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Earnings Call: H1 2025

Feb 13, 2025

Operator

I'd like to hand the conference over to Mr. Dig Howitt, CEO and President. Please go ahead.

Dig Howitt
CEO and President, Cochlear

Hey, everyone, and thanks for joining for our half-year results presentation. Here with me today have Stu Sayers and Sarah Thom, and Stu, who was our CFO until the end of December and is now President of Asia-Pacific and Latin America, will talk about the result because it's the result for the last half. Sarah, as our new CFO, is here with me as well. Okay, so thanks for joining. Let's get underway, and we have our mission upfront because that does guide all that we do at Cochlear, and it also sets out our longer-run ambition and underpins our long-term strategy for growth, so looking back at the first half of this year, overall, we were pretty happy with the outcome, but clearly, as you look into it, there's some mixed results in there.

Strong Cochlear implant revenue growth at 13%, acoustics revenue very strong at 22%, and services, which I'll obviously talk more about, declining by 12%, but all of that giving us a net sales increase of 6% in constant currency. Underlying net profit moved pretty much in line with sales on a reported basis, with our profit up 7% to AUD 206 million. Gross margin that Stu will talk more about in line with our targets and our operating expenses up 10%, so a bit faster than sales, and that's not unusual for us early in the year as we continue to invest into R&D and very much into driving growth. Balance sheet remains strong with AUD 383 million in cash. Now, that's come down a bit as we've been building up inventory ahead of new product launches, and Stu can talk a bit more to that.

And the dividend up 8% to AUD 215 million and just short of our 70% payout ratio. And we're maintaining our guidance range, but do expect to come in at the lower end of that range. And two contributors, which we'll talk more to, the lower services revenue and outlook for the year, and we've increased our cloud spending in this year as we move into the final phase of our cloud transition. So let's go into these in a bit more detail. So Cochlear implants first up is that sales revenue up 13% and unit growth of 6%. Now, developing 5%. Developed markets going 6%. And remember, here we had a 15% growth in the first half of 2024. We saw good growth across the U.S. and Asia-Pacific in our developed markets, but lower rate of growth in Western Europe.

Importantly, adults and seniors grew at 10% for the half, whereas their children declined modestly. And we're actually pretty pleased with that outcome for children because if you remember back to the first half of 2024, we had strong growth, actually had double-digit growth for children, which we said was a one-off. We thought some share gains. And in the U.S., with the FDA changing its indications from 12 months to nine months, made a pull forward of younger children getting surgeries earlier. So we were pleased to see that actually, rather than settling to a lower level, actually the children hasn't grown at that rate and has stayed pretty strong. And I think it's a good indication of our competitive position in children in pediatrics.

But we do continue to work on the core of this, obviously, our long-run strategy for growth in adults and seniors, which is by far the biggest opportunity that we have. And we continue to invest in our strategy for growth. We continue to see good adult referral rates. And we do continue to see some of the bottlenecks in a few places, as we've talked about, particularly at the full year for 2024, particularly around audiology. But equally, we're seeing increasing engagement and uplift of more efficient paths for audiology, fewer appointments in the first year. We still have a long way to go, but it is pleasing to see increasing adoption of fewer appointments based on the evidence showing that outcomes equally as good.

Now, in emerging markets, this was a bit behind where we had hoped to be in the first half, but recognizing that emerging markets has some volatility to it. We said at the full year that there were a number of markets, including India, where tenders hadn't come out at the rate that we had seen in the past or expected. We did expect those to come back through this year. We haven't seen as much of that in the first half, but the demand is clearly there, and the governments have funded before, so we do expect that to come back, and we did see a lift, that gap between the revenue and the unit growth rate, largely driven out of emerging markets, and it's a reflection of lower tender volumes, a positive country mix.

Obviously, countries have different prices, and some stronger growth rates in private pay segments and the premium segments in China and in India. So certainly pleasing to see the growth in those premium segments, and that's supported stronger growth in Cochlear implant revenue overall. Now, if we move on to services and to our upgrade business, so clearly down 12%. That wasn't where we expected. We did expect it to come off, given the 29% growth in the equivalent half last year. We saw that growth come off in the second half of 2024. We didn't expect it to come off by as much as it did. Now, there's a few factors underneath that.

One of the significant ones that we are seeing is this cost of living pressures, particularly in the U.S., that we are seeing a higher rate of cancellations or inquiries that don't follow through when people see they're out of pocket. We were actually asked about this at the half, at the full year, and then we said we were monitoring it, but we hadn't seen an impact from inflation and higher cost of living. In this half, we have seen, particularly in the U.S., an impact of inflation, higher cost of living, pressures of people deferring upgrades when they see the copay. Further on that, and part of the reason I'll do that is because Nucleus 7 is such a good product.

Nucleus 8 is a better product than people who switch, recognizing the benefit that we have these two pieces of Nucleus 7 being very strong in cost of living pressures, having people defer upgrades. In this area, we do, and as part of our cloud transformation, put in a new CRM and implementing a new cloud-based marketing automation system, which will enable us to much better segment our customer base and be able to therefore better target people on upgrades. Because while there's barriers around copays, one of the biggest barriers to upgrades still is awareness of eligibility, and we have made good progress, but there is more progress for us to make in actually being able to segment eligibility and where we are able to make people aware of their eligibility and the benefits of new products, and we're building the platforms to enable us to do that.

