Medacta Group S.A.

Good afternoon. This is the Coruscall conference operator. Welcome and thank you for joining the Medacta full year 2025 results conference call. As a reminder all participants are in listen only mode. After the presentation there will be an opportunity to ask questions. Should anyone need assistance during the conference call they may signal an operator by pressing star and zero on their telephone. At this time I would like to turn the conference over to Mr. Francesco Siccardi, CEO of Medacta. Please go ahead, sir.

Thank you. Thank you very much. And good afternoon or good morning. Welcome to Medacta full year 2025 results conference call. The slides of today's presentation can be found on the Medacta Investor Relations website, along with the media release. I would like to remind all participants that the presentation includes forward-looking statements which are subject to risk and uncertainties. Listeners and readers are therefore encouraged to refer to the disclaimer on slide two of today's presentation. So after those remarks, I will now turn to slide number four of The presentation with the highlights of today's publication. We did report already our revenues, 684 million with 18.5% growth in cost and currency. The EBITDA margin in constant currency hit 29% and 27.9 in euro with an increase of 19.1% year over year. Medacta's net profit increased as well, 31% year over year to 95.5 million euro. And the board of director is proposing a dividend per share of 1.1 Swiss francs with an increase of almost 60% year over year. We did commented already on the top line revenues, so I will fly through the next slides relatively quickly. As we said, 18.5% in cost and currency in 2025. Now bringing our CAGR for the last four years, 2021 to 2025 period at 17.4%. A very, very strong performance, significantly outgrowing the market more than four times. If we move to slide number six, we just reiterate again which are the key pillars of our above-market growth. We clearly focus on differentiating innovation with the aim of really impacting and improving patient outcomes in a healthcare sustainable way. We supported the introduction of this innovation in the market with a strong focus on medical education and training for surgeons worldwide. And as we needed to expand our sales force in different geographies, the constant hire of new talents across all the different business lines and the different geographies. If we move to slide number seven, we can repeat again the growth rate we experienced in the different geographies. We did grow 15.2% in the EMEA region, 19% in North America, 23% in Asia Pacific, and 42% in Latin America. We moved then to the business line growth contribution on slide number eight. Our hip grew almost 12%, knee slightly above 20%, extremities at 46%, and spine at 12%. All those growth rates are in constant currency. To be noted that the knee business line surpassed the hip business line for the first time in 2025, knee representing 42% of our revenues, hip 40%, extremities 10%, and spine 8%. Digging a little bit into the different business line, the HIP definitely benefit from our focus on minimally invasive procedures, in particular, anterior minimally invasive surgery, which has been our flag product for many years now and is now reinforced by additional platforms introduced into the market. And on the next slide, number 10, we can see the very strong performance of our knee, growing at almost 21%, clearly benefiting from Medacta focus and introduction of the concept of kinematic alignment. Medacta has definitely been The first company to push this concept in the market, and we are today still the only company with a dedicated and specifically designed knee, the GMK Spherica, which is clearly pushing our sales in a very significant way. If we move on slide 11, we can see our performance in spine, slightly above 12%. Here as well, we focus on innovative products, mainly associated with our MySolution platform. And the focus is clearly on personalized medicine with techniques and technologies like the Nexstar Spine or the Rod Optimizer. Last but not least, our extremities business line on page 12 with a very good 46.2% growth year over year. we did a benefit as well from last year acquisition in the sports medicine sector with the parkus move and the constant expansion of our shoulder arthroplasty platform associated with our next technology as well i would now uh ask Corrado Farsetta to go into the margins and into the P&L. Thank you.

