Good morning, good afternoon, good evening. Wherever you may be in the world, it's an absolute pleasure to be able to host you here. We are in person here in London, but we have many folks who have connected to us. I also want to make sure that I thanked you. This is a significant investment on your part in terms of time and energy, and so thank you for joining us here today. Hopefully you'll have a chance to learn a lot more about how we at ConvaTec are gonna be delivering sustainable and profitable growth. Please note the disclaimer. Let's take a look at today's agenda. What is it that we're gonna try to cover in the next several hours? The way we frame the agenda, in essence, is to really try to do three things.
I'll kick off and try to provide you a little bit with an overview of what is our path forward, what is our strategy moving forward to deliver sustainable and profitable growth. Thereafter, we're gonna go through five different deep dives. Four of those deep dives will actually focus on the key categories in which we compete in, Advanced Wound Care, Ostomy Care, Continence Care, Infusion Care. The last deep dive will focus on the whole simplification and productivity agenda, and we'll try to give you a lot more color around that. At the end, we'll conclude, and we'll talk a little bit about our financial prospects, and Jonny will try to go ahead and highlight those to you. Make sense to everybody? Okay. I'm getting quite a few nods.
At this point, look, I am super excited and really delighted that I can introduce you to the entire ConvaTec executive leadership team. One of our goals today was really to afford you the opportunity to interact with all the leaders that are really running the entire enterprise. At this point, I'm gonna ask for the ConvaTec executive leadership team to stand up so you can know everybody in the room. Thank you. Okay, we'll have a chance to interact more so throughout the entire day, but what I wanted to do now was to really highlight to you if there was one single overarching message we wanna leave you with today, it's that fundamentally we have laid the foundations for delivering sustainable and profitable growth. Now you might ask, what are the key drivers? What are the key elements of that foundation?
There really are three key elements to that foundation that then translate into very attractive financial prospects. The first element is all about the fact that we are leaders in the chronic care categories in which we compete in, and we have differentiated and complementary product portfolio. The second key element is that during the course of the last several years, we actually strengthened our competitive position, and we already are pivoting. The third element is that we've mapped out a path forward, which we've described as FISBE 2.0, and I'll be giving you a lot more color around what is FISBE 2.0. In essence, through this new path forward, this is our corporate strategy, what you'll be able to see is that we will deliver year in and year out organic sales growth of 4%-6%.
In addition, during the course of the next several years, you'll see us move our operating margin into the mid-twenties. This will be during the course of a medium-term outlook. When you go ahead and look at all these three elements that underpin the foundation, what that translates into is some very attractive financial prospects. Fundamentally, what you ought to be expecting from ConvaTec moving forward is that we will grow our free cash flow and our earnings double-digit on a compound and annual growth basis throughout the medium term. Okay? Now let's try to understand these three elements, okay, and give you a little bit more color. What are the categories that we compete in? Advanced Wound Care, Ostomy Care, Continence Care, Infusion Care. They are large, multi-billion-dollar categories. If you sum them all up together, they're roughly $14 billion.
The growth rates are attractive. Growth rates of anywhere between 4%-8%. In each and every one of these categories, we have a leadership position. Now you might say, what's driving this leadership position? Well, it has a lot to do with our portfolio. When you start thinking about our portfolio being differentiated and complementary, I think it's important to try to understand how is it so complementary? The first thing that should come to your mind is that fundamentally what we produce are high volume, high quality consumables for chronic care conditions and diseases. Now, when you look at the value chain, from R&D to quality and operations, all the way to commercial, please realize that the complementarity and synergies fundamentally are most pronounced at the back end of the value chain, in R&D and quality and operations. To some degree, in the commercial arena.
When you start thinking about R&D, let's think about, well, what technologies do we use and what capabilities do we use? When you think about technology, think about the adhesive and coatings technology. Does that only apply to Advanced Wound Care? No, not really. Adhesive and coating technology is fundamental to our Ostomy Care business. It's fundamental to our Infusion Care business. It's the same know-how. Very similarly, when you think about anti-infective technology, antimicrobial technology, which clearly we apply in Advanced Wound Care, is it only relevant there? No. It's relevant in each and every one of our four categories. Think about Continence Care and urinary tract infections. Think about Ostomy Care. Think about Infusion Care. The point I'm trying to make is that the technologies and know-how that we have are leveraged across the entire portfolio.
Similarly, there's a set of capabilities that we utilize. Process development, clinical development, regulatory that we use across the entire portfolio. When you look at it in terms of quality and operations, the technologies we use are common. Injection molding technology, extrusion technology. The capabilities are also very much the same. We're committed to one quality management system for the entire enterprise, and that's the way we run it. Even when you go further downstream to the commercial arena, realize that certain technologies are common. For example, our customer relationship management system, Microsoft Dynamics 365, we use across the entire enterprise. When you look at capabilities, when we interface, for example, with the payer, it's again a shared capability.
If you look at, for example, how do we interface with consumers via our home service group, there, for example, we're interfaced both with Ostomy Care consumers, but also with Continence Care consumers. Hopefully, you're getting the sense that the complementarity and synergies run across the value chain. You might say, "Well, Prem, why is this so significant? Why is this so relevant?" It's relevant 'cause it hopefully gives you insight as to how we organize ourselves. When you think about R&D, one global function headed up by Divakar Ramakrishnan, reporting straight into the CEO. We've doubled that investment. R&D and innovation are critical to us. Very similarly, quality and operations, one head, John Haller. We run that on a worldwide global basis.
In the commercial area, because we've got distinct customer groupings in terms of consumers and also in terms of healthcare providers, that's where we've created the global business units, and you'll have a chance to interface and interact with folks like Seth and Bruno and David and Kjersti today. Very well. Hopefully, you've gotten a sense now that we lead. We've got a complementary and differentiated product portfolio, which allows us to lead. In terms of progress we've made, what's happened the last several years? The first thing you'll note is that we have divested certain businesses. We divested the skincare business. We went ahead and moved away from the hospital care business. Was that a coincidence? No, very deliberate. We wanna focus on chronic care. 93% of our revenues, so over 90% are in the chronic care arena.
In fact, we've bolstered our position in areas like Advanced Wound Care and Continence Care through bolt-on acquisitions. The second thing that we've done is we've invested heavily in the R&D area to go ahead and increase the number of new products that we're in the midst of launching, and that's exactly what's happened. Heavy emphasis on intellectual property, so we've been filing and been very busy bunnies on that front. In terms of execution, whether it's in quality and operations and ensuring that the complaints per million are coming down by about 41% or increasing our productivity, making sure that our commercial efforts are focused on the A and B accounts, and we've increased that by 38%.
When you see that, then you might say, "Well, what are the financial benefits of doing what we've just described?" Well, let's see where we were back in 2018. Back in 2018, revenues were flat. Profits were down. Let's fast-forward several years. Revenues now are positive. They're accelerating, right? We're achieving already mid-single-digit organic revenue growth. Profits are starting to grow. The EBIT margin did come down deliberately 'cause we were investing more in the commercial arena, in the R&D arena. You'll notice that starting this year, we're starting to get the initial signs of the operating profit margin starting to grow and increase. Okay, enough about the past. Let's focus on what's happening moving forward. FISBE 2.0, what's this all about? Fundamentally, what we're gonna basically be doing is we're gonna be playing again the same five notes, right?
The same five pillars. We'll accentuate particularly the element of focus, of innovation, and simplification, and I'll give you more color. In terms of focus, we will continue to focus on 4 categories and 12 geographies, with the USA and China being uber important. Within those 12 geographies and 4 categories, we will become obsessive about customer loyalty, and I'll be giving you more color around that. On the innovation front, we wanna drive it even more aggressively. We wanna go faster and deeper so that we can make sure that our New Product Vitality Index increases, the more and the larger proportion of our sales are coming from new products. The simplification agenda, we need to drive productivity a lot more aggressively, and we'll spend a lot of time on that today.
Fourthly, we're gonna build and embed capabilities, but also work hard to create a winning and performance-oriented culture. Then lastly, when it comes to execution, we're gonna keep on focusing on ensuring that what we say, we do. We wanna make sure that we have a high do-say ratio. We're gonna do that while integrating ESG as a core element of our corporate strategy. Let's double-click at this point and understand what are the elements of FISBE 2.0. The first thing is, how are we gonna drive customer loyalty? First thing we're gonna do is consistently and systematically map out customer journeys. Should be thinking healthcare providers, doctors and nurses, consumers. We need to develop insight. What's the pain point? What's not working well? Then we need to correct it, so maybe there's a quality issue.
We're gonna measure systematically and consistently Net Promoter Score. It's a measure of customer loyalty. We're already starting to do this in some areas, but we're gonna do it systematically and consistently. The reason we're gonna do this is to ensure that we're driving the top line. What about on innovation? What are we gonna do there? Well, the first thing is we're gonna broaden and deepen our portfolio of new products. We're in the midst of launching 8 new products right now, but we already have line of sight of what are the next 8 products that we're gonna launch in 2023, in 2024, in 2025. I'm gonna share with you 2 examples. The first one is we're looking to basically introduce our infusion set technology in the area of Parkinson's. Kjersti will have a lot more color to share with you.
The second area is in Advanced Wound Care. When we think about our Hydrofiber technology, we're already working on the next generation Hydrofiber technology platform. The second thing we're gonna be doing is reducing cycle time, going faster and quicker. How are we gonna do that? We're gonna leverage the IDEAL process. There's a methodology that we've introduced at ConvaTec to develop new products, to scale them up, and then to launch them. We're gonna go ahead and leverage stronger clinical capabilities, proactively manage the regulatory agenda, and therefore we anticipate reducing the cycle time by 20%. Then you say, "Well, bottom line, what does this mean to me?" The bottom line, what it means to you is that we are committed to having at least 30% of our sales by 2025 derived or coming from new products. That's what it means for you.
What about simplification and productivity? What are we thinking there? The first thing you'll observe is that we're thinking that we're gonna drive simplification and productivity across the enterprise. We'll start in commercial. What can we do there? We can fully leverage, for example, our Salesforce Center of Excellence. We put in place a CRM system in North America and Europe. We're gonna deploy it across all of global emerging markets next year and fully leverage its capability. Brands, when we launch them, we don't wanna do it in a disparate way, each country doing its own thing. No, one global positioning. We don't need 16 different agencies. We can narrow those down. It's a global approach driven by the global business units. In the area of quality and operations, what can we do there? Significant opportunities to invest in robotics and automation.
Significant opportunity to drive our continuous improvement agenda. In G&A, yes, we've built a global business service infrastructure, but there's an opportunity to utilize it more broadly and frankly, to focus on end-to-end processes. Jonny will talk to you more about this. The bottom line, the simplification and productivity agenda is absolutely critical to ensure that we go ahead and drive and increase our operating margins. What about in the area of capabilities? Well, you need to be thinking about capabilities and culture. On the capability side, we've developed some fantastic new capabilities. As an example, in the area of pricing, we have a pricing center of excellence. We need to embed that so we're fully leveraging it consistently across the entire enterprise, all geographies, all categories. At the same time, there are some new capabilities we need to develop.
For example, how do we start focusing now not only on pricing, but also on reimbursement and access as we look at our portfolio becoming more technologically developed and more differentiated? On the culture side, this is a key element. One thing that we've done is to focus on how do you build high-performance teams. Think about who's getting all this work done. It's not an individual, it's a team. It starts with a ConvaTec executive leadership team, but it's a team. We've partnered with the University of Michigan Ross School of Business, and during the course of the last 18 months, we've been working with them and our top 100 leaders trying to figure out how do we drive the high-performance team agenda. It's an integral agenda of what we're doing.
The second thing we're trying to do is to make sure that all colleagues, frankly, have career growth opportunities, that we mentor them, that we coach them, that we reward them, and we recognize them, and we have a whole agenda around that. Then lastly, diversity, equity, and inclusion for us is core to what we do. We're trying to create a highly meritocratic environment and a highly performance-oriented culture. Lastly, on Execute, what are we looking to do there? Well, we already have a methodology today in terms of when we have big strategic initiatives, how do we approach it? We build the business case, we define who's gonna do what by when, we identify metrics and milestones, and then we track on a weekly basis, and we have full exposure across the ConvaTec executive leadership team, right? We're gonna continue to do that, right?
The second thing you'll notice is that as we think about ESG, we're incorporating it in the way we run our business. When we think about the environment, we're committed to net zero carbon emissions by 2045. We have robust plans now to reduce Scope 1 and Scope 2 emissions based on science-based targets. We're in the midst of finalizing our plans for Scope 3 emissions. When it comes to the whole area of customers, guess what? We wanna ensure that the quality keeps on improving, and we wanna ensure we have a stream of new products. When it comes to colleagues, we're very committed to sustaining our very strong safety record, and we're committed to a diverse, equitable, and inclusive environment. By 2025, we've committed that we wanna ensure that at least 40% of the senior leadership roles are actually led by women.
You might be saying, "Okay, I've gotten a better flavor for FISBE 2.0. Heavy emphasis on customer loyalty, heavy emphasis on more innovation to get to a 30% vitality index." They're gonna drive simplification productivity. They're gonna build and embed some capabilities and focus on their culture, and they're gonna execute and integrate ESG. But who's gonna do this? I thought at this point, what I would do is share with you a video that might give you some insight as to what is the ConvaTec culture like, right? About six months ago, we had an opportunity to bring together all the top 100 leaders across the company in Boston. I'm gonna let you watch the video, and hopefully it'll give you some insight. This event is really, really special.
It's been over five years, we've had a chance to have the 100 most senior leaders at ConvaTec all come together. Guess what? We're having a lot of fun.
We've got our top leaders from all around the world getting together for the first time in many years to reconnect, talk about our vision and our future together, and really get to know each other as individuals.
I'm able to collaborate, meet a lot of new colleagues, and at least talk to them in person, and I'm quite thrilled to be here.
Their message to us is, "Hey, we are not just patients. We are people. We are moms, we are dads." What they are looking for, simple, innovative solutions that not only help them manage their condition, but also their social and emotional well-being.
The vibe in the room that says people enjoy working together, they're aligned to produce a product, and most importantly, from my vantage point as a board member, they are aligned to serve the customers.
We've just rebranded, and that is so important to all of us employees, as well as all the patients and caretakers that we reach because we are, as a company, all about caring.
I've just been deeply impressed by the passion and the pride that actually people have in what we do for patients every single day. The solutions and, you know, the importance of what we actually do and the impact that we can have on their lives. This new, you know, Forever Caring promise that we're bringing, this just ties this all together.
Today, we're really all about building high-performing team. What an incredible opportunity to partner with Michigan Ross. Really a luxury to be guided, to spend time to interact with an incredible faculty so we can grow into one winning team.
ConvaTec is a fantastic organization with an inspiring purpose, the right strategy, and starting to deliver really good things for our customers, patients, shareholders, and other colleagues.
