Please welcome Vice President, Investor Relations, Dan Cravens.
Good morning, everybody. Welcome to Alcon's 2025 Capital Markets Day. Look, on behalf of everybody here at Alcon, I want to say welcome to our Fort Worth campus. I know a lot of you guys have been here. We were here two years ago for our Capital Markets Day, so welcome back. We're also webcasting, so I want to say good morning and welcome to everybody who took the time to dial in. We really appreciate your time and your interest in Alcon. My name is Dan Cravens. I am the Vice President of Investor Relations here at Alcon. You know, there's this old saying that time flies when you're having fun. For me, that couldn't be more true. I actually just celebrated my three-year anniversary here just last month, and I honestly can't believe that it's been three years. It just went by so fast.
For me, it's a real honor to be part of this team and to be here with you today to talk about all the really wonderful things that our more than 25,000 people are doing every day to help people see brilliantly. I'll quickly go into the agenda. Look, we've got a really good program for you this morning. David's going to walk us through how Alcon leads in eye care. He's going to talk about some of our end markets and our strategy. Tim will follow up with our financial outlook and expectations, and then we'll move on to a Q&A session with both David and Tim. We'll take a break after that, and then we'll dig deep into the franchise section. We'll start with Sean, who's going to walk us through how Alcon leads in ophthalmic surgery.
We'll hear some insights from both Max and Jonathan about our innovations in contact lenses and ocular health. Lastly, Jeannette's going to bring us home, and she's going to close us out and discuss how Alcon is innovating for the future. I think you'll find it really interesting. Lastly, we'll do a group Q&A with the whole team on the panel. After that, we'll have a launch upstairs for everybody just outside in the atrium up here. A couple of housekeeping items before we get going. I know a lot of you have asked about Wi-Fi. We've put the address, the network name, and password up there for you to take down. We'll leave it up here for a second. Laboratories, if you haven't found them, are just outside the atrium to the right.
There's power outlets that are down by your feet. It's dark down there, but they're there. They're hard to see. Take note of the exit signs in the unlikely event that we need them. Lastly, please just remember to silence your cell phones as a courtesy to everybody else. I will move on to perhaps it's the moment you've all been waiting for, but it's perhaps the least interesting part of the presentation, which is the forward-looking statements. Just note that today's presentation does contain forward-looking statements. There are numerous risks and uncertainties that could cause our actual results to differ materially from those that are included in the presentation. We undertake no obligation to update those assumptions subsequently, so please do not place any undue reliance on them. To review the risk factors, I would point you to our Form 20F and our Interim Financial Report.
Those are both available online and have been filed with the SEC. Lastly, in case you have not noticed, the presentation is posted on our website, so please download it and do as you want with it. Look, before I hand it over to David, I want to give a special shout-out to the team that helped put this event together. There is a lot of work in terms of planning, logistics, content creation. Everything has gone really well, so we really appreciate all the help and work you guys did to make this day a great day. Without further ado, I would like to hand it over and introduce our CEO, David Endicott.
Please welcome Chief Executive Officer, David Endicott.
Back to Fort Worth. If you haven't been here before, a little shot of your eyes. Kind of cool, wasn't it?
Cool.
Maybe this is what you've been paying for. It's an exciting time to be here in the campaign, so thank you. What we're going to do today is really focus on three ideas. The first one is really fundamental, which is the markets that we play in are resilient. They are underpinned by very positive megatrends, and that creates a base of financial security that gives us a market growth that generally runs in that mid-single digits. That's the starting point for us. If we show up, do well, we should be able to grow in that change. That's a really important concept because at some level, it gives you some confidence that over the long haul, these markets tend to run in a pretty predictable fashion. The second thing you're going to hear really is that we've entered a second strategic horizon.
From the time that we spun out, many of you have been here with us since we spun, and we had a real sense of urgency spinning out. We had to stand stuff up. We had to get clean. We had to get kind of a whole bunch of things organized. We offshored some things and created shared service centers. We've done a lot with this company in the last six years, but over the last couple, since the last Capital Markets Day, we've spent a lot of time thinking about what does a good company look like and what's a great company look like. We are in a different frame right now where we're thinking a lot about how do we create operational excellence.
We are really focused on things like reworking our end-to-end processes, things like how we deploy capital, things like how do we make decisions about upstream products. That efficiency and that excellence that we're trying to get after is really this next frame. The third thing you're going to hear really, and this is where you're going to see most of the day, most of the day is going to be about our innovation engine because it really is humming. I mean, it's hitting on all cylinders right now. We've got a lot of products coming this year. I think there are seven or so that will launch in the first half of this year. We've got a bunch coming along the way. You're going to see where we've been spending money and where that productivity has happened.