So let's move on now from services and going on to acoustics in a very strong half in acoustics, recognizing that it was a little bit weaker in the first half of last year because we introduced the OSI 300 in that half, and we saw some surgeries held in the U.S., which led to a 50% increase in surgeries, half on half for the OSI, for the Osia system. Baha continues to perform well, but Osia is absolutely the driver of growth. And as we have talked about for the last few years here, we see a huge opportunity, long-run opportunity for growth in acoustic implants. With Osia, we clearly have the right product to do it, delivering great power output in high frequencies, simple to implant, very good MRI compatibility, and extremely good feedback from virtually all of our Osia recipients. So we've got the right product.

We've got a huge opportunity. We continue to expand into new countries, so we are reflecting the quality of the product by asking for a higher price, which is appropriate, and that means it does take time for us to roll out country by country. But having added France and Italy recently and a number of emerging markets, we see good growth in those as we roll out. But lots more opportunity to come in acoustics, and very confident of our product portfolio there and that competitive position that we hold and our activity to drive growth. So with that, I will now hand over to Stu to talk through the P&L and the balance sheet, and I'll come back to talk about the outlook.

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

Thanks, Dig. Good morning, all. So you've heard Dig talk through the sales line, that 6% change year-on-year constant currency. I won't add further to that. If you look at gross margin, that's 75%. That's slightly better than we had expected, and that's really the tailwind of some higher ASPs in emerging markets, offsetting what we knew was coming in terms of a little bit of a headwind, whereas Chengdu is still very much in ramp-up stage. That Chengdu site, we are manufacturing and selling sound processors out of that site now. We've just got approval to manufacture and sell implants out of that site. They come through in December. So while that plant is in ramp-up, and that'll be for the next year or two, we'll still see a slight headwind there. We are expecting to be at about 74.5% at the full year.

Good growth in the sales, marketing in general, and that's really us continuing to invest in medium to long-term growth, so that's standard of care. That's direct-to-consumer activity, really all of the activity around expanding access and awareness, and we continue to see good progress and good wins in that space. R&D, as we often say, we aim to keep that at 12% of revenue, and it is there again for the half. It's up slightly more than that year-on-year, and that's really just a function of sort of timing more than anything, being slightly below that 12% mark and slightly but fractionally above it at the end of the half. Again, 12% of revenue is the set point we're aiming for there. Dig mentioned that cloud investment. H1 at 11.7% was slightly lower. Again, that's a timing thing. We are accelerating that program.

We're going to be spending more in half two. We still expect to be at it around AUD 40 million for the full year, and Dig will talk to more of that acceleration into FY 2026 as well. And lastly, underlying profit, both pre and post-cloud, given the slightly smaller cloud spend, 18%. And again, that's that checkpoint we're aiming for. So onto the balance sheet. Key change here is a pretty significant move in inventory. You can see that AUD 69.5 million increase in H1 and inventories driving the AUD 97 million change in working capital. That's really a function of two things. The biggest one, a build-up of inventory ahead of some major new product launches coming later in the year. And then also, again, some deliberate choices to hold high levels of safety stock on a couple of critical components.

And again, that just makes us more confident that there's no chance we ever run out of stock. That stock level, as I said, it's ahead of new product launches. We do expect it to stay at those elevated levels through the end of the financial year, and it'll start to, should start to moderate towards the end of calendar 2025. Property, plant and equipment up 18.6%. That's continuing investment in the Lane Cove site capacity expansion and the same in Malaysia and our KL operations. And the net cash line coming down to AUD 130 million. Really, that's a function of the inventory build and the higher inventory line. Obviously, we're still doing the share buyback and remembering that H1 is always a bit heavier on cash use versus H2 because that's also where the STI payments for the prior year come out. And then lastly, onto cash flow.

Operating cash flow down 47%. Again, that's a function of those inventory movements. We did get stronger cash coming in through the underlying business. CapEx, very much in line with last year and where we expected. And as previously mentioned, the AUD 19 million on share buyback, that's the amount we've spent since June, and that program is set to continue. And with that, I'll hand you back to Dig.

Dig Howitt
CEO and President, Cochlear

Okay, thanks, Stu . So let's go through the outlook. So we're still aiming to help over 50,000 people here with one of our implants, Cochlear or acoustic implants this year. And we remain on target for that guidance range of 14 to 430, but we'll be at the lower end, and that is driven by services revenue coming in lower than our expectation for the year and the higher cloud investment that Stu just talked to. So for Cochlear implants, we do expect to end up with a unit growth rate of around 10% for the year. We will be launching the next generation Cochlear implant around the middle of the year. Obviously, that's dependent on regulatory approvals.

And just to head off questions on that, so we are saying that we are launching the product around the middle of the year, but we're not going to go into any details on what's actually in that product. For that, we need to wait until, and our customers need to wait until we are ready to launch and we do launch the product. But obviously, we expect that to be available through FY 2026. Our activities to drive growth that I've talked about and Stu talked about, part of our longer-run strategy, particularly to focus on adults and seniors in developed markets, remains intact, and we continue to see good signs of raised awareness, more people being referred, and therefore more demand coming through in that very important segment.

That's supported by the ongoing increase in evidence showing the importance of treating hearing loss as people age, and particularly the links between hearing loss and cognition that continue to strengthen with a number of research programs around the world exploring that. So on services and on upgrades, we did, as you said, saw a really strong uptake of Nucleus 8 when we launched in financial year 2023. We saw the growth slow in the second half of last year. We still did expect modest growth for 2025. We're now expecting a single-digit decline. I've talked about there that that impact of out-of-pocket definitely being a factor there. And we certainly have more work to do to increase our ability to connect with recipients and to promote the benefits of Nucleus 8 over Nucleus 7.

But there still is a significant unmet demand or unmet need for upgraded and new processors that we have still a large proportion of our recipient base on processors older than Nucleus 8 and actually still older than Nucleus 7. So the opportunity is there, and we're working hard through a range of activities to lift the upgrades as we go into the second half. And certainly, as we go into 2026, we have an increasing eligible recipient base, and we'll have our new off-the-ear processor, Kanso 3, which will be part of this mid-year launch available both for upgrades and obviously as part of a new implant system.

