Baxter International - Q4 2023

Transcript

Operator (participant)

Good morning, ladies and gentlemen, and welcome to Baxter International's Q4 2023 earnings conference call. Your lines will remain in a listen-only mode until the question and answer segment of today's call. At that time, if you have a question, you will need to press star one on your touchtone phone. If anyone should require assistance during the conference, please press star, then zero on your touchtone phone. As a reminder, this call is recorded by Baxter and is copyrighted material. It cannot be recorded or rebroadcast without Baxter's permission. If you have any objections, please disconnect at this time. I would now like to turn the call over to Ms. Clare Trachtman, Senior Vice President, Chief Investor Relations Officer at Baxter International. Ms. Trachtman, you may begin.

Clare Trachtman (SVP and Chief Investor Relations Officer)

Good morning, and welcome to our Q4 2023 earnings conference call. Joining me today are Joe Almeida, Baxter's Chairman and Chief Executive Officer, and Joel Grade, Baxter's Executive Vice President and Chief Financial Officer. On the call this morning, we will be discussing Baxter's Q4 and full year 2023 financial results, along with our financial outlook for 2024. With that, let me start our prepared remarks by reminding everyone that this presentation, including comments regarding our financial outlook for the Q1 and full year 2024, new product developments, including the impact and status of pending regulatory approvals, the status and potential impact of our ongoing strategic and recent pricing actions, business development, regulatory matters, and the macroeconomic environment, including commentary on improving supply chain conditions and evolving customer capital spending trends, contain forward-looking statements that involve risks and uncertainties.

Of course, our actual results could differ materially from our current expectations. Please refer to today's press release and our SEC filings for more detail concerning factors that could cause actual results to differ materially. In addition, on today's call, non-GAAP financial measures will be used to help investors understand Baxter's ongoing business performance. A reconciliation of the non-GAAP financial measures being discussed today to the comparable GAAP financial measures is included in the accompanying investor presentation, along with our earnings release issued this morning, which are both available on our website. Now I'd like to turn the call over to Joe. Joe?

José Almeida (Chairman, President and CEO)

Thank you, Clare, and good morning, everyone. We appreciate you taking the time to join us. I will begin with a brief overview of Baxter's performance for the quarter and the year. After this, I will review our progress against the transformational actions we laid out for you just over a year ago, including the planned separation of our Kidney Care business. I will then turn it over to Joel Grade, who will walk through our results and outlook in more detail. Finally, we will open it up for your questions. As you saw this morning, Baxter reported strong performance for the Q4 2023, with top-line sales exceeding our projections and bottom-line results coming in at a high end of our guidance range. As a reminder, continuing operations exclude the impact of our BioPharma Solutions business, which we divested at the close of the Q3.

Sales from continuing operations rose 4% on a reported basis, ahead of our outlook of 1%-2% growth. On a Constant Currency basis, sales increased 3%, also ahead of our guidance, which projected growth of approximately 1%. Strength in the quarter was broad-based, with year-over-year growth in the Healthcare Systems and Technologies, Medical Products and Therapies, and Pharmaceuticals, which was slightly offset by an expected decline in Kidney Care. Relative to expectations, both of our Chronic Therapies and Drug Compounding divisions reported better than expected sales. On the bottom line, adjusted earnings per share from continuing operations came in at $0.88, at the top end of our prior guidance range of $0.85-$0.88. Our Q4 results further reinforce our building momentum.

In 2023, we focused on consistently meeting and/or exceeding our financial outlook, particularly in light of the significant supply chain and macro environmental challenges we encountered during 2022. As a testament to this focus, over the course of 2023, we were able to deliver sequential improvement every quarter, and we believe this performance provides us with a solid foundation to build off in 2024. Turning to the full year, sales from continuing operations are $14.8 billion, advanced 2% on a reported basis and 3% on a constant currency basis, driven by sales growth for all of our segments at constant currency rates.

First, looking at the Constant Currency sales growth in the segments set to comprise our future Baxter portfolio following the planned Kidney Care separation, sales in Healthcare Systems and Technologies were up 7% in the Q4 and 3% for the year. Medical Products and Therapies sales rose 4% in both the quarter and for the year, and sales in Pharmaceuticals were up 7% for both the quarter and the year. Performance in these segments was fueled by strong execution across our commercial and manufacturing teams. New product launches increased availability of electromechanical components in a more stable supply chain and macroeconomic environment relative to the significant volatility experienced last year.

With respect to hospital capital spending, while we still believe there may be pockets of softer spending, we are encouraged by the sequential improvement we experienced every quarter in 2023 within our Care and Connectivity Solutions division. Our Kidney Care segment, which will be called Vantive post-separation, declined 1% in the quarter and grew 1% for the year at constant rates. Strong growth in Acute Therapies was offset by flat growth in Chronic Therapies, reflecting a difficult year-over-year comparison due to certain discrete items that benefited sales in the prior year, as well as lower sales in China due to the impact of government-based procurement initiatives and a lower patient census due to the pandemic. The underlying state of the Kidney Care business continues to improve, and the momentum we are building is evident.

Among key indicators, we are seeing renewed growth in the Peritoneal Dialysis patient population following the earlier impact of pandemic-driven mortality issues. Our strategic rationale and hypothesis for an independent Kidney Care business remains as strong as ever. Our team is executing and gearing up for a successful separation this year. Given overall business performance and environmental dynamics, I'm optimistic as we look ahead to the prospects for both Baxter and Vantive as separate entities. Our solid financial performance was achieved in parallel with meaningful progress against the strategic priorities we announced to open 2023. We kicked off the year with an urgency to rethink both the scope and velocity of our transformation.