Yet, I think hopefully in the same sense, you'll get a feel for how productive we're going to be going forward as well. That's the gist of the day. Let me try and take you through a little bit of it at a high level. First and foremost, we are in very resilient markets, and it's underpinned because at the core of it, the population is aging, and eye disease comes with age. Certainly, the world is getting a little bit older. As we look at that and we say, "Okay, what is the opportunity in the Western markets where there's increasing wealth and people want to spend money in eye care?" It's a very high desire. When you ask seniors in particular what is it that they worry about, number one is they worry about memory loss, and the second thing is eyesight.
What you find is that in the aging population, there's a deep desire to spend on their eye care, and there is still a lot left to do. The other one that's obvious out there is that our kids are getting more and more myopic. 50% of the world is going to be myopic by 2050. That's a huge problem. It's one that we work on every day. It's a real opportunity, I think, to kind of solve some problems here, whether that's refractive surgery, whether that's contact lenses, whether that's spectacles. It doesn't really matter. It's a big problem that we're working on and want to continue to build against. At the core of it, there's a lot of new technologies, and there's a lot of stuff that just simply hasn't been solved.
I think you're going to hear a lot of those ideas today that we're working on long term that are real important ideas. There are more cataracts than there are cataract surgeons. We've got to figure out a way to be more productive, more efficient. You're going to hear about Unity VCS, which does a lot to improve that. We're working on a lot of different disorders. In glaucoma, for example, we know SLT is a really exciting idea, but it hasn't been easy to do. We think we've made some progress there. Very important for the glaucoma population. I think as you go forward, there continues to be a really large need for new technologies, new solves, because 90% of visual impairment could be prevented or curable if we were active with it.
The real potential of the market, if you were to treat a lot of these disorders that are simply out there untreated or have yet to be solved, is extraordinary. It is certainly more than $100 billion or so. We think about this market as having lots of unmet need, lots of opportunity to grow, and at the core of it then kind of consistently grows roughly in that mid-single digits around when you composite the markets in which we play. Really exciting place to start. This is kind of roughly how we see the markets that we play in. This is not the entire market, but it is the ones that we define. We have done this last several capital markets to give you some sense of how we see the next five years.
What we see is in aggregate, we play in a market that's about $35 billion. It will grow in the mid-single digit range. Depending year on year on where we are and what happens, we've seen that to be true for really the past 10 or 20 years. In the implantables business, probably a 6% growth, a little bit faster than procedural growth because we're seeing a move to ATIOLs. In consumables, you're going to see roughly a 5% growth, not too much faster than the procedural growth, but really driven by price and mix coming from, frankly, our new equipment that will be driving a more efficient market.
You see equipment and others continuing to grow faster than the other two segments principally because we will be entering some series of new equipment over the next five years that we think adds a lot to it, and that will drive real interest in productivity and productivity gain. Contact lenses, we have flipped to vision care, $22 billion market all in in vision care. And a combination evenly split between the contact lens market at $11 billion and what we have defined as our kind of addressable market in ocular health of $11 billion, which is a combination of pharmaceutical entities that we have taken the glaucoma market and the dry eye market and then the OTC market. We have added those together.
There is obviously more to the ophthalmic pharmaceutical market than what we have included in here, but this is where we are currently playing. Both of those markets, again, in the mid-single digits.
That gives you some sense of why we are confident that we can continue to grow with the market, certainly, but our objective, of course, is to grow faster than the market. If we invest properly, we do the right things, we can get there. That said, one of the core things we've spent time thinking about when I say we've kind of entered this new strategic horizon, it has been to really define who we are, what we're doing, and how we compete. At the core of it, we are a specialist. We're a specialty company that works in eye care. What we do is we apply a superior amount of customer knowledge and technical application knowledge to the markets in which we participate.
If we do that more efficiently, if we're just a little bit better than everybody else at making good decisions about technologies, good decisions about what customers want, and then deploy capital quickly, that's our competitive advantage. It sits in the people that work here. It sits with the intrinsic knowledge of a corporation that's spent its entire life thinking just about eye care. All right, that's the specialist view that we have. We're not doing anything other than eye care. We're really good at it, and we think if we can hit it just a little bit better than our competitors, we're going to continue to do really well here. If we do that, we will make good decisions about what we buy. We'll create data that is really important for our customers. We have one of the most extraordinary footprints in the world.
