Hello, everyone. I'm Siggi Olafsson, CEO of Hikma Pharmaceuticals, and I'm here with Khalid Nabilsi, our CFO. Thank you for joining our 2021 full year results presentation. I will provide a quick summary of our results and an update to our strategic progress before handing over to Khalid to run through the financial details. I'm really pleased to announce a strong set of numbers for 2021. While the year presented ongoing challenges as a result of the pandemic, we executed our strategy extremely well, delivering 9% group core revenue growth and 12% group core operating profit expansion. This reflects a strong performance of our three-business segment and led to a significant increase in operating cash flow at 38% over last year. Our results demonstrate the strong foundation on which Hikma is built.
Despite the challenges brought about by the pandemic, we've been able to leverage our experienced commercial teams and benefit from a highly responsive and efficient operations. Alongside delivering these results, our teams have also made excellent progress in investing for the future. Through the combination of strategic capital expenditure, acquisitions, and new partnership, we are continuing to build and evolve our manufacturing capabilities and capacity, as well as our portfolio and our pipeline. Our injectables business is now supplying U.S. hospitals with sterile compounded pharmaceutical product, has expanded into Canada, and is set to grow further with the acquisition of Custopharm and our expansion into U.S. biosimilars. Our generics business continue to win in a competitive environment by bringing more complex and specialty products to market, having launched cloxacillin and generic Advair Diskus in 2021, and with additional product launches planned for this year.
Our branded business has delivered a consistent growth with an increased focus on medications to treat chronic illnesses. Let's take a closer look at each of our three businesses. Starting with our injectable business. Following an exceptional performance in 2020, we delivered a high single-digit revenue growth. We grew in all our regions, including the U.S., where revenues grew by 4% despite a tough comparator due to the level of COVID demand that we saw in 2020. This year, we grew our market share and are now the second largest supplier of generic injectable medicines in the U.S. with a portfolio of more than 120 products. This helped us to manage the volatility we have seen in demand, driven by fluctuation rates of COVID infections, continued delays in elective surgeries, and significant gaps in diagnosis.
The chart in the top left corner shows the monthly variations in volumes that we saw for the U.S. injectable business compared to 2020. While we continue to see some volatility in the market and elective surgeries are not back to normal levels, our portfolio and successful new launches help us to capture new market opportunities. For some time now, we've consistently been launching a good number of new products each year with 50 launches in 2021. While they are predominantly small products, together, they have made a good contribution and will support growth going forward. In MENA, our biosimilar products are performing well and driving growth. We expect this trend to continue as we launch into new markets.
The graph in the top right corner shows how we have been able to expand patients' access to key biologic treatment compared to 2020, making these important medications significantly more affordable for patients in the region. This reflects the passion and commitment of our commercial teams who are working to give patients access to the medicines they need, connecting patients who urgently need treatment with doctors and hospitals that can administer it. Our business in Europe is also performing well, driven by our own products, recent launches, and ongoing demand for contract manufacturing. We are making good progress expanding our presence across this region. In France, especially, we are registering and gaining approval for our products. To accommodate a growing portfolio, we need to expand, and in some cases, build new capacity across our markets.
We continue to invest in our sites in the U.S. and Europe, establishing additional warehousing and packaging centers in Portugal, as well as adding new technologies and capabilities in the U.S. We significantly enhanced our new compounding site in the U.S., which we acquired in 2020 and believe it is now one of the highest quality compounding facilities in the U.S. I will be talking more about this business later on in the presentation. We are also strengthening our operations in MENA. We are making good progress with the construction of a new injectables plant in Algeria and are upgrading our capabilities in Morocco to support new market opportunities. This is an important aspect of our future growth strategy for this business. As with all our businesses, we need to keep investing in our pipeline, adding products through internal R&D and business development.
We have 113 products in our injectable pipeline, and we are strengthening our R&D capabilities for this business. As such, we are establishing a new R&D center in Warren, New Jersey, that will enhance our ability to develop more complex products. Through business development, we are filling pipeline gaps and adding complex products where we do not have the capabilities to manufacture them in-house. Biosimilars is one area where we see significant potential, and they will be an important part of our growth strategy for both the U.S. and MENA market. For example, we have made excellent progress this year in building a biosimilar pipeline for the U.S. market. In August, we announced a partnership with Bio-Thera to commercialize their ustekinumab, a proposed biosimilar referencing Stelara. In December, we announced our second biosimilar agreement with Gedeon Richter for denosumab in the U.S., with reference Prolia and Xgeva.
