Afternoon. Welcome. I'm David Phillips, Head of Investor Relations here at ConvaTec. Can I just set some quick housekeeping rules for the day? Can I please ask that you switch your phones off or put them on silent? In 30 minutes, we will split into four groups for the category breakout sessions, which are across the corridor. This will bring the best of ConvaTec to life. Pre-recorded videos of some of the presentations are online for those who are watching on the webcast. To enable us to keep to time today, we would respectfully ask if you keep your questions till the end. We've got ample time, and then all of the presenters and guests will be in the atrium and able to speak. We now have a very short video to introduce Accelerate, and then Jonny will begin. Thank you very much, and lights out.
Okay. Hello, everybody. Mic working?
Yeah.
Good. Welcome to ConvaTec's Capital Markets Day. I hope you had a sense from that short video of the excitement that there is at ConvaTec at the moment. It's a very special company with a deep sense of purpose. There were some difficult years in the run-up to and around the IPO, but that's all in the past. You will hear today how the FISBE strategy has rebuilt ConvaTec to be a stronger business and how we are now ready to accelerate. Our vision of pioneering trusted medical solutions to improve the lives we touch resonates across the teams in the organization. We support people living with difficult, chronic conditions, excuse me. That's what leads to our brand promise of Forever Caring. For many in the organization, this is personal as well as professional, including me. I am one of four siblings.
The other three have diabetes, and they use ConvaTec products every day. That's quite common in the organization. This personal dimension drives people on to do even more to improve what we do. It's one of the reasons why we rank in the top decile for colleague engagement among all of the companies measured. Usual disclaimer. Here's what we're doing today. We've got a real treat for you. I'm going to start with a description of the evolution of the strategy. We'll break out, as David mentioned, into four groups and rotate around the four categories, where you'll meet the category leaders, you'll see the products up close, you'll speak to users and healthcare professionals. For those online, I should say, there are pre-recorded videos, one for each category to follow.
We'll reconvene here in the room and online at 4:20 P.M., and you'll hear from Divakar about innovation and what comes next in our pipeline. You'll hear from Fiona about what it all adds up to. I'll finish off with how we're going to make sure we deliver all of this. There'll be plenty of time for questions, and the whole team will retire to the atrium if you want to keep the conversation going afterwards. Sounds good, huh? Here's the executive leadership team who are here today. I've mentioned that Fiona, Divakar, and I will present in this room. Tanja, Bruno, Mark, and Kjersti will be leading their category presentations in the breakout rooms. Emma, Ewy, and David will join us for Q&A afterwards. You're going to meet other colleagues today as well in the breakout rooms. Knowledgeable, experienced.
These, with other colleagues, are the ones who have driven the turnaround of ConvaTec, and who have got us into a position now where we're ready to Accelerate. Do make sure to ask them questions, I was going to say, but David might control you back here. Yeah. To cut to the chase, if you are to remember only three things from today, first, that would be a shame. Here is what we suggest they are. First of all, ConvaTec operates in large and growing markets. We have strong leadership positions as one of only a few global players, and there are very high levels of recurring revenue in these categories. Secondly, ConvaTec is a strong business. It has successfully turned around with the FISBE strategy. We've built new expertise.
The business is more resilient based on diversified and broad-based growth, and we are delivering sustainable and profitable growth now. The opportunity ahead is very substantial. Demand is growing. It's strong, and it's growing. Our new products are working. We're getting positive feedback from healthcare professionals and from patients, and they are winning share. We're investing to meet that growth, and we've got a good and detailed plan that you're going to hear about today, and a strong team to deliver the plan. Those are the three, the only three things you need to remember. Please look for more. Let's get into it. Here we are. I'll start with a quick recap of what is ConvaTec. We are focused on chronic care in four categories, which you can see on the screen. These categories are large and they're growing.
They share characteristics of requiring high volumes of high-quality consumable medical devices. Care for the patient is important, and all of our products touch the skin. We're going to get to that shortly. These categories are growing because the population's increasing. The population is getting older. The incidence of the diseases that causes these chronic conditions is increasing, and people are living longer with the chronic conditions. These macro trends that underlie the structural growth are here to stay. These four categories fit well together. All our products touch the skin, so our scientists are looking at polymers and adhesives for development of new products across all categories. All of the products are consumable, and we, therefore, are designing for high volumes at high quality. They're all chronic conditions, so we are offering training and education to healthcare professionals about how to use these devices best.
Increasingly, we are generating and disseminating more clinical evidence to demonstrate the value of these products. These products are all used repeatedly by people with quite difficult conditions. We have a range of different ways that we offer service and support to the people who use our devices. All of these areas of expertise apply across all four categories. They make it hard for others to do what we do, and they provide a real competitive advantage. It's by delivering value across the continuum of care that we ensure the growth is sustainable. Value for patients, value for healthcare professionals, value for payers. For patients, we're providing good products and good services which improve the quality of their lives. For professionals, we're providing products that work, and making sure they're available reliably and offering that education and training that I just referred to.
For payers, we're making sure that our products and services do, and that they know they do add value to the healthcare systems, and that they provide lower system costs overall and better medical outcomes. That's what we do, and I'm very pleased to say we do it really well. FISBE has made our business much stronger. Let's just cover that. FISBE was our strategy for six years in two different phases, but with very similar themes. A lot has been achieved. F was for focus, and we are now focused. We're focused on four global categories. The peripheral activity has been disposed of. The portfolios have been rationalized. I was for innovate, and we're launching, as you've heard, 16 products over five years. Innovation is flowing. S was for simplify, and certainly we've done that.
Our G&A used to be 13% of sales, and it's now below 7%, and Fiona promises me it'll keep going a bit lower. B was for build, and we have built a lot of new expertise and we'll refer to some of those teams a bit later on. Then E was for execute, and ConvaTec is much better at executing than it used to be, as demonstrated by the delivery of the targets that were set through the FISBE strategy. Now, we've got more to do. We can always get better, and that's why it's also in the new strategy, and we'll talk about it shortly. As a result of FISBE, ConvaTec is now delivering sustainable and profitable growth. Here are some examples of how FISBE has made us stronger. We are focused with bespoke commercial execution on four global categories, and that provides broad-based growth.
Those categories, which you're going to hear from shortly, are supported by some important . In there, we have science and innovation, quality and regulatory, medical. All of this expertise is supporting all four categories, developing and launching new products in all four areas. Operations didn't use to be global. It is now. That enables the operations team to be driving synergies across all four areas. Centers of excellence. We've developed new centers of excellence in market access, reimbursement, pricing, sales and marketing, even in change. This expertise is available to support those four global categories in everything they do. ConvaTec Business Services, that is the platform through which we drive productive and effective corporate functions. Most importantly of all, highly engaged team, really up for it. I've already mentioned very high engagement scores, ready to drive forward and deliver what we need to do.
The business is also more resilient. Now, we get a lot of questions about reimbursement, so I just wanted to spend a few moments talking about how we think about that. Reimbursement dynamics are part and parcel of med tech sector. Always has been, always will be. We expect it. We plan for it. We include it in our targets. We include it in our guidance. We are more resilient now to reimbursement dynamics than we used to be for a number of different reasons. First of all, we're launching new products. That innovation pipeline is flowing. With some of these new products comes an opportunity for a positive reimbursement move because the products are offering greater value to the healthcare system.
Secondly, we've got these areas of expertise that I've just referred to, market access, and others who are liaising with the authorities to demonstrate and make sure they know the value that our products are bringing to the healthcare system. We didn't use to have that. Thirdly, we are more diversified and have broader sources of growth than we used to have. More geographies are growing, more products are growing, the categories are growing faster, and that means we are less exposed to any particular dynamic, as we like to call it, but any particular announcement about one product or another or one market, it has less impact on the whole than it used to have. People talk about a rule of thumb expectation that you can bank on about 1% per annum on average of deflation in the med tech world.
Certainly, back in the day, ConvaTec used to be about there. Through the FISBE years, that has been translated into a positive price evolution. We've managed to improve our price position each year by a little bit. Not by much, but rather than negative, it's been slightly positive. We plan on holding it with a zero contribution in our guidance that we share for going forward. Now, this time series of sales, operating profit margin, EPS, and free cash flow, we've shown you a few times before. That's because I quite like it. What you can see from this chart is momentum is clearly growing. The flywheel is turning. We're making more sales and more profit and more cash each year. With that, we are investing to drive more growth for the future. That's how we plan to continue.
The FISBE strategy worked well, and we're now ready to accelerate. Why is that? You can see on the chart, I've talked about the fact that the business is now stronger. I've talked about the fact that demand is strong. Well, it is, but it's growing and it's getting stronger in a number of important areas. I've talked about our new products that we're launching. They are working. They're winning in the market. We're getting positive feedback from professionals and from patients, and they're gaining share. We are therefore investing to meet this opportunity. Our new strategy is called Accelerate, and it's an evolution of FISBE. A lot of things won't change. We're already focused. We're going to stay focused. Innovation, we've started. We're going to carry on.
I won't go through all of them, but B for build, for instance, we have built expertise in new teams. That has been done. We're going to keep that expertise and we're going to keep developing it. What the evolution of strategy to Accelerate enables us to do is focus on the areas that are most important for driving the next phase of growth. We're going to keep what's good and refocus in some areas that we'll talk about in a moment. What all that will lead to is, as you can see on the right, a continued launching of new products, faster sales growth, and sustainable double-digit EPS growth with strong cash flow conversion. Accelerate has four pillars, which you can see on the screen. Customer-focused growth, technology, execution, culture. Let's just go through each one of those.
The Accelerate strategy is all about driving faster growth. With growth, that means we support more people with chronic conditions. We'll be growing sales and we'll be increasing market share with the new and differentiated products that we are launching. We'll be focusing closely on all of our customers, the broad spectrum, patients, payers, professionals, business partners, and we'll be paying attention to the needs of those customers, retention and loyalty. We'll be measuring customer satisfaction through Net Promoter Score, and we've got some really good scores in certain areas, which we'll be looking to maintain and grow. As we invest, as we use the capital generated, as we allocate, as we use the cash generated, excuse me, and allocate the capital, that will be into the fastest-growing segments. It will include external innovation and M&A to drive that growth going forward. Technology and innovation.
Technology will be key to achieving all of our objectives. Under this pillar, we're including technology to develop our new products and services, and also technology to conduct our business. It includes AI. Continuing to develop new products and services to meet customer needs. Increasingly, we'll be generating more and more clinical evidence to demonstrate the efficacy of those products. We'll continue to deploy modern, standardized IT digital tools. We've made some good progress on that. For instance, we've just completed a global CRM system, which is much more productive and effective than the 64 previous systems that it replaced. There's a lot of potential here still to improve the systems that we've got, and we're making good progress with AI, actually. For us, initially, it's about driving productivity.
We've got some good examples where we are already securing benefit in translation services, in customer contact centers and in other areas. We're training our colleagues in how to become more productive, each one using their AI tools provided by suppliers. Execution excellence is about doing things really well, doing them effectively and quickly, a bias for action. We actually are much better at executing than we used to be, and I think I've already said, demonstrated by the delivery of the targets that were set through the FISBE strategy. We're starting to exercise new muscles. As we Accelerate, as we do more, we're going to have to get even better at executing, and that's what this is all about. Our innovation cycle time will reduce as we practice and as we get better at it.
