Good morning, ladies and gentlemen, and welcome to Siemens Healthineers conference call. As a reminder, this conference is being recorded. Before we begin, I would like to draw your attention to the safe harbor statement on page two of the Siemens Healthineers presentation. This conference call may include forward-looking statements. These statements are based on the company's current expectations and certain assumptions, and are therefore subject to certain risks and uncertainties. At this time, I would like to turn the call over to your host today, Mr. Marc Koebernick, Head of Investor Relations. Please go ahead, sir.
Thank you, operator. Good morning from Erlangen, dear analysts and investors. Our CEO, Bernd Montag, and our CFO, Jochen Schmitz, will be taking you through the details of our Q2 results for fiscal 2023 this morning. After the presentations, there will be a chance to ask questions. The Q2 2023 results were published this morning at 7:00 A.M. You can find all the relevant documents as well as a recording of this call on the investor relations section of the Siemens Healthineers website. Before we start, let me give you the usual reminder for our two-question rule in the Q&A. Now let me pass the word to our CEO, Bernd Montag. Bernd, the floor is yours.
Thank you, Marc. Good morning, dear analysts and investors. Thanks for dialing in and expressing your continued interest in Siemens Healthineers. Let me start by shedding some light on our financial performance in Q2. We saw overall very strong comparable revenue growth ex antigen of 11%, driven by Varian, imaging and advanced therapies. This growth was the result of excellent equipment revenue growth of almost 20%, paired with continuing strong growth of our service business. On top of this excellent growth, we were able to further strengthen our order book. We achieved an equipment book-to-bill of above one. Overall, including antigen revenues, we saw a 2.5% decline given the significant antigen revenue a year ago. The drop in antigen revenues to almost zero led to a comparable revenue decline of 39% in the diagnostics business.
Diagnostics profitability was in addition impacted by EUR 77 million transformation costs. As expected, Varian overcame its supply chain issues and delivered a truly outstanding comparable revenue growth of 27%. Its Q2 margin was at 14.4%. Imaging and advanced therapies had a strong quarter with comparable revenue growth of 13% and 10% respectively. Imaging showed a strong margin expansion of 130 basis points in Q2, leading to a margin of 21.5% and advanced therapies delivered a strong margin of 16.8%. We had flagged a portfolio review process at advanced therapies at the end of Q4. We have decided to focus the endovascular robotics business, which you may know as Corindus, on neurovascular interventions. You will get more insight on this topic from me as well as from Jochen later in this presentation.
Our adjusted earnings per share in at EUR 0.43 in Q2, down year-on-year for two reasons. A significantly lower antigen contribution. Remember in last year's Q2, the antigen impact was roughly EUR 0.23 and about EUR 0.05 this quarter from transformation costs in diagnostics. For the full fiscal year 2023, we confirm our outlook of 6%-8% comparable revenue growth ex antigen and adjusted basic earnings per share between EUR 2.00 and EUR 2.20. We lowered expectations for diagnostics for the full year. Overall, we expect to end up clearly in the upper half of the 6%-8% revenue growth range on the back of very strong revenue growth at imaging Varian and advanced therapies.
Due to foreign exchange rate expectations that have clearly changed since November 2022, when we issued the outlook for this year, we now expect adjusted earnings per share to end up this year at the lower end of the range of EUR 0.20 as mentioned before. Jochen will dissect all of the moving parts in the outlook in detail later. First, let me recap briefly what makes Siemens Healthineers unique. Three capabilities are the foundation of our success. Patient twinning, precision therapy and digital data and AI. They fuel our present and future growth and make us the holistic partner of choice for our customers everywhere. They are the source of a constant stream of innovations and pioneering breakthroughs.
Our unique capabilities put us in the situation that we benefit from innovations in other fields of healthcare, whether it is in pharma or the medical device space. One could say the world innovates for us. Let me provide you with two examples. With regards to patient twinning, upcoming medications for the treatment of neurodegenerative diseases such as Alzheimer's disease have the potential to further expand the need for MR and PET scans for patient selection and response control. When it comes to precision therapy in the field of interventional cardiology, advancements in minimally invasive procedures such as transcatheter aortic valve implantation or so-called TAVI procedures, need high-resolution CT planning upfront and high-resolution angiography throughout the minimally invasive procedure.
This theme to be at the core of medical progress, both as a driver and as a beneficiary, is key to understand our growth for the priorities we set and the strategic decisions we make. This brings me to the next chart. Where do we stand in executing New Ambition, the current phase of our long-term strategy? We laid out a New Ambition in November 2021 and quantified our midterm financial ambition for which we are on track. Since our capital market day in 2021, the world around us and the macroeconomic environment has changed significantly. A terrible war started in Europe. The pandemic went on for longer than most expected, with lasting impacts and inflation became the new normal in large markets of the world, triggering reactions of the central banks on interest rates.
We have swiftly reacted to these changed circumstances to stay on course. Here's why we feel very confident to reach our goals set out in New Ambition. Firstly, because we successfully built upon our unique capabilities and continue to expand our leading positions in imaging Varian and advanced therapies. The launch of photon-counting CT, NAEOTOM Alpha, and the MAGNETOM Free. family are proof points for the latest innovations in our imaging segment. Advanced therapies further expanded the ARTIS icono family with the recently launched ceiling mounted system for precise tumor embolization. This system can also be used in multidisciplinary settings and hence improves utilization in hospitals. In autumn last year, Varian launched its breakthrough innovation, HyperSight, and will show it for the first time in Europe at ESTRO in Vienna at the end of this week.
