Abbott Laboratories

Good morning and thank you for standing by. Welcome to Abbott's first quarter 2026 earnings conference call. All participants will be able to listen only until the question and answer portion of this call. During the question and answer session, you will be able to ask your question by pressing the star 1 1 keys on your touchstone phone. This call is being recorded by Abbott. With the exception of any participants questions asked during the question and answer session, the entire call including the question and answer session, is material copyrighted by Abbott. It cannot be recorded or rebroadcast without Abbott's Express written permission. I would now like to introduce Mr. Mike Camilla, Vice President, Investor Relations.

Good morning, and thank you for joining us. With me today are Robert Ford, Chairman and Chief Executive Officer, and Phil Boudreau, Executive Vice President, Finance and Chief Financial Officer. Robert and Phil will provide opening remarks. Following their comments, we'll take your questions. Before we get started, some statements made today may be forward looking for purposes of the Private Securities Litigation Reform Act of 1995, including the expected financial results for 2026. Abbott cautions that these forward-looking statements are subject to risks and uncertainties that may cause actual results to differ materially from those indicated in the forward-looking statements. Economic, competitive, governmental, technological, and other factors that may affect Abbott's operations are discussed in Item 1A, Risk Factors, to our annual report on Form 10-K for the year ended December 31st, 2025. Abbott undertakes no obligation to release publicly any revisions to forward-looking statements as a result of subsequent events or developments except as required by law. On today's conference call, as in the past, non-GAAP financial measures will be used to help investors understand Abbott's ongoing business performance. These non-GAAP financial measures are reconciled with the comparable GAAP financial measures in our earnings news release and regulatory filings from today, which are available on our website at abbott.com. Note that Abbott has not provided the related GAAP financial measures on a forward-looking basis for the non-GAAP financial measures for which it is providing guidance because the company is unable to predict with reasonable certainty and without unreasonable effort the timing and impact of certain items, which could significantly impact Abbott's results in accordance with GAAP. Unless otherwise noted, our commentary on sales growth refers to comparable sales growth, which includes the prior and current year sales of Exact Sciences, a cancer diagnostics company that Abbott acquired on March 23rd, 2026. Our definition of comparable sales growth can be found on page two of our press release issued earlier today, and a reconciliation table that contains data needed to calculate comparable sales growth can be found on page 13. With that, I will now turn the call over to Robert.

Thanks, Mike. Good morning, everyone, and thank you for joining us. Our results in the first quarter were aligned with our expectations for the start of the year. That included delivering adjusted earnings per share of $1.15, consistent with our guidance, despite absorbing the impact of earlier than planned financing costs related to our acquisition of Exact Sciences and a week in an expected respiratory season. This quarter also marked an important strategic milestone for Abbott with the completion of our acquisition of Exact Sciences. This acquisition adds a new, high-growth business to the Abbott portfolio. for the strengthening our leadership position in diagnostics and expanding our presence into one of the fastest-growing areas of healthcare cancer diagnostics. As we communicate at the time of the acquisition announcement, we forecast the addition of Exact Sciences to add approximately $3 billion of incremental sales in 2026 and accelerate Abbott's long-term sales growth rate. Before I summarize our first quarter results, I wanted to highlight a few pipeline achievements in our medical device business, and those include an earlier than planned approval and launch of two new PFA catheters, completion of patient enrollment in our catalyst left atrial appendage device trial, initiation of development activities to bring an implantable extravascular ICD product to market, and the announcement of positive results from our randomized control trial. which demonstrated that people with type 2 diabetes on basal insulin therapy benefited from using Libre, including seeing reductions in HbA1c and increased time spent in healthy glucose range. In addition to these achievements, our teams are preparing to initiate patient enrollment in several important clinical trials in the second half of this year. These trials represent a unique opportunity that could position Abbott to bring a new wave of highly differentiated technologies to the market. This pipeline of new technologies includes a balloon expandable TAVR valve, a leadless conduction system pacing device that utilizes our revolutionary AVERE leadless pacemaker, a mitral replacement valve developed following our acquisition of Cephia valve technologies, a peripheral IVL device developed following our acquisition of CSI, and a wearable continuous lactate monitoring sensor that will monitor for sepsis following discharge from a hospital. I'll now summarize our first quarter results before I turn the call over to Phil, and I'll start with diagnostics, where sales increased 2% on a comparable basis. In core lab diagnostics, growth of 3% was driven by growth in the US, Europe, and Latin America. Sales of core lab diagnostic tests, which exclude capital equipment and digital health solutions, increased on both a year-over-year and sequential basis. And this is a trend that we expect to continue and drive higher growth in the second half of the year compared to the first half. In our rapid and molecular diagnostic business, sales declined 10%, reflecting lower demand for respiratory virus testing due to a much weaker respiratory season compared to last year. And in cancer diagnostics, sales grew 13% on a comparable basis, driven by mid-teens growth of Cologuard and high teens growth in international markets. Moving to nutrition, where sales finished slightly ahead of our expectations for the quarter. As discussed on our January earnings call, results in the quarter reflect the impact of lower sales volumes compared to the prior year and the effect of strategic pricing actions implemented in the fourth quarter of 2025 with an objective of re-accelerating volume growth. While we are still early in the transition back toward a more sustainable balance between price and volume-driven growth, I'm encouraged by the progress we're making. Early data indicates we are seeing the intended effect with volume growth beginning to follow our pricing actions. We continue to expect that these pricing actions, combined with the launch of several new products, will result in growth improving over the course of the year. Turning to EPD, our pharmaceutical business, where sales increased 9% in the quarter. Growth was broad-based across the markets we serve, which included double-digit growth in several countries across Latin America and Asia Pacific regions. Demand in these markets continues to be supported by favorable long-term healthcare, economic, and demographic trends. With a broad product offering across five therapeutic areas, and an expanding biosimilars portfolio, which includes several market-leading oncology therapies, we are well positioned to serve the growing customer base in these markets. And I'll wrap up with medical devices, where sales grew 8.5%. Growth was led by strong performance in our cardiovascular device businesses. This included double-digit growth in electrophysiology, heart failure, and rhythm management. In electrophysiology, growth of 13% included contributions from two pulse-fueled ablation catheter launches in the quarter. The launch of our Volt PFA catheter contributed to a growth of 14% in the U.S., and the launch of our TactiFlex Duo catheter helped drive mid-teens growth in Europe. As we broaden the launch of both catheters, we expect growth in our electrophysiology business to accelerate. In rhythm management, sales grew 13% making third consecutive quarter that we have delivered double-digit growth and continued our track record of significantly outperforming the market. In heart failure, growth of 12% was driven by our market-leading portfolio of heart assist devices, which offer treatment for chronic and temporary conditions. In diabetes care, continuous glucose monitoring sales were $2 billion and grew 7.5%. Growth in the quarter reflects an impact from a delay in the renewal process related to an international tender We also saw the expected impact from a challenging comparison to last year. This comparison relates to shelf restocking dynamics that occurred in the first half of 2025, a topic that we discussed on an earnings call last year. As we look forward to the second quarter, we expect CGM to return to double-digit growth. So in summary, our results in the quarter were in line with our expectations to start the year. We remain confident in our expectation for an acceleration in growth in the second half of the year, and we had clear visibility to the key drivers of that acceleration and are highly focused on executing on them. Those drivers include, first, executing our growth strategy in nutrition, which is underway and on track with our expectations. Second, we see a clear path to accelerating growth in both electrophysiology and core lab diagnostics, supported by best-in-class portfolios, new product launches, and improving market conditions. Third, we will continue our proven track record of delivering strong, sustainable performance in EPD and across our medical devices portfolio. And finally, we are successfully integrating ExactSciences, which adds a compelling high-growth business to the Abbott portfolio for the strength and our ability to deliver long-term sustainable growth. And I'll turn over the call to Phil.

