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CFO Brian Andrews explained that the free cash flow improvement will be a 'stair step' progression each year, driven by lower CapEx, operating margin improvements, and working capital initiatives, aiming for margins closer to the historical low-20s percentage. President and CEO Al White added that some U.S. distributor inventory reduction is factored into Q4 guidance but is not expected to be an issue in fiscal 2026. He noted the Asia-Pacific e-commerce issue may persist in Q4 but should annualize thereafter.

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President & CEO Albert White projected MiSight growth of 25-30% in Q3, followed by an acceleration to over 40% in Q4 as the promotion drives fittings. He stated the myopia portfolio has good gross margins and is expected to be margin accretive long-term, though operating margins are currently lighter due to ongoing investments in commercial infrastructure.

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CEO Al White explained that the myopia sales force realignment, which is already complete, puts the product more directly into the hands of the strong traditional sales force to broaden coverage and is already showing benefits. On PARAGARD pricing, he noted that IUDs are a fully reimbursed category and the company is proceeding with an inflationary-plus price increase, suggesting confidence in its pricing power.

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CEO Al White clarified that myopia management growth is being driven by markets outside of China, which remains weak. He described progress with MiSight insurance coverage as "slow but sure." He confirmed PARAGARD is expected to be up slightly for the year, and that the stem cell storage business grew about 4% organically.

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CEO David Endicott detailed a comprehensive launch strategy for Tripteer, including a dedicated sales force and patient access programs, but was cautious on the revenue ramp pending full reimbursement, which is expected in about 18 months. He stated that data from the Vision trial is expected by the end of the year.

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Chief Executive Officer David Endicott highlighted PanOptix Pro's key feature of 50% less light scatter to reduce halos and glare, expressing confidence in its uptake while declining to comment on competitors. For Acultroman, he anticipates a launch late in the third quarter of 2025, with related investments, such as an expanded sales force, already factored into the company's guidance.

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CEO David Endicott acknowledged that while the U.S. AT-IOL market saw slight growth, competitive trialing and sampling created noise in the data. He noted that Alcon's overall AT-IOL share growth was driven by international markets, with a slight, expected share loss in the U.S. CFO Tim Stonesifer added that operating margin expansion would likely begin in the second half of Q2 2025, as Q1 faces tough comparisons and significant investment pressures for new launches.

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CEO David Endicott stated that Hydrus is performing well with double-digit growth and that the BELKIN DSLT product is expected to launch in Q1 2025. He clarified the pipeline product was likely a reformulation of Rocklatan. Regarding procedures, Endicott attributed the low-single-digit growth to softness in the U.S. market during the quarter, noting that international markets were stable and that such fluctuations tend to even out over time.

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President & CEO Keith Pfeil explained that the gross profit expansion is a year-three benefit of the NuVasive deal, with benefits expected to materialize in 2026 as lower-cost inventory flows through the P&L. SVP & CFO Kyle Kline added that the Nevro business, with a similar margin profile, will be a subsequent focus. Regarding cross-selling, Pfeil confirmed they are actively and successfully selling robots to legacy NuVasive accounts, aided by the availability of the Reline system on the robotic platform.

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COO and CFO Keith Pfeil stated they are in the early stages of Nevro integration and will 'aggressively' target OpEx reduction in 2025. CEO Dan Scavilla reported that the ePlex order book is building well and expects to enter the market in Q2, with implant pull-through ramping up in subsequent quarters.

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CFO Keith Pfeil stated that gross margin improvement in 2025 will be modest, with more significant expansion expected in 2026 as in-sourcing benefits are realized. He noted that increased R&D spending reflects continued investment across the portfolio to maintain new product cadence. CEO Dan Scavilla declined to detail future product plans related to Nevro's technology, stating it is a long-term strategy.

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COO & CFO Keith Pfeil reiterated that the company remains positive but appropriately conservative in its guidance and noted he did not reference the $150 million dis-synergy figure as it becomes part of normal business risk over time. President & CEO Dan Scavilla commented that both the base trauma and NuVasive specialty orthopedic businesses are growing well with high double-digit uptake but did not provide a specific revenue contribution.

