Earnings Labs

Edwards Lifesciences Corporation (EW)

Q2 2014 Earnings Call· Tue, Jul 29, 2014

$81.65

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Transcript

Operator

Operator

Greetings, and welcome to the Edwards Lifescience Corporation Second Quarter 2014 Earnings Conference. At this time all participants are in a listen-only mode. A question-and-answer session will follow the formal presentation. [Operator Instructions]. As a reminder this conference is being recorded. It is now my pleasure to introduce your host, Mr. David Erickson, Vice President of Investor Relations. Thank you, Mr. Erickson, you may now begin.

David K. Erickson

Analyst

Welcome, and thank you for joining us today. Just after the close of regular trading we released our second quarter 2014 financial results. During today's call we'll discuss the results included in the press release and the accompanying financial schedules and then use the remaining time for Q&A. Our presenters on today's call are Mike Mussallem, Chairman and CEO; and Scott Ullem, CFO. Before we begin I'd like to remind you that during today's call we will be making forward-looking statements that are based on estimates, assumptions and projections. These statements include, but aren't limited to our expectations regarding sales, gross profit margin, earnings per share, SG&A, R&D, interest expense, taxes, free cash flow and foreign currency impacts. These statements also include our current expectations for the timing, status and expected outcomes of our clinical trials, regulatory compliance, submissions and approvals, as well as expectations regarding industry growth expectations, new products, and launch expectations and reimbursement. These statements speak only as of the date on which they are made, and we do not undertake any obligation to update them after today. Although we believe them to be reasonable, these statements involve risks and uncertainties that could cause actual results or experiences to differ materially from the forward-looking statements. Information concerning factors that could cause these differences may be found in our press release, our annual report on Form 10-K for the year-ended December 31, 2013, and our other SEC filings, which are available on our website at edwards.com. Also a quick reminder that when we use the terms underlying, excluding the impact of foreign exchange, excluding special items and adjusted for special items we are referring to non-GAAP financial measures. Otherwise we are referring to our GAAP results. Information about our use of non-GAAP measures is included in today's press release and on our website. Now I'll turn the call over to Mike Mussallem. Mike?

Michael A. Mussallem

Analyst

Thank you David. While our litigation settlement provided a large boost this quarter we are particularly pleased that our sales were better than expected across all product lines, which drove strong bottom line results. The ongoing launch of SAPIEN 3 in Europe helped drive share gains in the quarter and the launch of SAPIEN XT in the U.S. which just got underway in June will enable treatment of an even broader group of patients while helping to reinforce our leadership position in that growing region. Strong contributions from our Surgical Valve and Critical Care product lines also helped drive the results. Even as TAVR competition intensifies with the increasing adoption of this therapy around the globe we believe that we are poised for continued strong sales growth in the second half of 2014. Now turning to quarterly specifics. Total underlying sales grew 11% to $577 million. These results exclude the impacts of foreign exchange, the THV sales return reserve and include the THV royalty payment which Scott will detail later. In trans-catheter valves underlying global sales grew 19% driven once again by strong OUS sales which accounted for approximately 60% of our total THV sales. U.S. THV sales were more favorable than our earlier expectations and on a global basis pricing was stable. Outside the U.S. THV sales grew 35% on an underlying basis once again driven by strong growth in Europe and the SAPIEN XT launch in Japan. In Europe adoption of transcatheter valve therapies continues to be quite strong and additionally we believe we gained share with SAPIEN 3. Representing more than half of our Europe THV sales SAPIEN 3 is being well received by clinicians who appreciate its best-in-class low profile and paravalvular leak solution. We have been aggressively launching SAPIEN 3 at the highest volume hospitals…

Scott B. Ullem

Analyst

Thanks Mike. I am pleased to report that we achieved non-GAAP diluted earnings per share of $0.88 driven by stronger than expected sales in the quarter. Total adjusted sales in the quarter were $577 million an 11.6% growth over last year. This includes royalties of $4.7 million and excludes the global net impact of the THV sales return reserve of $2 million. More detail regarding the sales return reserve is available in our supplemental schedule posted on www.edwards.com. For the quarter our gross profit margin was 73.7% compared to 76.1% in the same period last year. This reduction was driven principally by a negative impact from foreign exchange as well as the smaller impact of the write-off of SAPIEN Valves in the U.S. in connection with our SAPIEN XT launch. For full year 2014 we continue to expect our gross profit margin excluding special items to be approximately 73%. Second quarter selling, general and administrative expenses were $216 million or 37.5% of sales compared to $187 million in the prior year. The largest components of the increase were Transcatheter Valves launch related expenses and the larger accrual for incentive compensation. We continue to expect SG&A excluding special items to be between 37% and 38% of sales for the full year. We continue to aggressively invest in research and development and spending in the second quarter was $89 million or 15.5% of sales compared to $80.5 million in the prior year period. Heart Valve critical studies continue to be one of the largest drivers of our increased spending. We also increased our investments in our Transcatheter Mitral valve programs. We continue to expect our R&D investments to remain at approximately 16% of sales for the full year. During the second quarter we recorded four adjustments to our GAAP earnings per share…