Thanks, Robert. As a result of the March 23rd close of our acquisition of ExactSciences, Our first quarter financial results include the results of the Exact Sciences business from the close date through the end of the quarter. As Mike mentioned, our press release issued this morning provides sales growth in the quarter on a comparable basis, which includes the full quarter sales of Exact Sciences in both the prior and current year. To align with our reporting of comparable sales growth, our full year 2026 sales growth outlook of 6.5% to 7.5% is now on a comparable basis as well. The sales growth outlook includes the full year sales of Exact Sciences in both the prior and current year. Compared to our previous full year adjusted earnings per share guidance range midpoint of $5.68, our new guidance range midpoint of $5.48 reflects 20 cents of dilution related to the Exact Sciences acquisition, consistent with our assumption at the time of the announced transaction. Turning to our first quarter results, sales increased 3.7% on a comparable basis, and adjusted earnings per share of $1.15 grew 6% compared to the prior year. Foreign exchange had a favorable year-over-year impact of 4% on first quarter sales. Earlier this quarter, we saw the US dollar weaken, which resulted in a favorable impact on sales compared to exchange rates at the time of our earnings call in January. Regarding other aspects of the P&L, the adjusted gross margin profile was 56.3% of sales, adjusted R&D was 6.7% of sales, and adjusted SG&A was 29.3% of sales. Based on current rates, we expect exchange to have a favorable impact of approximately 1% on full-year reported sales. For the second quarter, we expect exchange to have relatively neutral impact on sales. For the second quarter, we forecast adjusted earnings per share of $1.25 to $1.31. With that, we'll now open the call for questions.

Thank you. At this time, we will conduct the question and answer session. As a reminder, to ask a question, you will need to press star 11 on your telephone. You will then hear an automated message advising you that your hand is raised. To withdraw your question, please press star 11 again. For optimal sound quality, we kindly ask that you use your handset instead of your speakerphone when asking your question. Again, that's star 11 to ask a question, and please stand by.

We compile our Q&A roster.

And our first question will come from David Roman from Goldman Sachs. Your line is open.

David Roman, Goldman Sachs, Thank you, and good morning, everyone. Thanks for taking the question. Maybe I'll start with just the updated guidance. And I know you touched on some of this during the call, but maybe you could just go into some further detail on, firstly, maybe your guidance philosophy and your just thought process in establishing the revised outlook. And then secondly, just the extent to which the outlook is, in your mind, sort of fully de-risks and captures upside potential, but also contemplates any downside unforeseen risks here.

