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ConvaTec Group Plc
2/26/2025
Good evening. Wherever you may be, it's an absolute pleasure to be with you here today. And we're going to have the opportunity to go ahead and review both the strategic progress and financial delivery of 2024 at Convitec. You're all probably familiar with our disclaimer. And today, Johnny and I are going to be hosting you. And we've got an exciting program for you. We're going to go ahead and discuss with you three key topics. I'm going to go ahead and kick off and provide you a little bit with an overview. And in the course of that overview, I'm going to try to highlight two key things. First, what's all the progress that we've made during the course of the last five years? And what have we been able to achieve at CombiTech during the course of the last five years? And what does that bode in terms of the future? After we're done with the overview, I'll go ahead and shift gears and pass the baton on to Johnny, and we'll talk about financial performance. How did we do in 2024? What is guidance looking like in 2025? And then lastly, I'll finish up, and we'll talk about our competitive position. What is competitive position, and what are the prospects for future growth? So why don't we kick off? If you take away nothing today, I'm going to ask you to take away five key overarching messages. The first is that we went ahead and delivered broad based growth. What that means is that in each and every one of our categories, we went ahead and drew and we went ahead and drove significant growth and we outgrew the market. Second, we went ahead and increased our operating profit margin once again. Thirdly, we delivered double-digit earnings per share and free cash flow growth. Fourthly, we find ourselves in a situation at Convatec with the richest new product pipeline in about our 50-year history. What does that mean? It means that we are reiterating our guidance for 2025, and we are reiterating our outlook from a medium-term perspective. Let's dig in now and try to understand what happened during the course of the last five years. I was talking to several of you, and several of you guys were commenting here this morning in London that, wow, there's been a lot of progress. And each and every time I spend time with the Comitech folks, I actually notice progress. And I thought it'd be good to go back to literally five years ago when we were sitting in this room and we were mapping out what was going to be the transformation game plan, what was going to be the turnaround game plan. And some of you guys may remember that we talked about a vision, pioneering trusted medical solutions to improve the lives we touch. There were three concepts we outlined then. R&D driven, innovation driven. That's at the heart of being a successful med tech company. Two, we talked about solutions. We didn't want to be a device company. We wanted to combine the device with digital and with service. And so we were solving a real problem in the marketplace. But that solution needed to be trusted, which meant we had to improve our quality record. So we worked very, very hard during the course of the last several years to improve the quality of our offering. And at the end of the day, True North was always improving the lives we touch. We touch people's lives physically. We're literally in contact with your body for months and years. But we touch people's lives physically. socially and emotionally. And those lives, those people, that could be your mom, my dad, your sister, my brother. It's very personal for us. So we took that vision and said, great, how do we bring it to life? Well, we need a strategy. So we mapped out a corporate strategy, which we entitled FISB. Focus on key categories and key geographies. Innovate, simplify, build key capabilities, and execute like there's no tomorrow. On top of that, we went ahead and reorganized the operating model. Historically, our operating model would have been focused on key geographies. The power center really lied with North America, Latin America, Europe, Asia. We said we're going to change the model, and we're going to be category-led. One head of advanced wound care, one head of infusion care, clear accountability, and a direct line of sight to our key customers. There were distinct customer groupings. Two, we said we're actually going to go ahead and create the role of a head of R&D for all of Combatech, all of R&D. That has to be a real strong muscle of ours. And we went ahead and made sure that the head of R&D reported into myself. And thirdly, when it came to all the customer supporting functions, we said, you know what? We're going to create something called GBS, Global Business Services, to go ahead and drive improved effectiveness and drive efficiency. And that's exactly what we've been doing. Beyond the operating model, we worked on people. We strengthened the leadership team. We engaged colleagues. That vision that I shared with you, it wasn't developed by myself. It wasn't developed by the executive leadership team. In fact, it was a thousand colleagues at Comvetech that developed that vision. And we drove the culture to be patient-focused, consumer-focused, but with a high focus on performance, on delivery. We worked on incentives and rewards to make sure that those incentives and rewards were consistent with the metrics and milestones we were pursuing. We refreshed our core values. So now you might be saying, well, what did that actually accomplish? So let's take a look. Where were we back in 2019 and where are we today? And we're gonna look at it through four different lenses. Lens number one, organic revenue growth. It was about 2% back in 2019. In 2024, 7.7% growth. Sixth year that we've accelerated organic revenue growth. Two, what about R&D? We said we're going to be pioneering, innovation-driven. What did we do there? We more than doubled the investment in R&D. We've built capabilities now in product development, process development, clinical development, regulatory. We're successfully launching new products, right? So now all of a sudden, we've got the strongest ever pipeline. In fact, we've launched in the last 24 months or so, eight new products, and we plan on launching an additional eight new products in the course of the next 24 to 30 months. And what about operating margin? For three years in a row now, we have increased the operating margin. That's been a 350 basis point increase. Now, let's step back and remember that back in 19, we deliberately told you that we were going to go ahead and actually decrease the operating margin. Why? We had to invest more in R&D. We had to invest more in sales and marketing. That's exactly what we did. And we said we were going to reduce G&A as a percentage of sales. We were driving efficiency through global business services. It used to be about 13 points of sales. It's about 7 now. So the reality is that we're now growing our operating margin. We've done that three years in a row. We are on track to deliver an operating margin of 24% to 26% in 26 or 27. And what about momentum? We really didn't have any momentum then. Today, I think it's fair to say that we've got momentum. We delivered double digit earnings per share and free cash flow growth in 2024. And so I think it's fair to say that we've got momentum, and we're going to go ahead and continue to deliver that double-digit EPS and free cash flow to equity on a CAGR basis. What I'm confident telling you today, we actually have pivoted to sustainable and profitable growth. I am using the past tense. So what about the future? What does the future look like? It's exciting, no other way of describing it. Our best days are definitely ahead of us. Why? Three reasons. First of all, we have leading positions in large and growing chronic care categories. Second, we are deliberately targeting the fastest growing segments, and I'll share more data with you here shortly, But we are deliberately targeting the fastest growing segments in these categories with new and differentiated and innovative new solutions. And lastly, the turnaround is complete. We have strong foundations in place and we have momentum. I hope that overview was helpful to you. I'm going to pass the baton to Johnny and we're going to talk about financial performance. Johnny.
