage expectations because it's a limited opportunity for Ilumetri.

Now moving on to the pipeline. You mentioned you have like 6 POC studies either initiated or to be initiated. Could you maybe provide a bit more color on the dual strategy for HS using both IL-1 and IL-21?

Yes, happy to do so. As mentioned, hidradenitis is an extremely complex disease, requiring potentially addressing more than one pathway. And we have been looking for molecules and mechanism that actually do that. The anti-IL-1RAP addresses 6 different cytokines of the IL-1 family of cytokines, IL-1 alpha, beta, IL-33 and 3 isoforms IL-36. And the fact that antibody targeting individual components of that have already shown effect in different aspects of the pathophysiology makes us believe that combining this in one molecule gives us a chance to see a really significant and meaningful efficacy in this disease. Now the anti-IL-1RAP targets the innate part of the immune system, while the anti-IL-21 targets more adaptive, both B and T cells. And again, compounds that target one of these cell types have shown efficacy, and we believe maybe the combination can do better.

Great. So how do you think your IL-1 and IL-2 assets compared with other programs, which are aimed at treating similar diseases?

I mean there is a lot of activity ongoing in terms of clinical development in hidradenitis suppurativa, which is good because there is a very high medical need and it's really a devastating disease for patients. Most of this is life cycle management of a mechanism that have originally been developed for other indications. We have been very carefully thinking about how can we make a difference to that approaches, and that's why we have come up with those 2 mechanisms. Now we need, of course, to prove this in these proof-of-concept studies. But so far, based on what we know, we are very optimistic.

Great. So in terms of just the overall market size and peak sales for like these new assets, do you have any guidance that you would like to share with us?

I mean this is pretty early. The next step is now that we show that they actually work in this indication and perhaps then there is more of a time to talk about what could we eventually see for those assets from a commercial perspective.

Great. Moving on to M&A and in-licensing. Carlos mentioned that you would remain opportunistic. So just in that win, could you just provide profiles of assets that you would be interested in, in terms of stage, target, size, geography indications?

From a license perspective, we remain very interested and as part of our core business to license exciting molecules across any stage of the development cycle. Being realistic, we think that it's going to be more towards early stage of clinical development or even maybe preclinical is where we will have more opportunities to license assets. And just from an M&A, as I said before, we don't want to -- the way we're creating value in this company is by commercial excellence with our biologics and by progressing the pipeline. So we don't want to be distracted by big M&A, by a transformational M&A today. So what we are looking maybe for more bolt-on opportunities or rare disease indications that will not distract us from the big opportunity of value creation for us.

Do you have anything planned in the near term?

Well, we always have a handful of business development opportunities, both licensing and M&A that we are either advanced or negotiating at different levels at different stages, but it's very difficult to predict what will materialize if and when.

Okay. Just then on the last question, what do you expect your free cash flow and operating cash flow to be going forward?

So, from operational cash flow point of view, our message is our top line growth will be going all the way down to earnings per share and cash because basically our SG&A will be increasing with inflation. So this is our commitment and our leverage. In terms of cash flow for investment and financing activities, investments, something in the proxy we are disclosing nowadays, CapEx for manufacturing activities in the range of EUR 40 million to EUR 70 million makes sense. And then CapEx for investments that we usually disclose here, milestones with signing fees for deals, sales milestones for this already in place and so on, something in the range of EUR 70 million to EUR 100 million can be a good proxy. But again, we will improve in our cash flow generation because our top line growth will be going all the way down to earnings per share.

Great. Then just lastly, was there anything particularly in 2026 that you were excited about? Like you have a very busy and a very exciting year ahead. Or was there anything in particular?

We are very excited for the progression of our pipeline. We think that all the programs that we have in the pipeline have the potential to be best in disease and to play a significant role in addressing the large unmet need that we have in all these indications. So that's progressing the science is extremely exciting.

Super. With that, we'll end the presentation. Thank you.

Thank you.

Thank you very much.

Good day, and thank you for standing by. Welcome to the Almirall 9 Months 2025 Financial Results and Business Update Conference Call and Webcast. [Operator Instructions] Please be advised that today's conference is being recorded. I would now like to hand the conference over to our first speaker today, Pablo Divasson, Head of IR. Please go ahead, sir.

