Gary Ellis
Analyst · Citigroup
Good morning, and thank you, Jeff. This morning, we reported fourth quarter revenue of $4.3 billion, which represents growth of 2% as reported or flat on a constant-currency basis. After adjusting for the benefit we received last year from a CRDM competitor's stop shipment, revenue growth was 4% as reported or 2% on a constant currency basis. Q4 non-GAAP earnings of $966 million and diluted earnings per share of $0.90 increased 2% and 1%, respectively. Before going into the details of the call, we would like to remind you of the announcement we made nearly 2 weeks ago when Omar Ishrak was named as Medtronic's next Chairman and Chief Executive Officer. Given that he does not officially start until June 13, he will not be on today's call. As we are in this transition, Jeff and I will be conducting the call and Q&A. Omar is a talented executive with a long history of success in healthcare technology, including an impressive track record of delivering top and bottom line growth at GE Healthcare. His strong global perspective and experience driving innovation will be valued at Medtronic. We are excited to have Omar join the team next month and look forward to his leadership and introducing you to him in the future. At the same time, my colleagues and I also want to acknowledge Bill Hawkins' leadership these past 10 years in Medtronic, including 7 as President and 4 as CEO. Since he announced his retirement in December, Bill has remained actively engaged with the Board of Directors and the management team. Looking back at Bill's tenure at Medtronic, he was instrumental in laying the foundation for our cardiovascular business' current success. He also championed our One Medtronic strategy, focusing the company on capturing the benefits of our size and scale. Under his leadership, we diversified our business into new areas, invested in the emerging markets, developed a robust pipeline of differentiated technologies and added key innovative therapies like Ardian and transcatheter valves to our portfolio. We thank Bill for his commitment to the Medtronic mission and many years of leadership. Now we would like to recap fiscal year 2011, provide details on our Q4 performance and conclude with our initial FY '12 outlook and guidance. FY '11 was one of the more challenging years in the industry's recent history. We experienced a significant slowdown in our markets early in our fiscal year, driven by the continued macroeconomic downturn, decreased utilization and increased payer pushback, which affected us, our customers and the industry. We estimate our markets are currently growing in the low single digits versus 6% to 7% a little over a year ago. In addition, our now resolved FDA warning letters delayed the launch of several key new products, which increased pricing pressure and delayed our ability to gain market share. Due to these numerous headwinds, our revenue came at nearly $1 billion below original expectations, although it was worth noting that despite this revenue shortfall, non-GAAP diluted earnings per share of $3.33 was only $0.08 below the low end of our original earnings per share guidance. We were able to minimize the impact on earnings per share through our focus on reduced spending throughout the year, and one-time tax items added $0.10 earnings per share benefit to our FY '11 earnings per share. Despite the challenges, we had several notable areas of successes in FY '11, including achieving great results in our international operations, launching a number of innovative products, making improvements to our quality systems and adding several strategic acquisitions. Our international business grew 5% -- or 6% after adjusting for the extra week in FY '10, driven by strong 20% growth in the emerging markets. We continued to make significant investments for growth in the emerging markets, recently opening our Asian manufacturing facility in Singapore, our new China headquarters and training center in Shanghai and our first Patient Care Centre in Beijing. In the U.S., we resolved all 3 warning letters and we continue to focus on meaningful quality improvement. Medtronic continues to set the standard for quality in the industry. We also launched a number of innovative new products in FY '11, including the Protecta ICD, Revo MRI pacemaker, and Arctic Front cryoballoon in our CRDM business. In CardioVascular, we launched and gained share with the Resolute Integrity drug-eluting stent in Europe, as well as the Integrity bare-metal stent and Endurant AAA stent graft in the U.S. In our Restorative Therapies Group, we had a number of new product introductions, including the Solera posterior fixation system, RestoreSensor spinal cord stimulator, Activa SC deep brain