Ladies and gentlemen, good morning, and a warm welcome to our Capital Markets Day here in London. I'm Markus Georgi. I'm heading the Investor Relations and Sustainability team at Fresenius SE. It's my great pleasure to have all of you here today, together with the management of Fresenius Group and Fresenius Kabi. I see many familiar faces. It's just great to have this meeting with you in person today, after the dreadful phase of pure virtual meetings due to COVID. This our first Capital Markets Day after more than a decade now. Let me give you a brief overview of today's agenda. We have three parts. In the first presentation block, Michael Sen, Group CEO, will kick off the event. Following him, we have Pierluigi Antonelli, the new CEO of Kabi, followed by Andreas Dünkel, Kabi CFO.
On the second block, we've got Marc-Alexander Mahl presenting Nutrition, and Christian Hauer presenting MedTech. We will have a lunch break in a separate area at the Tyburn Kitchen, which is located upstairs. In addition, you have the opportunity to visit our product show, which is located in the back of today's presentation room. You will hear a deep dive on Pharma from Marc-Alexander Mahl again, and on Biopharma from Michael Schönhofen. Each block will be followed by a Q&A session. We aim to conclude this event at 4:30 P.M. Before we begin, I would like to share a few technical details. You can see it in the back of this room. The entire event is being recorded and can be followed via webcast. A replay will be available on our corporate website following today's Capital Markets Day.
If you would like to ask a question from the webcast, via the webcast, please don't forget. Push the button on the screen. For good order, I would like to draw your attention on the safe harbor statement outlined in our booklets. Without any further ado, let us now start. Please join me in welcoming Michael Sen on stage. Michael, the stage is yours.
Good morning, everybody, from my side. It's great to have you all here. This is quite a lineup. Tells you that we gotta come back to having physical meetings, and just heard more than a decade ago, the last Capital Market Day. It's about time that we meet again. Also welcome to everybody who is watching us online here in London.
There's also a great lineup on the other side of the room, where we have a product exhibition, and there are colleagues of ours who are going to show you what the power is of this wonderful Kabi franchise. Look, I'm gonna start it off and kick it off, but I'll be very crisp and brief as well. Ever since we started the journey and I took over in October, I really believe, together with the entire team, and Sarah is also with us here from Group Management, that we've been moving rapidly.
There was something which was way overdue, and that is to really intensely have a dialogue with you, to really also outline our strategy as such, which I will be doing in the next couple of minutes, and then go deep into what we call the operating companies, i.e., being the core of our businesses. What you will see today is indeed showcasing the strength of Kabi in each and every individual business we're having and managing, now with a clear direction and being, with their Vision 2026, a clear pillar of future Fresenius. Next to the showcasing, you will see under the leadership now, the new leadership of Pierluigi and his management team, that there is commitment.
Clear commitment to be very ambitious in the marketplace, obviously vis-à-vis customers and serving patients, but also when it comes to financial outcome. You will hear about that one in a minute. All in all, we are very confident that ever since we embarked on that journey of Future Fresenius, we can build on a great momentum going forward. Everything starts with our mission. This is not just lip service. It is about advancing patient care. We deliberately chose those three words because they have a meaning. It is about looking ahead, advancing. It is putting the patient in the center. Then it is about care. We are in a very attractive sector. The sector is growing. It's the healthcare sector.
Everybody is talking about the healthcare sector growing and being improved and structurally changing, but we are a uniquely positioned company because we can advance care on many level. It starts with the patient, giving the patient access to medicine, access to the latest treatment, enabling the next level, providers, to use state-of-the-art tools in order to do nothing less than deliver care. Then the ultimate thing for healthcare system to increase the outcome and drive efficiency and effectiveness. With the Fresenius franchise, with the core businesses we have with Helios and with Kabi, we're doing this on a global scale. Yet, you will see later on, we are also a very relevant local player. Everything you're gonna hear about today from the colleagues is based on that very, very powerful mission: advancing patient care.
Next to what we've been kicking off in our agenda, and, you know, we are in reducing the complexity, simplifying the structure, we're increasing the focus, and we're accelerating performance. There is also a long-term vision. There is a strategy, there is a clear direction, which is kinda like the positive North Star for all our employees. Remember I told you when we started, when we embarked on that journey, we did that portfolio analysis. We dissected Fresenius into 28 businesses, we're comparing and contrasting them strategically. Then we tried to group those businesses. By grouping those businesses, we said we're gonna focus on the therapy space. In the continuum of care, therapy is 70%-80% of the entire continuum of care or a patient journey.
Within therapy, which has the biggest growth potential and the highest profit pool, with the businesses we have, and we have positioned them in the portfolio analysis, we really found out that we are catering key trends, and in essence, therefore, we derived three growth platforms within the therapy space, all our businesses, in one way or the other, can cater into. That is the biopharma platform, like in a larger and broader sense, including nutrition. This is the MedTech platform, and this is the care delivery, the care provision platform. We depicted only a few examples where you see not only from a market positioning, but from a medical and clinical relevance. We are right at the critical spots. MedTech platform, take breakthrough technology infusion system. If you wanna look at it's outside the room.
Cell and gene therapy, a topic of the future, already the foot in the door. You can go to the left side. When we talk about nutrition, you will hear later on, we talk about personalized nutrition. Care provision. Look at the 400K anonymized routine treatment data sets. There is no other institution which has the largest hospital chain in Europe, and therefore has access to data, and then can build on something which experts call proprietary data assets. If this is the strategy from the inside, from the portfolio analysis, it caters exactly into what really matters for healthcare systems. It's better products, it's better treatment, it's better outcome, and it's better care. That being said, we're all doing our homework.
With or without us, there are a few trends out there. I know it's sometimes overstressed, the term paradigm shift. Yet there are some shifts going on in the outside world, whether we want it or not. The good news is, with all our businesses, they are in our favor, or the other way around, we pay into these paradigm shifts. We call it the triple shift here: the bio paradigm, the tech paradigm, and the data paradigm. I gave you a few examples at the top of the page: what is going to happen when you think of biology, the progress in science. People say this is the age of biology, understanding people's biology. Think about the loss of exclusivity on biologicals. That is a huge market.
Therefore, just look at the number of monoclonal antibodies, which is going to evolve in the next couple of years. The tech paradigm, obviously, it is about, you know, surgical robots. Helios already applies surgical robots. You can do even more to increase the efficiency, to reduce the errors, to then, at the end of the day, maybe even make more revenue. Robotic surgeries, the procedure growth is going on. Obviously, the data paradigm, which I also mentioned already, having probably the potential data lake for the biggest proprietary data set with our clinic chains we have. The socio- economic and demographic trends. People wanna have access to healthcare, high quality healthcare, and that is what biopharma is all about.
It's about health equity. Therefore, our businesses are paying also into these long-term trends. That again, makes all our people working within Fresenius so proud, now having the clear direction and having a clear kind of vision in front of them. That is really worth working for and going to work every day. Again, starting at October and going into February 22, it's not only about vision, it's about the hard work, the structural simplification, the focus, the accelerating performance. Presenting this medical care, the deconsolidation, fully on track. We are looking forward for the extraordinary general meeting on July 14. We are preparing the legal paperwork. We're doing everything which is necessary on the carve-out, having a lot of conversation. You tell me whether this was thinkable a couple of months ago?
The new financial framework, we'll come to that one in a minute. A really kind of rigid, by the same token, transparent and very powerful tool to instill nothing more or less than a performance culture within the organization for good, on a very sustainable basis. It's clear, it is measurable, we're gonna also disclose it to you guys, and everybody within the company knows where we stand or what they need to do in order to increase performance. Cost savings or structural productivity in our business is becoming almost getting into our genetic disposition, and probably Andreas will talk about that later on, how it unfolds within Kabi. New people, new team, new incentives. Pierluigi joined the company a couple of weeks ago, already very happy as to how he's leading the team, and you will see that in a couple of minutes.
There's another colleague coming soon, Michael Moser, joining the Fresenius board. Then there's a lot of other changes also in many levels of the company, a few you will see later on. That all ends up structurally, if you have that strategy, which we just alluded to, into this house of Fresenius, into this operating model. This is where we're gonna double down our energy on the businesses within Kabi and within Helios to exactly cater these three growth platforms within the therapy space. The other assets are investment companies. One of them having more freedom. We're on the way of executing that one, Fresenius Medical Care. The other one, yes, we still got work to do, but we're on it, and we're gonna update you as we go along.
That will then, if the deconsolidation goes through, change obviously, also the interaction and again, the performance mindset, because we will be much closer and tighter knit with the core, which you see on that picture. Helios, just as a teaser, probably beginning of next year, we will do a Capital Market Day on Helios. Prime asset, 24 million patients a year. Very strong in the hospital setting, but also in the ambulatory setting. Very strong, for example, with Quirónsalud, managing patient flows, embedding digitization, working in an ecosystem. That's why prime asset paying into the strategy as you have seen it. Kabi, obviously, I don't want to steal the thunder of all the colleagues. Very good asset as well with all the individual businesses, and that is key.
The 28 business fields we dissected, you will see a little bit in an aggregated view where we had this 3+1 strategy. It is and was now about growth, about incremental growth in fields which are relevant, which are paying into future trends, and therefore, this 3+1 strategy, the growth vectors, and then the basis, the underpinning business, the IV generics and fluids, by the way, highly cash generative and nutrition, for example. Just picking out one. Many of you told me up until, you know, maybe months, quarters ago, didn't know that we have such a big nutrition franchise.
Marc is gonna tell you more about it and why it is so distinct in the clinical nutrition, why we have such a strong market position, and it is beyond EUR 2 billion, and I can tell you it's growing and it's profitable, and it will also deliver the necessary returns. Now, on a more aggregate level, two years back, when I joined Fresenius, and I had the privilege to be at Kabi, there are a few attributes from my point of view, which are then underpinned by facts, which really are the character and the profile of Kabi. The one thing is that Kabi has a very strong customer proximity. We are in so many countries of the world, and we are a relevant player with the portfolio.
The portfolio, first of all, in it itself, the IV generics is relevant. What we add to that, with the fluids, we have medical technology, we have nutrition. We are entering a completely new field. The customer relationship, the, I would say partnership, the reliability. We are talking here of critical medicine for the ICU or for chronic disease patterns. People need to rely on a partner to be delivered, and the good thing is we know how important that is because we have hospitals out on our own. This embeddedness, closeness to the customer, this partnership, this reliability and quality, and then the manufacturing capability. Michael Schönhofen, who is in the team, who has been with Kabi for quite a while, he's been very instrumental also in building up this, what we call vertical integration.
Why do you need the vertical integration? Why do you need the manufacturing network? If it's a competitive market, you want to control what you can control, and that is the unit or unit element costs. If you are good at that one, and I believe Kabi is, and that runs across Kabi, also in Christian business, because we talk about manufacturing platforms, we talk about capabilities on aseptic, for example, on sterile, which is highly important when you talk on quality, when it comes to nutrition and when it comes to IV generics, but even on sets and disposables on MedTech. This is on a very aggregate level, I think, core competencies Kabi can hammer home, will hammer home as we move forward. Yet, looking a little bit into the past, it has always been a growing business. This was nice.
When I joined, the team and myself, we realized that the growth dynamics, the growth rates had been easing. There was a reason for that, and we cracked our head, and we came up with Vision 2026 to say, we need focus. We need real focus, dedicated focus on new businesses, on growth businesses, on innovation, on launches. Vision 2026, this is which will again bring us back to the trajectory of growth or even cater more growth as we go forward. This is where the whole journey starts, the growth. You've got to be strong at the customer's end. You've got to win against the competition, but growth is not everything. Advancing patient care, the flip side is we need to advance improving bottom line, and that's why we introduced F-cubed, Fresenius Financial Framework.
I'm telling you, this is a very rigorous, candid, transparent change management tool for a performance culture. Everybody in the organization running the operational business know what they need to cater to in terms of margin. Here, very transparently for Kabi, in the last couple of quarters, I won't go into detail, but what I want to tell you is, think about it. If you manage a business by top line growth and margin, that is more rigid than managing by earnings growth only. If you grow in the top line and you are able to deliver margin expansion, you do the math. Even for somebody like Helios, who are growing in top line and hold the margin stable, what does it mean in absolute terms? It means earnings grow.
Therefore, we believe this is a very powerful tool, and as a group management, as the group board, we take care of the capital base because we said in November, when Sarah and myself went out, it's all gonna be about returns. The team, you will see them in a minute. I believe a fired-up team, very motivational, very ambitious, you will hear that in a minute, and a nice mix. If we wanna get a shift in mindset, and I told you, we not only believe, we know we have momentum, there needs to be the right balance of change, i.e., fresh pair of eyes, but also building on the things you have been doing good, which I told you, the capabilities, for example, on the manufacturing side. I think, I believe, I know, we have the right kind of mix, and it is going...
trickling down as Pierluigi is instilling more change. Pierluigi and Andreas, the CFO, both of them, a great track record outside the company and therefore, you know, very beneficial for what we are trying to achieve or they are trying to achieve going forward, especially vis-à-vis the ambitions. You will see that in a minute. Marc has been with the company for quite a while. He's an MD, so he knows what he's talking about. He, by the way, left the company, and then he came back home.
That is good because you have seen or he has seen something else, therefore, it was clear that he became a new board member within Kabi, then having this great responsibility for the IV generics and fluids business and for the pharma business, because he also knows what he's talking about when it comes to the clinical application, being an MD. Christian, MedTech. He came from a different company a couple of years ago, from the medical devices company. When I joined, I was impressed by seeing what Christian has done with the TCT, with the transfusion business, especially in terms of incremental growth and incremental margin expansion over the course of 3 years. It was easy for us to say, "Okay, we'll give him other parts of the medical technology business," and we ask him to do the same with the enlarged portfolio.
Michael has been with the team for quite a while, as I said, very instrumental also on that vertical integration, getting us to that competitive position we have in the IV generics. He has been, if I may say so, also the spiritus rector of Fresenius going into biosimilars a couple of years ago, and together with me and my team, it was last year, one and a half years ago, we started looking at how can we strengthen that business if and when we are serious about playing in that one, went into mAbxience. Very happy that now he will focus 24/7 on the now enlarged biopharma business, because this is important.
We are at a very important juncture when it comes to having de-risked the development pipeline and now being ready to launch in one of the largest markets, but already having had experience in other markets outside the U.S. Therefore, a great team, great lineup you will see today, going through the presentation. That one, I won't read through that one. All I'm saying is healthcare market is very attractive. Healthcare market is going through changes. We are very well positioned to really play into this one or ride that wave and being as relevant tomorrow as we are today. We have a very committed and dedicated team. They are ambitious, and they're gonna talk to you today about their ambition. Have fun. Thank you.
Good morning. Good morning, everybody. Thank you for coming here and also welcome to the people who are following from internet. My name is Pierluigi Antonelli, and I joined Kabi 3 months ago. As I was saying to some of you last night, they've been 3 very intense months, 'cause I've been traveling a lot. I've been visiting markets, R&D centers, plants, and we had very long conversation and discussions with my team to understand our business, and also develop and solidify the plans that we're gonna be discussing today, on how do we move from where we were last year to where we wanna be by the end of 2026. Before I enter into and I give you an overview with my colleagues, I wanna share with you 1 thought.
I mean, first of all, I'm here because I like healthcare, so I've been more than 25 years in healthcare, in multinationals, innovation-based, but geretics, MedT ech, and also family-owned businesses. Because, I mean, it's what I connect very well with our tagline. You saw Fresenius Kabi, Caring for Life, and this is what I discovered also when talking with many people. I do lots of breakfast meetings and lunch meetings with people within the organization, and I see that there is a sincere passion and attachment by all the colleagues and associates on this tagline. Secondly, before I joined Kabi, I had the possibility to do, I say, an outside-in understanding and assessment of the company, and I saw and I perceived that there was a significant potential.
Frankly speaking, when I came in after these 90 days, I'm very convinced that we do have great potential, and that with the plans that we have in place, that we're gonna be sharing with you across the different business units, we will be able to go from where we were with 13.8% in terms of EBIT to where I'm gonna share with you in a second by 2026. What will be the theme, the discussion about today, what we're gonna be sharing? Certainly financials, where we are, where we wanna be, what is our strategy, what are our plans to get there, and also, you know, share and discuss with you how we're gonna be getting there. 'Cause it's a lot about execution, it's a lot of hard work, as you can imagine.
It's a lot of discipline and attention, like Michael was saying, on how do we grow, but frankly speaking, how do we grow profitably and sustainably, driving margins up versus where they are today? First of all, yesterday was a good conversation across the table, right? Because, you know, I think we need to, that's a great opportunity for us to share with you who we are, right? Some still see us a bit as a pharma generic company. There is much more to it than that business, which is still important and fundamental. You see in the numbers. Those are impressive numbers, right? We touch more than 400 million patient lives every year, we do it through our portfolio. You see the relevance of those numbers.
More than 1 million of pumps installed. About 235,000 units of Fresubin, which is consumed every day globally. 1.2 billion of injectable units, of generics units every year. 1.4 billion on IV fluids, units, bags every year. I mean, those are impressive number that gives you a perspective of how relevant we are as a company, and why we think that we are quite unique in the healthcare setting. Q1. I think Q1, you know it very well. We started quite solidly, and we are very happy, and it didn't happen by chance.
There is a work, hard work by thousands of people and my colleagues who've been, frankly speaking, working here longer than myself, but that's a very good start of the year, and we are very, very happy and proud, because it's good to start well. One information that I wanna share with you, and we are very proud to do it today, is that we are upping our guidance. Some of you were asking yesterday, right? I think, I mean, it's important that we share this information with you. We are going, in terms of sales growth, from low-mid-single-digit number to mid-single-digit growth, and more importantly, EBIT is gonna go, which, you know, we were about 100 basis point below our margin, the structural margin band. We're gonna go to around 14%.
I think that's an important news, and it's something that we wanna stress properly, because it gives you the confidence that the team has to move in the right direction moving forward. As important, we also set for ourselves specific ambition for 2026, 'cause, you know, we're gonna stay between 4%-7% in terms of growth rate, but you see that we our ambition is to move towards the upper end of the structural margin band, 14%-17%. If you consider that last year we were at 13.8%, I mean, that's also a sign of strong confidence that we have as a team, and how to get there, we'll discuss shortly. How do we get there, right?
I think this is where I want to spend a couple of minutes. Our portfolio is unique. Some of you were asking me, Why you folks have to be in the four businesses? The portfolio we have is unique, is essential, is integrated, and we are able to leverage the depth and the breadth of that portfolio in a unique way when we go to customers. We have great pipeline, I think, across the board. I mean, you see that we have, from Michael, more than 10 molecules in biopharma. We're gonna be launching between 15 - 17 new products in a new first launches in pharma generics. We did this year 130 launches, okay? In pharma generics, in IV generics.