Thank you very much, Nadia, and good morning, everyone. Thank you for joining us for today's quarterly earnings update and review of Almirall's 9 months financial results of 2025. As always, we are sharing the slides we are using today in the Investors section of our website at almirall.com.

Please move to Slide #2. Let me remind you that the information presented in this call contains forward-looking statements, which involve known and unknown risks, uncertainties and other factors that may cause actual results to materially differ from what we are sharing today.

Please move to Slide #3. Presenting today, we have Carlos Gallardo, Chairman and Chief Executive Officer; Jon Garay, Chief Financial Officer; and Karl Ziegelbauer, Chief Scientific Officer. Carlos will start with the business highlights covered covering the first 9 months of 2025, followed by an update specifically on biologics and the key growth drivers of our medical and dermatology portfolio. Karl will provide you with an R&D status update presenting our pipeline. And Jon, will then talk you through the financials before Carlos concludes the presentation, and we open for questions.

I will now hand over to Carlos Gallardo, our Chairman and CEO. Please move to Slide #5.

Thank you, Pablo, and good morning to everyone on the call. Almirall delivered strong year-to-year-to-date results in 2025, and we are confident to reiterate our guidance, mid-term outlook and peak sales expectations. Our consistent growth is powered by the success of our medical dermatology portfolio, where we continue to deliver innovative treatments and broaden access for patients to support our physician community.

Ebglyss delivered strong momentum in the third quarter of 2025 as European markets start to scale with launches now completed in the key countries. Encouraging uptake in newly launched geographies reinforces our confidence in the product's positioning and growth potential.

Ilumetri continues to deliver steady year-on-year growth, keeping us on track to achieve peak sales of over EUR 300 million.

Wynzora now capturing leading market share in key countries, together with Klisyri, strong performance across Europe are 2 other important contributors to our European revenue base. This underscores the breadth of our dermatology portfolio and Almirall's position as a comprehensive provider one-stop shop for diverse dermatological needs.

We built our strong presence in the medical dermatology field throughout the year. In addition to participating in major events such as the 2025 annual AAD meeting, we reinforced our presence at the 2025 European Academy of Dermatology and Venereology Congress in Paris. Our contributions include 44 scientific abstracts, 2 expert live symposia and the presentation of 2-year positive study data on Ilumetri as a late-breaking abstract.

On the clinical side, we are excited to share that the anti-IL-1RAP antibody has entered Phase II for Hidradenitis Suppurativa. We also plan to start Phase II studies in the upcoming months for the other proof-of-concept assets. Karl will soon provide a full update on the recent developments in our pipeline.

Please move on to Slide 7 for an update on our biologics portfolio. In the first 9 months of 2025, Ilumetri generated EUR 171 million in net sales, marking a steady 12% growth year-on-year. We remain on track to achieve over EUR 300 million in peak net sales even as the product and the class start to reach a more mature stage in its growth curve. Ilumetri continues to be well positioned in the psoriasis market, keeping its market share and consolidating its position as a leading product within the leading anti-IL-23 class.

The successful launch of a 200-milligram formulation provides greater dosing flexibility for patients, enhancing its competitive positioning and supporting long-term growth. In addition, 2-year positive study data presented at the 2025 EADV highlights the product long-term value and the overall impact on patient well-being.

Please move on to the next slide on Ebglyss highlights. We view Ebglyss as one of the most successful atopic dermatitis launches in recent years since we gained approval in Germany in December 2023. It has quickly become our second best-selling product. Meanwhile, the advanced therapy segment within the atopic dermatitis market in EU5 continues to expand rapidly, growing at an annual rate of around 30%. Sales for the first 9 months of the year nearly quadrupled year-on-year to EUR 75.5 million, while Q3 sales reached EUR 31 million. Our focused execution has delivered solid quarterly growth momentum as European markets are scaling at a healthy pace following launches in most countries, with Portugal and Ireland undergoing negotiations. Encouraging early traction and market share uptake are evident across new geographies, building confidence in Ebglyss growth trajectory and positioning it as a key driver for future expansion.

It is important to note that good reimburse reflects the high unmet need in atopic dermatitis and the value health care systems place on innovation. We are continuing to expand and increase brand awareness across multiple markets within the first year, with which we are very pleased. In terms of clinical advancements, our collaboration with Lilly remains highly productive, fostering valuable knowledge exchange that drives ongoing market development. At EADV 2025, we presented numerous study results on lebrikizumab, reinforcing our commitment to advancing care in atopic dermatitis. This included new real-world evidence from the ADlife study, long-term extension data up to 3 years patient-reported outcomes and safety analysis. Collectively, these results highlight rapid symptom relief for sustained efficacy, further strengthening Lebrikizumab's differentiated pipeline.