We will improve commercial execution so that, for example, you'll hear from Tanja, in wound care, we're launching five new products simultaneously. Well, we've never done that before, so we have to get better and train at it. Simplification and productivity, there's further to go. We'll improve. Always with an eye to the highest level of quality and to responsible business within the communities we serve. If all of that is what we're going to be doing, then culture is about how. Similarly, ConvaTec has a strong culture. It's rooted in our vision and our promise that I shared at the beginning. The purpose of ConvaTec couldn't be clearer or more motivating for colleagues to drive performance forward. Similarly to execution, as we try and do more and go faster, strengthening the culture will help.
Purpose-led, performance-driven, we are developing our leaders to be collaborating more closely cross-functionally. A faster bias for action, smoother handoffs between teams, a bit like the baton in the relay race that the fancy picture shows. All of those leaders, we got a great set of leaders, all of those leaders will be exemplifying our values of own it, deliver results, do what's right. They'll be living our Forever Caring promise. That's a run-through of how the Accelerate strategy is an evolution from FISBE, keeping the best, focusing on new. The good news is it applies to all four categories. We're going to break out shortly, and you're going to hear from the categories directly. Let me just give you a few pointers for what to look out for. Tanja will be telling you how Accelerate applies to Advanced Wound Care.
The growth there is going to be driven by five new product launches, all running simultaneously. A very exciting one in there is, of course, ConvaNiox, where we are creating a new category. In technology and innovation, we'll be focusing on finishing the major trials that we've got on at the moment in InnovaMatrix and in ConvaNiox, and then developing more clinical evidence in other areas to support further innovation. The execution step up is going to be all about getting those new products to market, five simultaneously, all at the same time. That's going to require cross-functional collaboration, seamless, smooth handoffs across many functions in support of the category. The strengthening of culture that we are intending to implement applies across all four categories. I'm not going to repeat it for each one. It applies across the whole organization, actually.
I'm going to come back to culture at the end. In ostomy care, Bruno will be telling you how Accelerate applies there. Big focus on growth across the continuum of care. Acute, post-acute, and in the community setting. We're going to be expanding our portfolio to fill a remaining gap with the launch of Natura Body. Very important launch coming next year. Then the innovation will move on to peristomal skin health, which Divakar will talk about a bit later. Execution in ostomy care is going to be about driving the scale-up of Esteem Body, launching Natura Body, and then scaling up our manufacturing at high quality. Mark will tell you how Accelerate applies in continence care. There you're going to hear the passion and commitment that we have for service. Fabulous service organization in the U.S.A.
We're going to be exporting that model elsewhere in the world to drive growth outside the U.S., and we're going to be filling in a remaining gap in the portfolio of products in continence care with GentleCath Air Pocket and Set, which is launching this year. Execution there will be focused on trying to get these growth plans in the U.S. and elsewhere all to line up and be seamless. Seamless delivery of the ecosystem, as I think you will hear him call it. Then infusion care. Kjersti will tell you how we are working with our partners, to develop new technologies or working with their new technologies and our new technologies to jointly drive the penetration of pump therapy in different markets. We've got the big diabetes market, where we're a clear market leader, and there are good developments there. Obviously, Parkinson's is growing really fast.
Then we've got our eye on what comes next after that, and you'll see a reference here to high-dose biologics. In execution there, of course, we need to improve our quality, and we will. We're very focused on satisfying the FDA in all of their regards, in all respects. We'll get that done. We're building a lot more capacity because demand is so strong in infusion care. That's what to look out for in the categories. I do hope you'll be paying attention. Then we'll come back in here, and Divakar will talk about innovation and what comes next in the pipeline. Just to steal his thunder a little bit, we think about it in waves of new products, just for convenience. Wave one is already in the market, was in the market by the end of 2025. Those products are now scaling up.
Wave two are the products which we are starting to launch in 2026 and 2027. Those two together underpin the acceleration of growth to 6%-8% that we have shared previously. We've got wave three, which comes later and obviously less developed at this stage. That is what is going to sustain the accelerated growth further out. The good news is that there are strong ideas coming across all four different categories. You'll hear about that from Divakar. Then from Fiona, she's going to tell you what it all adds up to. To steal her thunder as well, I will share this slide. Just headlines being that for all four categories, the sales growth compared to the targets we set at FISBE and at the last Capital Markets Day, the sales growth targets are higher now.
We're accelerating across all four categories, as you can see on the left of the chart. That all adds up to Group growth of 6%-8%. We're planning to operate at mid-20s in terms of operating margin, with a preference for the reinvestment of the benefits of operating leverage to keep driving growth going forward. That will add up to double-digit EPS growth each year with a strong cash conversion to follow. Now, it's time for the highlight of the day. These are your hosts. A mixture of colleagues at the top, healthcare professionals, and users of our medical devices, which we're very grateful that they've all come along to talk to you today. What you'll see in the breakout rooms, you'll hear a video, you'll see the product, you'll hear from each of these people about their experiences of it.
I hope you find it interesting. David is very strictly trying to constrain questions to the back of the room at the end of the day. Please note them down and come on back. I'll hand back to you.
Thank you, Jonny.
Thank you. For the logistics of the next section, on your name badge, there is a little colored dot. If it's red, you're going to the Infusion Care room, which is just here. If it is blue, you're going to Ostomy. If it is pink, you're going to Continence. And if it is purple, you're going to Advanced Wound Care. If you could make your way out, the rooms are just literally 20 yards across the road, and we will start in a couple of minutes.
Great. Underneath.
Thank you.
Yeah.
End up with-
I was going to grab it, and I realized that could be misunderstood.
End up with a pink splodge on my bum. Yeah.
It might be Forever Caring, but.
What? Was that all right?
Yeah.
Thank you. That's mine, Divakar. Sorry. It was a trap for you, but you spotted it. Very good. Right. We're all in rooms, aren't we? Yeah, you are. You don't get a little lost.
Hi, I'm Tanja Dormels, President of Advanced Wound Care. I'm very proud to lead Advanced Wound Care at a time when we have such an exciting new product pipeline. I joined ConvaTec in 2019 after almost 20 years in healthcare, primarily with Novartis. At ConvaTec, I've had the opportunity to run Advanced Wound Care Europe, and lead the development of ConvaTec's groundbreaking platform, ConvaNiox. What has kept me in healthcare for my entire career is very simple: knowing that the work we do has a real impact on people's lives. Today, I'm delighted to share how Advanced Wound Care has strengthened with FISBE and why we are now ready to accelerate. We are increasing our Advanced Wound Care sales targets to high single-digit growth from 2028, driven by scaling up our product launches.
The Advanced Wound Care market is driven by structural drivers like increased prevalence of diabetes and vascular disease, and improving access to healthcare globally. In addition, people suffering from chronic wounds are getting younger. They live longer with chronic wounds as they are diagnosed earlier. Hard to heal wounds are one of the most severe disease burden in healthcare for patients, providers, and payers. For U.S. healthcare, cost is second only to cancer. This creates strong incentives to adapt advanced solutions to improve outcomes and reduce total cost of care. We are focused on severe chronic conditions, including diabetic foot ulcers, venous leg ulcers, and pressure injuries, affecting up to 100 million people globally.
These wounds are often associated with infections, frequent recurrence, and high mortality rates, which can exceed many cancers, reinforcing the need for effective treatment strategies. The advanced wound care market is large, valued at $6 billion globally and growing around 6% every year. Our portfolio spans all four major segments, antimicrobials and fibers, foam, single-use negative pressure wound therapy, and biologics. We provide high-quality solutions for over 10 million people annually. While the market is competitive and subject to reimbursement dynamics, a diversified portfolio across indications, technologies, and geographies supports a predictable, resilient growth. Strong customer relationships matter. Looking at our key segments, ConvaTec invented Hydrofiber dressing technology 30 years ago. Our AQUACEL brand is the global leader in silver-based antimicrobials with around 30% share. Since launch, we have sold nearly 1.5 billion AQUACEL dressings.
Looking back, in 2020, we were specialized in a single segment, and our growth was entirely reliant on Aquacel Ag+ Extra. FISBE has strengthened our business. Today, we are active across all four key segments, and we have created positive momentum. We continue to leverage our leadership position in antimicrobials, anchored by the AQUACEL platform. It remains our cornerstone franchise with over $300 million revenue every year. Under FISBE, AQUACEL has been further strengthened. We have demonstrated clinical superiority and published the only randomized controlled trial in antimicrobials for Aquacel Ag+ Extra. This has resulted in strong adoption and repeat use. Health economic evidence has demonstrated reduction in overall cost of care, driven by faster healing, fewer dressing changes, and reduced clinician visits. FISBE has reduced reliance on a single growth engine. We have strengthened key capabilities, clinical evidence generation, and launch execution, underpinning sustainable growth.
Our pipeline is the richest in our history and arguably in the industry. Five products will fuel our growth acceleration, and we will raise the standard of care. We are not reliant on any single product or reimbursement pathway. As shown on the slide, product differentiation increases from left to right. Starting with ConvaFiber, this is an upgrade of our non-silver Hydrofiber platform. Lab tests confirm 45% improved absorbency and better conformability to the wound bed. ConvaFiber also supports positive margin progression. Moving on. ConvaFoam receives excellent customer feedback, and I will present a case study shortly. ConvaVac™ is starting to launch in Europe. This is a competitive product in the fast-growing segment of single-use negative pressure wound therapy. ConvaVac™ offers a differentiated proposition.
It is enabled by our Hydrofiber dressing technology, and we are also planning a silver-based dressing, allowing us to uniquely address both exudate management and infection risk within approved indications. InnovaMatrix expanded our presence in skin substitutes with a placental-derived extracellular matrix. Its efficacy is supported by growing real-world evidence, which demonstrates clinically meaningful wound closure in complex real-world populations. Our randomized controlled trials are on track to publish in 2026. There was a disruption in the segment over the last couple of years as CMS seeks to address disproportionate cost increases, but that seems settled now. We expect GBP 20 million of revenue in 2026 and to grow from there. We are excited about the prospects for ConvaNiox. I have a separate slide on it, too. We support this pipeline with clinical education, our wound hygiene protocol, a four-step approach to treating wounds.
Over 200,000 healthcare professionals have been trained, and it has been widely adopted by clinicians globally. ConvaFoam exemplifies our ability to design, manufacture, and scale differentiated solutions. Firstly launched in 2023, ConvaFoam delivers high absorbency and effective exudate management. Key elements of differentiation include consistent performance across wound types, longer wear time, requiring fewer dressing changes, and improved patient experience. New clinical data underlines ConvaFoam's role in pressure injury prevention and management. Superior microclimate and moisture handling supports skin protection and reduces tissue stress. ConvaFoam has positive momentum in the $2.3 billion foam segment. Globally, our share has increased by about one percentage point to around 6%, as customers choose our product, and we leverage existing customer relationships. We are well-positioned to extend this momentum with multi-year share gain potential. We see a 10% global foam share as a realistic initial target over the next few years.