Thank you, Kareem. Hello, everybody. I'm going to present a summary of our financial performance in 2024, outlook for 2025, and then we'll hand back to Kareem for a strategic review and Q&A. We are very pleased to report a strong financial performance for 2024 with record organic sales growth, further operating margin expansion, double-digit growth in EPS, and excellent cash flow. Let's look at those. Organic revenue growth at 7.7% was broad-based across all four categories. This is the second year in a row when we have exceeded the top end of our target range of 5% to 7%. And operating margin, further progress, 100 basis points. That's 160 basis points on constant currency basis. Over three years, the cumulative impact of that is 350 basis points of improvement. Earnings per share was double digit growth. We forecast this time last year that it would be, and we reconfirmed at the interims that it would be, and it was. We expect double digit growth in EPS for 2025, one more year. Equity cash conversion was very strong at 97% and free cash flow to equity up 33%, benefiting from another year of strong working capital performance. And that cash flow enabled us to invest further significantly to grow the business whilst reducing leverage at the same time. The dividend per share, the dividend is proposed to grow 3%, same as it did last year, and that will take the payout ratio to 42%, back inside our target range of 35% to 40%. These strong results in 2024 build on the improvements over the last few years. And as you can see from these charts, and as we've heard from Karim already, sixth consecutive year of accelerating top line growth. Third year of operating margin expansion. Second year of improvement in cash flow and first year of double digit growth in earnings per share. I think what these charts confirm is that CombiTech has definitely pivoted now to sustainable and profitable growth. The sales growth was broad-based. You can see the contribution from each category in the columns on the left there. Significant contributions for them all. And on the right, there are two small headwinds, the last of the exit from hospital care and FX, leading to a total sales growth for the group of 6.9%. So let's look at the sales growth by category, starting with wound care, where organic growth was 7.4%. Our flagship brand, Aquacell AG Extra, had another strong year. And our new product, Convofoam, is building momentum through launches. Innova Matrix was up 34% to $99 million, and most notably, the indications outside the scope of the LCD, which we'll talk about in a moment, grew 70% to be a quarter of the total. Excluding InnovaMatrix, wound care grew 4.2%, faster in the second half than in the first, as we'd said it would be. And regionally, it was good growth in North America and in Europe, and strong growth in emerging markets. So on to ostomy care, where organic growth was 5.3%, continuing the trend of improvement over the last three years. The highlight there was Esteem Body, our new one-piece soft convex product, the first new product in ostomy for about a decade. It launched ahead of expectations and we expect continuing strong growth from that through 2025 as we launch across more markets. Regionally, we saw good growth in Europe and fast growth in GEM. And in the US, we're building momentum with another year of positive new patient starts. Onto the continence care, where growth accelerated to 8.3%, driven by volume and share gain in the USA, outstanding customer service and the improving product portfolio. We saw increasing sales of hydrophilic product and combatech product within our mix. And in particular, our new hydrophilic compact product, GC Air for Women, was very well received in the market. That's based on our FeelClean technology, which has a superiority claim with the FDA. And it's this performance that gives us conviction that the forthcoming change in reimbursement codes for catheters will be an opportunity for Convotec, because we are best placed to help healthcare providers and patients choose the best technology for them. Outside the USA, we're still small, but growth is building, and it now adds one point of growth to the category total. And then in infusion care, growth accelerated there to 11.2% for the year. Strong growth in diabetes with our major existing customers, Tandem and Medtronic, and also with newer customers like Better Bionics and Ipsomed. And we're really excited to see that the penetration of automated insulin delivery is accelerating. And that's driven by innovation across all different types of insulin products and pumps. And then in outside diabetes, the growth was very strong. And this is led by infusion sets for AbbVie's Parkinson's therapy. This outside of diabetes is becoming a bigger part of the category. We have a strong position in Infusioncare with increasing diversity across different customers and products. And this gives us confidence to say that we expect high single digit growth from this business for years to come. Let's look at profitability. We've said operating margin was up 100 basis points or 160 constant currency. There were improvements in price, in mix and in operations productivity around 50 basis points each. As expected, inflation eased through the year from 6% in the first half to about 3% in the second and that translated into a headwind of 160 basis points for the year as you see on the graph. Further progress on productivity in the commercial area and more efficiency in G&A, another 90 basis points. We've got to our initial target of seven basis points of sales for G&A one year early and there's more to do. Now, this chart just shows how we got to double digit EPS, and it's the same as we described at the interims. On operating profit growth of 12%, finance costs were about flat for the year, and the tax rate was close to flat, slightly up, translating into a 14% increase in the bottom line. We expect to deliver double digit EPS growth in 2025 in a similar manner. Now on to cash flow. Very strong conversion at 97% and free cash to equity up 32% year on year. The highlights I'd pull out from the slide are that EBITDA was up 12% based on the operating performance I've already described. Working capital decreased by 7 million despite the growth in sales, and that was 20 million better than the year before, mostly because of improved efficiency in inventory. CapEx was a little bit lower than the year before and at 5.3% of sales, a little bit below our target of six because of phasing of some projects into 2025. We paid a dividend of 130 million, and that is now all cash, no longer Scribd. And we purchased 11 million of treasury shares for incentive purposes. And then finally, 90 million of M&A comprised of the final payments for the Cure and Triad acquisitions. And we bought a small home services business in France in the second half of the year. So all that led to lower net debt by 71 million and improved leverage down to 1.8 times. So here is our guidance for 2025. And this builds on what we said back in November. We still expect five to 7% organic growth on the 96% of group sales, which are excluding Innova Matrix. And that growth will be broad-based. On Innova Matrix and based on the implementation of the LCD as scheduled on the 13th of April, we expect a headwind to sales of about 50 million dollars and that translates into about two points headwind on group sales growth. The LCD will remove coverage for Diabetic foot ulcers and venous leg ulcers, which will create a hiatus whilst we continue to generate clinical evidence. It's well underway. We expect to report that in 2026 and that will lead to re-establishing coverage. But in the meantime, the other there are another 13 indications which we are selling and over matrix four and that grew 70 percent in 2024. We expect continued strong growth in 2025. Operating margin, we expect to continue to expand. into the range 22 to 22.5. That's despite the headwind from the Innova Matrix reduction. And that's based on detailed plans for simplification and productivity in operations, commercial and G&A. That sales growth and margin improvement with little change to finance and tax expenses expected translates into another year of double digit EPS growth and cash conversion will be strong around 80%. It won't be as strong a conversion as in 2024 at 97% because that benefited from some favorable phasing. we would expect cash conversion to average around 85% on our double digit EPS growth going forward. Now, thinking about medium term targets, I thought it would be helpful to take a quick three year look. This is the last three years. We have delivered 350 basis points of operating margin improvement. And that has been against a very significant inflation headwind. 730 basis points. You can see the red bar there in the middle of the graph. That's an average inflation rate of 7%. There have been improvements in price. Improvements in mix as we have focused the business on the more profitable areas. Improvements in operations productivity as we have started to optimize and automate our factory network. During that time, we've made some investments in R&D to build the product pipeline and in sales and marketing to drive growth. And we have improved the G&A ratio, as already discussed, by over four points. Overall, we've improved productivity net of investments by about 11 points against inflation and FX headwinds of nearly eight points. So looking forward, we expect to make the same improvement over the next two or three years, the same net improvement in operating margin. but against a much lower inflation headwind. We're planning on inflation at about 3% per annum going forward. That's the smaller red bar you can see on this graph. And how will we do it? There'll be further benefits in price and mix as we continue to improve the product portfolio, but we are not baking in any general price rises. So that could be upside. There'll be further progress on operations productivity because in our automation, digitalization and continuous improvement programs, there is still a lot to do before we get to the level of best practice. And on other OPECs, and in particular on G&A, there is also more to do. Because not all of our geographies are included in our GBS at this stage, and not all of our processes are included end-to-end. We're investing in digital and AI tools, which will also help us further improve productivity. So taking all that lot together, we're well on track to reach our mid-20s operating margin in 26 or 27. And I'll just summarise by saying that 2024 was a year of strong financial delivery. Sales, margin, earnings and cash all finished a bit ahead of target. 2025 will be another year of delivery. Despite the headwind from Innova Matrix, we will deliver further expansion of operating margin and double digit EPS growth. And medium term, we are going to deliver 5% to 7% organic sales growth year in, year out, mid-20s operating margin, and compound growth in EPS and free cash flow to equity. Convotec is now positioned to deliver structural compound growth. Thanks very much. I'll hand back to Karim.