Yeah, sure. I mean, I think the philosophy here, David, is I think that maybe there's a portion there that is, you know, we've included exact sciences into the history. And our philosophy there has always been to ensure that our investors have you know, clear, transparent, detailed kind of breakdown of our performance. We did that during COVID. If you remember, we always split out the COVID sales. We got feedback that they really wanted to understand the underlying part of the business and the COVID part of the business. When we did the acquisition of St. Jude, the acquisition closed in the first quarter. And so we did the same approach there to fold in St. Jude into a kind of more comparable basis. And we just think it provides the investors really the most relevant growth rate, a growth rate that is of the new Abbott portfolio on a very kind of clean apples to apples basis. So I think that's the philosophy there as it relates to Uh, you know, the guidance, um, I think maybe maybe the view there was just maybe a little bit of a take a little bit of a conservative side here on on on, you know, some, some aspects that, you know, we felt in the first quarter. For example, if you look at the respiratory season, we forecasted Q1 to be a relatively weak season compared to other seasons that we had seen in the past. And then that was even weaker than what we had forecasted. And I think as we've looked at other comparable healthcare businesses that we look at, like for example, like OTC meds, which is a very good kind of triangulation there, we're seeing also those types of businesses have kind of this year-over-year effect there. You know, one of the ways to think about it is like, okay, you have two parts in the year where you're going to have this effect. You have it at the beginning of the year and you have it at the end of the year. So, one of the ways to think about it is, okay, we're going to make that lower respiratory season at the back end of the year. And then we would have to assume that you would have an above average respiratory season, at least from a testing perspective. But I'm only going to find that out just before Thanksgiving. So I just thought it was prudent to say we're not going to be able to make up. I'll put it this way. I'm not going to forecast that we're going to make it up in Q4, this respiratory aspect. That doesn't mean we won't be ready. Obviously, you know our portfolio, and we know we've got the manufacturing capabilities and the distribution to be able to do that. I just decided that I didn't think it was prudent to bake that into the forecast. The rest of the areas of the business, the sales growth out is very much in line with our January outlook. And if I go back to the way I described our year and the year progression, there's a couple key kind of blocks that really drive our growth throughout the year. I'd say the first block here is just, as I said in my comments, sustaining growth. the growth of our MedTech business and our pharma business. MedTech business, low double digits. Our pharma business, you know, above 7%. These are businesses that have consistently and reliably delivered this type of performance. And whether it's market conditions or new product launches in these businesses, we feel very good about our ability to be able to sustain that kind of performance. The other bucket, I would say, the second bucket would probably be more, okay, trajectory changing businesses. And I would put diagnostics, especially our core lab business and nutrition into those buckets. I think they're a little bit different though, David. I would say on our core lab business, and we talked about this last year, the impacts of China and the VBP and obviously COVID, that was about a billion dollar headwind that we faced last year. Other parts, The business geography, other parts of the platforms doing very well growth and we continue to see that. So what I've seen over the last six months really gives me confidence that we're actually on very much either on track or slightly ahead of that recovery in our diagnostics and that growth trajectory change. And I think the teams there have done an incredible job in China. And especially here in the US, too, I think the teams have done really good in terms of being able to capture market share. The nutrition transition, I think, is a little bit earlier on in that stage. But I still feel that what we're seeing right now, the decisions that we took, the timely decisions that we took in the middle of Q4, I think we're starting to see some of that activity right now in terms of being able to drive volume growth. It's still early. I can't declare, like, yes, it's done. But we're starting to see really good indications that the actions that we took and then combined with the new product launches that we're going to see that recovery. And then the third bucket I would put on that list is just the integration of the exact sciences, which adds, you know, a high growth business to the portfolio. It's been performing very well. I'm sure we'll talk about that also. But I'd say those are the three kind of big drivers of our sales forecast. And those really haven't changed. So the real thing here was just I'm not going to try and call what type of flu season we're going to have starting before Thanksgiving. But if the flu season is as aggressive as we've seen in other years, then we have the manufacturing, we have the distribution, we have the sales force, all of that in place to be able to do that. So hopefully that answers your question.

Yeah, thanks so much.

Thank you. Our next question will come from Robbie Marcus from JP Morgan. Your line is open.

Oh, great. Good morning, and thanks for taking the question. Robert, maybe to follow up on David's question, I appreciate that comparable growth is a much more helpful metric, especially if we're looking out to the future and what the new Abbott um, we'll be doing on an underlying basis. But when I look at organic growth, which I think is what a lot of people pay attention to in the health of the Abbott business coming into the year before the acquisition, it looks to me like growth is moving from the six and a half to seven and a half guide, uh, on the fourth quarter call is something more like five, seven, five to six, seven, five. If we adjust out exact sciences and the lost royalty revenue. So it does look like there's a bit of deceleration in the prior organic Abbott business. How are you thinking about managing that? How much is one time versus sustainable? And where do you see sort of the biggest pressure points and how you're addressing it? Appreciate it.

Yeah, I'm not sure I follow those numbers though, Robbie, but I think what you're trying to get to is, hey, by putting exact sciences into a comparable basis? Are there parts of the non-exact business that are underperforming? I'm assuming that's what you're trying to hint around. I would say, as I said to David, I think that if, I'll put it this way, if the business acquisition had closed after this call, let's call it Q2, sometime in Q2. I think we probably would have done, I think what you in the med tech space would usually expect is that you kind of keep it separate and then you kind of laugh it a year. But then what you'll then ask me to do is to always every quarter reconcile between what the acquisition did to the organic growth rate. So I just felt that because it was early in the Q1 before this call, that we could roll it in on a comparable basis And that would give our investors full visibility to the new Abbott with this addition of the exact sciences. And so, you know, I don't think that I know that might involve a little bit more work for some of you guys in terms of your modeling, all of that. But I think we try to make it very easy for you as part of our disclosures. Part of the business that, you know, we're focusing on, I think I went through that in a fair amount of detail here. I mean, if you want to go to specific kind of parts of the portfolio, we could do. But I think I described that to David pretty clear here. I think the – but I'll repeat it if necessary. The device portfolio, the pharma portfolio, we still feel very strong about those growth rates. We're not backing off of those. Obviously, there's opportunities to outperform in some of them. There are some more kind of challenging areas in others, whether it's market, whether it's competition. But overall, that combination, we feel very good about sustaining that. And then these trajectory-changing businesses, like we've discussed in diagnostics and core nutrition, I think we know what the issues were. We know what we're working on, and we're really focused on executing that. But if I take a step back here, I mean, I think ultimately, The way our business is, we're a very diversified company. We lay out all of the different businesses. We break out, even within sectors, we break them out and be able to show the performance in that. My view here is that, yeah, it would be great to have every single business beating all of the street expectations. Unfortunately, sometimes you're not going to have that. I'm not going to say that never happens because it's happened before, but sometimes it doesn't happen. And I think the important thing there, Robbie, is that you have a collection of businesses that we feel are very attractive and that the combination, that some of them are able to hit our commitments and deliver on our financial commitments. So I take a view of, I look at each business individually, but we also look at it as a whole. And I think as a whole, the company's well set up for this year.