stimulator, Interstim bowel and Enlite CGM sensor. Many of these innovative new products came out late in the fiscal year, and although we did not realize their full impact in Q4, we are optimistic about their contribution to growth and pricing improvement going forward. In addition, we added some exciting new technologies to the portfolio and strength in some existing product lines with the acquisitions of Ardian, Invatec, Osteotech and ATS Medical. Over the longer term, we remain focused on delivering the full growth potential of our emerging technologies, which includes the expected approvals of CoreValve and Ardian in the U.S. market and their continued contribution in international markets. These are 2 of the most exciting new technologies in MedTech. As I pointed out at a recent investor conference, over 2/3 of our revenue today is in markets growing below mid-single digits. Over time, we anticipate our growth profile will improve and by FY '15, we expect 2/3 of our revenue will be in markets growing in high single digits on average. In the meantime, our slower growth businesses are delivering significant and consistent free cash flow, allowing us to return cash to shareholders and make the investments that will drive our future growth. When you combine our portfolio of differentiated technology with our position in the emerging markets and the overall advantage we have on -- from our size and scale, we believe Medtronic is well positioned to deliver sustainable and profitable long-term growth. Turning to our Q4 results. We reported revenue of $4,295,000,000, which increased 2.4% as reported or flat on a constant currency basis after adjusting for the $83 million favorable impact of foreign currency. The benefit we received last year from a CRDM competitor's stop shipment had a 170 basis point negative impact on our quarterly growth rate. Breaking out results geographically, revenue in the U.S. of $2,337,000,000 declined 4% or 1% after adjusting for the stop shipment. International sales of $1,958,000,000 increased 12% as reported or 7% on a constant currency basis. Q4 international revenue results by region were as follows: Greater China grew 24% and is now annualizing at over $500 million, growth in Latin America was 22%, Middle East and Africa grew 19%, growth in Europe and Central Asia was 7%, other Asia grew 4%, and Canada grew 1%. Japan declined 3%. We estimate that the Japan earthquake and tsunami had an approximate $15 million negative impact on our Q4 revenue, which was somewhat less than we had originally expected. We would like to thank our entire Japan team for the tremendous job they are doing during these difficult times. Q4 GAAP earnings and diluted earnings per share were $776 million and $0.72, a decrease of 19% and 16%, respectively. After adjusting for several unusual items, fourth quarter earnings and diluted earnings per share on a non-GAAP basis were $966 million and $0.90, a decrease of 2% and an increase of 1%, respectively. This quarter's pretax adjustments included a $47 million net benefit for legal matters due in part to our ability to negotiate more favorable terms on our previously accrued Fidelis settlement, a $40 million noncash charge for convertible debt interest expense, a $14 million charge for acquisition-related items related to the accounting rules governing contingent consideration, and a $272 million restructuring charge, which included the net reduction of approximately 2,100 positions and is expected to result in approximately $225 million to $250 million in annual savings. It is important to note that our Q4 non-GAAP earnings per share of $0.90 included $0.02 from write-downs and our minority investment portfolio increased receivables. Adjusting for this as well as the stop shipment benefit to last year's earnings, our Q4 non-GAAP earnings per share growth was 6%. In our Cardiac and Vascular Group, revenue of $2,322,000,000 declined 1%. Results were driven by double-digit growth in AF Solutions, Coronary and Peripheral, Structural Heart and Endovascular, offset by declines in U.S. ICDs. In the quarter, we announced a new unified U.S. Cardiac and Vascular Group sales organization. While this change is seamless to clinicians, we will now be able to better leverage our unmatched Cardiac and Vascular portfolio breadth when serving hospital service line administrators. CRDM revenue of $1,315,000,000 declined 9%. After adjusting for the benefit we received last year during a competitor's stop shipment, CRDM revenue declined 4%. Worldwide ICD revenue of $760 million declined 16% or 8% after adjusting for the stop shipment. Our U.S. ICD business declined 25% or 14% after adjusting for the stop shipment. Although this was below our expectations, in order to