We have significant launches that happened recently and will be happening in MedTech, and I think, and in nutrition, more than 10 products in pipeline, plus a rollout of our existing portfolio in different markets. What is important, and I think you can appreciate it, at least, I mean, in my career, I think that's a uniqueness, which, you know, not many company can boast the level of record. We are number one. We have solid leading positions in many of these businesses. We are number one pharma IV generics company globally. We are number one in parenteral nutrition. We are number two in enteral in Europe and China. We are number one in global blood collection in MedTech.
I think if you consider how strong we are in our pipeline and our plans on how to drive efficiencies, you see that I think we are here to stay, and we are here to drive margins up and drive profitability up. Clear strategy. When I came, of course, as you can imagine, I spent significant time understanding what's the strategy, right? Do I see it the way it is? I'm gonna be spending some minutes and some words in a few minutes on a strategy. I believe it makes, and I'm convinced it makes a lot of sense. Clarity in terms of portfolio strategy, where we wanna invest, how do we wanna drive efficiencies moving forward? It's gonna stay. You see the results, right?
You start seeing results of what the strategy that's been started to be implemented last year is bringing. Of course, it's high-performing team, because nothing gets done. I mean, after so many years in the industry, it's all about people, right? You may have a beautiful strategy, I mean, the execution is where the rubber hits the road and where you need to have the right people in the right places. We have a good team, a very solid team, the one that you'll see today, but it's very well supported, and we have. I see, talking to people, that we have a great drive and a great passion within the company to advance patient care. We start from the hospital, okay? I think, I mean, we are a one-stop-shop company.
We start from the hospital across our business units, and we cater to critically and chronically ill patients. The beauty is that over the years, the team has been able to develop specific capabilities to actually follow the patient outside of the hospital. Therefore, you see there long-term care, rehab center, outpatient clinics, home care. I think it is a well-oiled machine, very competitive machine, that we have great teams and teams that have been able to drive that level of performance from a competitive standpoint. My colleagues will give you some examples, right, of patients with classic, unfortunately, pathologies, to whom we actually cater significant number of products and services. We have Agatha, with swallowing disorders, Jose, with a bacterial infection, Jasmine, with rheumatoid arthritis, Maria, with cancer, in different parts, in different settings of the healthcare.
Now, where do we play, right? I mean, Michael was alluding to the fact that we, you know, healthcare is the place to be, right? There are underlying trends which make the healthcare industry a very attractive one. Let's look at the four segment in which we play. We have pharma. The way we define pharma is IV generics, and we also have IV fluids. Big market, but of course, we play in the IV generic segment, growing single digit, very attractive from a profitability standpoint, and you know how much we also drive in terms of profits, right? Because it's visible. We made it visible for the first time with the Q1. It's very accretive, and we are competitive. We know how to drive it. We have nutrition.
Nutrition is a fantastic business that some don't know well, and this is a great opportunity for us to share where we are. It's a EUR 10 billion market, growing nicely, split between enteral and parenteral, and it's very attractive from an industry segment standpoint in terms of margins. MedTech, again, I mean, Christian will discuss about this, but, you know, cell and gene therapies is on the rise. We play very well there, plasma, and then we also have the pumps, large volume pumps with fluids, and we'll discuss about this. Biopharma. I think we, you know, everybody knows the importance of biologics, but also that there is a significant pressure from payers to save, to extract some savings that can be reinvested, and we are playing right there with our portfolio and with our company.
There are these trends that are industry-specific trends, and I think our portfolio is very uniquely positioned to leverage and to take advantage of these trends. You see therapy shifts, you know, biologics we discussed, and therefore, how do we play with our biosimilars and with the acquisitions of mAbxience? We have treatment shifts. You know, everybody in many countries, there is a desire to move away from hospital into home, and there we have our home care business. Very strong business. More than 20% of our nutritional sales are in home care, and it's more than EUR 500 million in home care. Very attractive segment. We play in more than 10 markets. We are very strong in those markets. Technology shift. You know, the importance of the digital revolution, data, connectivity of devices.
Here we are with the Ivenix, you have a chance, actually, outside to see the uniqueness and you know, how breakthrough is the technology of Ivenix pump. It's been also recognized, as you saw from Vizient and from Premier last week, as a breakthrough technology. I think we are very proud, we can make a difference, we will make a difference with it in the U.S. market. If those are the segments of the market, this is how we play in those markets. We have pharma, IV generics and fluids. You see the split between IV fluids and IV generics here, on that part, EUR 3.8 billion, very accretive. It's a competitive market, price pressure, we know how to compete in that market. We have strong operational excellence.
We have a portfolio which is unique, relevant, made of essential drugs. We are here to stay. We're gonna drive that business, and it's not gonna grow a lot, but I think if you consider the margin we have and the growth, we will generate incremental earnings, absolute earnings moving forward. Nutrition, EUR 2.4 billion. I think we are the only company where we play both in PN and EN, and you see also that also it's very nicely split, our portfolio, between enteral and parenteral, which is, I think, a strength 'cause we play within the, that market in both segments. Strong leading positions. MedTech, once again, we look at MedTech in two sub-segments. One is TCT, Transfusion Medicine and Cell Therapies, the other one is Infusion and Nutritional Systems. You see the split. It's important.
We made an important acquisition last year with Ivenix. We integrated, but now we are operationally integrating in our plans, Ivenix. We need to drive operating margin improvement. There is a clear plan. Christian will discuss and share with you the plan. Then we have Biopharma. Some people were asking me yesterday: "What do you think? What about Biopharma? Why is it part of your portfolio?" We have been investing Biopharma significant money over the last years. Now we have more than 10 molecules in pipeline. We are launching in the U.S., two drugs. We have the infrastructure ready in the U.S., marketing, medical, payer, you know, everything we need in order to launch these drugs and actually launch the future drugs.
We have de-risked a significant part of our pipeline 'cause it's about to be launched. Plus, we did with mAbxience, a great industrial acquisition because it complements fantastically well with our biosimilars, right? We have complement, full complementarity. Michael is gonna speak about it, if you think that by tech transferring two molecules from Merck into mAbxience, we will generate more than 30% savings in terms of unit cost. I think that's essential, because in biosimilars, you need to be cost competitive in the long term to stay in the game. Therefore, we have the pipeline, we have the infrastructure, we made the investment, and now we're gonna be driving sales and profits, it will become profit accretive within our midterm horizon. Going back to our portfolio, it is essential, we discussed, right?
That's an example, right? 70% of the IV drug shipped in U.S. from Kabi are part of the essential FDA list. We are critical for the healthcare system in the U.S. More importantly, there is a significant interlinks between all the different businesses, which I wanna share with you because It's true that we track performances by business unit, and we allocate resources by business unit, but those business units produces services and products that we are able to connect together when we go to the end customer. Let me give you an example. We have leading nutritional products, they are administered through state-of-the-art pumps with our disposable and also with our services, home care services. It's a combination of products and services that make us unique in the marketplace. If you think about IV generics, we have also fluids, IV fluids.
When you talk to customers, they wanna have this offering connected. When you think about, for example, the infusion ecosystem, now we have large volume pumps, Ivenix, with the IV fluids. Therefore, also there in the U.S., is essential. There are ways, and we know how to do it, where we synergize between our products and services across business unit to make us very relevant and unique vis-à-vis the customer. More than 90% of our customers buy from more than one BU, right? That's a key element that, you know, we are relevant, and we try and we drive that portfolio in a very relevant way. Then, of course, a good thing is that we have access, right? We drive access in more than a hundred. We are present with our products in more than 125 markets.
The beauty is that we have a very balanced portfolio, 1/3 U.S., 1/3 Europe, 1/3 rest of the world, and that allows us to, of course, have challenges in different parts, but also get opportunities and exploit opportunities in different parts of the world. I think it's good, by also reflecting on my past experiences, my other companies, to have a balanced portfolio rather than a portfolio where you have massive presence in one continent versus others. Of course, it's about operational excellence. We are master here, right? We know how to manage plans. We drive efficiencies. You see the KPI there, more than 1/3 of our plants in Europe produce for more than one business unit, and that's one, you know, exclusive trade of Kabi. Let's go to the Vision 2026.
I came, I discussed with the team. Do I see myself, apart from conversing with Michael before I came, do I see myself with the strategy, right? In my previous company, I had to reset the strategy, right? In this case, after multiple meetings, I think that it makes total sense from a portfolio standpoint. There are 3 vectors, growth vectors: Biopharma, MedTech, and Nutrition. There is full transparency across these 3 vectors, and then we have Pharma, which is providing, you know, great profits that we wanna keep, right? We wanna keep stable margin moving forward, but those profits are also help us to drive growth in the real growth vectors. How the strategy is founded, funded on 3 pillars. One is growth, and we have therefore identified specific growth levers across the different business units.
One is global competitiveness. That means how we are efficient and competitive in the marketplace, and I'll give you some examples. The third one, which is actually the one that I modified, is employer of choice. I am a true believer that people make a difference, and we have a significant HR agenda to drive, and that's one of the reason why, for example, in the leadership team, there is now the presence of an HR head, which before was not part of the leadership team. Speaking about growth, I mean, last year, like Michael was saying, we've been growing, right? You see also the acceleration that we had in the first quarter, with about 9%, over 10% in the growth vectors and 9% in totality. You see also how we are driving our acquisitions.
I share with you the importance of mAbxience, how it fits within our portfolio, how can we become, you know, more and more competitive? Also Ivenix, which is allowing us to enter in the U.S. market. It's a big market, it's an attractive market for pumps, we have the offering that allows us to be competitive. We're gonna drive, of course, as I said, with Christian, by industrializing and taking these startup within our plans, we're gonna drive costs down and therefore grow our margins. We have global competitiveness. More than 500 initiatives and measures that the team has been working on identifying and implementing. You see the...
You know, last year, we have EUR 74 million of structural savings, EUR 160 million this year, and cumulatively, we're gonna be driving EUR 440 million by 2024. How? Well, they can be bucketed in footprint and portfolio simplification. We've been closing plants. We have, you know, we'll give you some further elements. We're gonna be close, and we plan to close additional plants. We've been shifting production from different plants in different continents. We also are, for example, we exited Turkey. There is a plan also to relook at our geographical presence, right, moving forward. We also are simplifying our structures. This is an important thing, right? We need to simplify, streamline, delayering, and find opportunities to become more efficient in the way we look at our processes, and then procurement.
New team in place, we are now leveraging our scale, and that's fundamental, right? In order to drive, you know, savings, structural savings, every year, every day across functions. Employer of choice. We need to become faster in decision making, and that's the reason why we're gonna be delayering the organization up to three layers that we are now discussing with the management team. This will accelerate our processes, but we also want to change our performance schemes for managers below the leadership team to make it more pay for performance driven, and also to stress the importance of collaboration. Because when you manage the business in four business units, there could be the risk of looking at the, you know, losing the one Fresenius Kabi approach, therefore, collaboration, because there are, as I share with you, important synergies and complementarity between business units.
It's important to keep it as very relevant as value. We launch an HRIT system, which will allow us to drive digitalization and eliminate these paper-based processes that we still have. We have an ambitious ESG agenda. You see the KPI which set for ourselves, there we need to accelerate, and we are creating a clear plan with clear milestones. How do we move from today to 2040? This is the team we discussed. There is clear responsibility in terms of P&L for the three business units. Marc is Pharma and Nutrition. They are independently, separately managed, I mean, in terms of P&L, they are under responsibility of Marc, because from a go-to-market model, it would make not a lot of sense to separate them.
We have Christian with MedTech and Michael with Biopharma, supported by our commercial regional heads, because, you know, you also have specific trends in the geographies, and you need to cater to those trends and make sure they support our BU president. As I said, I'm searching for the CHRO, right? The HR. For the first time, we have the HR in the ELT, and then we have corporate development with Matthias, and it's a new role also, which is the Tech Ops Pharma Nutrition Head. 'Cause we have an important network in pharma nutrition, and we need to have somebody in charge of driving operational, further operational excellence, standardization, and looking also at our network. It's important for you because I got also some questions yesterday, how you are incentivized. We are, a very small part of our salary compensation is fixed.
The important part is variable, that part is driven by clear KPIs like margin improvement, ROIC, ESG, TSR. Therefore, we are only gonna be compensated if we generate value for shareholders. That has to be clear, right? How do we move from 13.8% to the upper end of our margin? You see down the growth rate in sales by business unit, which we have throughout 2026. Of course, I mean, it's a combination of elements, right? We have cross-cutting initiatives that Andreas is gonna discuss and share with you. We have nutrition, right? Accretive, higher than our structural band in terms of profit. We have pipeline, we have strong leadership positions, and we wanna keep it going. We have opportunities in the U.S., we have opportunities in China.
MedTech, it's about Ivenix, launching it, drive TCT, plasma, cell and gene, and profit improvement. It's a game changer for us, Ivenix. It's a truly game changer for us and frankly, for the customers. We have pharma. Pharma is core foundational business for us. As I said, we know how to play, we know how to compete. Yes, there are competitive pressures, but we know damn well how to make it competitive. We have pipeline, we have plans. I mean, Marc will discuss with you, we have made significant investments in 2 U.S. plans, now it's time to harvest this, right? We're gonna fill these plans, and we're gonna drive volume, by driving volume, we'll continue to drive, you know, profit, absolute profit growth moving forward. We have Biopharma.
You see here 3 x- 4x by 2026 growth. That means something between EUR 600 million-EUR 800 million in 2026 with Biopharma, thanks to the launches that we have planned in our during our plan. By the way, Biopharma, we did investments. We are ready. We're gonna be harvesting. It's payback time now, right? ‘Cause we have what it takes to launch drugs, to produce them, and to therefore reap benefits of the investments we did. We are gonna be here competing there ‘cause we have very competitive unit cost. We will. Therefore, we are a long-term player in Biopharma. There is a roadmap, right? What needs to happen for us to be able to drive to the upper end of the margin as an ambition.
You know, it's launching new products in generics, the biosimilar in the U.S. Wilson and Melrose Park are the two plants in the U.S. where we made massive investments, and they are coming up, right? Then we have Ivenix, of course, and the transfer of our existing molecule from Merck into mAbxience. Then, of course, nutrition U.S., where we are pretty strong in PN, but we have further growth because we have futher products and also we have an opportunity with China. Marc will discuss with you, will share with you about the FSMP market, the emerging market that exists in China, and therefore, that's also another opportunity. Of course, all of these different cylinders in this engine will drive growth, profitable growth, margin improvement, and therefore, you know, value creation for our shareholders.
To close, strong start. Very strong start. We are increasing our guidance for 2023 and setting an ambition which is clear for midterm. We have a clear plan in terms of value creation, clear actions by business unit, right? Clear efficiencies, cost savings initiatives that we are driving. Very disciplined as a team. We are super disciplined as a team, right? We are on execution. Of course, we have clear accountabilities and performance focus, which is gonna make a difference moving forward. This is where, no, you can count that we're not gonna leave any stone unturned in order to get where we want to be. With this, I pass the baton to Andreas, we'll take questions afterwards.
Good morning from my side. I'm delighted to be here today to support my operational colleagues. What you're gonna hear from me is three things: It's about transparency, it's about discipline, and most of all, it's about delivery. You've heard from Pierluigi Antonelli about our ambition through to 2026 and also for this fiscal year, I think one thing that I can promise you as an audience is that we're gonna be laser-focused on those numbers. I truly believe we're on a transformational journey financially within Fresenius Kabi, and I'm also delighted to be part of the team. Again, it's about healthcare, and this is obviously enabled by how we perform financially. In terms of my agenda as CFO, it's obviously about a clear focus on value creation and returns. Fresenius Kabi has strong fundamentals as a business. We have leading market shares across our portfolio.
We have invested significantly in terms of our R&D pipeline, and one of the main reasons for wanting to join the team was the ability and the opportunity to step up performance. Three main things for me: the transparency, so more focus, more discipline around cost and structural productivity, and finally, it's about delivery in terms of improving capital efficiency and returns. In terms of the focus and transparency, we've recently introduced an end-to-end business unit structure. This gives us more focus overall as a business, as an enterprise, and also allows me, as CFO, to exercise more control. On structural productivity, we have implemented a program with over 500 measures across 16 work streams, and we see already the benefit of those measures in the P&L in Q1. Most importantly, it's about the results.
You can have a lot of transparency, you can have a lot of productivity, but it's about the bottom line and also improvement in terms of overall performance. Together with the group, we defined targets for ourselves of an organic sales growth per annum of 4%-7% and also an EBIT margin range of 14%-17%, and you heard from Pierluigi already, we have an ambition to be at the upper end of the target margin band by 2026, and I will walk you through how we want to get there financially. In terms of the new reporting structure, we've established cleaner, simpler, vertical business units across the company. This enables us to have clear end-to-end accountability. We have four P&Ls, four business unit owners.
This allows a better end-to-end steering and also enables us to allocate capital better between each of the businesses. In terms of performance, I'm now gonna talk to some of the numbers that you see there on the chart on the right-hand side. We had MedTech last year with EUR 1.4 billion, grew 4%, broad-based growth across the globe. Nutrition at EUR 2.4 billion. Again, a solid growth at 4%. We did see a COVID-related slowdown in China in December, we saw a pickup already in terms of our Q1 performance. On Biopharma, we grew organically by 107%, doubling the growth rate from an organic basis. This added 1 percentage point overall to the Kabi growth rate.
On the Biopharma, growth at 1%, we did see a slight contraction in the U.S., offset by growth outside of the United States. In terms of overall margin, you can see there on the growth vectors, we are at 8.5%. We are not happy with the margin in the growth vectors, you'll hear both in my presentation and also from the other colleagues, how we're gonna improve that. On the Pharma IV Drugs and Fluids, we see a healthy margin above 20%, we want to stabilize that margin going forward. In terms of the margin progression year-over-year, we did see some cost headwinds from 2021 into 2022. Also saw within our growth vectors, certain unique topics relating to each business.
For example, Ivenix we acquired last year, which is dilutive to margin. We're building our infrastructure for our Biopharma business in the U.S., and in China, on the nutrition side, we did see some pricing pressure which impacted margins. We did have some cost savings, overall, we saw a contraction. Similar story on the Pharma IV Drugs and Fluids. Significant cost pressure, some pricing pressure as well, which we were partly able to offset through growth as well as some cost savings. I now want to look at the portfolio overall and give you some comments in terms of how we are structured. On the Pharma IV Drugs and Fluids, we show a growth rate there of 1%. On the growth vectors, we are growing last year at 6%.
We will stay accretive to the Kabi overall growth rate within the growth vectors over the period through to 2026. From a margin perspective, we see strong margins in Pharma, which we want to stabilize. Also, in the growth vectors, we see a margin of 8.5%. I now want to give you some color around the margin profile of each of those businesses. In nutrition, you know already that that business is margin accretive to Kabi overall, and also margin accretive to the target band of 14%-17%. You can orientate yourselves on the Pharma IV drugs as a margin for that business. Biopharma is in the investment phase for us as a company, and it is negative in EBIT, and based on that, you can triangulate that the EBIT margin for MedTech is low single digit.
