Danielle Antalffy

Danielle Antalffy from UBS asked for a high-level assessment of Enovis's portfolio, focusing on product breadth, competitive positioning, and areas needing improved execution or product gap filling, inquiring about organic versus inorganic strategies. She also questioned the sustainability of the PNR portfolio's mid to high single-digit growth for 50% of its products and the potential for further portfolio shaping.

Answer

Damien McDonald (CEO) emphasized opportunities in commercial execution and a rich new product introduction pipeline, adopting a 'singles and doubles' approach. He reiterated debt reduction as the primary capital allocation priority, limiting inorganic moves to 'generational opportunities.' For PNR, he discussed continued portfolio shaping, geographic expansion, and new product launches like Manafuse, with Ben Berry (CFO) adding that PNR growth is crucial for achieving consistent high single-digit overall growth.

Danielle Antalffy inquired about the extent of the market development component, asking how much of a 'heavy lift' market education is and its role in the procedure volume bridge and long-term plan. She also asked about the potential for Aquablation to be performed in an ASC setting as part of the long-term plan and for an update on the company's model for covering cases.

Answer

President and CEO Larry Wood stated that historically, the company focused on system placement and training, with minimal marketing or awareness efforts. He highlighted the need for fundamental work to articulate Aquablation's value proposition to patients (e.g., on WebMD, social media, comparisons), describing it as a continuous build rather than a quick fix. He confirmed that the ASC setting is part of the long-term plan, though not a near-term focus. Mr. Wood also mentioned that an update on how the case coverage model will evolve over time to improve efficiency will be provided at tomorrow's Investor Day.

Danielle Antalffy asked about the 'heavy lift' of market development and patient education, its role in the procedure volume bridge and long-term plan, and the potential for Aquablation procedures in Ambulatory Surgical Centers (ASCs) as part of the long-term strategy.

Answer

Larry Wood, Chief Executive Officer, noted that historically, the company focused on system placement and procedure execution, but 'none of that work was done' for marketing, awareness, or value proposition to patients. He emphasized that basic fundamental work, such as improving online presence and making the value proposition case, is a 'continual build' but can be done quickly to make a difference, with a significant focus at tomorrow's Investor Day. Mr. Wood confirmed that ASCs will 'certainly' be part of the long-term plan, though not a near-term focus. He also mentioned updates on evolving models for case coverage to improve efficiency.

Danielle Antalffy inquired about the levers driving Tandem's improved leverage and profitability in the recent quarter and going forward into 2026 and the next few years, specifically mentioning the role of pharmacy pricing and higher average selling prices (ASPs).

Answer

EVP and CFO Leigh Vosseller identified pricing, particularly from the pay-as-you-go model, as a major lever for revenue growth and profitability in the coming years. She also highlighted product cost reduction initiatives, noting that Mobi's manufacturing cost is 10-15% lower than t:slim, and its cartridges will be 20% or more lower. Vosseller emphasized that new products are designed with better margin profiles, and the company continuously seeks efficiencies in its infrastructure to reduce the need for future headcount growth.

Danielle Antalffy inquired about the specific levers driving leverage and margin expansion for Tandem Diabetes Care in 2026 and over the next few years, beyond the impact of pharmacy pricing.

Answer

EVP and CFO Leigh Vosseller identified pricing from the PayGo model as a primary lever. She also highlighted product cost reduction initiatives, particularly with Mobi, which has a 10%-15% lower manufacturing cost than t:slim, and cartridges with a 20% or greater cost reduction. She emphasized that new products are designed with improved margin profiles. Operating margin leverage is further driven by continuous efficiency improvements in infrastructure and optimizing headcount.

Danielle Antalffy asked about Insulet's competitive moat, specifically focusing on the physician office sampling program, its operational mechanics, patient training, and observed capture rates.

Answer

Ashley McEvoy (President and CEO) highlighted Insulet's evolving commercial prowess, including an expanded sales force (up 25% last year) and a messaging shift to emphasize clinical performance. She explained that Omnipod is the only AID offering that allows for in-practice sampling, which is a capital-efficient way to initiate trial and leads to strong conversion ratios due to the 'wow factor.' McEvoy also noted that DTC campaigns generate leads and new prescribers, contributing to 30,000 prescribers for Omnipod (up 28%).

Danielle Antalffy asked about Insulet's competitive moat, specifically focusing on the physician's office sampling program, how patients are trained, and the capture rates observed from this initiative.

Answer

Ashley McEvoy, President and CEO, highlighted Insulet's evolving commercial prowess, including an expanded sales force and a shift in messaging to emphasize strong clinical performance alongside differentiated technology. She described the physician's office sampling program as a capital-efficient way to initiate trial, leading to a 'wow factor' and strong conversion ratios. She also noted that direct-to-consumer (DTC) campaigns generate record leads, converting new users and prescribers, contributing to 30,000 prescribers for Omnipod, an increase of 28%.

