5/7/2026

speaker
Dani Segara
Head of Investor Relations and Sustainability

Hello everyone and thank you for joining us today for Grifols' 4th Quarter 2026 Earnings Call. My name is Dani Segara and I serve as a Head of Investor Relations and Sustainability. Today I'm joined by Grifols' Chief Executive Officer, Nat Shabia, President of BioPharma, Roland Vandeler, and Chief Financial Officer, Rahul Isrubinabhasan. As is our usual practice, today's call will last about an hour. including the Q&A session. Please note that this call is being recorded. You can find additional materials, including today's presentation, in the investor relations section of the Grifols website at grifols.com. A transcript and reply of the webcast will also be available on the investor relations website within 24 hours. Turning to slide two, I would like to remind everyone that forward-looking statements may be made during this call. This may include, among other things, comments regarding the company's future operating and financial performance, statements about our future expectation, clinical developments, regulatory timelines, and the potential success of our product candidates. These statements are based on current expectations and available information as of the date of this call and are subject to certain risks and uncertainties that may cause actual results to differ materially from those discussed today. Grifols financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions, including alternative performance measures, or APMs, as defined by European Securities and Markets Authority. Grifols management uses APMs to evaluate financial performance as the basis for operational and strategic decision making. These IPMs are prepared for all the time periods presented in this document. As announced on May 24, the Board of Directors decided to initiate a process to evaluate a potential IPO in the United States of a portion of the shares of its subsidiary and part of its U.S. by a former business. Any such transaction remains subject to, among other things, regulatory and legal requirements, internal approvals, and market conditions. In keeping with the legal and regulatory advice received, we will not be able to address any questions regarding this transaction at this stage. We will provide updates as and when necessary, remaining in full compliance with applicable laws and regulations. Now moving to today's agenda, I will turn the call to Nacho to kick it off.

speaker
Nat Shabia
Chief Executive Officer

Nacho? Thank you, Dani, and thank you all for joining us today. In the first quarter of 2026, we delivered a solid start to the year, maintaining our focus on our core priorities as outlined in the annual guidance provided in our previous call. The results of the first quarter were in line with our expectations and forecast. We are on track to achieve our guidance for the full year 2026 as we continue to build momentum over the course of the year. Today, we will focus on three key areas. First, we will talk about our commercial strategies across regions. with a clear focus on capturing growth opportunities in core markets. Second, we will further clarify the strategic importance of EGIP following EMA approval, a milestone that strengthens our global plasma diversification strategy, expands our sourcing capabilities, improves access to treatment in EGIP, the region and Europe, and structurally and meaningfully reduces cost per liter, thereby supporting our margin expansion. And third, we will address the continued strengthening of our balance sheet through disciplined refinancing and sustained free cash flow generation. Finally, we will review some key progress within diagnostics as we near an important milestone, the launch of a new platform that expands market opportunities in blood typing, as we committed at our last Capital Markets Day. These advancements reflect our ongoing commitment to innovation and to supporting long-term growth in this division as well. Turning to slide five. Revenue for the quarter reached 1.7 billion euros, representing an increase of 3.3% at cost and currency. Adjusted EBITDA increased to 404 million euros at cost and currency, 381 million euros on a reported basis, with margin broadly stable year-on-year. Request flow improved by 30 million euros, with leverage stood at 4.3 times, which is broadly stable versus year-end and consistent with the seasonality we typically see in the first quarter. Biopharma led this performance, with growth of nearly 7% at cost and currency, once again underscoring the strength of our IG franchise, which delivered double-digit growth, particularly in core markets. Our focus remains on executing our key priorities for 2026, driving adjusted VDI margins to at least 25%, while delivering 5-9% adjusted VDI growth at cost and currency. Improving free cash flow towards our 500 to 575 million euros target and maintaining strict financial discipline. We are actively pulling strategic levers across the organization to deliver on those objectives, which I will detail in the following slide. We also note the recent exception of plasma-derived therapies from U.S. tariffs under Section 232, which underscores the strategic importance of plasma in today's global environment. Finally, as announced in March, we are evaluating a potential IPO of our U.S. biopharma business. While it is still early in the process and we will not be able to provide additional information in today's call, it reflects our continued focus on maximizing shareholder value. We will update you with necessary details in due course and stay compliant with applicable laws and regulations. Now let me turn to our focus in 2026 in order to achieve our annual goals. Moving to slide 6. I want to detail the strategic drivers that support our confidence in achieving our 2026 guidance. Our focus is centered on five key pillars of execution. First, we are optimizing our biopharma product mix. While our IG franchise continues its momentum, we are balancing this with a continued focus to drive growth across our broader portfolio of proteins. Second, the ramp-up of our IG platform is a transformative milestone. As I mentioned, this is a structural shift in our sourcing capabilities. We are in a clear trajectory to collect 1 million liters of plasma in Egypt this year, scaling rapidly to 3 million by 2029. Third, this Egyptian expansion allows us to accelerate the optimization of our global plasma sourcing. By integrating this lower cost per liter supply, we can more aggressively optimize our U.S. plasma network, improving overall margin efficiency without compromising our supply needs. This also ensures flexibility and optionality to expand our plasma needs. Fourth, we are focused on the operational and financial turnaround of biotest. A key catalyst here is the commercial progress of both biotest new generation of immunoglobulins, Jimmugo, as well as fibrinogen products, Profibrai and Thestilty, which are starting to contribute to the top line as we integrate these assets more deeply into our global commercial portfolio. Finally, our commitment to financial discipline remains absolute. We are maintaining rigorous cost control and maximizing operational leverage across the entire group. These five drivers are not mere targets. They represent active strategic levers. Their successful execution is what will allow us to grow strategically, expand VDA margins, and deliver the improved pre-cash flow we have committed for the full year 2026 and beyond. Before moving to a more detailed biopharma update that Roland will provide, I would like to briefly comment on the performance of our diagnostic business on slide 7. It is important to note that the reported revenue decline does not reflect the underlying fundamentals of the business, but rather the temporary impact from the dissolution of the Quidel-Orzo joint business. On a like-for-like basis, our diagnostic revenue grew in the low single digits year over year. As part of the joint business dissolution, we agreed to a $65 million U.S. compensation payment to Grifols, which will be distributed over the next three years. While the termination of the joint business created a short-term headwind, the decision was ultimately a strategic one. Ending it unlocks full autonomy to offer a broader range of donor screening and clinical diagnostic solutions and better positions us to capture the full value of our new ISART platform rollout. These new immune assay platforms enable us to directly target the serology market, which is valued at approximately 1 billion euros. Additionally, it provides an opportunity to eventually expand into a much larger total addressable market of the clinical immune assay sector. This is a segment where our ability to operate independently enables us to fully participate, control the value change, and maximize returns. As such, ISART platform represents a key pillar in diversifying our diagnostic revenue base and expanding into adjacent high-value segments. Other than this significant step in our serological business, within blood-typing solutions, the Barcelona Next Generation Platform is our most significant upcoming catalyst. This platform delivers significantly improved performance in a smaller, modular design, with a simplified workflow and reduced footprint for customers. We remain on track for its launch in Q2-26 at the leading flagship industry trade fair. and we expect this platform to be a key driver in sustaining our leadership in this market beginning in 2027. In NIT, our Mundaka platform remain in track for launch in 2030, reinforcing our leadership position within that through higher throughput and sensitivity and advanced design. As we look beyond 2026 and specifically 2027, we expect our diagnostic business to continue to grow in the low single digits as we continue to grow our blood type in business, while MDS, we consolidate our strong donor screening market position and grow in the plasma screening segment. Respect the good performance of the BTS and MDA businesses to be partially upset by our IDS business as the supply agreement with Abbott ends and we gear the manufacturing towards ISAT. I want to reiterate here that our diagnostic business remains a vital complementary pillar to our biopharma franchise, providing significant contributions to our overall margin profile and cash conversion. Before moving to Roland, I would like to emphasize that the progress of the company in the first quarter reflects disciplined execution across our strategy, operations, and finance. We are building on strong fundamentals, advancing our margin initiatives, strengthening our global plasma platform, and reinforcing our balance sheet. This execution supports our confidence in delivering consistent progress throughout the year as we work towards our full year guidance and are looking at the full value of our competitive advantage. With that, I will now turn it over to Roland. Thank you.