Importantly, from an EBITDA perspective, it is mid-teen double-digit in terms of EBITDA margins. EBIT margins, low single-digit within MedTech, EBITDA mid-teens in terms of margin profile. Looking at 2023 performance and how do we want to get to the upgrade of around 14%, which is EUR 80 million in absolute terms. We had a margin in 2022 of 13.8%. We see volume growth benefiting the P&L from our mid-single-digit growth rate. On the price mix, the picture is differentiated. We see pricing pressure overall in the portfolio for 2023, but some positive impacts from mix.
On the cost increase, there we still have significant headwinds, also, carrying on from what we saw in 2022, albeit at lower levels, year-over-year, it's important that we're driving the structural productivity in terms of cost savings to get to the margin of around 14% for the business. I now want to illustrate more deeply what is going on in the business in terms of our performance over the last nine months. The last nine months, going back to Q1. The start of the graph is thirtieth of June last year, I want to stress, it is illustrative. What you see is a significant pickup in cost increases from June last year, which impacted the P&L from the second half of the year.
We do see those cost increases softening in terms of outlook for the rest of this year, but still persisting. We did have some positive success in terms of pricing initiatives that we definitely saw in terms of our Q1 result, but we see those pricing initiatives, the benefit of that, contracting over time, so that overall, for the full year, we will have a slight price pressure in terms of the portfolio. In terms of the cost savings, you can see that we had EUR 8 million last year, EUR 40 million this year on a cumulative basis, so incremental EUR 32 million year-over-year, and we're ahead of the curve, and we saw it in terms of the benefit of the P&L. One of the reasons why I wanted to join Kabi was the ability to step up performance.
Here on the cost side, I certainly see a lot of potential to improve the situation and to drive out cost for the business. On the left-hand side, you can see there the EUR 80 million, EUR 160 million, EUR 200 million ramp-up in savings, so it's accumulatively EUR 440 million by 2024. In terms of the levers that we're driving, it's footprint and portfolio, so we're targeting divestments, also consolidation and offshoring. We recently set up shared services in Pune, India. In terms of process optimization, it's about concentrating resources in key people, making decision-making faster and driving out efficiencies. On the procurement side, which has been recently established and is reporting into me, it's about centralizing contacts, contracts, and optimizing IT, leading to EUR 190 million in savings. What does this mean in terms of results?
On the CapEx side, we have spent a significant amount on CapEx over the last few years. You will hear from the colleagues, we've built out plants in the United States, in emerging markets, and in Europe. That spending is complete, and together with the operating colleagues, we will take down the level of CapEx intensity to around 5% of sales from 2024 onwards. In terms of inventory, there is significant potential in terms of optimization. We need to hold a high degree, a high amount of inventory to ensure customer supply, because we are obviously providing critical medicines to our customers and patients.
With a lot of businesses, we saw longer lead times coming out of COVID, as well as higher input prices, which has led to higher inventory levels, which means we have started an inventory optimization program across 14,800 SKUs to optimize our inventory level. In terms of cash conversion rate and return on invested capital, these are very key metrics for us in terms of improving capital efficiency and returns. We want to contribute to the overall group target of around one. The cash conversion rate is how much cash are we generating out of our earnings as an organization. You've heard about the initiatives that we're starting within CapEx and also within inventory, there is a significant potential to drive the cash conversion rate up in the mid to long term.
On the return on invested capital, we are committed to earning our cost of capital as a business. As I said before, we have spent significantly on CapEx. We have also invested in companies. It's now about making those assets more profitable, driving profitability, so that overall, we can see an appreciation in our cost of capital. What does it mean in terms of numbers for the business? Pierluigi has mentioned it already, but we started out strongly in terms of Q1, at a 7% growth and EBIT margin at 14.5%. We've upgraded the guidance for 2023 to a mid-single digit percentage in terms of growth and a margin around 14%, which, to repeat, is an EBIT improvement of around EUR 80 million. Also, it's about delivering on those numbers, just to be very clear.
Looking now at the outlook through to 2026 and also giving you some perspective of our expected evolution. On MedTech, you see that it's a growth rate of 8%-10% per annum. The EBIT margin ambition for 2026 is a significant improvement versus the low single-digit EBIT margin that we see today. Ivenix plays a part in that, but also, we have initiatives on the cost side that Christian will explain in his presentation. This will also lead, on the far right-hand side, to EBIT development in absolute terms, so that's absolute EBIT development. On Nutrition, we have a target, a growth rate there of 4%-7%.
Marc will talk to you about the EBIT ambition and the plans that we have there in terms of new product launches, but we are confident in seeing a sustained high margin in nutrition with potential for upside, so that overall, we will see also EBIT development in that segment. On Biopharma, it's about 3x-4x the 2022 revenue number. Michael will explain the plans. Financially, the fixed costs that we need for Biopharma are in play, so it's about growing the top line and dropping through to the bottom line in terms of performance, and that is why you see there an EBIT margin appreciation, as well as also a significant pickup in EBIT development.
On Pharma IV Drugs, there we have seen planning a 2%-4% growth rate per annum, an EBIT margin ambition of sustaining the stable margins, which will then lead to overall positive EBIT development and EBIT growth within the Pharma IV drugs and fluids business. Marc will also explain that in his presentation. Overall for us, it's about a growth rate of 4%-7% per annum. Increase in the EBIT margin towards the upper end of the range by 2026, and a higher EBIT development, given the growth and given our ambitions in terms of margin expansion. To summarize from my side, we are committed to delivering on our financial targets for 2026. As I said at the beginning, it's all about delivery for us.
From a profile of our portfolio, you see that 2022, 2021, and then the ambition level. The growth will be very much driven by our growth vectors remaining accretive to the growth, the top, blue line. The Pharma IV drugs stepping up performance, but in the 2%-4% growth range. On an EBIT margin, you can see that the Pharma business will sustain their margins at around the 20% level, as well as the, on the growth vectors through the growth, through the fact that we will have cost discipline and focus, that we will drive an expansion in margins into the range in 14%-17%, so that overall, we will be at the upper end of the EBIT margin range by 2026.
For me, it's definitely about delivery, it's about consistency and growth, it's about a better cost structure, it's about higher margins and also cash. Thank you very much for your attention.
Thanks, both. Thanks, Andreas. Thanks, Pierluigi. It's time for our first Q&A session. For the participants here in the room who would like to ask a question, please raise your hand. For the people joining us via webcast, please don't forget to push the button. You will see it here on the tablet, and then put you through. First question comes from Oliver.
Thank you very much.
Oliver Reinberg from Kepler Cheuvreux. Three questions, if I may. The first one would be on the historic performance of Kabi. The last 10 years, we have seen a EBIT CAGR, I think, of less than 2%. Obviously, there have been drivers like biosimilar investments. We have seen less shortages in the U.S. and VBP in China. Can you just talk around how much of this underperformance was down to market factors, and how much was down to potential homemade issues, quality issues, that are worth fixing now? Secondly, can you just give us any kind of color in terms of the composition of growth in the next 2 years? I guess two large profit pools, at least in the past, have been U.S. generics and nutrition in China.
I guess in IV generics in the U.S., there's no meaningful launches in the next 2 years, according to my understanding. While in China, there's still the continuous rollout of VBP. Is the growth in the next few years very much geared towards biopharma, or what other tangible short-term growth drivers can you point to? Last question, if I may, just any kind of relevant risk we should be aware of, any kind of quality findings recently, any kind of regulatory changes or reimbursement issues that we should be aware of? Thanks so much.
Look, on the first question, I mean, Oliver, honestly speaking, I'm here for 3 months, right? I'm not in a position to tell you what has happened the last years, right? I think what I'm committed to with my team, and I think that's what you're gonna be seeing from each of us, is how do we get from where we were in 2022 to where we wanna be in 2026? I think it's gonna be a combination, and I think I answer also to your second question, is a combination of growth levers, which you see in the three growth vectors. It's about, you know, launching properly and acquiring contracts with Ivenix.
It's about launching our two molecules this year in U.S., but there is a third one, tocilizumab, which is coming also in the near term. That is about also, you know, making sure that with MedTech, we improve our operating margin while we maintain the engine in Pharma U.S., in general. Also, apart from the U.S., where we have a high level of profitability, we are very competitive also in Europe and in other parts of the globe in terms of IV generics. I think in terms of the pipeline, you mentioned something which I do not fully agree, in the sense that in our pipeline, we're gonna be covering about 80% of the upcoming LOEs.
We believe that to be relevant and essential as we are to healthcare systems, we need to maintain that level of breadth of portfolio. Today, we have 160 molecules in the United States, and therefore, by having 80% of LOEs covered with about 15-17 launches in the upcoming years, we're gonna stay relevant there. The third question?
Risks.
Risks. Well, I mean, the risks are the usual risks, right? I think it's about there are things that are outside of our control. Take, for example, China, right? The large tenders, national tenders, are here to stay. You know, there will be a 8th, a 9, a 10, we know how to manage those, right? 'Cause we've been in China for decades. We've been, say, upping or, you know, reallocating resources when we got, for example, propofol into our large volume tender. We have a portfolio which allows us to shift resources in other parts of the portfolio. By the way, I mean, Marc will get into this, we invested EUR 100 million in Wuxi, in China, in order to be able to play in that emerging market, which is FSMP.
I think, yes, there will be pricing pressure, I think, I mean, it's good to have a position in China where we are leaders, right? You know, when you are a leader, you can, you have different moves that you can do. We have pipeline, we have investments, we have a very strong leadership team and team in general in China. It's a good place to be, right?
Next from Veronika.
Hi, good morning. Veronika Dubajova from Citi. I have 3 questions as well, please, if I can. The first one is just to go back to the IV Pharma and fluids business, your expectation is for flat margins through the midterm, but we've seen a fair amount of margin compression in this business over the last 3-5 years. Maybe walk us through the building blocks that give you confidence that you can sustain that roughly 20% profitability. My second question is on the expected improvement in the biosimilars EBITDA. I think I can just about work out what the EBIT is at the moment, or the losses, but I have no idea what the EBITDA is.
Maybe you can help us with that and just how much incrementally that is contributing to that margin improvement that you have. And then Pier luigi talks a lot about simplifying, delayering the organization. Obviously, that's a huge change, I think for a company that has been fairly static for a long time. How is that process going so far? And maybe what are the risks that you see from a disruption perspective around that, and how much of that is factored into the guidance that you've given today? Thank you.
I think for the first question, Veronika, I would actually defer to Marc because he's going to give you more color, and I think it makes sense that he answered that question. The second question, Andreas?
Was on the EBITDA versus EBIT, right? In terms of...
Yeah.
I think what I would say is, let's also listen to what Michael has to say in terms of his presentation. It's a good indicator for where we are in terms of absolute level of profitability. I think the numbers that you're probably working with from a, an EBIT perspective are a good proxy for that. Yeah?
On the third question, look, we cannot avoid simplification in our company. I think that's what I noticed when I came, is that we have too many layers, too many approval, say, decision makers. We gotta be streamlining, flattening, and enlarging the span of control. Also, I think it's an issue with processes. I think we have, as I shared with some of you yesterday, it is surprising to see how many tools, applications, and different processes we have within the company. Therefore, I give you an example. We have three CRM systems. Now, why would we have three CRM systems? I think there are things that are part of the past, and I think that this team is very committed to, you know, take that machine, open it up and understand, and go in priority, right?
Understand which processes and which tools, which applications we need to, frankly speaking, streamline, simplify. Because some of us have. I think it's, I agree with Michael's point that we are, we have a strong entrepreneurial spirit, but some of us have misinterpreted a bit that entrepreneurship in, "I do what I think it makes more sense within my region or my function." Instead, I mean, there are opportunities in terms of scaling and simplifying. That's why, the reason why we have functional functions like finance and HR in the ELT, right? We wanna drive functional excellence across. That's the reason why in corporate development, there will be a team on commercial excellence that is gonna be working with, you know, business units and regions to drive commercial excellence across the board.
In segmentation, targeting, incentive systems, there are many different areas where actually we can further, you know, take the extra opportunities which exist in the marketplace and be more effective and more efficient.
Graham will be next.
Thank you. It's Graham from UBS. Just one for Andreas on sort of the cost reorganization. You were talking about this regionalization down to verticals last night, it doesn't sound wildly different from what's happening at Fresenius Medical, where it sounds like there's lots of opportunity just to remove costs that's sort of unnecessary now. Is that the same sort of thing you're seeing? Also to that, are there businesses or regions where they're loss-making and maybe less economic, that you can just shut off, I suppose, over time?
Obviously, when you go through a reorganization or a transformation of an organization from one view to another, there are certain areas of that organization that become redundant. We're able, and we have done, is eliminate certain functions, certain activities, and concentrated decisions into key people. That certainly helped in terms of driving, streamlining. Pierluigi also mentioned in his presentation about the delayering topic. It's something that we will continue to do, and it's also part of the change that we will bring into the company, is this topic of ongoing productivity and cost improvement. All right? To me, it's not just a one and done. It's a continuous effort that we will look to improve the organization.
I will build on it to say that with the enhanced transparency that we now have in terms of P&L clarity, right. The P&L by business unit, and also how it splits in a country, this is an ongoing exercise we are doing to really understand where we have, you know, the right to compete, right. Where we actually generate accretive growth and margins, and where we are weaker, and therefore ways how to we can get into the we can make those geographies accretive or, you know, licensing out, and other alternatives that exist. That's an ongoing exercise, which is part of the portfolio and simplification, if you will, from a geographic standpoint.
Thank you.
Thank you. Next comes from James Vane-Tempest.
Hi, thanks for taking my questions. James Vane-Tempest from Jefferies. First, if I can just ask on return on invested capital, you've given an indication of the profitability drivers, but given your investment plans, can you give us a feel as to how much returns could increase at the lower and the upper end of your P&L targets, if your ROIC is 7.8% now, and also the greatest drivers of the ROIC increase of the business? Then my second question is just on the biopharma business. You talk about 3 x- 4x . Can you talk a bit about your capacity and how much of this is CDMO versus your own portfolio, and what your ambitions are on CDMO? Thank you.
You go.
I take the ROIC. I think the, you know, going forward, as I've said in my presentation, we'll be more disciplined about CapEx, and we'll also be very more disciplined around the whole topic of working capital. We've kicked off already a number of initiatives to support that. The way to look at the ROIC is the big driver for that improvement will be the top line growth, as well as the earnings conversion that we see, both in terms of absolute profit improvement, as well as the incremental margin, whilst being very diligent around the whole topic of investment, which I've explained in terms of the CapEx profile.
On your second question, again, because there are Q&As for other sections, you know, Michael is gonna provide you an answer on that one.
Next, from Oliver Metzger.
Hi, it's Oliver Metzger from Oddo BHF. Three questions I have. The first one is about the structural saving potential of EUR 440 million. If I do the math, it means that your EBIT margin might go to 19%, if you can realize that. Is it more a gross or net number? Perhaps you can give us more color on that. The second point is on your Biopharma potential. You say 3 x- 4x sales by 2026. The last information we had were a high triple-digit amount in revenues by 2024, and that was even before mAbxience. Basically, it means a downgrade of your ambition. Can you tell us what's happening in your expectations in 2024? Right now it looks that the numbers went up pretty well in, at least in 2022.
The third question is about the structural margin potential of biosimilars. If you compare it to the IV business, in the IV business, you have more competition, but at the end, an easier manufacturing process. Biosimilar, less competition, more complex manufacturing. If you compare the margin potential of IV versus biosimilars, where is it stands biosimilar? Thank you.
I'll take the second and the third question. Andreas, the first.
Yeah.
On the 2nd question, like, I mean, I said before, what was said before I arrived, frankly speaking, I cannot take responsibility for, right. I think Michael already provided you in the past, you know, that there was a clear differentiation versus what was said 2, 3, 4 years ago, and where, what he said and what I'm saying now. Today, I feel very confident with the 3 to 4. I think what happened before, I don't know, but I can say that there were totally different conditions, right, in the past, in terms of regulatory hurdles, discussion with also, I say, IP conversations, reaction by countries, right, in terms of accepting a specific dossier.
Today, we are very confident on 3 to 4, and we also are very confident the fact that this 3 to 4 multiple will generate accretive growth by 2026. Regarding your third question, which was, remind me?
Structural.
The structural-
Margins, right? This is biopharma versus...
No, we're not gonna go into specific. No, we're not gonna split this-.
Yeah
... this margin, as you can imagine, for also competitive reasons. I think, I mean, as I said, biopharma is important for us. We made significant investments. We have a pipeline which is significantly de-risked. We are launching products. We have the, how you say, the production volume. I think with the mAbxience operation, the M&A, we now have capacity that we can use. As I said, by tech transferring adalimumab and tocilizumab into mAbxience will drive more than 30% unit cost savings. As you know, that's essential to stay in the game longer term, right? 'Cause you need to be driving those savings in order to have the proper pricing, be competitive, and continue to drive. What I can say is that with the mAbxience M&A operation, we now are very solid.
We are an integrated player. We have, you know, all the conditions met in order to succeed and to be there and make money over the medium, long term.
Then on the EUR 440 million, I mean, you have to see that within the context of the ambition level that we've just presented today of being more towards the upper end of the 14%-17%. It is a gross number, and there are obviously other topics that are going against that in terms of pricing pressure, for example, as well as certain cost inflation that we're still seeing.
Thank you.
Hassan?
Thank you. Hassan Al-Wakeel from Barclays. I have two questions, please. Firstly, on your raised guidance at the Kabi level, do you now think that the upper end of group guidance range on EBIT growth is more realistic, or is this offset by Vamed and some of the challenging dynamics here? Maybe that's one for Michael. Specifically on Kabi, how have trends over the course of Q2 supported your decision to raise guidance, and how should we think about the phasing of growth for Kabi this year? Secondly, if I look at the helpful bridge on slide 39, nutrition looks to be the largest driver of margin expansion.
What are the key building blocks to increase profitability here, given margins are already relatively high, and the market continues to shift towards lower margin enteral nutrition? Is VBP in China a risk, to your mind, in this business in particular?
If I may, I grab the first one.
Sure.
Look, Hassan, today we are focusing on Kabi. A good start into the year. We're working on, and next stop on a group guidance will be- You wanna take it?
For Q2, I think, Hassan, we are very, I say, satisfied by increasing our guidance for 2023 to around 14%. Strong Q1, we still have a ton of work to do, right? We are very comfortable and confident on around 14% EBIT. We're not gonna be speculating on a quarter-by-quarter basis. I think, I mean, you have a first quarter result and a full year guidance, which has been upped. In terms of nutrition, the nutrition, I think Marc can answer your question because he has all the elements to provide color to your question.
Next comes from, Hugo Solvet.
Hi. Hello, Hugo Solvet from BNP Paribas Exane. I have three. First, on the cost increases on the bridge for the EBIT, on slide 47, can you maybe walk us through what has changed over the past couple months on this? Second, on CapEx, how comfortable are you with the 5% target, given a lot of work has been done already in the IV generic business, but still, a lot needs to be done in the biopharma, for instance, and maybe more broadly in terms of capital allocation, what are the priorities going forward? Lastly, to follow up on the VBP topic, you managed to successfully offset part of the VBP impact historically by restructuring in the country.