Our ambition is to establish in the U.S. a biosimilar structure as in the MENA region, and we will look to build a portfolio of these products. We are also making good progress rolling out biosimilars in MENA, as highlighted in the first slide. Earlier this year, we announced that we have expanded our agreement with Celltrion for a subcutaneous form of Remsima, the first of its kind. This new formulation enables administration outside of the hospital setting, allowing more patients access to the treatment. We are also adding products and strengthening our capabilities through acquisitions. In the U.S., we announced the acquisition of Custopharm, which will expand our portfolio of marketed products, bringing promising new pipeline opportunities and expand our R&D capabilities.
Just a few weeks ago, we also announced the acquisition of Teligent injectables assets in Canada, which adds 25 injectable products and provides us with a faster route into this attractive market. In addition to building out our pipeline, we see potential to expand selectively into new adjacencies. Earlier this year, we announced that we have launched a new sterile compounding business in the U.S. This presents a good opportunity to leverage our quality and commercial strengths to tap into a growing market. The business will focus on providing high quality, ready-to-administer injectable medicines that are customized to the specific needs of patients. This is an important specialized approach to drug manufacturing that serves a critical role in patient care. Hospital pharmacists, physicians, and nurses increasingly need these medicines, resulting in a growing U.S. market for these medications. This is estimated to exceed $2 billion annually.
Turning to our generics business. As we highlighted back in 2020, the pandemic created fluctuation in demand for prescription medicines. With doctor visits slow, we saw a reduction in the diagnosis of new conditions and as a result, lower prescriptions. In 2021, we started to see signs of improvement, with retail generics volume returning to pre-pandemic levels. Our business has proven to be resilient. We are benefiting from a differentiated portfolio, strong commercial and distribution teams, and from having a local manufacturing facility in the U.S. Looking at the top 15 companies in this space, Hikma was only one of four leading companies to achieve growth in 2021. The market remains competitive. In 2021, we saw an acceleration in price erosion to the high single digits in line with expectations, and you can see here that price erosion in the broader market has been even higher.
Competition is increasing, and we expect this to continue in 2022. Fortunately, our business is on a much stronger footing today than it was when we last saw annual price erosion at these levels. The strength of our operations and our focus on increasing efficiency and differentiation is enabling us to manage some of this erosion, and we are able to deliver an excellent performance in 2021. Revenue increased by 10%. Core operating margin expanded to 25%, continuing our impressive track record of revenue growth and margin expansion over the last four years. Our margins are now arguably best in class amongst our generic peers. Recently launched products helped to drive this strong performance, demonstrating our ability to deliver on our pipeline and launch differentiated products, and helping to offset some competition on our base business and related price erosion.
The efficiency of our operations has also contributed to our growth. We have continued to improve the efficiency of our Columbus plant while maintaining a consistent supply of medicines and minimizing service level penalties, despite some challenges posed by the pandemic. To ensure long-term sustainable growth, we must protect our base business while also focusing on building out the specialty business. Our commercial team has been very successful at maximizing the potential of our product portfolio, which has proved to be more resilient than those of our peers, and we must continue to focus on finding market opportunities. At the same time, we are building our pipeline. Through internal R&D, we are focusing on higher barrier to entry products, such as high containment products, inhalation products, and those that require REMS programs. We will also look at contract manufacturing to bring additional growth.
We have sufficient capacity to support both our own and third-party business and will help us to remain as cost competitive as possible. Through BD and M&A, we are looking to bring additional products to drive growth over the long term. Building out our specialty business will enhance our portfolio. Differentiation enable us to leverage the commercial expertise and infrastructure we built for Mitigare. We have made a good start this year through the launch of Kloxxado. In the next two to three years, we will further develop our commercial capabilities, ensuring we have the right people and a competitive cost base in place. We have some exciting opportunities in our pipeline, including RYALTRIS and Bilastine. By 2025, we expect around 30% of our generics revenue to come from specialty products. Finally, let's take a look at our branded business. This business continues to grow steadily.
We have seen a good growth across our markets, most notably in Algeria, where we are benefiting from the commercial and operational improvements, we rolled out in 2020, as well as from our new oncology plant, the only one in the region. In 2021, we launched eight products out of that facility. Overall performance was also supported by good growth across our tier two and three markets, including Jordan, Morocco, and UAE. Our ability to leverage our global capabilities and operate locally across the MENA markets has been key to our success. Having a local presence enables us to quickly respond to changing market dynamics, such as during the pandemic. In 2021, we further strengthened our operations. We have improved management of our commercial teams and introduced new sales structure to respond to the volatility caused by the pandemic. These efforts are paying off.