We have people in 140 countries. We run the biggest, most important service group in the OR. There is not an OR in the world that we do not have somebody sitting in right now. We reinvest our profits back into R&D in a very meaningful way. That obviously attracts people who want to be in eye care. If we can do that real well, obviously it is a positive cycle for us. That is kind of what we are trying to accomplish right now. We have been very excited about progress we have made. Let us think about it from where we have been. When we spun out, we had a whole different picture of where we are than where we are now. Today, we have got almost 2,000 folks in R&D working on eye care. It is the largest single eye care operation in the world.
Today, we've also spent over the last five years about $5 billion in R&D to try and advance the products that you're going to see today and some of the programs that you'll see coming in the future. Last year alone, we are lucky to see just about everything that's going on in eye care. People bring us ideas. We look at them. We did 20 deals last year, either in active projects that are on the market or things that are upstream that we are investing in that are better held outside until we can understand whether or not we want to take a bigger position in them. We also have obviously got 90 internal projects, 90+ internal projects that are generally on their way in the next five-year frame. Of course, we've been moving our R&D up slowly to kind of invest in this importantly.
We've been talking about really historically this kind of 7%-9%. What you're going to hear today is that we're moving ourselves into this kind of 8%-10% range to try and keep ourselves investing as we can into our R&D organization. We're very excited about what's going on here in the innovation engine. What you can see is what it's developed. Here's what you ought to be excited about. All of that money and all that time and all those folks working on this stuff have created an immense amount of product flow, both in the 2021 to 2024 frame, but what you're going to hear about today is Unity VCS. You're going to hear about PanOptix Pro. You're going to hear about Voyager. You're going to hear about Unity DX, all things that are in the near-term frame.
You're going to hear about, you know, about Systane. You know about TOTAL 30 and TOTAL 1, but you're going to hear about Precision 7. You're going to hear about our new modalities, AR-15512, which is our new pharmaceutical agent, and Systane Pro, which was launched just recently. Lots going on, and the productivity of what we're doing is the critical element of what we were trying to communicate today. That said, the reason we're doing it is because, of course, before we were spun out, we were growing at a certain rate, and it was obviously not, it was pretty much at or below market. Now we're growing kind of above market, and that, of course, is our aspiration. We got a little bit in 2023 of Aerie in there, so realize that that's a little bit smoother between 2023 and 2024.
Fundamentally, if you believe the markets are growing roughly in that 4%-6% frame, that's where we should be, and it is where we are for the last several years since spin. What that does for us, and the basic economic proposition, is that if we can grow sales faster than market and we can get it up into that kind of mid-single digits or better number, and we can grow the cost structure at a reasonable number, just slightly better than inflation, and create efficiencies inside the organization to allow us to leverage the organization, we can generate operating leverage. Most of the gains that we've had over the last really five years have been about operating leverage. Some gross margin gain, for sure, but really it's about operating leverage, which is where we've gotten probably 70% of our gain in operating income.
That is what you see here is that constant core net income growth year after year after year, compounding going forward. If you take a look back at 2019 when we spun, it is an interesting comparison, right? $7.4 billion in revenue, $9.8 billion this year, or last year, I should say. 38%. We shaved 5 percentage points of SG&A out. What did we do with it? We dropped 100 basis points into R&D, and we put the rest really to the operating income. That does not include what we covered in foreign exchange. When you really kind of add all that up, and Tim will show you a little bit more about that, we have had a terrific four or five years here since spin, and we are in a really good place. Cash flow, obviously, comes with that.
We said early on when we spun out, we were going to spend almost all the cash we had because we needed to invest to get everything running again. We've done a lot of that work. We find ourselves now in a new frame where we have the flexibility to do a lot of things that we couldn't once do. Again, really interesting picture from where we've been to where we are, and then we'll show you really where we're going on a next-generation basis. One of the things that we've been talking a lot about is when we think about this strategy that we've got, what are the priorities that we've got going forward? What do the next five years look like for us?
I think it starts with understanding that the most important thing we've got to do is continue to feed the core business. We have a lot of products that are in the surgical business. We have a lot of opportunity in the surgical business. We have a big bunch of products and a lot of opportunity in vision care. We need to continue to do that work. To do that, we have to accelerate R&D productivity. You are going to hear us talk about things like we are working on something called our end-to-end process, create to make. The purpose of doing that is to redefine the processes that we use to try and move data more quickly, to try and clean up and speed up our innovation process.