What room to maneuver you have left, should there be additional rounds?
I will take the topic on the cost increases. I think overall, when I first joined the company, it was a key topic to get their hands around, and I think that's also where we saw the power of the new reporting and the new business structure in getting an end-to-end view of these impacts. This is a topic that we're literally tracking on a very frequent basis within the organization. Overall, I would say we're seeing some cost relief in areas like freight, for example. In terms of our overall basket, it's a relatively small amount compared to our raw materials that we're currently working with. There, the picture is very nuanced that we have certain long-term contracts that we need to work through.
There's also an inventory topic that we need to work through as well. Overall, I would say it's got slightly better, but in areas that are not material, I would say, for the overall business. On the CapEx, as I said in my presentation, it's about delivery. We've put the CapEx number out there because we've signed up to that as a, as a board for the 5%. You've seen the CapEx that we've done in the past, and also the presenters later this afternoon will talk about that. We feel, based on the CapEx, based on what we need to get done, and also the focus that we have on returns as well as cash, that we are committed to the 5% from 2024 onwards.
On China, your China question, I mean, we've been there for decades. We have almost 6,000 people there with 4 plants, so I think we, and we've been operating in that space for also with the national tenders for some time. As I would actually reiterate that we know how to manage the business. The business has, you know, opportunities and challenges, as you know, right? I think, I mean, we have, as I said, also the possibility to play in this emerging market called FSMP because we have the investments, we have a pipeline, therefore, we feel comfortable and confident that, I mean, we're gonna be able to compete successfully in China. All these up and downs are actually built in our 2026 ambition. That's important to remember.
Thanks, all. Thanks for your question. I would like to stop here with our first Q&A session for today. We are now going for a 5-10 minutes, coffee break. I would like to ask you to be back on time, and then Marc is starting with its deep dive on nutrition. Thank you.
There they are! More than 300,000 employees around the world. Our common goal: improving the quality of life of patients. Founded in a pharmacy in Frankfurt more than 100 years ago. Today, one of the world's leading healthcare companies. We are there when it matters. With world-class therapies, with leading biological medicines, with high-quality clinical nutrition, with cutting-edge medical technology, holistic care services at in and outpatient settings. We protect lives. We save lives. Sometimes we also help give new life. We help advancing patient care. We are future Fresenius.
Would like to ask you to come back and take a seat again. Would like to step into the next presentation block, headed by Marc-Alexander Mahl, making deep dive on nutrition.
Good, let's wait for the colleagues and guests to come back. Good afternoon. After coffee break and before lunch break, we're going to talk about a really important portfolio segment for Fresenius Kabi, that is Clinical Nutrition. My name is Marc-Alexander Mahl. I'm heading the Pharma and Nutrition area. I'm a medical doctor by training, and I'm really happy to introduce you now to this portfolio here. Before we get there into the details, maybe a little bit for all those who may not be completely familiar with clinical nutrition, what is that? All of you may have...
someone close to your heart, a grandma and a granddad, an aunt who is in retirement home. She is 80, 85. She's not doing really good. She can't eat anymore. She's not drinking enough. She is diagnosed with cancer. I'm talking here about, in our example, about Agatha, but it could be anyone you know from your family. You care about that person, and you want she is getting well again, that cancer treatment is, let's say, picking up, and she will recover. Agatha, here in our example, she cannot swallow anymore.
That's right, she is not drinking, she's not eating enough. I want to explain you on this example, what we can do, what Fresenius Kabi can contribute to the healthcare professional who is taking care for Agatha, to bring her back into a state where the quality of life is proper and the treatment outcome is good. In her case, as she cannot swallow, we would either apply a tube or a PICC catheter. A PICC catheter is a direct connection between the outer skin wall and the stomach. We would feed through this connection our tube feed product. We would also help her volume balance, the fluid balance with our crystalline solution, Ionosteril . To make sure that everything is applied properly, we also use one of the pumps, which are coming from Christian's area.
This is a full process solution to help Agatha to come back, let's say, to a proper nutritional status. That is super important because it is proven that clinical nutrition helps to improve treatment outcome, it helps to reduce length of stay, and it helps to control treatment cost. We'll come to that when we're talking about education. Well, on this example, I just wanted to give you a glimpse of that, what is possible with our portfolio in the hands of a healthcare professional, whether it be a physician, a nurse, in a retirement home, in a hospital, in the ambulatory setting. We have all of that. We have products for parenteral nutrition, for seriously sick people who are on the ICU, where the intestine doesn't work, they need to be fed, completely depending on the content of these products.
We have patients who are living a life long on these products, and you can do so. When we had our centennial, our celebration of Fresenius Kabi in 2012, we had a few patients there on stage who explained how they're living on parenteral nutrition for a long time. You can do that only if these products have the highest quality, the formulations are perfect, and they address the patient's need. That is what we do, a business what we drive every day with these products: multi-chamber bags, single components, and all the systems you need to support the healthcare professional with software, devices, compatibility data. We give them all of that. For those patients who can still swallow the food, we have sip feeds , we have yogurts, we have creams, and I'll talk about that. We have also the tube feed medical nutrition.
It's a complete universe in the field of clinical nutrition, which we built over time, and it comes, let's say, with a lot of cross-selling opportunity from pumps, for IV fluids and others, and therefore it's great to have it. I would like to walk you now in the coming 20 minutes through our storyline. Why is that not working? The next slide. This one now. Thank you. I would like to walk you in the next 25 minutes through our storyline, in a nutshell, how we want to deliver these 4%-7% top line growth and to maintain or even further expand our margin, which is highly accretive. The most important point I want to strengthen, is the fundamentally attractive market in which we operate. Why is that so?
We have a growing population on this globe. We also have an aging population on this globe. In many countries, China, Japan, Europe, big markets where we have more older people. What does it mean? More older people means higher prevalence of chronic diseases, higher frequency for surgery, higher rate of diabetes, and so on. This is something which is not going away. This market is going to grow. There are reasons for that. I'm going further to elaborate on them. That means the target market, which we can address with our products, is going to grow. That is fundamentally in this business. I think that is good. We have a broad portfolio. We're a special company because we're not only active in parenteral nutrition, we're both in parenteral nutrition and enteral nutrition.
We can accompany a patient through his journey for clinical nutrition, in the hands of the clinical nutritionist or the clinical pharmacist and our physician, we have a full process solution. Whatever he needs, he can get it from us as a one-stop shop. We have a proven competence in our development, in our clinical teams, in our regulatory teams, not only to identify the right ideas, but to bring them to approval and to manufacture them in proven quality for supplies all around the globe. This is what is the great basis and the foundation of this great business. You may ask: Well, but you have been growing in the past like that. Why do you want to continue like that?
We have identified quite some geographic expansion opportunities. I will elaborate on two examples for you to give you an idea of how we're going to deliver these 4%-7% top-line growth CAGR, how we are going to keep these margin levels, which we have, which are highly accretive, and seize where we can, the upside potential. Let's look into that. We have a market which is about EUR 10 billion in total size. 60% of that in enteral nutrition, growing with about 6%, EUR 4 billion with parenteral nutrition, growing with about 4%. These are a few numbers. I don't want to bore you with that. You have probably seen them. This is not the part for my presentation. I want to strengthen these points, which I indicated.
The demographic development is a fundamental driver for these markets. Diabetes, just as one example, if you have increasing incidents of type 2 diabetes, and you have that in North America, you have that in Middle East, you have it in China, the children of these parents have a higher risk to develop type 2 diabetes as well. This is a self-perpetuating development, and you see similar trends also in oncology for cancer incidences. That means the number of patients is going up. If these patients or if these people require surgery, clinical treatment, and clinical nutrition, they need a dedicated feeding regimen, and we have the products for them. I will talk about that. The second mega trend for our business driving that is the home care segment.
Healthcare solutions or healthcare systems are in distress. Those who are living here in the U.K., we all see the news about the NHS, how it's struggling to keep up, let's say, with the cost and the patient requirements and so on. A lot of hospitals try to push out, release patients early on to home care segments after surgery, for example, or other treatments, to make sure that they can be taken care for in a less costly environment. That doesn't mean that the treatment need is going down. Malnutrition is carried from the hospital to the home care segment, therefore, it's important that we address that as well. Fresenius Kabi is already addressing this segment in various markets, and I will talk in the next slides about the opportunity here.
As a consequence of that, disease-specific foods, feeding regimens, and products addressing these are really key, and the innovation we are coming up with and we are going to launch we're exactly targeting these markets in a very successful way. This has made us a global leader in parenteral nutrition. We're the number 1 in this parenteral nutrition market. We're the number 1 in Europe, we're the number 1 in China, and we have a very strong leadership position also in enteral nutrition, with a strong number 2 position again here in Europe and China. This is the basis for the way forward, and I would like now to talk a little bit about how did we get into nutrition.
I don't want to do here now a history lecture, but I guess it's worthwhile to mention that our first IV lipid emulsion was developed and launched already 60 years ago. That means clinical nutrition is deep in our genes. We understand it, we know it, we know how to develop these products, we know how to produce them, we know our customers, we know our patients, or the patients of our customers, and we know how to serve them best. You see here, over time, we have innovated in this field in many dimensions. Three chamber bags, that simplified the life of the healthcare professional because you had a ready-to-store, ready-to-use solution with all the components in a bag. Just wrap it open, you can use it. I have samples over there in the demonstration. During the next break, I'm happy to explain to you how that works.
It's really impressive how simple that is. Here, with these 3 chamber bags, Fresenius has levered its competence in container development, in connectivity components, and to make sure that the use is safe, it's simple, it's cost efficient, and it's added value for the patient as well as the healthcare professional. We were the first one to launch a lipid with 4 different oils. Now, you might say: "Well, actually, I don't care about how many oils are in there or what they are," but the patient does, because its tolerability and its content. If you take, for example, fish oil, it contains a component which is called EPA and DHA, which is necessary if you give that to young infants or to preterm babies, like in the case of Omegaven. This helps brain development.
It helps to secure that the weight development, the development of the baby is good. We happen to have the fish oil with the highest content of EPA and DHA. Why is that so? Because we are vertically integrated. We do our purification, we do, let's say, the development of that in a way that we have the best solution for the patient. We launched specific products for the intensivist. We're looking at the patient, we're looking at the healthcare professional to have the right product to give it into the hands of them. This one here, in this EasyBag product, is dedicated intensive product for this target group.
It's also good for the hospital because this is a container under a sustainability aspect, which has the lowest plastic weight and the lowest waste weight, and so therefore, when you're looking about sustainability and waste and recycling fees, this helps the user also to reduce these costs. We're thinking in many dimensions. It went on. Fresubin PRO, a recently launched product, the sip feed, which is targeting the trend of high-caloric, high-protein food. This product has really picked off really well. Just to give you an example, in France, where it was launched, within two years, the sales increased by a factor of six. Really great pickup here, and you see we're continuing to launch products for pediatric indications. We're addressing regional rollouts like the FSMP in China. I'm going to tell you more about that.
I believe if there's something exciting, then this is the stuff, and I believe this is going to help us for the way forward to drive our growth, as shown by Pierluigi. Where do we stand in terms of competitive environment? We have multi-chamber bags, and we have them in different content with different formulations. We have them in different geographies. We produce them globally, but we produce them also locally in China for the Chinese market, which is a great and large market for parenteral nutrition. We have lipids, we have all the amino acids, we have a great basket of additives, which is vitamins, trace elements, what have you, and we have, in select markets, also compounding services. That is what I call a comprehensive basket. This is what I call a portfolio on which a customer can rely.
The same is true in enteral nutrition. You see here four boxes, and allow me quickly to walk over to that slide. For the enteral nutrition, it is important that patients who have to drink these things, that they try it, they like the taste, and then that they have a choice, because if you lived on that, say, eight days, two weeks, three weeks, you don't want to have chocolate and vanilla every day, three times a day. Yeah? That doesn't work for us. It doesn't work for the patient. Therefore, choice is key. We have meanwhile up to 11 tastes for the various formulations, and not only sweet ones, because some people want to have also something savory, salty. We have tomato carrot, we have white mushroom or others to make sure that the choice is driving patient compliance.
It means if they're prescribed to take the sip feed three times a day, they drink it three times a day. That is something what patients like and why the relatives are sent, "Go get me this Fresenius Kabi sip feed, because the taste is nice." That this is not only something I'm telling you, this is proven also in tests, independent tests we do between the various customers. We believe our taste is great, and that makes patient return to buy that stuff again. Another topic is volume. If I may go back to, let's say, the relative or the dear around you might think who is old and maybe not fit anymore, those people, the grandma, is not drinking a lot. I said that in the beginning.
If you give them always 250 milliliters to drink 3 times a day, they might say, "Well, that's too much for me." The topic of concentration is key to get as much as possible calories and content in protein, fiber, trace elements in as little as possible volume. That's why we came up with this 3.2 kcal product here, which is in 125 milliliters, 400 kilocalories. If you take 3 of them, you have the full day's demand in very small shots. It's 2 zips, and you're done. That's also something a 90-year-old grandma, mum can do and manage, and this is something which drives compliance, as said. That is the part which is driving the patient. For the healthcare professional, it's for me important that whatever they need, you have the tool for it, yeah?
If you want to have the professionals to be effective, you need to give them tailored formulations that they have for the patient with renal deficiency, with a hepatic deficiency, with diabetes, with cancer, recovering from surgery, or if it is a infant, that we have the right product. We have it. Now, you see it all down there, and we have it as sip feed. We have a tube feed. This is what I call a complete universe. We have it also for kids, because kids are not just small adults. They have specific requirements in terms of composition, in terms of volume, and in terms of additives. This is what we address in our Fresubin line here, both for tube feeds and for sip feeds.
We have also here, to complete this universe, the dedicated disposable and pump systems to make sure if you feed someone on a neonatal ICU, that the physician, the nurse, doesn't have to care about how does all this fit together. It matches connectivities. Given this works, and you can concentrate on your patient. This is what makes the difference. This has given us a strong growth trajectory. This has made us a leader in this field, and we keep continuously feeding this portfolio to make sure this stays attractive. As nutrition is not necessarily on everyone's mind, you need to do some education. If you educate nurses, physicians, hospitals about the benefits of clinical nutrition, you really get to see that this market is growing.
You can tap it, you can step into that, and then you can sell. Therefore, education is important, and I would like to put some numbers here in front of you to make them speak for themselves. 25% of hospitalized patients globally are malnourished. That's mainly older people. That means their status for vitamins and others is not perfect. They are sometimes obese or they're cachectic. It could be in various directions, but they are malnourished. The problem is that either way, if you're too obese or you are too cachectic, you have not enough substance in your body anymore, to say it in a simple way. This drives cost for treatment in the hospital. For the European Union, it's estimated that this is EUR 120 billion per year. Just imagine that healthcare systems could save a fraction of that.
That should be a big driver. Therefore, it's up to us also as an industry, as Fresenius Kabi, to educate the users. Also here from the U.K., there was a study from BAPEN, the British Association for Parenteral and Enteral Nutrition. They have assumed, calculated and analyzed that the treatment cost for patients who are malnourished, 3 x-4x higher than treating a patient who is properly nourished with exactly the same disease. That is something where we can help the hospitals, healthcare systems, to say, "If you buy this stuff, if you use that, you can actually benefit from that, and the patient will benefit, too." It's a win-win. To make sure that this is properly documented, we're running trials. We're helping professionals to learn about that with screening days in Latin America or in Asia.
We're running campaigns. We help young doctors, nurses, pharmacists, what is the right nutritional regimen and what kind of products would fit? This works quite well. Then we also do research grants to make sure that the ideas about the next level of nutrition, the next formulation, that we can seize that and we get it from the researchers. That is giving you an idea how complete this portfolio is. We're offering the products, we're offering the pumps, the disposables, everything in terms of cross-selling to that. We're offering digital services. This is a universe which is going across various channels, hospital, professional care, home care, and even to retail, where we can address it.
I told you, the home care segment is becoming more important. Therefore, it is very important to us that we are on top of it, that we have the access to that. Therefore, I'm very happy that already today, more than 20% of our sales in clinical nutrition are in that growing segment. That is a good starting point from where you can take the next step with more products, more markets, with the experience we have to make sure that we can grow also in this field to be the leader. More than 30% of the patients which are tube-fed in this segment are fed by us. That is good. Therefore, this gives you just the numbers of that. About EUR 500 million sales generated in 2022 in the home- care segment.
More than 10 markets already addressed today, with the opportunity to further extend it. This is also not a one-trick pony. This is standing on both legs. In this segment, we're offering both enteral nutrition and parenteral nutrition. We're offering product delivery services so that the patients get more or less a shipment to the home. I've seen that just a few weeks ago when I was in Austria, in our center there for supply chain center, pallets, where the patient gets more or less the complete equipment sent home. It's a complete starter package with a pump and a infusion pole and all the disposables. When the packages arrive, is arriving, they get a call. The nurse is there to receive that and set up everything in the patient's home, and they get the education.
It's a universe which goes beyond the product sales. This is connecting these patients to us, to us as a company, as a service provider, and this is really great. The best products, they won't work if you can't provide them. That means operations. Manufacturing is important, and of course, also the brain behind these things, the development. On this map, I just want to quickly give you an overview. We develop products in Europe for global markets. We do the development for vitamins, additives in India, and we do the development for the nutrition products for the Chinese market, or we support it there with a local development center. This gives us a global and local approach, and both is important. You need to have both in your big markets to be successful, and we have it. Same for the plants.
We have global plants, like in Uppsala, in Sweden. We have the local plants, like in Beijing and in Wuxi, to serve our important Chinese market. We invested in the last years in Netherlands, in Emmer-Compascuum, into a completely new, high-tech, highly automated, efficient tube feed production line, which is helping us to feed our growth now also on this one out of this plant. I would like to talk shortly about the 2 geographic expansion opportunities. One is in China. You see, the Chinese nutrition market here is around EUR 2.8 billion in size. Around 15% of that is enteral nutrition. You have seen on the slide before, we are a leader in parenteral nutrition. This is a segment where we have a clear number 1 position. That's good.
There was one question about national value-based procurement: What are you going to do? Yes, one of our three chamber bag formulations, for example, is part of this NVBP procedure, and we have adjusted our structure to the effect of that, and we have taken the right measures, and the effects are baked into our projection for the way forward. We do not stop here. We're looking for alternatives. How can we lever our competencies, our presence in the Chinese market, to continue to grow? Here, we looked into the food for specific medicinal purposes, FSMP, which is a new category in China. The interesting thing is, these are products which are prescribed in the hospital, outpatient clinic, for example, or in the hospital.
When the patient is discharged for the way forward, the patient has to pay it out of pocket, so they have to pick it up, and they have to pay it themselves. That means this is a growing segment, new, not yet completely overrun by hundreds of competitors. On the contrary, very specialized. We will launch our new products, this is protected against this value-based pricing pressure. Therefore, we believe this is a very, very good means in China to keep the momentum and to keep PN, but to add the FSMP. In a market which is aging, with increasing disease prevalence, our products are coming at the right time, from a company which is in China since 40 years, which has a all-China presence. We believe this is the right place to be.