To put this into context, a 1% ConvaFoam share gain equates to about 3% on advanced wound care growth and 1% on group growth. ConvaNiox is a first-of-its-kind nitric oxide-generating multimodal dressing, and we aim to create a new segment. It has a significant potential for life-changing impact for those suffering from diabetic foot ulcers. Data from a randomized controlled trial showed that 60% more ulcers were healed within 12 weeks of treatment with ConvaNiox compared to standard of care. Wound area reduction is three times faster. We are currently focused on gathering further clinical evidence, including a randomized controlled trial in the U.S. Over 250 patients have already been treated with ConvaNiox in Europe. Sales will build gradually. However, our early clinical experience in the hospital setting gives us great confidence that sales will accelerate once community reimbursement is achieved. We are now ready to accelerate.
Our markets are structurally attractive, with durable growth drivers and significant unmet patient needs. We will accelerate by delivering our strategic priorities. Firstly, scaling up our rich pipeline of innovative new products. Second, further improving execution excellence to deepen customer relationships and loyalty. Thirdly, creating a new category in advanced wound care with our groundbreaking ConvaNiox product. Together, these actions will deliver our medium-term target of sustainable high single-digit revenue growth. Thank you.
Hello. My name is Bruno Pinheiro, and I have spent my entire career in Ostomy Care. I joined ConvaTec working in sales, and over the last 21 years, I have led sales teams, launched our ConvaTec clinics, run our Latin America and Asia businesses, and I'm now leading our Ostomy Care business globally. That experience shaped everything I believe about this business. You have to understand the patients, their journey, and the importance of trust. When I took over this category, we're losing share. Today, we are growing faster than our markets, winning back trust, and setting new standards in Ostomy Care. We have positive momentum and a clear path towards our target of mid to high single-digit growth. While we are focused on delivering growth, what really drives me is the positive impact we have on people's lives.
Ostomy Care is a structurally attractive chronic care market, with recurring revenues, high customer lifetime value, and strong patient loyalty. The global market is growing at approximately 4%, supported by demographic megatrends driving volumes, and faster-growing segments such as convexity and accessories, driving mix. On the megatrends, there is increased prevalence of colorectal cancer, Crohn's disease, ulcerative colitis, and bladder cancer. At the same time, populations are aging and given advances in treatments, people are living longer, fuller lives with stomas. Healthcare systems continue to shift out of hospitals and into the community, generating a growing demand for products that enable confidence, independence, and quality of life outside acute setting. This is one of the reasons our hospital-to-home strategy is effective. Emerging markets are becoming an important source of growth, particularly as access improves and care pathways professionalize. Adding more colors.
The category is consolidated, with three global leaders representing approximately 85% of total market with a well-established dynamic. Success rewards those who win early, support consistently, and lead clinically. Combine these factors underpinning a large, resilient, and growing Ostomy Care market. Core to our FISBE strategy for Ostomy Care was a portfolio refresh. We began with a decisive portfolio simplification, removing approximately 40% of SKUs. This reduced complexity and cost, improved supply reliability, and sharpened focus for clinicians, patients, and quite frankly, for our teams. This was a strategic reset that created the foundation for scalable innovation. In tandem, we fundamentally changed how we compete. Prior to FISBE, we lacked rigor in the fundamentals of selling. Quality and inventory challenges weakened our credibility, innovation lagged, and we were excluded from key GPO contracts in the U.S. acute market.
We have focused on clinical evidence and on partnering with leading societies, and as a result, our evidence-based approach is transforming how we are viewed in the market, and now we are helping to elevate the standard of ostomy care globally. While these actions were not easy, we emerged with a much clearer portfolio, stronger clinical credibility, and a highly scalable growth platform. The most profound change in our performance has been commercial execution. We have moved from a transactional product-centric model to a clinically led relationship-based approach, acting as market thought leaders and a clinical partner. Today, we engage differently. With healthcare professionals, we are leading with science, education, and outcomes, particularly in acute care, where long-term pathways are established. We have taken responsibility for elevating the standard of care, doubling down clinical evidence in areas that matter most, like soft convexity, adhesives technology, and peristomal skin health.
This approach has delivered tangible results. We have secured our first two GPO contracts in five years, giving us the ability to compete for an additional 40,000 procedures annually in the U.S., or roughly 1/3 of the market. With patients, we support the full journey, especially through the critical transition from hospital to home. We have an excellent patient support service called me+, which drives strong customer satisfaction and loyalty. This combines with our Home Services Group, which is our fastest growing sales channel. This shift from transactions to trust has deepened relationships, improved adherence and outcomes, and increased lifetime value. We have successfully moved Ostomy Care from discrete sales to enduring relationships, and I believe this is exactly what a chronic care model should be. This is our future state portfolio, and we are well advanced on the journey to get there.
We have simplified the Plus line, progressed the rebranding of ESENTA™, and took our first step into the premium body platform with the successful launch of Esteem Body. Just notice that each move is intentional and aligned with our strategy. We are positioning this portfolio to compete and gain share in higher growth segments in Ostomy Care, convexity and accessories. By 2030, soft convexity and accessories will represent half of the total Ostomy Care market. Soft convexity is the fastest growing segment, growing at double-digit rate. Our portfolio and commercial reset created the foundation for meaningful innovation, and Esteem Body is the clearest proof point. On the business side, in just two years, it has delivered high single-digit market share. It is our first new ostomy product in more than a decade, built on an entirely new platform.
Equally important, independent market research across the U.S., Italy, and Germany confirmed a strong preference for Esteem Body among both healthcare professionals and patients. In this research, 93% of HCP say the convexity design meets clinical needs, and 95% of patients report high comfort, confidence, and wear performance. Great start for Esteem Body, and this is exactly the platform we will leverage for Natura Body, giving us strong confidence in our ability to scale premium innovation. Our team is energized, proving that when you build solid foundations, innovation can truly scale. Our strategy to accelerate growth is rooted in care, supporting healthcare professionals and patients across the full continuum.
Starting the relationship in the acute setting, and then, continuing to support patients throughout their journey with ostomy is how long-term loyalty and lifetime value are built. Our strategy is clear: be the preferred partner for healthcare providers so you can win new patients in the hospital and earn loyalty across the full -continuum of care. We do this by supporting HCPs and patients from day one with innovative, high-quality products designed to prevent leaks and promote healthy skin. We extended that support beyond the hospital through our me+ patient support program. With our me+, we are strengthening engagement across acute, post-acute, and community setting, ensuring continuity of care and frictionless experience for patients. As patients transition home, our service platforms make it easy to access supplies and navigate insurance and reimbursement. Together, this integrated ecosystem drives loyalty and long-term retention.
Our goal is simple but powerful: to build lifelong relationships that help people living with a stoma remain confident, independent, and supported at every stage of their journey from hospital to home. As you can see, we are now ready to accelerate. Ostomy Care has moved from turnaround to delivery to acceleration. Since our last Capital Markets Day, the market has continued to grow, supported by durable mega trends, but we are fundamentally a different business. We are ready to accelerate and deliver customer-focused growth with a clear line of sight to mid- to high single-digit growth. To achieve that, we have three priorities. First, leverage our innovative and expanding portfolio led by the Esteem Body platform, Esteem Body and Natura Body. Second, support healthcare professionals and patients across the full- continuum of care, leading to lasting relationships via me+ and Home Services Group.
Third, execute and elevate the standards of care across the industry with differentiated clinically-led solutions. This is our strategy, and this is our belief. We are highly motivated by our progress, and I'm pretty sure our best days are yet to come. Thank you.
Hello, I'm Mark Jassey, and I have the privilege of leading our Continence Care and Home Services Group since 2024. I'm in my 19th year working in continence care, having started my career at 180 Medical, which joined ConvaTec in 2012. Let me start by sharing a quick story. Two years into my career, friends of mine found out they were pregnant and soon learned their son would be born with spina bifida, a neural tube defect that often requires self-catheterization. You can imagine the shock. Soon after Finn was born, I had the opportunity to personally problem solve, support, educate, and take care of their needs. It was a watershed moment for me. Everyone in the world deserves that level of support, access, and care, not just someone who happened to be a friend of mine. So I dedicated my career to making that happen.
I've had the pleasure of holding roles covering nearly every aspect of our customer's journey, from product to support. It is my genuine pleasure to present our story today. Every year, our team serves over 200,000 people who rely on us for support, guidance, and expertise, and to supply over 150 million intermittent catheters worldwide. Demand for our products is growing, underpinned by structural trends like aging populations, and rising rates of urologic conditions like neurogenic bladder, spinal cord injuries, and multiple sclerosis. Improving products, better diagnosis, home-based care, reduced stigma, and expanding healthcare access in emerging markets are all driving growth. We are the leaders in the U.S., the largest global market, projected to grow around 4% annually. Outside the U.S., markets like Germany, Italy, France, and U.K. are also forecasted to grow around 4%, with emerging markets growing faster. FISBE has strengthened our business.
At our last Capital Markets Day, we said we would deliver mid-single-digit growth via leveraging service excellence, broadening our product portfolio, and growing outside the U.S. We have delivered strongly against these objectives, evidenced by our organic revenue growth of 7%. The U.S. remains our largest market by far, and we grew faster than the market, extending our leadership position. We broadened our portfolio, driving the shift to hydrophilic catheters. We successfully launched GentleCath Air for Women, our female compact catheter. This brought our proprietary differentiated FeelClean technology into a discreet form factor. The launch also helped grow our customer base outside the U.S. Our small positions in U.K., France, and Italy have strengthened, and our progress has accelerated through our direct-to-consumer home care businesses. These improvements demonstrate strong execution of our FISBE strategy. We are now ready to accelerate. Let me explain how.
We continue to see strong growth opportunities in the U.S. 180 Medical, our direct-to-patient company, is the No. 1-rated U.S. medical supply business on Trustpilot, with a 4.9 rating out of five from over 13,000 individual reviews. We enjoy a Net Promoter Score over 80, which is world-class and above well-known brands like Netflix, Amazon, and Apple. Research indicates more than one-third of all adults find it difficult to understand what health insurance will and will not cover, and over half of adults with a chronic condition had a denial or a delay for an insurance claim. This is a real frustration for patients. 180 Medical delivers outstanding service across the customer journey, obtaining prescriptions, navigating the complex health insurance landscape, filing claims, delivering supplies to the patient's door at no upfront cost, all the while providing education and emotional support.
No other company has the same capability and specialization to truly understand our customers' unique needs and support them. We have a leading payer network offering coverage over 90% of the U.S. population. The market is complex, with Medicare, Medicaid, and thousands of insurance companies participating. Our world-class service is underpinned by a proprietary purpose-built platform designed specifically for reimbursement complexity. By owning the code base, we can continuously upgrade. For example, embedding AI-driven decision support, workflow automation, and real-time insights directly into the frontline process, creating a customer experience competitors cannot easily replicate. It allows us to deliver a fundamentally differentiated customer experience at scale. This combination of emotional support to patients, clinical trust, and administrative simplicity underpin our recurring revenue growth. As a result, we are trusted by roughly 45% of all catheter users in the U.S.
