Well, good morning, everybody, and welcome to ConvaTec's 2025 Financial Results presentation. Press harder. Usual disclaimers apply. I'm going to start with an overview of 2025 and a little bit of what to expect 2026. Fiona will present the financial results and guidance, and then I'll come back and talk about where we are on our strategic journey, and what to expect next. Then we'll be very happy to take any questions you've got at the end. 2025 was a year of strong delivery. It was the 5th consecutive year that we delivered organic revenue sales growth within our target range. That was supported by 8 new product launches that we've got underway at the moment.
It was the fourth consecutive year of margin expansion. It was the second year we grew EPS growth by double-digit, and there's more to come on that. The strong cash we generated enabled us to invest more, to grow for the future, and also to do some return to shareholders. The growth is starting to compound. The flywheel is turning, and we are well set for the future. In 2025, there were some headwinds. We delivered despite them, which demonstrated the resilience of this business. As set out on the chart, we're in four chronic care categories. These markets are growing structurally, independent of the economic cycle. That provides a broad base for growth. There's a high proportion of recurring revenues, especially where we deliver excellent customer retention, loyalty, satisfaction based on the service we provide.
We have strong market positions, which gives stability to the earnings. We make differentiated products and solutions. We're innovating to satisfy unmet customer needs. We're investing in the fastest growing segments of our categories, and we've got the richest product pipeline in our history, which benchmarks pretty well with the industry. The growth is broad-based. We're not dependent on any one category, or product, or geography for our growth. There are reimbursement dynamics in this sector. There always have been. There will continue to be. We build in an expectation of those in our plans, and we grow through them. New product launches help us to overcome reimbursement pressures, and they help us to grow consistently ahead of the markets. This resilient business is strengthening in the results and the delivery.
The increased cash we're generating is enabling us to invest more in CapEx and in R&D to build for the future. The organic revenue growth has been increasing steadily throughout the FISB strategy period. The operating margin, we've delivered consistently 4 years in a row of margin expansion, well on the way to our target of mid-twenties. EPS growth was double-digit for the second year in a row, there's more of that to come. You can see our progress best by looking at how we've been using cash over the last 5 years. Starting from the bottom, operational cash flow, excuse me, operational CapEx has been consistent at about 2.5% of sales. Last year, growth CapEx increased significantly, we have a real opportunity here to invest to meet the strong demand.
Dividend grew slower at the start of the period until profits caught up. Now that profits are growing faster, we're in our target payout range, you can expect dividend to grow in line with profits going forward. On M&A, we've invested over $500 million over the period. Last year was a bit smaller. We will continue to be disciplined in acquiring only bolt-on investments, which increase our competitive strength in our focus areas. This remains a priority area for us, you should expect to see more investment here to increase growth going forward. Last year, we managed to return $300 million by way of share buyback within our prudent leverage target of two times EBITDA. To summarize this introduction, what I'll say is...
We are consistently delivering against the targets we've set in the FISB strategy and the targets we set three years ago at our last Capital Markets Day. The turnaround of the business from the poor state it was in when Karim arrived in 2019 has been delivered, and we're now ready to accelerate. With the rich pipeline of new product launches we've got underway and coming, supported by higher investment to grow the pipeline and capacity, we're increasing our target growth rate to 6%-8% per annum from 2027. We're looking forward to explaining how we're gonna do that at the Capital Markets Day in six weeks' time. Thanks very much. I'll hand over to Fiona and to talk about the financial results, and see you again shortly.
Thank you. Well, thank you, Jonny. Good morning, everybody. Well, I have met many of you here today. For those who I haven't, I'm Fiona Ryder. I've been the CFO for about 6 months, and I've been at ConvaTec for about 4 years, working closely with Karim and Jonny on the delivery of our strategy. I'm delighted to be here today to present a summary of our 2025 financial performance, plus our outlook for 2026, before handing back to Jonny for the strategic review and Q&A. We are pleased to report another strong financial performance for 2025. Organic revenue growth was broad-based across all 4 categories. Excluding InnovaMatrix, which I'll talk about shortly, revenue growth was 6.4%.
Operating margin expanded by 110 basis points to 22.3%, taking our cumulative margin expansion over four years to 460 basis points. We delivered double-digit EPS growth at 16%. Our cash flow was strong, with free cash to equity conversion of 101% under our new definition, which I will come back to later. This strong cash flow enabled us to increase investment for growth and for return to shareholders. Growth CapEx more than doubled, a 13% increase in dividend, a $300 million share buyback, while delivering our net debt to EBITDA at target of two times. These strong results demonstrate our track record under the FISB strategy and are further evidence of our ability to deliver sustainable, profitable growth. In ConvaTec, we are really proud of this slide that shows our turnaround.