Thank you, Francesco. Moving to slide 14. Yeah. Let me now review the financial figures of 2025, and the gross profit increased by almost 15% to €459 million, reflecting the strong growth in revenues. Operationally, we continue to deliver efficient improvement, supporting the resilience of our margins, which remain solid at more than 67%, despite a negative effects impact of more than 1%. Moving to slide 15, here you can see three lines. As usual, the gray line shows the long-term trend of our profitability, excluding translational effects, since 2019. The yellow line represents our reported ABDA margin, and the red line shows the ABDA margin in cost and currency for the year, which is then comparable with 2024 performance. As shown by the red line, in 2025, the adjusted ABDA margin reached 29% in cost and currency with an expansion of about 2% versus prior year, confirming the continued improvements in profitability and the strong operating leverage of this year and in general of the company over the years. Despite the negative effects impact of around 1.1%, the reported EBDA margin was about 28% expanding by 0.8% versus prior year. More broadly, looking at the long-term trend based on 2019 FX rates, which is the gray line, our adjusted EBITDA margin highlight the structural and significant margin expansion achieved in recent years. Moving to slide 16, here we see the net profit for the period reached 95.5 million compared to 73 million last year. which is an increase of more than 30% year-on-year. And this includes also the one-off effects related to the acquisition completed at the beginning of 2025. Moving to slide 17, the strong growth of the company has required and continues to require additional instruments, facilities, and production capacity. And this is where our investments are focused. Total capex amounted to 137 million last year, mainly related to instruments, as always, 78 million, land, buildings, and production capacity, 35 million, and research and development for 15 million. Investments in facilities and production capacity reported are under other tangibles. include the expansion of our production site here in Vincate and new fully automated warehouse and logistics hub in Italy. Moving to slide 18, you can see here our robust cash flow generation. In 2025, the cash flow from operating activities reached 153 million, reflecting the strong profitability and the solid cash generation of the business, thanks to focus on the effective usage of all our assets. This allowed us to largely self-finance our investment program for 137 million, as just discussed, and as a result, the free cash flow increased to 16 million in 2025. Moving to slide 19, Our balance sheet, as you see, remains very solid with the leverage in 2025 down to 0.88 times the ABDA of the company. Over the past five years, you see the red line is the average ratio, which was around 0.94, confirming our disciplined financial profile and the strong capacity to support our growth. The last slide from my side is the dividend per share. As Francesco said, the Board is going to propose a dividend of 1.1 per share, representing an increase of about 60% compared to the prior year. And with this, I will now hand over to Francesco for the outlook 2026, a midterm, and some final remarks.

Thank you, Corrado. The outlook is reported on page 22 of our presentation. For 2026, MetaConduct is targeting a revenue growth in the range of 10 to 14% in constant currency and an expansion of the adjusted EBDA margin of around 50 base point versus prior year, which we closed at 27.9% in constant currency, subject to unforeseen events. We did expand our midterm outlook as well, and the revenue compound annual growth rate for the period 2024-2027 in constant currency is expected to range now between 12% and 15%, with a gradual improvement in constant currency and subject to unforeseen events. We just reiterate as well the situation in terms of tariffs. Medacta remains not impacted by the U.S. tariffs. We continue, of course, to monitor the development of this situation together with the rest of the global world. Last point on slide 23, my key messages is to highlight once again the excellent and continued above market growth of 18.5% in cost and currency year over year. This results from our strong focus on differentiating innovations that really have an impact and improve patient outcomes and healthcare sustainability. This innovation is sustained by medical education and personalized training for surgeons, which allows us as well to expand our sales reps and team across the different geographies and across the different business lines. The effect of this expansion and careful execution is that we can maintain very strong financials. We have seen a very strong soar of our profitability, operating cash flow and dividend. The expansion of the adjusted EBITDA while growing at this pace is really extraordinary. The record net profit of 95.5 million, which represent now 14% of revenue. An increase of our operating cash flow by more than 42% to more than 150 million. And as we said before, a proposed dividend increase of almost 60% to 1.1 Swiss francs per share. And our goal, which is reflected in our short and mid-term guidance, is to continue to outgrow the market for the foreseeable future. I would like to thank for this excellent performance once again all our employees worldwide. Of course, all our customers that continue to believe in our products.

all of our suppliers and partners worldwide thank you thank you really to all of you for for the support i think is now maybe time for a q a thank you this is the coruscant conference operator we will now begin the question and answer session anyone who wishes to ask a question may press star and one on their touchstone telephone to remove yourself from the question queue please press star and two. Please pick up the receiver when asking questions. Anyone who has a question may press star and one at this time. The first question comes from Sam England of Barenburg. Please go ahead.