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CEO Dan Scavilla explained that he was drawn by the opportunity to apply his operational and execution experience to accelerate the company's progress. CFO Matt Garth detailed that premium implants declined about 5% due to product transitions, while value implants fell by low-double digits because of production volatility in the Middle East. He noted that the lab business was a key driver of weakness but expects full-year growth from sales force changes and China's VDP program.

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CEO Simon Campion explained that within CTS, a drop in CAD/CAM inventory was offset by a rise in imaging inventory, resulting in a net neutral impact with levels at historical averages. He acknowledged a disappointing quarter for U.S. implants, stating the company is still in a 'rebuilding phase' focused on improving the commercial team's clinical skills and customer relationships.

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CEO Simon Campion acknowledged disappointing U.S. Implants performance, outlining a plan to improve digital connectivity via DS Core, refocus clinical education to a local level, and simplify messaging. Interim CFO Herman Cueto declined to give a specific G&A benchmark but confirmed the company is over-indexed relative to industry averages, presenting a value-unlock opportunity.

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CEO Simon Campion explained that the Byte review is a complex, multifactorial assessment and could take time. He noted that the company has already ceased marketing and is redeploying assets. CFO Glenn Coleman added that Byte generated about $40 million in Q3 revenue, was dilutive to EBITDA margin, and operated at a loss in the quarter. Regarding implants, Simon Campion acknowledged a decline in the value segment and attributed underperformance to internal execution issues, which new leadership changes aim to address.

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CFO & Treasurer Robert Stefanovich indicated that Q4 is typically stronger than Q3 and highlighted significant improvements in gross margin and adjusted EBITDA. President & CEO Jerrell Shelton stated that capital deployment will be prudent and opportunistic, with a focus on share buybacks due to the stock's perceived undervaluation. He added that while M&A is not a current focus, compelling deals would be considered. Thomas Heinzen, VP of Corporate Development & IR, noted the company repurchased one million shares.

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CFO Robert Stefanovich stated that while the goal is to reach positive adjusted EBITDA 'during 2025,' the exact timing depends on the revenue ramp from the services business. Executive Jerrell Shelton confirmed there were no specific mix dynamics affecting the MVE business that he could point to.

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CFO Lawrence Lin attributed the Q4 confidence to momentum in NGS and stores, a significant C&I order that shifted from Q3, and improved on-time delivery. For fiscal 2026, he referenced the long-range plan of 5-8% CAGR. CEO John Marotta confirmed that the SMS product weakness stems from capital purchase pauses by pharma clients, not order cancellations.

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CFO Lawrence Lin stated that the 2025 quarterly revenue profile should be similar to the prior year, with second-half EBITDA acceleration driven by revenue drop-through and restructuring savings. CEO John P. Marotta addressed the SMS leadership change, confirming he is stepping in to directly run the division, which he described as the "crown jewel of the company," and is focused on driving growth by looking at its sub-segments individually.

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CFO Lawrence Lin attributed the Multiomics outlook to timing and noted Q1 EBITDA was over 10% excluding one-time costs, supporting the full-year margin expansion goal. CEO John P. Marotta added that the B Medical sale process is being accelerated by the Board's Value Creation Committee, which is focused on maximizing value, and noted there is significant inbound interest from potential buyers.

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CFO Herman Cueto explained that the 3-5% growth guidance assumes the current challenging macro environment persists, but the company remains confident in its long-term plan, including the 15-17% EBITDA margin target for fiscal 2026. He noted the FY25 margin guidance accounts for necessary investments. CEO John P. Marotta added that the guidance is focused on demonstrating improved execution and capability on the top line, an area of past struggles.

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CEO Laura Francis explained that while residents and fellows are an important long-term focus, the majority of new surgeon adds are still experienced physicians. On reimbursement, she clarified that while CMS deferred a decision on a specific DRG reassignment for Granite due to workload, it did increase related spinal fusion DRGs by 6-8%. She emphasized that they are confident in their data and view the process as administrative, while also highlighting positive outpatient reimbursement proposals as tailwinds.