Thanks, Charlie. Well done. Okay. Okay. So you can clearly see that from a financial perspective, we're well positioned. What about our competitive position? Because ultimately that really drives the performance of the company, right? And let's try to understand that category by category. We're going to first of all start off with the wound care category. And we've split up the wound care category into four key segments, right? And we're going to assess each segment and try to understand, like, how competitive are we and what are the prospects for the future? So let's start off with the first segment. And the first segment is the antimicrobial segment. It's about a $1.1 billion segment, right? It's growing at about 6%. And we have our flagship brand or product offering there, which is Aquacel AG Extra. right? We've got about a 30% global share of market. That's doing really, really well. So what's going to happen in the future? What's going to happen in the future is that we will be launching in 2026, ConvaFiber, okay? And so there, the idea is you're going to have even better exudate absorption properties, proprietary surfactants, and again, it's not going to have any silver, and that has benefits in some key markets, such as, say, France, as an example. What's also really exciting is that We're going to be launching Conviniox. And I'll be spending more time describing to you Conviniox. But it's got some great antimicrobial properties, but it also actually increases blood flow, right? So it accelerates wound healing. And we're very excited about this offering. And I'll talk to you more about how we anticipate regulatory approval in Europe, actually in 2025. And then we'll be launching in 26, both in Europe and in the United States. What that is going to allow us to do is to fundamentally accelerate the growth of this particular segment. It's a breakthrough technology. But let's just wait because I'm going to share with you some data here in a second, which I think is pretty darn compelling. Two, what about the phone segment? It's about double the size, about $2 billion. growing again at about 6%. Historically, we've not had a particularly competitive product offering, so we've had about a 5% share of market. We launched ConvaFoam, much better exudate absorption properties, much better adhesion properties, right? And so now all of a sudden we're winning in clinical evaluations over half the time. And we're actually growing share in places like the United States, places like Germany and places like the UK. And we're expanding that launch to additional geographies around the world. So that bodes well in terms of our ability to grow share. Third segment, biologics. We really were not participating in the biologic segment. We acquired Triad Life Sciences. We have a Nova Matrix. It's a fantastic product. It's being used by over 2,000 healthcare providers. 10,000 consumers or patients have benefited from it. We're actively driving its utilization in the 13 indications outside of DFU and VLU in the United States. We're actively now launching it in key markets outside the US, in key markets such as in Latin America. And so it bodes really, really well. And we're very much on track to complete our randomized control studies in diabetic foot ulcers and venous leg ulcers in 2026. which also will bode well in terms of growing. So we expect to grow Innova Matrix and to grow Cher. And then lastly, in the single-use negative pressure wound therapy, which is about half a billion dollars, 400 to be precise, but it's growing double-digit, we're planning on entering this particular segment with our new and innovative ConvaVac. It's going to leverage our proprietary wound dressings, but combining that with a very high-quality, high-reliability pump. So hopefully you're getting the sense that as we do all of this, this bodes well for us being able to deliver high single digit top line growth in wound care. But let's take a look now at some data. This is Conviniox, right? Randomized control studies carried out in the UK. And we're gonna go ahead and assess how does Conviniox compare to standard of care, okay? So you've got diabetes. You've got a diabetic foot ulcer and it's just not healing. For a couple weeks, it's just not healing. What do I do? Well, you can use Conviniox and you can increase your odds of actually healing that wound by 60% or use standard of care. But actually, let's go ahead and analyze this even more carefully and say, you know what? I'm going to look at if you have diabetes, you have a diabetic foot ulcer, very hard to heal wound, and it's infected. Now all of a sudden you use Conviniox, I double the odds that I will heal that wound. Standard of care, about 23% of the folks will actually have that wound healed. With Conviniox, it's 45%. It's nearly double. But then how fast do you actually heal the wound? The graph all the way to the right. We heal the wound three times as fast. Okay? You say, well, practically, what does that really mean? Because you can see the wound's healing within 12 weeks. Basically means you got diabetes, a diabetic foot ulcer. It's infected. On average, one out of every four patients will be healed with standard of care. With Convinox, one out of every two. We doubled it. And as opposed to waiting nine months to get that wound healed, it'll heal in three months. It's pretty darn dramatic. Think about the reduction in amputations, the reduction in hospital stays, how much better the patient and consumer is going to feel. The health care provider is going to look like a hero, right? This is super exciting. So we're basically on track, as I said, to go ahead and get regulatory approval here in Europe in 2025, and we would anticipate launching both in the U.S. and in Europe in 2026. What about ostomy care? This is a very exciting category, right? This is one we've had to work really, really hard, but we've got momentum now. And we broke it down in terms of three segments. In my overview, I highlighted to you how we are targeting the large and fastest growing segments with new innovation, right? You saw that in wound care, how we're doing that. In ostomy care, we're doing something very similar. So we broke it down in terms of three segments. Segment number one is what we call the whole area of convex products. You've either got a convex product or a flat product. Think about this as the adhesive base plate I'm talking about, okay? So when you're using a convex product, actually you can have soft convexity or just regular convexity. The soft convex, if you look at that in the pink, is actually growing a high single digit, 8%. So what did we do? We introduced a steam body, a soft convex offering, the first launch in ostomy care for Convitec in a decade, right? It's got the amazing Convitec adhesive base plate technology with leak defense. What that means is you're not going to leak. You would not want to have a leak, right? Whether that's urine or feces, that's not a good thing. Super embarrassing. You don't get that with us. And on top of it, we've got a very discreet pouch now, right? So now all of a sudden in key markets like the United States, like Italy, like Poland, like Slovakia, we are growing share of market. We're driving new patient starts. That's super exciting. And we're going to be launching the two-piece soft convex offering in the Tura body as early as 26 and early in 27. So in that 26, 27 timeframe period, we'll be launching that, right? So now all of a sudden, we're leveraging some really exciting product offering with our service capability. We're leveraging, for example, home care capability in the US with 180 Medical or the AmCare capability here in the UK, right? You look at the next segment, The flat segment doesn't look like there's much revenue growth there. But the reality is that we've got a very unique technology platform. It's called the moldable technology platform. We've got strong IP position