Thanks, Robert. Appreciate it.

Sure.

Thank you. And our next question will come from Larry Beagleson from Wells Fargo. Your line is open.

Good morning. Thanks for taking the question. So, Robert, I wanted to ask about CGM. We heard your comments about the CGM market or your business in Q1 and the expected acceleration in Q2, but the CGM prescription trends in the U.S. look weak. Can you talk about what's happening in the CGM market? There's a concern that the current indications are saturated and How are you thinking about Libre growth the rest of the year and longer term? And just lastly, remind us of the timing for type 2 non-insulin and the dual ketone sensor and the lactate sensor you mentioned. Thank you. Sure.

Listen, I think it's always important to look at weekly prescription data in one country. It's an important country. And the weekly prescription data is obviously great early indicators for for the market, even though that auditing channel that you guys rely on to look at weekly prescription data doesn't capture the entire market. It's very different from pharma where you've got a lot of other segments of the market that are performing. So I think using TRX data to ultimately look at how the market is evolving and only using that as, I would say, I'd caution, I think it's a little bit myopic. So let me take kind of a bigger view here, okay, Larry, in terms of how I think about the market, what's going on in the market, and the opportunities we have there. I'm very bullish on this market. If I look at the big picture here, I'm fairly bullish on the CGM market. As you know, Larry, I've always been and I continue to be. If I look at our assessment of the amount of people that should be on a CGM on a global basis, we estimate between 70 to 80 million people on CGMs should be. And obviously, there are different types of patients in that number, but overall, 70 to 80 million people. I think the market today is around 10 to 12. So 10 to 12 million people And again, you might think 78 is a lot but you know, there's about half half a billion people with diabetes So I felt that I've kind of narrowed it down quite a bit already and even in that narrowed down world We're still very under penetrated and I think if you look back to I'll speak for our growth trajectory because we've looked at this and we continue to look at it I go back like 15 years. I look at poorly and revenue over 15 years, so let's call it, you know, whatever, 60 data points there, it's never always up to the right on a perfect 45 degree, okay? I know we love businesses that are like that, but it never is. There are periods, if you look, at least for us, there are periods where there's a little bit of modest growth, and modest growth I'd call, like, whatever, you know, 8 to 10 percent, and then it's followed by very long periods of strong, strong acceleration, teens, 20% kind of growth. And if you look at those acceleration periods, they're typically driven by different types of catalysts, either a reimbursement catalyst, a geographic expansion catalyst, a new product launch catalyst. And as I look at this market and I look at our position, I see a lot of catalysts still ahead of us in this market. If I think about reimbursement as a strong catalyst, you just mentioned one. CSM type 2 non-insulin coverage. I expect proposed language of that coming soon. I can't tell you the exact month, Larry, and I'm not going to try and forecast what it is, when it is, but I know it's going to happen. And I know that it's going to add close to 10 million people that don't have coverage now that now will be able to have coverage. And that's obviously going to accelerate commercial coverage, too. So I think that's one that we've talked about. I have not included in my guidance, but it is a sweet spot for us in terms of our channel strength, our promotional strength, our reimbursement coverage there. So I think that's a catalyst that's on the horizon here for us. Internationally, I know we like to focus a lot on the U.S., but internationally, out of the top 10 markets in the world, only four have actually gone full-blown basal coverage. So there are another six very large markets that are still in the process of not evaluating, but going through the budget process, the criteria process, et cetera. And what we've tried to do is obviously you know, build evidence to be able to support that movement, not only from a physician's side, but also from a patient advocacy. We showed in RCT, I talked about in my opening comments at ATDD conference later this year, which showed, again, in a randomized control trial, not just using real-world evidence, but randomized control trial that patients on basal do better with Libre. So I look at those and there is so much opportunity still internationally and even in the US. So I don't think that the patient TAM is is tapped or anything like that you're just going to have these little moments where growth modulates a little bit and then these next catalysts come in and they continue to drop you have to look at the bigger picture which is you've got 70 to 80 million people that can be on this product and even if you look at a yearly revenue number that's lower than what we're seeing today because you've got different types of patient groups in that number you know you're looking at 30 35 billion dollar cam here uh that that's available to us and We're focused on that, Larry. We're focused on building competitive advantage to be able to be a leader in that space, whether it's product technology advantage, cost advantage, skill advantage. And we do very well there. And then if you think about kind of innovation as another catalyst, we have a couple that are on our way also for us too. We've got still committed to an expected approval of our dual analyte system in the second half of this year. That's going to open up about a million patients that we previously had very little access to on the pump side. You're going to have about 5 million SGLT2 users that aren't using the product, which will now have the benefit of having continuous ketone monitoring. We're working on a Libre 5. I'm not going to get ahead of myself here, but our view here is always, okay, How do we continue to sustain our competitive advantage? And you do that through cost advantage, and you do that through product innovation. So I still feel very good about this market, and I'm looking at it from a much bigger picture than just weekly TRXs, which, don't get me wrong, we look at it also, and we can see the trends, too, and there are obviously areas that we can do better, and we're working on that, too. But the bigger picture here is that we're very well positioned for what I believe is a very, very large kind of market.