Since then, our team delivered, executing on a range of goals to position a separated Baxter and Vantive for a new era of enhanced patient and shareholder impact, enabled by heightened strategic clarity, operational efficiency, and innovation. We realigned our businesses into newly streamlined, simplified operating models based on globally integrated business segments. Each segment is led by a seasoned and knowledgeable executive who has profit and loss accountability, inclusive of dedicated commercial research and development, manufacturing, supply chain, and functional teams. We are already seeing the benefits of improved line of sight to our customers and greater agility to recognize and capture growth opportunities. We completed the divestiture of our BioPharma Solutions business at the close of Q3, which further allowed us to streamline our strategic focus on our core businesses.

We are in the process of utilizing the after-tax proceeds of approximately $3.7 billion to pay down debt in line with our stated capital allocation priorities, including $2.8 billion of repayments in the Q4. Finally, we continue to make progress towards separating Vantive out of Baxter. As we have consistently stated, we believe this separation will ultimately empower both companies to pursue their own unique strategic and investment priorities. Many of you had the opportunity to meet designated Vantive CEO, Chris Toth, at the JPMorgan conference last month. Chris has been hard at work building out his organization, meeting customers, and setting near-term and long-term strategies. Among recent developments, Chris has onboarded Matt Harbaugh as designated Vantive CFO. Many of you may know Matt from his days as CFO at NuVasive.

Meanwhile, we continued to hit key separation milestones across operational, legal, regulatory, supply chain, and IT domains. In summary, 2023 was a year of rebuilding and renewing our momentum. We made significant progress on an ambitious slate of strategic initiatives, coupled with solid financial performance, while never losing focus on our foundational commitments to our customers and patients. Additionally, we have created new potential to embrace more exciting opportunities to come. I do not take the accomplishments of this past year for granted. I want to thank and recognize all of the employees whose hard work and commitment helped us to achieve our objectives. I have never been more impressed by what a team could achieve in a single year, and that is why I'm so energized by our potential to seize on opportunities we have created together.

Now, we turn it over to Joel for a closer look at our Q4 and full year 2023 performance, as well as our 2024 outlook.

Joel Grade (EVP and CFO)

Thanks, Joe, and good morning, everyone. I'm happy to be joining the call this morning to provide some additional details on Baxter's Q4 and full year 2023 financial performance, as well as commentary on our financial outlook for 2024. As Joe mentioned, we are pleased with our Q4 results, which represented another step forward in our ongoing business transformation. Q4 2023 global sales of $3.9 billion increased 4% on a reported basis and 3% on a constant currency basis, and compared favorably to our previously issued guidance of 1%-2% reported and approximately 1% constant currency. Outperformance in the quarter benefited from better-than-expected sales in many product categories, and particularly in chronic therapies and drug compounding.

As compared to the prior year period, we reported solid quarterly growth in healthcare systems and technologies, pharmaceuticals, and medical products and therapies. Collectively, sales for these three businesses, which will comprise Baxter post the separation, increased approximately 5%. As expected, kidney care sales declined slightly in the quarter due to the factors Joe mentioned earlier. On the bottom line, adjusted earnings totaled $0.88 per share, increasing 13% versus the prior year period. These results reflect the ongoing operational improvements we are recognizing, both commercially as well as within our supply chain network, as that team successfully executes on its margin improvement programs. Lower interest expense and a benefit from foreign exchange also contributed favorably to the quarter, partially offset by the impact of a higher tax rate compared to the prior year.

Adjusted earnings per share for the quarter came in at the high end of our expected range of $0.85-$0.88 per share, primarily driven by better sales and operational performance. Now I'll walk through performance by our reportable segments. Commentary regarding sales growth will reflect growth at constant currency rates. Sales in our Medical Products and Therapies segment were $1.3 billion, increasing 4%. Full year 2023 sales totaled $5 billion, also advancing 4%. Within Medical Products and Therapies, Q4 sales from our Infusion Therapies and Technologies division totaled $1 billion and increased 4%. Sales in the quarter benefited from strength in our IV Solutions Portfolio, particularly outside the United States, as well as solid performance in our infusion system portfolio.

Sales from advanced surgery totaled $278 million and grew 6%, coming in ahead of expectations and reflecting strong growth internationally. For our Healthcare Systems and Technologies, or HST segment, sales in the quarter were $795 million and increased 7%. Full year 2023 sales totaled $3 billion, advancing 3%. Within the HST segment, sales in our Care and Connectivity Solutions, or CCS division, were $492 million, increasing 11%. Performance in the quarter benefited from double-digit growth in all key product categories within the division, including our care communications, surgical solutions, and patient support systems product offerings. Growth in the quarter was partially offset by lower contribution from rental revenues.

Q4 United States orders within CCS continued to improve sequentially, but notably also grew on a year-over-year basis for the first time in 2023. While we are encouraged by the improvement in capital spending we've seen from our U.S. hospital customers, we continue to believe there may still be select pockets of cautiousness in the marketplace. Frontline Care sales in the quarter were $303 million, increasing 2%. Given the improvements in electromechanical component availability over the course of 2023, we were able to successfully address our elevated backlog and exited the year at more normalized levels. Sales in our pharmaceutical segment were $596 million, increasing 7%. For the full year, sales were $2.2 billion, also advancing 7%.