You're doing an amazing job. Your leadership's been incredible. The level of motivation, the level of passion, the talent that you've been displaying has been phenomenal. All I can say is that our best days as a company are yet to come. If you're ever in doubt, remember, we're here to bring Forever Caring to life.
I hope that was helpful to you to get a little bit of a sense of what ConvaTec is all about from a soft side, from a culture side. What I wanted to do now is just really try to conclude the opening by sharing with you what are our financial prospects looking like. I think what I would tell you is they're very attractive.
When you look at what we're gonna do in terms of revenue growth, once again, we're committed to delivering year in and year out, organic revenue growth of 4%-6%. Okay? When you look at the operating margin, we firmly believe that we can go ahead and move the operating margin into the mid-20s. In addition, you'll see that we have a strong balance sheet. We're highly cash generative. We will continue to proactively pursue bolt-on acquisitions that can strengthen our competitive position. They can be technology-oriented, geographically-oriented or capability-oriented. When you put this all together, our belief is that medium-term, what you should expect is that we will go ahead and deliver double-digit earnings and free cash flow growth on a CAGR basis. On that note, I'm gonna say thank you.
Now I'm delighted to welcome up to the podium, David Shepherd, the head of our phenomenal Advanced Wound Care business. David, it's all yours.
Thank you, Karim, and thank you, everybody. It's great to have the opportunity to be with you today just to share our Advanced Wound Care business. Before I begin, though, just a little introduction about myself. I've been with the ConvaTec Wound Care Business for four years now. Prior to that, I spent 27 years working in the medical device business for Johnson & Johnson, including as the worldwide president for the Biosense Webster business in cardiovascular solutions, and as the area vice president for all the medical device businesses in Southern Europe. Perhaps most relevant, I actually had two stints in the wound care business with Johnson & Johnson. In fact, my first commercial role was an advanced wound care sales representative competing against ConvaTec. It's safe to say I knew a little bit about the business and the company.
We're very proud of our global Wound Care business, and we're committed to improving our already strong position. We're already a global leader, and we have a clear roadmap for sustainable success for the future. We expect to consistently achieve mid- to high-single-digit organic revenue growth. Today, we have leading brands such as AQUACEL and DuoDERM, which give us a really strong foundation, and we'll enhance our leadership position with both organic and inorganic investments, ensuring that we retain our positions of strength and make inroads into those areas where we see significant opportunity. We'll continue on our journey of driving improved commercial execution with even more focus on driving a better customer and patient experience, leading to stronger loyalty, as Karim said. During this presentation, I'm gonna give you some insight into our Wound Care FISBE initiatives in these areas.
before I do that, just a little bit of context about the market that we operate in and ConvaTec's position. We operate in a large market, growing mid-single digits. As the population becomes more elderly and develops more comorbidities, such as diabetes, the need for wound care solutions will only continue to grow. Today, around the world, there are over 100 million patients suffering from wounds, and that's a tremendous burden on the patients themselves, but also on healthcare resources. Just to give you an example, here in the United Kingdom, it was estimated that back in 2018, the National Health Service spent over GBP 8 billion on treating wounds. On the right-hand side of the slide, you can see the various sub-segments of the wound care category. The size of these sub-segments varies, as does the growth rate.
We've clearly identified those key segments in which we want to compete and win. That's antimicrobials, foams, biologics, and single-use negative pressure. All high-growth segments. Let me explain ConvaTec's current position in the Wound Care market. From a segment viewpoint, we already have the number one position in several key areas, such as antimicrobials and Hydrofiber with our AQUACEL portfolio, and hydrocolloids with DuoDERM, and we expect to maintain these strong positions. Importantly, we've got clear plans for the high-growth segments where we're not as strong today, foam, single use, negative pressure, and the biologic segment. We've got organic developments in our near-term pipeline for both foam and single-use negative pressure. We're very excited about these two segments as we believe that our new launches we can grow share, leveraging the commercial infrastructure that we already have.
With our recent acquisition of Triad Life Sciences, which is now known as ATT, Advanced Tissue Technologies, we're able to successfully compete in the biologics segment, which is another very large, fast-growing segment. Today, it's primarily a U.S. market. On the longer term, we see potential for global expansion. We're confident that these new additions to the portfolio allow us to meet the differing needs of our healthcare practitioners and patients as their wounds progress to healing. Finally, just in terms of geography, we have a balanced global business. While the global emerging markets are a smaller part today, we see tremendous growth in this area. What have we achieved with FISBE 1.0? Well, in recent years, we've made great progress on pivoting our Wound Care business for sustainable growth.
Clearly, there was an impact of COVID-19 throughout the time period, especially in the US, where we have more exposure to surgical procedures, but we bounced back strongly and quickly. Alongside the other ConvaTec business units, FISBE has been the strategy to drive our success. We've focused in all areas of FISBE, but for today, I'll focus on just three. Firstly, as Karim said, our focus has been on the top 12 markets. Just as a simple example, we have increased our head count in China by over 100% to drive growth. This focus has also enabled us to exit non-core elements of the portfolio, such as skincare and also non-focus markets and SKUs, stock holding units. This drives better operational efficiency for us and also simplifies our offering to the customers.
Innovation is also key to our strategy, and as I said, we've made great progress on both our organic and inorganic portfolio, Triad being our most recent inorganic play. Finally, from a build perspective, we've created global centers of excellence for our commercial areas, sales force, pricing, and marketing, and these serve across all the business units. They've allowed us to focus on driving the effectiveness of our commercial teams in a simplified, consistent, global way. Just as an example, as Karim said, we have a sales force center of excellence that has delivered a CRM platform that's now available across 22 countries for the wound care business, representing about 70% of our revenue. The last few FISBE countries will come on board in 2023.
I'm also very proud we built a diverse, high-performing global team, and I'm proud to say that over 40% of our wound care senior leaders are female today, which is one of our key ESG objectives across ConvaTec. Overall, we're very pleased with our progress as we pivot towards sustainable and profitable growth, and we have a strong foundation on which to build for the future. Looking forward, just in terms of the organic pipeline development, we're making significant progress in two areas. We're very excited to be launching our new foam platform, our ConvaFoam portfolio of dressings very shortly in the U.S., and then around the world as the regulatory approvals follow. This is a large, fast-growing segment where we have great opportunity for growth due to our current modest share, and it's one of the four key segments we've targeted for growth.
With the launch of ConvaFoam, we'll be able to offer customers a broad portfolio of products that provide longer wear times due to increased absorption, a new layer that we've added, and also improved adhesive technology. We're also focused on simplifying the experience for our users, both healthcare practitioners and patients, and I'll provide more color on that shortly. This new ConvaFoam platform complements our existing portfolio and commercial structure and helps us drive synergies across the business. We're also moving ahead with our next-generation, single-use negative pressure platform. This is the fastest-growing significant segment in wound care today, and another one of our targeted segments for growth. Our combination of both new pump and dressing, offering a better patient experience due to ease of use, wear time, and noise reduction, will significantly enable us to strengthen our position in this fast-growing segment.
On the inorganic side, our major recent investment has been ATT, Advanced Tissue Technologies. We completed this acquisition in quarter one, and as we indicated in our recent trading statement, we're very happy with the performance. The integration into ConvaTec is going well, and we see clear synergies from bringing the two companies together. We've got a clear strategy for growth for this innovative technology. Our initial focus is on the large existing U.S. market. We can leverage the brand name of ConvaTec, along with the ConvaTec existing commercial infrastructure, to complement the Advanced Tissue Technologies commercial teams as we continue to expand. We expect these synergies to continue as the business grows. We're also making good progress on the U.S. pipeline and have recently received registry clearances to expand the portfolio with both InnovaBurn and InnovaMatrix PD.
These really enhance the current portfolio of InnovaMatrix products. Second phase, outside the U.S., the unique nature of this technology, being the only porcine placental tissue approved as a device, alongside the attractive COGS profile, offers us the opportunity to expand this technology to patients and HCPs around the world. The plans for this are currently in development as we continue to progress the integration of ATT. Karim talked earlier about improving the customer experience, whether that be patient or practitioner, to drive further loyalty. As a wound care business, we'll track our progress on this through the company-wide Net Promoter Score initiative. What does it really mean? Let me give you a couple of specific examples. With the launch of ConvaFoam, we'll roll out the use of simple QR codes.
The first time we've done this at ConvaTec, and these will allow both patients and HCPs immediate access to key information about their dressing, applications videos, tips on how to use, and easy-to-understand patient information. This will really help make the products easier to use, and this is especially relevant in those markets where more and more care is done at home, either by the patients themselves or their families. This is an increasing trend. The second area where we're improving customer experience is to provide educational support to help the wound healing process. Consistent with our Forever Caring promise, we're committed to improving patient outcomes. This is not only through the product innovation, but also through the engagement with healthcare practitioners and the solutions we can bring to them.
Since 2019, we've been working with some global key opinion leaders to create the Wound Hygiene framework, something we're very proud of. This framework, it's developed in partnership with clinicians around the world, provides our customers with a simple four-step process for treating their wounds. The customer feedback has been outstanding, very positive, as they integrate Wound Hygiene into their treatment regimes. Most importantly, the patients are happy as their wounds improve the healing even faster. We're very proud of this initiative, and I'd like to show you a quick video just to show the progress we've made. As I said, we're very proud of the progress so far, and looking forward, we're using Wound Hygiene to generate clinical evidence that demonstrates the positive impact this pathway can have on wound healing.
Just last month, as we continue to build on the program, we were fortunate to have 30 key opinion leaders from 16 countries around the world join us as we continue to build and expand on this framework for the future. Both these types of solutions just create a stronger link between ConvaTec and our customers that go beyond the products that we're traditionally known for. Finally, how are we driving improved commercial productivity? Across ConvaTec, we've been focused on improving the productivity across the group through the creation of centers of excellence across all the business units. Here I just want to focus on the impact that it's had on Wound Care.
Karim touched earlier on the rollout of our CRM platform and how over 70% of our revenues are now tracked through the platform, and by the end of the year, we'll have all the physical countries on. This platform allows us much better insight into our performance. We have insight into the sales funnels and sales plans at an individual territory level around the world, and it provides us with key performance indicators to allow us to drive further productivity. Alongside this, we have a global segmentation and targeting approach that ensures we have the right call frequency in the right accounts with the right products. This segmentation approach also helped drive the creation of an inside sales team in both the U.S. and Europe to better serve the accounts where we don't have direct field force coverage today.
The inside sales team is a new capability for us, but it's showing great progress as we continue to look for efficient ways to effectively support all our customers. We've also developed simplified global processes and tools for sales force training, incentive compensation, and business analytics, which are all part of our journey of productivity going forward. We're pleased with the progress so far, but we'll continue to build on our capabilities and drive execution as we grow the business. In summary, we're already a global leader in Advanced Wound Care, and we have a clear strategy for future success. Through the exciting additions to our portfolio in the four growth segments and the ongoing improvements in commercial productivity, we're confident we can achieve mid- to high-single-digit organic growth.
Thank you for your time today, and now let me hand over to Bruno to talk about our Ostomy Care business. Thank you.
Hello, everyone. I'm excited to be here and share our growth story of Ostomy Care with you today. Before I begin, let me introduce myself. I have 17 years in ConvaTec, and I'm in love with this company and passionate about Ostomy Care. I started here selling those products, and now I have the privilege of leading this business unit and make the difference for patients across the globe. For me, Ostomy Care is all about the patients. We have three pillars, the right products, the right support, and the right services. Now, let's talk about the business. In the coming years, our goal is to deliver middle single digit growth globally. We focus on three things. First, portfolio innovation, making it refreshed, simple, and complete. The second, keep our pace in the emerging markets with focus on patient access and loyalty.
Third, drive consistent commercial execution in the developed markets. Let me start and give you guys some perspectives about the market and our position. The Ostomy Care market is large and particularly attractive due to the recurrent revenues associated with this chronic condition. The market is about $3 billion today, growing at 4%, mainly driven by the aging population, increasing underlying condition, and improved access in the emerging markets. In the US and Europe, the markets are more mature and stable, growing at 3%, and the emerging markets is growing at 6% at this moment. Now, let's talk about the patients and how they are supported in their journey. There are roughly 2.8 million ostomates globally, with more than 400,000 new patients per year.
On average, 60% of the new patients have a permanent stoma, requiring solutions for the rest of their lives, and they can show a high level of loyalty to products and brands. For that reason, it's really important the partnership with the healthcare providers throughout the continuum of care, especially at the beginning of the journey. While it represents only 7% of the revenue, it is a very important moment to introduce our products and services to the patient. Therefore, we work very closely with the specialized nurses in the acute care, but it's also vital that we partner with nurses in the post-acute setting and support patients directly in the community. As you can see, the most significant part of the revenue lies in the community when the patients become consumers. As I said earlier, what they need is very clear.
They need the right products, support, and services to help them live their lives to the fullest. Now, let's talk about our business. Over the years, we have built a strong foundation. We have a global business with a strong presence in Europe, North America, and emerging markets. In many of them, we have number one or number two position. Another strength of ConvaTec is our strong brand reputation. This includes products, patient programs like me+, and services like 180 Medical in the US and Amcare in the UK. They are all well-known and well-accepted by healthcare professionals and patients. As you can see, we have all the elements to drive sustainable global growth in the coming years. Under FISBE 1.0, we have made good progress, and our actions have stabilized the business and positioned it for growth. Here are a few examples. Innovation.
We will launch our new offer in the convexity segment with the Esteem 2.0 starting late 2023. We complete our phase I of the essentials refresh. To simplify, we are executing the SKU rationalization program. So far, we have eliminated 650 SKUs. It represents roughly 75% of the program roadmap. We expect to complete it, the program by the end of 2024. We already see a positive impact in gross margin as a result of this. In terms of execution, we improved our productivity by focusing on segmentation and targeting powered by CRM. We are working in partnership with the Home Services Group to better serve our clients, delivering a superior service experience to our consumers.
Finally, we further improve service levels through consistent product quality and availability, aligned with the ESG commitments that we have. This has improved our performance. The graph on the left shows that we are consistently growing ConvaTec products at 3.1% as customers increasingly prefer our brands and solutions. When you consider our SKU program creates a headwind of about 100 basis points, then you can see that our products are already growing at market rate. What we are doing to drive sustainable global growth in the coming years. We will continue to build a complete offering of solutions based on right products, support, and services to drive a positive consumer experience and strong loyalty. Before I talk about our new product offering, let me try and educate you about ostomy needs.
They need to accommodate different shapes of stoma and abdomens. Our new offer in convexity will address these needs with a modern look and feel. They need reliable technology preventing leakage. Our moldable technology has demonstrated excellent outcomes, and it is a key driver of customer loyalty. They need accessories to protect the skin when applying and removing ostomy devices. Oh, sorry. We recently launched our ESENTA line of accessories. Why Essentials? If you talk to ostomates, this is not a simple accessory. It is an essential component to deliver on their quality of life, and we are already seeing substantial growth from the ESENTA portfolio. In terms of support and services, we'll continue to drive our me+ program, offering robust clinical support to ostomates. In the U.S. alone, we have more than 300,000 patients supported by me+ already.