better understand our performance, there are several factors that need to be considered. First, in our $70 million impact from a competitor's stop shipment, which should be backed out of last year's results. Second, we've clearly seen a dramatic slowing in the U.S. ICD market. We estimate the U.S. ICD market decline in the high single digits, with declining procedural volumes driving the market slowdown. There appears to be several factors affecting procedures, but our field checks indicate that primary drivers are the January JAMA article on ICD utilization and the DOJ investigations of hospitals. Third, we did fewer bulk purchase deals with our customers in the quarter. While this decrease is primarily related to the slower market, it also reflected some of the recent management changes we have made as well as the decision to take a much firmer stance on discounting our new products. In terms of evaluating share, there's a lot of noise in the numbers, but we believe our share was relatively stable. Our account-by-account data also shows negligible impact from any recent changes to GPO contracts on implant share. While the U.S. market is clearly struggling with unit growth, we saw our pricing stabilize sequentially for the first time in 7 quarters on the launch of Protecta late in Q4. Protecta, along with our recently proved Attain Ability Plus and Attain Ability Straight left-heart leads give us confidence that our high-power pricing will improve in FY '12, and we are well-positioned to maintain or improve share position going forward. Our international ICD business grew 2%, consistent with the market, although we estimate that we gained over 300 basis points of shares sequentially. In Europe, we launched Cardia and Egida into the value segment, allowing us to capture double-digit ASP uplifts with Protecta. Our well stratified high-power portfolio in Europe captured a point of share sequentially despite a competitor's well-publicized left-heart lead. In fact, clinical evidence demonstrates that our advanced bipolar left-heart leads match or exceed the performance of this competitive lead without additional complexity or cost. In Japan, we also gained high-power shares sequentially due to the improved sales execution and launch of Protecta. Pacing revenue of $506 million was flat while the market declined in the low single digits. U.S. pacing declined 2% as our U.S. business was affected by a product supply shortage of CRT-P devices in the first half of the quarter as we awaited the FDA approval of Consulta and Syncra. Excluding this approximately $10 million negative impact, our U.S. pacing business grew 2%, and on a sequential basis, we gained over 200 basis points of share. This acceleration was driven by the launch of the Revo MRI SureScan pacemaker. Revo's game-changing technology is commanding a solid double-digit percentage price uplift, which offset the mid-single-digit pricing pressure we have seen in pacing over the past year. With Revel’s accounting for just 10% of our implant mix, we had flat year-over-year pricing in our U.S. pacemaker business in Q4. Our international pacing business grew 1% versus the international pacing market declines in the low single digits. In Europe, the success of our MRI pacemakers continues to mitigate pricing pressure and grow our share. Our AF Solutions business grew in excess of 40%, driven by the ongoing successful launch in the U.S. and the continued adoption in Europe of our Arctic Front Cryoballoon. In Q4, we launched the Achieve Mapping Catheter in Europe, which is designed to verify pulmonary vein isolation when used in conjunction with Arctic Front. In FY '12, we expect to continue to take share in AF as we grow this business 30% to 40%. Our CardioVascular business had a very strong quarter with revenue of $879 million, growing 13%, including 15% growth in international markets. Coronary and Peripheral revenue of $440 million grew 12%, which includes $37 million of revenue from Invatec. Worldwide drug-eluting stent revenue in the quarter was $201 million, including $51 million in the U.S. While the global stent market continues to experience mid-single-digit declines, our stent business grew 5% because we are taking meaningful share with our highly deliverable Integrity platform. In Europe, we added over 200 basis points to our market leading share sequentially in bare-metal stents and gained over 300 basis points of drug-eluting stent share sequentially on the strength of Resolute Integrity. We are pleased with the results of the RESOLUTE All-Comers in Resolute U.S. studies, which were presented to ACC. We also filed the final module of our Resolute DES PMA, and we continue to expect U.S. approval late in FY '12. Turning to Ardian. Ardian