All right. Thanks so much. Thank you. Our next question will come from Vijay Kumar from Evercore ISI. Your line is open.

Hi, Robert. Good morning, and thank you for taking my question. I guess maybe I'll stick to exact, you know, given that the deal is closed, you know, this is an asset which has done phenomenally well over the years, you know, doing mid-teens kind of growth, You know, just talk about your plans for sustaining strong growth of Cologuard. Is there an international angle here for Cologuard? And sort of related to that, Craig, when I look at the guidance, you know, comparable growth is now six and a half to seven and a half, and we know X-Acto is growing faster. Is there some conduit that's perhaps being baked in the guidance? You know, could there be upside given X-Acto is growing faster? Thank you.

Sure. Listen, I think the integration is going very well. So I think it starts with that, right? We've named Jake Orville as our new leader in that business. He previously led the screening business of the Cologuard business, and he's reporting directly to me. It's reported in our diagnostics kind of queue, but it's operating standalone and it reports straight to me. I think right now we're very excited, and I know that the team is also very excited. I've had opportunities to field travel with reps. I've had opportunities to talk to physicians. And I'd say I'm very bullish about the ability to really accelerate this business. Sustaining Cologuard growth, I'll answer that, but let me just say when we looked at this strategically, Vijay, we really wanted to think about this not as a one-product kind of deal, but more as an opportunity to enter a space that is extremely exciting and very high growth. So not just screening with Cologuard, but therapy selection and And MRD testing, these are obviously areas that I know you know very well. And they have great opportunities here. So our goal in doing this is to actually be a leader across the entire cancer diagnostic span. And we believe that Xact was definitely kind of a beachhead building block for us to do that. And within that, obviously, Cologuard is the, you know, is the key growth driver there. And I would say, I think it's a very sustainable growth here for us for a couple reasons. One, the demand is still going to, is high, and it's continuing to increase, right? So, right now, if you look at, it's very underpenetrated right now. You've got 50 million Americans that are not up to date with their CRC screening. So, there's an opportunity here in the U.S., but internationally also, this is very, very under, like, very underpenetrated, Vijay. And And one of the things that we bring is established regulatory KOL healthcare system distribution relationships across a lot of markets. So, we've already set aside a group that's really going to focus on how do we develop the screening and the cancer testing market in these international markets. And then if you look at guiding screening guidelines, I mean, the age in 20, I think it was 2021, was lowered from 50 to 45. That added a lot of new patients. What I'm seeing, and I think it's more than anecdotal, I've seen studies now that we're seeing people like at 30 and 35 be diagnosed with like stage three. And so that's not good, obviously. So, you know, could I eventually see that being lowered from 45 down to 40? I think I can see that happening because there is a medical need for that, and that would add another 20 million people just in the U.S. So I think the demand is there. The piece of the Cologuard, which is an incredible value proposition, is that with this increasing demand for screening, there's only a certain, there's a fixed amount of colonoscopy capacity, at least in this country. It really hasn't changed. It's been six million per year pretty consistently. And if you factor in that there, if you look at gastroenterologists and look at the enrollment rates in medical schools, they're coming down. So you can see a world where you're going to have increased demand for screening and less supply to be able to do that from a colonoscopy perspective. And Cologuard does really well here. Not only is it convenient at home, but its sensitivity at 95% is equivalent to colonoscopy. So I think the combination of the The increased demand followed by this bottleneck. If you look right now, I think in the US, I was talking to the team, average wait time for colonoscopy is between three to nine months, depending on the state. So there's already a backlog. So I think the demand and the value proposition of Cologuard is very strong. And if I add a third part there, I think what the team at Exact Sciences has built is pretty unique. so you've got a thousand person sales force calling on primary care reps and and you know it takes time to build that it's not an easy thing and and you've got 200,000 healthcare professionals prescribing every quarter KoloGuard and they have this incredible system where everything is everything is integrated it's integrated into the healthcare records it's integrated into you know, your phone. I mean, it's a very seamless experience, and I think that's pretty unique. I think the other part that is unique to us is that rescreens are becoming a very strong growth contributor 25% of our tests today are rescreens. And, you know, you're eligible for a rescreen every three years. When you've got all the data, you can obviously interact with your customers to remind them. And what I saw in the data was that you've got a very high rescreen rate, and it gets even higher as the rescreens kind of progress. So I think right now we're seeing about 500,000 patients per year just for rescreens. So I think that that's That's something that's very unique to this business for us because, you know, they've been doing it for 10 years, so you've got this rescreen business that keeps on growing. And then the third thing, which I think is also very unique to us and what's been built is these CareGap programs, which I know you know very well also. CRC screening is one of the quality metrics that CMS uses for star ratings. and payers and providers, they get three times as quality score for Cologuard versus a fit test. So we're seeing a lot of interest from healthcare systems and providers to stay ahead and ensure that they're scoring their quality metric points. So I think those three things are pretty unique, and I add that with a combination of the demand, the opportunity international. So I feel very good about our ability to kind of sustain this growth. Now, internationally, is it going to be Cologuard? It could be in some markets. It could be other tests for other markets. But there's clearly a need here. traveled to Asia, I traveled to Europe this first quarter and I spoke to health ministers and top three things that we walked away from was they want to get cancer screening up and going in their countries. They see it as a problem and they see Abbott as one of those solutions. So I feel very good about this business and the integration is going very well. I couldn't have asked for a better integration. Culturally, I think both companies are very compatible, very focused on the patient. and on innovation and driving growth. So I feel good about it.