We will continue to expand our services in the community. For example, we have increased our new customer enrollment by 70% in the U.S. since 2019 through 180 Medical. In Latin America, our ConvaCare services continue to deliver great patient care with a Net Promoter Score over 19%. We plan to build on these foundational strengths to drive consistent commercial execution in developed markets and accelerate the momentum in emerging markets. Talking about emerging markets, every country in the emerging markets is at a different level of maturity and access to ostomy care. We know these markets, and we are already outperforming market growth. For example, China, we have excellent results, and we are growing significantly. By partnering with the healthcare providers, we are increasing both penetration in key accounts and hospital listing. Professional education.
It is another important part of our strategy, and we are investing heavily in this area. Another important point for us, pivotal point, is the expansion of services to drive patient loyalty. We are building on our successful clinic model in LatAm and expanding the me+ program in emerging markets. Now the developed markets. In these mature and stable markets, we will grow our presence with consistency in commercial execution and improving productivity. We are leveraging our sales force excellence to drive programs to improve commercial effectiveness. This integrated with our patient-centric programs, will enable us to deliver our growth in developed markets across the continuum of care. In summary, our goal is to deliver mid-single digit growth based on three things. First, the portfolio innovation, as I said, making it refreshed, simple and complete.
The second, sustain the growth momentum in the emerging markets with focus on patient access and loyalty. Third, in developed markets, improve the consistency on our commercial execution across the continuum of care from hospital to home. Thank you very much. Now I would like to introduce Seth to talk about our Continence Care business. Seth.
Thank you, Bruno. Beyond what's in my bio, I thought it helpful to provide some additional context. I grew up in a family where all of my immediate relatives are physicians. Most nights at the dinner table, I would listen to my family discuss stressful patient diagnoses. This would be followed by my father calling patients late into the night. I had a front row seat to what is required in true patient care. It went beyond the diagnosis and treatment and highlighted the vital importance of the emotional support and help with day-to-day needs. I also grew up understanding the demands and the pressures on clinicians. I witnessed the toll of regularly being responsible for delivering life-changing news. While I am the only one who did not pursue a medical degree, I felt a genuine draw to the societal benefit of healthcare.
After 10 years in the infection control industry, I moved into continence care, where I've had the pleasure of serving for the past 10 years, the last 5 of which have been with ConvaTec. ConvaTec's Continence Care is principally built around the marketing, the sales, and the servicing of single-use urinary catheters. This is a chronic care therapy. It typically grows as the population ages. For reference, the modern urinary catheter was invented in 1752. There are no pharmaceutical interventions or procedural cures for most conditions requiring catheters. We are distinguished in the largest region with a full solution that is solving the real physical and lifestyle needs of end users, both with products and quantified world-class service. We foresee a lot of headroom to achieve mid-single-digit growth via opportunities in product expansion and geographic access, specifically in Europe and key global emerging markets.
Unquestionably, this is a home-based or community category. Individuals themselves manually insert through their urethra and into their bladder a flexible catheter 3-6 times a day, which takes approximately 2-3 minutes to drain the bladder in the bathroom. It is important to highlight that we have enduring relationships. Many of our customers are on this therapy for years, if not for life. The U.S. is the largest single market at roughly $900 million, where ConvaTec has leadership positions in both direct-to-consumer service and manufactured products. While growth exists across different catheter product types, directionally, pre-lubricated and discrete configurations are the highest opportunities with Europe and GEM as areas for us to focus and to compete.
With a quick deep dive into the largest Continence Care global market, the U.S., we have achieved genuine leadership position as both the direct-to-consumer home care entity, known as our Home Services Group, with roughly 40% share, and as a manufacturer of the combined Cure Medical and ConvaTec GentleCath portfolios with roughly 23% share. Our strategy in the U.S. has been to shape the segment. We field discrete specialist sales and service teams, each focused on the end users, the referring clinicians, and the channel partners. There are resulting competitive advantages from establishing truly distinctive and quantified customer experiences. On a blended average, these are 3- to 5-year relationships with the customer. The tails being lifetime customers and some short-term post-surgical customers. I emphasize that relationships are important. This is not a transactional business.
We are involved in helping people reliably every single month with a wide array of catheter and broader lifestyle needs. For example, traveling with catheters, education on alternatives, general emotional support, billing issues. Those are just some examples. As evidence of our competencies, our Net Promoter Score, to which Karim referred, is a key measure of customer loyalty. This has been about 80% over the past 5 years. On a scale of negative 100 to 100, a score above 70% is deemed world-class. We are at 80% for the last 5 years. For reference, public data indicates companies like Starbucks at 77% and Amazon at 73%. Over the past 20 years, we have also established a comprehensive network of 1,700 U.S. insurance plans. What does that mean? We can serve the vast majority of our patient referrals.
The foundation of an excellent and sustainable service experience is our culture and our technology. Our mission-driven culture is evidenced by our McKinsey Organizational Health Index score, which is in the top 10% in the world. Marrying that with our cutting-edge enterprise software allows for accuracy and efficiency that is unrivaled. This is a productivity advantage, and we have proven it in our UK Amcare business as well. One result of these factors is having a customer churn rate of less than 1%. That is the percentage of customers we lose to a competitor. What does that mean? When we establish a relationship with the customer, we almost never lose them to a competitor. The combination of these forces, along with the intrinsic economics of the category, enable us to operate at a very compelling customer lifetime value to acquisition cost with high retention.
With this strong foundation, we leverage this in catheters as well as in ostomy. As Bruno described, our HSG is a key asset in how we approach ostomy in addition to our core catheter business. In both urinary catheters and ostomy, the vast majority of a customer's experience with their medical appliance occurs in the home or the community environment. Now there are two important themes to process here. Number one, we believe a major growth driver in healthcare is in the home or the community. It appears inevitable. It's actually been validated, if not accelerated by COVID-19. People were unable to visit physicians, clinics, or hospitals unless it was a true emergency. Companies and healthcare providers adapted to this remote dynamic as the need for healthcare did not stop. The second theme, how our customers live daily with their medical device is equally important to the device itself.
Therefore, having this distinctive direct-to-consumer service capability affords us a strategic edge in both catheters and in ostomy. We have proved that our service skill is exportable. We have standardized our US and UK service operations on a common technology platform and adopted similar approaches to providing superb customer experiences. Thus, we are now providing at scale, world-class direct-to-consumer services in the US and in the UK, both in catheters and in ostomy. Our strategy has been to focus on these solutions for our customers. This is a combination of the device and the monthly service support. Our customers have holistic needs. This is how they live with their chronic conditions. However, an important part of offering solutions is having a broad range of products with different underlying technologies and designs. People select catheters for a wide variety of reasons, some social, some emotional, some functional.
We continue to expand with both the ConvaTec FeelClean technology and the Cure Medical hydrogel platforms. We are advancing our different formats, including discrete, to help even more customers with their needs. While today over 95% of our catheter business is in the U.S. and over 85% via our HSG, we are focused on extending our reach in Europe, Latin America, and key Asian markets. I did want to clarify that in our HSG business, you will notice over 50% of our business is on ConvaTec brands. This is simple. We offer both ConvaTec and non-ConvaTec products in our service business, as clinicians and patients love our service, but may have preferences for a particular branded product. Historically, we have delivered consistent mid-single digit growth. I did wanna point out that in 2021, our rate of growth decelerated.
During COVID-19, in-person patient visits tapered significantly. This slowed our new patient starts in 2020, while the cascade effect of this was experienced in 2021. However, year to date, 2022 is accelerating and returning to mid-single-digit organic growth rates. As we look at our FISBE 1.0 initiatives, we have spiked on the focus, the innovate, and the build. Let me just step you through those quickly. With regards to focus, we have achieved quantifiable excellence in our service proposition to our customers. We are focused on how best to leverage this unique skill, and our first foray is in the U.K. and has been very successful with our Amcare team. In addition, we have executed a proactive strategy of rationalizing our categories to those areas where service best matches our customers' needs.
We narrowed our scope away from adult diapers and nutrition products in favor of an emphasis on catheters and ostomy. Secondly, in innovate. As cited earlier, we recognize portfolio expansion is important to meet the very diverse needs of our customers. Our technology and innovation colleagues, along with our global quality and operations teams, are laser-focused on additional portfolio extensions, such as GC Air and Cure One, all while ensuring our manufactured cost structure works for a reimbursement environment. Number three in build. We have strong experience in successful acquisitions, so we see both organic and inorganic approaches to advance our strategy. For example, Cure Medical, which was acquired in the U.S. in March 2021, has been very successful across the entire distributor channel.
However, beyond the product benefits of Cure's platform, we have many opportunities ahead of us in our R&D approach, our manufacturing capabilities and efficiencies, and our marketing expertise. A large part of our FISBE 2.0 efforts are on this innovate path. As an example, let's take the growing $500 million discreet catheter subsegment, especially prevalent in Europe. As longtime players in the catheter market, we know there are no silver bullets that solve all customer needs. Users have very different capabilities and wants. They select a product based on diverse criteria. However, thematically, both enhanced lubrication and smaller or discreet configurations are key growth areas. Our next generation FeelClean technology offers a simpler, smoother, cleaner, and frankly, more comfortable experience. Prior generation coated hydrophilic catheters, which lead the market today, actually were invented 35 years ago.
Our state-of-the-art FeelClean technology is developing greater evidence of an improved user experience. Leveraging this unique technology, we're expanding beyond our standard and very successful GentleCath Glide and bringing to market our pocket-sized GC Air offerings both for men and women. In fact, our GC Air for men was cleared by the U.S. Food and Drug Administration with claims of superior comfort and less stickiness. In addition, we are continuing to succeed with Cure Medical's ready-to-use hydrogel platform. This was developed through a long track record of user-driven rapid innovation. We will continue to innovate on this platform, expand the already broad range of discreet configurations available in the U.S., and make our Cure portfolio available in other regions of the world.
Bottom line, we are continuing to invest in both platforms as our fundamental belief is having more alternatives for customers, especially in this discreet subsegment, ultimately will increase our success. As we look forward, we have a strong solution orientation and advancing product portfolio. We absolutely recognize how important it is to continue bolstering our U.S. leadership position. We're investing in next-generation technologies and methods in both manufacturing and service delivery. Doing so ensures we keep our quality high, our costs aligned with reimbursement environments, and our service levels as the benchmark in the category, in both catheters and ostomy. We see Europe and GEM as genuine near to mid-term opportunities, but these geographies are at different stages. Major European markets are well-developed with reimbursement economics. In the U.K., we see our Amcare service as a key lever to success.
Thus, we have invested in 2022 to put a focused Continence Care field team in place. Each of France and Italy are key opportunities for us to advance, especially by gaining traction for our next generation state-of-the-art FeelClean technology and serving some niches with future editions of Cure Medical products. Within GEM, as Bruno highlighted, our Latin American teams have established leadership positions in ostomy as well as in wound.
Through their distinctive capabilities, we are starting now to make catheters a greater focus, even though the reimbursement environment in various countries is still evolving. Core Asian markets for us are at earlier stage investments as the reimbursement for, and thus the use of catheters is still embryonic. However, given the size of the populations, the breadth of our products, our manufacturing and cost ranges, we are confident we must be present. We will seek to do that in partnership with our GEM colleagues, who are eager to focus on this product category for growth opportunities. In summary, we are committed to the catheter category, and we foresee mid-single-digit% growth ahead. We will achieve this with numerous arrows in our quiver. Simply said, one, solutions, both products and services. Two, portfolio breadth. And three, geographic expansion. Thank you very much.
Now back to Karim for a Q&A session.
Thanks a lot.
Very well. What we thought we'd do at this point, hopefully, we've shared a fair amount of information with you. Our thought was to try to make this as interactive as possible. We thought maybe we could take the next 20-25 minutes just to really field any questions you may have had on what we've described to you up to this point, and then we'll do the same thing again after the next session. Really just opening it up to questions. Anything on your mind?
All right. It's Hassan.
Thanks, Hassan.
The first question is about the transformation of the business. We've seen sizable OpEx and CapEx going into the business supporting this over the last few years. Can you review these investments at a high level and walk us through how they've altered the top line with some examples, ideally, and where you are specifically on the cost savings run rate that you had expected as part of this initiative? That's the first question. The second, for Seth, the gap between your service and manufacturing market share is significant. Thank you for providing the data there. Can you talk about your ambitions here, and how you think the capital will be key in solving this, and perhaps also improving profitability in the future?
Super. Thanks a lot, Hassan. Let me take the first question, and then I'll probably ask Jonny here to help me out, too. We'll try to sort of do a little bit of a dual team here. In terms of the increased operating expense in CapEx, you know, where has it gone and what are some good examples there? I would say in terms of operating expense, probably R&D area, I think is a really good area, right? If you think about where we were at, historically, we would not have had, for example, capabilities in the area of process development. We didn't really have a clinical capability. Our regulatory was actually not fully focused and really run on a consistent basis worldwide.
We didn't have a team just focused on human factor design, which is really critical in all of our categories. When you look at the degree of investment that we've made in R&D, I think the output you're starting to see, frankly, is being able to launch 8 new products right at this point in time, right? I think there's clear evidence there of that. I can give you other examples of having increased our investments, for example, in the commercial arena, in a place like China or in a place like the US. We're actually growing our share of market in Ostomy Care in China. We are growing our share of market of Wound Care in China. We've accelerated our growth rate, frankly, in the US, for example, in Wound Care.
Hopefully that gives you some clear examples of how it's consistent and coherent with our strategy. On the CapEx side, look, I would give you maybe as an example there, what have we done on the capacity front? We've got a terrific business in the area of Infusion Care, significant differentiation, a strong IP position, robust partnerships. And frankly, we've been capacity constrained. And so we've been very, very busy bunnies, frankly, increasing that capacity, which has frankly helped us be able to drive top-line growth. In terms of cost saving run rates, I'm not sure if, Jonny, you wanna share anything on that topic or theme.
Is this working?
No.
Try again. How's that?
Yeah. Okay.
All right.
Great.
I would just add one comment, I think, which is that on operating cost investments, I think there's been two phases. Initially, there were some one-time type operating expenses to get the transformation moving. I think the commentary at the time was that these would be non-recurring. We've gone past that phase now. In 2021, we won't be talking about non-recurring operating expenses. The foundation has been set. Then I think there was a resetting of where the operating expenses were being directed. Karim mentioned that research and development expense has doubled, for instance. You know, that's been reset to a new level, along with investment in commercial effectiveness, and it's not anticipated that those levels are gonna come down.
Our road to mid-20s EBIT margin, as you'll hear a bit later, is gonna be by saving in other places rather than in those which have been set to new levels.
Thanks, Jonny. Seth, do you wanna take the question?
Sure. Can you hear me okay? Maybe you can just clarify. I think I heard something about launch, mix, and margin. I just wanted to make sure how I can be most helpful here.