speaker
Roland Vandeler
President of BioPharma

Thank you, Nacho. Moving to slide nine. The biopharma business overall delivered a solid start to the year with 6.8% growth at constant currency in the first quarter. I am proud of the dedication, passion, and commitment our team shows every day to deliver for patients and drive forward towards the goals we set out. Q1 growth was driven by continued strong momentum in IG, partially offset by albumin in China, as well as lower sales in other proteins. Let me briefly walk through each segment. Immunoglobulins were the clear growth engine. Our IG portfolio delivered 15.3% year-over-year growth at constant currency, driven by sustained traction of Cumminex in the U.S. and core European markets, fully aligned with our strategic focus. Performance was further supported by the successful U.S. launch of Dialtest Imugo, which is building on the strong underlying momentum of our existing brands. Xempify, our subcontainer's IG, continues to see strong double-digit in-market demand growth in the U.S. Reported ex-factory sales this quarter, though, were partially impacted by year-on-year inventory phasing, with Q125 benefiting from a wholesaler inventory build and Q126 reflecting some inventory normalization. Importantly, the underlying demand trend remains very strong, and for the full year, we continue to expect strong double-digit growth for Xendify. Turning to Albumin, Q1 sales declined 6.1% year-over-year at constant currency, reflecting the expected continuation of market and pricing dynamics in China that we discussed at year-end. Following several years of strong growth, demand flattened in 2025 and we adjusted pricing mid-year. Over the past quarters, pricing in hospital has stabilized, which is encouraging. However, the first half of 2026 continues to compare against a higher pricing base in 2025 and we therefore expect albumin sales to be lower year-over-year in H1 before stabilizing into the second half. Despite these near-term dynamics, our longer-term outlook for albumin remains constructive, supported by our strategic partnership with Shanghai Ras. With elevated in-country inventories in the market, our focus is firmly on driving demand with disciplined pricing and aided by an expanded joint commercial footprint and a more targeted marketing and contracting approach. These actions are aimed at increasing hospital access, including deeper penetration into lower-tier hospitals, while also expanding our presence in retail pharmacies. In parallel, our medical teams continue to invest in education and evidence generation around long-term albumin use in liver cirrhosis and an important and still unmet need in China. As conditions stabilize, we remain confident that these actions position us well to get back to growth in this key market. At the same time, we are actively pursuing opportunities outside China with a clear emphasis on expanding our albumin presence in the U.S. and other markets. This, together with increasing yields and the use of excess IG from email-proofed Egyptian plasma, will enable us to balance our IG and albumin growth over time. On Alpha-1 and specialty proteins, sales came in 7.4% lower year-over-year, reflecting a prior year comparison that benefited from inventory buy-in for both Alpha-1 and Vibrant Zealand at the time. Within Alpha-1, which represents roughly half of the category, We were encouraged by growth in new patient referrals during the quarter, highlighting the continued unmet need and the significant number of undiagnosed patients. While underlying dynamics are strong for Alpha 1, HCPs and patients continue to navigate access hurdles, especially in the first part of the year. We heard from physicians and patient associations that the reauthorization period in the U.S. was a difficult one, and that a number of patients had to go through multiple appeals to finally receive approval for their therapy this year. We will continue to do our part to appropriately support healthcare professionals in their work of securing access for their patients. And this is where we are looking forward to sharing our SPARTA outcomes trial results with top-line results expected later this year. Successful trial outcomes will help to further drive awareness to reach patients yet to be diagnosed, but also provide additional evidence that may bolster access for both new and existing Alpha-1 patients in the U.S. and abroad. In the remainder of the category, sales of fibrin sealant, factor VIII, and contact manufacturing were lower year over year. Following strong inventory build by Ethicum in 2025 to support global launches of fibrin sealant, Q1 reflected some inventory drawdown. This was partially offset by continued solid demand for hyper-RAP, While seasonally lower in absolute terms, we are encouraged by momentum as we move towards the summer peak season for this important product. Overall, we remain confident in the underlying fundamentals of Alpha-1 and expect the Alpha-1 and other proteins franchise to return to growth over the full year 2026. Moving to slide 10, what I'd like to highlight is how intentionally differentiated our approaches across both geographies and proteins. starting with Immunoglobulins, our growth engine. In the US, our priority is clear. Grow with the market on a higher base following our market share recovery in 2024 and 2025. We expect continued mid- to high-single-digit growth for GammaNex as our leading IVIG and strong double-digit growth for Xenify in SCIG. Outside the US, we are taking a more selective, value-driven approach. In Europe, we are focusing growth on higher-margin strategic markets, while actively optimizing our footprint in low-return markets. At the same time, we are advancing self-sufficiency in Canada and leveraging platforms such as Egypt as a plasma source to support IT supply into Europe. Turning to albumin, where the focus is balance and value optimization. In the US, we are benefiting from increasing demand for albumin in bags, as one of only two players with this differentiated offering, and where we are working to expand supply going into 2027. At the same time, we are effectively competing with our portfolio of albumin in vials with a disciplined approach to contracting. Outside the U.S., we have a two-pronged approach. In China, our focus is on driving demand and access, leveraging our strategic partnership with Shanghai Ross, expanding the tier 2 hospitals, and increasing our reach in retail pharmacies. In other markets, we see good progress and room to further grow our albumin sales. Overall, the objective is to stabilize performance in China and selectively expand beyond China, including the U.S. with the differentiated offering of alternate impacts. Finally, Alpha-1 and specialty proteins, where our ambition is to