Acoustics. I've talked about the outlook there, the continued geographic expansion, and also continued work on raising awareness of the benefits of acoustic implants in the markets where we've already launched, building patient pipelines, building the clinical evidence showing how good the outcomes are with Osia and the benefits that patients and healthcare systems see from people taking an acoustic implant over doing nothing or alternative therapies. And then finally, on the cloud investments. So as you know, we've been investing in working on our operating model on upgrading core and aging business systems to cloud-based systems over the last four years. All of this aims to improve our efficiency and agility as well as make sure that we are capable and able to support a growing and larger customer base.

We've increased the amount that we're going to spend by AUD 100 million- AUD 250 million from our previous estimate, and that is directly as a result of expanding the scope. As we've gone into this final phase of replacing our core ERP and manufacturing systems, we have found that we want to do more from a data perspective to make sure that we are set up to leverage the benefits of having clearer data, and particularly with AI, and to make sure that we can support our customers very well. From a manufacturing perspective, as we grow, we are adding a new manufacturing execution system that actually wasn't in the original scope, and that's to make sure that we can meet all of the regulatory requirements for traceability around our manufacturing processes.

But we're also going to accelerate that program so that we will finish it in 2027 with the majority of that balance spent in 2026. And so given the materiality of that increase from the rate we've been running at year-on-year, we will report it as a significant item for 2026 so that our underlying performance is clear. Okay, so that's the summary of the outlook. I'm happy now to switch over to questions.

Operator

Thank you. If you'd like to ask a question, please press star one on your telephone and wait for your name to be announced. If you would like to cancel your request, please press star two. If you are on a speakerphone, please pick up the handset to ask your question. Your first question today comes from Andrew Goodsall from MST Marquee. Please go ahead.

Andrew Goodsall
Senior Healthcare Analyst, MST Financial

Hi, good morning. Thanks very much for taking my question. Just asking, first question is asking around that second half. You're obviously expecting quite a big second half. I've sort of calculated about 15% unit sales growth. So yeah, just trying to get you to characterize sort of what sort of movement you're seeing in these first couple of months of the half and sort of, I guess, what that's pinned on. And maybe through China contracting there, perhaps that's a tailwind for you.

Dig Howitt
CEO and President, Cochlear

Andrew said, yeah, first up on the outlook more broadly, yeah, we do expect to get to around 10% and therefore a lift over the first half into the second half. And that's what we're seeing because of good momentum across key countries. Europe was a bit slower in the first half, and Europe always has a bigger second half than first half anyway, just because of the northern hemisphere summer and impact through July and August. And on emerging markets, with only 3% growth in the first half, we do expect significantly stronger growth there in the second half. And you mentioned China, so talk a little bit about that because I'm sure that there's going to be questions. That's really around what's the impact of the volume-based procurement mechanism that the Chinese government has been bringing in across a whole range of therapy areas.

So where I want to go there is first talk about more broadly what are China trying to do with volume-based pricing. Secondly, what's from a competitive or relative perspective, where's what China mean for Cochlear? And thirdly, what's the future look like? And the third of those is the hardest. It's actually the most uncertain. But first of all, just very briefly on volume-based pricing, the Chinese government have been doing this range of therapy areas, and their goal is really to both lower price and expand access. So they run a competitive process to try to bring the price of devices or of drugs down. At the same time, they effectively expand reimbursement, expand medical insurance so that there is still an out-of-pocket component, but there's a smaller out-of-pocket component and far more people eligible.

It's trying to manage costs, but also expand access is the goal of the program. In terms of us and China, we don't disclose how big China is as an individual country. Clearly, that's very sensitive from a competitive perspective. What we can say is we are least exposed to China than any of the Cochlear implant companies around the world. China forms part of our Asia-Pacific region, which you can see is less than 20% of our sales, and it is a big region. Now, the part of the China volume-based or the part of the market that is affected is surgeries done through the public hospital, so it excludes the special zones. So that's a significant portion of the business, but it is certainly not all of our China business. In terms of then the process, there's been a bidding process that's gone on.

Out of that, we've come out with a price that is at a premium to our international peers. We exercise some good discipline on managing where we priced. We will lose a little bit of volume in the short run, but as I said, the intent of this is actually to expand volume significantly, and we think we're very well positioned as that volume expands to pick it up. Now, how this all plays out is still very uncertain. It hasn't been implemented yet, but it's a long way around of saying we still believe in the significant long-run growth opportunity in China, and we'll be working on that growth with a price that's a premium to our competitors. I hope that answered your question, Andrew. Very long answer.

Andrew Goodsall
Senior Healthcare Analyst, MST Financial

Very comprehensive, but it does yeah, no, no, it's very hot. It probably means it wasn't China because I think that contract starts in March or that process starts in March, so.

Dig Howitt
CEO and President, Cochlear

Intended to start in March, yes.

Andrew Goodsall
Senior Healthcare Analyst, MST Financial

Yeah. Just a follow-on, more just maybe one for Sarah or Stu, just thinking about the hedge at second half, always trying to nail this down a bit better than I do. But with the drop in the AUD versus U.S. spot rate, what's your sort of just broadly sort of rough impact for the second half hedge effect?

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

We have not a huge amount, so we averaged AUD 0.66 in the first half. I think we think we'll be in and around AUD 0.65. We're planning about AUD 0.65 on balance for the second half, and obviously, it's a little bit lower than that on the spot rate, but the rates we're living in now were hedged six, 12, 18 months ago as well, so that moderates that a bit.

