Patrick Wood

Patrick Wood asked about the potential positive effects of CMS proposals related to PPE onshoring and API relocation on STERIS's supply chain. He also questioned the impact of CMS removing many surgeries from the Inpatient-Only List, specifically if this shift to ASCs would be beneficial or detrimental for STERIS.

Answer

Daniel Carestio, President and CEO, views the shift to Ambulatory Surgery Centers (ASCs) as generally positive for STERIS, creating new capacity demands and increasing the need for clinical support in sterilization and disinfection. He noted no material impact yet from PPE onshoring or API relocation initiatives.

Patrick Wood questioned the potential impact of CMS proposals, including PPE onshoring, API relocation, and the removal of surgeries from the Inpatient-Only List, on supply chain shifts and the acceleration of procedures into Ambulatory Surgical Centers (ASCs). He also asked for an update on STERIS's commercial push and integrated model strategy in EMEA.

Answer

Daniel Carestio, President and CEO, stated that the ASC shift has generally been positive for STERIS due to new capacity demands and the need for clinical support, which STERIS is uniquely positioned to provide. He has not yet seen material impacts from PPE onshoring or API relocation. Carestio confirmed STERIS's commitment to a commercial push in EMEA, noting structural changes are underway for a more integrated go-to-market approach.

Patrick Wood asked for details on the strong performance in healthcare services, specifically what factors were driving the growth. He also inquired about the contribution of the X-ray modality to overall growth.

Answer

Dan Carestio, President and CEO, explained that healthcare service strength comes from traditional equipment service, IMS repair, and instrument processing. He noted consistent double-digit growth, partly driven by pricing due to labor increases, anticipating a slight slowdown in growth as labor costs normalize, without affecting margins. Regarding X-ray, Mr. Carestio stated that STERIS does not break out specific technologies, viewing radiation as a single category, and highlighted X-ray as an important tool for expansion capacity.

Patrick Wood asked for details on the strong performance of the healthcare service business and what factors are driving this growth. He also inquired about the contribution of X-ray modality to overall growth.

Answer

President and CEO Dan Carestio explained that healthcare service strength comes from traditional equipment service, IMS repair, and instrument processing, noting strong volumes and double-digit growth driven by pricing power due to labor increases. He anticipates a slowdown in growth but not margins as labor costs normalize. Carestio stated that STERIS does not break out specific technology contributions like X-ray, viewing radiation as a single technology.

Patrick Wood inquired about customer conversations regarding onshoring manufacturing back to the U.S. and asked about the potential for industry consolidation driven by rising compliance costs for smaller sterilization players.

Answer

President and CEO Daniel Carestio stated that while some minor production shifts are possible, large-scale onshoring is unlikely due to the highly regulated nature of the industry. Regarding consolidation, he acknowledged it may occur but noted STERIS would likely favor greenfielding new capacity over acquiring aging assets.

Patrick Wood inquired about the potential for EO regulations to change under a different political administration and asked about demand trends in the endoscopy business, covering both scopes and reprocessing. He also asked for the proportion of consumables revenue derived from endoscopy reprocessing.

Answer

President and CEO Daniel Carestio stated it is unlikely the EPA will retract the existing EO rule and that STERIS is well-positioned to comply. He described endoscopy reprocessing as doing 'really well' due to a large installed base, while scope sales are growing 'at market.' Executive Julie Winter reiterated that endoscopy is a $1 billion business in total but did not provide a specific consumables breakdown.

Patrick Wood from Morgan Stanley inquired about potential supply chain shifts due to tariffs and customer reactions. He also asked for an update on the status of the company's ethylene oxide (EO) litigation.

Answer

CEO Daniel Carestio noted that while there's no direct feedback on tariffs, STERIS has observed a trend of "front-shoring" by customers, with significant growth in its Asia Pacific operations. Regarding the EO litigation, he referred to the detailed disclosures in the company's SEC filings and declined to comment further on the ongoing legal matter.

Patrick Wood inquired about the impact of significant investments in vascular sales forces, including the proposed Penumbra acquisition, on products like Seismic, IBL, and TCAR, and whether other unseen vascular products are driving this deployment of resources beyond Agent.

Answer

CEO Michael Mahoney highlighted Boston Scientific's substantial commercial scale in EI and interventional cardiology, with combined reporting structures. He expressed enthusiasm for the Penumbra acquisition, which will enable entry into new high-growth markets like PE and neurovascular with a scaled sales force. He emphasized the company's strong organic R&D (e.g., Agent) and clinical work (e.g., IVL, Vessix) in the ICVT area, indicating continued tuck-in M&A and significant investments in this segment.

Patrick Wood asked about the impact of significant investments in vascular sales forces, including the proposed Penumbra transaction and similar moves by peers, on products like Seismic, IVL, and TCAR. He also inquired if there are other unannounced vascular products beyond Agent driving these substantial sales force deployments.

Answer

CEO Michael Mahoney highlighted Boston Scientific's tremendous commercial scale in its EI and interventional cardiology businesses, which are now combined as ICVT. He expressed excitement about the Penumbra acquisition, which will provide access to new high-growth markets like PE and neurovascular with a highly scaled sales force. He emphasized the company's commitment to organic R&D, citing Agent as an example, and ongoing clinical work with new products like IVL and Vessix for hypertension, indicating strong bullishness and significant investments in the ICVT area.