Michael A. Mussallem

Analyst

Thank you, Scott. As we reflect on our first half results we are very pleased with the performance we have achieved across all our product lines and believe our future remains bright. Our transcatheter valve franchise is poised to drive market growth through indication expansion and next generation technologies. Our Surgical Heart Valve product line remain strong and we are investing in innovative products to strengthen our leadership position and our critical care product line should continue to benefit from sales of our best-in-class monitoring technologies including the launch of the non-invasive ClearSight system. Overall, we are confident in our outlook for a continued strong organic sales growth reflecting our focused innovation strategy and our commitment to helping patients. And with that, I'll turn it back over to David.

David K. Erickson

Analyst

Thank you, Mike. Before we open up the question I would like to encourage you to mark your calendars for Monday, December 8th when we will be hosting our 2014 Investor Conference in New York. This event will include updates on our new technologies as well as our outlook for 2014. More information will be available in next couple of months. In order to allow broad participation in the Q&A we ask that you please limit the number of questions. If you have additional questions please re-enter the queue and we will answer as many as we can during the remainder of the hour. Operator we are ready for questions please.

Operator

Operator

Thank you. (Operator Instruction). Our first question is coming from the line of Jason Mills with Canaccord Genuity. Your line is now open. Please proceed with your question.

Jason Mills - Canaccord Genuity

Analyst

Thank you, congrats on great quarter Mike. Can you hear me okay?

Michael A. Mussallem

Analyst

Yeah, sure can. Thanks Jason.

Jason Mills - Canaccord Genuity

Analyst

Great. First question for me is on the transcatheter mitral program. Perhaps you give us a broader prospective on how you are thinking about bringing product to market there both from an internal prospective and your considerations now with the incremental cash from the incremental cash from Medtronic as you have obviously a share repurchase program authorized but perhaps talk about the acquisition of additional program, additional shots on goal. Just generally speaking how you are thinking about building that franchise over the next couple of years?

Michael A. Mussallem

Analyst

Sure, thanks Jason. You know we are still early on in terms of the development of Transcatheter mitral valves. We're optimistic about FORTIS program but it's still difficult to fully judge the value. The path of commercialization of mitral transcatheter heart valve is likely to be a long and rigorous one similar to the experience that we had in SAPIEN valves. Our intention is to be the leader in this field. We remain open in considering acquisitions to supplement our existing portfolio but as it goes along with the comments that we made previously we're not really changing acquisition strategy based on the Medtronic settlement.

Jason Mills - Canaccord Genuity

Analyst

Okay. Just another one. On transcatheter side this time on the aortic in the U.S. is the SAPIEN 3 high risk valve brand [inaudible] 30 day endpoint, I was just curious what the discussions have been or what the possibility would be that you will be able to bring back to market perhaps sooner than what may have otherwise been expected if we would wait for a full one year if that’s possible?

Michael A. Mussallem

Analyst

Yeah. Thanks Jason. We're very excited about SAPIEN 3. We think it's a best-in-class valve. Obviously we're going to work to make that valve available to U.S. patients as soon as we can. We just don't have anything specific to share at this point.

Jason Mills - Canaccord Genuity

Analyst

Okay. And with that just let me drill in one another one. In the U.S. now have Medtronic on the market, one of the things that we've been discovering in our research is the length of stay is trending down. Seem to be perhaps an advantage that from we’ve heard with respect to the SAPIEN valves given the -- issues with the Core Valve. I am wondering if there is any data to come or there’s any anecdotal discussions that you had that you like to perhaps pass along to us with respect to length of stay and the competitive landscape here in the U.S.

Michael A. Mussallem

Analyst

Yeah, thanks Jason. We're going to have let others ask some questions. Overall we have been observing length of stay fall. This is something that we've been really working on and have been focusing on for more than a year at this point. It's too early probably for us to detail any comparison between ourselves and Core Valve but really familiar with our own experience and the clinicians that we're associated with are sharing optimism that they're able to drive better performance and we've seen certainly historically. Thank you.

Operator

Operator

Thank you. Our next question is coming from the line of David Roman with Goldman Sachs. Your line is now open. You may proceed with your question.

David H. Roman - Goldman Sachs Group Inc.

Analyst

Thank you and good afternoon everybody. I want to follow up a little bit on Jason's question here about the impact of Core Valve being on the market. I think Mike if I heard you correctly in your prepared remarks you listed out a few factors that you thought were helping market growth in the U.S. including new technology sizes and indications. Could you maybe help us understand how the competitive landscape has played out over the first six months and whether in fact you are seeing an uptick in demand associated with smaller products and a second player being on the market?

Michael A. Mussallem

Analyst

Yeah. So it's a good question, Dave. You got a few things wrapped up in there. It's difficult to peg exactly what is lifting the U.S. market but it feels like that U.S. -- the number of procedures in the U.S. has lifted. We feel that clearly the impact of a low profile system and larger sizes clearly has impact but we also believe that the continued strong data that's been demonstrated broadly in the field of transcatheter valves is also helpful. Did I get your question or there was more in there David? Do you want to restate?