lead and expand the category globally. In the U.S., the priority is to expand Alpha-1 diagnosis and treatment of appropriate patients in a market where 85% of patients are not yet diagnosed. We believe that our outcome study, SPARTA, which for the first time may show better maintained lung function versus placebo, will play a key role to raise awareness, broaden the share of physicians that consistently test their COPD patients, and facilitate access to therapy. Our team is preparing for top-line results expected by year-end and is planning a deliberate, coordinated approach to communicate SPARTA outcomes to support growth. In addition, we are encouraged by our momentum with HyperRab and excited about our upcoming vibration launch later this quarter. Outside the U.S., we continue to drive Alpha-1 growth in reimbursed markets and prepare to leverage Sparta to unlock broader reimbursement, increase awareness, and expand access in those markets that so far have limited treatment for Alpha-1 patients. In addition, we will continue to drive our launch uptake with fibrinogen in Germany and Austria as the two leading markets for the targeted treatment of acquired fibrinogen deficiency. So, stepping back, what you see is a disciplined and differentiated portfolio strategy to drive value. Drawing IG, where we have leadership and value, balancing and optimizing albumin across markets, and positioning alpha-1 and specialty proteins for continued growth. But value creation is not just about where we compete, it is also about how we source and produce our therapies, which is where plasma becomes a critical enabler of our model. Turning to slide 11. What we are doing in plasma sourcing is not incremental. It is a structural shift, both for Griffles and for the industry, and a core pillar of our margin expansion. Historically, the industry has operated with a structural imbalance. The US has been the primary source of plasma for the world, and a significant portion of that volume has been used to supply markets outside the US. Given that the US is a high-cost source of plasma, exporting that cost base into markets with more constrained pricing creates a mismatch between cost and revenues. At the same time, the high reliance on US plasma adds structural risk, particularly in a geopolitical environment that is increasingly favoring local self-sufficiency. What we are doing now is fundamentally changing that equation. Over the last years, we already increased ex-US collections with growth in our European centers and our self-sufficiency partnership in Canada. But following the EMA approval of Egypt Source Plasma in December 2025, as part of our self-sufficiency partnership in Egypt, we are now adding a third, scalable ex-US plasma sourcing platform. We are on track to collect around 1 million liters in Egypt this year, scaling to about 3 million liters by 2029. Together, this allows us to meaningfully rebalance our sourcing footprint. Where today, roughly 25% of U.S. plasma is needed to support demand outside the U.S., by 2029, we expect plasma volume sourced ex-U.S. to increase roughly two and a half fold, sufficient to supply our European and rest of world demand. This allows us to significantly reduce the need to use high-cost U.S. plasma for lower-priced markets over time. Instead, we move towards a two-system model. US Plasma will be primarily serving the US market where demand and value are highest and where focus will unlock further opportunities to optimize our CPL and operations. And XUS Plasma will be sufficient to supply XUS markets aligned with local economics and benefiting from XSIG in context of our self-sufficiency partnership with Egypt. This unique, geographically differentiated and vertically integrated approach unlocks two major benefits. First, cost and margin optimization. By aligning our sourcing with market pricing, we structurally improve profitability. And second, resilience and supply security, reducing dependence on a single geography with the potential to mitigate policy, tariffs, and regulatory risks. So to be very clear, this is not just about expanding plasma collection. We are fundamentally redesigning how plasma is sourced and allocated globally, creating a more efficient, more resilient, and structurally more profitable model. Let me close on slide 12 with how to think about our U.S. biopharma business, where Griffiths has, over the last decades, with foresight, built a unique, fully vertically integrated local-for-local value chain. Starting with the market, the U.S. is the largest and most attractive IT market globally, exceeding $20 billion, with continued strong demand for our therapies and a system that values plasma-derived medicines. This provides a strong foundation for continued growth, supported by increasing diagnosis and still high unmet need across our therapeutic areas. Looking at our model, as we have discussed in our previous call, our unique approach in the U.S. offers resilience and focus. Griffith is the only scale company with an established, fully integrated end-to-end presence in this key market, spanning everything from plasma collection to manufacturing and commercialization in the U.S. for the U.S. In the current political environment, this closed-loop system is increasingly recognized as a strategic asset, providing supply security and operational resilience. At the same time, it gives us greater control and visibility across the value chain, allowing us to better align plasma collection, capacity utilization, and commercial execution as our global sourcing model evolves. Lastly, looking at productivity, our local-for-local approach increases focus and allows us to drive efficiencies across our operations in the US. On the collection side, we are increasing plasma collections per donor site, which allows us to optimize our footprint. The recent closure of 29 underperforming donor centers with partial consolidation into higher performing locations reflects a disciplined approach to optimizing our cost space and network quality, all while still enabling an increase in our annual plasma collections in the US. On the industrial side, our facilities in California and North Carolina represent the largest fractionation and purification capacity in the US and are well positioned to support local demand growth. Importantly, Following prior investments, we are now able to capture this growth largely within our existing capacity without significant incremental capital. And lastly, looking at our supply chain, our local-for-local approach allows us to further optimize our working capital cycle across markets. Bringing these elements together, market, vertical integration, and productivity allows us to drive value for biopharma. With that, I will hand it over to Rahul to walk us through the financials.