Patrick Wood of Morgan Stanley inquired about the recent Nalu Medical acquisition, asking about the strategic timing of the deal, Boston Scientific's rationale for expanding into the peripheral nerve stimulation (PNS) market, and the commercial strategy for driving coverage over time.

Answer

Chairman and CEO Mike Mahoney expressed excitement about the Nalu signing, noting Boston Scientific was an early VC investor. He highlighted Nalu's strong portfolio, clinical evidence, Medicare reimbursement, improving commercial payer coverage, and solid sales track record as key factors. Mahoney emphasized that the timing was right for integration, given the Neuromod team's successful integration of Relievant. He described Nalu as a "perfect puzzle piece" that adds a highly differentiated peripheral nerve stimulation portfolio, accelerating Neuromod's growth and adding to Boston Scientific's weighted average market growth rate (WAMGR).

Patrick Wood sought further details on the Nalu Medical acquisition, focusing on the peripheral nerve stimulation (PNS) market, the timing of the acquisition, and plans for expanding commercial coverage.

Answer

Chairman and CEO Mike Mahoney expressed excitement about the Nalu acquisition, noting Boston Scientific's long-standing VC investment in the company. He highlighted Nalu's strong portfolio, clinical evidence, solid Medicare reimbursement, improving commercial payer coverage, and sales track record. Mahoney emphasized that the timing is ideal for integration, given the Neuromodulation team's successful integration of Relievant, and that Nalu is a 'perfect puzzle piece' that offers a highly differentiated portfolio in the pain space, accelerating Neuromodulation's growth in 2026.

Patrick Wood of Morgan Stanley asked for an update on the Cardiac Rhythm Management (CRM) business, specifically the outlook for the division and the potential growth impact from the anticipated approval of the Empower leadless pacemaker.

Answer

Michael Mahoney, Chairman and CEO, expressed long-term confidence in CRM, expecting momentum to accelerate in late 2025 and into 2026. This will be driven by the Empower approval in H2 2025 and the full Denali portfolio refresh. Dr. Ken Stein, CMO, added that Empower's key differentiation is its ability to communicate with the S-ICD, addressing a major unmet need and potentially expanding S-ICD adoption.

Patrick Wood asked about the Endoscopy business, specifically focusing on the medium-term potential of the Apollo ESG (endoscopic sleeve gastroplasty) procedure and its initial launch progress.

Answer

CEO Mike Mahoney positioned ESG as a significant long-term growth driver for the Endoscopy division, though not something that will reshape the company in 2025. He highlighted positive momentum from recent CPT code announcements and endorsements from bariatric committees. The company has a dedicated team and is investing in clinical trials to expand the indication, viewing it as a key part of the division's future growth.

Patrick Wood from Morgan Stanley asked about potential system-wide capacity constraints for electrophysiologists given the high demand for procedures like PFA and WATCHMAN, and how the system can adapt.

Answer

CEO Michael Mahoney responded that the FARAPULSE launch is still early, with many new accounts to open in the U.S., Japan, and China. He highlighted that FARAPULSE's efficiency allows hospitals to increase daily procedure volume by 25-30%. Furthermore, the new concomitant procedure reimbursement adds another layer of workflow efficiency for hospitals, patients, and physicians.

Patrick Wood asked about the implications of CMS deleting the inpatient-only list for endoscopy and other areas, questioning if it's merely a site-of-care change or if it significantly impacts the business. He also inquired if Stryker's M&A focus on vascular, initiated with Inari, is still a key area, including interest in ancillary fields like calcium management.

Answer

Chair and CEO Kevin Lobo stated that due to Stryker's high market share, it's primarily a site-of-care change, but new ASC construction and added procedures benefit Stryker's broad offering, especially the sports business. CFO Preston Wells confirmed that Stryker is never "one and done" with acquisitions and will continue to build around the Peripheral Vascular business and broader vascular customer set, as well as exploring opportunities in Health IT.

Patrick Wood asked about the implications of CMS's decision to delete the inpatient-only list for Stryker's Endoscopy and other businesses, questioning if it's merely a site-of-care change or a more significant shift. He also inquired if the Inari acquisition was a 'launchpad' for further building out the vascular channel, including interest in ancillary areas like calcium management.

Answer

Kevin Lobo, Chair and CEO, Stryker, stated that due to Stryker's high market share, the shift to ASCs represents a new site of care that benefits the company, especially with new construction and procedures, and particularly for the sports business. He confirmed that Inari was indeed a launchpad, and Stryker is never 'one and done' in a new space, actively looking to fortify the PV business and explore the broader vascular universe, as well as health IT.

Patrick Wood requested more detail on the performance drivers within the Endoscopy business and asked for early feedback on the limited release of Mako Shoulder.

Answer

CEO Kevin Lobo attributed Endoscopy's strength to the high-growth 1788 camera system and strong double-digit growth in sports medicine, fueled by new products. Regarding Mako Shoulder, he noted that while it was not a meaningful contributor in Q1, feedback from the limited release is very positive, and it is expected to become a significant growth driver starting in 2026.

Patrick Wood asked about Intuitive's medium-term strategy regarding new form factors and cost competition, particularly for lower acuity cases. He questioned whether the solution lies in a lower-end form factor, continued use of refurbished systems, or achieving superior speed and innovation with existing technology to surpass laparoscopic surgery at a lower cost.