Together with the benefits of our broadened portfolio, our attractive products are enabling us to grow our manufacturing share and increase the proportion of ConvaTec manufactured products in our sales mix, which is a significant benefit to gross margin. Since 2022, this mix has increased from around 54%-59% as more customers choose the differentiated technology we provide. With a 99% retention rate in our base, our customers trust and rely on our offering throughout their entire care journey, which for many, just like Finn, could be their entire lives. As previously reported, CMS has proposed a competitive bidding process for Medicare ostomy and continence products. If this comes into force, we have previously guided to a group revenue impact of 1%-2% in the year of implementation, which would be no earlier than 2028.
180 Medical is well positioned to grow and compete in these segments as the leading integrated provider with outstanding customer service and the ambition, capability, and expertise to deliver this to customers. We have two key brands, Cure, which is our value catheter range, and GentleCath, our premium hydrophilic range. Cure offers a wide portfolio that is easily accessible, reimbursement friendly, and has a strong U.S. heritage. GentleCath contains our next generation PVP-free FeelClean technology based on proprietary polymers that is a key differentiator for our premium hydrophilic offering. Our 2025 ex vivo study demonstrated that FeelClean technology causes up to 53% less urethral damage than the leading PVP-coated hydrophilic catheter. This is backed up by strong patient feedback, with 96% of new catheter users who responded stating that they would recommend GentleCath Air for Women with FeelClean technology to other women.
This is meaningful in a category where scientific evidence matters. Looking at the key segments, the compact segment, which is a significant portion of the European market, will be the fastest growing at 7%. Our recently launched and launching products, GentleCath Air for Women and GentleCath Air Pocket and Set, are expected to take share in this compact segment. Our broadening portfolio, proprietary systems, and strong culture are helping to drive our patient-facing services in Europe and the rest of the world. We are taking our best-in-class U.S. knowledge and technology infrastructure and combining it with local market expertise to enable our geographic expansion. From a low base, we added over one percentage point of category growth in 2024 and 2025. We have a potential to grow even faster, aiming to accelerate to two percentage points of category growth in the coming years.
GentleCath Air for Women has enabled our successful entry into the female compact segment. Clear clinical differentiation, strong healthcare provider engagement, and effective channel execution, supported by compelling patient advocacy, has translated into strong uptake in the fast-growing compact segment, particularly in Europe, and is shaping our broader compact launch strategy. Our male and closed system pocket versions, GentleCath Air Pocket and Set, and the standard ready-to-use Cure Aqua Hydrophilic Catheter are all launching later this year, subject to regulatory clearance. From 2027, I'm excited to say we will be ready to compete with a full- product portfolio in Europe. In conclusion, we are evolving to be a more differentiated business, better positioned to deliver long-term sustainable growth. We are ready to accelerate, and we are increasing our revenue growth guidance to mid- to- high single-digit sales growth in Continence Care over the next strategic period.
This will be driven by three main things. Customer-focused growth, driving further U.S. expansion with a world-class connected ecosystem of service, product, and support, and accelerate our growth outside the U.S., supported by our new products. Technology. Fully leveraging our product portfolio, including innovative, recent, and upcoming launches. Execution excellence in the implementation of our proven service model in the U.S. and beyond. This will allow us to fulfill our Forever Caring promise and serve more end users, just like my friend Finn. Thank you.
Hello, I'm Kjersti Grimsrud, President of ConvaTec Infusion Care. I met some of you at our last Capital Markets Day in 2022. I've been with ConvaTec for more than eight years, joining in 2018 as president of Europe, Middle East, and followed by two years leading Continence Care. For the last four years, I have been leading Infusion Care. I've spent more than three decades working in diagnostics and medical devices, primarily with a focus on diabetes. Diabetes is very personal for me. I have two daughters, one of whom was diagnosed with Type 1 diabetes at the age of seven. This area has been close to my heart, personally and professionally, for a very long time. Infusion Care has delivered significant growth through the FISBE strategy period, and I will present how we are now ready to Accelerate.
We currently operate in two main markets, D iabetes and Parkinson's disease, with smaller positions in immunoglobulin therapy and pain management. Automated insulin delivery in diabetes is a long-term growth and penetration story. There are approximately 370 million people living with diabetes worldwide, of whom around 10% need to take insulin exogenously. With this group, fewer than 3 million are currently using pumps, with nearly 34 million using multiple daily injections based on published estimates. There is substantial headroom for automated insulin delivery to continue to penetrate the market. This trend has accelerated following significant advancements in pumps, continuous glucose monitors, and the delivery algorithm. It is now widely recognized to provide improved clinical outcome for most intensive insulin users. Our products are integral to replacing multiple daily injections with pump therapy.
Type 1 diabetes is a chronic autoimmune disease in which the body's immune system destroys the insulin-producing beta cells of the pancreas. As a result, people with Type 1 produce little or no insulin and require lifelong insulin therapy from diagnosis. While GLP-1s represent great advancement for some patients living with Type 2 diabetes, they often do not eliminate a Type 2 diabetic's need for insulin therapy. Unfortunately, GLP-1 cannot replace the need for insulin in Type 1 diabetes. Our infusion sets are a key part of the system, and demand will continue to grow as pump penetration increases by at least 8% per annum in the next five years. Diversification into new therapies is a key part of our strategy, and the application of our solutions extend beyond diabetes. Parkinson's is the strongest example of this in Infusion Care, and our growth was excellent in 2025.
Parkinson's disease is a debilitating chronic condition impacting over 10 million people worldwide with significant unmet needs. It is a disease with no cure, with limited understanding around pathology, and patients often live for many years with progressively challenging symptoms. The market is now entering a new phase. A recently launched subcutaneous therapy for advanced patients, combined with infusion delivery solutions from ConvaTec, is driving very strong incremental growth. Non-diabetes revenue increased from 10% of our Infusion Care sales mix in 2024 to 15% in 2025. We are in the early stages of pump adoption, with penetration still very low. We expect strong growth to continue for some time. Our markets are growing. Increasing penetration means this growth is long-term, and our growth is broadening as we diversify customers and therapies. FISBE has strengthened our business. Over the past five years, Infusion Care has delivered sales CAGR of just over 10%.
In diabetes, as pump technology improves, we expect pumps to continue to gain share for the long term. This will drive high single-digit growth for our diabetes business. We continue to diversify within diabetes and partner with leading manufacturers: MiniMed, formerly Medtronic, Tandem Diabetes, Beta Bionics, and MyLife Diabetes, formerly Ypsomed. In 2022, we had a very small direct business outside of diabetes in areas like pain relief, immunoglobulin deficiencies, and Parkinson's disease drugs in Europe. Since then, revenue from these new therapies has tripled. We have delivered above-category growth in all of our non-diabetes therapies, but I'm especially proud of our progress in Parkinson's disease. We are a key partner with AbbVie, supporting their revolutionary Parkinson's disease drug, VYALEV, where we recently extended our exclusive long-term supply contract.
We are also supporting two other Parkinson's treatments, Supernus launched last year with apomorphine in the U.S., and Tanabe Pharma is expected to launch their new drug in Europe this year. This means that we will be the sole infusion set supplier to the three main suppliers of advanced Parkinson's treatment by the end of 2026. I expect non-diabetes growth to be double-digit for the next few years and to increase within our sales mix. We are the clear global leader for infusion sets. Our research, design, and manufacturing expertise makes us a partner of choice. We have worked with partners in a B2B setting for over 20 years. With our new Accelerate strategy, this will ensure strong focus on our customers with the offering of new technology as well as added capacity, both underpinned by a very collaborative cross-functional team.
Our scale, our technology, our portfolio, and unwavering focus on customers in a B2B setting puts us in a strong and leading position again and again as the partner of choice for infusion sets. Our infusion sets support over 1.4 million patients and growing every year. Demand for our product is very high. Last year, we produced well over 100 million infusion sets for different customers and therapies. We are investing significantly with growth CapEx to build new production lines. These will significantly increase our capacity over the next few years, and this investment is underwritten by long-term customer contracts. In diabetes, the infusion set is part of an automated insulin delivery system designed to simulate the pancreas. This consists of a pump, a smart algorithm, a continuous glucose monitor, and an infusion set, in many cases linked by a smartphone.
Our infusion sets are designed to be effortless to use, but that simplicity is powered by some very serious engineering. Inside the set, there are multiple high-precision molded parts working in unison. We have created an architecture that is robust in the field and optimized for high-velocity manufacturing. We are selling solutions with the design for manufacture that allow us to win in the market, and this is very hard for others to replicate. Our ability to manufacture at scale and high quality is a key competitive advantage. We have designed highly scalable platforms with capacity fungible between customers. We are the only supplier offering the full -range of infusion sets in the market. Our portfolio covers steel needles, soft cannulas, 90-degree and angled sets. All sets come with a range of tubing length to cater for different user needs and lifestyles.
We are investing to meet significant long-term demand in the market. We do not expect to win all business, and some backward integration to in-house supply by customers may occur. We are also seeing manufacturers with in-house capabilities seeking more supply through us as our product portfolio is broad and unique, high quality, and good value. A key market development is the many different form factors in the pumps being launched or announced in the next couple of years. The patch segment is currently outgrowing durable pumps, but the lines between patch and durable pumps are blurring. Wearability and adaptability are key user factors, and there are many benefits of a durable pump. Our infusion sets have the potential to support pumps across the technology spectrum.
The inserter mechanism, the needle, the soft cannula, and the adhesive are all parts that can serve the same purpose in, for example, a hybrid patch. Also, recent changes like monthly pump contracts and pharmacy distribution are making adoption easier. This is likely to increase type 2 penetration, and we look forward to supporting new customers in that segment. In conclusion, I'm very proud of ConvaTec Infusion Care business, and the dedicated and talented colleagues who deliver for our customers every day. We have delivered fast growth through the FISBE strategy period, and we are confident that we are now ready to Accelerate to deliver further customer-focused growth. We are investing in substantial additional capacity with fully automated state-of-the-art production. We started this expansion in 2024 and expect our first new lines to be on stream in 2027 with further new capacity in 2028.
Our platforms are scalable, and we are investing in innovation to drive growth in new therapies. From 2027, we will sustainably deliver our medium-term target of double-digit revenue growth. Thank you.
[Break]
We'll just be mic'd up in 60 seconds. For those on the webcast, thank you for your patience. Sorry for the slight delay. I hope you enjoy the views that are there, and we will kick- off with the second session. Thank you.
Good afternoon. I'm Divakar Ramakrishnan. I serve as the Chief Science, Innovation, and Quality Officer for ConvaTec. Some of you may remember me from 2022 at the conference, and I see some familiar faces, so it's great to see you all. Yeah. I've been with ConvaTec for just over six years, yeah, and joined in early 2020 as Chief Technology Officer, Head of R&D. More broadly, I've had about three decades of experience in healthcare, spanning biotech medicines, drug delivery systems, and medical devices. All in chronic care across R&D and manufacturing science. What I would like to do this afternoon is cover really how we are accelerating Forever Caring through pioneering innovation. More importantly, why I believe that innovation now is a repeatable engine. Yeah. Not just a set of one-off wins. I'll cover three things today in my presentation.