Performance in the quarter reflected double-digit growth in our U.S. injectables portfolio, driven by new product launches, as well as continued strong demand for our services within our Drug Compounding Portfolio internationally. Other sales, which represent sales not allocated to a segment and primarily include sales of products and services provided directly through certain of our manufacturing facilities, were $18 million and declined 58% during the quarter, in line with our expectations. This lower level of sales reflects reduced demand for certain contract manufacturing volumes and the termination of a royalty arrangement. Moving on to Kidney Care. Sales in the quarter were $1.2 billion and declined 1%. Full year 2023 sales totaled $4.5 billion and increased 1%.

Within Kidney Care, global sales for chronic therapies were $950 million, declining 3%, though, as mentioned earlier, came in better than expected. Sales growth in the quarter was impacted by a difficult comparison to the prior year period, which included certain discrete items in the US that totaled approximately $25 million. Finally, performance in chronic therapies continues to be impacted by lower sales in China due to certain government-based procurement initiatives and a lower patient census due to the pandemic. We estimate that collectively, these country-specific factors negatively impacted sales by approximately $35 million in the quarter. Sales in our acute therapies business were $206 million, representing growth of 6%, with strength across most regions, including double-digit growth in the United States, where we've now rebased this business following the pandemic-related benefits we previously experienced.

Now moving through the rest of the P&L. Our adjusted gross margin totaled 42% and represented an increase of 80 basis points over the prior year. The year-over-year improvement in gross margin primarily reflects the stabilization of macroeconomic factors and inflationary pressures that previously contributed to higher costs for raw materials, overhead, and labor that impacted our margins earlier in the year. Margin improvement in the quarter also benefited from pricing initiatives in select markets and ongoing margin improvement programs in our integrated supply chain network. Performance for the quarter was in line with our expectations, as top-line outperformance in the quarter was driven by lower margin divisions, which drove a slightly negative gross profit mix in the quarter. Adjusted SG&A totaled $829 million, or 21.3% of sales, an increase of 20 basis points versus the prior year period.

Performance in the quarter benefited from our ongoing transformation initiatives to enhance operational efficiencies, offset by higher bonus accruals under our annual employee incentive compensation plans compared to the prior year, and select investments in sales and marketing initiatives. Adjusted research and development spending in the quarter totaled $172 million and represented 4.4% of sales, increasing 20 basis points versus the prior year. We have ramped up our R&D efforts, particularly increasing our investments in advancing new products across the portfolio, and like SG&A, R&D expenses include the impact of higher employee incentive accruals as compared to the prior year period. These factors resulted in an adjusted operating margin of 16.2%, an increase of 30 basis points.

Overall, we are very pleased with the second-half margin expansion we were able to realize, with operating margins improving approximately 300 basis points in the second half of the year as compared to the first half of 2023. Net interest expense totaled $73 million in the quarter, a decrease of $44 million versus the prior year, and down $55 million sequentially, driven by debt repayment of approximately $2.8 billion associated with the utilization of the proceeds from our BPS divestiture. We plan to continue to repay debt in 2024, consistent with our stated capital allocation priorities. Adjusted other non-operating income totaled $11 million in the quarter, compared to an expense of $11 million in the prior year period. Year-over-year improvement was largely due to lower foreign exchange losses incurred as compared to the prior year period.

The adjusted tax rate in the quarter was 21%, compared to 14.6% in the prior year period. The year-over-year increase is primarily driven by statute expirations on certain tax positions benefiting the prior year period. The tax rate in the quarter came in higher than expected, primarily driven by changes in geographic earnings mix. As previously mentioned, adjusted earnings totaled $0.88 and increased 13% versus the prior year, primarily driven by better-than-expected sales and operational efficiencies, as well as lower interest expense, partially offset by the tax rate in the quarter.

For the full year, Baxter's adjusted earnings from continuing operations decreased 14% to $2.60 per diluted share, reflecting the impact of higher cost of goods sold, driven primarily by the macro environmental factors we previously discussed, greater annual employee bonus accruals, as well as increased non-operating expenses. These factors were partially offset by our operational and supply chain savings initiatives. With respect to cash flow, we generated free cash flow for the year of over $1 billion from continuing operations, compared to $411 million in the prior year period. Going forward, cash flow generation, and in particular, improving our working capital metrics, is a key priority both for me and the Baxter team. To close on our full-year results, we are pleased with our operating performance through 2023, which reflected both consistent progress and building momentum.

It is important to note that our teams were able to achieve this performance while also making meaningful progress against our strategic initiatives designed to enhance our future performance and drive incremental value for all stakeholders. We look forward to building on that positive momentum as we enter 2024. Let me conclude my remarks by discussing our outlook for the Q1 and full year 2024, including some key assumptions underpinning the guidance. For full year 2024, Baxter expects total sales growth of 2% on both a reported and Constant Currency basis, as the impact from foreign exchange is currently expected to be minimal on a full year basis. Constant Currency sales guidance for the full year by reportable segments is as follows: For Medical Products and Therapies, we expect sales growth of 3%-4%....

Sales in our Healthcare Systems and Technologies segment are expected to increase approximately 3%. We expect pharmaceutical sales growth of 4%-5%. Collectively, sales for these remaining Baxter businesses are expected to increase 3%-4% in 2024. For Kidney Care, we expect sales growth to decline 1%-2% as compared to 2023. Factors impacting year-over-year growth are primarily driven by select market and product exits in connection with our margin expansion initiatives for this segment, which we estimate will negatively impact sales by approximately $150 million. Additionally, the incremental impact from the ongoing government procurement initiatives in China is expected to total approximately $70 million in 2024. Now turning to our outlook for other P&L line items. We expect adjusted operating margin to increase by at least 50 basis points in 2024.