Answer

CEO Dave Rosa emphasized that the solution depends on the specific problem being solved, differentiating between complex cancer procedures and routine ambulatory settings. He believes the existing ecosystem, including the da Vinci XIR system, effectively serves the needs of ASCs for repeatable, reliable, high-quality outcomes within their economic structure. CFO Jamie Samath added that segmentation, using da Vinci 5 for broad procedures and XIR for HOPD/ASC settings, is important, and the current portfolio supports this strategy, though future developments are part of strategic planning.

Patrick Wood asked about Intuitive's medium-term strategy regarding new form factors and cost competition, particularly for lower acuity cases. He questioned whether the solution involves a new lower-end form factor, continued use of refurbished systems, or if technological advancements in automation and speed could make existing tech more cost-effective than laparoscopy for these cases.

Answer

CEO Dave Rosa emphasized that the solution depends on the specific problem being solved, whether it's complex cancer procedures or routine ambulatory settings. He believes Intuitive's existing ecosystem, including the XIR system, is well-suited to serve both complex and lower acuity, higher volume needs, and while optimization through new platforms is possible, the current offerings are effective. CFO Jamie Samath added that segmentation, using da Vinci 5 for broad hospital procedures and XIR for HOPD/ASC settings, is important and supported by the current portfolio, though future developments are part of strategic planning.

Patrick Wood questioned the primary constraints for Xi systems in alternative sites of care, specifically ambulatory surgery centers (ASCs), asking whether capital cost, Medicare/commercial reimbursement rates, or Ion instrumentation costs are the biggest factors. He also inquired about the significance of the sterilization challenge and if there's a need to further reduce the cost curve for Ion in ASCs or develop disposable instrumentation.

Answer

Jamie Samath, CFO, stated that the greater constraint for ASCs in the U.S. is on the capital side, with many systems being leased and a majority of ASC systems being Xi or X due to lower price points. He noted that procedure growth in U.S. ASCs is accretive to overall U.S. growth and that refurbished Xi systems will increase focus on this area, though reimbursement in ASCs is a fraction of hospital outpatient departments. Dave Rosa, CEO, clarified that sterilization has not been an impediment, and single-use INA is not a requirement for robotic systems in the ASC environment.

Patrick Wood asked a conceptual question about whether increased installed base density in specific geographic regions creates operational efficiencies and margin benefits, for example, in servicing or selling to those customers.

Answer

CEO Gary Guthart confirmed that the company does realize 'advantages of scale with geographic density.' He explained that as the installed base in a region becomes more concentrated, it provides 'cost advantages' in supporting those accounts through more efficient deployment of service, sales, and training resources.

Patrick Wood inquired about the pace of commercial payer adoption for Simplicity, specifically asking how these discussions reflect the broad Medicare NCD, any potential restrictions, and the overall tone of commercial payers in introducing this therapy to their patient pools.

Answer

Chairman and CEO Jeff Martha noted that commercial payers are coming online faster than anticipated, driven by patient demand. He highlighted that the Medicare NCD is broader and better than expected, incorporating physician and patient discretion. Martha mentioned one difference with commercial payers focusing more on adherence to multiple medications for a period, but overall, the NCD provides many avenues for Simplicity access.

Patrick Wood inquired about the pace of commercial payer adoption for Simplicity, how these discussions align with the broad Medicare NCD, and any potential restrictions or specific approaches payers are taking to integrate the therapy into their patient pools.

Answer

Chairman and CEO Jeff Martha noted that commercial payers are coming online faster than anticipated, driven by patient demand. He highlighted the NCD's broad and favorable terms, including physician discretion. Martha mentioned one difference with commercial payers focusing more on patients being on multiple medications for a period.

Patrick Wood of Morgan Stanley asked if it is fair to assume Medtronic's fiscal '26 performance will align with its long-term algorithm of mid-single-digit revenue growth and high-single-digit EPS growth, given this is the expected exit rate for Q4 '25.

Answer

Chairman and CEO Geoff Martha confirmed that while official FY26 guidance will be provided on the Q4 call, the company's objective remains unchanged. He reiterated Medtronic's commitment to its long-range plan of driving profitable growth and operating leverage, consistent with the algorithm Wood described.

Patrick Wood asked about Medtronic's M&A strategy, inquiring about the types of tuck-in assets of interest, and also questioned whether a more 'radical repositioning' of the business portfolio could be expected.

Answer

Chairman and CEO Geoff Martha reiterated the focus on tuck-in M&A to support high-growth markets and established businesses, using a top-down strategic approach. Regarding the portfolio, he emphasized that active portfolio management is an ongoing process to ensure the company is constructed to durably deliver its long-term financial goals of mid-single-digit growth with leveraged earnings and strong cash flow.

Patrick Wood asked about the origins of the 'Transform for the Future' program, inquiring if it was a pre-planned initiative or a response to tariff pressures. He also sought clarification on the primary areas for internal reinvestment of the program's savings, such as sales force or marketing.