We are doing that precisely to put more products through that funnel, but also to try and make that a much more efficient per-project cost. The second thing we're going to do, really importantly, is continue to work on world-class efficiency with what we've loosely called digital enterprise, which is exactly what I was just saying. It's really this quote to cash and create to make, which is basically, if you add them together, that's the way the business runs. We have a lot of effort going on in our commercial operation to try and streamline how much inventory we have, what our collections look like, what our customer service looks like, how we handle all of the things that create the experience that is the customer experience and what it costs us to do that.
We're doing the very same thing in the create-to-make world, which is how do we get from design and creation of product all the way through to production, transfer of technology from R&D to manufacturing. Those processes, the more efficient they get and the more we digitize those and use analytic tools to improve what we're doing, the more efficient we get, the more ability we have to scale on a fixed cost. It's an investment in what we're doing to try and hold cost in, as we said, kind of that slightly better than inflation zone and then get the leverage, operating leverage that we get if we can grow revenue in that kind of mid-single digits or better range. That's where we are.
The other two big things we're doing, and you're going to see them today, is we made—you would have seen last night. We talked about it a little bit with you all last night. We've made a few moves in the pharmaceutical business. We're going to continue to work on how do we take intelligent, smart moves to get ourselves into a business that we think we have a right to be in, which has been a very big part of—any of you guys went on the manufacturing tour. You saw we still make across the street most of what Novartis sells in the pharmaceutical world. We are very interested in getting back into that business, but we're patient, and we're also trying to find the right kinds of ideas. The Aurion Biotech thing we'll talk about today.
That is a really exciting front edge of the market kind of idea for us where we think we can participate in a very meaningful segment that does a lot for patients, but also is a very productive use of capital. World-class product development, commercialization capabilities are really what we're talking about in the underlying operational excellence frame. What we're trying to get to is a real knowledge of when markets are going to develop, what is the probability that they're going to succeed, what the size will be, and what the technology application is. It is those discussions that kind of inform the choice of how we deploy capital. We're going to spend a lot of time continuing to develop that. Obviously, what all that does is it drives that profitable growth. We're going to get that profitable growth from operating leverage.
All right, that said, let me just kind of cover what we released last night. Obviously, we had a real interest in this company called Aurion Biotech. We did acquire the majority interest in it earlier this week. There is a really interesting topic that is there are a few corneas around the world for a lot of folks who need them. When you look at corneal transplants, there is not enough tissue to really kind of supply the demand for people who are in a situation where they are either going blind or already blind. For endothelial cell disease, which is a common cause of that, where the endothelial cells do not function correctly and the cornea clouds because it cannot pump water out of the cornea, this technology has figured out how to take a single donor cornea and make almost 1,000 doses.
You can take 1,000 doses with a ROCK inhibitor injected into the eye after you denude the endothelium, and that will adhere to the endothelium, create a new pumping mechanism, and clear the cornea. It is an amazing technology that the Aurion Biotech folks have created. It has been designated breakthrough by FDA, and we are excited about the possibility of taking that worldwide. This has already been approved in Japan for Bullous keratopathy. We have a really good idea of what the data looks like in the phase two work, and we will start phase three in the fall. We are excited to work with those guys, and they are really smart folk, and we are really thrilled to have been part of this process for a while now.
This is the kind of thing, I think, that we get excited about where we can really solve a really unmet need that's important to patients and obviously is a good use of capital. That said, one of the things that, as I kind of jump off of that, that I want to just finish with is that the people that work here get up every day and have the kind of pleasure of saying to their kids, "Hey, what are you going to go do today at work?" We get to talk about helping people see brilliantly, and it is an animated feature of how we think about the world. I want to share with you, just as I exit here, kind of one of the local things we've done in Fort Worth because it's kind of cool.
If you have not done it before, you will see the kind of smiles on the kids' faces, but also watch for the smiles on our employees' faces. Run this video for me. Thank you. The Children's Vision Program was really created around the idea that when you are starting out as a child, you learn to read till about the third grade, and after that, you read to learn, and that is really important. If we can get them early on into glasses if they need them, that really does make an enormous difference. Many of these kids do not know they need them.
We provide eye care services and materials to those students who are eligible, and we provide those things free of charge.
Before the Alcon Children's Vision Center, there was no system in place to provide the comprehensive vision care that we are providing to our students now.