Let me turn it over to Karl for an update on our pipelines.

Thank you, Carlos, and good morning to everyone on the call. This slide shows you the status of our pipeline. Let me focus on the progress we made in the last month. We expect the approval of sarecycline in China still this year. Together with our partners, Sun Pharma and Eli Lilly, we continue to work on expanding the labels for our key products, Ilumetri and Ebglyss, respectively.

Our partner, Sun Pharma announced in July the top line results of 2 Phase III studies to assess the efficacy and safety of tildrakizumab in patients suffering from psoriatic arthritis. Both trials met their primary endpoint at week 24 and are still ongoing for additional 28 weeks until completing the open-label extension. We keep you updated for next steps.

Our partner, Eli Lilly has recently published data from an additional 32-week extension of the Phase III ADjoin trial at the 2025 Fall Clinical Dermatology Conference that indicates that lebrikizumab sustained similar levels of skin clearance when administered as a single injection of 250 milligram once every 8 weeks compared once every 4 weeks. This supports a potential less frequent maintenance dosing in patients with moderate to severe atopic dermatitis. These data build on lebrikizumab proven efficacy and demonstrate the potential for disease control with even less frequent dosing.

Lilly has submitted this data from the ADjoin extension trial amongst other data to the FDA for a potential label update. As the regulatory and market access environment is different in Europe, we will stick to our label with a recommended 250-milligram lebrikizumab for weekly pathology. At the same time, we are investigating lebrikizumab maintenance dosing of 500-milligram administered once every 12 weeks as part of our ADhope 2 clinical trial.

Together with our partner, Eli Lilly, we are running joint clinical development programs to make lebrikizumab available to additional patient populations. The different programs are well on track and a data overview can be found in the appendix. We have created an exciting early clinical pipeline addressing novel mechanisms and best-in-class compounds in high medical skin disease. In the coming 9 to 12 months, we plan to have initiated for proof-of-concept Phase II clinical studies across a spectrum of different dermatological diseases.

Let me highlight some of the progress. For our anti-IL-1RAP monoclonal antibody called LAD191, we have completed Phase I single and multiple ascending doses in healthy volunteers. We have also explored pharmacokinetics, pharmacodynamics and safety in patients suffering from hidradenitis suppurativa and presented those data at EADV meeting in September this year. LAD191 was well tolerated and demonstrated a favorable safety and PK profile with patients with hidradenitis suppurativa. LAD191 showed a trend in decrease in neutrophil count. Furthermore, it led to downstream cytokine reduction and early signs of clinical improvement in HS lesion count.

A Phase II study to explore the efficacy of multiple dosing regimens of LAD191 compared to placebo in participants with moderate to severe hidradenitis suppurativa has been started. Together with our partner, Simcere, we are developing a so-called IL-2 mutant Fc fusion protein to stimulate regulatory T cells as a novel approach to treat autoimmune kinase. We have recently completed Phase I and plan to start a Phase II study in alopecia areata within the next month. Our partner, Simcere has initiated a Phase II study to evaluate the efficacy and safety of this IL-2 mutant Fc fusion protein in subjects with moderate to severe atopic dermatitis. In summary, we're making good progress with both our early and late-stage pipeline programs.

With that, I will hand over to Jon for the financial review.

Thank you, Karl, for the update on our R&D pipeline, and good morning, everyone. As Carlos highlighted earlier, company's consistent execution continues to achieve solid tangible results. In the first 9 months of 2025, Almirall delivered a strong performance with net sales growing nearly 13% year-on-year on track with the company's full year guidance. European dermatology portfolio remains the key growth driver in net sales, reinforcing Almirall's path towards leadership in medical dermatology.

Gross margin moderated to 64.9% of sales in the first 9 months, reflecting ongoing pressure related to Ilumetri royalties. EBITDA for the period reached EUR 180.7 million, marking a 27% increase versus the same period last year, driven primarily by robust top line growth and a lower SG&A over net sales ratio. SG&A increased 6.2% to EUR 366.7 million, with the mentioned lower growth in the third quarter. However, as with previous years, we do expect a certain pickup in expenditure in the final quarter. R&D spending increased by about 14% year-on-year, representing 12.5% of net sales. The ratio of spending relative to net sales moderated this quarter following higher investment in Q2, keeping us on track with our annual target.