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CEO Laura Francis reported that TNT adoption is ahead of internal plans and expects the proposed NTAP of over $3,900, effective in October, to be a significant tailwind. CFO Anshul Maheshwari reaffirmed the goal of achieving free cash flow in 2026, noting the asset-light model supports this. He projected operating leverage could average 1.5x to 1.75x in the coming years, allowing for continued margin expansion.

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CFO Anshul Maheshwari indicated that historically, Q1 revenue sees a high-single-digit sequential decline from Q4 due to seasonality, which will be compounded in 2025 by one less procedure day. CEO Laura Francis confirmed that an application has been submitted to reassign Granite cases to a higher-paying code and that an update is expected from CMS by mid-year, aligning with the NTAP expiration.

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Chairman & CEO Pat Miles stated that while motion preservation is a valid surgical option, ATEC's priority is to exploit its current best-in-class ecosystem. He emphasized that the company will focus on its strengths in neurophysiology, navigation, and imaging, and will let competitors pursue motion preservation for the foreseeable future.

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Executive J. Koning confirmed the old rule of thumb is outdated, pointing to much stronger recent performance. He cited a 44% drop-through rate in Q1 and 49% in the prior quarter, attributing the significant improvement to a disciplined focus on profitability and cash management that he expects will continue.

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Patrick Miles (Executive) described the engagement in Japan as being in the 'pre-game' phase. While the local team is strong and key surgeons are engaged, the effort is still in its early stages and focused on a long-term, sustainable build-out. J. Koning (Executive) clarified that international surgical revenue currently contributes between 1% and 2% of total company revenues.

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Executive Patrick Miles shared that early cases are being performed and feedback is positive, highlighting Valence's small footprint and elegant integration into the surgical workflow. He stated the company is focused on refining the system through the middle of 2025, with the expectation to discern its readiness for a broader launch at that time.

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CFO Daniel Wilson explained the slight sequential decline for Q3 (around 1%) is consistent with historical summer seasonality and reflects prudence given the newer, less predictable prescribing patterns of innovative channels. CEO Quentin Blackford added that the renewed partner program is broader than the previous targeted one and is expected to be less lumpy, but the company is waiting to observe actual prescribing patterns before fully factoring it into expectations.

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CEO Quentin Blackford attributed the strength more to the latter, noting that new account additions in Q1 were near record highs and that word-of-mouth is spreading about Zio AT's quality. He highlighted that Zio AT's average wear time of 13.8 days is superior to the 12.8-day average for competitors' MCT products, providing a better patient experience and driving adoption.

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President & COO Joe Gilliam stated that while J-code payment is becoming consistent, establishing professional fees is a volume-driven process and he hopes to have more MACs finalized by year-end. Regarding Epioxa, he noted the rollout will be complex, with the main driver of near-term disruption being patients deferring procedures to wait for the superior, non-invasive option.

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President and COO Joseph Gilliam stated that the company is methodically expanding commercial and Medicare Advantage access, with coverage policies already in place for over 50% of lives in those segments. He emphasized that the main gating item for adoption is not surgeon training capacity, which is ample, but ensuring the entire physician's office is proficient in navigating the claims and reimbursement process.

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President and COO Joseph Gilliam noted that doctors typically start slow with iDose to build reimbursement confidence before expanding utilization. CFO Alex Thurman explained that iDose remains a modest headwind to gross margin but is improving and expected to become accretive by the end of 2025. He also reaffirmed the ~10% OpEx growth target for 2024 and deferred 2025 guidance to the next call.

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CFO Alison Bauerlein clarified that about 1,000 SmartLids were sold in total, with an increasing portion under the new pricing for reimbursed claims, but did not provide a specific breakdown. CCO Matthew Link addressed competition, stating it was factored into guidance and that he is confident in OMNI's market-leading position due to its clinical data and ease of use, further strengthened by the new OMNI Edge launch.

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CFO Alison Bauerlein clarified that the low blended TearCare ASP was due to legacy contracts, while new purchases are at a much higher price point. She noted the tariff impact on gross margin would be modest and phased, with mitigation efforts underway. CEO Paul Badawi and Executive Matthew Link added that while new competitors may cause temporary disruption from trialing, OMNI's strong clinical evidence and continuous innovation provide a durable advantage, and this dynamic is factored into guidance.