David H. Roman - Goldman Sachs Group Inc.

Analyst

No, that is what I was trying to get out whether I think coming in to this year you were concerned about the share loss impact and it sounds like there might be a market growth impact to consider as well?

Michael A. Mussallem

Analyst

That's right.

David H. Roman - Goldman Sachs Group Inc.

Analyst

Okay. And then my follow up just for Scott on the gross margin line, maintaining 73% gross margin target, can I just clarify that's a GAAP number because year-to-date you're obviously trending way above that and the impact of the Medtronic royalty base you disclosed in the 8-K sounds like that would add just about a 100 basis points to gross margin for the year. So is there anything else going on in that line that we need to consider?

Scott B. Ullem

Analyst

The other big thing that’s going in that line is just the effect of FX flowing through versus the rates in the second quarter of last year. So FX is the big driver of that shift in the gross margin

David H. Roman - Goldman Sachs Group Inc.

Analyst

Okay, but we are not rating gross margin even with the royalties is that implicitly lowering the underlying margin or is that not the right way to look at it?

Michael A. Mussallem

Analyst

Sorry David say that one more time?

David H. Roman - Goldman Sachs Group Inc.

Analyst

Are you lower why would you not raise the gross margin target to give in the now inclusion of the royalty from Medtronic which I am assuming has obviously a 100% margin on it. Are you lowering the underlying margin target here?

Michael A. Mussallem

Analyst

It does benefit the gross margin rate to the tune of about 30 basis points but again the big factor that influencing our rate this year versus last year is the FX move.

David H. Roman - Goldman Sachs Group Inc.

Analyst

I got it, thank you.

Operator

Operator

Thank you. Our next question is coming from the line of Mr. Bruce Nudell with Crédit Suisse. Your line is now open. Please proceed with your question. Bruce M. Nudell - Crédit Suisse: Good afternoon, thank you. Mike just to be clear royalties and de-stocking basically cancel each other and reserves don’t count to get to your 92 and if that’s the case it sounds like based on what we know the Medtronic I mean the market to be you know $125 million #140 million so, that means the market and the U.S. grown 35%-40% is that conceivable in your mind?

Michael A. Mussallem

Analyst

I think just from what you said Bruce sounds like you math about our sales is correct. I think you got that right. There is a lot of moving pieces and Scott can help detail if you want to get into it. In terms of estimating what the U.S. growth rate I don’t know it’s a little difficult there are so many moving pares right now you know we also believe that one XT is approved some of these patients that have large annulus that might be on the side line came into the system. So, exactly pegging the growth rate is tough but it does appear that we do have lift versus what we are expecting and we are very encouraged by that. Bruce M. Nudell - Crédit Suisse: And my follow-up is regarding Europe, could you just give us some sense of how you think market in aggregate is doing north, south Europe northern or southern Europe overall reimbursement you know constrains et cetera et cetera?

Michael A. Mussallem

Analyst

Yeah, thanks Bruce we actually find it remarkable the results in Europe were better than we expected. Of course we were optimistic about SAPIEN 3 but there really appears to be some strong growth in the number of procedures We think it’s probably going then in the mid-teens and that’s not exclusive to a single country that’s broadly across the continent and when we try and get into what’s behind it I think one of our belief is just the growing body of impressive clinical evidence is helping lift the use of transcatheter heart valves. Bruce M. Nudell - Crédit Suisse: Thanks so much Mike.

Michael A. Mussallem

Analyst

Sure.

Operator

Operator

Thank you. Our next question is coming from the line of Mr. Rick Wise with Stifel Nicolaus. Your line is now open. You may proceed with your question. Frederick A. Wise - Stifel, Nicolaus & Company: Good afternoon. Mike, you talked about in Europe for the first time it sound like you are saying competing product launching, you are starting to see the impact. Maybe if you can just expand on where you are seeing it, how you are seeing and is that certain geographic area or certain type of product or segment, maybe just give us a little more color and maybe as part of that can you discuss in the United States the impact of what seems to be an acceleration in competing U.S. pivotal -- competing clinical trials getting underway and is that should that be something we should be concerned about longer-term as well?

Michael A. Mussallem

Analyst

Okay, yeah, let me try and take the two pieces. First, on Europe CHV competition. Recall going into the year we indicated that we were going to have headwinds and that we are going to see the introduction of two large competitors, both Boston Scientific and Saint Jude. Although we have seen among the same we haven’t seen substantial impact so far this year. We think that might be because their introductions have been somewhat delayed in terms of having full product line. We expect to see the more complete product from those companies later on in the year. So, I don’t does that answer that question? Frederick A. Wise - Stifel, Nicolaus & Company: Sure.