Danielle Antalfy asked about Beta Bionics' high-level strategy for the Type 2 diabetes market, particularly concerning the go-to-market approach given that Type 2 patients are often managed differently than Type 1, ahead of a potential FDA approval for a Type 2 label.

Answer

Sean Saint, CEO, acknowledged that while endocrinologists are mature in understanding iLet's utility, a Type 2 indication will be crucial for marketing meaningfully in the primary care space, where Beta Bionics currently does not have a sales force. He emphasized awareness of the dynamic that Type 2 patients are managed differently.

Danielle Antalfy inquired about Beta Bionics' strategy for the Type 2 diabetes market, considering existing off-label iLet adoption and the different patient management landscape compared to Type 1 diabetes, ahead of potential FDA approval.

Answer

CEO Sean Saint acknowledged that while endocrinologists are mature in understanding iLet's utility, a Type 2 indication will be crucial for marketing meaningfully in the primary care space, where patient management differs.

Danielle Antalffy inquired about the shift towards standalone use for iDose TR and iStent infinite combined, and the market development efforts required to build this market, noting the significant focus observed at AAO.

Answer

Joe Gilliam, President and COO, confirmed significant investment in market transformation, including sales force incentives, marketing, medical affairs, and publications. He emphasized building on surgeon enthusiasm for interventional glaucoma to shift practice dynamics towards standalone treatment, noting substantial growth in standalone procedures for both iDose TR and iStent infinite. He reiterated the long-term goal for glaucoma procedures to eventually exceed cataract surgery.

Danielle Antalffy asked about the shift towards standalone use for the combined iDose TR and iStent infinite business and the market development efforts required to build this standalone market, noting the focus observed at AAO.

Answer

Joe Gilliam, President and COO, Glaukos, highlighted significant investments in market transformation, including sales force incentives, marketing, medical affairs, and publications, building on surgeon enthusiasm for interventional glaucoma. He reported substantial growth from standalone procedures (iDose TR and iStent infinite) and reiterated the long-term goal for U.S. glaucoma procedures to eventually exceed cataract surgery patients, driven by consistent engagement with surgeons and shifting practice dynamics.

Danielle Antalffy asked for more details on Medtronic's market development strategy for renal denervation (Symplicity), including how they are building referral networks and any directional numbers or progress updates.

Answer

Chairman and CEO Geoff Martha highlighted a significant spike in consumer demand, with website visits increasing from 50,000 to 2.5 million. He detailed market development efforts including hiring staff for referral pathways, health economics, coding, and billing, and emphasized strong patient outcomes and competitive dynamics. He also mentioned plans to build the Symplicity brand over time.

Danielle Antalffy, an Equity Research Analyst at UBS, asked for more details on Medtronic's market development strategy for renal denervation (Symplicity), including how the company is building out referral networks and if any directional numbers on progress could be shared.

Answer

Chairman and CEO Geoff Martha highlighted a significant spike in consumer demand, evidenced by a 50x increase in website visits (from 50,000 to 2.5 million). He detailed market development efforts, including hiring personnel for referral pathway building (from general practitioners to specialists), health economics, and coding/billing support for hospitals. He noted that foundational elements like broad FDA approval, strong CMS reimbursement, and favorable competitive dynamics are in place, with future plans to build the Symplicity brand.

Danielle Antalfe from UBS inquired about Dexcom's utilization trends across different patient segments, specifically how Basal and non-insulin Type 2 users might impact overall utilization rates in 2026 and beyond, and how to think about these qualitatively.

Answer

Jake Leach, President and CEO of Dexcom, detailed utilization rates: over 90% for AID users, 85-90% for Type 2 IIT and non-AID Type 1s, and 80-85% for Type 2 basal users. He noted that Type 2 non-insulin users in the registry are showing high utilization rates, similar to basal users, especially when reimbursed. Jereme Sylvain, CFO of Dexcom, advised modeling based on mix changes rather than declining utilization per cohort, emphasizing ongoing efforts to improve engagement through software updates and AI insights.

Danielle Antalffy sought clarification on whether Dexcom's preliminary 2026 guidance assumes no expanded coverage, and asked about the potential for expanded coverage in 2026 and how it would be reflected in future guidance.

Answer

Jake Leach, President and Interim CEO, clarified that the base case for the 2026 guide includes only current coverage. Jereme Sylvain, CFO, added that significant new coverage wins (e.g., non-insulin, basal, emerging markets) would be highlighted if they occur, but the base case will not incorporate them.

Danielle Antalffy followed up on 2026 guidance, seeking clarification on whether it assumes no expanded coverage, and asked about the latest thoughts on potential for expanded coverage in 2026 and how guidance will reflect it.