We closed September with a net debt-to-EBITDA ratio of 0.1 after solid cash generation in the quarter. Our low leverage provides significant flexibility to pursue licensing opportunities and targeted both on acquisitions on an opportunistic basis. These results reinforce our confidence in delivering full year 2025 guidance and the midterm outlook shared earlier this year. For the full year, we expect to land near the midpoint of our guidance range for both net sales and EBITDA. Please keep in mind the tough comparison against Q4 2024 revenue when the company reported sales growth of 17%. In addition, as mentioned earlier, we expect a pickup in SG&A in the next quarter, which simply reflects a natural pacing of quarterly cost and sales trends. As a reminder, our 2025 guidance calls for net sales growth of 10% to 13% and EBITDA in the range of EUR 220 million to EUR 240 million.

Let's move to the details of our sales breakdown on the next slide. The European dermatology business delivered a strong performance with net sales growing 24.5% year-on-year in the first 9 months. Additional details will be shared on the next slide. In general medicine and OTC, European sales were mainly impacted by the recent divestment of Algidol and the out-licensing of Sekisan. Excluding these portfolio changes, the segment remained broadly stable. A delayed allergy season in Ebastel continued erosion of Efficib/Tesavel and lower sales of minor products were largely offset by a solid contribution from Almax. On out-licensing, we expect full year income to remain broadly consistent with 2024 and prior years as these transactions are part of our ongoing strategy to maximize portfolio value, including the deals mentioned earlier. Performance in the U.S. declined and further details will be shared on the next slide. In the rest of the world, general medicine remained broadly stable, while dermatology saw a slight decline.

Let's take a closer look at the dermatology business on the next slide. Our European dermatology business continued to prosper. Ilumetri exhibited its characteristic summer seasonality with flat quarter-on-quarter sales and healthy year-on-year growth. Ebglyss consolidated its position as a primary growth engine for the company. Meanwhile, we are actively building market share for Klisyri and Wynzora as the launches gain traction across key European regions.

Ebglyss delivered EUR 75.5 million sales in the first 9 months as European markets scale up after launching in all key countries. This performance is in line with expectations and reinforces our confidence in the product robust growth potential. Both Skilarence and Ciclopoli maintained sales growth in line with prior years with a slight growth compared to the last year. In the U.S., performance declined year-on-year. While Klisyri's large field launch continued to generate growth, these gains were offset by persistent pressure on the legacy portfolio. Products such as Cordran Tape, Physiorelax and Aczone remain impacted by ongoing generic competition. Additionally, Seysara sales fell versus last year primarily due to a contraction in the overall oral antibiotic market for acne. In the rest of the world, dermatology sales dipped year-on-year, reflecting lower license income compared to 2024.

Now let's review financial statements on next slide. In terms of P&L and once revenue has been covered, gross margin moderated to 64.9% in the first 9 months of 2025 as we continue to face ongoing margin pressure, primarily driven by higher royalty tiers linked to Ilumetri's growth. At 12.5% of net sales, R&D spending remained broadly in line with the same period last year with the third quarter reflecting a moderation in investment levels compared to the elevated activities in prior quarters.

SG&A expenses increased 6% versus the same period last year as we continue to support these launches in new markets and other key products. As highlighted earlier, we expect SG&A to pick up in the final quarter of the year due to the typical seasonal timing of our marketing activities. Financial expenses improved year-on-year, primarily reflecting an EUR 8 million positive impact from the valuation of the equity swap driven by share value increase year-to-date. Finally, a reminder that our effective tax rate remains impacted by the inability to offset the U.S. tax losses against European profits, consistent with the full year guidance provided earlier this year.

Please move to the next slide to take a look at the balance sheet. Our balance sheet remained very stable in the first 9 months of 2025 compared to the same period prior year as shown in the slide. Goodwill and intangible assets decline was driven by depreciation, which outweighed the impact of R&D capitalization and progress in our pipeline. In the third quarter, capital expenditures remained minimal, primarily related to the recently extended collaboration agreement with Simcere. Our net debt ratio remains low at 0.1, providing continued flexibility to pursue inorganic growth opportunities. The decrease in net debt primarily reflects solid cash flow generation during the third quarter.