It's right at the core of what we should be doing. I mean, we are about helping people get access to sight. This is a fundamental idea for how we operate. Some of these kids are just never going to get glasses if we don't help.
What gets me most excited about this program is the fact that we are helping kids, and we are really changing lives. It's just the most rewarding thing in the whole world.
What we're trying to do is get into the schools early and make sure that schools are able to identify people who may need visual help. We screen. We take an army of Alcon volunteers who go in, and they've been taught and trained and certified to screen these kids and make sure that if they don't see well, that they have an opportunity to get a full eye exam. I think what's exciting is to see what we do come alive in real-world time and to see kids screened for the first time where you know they have a problem and then see them at the end, pick up their glasses, put them on, and kind of see the world brilliantly.
Please welcome Chief Financial Officer Tim Stonesifer.
Thank you. Thank you very much. My name is Tim Stonesifer. I'm the CFO here. I've met most of you, but for those of you who I haven't, just a brief introduction. I started my career at General Electric.
I spent 18 years there in a variety of operating finance roles, and then I spent three years at General Motors as the CFO of their international operations based in Shanghai. I went to Hewlett-Packard, and I was there for about five years, and I started out as a divisional CFO. When they separated, I was the CFO of their enterprise business. I started here in April of 2019. I've been here for six years now, close to six years, and it has been an incredible journey. Enough about me. Let's talk about you, okay? Thank you so much for those of you in the room who made the trip here. I know traveling now is a little bit difficult. Talking with folks last night, we've got people coming in from Zurich, from London, from Geneva, Paris, New York.
Thank you very much for investing the time. It was great. I know the management team really enjoyed spending time with you and getting your perspectives last night, and hopefully, you enjoyed the product demos and the manufacturing tour. For those of you on the webcast, thank you for investing your time this morning. Hopefully, you'll get some insights out of here that will be helpful going forward. With that, David just walked through the strategy, and now what I'm going to try to do is walk you through how that strategy translates to the financials. I'm going to share with you some accomplishments that we've had in the last five years, and I really want to do that just because I think that's what gives us the confidence that we can deliver the results going forward.
Lastly, we're going to walk you through how we plan on growing faster than the markets, how we plan on expanding our margins, driving significant free cash flow, and that's really going to allow us to fuel our innovation going forward, which will drive a lot of shareholder value. Here's our financial framework. It's basically four pillars. If you look at the first one, it's we play in resilient markets that are growing nicely. The unmet eye care needs out there, an aging population, the favorable macro trends that David alluded to, those all underpin the growing markets. Given our commitment to innovation, we would expect to grow faster than those markets. From a geographic perspective, we operate in over 140 countries around the world, and we'll continue to serve patients with our broad portfolio of products.
We are hyper-focused on streamlining our end-to-end processes, and that is going to help drive some efficiencies that will help us expand our margins and drive operating leverage while we improve our R&D spend. If we grow faster than the markets, we expand those margins, we generate that significant free cash flow, that gives us a lot of flexibility along with our balance sheet that is very strong right now to execute our capital allocation priorities. Here is a little bit about the results. If you look at revenue, we have grown revenue roughly $2.5 billion since 2019, and we have done that through innovation, and we have done that through strong commercial execution. If you look at contact lenses as an example, we launched new products, we took price where it was appropriate, we gained share.
about Precision 1, TOTAL 30, Dailies TOTAL1, all of those products performed very well over this timeframe. When you look at ocular health or artificial tears, our Systane product continues to resonate with customers. I mean, that's been growing double-digit for a couple of years now. That's a very strong piece of the business. When you look at the implantable segment, we have built and maintained significant share in ATIOL markets globally, and that's really through the launch of PanOptix and Vivity. We have a lot of momentum. We had a lot of momentum that drove that revenue growth. From a profitability perspective, we delivered $2 billion of operating income last year, which was up roughly $700 million versus 2019. We were able to do that by expanding our margins.
Our margins were up roughly 340 basis points, again, driven by that cost discipline and some of those efficiencies that I talked about earlier. Lastly, we generated $1.6 billion of free cash flow. Now that separation is behind us, and now that transformation is behind us, we're really getting into a more normalized free cash flow generation, which again gives us a lot of flexibility going forward. Here's kind of an interesting page. I think it's always important to reflect on what you committed to, what your goals were, and how you actually did. What I did here is I took our goals from the 2021 Capital Markets Day. The reason I picked 2021 is because the last year of that plan was 2025. I figured since we're here now, we should just take a quick look.