Excluding InnovaMatrix, it's 5 consecutive years of organic revenue growth above 5% and 3 years above 6%. Margin is continuing to expand, accelerating EPS growth and strong cash conversion. In 2025, sales growth was broad-based across all 4 categories, as this chart demonstrates. Infusion care was the standout performer. On the right, you can see the impact of the significant market uncertainty in skin substitutes, with InnovaMatrix sales down around $30 million year-over-year. Let's look at sales by category, starting with advanced wound care, where sales were up 4.1%, excluding InnovaMatrix, or flat, including. We saw good growth in North America and Latin America, with an improving performance in Europe in H2. Our flagship brand, AQUACEL Ag+ Extra, delivered another good year, and we are very pleased with the launch of ConvaFoam, which is gaining share.
InnovaMatrix sales decreased $30 million to $69 million, with H1 down about 13% and H2 down about 44%. As you know, from the first of January 2026, CMS has introduced a price rate of $127 per square centimeter, which represented about an 80% reduction for InnovaMatrix. As previously guided, this equates to a headwind in 2026 of around 2% of group revenue. As a result of the estimated impact on future forecasts, we have recorded a non-cash accounting impairment of $72 million for our InnovaMatrix platform, equating to about 20% of the acquisition consideration. We still believe that InnovaMatrix is a highly effective product, beneficial for patients and trusted by HCPs. We look forward to it returning to growth in 2027.
In ostomy care, organic growth was 4.5%. The highlight of the year was the performance of Esteem Body, our one-piece soft convex pouch, which grew ahead of expectations and where we anticipate further strong growth in 2026. Growth was also supported by our updated Esenta accessories range. We were also delighted to secure our first group purchasing organization win in the U.S. in 5 years. We followed this up with a further GPO win post-year-end. Good U.S. growth was supported by continued new patient starts from our home services group. Growth in Europe increased during the year. Latin America performing really well. In continence care, organic growth of 6.6% was driven by further volume increases in the USA, backed by our outstanding customer service and our broadening product portfolio.
We saw faster growth in sales of Convatec product relative to other manufacturers, which is now 59% of our sales mix, given our improved product portfolio of products, and faster growth of hydrophilic product, which was again over 60% of our revenue. We grew strongly outside the USA from a low base, international again contributed over 1 percentage point to the category growth rate. Infusion care, where organic growth was double-digit at 12.5%. Growth was faster in H1, as expected. There was continued strong demand in diabetes across both long-standing and newer customers, as the penetration of automated insulin delivery over multiple daily injections is increasing. Outside diabetes, growth was excellent, led by infusion sets for AbbVie's Parkinson's disease treatment.
Other therapies now represent 15% of our infusion care revenue, up from about 10% in 2024, with scope to grow further as a share of the category. We have a strong position in infusion care, with increasing diversity across customers and products. We are confident that 2026 will see another strong year with high single-digit growth. Moving on to profitability. 2025 was another year of improvement. Operating margin expanded by 110 basis points or 100 basis points in constant currency, in line with progress over the last few years, where margin has increased 460 basis points since 2021. The strong growth in infusion care and the reduction in InnovaMatrix contribution results in movements in margin mix and OpEx, which broadly offset each other. Price and productivity contributed 30 and 130 basis points, respectively.
Inflation was around 3%, as expected, a headwind to margin of 110 basis points. I would expect a similar level of inflation in 2026. We saw further material cost benefits from our simplification and productivity programs. GNA was down a further 50 basis points to stand at 6.8% of sales. This slide shows how we have delivered mid-teens growth in earnings per share. With operating profit up 12%, finance costs were down about $2 million. Our tax rate was steady at 24%, leading to a 15% increase in net profit, which, with a reduction in shares, led to 16% increase in earnings per share. Turning to cash, we had a strong year, with free cash flow to equity of $362 million and a conversion of 101%.
We have redefined cash flow to equity to better reflect the free cash available for capital allocation. We have separated operational and growth CapEx, increasing disclosure transparency, we've adjusted for some small non-cash items. Using our previous definition, free cash flow to equity was 61%. The main points to highlight are: EBITDA increased 12% from our improved operational performance. Working capital increased by about $40 million, in part due to the fourth quarter being our highest sales quarter. As this unwinds, we expect working capital growth to be lower than revenue growth in 2026. Operational cash payments of $64 million were unchanged year-over-year, cash adjusting items of $16 million were slightly below our guide of $20 million.