Thank you.

And our next question will come from Matthew Taylor from Jefferies. Your line is open.

Good morning. Thanks for taking that question. I was hoping that you could talk a little bit about the trends in structural heart And maybe within that, just address what's going on in left atrial appendage closure. And not only do you have programs, including the NextGen 360, which I think people are excited about, but I was hoping you could comment on what you think the impact could be from the champion study from your competitor. And you have a similar study, Catalyst, that I'll read out here in a year or two. But would love kind of an overview of Structural Heart and LAAC.

Yeah. So I think that's an interesting question because I think historically what we've done is we've had left atrial appendage closure device within our structural heart business. And what we decided to do is to move it outside of our structural heart business and put it into our electrophysiology business. And we did that in, you know, end of last year and beginning, starting in January 1st, where we moved the sales floor of clinical teams and eventually moved manufacturing, et cetera, over. And we did that just because we felt that this would be beneficial for our electrophysiology business, but quite frankly, it would be more beneficial for our structural heart business. So I'll focus on the structural heart business and the trends there. Listen, I think we've been doing pretty well with this business. So when you look at the, I think in our queue we've got a reconciliation of the impact of moving those sales out of Structural Heart into EP. So that's a big contributor to the disconnection between the street model and what we delivered. But on top of that, you know, we have seen some competitive intensity increase here in the mitral space as one of our main competitors here has kind of expanded their portfolio. So, yeah, I think my team can do a better job there. They know that also. We need to improve our execution in the U.S. We've done some changes to leadership. And I'm expecting our U.S. commercial team here to respond to the challenge. Internationally, growth continues to be very, very strong across the entire portfolio. And we're delivering double-digit growth in Mitral and Triclip. in our structural interventions business. So I think that's going very well. And while there's going to be some geographic differences there, Matt, I think that geographic difference might persist for a little bit. I continue to expect our structural heart growth here to be a high single digit for the full year. So I feel good about the Structural Heart portfolio. There are areas that we've got to do better in. I kind of highlighted the product and the geography, and I'm expecting the team to really respond here. So I think the business is doing very well. And then, as I said in my opening comments, we've got a couple trial readouts. As you mentioned, we've completed enrollment in our catalyst. I don't have a big reaction to my competitors' trial. I'm going to let them, as I'm assuming they probably have done, talked about it. So I'm going to wait until ours comes out, and then I'll comment on ours. But I think it's a high-growth, attractive business. I think you mentioned our next-generation product. I think it is a very, very exciting product for us, and that's why we thought that moving it over to our EP business would actually provide a better acceleration for that product per se and then actually allow our structural heart team to be more focused on kind of valvular products and selling and keep them more focused.

Thank you very much.

Thank you. Our next question will come from Travis Steed from B of A Securities. Your line is open.

Hey, everybody. I wanted to ask on the nutrition business, and I heard you mention that volume is starting to recover, but is there any other call you can give on getting confidence in that business returning to growth in the back half and volume picking up, and how you're thinking about ongoing portfolio management and value creation and how nutrition fits in that strategic thinking?

Yeah, sure. Like I said in my comments and in a couple of the early questions, I think we're starting to see that impact. We did a pretty comprehensive price assessment, not just at a product level, but a geographic level. We evaluated our gaps versus our competition. So we didn't reduce prices just basically uniformly across the portfolio, Travis. We kept it very focused on the products that we believed and based on our experience that would demonstrate this positive volume response to a reduced price. So when the price is passed on to the consumer, we're seeing this kind of immediate effect. But it takes time for some of that price to get passed on to the consumer, right, because you've got inventory in the channel, et cetera. So that price reset to the consumer doesn't happen overnight, which is why, because we know that we wanted to get ahead of it as quickly as possible, which is why we did it in Q4. of last year. But when you see the lower prices get passed through the consumer, you're seeing the intended effect. So if you look, for example, at our U.S. adult nutrition business, specifically on Ensure, that was a product that we knew had some elasticity in its price, just based on my experience. We've seen volume grow across all the retailers that have actually passed that on here in the U.S., passed that on to the consumers. So you're seeing that increase in volume, and we kind of use the 2025 as kind of the baseline. Obviously not Q4, but at least the first half of the year is the baseline. So we're tracking this on a monthly basis. I know my team looked at this on a weekly basis with the data that's available. I feel good about where we are right now. I mean, I'm not going to say right now that it's all done and let's just let time pass and it'll all come through. There's work we've got to do. There are product launches that also allow us to gain distribution. There's work that we need to do in terms of expanding distribution into the distribution channel. So there's a lot of work going on right now, but the team is incredibly focused. And I think this is a team that's been pretty resilient. Travis, and does pretty well, you know, at least has shown to do pretty well when it encounters some of these challenges, they're able to bounce back pretty quickly. So right now, I'd say on track, encouraging early signs, but still work to do. As it relates to the portfolio, listen, I like the diversity of our business model and the diversities, not just across business segments, across products. It's diversity in our geography. It's diversity in our customer base and different payer types and different innovation cycles. We don't want to be so heavily weighted on one or two products that the company is kind of driven there. And I think that diversity really provides us a pretty unique perspective on the global healthcare system. That being said, Travis, we're constantly looking at our portfolio. We're constantly looking at Are there, you know, is the market still attractive? How is our competitive position, you know, so that we can determine do we expand, do we maintain, do we potentially reduce? And we do this on an ongoing basis with management, and we do it with our board at least once a year, sometimes twice a year. So this is evaluating our portfolio for value creation is not like a once every five-year exercise. We're constantly doing it. And I think I'd tell you if we see an opportunity, we've demonstrated that we can act upon it. So right now, my focus here is I'm never going to make a long-term strategic decision based on kind of near-term challenges. Obviously, nutrition is going through some near-term challenges and going through some transition and recovery phase. And that's what my focus is on, is on getting our business back to a growth rate that we had seen, you know, over the last kind of four or five years. But the idea of constantly evaluating the portfolio, that is something that we do for all businesses in the company, and we do it on a pretty disciplined basis.