Michael A. Mussallem

Analyst

And then on the U.S. side so far clinical trials in 2014 have probably have been somewhat similar to what they were in 2013. Remember 2013 we thought it probably accounted for close to 15% of all the procedures done. We are starting to see more clinical trials, it’s tough for us to define that Rick but we do think it is going to lift in the future those competitive clinical trials. Frederick A. Wise - Stifel, Nicolaus & Company: Which should be an accelerant do you think for you…?

Michael A. Mussallem

Analyst

Well no I would say depending on the growth of overall procedures if some of them go to competitive clinical trials we would probably feel that. But there are so many movements parts Rick it’s kind of difficult to quantify that now. Frederick A. Wise - Stifel, Nicolaus & Company: Yeah. Just a quick follow-up on CENTERA the delay and it makes sense that you’d want to keep focusing on new kind of capabilities but does this at all suggest that you are less interested or less optimistic about the software expanding segment and maybe if you can give us any color on what you are thinking about there and just the new capabilities. Thanks so much.

Michael A. Mussallem

Analyst

Okay, yeah, thanks. No, as a matter of fact we very optimistic about CENTERA. Matter of fact we think that we have shot here to introduce a best-in-class self-expanding THP. There is a number of opportunities though for enhancement that we identified during the initial clinical experience and so as we have seen so much enthusiasm for SAPIEN 3 we just have elected to slow down CENTERA so that we can incorporate those enhancements but no we have not lost enthusiasm. Frederick A. Wise - Stifel, Nicolaus & Company: Thanks.

Michael A. Mussallem

Analyst

Sure.

Operator

Operator

Thank you. Our next question is coming from the line of Mr. Larry Biegelsen with Wells Fargo Advisors. Your line is now open. You may proceed with your question.

Lawrence Biegelsen - Wells Fargo Securities

Analyst

Good afternoon, thanks for taking the question and congratulations on a good quarter. Let me start with the guidance and then I had a follow-up, so I think I guess you raised the guidance by $0.14 to $0.24, can you kind of parse that out for us? I mean the royalty when you put out the 8-K with Medtronic you expected the royalty to initially be $25 million to $28 million or by our math by about $0.16 but yeah you know you are increasing our sales guidance to the high end. So can you just help us understand know the components of the guidance raise?

Michael A. Mussallem

Analyst

Yeah so, I think it’s a good question and thanks Larry. The point that you mentioned of course we had a beat in the second quarter and yes we got lift from Medtronic. So those things clearly help us but I think as Scott detailed when he talked about our expenses we are going to have a little higher incentive comp. Our performance that is performance based in the second-half of the year and also we have some new expenses related to our CSS products in Draper, Utah. So those provide somewhat of a drag Larry and that’s where it sort of nets out the lift that we have in there.

Lawrence Biegelsen - Wells Fargo Securities

Analyst

And so just to confirm the royalty you are still expecting $25 million to $28 million this year and then for my follow-up on SAPIEN 3 with the intermediate risk trial coming to an end soon how should we think about the likelihood of a cap and how should we think about clinical implants for you in the second-half of 2014 and 2015 because if you don’t get a capital you know your clinical sales which were approximately $25 million in the first-half of this year you know go away thanks?

Scott B. Ullem

Analyst

Hey, Larry its Scott. On the guidance for royalties we booked $4.7 million in the second quarter as you know. We expect that for the full year will be around $25 million give or take. There is nominal royalty on top of the U.S. royalty for outside U.S. sales and that will contribute to that the total that we end up booking but $25 million range is the right assumption for now.

Lawrence Biegelsen - Wells Fargo Securities

Analyst

Thank you. And then typically -- yeah…

Michael A. Mussallem

Analyst

Yeah, and related to clinical sales as we mentioned the clinical sales were up this quarter that was driven by SAPIEN 3 we don’t have clarity on whether there was going to be continued access program or not. You know if you are asking us to estimate at this point this might be the higher watermark for our clinical sales you know it’s difficult for us to say right now.

Lawrence Biegelsen - Wells Fargo Securities

Analyst

Thanks guys.

Michael A. Mussallem

Analyst

Sure.

Operator

Operator

Thank you. Our next question comes from the line of Brooks West with Piper Jaffray. Your line is now open. Please proceed with your question.

Brooks E. West - Piper Jaffray

Analyst · Piper Jaffray. Your line is now open. Please proceed with your question.

Thanks, thanks for taking the question. Mike I wanted to ask a question on hospital profitability and how I might think about the impact of the proposed reimbursement you have spent a lot of time helping hospitals with their profitability I am specifically thinking about the U.S. on THP procedures. Can you give us an idea of how many U.S. hospitals are profitable all in on the procedures and how you think this proposed reimbursement increase might impact that?

Michael A. Mussallem

Analyst · Piper Jaffray. Your line is now open. Please proceed with your question.

Yeah, thanks Brooks. That’s a really tough question. You know when you go from hospital to hospital you get very different accounting system and we are not sure that they are fully transparent with us about their actual profitability. So it’s tough for us to say. I think we have estimated in the past that on average hospitals used to breakeven on transcatheter heart valves. We think that's been gradually improving overtime as they gain experience and they shorten our length of stay. We're optimistic that this change to the new DRG is going to be helpful. And we did some modeling on this and there are lot of things that depend on. It depends on hospital case mix, on their practice pattern on their regional payment but we think on average that we model the payment could increase 10% to 15% for most hospitals.