HyperSight offers substantially improved image quality at an increased speed and allows for substantially improved cancer treatment planning capability right in the treatment room. It is showcase of imaging and therapy coming together. A theme which will now be driven by Arthur Kaindl, who takes over from Chris Toth as head of Varian, as we announced last week. I am very grateful to Chris for his huge contributions to the success of Varian for many, many years, and for being such a strong promoter of the great combination of Varian and Siemens Healthineers. I'm very happy that Arthur takes over. He led our very successful MRI business for the last years and was instrumental to set up our comprehensive syngo franchise of software and digital offerings. Under his leadership, we will execute on our strategy of comprehensive cancer care, bringing imaging and therapy further together for the benefit of patients.
Comprehensive cancer care, together with neurovascular and cardiovascular care are the areas of focus within our growth vector, fighting the most threatening diseases. The growth vectors are company-wide driven initiatives to foster further growth across the organization. The second growth vector, access to care, focuses on increasing healthcare coverage, especially in low and middle income countries, to bring healthcare to everyone, everywhere. Finally, enabling efficient operations on the customer side by driving digitally enabled services and growing value partnerships. Through our value partnerships, we are accelerating our success and strong order backlog, generating predictable revenues for the future. Next to building upon our strengths, we have acted decisively to adapt our business to changing circumstances. As an answer to the inflationary headwinds, we swiftly implemented pricing measures to balance the cost increases.
Those pricing measures are now rolling into our top and bottom line, especially in the second half of this fiscal year. As announced at our Q4 2022 results, we are driving a decisive transformation process in our diagnostics business, also as a reaction to the changed macroeconomic environment. The transformation will ultimately lead to a significantly streamlined portfolio as well as an organizational simplification and enhanced internal effectiveness and efficiency. While profitability was especially under stress this quarter, we are optimistic for a significantly better second half of the year, also helped by turning to growth again and seeing first cost savings starting to ramp. It is quite some heavy lifting that needs to be done here. The diagnostics business has attractive fundamental potential, and the diagnostics teams currently does not leave a single stone unturned to transform the business to its potential.
In the endovascular robotics business, known to most of you as Corindus, Advanced Therapies decided to exclusively focus on the neurovascular space and to discontinue the CorPath GRX platform which was designed as a cardiovascular solution. Adoption in the field of cardiology has clearly not met our initial expectations. The unmet clinical needs in neuro, i.e., stroke and neurovascular interventions, have been the primary driver of the business case for the acquisition in 2019. This field will be the team's sole focus with the next generation robotic system it is working on. Jochen will later discuss the financial impact of the decision in his part of the presentation. This brings me to my last slide for today. Siemens Healthineers is a unique investment case. Let me tell you why. We operate in structurally growing end markets which benefit from several secular growth trends.
With our leading portfolio and consistent rollout of innovative solutions, we are convinced we will continue our path of outperforming our markets. We advance ways of treating the most threatening diseases in cardio, cancer, and neuro. Our products and solutions enable next-level medicine, and next-level medicine develops such as pharma and device innovations often drive our procedure growth. We lead in innovation for growth, plus the world innovates for us, as discussed before. Sorry. In challenging times like this, where our customers face staff shortages and inflation, our technologies are key to help improve productivity. They may be our AI and tech-enabled services or with our new generations of equipment that are faster and more automated than ever. Furthermore, we generate growth by consistently expanding our markets with new solutions, also via M&A if it adds value.
These drivers guarantee strong, consistent growth, even in times of a challenging macroeconomic environment. We see a fundamental need and consistent demand for our products and solutions. Furthermore, the consistent demand is paired with a high degree of resilience. About 55% of our revenues are recurring. Adding to this, value partnerships are a very fast-growing part of our business and make us even more resilient as they guarantee a reliable recurring flow of revenues for years to come. Our geographical diversification has proven to be an important resilient factor over the years. The strong and resilient growth prospects we have are also paired with market-leading profitability levels. We have sector-leading margins in imaging and at Varian, with further room for expansion. At the same time, we have a clear roadmap to generate significant margin accretion at diagnostics and advanced therapies in the medium term.
All this combined makes Siemens Healthineers a unique investment case. With this, I hand it over to you, Jochen.
Thank you, Bernd. Good morning to everyone. Glad that you are joining us again. Let me take you through the financials of our second quarter. We posted very strong comparable revenue growth of 11.2%, excluding antigen. Due to our very strong backlog substantiating future revenue, we could already point in our last earnings call to accelerating revenue growth this quarter. As expected, we now saw in Q2 equipment revenue growth accelerating to almost 20%, as well as accelerating service revenue growth. From a regional perspective, we saw very strong growth across the board, excluding antigen. China stood out with a steep recovery to 25% growth, but also EMEA and the Americas posted very strong growth at 10% and 7% respectively. Adjusted basic earnings per share declined year-over-year by 36% at face value.
In the prior year quarter, we booked around EUR 680 million in antigen revenues, which lifted earnings per share by around EUR 0.23. It is fading away in 2023 as expected. In Q2, we book only EUR 4 million in antigen revenues. Also this quarter, we saw, as expected, charges of EUR 77 million for the diagnostic transformation, which we do not adjust for in our adjusted EBIT or adjusted EPS. Excluding the antigen contribution in the prior year and the charges for the diagnostic transformation, earnings per share grew by 11% in line with revenue growth. Let me give you some more color on the development of the adjusted EBIT margin in Q2. We still see inflation coming through in Q2, particularly in procurement costs. Albeit now with much less escalations and spot buys than last year.