We are now ranked the fourth largest pharmaceutical company in MENA region by sales. As with our other businesses, key to our success is pipeline development and execution. Our focus on building a portfolio of high-value treatments for chronic illnesses is enabling us to respond to changing market dynamics, including an increasing prevalence of lifestyle diseases and is driving revenue growth. In 2021, our chronic medications contributed to 58% of branded revenue. Of course, we are also building our pipeline of differentiated products in the branded business. We have around 130 products in our pipeline, primarily high-value therapeutic area, such as oncology, diabetes, CNS, and potent products. We are also leveraging our partner of choice status to expand our network of global partners and increase patients' access to novel treatment options.
Over the last 18 months, we've launched more than 40 products through partnership, and we announced a new licensing agreement with Almirall for Finjuve, a spray indicated for androgenetic alopecia. We are adding new technologies and capabilities to develop complex products, such as lyophilization for oral solid doses, top spray granulation, and hot melt extrusion. The addition of these capabilities will help us to bolster our portfolio differentiation in the region. Hopefully, this gives you a good flavor of our strong strategic progress in 2021. I'll now hand it over to Khalid to take you through the financials.
Thank you, Siggi, and hello everyone. I'm pleased to report that the group has delivered another strong set of financial results in 2021, delivering good growth in both revenue and profit, particularly in Generics. As Siggi highlighted, we have made excellent strategic progress, and our business is operating from a position of strength. The resilience of our base business in each segment, our broad product portfolio, and the success of recent launches enabled us to achieve this strong performance with core revenue up 9% to $2.6 billion and core operating profit up 12%. Given these good results with core EPS up 13%, the board is recommending a full year dividend of $0.54 per share, up from $0.50 in 2021. We have maintained a strong balance sheet underpinned by very strong free cash flow generation.
We are in a position where we can deliver further value to our shareholders. As such, we announce today that we will be buying back up to $300 million of our shares by the end of the year. This reflects our financial strength and the board confidence in the prospects of the business. Now, let's have a deeper look at the financial performance of each business. Starting with injectables. The injectable business has performed well. We are benefiting from the breadth of our portfolio, geographic spread, manufacturing flexibility, and new product launches, which drove revenue growth by 8%. Looking at each of our regions, in the U.S., revenue grew by 4%.
Following a year of strong growth in 2020, driven by demand for COVID-19 products, we were able to grow the business in line with expectations, leveraging our broad portfolio of more than 120 products and the flexibility of our manufacturing facilities. We continue to launch new products. The incremental benefit from new launches is helping us offset the gradual return of elective surgeries. In MENA, sales were up 13% on a reported basis and 4% on a constant currency basis. This growth reflects a strong performance across most of our markets and good demand for our growing biosimilar portfolio. As Siggi highlighted, the team is doing an excellent job at increasing patients' access to these products in the region, expanding the overall market.
In Europe, revenue was up by 17%, reflecting a good performance from our own products, new launches, and continued demand for contract manufacturing. Injectables core operating margin was 37.5%, slightly down from 38.6% in 2020. This normalization reflects a change in product mix in the U.S. following the strong demand for COVID-19 related products in 2020 and a good control of costs. As Siggi highlighted, the generic business is on a much stronger footing today, delivering an excellent performance in 2021, with revenue up 10% and a significant improvement in core operating margin. This growth is driven primarily by a strong performance from product launch over the last 18 months, which are helping us more than offset higher price erosion resulting from increased competition.
Even as we saw an acceleration in price erosions towards the end of 2021, we were still able to grow in the double digits. Generic core operating profit increased by 25% to $202 million, and core operating margin improved by 300 basis points to 24.6%. The increase in profitability primarily reflects the improvement in product mix as a result of the successful new launches. While we did see an increase in sales and marketing costs related to the launch of Kloxxado and the expansion of our specialty business, we were able to partially offset that through good control of other costs. Our branded business continued to be a steady performer, with revenue up 9% on a reported basis. This partly reflects a $31 million benefit from hyperinflation in Sudan and Lebanon on sales.