speaker
Rahul Isrubinabhasan
Chief Financial Officer

Thank you, Roland. On slide 14, we summarized the financial highlights for Q126. As Nacho and Roland highlighted, our Q1 performance is entirely in line with our plans and expectations for the full year, notwithstanding the complex geopolitical and macroeconomic backdrop. Before I go into the financial performance, I'd like to highlight a couple of points. Firstly, it's great to see the strong execution across the board by the entire team, and in particular the resilience in Biopharma driven by the continued strength in our immuno-global franchise. Second, please keep in mind that Q126 relative performance compares to a Q125 that was our best Q1 in history, a record performance that also benefited at the time from some phasing and a stronger U.S. dollar. And finally, we have considerably de-risked our balance sheet since our last update, and I will elaborate on that later in the presentation. Moving on to the financial highlights in Q126. We achieved reported revenues of 1.7 billion euros, representing a 3.3% growth at constant currency, with our biopharma division growing considerably faster than that, and I will touch on the performance of the other segments on the following page. With regards to the reported gross margin, consistent with our assurances during the full-year call at the end of Feb, our gross margin has improved by 180 basis points, compared to the gross margin in Q4-25, taking into account the pricing concession offered in Q3 and Q4 last year, to support our joint efforts with our strategic partner to navigate the albumen market in China, as well as the gross-to-net adjustments for full-year 2025 being applied entirely in Q4-25. In this regard, the gross margin comparison to Q1-25 is therefore less relevant. Other aspects impacting comparability to Q1-25 include the dissolution of the joint business with Quidel Oracle, buy test strong sales growth in Q126 as operational enhancement progresses during the course of the year, and general phasing across the Griffles Group in 2026, where we expect Q3 and Q4 to be our strongest quarters, partially aided by the ramping up of our plasma collections in Egypt during the course of the year. As per my guidance at the time of our full year call, the full year reported gross margin for 2025 of 38% is the right benchmark for 2026, and a portion of the adjusted EBITDA margin improvement being targeted in 2026 is expected to also flow through gross margin. Adjusted EBITDA stood at €381 million, up 0.8% at constant currency, maintaining a margin of 22.4%. in line with our record Q125 performance last year and supported by continued OPEX discipline. From an FX perspective, the depreciating US dollar had a translation impact during the quarter, with EURUSD moving from an average of 1.04 in Q125 to 1.18 in Q126. Consistent with our prior guidance, a weaker US dollar has the greatest impact on revenues, And the impact diminishes as we go down the P&L with EBITDA less impacted than sales and impact on group profit being broadly neutral. In this regard, it is great to see the 22% growth in our bottom line group profit for the quarter to 73 million euros. Free cash flow for the quarter was negative 8 million euros, reflecting the usual free cash flow seasonality of the business and a 30 million improvement in free cash flow compared to Q125. And there are some aspects that I will clarify further in the free cash flow slide later. Turning to leverage and liquidity, our balance sheet is in a significantly improved position. We continue to make steady progress on deleveraging, with total net leverage improving to 4.3 times a reduction of 0.2 turns year-on-year, and liquidity remains very strong. More on that a bit later. Slide 15. As you will see on this slide, the biopharma business continues its strong top-line momentum with a 6.8% growth in constant currency turns. As Roland highlighted, this was driven by continued momentum in our immunoglobulin franchise, which remains the co-driver of growth. In diagnostics, if we were to isolate the termination of the joint business with Quidel-Alpo, diagnostics revenues, in fact, grew at a low single-digit rate on a like-for-like basis in the quarter, consistent with prior years. Reported performance reflects the impact of the dissolution of the joint business, as previously discussed. The dissolution agreement includes a $65 million compensation to Griffles for, amongst other things, cost absorption at Griffles, to be received in free payments across 2026, 2027, and 2028. Critically and very positively, the dissolution paves the way for Griffles to pursue its strategic aspirations in the immunoassay donor screening and clinical diagnostics markets over time with the development of the ASAD platform. Within bias supplies and others, lower revenues in the quarter reflect phasing effects of a segment impacted by timings, of individual contracts and dispatching of sales, all products, and we expect a catch up during the course of the year, particularly in Q3 and Q4 this year. Looking ahead, we remain focused on executing the various building blocks of our plan for 2026 as outlined by Nacho, which I will elaborate on in the following slide. Slide 16. As I said earlier, when we consider the relative Q126 adjusted EBITDA performance to Q125, please remember the Q125 represented our best Q1 adjusted EBITDA performance in history that benefited at the time from some phasing-related momentum. So for us to be able to emulate that performance in Q126 on a constant currency basis demonstrates the resilience of the business led by a continued adjusted EBITDA momentum in biopharma. and this momentum in biopharma EBITDA despite the fuller impact of the China albumin pricing concession in H2 last year. Yes, U.S. dollar weakening continues to impact the absolute EBITDA levels, broadly consistent with the sensitivity analysis we discussed last year. Some of that biopharma momentum has been offset due to very specific and mostly temporary reasons in other segments. In diagnostics, for