Long-term procurement contracts for materials and components partly protected us in the past. We do see inflation impacts over time. We do see some easing in logistic costs, particularly from lower freight charges. In the segment diagnostics and Varian, we have a high exposure to freight costs. The increased procurement and easing logistic costs are roughly canceling each other out there. In imaging and advanced therapies, where freight costs have a smaller share of total costs, we still see a net headwind from procurement and logistic costs as we do for the group. The impact on the adjusted EBIT margin in Q2 of the increased procurement logistic cost year-over-year and from the diagnostic transformation costs amounted to over 200 basis points.
If you adjust last year's margins for the more than 400 basis points antigen contribution, the decline year-over-year is only around 100 basis points, which is more than explained by the over 200 basis points headwind from procurement and diagnostics transformation cost. Both headwinds are clearly only temporary. We do see underlying margin expansion mainly from conversion. Below the EBIT line, financial income net came in at negative EUR 47 million, pretty much on the run rate we expect for the full year. Our tax rate of 23% is developing towards what we expect for the full year, but I will come to that when I comment on the outlook. One last comment on cash before we look at the segments. We saw very good free cash flow of EUR 731 million pre-tax, driven by the cash in of receivables.
Obviously, as in every second quarter, we record the cash out for the dividend payment, thus negatively impacting the cash flow from financing activities. Leverage temporarily increased in Q2 and will come down again in course of the second half. As always, you will find the EBIT to cash bridge as well as the net debt bridge in the appendix of this presentation. Now let us have a look at the segment performance in detail, starting with imaging and diagnostics. Imaging had very strong comparable revenue growth of 12.7%, with broad-based growth across the businesses. On the margin side, imaging showed strong margin expansion year-over-year of 130 basis points driven by very healthy conversion. In imaging, we started to see the first tailwinds from pricing measures. As expected, pricing is so far only the smaller contribution to margin expansion.
The larger part this quarter is the healthy conversion from the very strong revenue growth. We continue to expect in the second half of the year, pricing will be a larger contributor to margin expansion. Foreign exchange tailwind of around 100 basis points was more than offset by cost increases, particular for procurement and logistics. Diagnostics saw a sharp revenue decline as the antigen business faded almost to zero in Q2, having peaked at EUR 680 million in Q2 last year. Excluding the antigen contribution, core business revenue was muted primarily due to the fading out of other COVID-related tests like PCR and antibody tests. The margin in diagnostic was down year-over-year due to the significantly lower antigen contribution.
In the core business, Diagnostics faced headwinds from foreign exchange of around 150 basis points year-over-year. In addition, Diagnostics booked transformation costs of EUR 77 million, which consist mainly of effects triggered by portfolio simplification. Hence, the vast majority of transformation costs were booked in the first half as expected. I will talk in more detail later in the presentation about the financial impacts of the transformation program. Now let's look at Varian and Advanced Therapies on the next slide. Varian very successfully converted the strong order book to excellent revenue growth of 27% after resolving the one supplier issue that we have reported in the last two quarters. This was achieved on back of impressive equipment revenue growth this quarter, significantly above the almost 20% we saw for the group.
When looking at margin performance, Varian delivered a solid 14.4%, burdened by negative mix effects as well as foreign exchange headwinds. The mix effect stems mainly from the significantly above normal equipment growth, which is rather margin dilutive. Also, the conversion of the order backlog of these pent-up deliveries meant converting with older, less effective pricing. I would also like to emphasize that the commitment to do everything in our power to get the delayed equipment to our customers as quickly as we could did come at a certain additional cost. Advanced Therapies continued its healthy momentum with very strong comparable revenue growth of 9.9%, driven by a very decent backlog. On the adjusted EBIT line, Advanced Therapies saw strong year-over-year margin expansion of 470 basis points, driven by very healthy conversion.
In addition, the first positive effects of pricing measures started to take effect. A foreign exchange tailwind of around 200 basis points could more than offset cost increases, particularly from procurement and logistics. As Bernd highlighted, Advanced Therapies decided to exclusively focus endovascular robotics business on neurovascular interventions. However, while this decision has triggered quite substantial one-off items, which I will comment on in more detail in a few moment, the investments into the endovascular robotics business continued to weigh on margins in Q2 to a very similar extent as in prior quarters. Now let us have a closer look at the dynamics of pricing and orders.
Starting with pricing and with the graph on the left-hand side of the chart that you have already saw in our disclosures from the last three quarters, we continue to expect our successful focus on pricing to lead to stronger margins, notably in the second half. The pricing measures are steadily gaining share in the backlog. As stated previously, there is a time lag of around 3-18 months on average, varying from product to product between order entry and revenue. As mentioned before, we already see the first measures taking effect in imaging and advanced therapies. In Varian, this is not yet the case to the same extent. Since especially the LINAC business sits probably on the top end of the 3-18 months time lag between order entry and revenue.
We also see the pricing measures phasing into Varian backlog. It will be only a matter of time until we see the measures also taking effect here. Let's have a look at orders on the right side of the chart. As Bernd has mentioned, in Q2, we further strengthened our order book on top of excellent equipment revenue growth of almost 20%. Varian stood out as an equipment book-to-bill of 1.05. Also imaging and advanced therapies posted book-to-bills above one. We saw some lumpiness in book-to-bill ratios in Q1 and Q2 this year, especially on the denominator. Q1 at 1.36 had softer equipment revenue, whereas Q2 at 1.01 had super strong equipment revenue. Looking at the first half year gives you a more balanced picture.