Answer

CEO Bryan Hanson clarified that the 'Transform for the Future' program was always contemplated as part of the transformation phase but was launched after achieving readiness through 'Solventum Way' restructuring, 3M separation, and the P&F sale. CFO Wayde McMillan detailed that savings would come from a comprehensive review of operating structure, procurement, supply chain, manufacturing, global footprint, and system streamlining. Bryan Hanson added that reinvestment would accelerate the shift of spend to high-return areas like research and development and commercial infrastructure.

Patrick Wood asked about the origin of the 'Transform for the Future' program, specifically if it was an early initiative or a response to tariffs, and inquired about the main areas for internal reinvestment of the savings, such as sales force or marketing.

Answer

CEO Bryan Hanson explained that the 'Transform for the Future' program was always contemplated as part of the transformation phases but was initiated after completing the 'Solventum Wayde restructuring,' 3M separation progress, and the P&F sale, gaining the necessary systems and bandwidth. He noted that tariffs certainly heightened the focus on the program. CFO Wayde McMillan added that the program is comprehensive, examining operating structure, procurement, cost management, supply chain, manufacturing, global footprint, and system streamlining. Bryan Hanson concluded that reinvestment would accelerate the shift of spend to areas with the highest returns, including research and development and commercial infrastructure.

Patrick Wood asked about the company's capital allocation strategy, specifically how management views the necessity of bolt-on M&A to achieve midterm growth targets given the strong organic performance.

Answer

CEO Bryan Hanson clarified that he views M&A as an 'enhancement to, not a requirement for,' achieving the company's long-range plan of 4-5% organic growth. He expressed growing confidence in reaching that target organically and sees potential M&A as a tool to accelerate that timeline or overachieve the goal.

Patrick Wood from Morgan Stanley questioned the durability of the Q1 top-line strength, asking for confidence in the underlying 2.5% organic growth figure and whether it was driven by sustainable commercial execution rather than customer stocking.

Answer

CFO Wayde McMillan affirmed confidence in the estimated 2.5% underlying growth, noting it's based on analytics and customer discussions. He emphasized this represents a significant acceleration from 2024 and confirmed that pricing was stable, with the outperformance being driven by volume, which is the company's strategic focus.

Patrick Wood asked if the 2026 SKU rationalization headwind would be offset by margin improvements and questioned the company's organizational readiness for M&A following the P&F divestiture.

Answer

CFO Wayde McMillan clarified that the SKU rationalization offers minimal margin benefits (10-20 bps) and is primarily about business simplification. CEO Bryan Hanson stated that the P&F sale accelerates the M&A timeline and that the company has been building capacity for tuck-in deals, targeting early 2026 to begin transacting after a period of deleveraging.

Patrick Wood from Morgan Stanley inquired about the timeline for Transitional Service Agreements (TSAs) to roll off and the associated reinvestment strategy. He also asked about dynamics in the negative pressure wound therapy market.

Answer

CFO Wayde McMillan stated there are no updates to the TSA timelines, which range from 2 to 12 years, noting the company is still in the early stages of the separation. CEO Bryan Hanson clarified that the softness in traditional negative pressure wound therapy was partly due to a tough year-over-year comparison. He explained that the single-use Prevena product line is separate and growing steadily, while the new Peel and Place dressing is expected to help unlock growth in the traditional NPWT market.

Patrick Wood asked for an updated timeline on the Transitional Service Agreements (TSAs) with 3M and how the company is thinking about reinvestment as they roll off. He also questioned if the softness in traditional negative pressure wound therapy alongside strength in disposable options indicates a market transition.

Answer

CFO Wayde McMillan stated there are no updates to the TSA timelines, which range from 2 to 12 years, noting the company is still in the early stages of the separation. CEO Bryan Hanson clarified that the traditional and single-use negative pressure wound therapy markets are separate. He attributed the traditional segment's softness partly to a tough year-over-year comparison, while noting the single-use Prevena product line continues to see steady growth. He highlighted the new Peel and Place dressing as a key innovation to unlock growth in the traditional market.

Patrick Wood inquired about BD's capital allocation strategy, specifically questioning if the company would consider even more aggressive share buybacks given the stock's current valuation and the upcoming RMT transaction.

Answer

EVP and CFO Chris DelOrefice and Chairman, CEO, and President Tom Polen highlighted the commitment to cash generation and disciplined net leverage, noting the incremental $250 million buyback and the plan to use at least half of the $4 billion Waters transaction proceeds for buybacks. They emphasized the significant value creation unlock from the Waters transaction and the intrinsic value disconnect of new BD trading at a 10x multiple despite strong fundamentals.

Patrick Wood asked about BD's capital allocation strategy, specifically questioning why the company isn't pursuing even more aggressive share buybacks, given the stock's valuation and the upcoming Waters transaction proceeds.

Answer

Chris DelOrefice, Executive Vice President and Chief Financial Officer, and Tom Polen, Chairman, CEO, and President of BD, emphasized the focus on cash generation and disciplined net leverage. They highlighted the Waters transaction as a significant value unlock, with $4 billion in proceeds, at least half of which will go to share buybacks, expected to increase new BD's EPS growth rate by over 200 basis points. They noted the perceived undervaluation of BD's stock, trading at a 10x multiple for the remaining business, justifying the incremental $250 million buyback and future capital allocation strategy.

Patrick Wood of Morgan Stanley asked about the growth outlook for the post-separation 'RemainCo' business, questioning if its 4% growth rate could stabilize in the mid-single-digit plus range long-term, given momentum in APM, biologics, and urology.