Great. Thanks a lot.

Thank you. And our next question will come from Joanne Wunsch from Citi. Your line is open.

Good morning, and thank you for taking the questions. I'm sort of surprised we're 50 minutes into this and no one's asked about macro issues, so I'm going to go there. I'm curious what you're seeing in terms of the potential impacts for the conflict in the Middle East on your business on oil and resin costs, but also just big picture what you're seeing in terms of patient volumes and reimbursement and, you know, outside of your comments on the respiratory snow days and things like that. Thank you.

Sure. Listen, the way Abbott has been built, it's been built to withstand these kind of events. And our discipline here is to ensure that we try and get ahead of it. As it relates to oil costs, I mean, I think that's an impact that it's too early to tell. We're not seeing any of that in our costs right now. We're not seeing freight rates increase from our suppliers right now. But we're monitoring it, and we have a whole team that monitors and stays close to it. I think one of the things that we do to stay ahead of this, Joanne, is that each one of our business has dedicated teams. Monday through Friday, 8 a.m. to 6 p.m., what they do is they work on gross margin improvement. What are ways that we can do that? to be able to anticipate cost shocks, to look at ways that we can be more efficient, more effective, look at ways at how we can negotiate with our suppliers. And so I look at the cost element of the conflict. Right now it's totally to tell, but I'm not saying that I think that there is a big impact because I think that we've got teams in place that are working hard to kind of mitigate that. The impact that we saw in Q1 was very minimal, but I wouldn't call it a demand impact. I would call it more of a getting product into the region kind of impact. As you can imagine, shipping lanes became, you know, everybody wanted kind of spots on planes and all different types of supply and transport methodology. that's just something that we've got to kind of stay ahead of. One of the things, the reason we felt a little bit of impact is we run pretty efficiently with our inventory. So now we need to make sure that we've got a little bit more inventory, at least in our affiliates, that we have warehouses in the areas so that we have enough product so we don't have any kind of back orders. But I didn't see drop-off or demand or reimbursement challenges or issues as a result of the conflict. For us, it was more just ensuring that we could get product into the area. And we're highly focused on that. But as you can imagine, the teams that Abbott has in this region, Joanne, I mean, they've, unfortunately, they have been through a lot and seen a lot. And I give them a lot of credit because, you know, while we focus on kind of growing the business and driving the business, they've got to do that under some very, very tough challenges. So I give a lot of kudos to the work that they've been doing.

Thank you.

And our next question will come from Josh Jennings from TD Cowan. Your line is open.

Hi, good morning. Thanks for taking the questions. Robert, I was hoping to get some more details on the EP franchise and the Volt launch internationally and now in the U.S. Internationally, any quantification of how Volt is impacting its share recapture in the ablation catheter segment? For the U.S., just with the earlier approval of, I guess, Volt 2.0, Any updates just in terms of the timing or just how your team is going to move forward into a full launch this year? And then overall, maybe just help us think about Abbott's updated views on just EP market growth, volumes, pricing, if you would. Thanks so much.