In the first half of the year, the equipment book-to-bill was at 1.17, significantly above equipment revenues. On the graph, we also include the book-to-bills of the last year. As you can see, we continuously grow backlog with book-to-bills clearly above one. This sets us up for equipment revenue growth in the future. On the back of growing equipment places, we also accelerated service revenue growth substantially. We keep our high share of recurring revenues alongside growing equipment revenues. Equipment order growth in Q2 was muted partially to very tough comps in the prior year, which was in the high teens and due to some volatility that we have seen historically, which with order intake in the more odd quarters. As you probably remember, we had excellent equipment order growth in Q1.
We have seen lumpy order intake in quarters before, which is absolutely no concern to us because looking at the full year, equipment order growth is rock solid. Now from the top line to the bottom line on the next chart, I will explain the special items impacts for this quarter in advanced therapies and diagnostics. Let me now give additional color on the financial impacts of the important measures Bernd mentioned earlier. The decision to exclusively focus the portfolio of endovascular robotics business on neurovascular interventions was taken in Q2, and consequently, the related charges were booked in Q2. We do not expect any further material charges related to this topic. The charges were triggered by discontinuing the endovascular robotics business in cardiology, resulting in total charges of EUR 329 million. Those charges related to a portfolio decision were fully adjusted.
Within the EUR 329 million, the largest item was a EUR 244 million impairment of other intangible assets related to the cardiovascular solution. These EUR 244 million are included in the depreciation, amortization, and impairment line for the reconciliation of EBITDA. We will not see the positive impact from the discontinuation of the Corindus this fiscal year yet because we are ramping down activities in course of the second half. From Q1 of fiscal year 2024 onwards, we expect to see significantly less margin dilution in advanced therapies from the investments in the endovascular business. The margin dilution will not reduce to zero because we continue to invest into the neurovascular application, the best assumption as of now would be that the dilution will halve.
At Diagnostics, a comprehensive transformation program is currently being executed with a newly established leaner organization with measures to streamline the portfolio. As stated previously, only the charges related to severance fall under our adjustment definition. The material part of the planned transformation cost for fiscal year 2023 was booked in the first half as planned. This included the EUR 111 million costs in the first half not falling under our adjustment definition, which were predominantly costs related to the streamlining of the diagnostics portfolio. In the second half, we expect the charges to be primarily related to severance. We do expect less impact on adjusted EBIT in the second half. The assumptions from the beginning of the fiscal year of EUR 100 million-EUR 150 million transformation cost and around EUR 50 million related to severance for fiscal year 2023 remain unchanged.
With transformation running as planned, the assumption for 2024 and 2025 are also unchanged. We expect total transformation cost of EUR 350 million-EUR 450 million until 2025 to generate annual savings of around EUR 300 million by that time. Let's look at the fiscal year with the outlook for fiscal year 2023. First, we confirm our outlook for fiscal year 2023. As I outlined before in this presentation, we saw very strong revenue growth ex antigen in Q2, and the second half year is well supported by our growing backlog and our high share of recurring revenues. We would expect to end the fiscal year clearly in the upper half of the range of 6%-8% growth excluding antigen or of the -1% to +1% growth including antigen.
On the earnings side, exchange rates have clearly changed from the assumptions in the outlook we gave in November 2022. I would like to point out that this is not only the US dollar that developed against our initial assumption, it is a broad group of currency that has weakened since then against the euro. Including today's spot and forward rates into our assumptions on foreign exchange results in a negative effect of more than EUR 0.10 on adjusted basic earnings per share for fiscal year 2023, relative to our assumption for the guidance in November 2022. Therefore, we expect to end the fiscal year at the low end of the range of EUR 2-EUR 2.20 for adjusted earnings per share.
Let us now have a look how this outlook comes together from the bottom-up view via the segment performance, starting with comparable revenue growth. For the segments Imaging, Varian, and Advanced Therapies, we expect to end the fiscal year at the upper end of the respective ranges for comparable revenue growth. Based on the strong revenue growth in the first half, very strong backlog and high recurring revenues share. For the segment Diagnostics, we lowered the guidance for the core business, excluding antigen, to -2% to +1% comparable revenue growth, and consequently for all in-growth to -26% to -23%. Please bear in mind that we booked EUR 1.5 billion of antigen revenues in last fiscal year, whereas for fiscal year 2023, we expect only around EUR 100 million revenue from antigen.
I would like to give you the key reasons why we updated the growth guidance on Diagnostics. There is no pent-up demand, or almost no pent-up demand in the Diagnostic business. Therefore, we do not expect to fully catch up the revenues lost from the first half of the year, primarily from the situation in China. Obviously, we also took decisive actions to transform the Diagnostic business. That means that the organization will be doing a lot of heavy lifting executing the transformation. We are convinced that those measures will lead to our midterm ambition for Diagnostics while weighing on the current performance of the business in this fiscal year. Over to margins. Both Imaging and Advanced Therapies have shown good margin momentum in the first half.
In the second half, we obviously expect the pricing measures to be much more supportive, adding momentum to already good effects from conversion. We are rather optimistic for their full year performance within their respective ranges. We also expect Varian to improve its margins sequentially in the second half based on conversion from the very strong top line. As mentioned before, due to the longer lead times in LINAC business, the pricing measures, which are gradually phasing into the Varian backlog, do take longer to convert into revenues and margins. We currently expect Varian to end up rather towards the lower end of its margin range. For the segment diagnostic, we lower the margin guidance for the core business to -3% to +1% adjusted EBIT margin in 2023, and consequently, the all-in margin to -4% to break even.