We expect our non-operating expenses, which include net interest expense and other income and expense, to total approximately $350 million in aggregate during 2024. We anticipate a full year adjusted tax rate between 22.0% and 22.5%, which reflects an approximate 100 basis point impact to the 2024 tax rate from the implementation of Pillar Two. We expect our diluted share count to increase slightly and average 510 million shares for the year. Based on all these factors, we anticipate full-year adjusted earnings, excluding special items, of $2.85-$2.95 per diluted share. Specific to the Q1 2024, we expect global sales growth of approximately 1% on a reported basis and 1%-2% on a constant currency basis.

We expect adjusted earnings, excluding special items, of $0.59-$0.62 per diluted share. With that, we can now open up the call for Q&A.

Operator (participant)

Thank you. We will now begin the question and answer session. If you have a question, please press star one on your touch tone phone. If you wish to remove yourself from the queue, press star one again. If you are using a speakerphone, please lift the handset to ask your question. So that we may be respectful of everyone's time, please limit your comments to one question with one follow-up question if necessary. We appreciate everyone's patience and would like to provide as many of you as possible the opportunity to ask a question. We will pause for a moment while the list is being compiled. I would like to remind participants that this call is being recorded, and a digital replay will be available on the Baxter International website for 60 days at www.baxter.com. Our first question comes from Travis Steed of Bank of America Securities.

Your question, please.

Travis Steed (VP and Equity Research Analyst)

Hi, good morning, everybody, and thanks for taking the question. I'll go ahead and ask both of mine up front. One, on the revenue side, you talked about sequential improvement every quarter, and when you look at the 2024 revenue guidance of 2%, maybe, maybe think through some of the, the areas that could improve over the course of the year, where there could be some conservatism built in to the 2024, and how to think about the cadence of the year. And the second question really is on, on margins. You think about the, the 50 basis point margin guidance. Curious what some of the underlying assumptions are on FX and inflationary pressures and, and stuff like that. Thanks a lot.

Joel Grade (EVP and CFO)

Hi, Travis. It's Joel. Thanks for the call. So I guess I'd say a couple of things. First of all, we are, we feel very good about the momentum in our business. I think we had, as you saw, a solid Q4. We are pleased with some of the results that we have heading into this year. And I think the revenue guidance that you see, you know, if you think about overall, the business outside of kidney is growing 3%-4% that we have, as we talked about our forecast. With kidney itself, if you think about that, we actually have about—there's about $150 million of purposeful business that we're actually exiting products, we're exiting markets.

And so if you actually factor that into that equation, again, we're up, you know, over that 3% number for the year, which I think is great. If you think about the full year guidance itself, couple some of that strong sales performance with the fact that we're actually expanding our margins over 50 basis points, and we're actually leading to double-digit EPS growth. I said, "We feel really good about that." Now, on the margin side, which you asked the question, you asked, I think the main puts and takes in that, the main part of it is the operational cost improvements. In that, there's a big piece of that from also pricing, from volume.

And again, so I think some of the things that you have in there, are some of the key assumptions on the margins. I think in all those areas, we feel good about the opportunities, again, to build on the momentum we've had. If you remember in the last quarter, our HST business, we're very pleased with the momentum we had from a sales perspective in Q4, and we do anticipate that, heading into the year as well. So again, lots, lots of good stuff there, but, I'll pause there for any other points that you didn't want-

Clare Trachtman (SVP and Chief Investor Relations Officer)

Yeah. And Robbie, I'll add in a little... Or sorry, Travis, I'll add in a little bit here. That was my fault. So in terms of the cadence, I would say, you know, if we think about just the shape of the P&L, I think sales will be relatively, you know, you'll see some slight acceleration in the second half of the year. But in terms of margin expansion, you are going to see first half margin expansion more outsized than you will see in the second half, obviously, just given the comps. And similarly, you'll see that on earnings growth. So earnings growth in the first half of the year will be very strong.

Your question on FX, Travis, was FX is negative on margins for the year, about 40 basis points, of an impact on our operating margins on a year-over-year basis.

Travis Steed (VP and Equity Research Analyst)

Great. Thanks a lot, Clare and everybody.

Clare Trachtman (SVP and Chief Investor Relations Officer)

Great. Thank you.

Operator (participant)

Robbie Marcus of JPMorgan has a question. Please state your question.

Allen Gong (Equity Research Analyst)

Thanks. This is Allen, on for Robbie. I had a question on some of the strength that we saw in Q4 and, you know, the little bit of the softer Q1 guide. Was there any pull forward of sales into this quarter? You know, you talked about how you recovered some of the backlogs. I expect some of that drove the outsized strength. But also just looking at Q1, you know, given what we view as an easy comp, why aren't you, you know, able to put up a better growth number to start off the year? How much of that is conservatism versus realism?

Clare Trachtman (SVP and Chief Investor Relations Officer)

Yeah. So what I would say is probably one of the biggest drivers in terms of the quarterly cadence is within our HST business, where sales do ramp over the course of the year. So very similar to what we saw in 2023, you will see our HST business have accelerated growth in the second half of the year as compared to the first half of the year. So I think that's probably one of the bigger drivers in terms of the Q1 guidance.

José Almeida (Chairman, President and CEO)

And also, we are continuing to see momentum from 2023 into 2024. So I feel cautiously optimistic about the momentum that we got in Q4 into going to Q1. Of course, we look at many different factors when we are guiding, but I can tell you that based on the market growth, some of the demand that we're seeing, we feel very comfortable with Q1. And also, we have always a crescendo throughout the year, whereas we have product launches. We have 10 molecules launching in pharmaceutical, just starting this quarter, that we see ramping you know, throughout Q2, Q3, and Q4.