example, the dissolution of the joint business with Quidel Alto is a temporary headwind from a revenues perspective. However, it completely frees us to pursue our strategic aspirations in the immunoassay donor screening and clinical diagnostics markets, and the compensation payments over the next three years will mitigate EBITDA impact. As we look at the drivers of adjusted EBITDA growth and margin improvement in 2026, as Nacho said at the start of the presentation, it will be driven by each of the following. Number one, biopharma product mix. Whilst the full year impact of H225 China albumin pricing concession will weigh on H126 comparison to H125, the combination of A, the strong and continuing momentum in IVIG, B, you heard Roland's confidence about strong double-digit growth in sub-Q from a growing and higher base. And finally, C, the expectations for Alpha-1 and other proteins growth in 2026 will support EBITDA growth and margin improvement. In addition, for example, the diagnostic segment, the compensation payment in respect of the dissolution of the joint business will also help. Number two, the game-changing impact of the EMA approval for Egyptian source plasma will support balanced LAS-LETE-REPA-DA growth as well as contributing to margin improvement. And it will also help to unlock point three, the global plasma sourcing footprint optimization opportunity that resulted in the closure of our weakest performing centers in the U.S. that will drive cost efficiencies and lower CPL. Number four, the team is making progress with providing biotests essential support to help with this operational and financial turnaround. And finally, number five, our focus on OPEX discipline is delivering results with operating expenses reduced by 7.7% at constant currency versus Q1 last year. We will continue to stay vigilant and cost-conscious across the entire organization. We look forward to updating the market with our progress in the coming quarters. Slide 17 on free cash flow. In the first quarter of 2026, free cash flow pre-M&A was negative 8 million euros. Whilst adjusted EBITDA is negatively impacted by a depreciating US dollar, the impact on free cash flow pre-M&A remains broadly neutral. You will notice a considerable investment in inventories in this quarter to support the continuing strong demand for our medicines. We have balanced that investment in inventories by continuing to manage our working capital diligently. The reduction in CAPEX is consistent with our year-end financial disclosure and our discussions with our auditors where the final payment in Q126 in respect of Immunotech that was made to JP Morgan was classified as a repayment of financial liability and hence flows through financing activities. Notably, our cash interest in Q126 compares favorably to Q125 and I will elaborate further on this in the next slide. And finally, the increase in others was primarily due to the timing of our first 2025 IRA payment that was made in April 25. In conclusion, our free cash flow trajectory is progressing as planned in 2026, aligned with the typical seasonal patterns of the business, and we remain confident about delivering on our full year guidance. Finally, turning to slide 18. I want to highlight the significant strides we have made in strengthening our capital structure and enhancing our financial flexibility. We have materially reshaped our debt maturity profile through the successful and proactive refinancing earlier this year of all our 2027 maturities whilst effectively navigating highly dynamic capital markets currently due to events in the Middle East. Now, our next set of maturities are not until Q428. effectively eliminating any near-term refinancing risk. The refinancing was upsized significantly in market, demonstrating once again the strong institutional support Griffiths benefits from in the credit markets. The strong investor demand from global institutional investors and banks enabled us to deliver key structural improvements despite the challenged market backdrop. We more than doubled our revolving credit facility from approximately $940 million to over $2 billion today. while extending its maturity to six and a half years. And the revolver now benefits from three margin ratchet step downs that are leverage-based. Both tranches of the institutional TLB were upsized significantly in market. Both tranches also benefiting from leverage-based margin ratchet step downs. You may have noticed that we have made a number of changes with regards to the approach we take with our capital structure. By right-sizing our revolver, we now benefit from very robust liquidity levels, allowing us to use surplus cash to reduce gross indebtedness with the 500 million partial redemption of the 7.5% bonds. We have also considerably reduced our factoring activity levels all year round. Both these actions help us to be more efficient with our cash interest levels. Despite refinancing our cheapest debt in our capital structure this year, something analysts and investors were very focused on, we are now still targeting cash interest levels in 2026 to be at or below 2025 cash interest levels. And it is great to see these actions being recognized positively by all three rating agencies with a substantial re-rating of our credit profile in a short period of time and with two out of three agencies upgrading us back into the BBB space. Long story short, our capital structure is in a considerably better place. Of course, we will continue to focus on deleveraging. Finally, following the reinstatement of our dividend policy in 2025, the upcoming AGM will consider the approval of the final 2025 cash dividend. The considerably improved capital structure position, whilst continuing on our deleveraging part, also supports some capital allocation optionality, including the potential use of share buybacks, as part of our capital allocation toolkit, can be considered in due course to drive shareholder value as and when best determined by the board. With that, let me hand it back to Nacho to conclude the presentation.