Growth CapEx of $121 million more than doubled year-on-year, as we identified compelling organic investment opportunities at high returns, given strong demand for our products and our exciting product pipeline. We paid dividends of $140 million, we completed a $300 million buyback in the second half. Net debt increased by $272 million, with leverage landing at our target of two times. Here is our outlook for 2026, reiterating our early guidance from November. We continue to expect 5%-7% organic growth in group revenue, excluding an InnovaMatrix. Group revenue will be second half weighted as product launches build. Following the significant CMS price reduction, we expect InnovaMatrix sales of around $20 million for the full year, strongly H2 weighted.
On operating margin, we expect further progress in 2026 to reach at least 23%, irrespective of InnovaMatrix headwinds. This will be further underpinned by simplification and productivity improvements across operations, commercial, and GNA. On profit phasing through 2026, I expect us to make modest margin improvements H1 2026 on H1 2025, and greater margin progress in the second half. This sales growth and margin improvement, coupled with largely unchanged finance and tax costs, and the reduction in our average share count from our buyback, translates to another year of double-digit EPS growth. Cash generation will be strong, targeting around 100% of free cash flow to equity conversion. Operational CapEx will continue to be around 2.5% of sales, with growth CapEx increasing to drive organic growth. To wrap up, 2025 was a year of strong financial delivery.
We hit our targets across sales, margin, and EPS. 2026 will be another year of double-digit EPS growth, as well as significant investments to accelerate future growth. From 2027, we are set to sustainably deliver 6%-8% per annum organic growth, a mid-twenties operating margin, and double digit in EPS and free cash flow to equity. Our financial results are starting to compound. Thank you, and I'll now hand back to Jonny.
Right. Thanks, Fiona. We've said that Convatec is delivering against the FISB strategy, and that now is the time to evolve that strategy. We're not gonna get into the details of the strategy evolution today. That will be at the Capital Markets Day. I'll just spend the next few minutes expanding on the delivery to date and why now is the right time to evolve. This is a slide which Fiona just showed. It's known internally as my favorite slide. I'm not gonna go through each metric, but just to show how the momentum is building. On sales, on margin, on EPS, on cash, momentum is building. We are becoming a stronger business with more to invest, and that sets us up really well for the future. We've also shown before how that growth is broad-based.
All four categories are contributing to the growth, as you can see from the chart. Four strong categories working together, That's despite the reimbursement headwinds that they have faced along the way. That growth is supported by new product launches into each category, as you can see from the colors on this chart. We've got eight products in the market now launching on the way, We've got eight more to come across 2026 and 2027. At the end of 2027, guess what? We're not gonna stop. There's more to come, there's more in the plans, We will be describing what that is at the Capital Markets Day. Let me just take a moment to reflect on where we are now. ConvaTec is a strong and growing business.
We've got strong leadership positions in markets that are fundamentally growing, with high levels of recurring revenue, and that makes us very resilient as a business, and we've established a track record for delivering on what our targets were. It isn't always right first time. It hasn't been as smooth as it could be. Growth last year was good. It was strong. If we had executed seamlessly, it could have been even stronger, and that's what gives us confidence that we can grow faster in the future. We are learning as we go. This intensity of new product launches and this faster growth, these are new muscles for Convatec. The FDA letter that we received just recently was very disappointing. It relates to the management of our complaints handling and our corrective and preventative actions. We're working on that.
The FDA said it's not good enough, and we agree. This is now top priority. We've got our best internal team working intensively on it. We're working with the FDA, with our customers, and with external advisors, because we're determined to become best in class in this area as quickly as possible. Our execution is improving. I mentioned that just now. You know, last year, as I said, growth was strong. It could have been even stronger. The opportunity ahead of us is substantial. We're in these four categories that we are experts in. They benefit from a common set of technologies across operations and research and development. They are synergistic together, and the demand out there in the market is very strong. Our new product launches are working, and they're winning share.
That's what gives us confidence that now is the time to be accelerating those sales growth targets. Going forward, based on this rich pipeline of new products and strong demand, we're gonna be executing smoother, sharper, simpler, faster, and we're gonna be backing our growth with investment in more pipeline and in more capacity in order to drive that faster growth. Let's look at that by category, starting with wound care. In 2026, we expect mid-single digit growth for wound care, apart from InnovaMatrix, which Fiona has talked about, and that's a special case. Mid-single digits is based on continued growth of our market-leading strong brand, AQUACEL Ag+ Extra. Strong market share, still growing very nicely. ConvaFoam is winning share now in Europe and in North America, and that will scale up.
We'll be launching, through 2026, ConvaNiox, ConvaFiber, and ConvaVAC, and we'll be repositioning InnovaMatrix to win in the years ahead. In addition to those product launches, generating and disseminating clinical evidence is becoming a bigger feature of our product launch pipeline, and we'll be doing that for all of these products through 2026. From 2027, the growth is gonna accelerate because all of these new product launches will be scaling up, and InnovaMatrix will return to growth. If we look at ostomy care, in 2026, we're targeting mid-single digit growth. Esteem Body is proving to be a really successful product launch. Our one-piece, soft, convex, new ostomy bag product growing very nicely.
