Cambridge Cognition’s 2025 results: sales momentum returns, healthcare push begins
Cambridge Cognition (AIM: COG) has posted a clear swing back to sales growth, even though reported revenue dipped for the year. The company signed materially more work, rebuilt the order book and nudged operating cash flow back into positive territory. The step-change came alongside a strategic expansion into professional healthcare and consumer health & wellness with the new CANTAB Pathway offering.
Here is what stood out – and why it matters for investors.
Key numbers investors should know
| Metric (year to 31 Dec 2025) | 2025 | 2024 | Change |
|---|---|---|---|
| New sales orders | £12.8m | £7.4m | +73% |
| Order book (year end) | £16.5m | £13.6m | +21% |
| Revenue | £9.4m | £10.3m | -9% |
| Adjusted EBITDA | £(0.5)m | £(0.0)m | Down |
| Cash from operating activities | £0.1m | £(3.1)m | Improved |
| Cash | £1.1m | £1.3m | -£0.2m |
| Loans and borrowings (current) | £0.9m | £1.0m current; £0.9m non-current | Reduced |
| Net cash / (debt) | £0.3m | £(0.6)m | Improved |
Definitions in brief: “Order book” is contracted work not yet recognised as revenue. “Adjusted EBITDA” strips out non-cash items such as amortisation and share-based payments to give a view of underlying operating profitability. “Deferred income” is cash received up front for work to be delivered later.
Sales momentum is back: what drove the 73% surge in orders
New orders shot to £12.8m, a 73% uplift. The engine was Clinical Studies, where orders rose 79% to £11.9m as the sales team focused on key accounts with deep CNS pipelines and budgets. Academic Research also ticked up, with orders of £0.9m, up 20%.
Operational delivery and client satisfaction remain a strength. Across 114 clinical studies, the company reported “excellent” CSAT/NPS scores during start-up, monitoring and close-out stages – a signal that repeat business should stay healthy.
Revenue dipped, but margins stayed robust and cashflow turned positive
Revenue of £9.4m fell 9%, reflecting the thin starting order book at the beginning of 2025. Gross margin remained high at 75% (2024 restated: 78%), underlining the attractive unit economics of digital assessments.
Adjusted EBITDA moved to a £0.5m loss, but cost control helped contain the damage. Importantly, operating cash flow flipped to a £0.1m inflow after two heavy cash-consuming years. Deferred income held steady at £5.4m (2024: £5.5m) – a good sign that revenue recognition is being matched with cash receipts.
On the balance sheet, year-end cash was £1.1m with borrowings down to £0.9m, leaving the group in a small net cash position of £0.3m. The company also raised £1.1m via a placing at 27.25p to smooth working capital, and it continues to amortise its loan which is due to be fully repaid in the second half of 2026.
2026 outlook: revenue guidance raised to £9.5m, but Q1 orders were slower
Management now expects 2026 revenue of £9.5m, supported by the current order book and revenue already recognised this year. That’s up from the £8.8m expected at 31 December 2025 and already equivalent to full-year 2025 revenue.
Two balancing facts for investors: new orders in Q1 2026 were £2.6m (Q1 2025: £4.2m), and the order book stood at £15.6m at the end of Q1 (down from £16.5m at year-end). The company says several contracts slipped due to extended negotiations and indicates a strong pipeline into Q2. H1 order intake is “essential” to meeting expectations.
New markets: what CANTAB Pathway brings to healthcare and consumers
The big strategic shift is taking Cambridge Cognition’s validated digital assessments beyond research and pharma into real-world healthcare and consumer environments.
- CANTAB One – a brief assessment of overall cognitive function.
- CANTAB Insight – three tasks covering five cognitive sub-domains.
- CANTAB Plus – disease-specific modules for qualified clinicians across eight indications, including Parkinson’s, ADHD, multiple sclerosis, Huntington’s, schizophrenia, depression, and Alzheimer’s disease and related dementias.
Early commercial steps are partner-led, which is sensible for scale and adoption:
- Pilot with a major private European healthcare group to enable regular cognitive and mental health assessments.
- Agreement with Ivory in India to explore professional healthcare and consumer deployments.
- An institutional review board-approved pilot with a leading health technology company to pair cognitive measures with wearable-derived physiological and behavioural data until the end of 2026.
Revenues from CANTAB Pathway are expected to start in 2026. In 2025, Professional Healthcare income was mainly legacy distributor royalties of £0.2m.
Risks and watchouts: going concern, order timing and execution
The auditors included an emphasis of matter referencing a material uncertainty over going concern. The crux is timing and value of new sales orders – the business invoices a significant portion on signature, so order slippage can squeeze cash. A reverse stress case showed that if orders fell versus plan (modelled at 94.7% of 2025 order levels), cash could reduce to nil in Q3 2026 without further actions.
Management notes a strong pipeline and has identified cost levers and, if needed, potential financing options. Still, investors should treat H1 order intake, cash movements and deferred income trends as key indicators.
My take: cautiously positive with clear milestones to watch
On the positive side, the company has done the hard bit – reigniting sales. New orders up 73%, order book up 21%, gross margins still 75% and a return to positive operating cash flow are all meaningful green shoots. The pivot into healthcare and consumer markets, backed by 30 years of clinical evidence, opens much larger addressable markets with partner leverage.
On the negative side, revenue is still lagging the sales revival, adjusted EBITDA is loss-making, Q1 order intake was softer year-on-year, and the going concern emphasis highlights the importance of converting the pipeline quickly. The first meaningful CANTAB Pathway revenues won’t arrive until 2026, so near-term delivery rests on pharma and academic projects plus timely signatures.
Net-net, I see a business that is stabilising and setting up for growth, but where execution in H1 2026 really matters. If orders land as indicated and pilots translate into commercial deals, 2026 should show revenue and cash progress.
What I’ll be tracking next
- H1 2026 new sales orders and whether they meet management’s “market expectations”.
- Conversion of the European healthcare pilot and the wearable-tech study into paid roll-outs.
- Any uplift to the £9.5m 2026 revenue expectation as orders sign in Q2-Q4.
- Cash, deferred income and loan repayments as the term loan approaches maturity in H2 2026.
- Gross margin sustainability as delivery volumes rise.
- Academic research output (258 peer-reviewed papers in 2025) sustaining brand strength.
Housekeeping and access to more detail
- The audited Annual Report and Accounts will be available at https://cambridgecognition.com/reports-and-accounts/.
- A pre-recorded presentation is on Investor Meet Company, with a live Q&A on 13 April 2026 at 15:00 BST: https://www.investormeetcompany.com/companies/cambridge-cognition-holdings-plc/.
Bottom line: Cambridge Cognition has rebuilt commercial momentum and set out a credible route into healthcare and consumer markets. Execution through H1 will decide whether those green shoots turn into sustained revenue growth and stronger cash generation in 2026.