And also, there's some very important accounts that we are still closing on for the rest of the year that will also boost our ability to do well in 2024.

Allen Gong (Equity Research Analyst)

Got it. And then if I could slip in a quick one. You know, you've talked about the capital equipment environment continuing to improve, you know, some pockets of weakness. What are you assuming for 2024 in the guidance? You know, are you expecting continued, you know, little bits of pockets of weakness, or are you having that basically normalized over the course of the year? Thank you.

José Almeida (Chairman, President and CEO)

Most of our assumptions are large system, medium to large systems continue to improve. We can see that, and we're going to see that, you know, slightly in Q1, but going into Q2, Q3, and Q4. There are pockets of softness in capital, like always are, primarily smaller systems. You remember, interest rates are still very high, and those affect the smaller systems. But for the majority of our customers, we're starting to see a recovery in, in capital, and we feel, feel really comfortable in 2024, that that is, that is, recovering completely from what we saw in the beginning of... end of 2022 into 2023.

Clare Trachtman (SVP and Chief Investor Relations Officer)

Yeah. And, and Allen, just to add on to that, similarly, I think we will see sequential improvement for capital orders within our CCS business every quarter this year, leading to orders being up on a year-over-year basis. And as mentioned in our prepared remarks, we saw a very similar trend kind of in 2023 as well. And then in the Q4, we did see our orders up on a year-over-year basis. So we've been seeing this steady sequential improvement, and so we're going to build on that momentum as we go into 2024.

Operator (participant)

Matt Miksic of Barclays is on the line with a question. Please state your question.

Matt Miksic (Managing Director and Senior Equity Research Analyst)

Hi, thanks so much for taking the question. Can you hear me okay?

José Almeida (Chairman, President and CEO)

Yes, we can.

Matt Miksic (Managing Director and Senior Equity Research Analyst)

Great. Thanks. So I had congrats on the solid results here, and the pickup in the Hillrom business. I just had a question on the seasonality of that business, and also, if you could, maybe just the extent of recurring revenues in that business. And I think we're used to a history there of being capital-driven, Q4-driven, but with some of the increase in sort of contracting around connected care and systems, that. I'm wondering, you know, is that a mix of recurring revenues that we should see over time, or you're starting to see a mix change in that business? Any color on that front would be super helpful. Thanks.

José Almeida (Chairman, President and CEO)

So, we always have the seasonality. We see hospitals a little bit more cautious in the Q1, and then as they get through the Q1, they start spending the money that they have for the year, and it culminates usually with a strong Q4 in terms of growth, because a lot of spending gets done there. We try to, as much as possible, create more of a less seasonality, but those things happen. And our folks are there. I think the one important program we have in Vantive, as you'll notice, strengthen our beds in the Q4. We continue to go for some large accounts and conversions, and we're starting to get some success there when we bring Baxter together.

You know, what Baxter can do as one company is incredible for hospitals. So we feel that the momentum is starting to kick in with accounts that are partially penetrated, going full blow into a Baxter account. We saw that with a conversion that we get that's gonna launch in early 2025 in Northern Cal, that we have large accounts and other things that we can see. So this is a really good momentum for Baxter. We can see that going. But the Q1 is always a much lighter quarter than the rest of the revenue in terms of Frontline Care is a business that has less seasonality than the CCS business and the HST.

The reason is that it's more consistent with procurement in doctors' offices and monitors into hospital, med surg floors. So that brings less seasonality. A business that is very, very predictable is our, is our MPT business, which has been, you know, successfully growing, as you can see in 2023, 150 basis points above its market growth rate, driven tremendously by infusion systems as well as solutions, IV solutions. So that brings that business quite to a quite less seasonable, more repeatable. I hope I was able to answer your question.

Joel Grade (EVP and CFO)

Yes, if I could just add one thing to that.

José Almeida (Chairman, President and CEO)

Yeah.

Joel Grade (EVP and CFO)

I mean, I think the way to think about that HST business over the course of the year, and just to build on what Joe said, is that we're gonna see, I'd say, sequential ramp-up over the course of the year in that business. So I think the, you know, again, as Clare talked a little bit earlier, but there's gonna be somewhat of a ramp-up in sales that you're gonna see, and that's particularly gonna be applicable to that segment. The other thing I would just say, you'll recall last year, Frontline Care had a fairly sizable amount of growth in 2023 as they worked through some backlog. There's a bit of an early headwind on that business during the first part of the year as well.

So again, sequential ramp-up on that business is just one add I would make to that. So thanks.

Matt Miksic (Managing Director and Senior Equity Research Analyst)

Great. Thank you.

Operator (participant)

Vijay Kumar of Evercore ISI is on the line with a question. Please state your question.

Vijay Kumar (Senior Managing Director)

Hey, guys. Thanks for taking my question. Joe, maybe my first one to you. High level, when I just look at the business ex kidney care, 2%-4%, that's a reasonable number, but it's still below medtech, right? When I look at this utilization environment, what some of your peers are talking about, like, why is Baxter 2%-4%? Are there any one-offs in that 3%-4% ex kidney care? You know, when I look at the legacy Hillrom business, Q4 was really strong. Why should that business slow down if capital order book is turning around in fiscal 2024?