Let's take a look at the cash flow statement next. Company improved cash generation during the first 9 months of 2025 by EUR 44 million versus same period prior year. Cash flow from operating activities was EUR 146 million during the period, representing an improvement by EUR 40 million versus last year, mainly driven by material improvement of profit before taxes is slightly offset by working capital increase as our business grows. Cash flow from investing activities reached minus EUR 104 million, improving EUR 20 million versus prior year, driven by lower investments, mainly EUR 43 million in the sales milestone booked in 2024 partially compensated by milestones related to Wynzora and pipeline progress. Finally, cash flow from financing activities was minus EUR 43 million, an increase in cash outflows by EUR 17 million compared to last year, driven by higher cash dividend selected by shareholders and partially offset by the positive equity swap impact mentioned earlier.

With this, I would like to pass the word to Carlos for his closing remarks. Thanks a lot, everyone, for your attention.

Thank you, Jon. As Jon confirmed, we remain on track to deliver our 2025 guidance and midterm outlook as we have a clear ambition to achieve our double-digit net sales CAGR through 2030 and reach an EBITDA margin of approximately 25% by 2028. We are poised to lead in a rapidly expanding medical dermatology market, leveraging a proven platform for sustainable growth. Over the past decade, we have built a foundation that combines scientific depth, operational excellence and a pipeline with disruptive potential, including several first and best-in-class assets.

Together with our long-standing relationship with dermatologists and patient communities across Europe, which drive our relevance as a leader in medical dermatology, this strength represent a clear competitive advantage, positioning us to capture a meaningful opportunities for both growth and margin expansion. To translate this strength into sustained value creation. We apply a focused and prudent capital allocation strategy. We are investing in current and upcoming launches to drive midterm growth, actively strengthening our pipeline through internal R&D and in-licensing, maintaining a stable dividend policy and remaining open to targeted business development and licensing opportunities, all supported by a solid liquidity position.

Our strategy of turning disciplined execution into solid financial results is encouraging. As we close the third quarter for 2025, momentum remains strong. Ilumetri and Ebglyss continue to drive double-digit total sales growth, reinforcing the strength of our dermatology franchise. Looking ahead, we expect further pipeline milestones in the coming months, adding depth to an already differentiated portfolio. We are committed to shaping leadership in medical dermatology in Europe, turning innovation into growth and delivering lasting value for patients and shareholders.

With this, we conclude the presentation. And I hand it back to Pablo for the Q&A session.

Thank you very much, Carlos. Nadia, back to you for the Q&A, please.

[Operator Instructions] And it comes the line of Lucy Codrington from Jefferies.

Just a few pieces. Starting off with Ebglyss, please could you remind us, is the pediatric opportunity included in your current peak sales guide? And what's the overlap there with your current sales force? Or would that require additional SG&A investment? And then with Ebglyss with the peak sales guide, have you ever disclosed kind of what that implied penetration is would be of the European ATD market when you reach that peak? And then secondly, on your midterm guide, how important is the Klisyri inflection in terms of reaching that midterm? Or is it primarily driven by your 2 biologic therapies? And then finally, I may be looking incorrectly, but I couldn't find the IL-1RAP trial? And when might we expect the data from that to read out?

Thank you very much, Lucy. I'm not sure I got your last question about the anti-IL-1RAP. Is the question about what?

It is when will we expect the data from that?

Maybe you can with this question.

Thanks a lot, Lucy for the question. As I mentioned, for our anti-IL-1RAP monoclonal antibody, we have just started a Phase II in hidradenitis suppurativa and we start getting data towards the end of 2026, 2027.

Thank you, Karl. And about your other questions, Lucy. So pediatric indication, yes, it's ongoing. It's an important part of our clinical study to generate further data. And yes, the potential of this population is already included in the peak sales estimate, and we don't expect further investment. We don't need further investment. We already have the necessary infrastructure to capture the pediatric opportunity. In terms of the peak sales, we have not disclosed the penetration, but we believe we have the best product in our hands. So it will be -- a we believe that at peak sales Ebglyss will be playing a very significant role in treating naive patients for moderate to severe atopic dermatitis. Lastly, your question about the midterm, the key is to realize the value on our -- on 2 of our biologics, Ebglyss and Ilumetri, that's what will drive our ambition to grow double-digit growth and the margin expansion. Klisyri and Wynzora will play a lesser role on that regard.