Brooks E. West - Piper Jaffray

Analyst · Piper Jaffray. Your line is now open. Please proceed with your question.

Okay. And then thanks for that. And then on Japan came in a little bit below what we were thinking. You are running about $17 million for the first six month, did you see some -- other companies have seen some weakness in Japan in Q2, was anything specific there and then how should we kind of think about the drivers of the acceleration there to make $40 million or $50 million in guidance? Thanks.

Michael A. Mussallem

Analyst · Piper Jaffray. Your line is now open. Please proceed with your question.

No. We didn't see anything noteworthy but we’re right on track with our plan. I think we did $7 million in the first quarter, $10 million in the second. It's clearly a ramp and it's building and we continue to expect to be in the 40 million to 50 million range this year.

Brooks E. West - Piper Jaffray

Analyst · Piper Jaffray. Your line is now open. Please proceed with your question.

Great. Thanks Mike.

Michael A. Mussallem

Analyst · Piper Jaffray. Your line is now open. Please proceed with your question.

Sure.

Operator

Operator

Thank you. Our next question is coming from the line of Danielle Antalffy with Leerink Partners. Your line is now open. You may proceed with your question.

Danielle Antalffy - Leerink Swann

Analyst

Hi. Good afternoon guys. Thanks so much for taking the question. Mike I was hoping you could give a little bit more color on the SAPIEN 3 rollout in Europe specifically in the centers in which you launched how much of the growth that you're seeing is market gain versus more aggressive implanting of intermediate risk patients and how much incremental runway do you see there particularly on the intermediate risk patient side of things, any color there?

Michael A. Mussallem

Analyst

Yeah. It's very difficult to say overall with any level of precision Danielle. Overall we would say no, it's not like a bunch of intermediate risk patients are coming into the system but if you look out our surgical heart valves business it's continued to grow and that would be a good indicator if that we're shifting. But rather we see a general lift in the overall number of procedures and that's almost the biggest impact. We did note that we have some share gain but we think that's the smaller component of the two compared to procedure growth.

Danielle Antalffy - Leerink Swann

Analyst

Okay. And then just as follow up because I am viewing obviously the intermediate risk population as the next leg of growth for this market where there’s still some runway on the high risk side longer term of course need that patient population. So what's the first key data point we should expect to see there you got several -- you and Medtronic both have registries in Europe and the U.S. trial what should we expect to see first and when if you can put a timeline to it?

Michael A. Mussallem

Analyst

Yeah. Broadly Danielle you're on a key point. If the data demonstrates that we can effectively treat intermediate risk patients that clearly be a lift to the field and we're optimistic that will be the case. Because all that presented in a clinical setting and clinical meetings we really don't have complete control of that and we're not sure when it's going to happen. We're currently and our trial pointed out a two year endpoint so you know what the implications of that are. We continue to have discussions, you can imagine on changing or looking at other options to that but we have really nothing to speak about at this point.

Danielle Antalffy - Leerink Swann

Analyst

Okay. Thanks so much.

Michael A. Mussallem

Analyst

Thank you.

Operator

Operator

Thank you. Our next question is coming from the line of Raj Denhoy with Jefferies. Your line is now open. You may proceed with your question.

Raj Denhoy - Jefferies LLC

Analyst

Hi. Good afternoon. What if I could ask a bit about the competitive dynamic in the U.S. as the quarter progressed with Medtronic obviously the litigation getting settle and with the XT getting on market I am just curious how things ebbed and flowed over the quarter whether you saw accounts maybe moving away to get trained with Medtronic and then perhaps coming back once XT got approved and just trying to get a sense of how that dynamic is shaking out and how you expect this is going to play out for next quarter or two?

Michael A. Mussallem

Analyst

Yeah. It's a good question, Raj. If you go early back to our investor conference in terms of what we assumed, we thought that they were going to get their high risk approval in Q3 and they actually got that in June so that sort of one third direction. We probably thought our XT approval would sooner although still within our guidance. And so during that period where we have SAPIEN available at the same time they had Core Value they had the ability to treat some larger angulus patients and so we did see accounts trained we did see some larger angulus patients patient go that way and then obviously that changed once SAPIEN was available particularly the 29 millimeter valve and we know that some of these patients were being queued for that. So I am sorry, related to the approval of XT so, there has been a lot of back and forth in the quarter. I am not sure that you can know exactly where it is we feel like we exited strong and we are strong and we probably didn’t see the Medtronic's sort to be as aggressive as we thought they were going to be during this early launch period.

Raj Denhoy - Jefferies

Analyst

Okay, fair enough and maybe just my second question I was – a about SAPIEN 4 from some clinicians you might in the know and I am curious if you can offer about that or any details you can provide on and if there is a SAPIEN 4 we might hear about anything around will be helpful?