José Almeida (Chairman, President and CEO)

Vijay, let me give you perspective on 3%-4% for this business. It's still growing above its market growth rate because we expect to be on the high end of that guidance. What makes that business go 100 basis points above that? First of all, this business has pharmaceutical in it. We still have price erosion there, but pharmaceutical is gonna be punching 4%-5%. Our MPT is gonna be between 3%-4%, and probably with opportunity to go above that. Now becomes HST. What is happening in HST? We have significant amount of launches going in the end of 2024 and 2025.

We have new monitors, we have a new cardiology device, and we continue to be success on Progressa Plus. So a lot of that has to do with our... To get to the 4%-5%, it has to be new product launches in 2025. Not for pharmaceutical, that because that you can see already is making a difference to their growth rate. It's not for MPT, which continues to do extremely well in infusion systems. We're gonna have more than 40% growth between 2024 and 2023 in our infusion pumps. It's going to be new products in HST, primarily Frontline Care and CCS with care communications, new versions of Voalte.

Three new versions will be launched this year, as well as our new wireless communication device that we plan to launch in 2025. So monitors, wireless communication and cardiology. That is what is gonna drive that business to go above 4%. And if we execute well, it will do it.

Joel Grade (EVP and CFO)

I would also say, too, if you think about the, as we separate the kidney business and we talk about later on in this year, having an investor event, what you're gonna hear us talk about is how we think about capital allocation, how we think about the opportunity for, again, portfolio ultimately to. Because think about it, we have a lot of products with very high market share businesses, and so the opportunity to accelerate that growth is something we're gonna talk about later on. But again, that's part of the benefit of the kidney separation is the ability to actually really focus our capital allocation on accelerating the growth to the levels you're thinking about there.

Vijay Kumar (Senior Managing Director)

Understood. And then maybe one on the guidance question. What is inflation still a headwind to margins? What is price versus inflation and interest expense? Q4, you know, you didn't note the sequential step down on debt payments. Is that a sustainable number? Thank you.

Clare Trachtman (SVP and Chief Investor Relations Officer)

You want me to. I'll start with interest. What I would say, Vijay, on interest is that in the first half of the year, it's probably, you know, I'd say Q1, probably similar. It steps up likely a little bit in the Q2, and then will step up in the second half of the year. We are planning to pay down some low coupon debt in the Q2, and so right now we're earning interest income on the cash that we have, and so that will go away in the second half of the year. So that's why you'll see a bit of a higher interest expense in the second half of the year as compared to the first half.

Joel Grade (EVP and CFO)

Yeah, and on the debt pay down, I mean, again, we use, you know, of the $3.7 billion of proceeds after tax we got from the sale of BPS, we actually used $2.8 billion of that to pay down debt in the Q4. Again, we have some debt coming due that's maturing in 2024 that we'll use some of the rest of that for, particularly the Eurobond, as Clare talked about. And then obviously, we have some debt maturing later in the year that we'll actually address at that point in time.

Clare Trachtman (SVP and Chief Investor Relations Officer)

And then, to your other questions, kind of just on overall the inflationary environment and pricing. What I would say, and we referenced this earlier, is that our, you know, integrated supply chain team is executing on their margin improvement programs. And so those programs and the savings we will generate this year will positively contribute to our margin expansion. So they will more than offset any sort of normalized inflation that we have. In addition, we are getting pricing will be a benefit this year as well, so we are getting pricing, particularly in markets outside the US as well. So we are going after all of those, you know, our businesses are targeting price in all of those markets as well. So pricing will be positive for the year as well.

In terms of kind of all of those pieces, what I would say on the non-ops side is that, well, you know, you, you have a positive on interest, but, you know, you will see that our tax rate is increasing. We, we did comment on that because of the implementation of Pillar Two effects. So we have some effects. I talked about it being kind of negative on the operating margin. So all in, our non-op is probably, you know, probably about $0.02 negative impact for us, on the year.

Vijay Kumar (Senior Managing Director)

Understood. Thank you, guys.

Operator (participant)

Pito Chickering of Deutsche Bank Securities is on the line with a question. Please state your question.

Pito Chickering (Managing Director and Senior Equity Research Analyst)

Hey, good morning, guys. Joel, like, you've not been in that seat for very long, but I just think a fresh set of eyes on the operations of Baxter. Can you walk us through where you think the most margin upside is, over the next several years, and what you need to do to hit those cost reductions, you know, like any areas that you want to highlight, like procurement or any other sort of low-hanging fruit?

Joel Grade (EVP and CFO)

Sure. Absolutely. Thanks a lot for the question. Yeah, I think, I think one of the biggest opportunities we have from a margin perspective is to continue the work that we're doing in our independent supply chain group. I think the, the team's got a lot of really good, market, you know, margin improvement programs going that are designed specifically around things like automation. They're designed around things like: how do we enhance our procurement abilities? They're around, continuing around things about how do we optimize our network, and some of the logistics opportunities. I think some of the, the areas that are the most impactful over time sit in that space. Again, and that's, that's the team has gotten off to, again, a really good start on that.

You've heard Clare talk about the fact that, you know, as we continue to see some inflationary pressures coming out, I think the work that they've done has gotten us to a place where we're, we have the ability to offset that. But to continue the expansion of the margins, to your point, fall into some of those categories that I just referred to. I think the other piece of it, and, you know, some of you heard me say this already, we're not going to SG&A ourselves to prosperity, but nonetheless, there are still opportunities in that space as well, around things like, again, how do we think about a shared services environment that actually allows for consistent execution of operations across the business?