Yes.
The service and the manufacturer market share is quite large in the U.S. Your ambition in terms of closing that and how meaningful, you know, the current launches will be in solving that difference, but then also potentially helping with the competitive advantage.
Yes. Thank you for the question. Let me try and answer it this way. We always start with the patient, right? From a service perspective, our interaction with the patient, we believe in choice, right? As I said, patients choose a variety of catheters for a variety of different reasons. Nothing will change about that. We will continue to educate patients and clinicians about alternatives that exist in the market and help them find the best product that might be suited for them. On the second side, on the product side, our responsibility, in fact, our obligation, is to keep advancing our portfolio so that those same patients and clinicians actually desire and want more ConvaTec products, whether it's for their FeelClean technology, the ready-to-use or otherwise.
We have a two-prong effort to continue on the path that we're on, right, which is just choice and enhanced product.
Super. Thanks, Seth Segel. Veronika Dubajova.
Hopefully this works. Thank you, guys for today. It's Veronika from Citi. Question for David, maybe to start. Just David, curious on the ConvaFoam launch. Why is the timeline between the U.S. and the European launches so different, and how are you thinking about the opportunity in each of those markets respectively? That'd be great. And then on the ostomy mid-single digit growth ambition, is there a timeline to that? When do you expect, Bruno, you will get there? Is that a question of do we need to get Esteem 2.0 out there? Do we need to stop the SKU reductions there? Just if you can contextualize that. Thank you.
Sure. David, do you wanna take the first one?
On timelines, it's really very simple. It's the new medical device regulations in Europe put extra onus on approvals here in Europe now. It's gonna be a consistent, I think, on most products that we launch, that contrary to what we used to have, where Europe launched first and the U.S. followed, now it's going to be U.S. first, followed by Europe. It's really a factor affecting all of the medical device industry. In terms of opportunity, I think equally excited about both. Probably a bias to the U.S. because it's closer. Our share in the foam segment is similar in both parts of the world, and we're really excited to get the technology out in all the regions as soon as possible.
Thanks, David. I guess, Bruno, the question was, when will we get to mid-single-digit growth in Ostomy Care?
Yeah. Look, I think there are three ways, right? As we are completing our portfolio offering, we will see more opportunities for us to deliver growth, right? It will start next year as we present it to you guys. Commercial execution improvement is another lever, right? We expect to see more from these investments in sales force that we have at this moment. The third, as we are offering more products through HSG, so this is a third lever that we feel that will make us more strong to deliver this mid-single digit growth that we talked during the presentation. All combined, I expect to see that next year and growing in the midterm.
Super. Thanks, Bruno. I think there was first here, now I'll go back to you. Please, just introduce yourself.
Thank you. Edward, today, Redburn. David, some questions on wound care. Great to see your initiatives to enter new markets. First on biologics. Obviously an interesting history of biologics, as we all remember, with some of your major competitors. Reimbursement's always been a pressure, so great to hear you talk about the cost profile. Can you give some more color on that, about the lower cost profile? And also on the relative affordability in terms of how you're gonna position it in the market given the importance of pricing for that kind of technology. Secondly, on negative pressure, very interesting update today on that. How are you gonna position that against PICO?
Okay. Two questions there, right, David? I think one was cost profile and biologics, how are we thinking that through from a pricing perspective? How about Avelle 2.0, how are we thinking about that relative to maybe PICO?
You're right. I think the biologics segment reimbursement has been a topic for many years. Clearly, we were aware of that as we looked at the potential inorganic opportunities. When we assessed all the companies, and particularly looking at Triad, we were very aware that there is potential for changes in reimbursement. Now it's an uncertain market. I think there is no clarity today what's going to happen. As we look to the products, we know that it's a lot easier to be a 510(k) device in that market than it is perhaps some of the other types of technology. That affordability also then allows us to assess the markets outside the U.S.
Now every market will be different, and so we'll have to work both on regulatory approvals and reimbursement with the different countries. But again, having a device product allows us that flexibility. And then on negative pressure, listen, it's a great market, growing fast. We're really excited. You know, we have a platform with Avelle today, but our next generation platform, we believe that the learnings that we've had from the first generation, typical of the medical device sector, you build into your second generation. And so
With the, you know, noise reduction, the combination of a new pump and addressing, leveraging the technologies that we already have today, such as Hydrofiber and antimicrobials. We believe that gives us a very strong offering to go into that segment and take share.
Great. Thanks, David. I'll try to go here just horizontally. Jens, do you wanna start?
Yeah, a couple of questions from Jens Lindqvist at Investec. First of all, on Advanced Wound Care, or ATT specifically, what are your thoughts on the reconstructive surgery market? I mean, when biologics are very widely used in reconstructive procedures. You know, but it does not appear to sit at face value, at least, particularly well within your focus on chronic care. My second question on continence care. Perhaps we'll do the first one first.
Okay, great.
Yeah, listen, when we acquired ATT, we looked at it as a platform. We're also very clear, sometimes you can have too many opportunities. As we laid out our strategy, there is a large existing market today where we believe we can play in the U.S., and that's the number one focus. After that, we believe taking the technology outside the U.S., the same products that we have today. The third, which is, you know, more further out, more medium to long term, is where else can you take this technology? We believe there are opportunities there. I think, you know, 8 months into the acquisition, let's get the focus areas completed first.
Okay, understood. Moving on to Continence Care. Seth, great presentation, by the way. Did I understand you correctly, that as you aim to grow a share in Europe and emerging markets, that you will replicate the HSG model and market third-party products with regional appeal alongside your own? Is that correct?
Thank you for the question. Not necessarily will we create an HSG in every part of the world, right? We've first proven we've been able to do that successfully in the UK. That's a primary market for us. That's attractive and we're well set. I think the bigger driver for us as we expand in the short to medium term, will really be around the FeelClean technology, right? We're solving real customer problems around stickiness, discomfort or otherwise. Bringing this next generation FeelClean technology to the forefront, we believe will actually influence patients and clinicians to help us succeed as we get going in the UK and in the rest of Europe. Frankly, we are not closing off opportunities to recreate HSG type of experiences, but that all depends on reimbursement environments and market access to us.
Okay, thank you.
Yeah, just go middle, then I'll go up.
Hi. Yes, David Adlington from J.P. Morgan. Firstly, just on the ostomy side, I just wondered if you could talk to the trend that you're seeing in temporary versus permanent ostomies and the impact that might have on the market. Secondly, in continence care, as you expand out of the U.S., what sort of investment will that require? How long will it be until you actually be able to turn those businesses into profit making? Thanks.
Two questions. I guess what's the impact of sort of temporary stomas?
That's for Bruno. When am I gonna get my ROI back on Continence Care investments, I think Dave is asking. That goes to Seth. Bruno.
Okay. Look, the idea of permanent versus temporary is a reality, right? This is good because we are here for the patients, so we have to understand that. Another factor that is important for us to bake in is we are seeing more surgeries across the group, right? It's a balance between new ostomates, even over a period of time, but also amplifying the number of surgeries or patients. I think that the industry is accommodating how to deal with that and how to serve better the temporary versus the permanent. Different types of approach, different types of support, but we are getting used to that and it is the reality. Good for patients.
Thank you. Okay, with regards to the question on Continence Care, 2 vectors there, right? Investment size and time. So let's just break that up into EU four. The nature of the investments is typically commercial in nature, right? Sales and marketing. Those investments have been made in the UK and in France. We're expanding Italy now. But those are mostly commercial investments and very important ones. As we think about Latin America and GEM, we have the benefit of leveraging the existing teams that we have in place. So really the investment is much more around opportunity costs more so than anything else. But those teams that we have, under Ann's leadership are extremely excited, so we see the investment size there as more moderate.
In terms of time, I think as I relate to you, this is a one patient at a time type market, right? This will take slow, steady growth. There are entrenched competitors, especially in the EU four, right? We need to win with the FeelClean technology. We need to win with the capabilities of our sales execution. And frankly, that will be measured in years. Super. Let's go all the way in the back and then come back. The gentleman in the back has been waiting for a little bit.
Hi. Sorry.
No worries.
No, you're good. We can hear you. We can hear you.
Yeah.
Rajesh Kumar from HSBC. Finally, we got there. If I heard you correctly, you said that by a certain year in the future, a third of revenue will come from new products. You know, that's 30% growth. But when I look at the organic growth figures, you, the targets you're setting, it's all in mid-single-digit. So there's another piece in that equation which I'm missing. You know, is there a churn which we need to think through in terms of. Because if 33% of revenues you're adding with new product in two years' time, then why are we not talking about 15% or 10% growth a year? Why are we talking about mid-single-digit?
Yeah. Look, I think it's a fair question. The first thing I'll just clarify what I stated. What we stated was that, in terms of New Product Vitality Index, our goal is to get to 30%, so approximately a third, but 30% to be precise, by 2025, right? The second thing to realize is you need to think about to what degree when you're launching new products, is there substitution of maybe some current revenues you have, too, right? You have to factor that's an element in the equation, right? I think the other element here really is you're sort of asking the question saying, "Hey, could you do better than 4%-6%," right? I think that's a fair and legitimate question.
I think the reality is that we are confident that we can deliver 4%-6%, and I think it's plausible that we could do better, right? On the other hand, I think it's important to be grounded and to ensure that we deliver on what we say. That's really important to us as an organization, right? If you think about the history and the context of ConvaTec. That's the way I would answer that question. Certainly, we'll strive for as much as we can do. We're gonna drive the levers that we can influence and control.
Got it. Just a linked question. When we look at this mid-single digit growth figure, you know, we are looking at a world where inflation rates are absolutely crazy at the moment. But, you know, all these growth figures seem to be anchored to a world where inflation was not as crazy. Are you implicitly making an assumption that pricing contribution in that growth is going to be how it was, say, last five years on average? Or are you saying, no, the pricing element is going to be 100 basis points more, and therefore, we are getting this growth?
Yeah. I don't wanna steal all of Jonny's thunder and lightning 'cause I think he answers that directly. What I'll just say at this point, and if we don't answer at the end, please come back to me. I think fundamentally, our view is that our pricing center of excellence has been doing a really good job, and I expect it to continue to do a really good job. Let's come back with specific numbers when Jonny's on stage. You're welcome. We go here first.
Hi. Yeah, Christian Glennie from Stifel. Maybe just a few ones for David on the Wound Care side. You made a point about China and the investment in the sales team there. Just wondering if you could put a few more numbers around that for some context in terms of you know the numbers around the sales, the proportion that China contributes to the division at the moment, and how do you see that you know growing over the next few years? That's the first one.
Do you want me to take it?
Sure.
Yeah. Why don't we do a double act here? We'll have David kick off, and then Anne, who heads up our global emerging markets business. She maybe can give you even more color as to what's happening in China. Do you wanna start?
Yeah.
Listen, I'm very excited about China. It's one of our top two FISBE countries, so we have a focus, too, but China and the U.S. are one and two. We made substantial investment, as I said, in the footprint, and the business is now growing very nicely and taking market share. Having said that, it started from a relatively low base, so it's still a small part of the Wound Care business today, but I think we're very excited about the potential in the market and where it can go. Why not?
I'd like to add to David's comments here. Actually, we've not just added resource and investment in wound. We've also done the same in ostomy. Actually, we're seeing very similar results. In both areas we're delivering this year, despite the COVID environment in China particularly. However, we're delivering very strong double-digit growth. We're advancing significantly in terms of market share. In the areas that I think both Bruno and David outlined, in terms of areas of focus around really lifting our sales force breadth and penetration in key accounts, improving productivity is obviously a key element of sales, of what we're doing with sales force as well as delivering and improving on professional education.
There are a number of attributes that are aligned with the points that David and Bruno made, which are actually helping us drive very strong growth, which we anticipate to continue across the coming years.
Thanks, Anne. Very helpful.
Thank you. Sorry, second one quickly was on just a reminder on timelines for the next gen negative pressure and you know key markets and the timelines of launch for that.
David, do you want to take that?
Yeah.
The next generation.
Key markets, very clear. The U.S. and Europe are the big two for us. I think what we'll see is the same as we touched on with ConvaFoam. The U.S. will launch first, because of the regulatory timeframes. We'll have to do clinical work to get the European approval. We're looking into 2024 for the U.S. launch.
Just one more, then, in terms of potential other bolt-on you did the Triad earlier this year. What other areas and/or complementary, you know, if you look at potential for bolt-ons, what sort of technologies maybe or capabilities you would like to add through the inorganic in wound care?
Yeah. Listen, I think first of all, first off, our real focus right now is making a success of the one we've done. I think it's very easy to go shopping after you've just finished and not focus on delivering. We're really driving the ATT integration. We think it's pivotal. It was a significant segment. It was clearly one that was an organic play for ConvaTec, and so a real drive and focus to make it a success. It doesn't mean though that our, you know, we're not keeping our antennas up and looking at other opportunities as they may come up.
I would just build on David's comment. He's spot on. When it comes to bolt-on acquisitions, we're looking at them across the entire portfolio. Okay? So it's not exclusive to any one category. Again, the radar is up, whether it be a technology play, whether it be a geographic play, whether it be a capability play. You know, we're very thoughtful in terms of assessing it from a strategic vantage point. What about the financial returns we expect? You know, I think with Jonny, we tend to be, you know, prudent and thoughtful as we do that. Then Evelyn Douglas, who's with us here today, who heads up our corporate strategy and corporate development team, is also instrumental in helping you drive that agenda. Please.
Good afternoon, everyone. Thank you for the insightful presentations. Oh, I'm Siddharth from J O Hambro. My first question is for Seth and Bruno. You've both been here for a very long time. Just could you talk a little bit about how you've seen ConvaTec transform in the last three, four years? So any color you can give us on the day-to-day, what you've seen in terms of culture in your respective divisions would help. Second, you said you now have visibility on 8 new products on the innovation front. Could you talk about what proportion of these products you would now classify as transformative? The last, you've talked about embedding the existing capabilities and building new ones. Any color you can provide on the cost of building these new capabilities?
Sure. Okay. Three questions. Maybe the first one in terms of how has the culture changed through time. I'll ask both Bruno and Seth to answer. And then, I'll come back to the eight new products and what part is transformative. And then as we build new capabilities, what is the cost implication. I think is where you're going. Seth, Bruno, do you guys wanna start?
Sure. You want me to go?
Yeah.
I know you're the long-timer at 17 years, but
Let's see if I have the same perspective.
Let's see. I love the question about culture. Look, I think the foundation of great teams and organizations is rooted in trust. In the five years that I've been here, the amount of trust that has been built in the organization is phenomenal, right? Now, why is trust built, right? It's capabilities. It's do what you say you're gonna do and do it ethically. I would say as Karim has come on board, and we've built the team and added to it, from the executive leadership team right through the organization, I would say there's a wholesale uptick in the amount of trust throughout the organization. I view it extremely positively.