It might be insightful to see how the team is doing. In 2021, we said that we would be at $10 billion of revenue in 2025. We said that operating margin rates would be approaching the mid-20s. I spent a lot of time defining what approaching meant. I won't do that again. We said we'd generate $1.8 billion-$2 billion of free cash flow. Those are the goals that we laid out in 2021. If you look at the middle column, that's what we guided in February of this year. If you look at the far right, that is the 2025 guide, and we've adjusted it for two things. We've adjusted it for foreign exchange rates. We applied the 2021 foreign exchange rates to 2025, so you have an apples-to-apples comparison.
We excluded any M&A impact that we had done that was not contemplated in the 2021 plan. When you get through all that, we are very pleased with how the team has progressed. We have delivered on our financial commitments from our perspective, and we feel that the fundamentals of the business continue to be very strong. Before we get to the long-term goals, here are the assumptions that we made. Again, top line, we believe that markets will grow at historical levels. It will be a little bit different depending on what segment you look at. It will be a little bit different depending on what part of the world you are talking about. On average, markets should grow at historical levels. Given our commitment to innovation, we feel that we can grow faster than the markets.
From an R&D perspective, you'll notice we made a little bit of change. Historically, we've said we want R&D to be roughly 7%-9% of revenue. We've increased that to 8%-10% of revenue. We have a lot of good ideas that we want to continue to invest in. We would expect to continue to get operating leverage. From a tax rate perspective, tax rate should remain at 20% roughly. We're not expecting we haven't anticipated any structural changes. From a CapEx perspective, now that we're through the heavy investment that we had in the last few years on those DSM flex lines, we'd expect that to normalize to meet sort of normal demand, and that should be at 4%-6%. From a foreign exchange perspective, we assume that rates remain consistent throughout the course of the plan.
Those are the core assumptions. From an M&A perspective, we have not included any M&A in the long-term goals. The one thing I will note is on the Aurion Biotech transaction, we have included that in our long-term goals. I would expect that to be in the near term cause some earnings pressure because we're going to continue to invest in R&D as we develop that product, and the revenue does not really come into the latter part of the plan, think 2028- 2029. That will cause some near-term pressure, and that is incorporated in the goals I'm about ready to share. Those are the assumptions. Here's the money page. Revenue. We expect revenue to grow 6%-8%. Again, we expect to grow faster than the market given the innovation, and we would expect some share gains across parts of the portfolio.
Now, assuming that we grow at 6%-8% and assuming that we continue to optimize our cost envelope, we expect to deliver core EPS growth of 12%-15%. Now, for those of you who are at the Capital Markets Day two years ago, you'll notice we don't have margin rate on here. We are still very committed to a margin rate in the mid-20s in the long-term plan, but we feel given the maturity of the business, given our performance, that EPS growth is a more relevant metric, and it also more closely aligns the long-term management incentive plans that we have in place. From a free cash flow perspective, we're going to change that a little bit. We're going to change it from an absolute dollar goal to a cash conversion metric.
Again, we feel that it's more relevant, and we'd expect to have a free cash conversion goal of roughly 90%, which would put us in the top quartile when you look at companies in our particular space. Those are the long-term goals that we have laid out. Let's talk a little bit about revenue. I'm not going to spend a lot of time on this because Sean, Max, Jonathan, and Jeanette are going to walk you through the innovation that we're very excited about. At the highest level, I'd say two things. I'd say there's two pieces to the growth. The first piece is market growth. We should get 4-6 points of growth if those markets grow at historical rates. Then we should get another couple of points for the innovation. That's how I would sort of think about it.
On the right-hand side, you could see some of the innovation that we're very excited about, and again, the team is going to walk you through that. Again, I think the key takeaway here is we have a broad portfolio of products. We operate in over 140 countries, and we feel like we can grow. Because of that, we can grow faster than the market. From a profitability perspective, as I said, we'd expect to continue to expand margins. As you can see here, we've taken out five points of productivity on SG&A, and we've basically done that through a lot of the infrastructure building, the IT investments that we've had over the last few years. As you think about this going forward, we'd expect to continue to get some expansion, and it's really driven by two things.
First of all, when you look at our shared services, we have world-class shared services capabilities now. We have over 2,500 people in places like Bangalore, Mexico City, Kuala Lumpur, Warsaw. We'd expect to continue to leverage those capabilities and help drive efficiencies. As I said earlier, we are really focused on continuous improvement and streamlining our processes, particularly create-to-make and quote-to-cash. If we do those two things, we will continue to drive some of these efficiencies while we continue to invest in R&D. Think about it as operating leverage. It's not an either/or. We're going to continue to expand margins and increase our spend in R&D. Here's our capital allocation philosophy or framework. Again, it's three pillars to it. It's been very consistent since the spin. Our first priority is organic investment.