Yeah, sure. Well, that's 55 minutes with the first EP question. So, listen. I think the team has done an incredible job over these past years here of driving double-digit growth. During a window where we didn't have PFA, that window is now closed. So, obviously, we naturally have expectations and outlooks here that are on the rise. The U.S. launch of Volt and the European launch of Tactiflex Dura are on the way. And both these launches are in what we call like a limited market release phase. We do that with all of our products. It's just part of our process, whether it's in devices, whether it's in diagnostics. What we want to do is, before we go to full-blown, we believe there's an immediate step between what I would believe to be a little bit more of a controlled environment or a clinical trial before going full-blown. And that helps us. It helps us understand resourcing. It helps us understand positioning. It helps us quite frankly, uncover insights that you might not get during a clinical trial. The feedback we're getting from both these products is extremely favorable and positive and very much aligns to at least our expectation that we did when we were building this portfolio two years ago. a lot of questions of, Hey, we were, we were late and we said, okay, we realize we're not first, but we want to take advantage of, uh, we want to take advantage of our mapping systems and, and develop what we believe was going to be an upgrade to the, to the first generations. I think we're seeing that with volt. I think like the conscious sedation aspect of volt is extremely valuable, uh, more so now as, uh, in, in the U S but even, even internationally, And that's something that's specific to Volt in terms of how we design that. And I think if you paid attention to the European Heart Rhythm meeting that occurred last week, I think you saw also, albeit preliminary and maybe small, but this idea that the lesions that Volt creates are more durable. And I think ultimately that repositions, I think, or at least balances the discussion on the P market to be, yeah, we want more efficiency, we want more speed in these procedures because you've got so many patients that you can treat, but we want to also figure out how to do better outcomes and how to improve patient outcomes. And I think that that's what we believe that BOLT can do is to actually deliver on the promise of speed, efficiency, but also an ability to deliver better outcomes I think the TactiFlex feedback that we're seeing, Josh, is very positive also, easy to use, very fast lesion creations. This is on the TactiFlex chassis, so there's a lot of experience with that catheter. Pretty seamless switch between RF to PFA, so all very positive. I think the combination of that great feedback and now us starting to move to broaden the launch is going to give us a lot of confidence here in the growth rate to accelerate. And I think that includes growing faster than the market by the exit of this year. To your comment, I mean, I know there's a lot of debate about what is it? Is it 15? Is it 20? We think the market is going to be in the mid to high teens. We're shooting to do better than that. So I think there's an acceleration here. So the near term outlook, I think, for the business looks really, really strong. But I think more importantly here, Josh, is I like our position long term also. You got two new PFA catheters. You got a new ice catheter. You got a new introducer. We're constantly making upgrades, annual upgrades to our mapping system. you have the mapping infrastructure in place with the clinical specialists, highly, you know, a highly valuable asset to our customers to have that. And then on top of that, we're now going to be adding a second generation LAA device to this group. I think that no company in this space has got the kind of portfolio that we have and the completeness of the portfolio that we have and the experience and the field teams, et cetera. So, And I know this is not a product that specifically falls into EP as a reportable segment, but we have a lot of EPs that are also using devices, pacemakers, ICDs. And then you add on our leadless technology, which is, you know, very fast growing. I think we have a very, very differentiated EP product portfolio. And so I think there are a lot of exciting times in the horizon here for our EP business.

Crystal, we'll take one more question, please.

Thank you. And our final question will come from Marie Thibault from BTIG. Your line is open.

Good morning. Thanks for squeezing me in. I just want to get a little bit closer to understanding what's going on in the core lab business. I think you've called out strengths in the US, Europe, and Latin America. I think we're moving past some of the China VBP So wondering if you can just characterize the CoreLab trajectory by geography during Q1. Any share gains, any notable product launches, things like that to call out? Thanks for taking the questions.

Yeah, sure. I think you kind of characterized it well. I mean, I think our sales in China for CoreLab were flat in Q1. If you think about what they were in last year, we were, you know, between 15% and 30% down every quarter. So I think the teams here are making good progress. We're lapping, obviously, some of the price and the volume headwinds, so that's also a contributor there. So I think the market dynamics that we faced, you know, kind of has kind of shined out. I'm cautious to say... You know, like it's all a lap because, as we know, in these VPs, you've got different kind of phases. You've got regionals. You've got nationals and all of that. But I think the impact here is we've got China modeled in at a single-digit decline for the year. You know, could we do better than that? It seems like the team has done better than that in the first quarter, and I'm hoping they'll be able to do that. I think if I move to the U.S., I think, as I said in the previous question, I think the U.S. team has done a fantastic job, and the growth rates there are all in the high single digits, and they've been there, and they've been like that for some time. So we're clearly having an ability to renew our contracts at a very high renewal rate, so call it 90-plus, and share gains are now accelerating significantly. You know, so our win rates, I would call, you know, 55 plus. So every business that we're up in, new business, we're able to, you know, win one out of two. So that's a good trajectory over here. You know, Europe, it's difficult to characterize as one big Europe because, as you probably know, you've got different situations between north and south. But in general, that business has been doing, you know, mid to high single digits pretty reliably. So we feel very good about the diagnostic business. It has been performing well, all but, you know, the impact of VBP in China, and that seems to be lapping. So I expect to be getting the full year for our CoreLab business is kind of in that mid-single-digit growth rate. I was talking to the leader of that business yesterday. You know, they've got a plan and some strategies of how they could do better than that. but obviously the second half is higher than that, and it falls into what we've historically been doing. And like I said, I think the team has done a very good job there at navigating VBP in China and continuing to drive growth in any other parts of the business. So I think that's gone very well. Pay attention. For us in China, about 80% of our portfolio has gone through VBP. I think you'll probably hear about new ways of VBP, like a fertility VBP, a cancer VBP. And so we have very little share in those segments. So I think... I don't want to say we're past the eye of the hurricane here, but it seems like the teams have been able to stabilize China, and then the other businesses continue to perform the way they've historically been performing. Just before we end the call, I'd like to reiterate my comments that I've made. At the end of my prepared remarks, I remain very confident in our expectation here for an acceleration and growth in the second half. Like I said earlier, we know what the drivers are. We know where the accelerations are. We know where areas that we need to improve our execution on, and we are just laser highly focused on executing on them. So with that, I'm going to wrap up, and thank you all for joining us today.

Thank you, Operator. Thank you all for your questions. This now concludes Abbott's conference call. A webcast replay of this call will be available after 11 a.m. Central Time today on our website at Abbott.com. Thank you for joining us today.

Thank you. This concludes today's conference call. Thank you for your participation. You may now disconnect. Everyone, have a wonderful day.