Andrew Goodsall
Senior Healthcare Analyst, MST Financial

So probably still to come in with a slight negative, though, if you're hedged above the spot?

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

Yeah, somewhere sort of AUD 5 million- AUD 10 million.

Andrew Goodsall
Senior Healthcare Analyst, MST Financial

Okay. Got it. Thank you very much. Appreciate it.

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

Thanks, Andrew.

Operator

Thank you. Your next question comes from David Low from JP Morgan. Please go ahead.

David Low
Executive Director, JPMorgan Chase

Thanks very much for taking my questions. Can we start with the service revenue? And I hear the explanations, but I guess some of the feedback we get is that it's much more difficult these days to show a clinical or a hearing outcome benefit with the latest processor. And that being the case, insurers or payers are more reluctant to pay for the next generation certainly quite as quickly as in the past. I was just wondering, one, do you think that's a factor? Two, what can be done about it?

Dig Howitt
CEO and President, Cochlear

Yeah, so first one is actually we don't see that as a significant factor. Navigating insurance in different countries requires some knowledge and some challenge, and we do get insurance rejections, but we are not seeing many for lack of benefit, and we've got some good clinical evidence showing the gains in hearing and noise on Nucleus 8 over Nucleus 7, it's a core part of our design philosophy is to improve hearing outcomes, so we've done it with Nucleus 8, and we think there is clearly headroom to go further, and that's part of our development of future sound processors.

David Low
Executive Director, JPMorgan Chase

Thank you and just on it related, I see the hearing aid companies are introducing AI-supported devices and claiming better hearing outcomes. Can you talk at all about where Cochlear is at with similar development?

Dig Howitt
CEO and President, Cochlear

Yeah. We've been aware of the opportunity for neural networks to even do even better in hearing and noise. And so clearly, that would be part of our future is to make sure that we keep across technology. I mean, one of the things we've done for a long time is monitor what's going on in hearing aids from a technology perspective and to make sure that we're relevant. We incorporate those sorts of things into our products. Apart from a competitive perspective, our growth comes from getting people to move from high-powered hearing aids to Cochlear implants. And they all do better when they do that, but part of the assessment going in is, do they get all the features that they were getting on the implants? I mean, we were first in iPhone and Android phone connectivity in Cochlear implants.

We did that on the back of our relationship with GN ReSound. We did that because there's a clear benefit for our customers, but also because they were used to that from a hearing aid and trying to get someone to switch from a hearing aid and say, yeah, but you lose this benefit, makes that task much harder. So yeah, well aware of the opportunity there. And if it proves to be successful, it certainly will end up in our products.

David Low
Executive Director, JPMorgan Chase

Right. And just one other, I mean, so going back to Andrew's question on unit sales, so an uplift in the second half, yet you've announced the new product is coming. Yeah. How much have you allowed for the fact that there will be some postponement? I mean, frankly, I would have thought potential recipients who become aware that there's a new version, a next-generation version coming, are likely to postpone, and that will have a detrimental impact on sales this half. Just wondering how you've thought about that, please.

Dig Howitt
CEO and President, Cochlear

Yeah. We think that will be pretty muted. I mean, most people who end up getting a Cochlear implant have not heard anything about Cochlear implants until they have had hearing loss for a long time and are really struggling with hearing loss, and they get significant benefit from switching over, so not like people on this call are monitoring what we're doing regularly. Tens of thousands of people out there who are going to get Cochlear implants are completely new to the field. The other factor there is that hospital and audiological capacity is tighter, and the giving up of a surgical slot and hoping that it can be made up later. We're just not seeing hospitals do that. Even now, forget about a new product, but when surgeons have surgical slots, they want to use them.

So look, there is some risk there, but we don't see it as significant. And the other thing is that we have a couple of regulatory approvals. It's not too broad yet, and we haven't in the past seen people hold when there's not regulatory approvals in place.

David Low
Executive Director, JPMorgan Chase

Understood. Thank you very much.

Dig Howitt
CEO and President, Cochlear

Thanks, David.

Operator

Thank you. Your next question comes from Saul Hadassin from Barrenjoey. Please go ahead.

Saul Hadassin
Equity Analyst, Barrenjoey

Thanks. Good morning. Dig, can I just ask you about the upgrade sales again? Noting you've flagged again the Kanso 3 release. These sort of mid-upgrade cycle releases, can you talk to your thoughts about the recovery and services revenues beyond FY 2025? I guess what I'm trying to work out is to what extent do you think N8 will continue to be a drag on the basis of a very strong first 12 months? I assume an N9's not due out for several years. So to what extent do you think the Kanso 3 can resolve some of that softness as you head towards the mid and late part of the N8 upgrade cycle?

Dig Howitt
CEO and President, Cochlear

Yeah. I'm certainly confident of seeing a lift with Kanso 3. There is a good proportion of our users who prefer off-the-ear processor, and the opportunity to go from Kanso 1 or Kanso 2 to Kanso 3 is important for people, so we'll see an uplift there. And also remembering that we certainly do see these cycles of a jump on launch and then tails off over the life of a product till we launch the next one. Still, the biggest driver of our services over any cycle is the increasing number of people who are eligible for an upgrade. So as we look out over 2026 and 2027, even into 2028, we're cycling good high growth in our first-time Cochlear implants in terms of people being five years out from getting their first implant.

And so that lift in the eligible base, we expect to see that continue to drive upgrades in the future. And if you go back and look at the chart, I think on our third slide, you do see long-run growth there, but you do see half-on-half some variability.

Saul Hadassin
Equity Analyst, Barrenjoey

Thanks, Dig. And if I've got just one question for Stu, Stu just gave the other income for the half. Just noticed a couple of items in there. Can you talk to what the other income is? Is it gain on investments or just that doubling of that profit this half versus PCP?