Yeah, I would reinforce one specific point because it was in my presentation. It's about consistency, right? In execution, especially. I think that we are pivoting, but we've made a lot of progress in that area. It's the most clear factor that is driving these results that we are presenting to you. The consistency or the awareness that this is a need, and we need to achieve that sooner than later.
Super. Thank you. In terms of eight new products, which ones are transformative? I might invite Divakar Ramakrishnan, our head of R&D, maybe to comment since he's sort of driving the portfolio. Divakar, how do you think about that?
Yeah. As a matter of fact, great question. I think, as I think about this, the wound biologics segment with ATT actually represents a transformative platform for us. When I think about the question for Bruno and Seth, you know, about half of them are what we call in the rapid iteration category, and about half of them are in new platforms. These are new platforms where we build more skill, and then we leverage them for other rapid platforms later on. Yeah. Does that answer your question?
I should clarify.
Yeah.
The 8+ that you said in terms of infusion set for Parkinson's and next generation Hydrofiber, you've not given all 8 or whatever it is that you're thinking about. You might color that later. Within that next set of products that you're using, what proportion of new is coming?
Okay.
Yeah.
You're saying, sorry, just to confirm. Compared to the first eight, how does the next eight potentially compare, right? As Karim mentioned, we have line of sight to the next eight. We clearly see more of the next eight in the rapid iteration category versus the new platform and transformative. That is really in you know, trying to deepen our portfolio and you know, hit the vitality and also increase cycle time.
Yeah.
That's what's reflected there.
Thank you.
Thanks, Divakar. Look, in terms of cost of building, you know, additional capability, I say modest fundamentally. So you look at an area, for example, such as reimbursement and access, right? Up to this point, really focused on pricing. So it's really sort of an add-on of capabilities. So this is not armies of individuals or major investment, but it's an important capability that we need to establish. So you look at how do we systematically go ahead and ensure that we're mapping out patient journeys, and we're measuring that promoter score. Well, I would argue too that, you know, within our current budgets, that's what we should be doing, right? So I don't think it's gonna be a key driver of incremental costs. I think these are just good business practices for a successful medical technology company like ConvaTec.
Yeah. Paul.
Thank you, Karim. Paul Cuddon from Numis. I think over the years, I've heard about the commercial synergies that you're getting between ostomy and continence, particularly in the U.S. on the home services side, wound care and ostomy, and ultimately continence for emerging markets. I'm not entirely sure you've ever mentioned the synergies between divisions for the European markets. Perhaps you could elaborate on how you could kind of get the divisions working better there. Then secondly, just on the general pricing environment across the divisions and the ability of your new products to kind of partly mitigate some of those pricing pressures and potentially, in future, extract better gross margins. Thank you.
Yeah. I'll ask the team to help me out on the synergies across Europe. I think the reality is that there are synergies, right? I mean, you look at the way we interface with, for example, the payer. If there's tendering activities, you know, it's the same teams that are doing this, whether it be in Italy or France, as an example, right? I think if you think about synergies, for example, with the Amcare service business in the UK. You know, it does a lot of work in Ostomy Care, does some work also in Advanced Wound Care, and frankly, does also a fair amount of work in Continence Care as we go ahead and expand our portfolio, right?
I could go and give you many more examples, but I think maybe we haven't highlighted them to the same degree. Where there is commonality in terms of customer interface, clearly we try to seize those opportunities. Let me ask my colleagues. Would you add anything there?
I just had the commercial centers of excellence we talked about.
Yeah.
SFE, marketing, and pricing, they serve all businesses.
Yeah.
All regions. We're really getting synergies there and getting people to work together.
Thank you.
Look, I would say there's a reputational benefit, right? As the company grows, as the Forever Caring promise grabs hold, that crosses ostomy, catheters-
Yeah.
wound, as you speak to hospitals, clinicians.
Yeah.
whoever it may be, and I think we're starting to get real momentum there.
It's a really good point, and I don't know if Kjersti wants to comment on this 'cause she's really sort of been championing the whole idea of a master brand, right, and the refresh here. I can tell you, frankly, my visits out in the field, the fact that we now have a master brand under ConvaTec. "Oh, I didn't know that was the same company that was doing Ostomy Care. Oh, you guys do infusion? Really? I had no idea you're so active in diabetes," right? There is an element of positioning the company as being highly innovative, highly pioneering in consumables across chronic care categories. I think we're just starting to get some of the initial benefits of that kind of a positioning. I don't know, Kjersti, would you wanna add anything? Please.
Branding has been very close to my heart for a very long time. I was actually very saddened when I joined ConvaTec, because people in the healthcare business had no idea who ConvaTec were. They knew about AQUACEL, they knew about DuoDERM, but not ConvaTec as a company. Also, we felt quite stale. People saw the logo and thought it was a finance institution. It could have been any of yours. I think it didn't really tell about who we were and what we're actually doing. The fact that we are rebranded now and can see that it's actually lifting all of ConvaTec and people understand who we are, what we stand for, and that goes across all categories. I think we've just started that journey because we started the rebrand in May.
I think we will see amplification of this in the years to come.
Super. Thanks, Kjersti. It's 3:44 P.M., and I think we've earned ourselves all a break. I'm gonna encourage us to have a break. If I could ask for all of us to come back sharp, okay? We will start right at 4:10 P.M. here. Maybe come in even a couple minutes earlier. But there'll be some coffee and tea and biscuits, etc., outside. We'll start up again at 4:10. This is about a 25-minute break. Okay.
Healing wounds is no easy task. The road to recovery can be long, and the outlook is often bleak. A desperate lack of resources, too many patients, and not enough time means healthcare professionals are unable to provide the level of care they'd like. While patients find themselves with little support, ill-equipped to practice good self-care, which leads to poor quality of life and a higher rate of recurrences. Not to mention needless amputations and staggering mortality rates. It doesn't have to be this way. At ConvaTec, we believe in better healthcare, not just for some, but for all. We know that with the right education about wound hygiene and the right treatment choices at each stage of the journey, wounds can be healed and even prevented. That's why we're always developing new technologies that help minimize the risk of complications and reduce the time it takes to heal.
It's why we're always working with clinicians and key opinion leaders to roll out much-needed educational programs. It's why we're always listening to what patients have to say so we can provide services and support that make a real difference in people's lives. That's our commitment to you that we'll keep doing everything we can to empower healthcare professionals and support patients. We will make people care as much as we do, and we will make change happen because we know that by improving the standard of care and supporting better self-care, we will improve the lives of those we touch for today, for tomorrow, and forever. ConvaTec. Forever Caring.
ConvaTec cares about my skin.
They understand when the skin around my stoma thrives, it creates a healthier bond between my ostomy system and my body.
Making living with an ostomy more about living.
I feel like my life has changed for the better. I feel like this experience has enriched me so much, and I've been able to be more gentle and forgiving and accepting and proud of myself, loving on every part of my body, my scars, my bag.
I could leave the house and be secure throughout the day. Being able to get up in the morning and maybe go out, throw a ball with the dog for a little bit.
The thing I do now that I did not do before I had an ostomy was fully be present in life.
I wake up every day and I just think, man, I don't have enough time in the day to do all the things that I've got to do.
I feel like now I have my life back. The bond between my ostomy system and my body has allowed me to get back to the life that I was used to living.
My most important bond is with myself.
With my community.
My most important bond is definitely family.
My bond has given me extra life. It's given me extra time with my family.
My most important bond makes me feel good.
My most important bond makes me feel confident. I've got my life back.
My most important bond is with myself. The thing I do now that I did not do before I had an ostomy was fully be present in life. I feel like my life has changed for the better. I feel like this experience has enriched me so much, and I've been able to be more gentle and forgiving and accepting and proud of myself, loving on every part of my body, my scars, my bag. I feel more confident than I've ever felt in my entire life. ConvaTec cares about my skin. They understand that when the skin around my stoma thrives, it creates a healthier bond between my ostomy system and my body. It has given me extra life. It's given me extra time with my family. Healthy bonds make living with an ostomy more about living.
When I was in the hospital, they gave me the urostomy bags, and I'd never even thought about this thing. Never worked on before. We don't know how to do it. I found out that there was a place that you could go to get answers. Whenever I have a question, I can call a me+ nurse, and he said, "Well, here, this is the way you do it." He shows you. They got a video that shows you how to do it. I mean, this is great. me+ nurses have helped me with my urostomy products. I'm grateful for ConvaTec, I assure you.
A recent study showed that 40% of catheter users find the process difficult and painful. Allison found that using catheters with a sticky lubricant often gave her debilitating urinary tract infections. She now uses one made by ConvaTec with the company's patented FeelClean technology, and things are much better.
The catheter that I use now is the GentleCath Glide. I find this one is a lot better, one, because it doesn't use that lubricant on it, that sticky lubricant, and it's quite a soft one. It is quite easy to use.
Paul Carenza joined a Facebook group where catheter users share experiences and advice. He's been self-catheterizing since he was eight years old. Now he's a stand-up comedian. Work trips have to be carefully planned.
When I was born, I had some organs on the outside, which isn't ideal because they're called internal organs. It's one of those hidden disabilities, I suppose, even though I kind of almost don't think of it as a disability for myself because I've always had this. Certainly, as a young adult, that was probably the time of most anxiety for me as I was working out how to take this existence that I had in the home, how to take that into a social life, and how to take it out of the house and go and do things and live the life I wanted to live, really.
It's funny how we take many things for granted. Everyday things that we just expect to work. I switch on the light, I turn on the water, I make my coffee, and the milk is cold. We just trust a lot of things to work. Imagine if we had to spend time worrying about all the things we trusted. What a waste of time that would be. ConvaTec, just one of all the things I trust.
This event is really, really special. It's been over five years that we've had a chance to have the 100 most senior leaders at ConvaTec all come together. Guess what? We're having a lot of fun.
We've got our top leaders from all around the world getting together for the first time in many years to reconnect, talk about our vision and our future together, and really get to know each other as individuals.
I'm able to collaborate, meet a lot of new colleagues, and at least talk to them in person, and I'm quite thrilled to be here.
You know, their message to us is, "Hey, we are not just patients. We are people. We are moms. We are dads." What they are looking for, simple, innovative solutions that not only help them manage their condition, but also their social and emotional well-being.
The vibe in the room that says people enjoy working together, they're aligned to produce a product, and most importantly, from my vantage point as a board member, they are aligned to serve the customers.
We just rebranded, and that is so important to all of us employees as well as all the patients and caretakers that we reach because we are, as a company, all about caring.
I've just been deeply impressed by the passion and the pride that actually people have in what we do for patients every single day. The solutions and, you know, the importance of what we actually do and the impact that we can have on their lives. This new, you know, Forever Caring promise that we're bringing. This just ties this all together.
Today, we're really all about building high-performing team. What an incredible opportunity to partner with Michigan Ross. Really a luxury to be guided, to spend time to interact with an incredible faculty so we can grow into one winning team.
ConvaTec is a fantastic organization with an inspiring purpose, the right strategy, and starting to deliver really good things for our customers, patients, shareholders, and other colleagues.
You're doing an amazing job. Your leadership's been incredible. The level of motivation, the level of passion, the talent that you've been displaying has been phenomenal. All I can say is that our best days as a company are yet to come. If you're ever in doubt, remember, we're here to bring Forever Caring to life.
It's funny how we take many things for granted. Everyday things that we just expect to work. I switch on the light, I turn on the water, I make my coffee, and the milk is cold. We just trust a lot of things to work. Imagine if we had to spend time worrying about all the things we trusted. What a waste of time that would be. ConvaTec, just one of all the things I trust.
This event is really, really special. It's been over five years that we've had a chance to have the 100 most senior leaders at ConvaTec all come together. Guess what? We're having a lot of fun.
We've got our top leaders from all around the world getting together for the first time in many years to reconnect, talk about our vision and our future together, and really get to know each other as individuals.
I'm able to collaborate, meet a lot of new colleagues, and at least talk to them in person, and I'm quite thrilled to be here.
You know, their message to us is, "Hey, we are not just patients. We are people. We are moms. We are dads." What they are looking for, simple, innovative solutions that not only help them manage their condition, but also their social and emotional wellbeing.
The vibe in the room that says people enjoy working together, they're aligned to produce a product, and most importantly, from my vantage point as a board member, they are aligned to serve the customers.
We just rebranded, and that is so important to all of us employees as well as all the patients and caretakers that we reach because we are, as a company, all about caring.
I've just been deeply impressed by the passion and the pride that actually people have in what we do for patients every single day. The solutions and, you know, the importance of what we actually do and the impact that we can have on their lives. This new, you know, Forever Caring promise that we're bringing. This just ties this all together.
Today we're really all about building high-performing team. What an incredible opportunity to partner with Michigan Ross. Really a luxury to be guided, to spend time to interact with an incredible faculty so we can grow into one winning team.
ConvaTec is a fantastic organization with an inspiring purpose, the right strategy, and starting to deliver really good things for our customers, patients, shareholders, and other colleagues.
You're doing an amazing job. Your leadership's been incredible. The level of motivation, the level of passion, the talent that you've been displaying has been phenomenal. All I can say is that our best days as a company are yet to come. If you're ever in doubt, remember, we're here to bring Forever Caring to life.
First one is that.
We've gone through basically three deep dives, and I think we promised you five deep dives. We're gonna go ahead and dive deep now into Infusion Care. I'm gonna do something very similar with the whole simplification and productivity agenda. We'll have a little bit of a double act there with John Haller and Jonny. We'll conclude with financial prospects, and Jonny will go ahead and do that. Just kind of give you a sense of where we're at from a process perspective. The second thing, I've just gotten some feedback that when we do Q&A, if you guys could just be a lot louder when you're introducing yourselves in terms of your name and your firms. There's a lot of people that are connected, and they weren't quite sure who was asking what questions.
If I could just provide you that friendly reminder that would be most helpful. At this point, look, super exciting business, Infusion Care. Without any further ado, Kjersti.
Thank you very much. I hope you all got a little energy boost during the break. I'm very excited here to be here today and to discuss the Infusion Care business in a little bit more detail with you. Before diving in, I'd like to give you a little insight into my background. I've actually been with ConvaTec for five years. I joined as President EMEA, and then when we changed the operating model, I got to lead the Continence Care business unit for two years. I got the responsibility for Infusion Care at the beginning of this year. Before joining ConvaTec, I spent my whole career in the diabetes field in vitro diagnostic, mainly point of care. We developed small benchtop analyzers and diagnostic tests that gave results in minutes.
I held positions ranging from R&D, commercial positions, and also leading manufacturing sites. In addition to that, I have two daughters. They're now in their late twenties, and when the youngest was seven, she was diagnosed as a type 1 diabetic. As you can understand, this area has been very close to my heart, both professionally and personally, for a very long time. Before I get into the details, I want to highlight the key takeaways. We are the global leader of infusion sets, and we have a very clear strategy. We will continue to be the partner of choice and the clear market leader in diabetes. We will leverage our proprietary modular platform beyond diabetes, where there are some significant opportunities, such as Parkinson's and in the treatment of pain. By doing this, we expect to deliver high single-digit revenue growth.