Please bear in mind that the all-in margin includes the non-adjusted transformation cost of EUR 100 million to EUR 150 million and some contribution from antigen. Again, let me point out three main reasons why we updated the margin guidance on diagnostics. On the positive side, we expect conversion from accelerating growth as well as the first savings from the transformation program to support margins in the second half. On the other hand, the worsening regional mix from lost revenues in China impact the overall margin. As having said beforehand, we are convinced that the measures from the transformation program will lead to our midterm ambition, but weighing on the current performance of the business in this fiscal year. Below the line, we expect financial income net to end up within the guidance range.
The tax rate in the first half was low due to the release of a tax provision in Q1. We expect the tax rate in the second half to be around the high end of the range. For the full year, we would expect that we approach the range of 26%-28% for our tax rate guidance from below towards 26%. Before we close, let me quickly share our current view on the upcoming quarter, our Q3. We expect to turn back to positive growth for Siemens Healthineers, also including antigen for the group on the back of the expected very strong revenue growth in imaging, Varian, and advanced therapies. Our margins at imaging, Varian, and advanced therapies, we expect a year-over-year expansion in Q3, driven by conversion and the pricing measures taking even more effect.
At diagnostics, we expect to turn back to growth in the core and sequential improvement of core margins. We only expect very little impact on adjusted EBIT from the transformation side. With that, I hand over to Marc for Q&A.
Great. Thanks, Jochen. We already have some people queuing up for the Q&A, and let me just briefly remind you of our two-question rule. The first caller in the line will be Veronika Dubajova from Citi. Veronica, please go ahead.
Hi, good morning. Bernd, Jochen, Marc, thank you so much for taking my two questions. Really appreciate it. First, just want to start big picture diagnostics, and if I look at the direction of travel, obviously it's making it seem an even bigger stretch for you to get to your 8%-12% midterm ambition. So just would love to get your updated thoughts on how realistic that midterm margin range for diagnostics still is, and what is it that you need to do to turn this business around? You know, what is going wrong and what are you going to do to improve that? That would be the first one. The second one, just on order growth. Jochen, if you could confirm what the equipment order growth number was in the quarter.
Bernd, would love to get any color from you on the modalities and the regions that were particularly strong this quarter. Those are my two questions. Thank you.
Okay. Thank you, Veronika. I mean, on diagnostics, we are convinced of the margin targets we have given. The transformation program is a very decisive set of measures to get us there. It is about radically simplifying the portfolio with migrating faster to the Atellica platform. We are very happy with the progress on the Atellica CI 1900, which is completing the portfolio.
At the same time, this improved or this radically simplified portfolio based on Atellica allows us now, and this is what is triggering the transformation costs to get rid of certain legacy platforms plus all the related efforts around them in R&D, in later in supply chain, in certain locations, and closing down certain locations where these, the instruments and the reagents have are getting produced. Plus a much more verticalized way of running the diagnostics business, including really pointing sales and service to where it is, where it's making the fastest progress and contributes fastest to accelerating growth, and improving margins. Yeah.
To some extent, yeah, the deeper the cuts and the more decisive the actions in this fiscal year, yeah, the more confident we can be about the trajectory moving forward. We are confident, yeah, that in Q2, in the second half of the year, we will return to growth, and we will see the first savings kicking in. Jochen, you want to add?
No, I think on the, on the
Yeah.
I start with the orders that you might shed some more color on it. On the order side, when you just look at the growth rate, and I put it straight, it was flattish, yeah, on the equipment order for the quarter. Again, yeah, when we look at the book-to-bill, I want to say that this, and it sounds a bit, I would say, like a lecture, yeah, but it's a fraction, yeah. It's a fraction, and we had in the denominator a completely different number than last quarter. We also need to be mindful. On a super strong equipment revenue growth, we were able to increase the backlog, yeah. I think that is a strong message.
When you look a bit deeper also from a regional perspective, that you see that we saw regions with super strong equipment order growth and regions with muted equipment order growth. In the areas where it was muted, it was a function of prior year superb growth, yeah. I talk here about growth rates in those regions which were north of 30% last year, yeah, just to say that. Therefore, we are very satisfied with where we stand, yeah. We are very, very convinced on the revenue growth going forward, as I highlighted in my comments to the outlook, yeah, where we guided for imaging, advanced therapies, and Varian for the upper end of the range.
Yeah. I can only echo that, yeah. I mean, I'm really extremely happy, yeah, about this positive... I mean, building equipment backlog on top of a 20% equipment revenue quarter. I mean, I don't know whether I had something like this in my life, yeah. It's something which is pretty amazing, yeah. Looking into the details you ask, I mean, on the modality side in imaging, there's basically nothing which stands especially out. It has been a mix as normal or more positively. I mean, everybody was contributing to both the strong revenue but and the strong order intake. I mean, especially also nice to see, yeah, that Varian continues, yeah, with a very strong order book, yeah.
Also, I mean, also here, yeah, in addition, yeah, to the, to the extremely strong revenue slice. Bear in mind, I mean, when we speak about 27% growth in Varian, and equipment is only about half of the top line, typically, it means that equipment revenue growth in Varian was, I mean, north of 40%, and still a lot of orders coming in, yeah.
Okay. I think that was really sufficient color, Veronika. I hope.
It was fantastic. Thank you, guys.
Veronika needs to decide this, yeah. I mean, you know, one more thing, I mean, regionally, yeah, I mean, what we saw, yeah, is, I mean, basically across the board, I mean, in a very good comeback of China.
Yeah.
A strong Europe. The U.S. strong in absolute terms, yeah. I mean, that is one of the regions where we had a very stellar Q2, yeah.
Last year.
Still, I mean, when you look at the absolute numbers, pretty amazing, yeah. From that point of view, you know, from a global point of view, very positive, yeah.