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

Yeah. It's definitely not gain on investments. So anything that goes to the P&L comes in underneath underlying. So the only real material rebate we've had this year or this half's been Excel, but that goes through the balance sheet. In terms of that other line, there's about AUD 6 million-AUD 7 million of FX gains. It's about AUD 3.2 million, but it's off a negative of AUD 3.6 million last year, so it's about a AUD 6.8 million swing on FX on balance sheet items. But that always goes through that line. There's been no change in what's in that line this half versus others. The other two things that are in there, again, things that we're always doing, they're grants. So R&D grants where we can apply for funding or co-funding from payers or other philanthropic institutions for R&D research we do, and we do every year.

And then some small amount of collaboration income, and that's where we might offer contract services to small players who we think have aligned interests. So that's the nuts and bolts. It's largely rats and mice.

Saul Hadassin
Equity Analyst, Barrenjoey

Great. Thank you.

Operator

Thank you. Your next question comes from David Stanton from Jefferies. Please go ahead.

David Stanton
Head of Healthcare Equity Research, Jefferies

Good morning, team, and thanks very much for taking my question. In terms of perhaps start with one for Stu and/or Sarah, in terms of gross margin, you talked to the fact that Chengdu will impact this year, but into next year, should we be thinking that gross margin will get back to its long-run average? Is that the way to think about it?

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

Look, we think Chengdu's likely to have an impact for at least another year or two. We started production really in the last six, 12 months. It'll take a couple of years to get up to full capacity. So until you get there, you have that higher overhead per unit drag, so it's at least a couple of years financially.

David Stanton
Head of Healthcare Equity Research, Jefferies

Understood, and then just want to confirm, you're still targeting circa 18% EBIT margin over the longer term for the business?

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

Yes. Yes.

David Stanton
Head of Healthcare Equity Research, Jefferies

Understood. Okay. Very good. And then I guess two competing things in terms of that, what we're all talking about, that circa 15% growth in the second half in terms of unit sales. How much of that is going to be driven positively by visibility of referral rates? Do you get a better look at what's in the pipeline than perhaps you did even two, three years ago? And if so, what's the reason? Versus the impact of, we continue to hear, in the developed world at least, you've got lower surgical support staff, which you've sort of somewhat alluded to a little bit, I guess. How do you sort of offset the two of those going forward?

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

So yeah, look, I think first on the visibility, we do have better visibility than we had, but we still want more. Still, the majority we talked about this in the last few results, the majority of people who get a Cochlear implant, we still don't have visibility of them until they get to a clinic. But the proportion that we are engaged with or in touch with is certainly growing. So it's improving, but there's still room for us to do more. And then on the surgical capacity, it's actually still really audiology. We do that's more of an impact. There are cases of surgeries rescheduled or at least it just stopped being available, but it's the audiology faces more of a constraint than the surgical one.

I think we are seeing some better adoption of fewer post-surgery appointments, which is helping create a bit more capacity for evaluation.

David Stanton
Head of Healthcare Equity Research, Jefferies

Thanks. Very clear. Thank you.

Operator

Thank you. Your next question comes from Steve Wheen from Jarden. Please go ahead.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

Yeah. Thanks very much. I just had a quick question on the new implant. Just wondering whether or not that's been approved by the FDA yet to give you the confidence to announce the launch date? Probably asking mainly from the point of view of being looking for signs of clinical trials on this and have come up with not very much. So just wondering where it stands from an approval point of view?

Dig Howitt
CEO and President, Cochlear

Yeah. So Steve, we don't have FDA approval yet, so I'm sort of happy to answer on the FDA, but don't want to and I know you're not going there to do a country-by-country where it's approved and not approved. The FDA approval, when it happens, is reasonably public, so you have to find it.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

The clinical trial's been complete?

Dig Howitt
CEO and President, Cochlear

We don't necessarily need to do a clinical trial to get an implant approved. They're sort of independent functions in this case of us doing clinical trials and regulatory approval processes.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

Okay. Just switching to the Nucleus, just I'm not sure if I missed this, but did you quote a number as to what sort of penetration you've already achieved with the eligible cohort for upgrading?

Dig Howitt
CEO and President, Cochlear

No, we haven't quoted a number. The penetration in the last half is we haven't quoted a number on it, but it has fallen from where we were, and that's our opportunity to lift that back up, as I said, but part of that is a cost of living issue.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

Okay, and then the last one, just trying to think about how we treat this cloud increase in the investment. There obviously was a balance of that spend, which you were previously absorbing into the underlying numbers for FY 2026, so when you give guidance for 2026, will you be taking all of that out and putting it below the line or leaving the amount that was originally in and just putting the extension of your project below the line? If you understand what I mean.

Dig Howitt
CEO and President, Cochlear

No, we'll put the whole amount below the line.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

Right. So we'll get an upgrade in the underlying. We'll get a big upgrade in the underlying relative to the way we're expecting or forecasting it, and then the total amount will go below the line.

Dig Howitt
CEO and President, Cochlear

Yes. Yeah.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

Okay. Got it. All right. That's all from me. Thanks.

Dig Howitt
CEO and President, Cochlear

Thanks, Steve.

Operator

Thank you. Your next question comes from Dani from Goldman Sachs. Please go ahead.

Thanks. Hi, Dig and team. Just a question on, I guess, your implant market share. There's a bit of feedback from the channel suggesting that some of your competitors have released new features, have managed to shift some of that share to the other business. Just curious on your thoughts there in light of the number that you've put in the half, just your ability there to sort of either hold your long-term market share. And then the next question on that would be, with the new implants that you are launching, just the ability to, I guess, innovate ahead of the field. Thank you.