there. And now you can leverage that technology. And in fact, we've been growing that technology base and that offering in global emerging markets, double digit. And so we're going to be redoubling our efforts there to leverage that moldable technology and drive further growth. The accessory segment is also an exciting one. Again, you'll see it's about $0.6 billion, growing high single digit. And there we're looking to go ahead and leverage our refreshed brand there, Ascenta, which we're leveraging on a global basis. So clearly we're targeting the fastest growing segments, refreshing our portfolio and leveraging our services, whether it be our clinics in Latin America, whether it be our home care capability to drive growth. So we fully anticipate being able to go ahead and drive at least mid-single-digit growth in ostomy care moving forward. What about continence care? Similar story. Once again, we're targeting the fastest growing segments in continence care, but we're also growing outside the United States. So if you look at the U.S. area, what you'll notice is we've actually got a 40% share of market when you look at it through the service lens. We're the number two manufacturer, the number one home care company. But there's actually a segment there, the compact segment, which is growing very rapidly. Relatively small today, but it's growing rapidly. That's where we've launched GCR for Women, right? The Feel Clean technology. Superiority claim from the FDA in terms of comfort and less stickiness. That's doing very well, right? It's a hydrophilic, ready-to-use, compact catheter. We're going to be launching... the male version and the set version in 2026 on a global basis, including the United States. You look at Europe, that segment, the compact segment, which is growing again, high single digit, about 7%. We've historically not participated, and now we have our compact offering, GCR for women, right? And so we're leveraging that capability, and we'll also be launching the male version in Europe, right? And then you look at global emerging markets. We're also driving growth there. So all of a sudden now, we're driving growth both in terms of geography, outside the United States, and having a competitive offering in the compact segment, which is the fastest growing segment, and leveraging our tremendous service capability. This goes back to offering a solution. And what about infusion care? What's happening there? Very interesting. If you look at the top of the chart, let's look at the market dynamics. 350 million patients have diabetes worldwide. About 10% of them, 35 million, are in advanced stages of diabetes. And if you have advanced diabetes, you're no longer producing insulin. So you have to administer your insulin exogenously. So either it's an injection, it's a pen injection, or I use a pump. And what you'll notice is the ratio is about 94 to six. So it's 94% to 6%. But pump utilization is growing much, much more rapidly. You see that number of 11%, right? Why is that the case? Fundamentally, pumps are becoming a lot simpler to use, but you've also got continuous glucose monitoring. It's making the pump smart. It knows when your sugar is high or low. And when you combine that, all of a sudden, the artificial pancreas is here. That's why you see automated insulin delivery, fancy way of saying artificial pancreas, fancy way of saying pump plus continuous glucose monitoring. So as you see that happening, what we see on the pump side of things is that both durable pumps and patch pumps are growing rapidly. There's an acceleration occurring. as we move forward. And we benefit from that because we are the leader in providing infusion sets there. And in fact, now we've been able to diversify our customer base. We continue to have strong collaborations with Medtronic, strong collaboration with Tandem, but we're also working with IpsiMed. We're also working with Beta Bionics. And so now we find ourselves where our diabetes business is growing and is robust. But what about what's happening outside of diabetes? Well, outside of diabetes, We work in areas like Parkinson's, immunoglobulin replacement therapy, pain management. These three. arenas are also growing high single digit to double digit and you look at for example parkinson's where we're collaborating with abv and well positioned to be collaborating with mitsubishi tanabe in the future again in parkinson's there is very significant growth right so frankly we're investing heavily in infusion care and adding capacity to be able to go ahead and service all this demand so our level of confidence is high that we'll be able to grow this business in high single-digit there's growth in diabetes and outside a diabetes guess what we plan on growing in the mid-teens to high teens today it's over 10 percent of our business and it's going to become a larger and larger portion of our business hope we've gotten a sense that our competitive position across all four categories is actually strengthening year by year we're executing better Our pipeline is richer, and we're starting to get success in the marketplace in terms of these new product launches. We've launched eight, and there's eight more to go. And we haven't even talked about wave three. So I've been commenting on wave one and wave two. That's not for today. Okay, let's try to summarize. So here are the 16 products. You will notice that the 16 products are across all categories, right? So what have we said? In 2024, hopefully what you've been able to see is that this was the sixth year of accelerated revenue growth, 7.7% organic revenue growth. This was the third year in a row in which we went ahead and increased our operating profit margin. And we went ahead and delivered double-digit EPS and free cash flow growth to equity. We had record sales and record profits for the company. In 2025, what do we plan on doing? We plan on growing our organic revenue 5% to 7%, excluding Innova Matrix. We plan on increasing the operating margin to 22% to 22.5%. And we plan on delivering double-digit EPS growth, along with strong cash conversion. And in terms of medium term outlook, hopefully you've gotten a sense and it's clear to you that we have leading positions in structurally growing chronic care categories. That's a real big positive. You've also gotten a sense that we've got the strongest pipeline we've ever had in our history. There's a lot of innovation that is flowing into the marketplace, helping consumers, helping patients, helping health care providers, and frankly, allowing us to be successful. And lastly, I would say, I think it's fair to say that we are very much on track to deliver double-digit EPS and free cash flow growth to equity on a compounded annual growth basis. On that note, thank you. Let's open it up for questions. I think Hassan's hand was the first one to go up. You guys all have mics. We will make sure we get to all of you. There are folks that are also online. And so if the folks online have questions, we'll certainly take those questions also. So, Hassan, do you want to kick us off?
Morning. Hassan Al-Aqil from Barclays. Three for me, please. Firstly, for Johnny, can you talk about the margin expansion target for 25? I appreciate you're already there in the second half, but what are you doing specifically to offset within wound care the 50 billion loss in revenue? and any FX impact that we should be aware of for the margin in 25. Secondly, a year of record growth for the company, but also in continence care. Both you and your key competitor are benefiting from product launches. So I wonder if you can talk to whether this market is accelerating in value terms, and who you think you're gaining share from. And then finally, related to this, can you expand on continents' progress in Europe? Which products are you seeing the most traction here? And what is your near-term and medium-term ambition in terms of share? Thank you.
Should I start?