The investment is already done on the concrete and steel. We need to roll out our pipeline. We need to feed here and there some clinical trials to make sure that the pipeline is nicely building up and to meet the regulatory requirements in China, this is a great place to be. The other one is PN in U.S. We have launched the lipids in the U.S. We have brought our multi-chamber bag already there. With that, and the business of about EUR 60 million in 2022, we address about 20% of this EUR 800 million market in the US. That is not sufficient for us.
We want to get more from this cake. Therefore, we will keep launching amino acids, trace elements, and other things to make sure that we complete our portfolio, that we can address about 70% of the PN market with our registered portfolio. Here, the good thing is, there is a good cross-selling opportunity with around about 1,500 hospitals and accounts where we're selling our IV drugs. We'll talking about IV solutions later. That is a great, let's say, synergy within the market. If you combine that with the innovation coming, that's all the pioneering, which is coming with the fish oil, and the high EPA content fish oil, which we have there, that is then giving you the picture how we intend to succeed in the U.S. market. I would like to wrap up. Time is more or less over. The markets are attractive.
They're growing. The demand is going up, driven by disease prevalence, driven by demographics. I think I mentioned that. Therefore, this is a wind which is driving us forward. We have a leading portfolio, and we will keep innovating. We have attractive solutions in our basket, right for the market, right for the situation there, as I explained with the FSMPs in China. We have the scaled production. We did the investment in Wuxi. We did the investment in Emmer-Compascuum. That means this is the basis and the foundation that we can continue to grow. The geographic expansion opportunities, like in China and the U.S., will further fuel our growth.
With that, I'm absolutely confident that we will live up to the sales growth of 4%-7%, and we will continue to deliver strong margins to contribute to future Fresenius and our story at Fresenius Kabi. Thank you very much.
Next speaker will be Christian Hauer from MedTech. Christian, stage is yours.
Thank you, Marc Good morning, everybody. My name is Christian Hauer. I'm leading the MedTech business. I gathered meanwhile, 25 years experience in MedTech in various positions, working for Fresenius Kabi, and before, for Dräger Medical. Let me start to explain our MedTech business a little bit. You heard about the two big segments already, TCT, we call it, and INS. Let me start with TCT. That is Transfusion Medicine and Cell Therapies. Here, our strengths is how to separate, how to extract, how to wash certain components out of the blood, being it plasma, red cells, platelets, white cells, and so on. You see here the different equipment that we have for that. On the other side, we have here our drug delivery business, INS, Infusion and Nutritional Systems. We have here pumps, like the Agilia pump or the Amika pump.
You might have seen them when you are in a hospital. We have a high market share. When you are here in London, for instance, if you go to King's College Hospital or St George's Hospital, you will see our products there. In total, we have 1.1 million installed base of devices. I like to come back here to the patient story for Maria. She's a cancer patient, and we would like to explain a bit how important Fresenius Kabi is along the patient journey. Maria has cancer. She has a special cancer, multiple myeloma, and therefore, there's meanwhile an approved CAR T-cell therapy. In a CAR T-cell therapy, first of all, we need the autologous, so the patient's own blood, the white blood cells.
You can use our apheresis machine here, for instance, the AMICUS device you could use for that to collect the white T-cells. Then you need to send them to a manufacturing site, to the biopharma company, and there, the cells will be washed, will be extracted, will be prepared, will be multiplied. There you can use our CAR T-cell device, Lovo, the washing device, and then the product goes back to the patient to be infused and to help the treatment. Of course, it's a very severe illness for Maria, so she also needs nutrition. We have here this three-chamber bag, as described by Marc and also some IV generics. You can see how important in this multiple myeloma case our products are for her treatment. I like to highlight some or two specificities about the MedTech business.
The first topic is that we have with our customers, a multi-year contract, usually 5 years, 8 years, 10-year contracts, because there's an effort to connect our product to the IT system from the customer, to train the users, to train the nurses, so there's an effort to do that. We have, at the moment, as an example, more than one-third of our net sales is with existing customer contracts for more than 5 years. The other important topic of our business is that this is a recurring business. I have here, for instance, an IV set for here with me. This you need for the Agilia pump, as an example, and you can run our products only with a dedicated set.
It's a razor blade model, and so it's very important for us to have a huge installed base globally then to sell these sets. You see over the last years, this reoccurring business, we were able to increase the share within our business. Yeah, we heard from Andreas Dünkel already, that the MedTech business within Fresenius Kabi is below the margin bend. Of course, that's a very big task for me to bring this up. This is a high priority to increase the profitability of Kabi's MedTech business. There's four levers, main levers, how we like to achieve that and how we will achieve that. The first one is that we have a leading position in our Transfusion Medicine and Cell Therapies business, and there is especially two growth elements in there.
This is the plasma collection and also the cell and gene therapy business to drive that business, also better margin and drive here. Now we acquired Ivenix, and that gives us an additional momentum to really approach and attack the IV therapy market in the U.S. The other topic is we have to continuously, rigorously work on the optimization of our production network and further in-source to improve the cost position. You see, we do millions of these sets, and you can imagine if you take their 1, 2, 3 cents out, these are very big and important effects. Last but not least, we have a big installed base.
There's a lot of data we generate with our products, and we have more and more software products to come, adding value to our users here. This is also an additional business, helping us to grow and helping us to improve the margin. Some are specific on the TCT business. Overall, here we have a very strong global position. In the biggest U.S. market, we are even the leader. Also, strong position in EMEA and rest of world. You see here basically how we sub-segment the market. We have blood collection, plasma, cell and gene therapy, and then hospital business. You see the market sizes of these segments, basically. Yeah, we are very proud that we have good customer relationships here. We are very deep inside these customers.
We work for many years together with them and develop solutions with these customers. Yeah, about these segments, the biggest is blood collection. Here we are the global market leader in blood collection. This is a market, yeah, with stable development. It's a very stable business, and this is mainly for us to defend the business. It's also to have all the production, everything up and running, because it's a big segment and a big entry point in that business. The real 2 growth areas are plasma. Let me start with plasma. There is a clear expected continued market growth for intravenous immunoglobulins.
There is more and more geriatric patients, there is more occurrence of immunodeficiency diseases, there is more adoption of IVIG treatments, the market is predicted in the next, yeah, 10 years to grow 7%-8%, we are well placed here with our products to participate in this growth. We saw in the last years that we had double-digit growth. We see that for this year. We have new products. You can see that also in the room next to us, in the showroom, we have one device with us. We will continue the growth here in this area, also with additional software and bundling with our IV solutions. The other very exciting topic, of course, cell and gene therapy here. It's a nicely growing market, more than 20%.
We could use many models in our technology, modify them slightly, that we use to collect other blood components, also here for white T-cells, and this is a strong growth market. We have meanwhile, we are very proud, so as far as I know, there are 7 FDA-approved CAR T-cells out there, and 3 out of these 7 therapies, our equipment is in the registration, and these are done with our products. We work here with more than 250 other customer startups together in clinical studies, and as far as we know, it's very confidential, but we know in 33 cases, we are part of a therapy that is meanwhile in the filing process to the FDA.
We have also built a joint venture here together with 2 other companies in that space, with Bio-Techne and with Wilson Wolf, with company name is ScaleReady, that we have a comprehensive portfolio along the value chain, we share here jointly our commercial team, our sales forces. Here, the Cue device, you see that here. We launched that last year in October. You will find that also here in the other room as an example of one of our latest launches. This is overall the biggest products we launched in TCT recently. These products drive a lot of organic growth additionally to our baseline, to our business, and the beauty is these products deliver a higher margin than our traditional business. There is an uptake. There's more to come.
We have a strong pipeline here. We are also very proud that we have a very experienced R&D organization across the globe. You might know we acquired Fenwal. They are based in Lake Zurich in the U.S., a very strong R&D capabilities, and we have also two R&D centers here in Europe, so that we are really balanced and listen carefully to demands in Europe, but also in the United States. You see, we were quite successful here, driving really the organic growth and also margin improvement by this end-to-end responsibility. There was a decision to really carve out the TCT business, has certain specifics, that this is an own end-to-end business. Within Vision 2026, when Michael Sen came and was leading us, there was a discussion, okay, what to do with that?
Was a decision made, INS is very close to TCT. You see from the production process, for instance, from the technological expertise, also from direct procurement, many topics in R&D. Decision was made to bring that together to form one MedTech business with the same Fresenius Kabi and apply the same things that were successful in TCT also for INS. Now talking about the INS market, you see, we have a good position here in Latam and in EMEA, but our weak spot is the U.S. market. For us, of course, when you are leading in EMEA and Latam on IV solutions, IV therapy, and the pump business, of course, you are desperate also to get into the U.S. market, which is the biggest market here, with $4 billion in IV therapy.
There is a certain uniqueness in the business. We try to really enter the market with the Agilia pump, but there are certain software requirements that are very specific, high-end. That's why we decided we want to invest in the U.S. We are very serious about that. You will hear about major investments in the plant structure for IV solutions from Marc later on, and also, of course, about Ivenix. We said we need the best pump there. We were monitoring the start of Ivenix for many years, and last year was the right moment to really go after them. This is here, the Ivenix pump. It's really a game changer in the market when you see the pump. Let me start with the interoperability.
This is a very important topic here, that you can, as a hospital, integrate the infusion pump with your electronic medical record, being it Cerner, being it Epic, you can then have that all paperless. Let's say you are the pharmacist in the hospital, you update your drug library, of course, you want to ensure that the new drug library data are immediately, basically, on all pumps in the hospital, wireless, immediately. This, for instance, can be done with the Ivenix pump. The other beauty is here, when you see, this is a touch display here. It's colored, it's big, relatively big for such a device, this is optimal, easy to use for the nurse. With that, we have studies out there that we can significantly reduce infusion-related errors.
It's a big topic here in the industry, and we are very powerful in the workflow and also able to reduce these errors. The last thing I'd like to highlight is that the pump has a very precise flow rate accuracy. You have to imagine, you're a very severe ill patient, you get critical drugs, yeah, and then the flow rate is, of course, very important, that it is very precisely administered. We have a pneumatic patented pumping mechanism with a cassette. It's very precise, and it doesn't matter under which clinical conditions. For instance, some pumps, the head height makes a big difference towards the patient. In our case, with a pneumatic pumping mechanism, it doesn't matter, yeah.
It's an unmatched performance here that we offer, and also here, we have in the room next to us, we have a sample here. Steve Scheeler, the leader of our U.S. implementation team, is here. Feel free to go to him to ask him. He's happy to do some kind of demonstration to you. With that, with the Ivenix acquisition, we have this high-precision flow rate pump with a great interoperability, plus we also acquired an R&D center. It's in near Boston, really a mecca for MedTech. We have a very strong R&D team, which is also helpful to be close to U.S. customers, to understand, to enhance the product, and so on. On the other hand, there is, of course, the products from traditional Fresenius Kabi on the table, like the IV fluids.
We're the only company in the U.S. market offering DEHP-free containers, having also a self-sealing port, so nothing is dripping out. Small things, much better than what competition can offer. It's a premium offer that we have there. Our Fresenius Kabi portfolio, when it comes to disposables, like needle-free connectors and so on. Of course, super important, Ivenix was a start-up. We have the plants. We have the plants to manufacture that, yeah? We have here our plant in Haina, in the Dominican Republic, almost 5,000 people working there. We will bring there the Ivenix set production, and we will bring the device production to our site in Warrendale, near Pittsburgh. With all that, we have the clear ambition and target to deliver a EUR 200 million-plus margin accretive business in IV therapies by... or in 2026.
I like to share with you some highlights that we are on a very good track here. First of all, I think a big highlight was for us, Vizient. You might know that in the U.S., you have GPOs, group purchasing organizations, and usually they have contracts already and you are signed up. Of course, Vizient, Premier, they have already pump suppliers in that contract. Vizient, for instance, they run once a year a big show in Las Vegas, where you can apply when you have something like a breakthrough technology, something really innovative. They have a team of experts, of nurses, of CIOs, coming, looking at your products. We feel very proud, we have been selected. We are awarded meanwhile with Vizient. You might have seen that also.
Vizient is the largest GPO, covering more than 50% of the U.S. hospital space. Also this week, Monday, we announced Premier followed. They said also, "Ivenix, it's a great technology. We want to make sure that we have that in our portfolio." Meanwhile, we have signed contracts with 10 additional providers. We have a very strong, yeah, pipeline here with many big, prestigious hospitals. We just finished this week, Monday, our next installation here in a hospital in California, and Steve Scheeler, that you will see, will go next week to Wisconsin to do the next installation. That was about Ivenix. The other important topic is, of course, when you understand this razor-razor blade model, you understand how important the razor blades are to us.
There's millions of sets that we are producing, for that, we, of course, need a very strong global manufacturing footprint. Here you see our plants. To be honest, this is currently still too many. You will hear in a moment, more from me. We have invested here to, yeah, automate more, to increase capacity, and also to do transfers. We have closed five smaller locations in the last years, which is driving a double million savings here, and we continue to do so. I have here one small example for you, a product that we insourced. With Fenwal, this product came to us, was bought by a supplier, and we decided to insource it.
That is a leukoreduction filter, in this case, that we need in various areas for TCT, and that filter we could reduce by more than 60% in cost. This is overall annual saving of more than EUR 25 million per year when you really are focused in insourcing that, and I think that's very important to understand. that we have the capabilities, that we have that track record, because on Ivenix, we also want to insourcing and knock down the cost here significantly. I like to share with you 3 details here, or 3 projects that we are currently working on to improve our operational cost. One is, you saw in Marc's presentation, our nutrition plant, Emmer-Compascuum. It was in the past an assembly plant for TCT. We are transferring, as we speak, step-by-step, the productions to Haina, to our bigger plant.
That should be accomplished by middle of next year, bringing significant savings. The other topic is Ivenix, of course, very big topic. Ivenix had different suppliers. We need to ensure to bring it over to our suppliers, where we have other conditions, of course. We can even get, for our traditional business, better conditions because we have more volume. We work on injection molding, higher cavities, tube extrusion, bring things in-house, and mainly bring it in-house and scale it up in our big plant in Haina here by the end of 2024. The last topic we are working on is in Puerto Rico.
We currently have 2 plants. We are in the process of filing for the 1 plant, all the products we do in the 1 plant, to step-by-step also bring it down. There is a closure plan for that plant by the end of 2026. These are big savings, big potential, that we have to really, like a Swiss watch, to execute step-by-step, transfer, automate, and bring in-house. The last important topic that helping us driving the margin is, I spoke about the big installed base, that we're having the more than 1 million devices out in the field, gathering data every day. We have here software solutions that is adding value for our customers, being it nurses, being pharmacists, other healthcare professionals, mainly with respect to patient safety and process efficiency.
We have here software solutions, for instance, on the INS side. This is an infusion dashboard, very in vogue. Of course, you can, as a healthcare professional, as a nurse, you have a multi-viewer. You can see all the beds, all the infusions. When there's an alarm or when you have to exchange a line, you can see that. We have, for instance, another very successful software on the plasma collection side, where you can optimize based on your personal donor data, your age, your gender, your weight, how much you can donate. Of course, if you can optimize that, every milliliter of plasma has a high value to our customers. Then you can ask for pricing for these softwares.
We see a strong growth in this area and good EBIT margin, that is also an important driver. Overall, big ambition. My personal ambition also to bring the Fresenius Kabi MedTech business up in the profitability, bring it into the margin band. Again, how to do that? Utilizing the strong TCT position, especially in plasma and cell and gene therapy, using Ivenix, the momentum that we have versus new acquisition in the U.S. market, continue being rigorous on the optimization of the production network and insourcing, and of course, gain traction with the software solutions here also. Thank you very much for your attention. Markus, I hand over to you now for the Q&A.
Very good. Thank you, Christian. Very good. Thank you, Christian. Would like to enter into the next and to today's second Q&A session, focusing on nutrition and MedTech. Again, if you would like to ask a question here from the room, do us a favor and raise your hand. This first comes from Hassan.
Hi, it's Hassan Al-Wakeel from Barclays. I have three questions, all on nutrition, please. Firstly, as the nutrition market in China pivots towards enteral nutrition, could you talk about the synergies from your strength in the parenteral space, and what you are doing to ensure that you stay ahead of the more traditional enteral peers? Secondly, on slide 32, you show that your sales are slightly more enteral than parenteral, which is a little surprising, to me at least. How do you see the mix trending over time, as China shifts enterally, and you expand your presence in U.S. parenteral nutrition?
Finally, if I can come back again on the margin point, where is the upside in nutrition margins from currently pretty high levels, given this looks to be the largest lever of margin expansion for Kabi out to 2026, and does VBP pose a risk longer term here? Thank you.
Yep. Thank you for the three questions. Let me take them by order. On China first, we're selling with the FSMP, as I have shown here on my slide, into the hospital outpatient clinic setting. That is typically where these specific foods, the FSMPs, are prescribed. That is where we are also with PN, so that mean there is a synergy in terms of brand positioning, brand reputation, but also a synergy in terms of, the first contact, to explain the concept of FSMP and to make sure that the prescriber understands our product. That is, for me, the key synergy.
That is on China. The other question was, how do we stay ahead of the traditional ones? Well, with the FSMP, and that is the beauty of it, we're not competing with a standard sip feed, let's say, where you have local players and whatever. The EN segment, as you have seen in this pie chart, is at the moment only about 15% of the Chinese market, so it's smaller than PN. The FSMP segment is something new. This is something we will develop, which we will build on our competence, therefore, I do not see ourselves here competing with a lot of standard sip feed competitors, but only with, even if, let's say, a very small number, I'd say, of FSMP players, specifically in the beginning, as the category is new.
On your question on EN sales, you have seen in Pierluigi's presentation, the pie chart. I guess what is important to understand is that there's this PN segment. In the EN segment, you also have the product, which is called Ketosteril. Ketosteril is around EUR 300. It's a triple-digit number of sales. It's a combination of Ketosteril and enteral nutrition to explain that this is in one segment. On the margin upside, you have heard in the presentation from Michael Sen, but also in the presentation from Pierluigi, that we're focusing on, well, synergies, structural synergies, operational excellence, and to deliver on our projects faster. The margin upside, I see mainly through levering, let's say, these measures over time.
You have also seen the geographical expansion into the U.S. market, for parenteral nutrition, where we want to broaden that one. That should also give a certain margin uplift under ideal circumstance, though it's a mixed bag of that.
The way I would also integrate is that as we were discussing, asking before in the break, we are above our margin, structural margin, 14%-17%, and our goal is to keep it steady, right? To increase our growth, and automatically by increasing, by delivering the growth that you saw on nutrition, will drive an absolute EBIT improvement, right? It's important to remember, it's above our 14%-17%. You throw a number during the break, I think I would stay on the above 14%-17%.