speaker
Nat Shabia
Chief Executive Officer

Thank you, Rahul. I would like to conclude today's presentations with a few final remarks. Our first quarter performance confirms that we are on track to deliver our 2026 objectives. With biopharma continuing to lead our growth, driven by the strength of our immunoglobulin franchise and consistent and disciplined execution across key markets. At the same time, we are advancing a key strategic priority, the optimization of our global plasma footprint. The progress we are making in Egypt is essentially important, as it drives a structural improvement in cost per liter while further strengthening the resilience and security of our plasma supply. Additionally, increased plasma supply from Egypt to Europe will progressively reduce U.S. plasma exports, supporting margin expansion over time. In parallel, we've taken decisive steps to strengthen our financial position, including the successful refinancing of our 2027 maturities, which enhances liquidity and reduces our cash financial expenses. This reinforces a clear and disciplined path towards the leverage. Collectively, These actions are building a stronger, more efficient, more disciplined, and increasingly cash-generated business, positioning us well for the remainder of the year and beyond. As we move forward, our focus remains clear, delivering on our commitments, further strengthening our financial profile, and unlocking the full value of Grifols. Thank you again for your continued support. We look forward to updating you on our progress in the quarters ahead. With that, Danny, please back to you.

speaker
Dani Segara
Head of Investor Relations and Sustainability

Thank you, Nacho. Now let's turn to the Q&A session. Please remember to press star 5 to ask a question. We need to place a limit of two questions per analyst, but if you have follow-ups, please dial star 5 again to get back on the list. Today our first question is coming from Charles Pittman from Berkeley. Charles, please.

speaker
Charles

Hi, guys. Thanks very much for taking my questions. Two from me, please. Just firstly on the Alpha-1 specialty decline in 1Q, just noting that last year you reported a 1% organic growth and then 2.3% on the like-to-like basis that you introduced. I'm wondering if you can quantify the size of this phasing benefit that you're referring that really drove this reported 7% decline. I wonder if you can commit to low or mid-single-digit growth for the division. Then just secondly, I'm hoping you can provide a bit more insight into the current US IG market share dynamics. given a competitor yesterday flagged challenging commercial backdrop and a spike in raw material, plasma, and finished products, creating an aggressive pricing environment. Just noting that your target is to grow in line with market and not drive further price erosion. I'm just wondering what you're seeing on this and how your launch of Emugo has been shifting your market share. Thank you.

speaker
Roland Vandeler
President of BioPharma

Charles, thank you for these questions. On Alpha 1 and specialty, yes, we can confirm that we expect a low to mid-single-digit growth for the full year. And, you know, in terms of the different components that add to the phasing, we don't provide that granularity. But, you know, as we tried to explain in the remarks today, this category is made up of different parts, Alpha 1, fiber and sealant, contact manufacturing, Factor 8. And what we saw this quarter is basically a comparison year over year in each one of them that added up and led to this result. But we're very encouraged by the underlying drivers in Alpha 1, the growth that we saw in new patient referrals. Yes, we had to work through some headwinds in terms of re-off period earlier in the year, but we saw patients come through in February and March and obviously continue to work on that. So as I said, we confirm that we are looking at growing that category year over year. And on the USIG part, we are very encouraged by the underlying demand that we continue to see for Gamonix and for Xentify in this market, which reflects the reception of the product. We have a high share of branded scripts, as well as the ability of our team and the focus of our team in the US. The market in itself is not a material change for our part. It's a competitive market, that's true. But it's a market that has very strong fundamentals. We see demand and patience treated continuing to grow. We see it's a rational market largely. It's one where in some segments we're able to adjust price. And we're very disciplined in our own approach to competing in this market. So from our side... This remains our key focus market, and we expect to grow with the market throughout the year. As you saw, we have Q1 growth above the market, if you want. So expect this to normalize throughout the year and get more in line with market growth. At the same time, the strong momentum that we see allows us to be selective on where we can titrate back in lower margin accounts or lower margin countries. So we believe that we start from a strength base when it comes to IGP.

speaker
Dani Segara
Head of Investor Relations and Sustainability

Thank you so much, Roland. Thank you, Charles, for your question. Now we would like to get questions from Santander, from Jaime Escribano. Jaime, please. Jaime, thank you.

speaker
Santander

Yes, a couple of questions from my side. The first one, would be regarding the announcement of the potential spin-off or IPO of the U.S. plasma business. If you can tell us a little bit there, rationale, potential timing, what you're thinking about some of the passions. You only did the release and this is the first time that you have the opportunity to maybe speak to the market. It would be great to to have your views. And the second one is HEMA and BPC in the capital markets day, you said the 2026, 2027 as potential years to buy in these two. What are the next steps or what do you have in mind with this regard? Thank you very much.

speaker
Nat Shabia
Chief Executive Officer

Thank you, Jaime. As I mentioned at the beginning of my presentation, so at this stage we are in the initial phases of the consideration of the potential IPO, and therefore there is no further information we can comment on at this time. We will provide updates as when necessary, remaining in full compliance with applicable laws and regulations. So please, at this point, we cannot answer any questions regarding that topic. As for HEMA VPC, Raúl?

speaker
Rahul Isrubinabhasan
Chief Financial Officer

Yeah, HEMA, VPC, Jaime, no change. We continue to look at the 2026-2027 timeframe. You will recall we had talked about funding those buybacks through Free Cash for Generation. As you will have seen, we recently announced the redemption of our 500 million Euro of 7.5% bonds using surplus cash. So all of that is tracking as normal. But in terms of timing, it still remains in the 2026 to 2027 timeframe, Jaime, no change.

speaker
Dani Segara
Head of Investor Relations and Sustainability

Thank you so much. Now let's move to the next question from Morgan Stanley. Thibault, please.