Hi, guys. Thanks for taking the questions. The first one, can you just provide some colour on what's changed over the past few months to support the increase in the mid-term revenue guide? I suppose in particular, which segments or geographies are now expected to perform better than your previous expectations to support the raise? And then also around the midterm guide, you're now guiding to a gradual improvement in margins. So can you talk about the shift in messaging there and why you're expecting margins to expand? I think previously when you've talked about it, you said you'd rather reinvest in the business to drive growth as opposed to letting margins expand. So is there a shift in focus implied there? So a little bit of colour around that would be good as well. Thanks.

Thank you, Sam. So I will take the second question on the marginality expansion. We have seen that under a an operational point of view, we can really achieve what we want to achieve in terms of growth with at the same time the ability to slightly expand margins. We were maybe a little bit cautious when we provided the previous guidance and we wanted to have a little bit of space to operate, but we believe we can achieve our mid-term top-line guidance while at the same time expanding margins. This means that we did identify, for example, some important synergies, stronger synergies between shoulder and sports medicine and joint and sports medicine, both in terms of medical education, in terms of sales force, in terms of marketing. And those are not only positive under a practical point of view, but they do actually have an impact under a P&L point of view. I would maybe like to ask Corrado to take on the midterm CAGR, because it's probably more mathematical than anything else, given our past performance.

Yeah, sure. So basically, the revision of the guidance, the CAGR, is the result of the super strong performance in 2025. The guidance that we gave for 2016, 2017, sorry, 2026, sorry again. And for 2027, it's just the... we believe that the picture the framework is not going to change so basically based on our three-year plan the result of the top plan expansion in 2027 will be then based on this CAGR, three-year CAGR between 12 and 15. So it's just an arithmetical calculation taking into account that 2025 was already achieved, the guidance for 2026 was given, so the result, based on what we see in the future, it should be between 12 and 15. This is what we think, just an arithmetical update.

Okay, great. Thanks very much.

The next question is from Ed Hall of Stifel. Please go ahead.

Thank you very much for taking my questions. A couple from me. Just firstly on the profitability, and I appreciate you don't break it out in terms of subsegments, but is it still fair to assume that the smaller units, extremity and spine, are operating at negative margin? And if that is the case, when do you expect these to turn positive? That would be my first question, then I'll follow up afterwards.

Yeah, I can take this, of course, under a qualitative point of view. Spine is not a negative contributor. It is dilutive versus the core business if you consider hip and knees, but it's not negative and actually is improving year over year. So that is maybe another element I should have mentioned before talking about margin expansions. The extremities is we basically have two product lines within extremities, one which is the shoulder arthroplasty, which is extremely positive in terms of contribution margin. And then we have a sports medicine, which is in an earlier stage, and it does require probably more dedicated sales force equipment. And I mentioned that there are some synergies, but it's definitely still negative and it will remain negative, although reducing the negative profitability year over year while we scale this business. So it is still fair to say that the smaller business line are dilutive, but spine is not negative. And within extremities, only sports medicine is still negative, but is very small.

Okay, that's really clear. And then just another question on sort of CapEx expectations for this year, given a lot of the expansion that you've done in your facilities in Switzerland is coming to an end. I'm curious as what that would look like as things stand today.

Yeah, I don't think, and frankly, actually, I hope it will not come to an end because it will mean that we are significantly slowing down. As you know, the CAPEX we are referring to, both manufacturing capacity and instruments, are growth-related CAPEX. So we have quite ambitious plans ahead of us for the next five to seven years. We definitely need to continue to finish at least our expansion plans here in Europe. We will continue to feed the market with instruments associated with new customers generation. We do have new products launching expected in the second half end of the year. So we don't expect at all a decrease in our required capex. We might add a little bit more color in the future, in the next maybe early call at the end of H1. to share with the market a little bit more details of what we expect to do in the upcoming years in terms of CapEx needs and opportunities. We see a lot of opportunities and we are very happy actually to invest in our growth. We have a very good, in our opinion, return on invested capital and we are not afraid to invest in our future.