Yeah, that'd be great. Okay, I'll start with the first one. Yeah, Hasan, look, you're right to note that there is obviously a headwind from Innova Matrix in 2025, and we're really pleased to be able to guide towards continuing operating margin despite that. We've got good momentum and detailed plans in our simplification and productivity agenda, as we call it, which affects three different areas. Increasingly, our operations is going to be contributing strongly to cost efficiency. We've referred previously to the optimization of our factory network, and you'll have seen that we've closed two of our smaller factories in recent years. and we are automating compared to others in in you know comparable industries our automation is is still way behind and so we are catching up with automation and we're investing in better systems and digital tools in the factories that plus the continuing Increase in scope of our global business services function and better tools leads us to be confident in delivering cost efficiencies through 2025, which will more than offset headwinds from elsewhere. In terms of FX, you asked, as FX rates stand today, we're not pointing to any particular FX move on EBIT or EBIT margin. There's a little bit of a headwind on sales growth at the moment, a bit over 1% on sales growth, but nothing on margin.
Super. Look, on continents, Kerry, what I'd say, is there growth in terms of value? I think the short answer is yes. I would say that as you look at the global market, particularly the U.S. and Europe, there is a move in that direction. There are some markets where new reimbursement codes are being introduced, so I think it's fair to say that. I think for us, look, I think the reality is that particularly with a focus on Europe, we've expanded our commercial presence in key markets such as the U.K., such as Italy, France, and Germany. We also have a strong commercial presence beyond that with Europe. the rest of our our businesses and what's clear to us is there's a significant opportunity particularly in that compact segment which i highlighted to you so i think there's an opportunity for us to grow our share but we're starting from a very low base right so frankly the the hurdle bar is relatively low but on the other hand you know we've been in these markets we understand these markets i think with a very competitive product offering and if we can wrap-around service along with that, I think you will see us grow our share in a meaningful manner. And I think that sales outside the United States will contribute in a meaningful manner to the growth equation, is what I would say. Super. As we go through, can you just introduce yourself? There's other people online. And maybe we'll just start here in the front, I think, with Aisha.
Hi, can you hear me? Yeah. Great. That's Aisha Noor from Morgan Stanley. Thanks for taking my questions. I just have two. The first one is on the infusion care business. So are you able to share which of the launches or products in particular drove this big acceleration in November and December? And why wouldn't this take your growth to the double-digit range for infusion care in 2025? So are you a little bit conservative with the guidance of high single-digit? And then the second question is on the mid-term margin targets of mid-20s by 26 or 27. So why have you decided to keep with the ambition of potentially getting there by 2026, which is next year? Is this all kind of OPEX and cost-driven, or would you consider more transformative initiatives to get there sooner? Thank you.
I'll let Johnny take a stab at both, and then I may add some commentary. Sure.
Okay, well, on InfusionCare sales, we know it's lumpy, and I would say the acceleration in the end of the year was just that. It was just phasing of sales. We, throughout the year, said we were going to deliver high single digits for that business, and it built through the year. We're very pleased with the performance. I'm not sure I'd point to any specific product other than to say that the new sources of growth are performing really well. We're very pleased with the diversification. So we're still getting growth from our major existing customers. But the new customers, Betabionics, Ipsomed, AbbVie, that's all adding strong growth to the category overall and particularly pleased with the growth outside of diabetes. In 2025, I would just say, you said, can it be double-digit? Maybe, but let's not get carried away. We think it's a sustainable, high single-digit growth business. One thing to point out is that we do expect infusion care sales to be front-end loaded in 2025. Sometimes we've warned of the opposite, but when we look at our forward orders and we look at the comparatives, the growth in infusion care is likely to be stronger in H1 than H2, but high single digit for the year. And then on mid 20s. Why are we – look, we have got clear plans to deliver improved cost efficiency in margin. And that's what underpins our confidence in getting to mid-20s. Now, the track that we're on at the moment, we've been doing a bit over 100 basis points, 110, 120 per annum. for the last three years, and if we continued at that rate, it would be more likely 27 than 26 we'd hit it. But there are some variables. I've said potentially price could be an upside. Maybe not. We're not banking on it. Who knows where inflation and FX will turn out? So I think as I shared in that graph at the end, it is mostly on the controllable cost levers that we are pinning our confidence in getting to mid-20s. There are other variables that leave the time bracket a bit open.
I would just add a little bit of commentary just to say, look, fundamentally what we're focused on is sustainable, profitable growth, right? So when you think about that equation in our mind, fundamentally, we're looking at this through very much a medium-term lens. And we're not going to let, frankly, the next quarter or the next six months affect the direction of travel, right? So we want to make sure that year in and year out, we're delivering double-digit earnings per share growth, right? On a compound annual growth basis, we want to see that free cash flow grow double-digit. That's really what we're all about. And so the reality, when push comes to shove, we're going to make sure that we can sustain and further grow that top line, right? And so I think that the whole idea of the mid-20s is very doable. We see a clear path to getting there. We will make the investments in automation. We will go ahead and optimize our network. We will drive all the continuous improvements in GQO. We will drive productivity in commercial by doing a better job of targeting, leveraging AI to develop our content, narrowing all the suppliers in terms of all the agencies we use. I could keep on going on and on. I mean, there's very clear plans to do all of that, but ultimately it's about sustaining and making sure that we're not focused on the one semester, the one quarter. I just don't think that's the way we want to run the business, and that's the way we're approaching it. I'm just going to go row by row. I hope you don't mind. Please.
Hi, good morning. This is Anshul Verma from J.P. Morgan. I have two pleas. Firstly, just a bit of a follow-up on the phasing question for this year. You've given us the phasing for infusion care, but could you please give us a bit more color on the phasing of growth across the divisions and for margins as well for FY25? Also, have you baked in anything from potential headwinds from the tariffs? I'm aware you guys have a manufacturing facility in Mexico. And then the second question is on the medium-term targets. For the top-line guidance of 5% to 7%, what does the bottom end perhaps bake in? What are your assumptions for the bottom end? And what are your assumptions for reaching the top end? Thank you.
Should I start phasing? Yeah, go for it. So there aren't any other significant phasing effects to call out for FY25, right? Infusion care front end loaded. The other three categories relatively flat is how we see it at the moment, you know, within within not material changes and likewise on margin as well. Last year, the margin improvement was back end loaded because of the effect of inflation easing through the year. We're not expecting that this year. We are expecting this year more of an even progression through through the year. And then on tariffs, we're not expecting a material impact from tariffs. Historically, the nature of our products has meant that we haven't been subject to tariffs. Last time there were tariffs from the USA, we weren't subject to it. There are various legal protocols and precedents which lead us to believe that we won't be impacted by tariffs this time either. So we haven't built it in, no. Do you want to take medium-term guidance 507? What leads to five, what leads to seven, I think is the question. Well, look, we're launching a lot of new products, and this is a new muscle for CombiTech. we've been very pleased with how the launches have gone over 23 and 24, and that has led us to be above the top of our target range. If our new products continue to launch successfully and strongly, one would hope we'd be towards the top end of our range. But stuff happens in the world, and we want to be cautious, and that's why there's a range. And if particular new products were a bit slower to launch or for some other reason, that would be what would lead us to the bottom. But we'd like to be closer to the top.