First, our innovation mindset and the capabilities we have built. Second, is the evidence and the portfolio output from the two waves of innovation that Karim talked about. Finally, the third one is really about how this next wave after that we call wave three, extends this repeatable engine into higher value and more differentiated growth for the company. Let me start with the mindset first. Our innovation mindset really starts with the reality of chronic care. We design for people with chronic conditions, not just as patients. That means user-centered design is a core guiding principle for us and a mindset across the entire organization, including R&D. The second one is we build single-use products which require design for high volume and design for high quality from day one.
Finally, our output here also relies on deep scientific depth, and that depth spans three particular areas that span all four categories. First is skin-material interfaces, second is tissue repair and healing, and third is infection prevention. Eventually, the output becomes more than just products alone. We generate products. They're enabled by digitally enabled tools, educations, and services, not as add-ons, but as integrated solutions. Finally, what I would like to say is the key point I'm trying to convey here is, it's leverage. We build knowledge once, and reuse it across the categories. This allows, in my mind, innovation to scale, not fragment. Let me go into investment and output. We increased over the several years. What I would say is, first, we roughly doubled R&D as a percentage of sales since 2019.
Second, in terms of capability, you can see on the slide, there are at least five capability areas, clinical evidence, reimbursement, regulatory, design for manufacturing, and user-centered design. Plus, we broadened out our leadership bench with deep expertise. What this has resulted is a significant output in terms of the number of clinical trials, publications, and patents filed. You can see them on the slide there. Most importantly, that has allowed us to launch eight products in the last three years and another eight in the next two, starting this year. We also achieved what I believe is a watermark level in terms of 30% of revenues were generated from new products as of 2024. This is no longer a rebuild of our innovation engine. It's a durable operating model.
Now let me double-click into one area that shows our mindset shift, which is generating clinical evidence. This has been a defining shift because of our ownership of clinical evidence as not just as validation at the end, but it's a core design input of our key scientific platforms that we would like to use in future products. Today, we are running over 30 studies, as we have seen on the graph, of which several are actually randomized controlled studies. The slide here shows the middle and the right columns show an example from a large randomized controlled trial that we published about this time last year. It was run across three countries, Colombia, it was run in the U.K. and Germany. In 203 patients, the AQUACEL Ag+ platform demonstrated a significantly higher likelihood of complete wound closure and faster healing.
The point of this is not just to rattle out statistics. To me, it's really about two things. First, it's a cultural shift towards measuring outcome, not just activity. Second, it's having our homework graded. When I mean homework, I mean the innovation homework graded by rigorous clinical studies. Third, this level of evidence strengthens regulatory pathways, accelerates adoption, supports reimbursement, and reinforces premium positioning. What this does for us is turns this innovation into a durable value. That's why I thought to share this example. Now, I want to show you the tangible output we have been able to generate in terms of our innovation system, which we fondly refer to as wave one and wave two. Okay. We've launched 8 products between 2022 and 2025. We have 8 more on track between 2026 and 2027.
Key point to observe, it spans all four business categories, and we have done it with disciplined global sequencing. These are also not incremental or catch-up launches. Yeah. They are purpose-built, clinically relevant solutions designed around real unmet needs. We have integrated user insight, high volume designed for manufacturing, and increasingly, we have started integrating digital and service components into these product launches. Just to put it in context, we had one-off product launches when I started in 2020. Really good launches, but they were one-off. Now what we see is repeatable and continuous cadence of innovation across all four categories. What I would like to do is show you how the portfolio has evolved from 2022 to now. What you'll see is back in 2022, across all four categories, we had a suboptimal and narrow portfolio across the categories. Let me start with wound care.
In wound care, we have now expanded and strengthened the platform depth across five technology platforms. We are now creating a new category, as Tanja mentioned, in terms of a category to target hard-to-heal wounds with our nitric oxide-powered multimodal platform. Second, in infusion care, we have diversified to additional partners in diabetes, and we've also, as Kjersti mentioned, we have gone into fast-growing new therapy areas such as Parkinson's. Finally, in ostomy and continence, what you'll see in the graph is we have shifted from more premium into more premium differentiated solutions, now being supported by digital tools also. The takeaway here is we have a broader, stronger, and more differentiated portfolio that is continuously being refreshed. Let me showcase three examples for you. ConvaFoam, this is a highly technical multilayer foam dressing, as you saw.
It has about five layers, and so it's quite exquisite in terms of both the design and the manufacturing know-how. What was particularly unique about it was it was designed around the clinical workflow. Nurses can peel open the dressing, inspect the wound, and replace or reposition it without wasting the product, saving time, reducing waste, and improving clinical care delivery. Second, I want to go to our nitric oxide-powered multimodal dressing. We already have compelling randomized clinical trial evidence in diabetic foot ulcers, and now I'm proud to share with you that we have additional data in venous leg ulcers, supporting what we believe will be a new way to manage hard-to-heal wounds. Given the novelty of the technology, we plan to pursue the FDA De Novo pathway for the U.S., alongside new clinical and health economic studies to maximize market access, adoption, and premium pricing opportunities.
Finally, I also wanted to mention what Esteem Body that you saw. This product combines user-centered design for discretion along with soft convexity, improving fit and leak confidence. This is being able to be provided across different body shapes and stoma types. What's been most powerful to me is the real-world feedback we have gotten. People with chronic conditions such as Sara, that some of you might have met in the room, tell us that they've been able to sleep uninterrupted for the first time in over a decade because of some of the design features we put in, such as the filter. Together, I hope you take away these examples show you how we have taken science, evidence, and human-centered design to create durable differentiation. That's where we are today. Now let me pivot to what the future brings.
This is what Jonny referred to as wave three. It represents our next horizon of value creation. The strategy here, as you can see, is to maximize our internal manufacturing platforms, leverage the proprietary science across all four categories, and back it up with clinical validation. The examples here that you see, next generation ConvaFoam and next generation FeelClean catheters. One is in wound care, the other is in continence care. Both will leverage our proprietary infection prevention science platforms. We're also looking at a next-generation product based on the science of ConvaTec's. Okay. We are going to go after more wound types and other indications based on the compelling scientific data we are seeing so far with this scientific platform.
In ostomy, we intend to further build on our gold standard adhesives and accessories, which are quite sought out already, with proprietary scientific solutions to reduce peristomal skin complications. Now let me go to infusion care. In the world of infusion care, we are seeing two big trends. Intravenous therapies are increasingly shifting from the hospital to the home via subcutaneous delivery solutions. At the same time, newer biotech medicines, such as bispecific antibodies, are beginning to require higher volumes or higher concentrations. Both these are driving our next generation Neria Guard innovation for high-dose biologics. What's unique about it is we intend to leverage our existing manufacturing platform and proprietary technologies to do this. In summary, wave three reflects a deliberate move on our part to go towards higher growth, stronger differentiation, and attractive new segments, all of which will also represent better economics.
Equally, you will note that wave three is predominantly organic, built on platforms we already have invested in, while we remain open to external innovation by way of partnerships or deals if they accelerate our roadmap or help access new technology build-ons. Now let me shift to our innovation operating system. As innovation output has increased for us, so has our ability to execute predictably and at scale. First, we have embedded design for manufacturing, both in terms of advanced operations in our global operations team and process development expertise in R&D. What this has done is it has enabled reliable high-volume production, and as a result, we have also built repeatable muscle memory to de-risk and accelerate scale-up by using pilot lines to test and industrialize new manufacturing technologies. Second is a point about innovation at scale.
Today, we have 16 innovation projects running simultaneously at different levels of globalization and launching. This has required seamless coordination between the commercial functions, all the technical innovation functions, and our operations colleagues. What we are doing here is continuously improving our stage gate business process that helps codify this coordination. We've also spent quite a bit of time recently to improve ways of working between these teams for the seamless handoff that Jonny mentioned. We are also uniquely differentiated in our industry in the sense that we have our own clinic network in Latin America. These clinics provide industry-leading chronic care, and they also serve as a platform to run clinical studies and accelerate clinical evidence generation and de-risk innovation. More recently, we have been leveraging natural language processing or AI-based anonymized real-world evidence generation.
What this is doing is helping us generate new insights for commercial purposes, as well as decision-making, and also post-market clinical evidence. Taken all together, what you see is tangible results where wave two innovation is 30% faster than wave one. Secondly, when you look at the overall portfolio cadence, it has accelerated. It has moved from eight launches in three years to now eight launches in two years. Guess what? We are running 30+ active studies today to enable regulatory pathways, reimbursement, and market access. In 2019, I would say we were in single-digit levels in terms of clinical studies, publications, and patents. Low single digits, if I may. In summary, we are building two reinforcing strengths. Predictable, scaled execution with faster time to market. That's point number one. Point number two, innovation portfolio that's moving towards greater differentiation and higher value.
To close, I want to leave you with the point that ConvaTec is positioned for long-term innovation-led value creation because our advantage is anchored in four things. Unmet needs discovery and user-centered design that I've already highlighted. Second is, it's a platform-driven architecture on two fronts, manufacturing platforms and science that can be leveraged across all four categories. The third point is high-quality clinical evidence that can get us regulatory approvals faster, market access, and reimbursement. The fourth one is the operational discipline that we are pursuing that accelerates and de-risks execution. The pictorial there shows our ambition quantified. First, we want to pursue disciplined investment of 5% of R&D as a percentage of sales. Second, we want to lock in and deliver a 30% cycle time reduction versus the wave one innovation you heard about.
We believe these two things will in turn continue to help us drive a circa 30% new product vitality across our strategic planning horizon, which is the next three to five years. In conclusion, wave one is scaling or globalizing, wave two is launching, and wave three is emerging. I remain confident that our best days are indeed ahead of us. Thank you. Over to you, Fiona. Thank you.
Good afternoon, everybody. I'm Fiona Ryder, the group CFO, and I am here to tell you about the exciting returns of our new Accelerate strategy. I did that so I could skip over my picture. Let me start by setting out our value creation framework. Organic revenue growth is our key driver of value. This is supported by structural volume demand, execution excellence, and our broadening innovative product portfolio. We translate this into sustainable, profitable growth through investment in R&D and commercial capabilities, disciplined P&L management, and our ongoing simplification and productivity initiatives. We actively deploy cash generated into the highest returning areas. We prioritize high return growth CapEx, but the cash generated also funds our growing dividend, selected M&A, and, as we did last year, buybacks. Today you have heard consistently that FISBE has delivered. Let me remind you the financial outcomes of this.
In the last five years, as a result of our enhanced commercial execution and the creation of our innovative pipeline, we have delivered broad-based growth across all of our categories. Since 2021, growth excluding InnovaMatrix has been consistently within our 5%-7% revenue target. FISBE has also delivered an expansion in our adjusted operating margin. Since 2021, margin has increased by 460 basis points despite considerable inflation in this period. We are making good progress towards our target of mid-20s% operating margin by 2027. Let me remind you how we achieved this margin progression. We simplified our manufacturing network, moving from seven to five main manufacturing facilities, and we significantly invested in the automation of these facilities. We centralized and enhanced our procurement function.