Perfect. Thanks a lot.

Thank you, Anne.

The next question comes from Sandra Ditchie of Octavian. Please go ahead.

Yes. Good afternoon, and thank you for taking my questions. I have also a few. Maybe I'll take them one by one. Sorry to follow up again on the margin topic, but given what you just mentioned, is it fair to say that kind of the majority of the improvement is coming from scaling up the currently dilutive segment like the spine and sports medicine? Or do you also expect margins in the core hip and knee business to improve from the current levels?

So thank you, Sandra, for the question. We actually see both effects. We definitely have still margin improvements on the core business of Medacta, the hip and knees. We do see as well, as I was mentioning, a less dilutive effect from spine. Shoulder is definitely continuing to expand as well. It's marginality. And from those core business, we can now finance fully our sports med. So it's both the effect of decreasing dilution of the smaller lines and still significant expansion on the core hip and knee side, both under a manufacturing and operational point of view, vertical integration point of view in manufacturing still, and some leverages because we still have some markets like UK, Spain, Italy, Germany, where we are growing very, very fast, and therefore we can see some leverage on the fixed cost and improved marginality at country level.

Okay, super. Thank you. And then one on your U.S. business. Now, excluding the impact from PARC, I estimate that organic growth in the U.S. was in the mid-teens range last year, and that was certainly supported by a strong exposure also to the ambulatory surgical centers. Now, you previously indicated that this ASE segment could grow around 25% annually, that you have some 40% of your U.S. business is already generated through this channel. Now, just from this tailwind from the ASE segment alone, that should make it relatively straightforward to sustain a mid-teens growth in the U.S., Is that the correct way to look at it or are there any factors that could make it more challenging to to have such a growth level going forward?

Yeah, unfortunately, it's a little bit more challenging than just automatically following the market trends simply because of. sales force expansion so without sales force you cannot capture this transition from hospital to asc's we have been actually further expanding our percentage of revenues in asc versus hospital in the us we are around now 45 percent compared to previous year and we expect this to continue to be the case. But you really need to think about Salesforce expansion as a key necessary driver for our growth in the U.S. We are covering between 2% and 3% market share in the U.S. We need boots on the ground to really spread Medacta message and cover Surgeons that are transitioning from hospital to, but as well, we are starting, for example, to work with the prominent academic centers, large hospitals. So, it's all about the distribution. I think we have a very good products across the different business line that prove their. ability to improve patient outcome, but we need salespeople and sales force. And that's the constant game for us across the different geographies and in particular in the US. Hiring and hiring and hiring good talent salespeople, which are happy to jump on board and sell our product ranges.

Perfect. Thank you. Appreciate the details. And then I have a very quick one for Corrado on the tax rate. As it was just last year, a little bit higher than what I had expected. Can you help us? What's a good tax rate level to assume going forward for Medacta Groups?

Yeah, sure. Hi, Sandra. So let's say the increase in 2025 is attributable to some, let's say, transfer pricing optimization policy that we have implemented at group level, which means that basically some of our tax assets that we accrued in the past have been now relieved in 2025. And given the higher tax rate in the other countries, this has generated an increase in the average group tax rate in 2025. This can be considered as, say, a one-off effect because it is not that you are going to review again significantly our policy, but this was as happening in 2025. For 2026 and 2027, I think that we should go down to 16% or less. We should be confirmed for the next three years. The other change that we are still not able to judge in terms of and say impact on our tax rate is the application of Pillar 2 from 2028. It is not feasible because today is not still 100% clear how this will be implemented in Switzerland. We don't think it's going to significantly change the tax rate from 2028 onward, but I would say that definitely 2026 and 2027, we should go back to 16% more or less.

Oh, super. Very clear. Thank you.

Good. Thank you.

The next question comes from Michelle Bushler of Zurich Cantonal Bank. Please go ahead.