integration activities are on track. This impressive therapy for hypertension is generating a lot of customer excitement, and we expect revenue to ramp in FY '12 as we execute on this multibillion dollar opportunity. We are focused on building our European sales channel, and we submitted the IDE for our U.S. pivotal trial and have started discussions with the FDA on the final trial design. We believe Ardian represents one of the most important product advances in MedTech in several years, and we intend to maximize its potential. Structural Heart revenue of $274 million increased 13%. Growth was driven in part by our ATS acquisition, which added 800 basis points to growth in the quarter as well as the strong adoption of CoreValve in international markets. The TCV market is now annualizing at over $500 million. We continue to split the market with our competitor and are the clear leader in the transfemoral segment, which is the preferred implant method. We also have approval for the subclavian indication in Europe and are in the process of training physicians on this important alternative implant method in other international markets. In the U.S., we were pleased by the FDA's positive modifications to our U.S. CoreValve trial. We obtained IRB preapproval at all sites and enrollment is back on track. Looking ahead, we continue to advance our innovative TCV product pipeline. We expect CE Mark of -- mark approval for our 31-millimeter CoreValve on an 18 French delivery system in the first half of FY '12 and our 23-millimeter CoreValve on a 16 French delivery system in the second half of FY '12. Both of these innovations will help expand the patient population that can be treated with CoreValve technology. Turning to Endovascular. Revenue of $165 million grew at an impressive 20%. In the U.S., revenue growth of 31% was driven by the continued success of the Endurant Abdominal Stent Graft, which drove a significant 14 percentage points sequential share increase. In Europe, we gained 7 percentage points of shares sequentially in the AAA market and 6 percentage points of share in the thoracic market on the continued strength of Endurant Abdominal and Valiant Captivia Thoracic Stent Grafts. In FY '12, we are moving our peripheral vascular business into endovascular to take advantage of customer synergies, and we expect this combined business will generate approximately $750 million in revenue. Physio-Control revenue of $128 million declined 6%. After adjusting for the approximate $15 million one-time benefit we received last year from pent-up demand upon resuming our newest sixth global shipments, revenue this quarter grew 6%. Our pre-hospital business had double-digit growth, as LIFEPACK 15 continued to take market share. We also had a very strong quarter in automated CPR with the LUCAS Chest Compression System taking over market share leadership in this product category. As we announced last quarter, we have reinitiated our efforts to divest Physio-Control. We are pursuing a dual path strategy, investigating both the option of an asset sale and the option of spinning the business to our shareholders. Now turning to our Restorative Therapies Group. Revenue of $1,973,000,000 grew 2%. Growth was driven by another quarter of solid performance in diabetes and Surgical Technologies as well as improving growth in Neuromodulation. Spinal revenue of $875 million declined 2%. This quarter, the global spine market was somewhat stable with low single-digit growth. Although the U.S. market continues to be challenged, our new products drove solid 6% growth in our international business. In Core Spinal which includes Core Metal Constructs, IPDs and BKP products, revenue of $648 million declined 4% as this business continues to feel the impact of its exposure to the BCF and IPD markets. Core Metal Construct products declined 1%. While Solera accounts showed strong double-digit growth and Solera is starting to drive the overall posterior fixation category, it is in less than 30% of the U.S. accounts that have our legacy system. We continue to ramp the launch of Solera and expect to penetrate nearly all of our U.S. accounts by the end of FY '12. In DLIF, we saw a solid high-teens growth, and we expect our DLIF solution to be navigation enabled this summer. Turning to cervical. Growth continues to be driven by VERTEX SELECT. In Q4, we launched the Atlantis Vision Elite cervical plate, which is seeing positive early adoption. In Kyphon, revenue declined 9%, but was relatively stable sequentially for the third quarter in a row. We were pleased to see the recent positive coverage decisions on Kyphon BKP, that Meridian issued earlier this month and believe that the positive coverage decisions, the new products including the