Under FISBE, we created ConvaTec Business Service Centers, which was a key- enabler in the reduction of our G&A, as Johnny mentioned earlier, from about 13% in 2021 to less than 7% last year. CBS started with finance, HR, and IT activities. We have also established our centers of excellence, market access, strategic pricing, change, and marketing and sales. We have deployed digital and AI to drive productivity and to enhance customer outcomes. A great example of this is Talkdesk, which we use in 180 Medical, which provides real-time AI-powered speech-to-text capabilities for voice interactions. This has so far driven a 10% patient per agent efficiency improvement and therefore a significant reduction in OpEx to sales. Looking forward, we have more opportunities. The CBS is now being used to support a much broader range of activities. We're supporting pricing, procurement, customer service, and legal from our CBS.
We're also driving more productivity from our investment in digital capabilities. Importantly, FISBE has delivered momentum across the business. Our strong cash generation has allowed us to double investment in R&D, as Divakar said, and that has built our product pipeline and created a virtuous cycle of faster revenue growth and further reinvestment. We have delivered two years of double-digit EPS growth, an upgraded investment-grade credit rating, and a $300 million share buyback. You have also heard today that we are ready to accelerate, and we will do so from a position of strength. We operate in structurally growing markets. Demand for our products is increasing. Our new product pipeline is launching successfully and gaining share, and we are investing in capacity to drive faster growth.
In the category breakout sessions, Tanja, Mark, Bruno, and Kjersti have talked about how our operational and commercial execution will underpin this acceleration. Waves one and two of our innovation pipeline specifically targeted the fastest-growing subsegments of the categories in which we operate. This is driving high-quality revenue growth, stable, recurring, and diversified across the categories and geographies in which we operate. You've just heard from Divakar about our exciting next wave of innovation. These factors combined underpin our acceleration in organic revenue growth from 2027 to 6%-8%. This revenue growth, coupled with disciplined P&L management, will enable us to reach our mid-20s operating margin, and we intend to remain within this range. We believe that mid-20s is right for us. We want to continue to invest in key capabilities and ongoing innovation to sustain our acceleration.
Additionally, mid-20s benchmarks well against our peer groups of European and U.S. med techs. The framework creates opportunities to reinvest to underpin future growth, and we will invest in R&D, marketing and sales to launch new products, clinical evidence capability and geographic expansion, taking our new products and solutions to all key markets. Now, I'm sure many of you have got questions about the recent spike in oil prices and what that means for our cost of goods. Given our enhanced procurement rigor, we are now much better placed to deal with inflation. In full -year 2025, our cost of goods represented about 40% of group revenues, and within this, raw materials were about 45%. The next largest component were overheads of about 30%, including freight at 5% and utilities at 2%. We have significant hedging and forward purchases in place for 2026, covering about 80% of our raw materials.
We are carrying about five months of finished goods and of raw material stock. On this basis, the impact to our P&L of a sustained period of higher inflation is low. As you know, our full- year 2026 guidance on inflation is about similar to 2025, around 3%. Given the hedging that we have in place and these stock levels, we estimate that an incremental point of inflation above 3% could represent, in 2026, about $2 million-$3 million additional P&L cost. But of course, we would look to mitigate this through efficiencies or pass through where possible. The cost impact in 2027 would be slightly higher , at about 7%-8%, sorry, $7 million-$8 million for an additional point of inflation.
However, I note that in 2022, when oil prices were also above $100 bbl for a period of time, our COGS inflation in aggregate was 8.6% for the year. Our business is cash generative and our capital allocation strategy is clear as demonstrated by this chart. We are also committed to a two times net debt to adjusted EBITDA leverage target. We are investment grade and this feels right for us. No need to delever further. Investing to drive faster organic growth is our top priority, and as we reported at our full- year results, we are accelerating growth CapEx to meet demand and to develop new products.
We will grow our dividend in line with earnings, and we will continuously scan our key markets looking for attractive bolt-on M&A which will enhance our competitive positioning, and we would go above two times leverage for the right deal, providing that there is a clear path back to two times. We have no desire to be below two times net debt to EBITDA for a sustained period. Our fourth priority of returning cash to shareholders is likely to be used, as it was in 2025, with our $300 million share buyback. As a reminder, growth CapEx develops new products and creates or increases capacity. In 2025, we spent $121 million on growth CapEx. This will increase to between $135 million-$165 million in 2026, and we expect a similar quantum in 2027.
Total CapEx will be around 9% of group sales in 2026 and likely similar in 2027, then falling back to our normal range of 5%-7%. We are investing across all categories. The majority of our 2026 growth CapEx is in Infusion Care, where we are significantly increasing capacity, in many cases underwritten by long-term customer contracts. Importantly, we are adding material capacity to meet demand across all areas. In Advanced Wound Care, we're preparing to scale up ConvaNiox, ConvaFiber, and adding further capacity in ConvaFoam. In Ostomy Care, we're adding further Esteem Body capacity and preparing for the launch of Natura Body, our new two-piece soft convex pouch. In Continence Care, we're expanding capacity to launch our male compact catheter, GentleCath Pocket, and GentleCath Set later in 2026. Growth CapEx investments are creating valuable, high return, long-term assets.
It can take up to three years to build, install, and validate a highly automated manufacturing line, and therefore, as we invest, assets under construction on our balance sheet increases. Assets under construction commence depreciation when the asset are ready for use. We then expect our depreciation costs to increase steadily over time, but this is fully- factored into our margin guide. Of course, the anticipated revenue streams from our capacity expansion, in many cases underwritten by long-term customer contracts, will drive higher profits and return on capital employed. Our improved financial performance and financial discipline has increased our return on capital to over 14%. Given our positive momentum and these compelling growth projects, we expect returns on capital employed will continue to increase in 2026 and 2027, inclusive of the higher CapEx that I have just discussed.
Our significant cash generation and balance sheet strength will further drive EPS growth. Over time, investors can rely on our operating profit growth, cash generation, investment grade rating, and commitment to two times leverage to consistently drive group EPS. This will be enhanced by attractive M&A or share buybacks. In conclusion, we have a resilient and reliable business with broad-based revenue growth and a strong track record. Our compounding growth algorithm is clear. Our strong balance sheet provides optionality, and we are reaffirming our medium-term targets of 6%-8% revenue growth, mid-20s operating margin, double-digit EPS, and double-digit free cash flow to equity CAGR. We are ready to accelerate. Over to you, Jonny.
I'm conscious we're running a little bit over time. I'll wrap up quickly, because I suspect you might have a question or two. You've heard today that the FISBE strategy has largely worked. We are now a stronger business. We are delivering sustainable and profitable growth. But the opportunity ahead is substantial, and we're ready to accelerate. The Accelerate strategy that we have described today, based on these four strategic pillars, customer, technology, execution, and culture, will enable us to grow ahead of the markets throughout the entire strategic period. Across each of those four categories, we'll accelerate in each one. These four categories, as we said at the beginning, they sit well together. There is synergy across them. Each one of them will grow faster through the next strategic period, and that will add up to 6%-8% for the group as a whole.
The enablers to deliver this strategy are in place. These are all teams and expertise that was built through the recent years of the FISBE strategy. I'll just quickly skip through them because we've talked about them all today already. Science and innovation. We have a substantial team of expert scientists under Divakar's leadership, who are pushing the boundaries to find and solve unmet patient needs in areas like adhesives and their impact on skin condition, in areas like plastics extrusion and the impact on high volume manufacturing. We have invested. You may have seen some announcements. We've got new centers in London, in Boston, in Slovakia, in Denmark. Substantial team delivering that pipeline that we are so proud of. Quality and regulatory. In general, quality in ConvaTec is really good.
We manufactured last year about 1 billion products for people to use with very low quality comments or complaints. Now, we do recognize that we have one specific issue in one subsidiary related to the management of complaints processes, and we're very disappointed that that's happened. We're on it. We're going to fix it. We take it very seriously, and we will demand of ourselves the very highest standards of quality. It is important to acknowledge, important though that is, it doesn't relate to product quality or to patient safety. Medical and clinical affairs, I can't add much to what Divakar said already. Over 30 trials running at the moment.
Some important ones that we're looking forward to reporting back on InnovaMatrix and ConvaNiox, but a wider range, and following the theme of developing more clinical evidence to support value going forward. Market access and reimbursement, that does that too. These are our experts based mostly in the U.S., elsewhere too, who are representing our case, our economics case to the authorities and securing appropriate value for the contribution that our medical devices are adding to the healthcare systems. In operations, we made really good progress through FISBE, rationalized our footprint, delivered productivity. We're well down the journey of automation in our factories. The next stage in this group operations function is about finishing off productivity because there's more to go for. We're not yet fully automated.
It is about delivering more capacity to meet this strong demand that we are lucky enough to have in the market. Very focused on capacity build in all four categories, actually. On improving resilience at the same time across the network. In technology, similarly, great progress through FISBE. There's more to do. We've already implemented many standard and modern systems, which has helped drive our productivity. For instance, MES systems to roll out across the factory network is part of the automation journey. That's not been finished yet, so we'll finish that. We're making, I think, good progress in the use of AI. It's a very hot topic these days. We're being selective. We're being focused. We are using AI tools developed by other people, honestly, to deliver productivity within our business, and you heard some good examples from Fiona earlier today.
All of our colleagues internally are being trained in how to use AI tools to make their individual day's work more productive. We're starting to see some rewards. On M&A, Fiona also mentioned this. It's going to be an important part of our future growth story, but we are disciplined about it. We are focused now, and we're going to stay focused, and we are looking to deliver superior returns through bolt-on activity, and that might be new technologies or new capabilities similar to the pattern we've had over recent years. Most important is people. I've talked a bit about culture already. We are developing stronger leadership to drive a stronger performance culture. That's not to say we're not good. We are. We're in a good place right now, but we want to accelerate, do more and better.
I've got one more slide on culture because it feels worth a double click. We've heard a lot about strategy today, and culture is one of the pillars in strategy. You're probably quite familiar with Peter Drucker's famous quote that culture eats strategy for breakfast. This is how we get stuff done. This is how it all gets delivered at the end of the day. purpose-led, performance driven, that's our call. We are developing the leaders, and we're training the teams to be more cross-functionally collaborative. Don't drop that baton between teams. Perform as one ConvaTec team. actually, we're doing pretty well. All of the people metrics, they're sort of listed on the right-hand side, how we follow it. They're all going in the right direction. Very strong engagement. I've referred to that already. Our voluntary turnover is going down.
Our internal promotions proportions are going up. Diversity is very strong, which helps with our avoiding groupthink and get the right ideas into the room. Really strong diversity. We got an award for that from the FT, in recent weeks. Our cycle time's improving. Culture, really important. It's how we get it all done. I'll just conclude then by saying, here is ConvaTec. This is the investment proposition that we are presenting to you today. We are well-placed to deliver the organic revenue growth guidance that we've suggested and double-digit EPS growth year- in- year-
out because we've got very strong market positions in structurally growing markets, leadership positions where we are one of only a few global players. Because it's consumable products and chronic care, it's a high quality of recurring revenue. Our new products are working. They're getting great feedback. They're winning market share.
What all that means is the flywheel of investment is turning. More sales, more profit, more cash every year to invest to drive more growth. We're building a stronger business for customers, and we're driving sustainable value growth for shareholders. That's ConvaTec. I'll just leave you coming back to the three takeaways that I mentioned at the beginning of the day. You probably can all remember them anyway, but this is the short version. Very attractive markets, strong and resilient business. The opportunity ahead is substantial. Thanks very much for your attention. You might have a question or two. Please feel free to ask a question of anyone in the executive team. We're all here, and we're all ready to take any questions you've got. David, do you want to-
I think Kane had his hand up first, but keep an eye on you.