Thanks, both. Next, Holger.
Hi, David Adlington, J.P. Morgan. Just one quick question on MedTech. Given the quite long contracts you've got, sort of five years plus, just wondered what protection you've got in there from inflation, and as those contracts get renewed, what's the pricing environment like currently?
Yeah. That really depends customer by customer, but there are various kinds of how to build in the inflation, yeah? There's indices that we have as a baseline here, and that's how these contracts adjust the pricing then on an annual basis, basically referring to CPI indices.
Okay, next comes from Holger Blum, second row here on the right-hand side.
Thank you. Holger Blum, Patinex. To two questions. One, I remember the capital markets day of Karl back in 2004, when I got excited about the nutrition story, that we had data that people can reduce hospital stay. It was impressive data, like we presented today, but if I look at the market development since then, if the data is consistent, we are EUR 6.3 billion 20 years ago, excluding Japan and the U.S. If you now get to EUR 10 billion, that would be a CAGR of 2%, which is not reflecting the big unmet medical need that you can fulfill with nutrition. What's your sense of the historic CAGR of the business, or is it more of a mismatch of the data back then to today?
Thanks for reminding us on the number for 2004, because I must say. Well, if you take it like that, you could say it's only a 2% growth. Between 2004 and today, a ton of things have happened. If I think back to that time, and at that time, I was in transfusion technology, but we followed, of course, what nutrition was doing. You had professional societies discussing what is the right nutrition regimen. The demand of malnutrition is nothing new, but to understand the value of proper clinical nutrition is huge. That's the one thing. The second thing is to help the healthcare professionals to understand how they can use the tool of clinical nutrition to help them to really get benefits for the length of stay and so on.
I would firmly assume that over these 20 years, the situation has completely changed. There is a huge increase in understanding compared to 2004. From that side, I guess we have today a different momentum, though I acknowledge education is still key. This is what we have learned also over the last years. I've shown you the slide here with the education days, the screening days we do, where, let's say, meanwhile, we have the support as an industry also from the professional associations and so on.
... propagate the need of clinical nutrition. In a nutshell, I would say the situation in 2004 was more or less the Klondike stage. You knew there was something you had to shovel. Today, we have a completely different universe and environment in which we can take this forward. This is why I'm more confident today, let's say that we are growing with a 47% than the 2% you have shown.
The second question, more general, maybe on your innovation spending and margin focus. You seem clearly excited on the Ivenix acquisition. Are there more Ivenix-type companies around that you focus? Or is it mainly now the focus on execution and less on business development?
I think, I mean, with our 2 acquisitions of mAbxience and Ivenix are very recent, last year. I think as we've been sharing with you, now it's time to deliver. It's discipline, it's execution, it's driving margin up, and our plate is quite full as we speak. Therefore, for the time being, we are not actually planning to do any M&A. As usual, like any good team, we're always scouting for opportunities, but this will be happen in due time. For the time being, no M&A.
Next comes from Veronika. Please go ahead.
Thank you very much. Veronika Dubajova from Citi. 2 questions, please. One is just on the MedTech business and the margin ambition that you've communicated, obviously, moving into the double digits. I'm curious if you can give us a bit of insight on how we get there. Is it mix? Is it the U.S. expansion? Is it, you know, efficiencies? Just build a bridge for us, if you will. Then I'm not going to date myself all the way back to 2004, but I will date myself back to 2012, where if I look at both nutrition and MedTech, the organization has, for a long time, had an ambition to expand into the U.S.
I think there was a target for EUR 50 million-EUR 70 million of sales from nutrition and pumps in the U.S. in 2012. It seems like we're maybe just about there or maybe slightly ahead of it, but it's been very slow progress. I'm just curious, what gives you the confidence? I think this is a question for both of you, both on nutrition and MedTech, that this time around, it's going to be different, and you can hit these numbers, which are suggesting sort of multiple hundreds of millions of EUR of sales from the U.S. Thank you.
Okay. Yeah, on the margin, coming back to the question, how to address the margin topic and increase it significantly, that is basically a mix of growing. We need this growth, and you see we have a strong organic growth, especially in areas with higher margin, being it cell and gene therapy, for instance, being very attractive, software, plasma, and also the Ivenix case delivering higher margin in these businesses. Simultaneously, we have, of course, to work on our cost position, continue to work very hard on transferring, closing down plants, and continue the insourcing to drive down our cost, especially on the disposable side. Both things go hand in hand, we're sure that we can deliver that. Then maybe for your other question about the U.S. business, I think it has changed already significantly.
When you look for MedTech, we do almost 40% of our business in MedTech in the U.S., meanwhile. A very strong player on the TCT side. I said we are there, the number one. We have a very strong position in that market, and it's a big business for us, meanwhile, yeah.
In general, I would say also to cover the nutrition part, we have a different team, right? I think from 2012. I don't know who was in 2012, but I can say that today we have clarity in terms of who is driving which business unit. Therefore, I believe that, I mean, transparency and clear accountability makes covers a lot of ground moving forward. Of course, what you'll need to do is, which I guess you will do, is to measure ourselves on what we are telling you today, right? Give us for the time being, I think it's a good first quarter. We have clear plans. People are, you know, managers, executives are associated with a specific business unit, and measure ourselves moving forward.
Thank you. Next comes from Jane Bleeg.
Thanks. I just wanted to dig in a bit more to what Veronika was asking. Going from low single digits to low double digits is fairly hard. How much is Ivenix a drag right now? I think it's important for all of us to understand. Secondly, you know, to the point of how much is growth versus actually how much is cost out, are we in a situation like care delivery at FMC, where it turns out your margins are actually low single digit due to lack of understanding previously over what your cost centers were or what your production costs were? Or is it really dependent on top line growth?
Understand your question. I think we're not gonna be giving you the, unfortunately, this level of details, right? I think you should be happy with the, you know, the, what we've been sharing with you in terms of MedTech, how do we wanna grow. We said about Ivenix, right? We spoke about margin improvements in terms of, you know, all the initiatives that Christian and his team are deploying, you know, shifting productions from one plant to the other, industrializing the Ivenix pump, and therefore, taking down the unit cost. I think we have a solid plan, and we have to deliver moving forward to get into the margin band for MedTech.
Thank you, Pierluigi. Last one comes from Oliver.
Yeah, thanks very much. Oliver Reinberg, Kepler Cheuvreux. First question, just coming back on VBP. Not sure how much details I will get, but can you give us just a feeling, when is the eighth round starting? Any kind of feeling for the magnitude of sales that are affected here in China. Secondly, on U.S. parenteral nutrition, I mean, this was a kind of multi-year effort, actually, to get to the EUR 60 million where you are now. It took quite a while. Is there any kind of inflection points now that this kind of EUR 60 million can significantly accelerate? If so, what are the action points? Third question, just on U.S. enteral nutrition. Is that a no-go for you at this stage, or what needs to happen to change your mind to potentially tap that market as well?
Thank you.
Marc will take the first 2, I'll take the third 1.
First then on the NVBP. The eighth wave of the NVBP was scheduled for November last year, was due to the pickup of the corona situation in China, postponed. We expect that it will come later this year, likely around September. I think we had the discussion yesterday evening on this. The Chinese government is driving in this NVBP procedure, the cost down for 500 products. Which drugs, which products are included in the eighth, the ninth or the tenth wave, when the program is supposed to stop, is not completely clear, because it is driven by how many local competitors and international competitors you have. We have an assumption, which is probably quite precise on the eighth one, and then indications on the ninth and tenth one.
I guess I understand where you're heading to. I would say whatever could be the effect, what we foresee is baked into our strategy and the projection for nutrition. On the EUR 60 million sales for PN in the U.S., you have seen that we have shown a sales projection, a dotted line, with some products coming. We have some files lined up. We intend to launch them. That drives the growth. I don't want to have here give you here the details. I think it fits and plays into the overall basket, 4%-7% top line growth and stable margins with upside potential. That is what we baked in, the downsides from the NVBP potential ones, the upsides from others, that this trajectory is supported.
On your third question, I think we are fully aware that in the enteral segment, in U.S., we don't play. I think, I mean, this would be possible to enter through most possibly, most probably an M&A, right? As I said before, I go back to my previous question, right? I think we have more than enough to chew, no, to deliver on our plans and to be executing them, than be thinking now into an M&A in the EM-U.S.
Thank you. Very last one by James.
Thanks for sneaking me into the Q&A. James Vane-Tempest from Jefferies. just one actually, just on, the MedTech business and innovation, I guess coming back to some of the other questions around top line growth. How do you measure innovation? I guess if new products are expected to grow 40% for the next 4 years, what are those today? I guess when we think about potential new launches over the next few years, how would you measure that? Help us give a sense of what could contribute to that.
Yeah. I mean, we have a launch tracking here. When we launch a product, we exactly look how much is coming on top of the business. Of course, you have also traditional products that sometimes decline, but usually these new products, especially when you see cell and gene, it's all coming on top, because we didn't have previous products there. This is all contributing to top line business. The starting point that you saw on my slide is a mid double digit million EUR amount. That is the starting base where we are with this recent product, and there we see this organic growth coming.
Thank you. It's time for lunch break now. Lunch will be served upstairs in Tyburn Kitchen. In addition, don't forget and use the opportunity to have a closer look to our product show in the back of this presentation room. Would like to ask you to be back on time. Next session will start 2:40 on the dot. Thank you.
Founded in a pharmacy in Frankfurt more than 100 years ago. Today, one of the world's leading healthcare companies. We are there when it matters. With world-class therapies. With leading biological medicines. With high-quality clinical nutrition. With cutting-edge medical technology. Holistic care services... At in- and outpatient settings. We protect lives. We save lives. Sometimes we also help give new life. We help advancing patient care. We are Future Fresenius.
Welcome back. I hope you enjoyed your lunch. Next presentation will be Focus on Pharma, presented by Marc Mahl. Marc, the stage is yours again.
Thank you very much.
Welcome back after lunch. It's my task to keep you awake after your lunch with a really exciting business, pharmaceuticals, IV fluids, and IV drugs. In the next 30 minutes, I'll walk you quickly through the portfolio and how we want to further grow the business. First, again, the topic on a patient. What do we contribute to healthcare professionals? How can we help? This is here an example of different age group. José is, let's say in 30, he likes an active lifestyle. He likes cycling, and he fell off the bike and bruised his skin, and a few days later, got inflammation. First, it became warm, he started to get fever and became reddish and so on, and he went to see his doctor and he said, "Well, that's a soft tissue infection.
You need to take some antibiotics, here it's not sufficient to take them as pills. In the soft tissue, we need to make sure that there's sufficient antibiotic available, therefore, we'll give you an infusion. This is a patient who would be taken care for in the home care segment or with a general practitioner, he would have to receive this infusion two times, sometimes three times a day. Well, we have whatever antibiotic is required here. In this case, I would prescribe him cefoxitin. We would dilute it in a IV solution to make sure that it can be infused. Then, as the GP has not time to, let's say, look all the time for him, we would put him on a pump that the infusion time is completely controlled.
In a nutshell, three products here from three product lines, which can come from our side. It is the antibiotic, it is the IV fluid, and it is the IV pump, including a set. This is showing for, let's say, this area here, also the cross-selling opportunity, which we have for hospitals, for home care setting, for practitioners, and whatever it might be. This is a huge portfolio. We're a leader in this field, and we built it brick by brick over the last 20 years. It started with propofol here in the early 2000s, then with antibiotics and so in the mid-2000s, and then with the APP acquisition, Dabur Pharma, we brought two big stones with the entry to the North American market, and then also with the oncology products, to get a complete, meaningful platform to start from, and also the global coverage.
From there, we have taken it well up, substantial sales to grow here, really the portfolio in IV generics to a global leader. We have everything what you need today to be a one-stop shop in an anesthetics and analgesia segment. If you go to a surgery, you need to be put asleep, you need to relieve, the patient from pain to make sure that he doesn't wake up when someone cuts open the belly, and you need to make sure that the muscles are relaxed, that you can ventilate the patient. This was, for us, a key task to get this complete portfolio together with our pumps, which have the ability to do TIVA TCI, a fully controlled anesthesia. Again, a very nice process solution, which we're offering to the anesthesiologist, from Christian's portfolio together with ours.
This is what is driving today the majority of surgeries or anesthesiologies, I would say, when people are ventilated in the OR room. We have a full basket of anti-infectives for both bacterial infections, fungal infections, viral infections. We have a full critical care portfolio with a flagship product, heparin, which is required to prevent clotting of the blood when you're, for example, required to lay in bed for a longer time. We have a full basket of oncology products. Workhorses in all kind of regimens to treat solid and blood tumors, products like paclitaxel, methotrexate, carboplatin, which are required in oncology therapy or immune therapy.
Even if you're talking about most modern oncology therapies, these ones are still there, and all of these products will be there also in 10 years and likely in 20 years, because these are the basics of modern hospital treatment with drugs. Whenever something is required in IV form, we have it, and these essential medicines are likely to stay. To make sure that you can bring, infuse these products into the body, these are sometimes powders or concentrated versions, you need to dilute them. You need some sterile fluids, and we have them. We have them to reconstitute these products, but we have them also in all kind of forms you need to substitute lost volume in the blood circulation. It could be crystalline solutions, or it could be colloids, which are required in certain, let's say, severe disease statuses.
I don't want to make this a medicine lecture now or pharmaceutical lecture, so therefore, I just want to give you an impression. Four therapeutic areas, big baskets which are relevant in the hospital, in the ICU, in the OR room, in the emergency room. Let's say, on the ward to treat critical and chronically ill patients, let's say, in their disease state, we have it. I would like to come to the market now and tell you again, like in my nutrition presentation, in a nutshell, how we're going to grow that. I would like to start here with our full range. IV generics, in general, are required to make modern healthcare affordable. People, patients, and healthcare professionals rely on the fact that whatever they need, it is available, where they need it, what they need, in the quantities they need.
We have supplied, in the last 10 years, all our customers in North America and Europe with the products they needed. We have created here a big reputation, and we have earned the trust. This full range here has made us a leading supplier, combination of the portfolio and the supply. We have received here also a strong footprint in attractive markets with our contract customers. We support our portfolio also with attractive launches. We are continuing to launch products in Europe, in North America, and in other markets. As the question was already coming up, we're covering an average 80% of the loss of exclusivities, for example, in the U.S. You may ask, "Why are you not covering 100% of the patent expiries?" Well, some products are too small to attract our attention.
Some products are outside of our channel, which we believe we can properly address. Those which we can sell, those which are sizable, those which we believe are important to us, we secure. In case you think already about your question for the Q&A part, is this drying up? I can tell you for the four years which we cover here on the projection, the value is higher than what we had in the four years in the past. From that side, this value is not going back, so you don't have to have the concern that our launch pipeline is drying up and that we're running out of ammunition. We keep this engine well-greased, and we'll keep it well-fueled.
To make sure that we have all these products which we launch, that we can supply them, that we can live up to our promise that we supply generics wherever they need it, whenever they need it, we have also an at-scale operation, which allows us to supply global markets from global plants with specialized technologies. Local plants for local markets were required to exactly deliver what our customers need. These investments are done. Here, the investment in concrete and steel, again, is done. Therefore, when we're talking later on about our U.S. investments, we are well prepared for our growth, but the big investments in capacity have been done and are in the past. Let's have a look into the market. Here, we're talking about around a EUR 50 billion market, EUR 44 billion in IV drugs, about EUR 6 billion in IV fluids.
As you can see, this market is, with the IV fluids, is a little bit more static, 0%-2%. We see here, say that, it's more or less driven by population growth and a little bit of the demographics I have mentioned before, but this is the market we see for IV fluids and here for IV drugs. For the segment, we address IV injectables in the hospital segment. I don't have to go again into the demographics, the same what I mentioned in nutrition applies here as well. Growing population, aging population, growing expectations in modern healthcare, all these are drivers which are driving up demand. You may say 2%-3% is not a lot, but constant on a large base, this is attractive, and as the leaders in this field, we will get our share to that.
You see pricing pressure, competition as arguments down there. That is nothing new to us. We're in generics since 20 years. We're a leader in this field since many years, and we know how to deal with that. That means the effects from pricing pressure, the effects from competition, are baked into our strategy, and we know how to deal with that. I will talk to you, let's say, on the next 2 slides, a little bit on how we do that. What is our pipeline to make sure that we overcome these in a proper way, to keep our margins where they are? Before we get there, I would like to come once more to the topic of supplies and trust.
When you think back on the corona crisis in May 2020, you still remember the pictures when in northern Italy, a lot of people had to go to the hospital and required ventilation, or in New York, yeah? We had these pictures of crowded hospitals. Every hospital required now propofol. They needed drugs to put these people on the ventilator and to bring them over this critical period. During this time, our propofol demand went up through the roof. Looking at our facilities at that time, they were all full, and we had to look, what can we do? We rolled up our sleeves, we rededicated the lines, we rewrote the production plans, and we developed and came up with a new formulation. 100 milliliter with 2%, we got from the FDA emergency use authorization.
We succeeded, not only short-term, to ramp up our supplies by 70% to the market, but even to keep it over the full 2 years period, let's say with 30%-35% above the pre-crisis level. That shows what we can do, that even a big company can be agile and can make sure that customers who trust us get supplied. We live up to the promise of the availability of generics wherever they are needed. That has made us a leader. A strong portfolio, a reliable supply chain, reliable agility.
We delivered when we were required. That has made us a leader on global markets, in IV drugs in Europe, in North America, and for IV fluids, let's say, a strong number one in Europe, where we're as strong as number two and three together, and a leadership position in the global markets. You see us here, it says, "The U.S. is, for IV fluids, an emerging market for us." We have registered our products, we have created a facility. We're already starting, let's say, to roll this out, and when we have a next capital market date, I hope we can show a leading position also on this segment and the way forward. I would like to come to the portfolio part. You see, in North America, we have the largest portfolio in terms of molecules.
Around 160 molecules, which are registered in numerous forms of SKUs for the various customers. That's more than any other company is offering. We keep fueling that. You see, around 17, 15-17 products we're launching globally. We have about 130 launches continuing to be rolled out this year. The products we address are to 70% part of the essential drugs list of the U.S. FDA. That means we're at the core of the hospital-required drugs. We keep it fueling. We're still, let's say, at the stern of the ship, where we, let's say, are leading with the number of the products. We want to go beyond the pure launch at exclusivity, expiry, want to bring to customers added value. We want to address unmet needs.
We want to make the life easier of the pharm tech, of the nurse, of the physician. I want to give you some examples what we do here. The topics, what you might hear also from other companies, are the forms to, let's say, bring a lyophilized product into a liquid formulation to ease the reconstitution. We're going beyond that. We're not only reformulating the product, let's say, from cold storage to room temperature storage, and so on. We try to simplify the life, and I would like to show you now some examples. Of course, you know, if you have a vial like that and you want to get it into the patient, you take a needle on a syringe, you withdraw, let's say, the content.