Hello, thank you for taking my questions. I have a question on geographic expansion. Would you give us some more color on the efficiency gains we can expect from the Italy facility? And also, I saw you mentioned a new subsidiary in India. Do you have plans on expanding to India? Thank you.

Yeah, I can take this question. I guess you are referring to our new operation facility, the distribution center in the southern part of Europe. This distribution center would potentially have a decrease in some of our shipping costs for southern part of Europe. And a decrease as well in networking capital in stock that is currently distributed across different warehouses in the southern part of Europe, Italy, Spain, Switzerland, Austria, et cetera. We will be able to concentrate most of the stock in one location, reducing networking capital requirements. and at the same time, as I said, potentially reducing our shipping cost. So we will probably see an impact more in 27 than in 26, but it's definitely something that will help us to improve and constantly increase our margins. So that's a good thing. Regarding India, if I address your first point, India will be, of course, a new venture. We are starting from scratch. Our products are not yet cleared under a regulatory point of view. It might happen any day now, any week, but you never know with the regulatory. You can wait another quarter or maybe it's tomorrow. In any case, we are ready. We have prepared the market. We have hired some key people. We lined up distributors. We started already to train surgeons on cadaver labs, and we can expect a good We have seen a very good appetite for our products in the Indian market, which is a rapidly growing market, probably around 10 to 12% per year growth. Prices are okay in line with some of the European markets, so we can definitely start to compete and we are ready to roll. Thank you. Thank you, Michel.

The next question is from Graham Doyle of UBS. Please go ahead.

Good afternoon. Thanks, guys. Just one for Francesco and then a couple of quick ones for Corrado. Francesco, just on NEED, it's been incredibly strong and we are seeing some launches from some of the bigger competitors over the course of this year. Do you think that they're more kind of catch-up launches and you're still ahead? And is there anything in the pipeline on these that makes you quite excited in terms of your own developments? And then just quickly, Corrado, on the guidance. So the midterm guidance around EBITDA, nice to see that sequential improvement. But would you expect EBIT margins to improve? So after accounting for DNA. And then is it fair when I look at the top-line guidance, when we just work out the math, that we should expect something like 10% growth in 2027 if you hit the midpoints. Thank you, guys.

And thank you, Graham, for the question. Just to make sure I address your first question on the knee correctly, which are the launches you would like me to comment about and to position our knee versus our competitors? Just to make sure we have seen the same things.

So there's a couple of things from Striker, and we're seeing a new platform from Smith & Nephew. So the landmark is one that's a little interesting. It doesn't look to be quite the same as what you guys have. It looks slightly different and maybe not as much functionality. But just to get a sense of how far you think the gap is between what you guys currently offer and where the competition is. And also, genuinely, what are you working on next? Because you have led the way.

Yes. So if we talk about Stryker, they've been presenting the last academy a couple of weeks ago, an expansion of their portfolio, which brings them in par with what Zimmer and Depew and Smith & Nephew already did recently. three four years ago with their media congruent insert that is uh what they are about to launch and frankly was about time because uh they were the last let's say to join the club of the medially constrained liners which are still quite a bit different compared to our first generation bowling socket design which was sphere and still a generation behind compared to spherical which has been further adapted in its shape of the patellofemoral joint. So some elements of the components of the design, which have been clearly adapted to kinematic alignment. So at the moment, we know they're starting to work on and they understand that they needed to redesign their knees. And I believe this will give us at least another three to four years, especially in Europe, even longer of a window where we think we can definitely show how our different design is superior. So talking about the future, we are working on our – future generation of products as well across a knee portfolio technology portfolio uh hip portfolio and we definitely look forward to come out with with the next improvements uh hopefully when our competitors will will try to catch up in three four years as we all know innovation is a very dynamic uh definition, if you stop to innovate, you become a commodity and an older product relatively soon. So we cannot stay still, and we are already very, very active in developing the next generation. I hope I addressed your question, and I would then leave the floor to Corrado.