Okay. Thanks. Let me just briefly remind you, 'cause I think that dropped out in the beginning moderation. It's star five to register for the queue, in case you didn't remember that from previous days. Star five if you wanna get into the queue. Next caller in the line would then be Hassan from Barclays. Hassan, you should be live now. Go ahead.
Thank you for taking my questions. I have two, please. Firstly on imaging, which modalities drove the strong revenue performance? I think you highlight more moderate growth in the Americas and would love the color here. Why did you not decide to upgrade your guidance across imaging and Varian despite, you know, I guess, given growth is now towards the upper end of the growth guidance for the first half. Related to that, how are you thinking about H2 equipment orders, given you have another strong mid-teens comp in Q3 and 10% in Q4, I believe. Secondly, if I look at the Varian margin for H1, it implies quite a steep acceleration into the second half to hit the lower end of your segment margin guidance.
How are you thinking about this, and what are the building blocks to your mind? Thank you.
Okay, thank you, Hassan. I mean, talking modalities, revenue growth in imaging, it is basically across the board. Very strong, in and this double digit growth was basically carried by all modalities. I mean, what is good about it is that especially also, I mean, this includes, the high margin businesses, which are, as you know, I mean, CT, MR, and then followed by molecular imaging. There was. Read the.
So-
Orders, I mean, here, we are, as Jochen also talked about, very positive about the book-to-bill ratios being in a similar level as in the first half of the year. Bear in mind, I mean, here it's as Jochen lectured, this is a fraction or a ratio of orders to revenue. We had, I mean, we had a weak revenue quarter or not so great. We are never weak, but we were not so great in Q1 in terms of revenue. We were, I think, pretty outstanding in terms of equipment revenue in Q2. I mean, that is what is distorting a little bit or changing the picture in the ratio of book-to-bill.
We are as Jochen also talked about, very positive that the picture on the book-to-bill in H2 will be on a similar level and as in H1. Growth rates, we are very positive to continue the momentum. When it comes to the guidance, we, I mean, we clearly said we are looking at the upper end in growth rates. That is basically why we decided to send this very clear signal. Not to change it. There's nothing to read into it, because we still believe, you know, it's in the upper end, but not a completely different picture.
It shows also that we are very positive about the development.
Yeah, Hassan, on the Varian margin, when first of all, Bernd highlighted that, and he talked about the, I would say, extraordinary equipment share in the revenue line for Varian. He pointed towards the more than 40% growth on equipment. Therefore we had to live with this stellar revenue with a little, I would say, dilution in margin from a mix standpoint, equipment versus service. Going forward, I think that was your question, how do we get from the 14.5% to the 16% for the full fiscal? First of all, we expect, again, very strong revenue quarters for Varian also in the coming quarters, but not to the extent we have seen in Q2.
Therefore we expect significant help from just the, as I said before, an equipment service mix. Secondly, as highlighted, we expect to see I would say the better priced backlog now taking a larger share into a constantly larger share into the revenue line of the equipment side of Varian. These are the two main drivers of margin improvement in the second half.
Very helpful. The Americas question on more moderate growth?
On revenue, on orders?
Revenue-
On revenue.
7%.
Oh, how am I?
Seven.
I mean, I think revenue was pretty decent, yeah. Yeah. It's a very good quarter, yeah, and mind you should also know that in the 7% we have diagnostics in there, yeah. This is, therefore on the, on the equipment businesses, we were in the, in the double digits, yeah. You know, that was not, from my understanding, a very solid quarter, yeah, in Americas revenue-wise, yeah. Yeah.
Very helpful. Thank you.
You're welcome.
Thanks. That brings me over to the next caller. That will be David Adlington from JPMorgan. David, you should be live now.
Hey. Morning, guys. Thanks for the questions. Maybe just a bit more focus on orders and particularly your funnel of orders into the second half. I think you've mentioned that you're looking at book-to-bill similar to the first half, which I think from memory is 1.17. Just wondered how you're feeling in terms of customer appetite for order growth. Are you seeing any signs of any particular concerns in the CapEx environment? Also any pushback on the price increases you're putting through? Thank you.
David, basically it's an unchanged picture on both topics, yeah. When it comes to the health or healthiness of the market, but also the pricing situation. Looking at markets globally, we see a very stable demand, very good, very healthy Europe. It's very helpful, yeah, that China is now also a contributor. And we see the U.S. on track, yeah, with a very solid continued demand for imaging. I mean, you see the trend towards building ambulatory centers. You see imaging but also radiation therapy just be a key topic, yeah, which kind of defines also what a hospital offers, yeah, including being this is.
I mean, on the imaging side, the diagnostic entry door of a hospital and there's continued interest, yeah. That is very healthy. On the pricing side, we see a good development, yeah. I think we have, as we called it several times here, developed a good pricing muscle. When looking at the competitive situation, we see also that we have some pricing power simply because of the super strong portfolio we have. I mean, this lighthouse product on the one hand, but on the other hand, with a completeness of the portfolio when it comes to addressing all segments of the market, which we never had before, yeah.
Plus, of course, having competitors who are struggling on the margin side, which also kind of helps, that, you know, undercutting us on pricing is not really a super great idea to make up for that.
Very clear. Maybe just a follow-up on photon counting CT. It wasn't really mentioned that much in presentation. Just wondered any sort of further color in terms of demand profile there?
Very positive. Yeah. I mean, this is absolutely undisputed, yeah, that this is the way to go. Yeah. It is the discussion with customers is a when discussion, not an if discussion. Yeah. When is the right time, yeah, for a respective customer to also get one? Yeah. I mean, it's clear it starts more in the high end, but we see it now getting into the special imaging centers. It is the topic which it's a must-have, or you cannot afford not to have it in academic medicine. I can confirm what we said multiple times here. It is undisputed, yeah, that this is the future standard, but also, yeah, that there's only one solution available, with more to come. By the way, from Siemens Healthineers.