If it's a powder, you first need to, say, get some fluid into the syringe, into the vial, get it out of the vial, in a bag, and so on. Quite tedious. Needle stick injury risks. Risks that if you're not working under sterile or aseptic conditions, that some bacteria might get in here. How can we simplify that? There are various ways where we can lever the competencies, the container competence, the connectivity competence from Fresenius Kabi in a beautiful way. The first one is you can put it in a prefilled syringe. If the product is sterilizable and survives the temperature exposure, you can put it into something like that, and you can sell it. Nothing really new. If you store a lot of these things, they're quite bulky.
You have on the emergency room, on the ambulance, on the emergency ambulance or somewhere, you have, let's say, to put everything into a tight space, therefore, space matters. This is, for example, our container we have in North America from our design. It's a proprietary design. You see the length difference. You get much more of these in a drawer. You can store more on the limited space you have. These are the things which count for a pharmacist when it's about making a decision. That makes the difference. The second topic is, when you're storing in something like that, fentanyl or an opiate, you could take a syringe with a needle, you go through the paper and the stopper, you withdraw it, and you put it back. You can divert opiates from that. It is not immediately visible.
Yeah, it's stolen, but it still looks like untampered. Try that here. It's a hard plastic shell. It's easy to twist open, but it's absolutely tamper-proof. This makes also under the aspect of diversion control for controlled substances, a huge difference. These are the kind of arguments when we're talking about intelligent container development, understanding what are the unmet needs in the hospital and the pharmacy, how we can come up with solutions which have an added value, which make customers buy from us and not competition. Let me come to another one. That is if you have products which need to go into larger volume, you can have, of course, again, your procedure with the vial and the syringe and needle, you know it. I don't have to repeat it, inject it here, and give it to the patient.
What we have come up with and what we're going to launch in the U.S. very soon, it's already approved, is you use this vial. You connect it here to the adapter, then you might say, "Well, that's nothing new. Vial adapters we have seen from competition as well." You're probably right, but this one is anyhow special, because with the other ones, as soon as you connect the vial, the fluid will run into it, the vial is full. When you then hang it for the infusion, you will lose the vial volume in here. It's very tedious to get it then out again. What we do is we have an open-close mechanism here. You go to open, I can put in the volume. It's resolved.
I get out the volume, and I close the adapter, and you can hang it, and nothing runs into the vial again. This makes it much easier for the nurse to apply it. You don't have to pay attention to detail. It's easy to operate, it's very straightforward, it's time-saving, and it's also waste-saving because you don't have the waste for the syringe and the needle and so on. What I want to tell you is prefilled syringes, premix containers, are not necessarily something new, but the success is in the detail. The success is in the minute things which make the life of the nurse and the physician easier. Here we have great engineers, we have great production skills, and we have sales teams which can sell them, and this is how we want to roll them out.
These are the facilities to serve the markets. We have for the North American market, which is our largest single market for IV fluids, IV generics, we've invested in high-tech, modern facilities. I've just been there for 3 weeks, 3 weeks ago, and they're really looking fantastic. You may say a lot of money invested, but this is high tech. It's state-of-the-art technology. It's highly automated to allow us to produce in a very efficient way in the North American market, close to where our customers are, and serve the market. To make sure that if there are shortages, that we can address them like we did in the past. For all those who may ask, are there still shortages in the U.S. market? Yes, there are. There is still a long, long list from the FDA.
It's actually the longest in the last 10 years. From that side, it is good to have this specialized capacity in North America to participate in that game, to supply that market, and to secure our position as a leader in this field. This is our network overall. We're serving more than 125 markets across the globe. We have global plants which are supplying global markets. We have the U.S.-specified markets, plants to supply the North American, specifically the U.S. market, Wilson for standard solutions, Melrose Park and Grand Island for IV fluids. We have also reduced our network where we felt that the performance is not up to our expectations. We have recently divested a site in Indonesia, which was for injectable generics.
We have closed 1 site for standard solutions in Goa, in India, and we have also closed 1 compounding center in Boston. Nevertheless, the focus or the option to produce locally remains in place. Specifically for standard solutions, where freight cost is an element, we continue to manufacture standard solutions in the markets close to the customers to make sure that freight costs are limited and we can efficiently run this business. To give you an idea, how do we address it from a technical perspective? From a technical perspective, we optimized the output and the production. Sometimes, for example, here in Louviers for bag products like these, without the vial adapter, by bringing the latest technology, very modern production lines to our sites.
Here, for example, what we have done in France, is that we can produce the volume of formerly 3 lines on 2 lines. That means you spread your cost, let's say, on the output of 3 lines, but you have only the cost from 2 lines. This gives us a substantial cost advantage, about 10%-30% per unit, which is a lot for standard solutions. Together with most modern digital monitoring tools, we can track our OEE and our efficiency of the plant very effectively. This is really, for us, the way forward, to use the setup we have and to optimize it to make sure that we can produce also for the way forward, always more effectively. Then it's not only about effective production, it's also about sustainability.
For this CarbiClear container, it's this one. We have modernized the production process. This bottle pack format comes typically from lines which are externally sourced. We thought, how can we improve that further? Increase transparency, collapsibility, that the bottle empties, and so on. We have developed a proprietary new technology for production, which was first rolled out in Kutno several years ago, and now we have installed a second line in Germany, in Friedberg, to use this container. This is cheaper to produce. We get out of 1 line, more than 2 times the volume in terms of units. The 1 in Friedberg, it's a mid-double digit million units number, let's say, out of 1 line.
What is also very nice is, the plastic content of this bottle is only about half of what the old container or the former or the alternative container has. This is under cost perspective attractive, but it's also under sustainability aspects attractive. This gives you a little bit an idea how we drive innovation in IV fluids, in IV generics, and how we want to stay in an environment which is cost sensitive, which is seeing increasing number of competitors. How we stay in this market, in our leadership position, and how we keep our margins where they are, into margins, on the level where they are. Let me summarize. We have a huge portfolio. In the U.S., 160 molecules. We keep adding to that.
Everything which has a value for us, everything which can be sold in the channel we address, we address and we develop in our development centers. Our connection, our relationship with big GPOs, with partners in the various markets, in tenders and contracts, are grown over a long time. We are respected there for our supply performance, we're respected there for our quality, and we're sizable. We have a broad portfolio that, together, gives us also for the future, with our new products, with our new solutions, which I have explained to you, an attractive position to expand our business and to grow along our trajectory.
Our at-scale operations, which we modernize, which we update on a regular basis, gives us the platform to supply these customers in a cost-effective way, addressing the quality requirements from the governing bodies, and to make sure that even when there are shortages in the market, that we can address them. That, in a nutshell, gives us the confidence that we can grow this business with the shown 2%-4% for the way forward, and that we keep our margins stable. Thank you very much.
The next one is Michael Schönhofen for Biopharma.
Good afternoon. Welcome also from my side. Last but not least, I'm very happy to present you our thoughts, our aimings, our targets for what I would call the smallest kid on the block, or should I say, the presently smallest kid on the block, the biopharmaceuticals world of Fresenius Kabi. Some of you might ask yourself: "Why does he talk about biopharmaceuticals instead of just calling it biosimilars?" Because we have a little bit of a wider view on what we want to do, and I would like to share with you today some of these elements a little bit more in detail. Of course, the biggest part on what we will talk about is the biosimilar business as such.
This is, we are developing molecules, we are manufacturing them, and we are going to commercialize them to our customers in the respective areas in the world. Through the mAbxience acquisition, there is a second business model. We do not need to sell all of our molecules to the end customers, and not everywhere. There's a chance to also out-license some of the molecules, depending on the needs, depending on the benefits for us, to external industrial partners. mAbxience has started that business. We know this business also from our own, in small molecule area, and I think it's a nice add-on to the classical biosimilar franchise. Just to play on a bigger scale. The third leg, which you should think about it a little bit more mid to long term, is the classical CDMO business.
I'm going to show you a little bit later the technical capabilities of mAbxience, that allows us also to play a role in the continuously growing outsourcing market or the outsourcing trend in the biological field. Of course, the first examples we will talk about is adalimumab, pegfilgrastim, and tocilizumab for the first part. The two right now commercialized product is mAbxience's rituximab and bevacizumab. The first one on a regional scale, the second one even globally. Then the capabilities I was referring to at mAbxience, think about that they very successfully delivered, during the Corona period, the vector vaccine to AstraZeneca. Ramp-up was done in an extremely short manner, very successfully.
Now I can say from a business perspective, well, what a pity that this business is over. Of course, I think you would all agree with me, Thank God, the COVID period is over, and hopefully, we will have more opportunities to step into this business opportunity, call it on the vector technology, call it on the mRNA technology with our capabilities. Similar to what the colleague said, I also would like to spend a second on when we talk about Fresenius Kabi and caring for life, what does it mean? Also here, the name of the patient, the young lady, Yasmin, unfortunately, is suffering on rheumatoid arthritis, a quite painful disease, chronic disease, and we just do not think about a single treatment. I think our offering actually is addressing it from the day of the diagnosis.
We are offering contrast agents, iodixanol is just one example. Of course, you need these agents also when you go later on and try to understand how the disease is progressing. This is a kind of recurring element. Then, of course, there are different mode of actions, different treatment modes through the patient journey. Of course, I can tell you, we are covering a lot of them. Even then upcoming to the biologics, in this case, it is the TNF-alpha blocker, adalimumab, who is then the next state-of-the-art treatment for Yasmin. Medical doctors know that this might not take forever, and maybe this patient is less reactive on this substance, and then they need another one. Now, think about the mode of action, tocilizumab could be the next version, and maybe others.
Of course, those patients, I said already, need pain treatment, and just acetaminophen is one example, we are also offering. Again, the same message as what you have heard from my colleagues, I think we have a pretty comprehensive view on the patient journey, when it comes to our applications. What are we actually aiming for? What are the targets? You have heard a lot. We invested significantly into biosimilars. It is about development, clinical trials, but now also about sales forces, market access teams, and whatever you think about. It's time to commercialize, which means it's time to pay off our investments. I think I can say that the first steps are done. I can show you a few numbers a little bit later, that there is already a track record of successful market entries.
I'm very confident that also to develop this pipeline we have in mind in the two big segments, so we are talking about the autoimmune segment, as well as on the oncology side, that we are able, with this kind of offering, to even outgrow the market. Third, through the mAbxience acquisition. I think Michael was so kind to talk a lot about vertical integration. You heard it heard differently on other elements as well. This is another example where to run the value chain completely gives you really a synergistic effect, and I will show you a little bit later what are the numbers in relation to the benefits of that.
The fourth one is, again, as I said it already before, a bit to a more long-term view on how we can expand this additional business model when it comes to the contract manufacturing, into in a wider range of the biological field. The targets you have heard. We clearly aim for a tripling or quadrupling of our 2022 sales within the next 3 years. The good message is, the 2021, 2022 is already a doubling. Starting, as I said, or create from a smaller scale. Nevertheless, I think the dynamics is there, and I'm confident that these are the targets we will achieve. At the same time, I think you also heard Pierluigi saying already, there is a clear commitment to achieve the EBITDA breakeven in 2024. Just 1 minute on the journey of our biosimilars.
We started in 2017 through the acquisition of the portfolio, partially quite early stage, of the Merck KGaA, and we founded the headquarter around these development activities in Switzerland. It took us about 2 years. One molecule, Idacio, adalimumab, was already in phase 3, so it took us 2 years to get it launched in Europe. We knew from day 1 that we will be not in the 1st wave. I will show you a little bit later what we have achieved so far. Again, the strategy, being cost leader, knowing the processes in the best way, being flexible, have a reliable supply chain, all these elements, again, running into the mAbxience acquisition, in order to get really a global footprint and to be a global player in the best sense.
EUR 200 million last year, you have seen the numbers already. What is to come? What is to come are the launches. Stimufend prefilled syringe already happened on a small scale earlier this year. Idacio to come in the U.S., July 1. In the outer years, we talk about tocilizumab with a trade name, Tyenne. ustekinumab, rituximab are the next ones. denosumab is another one, and some more in the outer parts of this decade. I strongly believe, and I know that some of you are a little bit skeptic on that this market is attractive, and it will be even more attractive, and we have the clear ambition to outgrow that market. Why is it ambitious to say that? Well, we have competitors, of course. There are other global big players, but I think we are well equipped.
We have a strong entry position in the market, in many markets, in many territories. Again, the message about the portfolio. Within the portfolio, of course, you can also have differentiations here and there, so you need really attractive products to the customer needs. Synergies in countries, it doesn't mean that we have them everywhere, but there are experiences which can be shared with the other business segments, and of course, our capabilities, technical-wise, on the manufacturing side, especially in the drug substance, we reached through the mAbxience acquisition. All in all, the growth rates of the biosimilar market, and those numbers here are really representing the pure biosimilar market right now, are really attractive. Of course, it happens because there are lots of exclusivity stories also within the next years.
I think probably a lot of you think about oncology, and everybody says, "Yeah, okay, if you have the PD-1s and the PD-L1s coming out of patent, that is a huge chunk of business which might be available." True. There is more. Also in the autoimmune, which is maybe not in the focus of all of you, the number with loss of exclusivities until the end of the decade is pretty similar. Therefore, there is really a quite a potential to be attracted to. Then, of course, for the CDMO part, well, the trend to outsource is there, and I think it's even more there when it comes to the biologics and the bigger molecules, and we would like to participate on that. What is now actually our portfolio, expanding our footprint to be a portfolio player within a segment?
Well, I mentioned already adalimumab, tocilizumab, pegfilgrastim, rituximab, ustekinumab, denosumab, and mAbxience, outlicensed bevacizumab, rituximab. There is more in the pipeline. There is much more in the pipeline, and that should be the foundation on making this commitment true, tripling, quadrupling the sales within the next 3 years. I know that the U.S. is in everybody's mind. It's about the launches in the U.S. Where are we? Of course, we all know that this is one of the key success factors for the rollout. Let me start a little bit, time-wise, with the lowest one on the page, which is Stimufend, which is our trade name for pegfilgrastim. We started, again, knowing from day 1, that we will not be in the 1st wave when we come to the market with our prefilled syringe.
We are the eighth launching company in the U.S., so quite a generic environment, I would call it. We made it. It's approved. We launched in February. Just about a week ago, we got the famous Q-code, so now we are entitled really to get reimbursed through the normal channels, through the normal systems. We do not need any kind of additional work in order to get this kind of feedback. PFS alone wouldn't make sense for us, so we need the second part here, and this is the OBI. Some people call it OBD, on-body injector, on-body device. If you think about the numbers, you will see that before generic entry, more than 50% of the sales of the originator was, maybe is still, on the OBI segment.
Here, our clear ambition is to be one of the top 3 launchers. The target launch is scheduled for next year. Idacio, adalimumab, yes, there is a very competitive race ongoing. You can speculate how many will launch after this IP settlement discussion with the originator on July 1. Is it 7? Is it 6? Is it 8? I don't know. It will be quite some. We will be one of them, and we are ready to be there with a variety of application forms, and we believe that there is a substantial potential there. Yes, this is highly competitive, but the cake is big, and to grab a part of the cake is still an interesting endeavor. Again, the message here is we are in a top-tier launch position. Let's grab what we can get.
How quick it will be, it depends also on how the American system will do that, because please be reminded that adalimumab is the first Part D reimbursed drug in the U.S., which is running into biosimilars now. We are really tapping here on a little bit on unknown territories, and I think it's not only for us, it's for all competitors, but my personal feeling is it's also a little bit for the customers, and I think also the reimbursement schemes are still under development. The third one, tocilizumab. The files are with the agency. We will be on the market with an IV formulation, as well as with a subcutaneous formulation. There is no biosimilar on the market yet, and the target is to be clear, the number one when we will launch. I told you about the investments. Development, you have seen.
I can guarantee you, another big part has been done now in people, in infrastructure. SG&A is a very neutral name. I mean, these are sales reps, medical liaison managers, huge market access team. They have worked a lot over the last weeks and months in order to be present when the market will form it. On top of that, of course, in order to guarantee the most modern interaction with your healthcare stakeholders, of course, we have developed a very comprehensive offering when it comes to omni-channel sales and marketing capabilities. That, of course, includes full personal and non-personal promotion. Of course, gives any kind of ads when it comes to channel enablement. Of course, we also have installed the right data analytics in order to be responsive to whatever the needs are of our stakeholders.
Let me spend one minute on the markets outside of U.S., because they will contribute a significant part of our growth as well. We have launched Idacio in close to 40 countries outside of the U.S. We have achieved, I can say it's even now 11% in the last quarter, market share in Europe. It is about a lot that we have an establishing of the relationship with the stakeholders in all aspects. We know how to run the tender intelligence, the commercial intelligence, and we have built with Idacio in all these countries, the infrastructure, in order to approach the therapeutical expertise of our key opinion leaders and the patient needs. Therefore, we are ready to gear up when the next products come out of the immune franchise.
Of course, Idacio was also very valid and very good in order to establish our quite sophisticated patient care support program called KabiCare. Moving over to the vertical integration as another big pillar, and running the full pharma value chain, so from product, sorry, drug product development into drug substance, drug product, commercialization and all of that. Well, you might say there can be an overlap. Well, have a look at this. It's not true. We have, from our portfolio, we started with a kind of a focus on the immunology side. The mAbxience team has a much bigger focus when it comes to the oncology molecules. So far, before the acquisition, no competency on drug substance. mAbxience is a world-class facility when it comes to state-of-the-art biological manufacturing drug substance.
Fill and finish, well, I think it's our bread and butter business, we know how to do that one. mAbxience completely outsourced when it comes to their drug product facilities. I think about the two different commercial setups I have already told you. I think just from this picture, you should be really realizing easily that this is a quite synergetic element. When it comes to the real footprint, globally, we have facilities now for drug substance in Spain and Argentina, the R&D headquarter in Eysins, in Switzerland, I have already mentioned, we are still running quite some classical CMO, contract manufacturing organizations, for our existing products. At the same time, we made already an investment into the fill and finish for biologics, the number for some of you might look small....
The simple reason is, this you can call a synergy, because the facility in Graz is there, utilities are there, infrastructure is there. We have to use our knowledge to plug in a new line, formulation area, whatever, so there is a little bit of effort, but we do not need a greenfield. We do not need a new house. Therefore, I think we can really leverage here on the different areas in our heritage, if you want to say, from the other parts of the business. Having said that, supply chain security, flexibility in our lines, capacities are available. I mentioned already a broader range of capabilities for biological manufacturing when it comes to technologies outside of the monoclonal antibodies. What does it mean if we talk about vertical integration? You do not start with the most difficult one, normally.
Therefore, read the slide from the bottom to the top, and then you know how we did it. After the acquisition of the Merck portfolio, when we are approaching the commercialization, we started, of course, first with the most easy one, which is normally the label and packaging. Done. The next one is the assembly. For those who have seen the auto-injector outside on the little booth, I mean, this is a combination product. This is a drug with a medical device environment around. There is an assembly process behind. Done. The next step is the drug product manufacturing. Presently done with CMOs or with Merck, still, but on the way to be insourced into the facility you just have seen on the slide before.