In addition to that scaling up in Europe, USA, and other markets, we'll be launching Flexi-Seal Air, our new fecal management product, and we'll be continuing to improve commercial execution across the continuum of care. That's where we've been really successful over the last couple of years. That's what's led to the winning of GPO contracts for the first time for a long time. You know, folk are saying, as regards ostomy, Convatec is back, and we're very proud of that. In 2026, we'll start to build on those GPO contract wins, going into 2027, growth will accelerate because we'll win some more contracts. Esteem Body will keep scaling up. We'll be growing our Esenta accessories portfolio, and very importantly, we'll be launching Natura Body.
This is the two-piece equivalent of Esteem Body, important for the U.S. market, which is more of a two-piece market. We'll be very happy to see Natura Body launched, expect it to be just as successful as Esteem Body, and that will support our faster growth going forward. Incontinence care. In 2026, we're expecting mid-single digit growth there, too. This business, we're very big in the U.S. As we've said before, this is based on excellent service. Our home services group has customer satisfaction scores, which are really world-class. High customer retention, high customer loyalty, and we continue to grow share, to grow volume, despite being clearly the market leader. Through that growth, the proportion of Convatec products that we sell is increasing because our product portfolio is improving. We launched GC Air for Women a while ago. It's growing.
We're gonna be launching GC Air Pocket, which is for men, and GC Air Set, which is unisex, in 2026, in Europe first, then 2027 in the U.S. We'll also be launching Cure Aqua, which is starting in the U.S. New product launches coming in continence care, which will underpin that growth, and then it will accelerate from 2027 as these new products build and as we expand the excellent customer service model outside the U.S., where it is still very small. Then Infusion Care. We're targeting high single-digit growth in Infusion Care in 2026, which is consistent with what we've been targeting over the last few years. Although we have delivered a bit higher than that, but, you know, the plan is high single digits for the year ahead.
It's gonna continue with further diversification of products and customers. The technology in this area is evolving. Our customers' technology and pumps is evolving very quickly, and our infusion sets can service the whole spectrum of pumps across the industry. It's strong demand out there. Whilst we grow through 2026, and as I've just referenced, with regards to the FDA's observations, we'll be improving our system for complaints validation and for corrective and preventive actions, following up on those customer observations. From 2027, we will be accelerating growth in Infusion Care. We'll be investing significantly in more capacity, and that will be in Inset Guard to service the diabetes sector, and in Neria Guard for the other therapies, principally Parkinson's.
There are other therapies in addition to Parkinson's that we will be developing as well. Very strong demand from Infusion Care, strong growth to come. Let me conclude then by saying that Convatec is delivering. This, we've described a resilient business model which is delivering through the headwinds, and that growth is sustainable going forward. The simplification and productivity agenda that we have been running for the past few years has got further to run. That's what will lead us to be able to expand operating margin further in operations, in commercial, and in GNA to get to our target of mid-twenties, which we're still focused on. Growth is starting to compound. Double-digit growth in EPS is what you should expect going forward. That will be based on an acceleration of the top line.
Really pleasing that this rich pipeline of products that we're launching into the market, they are working. They're gaining share. This pipeline is the richest we've ever had, and we think, as I've said, it benchmarks very well against anyone else in the industry. As we learn with all of these products, as we grow faster, our execution is strengthening. That, plus the CapEx that we will commit to supporting more pipeline and more capacity, is what will underpin our faster growth rate. We're increasing our target growth rate from 22 and 27, to be 6% to 8% per annum. We'll tell you more about how we're gonna deliver that at Capital Markets Day on the 9th of April, and I hope to see you all there. Thanks very much for your attention.
We'll be happy to take any questions you got.
Jonny, just, we'll take questions from the room, then there's 65 people on the call. We gather there's been some issues with the website streaming. We apologize for that, but the call is live. We'll go room, then call, and then website. First question, Hassan.
Good morning, Hassan Al-Wakeel from Barclays. A couple, please. Firstly, on Ostomy Care, can you talk about how you're seeing new patient capture and share dynamics in the U.S., and how you see some of these GPO wins to change that in 2026 and then Natura in 2027? Secondly, on the margin, you expect to lose around $50 million of InnovaMatrix revenue in 2026, a 2% headwind versus the 1%-2% expectation that you talked about. Can you talk about some of the offsets to this loss of revenue and your confidence in the building blocks in being able to drive that at least 70 basis points in margin expansion in 2026? Thank you.