Yeah. Yeah, sure. So let's speak a bit about the Milton Guidance. So We wanted to update both top line, of course, and WDR margin. I will start from the top line again. As you know, we have done 18.5% in 2025, which means that we have also guided for 2026, 10, 14. So let's say the following scenarios. If we say that we perform 10% in 2026 and 10% in 2027, then the midterm would result into something in the region of 12% in the three year plan, in the three year plan. If we perform 14% in 2027 and 14% high end of the guidance in 2027, then you will finish to 15% more or less. So that's why we updated the range in the way we have saw, we say before. So basically, I believe that something in the region between say 12 and 15% is what we really expect based on the results and the guidance from 2026. Speaking about the ABDA margin expansion, if you remember, we guided in 2024 to be stable at 2024 ABDA margin. last year we updated the guidance we increased this to 28 which was already in expansion now based on this year very good performance we decided to update and guide again the further expansion in the coming years because there is let's say more or less at the point coming in 2026 and something similar in the region of zero and alpha point again in 2026. So what we could see is an expansion of this size between 2026 and 2027. We didn't want to give a precise number because we believe that in this case the cost and currency is difficult to apply because we are basing our calculations on 2024 currency rates. which we understand is difficult for you to follow. That's why we guided as gradual expansion in 2020, six and seven.

Thank you very much. Thank you, Francesca, for a really detailed answer. It's very helpful. It was very clear in the review, so that's super helpful. Just on the margin, what I meant was more, it totally makes sense that EBITDA margins expand But EBIT, so after you account for the cost of depreciation and amortization, would you expect EBIT margins to expand as well?

I would keep something similar in terms of expansion. So more or less the same expansion of the EBIT margin, you could use the same expansion for the EBIT. More or less, we believe that the DNA should stay more or less in line with this year over the next year. So that's why I believe that the EBIT expansion should be aligned with the EBDA margin expansion.

Perfect. Thank you so much. That's really clear. Thanks a lot for your time, guys. Thank you.

For any further questions, please press star and 1 on your telephone. The next question is a follow-up from Ed Hall of Stifel. Please go ahead.

Thank you for taking my additional question. It was just a question on this year's guidance of Of 10 to 14% in constant currency. If I do the math on last year's absolute revenue that you added on a constant currency level, it was around 100 to 110 million. Now, if we look at this guidance for this year, the absolute number added is a bit of a... step change down. So I was curious as to what are the reasons for that? Is there a layer of conservatism in there? Is there product launches from competitors that you're taking into account? Or is there something that I am missing on that analysis? Any clarity there would be amazing.

You know, I think that to give for granted that every year you can add 100 million of euro just because you did it the previous year, it's a little bit simplistic. So, as I said, we do have really to find and to feed Salesforce expansion, and that's a constant effort. It's always a challenge to find those people at the speed we want. We think that 10% to 14% remains very challenging. We do not expect, frankly, the market to continue to be that strong. We have seen some... markets as well with some price reduction that has been announced in France, in Belgium, in Japan, so you have to consider that as well. So there are some elements that call for a little bit of cautious, and I think 10-14% remains a very substantial growth rate, especially again compared to the market and to our peers. Can we do better? I think it's very challenging to do better, but we have been positively surprised ourselves in the last five years. But I'm happy to be surprised by our performance every year, frankly. But this is a number that we think is solid. It's challenging. It's difficult. It's a battle every day to go and take market share. And we are ready to fight this battle, of course. But we don't give it for granted. So, you know, the past year performance is not predictive of the future year performance, as you well know.

No, absolutely. Thanks a lot for that clarity. It's super helpful.

Thank you very much. Sorry, Ed, just another point. There was an acquisition as well last year. So let's consider that as well when you look at the absolute numbers.

Yeah, absolutely. Perfect. Thank you.

Thank you.

That was the last question. Gentlemen, back to you for any closing remarks you may have.

No, I would like once again to really thank our team across the globe, our customers, suppliers, and partners, because it's always tough to grow at this pace, and we try to do it in a very diligent way, which is even tougher. So congratulations to all our team members worldwide, and a big thank you for all our customers and suppliers. Thanks a lot.