Michael A. Mussallem

Analyst

You are making smile Raj you know that obviously there wouldn’t be something that we would talk about. We value keeping confidential our next generation development as you might imagine we do work on next generation products. We are working products beyond SAPIEN 3 and beyond CENTERA and you can be sure of that but we don’t have anything to announce at this point. Raj Denhoy – Jefferies: Fair enough, thank you.

Operator

Operator

Thank you. Our next question is coming from the line of Mr. David Lewis with Morgan Stanley. Your line is now open. Please proceed with your question.

David R. Lewis - Morgan Stanley

Analyst

Good afternoon. Mike you made a lot new comments about the European market specifically around S3 and there was some comment you made that was news to us, one-third conversion last quarter I think you mentioned one-half conversion second quarter, obviously those are pretty remarkable results but it slowed a little bit on the second quarter. I guess the question I have is what do you think is the barrier why that number wasn’t two-thirds in this particular quarter, is it training is it just your focus on specific regions but we would have thought that number could actually been a little higher here in the second quarter even though it’s a pretty good number?

Michael A. Mussallem

Analyst

Yeah I think what we said in our results are about 50% of the sales this quarter were from SAPIEN 3. So I am not sure that it speaks in to some extend the sales are probably a little bit of lagging indicator of exactly what’s going on. The conversion across Europe is happening at pretty much our planned pace which is pretty aggressive. We first went into our largest hospitals for the most part and those have been the people we have gone to first but we are just working our way through this in a very uniform fashion. We are pleased with what’s going on. I mean you think about we have got a 35% underlying growth over U.S. and so that’s even better than we expected.

David R. Lewis - Morgan Stanley

Analyst

Okay, and Mike just a related question in the U.S. market around XT is there any reason to believe in across valve sizes or any XT conversion we would expect the XT conversion in the U.S. to be much more rapid to the S3 conversion in Europe is that kind of a safe assumption, can you share with us sort of how you’d expect that mix to progress here in the U.S.?

Michael A. Mussallem

Analyst

Yeah, there is rapid conversion that’s going on from SAPIEN to SAPIEN XT. It’s been greatly anticipated and that’s been moving very quickly. We expect the vast majority of hospitals to be converted by the end of Q3.

David R. Lewis - Morgan Stanley

Analyst

Okay, thank you very much.

Michael A. Mussallem

Analyst

Sure.

Operator

Operator

Thank you. Our next question is coming from the line of Mr. Bob Hopkins with Bank of America. Your line is now open. You may proceed with your question.

Robert A. Hopkins - BofA Merrill Lynch

Analyst

Hi, thank you very much and good afternoon. Would love to start out, Mike if you can just give us a little bit of insight as to what kind of incremental clinical data you expect might come out of the coming TCT meeting here in just you know short period of time are we going to see some tier data on XT and just if you just highlight the confidence and what we should expect that would be great?

Michael A. Mussallem

Analyst

Yeah. Thanks Bob. We expect there is going to be a number of key presentations at TCT related to the partner trail. We just don’t know right now which ones are being accepted. Remember that partnered data in a publication office that’s jointly managed with clinicians and the exactly how that’s going to roll out is not clear to us yet but we expect there to be news.

Robert A. Hopkins - BofA Merrill Lynch

Analyst

Okay. I guess will just wait on that. And the other thing I wanted to ask on I know the question was asked earlier about SAPIEN 3 in the prospects for a time frame in the United States a little faster than people expect. Could you just give us a sense to what data exists on SAPIEN 3 that you might to be able to show FDA they could shorten that process relative to the current expectations, does any incremental data exists on that front?

Michael A. Mussallem

Analyst

Well as we have mentioned we already enrolled our 500 patients high risk trial that was done in 2013 and we’re rapidly enrolling the 1,000 intermediate risk that will be -- we felt like enrolled here over the next several months. In addition to that there is European data and the European data is not only the data that was used for CE mark but there is Europe registry that’s collecting data for SAPIEN 3. So, there is fair amount of data out there already you know quite a lot of patient and so the ability to be able to use that to access the performance will be what’s key determinant and our ability to make any more aggressive arguments.

Robert A. Hopkins - BofA Merrill Lynch

Analyst

Great, thank you very much.

Michael A. Mussallem

Analyst

Sure.

Operator

Operator

Thank you. Our next question is coming from the line of Kristen Stewart with Deutsche Bank. Your line is now open. Please proceed with your question.

Kristen M. Stewart - Deutsche Bank

Analyst

Hi, thanks for taking the question. I just wanted to go back to the U.S. sales and Mike you mentioned I think was $92 million I wasn’t exactly sure how that that broke down and sounded like it royalties added back reserves but that I am sure we are stocking clinical kind of out there?

Michael A. Mussallem

Analyst

Yeah, Scott why don’t you…?