And the question comes from the line of Guilherme Sampaio from CaixaBank.

Two, if I may. The first one on ADjoin and of course, the data was quite enticing. I appreciate the additional color that you provide on what you're doing. But you could provide a bit of time line for the options that you're following to obtain a label update? And the second question is a bit towards 2026. If you could provide us some initial indications on how you're seeing the year in terms of top line and EBIT expansion?

Thank you, Guilherme. The time line, I missed probably for ADjoin. Karl, can you take this question please?

That you mean -- Sorry, the ADjoin study?

No, no, no. I mean so the efforts that you are undertaking to leverage on data that could be similar to ADjoin to obtain potential more favorable dosing...

Yes. AD is a chronic disease that requires chronic treatment. That's why generating data that shows a long-term efficacy and safety are very important. We are running a study that is called ADlong, where we will generate data on efficacy and safety of lebrikizumab for up to 5 years. We have recently published 4-year interim data that have shown that patients who have been well controlled after week 16 maintain a very good skin clearance and efficacy for up to 4 years. And we will have then 5 years data next year 2026.

And here about your question about the 2026 outlook, we have to be a bit more patient as we typically shared these expectations in February. But I think that Jon has provided already a highlight, right? You can comment.

As Carlos has mentioned, Guilherme, it's too early to provide detailed performance figures for 2026. I know that my predecessor, Mike used to share some high-level indications with you all ahead of the fiscal year results. So if some context can help, we can offer that we expect 2026 growth and EBITDA to be in line with the most recent midterm guidance. We expect net sales to remain into the double-digit territory. And please bear in mind that our midterm guidance does not include a typical M&A except beyond the usual portfolio optimization we do every year.

We will see certain pressure in the gross margin as we have several licensed products that are subject to royalties, which means that actual margin expansion will happen at EBITDA level as sales are expected to grow more rapidly than SG&A expenses once the commercial infrastructure for Ebglyss has already been fully deployed in Europe. R&D expenditure or the net sales ratio aligned with the 1 shown in 2025 seems to be a fair proxy in the near midterm. So hopefully, this helps and we will disclose further details early next year.

And the question comes from the line of Natalia Webster from RBC.

Firstly, just a follow-up on Ebglyss. This continues to grow well quarter-on-quarter, but I was just curious to hear a bit more about how you're seeing the competitive dynamic evolving in Q3? And if the continued NEMLUVIO launch has impacted Ebglyss' market share in key European markets? And then my second question is on Efinaconazole following the approval in Germany in August. Are you able to provide some more details on your launch preparations and thoughts around growth potential for this product over the medium term?

Okay. Natalia, thank you for your question. So as I mentioned before, Ebglyss dynamics remain very favorable and in line with our expectations. We continue to receive very positive feedback from dermatologists, both in the more experienced ones in countries where we have launched already a number of months ago, but also in the newly launched countries such in France, the feedback form remains very consistent. So very good news. The majority of the prescriptions continue to come from naive patients, and that's very aligned with our strategy. So also confirmation of our expectations and good news there. In terms of NEMLUVIO impact, it's too early to say as NEMLUVIO has only launched in Germany, in Europe.

So far, as we mentioned in other calls, we believe that new entrants will expand the market, and we remain confident, and that's based on the feedback of the dermatology community, that the anti-IL1 and anti-IL13 remains the key class to treat these patients. And also, we believe that IL-31 is more indicated for prurigo nodularis. But in any case, we believe that new launches will have to make even more noise and expand the market as only 10% of eligible patients that could be treated with advanced biologics or advanced treatments are only treated today with this treatment. So there's a tremendous opportunity to continue to help patients in this class that will lead to market expansion. On Efinaconazole, we are getting ready for launches in selected countries, and we will update you more probably in 2026. And -- but we will play a modest role in the contribution to sales at the end.

And the question comes from the line of Joaquin Garcia-Quiros from JB Capital.

Yes. So the first one, there was a EUR 20 million -- a bit more than EUR 20 million positive impact in free cash flow from other adjustments. Just if we could have more color on what exactly was the cause of that? Then on M&A, would you consider now that I know is still on ramp up, but there's been a few years now since launch on a more relevant M&A acquisition or you're still targeting on smaller deals? And then lastly, could you have a bit of insight on to hidradenitis suppurativa and the alopecia areata market? Do you have some information on these? How big could this be for you?