On a constant currency basis, revenue was up 5%, reflecting a good performance across most of our markets. Algeria continues to be a top performer and driver of growth, where we are benefiting from new launches from our local oral oncology plant, the first in Algeria. Across the region, we are benefiting from our increasingly diversified portfolio of high-value treatments. For example, we saw good demand for our tonic treatments in Egypt and Saudi Arabia, which helped partially offset lower demand in the government tender business in Saudi Arabia. Other markets, including Jordan, UAE, and Morocco, grew strongly. Branded core operating margin was 18.7%, down from 20.6% in 2020. This decrease is due to hyperinflation accounting in Lebanon and Sudan. In constant currency, core operating margin was stable.
As Siggi mentioned, key to the success of our business is ensuring that we have a pipeline of differentiated products to sustain future growth. We continued to progress with our R&D project and invested $143 million in core R&D, representing 6% of revenue. Our CapEx spend was $145 million in 2021. In the U.S., $56 million was spent upgrading equipment and adding new technologies for our generic and injectable businesses, including our new compounding facilities in Dayton, New Jersey. In MENA, $66 million was spent on strengthening and expanding manufacturing capabilities. In Europe, we spent $23 million on strengthening our capabilities. The group continues to generate strong cash flow, and in 2021, cash flow from operating activities grew an impressive 38% to $638 million.
This year, we really focused on optimizing our inventory levels following the COVID-19 related stocking we saw in 2020. Thanks to the hard work of our teams, we managed to lower our inventory levels in 2021, driving an improvement in operating cash flow. The group's total debt decreased to $846 million. This reflects the strong cash flow which enabled a reduction in short-term borrowing while maintaining the repayment schedule of long-term loans. Our leverage remains low, with a net debt to core EBITDA ratio of 0.6x. As Siggi highlighted, we have made excellent strategic progress this year and have demonstrated our ability to add to growth through M&A and business development deals such as the biosimilar deal in the U.S. and the pending acquisition of Custopharm.
Therefore, as I mentioned at the beginning of the presentation, we are initiating a share buyback program of up to $300 million by the end of this year. Importantly, we will maintain the financial flexibility needed to invest in our business and pursue inorganic growth opportunities. Finally, the outlook for 2022. Our strategy continues to deliver results, and we are pleased with progress made to date, which is reflected in this strong set of results. Looking at 2022 and beyond, the business is well-positioned to continue on this trend, benefiting from our broad portfolio and pipeline as well as our high-quality operations. For injectables, as the COVID-19 volatility continues to ease and we see a gradual return of elective surgeries, we expect for revenue to grow in the low- to mid-single-digit%, supported by new product launches.
We expect core operating margin in the range of 35%-37%. Our guidance does not currently include a contribution of Custopharm, which remains subject to FTC approval. For generics, we expect revenue to grow in the range of 8%-10% and for core operating margin to be in the range of 24%-25%. This reflects the good contribution from new and recent launches, which will help us offset an acceleration in price erosion, which we expect to be in the low double digits in 2022. Our guidance also assumes mid-year launch for sodium oxybate. We expect branded revenue to be in line with 2021, excluding the impact of hyperinflation in 2021. As I pointed out when I went through the branded performance on slide 21, we expect branded revenue to grow mid-single digits in 2022.
We expect group core net finance expense to be around $55 million and core effective tax rate to be in the range of 22%-23%. We expect group capital expenditure in the range of $160 million-$180 million. This wraps up the financials. I will hand it back to Siggi for some closing remarks.
Thank you, Khalid. As you can see, our strategy is paying off, and we have been consistently delivering results. Since 2017, our revenue has grown at a four-year CAGR of 7% and the EBITDA at a CAGR of 12%. What is truly impressive is our track record of cash generation. This has further strengthened our balance sheet and enable us to return value to shareholders through the share buyback program we announced today, while also providing us with the optionality to accelerate growth. As I've highlighted through this presentation, our business is on a much stronger footing today, and we are well-placed as we look towards our next chapter of growth. Alongside these great achievements, we have also been working on ensuring we operate responsibly in all aspects of what we do.
We have identified four focus areas where we can drive positive impact, and that is by advancing health and wellbeing, empowering our people, protecting the environment, and building trust through quality in everything we do. Today, I'm pleased to announce that the board has approved a new target to reduce our greenhouse gas emission by 25% by 2030. To close, I hope this has given you an idea of our strategic progress to date. I'm very proud of our strong performance, and our ambition is set to achieve more. By executing on R&D, establishing strong partnership, developing our specialty portfolio, and expanding into adjacent businesses and new markets, we will further diversify and transform our business in order to achieve the next phase of growth. Thank you.