Last but not least, now, the tech transfer of the drug substance from Merck, and we are in a good agreement here, how we have to run that, into the mAbxience facilities, and adalimumab and tocilizumab are the first two examples on that. More than 30% COGS saving can be realized on that, and on top of that, you have additional benefits like a better grip on the quality control, much better flexibility when it comes to regulatory changes or demand requirements. At the same time is, of course, from a customer perspective, I mean, your planning, of course, is much easier and flexible.
I do hope that I could show you, in a nutshell, why I strongly believe that we are ready to be geared up for really a powerful, significant sales increase, and that, of course, at the same time, after having done all those investments, also for a significant margin improvement. Yes, it's payback time, but we are not milking. We look forward. We want to be on a long-term pathway. We want to be a sustainable global player in this field. The portfolio, I think, gives us the chance to do that and to outgrow the market in many areas. mAbxience is of a strategic synergistic value for us. Cost benefit, process benefits, flexibility, but also knowledge, which allows us mid to long term, to also participate in further trends when it comes to wider biological applications. Thank you very much.
Thank you, Mike. Very inspiring. We enter the last Q&A session for today. Therefore, I'd like to ask complete Kabi team on the stage.
I always ask if it's possible to lower a bit lights. Thank you.
Okey doke. Victoria, would you like to start?
Thanks for taking my question. The first one's just on biosimilars. Could you please quantify your sales in the US and just launching your PEG biosimilar in February? We'd just like to get a better idea of how that's ramping up, and then just where you what number you think you'll be launching your Humira biosimilar. Thank you.
I told you that for the Stimufend launch on the PFS being the eighth in the row, of course, we are not talking about huge numbers, but I can tell you that our expectations are actually overperformed. That means the start is good on a small scale. The reason is pretty simple: we just got the Q-code a few days ago. Also, we will focus on individual channel access only in order to be also ready then to have everything in place when the onboarding device comes. When it comes to adalimumab, I think it would be very courageous to speculate on how this works. I think we have a conservative plan in place. We don't dream. We don't think that we will be the master of the ceremony and run now through this launch.
I think, we will get a share, and, we will prepare the landscape for what comes afterwards.
Thank you. Next comes from Falko Friedrichs, and after that, Sezgi Özener.
Hello, it's Falko Friedrichs from Deutsche Bank. My first question is on the EBIT margin in pharma, which was 20.0% last year. If that margin comes out at 20.0% again in 2026, would you consider that a success, or are you clearly shooting for a little bit more in 2026? Secondly, also on pharma, we noticed that you don't have a production site in China, so wondering what the reason is and why that is the case. My last question is on Biopharma, and again, on the margin. You said it's supposedly break even in 2024. On one of the earlier slides, you showed that the structural EBIT margin for the business is north of 20%.
Can you give us a rough idea for when we are getting closer to this 20% plus margin level? Is that by any means achievable by 2026, or if not, this decade? Thank you.
I'll take the first one. In 2026, it will be a success, this is where we are now committing to stay at 20% in Pharma, IV generics. That is our goal, and this is where we commit to. Second one?
Yeah, on the generic side in China, we have supplied the Chinese market with generics from our global sites. These were sometimes products requiring emulsion technology and so on, and there, scale matters. Therefore, there was no decision for localized production for generics. We keep it for the moment like that. Therefore, the production footprint is for the nutrition products, as you have seen in the presentation earlier today.
I think the last one was on the margin development. I think in a certain way, I think you can do the math on your own. I mean, if you are EBITDA break even in 2024, and I think you said 2026, we should be no longer dilutive. I think you have a kind of a hint.
Sesgi?
Sezgi Özener, HSBC. Thanks for taking my questions. I'll have a few, please. On biosimilars, thanks for giving us the details. Compared to your pre-acquisition plans, how has the total that you're expecting changed? You're expecting the sales to rise by 3 to 4-fold by 2026. What would this be without the mAbxience acquisition? Second one is on pharma. You expect margins to remain flat. Are there any more volume-based procurements that are coming up that we should be mindful of? My last question is, again, on mAbxience and Ivenix acquisition. When do you expect to meet your cost of capital?
In terms of the returns you're making that, where are you compared to the initial plans you had announced at the time of acquisition?
Should we start with the last one, Andrea?
Yep. I think in terms of the two acquisitions, in terms of actually earning the cost of capital, that's very much out in towards the 2026 time frame. In terms of the, let's say, the statements made at the time of the acquisition, I could say operationally, we're on track to achieve those metrics.
Should I take?
Please.
We will not disclose any more details on the split between the different segments. I think you have to live with the number you have seen between mAbxience and captive cardiac business.
On the procurement effect, we have considered all the effects, impacting our business in pharma, so from growth or procurement effects into our trajectory. What we know, what we could foresee, is factored in.
All the variables have been baked in, to our knowledge today.
Okay. Graham, please go ahead.
Thank you. I'm Graham from UBS. Can I ask one on mAbxience in terms of your capacity? How much do you have currently to go for, and how much expensive would it be to add a bit more? I know on the slide, and obviously, given what you said before on vaccine manufacturing, can you guys do gene therapy, such as viral-based drugs? Could you be a CDMO in that space as well?
What we can do is, we can do basically everything as long as it is based on, in general terms, CHO technology, on a show baseline. Whatever application goes into that, so whatever kind of recombinant story is behind, we could do, yes. When it comes to capacities, as we stand here, we are just building additional capacities. I mean, at the moment, we are ramping up. We have a significant expansion at the moment ongoing in Spain. That comes actually alive within the next weeks, so we are very close. Early next year, we have a doubling capacity in Argentina. This gives us a quite long pathway forward in order to address all our needs, and happy to find more customers on the CDMO side for any kind of additional business.
Let me just quick follow-up. On the vaccine contract that you had, has that helped to sort of build credibility when going to new customers, given the scale of that and the trouble that some competitors had servicing that particular customer, actually?
I mean, it's basically a question to potential customers, but I would say yes. Clearly, yes. Clearly, yes. I mean, we as a team, we also have. I mean, at the moment, I said, "Thanks God, the Corona period is over." If it would come back in one way or the other, and if the WHO would need additional vaccines again, in this time, it's about mRNA technology, we would be one of the manufacturers.
Thank you.
Good. Veronika.
I had one left over from earlier, so I was gonna ask it again, but I actually have 2 more, so I'll make it 3. The first one is just on Melrose. Where are you with the resolution of any of the FDA issues? Is there anything pending, remaining that you need to fix? Maybe to challenge you a little bit, again, I'm gonna date myself, but it used to be a good year when you launched 10-15 new molecules in a year. At the moment, you're targeting 15 molecules over 4 years. Is this just the new cadence of launches, or is this related to Melrose in any shape or form? That's my first question.
My second question is, on the EUR 600 million-EUR 800 million for biosimilar sales, any chance we can get a U.S. versus OUS breakdown in how you're thinking about it? Try my luck, then back to my question on the Pharma and IV fluid margins, and what's the risk that those margins actually compress as opposed to stay flat? What are the things you have in your back pocket to try to deal with that? Thank you.
Let me start with Melrose Park. We have been in close contact and close cooperation with the FDA to resolve the observations from the last inspection we have, and we're confident that we're here, let's say, on a good pathway when the prior approval inspection is going to happen later this year, that this will be somehow resolved in a proper way. Here, we're on a good way. The existing facility is fully operative and supplying the market, so there are no limitations to that. That links a little to your second question. There's no Melrose Park, immediate connection or something like that to the launch performance. For example, this year, you mentioned four per year.
The number we have is higher for this year, what we expect in terms of launches. I will not go into the detail of the launch performance per year. I can just tell you that the basket we foresee for the trajectory we have seen here, assuming that we get timely approvals and so on, is larger than what we have seen in the past. Therefore, what we have ahead of us is supporting our growth, which we show here for this portfolio.
Yeah, when it comes to the split, actually, I think I gave you the answer on the international slide, because there we clearly said a significant portion for the further growth will come from, the non-U.S. countries. The other way around is then the North American piece.
Yeah. Okay.
Okay, in terms of the last question on the staying flat versus compression in the margin, we're obviously aware that we've had margin compression, particularly in the U.S., in the past. I think Marc's laid out a plan whereby we can stabilize the margins. As I said before, for us, it's about delivery, and we're committed to that.
That's right. At the end, margin is not everything. It's also volume, you know, to grow. We find the balance between, let's say, where we can roll over price increases, where volume increases addressing so that. Depending on the customer and depending on the setup, we, yeah, choose between the options here in the interest to deliver our numbers.
Okay. Oliver, please go ahead.
Hi, it's Oliver Metzger from Oddo BHF. First question is on the new drug launches. You said you have a quite well-filled pipeline, which is good. Historically, we had years with 10 to 15 drug launches with a rather little weaker years of above 15, which were quite good. How should we think conceptually? Is it still 15, the benchmark, which decides between a good and a bad year? Would you say you are rather north of number or south? Second one is on the preferred syringes. You presented the solution, which is tinier. The deal you made with Becton Dickinson was in 2016, and it lasts for 10 years.
The invention you made, is it on your own IP, or is it that Becton Dickinson, at the end, does the manufacturing process, and it will go away, in extreme case, in 3 years? The last question is on the transfer from Merck to mAbxience, so the CDMO business. Could you describe the regulatory process which is necessary if you transfer the development of biologic drug from manufacturer A to manufacturer B, please?
You go with the first one?
With the launch performance, as we're getting more question on that, let me say very clearly, I am extremely happy with the basket we have in our pipeline for the way to come. We have taken some activities to develop and submit dossiers, let's say, also with the hard-to-make, more complex formulations lined up for approval. Let's not look back. We need to look forward, the number, if 10 or 15, is at the end, meaningless. It's the value. It depends on the Orange Book, it depends what we do. I guess what counts is that we're confident with what we have in this basket, what is lined up for approval in 2024 to 2026, that this is creating the value to support us here. Here, I can just tell you, I am very happy with that.
The other topic is on BD, the IP. We source from BD, certain components of the syringe. The packaging, what we do here, that is proprietary technology. That's what we produce in our own facility, so here we're not depending on external third party.
I wanna build on what he said, Marc on the launches. You, you remember that what we discussed initially is that we are relevant to our customers. You saw that we have in U.S., 160 molecules, and we're gonna be covering about 80% of the LOEs. I think as a, as a reference, we're gonna stay very relevant to our customers, and we're gonna have all launches which are necessary to remain essential in the markets in which we play. There was another question.
Yeah, the tech transfer, not to make a big story out of that, but what you have to do if you have a site change, and in this respect here, we are talking about moving a fat batch into a single-use batch manufacturing facility. It's really a site change, so that means you have to transfer manufacturing methods, laboratory methods, assays. There is quite a comprehensive stuff to be done. Then, of course, you have to file it as a site change, so there's no clinical or whatever involved, unless you would even change the cell line or whatever, but this is out of scope. You take the product, you move it. It's a little bit more complex in biologics than in small molecules.
Think about 3 years in total until from start to getting approved, and, well, the train left the station already.
Thank you, Marc Next question comes from Hugo.
Hi, thank you. Hugo, BNP Paribas. On pharma and IV generics, could you maybe talk to your relationship with large GPOs, the lengths of contract and any inflation adjustments that are embedded in those contract, and maybe update us on the price pressure you're seeing in the U.S. market? On Biopharma, thank you for giving us indications on the U.S. and outside U.S. contribution, but can you maybe, beyond the three molecules that are expected or already commercialized, share some launch date for the others that you have in the portfolios and that are in late stage now? Any overlap between the mAbxience and Kabi portfoli o, except rituximab.
Lastly, on still on the Biopharma, can you maybe explain a bit on the commercialization strategy here in Europe, with some partnerships in the U.S., direct? Do you aim at going direct in the longer term or have a dual strategy? Thank you.
I'll take it. On the length of contract, I don't want to comment here. This is information which is confidential between the parties. These are details I don't want to roll out. Also on the price pressure, I think you have seen our sales projection. You have seen our projection on the margin. We know how to operate in a hyper-competitive market.
Mm-hmm.
We know how to deal with price erosion and price pressure through new launches, bundling, positioning, improvements, and on the other side, to deal with it also with our optimization of our structural costs, which we have seen in the presentation. Therefore, take it like that. We know how to manage that, to deliver the numbers we have shown here this morning.
Yeah. I try to remember all the parts. Well, please apologize, but based on competitive intelligence, I cannot give you any launch dates beyond that. Also from a more general perspective, I mean, you might have seen this week the press releases from two competitors when they talked about Stelara. There are quite also a few unknowns in between, and you have to go on to all these steps. I think it would even be a little bit-
... not serious if we would make statements like that and talk about dates and so on. Again, based on competitive reasons, I think you certainly understand that I will not do that. When it comes to the sales and marketing, well, we take it a little bit, what is best for Kabi. Very simply said, not in all regions in the world, not in all countries, we have the same infrastructure. Not everywhere we might be able to approach the biosimilar customers, the end customers, in the most efficient manner. Maybe there are industrial partners which are much better for us as a partner to do that. Last but not least, probably to spend the money to develop another 10+ molecules on your own, to get launched until the year-end, would be another significant investment phase.
Therefore, you have to find a good balance between the two models. I think with our autoimmune franchise, looking a little bit more focused on that one, that gives you already three areas. It's gastro, it's derm, and it's rheumatology. This is not only one. Please keep that in mind. Therefore, I think this is already quite a reach, if then one or the other area we will give to industrial partners, I think this would be a good compromise.
James, taking the last question for today.
Oh, thank you. Thank you very much for taking the question. Just two on the biosimilars business. Just wondering whether you could remind us, I guess, at the time of the Merck deal, I think spending was gonna be capped. There was milestones payable, royalties on sales, et cetera. I was just wondering, when we think about the margin evolution over the next few years from here, is any of that partly because some of that spending might be capped, which is no longer there? My second question is just the, I guess in the upfront, you mentioned looking at the portfolio, you could do it yourself or out-license. Is that a sort of a hypothetical, or are there sort of candidates which I guess are undisclosed at this stage, where you might be considering to out-license?
If so, what would be the parameters to consider out-license versus going alone, you or yourself? Thank you.
As I said at the beginning of my little talk, the main investments are done, so therefore, the package we had in mind for 2017 onwards is mainly done. You really can think about this as ticked it off. I think we are in a good position to deliver contributive margins now, from now onwards, going forward. Contributive in the sense it getting more than today, with the EBITDA breaking even in 2024, and then ramping up over the next years. The next one, what was... What was the second? Sorry.
Out-license.
We have looked into clear candidates. Yes, there is a process behind, and it's a multifactorial element. It's market access, IP reach, manufacturing capabilities, because not everything can be done in-house. Sometimes it's also linked to a different technology, which we cannot do right away. Think about profusion technologies, as an example, and stuff like that. There are different elements, which at the end of the day, come together, and then come to a decision whether this is on the, let me call it the captive within Kabi biosimilar side, versus the out-licensing possibility. I can tell you, there is a clear tick on each and every molecule where it should go.
Thank you, Michael. Thank you, all. Thank you, big thank you for this inspiring, focused presentation, and details on the different business units. We are coming a bit to an end, and therefore, I would like to hand over to you, Pierluigi, for your closing remarks.
Thank you. All right, almost to the end. Look, I want to close with two slides. The first one is what we already shared with you. We are a relevant company. We compete well. We have solid plans. We are focused, and we're gonna be super disciplined in delivering and performances moving forward and improving our margins. Plans are there. The organization is set up in order to have clear accountabilities on those performances and delivering those performances. We changed it also recently, right? In order to drive clear accountability. The first quarter is a good start. Of course, it didn't come by chance. There is work that we've been doing for months and months in the past, based on the new Vision 2026 strategy and with the new implementation plan.
We are very much convinced that we're gonna be on the upper end of the margin band by 2026 in terms of ambition, that we're gonna be delivering on the 14% of this year in terms of EBIT. We have plans, we have people, we have resources, and you saw from the different business units that each of them is in the right phase, right? The key, the big investments are behind us. Now it's payoff time in biopharma. It's harvesting on pharma, because we did several investments in bringing up our plans also in the States. We have pipeline, we have a strong portfolio. You'll see us quarter after quarter, and I think, I mean, you'll see how we're gonna be driving this value moving forward. This is my last one, therefore, I want to again hit the message.
40% this year, mid-single digit. This is our ambition going forward. This is how we work with our management team and with teams across the board within Fresenius Kabi. 43,000 people that are committed on delivering these numbers. It's a new start. You'll see it. We will demonstrate it to you months after months. Thank you for your attention. I pass the baton to Michael.
That was exciting. At least I thought that was very exciting, informative, inspiring. It's been a long day for all of us, also for you, therefore, I would like to start and end with a big thank you. Thank you for your patience. It actually started last night for some of you, and also those viewing online. We had a high level of participation, at least during the day, thanks for your participation. Thanks for staying energized, asking questions. When I have to conclude, I would say this is just the beginning of what we are embarking on with future Fresenius.
This is part of a larger journey of a transformation of Fresenius with a clear direction, and today you have heard one of the key pillars, the two operating companies we have, and what the business and the leaders of that business have to offer. I think it goes without saying that there are a lot of businesses in there which are very, very well-positioned. Think about what I said at the very beginning, those who are well-positioned in the therapy space and are relevant or are hitting a mission-critical topic in therapeutics and in treatment, are at the core of our portfolio. It has been a lot to digest, probably more than anybody's capable of digesting in a couple of hours, so it will take a few, maybe days to marinate.
As much as I understand that we like to kind of reference to the past, and I'm impressed that we even went to 2002 today, I think it was 2002, right? The world is changing. The world is dynamic. There is a lot of change, and also we are changing, and we wanna be at the forefront of this one. There are different businesses with different business dynamics, and yes, there are pros and cons, and risks, and not risks, but the team said they baked the profile of risk and opportunities, ambition, and execution capability into what they've been outlaying as in towards 2026. I believe there are enough levers on that one, because all of the businesses are growing. They are growing in top line.
You've heard from the team that it is about now harvesting. Sarah and myself, we are very happy about that, you know, because if you look at our capital deployed and our balance sheet, it is over for the time being that we are just buying growth by deploying capital. There's been enough capital deployed in businesses which really matter and are relevant, and hence, they can reap and harvest now, which will be translated into organic growth. If you then are capable of managing the business, being close to your customer, having your costs under control, having the right portfolio in place, then it. You should yield earnings, growth, margin expansion, especially when we talk about Kabi. I thought this was very inspiring and also laying out the path.
It is just the beginning, and we are very well aware that we have to earn the trust. That is very clear from the very beginning. To lay the foundation, we've got to be very transparent on what we wanna do, this is what you saw today, and how we can measure ourselves against the ambition, and you can measure us against the ambition. Also be rest assured that we're moving. We're gonna move. We're gonna move rapidly and implement on what we've been talking about today, because we will focus on what we can do best, and that is the business. Everybody who wants to join in, we're happy to have them in the team or as a shareholder. Thank you very much. Safe travels.