Answer

Jake Leach, President and Interim CEO, and Jereme Sylvain, CFO, clarified that their 2026 base case guidance will only include existing coverage across insulin and non-insulin use globally. They noted that significant new coverage wins, such as broader non-insulin or basal coverage, would be considered upside and highlighted separately if they materialize.

Danielle Antalffy asked CEO Andrew Hider for his perspective on the current state of Baxter's portfolio, identifying the most exciting and potentially underappreciated opportunities, and areas where the product portfolio could be ramped up, acknowledging the focus on deleveraging over immediate M&A.

Answer

CEO Andrew Hider highlighted Baxter's fundamental role in healthcare, market leadership, resilient portfolio, and deep customer relationships as competitive advantages. He emphasized innovation as critical, focusing on consistent 'base hits' rather than 'grand slams' to meet customer needs, and noted that the Baxter GPS system will drive disciplined operations and innovation. He expressed satisfaction with the performance in Advanced Surgery and other segments (MPT, HST, Pharma). Regarding capital allocation, Mr. Hider reiterated the priority of deleveraging, followed by reinvesting in the business (R&D at or above historical levels) and, eventually, M&A for high-value targets.

Danielle Antalffy asked Andrew Hider about his perspective on Baxter's portfolio in its totality, specifically identifying underappreciated opportunities and areas for ramping up the product portfolio, as well as the company's innovation strategy and capital allocation priorities.

Answer

President and CEO Andrew Hider highlighted Baxter's fundamental role in healthcare, market leadership, resilient portfolio, and deep customer relationships as competitive advantages. He emphasized innovation as critical, focusing on 'base hits' (constant product launches and solutions) driven by customer needs. He noted opportunities across MPT, HST, and Pharma segments. Regarding capital allocation, Hider reiterated the priority of deleveraging the balance sheet, followed by reinvesting in the business (at or above historical R&D levels for new product launches) and, eventually, value-adding M&A.

Danielle Antalffy expressed concern about managing a growing patient funnel with a potential physician bottleneck due to reimbursement issues, asking what happens to patients and if some centers might be willing to take on more patients.

Answer

Tim Herbert, Chairman and CEO, emphasized that Inspire V is a 'rock-solid product' with strong clinical evidence, driving the company's commitment to patients. He acknowledged variability in professional fee reductions with the -52 modifier but believes Inspire's experience with 10,000 Inspire V procedures in 2025 provides a strong basis to work with payers to minimize reductions. Herbert noted that facility reimbursement actually increased by $1,000 from last year, making it strong at facilities. He stated that Inspire can direct more patients to salary-based surgeons or centers where surgeons are partial owners, as they are less impacted by professional fee changes, while diligently working with private practices.

Danielle Antalffy asked about the basis for confidence in the Salesforce transition, specifically whether it stems from competitor best practices, market research, or physician feedback. She also inquired if 2027 is expected to be a year of growth acceleration compared to 2026, or if other factors should be considered.

Answer

Ivan Tornos, Chairman, President, and CEO of Zimmer Biomet, stated that the company is not discussing 2027 guidance at this time. He affirmed that confidence in the Salesforce transition is rooted in data, specifically benchmarking productivity rates against fully dedicated and specialized competitors, where Zimmer Biomet currently lags. Tornos highlighted that dedicated and specialized territories demonstrate significantly greater productivity. He emphasized the critical importance of optimizing the U.S. market, which accounts for 62-63% of revenue and over half of the company's profit, to achieve consistent mid-single-digit, and eventually upper single-digit, growth. He concluded that with current leadership, a strong new product cycle, and upcoming innovation like Monogram, now is the opportune time for this transformation, despite short-term disruption.

Danielle Antalffy asked about the lower gross and EBIT margin guidance, potential levers for leverage, and the conservatism of the outlook. She also questioned the market expansion and Total Addressable Market (TAM) increase from new laser product launches.

Answer

Yair Malca, InMode CFO, stated the guidance is conservative. Moshe Mizrahy, InMode CEO, explained that new laser products (Pico, Erbium YAG, CO2), some acquired from external companies, have inherently lower gross margins and are subject to U.S. tariffs, impacting overall margins. Mr. Mizrahy noted that while lasers are 'bread and butter' in medical aesthetics and complement InMode's RF technology, the laser market is saturated, leading to lower prices and margins.

Danielle Antalffy questioned Johnson & Johnson's long-term strategy for participating in high-growth markets. She asked if the projected 70% participation rate post-ortho separation is an aspirational peak and what other growth markets, in both Innovative Medicine and MedTech, the company plans to enter via organic or inorganic moves.