Sure. Ostomy development in the U.S. is building nicely. We were declining for some years until our new leadership took over, and our commercial execution improved. In the last few years, our new patient starts have been stable, and we've been building share through an improved product pipeline. That's been helped by the improvements to the ESENTA accessories range and now most lately by the launch of Esteem Body. It's the improvement in commercial execution, the education offer to healthcare providers, the me+ service support to patients, which has been leading our relationships to strengthen and to us gaining those GPO contract wins. We expect this to build further going forward. We expect to be gaining share in new patient starts as well, and for that to accelerate when Natura Body is launched in 2027.
It's a steady build. We've said mid-single-digit growth for ostomy care in 2026. That's what we are confident of delivering, and then it will accelerate after that for those reasons described. Do you wanna talk about?
Yeah. Thank you, Hassan. We are guiding in 2026 to at least 23% operating margin. We have delivered 460 basis points over the last four years, and our top line will be growing, excluding InnovaMatrix, 5%-7%. That, coupled with the simplification and productivity programs that we continue to drive, will underpin the margin expansion. We have a track record there.
Okay. Do you want to pass to Seb?
Thanks. Morning, it's Sebastien Jantet from Panmure Gordon. questions, if I may. First of all, just on the medium-term margin kind of guidance between 24% and 26%, you know, we're kind of in the early months of 2026. That's not that far away now as we look into 2027. I'm wondering what are the things that make it land towards the top end of that guidance versus the bottom end of that guidance? The second question is just, you've talked about factoring in reimbursement headwinds in your guidance, you've upped your revenue guidance. Perhaps give us a sense of what are you factoring in for reimbursement headwinds within that revenue guidance?
Yeah. You wanna take the first one?
Yeah. We are guiding or have guided to mid-20s by 2026 or 2027, we still hold to that. Now, it's likely to be at the lower end of that. In 2027, it'll be closer to 24%. I think we've said that a number of times. We think mid-20s is the right place for our margin, we think that benchmarks well, it allows us to continue to invest in top-line growth.
Yeah, as regards to the detail of the reimbursement headwinds, I don't wanna get into the specifics product by product. Over many years, the headwind has been quantified as roughly a point of headwind, and we've used a point of headwind per year across all the categories. Now, it varies depending where different countries at different times. We've had different examples of where that's come from. The intensity of it in the U.S. has been more than normal over the last couple of years, and the headwind has been a bit higher than that. Before that, we had tenders in the NHS. We've had the French hospitals reducing the quantum of products that they have issued. We've had German pressure on silver reimbursement. There's always been something.
With the new product launches and with the pricing COE that we have introduced, and has been delivering now for a few years, we've managed to counteract these reimbursement headwinds. In our targets of 5-7, we include the headwinds in there and that we will deliver through them. Likewise, for our accelerated growth, 6-8, that is after absorbing whatever the reimbursement headwinds will be in the future.
Thanks. Can you just pass back to Kane? Cheers.
Morning, it's Kane Slutzkin from Deutsche. Just guys, on the growth side, I'm just wondering, are you being a bit conservative on the infusion care guide? I mean, you've sort of been beating it for a while. On ostomy, following up from Hassan, you were sort of saying, you know, you're gonna accelerate from 27. You've got obviously another GPO win. Are we looking at sort of a mid to high single digit grower in time? Is that kind of what you're implying? On the M&A story, how is that pipeline looking and in the absence of anything, I mean, would you be considering further buybacks, or do you have enough on your hands in terms of the increased CapEx? Thanks.
Take that one.
Yeah.
Are we being conservative on infusion care? It's quite interesting to compare. You know, two years ago when GLP-1s came out, all those stories were around, everyone thought the infusion care business was in trouble. Far from it, really strong demand. Our products, as I mentioned in the presentation, are able to service all sorts of different pump technologies, and the prevalence of pump technologies in the market is increasing significantly, both the penetration of pumps in diabetes compared to multiple daily injections. That's growing nicely, but also in Parkinson's therapy and in other therapies, too. Strong demand pipeline going forward. We have delivered more than high single digits over the last couple of years, just about in infusion care. The, you know, the customer orders are predictable but not uniform. Right.
They are a bit lumpy, but we know what they are because we talk very closely, work very closely with our, with our customers. As we look out into 2026, we think it'll be high single-digit growth. I don't think we're being unduly prudent there. I think that's the best basis to plan on. Thereafter, we do think there's an opportunity to accelerate because we'll have more capacity coming on stream, and the therapy application areas will be growing. You asked about ostomy care. Look, yes, I think that is a reasonable, a reasonable expectation.
It's mid-single digits in 2026. We think we will accelerate growth thereafter when we have the full portfolio of products with which to compete in the markets in U.S. and in Europe. I think you can expect a bit stronger growth than that going forward from 2027.
I'll pick up the question-
Oh, sorry.