Scott B. Ullem

Analyst

Yeah, sure Kristen hey there a lot of different elements to this and maybe the easiest way to approach it is to say the re-order sales for commercial combined with clinical was $92 million. Three other elements that influenced the GAAP result were or the net stocking charge, royalty and the sales return reserve and that’s again to that $86 million that’s on the far left hand of the schedule on the website.

Kristen M. Stewart - Deutsche Bank

Analyst

Okay. And so the $86 million would be your non-GAAP U.S. transcatheter valve number?

Scott B. Ullem

Analyst

No.

Kristen M. Stewart - Deutsche Bank

Analyst

Sorry?

Scott B. Ullem

Analyst

The $86 million is the GAAP U.S. transcatheter valve sales number for the second quarter.

Kristen M. Stewart - Deutsche Bank

Analyst

Okay, so to that let me add back to get to non-GAAP your $6 million I guess in sales return or is it the $2 million?

Scott B. Ullem

Analyst

Yes, if you had $6 million in the sales return reserve you get the $92 million which is inclusive of the other three elements.

Kristen M. Stewart - Deutsche Bank

Analyst

Okay, got it. And then just in terms of going back to SAPIEN 3 and intermediate risk. Is it your expectation that will have a one year follow-up period at this point it seems to be adjusted by the clinicaltrials.gov site?

Michael A. Mussallem

Analyst

Yes, that’s our understanding.

Kristen M. Stewart - Deutsche Bank

Analyst

Okay, perfect. And then the last question that I had is just to go back a little bit to the lack of I guess better leverage I would have expected given the increase amounts with the royalty and the higher sales result. Can you maybe help us quantify what the incremental cost related to the 43 observations and it sounds to me like you would be expecting to get warning letter is that fair to say? Maybe in the…

Michael A. Mussallem

Analyst

No, it’s not fair to say that we are expecting to get a warning letter I think what we say it is that we had a significant number of 483 observations in that. We have two things that we are doing you know one is applying additional resources to our CSS operations and the other focus effort on the action plan around the XT delivery and those two things are driving from cost are not going to detail those out but those significant and they are having they are having an impact on the earnings growth here in the near term.

Kristen M. Stewart - Deutsche Bank

Analyst

What exactly are the XT delivery system changes? I assume that’s within the market today?

Michael A. Mussallem

Analyst

There are no changes. These are simply compliance issues.

Kristen M. Stewart - Deutsche Bank

Analyst

Okay, thank you.

Michael A. Mussallem

Analyst

Sure.

Operator

Operator

Thank you. Our next question comes from the line of Michel Weinstein with JPMorgan. Your line is now open. You may proceed with your question.

Michel Weinstein - JPMorgan

Analyst · JPMorgan. Your line is now open. You may proceed with your question.

Thanks for taking my question. Let me just clarify things from the back of -- thee you sell in U.S. in the quarter the SAPIEN XT are you recording stocking revenue for XT, the existing accounts?

Michael A. Mussallem

Analyst · JPMorgan. Your line is now open. You may proceed with your question.

No, we are not.

Michel Weinstein - JPMorgan

Analyst · JPMorgan. Your line is now open. You may proceed with your question.

Okay, so the net stocking then we get – the positive stocking on new account and the negative account that was that did have inventory and has moved the consignment is my understanding correct?

Michael A. Mussallem

Analyst · JPMorgan. Your line is now open. You may proceed with your question.

You understand it perfectly.

Michel Weinstein - JPMorgan

Analyst · JPMorgan. Your line is now open. You may proceed with your question.

Okay, good, and then Scott I heard you say that on the 2Q you might be in a better position to talk about the use of the proceeds from the Medtronic windfall here, the current with you guys on that point. How do you want us to think about the balance today that you got this great cash position, you're generating good cash flow but it seems like it's being underutilized. And I know that’s far from your… So could you…

Michael A. Mussallem

Analyst · JPMorgan. Your line is now open. You may proceed with your question.

Sure. It's something we've been spending a lot of time thinking about and talking about with our Board and listening to what investors are thinking and hearing out there. At this point we think the right thing to do is to preserve the cash and liquid shorter duration investments and have it available for share repurchase and potentially down the road funding and it kind of acquisitions. But well, we like buying back our stock. We demonstrated that we brought back stock by $800 million in 2013 or the first quarter of 2014. We also want to be careful about how much we buyback all once we believe in – averaging but you should expect that overtime we're going to active in the share repurchase market. I don't think we likely negative – cash sitting our balance sheet but we're also very deliberate and disciplined on how we spend it.

Michel Weinstein - JPMorgan

Analyst · JPMorgan. Your line is now open. You may proceed with your question.

Mike you have been pretty clear on acquisition but more staying structural -- but the challenge there is there hasn't bit a lot of progress outside of what you’ve done internally, is that still the thought process that structural heart is where you want to stay and you want to want your assets in structural heart is that what you consider for M&A

Michael A. Mussallem

Analyst · JPMorgan. Your line is now open. You may proceed with your question.