Dig Howitt
CEO and President, Cochlear

Yep. Thanks, Dani. Good questions. So first of all, we're confident of our long-run position on share. We hold a very strong share across the world and certainly in developed markets. And that's on the back of the strength of our product portfolio, our history and reputation, and the strength of our local sales and field clinical teams. Yeah, competitors are always going to try and find things that we don't do and aren't doing and try to differentiate themselves on that. So we see that from both our competitors. Because they do that, they will have some successes here and there, but we're not seeing that happening at a material level. And remembering, one of our competitors is coming back from a pretty significant recall, and the further that fades into the distance, that certainly helps their share a little bit.

But as we look forward to our product portfolio and the future, we are very confident that we will be able to not only hold our share but lift our share as we look forward, knowing what we have in the pipeline. We spend a lot of money on R&D, and I think we're spending it wisely. And that means that we do, as we've said in the past, we've got a full pipeline of products coming out over the next several years, and we don't see that our competitors have the financial capacity to keep up with what we're doing.

Okay. Thanks, and the next question is on the cloud spend that you've increased quite materially by about AUD 100 million relative to the baseline. Could you give us some better sense of what you're spending that on? I saw the release was on core ERP data and manufacturing systems. Could you just elaborate further on why you've lifted the spend there? And then secondly, the expected benefits that you would expect out of that spend? That'd be very helpful. Thank you.

Yeah. So go back first on the why we've lifted what it's going on to and then the benefits. So when we set out on this in 2020, 2021, at that point, we're actually going to capitalize what we spent. And there was a clarification of interpretation of accounting laws, which meant that all investment in cloud computing and transformation had to be expensed rather than capitalized. So we had an estimate at that time, and that was done sort of looking forward but without detailed scoping. So now, four years on, we've gone and we've implemented a new human capital management system. We've implemented a new CRM. We've put some supporting systems around those. And now we're going into replacing our core ERP. So we have a 20-plus-year-old ERP. This is something that we expect to do about every 20 years.

So as we've gone in and scoped this in depth, we want to make sure we get it right. We want to make sure we're building a platform for a much larger business. So we have gone into more depth, which enables us to get a better estimate. The cost of putting these things in has not been immune to inflation over the last four or five years. So just the actual cost, effectively per day of implementing these things is considerably higher than it was. And we've added a manufacturing execution system. When we went into this, we hoped that we would be able to use sort of an off-the-shelf ERP for our manufacturing, given they've developed quite significantly over the years.

As we've gone into further detail, we've realized we need to put a manufacturing system over the top of the ERP to have the level of visibility and control that we have and that we need. And so that's an additional cost that we didn't have at the start. And we're doing much more on data than we were initially. And that's looking forward to, obviously, the value of data, but also the potential that not only these systems bring, but also with AI into the future and making sure that we get the foundations for that right. So it is a material uplift, and it's driven by that going into more detail. And we said we deliberately left this part to last so that we would learn as we went through the first few phases.

Okay. Thanks, Dig.

Thanks, Dani.

Operator

Thank you. Your next question comes from Mathieu Chevrier from Citi. Please go ahead.

Mathieu Chevrier
VP of Healthcare Research for Australia and New Zealand, Citi

Thank you. Good morning, Dig. Thanks for taking my question. My first one was just on Cochlear implants, the ASP benefit that you have in the first half, and I guess that was from the mix shift. How do you see that evolving in the second half, and then how do you see the new implant impacting that in 2026 and onwards?

Dig Howitt
CEO and President, Cochlear

Yeah. Mathieu, thanks for the question. So we expect that, particularly as emerging markets, we get more of that tender volume coming back, but the ASP will come off. So it was higher in that first half. As we look forward to new technology, we will certainly be seeking price increases in the markets where we have the opportunity to do that on the back of the benefits that the new technology brings. The magnitude of that, I'm not going to go into. We think we can get at this stage.

Mathieu Chevrier
VP of Healthcare Research for Australia and New Zealand, Citi

Yeah. Okay. And then in terms of how you're thinking about the potential penetration rate of upgrades over time, has what happened in the last kind of six, 12 months made you reconsider where that could land over time?

Dig Howitt
CEO and President, Cochlear

No, it hasn't. As we said at the full year, the question was raised on cost of living and inflation, what impact? And we said that we haven't been through with upgrades of volume to see what impact that has. And we have seen some impact. Given inflation is coming off and hopefully cost of living pressures moderate, that should fall away. And as I said, we are working with our new platforms. The ability for us to segment and target to make more people aware of their eligibility will lift. And people's awareness of their eligibility is still the biggest factor in lifting up penetration. So I do think that there is opportunity to lift the penetration, certainly back to where it was, but as we've been talking about for a while, lift it further still.

The underlying base of recipients just continues each year to grow in volume.

Mathieu Chevrier
VP of Healthcare Research for Australia and New Zealand, Citi

Okay. Thanks very much.

Dig Howitt
CEO and President, Cochlear

Thanks, Mathieu.

Operator

Thank you. Your next question comes from Craig Wong-Pan from RBC. Please go ahead.

Craig Wong-Pan
Director of Equity Research, RBC Capital Markets

Thanks. And good morning. In services, which region experienced the largest declines, or was it a fairly broad-based fall in services revenues by region this half?

Dig Howitt
CEO and President, Cochlear

Yeah, Craig, I can give you a little bit of detail on that. I don't want to go too far, but certainly the U.S., where it's probably most exposed to co-pays, had the most significant falls. There were a couple of other countries where we saw falls. Equally, we had some countries where we grew, but the U.S. was the most affected.