Sorry, on M&A. We have really clear capital allocation priorities: invest organically in the business, pay the dividend, which we are in the middle of our range for this year. M&A opportunities when they are attractive and accretive to growth and returning excess capital to shareholders. Every year, we go through the process of looking for the right M&A opportunities. We look at the opportunity to invest organically. For 2026, we see great opportunities to invest organically in the business, as we have said, with the increased growth CapEx. If we don't find any M&A opportunities, we will return capital as we did in 2025, but we continue to look.
Should we Jack?
You got Graham.
Hi there. Jack Reynolds-Clark from RBC. Thank you for taking the questions. The first is on the midterm guidance. What are your expectations for the kind of the phasing of that, of that new revenue or that updated revenue guidance beyond 2026? Fiona, you mentioned that you still see mid-20s as the fair level of margin for the business. I guess, would you expect it to trend towards the top, the upper end of that range over the next few years? What are your expectations for kind of margins in a few years time for the business? My next question was on ConvaNiox. You mentioned the slow launch in Europe, initially ahead of a more accelerated launch later on. Kind of what feedback are you getting?
How's the launch progressing versus your expectations, and what pricing are you able to take there? Thank you.
Do you want to do the first one?
Do you want me to start with the first?
Yeah.
Midterm guidance, we're upgrading that today to 6%-8%. I'm not going to guide any more specifically about what that will look like in those years. You asked about the margin being at mid-20s. Yes, we think that margin at mid-20s is about right for us. We're guiding to at least 23% for 2026. You can expect that to increase a little more over the next couple of years, we think staying at the mid-20s would be right for us. On ConvaNiox?
Yeah, prioritizing investment in growth going forward. You know, once we get to mid-20s, there's plenty of things to invest in. ConvaNiox, yeah, it is going really well. We've got a few hundred patients now who have been treated. We are deliberately taking that slow and building evidence. We're working with key opinion leaders and we'll build the network of healthcare professionals from there. Everything we've seen so far reconfirms the strong performance of the dressing. We believe this is a dressing that does things that nothing else in the market does. It's that combination of antimicrobial action and also accelerating the wound healing.
We've got 1 RCT, as I'm sure you've seen, from a while ago in the U.K., which showed 2x as fast healing rates and 3x as fast wound surface reduction as standard of care. We're now running another RCT in the U.S. to build further evidence, but don't expect material sales in 2026. It's about building that evidence base, and then sales will grow thereafter, I think. We don't want to talk about reimbursement levels at this stage. Yeah.
Graham.
Thanks. It's Graham from UBS. Could I just ask two: one, on InfusionCare, to the point on the CapEx, expansion, and obviously, the, you alluded the acceleration potential. Is it reasonable to say, given historically you've had these minimum volume contracts, that it's very visible, as in this CapEx is for something very tangible and visible that you can see in the next few years, and that's the inflection? On that, could you maybe talk to the return on invested capital expectation for that CapEx as well, please?
Yeah. Well, let me start. I think what you might be asking in terms of visibility is. Yes, we work closely with our big customers in expansion plans and have got with them long-term contracts. You know, in particular, that contract base has been strengthening as the demand in the market increases. We're very sure that we'll be getting good returns on this CapEx that we're committing on the basis of those long-term contracts.
I think I picked up the returns. Yeah, we assess all of our projects, and ensure that the returns are accretive to our group returns. Yeah, these infusion care ones certainly fit that criteria.
Maybe really quick one. You mentioned earlier, if the execution was better, the growth would have been better.
Yeah.
What wasn't, like, super hard-
Yeah.
What's like the key learning point from last year?
Look, as I said, we are, we're learning as we go. I think the main area is handoffs between different functions within the organization. You know, we've got a really great team of scientists doing R&D. We've got a great team of operations executives running our factories. We've got great teams of commercial out in the markets themselves. The handoffs, it's, you know, a bit like a relay race. Handing that baton over wasn't as smooth as it could have been in all cases. You know, we ended up with a few isolated back orders here or there, which, if we hadn't had, we'd have sold even more. You know, I don't wanna make this a big deal, but it's just to say we grew strongly despite learning. Now we are learning, and we're getting better, we'll grow even faster.
Thank you. Any more in the room? Fine.
Hi, Beatrice Fairbairn with Berenberg. Thank you for taking my questions. I had a few on InnovaMatrix. Firstly, what level of confidence do you have in reaching the $20 million in sales guided for 2026? Also in the release, you noted that you are reorganizing your sales team. Just to clarify, has this now been completed? Could you provide some color on what changes have been made and how you expect it to impact? Finally, how do you see InnovaMatrix sales in the inpatient channel developing in the midterm, given the changes we have seen in the outpatient setting? Thank you.