Answer

Tom Polen, Chairman, CEO & President, affirmed that the positive growth trends across BD Interventional and the Connected Care Medical segment are expected to continue. He highlighted that APM's 13% pro forma growth was ahead of the deal model, driven by strong execution and incremental sales investments. Polen also noted that the company is making further investments in Q4 to support new launches like Pyxis Pro and build momentum for fiscal year 2026.

Patrick Wood inquired about the internal impact of continuous efficiency programs like BD Excellence, asking how the company balances the drive for optimization with employee morale and capacity, ensuring it doesn't detract from product development and market focus.

Answer

Chairman, CEO and President Thomas Polen described the BD Excellence (Kaizen) events as highly engaging and inspirational, empowering employees to improve their own work processes. He noted the program is still in its early innings and is expanding into R&D and commercial areas. Mike Feld, President of the Life Sciences segment, added that these initiatives free up employee time from mundane tasks, allowing more focus on creativity and strategic problem-solving, which he views as energizing rather than exhausting.

Patrick Wood asked about potential areas for investment or acquisitions if the separation results in a cash injection from a sale, and which parts of the business management could dedicate more time to post-transaction.

Answer

Chairman, CEO and President Tom Polen highlighted that all business segments are performing well against their markets. He emphasized that high-growth, accretive M&A remains a priority, particularly within the Interventional segment, which presents numerous attractive market opportunities. He noted the focus will be on accelerating the R&D funnel and maximizing growth in existing high-potential platforms like APM, incontinence, and biologics delivery.

Patrick Wood asked about the potential impact of tariffs and supply chain issues, specifically whether BD would benefit from onshoring and how the company is thinking about its pricing strategy in that context.

Answer

Chairman, CEO, and President Tom Polen stated that BD's 'in China for China' manufacturing strategy minimizes exposure to potential tariffs, as very few products are exported from China. He emphasized that BD's global network is designed for local manufacturing in key markets, which helped the company navigate previous tariff situations effectively.

Patrick Wood asked about potential implications for GE HealthCare's competitive position in the ultrasound market following a peer's FDA issues. He also inquired about GE HealthCare's interest in the longer-term cardiac terminator market, specifically patch players, given its strong MUSE platform in ECG.

Answer

President and CEO Peter Arduini stated no comment on the peer's FDA issues and no effect on Q3 performance, attributing AVS strength to strong execution and new products. He acknowledged the significant position of the MUSE platform and its existing integration with devices like AliveCor, indicating future departmental solutions under the CareIntellect platform will connect such information.

Patrick Wood asked about the potential implications for GE HealthCare's competitive ultrasound market following a peer's FDA issues and the company's interest in the longer-term cardiac terminator market, leveraging its Muse platform and ECG market share.

Answer

President and CEO Peter Arduini stated that GE HealthCare had no comment on a peer's FDA issues and saw no effect in Q3, attributing AVS strength to strong go-to-market execution and new products. He acknowledged the significant position of the Muse platform in EKG data recording, highlighting the AliveCore partnership for portable monitoring and its integration into the system. He indicated that future departmental solutions under the "Care Intellect" branding, like the perinatal example, would connect multiple data flows for longitudinal solutions in cardiology and other areas.

Patrick Wood inquired about the newly introduced 'Financial Excellence' pillar, seeking clarification on its interpretation, whether it focuses on cash conversion or margin structure, and the underlying impetus for its addition ahead of the Investor Day.

Answer

Chairman and CEO Brent Saunders explained that 'Financial Excellence' is about sharpening day-to-day execution, ensuring every dollar drives growth or efficiency, and is part of the broader Vision 27 project. CFO and EVP Sam Eldessouky added that this strategy aims to drive top-line growth, margin expansion, and strong cash flow generation, with Q3 showing sequential margin improvement and lower SG&A.

Patrick Wood asked for high-level commentary on the newly introduced 'Financial Excellence' pillar, inquiring if it primarily focuses on cash conversion, margin structure, or other aspects, and what the impetus was behind its addition ahead of the Investor Day.

Answer

Chairman and CEO Brent Saunders explained that Financial Excellence is about sharpening day-to-day execution, ensuring every dollar drives growth or efficiency, controlling operating expenses, improving MECs, and setting up for meaningful margin expansion. CFO and EVP Sam Eldessouky added that this strategy drives top-line growth, margin expansion, and strong cash flow generation, noting sequential improvements in SG&A percentage and robust adjusted cash flow from operations of $161 million.

Patrick Wood inquired about the impact of the enVista IOL recall, focusing on customer feedback and the company's assumptions for the revenue hit. He also asked for commentary on the overall U.S. cataract market volume trends observed in Q1.

Answer

Chairman and CEO Brenton L. Saunders stated that the company earned significant trust from customers due to its swift and transparent handling of the recall. He noted that while Q2 will be impacted, he expects a pickup in Q3 and a full restoration of trust and business by Q4. Regarding market volumes, Saunders described them as 'normal' and 'very steady,' with notable growth in the monofocal plus category where Bausch + Lomb competes with Johnson & Johnson.

Patrick Wood asked for more detail on the execution component of Bausch + Lomb's growth, seeking to understand how much is driven by customer-level improvements like increased shelf space or new surgeon acquisition, relative to new product innovation.