These key numbers give an overview of what we do and how broadly we reach people with chronic diseases. We are the global leader of subcutaneous infusion sets, and every single day, 1 million people living with chronic conditions are supported by us. In order to serve all these people, we manufacture and deliver more than 110 million high-quality products every year. We got 3 production sites, which John will talk a little bit more about. We have 2 in Denmark and 1 in Mexico. Capacity and resilience have been the focus for us over the last couple of years, and we're making great progress. This year, we will finalize expansions in both Mexico and Denmark. The market we operate in are diverse and very attractive. Diabetes is currently the single biggest opportunity.
The number of people diagnosed with diabetes, it is currently at more than 300 million, with both Type 1 and Type 2 growing at 3%-4%. Our target group are the patients using automated insulin delivery solutions, where the overall growth is approximately 8%. We have a fantastic group of partners. We work with Medtronic and Tandem for many years, and we have newer partners like Beta Bionics, who will be launching their iLet offering, including our infusion solutions. Our aim is to continue to be that preferred partner for all of them in years to come. To do that, we need to continuously offer product enhancements as well as completely new technologies based on deep understanding of the customer needs combined with market insights.
We can deliver solutions based on really good customer insight, and we can design them for high volume production. Our infusion sets are being used for other applications in addition to diabetes. There are approximately 8.5 million people living with Parkinson's disease, and currently, the drug apomorphine is approved in Europe as third-line treatment for Parkinson's. Many patients are now using our solution, the Neria infusion set together with a pump. In addition, palliative pain management as well as primary immunoglobulin deficiencies are areas where we do see uptake of our solutions. COVID has accelerated the trend towards more at home treatment, making the subcutaneous therapies more and more relevant, and that's a key opportunity for us medium to long term. If we look more at the diabetes segment, we believe it remains a very attractive market.
The prevalence of diabetes is improving, and is increasing, and technology is improving. We expect the penetration of automated insulin delivery to continue to grow. Pump therapy is under-penetrated and like I said, growing at 8%. Today, only 27% of type ones are using pumps and less than 1% of type two. That combined with the fact that more than 50% of all people living with diabetes do not meet the treatment goals, and hence would benefit from changing to pump, which is proven to give better clinical outcomes. The fact that so many people living with diabetes are underserved in terms of treatment, that's a significant opportunity for growth. The automated insulin delivery is a closed loop with an insulin pump, an infusion set, and a continuous glucose monitor.
This serves as close as technology allows as an artificial pancreas for the patient, and the parts are connected via software algorithm, ensuring optimal glucose levels at all times for the user by adjusting insulin boluses from the pump. Our traditional infusion sets last from 2-3 days before they need to be replaced by a new set. The sets have different designs and features catering to the different needs of the customers. Our technology platform is modular-based, and it opens up for applications beyond the traditional infusion sets. If you look at this, our products are made of four distinct parts, of which we have built deep expertise over the years and leverage capabilities from other parts of the company. The inserting device has a retractable needle, ensuring that insertion is safe, easy, and ensure consistent performance and an absolutely exceptional user experience.
The adhesive technology, ensuring both skin adhesion as well as being skin-friendly. Our competencies and technologies in this area is not only stemming from Infusion Care, but drawing on technologies and expertise both in Wound Care and in Ostomy Care. The tubing is made from a tunable high-performance polymer for properties including hydrophilicity, multiple layers, kink-free flexibility, and drug compatibility. Here we've been able to, leverage expertise from catheter material technologies. The cannula is the part that goes into the body and hence must stay open, prevent occlusions, and consistently and safely deliver the drug. This can be soft steel-based, and it can be inserted at different angles. We have built a strong base of competencies, processes, and platforms that enable us to innovate, develop, and market high-quality products at scale and at cost.
The modules of the platform can be applied to more than durable pumps, where both patch pumps and glucose sensors will benefit from several of the technologies. We actually believe that we are well-positioned to play a major role in the patch segment, thanks to our core capabilities and our knowledge around insulin delivery. Also, our business unit has made good progress on the FISBE strategy. Focus has been and will be to be the leader in diabetes with our infusion solutions. This is our base and will continue to be top priority, and where we have seen strong growth over the last three years. While performance can be varied from year to year, depending on our partners. I'm confident that we will achieve high single-digit growth in the coming years.
Innovation is key to our success, and our partner, Atomic, has launched the extended wear infusion set in Europe, and this week they're launching in the U.S. We are also developing infusion sets for the new very small Mobi from Tandem. This will be the shortest infusion set on the market and offer a very flexible solution for the patients. As already mentioned, there are other disease areas where our solutions can be key, and we're working with different pharma and biotech companies to map and deliver on these opportunities. On execution, our ability to serve our customers, and can we mention that we have been capacity-constrained, this is absolute key, and we made a lot of progress with addition of several new production lines and footprint expansion in Denmark and Mexico.
Overall, when we get to the end of 2023, we should have ample surge capacity for all of our partners. I wanted to zoom in on innovation effort and talk a little bit more about the extended wear infusion set, because this is a really good example of a co-developed innovation addressing key unmet needs. Like I said, the offering is now available both in Europe and in the US. With this standard infusion set, the patient need to change every 2-3 days. Think of this, when you saw the picture. You have a pump, you have an infusion set, you have a CGM. They need to be changed at different intervals. I can tell you to live with this condition, it's a heavy burden.
I just actually read yesterday on Twitter, it's Type 1 saying, in general, a Type 1 are making 180 decisions every day related to their condition. Just think about that. With the extended wear that is already launched, like I said. Now you don't have to change every 2-3 days, you can change every 7 days. It reduces the number of changes by half. In addition, it reduces the amount of plastic with 2 kg per patient per year. ConvaTec has introduced green design guidelines into our development processes, and Infusion Care is leading the way with this launch. This further builds into our ESG strategy to reduce ConvaTec overall footprint. As already mentioned, medical conditions like Parkinson, pain, and PID are treated using our infusion sets.
Our Neria Guard infusion sets will be part of the AbbVie drug 951, which is the very first subcutaneous delivery of the combined levodopa/carbidopa treatment for Parkinson's disease. With that, I also wanted to just give you a glimpse into the daily life of a person living with Parkinson's, being supported by our solutions.
When I first got the diagnosis years ago, I was devastated. Parkinson's. I used to think that's what old people get. I was not ready to get Parkinson's. I started off taking a lot of pills, but as my condition progressed, I was offered a more advanced treatment: pump therapy. This treatment really helps me live a more normal life with my condition. Luckily, I have my family supporting me. I'm fortunate enough to have a healthcare professional who cares about my condition. She keeps encouraging me to exercise. Now I meet my friends once a week and ride my bike. We always end up at a cafe and talk about life over a cup of coffee. I'm still learning to live with Parkinson's. Just talking about it with my friends was a big hurdle.
It is not easy, but at least I have treatment options and support. I have hope for the future.
To summarize, we're a global leader for infusion sets for sub-q drug delivery. The lion's share of the business is in the diabetes segment and will continue to be the main focus. Key driver will be continue to innovate and develop new solutions at scale and cost for our customers. We can expand our platform technology to current and new partners in durable insulin pumps as well as patch pumps and CGM. Outside diabetes, there are several exciting opportunities for us to pursue. With that, I bring it over to John, who will talk about GQO. Oh, I'm going to be quick.
Thank you, Kjersti. I'm excited to talk to you today about our simplification and productivity journey in global quality and operations. Before I do, just a brief introduction. I started my career as an Army officer, airborne ranger, member of a worldwide rapid deployment force. I loved the sense of clarity around the mission and the need for teamwork that the military brought. When I transitioned to medical device many years ago, I found a similar sense of mission in connection to why we do what we do. I spent 26 years at Stryker Corporation, mostly in operational leadership roles, living and working in different geographies around the world.
Had the opportunity to lead the global operations team of 12,000 people in 43 sites around the world at a time when we grew the business from $9 billion in annual revenue to $14 billion in annual revenue. I'm delighted to be at ConvaTec, where we have absolute clarity on our promise, on our mission and our values, and complete alignment on those. I'm excited to work with our global operations team around the world to do the great things that we can do to build a world-class supply chain. Let's talk about simplification and productivity. You heard from the four business unit leaders about the commercial excellence journey they're on and what they're doing to drive simplification and productivity. You'll hear from Jonny talking about the G&A component of that journey. I'll talk you through three global programs that we're driving in GQO.
That's gonna be plant network optimization, it's gonna be automation and robotics, and continuous improvement. Before I do that, I would like to spend a little bit of time just talking about our GQO team, our manufacturing network, and some of the other key initiatives that we have going on. Our manufacturing network consists of 10 sites around the world. Nearly 60% of our employees work in those manufacturing locations. You'll notice that each of our business units is supported by multiple manufacturing locations throughout the world. You'll also notice that some of those manufacturing locations serve multiple business units.
We do have a fair amount of shared technologies, product, and process that's leveraged in those facilities and great opportunity to drive continued productivity across that manufacturing network. Beyond the data points that have been expressed so far, I just wanted to add a little bit of perspective to our GQO team. My first couple months in the role earlier this spring when I joined the company were spent traveling to our manufacturing locations. I was very pleased with the level of professionalism and the strong capabilities that our people have around the world. We've got a very capable and committed team in each of these manufacturing sites. We've got strong manufacturing capabilities to do the processes that generate the products that we put into the market every day.
The real opportunity that's there that we've gotten the team to collaborate and sign up for now is to drive standardization of those best practices across the global network, and that's a big part of our journey for productivity. Safety first, quality always. This phrase resonates throughout our manufacturing locations worldwide. Very simple phrase, yet very powerful. It's also completely aligned with our ESG agenda, and I wanna talk to you about three specific areas where we see that alignment. The first is with safety and our commitment to our colleagues. We have a very low lost time injury rate. We're sustaining that. The way we sustain that safe environment is we proactively look for hazard observations, looking for things that could cause accidents, and then eliminating them before accidents happen, and that's our commitment to our colleagues.
With regard to energy, you see a really nice trend, and I'm very proud to be able to say that next year in 2023, across that global manufacturing network, 100% of the electricity in all of those locations will be of renewable sources. We also have four of our locations that generate some of their own energy through solar panels, and we'll continue on that journey. The third pillar, which lines up very well with our ESG agenda, is quality and our commitment to our customers. We're fully committed to one global quality management system.
We have a very robust internal audit program, and that is our way of intensely looking within our operations at where are the areas of opportunity to strengthen and to identify those and resolve those before we have external audits, and that's how we maintain a very high level of compliance throughout the network. Then with regards to complaints per million, you heard Karim speak earlier about the nice reduction we've seen over the past couple years. We're committed to continuing to drive that reduction, signing up for a 10% year-on-year reduction. We've made great improvements in our ability to deliver product to our customers on time in 2022. You can see that we struggled like many other companies in the fourth quarter of 2021.
The global supply chain challenges. Ports were pretty well clogged up. Containers were hard to come by. Raw materials were difficult to source, so our ability to deliver on time to our customers suffered. Great, steady progress throughout this year. In the first half of 2023, we'll get those service levels above 95%, and then we'll take them upward from there. To improve our customer experience, we've added capacity throughout the network to be able to produce sufficient product to insulate our customers for future supply chain disruptions. We've also introduced a real-time tracking system, which allows our customers to have visibility from order right through to delivery of their product.
When it comes to resilience, in the short term, we've invested in strategic inventory, raw materials, and finished goods in adequate quantities to provide security for our customers to know that products will be delivered regardless of supply chain challenges. We're continuing to expand our efforts to dual source raw materials and do more dual manufacturing throughout our manufacturing network. All of these efforts around quality and customer service are lined up behind our objective to drive NPS, net promoter score, higher. We're connecting every employee on the GQO team with NPS to understand what he or she does on a daily basis to help improve our ability to take care of the people that rely on our products each and every day. Let's talk about the three global programs that will drive simplification and productivity, and we'll start with plant network optimization.
At the end of the day, plant network optimization is all about creating the most efficient manufacturing network, both internally and externally. How do you do that? You look outside at the external environment. You look inside at your internal capabilities. We identify all of our core competencies in our manufacturing locations, but then with a very critical eye, we select the ones that help us create a competitive advantage in the marketplace. Then in the core competencies where you can create a competitive advantage, that's the ones that you keep in your internal manufacturing network. That's where you invest your capital and spend the energy. Then you're very willing to outsource to qualified partners in our supply base to do the other work.
If they've got strong quality systems, a keen ability to deliver to customers on time, and good cost, that's the outsourcing that we do. Collectively, that drives plant network optimization. Automation is a tremendous opportunity for us at ConvaTec. We're on a journey with this one. Østed in Denmark is the only site that we would consider as highly automated. The vast majority of our fabrication and production is done in a highly automated environment. We've also deployed packaging automation in Østed, not throughout the entire site, but a fair amount of it is also resident in the Østed facility. Of our other top five sites, which is where most of the opportunity lies for automation, we do have some automation, and the teams have done a really nice job automating some of their production lines.
We've not yet taken on the packaging challenge in those other facilities, but the beauty of the opportunity is that it's not a question of whether we can automate our production and our packaging. It's just a question of how quickly can we proliferate already existing know-how throughout the network. For example, the automation that we deploy in Reynosa in Mexico is the exact same equipment doing the exact same process that we already have in Osted, Denmark. We have a packaging automation project in Deeside in the UK, and the equipment that will be used for that is very similar to the equipment that we're already using in Osted. Our challenge now is to, as quickly as possible, drive that automation agenda. I'd like to give you a really clear example in our Infusion Care business of how powerful automation can be.
If you look at these two lines, it's the exact same product being packaged. The only difference is on one line, it's staffed by our team members. On the other, you see collaborative robots positioned to do the packaging. This is where infusion sets are put into thermoform blisters that then go into containers and cardboard boxes and are then palletized. All of that happens without human contact where we have packaging automation. The benefits are many, and they start with the employees. What we're able to do is take the tasks that our employees like least, either for the difficulty of the task or the repetitiveness of the task, and we automate those. This allows us to have fewer employees in our manufacturing locations doing more skilled efforts to create value for our customers. From a company perspective, it drives improvements in quality.
We have better process control, more predictability, and lower cost. Really important that we drive the automation and robotics agenda throughout ConvaTec. Each time we deploy automation, we also further insulate ourselves from labor inflation in the future. I'd like to show you a short video with a good example of what this high-speed precision automation look like. This is taken from our facility in Osted. I'll ask you to take a look at it. In our high-speed automated lines, what you observed was the preparation and the placement of the components into the automated line. You saw a variety of very precise assembly processes taking place. What you may not have seen is that we have some very high-tech vision systems that do verification throughout the process to really monitor and control our process and ensure that the output is a quality product.