Thanks Mike. We're going to need to let other ask questions after this. But yeah, to your broad point, yes, our focus is structural heart but also critical care technologies so we're focused on our core. Our intention is not some kind of a broad diversification strategy. And even though you maybe haven’t seen do anything that really sizable or public, we have been active out there looking for the new bright ideas that we might we use, that can be meaningful in the area of structural heart and critical care technologies in the future.

Operator

Operator

Thank you. Our next question is coming from the line of Glenn Novarro with RBC Capital Markets. Your line is now open. You may proceed with your question.

Glenn J. Novarro - RBC Capital Markets, LLC

Analyst

Hi. Good afternoon. Just had two follow-ups. One on price. Mike I think you said in the quarter pricing really didn’t have much of impact particularly on transcatheter valves and I was just wondering in Europe is SAPIEN 3 being priced at a premium and you’re discounting for example SAPIEN XT and I am wondering if the same dynamic maybe happening in the U.S. so any additional color?

Michael A. Mussallem

Analyst

Yeah. Thanks Glenn. Yeah, in an effort to make sure that we were an aggressive competitor we made the conversion from SAPIEN XT to SAPIEN 3 essentially at the same prices. We had a few places where so for example in the UK where pound didn’t move where we made some adjustments but overall pricing is pretty much flat or pretty much constant with the one thing being some discounts for large volume customers. Much of the same is true in the U.S. where we're moving customers are helping them move from SAPIEN to SAPIEN XT at same prices and so continuing to use the 30,000 for modeling purposes is still a good surrogate.

Glenn J. Novarro - RBC Capital Markets, LLC

Analyst

Okay. And then just quickly on a follow-up on Mitral so you've done a few implants now and I am assuming that there is going to be some tweaks to the design so I am wondering if you can walk us through the timeline as to when we can see some design changes, when you can initiate maybe first like a small pilot study again and when we can get into perhaps a European transcatheter mitral pivotal trial? Thanks.

Michael A. Mussallem

Analyst

Yeah. Thanks Glenn. The bottom line is pretty immature to be able to anticipate a pathway to commercialization. We're still in the midst of our first in human experience still learning a lot and we want to let ourselves complete that experience and gain all that knowledge and insight before we decide on any clinical trial or regulatory pathways.

Glenn J. Novarro - RBC Capital Markets, LLC

Analyst

Okay. Maybe we'll get an update in December at the analyst meeting?

Michael A. Mussallem

Analyst

I hope we have clarity by then, Glenn that's for sure. We will let you know if we do.

Glenn J. Novarro - RBC Capital Markets, LLC

Analyst

Okay. Thank you.

Michael A. Mussallem

Analyst

Sure.

Operator

Operator

Thank you. Ladies and gentlemen due to time constraints we will have one final question. Our final question will be coming from the line of Ben Andrew with William Blair. Your line is open. You may proceed with your question.

Ben Andrew - William Blair

Analyst

Great. Mike can you hear me?

Michael A. Mussallem

Analyst

Yeah. I hear you great.

Ben Andrew - William Blair

Analyst

Okay, good so, you have talked in the past about the different down margins on the past as kind of things scale. How is the ramp going with SAPIEN 3 and the margin structure this year your guidance was consistent but is there an opportunity with that in the 2015 to see you know margin moving higher as volume decrease on that?

Michael A. Mussallem

Analyst

Yeah, as you can imagine it’s a scenario of focus for us. We do get improvement that comes along with volume but you also have to anticipate that we anticipated some of that volume improvement. So that’s in front of us I hesitate to give the really guidance on margin for 2015 at this point Ben. we will provide a lot more clarity on that when we get into our Investor Conference in December.

Ben Andrew - William Blair

Analyst

Okay. And then you talked the clinicians wanted to show the mitral data is it possible to see something at PCG?

Michael A. Mussallem

Analyst

Yeah, it is possible I think you all know the clinician community pretty well. If they have some things that they are able to report on and they get accepted by TCT it would be presented by them yeah, I just don’t know how to be able to advise you on that.

Ben Andrew - William Blair

Analyst

Okay, thank you.

Michael A. Mussallem

Analyst

Sure. Okay.

Operator

Operator

Thank you.

Michael A. Mussallem

Analyst

All right, thanks very much for your continued interest in Edwards; Scott and David and I welcome any additional questions by telephone and with that back to your David.

David K. Erickson

Analyst

Thank you for joining us on today's call. Reconciliations between GAAP and non-GAAP numbers mentioned during this call, which include underlying growth rates, sales results, excluding currency impacts and amounts adjusted for special items are included in today's press release and can also be found in the Investor Relations section of our website at edwards.com. If you missed any portion of today's call, a telephonic replay will be available for 72 hours. To access this please dial 877-660-6853 or 201-612-7415 and use conference number 13585946. I’ll repeat all those numbers for you 877-660-6853 or 201-612-7415 and the conference number 13585946. Additionally, an audio replay will be archived on the Investor Relations section of our website. Thank you very much.

Operator

Operator

Ladies and gentlemen, this does conclude today's teleconference. You may disconnect your lines at this time. Thank you very much for your participation.