Answer

Chairman and CEO Brenton L. Saunders explained that two years ago, the company focused on fixing operational issues like product supply to enable selling excellence. He stated that with operational stability achieved, the company is now seeing broad-based growth across all segments and geographies, driven by a holistic commitment to selling excellence. He noted that customers, particularly surgeons, are showing renewed excitement for the 'new BNL' due to both innovation and reliable execution, leading to strong uptake of new products like the enVista Envy lens.

Patrick Wood asked about the single biggest factor driving Bausch + Lomb's recent performance and how the company balances investing in multi-year product launch cycles with its goals for margin expansion.

Answer

CEO Brenton L. Saunders attributed the success to a relentless focus on execution across the company, which has led to broad-based growth in areas like contact lenses. He emphasized that the company is in the early stages of numerous launch cycles and that management carefully balances the necessary investments with a commitment to margin expansion by continuously evaluating the ROI of its spending.

Patrick Wood of Morgan Stanley asked how management specifically identified the dynamic of customers pausing Clarity orders to focus on MyDay fittings, questioning whether the insight came from sales force feedback, direct conversations with optometrists, or data analysis of ordering patterns.

Answer

President and CEO Al White explained that the dynamic was identified in a 'pretty straightforward' manner. The clearest signal came from large accounts with standard ordering cycles. When expected Clarity orders did not materialize, direct conversations with these accounts revealed they were intentionally pausing to focus their efforts on MyDay fitting activity, confirming the trade-off dynamic.

Patrick Wood expressed concern about cumulative price increases impacting consumer behavior, especially in light of destocking, and asked for management's source of confidence that behavior isn't changing.

Answer

President & CEO Albert White provided a key piece of context, explaining that the decline and discontinuation of older, legacy hydrogel products is a significant factor. This trend puts pressure on reported growth rates and channel inventory, helping to reconcile the softness despite strong performance and pricing in newer silicone hydrogel products.

Patrick Wood of Morgan Stanley asked for an update on toric lens penetration in the U.S. for astigmatic patients and the primary reasons why some patients have not yet switched to toric lenses.

Answer

CEO Al White explained that toric penetration is highest in the Americas, mid-level in Europe, and lowest in Asia-Pacific, but is growing in all regions. He noted that revenue from torics is increasing as a percentage of the total, now likely in the low 30s. He attributed the growth to improved lens technology, like the stable design of Biofinity and MyDay torics, which makes fitting easier and more successful for practitioners, thereby increasing their confidence in prescribing them.

Patrick Wood from Morgan Stanley inquired about the strong performance in the Hip segment, specifically asking if the growth from the Z1 stem was broad-based or concentrated in certain areas.

Answer

Chairman, President & CEO Ivan Tornos confirmed the Z1 stem is driving market share gains, with roughly 50% of users being competitive conversions. He noted that supply challenges from late 2024 are resolved and that growth is amplified by the OrthoGrid system and HAMR surgical impactor. He expects the ~5% U.S. growth run rate to continue or improve.

Patrick Wood from Morgan Stanley asked about the Paragon 28 acquisition, focusing on the strategy for leveraging Zimmer Biomet's distribution network and managing potential integration disruption.

Answer

President and CEO Ivan Tornos stated that Zimmer Biomet is highly excited about Paragon 28's innovative culture and plans to preserve its dedicated sales channel and management team to minimize disruption. He emphasized that the business will be run in isolation initially, focusing on integrating quality management systems and operations, leading to high confidence in a smooth integration with minimal commercial disruption.

Patrick Wood of Morgan Stanley inquired about any early feedback on the new Category 1 CPT code and asked about the company's strategy for penetrating lower-volume hospitals, particularly through IDN relationships.

Answer

EVP & CFO Kevin Waters clarified that since the Category 1 code is not effective until January 2026, there is no user experience yet, and feedback has been neutral. He highlighted that Integrated Delivery Networks (IDNs) are a key growth strategy, representing 30% of procedures, and that a new strategic accounts team is now working "top-down" with these large systems to accelerate adoption.

Patrick Wood questioned the company's strategy for resourcing and expanding its international (OUS) business, given the large opportunity. He also asked for updated thoughts on the U.S. physician fee ahead of the move to a permanent reimbursement code.

Answer

Executive Sham Shiblaq explained that the international strategy is disciplined, focusing on winning decisively in key markets like the U.K. and Japan before broader expansion. Executive Reza Zadno addressed the U.S. reimbursement question, stating they feel good about the physician payment and anticipate it will be similar to other resective procedures, which importantly does not impact the hospital's APC payment.

Patrick Wood of Morgan Stanley asked for more detail on customer feedback for the new HYDROS system and the mix of high-volume versus lower-volume hospitals adopting the technology. He also inquired about the risk of patients from the Q4 backlog seeking alternative procedures with lower saline requirements.

Answer

CEO Reza Zadno reported that HYDROS reception has exceeded expectations, with strong uptake of the FirstAssist AI feature. CCO Sham Shiblaq added that demand is surging from medium and low-volume BPH hospitals, expanding beyond the initial high-volume focus. CFO Kevin Waters addressed the follow-up, stating they do not believe any procedures were lost to other modalities, as affected hospitals paused all resective surgeries.

Patrick Wood asked for commentary on consumer health and mix shifts across different regions for both contact lenses and IOLs, focusing on new fittings and the adoption of premium lens options.