There are over 70 distinct feeding, assembly, and verification steps on the high-speed line that you just observed in the video. Continuous improvement is really the core of our simplification and productivity journey. It starts with ideation events. We're trying to drive a continuous improvement culture throughout all of our manufacturing sites. Ideation events involve bringing cross-functional teams together at multiple levels of the organization. Meetings take place in conference rooms, on the shop floor, and in labs. The one thing that everybody has in common is just bringing ideas on how we can improve. Those ideas come together cumulatively and result in a variety of projects being executed at each of our manufacturing locations. Those projects lead to benefits in quality, ability to deliver to customers on time, and also cost. I highlighted one for you today, which is our FlowWrap packaging project.
What this will do in the first quarter of 2023, we'll begin to ship product that our customers prefer with a flexible, lightweight packaging they've given us great feedback on. It is far less packaging material that's consumed to package our product, and therefore, significantly less cost. Because it is smaller, it's also cheaper to transport it around the globe. The benefits for, again, our customers as well as our ESG commitments are resident in a single project like that. That's not uncommon that many of these continuous improvement projects bring multiple benefits. Those are the three global programs we will drive. What does it all mean that we're gonna deliver? You can count on us for enhanced quality, greater resilience, and improved productivity throughout our manufacturing network.
Our efforts in the medium term will lead to an approximate 50-75 basis point improvement to margin. As I said at the outset, I'm very confident in the capability and commitment of our GQO team around the world to deliver on these initiatives and deliver these results. I'd now like to turn it over to Jonny, who will talk to you about G&A. Thank you.
Thank you, John.
Hello, everybody. Very nice to see many of you again. For those of you I haven't met yet, I'm now into my tenth month as CFO here at ConvaTec, and enjoying it very much. Previously, I've got 16 years of experience as a CFO in public listed companies and private equity-owned companies, big ones and small ones. In particular, I've had a lot of experience of leading transformational change, simplification, and productivity programs, which is directly relevant for this stage of ConvaTec's journey. I'm the last presentation today, and in about 20 minutes, we'll go back to Q&A. I've got two parts. First of all, I'm gonna talk about simplification and productivity in G&A, and then I'll move on to talk about the financial prospects for the business. As you've already heard, our simplification and productivity agenda has three parts.
You've heard about the commercial piece from the category leaders. You've just heard from John on operations. On G&A, we spend over $200 million per annum, about 10% of our sales, on the important administrative functions of the business. Now these functions are vital, but that's not efficient. It's too expensive. We've made good progress. We're well on the way in our journey to improve G&A. We established a global business services function in 2020, and it's now up to a decent scale. It enables us to deliver economies of scale by centralizing expertise in cost-efficient locations. We can drive productivity by standardizing and simplifying processes and by reducing low-value activity. We've set up all of the major finance and IT processes in our global business services. You can see them listed in the middle of the chart.
The volume of transactions that we are processing now has increased to a substantial scale. Just a few examples. We're serving 12,000 customers in nine different languages. We pay over 200,000 invoices each year, and we're making and delivering management accounting reports for 70 countries. Here's a couple of examples to bring to life the progress so far. On the left, automation. Through 2020 and 2021, we've been automating the receipt of customer payments. We now process over 14,000 customer payments each month with very little manual intervention, which reduces error rates and improves productivity. On the right, reduction of low-value activity. This graph represents the number of low-value manual journals processed each month for the business. Through this year, 2022, the number of those has been reduced by 47%.
Continuous improvement of this nature is what enables our colleagues to spend more time doing high-value activity and also for us to reduce costs. Reducing costs. We've reduced G&A by approximately $50 million over the past couple of years when taking account of inflation. That reduction has included less reliance on external consultants and contractors. Some of those were brought in temporarily, to be fair, in favor of using internal expertise. It's involved relocating headcount dispersed around the globe to central locations of good cost efficiency. It's involved standardizing projects and starting to introduce automation. There's a long way to go, and there is significant further opportunity. On an ongoing basis, we are leveraging our GBS platform. Finance and IT, which are well established there, we are increasing the scope of the activities, and we're increasing geographic coverage.
We are adding more digital tools and more automation, including, for example, some self-service apps. We're incorporating more of the group's processes within GBS, which I'll give you an example of in a moment. Next steps, further opportunities going forward. We have a large network of fixed offices around the globe, which dates from pre-hybrid working times. We've got the opportunity to improve the working experience of our colleagues and to save costs. We've got an HR transformation underway, which will modernize the way we manage ConvaTec's most valuable resource. Including talent development, career pathways, and other factors. It will also give us a simplification and productivity opportunity as we deploy central processes such as payroll, training, onboarding centrally into GBS, and we can use people analytics to improve the experience of our colleagues.
We can also include more functions within the simplification and productivity journey. For example, procurement, pricing, and some legal operations. Now this chart is intended to show the opportunity to increase efficiency of including processes end to end within GBS. At the top, we've got record to report, which is entirely managed by GBS now, and it works well. We do 6,000 journals, we complete the financial statements for 40 legal entities all in one location. The opportunity there is to expand this process that works well into greater geographies, such as our operations in Asia. At the bottom, that process is source to pay, and you can see that only some parts of it are managed by GBS currently. Outside of GBS, we have 15,000 suppliers who provide products and services to the organization.
They're managed in the countries around the globe, and that generates about $100 million of invoices per annum. The opportunity there is to create a catalog of standard products and suppliers in order to leverage the group's buying power, and then to automate those cataloged products for processing within GBS. By standardizing further processes and automating more, it gives us the opportunity to become more productive and to save more costs going forward. As I've said, and to conclude on G&A, we are well on the journey of improving productivity. This year we expect costs to be around about 10% of sales, which is down three points over the last couple of years, and we have a clear target to get down to 7% over the next few years. Now there's a lot of work to do, but we have a plan.
In this area of G&A, we're not innovating. This is not rocket science. You know, what we'll be doing is only what other people have already done before. That's what gives us confidence that we will achieve our target. Let me change tack and talk about the financial prospects of the group, which you can see are attractive. First, a reminder of the targets we've discussed already today. Top line growth of 4%-6% per annum organic revenue, that will be delivered by the categories as you can see on the screen, with infusion care and wound care growing fastest, and then with ostomy care and continence care growing at mid-single digits. We will increase our margin to the mid-20s with three main levers. We've already talked about simplification and productivity.
I'm gonna talk about margin mix now, and then I'll wrap it all together with operating leverage thereafter. Margin is gonna improve through mix for three main reasons. The first one is portfolio focus. Over the last couple of years, we've made a number of divestitures and acquisitions to focus the business more on chronic care in our four categories. Now this has the benefit of improving margin because we are divesting lower margin and lower growth sales, and we're increasing higher margin and higher growth sales. That will continue. The second area is growth across categories. Our categories with richer margins, being Infusion Care and Wound Care, are growing faster, and that will continue into the medium term. The third area is within categories.
Within each category, we're working really hard to improve the margin by increasing the proportion of ConvaTec manufactured product in our sales, by increasing the amount of in-house manufacturing in those products, and by rationalizing out lower profitability SKUs. A combination of all these three factors means that we will see positive margin mix going forward over the medium term. A word on price. We have made good progress on price since we introduced the Center of Excellence. We operate in markets where it is not straightforward to pass on price increases because of inflation in costs. There are some opportunities in B2B relationships or where there are distributors, and certainly the existence of high inflation gives you better grounds for discussing price with customers. Nevertheless, it's not straightforward.
The progress we've made has been by rolling out best practice around the operations. Disciplined approach to discounting. Global minimum prices controlled centrally. Better training, better reporting, better analysis, but more focus. By rolling out best practice of this nature, we've seen positive price development last year and in the first half of this year by 50 and 60 basis points respectively. That compares to a previous pattern of 1%-2% price deflation across the sector. Our medium-term target is to deliver flat to positive price development. Now inflation is a significant headwind to our progress on margin. We've set out on the left there the approximate proportion of a composition of our cost of goods. The arrows indicate the intensity of inflation that we have been experiencing.
In 2022, we expect inflation on all of our cost of goods to be in the range of 8%-9%, as we said back in March, albeit it will end up at the top of that range. We see the shape of inflation changing. In raw materials, in freight logistics, the rate of inflation is abating. In utilities and in labor costs, the rate of inflation is increasing. When you put it all together, we think that in 2023, inflation will still be a very significant headwind to the business and to margin improvement, albeit perhaps slightly less overall than in 2022. This pulls it together. This is how we are going to deliver improvement in EBIT margin from what we expect to report in 2022 of 19%+ to mid-20s over the medium term.
The biggest improvement will be from simplification and productivity, where you'll get 3 points from G&A, and then across a combination of commercial and operations, there'll be another couple of points. Margin mix, the three areas that I've just talked about, that will add another couple of points. I've said that inflation is a headwind. Operating leverage. The benefits of 4%-6% sales growth every year on a partly fixed cost base will cover inflation over time, but not next year when inflation is expected to be more significant. Now the simplification of productivity and the mix levers are within our control, and that is why we are confident that we will be able to deliver the target. Now, we don't wanna be precise about timing at this stage because of the macro uncertainty there is out there in the world.
Unless inflation deteriorates further, you should expect positive margin development every year until we get to the target. You know, honestly, if it hadn't been for inflation, we'd be well on the way towards it already. Now, when we deliver the sales growth and the EBIT margin targets, that will lead to, as Karim said at the beginning, double-digit growth in earnings and free cash flow. Now, the growth won't be double digit next year because of the external drivers of significant inflation and also the market rates on financing costs. But it will be double-digit growth over the medium term as these targets get delivered. Delivery of the sales growth and the EBIT margin improvements will also drive strong growth in cash flow.
This chart shows EBITDA in dark blue on the outside, current on the left and medium term on the right, with the uses of cash in colors in the middle. Let me just talk to those very briefly, from the bottom up. Working capital. That includes the $20 million additional investment in strategic inventory that we've made to improve resilience in our supply chain. CapEx. We expect that to settle at a run rate of about $100 million a year, after, though, a few years of higher investment. Leases and adjustments. That's where the transformation costs sit for fundamental restructurings of the business, such as the exit from hospital care this year. Then you've got financing and tax, which we expect to go up following the development in the market rates.
Even though some of these uses of cash are expected to increase. What you'll see from your models is that the free cash flow increases quite substantially, and it increases faster than the EBITDA. How will we use that cash? Our capital allocation principles are underpinned by a strong balance sheet, prudent approach. We are reiterating our target of net debt being 2x EBITDA. Now, we will apply that flexibly, and we'll be comfortable going up to 2.5x for appropriate M&A. There will always be a clear path back towards our target of 2x. We've just announced today that we have refinanced our bank facilities, $1.2 billion of bank facilities, for 5 years. We've got some of the audience in the room to thank.
These have been refinanced at slightly improved credit margins compared to our previous bank facilities, reflecting stronger credit standing. Those, in addition to the bond, which we also have $500 million, mean we have got plenty of liquidity for any circumstances. Our first priority for investment will be organic growth, whether that be OpEx or CapEx, we will invest in the innovation pipeline and in commercial effectiveness to sustain the growth of 4%-6% per annum. It'll be a progressive dividend policy. We'll look to increase the dividend every year in line with our payout ratio of 35%-45%. Bolt-on M&A is next. This will be focused on strengthening our competitive positions in our focus areas. Thereafter, any surplus capital would be available for return to shareholders.
With all of the good opportunities that we've got to invest in the business, we don't think that's likely in the medium term. Let me finish with this slide, which Karim showed at the beginning. Just to reiterate that delivery of the sales growth of 4%-6% per annum, and delivery of the margin improvement to mid-20s% leads to double-digit growth in earnings and in free cash flow over the medium term on a compound basis. It's an attractive financial profile, and I hope you've heard today that we have the ability to deliver it, and we're looking forward to the journey. Thanks very much for your attention. I'll now hand you back to Karim for Q&A.
Thank you. Okay. Do you guys feel like you know a lot more about ConvaTec?
Oh, yeah.
Yeah, I get lots of nods. Okay, excellent. Look, we wanted to make this an interactive session again. We welcome questions. Anybody who hasn't yet asked a question. Let's start with folks who have yet to start. I'll start right here. Please introduce yourself nice, loud and clear.
Yeah. Hi there. Jack Reynolds-Clark from RBC. Thanks very much for taking the questions. First one on the infusion devices side. Wondering if you could give any color around kind of the timelines to the patch pump products and also potentially the Parkinson's and other indications there. And then just on the margin bridge-
Can we just take one? It might be easier if you just take them one at a time. Would that be okay?
Of course. Yeah, no problem. Yeah.
Yeah. I think the first one is timing around the whole area of diabetes and patch, and then timing maybe around Parkinson's. Maybe I would pass that on to Kjersti.
Yeah, thank you for the question. Yeah, as we saw for patch, our technology, we have a technology platform that can be used. We're working with our partners, the current ones and the new ones, to see what's the next stage in the development of pumps. 'Cause you have the durable ones, then you might have hybrid pumps. I think you might have heard about that, thinking of the Omnipod, which is fully disposable, but there might be hybrid ones that is actually a better solution. We're working on all of that without giving any exact timelines. On Parkinson's, we know that AbbVie waiting for approvals, so that would most probably launch next year. We're very excited about that opportunity, and for two reasons. One, it's a fantastic solution for the Parkinson's patients and you saw the number of Parkinson's patients is huge.
We just have to see what this could be. Again, the launch of this might be already next year, and we'll take it from there.
Excellent. Please, Jack.
Great. Thank you very much. The second one was on to Jonny on the EBIT bridge. Obviously very, very helpful diagram there. I know you said that you wouldn't discuss or you don't quite know what the medium term means yet. But I was wondering if you could provide any color on kind of the timings of those relative components. What should we start to see coming through first and what are the easy wins and kind of the harder things to achieve?
Look, I think you should expect steady progress. You know, certainly on G&A, steady progress on simplification and productivity and all its components, steady progress, and on mix as well. You know, those programs that are under our control, well, they're under our control, and we'll deliver them. The uncertainty is in the macro environment, and that's why, you know, we just think it's imprudent to be very precise about timing, when there is so much uncertainty in the macro environment. You know, it's medium term, it's not forever, and you should expect positive progress every year.
Great. Thank you so much.
Thanks, Dan. Okay. Why don't we go to the gentleman here with the pink necktie, I think.
It was Robert from Morgan Stanley. I had two questions. The first one was just around comments you made on SKU rationalization. I'd just be curious to know how much further you've got to go there, and what's the risk it takes the part of your growth targets away or makes the growth ambitions more difficult if you're taking on product offerings to your customers at the same time?
I'm assuming here, Robert, you're referring to the SKU rationalization in Ostomy Care. Is that what you're referring to?
Yes. Correct. Yeah.
I think Bruno highlighted this, and please Bruno, jump on in here if you wanna add any more. Fundamentally, you know, we've reduced the SKUs by about 650. I think Bruno highlighted that about 75% of the SKU rationalization has been completed, and by the end of 2024, we should be all done. Clearly, you know, that has created a headwind of about 100 basis points. I think that's what Bruno said. I think there'll be still some continued, you know, headwind that we will experience in 2023 and in 2024.