Yeah, let me take that. It's obviously a highly uncertain situation in the market as regards all skin substitutes. InnovaMatrix is a great product, and we are pleased to be able to report that volumes are strong still. You know, our volumes are, despite the uncertainty, as strong as they were last year and have been, if anything, building a bit since Q4. The sales have come down a lot because of the price, of course, they have. We are still getting strong response from healthcare professionals and patients really like the impact of these dressings. We have finished the reorganization of the sales force. That was an unfortunate necessity.
We've always said there was a very high level of variable cost in this sector of the market. In particular, you know, some of the commercial execution was very expensive. We've resized that to be appropriate to the target markets going forward. We've got national coverage now, which is a bonus for the InnovaMatrix. Our sales force is spreading out further across the U.S. to sell where we can. Last year, we started to sell beyond the indications of venous leg ulcers and diabetic foot ulcers. Those are still the two biggest, sales are starting to grow outside of that area, too. We're still primarily focused in physicians' offices.
I think one of your questions might have been about hospital channels. That's an area we will get to, but it's still quite small.
Thank you. I think that is the questions in the room. I know we have, certainly Veronica has a question online.
Okay.
If you could go to that, please. As a reminder, if anybody would like to ask a question on the phone line, the moderator will inform them how to.
we're doing-
Hi, can we go to the telephone questions now, please?
If you've joined us on the conference call and you'd like to ask a question, please press star followed by one on your telephone keypad. Our first question comes from Veronika Dubajova from Citi. Your line is now open. Please go ahead with your question.
Excellent. Hi, good morning. Thank you, Fiona and Jonny, for taking my questions. I'm gonna try to sneak in three, if I can.
The first one is just trying to reconcile the InnovaMatrix guidance for $20 million. Just if you can help us understand the price versus volume expectations that you have. I think just simplistically on my math, if price is down 80, you'd be assuming volumes are up 50%. Obviously, I appreciate, Jonny, you said you feel like the volumes are maybe picking up a little bit versus where they were in November and December, but that would be a pretty substantial pickup that's necessary through the rest of the year. If you can just kinda help us through the building blocks of that would be super helpful. My second question is just on wound care.
Obviously, a bit surprised by where the growth rate ex in InnovaMatrix came in in the back half of the year. I think, you know, there was maybe some hope of some acceleration moving from H1 to H2. Instead, we sort of ended up at sub 4%, stripping out to InnovaMatrix on an organic basis. Kinda what gives you confidence that you can accelerate that growth rate there? I guess especially if foam is performing well, can you talk through the things that are not, and your ability to kind of influence that growth and drive some improvement there, that's clearly important to your midterm ambitions? My final one, obviously, I appreciate that tariffs today might not be the same as they were tomorrow.
As we head closer to the end of the Section 232 investigation, I'm just curious what your thoughts are on what's the most likely outcome there, and what you would be able to do should the Nairobi Protocol not hold. Thank you so much, guys.
Quite a range there, Veronica. Thank you. Look, let me start, and then maybe you'll see if you want to add, Fiona.
Mm-hmm.
On InnovaMatrix, first of all, $20 million in sales. Yes, that does anticipate that our volumes grow significantly later in the year. You know, you've done the maths. Price down around 80%, sales down less. Where the volume growth is gonna come from later in the year, and as we've just said, we have already reorganized the sales force, is I guess 3 areas. First of all, we have a wider geographic scope now that we're covered for the whole country. That's 1 part of the growth. We're growing in other indications outside VLU and DFU as well. That's another part of the growth. We are anticipating that some of the competition is going to fall away as the year goes by. Now, we haven't seen that yet, in any material way.
People still have inventory. People are still running legal challenges to the price change that was made. We are planning on the fact that that price change will stick, and when it is confirmed as sticking, some of the operators in the human tissue area who have higher costs of sales than us, significantly higher, they will fall away, and that will provide a volume growth opportunity. That's how we're planning on InnovaMatrix, and it does mean, I think as Fiona referred to before, that we see the InnovaMatrix sales as being stronger in the second half than the first, for those reasons.
On wound care volume, it was hard to catch exactly the question, but I think it was: How are you going to accelerate wound care from where it delivered in 2026? I think that seems obvious to us anyway. We're launching 3 new products. AQUACEL is still growing. ConvaFoam is building and gaining share nicely now. It took a while to get started, but it's gaining share nicely now in Europe and in North America. We've got ConvaFiber coming. ConvaVAC and ConvaNiox are going to be very small in 2026, but they will start to build through 2027. That's where we see the accelerated growth in wound care coming from over the next few years. Do you wanna talk about tariffs?