Thank you, Joaquin, for the question. So I will leave the first one to Jon, but let me answer the second question from my side. In terms of M&A, we remain extremely focused on delivering value for the company in organic growth to make sure we maximize the penetration Ebglyss and Ilumetri. And of course, moving our -- the assets into POC, right? So that's where we dedicate a lot of our efforts. However, licensing and M&A continues to be an important part of our strategy. So far, now we are looking at bolt-on opportunities from an acquisition perspective and platform licensing from early and late-stage opportunities in all geographies.

HS and alopecia areata, these are 2 areas where there's tremendous unmet need from a patient perspective, and that's based on strong feedback from the dermatology community. We are very exciting to have 2 assets that have potential to be the first and best in class. And we believe that if we get positive results and our target product profile is confirmed that we will have a therapies in our hands that will have a significant impact on the company, on the patient, but also from a sales perspective in the company. And we cannot -- now we're not prepared to provide more specifics here, but could be a major impact to the company is a target product profile is confirmed in the clinical trials.

Jon, so for the first question, Joaquin.

It's Jon, yes. Sorry for the first question, Joaquin. Thanks for your question. Yes, the improvement you have seen in our cash flow statement relates to an advanced payment received during the quarter regarding a license deal for one minor product in our portfolio to commercialize this in the countries included in the Eastern Europe and Western Asia, most only in the Commonwealth of Independent States. There is no impact in the P&L as it will be recognized in the future years. I hope it helps.

And the question comes from the line of Jaime Escribano from Banco Santander.

So a few questions from my side. Could you remind us the pediatric indication for Ebglyss, when do you think it can be launched? Or when could we have some impact in sales basically? Second, on Seysara in China, what could we expect here? Any news? And what's the potential in revenues? And then a little bit of housekeeping for the modeling. Can you remind us tax rate for this year more or less where could we stand? Also the milestones for 2026, if you can remind us? And a final question. Yes. My final question is a spicy one. I don't know if you will answer, but basically, when you see Bloomberg consensus at around EUR 280 million EBITDA for 2026, how do you feel about this figure? Is it something fair? Is it something ambitious? Or you feel comfortable with that?

Yes Jaime, this is Karl speaking. Thanks for your question. The pediatric study called ADorable 1 and ADorable 2 are run by our partner, Eli Lilly for the first one that covers participant 6 months to younger than 18 years. The Lilly expect primary completion in December this year and full completion in December 2026. And ADorable 2 is then the long-term safety and efficacy and the primary completion is expected in December 2027. Then after that, of course, there is the combination of the data, the submission and then the extension of the label before we then can finally launch.

Do you want to comment on Seysara China?

Yes. On Seysara, China, as I have mentioned in the presentation, we expect the approval of Seysara in China still within this year.

Thank you Karl. Jon do you want to take the other 2 questions from Jaime?

Thank you very much, Carlos. I think the first question regard -- related to the tax rate for this year. So right now, the tax rate is around 40%, which is a significant improvement versus prior year and is aligned with the full year guidance we provided for this year. We are working as hard as we can to try to be more effective here. But right now, I'm not confident providing any guidance for next year. We will just try to work and see how much we can improve. The other 2 questions regarding to 2026 in the sense of milestones and EBITDA.

If we start with milestones, I think that, again, bear in mind for us, it is too early provide the detailed performance figures for 2026. But bear in mind, I think to assume certain milestone levels similar to 2021. Initially, it could be a good estimate, and we will provide further details in February 2026 when we disclosing the guidance. Regarding the Bloomberg consensus, right now, we are very positive about the performance of the company and confident in achieving our stated guidance. That's why we have reiterated it this quarter.

Coming back to next year, it is still too early. But so far, we cannot -- I cannot tell you if we agree or we do not agree. It's a statement based by third parties. And what we have shared just in this call is that we expect to remain in the midterm range provided for the company. We will provide more information in February, so please stay tuned. Thank you very much.

Dear speakers, there are no further questions for today. I would now like to hand the conference over to your speaker, Pablo Divasson for any closing remarks.

Thank you very much, Nadia. Thank you. As there are no further questions, ladies and gentlemen, this concludes our today's conference call. Thank you for your participation. You may now disconnect.

Thank you for joining today's conference call.