Gary L. Ellis
Analyst · Citigroup
Thanks, Omar. Fourth quarter revenue of $4,297,000,000 increased 3% as reported and 4% on a constant currency basis after adjusting for a $42 million unfavorable impact of foreign currency. Q4 revenue results by region were as follows. Growth in Central and Eastern Europe was 27%. South Asia grew 25%. Growth in Greater China was 23%. Middle East and Africa grew 16%. Growth in Latin America was 11%. Asia-Pacific grew 6%, including a 7% growth in Japan. Growth in our Western Europe and Canada region was 4%, while the U.S. grew 2%, which is the highest quarterly growth we have achieved in the U.S. in 2 years. Emerging markets grew a combined 20% in Q4 and represented 11% of our total sales mix. Q4 GAAP earnings and diluted earnings per share were $991 million and $0.94, an increase of 28% and 31%, respectively. After adjusting for certain acquisition-related items, Physio-Control divestiture-related items and net restructuring charges and certain litigation charges and the noncash charge for convertible debt interest expense, fourth quarter earnings and diluted earnings per share on a non-GAAP basis were $1,036,000,000 and $0.99, an increase of 7% and 10%, respectively. In our Cardiac and Vascular Group, revenue of $2,253,000,000 grew 4%. Results were driven by growth in Coronary, transcatheter valves, endovascular, AF Solutions, renal denervation and Peripheral, partially offset by small declines in Pacing and ICDs. CRDM revenue of $1,295,000,000 was flat. Worldwide ICD revenue of $744 million declined 1%, and we estimate that the worldwide ICD market declined in the mid-single digits. Both the market and our results showed sequential improvement in Q4. In addition, our global ICD share improved on both a year-over-year basis and sequential basis. The combination of our Protecta ICD with its shock reduction and lead Integrity alert technologies, along with a proven long-term performance of our Sprint Quattro leads, continues to perform well, both in terms of share and pricing. In the U.S. ICD market, it is worth noting that the market did stabilize this quarter, as expected, even as we continued to see a reduction in customer inventory levels. Pacing revenue of $492 million declined 2%, and the market declined in the low single digits. Our MRI SureScan pacemakers continue to drive our market outperformance as we continue to gain share in both the U.S. and international markets. Our AF Solutions business had solid growth in excess of 20%, despite anniversary-ing the U.S. launch of the Arctic Front cryoballoon. We continue to take share in this important growth market. Cardiovascular had an outstanding quarter, with revenue of $958 million growing 10%, with 9% growth in the U.S. and 11% growth in international markets. Coronary revenue of $450 million grew 12% on the global strength of Resolute Integrity. Worldwide DES revenue in the quarter was $243 million, including $80 million of U.S. revenue. Resolute Integrity's deliverability, unique diabetes indication and long-term clinical performance received a strong customer acceptance during our recent U.S. launch, resulting in a doubling of our market share in less than a quarter. U.S. DES market pricing was relatively stable sequentially, with pricing down in the mid-single digits year-over-year. In international markets, we gained 150 basis points of DES share sequentially on the continued strength of Resolute Integrity, with particularly strong performances in Europe and China. We look forward to extending our DES share with continued expansion in the U.S. and our expected launch of Resolute Integrity in the important Japanese market. We expect to become the global market share leader in coronary stents in FY '13, adding to our market-leading positions in ICDs, pacemakers and endovascular stent grafts. Turning to renal denervation. We continue to lay the groundwork to realize the multibillion opportunity in hypertension, with major investments in our product pipeline, clinical evidence and market development, including building therapy awareness and care pathways. In Q4, we received approval for our SYMPLICITY system in Canada as we continued to expand this therapy into markets beyond Western Europe. We continue to enroll our U.S. pivotal study and remain on track for U.S. approval in FY '15. In FY '13, we expect our renal denervation revenue to nearly double to $60 million to $70 million. We intend to maintain our leadership based on our robust pipeline, growing breadth and depth of our long-term safety and efficacy data and strong intellectual property in both the U.S. and international markets. Structural heart revenue of $289 million increased 7%, driven by strong growth in transcatheter valves. This quarter, data was announced at ACC and EuroPCR from our advanced study, one of the largest prospective, multicenter TAVI trials to date, which showed high procedural success combined with positive clinical outcomes and low complication rates with our CoreValve system. In the international markets, we continued to gain share, and we are the clear market leader in transfemoral, the largest TAVI segment. Our larger 31-millimeter CoreValve continues to perform