Yeah.
Okay. Thanks, David.
Thank you very much.
We have the next caller. That would be Graham from UBS. Graham, please go ahead.
Morning. Thanks, guys. Just a couple of questions. One on China. Obviously your order growth's been very strong this year in part driven by sort of government stimulus. I just wonder would you have a sense as to how durable that is through the rest of this year, I suppose, and also how that will eventually convert into revenue. That's still a sort of 12-month data look that we should be thinking about and therefore the benefit coming next year. Just a quick one on Varian. Obviously a very strong top-line performance. Is there anything that you're now seeing commercially that's driving better sales than these, I suppose? Because I know that's something you've outlined at the transaction, but it'd be good to get a better sense and an update on that, please.
Thank you.
I mean, on China, we see this stimulus program has definitely been very helpful in restarting the growth engine. Will help us on the revenue line, yeah, for the quarters to come. The good thing is, and that's why I phrased it like restarting the growth engine, yeah, that China is back to normal, and back to normal means this is a market with high single-digit growth, with the clear possibility for us to grow in double-digits on a sustainable basis. That is a big additional driver for us. Yeah. On the Varian side, I mean, it just shows two things.
On one hand, that this is a very, very healthy market radiation oncology, but also the other areas Varian is focused on in comprehensive cancer care. Basically across all geographies. In addition, it shows that we have a very strong competitive positioning, yeah, with, a much, I mean, with a extremely complete product line, yeah, from Halcyon to TrueBeam to Ethos, with now HyperSight as the first proof point of the combination of imaging and therapy, or Siemens Healthineers classic with Varian.
Great. Thank you very much. Thanks, Graham, for your question. We head on to, Odysseus from, Berenberg. Odysseus should be live.
Hi. Morning. Thanks for taking my questions. A couple on diagnostics, please. First, as a follow-up to Veronica's question, how far are you into replacing your legacy installed base with the Atellica CI 1900? Are there any KPIs you could share here? Would it be too optimistic to assume that you would have replaced the majority of your legacy low mid throughput installed base with these instruments by the end of the fiscal year? Secondly, how far are you into reaching your historical run rates for China diagnostic routine testing in the past few weeks? How does that compare to Q2? Thank you.
To the first question, I maybe need to shed some light. I mean, the idea is not to replace the installed base at one in one go, yeah? I mean, what you do in diagnostics is a re-selling a basically a reagent contract, which typically is five to seven years. As part of this, if you don't prolong an existing instrument, you deliver an instrument, which to some extent, and we had that discussion also when it came to the Atellica rollout, is in the beginning more of a cost than a benefit for our bottom line. From that point of view, it's not a target to as quickly as possible change the installed base, yeah?
It is important to win reagent contracts, and this is and to migrate step-by-step the existing installed base to the new platform, yeah. And that is where we are where we are very well positioned, and where the Atellica CI 1900 gets extremely good press from customers, especially in this segment, yeah. Rushing this, yeah, is not the business case. Jochen, you wanna...
Yeah. Maybe to add to this, what Bernd has said, which I fully concur with obviously, is that the majority of the efficiency you can drive with just making this decision, yeah, because you can then immediately refocusing your R&D towards Atellica only. You can immediately start optimizing your supply chain management footprint, you can also start realigning and focusing your service network, yeah, to this, yeah, because you don't need to train new people on legacy platforms and things like this, yeah, but only, for example, only on Atellica. Obviously your go-to market is then very straightforward, yeah, because it goes directly. Therefore, you don't need to have replaced the installed base by the new product, but the majority of the efficiency comes with just making those decisions, yeah.
Just to say this, to add to Bernd's comments. Ex China.
The ex China, I mean, there's the normalization of growth rates will probably take two more quarters, yeah, because I mean, there are moving parts. I mean, on the one hand, what is happening in the market, and also, you know, working through the transformation program. I think, yeah, Q4, Q1 would be the answer.
Over to you. Thank you.
Okay. Thanks, Odysseus. We head on to Falko from Deutsche Bank. Falko, please go ahead.
Thank you. Good morning. I have two questions left then. In your imaging segment out of the 13% organic growth, can you provide the volume price split over there? And also provide the split for us for the whole group in the quarter. Then a follow-up on Corindus, please. Thanks for the color on the margin dilution from next fiscal year onwards. When do you think it can reach the sort of margin break-even now? Thank you.
Falko, I think we on volume price, yeah. I think mix, I think that is when you talk about mix in imaging, I think it comes in a lot of flavors, yeah. You need to be super mindful. I'm not sure for what you want this, yeah, when you build your model, yeah. Because mix comes regional mix, business line mix, within business lines, yeah, product mix. Yeah. What I can tell you is we had very good volume, and we had the initial effects from pricing in it, yeah. Therefore, yeah. It is still dominated by volume, yeah, and pricing has its thing, it's increasing over time, yeah.
This is, I would say, most prominent in imaging, followed by advanced therapies and with a significant distance with Varian because Varian has the longest lead times, yeah. Yeah. Just to say that. The growth in Varian was clearly dominated by volume only, so to say. Just to say this, yeah. What was your second part again?
The Corindus
Corindus dilution.
When can it break even, on margin?