speaker
spk09

Thank you very much. My first question is just on albumin in China, if you could help us understand better the shape for this year. So you talked about the price impact that started in the middle of 25, so presumably after washing out in mid-26. But is there any other elements to help us understand what's happening on that market in terms of volume in terms of competition and so basically what to expect from the second half of this year. Can this market go back to growth in China or should we expect the market to remain challenged a bit longer than mid-26th? And then just one question on the OPEX this quarter. I mean, definitely lower. Can you give us more color on where you're finding the savings, you know, where you managed to sort of lower the cost and sort of, you know, how much can you drive these initiatives going forward? Thank you. Okay.

speaker
Dani Segara
Head of Investor Relations and Sustainability

The first question is going to be Roland and probably Nacho and then also Rahul. We'll tackle the OPEX question. Roland, please.

speaker
Roland Vandeler
President of BioPharma

Yeah, Thibault. On China, if we take a step back, what we see happening in China is, on the one hand, continued underlying demand from patients and physicians that want to get albumin, meeting overlay of government pressures. And what this resulted in last year is a stagnation of the market, a flattening of the market, and pricing pressures. And as mentioned before, and as you stated, we adjusted our prices mid-year. We are, you know, in this market where we also see inventories across the market be relatively high, our main focus is on pull-through on demand and cost and demand. And what we see there is that the Q1 this year is trending higher than last year, which is a positive. We also see that pricing in hospital is stabilizing, which is a positive. So we're cautiously optimistic that from here we can build. Having said that, there's more work to be done. But at the same time, the market fundamentals, the aging pyramid in China all point towards continued demand for albumin and we believe that with Shanghai Ross we're well positioned to compete in this market as it will return to grow over the next years. Having said that, I want to leave clear that China is not our only heart that we have here. We see room to grow in other markets outside of China and we're pleased to see the momentum there. And we also see that we have in the U.S. a differentiated offering with our bags where we're adding capacity in 2027. And on top of that, as we explained in the last call, with our plasma sourcing in Egypt, where there's a strong local demand for albumin and there's an excess IG that can be used in Europe, we believe that we have the pieces in place that will enable us to balance IG and albumin growth over time.

speaker
Rahul Isrubinabhasan
Chief Financial Officer

And on OpEx FIBO, it's mainly just better and more efficiently and more diligently run across SG&A. R&D is broadly flat, so we continue to prioritize our R&D spend, but it is just being more efficient. on the SG&A front across the board. So we'll continue to look at that. Clearly, we've made a lot of progress over the last year or two, but I think from our standpoint, we still see further opportunities to do better, and it'll just be a case of head down and diligent execution, so we'll see.

speaker
Dani Segara
Head of Investor Relations and Sustainability

Okay, thank you so much, Rahul. Thank you so much, Debo. Now, I mean, we will take a question from Charlie Haywood from Bank of America.

speaker
Charlie Haywood

Hi, Charlie Haywood, Bank of America. Thanks for taking the questions. I have two, please. The first is just on the planned US IPO or potential planned US IPO. From your CMV, I think 13 months before the IPO announcement, I think you outlined a fairly clear sort of five- and ten-year view of cripples that obviously didn't include a potential IPO. So could you just help us understand what's changed in the last 13 months to prompt a decision to act on this? Is there any different view on leverage, financial structure, anything on those lines that prompted that decision? And then the second one is just sort of, I guess, the IPO adds potential complexity to your structure. You know, you've obviously got the human VPC, which you have a plan on. Your A versus B shares, you previously outlined, potential diagnostics, exit. So how do you balance all of these sort of increasing complexity for gristles versus the option to add the IPO as another layer on top, and then any update on the A versus B collapse alongside central IPO or other routes to simplification? Thank you.

speaker
Rahul Isrubinabhasan
Chief Financial Officer

Yeah, look, I think on US IPO, again, we're somewhat constrained as we talk about that topic going forward. But your question is much more around is there a capital structure issue or is there a balance sheet issue? No, absolutely not. You've seen the progress that we've made on the balance sheet front. There is absolutely no issues there. We will continue on our deleveraging path. you know, as you think about the status quo. At the end of the day, this is really about trying to see if there are aspects that we can consider to accelerate or maximize shareholder value. So that's something that we will continue to consider and update as and when there is an update to provide. On HEMA, BPC, and, you know, and I think you talked about complexity, Absolutely right. The focus is to simplify. And HEMA BPC, we do intend, as I mentioned to Jaime's question earlier, we do intend to exercise the option during 26 or 27. And we're keeping very much to the same parameters that we set out at the time of our capital markets day, around it being funded through free cash flow generation, not adding to gross debt to the extent that we're able to do that. And so we're sticking diligently to the plan that we set out. So no real change, and there's nothing hidden from a balance sheet perspective. This is all about trying to ensure that we, you know, optimize, maximize shareholder value if we see an opportunity to do that. So I'll leave it at that, Charlie.

speaker
Dani Segara
Head of Investor Relations and Sustainability

Thank you so much, Rahul. Thank you so much. Charlie now is the turn of Guilherme from Cash On Bank. Guilherme, please.

speaker
Charlie

Yes. Good afternoon. Thank you for taking my questions. So the first one regarding margins. Would you be able to quantify the potential saving expectations from the U.S. donor center optimization? Or on top of this, any indication on the contribution of the plasma sourcing redesign to the 450 BFs margin improvement target by 2029. And the second question is regarding diagnostics. So you've communicated to Capital Market today an expectation to deliver a 5% annual growth until 2029. You mentioned at that time that it was going to be back-end loaded, but you're now mentioning a low single-digit expansion, if I understood correctly, until 2027. But you have also the Barcelona platform launched later this year. Are you still confident with these 5% growth until 2029? Thank you.