Sure. Thank you, Veronika. Yes, tariffs are a moving feast at the moment, but we do expect the Nairobi Protocol to hold for our products that are currently covered by it. The Nairobi Protocol has held since the 1970s, I believe, so I think it is unlikely to be challenged. If it is, we would be in a similar position as our peer group, and we would deal with it then. As I say, we are expecting the Nairobi Protocol to hold.
Any more questions on the phone? I think there's two more.
Yes. Our next question comes from Susannah Ludwig from Bernstein. Your line is now open. Please proceed.
Great. Thanks. Good morning, thanks for taking my questions. I have two, please. I guess apologies in advance if you've already addressed them, as I was on the webcast and as I highlighted, there was the disruption. First, would be on Infusion Care, which is the fastest growing category. Could you quantify what % of infusion care growth in 2025 was driven by non-diabetes versus diabetes? How should the mix between diabetes and non-diabetes evolve over the medium term? How, as non-diabetes grows, does that impact margins from that business? Second, on the FDA warning letter, in the press release, you highlighted that there was not an issue related to product safety. However, the warning letter does cite 5,000 complaints related to leakage and potential under-deliver re: insulin.
What makes you comfortable that there is not a leakage problem with some of your infusion sets?
Okay.
Thanks, Susannah. I'll take the first question, then I'll hand to Jonny for the question about the FDA. Look, we're really pleased that the share of non-diabetes product in our infusion care category continues to grow. It was 10% in 2024, it was 15% of the category in 2025. We expect it to continue to grow as a proportion of the category. You're right, the margins for non-diabetes are slightly higher than those in diabetes, and so it will continue to support our margin growth for the group.
On the FDA commentary, leakage can be caused by lots of different things, including inappropriate application, reasons that are not to do with product inadequacies. What the FDA commented on was that we were not pursuing rigorously enough these observations from customers to be sure that it wasn't any product related weakness. Look, we are, we agree with their observations. We are pursuing more vigorously, chasing down every bit of information we can. It's more complicated in this category because any comments from customers, any comments, excuse me, from people using the devices go to our customers. They don't come to us. It's through that interface that we have to be more rigorous in making sure that we've chased down every possible piece of information and every bit of learning.
We've done some investigations before and, but more importantly, since then, a lot of evaluations, and we haven't found any deficiencies in products. As I say, the FDA didn't point to that either. What they said was, "You're not managing the information flow tightly enough," and we will get better at that.
I think there's one more online, or one more telephone question.
Our final telephone question is from David Adlington, from JP Morgan. Your line's now open. Please go ahead.
Thanks for the questions. firstly, I just wanted to, more specific in terms of what you've assumed in terms of CBP, in terms of pricing pressure in 2027. You sort of answered in the round in terms of pricing pressure, but maybe just specifically on CBP, what your assumptions there are. And just on InnovaMatrix and the write down, I think, again, apologies because the webcast wasn't great, but I think you've written down about 20%, about $72 million. That leaves about $280 million left. Obviously, your... has fallen, yes, fairly significantly, so you're now valuing the asset at 14 times sales. I just wondered why you only wrote it down by 20%. Thank you.
Should I take the first one? Yeah.
Yeah.
CBP, our assumption hasn't changed from what we described last summer, which is that we think if it's implemented in both ostomy and continence categories, then the headwind will be between 1% and 2% of our group revenue. Now, 2% is based on the fact that 7% of our group revenue is exposed to the CBP, being the Medicare revenue in those two areas, and that 30% is the average of CBP impacts over the full extent of the CBP process with CMS, and also that there isn't any more profit in the industry. You know, we don't think a price reduction of more than that is possible to push through. That would give you a headwind of 2%.
We think we're in a strong position to gain volume. The CMS has expressed a preference for there being 7 or 8 distributors in each sector, compared to the thousands that there are now. Granted, some of these thousands are pretty small, but as some of those smaller distributors decide not to participate and wouldn't win anyway because they can't fulfill the national supply objective, which has been required or expressed as a condition for the CBP, there's gonna be market share gain opportunities for stronger players like ourselves. That's why we've expressed a range between 2 and 1. Let's see how it develops.
I would just add to that the CMS has said that the CBP, if implemented, would be in 2028, not 2027. I'll take your second question, David, which I think was I was struggling to hear you a little bit, but why did we write down $72 million of our InnovaMatrix assets? Well, you know, we have followed a really clear approach here. We have taken prudent and risk-adjusted forecasts. The impairment that has fallen out is $72 million. As Jonny said, we are still selling the product. The product is selling well, volumes are increasing, and we believe that we're holding it at the right value at the moment.
Any more, David?
I think that's all the questions. Thank you, everybody, for coming.
Okay. Thanks very much indeed. We look forward to seeing you in about six weeks time, when we'll have more to share. Thanks for your questions today.