Thank you for that. And just to follow up, is the bottom end perhaps making further headwinds from the LCDs?
No, no. So we have separated those two things. The LCD, as we see it, is a one-time event. It will lead to a one-time reduction in sales in 2025 from where we will rebuild. We'll rebuild in over matrix sales in other indications, which are growing quickly. And also by launching outside the USA, although that will be very small initially. And then down the line, when we've got clinical evidence, we anticipate re-establishing coverage for DFU and VLU. The five to seven on the rest of the business is independent of the LCD.
Okay. One more here up front. Sorry. I'll come to you, Graham, here. I think you've got to press the button.
Okay. Thank you for taking my questions. The first one is just a follow-up on, again, the topic. Oh, sorry. Zhang from Citi. The first one is just a follow-up still on the topic of infusion care. Understood that you literally just said high single digit is the sustainable growth outlook for this business. But I was wondering if you could perhaps break it down into the outlook for diabetes indication versus non-diabetes indications. The reason is I'm a little bit surprised that you're not more excited or more upbeat about this growth outlook, given that you have been talking about very strong outlook outside of diabetes, new customer acquired, and also you're looking to increase capacity for Parkinson's, for example. So that would be my first question, and then I'll come back with the second one.
Yeah, look, I think the reality is that we're very much focused on achieving at the high single digit. And I think you're basically posing the question saying, could it be double digit? I think there's been that line of questioning. It could be, right? But I think we need to stay grounded, right? I think we're improving our performance. I'm dancing here. We're improving our performance, and, you know, one step at a time. Are we going to go ahead and secure Mitsubishi Tanabe, and how is that going to do? How is AbbVie going to continue to do as it launches in the U.S.? They only received their approval, frankly, in the fourth quarter. Let's see this expansion in diabetes. Let's see us continue to diversify. So, look, you could clearly build scenarios. You know, we could sit here and tell you, well, what about continence care? What about ostomy care? Could it do – look my basic response to you is that we've guided medium term right we said wound sustainably high single digit i see high single digit and the other two we've said basically hey from a medium term outlook perspective mid single digit could it be higher i think the short answer is yes there is that possibility But again, this idea of us launching new products successfully, we're just starting, right? We're just starting to get positive feedback, encouragement with ConvaFoam, Esteem Body, GCR. Let's keep on doing that. Let's collect more data, and then we'll see.
Thank you. And then my second question is on advanced wound care, and this will come with two parts. So the first part is, can you provide a bit more details around convertible momentum, both in the U.S. and OUS? For example, how much did it contribute to growth in the second half or in full year 24? And also, can you talk about what markets are you looking to further launch it out in 2025? And the second part to this question is, you mentioned that you're also rolling out InnovaMatrix outside the US. So for example, LATAM, can you comment a little on the appetite or the receptions of InnovaMatrix in LATAMs and any colors around pricing levels or further investment required? Thank you.
Yeah. Look, I would say on combifoam, you know, we're not breaking down product by product what the contribution is. I think that we're going to start seeing an important contribution of combifoam from a financial perspective in 2025. So what we saw initially was some really encouraging clinical response to it in terms of winning over half the clinical evaluations. What I can tell you is that as we're launching it in places like the UK and Germany, there's very, very strong demand. And we're pleased. And we're seeing even stronger demand and more demand in the US marketplace. And our plan is, frankly, to focus on the FISB 12 markets. And so I would anticipate that during the course of the next 24 months, you'll see us launching combifoam more broadly. So for example, in places such as Brazil, right? you ought to be expecting us to go ahead and do that. On Innova Matrix, it's still very early days. But I think in terms of financial attractiveness, it's very financially attractive for us to do that in places also in Latin America. And so we're going to continue to explore how can we introduce Innova Matrix in markets in Latin America, potentially in Europe. But on the other hand, I think Johnny was very clear. It's a relatively small opportunity. So I also want to make sure that I'm giving you a fair balance here.
I wonder if it's worth, may I just add that Kareem said we don't talk about products specifically, but he described the breadth of pipeline in wound care. Several new products coming off the pipeline over the next few years. That's what gives us confidence that wound care is, you know, irrespective of Innova Matrix, is a high single digit business in the medium term.
Let's go to Graham.
Morning. Graham Doyle from UBS. Just two questions. One quick one, Johnny, on the guidance. Just if you are talking about IC being H1-weighted and wound logically must also be the same, fair to say group is probably more H1-weighted if you do those things and do the maths. And then just a second question on conviniox. It's a slightly different product from your traditional antimicrobial product. It looks like it has an underlying... healing benefits almost akin to what we see with innova matrix does that mean it's potentially like a new category and you can do things with this that you couldn't do with the traditional antimicrobial products and therefore maybe expand the category because i'm trying to get a sense of how big this could be given it's already a big franchise but this doesn't feel iterative it feels quite different
I'll let Johnny take the first question, and I'll comment on common IOCs.
Yeah. So in wound care, I think you're referring to the Innova Matrix effect. If we take that out, the phasing of sales growth across the other three categories is pretty flat. There is a small impact from infusion care being front-end weighted on the group. But by the time you boil it down with the other three categories, it's not a big difference.
Look, on combiniacs, I would say the nitric oxide technology that we've developed, and gone ahead and secured and have been actively developing is very exciting. There's no other way to say it. And as you recall, when we first went ahead and pursued the technology, we really looked at it as a platform technology. We were going to start in wound care, but we saw potential applications in other areas, say, such as continence care or ostomy care, right? I think that thesis of ours from a scientific perspective not only still holds, but maybe we have even more conviction, okay? I think in the area of wound care, because it has this ability to basically be a great antimicrobial treatment, similar to AquaCell AG Extra, but also frankly to impact and accelerate wound healing, I think it clearly has the opportunity to significantly expand the category. Two ways, I think one, there's a volume aspect to it, but then when you think about pricing and reimbursement, clearly here there's a very compelling health economic story. And so if you're sitting there, as the NHS or United Health or CMS, you know, we can go through all the various arenas, I think this could be a very, very attractive opportunity. So we're very excited, very committed to launching it, and we're going to be investing appropriately. Okay. Please, go ahead, Sam.