Answer

Chief Executive Officer David Endicott described international markets as solid and the consumer as resilient, pointing to increased unit volumes and a trade-up in mix for contact lenses. For IOLs, he highlighted a 200 basis point global increase in AT-IOL penetration, indicating healthy out-of-pocket spending. He reiterated that the U.S. cataract market softness is a surgeon productivity issue, not a consumer demand problem.

Patrick Wood inquired about Alcon's interest in entering the drug-eluting IOL market, where the lens haptics are used for drug delivery.

Answer

CEO David Endicott responded that while Alcon is aware of and has explored these technologies, the company's current strategy is to be a 'fast follower.' He indicated they prefer to wait for the market and, critically, reimbursement pathways to develop and stabilize before committing, noting they could enter the space quickly if needed.

Patrick Wood asked about the strategy for incremental sales and marketing investment to support the upcoming wave of new products. He also inquired about the rationale for partnering with OcuMension in China for ocular health rather than using a direct sales model.

Answer

CEO David Endicott explained that while they plan to increase investment behind major launches like Unity and AR-15512, the exact budget is still being determined for 2025. Regarding China, he stated that partnering with OcuMension was a strategic decision to leverage their existing local expertise in R&D, manufacturing, and commercialization, which was a more efficient and effective path to maximize profitability for the eye drops portfolio compared to building those capabilities from scratch.

Patrick Wood inquired about the feedback from healthcare providers regarding the patient journey for type 2 diabetes conversions, specifically asking about the speed of the process and any potential challenges or sticking points.

Answer

Chief Product and Customer Experience Officer Eric Benjamin stated that the process is meeting expectations. He explained that the commercial team is effectively using clinical data to educate providers on the value of automated insulin delivery for type 2 patients. Once a provider is on board, the patient journey is reportedly smooth and similar to that for type 1 patients, with the product's ease of use being a key factor.

Patrick Wood of Morgan Stanley asked for an analysis of the international (OUS) business, seeking to understand the sustainability of its growth and the relative contribution of Omnipod 5's appeal versus operational improvements like mass training.

Answer

President and CEO Jim Hollingshead attributed the success primarily to the compelling features of the Omnipod 5 platform, stating it "wins everywhere we take it." He highlighted its discrete form factor, ease of use, and sensor choice as key drivers for converting MDI users who previously avoided pumps. He expressed confidence in the sustainability of this growth, citing strong performance in established markets like the U.K. and Germany and great early adoption in newer markets.

Patrick Wood asked for early feedback and any surprising learnings from the initial Type 2 label launch that could provide insight into the adoption ramp for next year.

Answer

President and CEO Jim Hollingshead shared that the team successfully launched ahead of schedule and saw a lift in Type 2 MDI patient starts in September. Key learnings include the significant unmet clinical need among Type 2 patients and the keen interest from PCP practices, which are often pleasantly surprised by Omnipod's simplicity compared to their preconceived notions of insulin pumps.

Patrick Wood of Morgan Stanley inquired about the go-to-market strategy in the U.S., asking whether the company believes its prior strategic initiatives were correct and if that approach is subject to change under the new leadership.

Answer

President and COO Warren Foust affirmed that the core U.S. strategy remains focused on building clinical and economic confidence among surgeons to create a 'culture of EVO.' He stated that while targeting high-potential customers will continue, the strategy is expanding to focus on converting patients from glasses and contacts, not just from laser procedures. The company is also creating new pathways to onboard surgeons who are newly interested in offering EVO ICL.

Patrick Wood of Morgan Stanley asked about the go-to-market strategy in the U.S., questioning if the existing strategic initiatives like 'Highway 93' are still considered the right approach or if changes are being contemplated.

Answer

President and COO Warren Foust affirmed the core strategy of helping customers become clinically and economically confident with EVO to drive adoption. He stated that initiatives like 'Highway 93'—a customer segmentation strategy—remain relevant for targeting high-potential practices. However, he expanded on the strategy, noting a broader focus on attracting patients from glasses and contacts, not just converting from laser procedures. Foust also mentioned creating pathways for new customers who want to adopt ICLs, ensuring investments are balanced and right-sized for the U.S. market's growth.

Patrick Wood of Morgan Stanley inquired about the company's strategy for mitigating potential U.S.-China tariffs and the possible impact on the supply chain. He also asked for a qualitative assessment of what China inventory levels would look like by mid-2025 if the company's guidance materializes as planned.

Answer

CEO Tom Frinzi explained that shipping the upcoming EVO+ lenses from their new Switzerland facility will minimize direct tariff impact, while existing in-country inventory provides a further buffer. CFO Patrick Williams added that STAAR's supply chain is highly vertically integrated with key raw materials sourced from the U.S., limiting exposure to geopolitical risks. Regarding inventory, he stated the goal is to work down levels to the contractually required amounts during the first half of 2025.

Patrick Wood of Morgan Stanley inquired about the status of patients in China who have delayed procedures due to the economic slowdown, asking if they represent pent-up demand that could lead to a surge in volume once consumer confidence returns.

Answer

Tom Frinzi, Chair, President and CEO, expressed his belief that these patients represent deferred, not lost, demand. He referenced historical precedents in China, such as in Q1 2023, where the market returned very quickly following stimulus activity, suggesting it is reasonable to assume volumes could pick back up rapidly as the economy turns.