I think what we have now done is the following. We have made a business decision where to stop selling into the cardiology field and to stop developing in the cardiology field. What we did already so far, to focus only on developing a new robot for the neurovascular field. That means we turned the business into an R&D project. The R&D project is like every R&D project. It is a J curve. Whenever you start a new platform, you start with investing, and that's what we currently do. Therefore, it will take until we go to market with that new product, then we will when we start doing this, we will be relatively immediately being break even.
It is, as I said, it's a project now, like every other R&D project in a very, very attractive field. Therefore, this is, I would say, we talk about several years before we will go to market and then turn into break even.
Okay. Thank you.
Thanks, Falko. We have time for three more callers. If you limit yourselves to one question, please, yeah. Otherwise, we'll run out of time here. Lisa would be next with your question. Please, Lisa, you should be live.
Great. Thanks. Just a question about China. Clearly, it's a increasingly important part of your business. Very healthy growth recently. There's been a lot of focus on VBP, and the government's been rolling it out to different subsectors of MedTech. Can you just remind us how equipment is purchased in China today for you? Could you comment on revenues and EBIT from those actual purchases versus services that you provide? Also any thoughts on the local competition from the likes of United Imaging and Mindray? Thanks.
Thank you. I mean, let's say there's a public and a private market in China. I mean, private market does private decisions. I mean, there are not many chains. This is, I mean, give you a rough feeling, it's maybe 30% or so of the business. 70% is public hospitals who do independent decisions and typically do a RFP, a tender process in which we compete. Both markets are very healthy. I also believe when it comes to, since you mentioned GDP, I mean, when it comes to building healthcare will certainly be, I mean, on the one hand, there's big demand here, but there's also high interest.
When it comes to, and this is why there's also, you know, there has been the stimulus program, then it's very much about also, how to further invest into a modern infrastructure in the country. Yeah. Which is why we are very positive about.
Sustainability of the demand curve in China. Looking at competition, I mean, Mindray is not really a company we run into so much in... with our businesses. In parts of the public business, especially in the lower end segments or in the smaller hospitals, yeah, local competition plays a role, yeah, especially United Imaging. While on the other hand, we see, let's say the number two and number three in global competition here have, you know, a little bit weakening in China. Yeah.
Okay.
Okay.
Thanks a lot.
Thanks, Lisa. We quickly head over to Robert Davies from Morgan Stanley. Robert, please ask your question.
Thank you. My question was just around equipment purchasing, and just wondered whether you saw any regional weak spots in terms of customer financing and just around sort of deterioration of credit conditions. Just be curious if there's any particular pockets of weakness, 'cause it seemed like you were flagging obviously, strength across the board. I just wondered if that was an issue for any of your customers.
I mean, the short answer, no.
Mm-hmm.
Not in the mix we saw. I mean, you know, there's. I mean, it's. I always say healthcare is local, yeah. MedTech is global. When looking at key geographies, it doesn't come up as a theme. Yeah. Jochen, you want to add?
No. When you look at it, when we look at it regional wise, I think we have a very, very healthy situation in general. In particular, if you look over a two-year timeframe, yeah, there's nothing which makes us nervous in this regard with regard to, I would say, more macro terms around us, yeah. We have also, as we said, for example, Varian is working in all markets, yeah. Super strong equipment revenue growth again, yeah. I think that there is nothing really what is really hindering us, yeah, getting or keeping our very well, I would say, backed up growth trajectory for the overall business. Yeah.
Okay. That's great. Thank you.
All right.
Thanks, Robert. The last question of the day comes from Cesky. Cesky, please ask your question.
Hi. Thanks for taking the last question from me. Just on your book-to-bill ratio, what would you deem a normalized book-to-bill ratio be? Would you expect it to revert to one levels when all the tough comps and COVID wave and everything is over? Or how should we consider the normalized book-to-bill ratio?
Cesky, now I need to lecture to myself mostly. I would say in general, I think when you look at the first half, 1.17 is a good number, yeah. Is it always 1.17? Yeah. We expect to see a similar development in the second half. I would say north of 1.1 is something I would say I would consider as, I would say, a normal trajectory, yeah. More a normal one, yeah. It's always a bit tricky with book-to-bill. We need to be careful with this, yeah, because it has a nominator, a denominator, yeah, and they are not, they are not... The two lines are not connected necessarily in a quarter, yeah. Just to say this.
I mean, another way to look at it, but we need to give more color on this. I mean, when you say assume a one-year time between orders and revenue, I mean, just for the sake of math, and if you want to grow by 8% and you take out any pricing and currency effect, yeah. The number would be 1.08. Yeah. There are moving parts in this. Yeah. We will noodle on this. Yeah. That we give a better answer.
Maybe just to say that Bernd applied logic, yeah, which is good, yeah. I would say I think I had that in mind. Yeah.
Yeah.
On top, we have this faster growing ES business.
Yeah.
which is a structural topic which brings it above the 1.08, just to say this. Yeah, that's why.
Then the-
justify my number more than 1 point.
You are right here because then my one year hypothesis doesn't make sense, yeah. Okay.
Thanks very much. That's very insightful.
Thanks for that question, Cesky. That was the last question of the day. Now it's for me to thank you for the good discussion. I'm looking forward to continuing this dialogue with you on our roadshow and at several conferences which we're taking part in the next two months. Last but not least, I'm looking forward to our Meet the Management on the seventh of December in Forchheim. We are inviting you to join us for an exciting day of touch and feel of our innovations as well as our production and of course, interesting presentations from our four segment heads. If you have not received an invitation and wanna join, please do reach out to the IR team. With that, I would like to say goodbye, stay healthy and invested in us.
That will conclude today's conference call. Thank you for your participation, ladies and gentlemen. A recording of this conference call will be available on the investor relations section of the Siemens Healthineers website.