Where we do that well, it's good for patients, it's good for doctors, it's good for shareholders, and quite frankly, it's good for employees. Think about PanOptix, Vivity, Precision1, all those types of products. That's going to continue to be our number one priority. We realize that we can't develop everything, so we will continue to be active and disciplined in M&A. I think the LENSAR is a perfect example. Bolton deals, $50 million-$500 million. Those tend to work well for us. We're going to continue to do that. The third pillar is around returning cash to shareholders. As you all know, we currently have a dividend that's 10% of prior year core net income. We recently announced a share buyback up to $750 million over three years. That's really intended just to offset employee dilution.
That is the capital allocation framework we are going to operate within. We make those decisions and those trade-offs all while maintaining that investment-grade credit rating. I am going to end where I started. This is the framework that we are operating with. The priorities are clear. We feel like we are very well positioned to go execute. The four things are really around we play in resilient markets that are growing. Again, those macro trends support that growth. We are committed to innovation. We have 1,900 R&D folks around the world. We have invested over $5 billion over the last five years in R&D. We are going to continue to invest. Given that commitment to innovation, we would expect to grow faster than the markets. We are going to be disciplined around the cost. We are going to drive further efficiencies. There is still more work to do.
We've just built the scale now where we can really leverage that. When we do that, that's going to drive further operating leverage. Lastly, if we grow revenue, if we improve the operating leverage, that drops down a lot of free cash flow. I mean, that's just the math. That's how it works. If you believe in these four things, you should buy our stock because we believe that these four things will drive a lot of long-term sustainable shareholder value. Appreciate the time. With that, I'm going to ask David to come on up, and then Dan is going to moderate a Q&A session.
All right, everybody. Thanks, gentlemen, for the presentation. Just a couple of housekeeping before we do the Q&A.
When you ask a question for those who are listening online, please remember to state your name and the firm you're with so people can know who's asking the question. Also, the intent of today is to really talk about the long term. Try to keep that in mind as you ask your questions. We don't really want to talk about the quarter or even the year. It's really about the long term. With that, we'll open it up to Q&A.
You're going to grab them or you want me to? There you go. There you go. Thanks.
Thanks. Chris Pasquale, Nephron Research. The 6%-8% long-term revenue growth goal in line with what you guys are talking about for 2025, despite the fact that this year is a bit of a transition year, you've got a bunch of new products coming, those are going to have a bigger impact as we get into 2026. Do you see the potential for 8%+ growth in sort of the intermediate term as you get the benefit of all these new products, or should we think about that 6%-8% being a steady state?
I would think about it as the average over that stretch of time. I think there's going to be some years where we've got more than others. Again, this year will be a little bit on blend, a little bit lower on that end. Obviously, it depends on how the back half goes. As you go forward, 2026 should be a very strong year, and then we'll see how that takes shape. You can imagine it just really is dependent upon what's coming out and when it matures.
Thank you. Anthony Mazzullo, thanks for having us here at the campus, and barbecue was great last night, as Dan mentioned. One on margin and EPS. I know, Tim, you're staying away from issuing margin guidance. 12%-15% compound annual growth is $537 million-$613 million in earnings. The street's at $505 million. Tax rate's 20%. Is there any input that you can give for share buyback and other income?
If not, and we assume roughly steady state to street models, it's flushing out 26.5%-27.5% margin, which is a tremendous amount of margin expansion over this time. Anything you can give just middle of the income statement, other inputs into the 12%-15% compound annual growth?
There was a lot in that question. I appreciate it. Thank you for that. No, listen, I think the 12%-15% core EPS growth we feel very comfortable with. And as I said in the prepared remarks, we feel that's appropriate given where we are. I would expect we're not backing off the margin commitment. We're still committed to mid-20s.
I think what would hold, I mean, 26.7% or the math that you just did there, I'm not sure how the math works, but I think we'll stay consistent with what we've talked about historically is, hey, look, when we get to 24% or 25% or wherever that number is, at that point in time, we'll evaluate what type of innovation programs we have that we want to invest in, and then we'll decide what we want to do. Do we want to further invest and hold that margin rate, or do we want to drop it to the bottom line? Our view has always been that revenue growth drives the valuation of the company. I would be much more interested in an incremental point of revenue growth on a sustainable basis versus an incremental point of margin taking it from 25% to 26%.