I know this is not a margin question, but the other part of what we're gonna focus on heavily is our cash that we will continue to... How do we drive improved use of working capital? How do we improve our cash conversion ratio? Again, I know that's not specifically what you asked, but again, that's gonna be some an area I see the opportunity. What that all leads to is then the opportunity for us to continue to reinvest some of that back into our business around innovation, around new product development. Back to the question that was asked earlier: how do we continue to accelerate growth?

That's a, what I call a flywheel that allows us to continue to grow, continue to invest, to continue to grow, et cetera, et cetera, which is where we want to get to the company.

Pito Chickering (Managing Director and Senior Equity Research Analyst)

Great. Then for follow-up, you know, you opened Pandora's box a little bit here by providing segment level margins for Q4 in 2023. And now we're gonna, you know, be looking possibly to rebuild our models. Can you break out sort of the margins in each division for we assume for 2024? And then a quick pump question here. You know, how is market share for pumps in Q4 as you're competing against next-gen pumps? And any update on Novum?

José Almeida (Chairman, President and CEO)

Let me start with the pumps, and then Clare is gonna answer the first part of your question. You know, yesterday we just got awarded Best in KLAS for our Sigma Spectrum pump, which is a great honor. That pump continues to do a great job. Nonetheless, we're looking forward to get Novum approved. But in terms of market share, we continue to advance our market share. This year we have 40%+ growth in our pumps versus last year. That's our forecast. So we continue to do well, and we look forward to continue to gain market share and now with a nice award to our pump. It's the seventh award that that pump received since it was launched.

Back to Clare now to answer the first part of the question.

Clare Trachtman (SVP and Chief Investor Relations Officer)

Yeah, Pito, in terms of the 2024 operating margin guidance, we aren't going to give that by segment, but obviously all of our actions are aligned to improve, you know, both the segment and total Baxter margins. The one caveat I would point out is that within our Pharmaceuticals business, as you're aware, we did divest our BioPharma Solutions business last year. And so as a result, we entered into some MSAs, which will have a negative impact on the pharmaceutical margins and obviously on total Baxter margins for the year as we've now entered into that MSA. So you will see that impact in the Pharmaceuticals margins.

Pito Chickering (Managing Director and Senior Equity Research Analyst)

Great, thanks so much.

Operator (participant)

Of Wells Fargo is on the line with a question. Please state your question.

Lei Huang (Equity Research Associate)

Hi, it's Lei calling in for Larry. Thanks for taking my question. I just want to make sure I didn't miss it. Did you comment on the status of Novum IQ, the resubmission, and your thoughts on potential approval in 2024? And I have a follow-up.

José Almeida (Chairman, President and CEO)

I didn't comment on the details, and we usually don't comment on anything that is with the FDA on behalf of the FDA. We can tell you that we answer all their questions. There's no other questions to be answered. All the documentation was submitted. So, as always, it is at their side now to make a final decision on this. But, as I said before, and I said this about a month or so ago, I feel cautiously optimistic because there is nothing else for us to do. We answer all the questions. So, that will be a, you know, if that happened in 2024, it would be a great thing. Nevertheless, we continue to gain market share with Sigma Spectrum.

As I said before, we just got an award at Best in KLAS for that pump, and we're very happy, and we continue to be very busy quoting new accounts and competitive accounts, which we are actually winning with that pump.

Larry Biegelsen (Managing Director, MedTech Analyst)

Got it. Thank you. My follow-up is just, your what you said about expectations for the two segments in 2024. So Baxter ex-Renal, you expect 3%-4% growth. Is that the right way to look at it longer term? And similarly, in the renal business itself, you're expecting 1%-2% decline this year, but once you adjust for the exits in China VBP, does renal normalize to kind of low single digit growth longer term? Thanks again for the questions.

Clare Trachtman (SVP and Chief Investor Relations Officer)

Yeah. So Lei, I'm going to go back to something that Joel mentioned earlier. We, you know, plan to have a Capital Markets Day, you know, later this year, where we will discuss our long-term expectations for the business. But I think that both Joe and Joel have said that, you know, while we're growing 3%-4% through the introduction of new products, you know, continued market expansion, our goal is to grow ahead of our weighted average market growth rate. So we do want to grow in advance of that. And so we'll be unveiling kind of those longer term. But no, I would say our goal is to accelerate growth off of that.

With respect to Kidney Care, again, yes, you know, we made $150 million of exits to that business, all aligned with our goal of enhancing profitability for that, for that business post-separation. So I think that what we want to ensure is that we're setting this business up for success as a stand-alone entity. We also have the Volume-Based Procurement. There might be some follow-on to that in 2025, but I think the key is that, that the fundamentals for this business are improving. We're seeing solid patient growth. We're seeing a rebound in our Acute Therapies business. So I believe this business can accelerate off the levels or that will grow off the levels that we're seeing once we make these adjustments.

Joel Grade (EVP and CFO)

Yeah, and I would just, just to the question you asked, the, we did again, make purposeful decisions around exiting markets, exiting products. And so if you actually add that back, some of that $150 million we referred to earlier, you think, yes, you would find yourself in a place where there's a, where the growth is actually in the low single digits.

Operator (participant)

Matt Taylor of Jefferies is on the line with a question. Please state your question.

Matt Taylor (Managing Director and Senior Equity Research Analyst)

Hi, thanks for the question. I know you noted some progress on pricing. I was wondering if you could comment on that and your expectations for pricing in 2024, and any updates on some of those bigger contracts that you've talked about in the past, and your opportunities to reprice solutions, dialysis, nutrition, et cetera.