Expander [indiscernible] the Japan expansion and increasing awareness of our growing body of positive clinical evidence will continue to stabilize Kyphon. Biologics revenue of $227 million grew 4%. Results were driven by our recent acquisition of Osteotech. Sales of INFUSE declined in the quarter due to softer procedural volumes and contingent mix pressure from the shift to smaller kits. Although we received a non-approval letter on AMPLIFY, we continue to work with the FDA to determine the path to approval and remain optimistic that we can bring this product to market. Neuromodulation revenue of $432 million increased 4%. The results were driven by InterStim and improved growth in drug pumps. In pain, we received CE mark in Europe to use our neurostimulator portfolio for peripheral nerve stimulation to treat chronic back pain. Meanwhile, RestoreSensor, with our proprietary adaptive stim technology, continues to gain traction in Europe and was launched in Australia and Canada this quarter. We are making progress on bringing this breakthrough technology to the U.S. market. We also have received CE mark for our new Ascenda pump catheter and are working to bring this new technology to the U.S. market in FY '12. In DBS, we continue to expand our industry-leading portfolio by launching Activa SC, a single-chambered DBS device in both Europe and the U.S. In Uro/Gastro, we received FDA approval for our InterStim Therapy for bowel control. We are now focused on obtaining reimbursement for this unique therapy as we ramp in its launch in FY '12. Diabetes revenue of $368 million grew 9%, driven by CGM growth in excess of 20%. Insulin pumps also had a good quarter with solid growth in the U.S. on the strength of Revo and continued strong growth in Europe with Veo, the only pump with a Low Glucose Suspend feature. We also remain differentiated as the only company offering integrated insulin pump in CGM systems. Late in Q4, we launched the Enlite CGM sensor in more than 35 countries outside the United States. Enlite is one of the more important advances in CGM technology in many years as it is more comfortable, accurate and easier to use than previous sensors, and we believe it will support continued growth in our industry-leading CGM business in FY '12. Surgical Technologies revenue of $298 million grew 7% or 9% after adjusting for the divestiture of our Ophthalmic business in FY '10. The solid growth was driven by strong ENT NT growth in image-guided surgery, power and monitoring. Navigation growth was equally solid, driven by strong performances of StealthStation S7 and O-arm as we continue to see strong growth in capital equipment in the U.S. During the quarter, we were also pleased to resolve the FDA warning letter in our Navigation business. Now turning to the rest of the income statement. The GAAP gross margin was 75.1% compared to 75.9% in the fourth quarter of last year. After adjusting for the $11 million product cost component of the restructuring charge, our Q4 non-GAAP gross margin was 75.3%. The gross margin was negatively affected by a lower mix of ICD systems, driven by the decline in the U.S. ICD market, as well as lower gross margin percentages on some of our newer products. In FY '11, we were able to partially offset some of the pressures on our gross margin by taking out $200 million in product cost. We are now 4 years into our 5-year plan and have removed $820 million in product cost, which is clearly within reach of our $1 billion goal. For FY '12, we expect gross margins in the range of 75% to 75.5% on an operational basis. Fourth quarter R&D spending of $394 million was 9.2% of revenue compared to 9% last year. We remain committed to investing in new technologies to drive future growth. And for FY '12, we expect R&D spending in the range of 9% to 9.5%. Fourth quarter SG&A expenditures of $1,435,000,000 represented 33.4% of sales, down 180 basis points from last quarter. Included in our SG&A expense this quarter was an $11 million bad debt expense for Greece receivables resulting from the financial crisis in that country, which had a negative 20 basis point impact on our SG&A. For the year, we held our SG&A relatively stable as we continue to focus on several initiatives to leverage our expenses while continuing to invest in new product launches and adding to our sales force in faster growing businesses and geographies. We will continue to focus on SG&A leverage in FY '12 and expect to drive 80 to 100 basis points of improvement, which would put us in the range of 33.5% to 34%. Net other expense for the quarter was $182 million compared to $95 million last year. The year-over-year increase is primarily a result of a $29 million expense from the recently implemented Puerto Rico excise