Morning, guys. It's Sam England from Berenberg. And the first one just on ostomy care. Can you give us a sense for the contribution to growth you saw from a steam body following the launch in 24 and how we should think about its contribution to growth in 25? And then on the infusion care side and the strength of growth in non-diabetes revenues, where do you see those non-diabetes revenues getting to as a proportion of the segment in the longer term? Could it be sort of 50% or more in the longer run? Or do you expect it'll always be diabetes sort of dominated?
Yeah. Look, I think on ostomy care and esteemed body, again, we don't sit there and sort of break down a specific product, but I would say that clearly the body line is a was a good contributor last year, will be an important contributor this year, and will be a very meaningful contributor to growth for Austinicare. So you should definitely be following Esteem Body and Natura Body. I think I said we're going to be launching Natura Body in the 26-27 timeframe period. So clearly, there's a real opportunity there. On the other hand, we're also seeing growth from our accessories business, the whole line of Ascenta, which we've refreshed that brand. And I do think the moldable technology, which I highlighted, we're able to grow double digit in global emerging markets. So it's pretty well balanced is what I would say. I think historically, the issue for us has been we haven't executed as well commercially. Our quality hasn't been right up to snuff. We've been improving that. And we didn't have a full product portfolio. It was a partial product portfolio that needed to be refreshed. And so I think by the time we launch Matura Body, say in the next 24 months, we'll have all the components, and frankly, we can compete a lot more effectively. On the non-diabetes and infusion care, I think clearly it can go beyond the 10%. Sam, I don't know if it'll be 20%, 30%, but I think it'll be a meaningful portion. And we're very committed to doing that. I mean, we haven't talked about, are there other therapeutics beyond immunoglobulin therapy, Parkinson's, pain management? And I think the short answer is there is. I alluded a little bit to wave three. Today, that's not the focus. We're not going to talk about wave three, but you can imagine that's a technology platform, the infusion care technology platform, that we do see opportunities in therapeutics beyond the ones we're currently focused on.
Hi there, Jack Reynolds-Clark from RPC. Thanks for taking the questions. I've had a couple, please. First on ConvaNiox. Just following up on Graham's question, what conversations have you had with payers? Obviously, you talked about European launch and then US launch. What conversations have you had from both sides of the Atlantic there? And the second question, just on wound care, thinking about 2025 guidance of mid-single digits. Should we be thinking about that more towards kind of the last year's performance at kind of near to 4% or more in the context of the slide that showed market growth at around 6% or above? And then how do you see that then progressing next year and following years?
Okay, why don't I take the first one? I want Johnny to comment on the second one. Yeah, look, I think what's fair to say is that – you know, there's public data out there about sort of, you know, from a health economics perspective, how does Combiniox perform? And I think it's got a pretty compelling data in terms of its performance. So I think we're very well positioned. And, you know, I think for competitive purposes, I'm not going to get into the detail, but let's just say that we're very well aware of who are the payers, who are the payer influencers, and our level of confidence of having a compelling narrative based on real clinical data, based on real health economic analysis is pretty darn high. So we're looking forward to all the necessary engagement and discussions in that arena, both in the U.S. and in Europe.
And then on wound care, last year was 4%, just over 4%, excluding Inova Matrix, but it was very different half on half. Second half was over 5%. That's because the first half was held back by pressure in China, among other things. So I think it's fair to say that mid-single digits is where we should be expecting wound care to be. Solid mid-single digits for 2025.
And beyond that, how do you see that?
Well, we have said that we are expecting wound care to build to be high single digits and beyond 25. And that's as this pipeline, this exciting pipeline, a new product starts to roll off. ConvaFoam will start to build momentum. And then there's ConvaFiber and ConvaNiox and others that Kareem referred to. You have to hold it.
Morning, everyone. It's Cain Slutsk in Deutsche Bank. Just on the LCD piece, clearly the sort of non-DFU VLU piece is doing quite nicely with good growth. I'm just wondering when the implementation does ultimately come. Are you expecting any sort of knock-on effect or change in buying behavior on the indications outside of the scope? Is there any risk there given the good growth? And then just on the balance sheet, I mean gearing at 1.8 now, that's come down quite nicely. And I think historically there's been a few bears who have been sort of always concerned around the stickiness of leverage. So now coming down below 2, do we sort of – is this a place you're going to sort of just – or is there going to be sort of more meaningful kind of investment going forward perhaps in M&A? And is there a fifth category sort of thinking very big picture? Thanks.
Super. Thanks, Cain. I'll take the first one. I'll let Johnny handle the second one. Look, I think that the reality is when you look at the indications outside of diabetic foot ulcers and venous leg ulcers, I think they tend to stand alone. So I'll give you a very practical example. One of the areas we're seeing significant growth is in the area of Mohs. So we're talking about post-skin cancer surgical intervention. So you're talking about a different point of care. Typically, you're talking about the dermatologist. They're having a lot of success in that arena. So I don't honestly see a significant risk. There's always going to be some risk. But I think it's reasonable to assume that in the non-DFU VLU indications, and particularly the way the legislation currently reads, there's an opportunity to grow that business. And we're very committed to that, both in terms of from a commercial vantage point, from a clinical vantage point. And so I think it bodes well.
And then on leverage, yes, very pleased with the cash flow and how that turned out last year. You're right that ongoing the profile is to delever. We've got a target for CapEx about 6%. We think working capital will stay as a ratio of sales. And so that generates cash every year. We don't have an ambition to keep delevering. Our target is about two times. Now we interpret that flexibly, but that's the target. And so we are actively looking for M&A, which will strengthen our competitive position in our focus areas. And we've been successful in that over the past few years. We hope to be successful with it going forward. But. you know, absent M&A, then as our capital allocation priorities set out, any surplus would be available for return to shareholders.
Okay. Three quick questions, if I may. First of all, just going back to the automation side of the business. I seem to remember you telling us a few years ago that you then had seven plants with one that had automated packaging. I think you're down to five plants now. I'm just wondering to what extent you're actually automated within those plants, both in terms of packaging and the rest of it. obviously that could drive some quite meaningful kind of margin gains. Second question is just around Conviniox. Can you just remind me how that works? Is it a simple dressing? Is it a dressing with a device attached to it? Just thinking about what the ongoing costs from a healthcare perspective might be in terms of managing that wound. And then lastly, and this is just me kind of maybe reading too much into it, but in your statement you talked about if the LCD is enacted. Are you trying to tell us you still think there's a risk it may not be enacted or is that just kind of technically speaking correct?