Craig Wong-Pan
Director of Equity Research, RBC Capital Markets

Okay. And then you mentioned about the cloud systems and the benefits of that, allowing you to target patients to greater target them for an upgrade. But the full benefits of that aren't sort of there yet. I mean, when do you expect to see the benefits of those cloud systems helping you drive upgrade services revenues?

Dig Howitt
CEO and President, Cochlear

So we think certainly in 2026, the next financial year, we will be able to get some of those benefits, but we'll get some through this year. I mean, we have a number of activities underway. These things don't tend to happen in a step change. They have to gradually build functionality in and learn how to use that functionality. So it will happen gradually, but starting this year and certainly into 2026. And I realize just on that, I didn't say to answer Mathieu's question just on the broader benefits. And there are, particularly with the ERP and manufacturing, significant efficiency gains that we will get in manufacturing. A reasonable portion of time now we spent on recording that we can automate with the new system. So we'll get just straight-out efficiencies in our manufacturing line.

Similarly, from the ERP, we have a lot of manual transactional processing, which is inherent in a 20-year-old system that we will be able to automate. There are efficiency gains that we will see after we put the new ERP in.

Craig Wong-Pan
Director of Equity Research, RBC Capital Markets

And then one last question. Just on the CapEx, at your full-year result last year, you guided to CapEx of AUD 110 million-AUD 130 million. Just wondering whether you're still expecting that level of CapEx this year?

Dig Howitt
CEO and President, Cochlear

Yes. We're holding to that range.

Craig Wong-Pan
Director of Equity Research, RBC Capital Markets

Okay. Thank you.

Dig Howitt
CEO and President, Cochlear

Thanks, Craig.

Operator

Thank you. Your next question comes from Sacha Krenn from Evans & Partners. Please go ahead.

Good morning. Thanks for taking my questions. First question, just on developed market pediatric implants. Just wondering if you can talk a little bit about the outlook there. Do we sort of expect growth to plateau or penetration, I should say, to plateau, or are there still opportunities for further penetration and possibly increases in bilateral implantation as a proportion of surgeries?

Dig Howitt
CEO and President, Cochlear

For pediatric implants, we expect that to grow at a couple of percent a year, largely in line with the growth in birth rates. The penetration across most markets is very high, and the uptake of bilaterals is very high, certainly across developed markets. There are countries like the U.S. where there is still an opportunity to lift the penetration. Japan is another one. There are some small opportunities for more penetration, but largely we're expecting just growth in line with birth rate.

Okay. Second question. We're hearing about some good outcomes on residual hearing out of some trials in Melbourne. I'm just wondering if there's an opportunity to expand that more broadly and achieve better outcomes on that globally.

Yeah. So residual hearing is certainly one of the areas of research and product development that we are working on. It's one of the barriers to people getting a cochlear implant. They can hear a bit. It's not really very functional hearing, but people rightly are concerned about losing that hearing. Now, whether they lose it or not, they still get extremely significant lift in hearing performance. But having been able to make stronger claims around residual hearing would help remove barriers to people getting an implant. We have made some progress on a couple of, or aiming to make progress on a couple of, fronts. One is that with our Slim Modiolar electrode, there's a number of surgeons around the world who are reporting good hearing preservation with that electrode because often the loss of hearing is caused by trauma from the electrode being inserted into the cochlea.

With the Slim Modiolar, it actually should stay away from the walls of the cochlea and therefore not cause trauma. So that's encouraging. We think there's more in future in design opportunity there. And the other one is a drug-eluting electrode. So if there's trauma, if there's a drug or steroid that can minimize the reaction to that trauma, the inflammation from that trauma, then there's potential to improve residual hearing. So we are in the middle of doing some trials with drug-eluting electrodes. Some early indications there are showing some interesting indications on hearing preservation. Certainly not at the scale and the volume to make any claim, but I wouldn't expect that at this stage of the trial. But there's definitely some opportunity there that we will continue to explore through our clinical work.

Okay. Thank you. And just one clarification question on the Chengdu ramp-up. Just wondering what capacity you're talking to when you talk about the ramp-up. Is that the 10,000 that's been quoted?

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

Yeah. So it'll happen in stages. So we've got capacity for at least that at the moment. We'll want to obviously be willing to use that capacity, and then we can add further capacity over time by adding extra equipment. So we've got plenty of floor space for a lot more capacity than that, but obviously we'll add equipment and people as demand grows.

Got it. Thank you.

Dig Howitt
CEO and President, Cochlear

Thank you.

Operator

Thank you. Your next question comes from Laura Sutcliffe from UBS. Please go ahead.

Laura Sutcliffe
Head of Australian Healthcare Equity Research, UBS

Hello, and thank you for taking my question. The first one is just a bit of a revisit on the unit growth expectation for the year. Is there anything that you're expecting in the second half that you wouldn't class as underlying? And what should we think about as a kind of fair run rate? Is the first half more of a fair run rate, or is the second half more of a fair run rate, or is it something in the middle?

Dig Howitt
CEO and President, Cochlear

I'd take the annual run rate. We're aiming to grow Cochlear implants around about 10% per year. We had grown faster than that for the last couple of years, but we've been continuing to talk about 10% being, I think, a sustainable rate when we look at the work to drive demand and to make sure that there is capacity through the system.

Laura Sutcliffe
Head of Australian Healthcare Equity Research, UBS

Okay. That's clear. Thank you. And then just secondly on bottlenecks in the system and trying to tie together a few of the comments that you've made around maybe waiting times and things like that over past sets of earnings. Is it the case that some of the greater visibility that you've got into the pipeline, if I can call it that, of patients can help you be part of the solution to people falling out of the funnel, waiting too long, getting around some of these bottlenecks? Or is it really a case of just sit back, wait and see, let awareness increase, and then sort of the benefits will come in time?