tax, which is almost entirely offset by a corresponding tax benefit I will discuss in a moment. Net other expense was also affected by increased hedging expense, which was $25 million during the quarter compared to $11 million in gains last year. As you know, we hedge our operating results to reduce volatility in our earnings. In addition, Q4 net other expense includes $88 million of noncash amortization expense and a $9 million write-off of our minority investments. For FY '12, we expect net other expense in the range of $730 million to $790 million, including $200 million to $210 million in Q1. Based on current exchange rates, this would include expected FY '12 hedging losses in the range of $180 million to $210 million, including the hedging losses of $50 million to $70 million in Q1. FY '12 net other expense will also include an estimated $110 million to $120 million of Puerto Rico excise tax. Net interest expense for the quarter was $68 million. Excluding the $40 million noncash charge for convertible debt interest expense, non-GAAP net interest expense was $28 million. At the end of Q4, we had approximately $7.7 billion in cash and cash investments, and $9.8 billion of debt, after issuing $1 billion of senior notes in March and repaying $2.2 billion of convertible debt in April. With the repayment of this convertible debt, our noncash charge for convertible debt interest expense for FY '12 will be cut in half to approximately $21 million per quarter. For FY '12, we expect non-GAAP net interest expense in the range of $105 million to $115 million, which excludes the noncash charge for convertible debt interest expense. Let's now turn to our tax rate. Our effective tax rate in the fourth quarter was 15.5%. Excluding the impact of one-time charges, our adjusted non-GAAP nominal tax rate in the fourth quarter was 19.3%. It is worth noting that our Q4 tax rate included a $25 million benefit associated with the U.S. foreign tax credit from the Puerto Rico excise tax, which mostly offsets the charge recorded in the other expense. For FY '12, we expect an effective tax rate of approximately 19%, which includes the tax credit associated with the Puerto Rico excise tax and assumes the R&D tax credit will be extended. Fourth quarter weighted average shares outstanding on a diluted basis were 1,075,000,000 shares. In FY '11, we repurchased over $1 billion of our stock and we expect our share repurchases to continue at a similar level on FY '12. For FY '12, we expect diluted weighted average shares outstanding as a range of 1,055,000,000 to 1,060,000,000 shares. Let me conclude by providing our initial fiscal year 2012 revenue outlook and earnings per share guidance. The growth in our markets continues in the low single digits. While we are optimistic that they will recover over time, we are basing our outlook on this low single-digit market growth. We are excited about our new products, many of which we just launched in Q4, and in the investments we are making to further diversify our product and geographic mix. As a result, we would expect our revenue growth to remain at or above market growth. We believe that constant currency revenue growth of 1% to 3% is reasonable for FY '12. While we cannot predict the impact of currency movements to give you a sense of the FX impact, if exchange rates were to remain similar to yesterday for the remainder of the fiscal year, then our FY '12 revenue would be positively impact -- affected by approximately $350 million to $390 million, including a positive $170 million to $190 million impact in Q1. Based on the current market conditions, our revenue outlook assumes CRDM and Spinal growth is flat to slightly positive on a constant-currency basis. Our outlook also assumes that the rest of our businesses grow in the mid- to high-single-digit constant currency. Turning to guidance on the bottom line. Based on expected constant currency revenue growth of 1% to 3%, we believe it is reasonable to model earnings per share in the range of $3.43 to $3.50, which includes approximately $0.04 to $0.06 of dilution from the Ardian acquisition. After adjusting for the Ardian dilution and the previously mentioned $0.10 of one-time tax benefits in FY '11, our guidance implies FY '12 earnings per share growth of 6% to 9%. As in the past, my comments on guidance do not include any unusual charges or gains that might occur during the fiscal year nor do they include the impact of the noncash charge for convertible debt interest expense. With that, we would now like to open the phone lines for Q&A. In the interest of getting to as many questions as possible, we respectfully request that each caller limit themselves to one question with one follow-up. Operator, first question please.