All right. Because you've got questions online as well, I think.
We're going to prioritize the floor.
Okay.
Hi there, it's Kane Slutzkin from Deutsche. Just on the raw materials comment, what percentage of the? You said it's 45% of COGS. How much of that is polymer or petrochemical related? Is that the majority, I would assume? And on the mitigating sort of factors, what is the sort of timing lag on a sort of pass-through or the like? And then just on margins, you sort of, today seems the theme of reinvestment has been quite a big theme for you. Does that sort of mean that we should assume that in any given year, your margins could swing a little bit up or down versus the mid-20s% and sort of capped at that level?
All yours.
Thank you. Yes, our raw materials, as I said, 40% of revenue, 45% of our cost of goods are raw materials. The components within there are all different and move at different speeds or different pressures within there, which is why I gave that aggregate impact back in 2022, because there will be some spikes. We have different contracts for different subcategories and different levels of stock. That takes me onto your second question. How long does it take for those impacts to flow through? Well, as you saw for 2026, we're 80% hedged. We have five months of finished goods stock. We have about five months of raw material, and that differs by category, as do the pricing pressures. How long will it take to flow through? A while. It will take a while to flow through.
On your margin point, we are on track to get to our mid-20s% margin by 2027, and I think we have been clear by saying that that would be 24%. Our range is 24%-26%, and we intend to stay within that range.
All right.
Hi. Hope you can hear me okay. Yes. It's Aisyah Noor from Morgan Stanley. One question for Divakar on R&D. Has there been a fundamental change in the way ConvaTec thinks about R&D? Where in the past, for example, we saw the risk that InnovaMatrix would be excluded from LCDs due to lack of certain clinical studies or criteria. Does this inform your approach to R&D going forward, or is the burden of clinical proof much higher now when you're developing these new innovations, such that the R&D outlay for a new innovation is much higher? That's my first question. Second question, there was a slide on capital allocation.
Given the very focused growth investments and potential for M&A in the next 12-18 months, is it fair to assume share buybacks take a bit of a backseat until then, or are you still keen to keep buybacks on the table for 2026? Thanks.
You want to start, Divakar?
Yep.
Yeah.
Can you hear me? Yeah. Aisyah, thank you for the question. I think, in terms of clinical studies, I think the point I was trying to make was, we don't necessarily see clinical evidence as an add-on at the end of a launch or as a defensive approach. We are seeing clinical evidence as an input to help inform the choices we want to make as we commercialize products. That is the core element of it. When you see the studies, even the one that I shared in terms of our antimicrobial platform, we actually see that as one of the scientific platforms that can inform future innovation. That is core to it, and that is how investments are being planned and invested. InnovaMatrix, as you know, we have really good real-world evidence already for very complex wounds. It's already compelling.
We are awaiting results that we intend to publish by end of this year. I don't know. That's what it is. I think if it's about outlays, maybe Fiona can help. Yeah.
Yeah.
Do you-
Let me just add first, Fiona. You're doing the next one. Look, I think there's a general trend which Divakar described, though, which is we are moving more towards innovation, which warrants and will benefit from clinical evidence. We're going to be doing more of it, and that, of course, will cost something, but it delivers a higher return in the long run. Sorry, Fiona. Share buyback.
It's okay. I just want to see Aisyah when I answer her. Well, what can I say? We have our four capital allocation priorities, which remain the same.
M&A comes before return to shareholders, but I think it is fair to assume that there will be some M&A or return to shareholders over this medium term.
Yeah. There's no sense in which anything is on the back seat for 2026 at this stage. We're still looking at everything.
Can we go to Veronica, and then we'll go over this way to Graham. Thanks.
Excellent. Thank you. Veronika Dubajova from Citi. Two questions from me, please, and they're going to be divisional. I'm going to give this very senior leadership a second to take a breath. The first one is on Infusion Care. Kjersti, I would love to understand your expectations for the non-diabetes part. If we fast-forward, you've moved from 10%-15% over the last couple of years. What is a reasonable ambition level that you have? I guess if we get to 2030, what would you expect the non-diabetes proportion to be? Obviously, a huge amount of success with AbbVie so far. You've told us about a couple of other folks you're working with already. Can you maybe shed some light on the pipeline of number of conversations that you're having that you haven't been able to tell us about, but might translate into something? That's my first question.
Then my second question's on Wound Care. Obviously, if I look at the business excluding InnovaMatrix, you've been growing about 4% the last two years. It looks like it'll be fairly similar this year. I'm just trying to reconcile, you've had success with ConvaFoam, so why has the growth rate not been more impressive, and are there other parts of the portfolio that maybe need a little bit of work or focus to get that growth acceleration? Just if you can maybe give some color around that. Thank you.
Yes. I think it's on.
Yeah. It is. Yeah.
Yeah. Okay. Super. Thank you for the questions. First on the non-diabetes therapies, like you said, correctly, it's now at 15%. Of course, those therapies are coming from a much smaller base. What we said is that diabetes will continue at high single digit, which is also coming from a very substantial revenue size. I'm not going to give you a number for 2030, but I absolutely see in the 2030s high double-digit growth for non-diabetes. In terms of who we're working with, like I've said in there, and you just mentioned, three partners just in Parkinson's. Actually, Parkinson's came out of. We have a small direct team in Infusion Care.
Mainly, as you know, we're B2B, but we have a small direct team in Europe, and the Parkinson's opportunity came from them having worked in the field, with apomorphine in Europe, which is an old drug. We are working on the pipeline with the current Neria Guard platform, and then as you heard Divakar mention, the next generation Neria Guard will be able to cater for different drugs. Mainly, for example, bigger volumes, or higher viscosity. The opportunities is quite broad, I would say. When we get to 2030 and look at this, it will be a different shape, but still diabetes will be very big.
Great.
Thank you. Can you hear me? Yeah. Thank you also for your question for Advanced Wound Care. As we had showed in the Advanced Wound Care breakout session, the growth acceleration will come from five products we are focused on. What we have already launched more broadly is ConvaFoam, and we see clearly a positive feedback from our customers, and we have also seen a share gain with that particular product. 2026 is an exciting year because we have several launches coming online with ConvaVac™ and also ConvaFiber, as an example, and we will also further broaden ConvaNiox going forward. All of this will really give us the confidence that we will accelerate, and increase our growth targets for Advanced Wound Care. I hope this answers your question.
Yeah. If I may just add to that, Tanja, that's all exactly right. You asked about the past as well. Why wasn't the past bigger? Remember, we were doing really well in antimicrobial. Market leading brand in AQUACEL, but that's only one of the big four categories. The foam category was growing faster, and we were tiny and didn't have a good product before ConvaFoam. The single-use negative pressure wound therapy area was growing the fastest of all, and we didn't have a product in that either, which I hope you enjoyed seeing ConvaVac™ today. Very excited about where the growth is going to come from, but that's why it wasn't growing so fast in the past.
Graham, then we'll come back to David in the middle. Over this side.
Thanks. Just one question for Divakar and one question for Kjersti, which is on nitric oxide, you've talked before about using it in other applications, and it kind of looks like there might be something in wave three. But what's the most obvious next place to put that technology into? And then on Infusion Care, in a world where there is a patch pump and you're working on that, from a manufacturing perspective, does it involve anything different? Can you do it on the existing lines and manufacturing footprint that you have to produce the key components?
Yeah. Thank you for the question. I think the ConvaNiox technology, this is a nitric oxide-powered multimodal technology. What we mean is nitric oxide is one of the modes. There are two or three other modes built into that platform. Logically, the next immediate application, that's one of the reasons why we've called out in wave three, we do see an additional one in wound care, and we've called that out. We're not limiting it to it. We think these four modes have additional applications. You also saw in our wave three, we have highlighted how we also want to use infection prevention scientific platforms, of which nitric oxide is one, and we have a few more, that can be applied also to our next generation FeelClean. Those are two.
Obviously beyond the other scientific platform that we're also pursuing is, how do we take our gold standard adhesives and accessories and try to go after peristomal skin complication. Hopefully, that's the extent to which I can share today, but remain exceedingly excited about it. Yeah.
Just to make sure that I got your question right. You were asking whether if we are producing for a patch pump, if that can be used the same lines as we're using today for the Neria Guard? That was question. Yeah. Right. It would depend on the exact product, but think of the Neria Guard, it's a lot of parts in there, so it would be modular. Even though we have fully- automated lines, there could be stations that we would need to modify. In general, the principle is the same, but it would be some modification needed depending on the exact solution that we were supporting.
Maybe then we'll go back to Richard. Sorry, I didn't know.
Thank you. David Adlington from J.P. Morgan. A couple questions please. Firstly, on wound, on ConvaNiox, I was just wondering how your conversations are going with reimbursement agencies, what sort of premium you're looking for, and when we might get an update on what reimbursement you have secured. Secondly, on ostomy, maybe you could just remind us what percentage of the market is two-piece, both in the U.S. and ex-U.S., and what percentage you are currently in two-piece.
Yep. Yeah.
I get started with ConvaNiox. As you heard, we are super excited about ConvaNiox, and we have already released it into the hospital channel, and it's covered, in the hospital channel. You also heard Divakar talking about additional clinical evidence, real world evidence we are generating. This will also help us to further diversify into other channels, specifically the community channel going forward. This is work which is undergoing, but we are very positive and confident about that. It is reimbursed in the hospital. We have, as you heard also from Dr. Chris, fantastic feedback, not only from practitioners, but also from the patients, and we will continue to also make it available in other channels as well. Did this answer your question?
I wonder if Divakar might add a bit about.
Yeah
U.S., as well. If that
Thanks. You can. Yeah. I think, just to build on Tanja's comment, right. I think we got clearance for it in April in Europe. We've launched it, and as she shared, the testimonials and the feedback both from patients and HCPs are as encouraging or, as the RCTs suggested. I think for the U.S., based on the compelling nature of the science and the clinical data, we are going to pursue the FDA De Novo pathway, which means there was no precedent before this. Yeah. In addition to that, we are running clinical studies for health economic reasons as well as reimbursement. What I can share with you today is these are RCTs, so I really can't comment on the RCTs except to say that recruiting is going quite well. That gives us continued enthusiasm about the prospects of this platform and this product.
Thank you.
Bruno, do you want to?
The best way to look at the split between one-piece and two-piece is in the U.S., you have probably 60%-65% two pieces. The opportunity for Natura is really important in that geography. The opposite in Europe, where one-piece is a bigger market, and that's the reason the Esteem Body is getting more traction in this market. In the emerging markets, you see that are very fluid. Depending on the market, you see more two pieces than one piece, which is in the majority. Yeah, you can have the opposite situation, too. I hope it clarifies the opportunity.
David, where did you want to go? Oh.
There we go.
Ah.
Thank you. Richard Felton from Goldman Sachs. First one, to Tanja on wound. On ConvaVac™, what gives you the confidence that this product's going to get more traction than Avelle™ ? That's the first one. Then I've got a follow-up after.
Yeah. You have another one, or shall I get started?