Patrick Wood of Morgan Stanley requested more insight into the 'workload challenges' faced by customers and asked for the rationale behind expecting macroeconomic factors to improve for the company's patient demographic in the second half of the year.

Answer

President and CEO Dr. Ron Kurtz clarified that 'workload challenges' refer to persistent staffing issues within customer practices, a key finding from a recent survey. Regarding the second-half outlook, he explained that the expectation is for a normalization of patient behavior rather than a major economic turnaround, as cataract surgery can only be deferred for a limited time.

Patrick Wood of Morgan Stanley inquired about potential incremental demand for Teleflex's OEM business from supply chain onshoring and the long-term strategic focus on the vascular business following the Biotronics acquisition.

Answer

CEO Liam Kelly responded that while OEM order rates improved through the quarter, it is likely due to base demand rather than early onshoring trends. He affirmed that the cath lab will be a strategic focus for the post-separation 'RemainCo', which will have approximately $1 billion in revenue in that area, though the immediate priority is integrating Biotronics and managing the NewCo separation process.

Patrick Wood asked about the timing and strategic rationale behind the decision to separate the company and acquire Biotronik's Vascular Intervention business, and inquired about sales force synergies from the acquisition.

Answer

CEO Liam Kelly explained that the decision resulted from ongoing portfolio reviews, with the Biotronik acquisition making it clear that Teleflex comprised two distinct businesses. He noted the separation was logistically clean. Kelly confirmed the acquisition offers strong geographic synergies, with Teleflex's strength in the Americas complementing Biotronik's in EMEA, creating a channel for existing TFX peripheral products.

Patrick Wood inquired about the specific drivers of the top-line revenue guidance cut, asking for a breakdown between the OEM business and other factors like weather. He also asked about the company's capital allocation strategy, specifically the balance between executing the remaining share buyback and pursuing bolt-on M&A.

Answer

Liam Kelly, Chairman, President and CEO, clarified that of the approximately $22 million guidance reduction, the larger portion ($14 million) stemmed from the OEM business due to a customer's unexpected vertical integration and inventory management. The remaining $8 million was from Interventional Urology, reflecting UroLift softness despite strong Palette performance. Kelly affirmed that due to a strong balance sheet (1.7x net leverage) and robust cash flow, Teleflex is confident it can pursue both opportunistic share repurchases and M&A.

Patrick Wood asked for feedback on the conversations between physicians and patients regarding the iDose value proposition and how easily patients are accepting the new therapy.

Answer

President and COO Joseph Gilliam explained that the product is "performing as advertised," which builds physician confidence and enthusiasm. This, in turn, makes their conversations with patients more effective and compelling. He noted that as physicians see terrific outcomes, they become better at recommending the procedure, leading to a positive feedback loop that drives adoption.

Patrick Wood asked for an update on the timing of Phase I data for the wet AMD program and whether there was any read-through from AbbVie withdrawing DURYSTA's EU marketing authorization.

Answer

Chairman and CEO Thomas Burns confirmed the Phase I study for their wet AMD candidate (Axitinib) is enrolling, with proof-of-concept data expected in late 2025 or early 2026. President and COO Joseph Gilliam stated there is no significant read-through from the DURYSTA EU withdrawal, as it is specific to that product and does not alter Glaukos's strategy.

Patrick Wood asked about PASCAL adoption, specifically the mix between adding new accounts versus increasing utilization in existing ones. He also inquired about potential impacts on FDA approval timelines due to recent leadership changes.

Answer

Daveen Chopra, Global Leader of TMTT, said PASCAL is growing in both breadth and depth, with strong outcomes driving deeper penetration and attracting new centers. She noted PASCAL is in fewer than 50% of potential U.S. centers, leaving ample room for growth. CEO Bernard Zovighian stated that despite a 'fluid situation' at the FDA, they have seen no impact on timelines and do not anticipate any, citing the professionalism of the agency's staff.

Patrick Wood inquired about TAVR growth trends in large versus smaller centers, particularly whether larger academic centers adopting new TMTT therapies are showing different growth profiles.

Answer

Larry Wood, Group President of TAVR, confirmed that larger academic programs, which are often the first to adopt new therapies like EVOQUE and PASCAL, are also the ones most likely to be near their capacity limits. He noted that while it's hard to generalize across all 850 U.S. centers, the pressure is felt more significantly in these large, early-adopter sites.

Patrick Wood inquired about the long-term expectation for the average sensor wear time, considering that some patients may not consistently reach the full 15 days.

Answer

CEO Kevin Sayer stated that 15-day wear is the preferred use case for patients and that early data from Stelo shows strong performance in users reaching the full wear time. CFO Jereme Sylvain added that while there will be a transition period, the long-term expectation is that virtually all users will want the 15-day product.

Patrick Wood inquired whether the sales mix between the Tandem Mobi and t:slim X2 pumps was meeting initial expectations and how that mix might evolve.

Answer

President and CEO John Sheridan stated they are "very pleased" with Mobi's performance and the positive reception it's receiving. He credited Mobi with driving year-over-year growth in new pumps and MDI conversions. While it's too early to predict a long-term ratio, he confirmed the launch is achieving its objectives and contributing to the company's outperformance.