Dig Howitt
CEO and President, Cochlear

No, we can definitely play a role, and we are playing a role now, working in two ways. One is working with clinics to take them through the evidence that shows that the optimum number of post-surgery appointments. And we continue to see a reduction in the average number of post-surgery appointments, which frees up capacity on the front end for evaluation. We also do work from a technology perspective. So our Remote Care and Remote Assist enables audiologists to check the status of people's processor and implant and map and do that remotely and do that in a shorter time than a full programming session, whether that's a face-to-face session or a remote session. So with technology, we can take time out of appointments, and we're making progress there. But again, that takes some time. But also the weight of demand is an important factor.

The clinics having waiting lists is an important motivator to increase capacity, whether that's through hiring more people or through changing practice, but having those waiting lists is a very important part of the motivation.

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

Yeah. And if I could just add to that, I think a big continued focus has been identifying candidates earlier in the funnel, being able to see more of them before they get to surgery because still a lot of the patients, the first time we know about them is when they're being implanted. And certainly that data and that access is very helpful in, as you said, being able to do everything we can to make sure those patients make it all the way through the funnel and don't fall out. And I think our capability is getting better, one, at identifying and bringing them in initially, and two, at holding them in the funnel and sort of holding their hand through to surgery.

Laura Sutcliffe
Head of Australian Healthcare Equity Research, UBS

Thank you very much.

Dig Howitt
CEO and President, Cochlear

Thanks, Laura.

Operator

Thank you. Your next question comes from Lyanne Harrison from Bank of America. Please go ahead.

Lyanne Harrison
Equities Analyst, Bank of America

Hi. Good morning, all. Just to continue on Laura's line of questioning, with those bottlenecks in audiology, are they getting worse, or is it a matter of just has it been stable over the last six to 12 months but still seeing bottlenecks?

Dig Howitt
CEO and President, Cochlear

So capacity has been increasing, but there are still bottlenecks. So it has been getting better, but there is more work to do.

Lyanne Harrison
Equities Analyst, Bank of America

Okay, but effectively, we're starting to see more people move through the funnel as you continue to do your work there as well as the audiologists?

Dig Howitt
CEO and President, Cochlear

Yes.

Lyanne Harrison
Equities Analyst, Bank of America

Okay, and then if I could move on to the emerging markets. We saw private pay. There was a good tailwind in this half. Can you comment on what's really driving that, and do you expect that to continue over the next six months?

Dig Howitt
CEO and President, Cochlear

From private pay or premium-tier private pay, yeah, there continues to remain a good and actually growing opportunity there because it's largely related to wealth and to a little bit to if there is any local reimbursement. Across emerging markets, as wealth grows, we continue to see a good opportunity in that premium private pay. But also recognizing that in emerging markets, like in developed markets, the long-run opportunity is a level of government funding and government support to really significantly increase access.

Lyanne Harrison
Equities Analyst, Bank of America

Okay. And then if I could come back to services, obviously some challenges there with services revenue. But given what you're trying to do more around creating awareness and working out who's eligible for an upgrade, are we likely to see an increase in the sales and marketing spend as you target those customers over the next six months?

Dig Howitt
CEO and President, Cochlear

No. Not outside the boundaries that we set of having the 12% into R&D and that 75% gross margin will be a little bit lower with Chengdu and 18% net profit. So we've got an envelope there to spend. And part of putting these systems in is it doesn't really cost us more to market. It's more effective. It's the effort we put in can be more effective.

Lyanne Harrison
Equities Analyst, Bank of America

Okay. And just one last question around the cloud costs, about AUD 120 million balance for 2026, 2027. How will that be phased over those two years?

Dig Howitt
CEO and President, Cochlear

Yeah. We're still working through the detail of that as we go into the detailed design, but the majority of it we anticipate will occur in 2026.

Lyanne Harrison
Equities Analyst, Bank of America

Okay. Thank you very much.

Dig Howitt
CEO and President, Cochlear

Thanks, Lyanne.

Operator

Thank you. Once again, if you would like to ask a question, please press star one on your telephone and wait for your name to be announced. Your next question is a follow-up from Steve Wheen from Jarden. Please go ahead.

Dig Howitt
CEO and President, Cochlear

Oh, yeah. Thanks very much.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

Hi, folks. Gooday, Stu. This is a question for Stu. I'm just following up on the comment about Nyxoah. I was looking at your annual report for FY 2024, and it talks to the fair value going through the comprehensive income line. I'm only raising it because the stock's up like 22% in the half. So just trying to understand where that sits in the P&L from a mark-to-market perspective.

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

It's definitely on the balance sheet, and it is through that investment line.

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

Do you know what the other side is? We've got the one side on the balance sheet. Do you know what the other side of that entry is or where it is?

Stu Sayers
President of Asia Pacific and Latin America, Cochlear

Yeah. Why don't we get back to you on that one, Steve?

Steve Wheen
Head of Healthcare, Managing Director, and Equity Research Analyst, Jarden

Okay. Thank you. That's all from me.

Operator

Thank you. Your next question comes from Eric Johnston from The Australian. Please go ahead.

Dig Howitt
CEO and President, Cochlear

Hi, Eric.

Operator

As he appears to have his phone on mute, that does conclude our conference for today. As there are no further questions at this time, I'll now hand back to Mr. Howitt for any closing remarks.

Dig Howitt
CEO and President, Cochlear

Thanks, everyone, for joining today, and look forward to talking to you all at the full year. Thank you.

Operator

Thank you. That does conclude our conference for today. Thank you for participating. You may now disconnect.

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