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CFO Shelley Thunen attributed the high gross margin to volume leverage from increased LAL+ production in 2024, noting some benefit will carry into Q2 before moderating. President and CEO Dr. Ron Kurtz and Shelley Thunen discussed the potential of the South Korean and European markets. They also stated that their U.S.-made products have generally been exempt from tariffs in target markets.

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CFO Shelley Thunen reiterated expectations for typical seasonality in 2025, with Q1 and Q3 being weaker than Q2 and Q4, suggesting a sequential decline in Q1 is possible. CEO Dr. Ron Kurtz addressed competition by stating that while there could be some impact, he believes new competitive launches will primarily affect other presbyopia-correcting IOLs rather than RxSight's unique adjustable technology.

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CFO Shelley Thunen estimated the number of physicians per LDD is around 1.5 to 1.6, up from 1.3 previously, but noted it varies by market. CEO Dr. Ron Kurtz cautioned against focusing too heavily on this single metric, as practice structures vary widely. On international strategy, Dr. Kurtz stated that post-approval, the focus will be on establishing strong in-country physician partnerships to serve as reference sites, similar to the U.S. launch. He confirmed the channel strategy will be market-dependent, using a distributor in Canada but potentially going direct elsewhere.

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CEO Vafa Jamali attributed the late December softness to extended holiday office closures rather than market share loss, noting that business stabilized in January. CFO Richard Heppenstall added that for 2025, the digital and biomaterials segments are expected to continue their strong performance. He also mentioned that pressure on lower-margin oral scanner sales should normalize after Q1 and highlighted a new data-driven sales strategy to boost the core implant business.

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Executive Vafa Jamali expressed optimism for a U.S. recovery in Q4 and noted that order timing in Japan and Italy should resolve, though Europe faces macro pressure. Executive Richard Heppenstall added that the U.S. grew 1.6% ex-scanners and is expected to continue growing. Heppenstall explained that gross margin improvement is sustainable due to manufacturing efficiencies and that higher SG&A reflects strategic reinvestment of those gains into the U.S. sales force and R&D to drive long-term growth.

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Executive Vafa Jamali explained that ZimVie is focused on the premium implant market, leveraging its digital offerings like Implant Concierge to expand the market. He noted the Medit scanner partnership offers a better margin profile and a new price point. CFO Richard Heppenstall added that the iTero delay was already factored into guidance and that the Q3 outlook is prudent due to persistent market challenges. He confirmed the implied Q4 EBITDA margin ramp is correct, driven by fixed cost absorption and cost-saving initiatives.

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CEO Tom Frinzi stated that the guidance assumes a minimal impact from iBright, which is expected to generate around $5 million in its first year, and that STAAR remains well-positioned against this new competition. CFO Patrick Williams clarified that revenue for the $27.5 million shipment will be recognized upon receiving payment from the distributor, for which they have commitments by the end of Q3 2025. He emphasized this was an exceptional circumstance driven by the distributor's request for a highly extended payment term.

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Executive Thomas G. Frinzi clarified that SMILE, not LASIK, lowered its price within Aier, but STAAR's relationship remains strong with continued EVO growth. Executive Patrick Williams added it was too early to speculate on Aier's M&A. Regarding guidance, Williams confirmed it implies a revenue reacceleration in Q3 and strong growth in Q4, reflecting the company's momentum.

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CEO Joe Hogan confirmed the 2025 forecast implies slower growth in the U.S. compared to international markets, projecting forward the trends seen in 2024. CFO John Morici explained that Q1 ASPs are most heavily impacted by unfavorable FX year-over-year, and this headwind should lessen as the year progresses and the comparison basis normalizes.

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CEO Joe Hogan stated that Lumina is a brand-new platform, not an iteration, and its unique technology is driving sales despite capital equipment pressures. CFO John Morici added that flexible leasing and rental programs are helping adoption. Hogan confirmed that the weakness in the U.S. is being felt almost equally in both the orthodontist and GP channels due to challenged patient traffic.

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