You can go first. It's another topic after.
Okay. We have demonstrated ConvaVac™, and this is really a highly competitive product with a fantastically working pump, which is very convenient and very silent. This is combined with our dressing, which is supported by the Hydrofiber. This is very unique, and we are very proud about that technology in particular because what is in contact with the wound, it is the dressing too. We are combining here two fantastic elements, a well-functioning pump with a Hydrofiber dressing technology, and this really gives us the confidence. We are already in the phase of launching it in Europe, and the feedback is very encouraging too. We are really excited about that technology.
Thank you. Second one was on the Infusion Care business. You mentioned a couple of times in presentations that there's longer term customer contracts in that part of the business. How should we think about your ability from, on pricing or passing through cost inflation, within the frameworks of those longer term customer agreements? Thank you.
That's a good one. Thank you. Like you said yourself, it's long-term agreement. We've had, I think with Medtronic, for 20+ years. We have very good and solid contracts for ConvaTec. I will not tell you exactly how those contracts are constructed, but the margins are healthy in our business. They will continue to be that. When we are moving into new therapies, there is also opportunities in that for different constructs that I would see an upside in.
Yeah. If I may add to that, Kjersti, there's no automatic pass-through, but there is a symbiotic commercial relationship where everything is up for discussion. The contracts serve very well to drive stronger volumes, which really helps with operating leverage and other things to overcome any inflation that you might face.
Divakar, you got a build on that?
I just have a build on Tanja's comment. Tanja also mentioned that with the ConvaTec technology platform, there is clearly the pump, there is the Hydrofiber, and then we have one more, which is the silver. We are coming with a silver-based technology on top of it. When you combine all three, I think we have a winning platform. Yeah.
We have two questions over here, then we'll take a couple online. Susannah and then on to Seb.
Great. Thanks. Susannah Ludwig from Bernstein. I guess first, you guys have shown that you've had good growth of your own products within 180 Medical and your own distribution. I guess part of that is sort of higher quality products, but how much influence do you have over product choice in your own channels? Then second, on Infusion Care, you've talked about investing significantly for capacity expansion. I'm just wondering how much has supply, if at all, been a constraint on growth, in sort of your recent performance?
Thank you for the question. On influence of choice, I would look at it more about education. These are long-term relationships, and with long-term relationships and trust, we have the opportunity to really educate our patients and the people that trust us. With that opportunity, they get exposed to our innovative products like you saw today in the breakouts. That's the really winning formula for success, is how I would characterize that.
Good. Your question was whether it has constrained us now, the capacity. The answer to that is no, but what we want to do is to be able to capture the future growth. Some of you saw the slide that we had in my breakout session. In 2024, there was an uptick in growth for durable pumps, which maybe surprised many because that was the year when the GLP-1s came as well, so there was a little bit of a worry, but it started there, and that's also when we started pushing the button for the investments that are coming online. They're landing this year, and we will start to deliver from them at the beginning of 2027. It hasn't constrained us, but now we will have the ability to get more customers, more therapies, and grow even further.
May I just add, Mark, to your answer, which is the philosophy Mark's always telling me about this. The philosophy in 180 is customer focus. That's why the satisfaction scores are so incredibly strong. We do have an opportunity to influence, but we will never force. It comes down to the customer choice. I think that's where your education point came in, Mark.
Hi, Seb Jantet with Panmure Liberum. Primarily Panmure Liberum. Two questions if I may. First of all, just on continence care. You've shown how strong that service business is and how important that is in driving the growth. As you expand into Europe, how are you going to replicate that service infrastructure? Does that require acquisitions? The second question is just around margins and about capping the margins essentially at the mid-20s%. I guess I'm just going to challenge a bit and wonder why that is, because you've got some manufacturing efficiencies coming through in the business. You've clearly got some more scope for G&A savings. If I look at your revised guidance, it's the two higher margin parts of your business that are growing fastest. Why should we assume that margins get capped? What are the drags on it, basically?
Thank you for your question. On expanding our service outside of the U.S., there is certainly a lot that is transferable. The back office, the technology infrastructure, and really the culture is very key. We've made some selective M&A opportunities to break into that space, but then we get to take our knowhow that we've developed in the U.S. and really combine it with the local market expertise, and it's kind of proven to be a very winning formula. That's how I would answer that question.
I didn't mean that.
Oh, sorry.
Thank you for your question. Look, we're really excited about the opportunities ahead of us. We're excited about our acceleration of top-line growth, and we have the building blocks in place to take us to the mid-20s% margin, and we will be doing that over the next 18 months to two years. We want to continue to drive top-line growth, and therefore for our operating profits to continue to grow. We believe that continuing to invest in the exciting R&D in our commercial capabilities to sell and market those products in the markets in which we operate is the right thing to do. You can rely on top-line growth, operating profit growth, double-digit EPS, and strong cash flow.
David, last one. Oh, yeah, and there's one there.
Yeah. All right. Christian Glennie with Stifel. I guess one on ostomy. You made a point about the key one critical success factor is the winning of patients in the acute setting and then the transfer of that when they leave. What takes it to win that patient initially in the hospital, and what's your rough sort of win rate, if you can articulate that? And then once patients are on your products, how much do they then switch away? I think that'll be the first one.
Can you hear me? Yeah. Good question. No, I think it's important to understand the journey, right? That's the first point. In the initial point of the journey, the HCP is really important. Having HCP engagement, clinical education, and all the way to show the quality of our solutions early days for HCPs is key for us to win, right? Patient loyalty is very important in ostomy care. Once you win and you make them feel confident that they have the right product, this loyalty will drive through the continuum of care. In terms of win rate, I think once we have this patient in ostomy care with ConvaTec is really high. We're confident that if we win in the acute, you can drive that moving forward in the journey.
Yeah. I mean, we haven't shared any specific stats on that. What is true is that we used to be losing share through new patient starts. That was under Bruno's leadership of the team in the USA. That has been stabilized, and we are now starting to recover share in the U.S. market because of accelerated new patient starts. You can do the math on that.
Yeah. Second one, maybe just on Continence Care.
Mm.
Okay, I know that officially the growth was mid-single-digit , but if you look back over the last few years, you could argue it's actually already been in that mid- to- high single-digit , if we look at that chart and the numbers there. I guess you would've had maybe some pricing reimbursement benefit, bit of tailwind there. Just to understand, is it really accelerating, or is it just a continuation of what has actually been in that range already?
Well, I'll answer that one first, and you can add if you want. Look, they've done really well. Their target was to deliver mid-single-digit growth, and they've beaten it. The target is accelerating. Now, maybe they'll keep beating it. You never know.
Beatrice.
Hi, Beatrice Fairbairn with Berenberg. Thank you for taking my questions. You've spoken a little bit about the automation journey. Would you be able to give us a bit of color about how far along the business is with this, and I suppose if there are any assumptions embedded into the new Accelerate strategy and guidance?
The what journey? I'm sorry. I didn't.
The automation journey.
The automation journey. Yeah, absolutely. Well, look, we have got five big factories, and two and a half of them are fully- automated. I mean, it's not quite as black and white as that. We're doing bits here and there. We are more or less fully automated in Ørsted, Denmark. That was the first one, Infusion Care. Deeside in the U.K., Advanced Wound Care factory, has got a high level of automation. We're working our way through. Slovakia is advancing nicely. We've got Dominican Republic and Mexico where there are still opportunities to complete. We should get that done in the next few years.
Okay. Thank you. I've got another one on Advanced Wound Care and InnovaMatrix specifically.
Yeah.
You've given guidance for Advanced Wound Care over the medium term, and I know you've previously said that InnovaMatrix can return to growth from 2027.
Yeah.
I suppose, would you be able to give some more color around how that growth looks relative to the medium-term guidance for the segment?
Well, okay. Let me start that, because we've had a lot of InnovaMatrix questions. It's been a big distraction, hasn't it? The fact is, it doesn't matter for our medium-term growth targets. InnovaMatrix this year will be less than 1% of group sales. Now we are confident it will grow next year, but it's not going to move the needle in terms of group sales growth. Now, maybe, Tanja, I can ask you to comment on why is InnovaMatrix going to grow?
Yeah. As you said, there is a new base in 2026, and starting from that, we will grow InnovaMatrix. We have seen that InnovaMatrix has increasing clinical evidence based on real-world evidence. What we have also seen is the impact it has on the patients in the United States over the course of the last years. This really gives us confidence that this differentiated technology will continue to perform very well. In addition, we will continue to generate new clinical evidence, which will also underline and confirm what I just said. Obviously, we are also working on further diversification from an indication point of view and across the channels. This is really one of the five products I have been talking about, and it will continue to fuel our growth.
Divakar, yeah. Please add.
Just a comment. Just to build on what Tanja's saying is, when we made that acquisition, we made it not just for the product, it's a platform. It's a platform which has a lot of promise and properties. That's the conversation Tanja and I are having. We actually see an opportunity to generate evidence and go into additional diversification. I think that's how I would continue. Thanks.
Yeah. Look, I was slightly glib when I said it didn't matter. What InnovaMatrix becomes now is not the thing that moves the needle on its own. It is one of many products which will be growing, all contributing to growth. It's the diversified, broad-based growth going forward that it will add to.
We have a couple of questions online. I will just ask them out. If anyone else online would like to ask one, please, this is your opportunity. First question would be for Mark. When will Pocket and Set launch in Europe? And what's the plans beyond that? One for Jonny, is if you were to pick one product from waves two and three, which would it be and why?
Argh. Time to think.
Yeah. Time to think. Pocket and Set will be launching in Europe later this year, with the rollout into next year in European countries, followed by the U.S. after that.
That wasn't enough. Look, I can't choose. You love all your children equally, right? I think there are a lot of great products coming. I mean, seriously. Obviously, we've talked a lot about ConvaNiox today. It's really exciting. That's going to be a bit slower burn, a bit longer term. Some of the other opportunities in wound care are fantastic. ConvaVac™, very exciting. It's so much better product than our predecessor product, to Richard's question. It's just night and day. That will be great. ConvaFoam we know is already building. ConvaFiber, dramatically better product than its predecessor, as demonstrated by the clinical stats. Natura Body used to be my favorite, but it's just one of many favorites now. Esteem Body is growing so well in ostomy care that it feels we're a bit naked in the U.S. without the two-piece version of it.
When that lands, that's going to be really great. Same thing in Continence Care, right? We've got a gap. We are fighting still with one arm tied behind our back in Continence Care and in Ostomy Care. That will start to be solved at the end of this year, although it will take a few years till it launches fully. Then Infusion Care. Well, demand is just fantastic in Infusion Care. I think the Parkinson's, Kjersti Grimsrud's being a bit modest today, but winning that Parkinson's business was fantastic, and there are now three companies delivering different medicines to the market for Parkinson's treatments, and we are the exclusive supplier of infusion sets to all three. It's really strong and powerful testament to what the business can do, and that's before we talk about the therapies that come after diabetes and Parkinson's. I love them all.
I think we are complete.
Brilliant. Well, listen, just a quick word to say thank you very much for your time today. It's been a long afternoon. I hope you've learned something. I hope you've enjoyed it. You know where we are if you have any further questions. Remember your three takeaways. Thanks very much.