Joel Grade (EVP and CFO)

Yeah, sure. So we did make progress in pricing in 2023, and some of that was more temporary in nature, in the sense that we had some adds to pricing that will, you know, again, fall off at the end of the year here. But we do have part of our growth and our margin expansion in 2024, that is continued progress in the areas of pricing. And I think, you know, one of the things that, you know, we've talked about is, just as a reminder, some of the contracts with the GPOs that we've signed, we've made continued progress on. That actually doesn't kick in until 2025. So just to remind you of that, that's not part of what we're talking about in terms of progress.

But again, the team has made solid progress in terms of continuing to take pricing in 2024. And the other thing I would say that we've done a good job of, or continue to do an even better job of, is to give ourselves the opportunities to actually have indexes within our pricing that allow us more flexibility to pass along.

... costs that are coming into our world that we have historically struggled to pass along to our customers. Again, we're making progress in that area as well. So generally speaking, you know, as Clare talked about, our expansion margins really is focused around some of the operational work that we're doing, but also again, our pricing progress continues in 2024, and we look to accelerate that further in 2025 and beyond.

Matt Taylor (Managing Director and Senior Equity Research Analyst)

Thanks. Can I just ask a follow? I mean, when can we hear more about the bigger contracts? Are you going to talk about that throughout the year? And can you comment at all on the kind of opportunities you have with some of those contracts? What's the order of magnitude of pricing you could get?

José Almeida (Chairman, President and CEO)

We are making great progress. We're in the middle of doing it. Once these contracts are signed, the next step is for us to secure the IDNs underneath them, and Baxter will do well in that. We are well poised to take that action. We are feeling quite comfortable where we are today in terms of signing these agreements. We're not going to tell exactly the status of where we are signing them for competitive reasons, neither the volume of dollars. So you need to think about this as value. Value is dropping profit to the bottom line, is value. That will be achieved with pricing and volume. Volume is important to us, the size of our plants. So we're getting a combination of both, is the important thing for us.

So our focus, price is always important because the amount of headwind that we had in 2022, of course. So we are considering that, but also expansion of market share is important to us as well, because we have capacity, and we've been serving the market very well. So think about our objective in 2024 into 2025, is to continue to add value and, significant accretion potentially to the bottom line by getting those contracts signed. But we are in good position.

Joel Grade (EVP and CFO)

We're not going to give specific details on the pricing or volume, as Joe referenced. So just think about that as guidance that we ultimately give on margins, and volume growth will be inclusive of the progress we'll make with those contracts.

Thanks, Joe. Thanks, Joel.

José Almeida (Chairman, President and CEO)

Thank you.

Joel Grade (EVP and CFO)

Thank you.

Operator (participant)

Danielle Antalffy of UBS is on the line with a question. Please state your question.

Danielle Antalffy (Senior Analyst and Executive Director)

Thanks, everyone. Good morning, and just a quick question on sort of what the longer term focus is post kidney care. I assume we'll get some more color here once we have the, you know, pre-spin Analyst Day. But just at a high level, Joe and Joel, curious about where you see the most opportunities to improve, whether organically or inorganically, from an R&D perspective, and just longer term, i.e., over the next few years, where you think Baxter will be most focused.

José Almeida (Chairman, President and CEO)

Mm-hmm

Danielle Antalffy (Senior Analyst and Executive Director)

... and investing behind? Thanks so much.

José Almeida (Chairman, President and CEO)

So Danielle, we're thinking about a strategy, and the overarching imperative of this strategy is to, is to advance and significantly improve the intrinsic value of the company. And we're going to do that organically and eventually inorganically, as well, with some tuck-ins and strategic acquisitions that will supplement some of our business. But so in the organic side, to drive that, that intrinsic value multiplier is innovation, acceleration of innovation, expansion of our commercial footprint in areas that we currently don't participate well, as well as doubling down in, in, operations excellence in all aspects of Baxter, from the plants all the way to our back office. So creating value in all parts of the company, so we can take some of that money, reinvest modestly in research and development, and continue to the, to, to accelerate the innovation.

The innovation, all of this is going to be done with a significant amount of importance to capital allocation, meaning where money goes inside of the company, how much is share buyback. So this is a post-spin, when we are looking at a different debt structure and a different company past that. So think about our strategy to accelerate innovation, accelerate a penetration in commercial areas where we're not like alternate sites of care, ASCs. Those are the drivers of our organic growth, and that should drive a quest for a multiplier on our intrinsic value as a company.

Clare Trachtman (SVP and Chief Investor Relations Officer)

Danielle, just to follow on and, you know, specific to kind of kidney care, you know, what I would say is, you know, within kidney care, and obviously, Chris Toth will, you know, elaborate more on this, but they're going to focus on continuing to increase PD penetration globally, really focusing on how do they enhance this digitally as well, and what digital capabilities are out there to really help both clinicians and patients advance that therapy. In addition, within the acute therapies business, I think they'll continue to build upon the continuous renal replacement therapy and broaden it into more multi-organ support therapies as well. So I think that they have a strategy there that they'll continue to build upon and execute, you know, as a standalone entity.

Joel Grade (EVP and CFO)

Yeah. And I just think what Joe said and what Clare's talked about is just reinforcement of the strategic rationale for the separation that then allows us, and Kidney, frankly, to both focus their capital allocation on those areas that really accelerate their growth. And as Joe said, I see that, once our debt is at a level of, you know, that we've targeted, to actually reinforce this idea that we're going to have both organic and inorganic growth, opportunities ahead of us.

Danielle Antalffy (Senior Analyst and Executive Director)

Thank you so much.

Operator (participant)

Ladies and gentlemen, this concludes today's conference call with Baxter International. Thank you for participating.