speaker
Nat Shabia
Chief Executive Officer

So let me take the one on diagnostic first, and Rahul will comment on the margins. On diagnostics, yes, we are still confident with our plan. I think that what is most promising within that business is the fact that the development of the three platforms, which is quite unique and important, I mean, the serology, the blood typing, and the molecular platforms, are progressing very well and really under our expectations. The first launch is going to be Barcelona this year, and that is going to start building on additional revenues already in 2027, and certainly more to come as we progress. So we are very optimistic about our diagnostic business. It's true that the solution of the joint business is going to present some headwinds this year, but certainly more focus on the revenue or EBITDA, while cash flow-wise we'll continue delivering a very high profile. And most important, as I say, our developments on the R&D side are moving along very well and as expected, and we expect to generate very significant revenues from it as the capital markets they plan for the next five years will advance.

speaker
Rahul Isrubinabhasan
Chief Financial Officer

The margins, Prabhu, do you want to comment? Closure of centers, Jeremy, you're absolutely right that it will contribute to margin improvement. What we haven't done is separate the margin improvement between each of our drivers, whether it's biopharma product mix, segmental mix, the impact of Egypt sourcing, the footprint optimization, biotest. There are a whole bunch of drivers, but no question, that as you think about the scale of what we've talked about, we see a considerable opportunity to optimize our CPL, and it will contribute to margin improvement. We're just not separating out what that impact would be factor by factor.

speaker
Nat Shabia
Chief Executive Officer

And I would add that from an operational efficiency perspective, I think this is certainly... one of the big contributors as well to our OPEX management in the last years, which has been clearly showing efficiencies in many places. The plasma, the donor centers are a key part of that. It's a significant cost and it goes to the cost per liter. And we are continuously working to make generating efficiency in that area. The closing of these centers, that obviously were centers that were the less performing centers, Obviously, it certainly will help to continue decreasing the cost per liter in the U.S. And as I explained by Ron in his part of the presentation, I mean, step by step, we will transfer the needs of the European plasma sources from the U.S. to our resources, and all that will benefit on optimizing cost per liter all over the world. So I think that while we don't disclose the specific details, I think that our margin expansion is composed to many, many levers. and all of them are contributing to that.

speaker
Dani Segara
Head of Investor Relations and Sustainability

Thank you so much, Nacho. Let's move to the next question. It is coming from Justin Smith from Burstein.

speaker
Justin Smith

Thanks very much. One for Rahul, if possible. Just on the buybacks, if we get to that point, do you want us to think about that more as a perspective of increasing more tax-efficient returns to certain shareholders, or is it more about sort of a ROIC versus WAC equation, or is it a combination of both?

speaker
Rahul Isrubinabhasan
Chief Financial Officer

Yeah, look, I think at the end of the day, it's just a comparison or judgment on intrinsic value, balance sheet capacity, and timing. You know, at the end of the day, this is a judgment that will be made by the board as and when is right. We talked about this as part of our toolkit yesterday, even when we spoke about capital markets they planned 15 months ago, and all I'm saying is with the balance sheet in a considerably better place, this is capital allocation optionality that may be considered by the board as and when it deems fit. That's the only point for the moment, Justin.

speaker
Dani Segara
Head of Investor Relations and Sustainability

Thank you so much, Rahul. We are close to the hour, but we have a second set of questions from Charles Bidman from Barclays. Charles, please.

speaker
Charles

Hi, guys. Thanks very much. Just very briefly wondering if you could give us a quick update on the progress for the 2Q26 facility launch in fibrinogen and whether you have an updated timeline for the acquired form of the disease. And if there's any time to comment, just your thoughts on the CIDP market following anti-SCRNs remaining confident they can move into early lines. Thank you.

speaker
Roland Vandeler
President of BioPharma

Yeah, looking at the facility of Profibri launch outside of the U.S. In Germany, we launched last year. We're very pleased with the early feedback we received in Germany and in Austria, where physicians highly appreciate the room temperature storage and the ease and speed of reconstitution, as well as the speed of infusion. So pleased with the progress there, ex-U.S., in the U.S., We're ramping up, have the team in place for a launch later this quarter, and we're excited about that. At the moment, focusing on contentable for beginners and efficiency, as you know. But, you know, in parallel advancing our trial for AFD, we will share timelines as we have this more in place. But just recall that as we look at the U.S., that market today, has a size of about $50 million. The potential is to $800 million. We believe that this AFD trial will be with our design helping to make that change of standard of care happen that is required in this market. And so we believe that we're in a position to effectively launch now. We look forward to it. And we'll then over time build in this market and believe that we can capture a significant share of the potential over time. In terms of CIDP, you know, we continue to see growth in CIDP at this moment in time. As you know, we now have more than one and a half years of the FCRNs in the market. It showed that IDIG, and in general, It's very well suited for this multiviral disease. So as we look at new competitors possibly entering, we know that we have a treatment in place that treats different parts of the disease mechanisms in the ATP and therefore remain confident. That's what we hear back from physicians at this moment. But at this moment, we continue to see growth.

speaker
Dani Segara
Head of Investor Relations and Sustainability

Thank you so much, Roland. We are going to squeeze Jaime from Santander. Jaime, the very last one, please.

speaker
Santander

Yeah, hi. Super quick question. We never talk about biosupplies, but because it was a particularly weak this quarter, just if you can provide a little bit of outlook for the following quarters. Thanks.

speaker
Nat Shabia
Chief Executive Officer

Yeah, I mean, we normally don't provide much of this in biosupplies. Biosupplies is a business which is characterized for one-spot deals, and it might have a very significant variance to the year. I think it's in a way is a business that without existing probably we would miss those opportunities in the markets, but we know as well that it's very difficult to plan and forecast that, as I say, because of these spot deals that are generated through the year. We are confident and we are working on a number of those deals that we hope that will materialize through the year. But it will be difficult to anticipate at this point how many of them will be in 2026 versus 2027. So I think that we will provide updates as things will happen. Thank you, Jaime.

speaker
Dani Segara
Head of Investor Relations and Sustainability

Thank you so much, Nacho. That was the last question for today. Thank you so much for having us and for your support. Thank you.

Disclaimer

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