Thank you. My follow-up was just around the automation opportunity. You flagged robotics and automation in one of your slides. I'd just be curious there, how big of a component is that in your assumptions of your EBIT bridge in terms of your progress? I guess I'm sort of slightly asking the question of how much is headcount reduction coming in in the next sort of 2-5 years? How much is the direct cost out part of that bridge assumption?
Yeah. Maybe I'll ask Jonny to try to answer that, and then, John, if you have anything else you'd like to add to it.
Yeah. John showed a number of 50-75 basis points of productivity improvement for everything going on in GQO. Automation and robotics is one part of it. There's also continuous improvement. There's also network optimization. When you ask how much is it, you know, it's less than the total there, without wanting to get too specific about it. I don't think you should be expecting to see any large redundancy bills coming, if that's what you're worried about. You know, this will be gradual over time and absorbed.
Yeah. I would agree. I think it's important to point out that that gradualness that Jonny refers to, when you're keeping up with a growing business, it allows that to be a very graduated impact.
Yeah.
Let's see who's yet to ask. I'm gonna go to the gentleman with the glasses there, please. Both of you have glasses. I'm sorry. I think the person who's closer to me. I think you got a pink shirt, if I have some.
Michael Wilson.
We'll go to the white shirt. Yeah, sorry about that.
Hi. Sebastien Jantet with Liberum. Two questions, if I can. On the extended wear sets, so clearly you've got a product that's gonna be changed less frequently, but you know, there's a lot of value created for the customer. I'm wondering how you split that commercial kind of value creation with the customer and how we should think of that in terms of impacting revenue growth and margins in that business. The second question is one for John, which is more around the packaging piece. 850 million kind of products produced this year. You've got automated packaging in one out of, I think, five of your kind of sites there. Why aren't you changing it more quickly?
Okay. Great questions. I've never asked you on that question, by the way. Let me pass it on to Kjersti first. Extended wear infusion sets, I think, value creation versus value capture, how are we managing that?
Yeah. You're right. For the person with diabetes, the value of this solution is higher than the effect of selling less infusion sets. You can actually think of it a little bit like when the blood glucose strips went to a CGM, very high value for the patient. When it comes to the split between our partners and us in that respect, that's not something that I'm going to share with you at this point in time.
The only thing I would say, though, in terms of value sharing, from a margin impact, it doesn't worsen in any way, shape, or form for us, right? If you're sort of doing simple math and saying, "Hey, I doubled the length, what happens to price?" I think for a, from a ROI perspective, I think it's fair for you to assume that in terms of value capture, it's at least as good as what we have been capturing historically.
Okay.
I'll just add that.
Yeah.
Let's go to the next question about packaging and why can't we go faster, John, than earlier? Yeah.
Thank you. What I alluded to, which you might have picked up on, you know, in our global manufacturing network, historically, it was not run as one global network. Where we are today is we're at the beginning of a journey where 10 locations are learning to collaborate and share best processes. If you take the packaging automation as an example, the first thing we have to do is just demonstrate feasibility across those different sites and come up with a platform and validate it and demonstrate that we've got something that works across the board, and then as quickly as we can scale that.
It's a multi-step process, but if you take that time up front, it'll pay dividends later, as opposed to going as fast as you can in 5 or 6 locations at one time. Makes sense. Super. Gentleman behind you, please.
Hi, everyone. Tanya from UBS. I just wanted to talk about 2023 growth. Just given the fact that this year you're probably gonna be in the upper end of your organic growth guidance. You've also got the hospital business that you are closing down. Ostomy rationalization is gonna be a smaller headwind next year. You've got the Triad coming into organic growth next year. Are you not tempted to raise your growth range next year? Just my second question is just on pricing. What do you expect for pricing next year relative to this year? Thank you.
Okay. Sounds like Jonny, there's a lot of questions about what's gonna happen in 2023. What do we anticipate in terms of revenue growth and pricing? Jonny, how do you wanna handle that one?
Well, I will start by saying today is not about detailed guidance for 2023. You'll hear more on that in the normal calendar, which will be in March in our year-end results. All that said, yes, we're pleased with how organic sales have gone this year, and it was nice to be able to bump up slightly the growth expectations for this year. It's still within the range. I doubt we will be increasing the range next year, but let's see in March. What was the other one?
Just on pricing, what's gonna happen?
Oh, pricing. Yes, no, pricing. Well, that's, you know, that's clear, which is that, as I said in the presentation, we are looking to have a flat to a small positive impact from price every year, benefiting from our pricing COE. Now, that might sound like a modest ambition, but it's in the context of a sector which has previously gone down by 1%-2% per annum. Small positive is our target.
Super. Okay. Good gentleman, right above Hassan, please.
I'm not sure it's working. There we go. Okay, so that's getting numerous. I'd just like to take you back to a comment you made earlier, Karim, around the vitality index. You mentioned I think the word substitution. I'm just wondering, with sort of the new launches, is there an element of cannibalization that takes place with your existing sort of products? I'm not sure if that's what you were referring to in substitution. You know, and how confident are you that those sort of new products are coming in at high gross margins?
Yeah. It's a two-pronged question. I think on the first part is, you know, to what degree could there be substitution or cannibal? I think it's fair to say that there could be some. So, you know, just as a practical example, as you go ahead and provide a higher performing offering, say in the case of foam. David was talking about foam earlier. We do have a foam offering already in the marketplace, right? So again, it's gonna vary category by category and product offering by product offering. That'd be my first comment, that I would say in terms of substitution. Help me out again with your second part.
I'm just wondering why product launches and margins on that?
Yeah. I'd say, like, in terms of margins, it's something that we're always focused on, meaning we're focused both on top line growth and, margin expansion, and then ultimately, frankly, you know, what is the ROIC and IRR. Fundamentally, that's what we're looking at. I think with new products, we're striving continually to improve from a mix perspective. I think Jonny alluded to this. The reality is that oftentimes when you're launching a new product, there is a learning curve element to it, right? So maybe initially your volumes are a little bit lower, and you gotta slide down that learning curve, see the volumes grow and increase. I don't know, Jonny, would you wanna add anything? No, I think that's it. Did that answer your question?
Yeah.
Super. Why don't we go to Hassan?
Hi. Thank you. It's Hassan from Barclays. I've got 2, please. So firstly, on Infusion Care, could you update us on the rough mix and concentration of key customers, as well as the risks you see from, A, your customers, such as Tandem, producing their own infusion sets, and B, market share gains in patch pumps at the expense of durable pumps. Secondly, Jonny, following up on the bridge and timing, if I could push you a little, if we did happen to assume that medium term was a five-year horizon, then margin expansion would be anywhere between 400 to, you know, 700 basis points or 80+ per year, which is significant.
I guess, you know, given what you talked about, 50-70 with operations, is this the right way of thinking about it, or is it far off the mark? Is it more back-end loaded?
To try to untangle this whole margin area, right? We'll give Jonny a little bit of time to reflect on the answer to that question. Why don't we start off with the Infusion Care area? I think a little bit of questioning around mix and concentration and, hey, are there any risks? I think you highlighted Tandem and the patch area, right? I'll pass it on to Kjersti.
Very good. Yeah. I mean, there is no secret in the fact that our two big long-term partners are Medtronic and Tandem, who has been growing really, really well in the patch pump market. But also, like you said, the fact that the patch pump with Insulet Omnipod 5 is doing a really good job, but when you look at the overall automated insulin delivery, it's growing at 8%. And the fact that, like I said in my presentation, so many people are not meeting the treatment target for people on MDI to get onto pumps, whether they're durable or patch, because there will be a solution for all of them, and it won't be the same. I think for me, it's actually more opportunities when you see how many people are not yet on automated solutions.
Just to really emphasize, I mean, I think most of you will know, but, you know, the real area that we're competing with is multiple daily injections, which we call MDI, right? Our fundamental thesis is that automated insulin delivery will displace multiple daily injections. If you don't buy that thesis, then hey, there's an issue. We firmly believe that, okay? I think what Kjersti did wonderfully was just to highlight that if you believe that automated insulin delivery is gonna grow in a material way, then there's much more opportunity than just being on a durable pump. She highlighted to you the CGM area. She highlighted to you the patch pump area. From our vantage point, there's significant opportunities. I just wanna echo her thoughts or ideas.
Yeah, good try, Hassan. Look, I don't think you are wild off the mark, first of all. I think important context is that we will be delivering an increase in margin this year despite inflation being 8%-9%. We're on the road. If it hadn't been for inflation at 8%-9%, we'd be further down the road. There are certain of the levers we talked about today which are in our control, and we will deliver them in a steady manner. There is no sense in which they will be back-end loaded. We can't be precise about timing. It would be imprudent to be, because we don't know what inflation is gonna be over time. How long will operating leverage cancel out and cover inflation? That's an unknown, which isn't in our control.
Super. Gentleman with the blue tie.
Thanks very much. It's Sam England from Berenberg. Could you just give us a sense of the CapEx expectations for the automation strategy, and then over what sort of period that's gonna be phased in? Give us a sense for how you assess the ROI on the automation strategy, sort of what the payback period is.
Okay. CapEx for automation and how much might we wanna invest there, and what kind of paybacks are we thinking about? I think, Jonny, this one seems squarely your court.
Shall I kick off with that one? Look, we described a run rate of CapEx of being about $100 million in a couple of years' time, and probably two-thirds of that is likely to be in operations, I think. Then of that two-thirds, you know, you'll have half of it related. These are just, you know, broad numbers. Half of it related to simplification and productivity, and the other components dealing with maintenance and network optimization and the other things in John's control. The way we measure the financial return on automation is the same as we measure anything else, actually.
We're looking for IRRs comfortably above our cost of capital, and that usually means in the kind of mid-teens or upwards, and we're looking at net present value and payback. We are, you know, very focused on delivering a strong financial return for all of the CapEx that we deploy.
Great. Thanks. Maybe just to follow up on the outsourcing strategy that you mentioned, what's the current split between insourcing and outsourcing? Where do you think that'll get to over time? What sort of cost saving do you think you could achieve from sort of like more outsourced manufacturing?
What is our current split between outsourced and insourced, and what might our strategy moving forward look like? Maybe, John, do you wanna take that one?
Yeah, sure. If you look at the strategy, I think it's not so much a question of changing our ratio in the middle of our COGS portfolio. It's not so much shifting the balance of more out versus in. It's really making sure that you are investing internally where the key capabilities are to give you a competitive advantage. As new products come out with those inherent processes in them, investments will take place there. What you'll see is our manufacturing network will become more focused and more productive, and then our strategic partnerships outside, who will also start doing more work for us, will be at a deeper level because the dependency goes to a higher level as well.
Super. Okay. Why don't we go back to Veronika, and then we'll go back to the gentleman in pink.
Excellent. Hi, it's Veronika Dubajova from Citigroup. Two questions from me. One, just circling back to the CGM topic, and would love to understand, Kjersti, from you, what the development timeline looks like, and what do you need to do to get into that space. Maybe sort of what's your competition, if you are to play in that space. That would be helpful, I think, for everyone to understand. I'll ask my financial question after that, if that's okay.
Okay. Kjersti, please.
Yeah. As you saw, we have a modular technology platform now. There are a lot of components in place that can be supplied. Thinking of CGMs, which we're not going to do a sensor, right? You have some really strong competitors that would have been out there that's doing that that we can deliver better solution for any of them with our technology, that's clear. That's something that Divakar and team are working on. I don't know whether you would like to say anything about timelines, opportunities, at least on that, Divakar.
I would just say, sorry, I'll let Divakar comment. I think in terms of timelines, it wouldn't be appropriate to comment, honestly, Veronika. So Divakar may wanna add more color to how we're thinking about it. I would just echo Kjersti's thought, which is there's a clear opportunity. The opportunity has been identified. We're actively pursuing it. I don't know if you wanna add to that.
Yeah. I think from a technology perspective, I mean, it's a modular platform, so whatever time it takes for us to do our internal one is what it would be for others. It comes to volumes. It also comes down to whether our partners would have to do clinical studies with all this. That's as generic as I can get. I think Kjersti's point really was, hey, we have an amazing platform, and we can double down. We can go deep. We see a huge opportunity in type one and type two, and it's not just the durable pump. It gives us a broad moat so that we can go offensive. We can broaden our portfolio of innovation. Yeah.
Thanks, Divakar.
I know you don't wanna comment on the timeline, but if I say, is it in the medium term? Is the answer to that yes, or is it in the long term?
I would say, look, the entire theme today has been medium term, so. Medium term it is.
Well, whenever we figure out the magic answer to what medium term is, that's when it is. Excellent. Thank you, guys. Just one for Jonny on the capital allocation and returning excess cash to shareholders. I'm just curious how you're thinking about that in terms of obviously wanting to maintain flexibility for M&A. Is that something that's a short-term priority, or, you know, are we gonna see you guys accumulate cash for the next couple of years until you make a decision on that? Thank you.
No, I think I said in the presentation, we don't see it as likely that there will be cash available for return to shareholders in the medium term, because we've got lots of great opportunities to invest in the business. That starts with organic opportunities that we've been talking about today, both OpEx and CapEx, and it also includes bolt-on acquisitions. You know, the difference between internal investment and external investment effectively is sometimes they're delivering kind of the same thing. So we do see that very much as a pool of investment available to drive the business forward.
Super.
It's David Adlington from J.P. Morgan. Just on the Parkinson's opportunity again, how many of those 8.5 million patients are stage three and four, and how long do you expect them to stay on infusion therapy? And then just in terms of the price of the IC device for Parkinson's, is that a premium to diabetes or a similar sort of price point?
I guess I can take the last part first. If you think of what a treatment total cost would be for a Parkinson's patient and the fact that it is on our own branded solution, I would probably say it would be in the premium range. I have to admit, I don't know the exact number of patients being in stage three and four. Unfortunately, nearly everybody gets there. When you get on this medication, you will stay on this medication because this is as good as it gets in the treatment timeline.
Super. Thanks. David, any other questions? No. Anybody else? Okay. We're running right on time, so we're on schedule, as we would say here. What I wanted to do at this point was just really say a huge thank you to all of you. It's really been tremendous just to have you actively participate and learn more about ConvaTec. I hope you've gotten a clear sense that fundamentally, our level of optimism and confidence that we're gonna deliver sustainable and profitable growth is high, right? I'm very comfortable telling you that my level of optimism and confidence relative to three years ago has certainly increased. On that note, I'm just gonna say a big thank you to all of you. For everybody here in the UK, in London, we've got a wonderful reception.
Not only will there be some food and drinks, but we're also gonna have some demos. If you're curious to learn more about our customers and more about our products and services, each one of the category leaders will be hosting a booth with a demo, and we would encourage you to actively participate. On that note, thank you very, very much, and we'll be in touch.