Yeah. Okay. Let me take those three questions. So, look, I think in terms of automation, historically we referred to our facility in Denmark, which is highly automated, right? This is where we make our infusion sets. The reality is that we've broken down all of our five major sites, and we break them down in terms of production, primary packaging, and secondary packaging. So, we know exactly... you know, where is there a gap in terms of automation? We've made a lot of progress. So, for example, in the UK, which is a big wound care facility up in Deeside, we frankly have, by and large, automated that facility across the board, right? By and large. So it'll be all done here in 2025. So that kind of gives you a sense of significant progress there. So we should start seeing some of the benefits rolling in in 25 and certainly in 26 and 27 from that facility. Then what we see happening in some of our other facilities, say, such as Slovakia or such as, say, the facility in Mexico, we're incorporating more automation in those arenas, and I would continue to see us do that during the course of the next, say, 36 months. So I think that the next 36 months, we're going to continue to be very, very busy bunnies, but I think at the end of the 36 months, so if you say 25, 26, and 27, we should have made significant, substantial progress, and I think the cumulative effect of that automation will benefit us. But I would also highlight that it's not strictly automation. It's also a lot of continuous improvement initiatives. I mean, literally, we're talking about hundreds. And so we've got a very rich pipeline there. And so think about areas such as procurement, which we're being much more aggressive on and just building competencies and capabilities and thinking about what proportion of all of our supply agreements are actually covered by contractual agreements. It was, frankly, somewhat loose historically. Let's just say it's being tightened up in a very significant manner. carbon ix how does common ice works it actually is a wound dressing the reality is that nitric oxide is frankly uh quite unstable it's a gas actually of all things and so you actually got to create the nitric oxide in the wound dressing and there's a lot of know-how ip as to how do you do that so when you look at it physically it's going to look to you like it's a wound dressing but in reality um nitric oxide is generated, and then that nitric oxide has the benefit of going ahead and driving killing of all the bugs, and frankly, accelerating the wound healing process. So I think it's going to be actually relatively easy to use. And then you can imagine different sizes, different formats. Initially, we're very focused on diabetic foot ulcers. That's going to be the first indication. But we're actively pursuing and planning on developing it for venous leg ulcers and also potentially for pressure ulcers. So we see a lot of potential there. And then on the LCD, look, we've assumed the LCD is going to be implemented April 13th. I think that's just a wise and prudent way about thinking about it. We know we've got 96% of our business is outside of the whole area of Innova Matrix, so it's a very robust business. We're going to drive the RCTs. We're going to drive diversification, and that's what we're assuming.
Edward today, Redmond Atlantic. Karima, we've been discussing, great to see the strategy of investment in R&D continue to bear fruit. Two other areas, maybe good to look in more detail. Interesting to see the Convovac product, an area that many people, it's very competitive. Clearly, you feel there's a way that you can disrupt that market. There's a lot of Me Too products on the market, so if you could talk a bit more, as much as you can, about how you can disrupt that. And then also in pain management, in IC. I know you can't discuss who you're talking to, but can you perhaps give us some idea on timelines about how we might see the pain management offer come through?
Just clarify your first question for me again.
Yes, just on ComboVac, how you feel you can differentiate in a market that's highly competitive.
Yeah, look, I think the reality is, first of all, we're talking about single-use negative pressure wound therapy there. I think many of you know that we had an original offering, which was called the VEL, and it was not successful. It literally wasn't ready for showtime. And I think that the opportunity there is to make sure that you've got a very robust, highly reliable pump that actually generates negative pressure, right? Because negative pressure helps in the wound healing process that accelerates wound healing. But on the other hand, you also would like to combine that with a very unique wound dressing that maybe has properties and benefits that others don't have. I'm not going to say more at this point, but at least that gives you a sense of the concept. I think, look, on infusion care and pain management, there's a series of medications or therapeutics with which we work on today. I wouldn't want to create the impression that there's some additional new therapeutic out there in pain management that we're actively pursuing. So I think that would be misleading you. So that's what I would say there.
We have a question online. Yeah, great. I think the room is full now. It's from Julian Dumas at Jefferies. Four-point question, so I'll just ask them one by one. What are your expectations for Innovo Matrix in 2025 in the non-LCD indications? Would you give a growth prediction on that one?
Yeah. I mean, not specifically. We did 70% growth last year. We're expecting ongoing fast growth in 2025. But let's not get into product by product. It's a bit too detailed at this stage.
Thank you. Some competitors have said that they expect the wound biologics market to shrink in 2025 due to the LCD. Do you believe the same?
Yeah, look, I think that the reality is that when you look at it through the eyes of CMS, right, the Center for Medicaid and Medicare Services, you've got two phenomena. You've got clearly, you know, how much do these extracellular matrices cost us as a system, whether they be synthetic or whether they be, you know, xenograft or whether they be allograft, right? But then we also have to acknowledge that in terms of integrity and how billing has occurred, there have been some bad actors, right? And so I think that when you look at what has happened, particularly in the 24, 23 timeframe period, those bad actors, there are a few, but unfortunately they do exist, have maybe made the market larger than what would be a sustainable market, if that makes sense. So that would be my first comment. So I think that the bad actors will be tackled, and I think that will have an impact. And then, B, the question just is, you know, what will happen in terms of payment and reimbursement? And I think that if you look at the current mix of producers on the LCD, I think that would lead you to believe that in 2025 that there would be a reduction in the size of the overall market. I think that's probably a reasonable assumption.
Thank you. Third one, can you give us an update on any progress in diabetes patch pumps?
Yeah, look, what I would say is two things on patch pumps and diabetes. The first one is that irrespective of whether we're on a patch pump or not, we will deliver high single-digit growth. So I think that's a really important point. Second, we continue to make good progress with a variety of players. It would not be appropriate for me to say anything beyond that.
And final one for Johnny. CapEx last year was slightly below the 6% of sales. How are you thinking about it in 2025?
We've given a guidance range for 2025, which is 130 to 150. So, you know, 6% or possibly even a bit more because there was some phasing effect of projects from 24 into 25. So slightly higher, but close to our target 6% range.
Okay. Any last questions here in the room? I've got one more. Please.
Hi. Hi, it's Estelle Pound from Bernstein, and I'm asking the question on behalf of Lisa Clive. So we have a question on the most indication for Innova Matrix, and that looks quite interesting. How will you see the growth opportunity unfold? Is it your sales rep building out the market already, or are there established players in the indication already? Can we assume that this is very low penetration today, so a high growth market more generally?
Yeah, look, I think the question is, what is the nature of the opportunity and indications outside of DFU and VLU, and how are we positioned there? I think it's large and I think it's largely unpenetrated is what I would say. So there's a large opportunity there. B, we've already been executing our diversification strategy. So we've not waited. We've been at it, frankly, both commercially and also just from an R&D perspective. There's an opportunity there to generate evidence and help people understand how would you go ahead and utilize the tools that we made available. So I think you continue to see us, frankly, drive growth in that arena is what I would say. Okay, anybody else? Fantastic. Look, I'm going to bring the session to a close. I just want to say a big thank you to all of you, and we look forward to seeing you here soon again. Take care. Thanks very much.