well, bringing TAVI technology to a previously untreatable patient population. Cardiac surgeons are also increasingly attracted to our direct aortic approach, an alternative to transapical implantation. We will introduce our next-generation TAVI system later this year, which will leverage CoreValves' strong market and clinical performance while integrating new technologies to enhance deliverability and anatomical fit, as well as provide valve recapture ability. In the U.S., we are pleased with the progress of our pivotal trial. Enrollment in our extreme-risk arm is complete, and we are enrolling patients through a continued access. We expect our high-risk arm to be fully enrolled this summer. Turning to endovascular and Peripheral. Revenue of $219 million grew 10%. Our Endurant Abdominal Stent Graft continues to drive performance in markets around the globe, including Japan, where it was launched in Q4. Endurant II, our next-generation AAA Stent Graft is performing well in Europe, and we are pleased to announce that we recently received FDA approval for U.S. launch. In Peripheral, our drug-eluting balloons are delivering strong double-digit growth in international markets. At EuroPCR last week, 2 randomized controlled trials were presented that demonstrated the advantage of our IN.PACT drug-eluting balloon over uncoated balloons and drug-eluting stents. We intend to be in enrollment soon for our 1,500 patient global DEB study that will ultimately include more than 80 sites in over 30 countries. In the U.S., we began enrollment in our IN.PACT SFA II pivotal study in late April. On the commercial front, in the U.S., Assurant Cobalt Iliac Stent and Complete SE Vascular Stent are posting very solid results. Now turning to our Restorative Therapies Group. Revenue of $2,044,000,000 grew 4%. Growth was driven by strong performances in Surgical Technologies, diabetes and neuromodulation, partially offset by declines in U.S. Spine. Global Spine revenue of $818 million declined 6% or down 2% after excluding the negative impact of U.S. INFUSE. International Spine grew 8%, including over 20% growth in the important Japanese market. In core spine, which includes core metal constructs, IPDs and BKP products, revenue of $629 million declined 3%. The U.S. core market continues to decline in the low single digits, with flat procedural growth and mid-single-digit pricing declines partially offset by positive mix. Our core metal construct products declined 3% but grew 5% sequentially. We continue to focus on a number of initiatives to improve performance, including the continued launches of Solera, POWEREASE, ATLANTIS VISION ELITE and our MAST MIDLF and navigated DLIF procedures. While we are still early in these efforts, we do expect their contribution to our growth to increase over the coming quarters. BKP revenue grew 1%, an encouraging result, given this is the first time BKP has grown in nearly 3 years. Biologics revenue of $189 million declined 16% in the quarter. BMP sales declined 24% in the quarter, including a 26% decline in the U.S. However, it is important to note that INFUSE is one of our lower-margin products, muting its impact to our bottom line. Despite the increased pressure on INFUSE, our differentiated DBM offerings, including MagniFuse and Grafton, are driving double-digit growth in Other Biologics, including mid-teens growth in the U.S. Turning to neuromodulation. Revenue of $463 million increased 8%, led by the strong acceptance in the U.S. and Japan of our RestoreSensor spinal cord stimulator. RestoreSensor with its proprietary AdaptiveStim technology allowed us to capture over 600 basis points of U.S. market share sequentially. Our DBS business had its strongest quarter in recent history, as our strategy to focus on neurologists' referrals is yielding results. Our Uro/Gastro business delivered strong double-digit growth in Q4, driven by acceleration of new InterStim implant growth. In fact, pain stim, DBS and InterStim all saw the strongest U.S. new implant rates in years. Diabetes revenue of $392 million grew 8%, driven by double-digit growth in CGM and solid growth in insulin pumps. Our international diabetes business delivered another strong quarter, as we continue to see great acceptance of our Veo pump with Low Glucose Suspend, augmented by our Enlite Sensor and its improved comfort, accuracy and ease of use. Surgical Technologies revenue of $371 million grew 25%, which included $34 million of revenue from Advanced Energy. Navigation had a strong 18% growth performance in the quarter, in Q4, led by capital equipment sales, including the StealthStation S7 and the O-arm. ENT also had a strong Q4 with growth of 16% driven by sales of image-guided surgery and power equipment. Turning to rest of the income statement, the Q4 gross margin was 75.6%. After adjusting for the 30-basis point negative impact from foreign exchange, the Q4 gross margin was 75.9%. In FY '12, we completed our initial $1 billion COGS reduction program, which allowed us to mitigate pricing pressure, but we are not stopping there. In FY '13, we are starting a new product cost-reduction program with a goal of reducing COGS by more than $1 billion over the next 5 years. For FY '13, we expect gross margins in the range of 75.5% to 76% on an operational basis. Fourth quarter R&D spending of $393 million was 9.1% of revenue. We remain committed to investing in new technologies and evidence-creation to drive future growth, and for FY '13, we expect R&D spending to be approximately 9%. Fourth quarter SG&A expenditures of $1,462,000,000 represented 34% of sales. This result was above the range we provided on our Q3 call. As Omar mentioned earlier, given the strong revenue that we saw from product launches in Q4, we decided mid-quarter to increase investment in these launches to maximize our share capture, as well as pull forward some planned FY '13 expenses in renal denervation in emerging markets. We expect to realize the return on these investments in FY '13. In addition, our Coronary and Surgical Tech businesses had extremely strong quarters, with results well above our expectations, which led to higher incentive payouts and contribute to the higher SG&A expense this quarter. We continued to focus on several initiatives to leverage our expenses. In FY '13, we would expect to drive 30 to 50 basis points of improvement, which would result in SG&A in the range of 34.2% to 34.4%. Amortization expense for the quarter was $80 million compared to $87 million last year. For FY '13, we would expect amortization expense to be approximately $80 million per quarter. Net other expense for the quarter was $48 million, driven by our hedging program expense. As you know, we hedge much of our operating results to reduce the volatility of our earnings. Based on current exchange rates, we expect FY '13 net other expense will be in the range of $185 million to $225 million, which includes the expected impact from the U.S. MedTech tax that will begin in January 2013, as well as higher royalty expense due to increased sales of Resolute Integrity. For Q1 FY '13, we expect net other expense to be in the range of $40 million to $50 million based on current exchange rates. Net interest expense for the quarter was $46 million, excluding the $22 million non-cash charge for convertible debt interest expense. Non-GAAP net interest expense was $24 million. At the end of Q4, we had approximately $10.3 billion in cash and cash investments and $10.6 billion of debt. For FY '13, we expect non-GAAP net interest expense in the range of $70 million to $80 million, which excludes the noncash charge for convertible debt interest expense. Let's now turn to our tax rate. Our effective tax rate from continuing operations in the fourth quarter was 13.9%. Excluding the impact of one-time items, our adjusted non-GAAP nominal tax rate in the quarter was 16.7%. Included in this rate was our favorable operational tax adjustments, which include the release of a valuation allowance associated with the usage of capital loss carryover and the impact of the finalization of multiple state and foreign tax returns. Excluding the impact of one-time items, our FY '12 tax rate was 18.5%. For FY '13, we expect an adjusted non-GAAP nominal tax rate in the range of 19.25% to 20.25%. During FY '12, we generated almost $4 billion in free cash flow. We remain committed to returning 50% of our free cash flow to shareholders. In FY '12, we have paid over $1 billion in dividends and repurchased over $1.4 billion of our common stock, which includes the share repurchases we executed to offset dilution from our divestiture of Physio-Control. As of the end of Q4, we had remaining authorization to repurchase approximately 58 million shares. Fourth quarter average shares outstanding on a diluted basis were 1,049,000,000 shares. During FY '13, we expect diluted weighted shares outstanding to decline by 30 to 35 million shares. Let me conclude by providing our initial fiscal year 2013 revenue outlook and earnings per share guidance. While we believe our markets have improved modestly, we estimate market growth remains in the low single digits. Based on this, as well as the expected growth from recent product launches, we believe that constant currency revenue growth of 2% to 4% is reasonable for FY '13 and would reflect improvement from our organic growth in 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 '13 revenue would be negatively affected by approximately $330 million to $337 million, including a negative $100 million to $120 million impact in Q1. Turning to guidance on the bottom line. Based on expected constant currency revenue growth of 2% to 4%, we believe it is reasonable to model earnings per share in the range of $3.62 to $3.70, which implies FY '13 earnings per share growth of 5% to 7%. While we do not provide quarterly guidance, we would point out that the current consensus reflects Q1 earnings per share growth of 10%, which is outside our issued guidance, and therefore, we would not be surprised to see some modest shifts -- modest -- models shift a couple of pennies from Q1 to Q4. As in the past, my comments and 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, Omar and I would now like to open the phone lines for Q&A. [Operator Instructions] If you have additional questions, please contact our Investor Relations team after the call. Operator, first question, please?