Answer

Joseph Wolk (CFO, Johnson & Johnson) stated that the aspiration is not to limit participation in high-growth markets, conservatively estimating 'at least 70%' post-ortho separation. He highlighted ongoing opportunities within MedTech (Cardiovascular, Surgery, Vision), emphasizing Ottava's unique De Novo pathway and global expansion plans. Jennifer Taubert (EVP and Worldwide Chairman of Innovative Medicine, Johnson & Johnson) listed potential future growth drivers in Innovative Medicine, including Rybrevant in head/neck/colorectal cancer, Amave in Sjögren's/SLE, atopic dermatitis assets, B-cell malignancies (BiCAR), and Milvexian (with BMS) for AFib/secondary stroke prevention.

Danielle Antalffy from UBS asked about Johnson & Johnson's "move to higher growth end markets" strategy, specifically if the 70% target for participation in such markets could increase further, and what new growth markets (in Innovative Medicine or MedTech) J&J aims to enter organically or inorganically.

Answer

CFO Joseph Wolk stated that J&J's aspiration is not to limit participation in high-growth markets, conservatively aiming for at least 70% post-ortho separation, with tremendous opportunities within Cardiovascular, Surgery, and Vision. He emphasized the potential of Ottava in surgical robotics, highlighting its unique De Novo regulatory pathway and planned global expansion. EVP and Worldwide Chairman of Innovative Medicine Jennifer Taubert added that Innovative Medicine is expanding into new areas with ongoing clinical work, including Rybrevant in head and neck/colorectal cancer, Amave in Sjögren's disease and SLE, atopic dermatitis assets, B-cell malignancies with BICAR, and Milvexian for atrial fibrillation and secondary stroke prevention.

Danielle Antalffy questioned whether the projected 75 basis points margin improvement for MedTech post-ortho spin felt conservative, given the higher-growth, higher-margin profile of the remaining cardiovascular surgery and vision businesses.

Answer

CFO Joe Wolk clarified that the 75 basis points margin improvement is a longer-term projection, and for 2025, the impact would be closer to 100 basis points. EVP, Worldwide Chairman, MedTech Tim Schmid emphasized that the separation is aimed at 'shrinking to grow faster' for MedTech, focusing on best-in-class performance in cardiovascular, surgery, and vision. Chairman and CEO Joaquin Duato reiterated the commitment to making the MedTech sector a leader in the industry.

Danielle Antalffy questioned the projected 75 basis point margin improvement for MedTech post-orthopedic spin, suggesting it might be conservative given the higher-growth, higher-margin profile of the remaining cardiovascular, surgery, and vision businesses.

Answer

CFO Joe Wolk acknowledged that the immediate impact on margins might be closer to 100 basis points, but the 75 basis point projection accounts for a longer-term view as higher-growth businesses mature. EVP, Worldwide Chairman, MedTech, Tim Schmid emphasized that the separation is about 'shrinking to grow faster' and focusing on best-in-class performance in the remaining MedTech priorities. Chairman and CEO Joaquin Duato reiterated his commitment to making MedTech the industry's best-in-class sector.

Danielle Antalffy from UBS asked about the cadence of growth in Boston Scientific's Cardiac Rhythm Management (CRM) business, which has been growing below market, especially with a competitor in a new product cycle. She sought insights into how upcoming new product launches, such as Denali and EMPOWER, are expected to impact the business's growth trajectory.

Answer

Chairman and CEO Mike Mahoney noted satisfaction with LUX ICM performance and highlighted multi-year investments in the Denali platform, a complete refresh of core pacemaker/defibrillator products launching in late H2 2026 and throughout the LRP. He also expressed enthusiasm for EMPOWER, their entry into the leadless pacemaker market, which will complement SICD. Mahoney stated that while unit growth has been at market, dollar growth has been below due to gaps in higher ASP leadless products. He is confident the CRM business will strengthen and contribute more significantly over the LRP. Chief Medical Officer Dr. Ken Stein added that EMPOWER is important for leadless and SICD growth, and the Elutia acquisition provides an important adjunctive technology. He also highlighted the generational opportunity with the implantable platform refresh and the disruptive potential of conduction system pacing technology.

Danielle Antalffy asked about the growth trend in the AtriClip business, questioning if the competitive impact had bottomed out and how centers are adopting multiple devices. She also inquired about the current market penetration of the EnCompass Clamp in CABG procedures.

Answer

CEO Michael H. Carrel attributed the accelerating AtriClip growth to broader market expansion driven by competition and innovation like the new FLEX-Mini. He noted that while some accounts use both AtriCure's and a competitor's device, no accounts have been lost. Regarding EnCompass, he estimated that penetration in cardiac surgery patients with Afib has increased to the 30-35% range, highlighting a substantial remaining growth opportunity based on global treatment guidelines.