There is still more work to do, but that is how I would think about it.
I think you can read, Anthony, that 8%-10% is a bit of a movement that we have made to try and accommodate for that idea.
Great. David Saxon from Needham. Just a couple of market-related questions. It looks like growth expectations for consumables, equipment, and ocular health are about a point above what you laid out two years ago. I think you kind of touched on the consumables and equipment dynamics. For ocular health, what is driving that acceleration in growth? The second question is just on implantables. Growth assumption is stable. What are you guys assuming for ATIOL penetration over the LRP? Thanks so much.
Yeah, on the ocular health, what you're seeing in there to a certain degree is optimism around the OTC businesses and the Rx businesses in which we participate. Again, I think in the dry eye space in particular, there's going to be some more activity, a lot more promotion, and I think you'll see that market pick up just a little bit. That said, I think the implantables business, penetration is largely going to continue along what we think has been a historical rate of about 50 basis points a year. If you regress the kind of long term on that, that's kind of what it looks like. That may turn out to be more international than the U.S., but there's still a ton of headroom even in the U.S.. I think Sean will talk to this in a little bit.
We still think that we survey this most every year, that consumers are willing to pay for advanced technology lenses. It is a matter of kind of continuous steadily kind of gaining over time. I would think about that as kind of 50 basis points a year globally.
Cool. David, we've got a bunch online. I wanted to lob one in. First, in which of your businesses do you see the greatest opportunity for above-market growth? Part two of that question is, you talk about new technologies and areas with unsolved problems as a growth driver. Could you share some of the clinical areas of unmet need where you are most excited about that opportunity?
Today I'm most excited about the Aurion Biotech thing because we've followed it for a while. We're excited. These are blind patients who are going to get better.
That's a really powerful idea. It also has a really nice profile, both in terms of the cost per procedure and the savings we can create, I think, for the system. I think there's a lot to be done in that area. Again, we'll talk about it in a little bit, but it's an exciting product. I think I'm also excited about it because I think it's kind of the front edge of biopharma, which is an area that we'd like to participate in. I think the first bit of that, Dan, was? Sorry, the first bit was which segment? Which segment of your businesses do you see the greatest opportunity for above-market growth? It's really equipment. I think you'll note that because typically we call the equipment market roughly in that kind of 3% ish.
It should grow kind of roughly around what procedural growth is globally. It's growing a little faster than that because, frankly, we're entering a lot of equipment over the next—you'll see that in a little bit here. We're entering a lot of equipment over the next five years. That equipment will be premium. It'll help drive a premium consumable. If you think about our surgical business, in truth, two-thirds of our surgical business is basically consumables attached to our equipment. Between the equipment and consumables, that's where the surgical business really makes most of its money. I think that's really the most exciting part of that one. The other segments are doing really well, but that's kind of a one-by-one idea. In the back—
Tom Stephan with Stifel. Tim, maybe two for you. The 6%-8% LRP for sales growth seems innovation maybe about 200 basis points on top of the 4%-6% market. Can you dig into that a bit? I mean, how much of that is Unity? What else is at the top of that list in terms of key drivers? Follow-up just on M&A. You talked about $50 million-$500 million being kind of that sweet spot. Is there appetite for anything above that, maybe in the $1 billion plus range? Thanks.
Yeah, I'll handle the first one. You might want to do the M&A one. I would say it's a combination of all the launches, which may sound a little soft. Again, we're obviously very excited about Unity. That's going to drive a lot of growth going forward. We're excited about 512. That we think has a lot of opportunity.
That's coming in kind of the mid to late part of the plan. We've got some PanOptix Pro is coming out this year. It is really going to be driven by the innovation that we've invested in. I'd say overall, thinking about it as a couple hundred basis points is probably about right.
That is a pretty diversified group of products by design. There is not a single—one of the good things is there really is not a single product that is driving everything. We've got in every category—we were talking about this earlier—almost every one of our sales forces this year has got something new to sell. That is a really nice diversity of opportunity. If one goes really well and one does not go as well, we've got some flexibility there. Market-wise, our geographic dispersion is really good for us.
W e're getting good market growth in certain parts of the world that's better than that. It is really kind of a nice even distribution of stuff over time. On the—what was the other one?
$50 million- $500 million.
Oh, yeah. On the acquisition side, we have the capability of doing a lot. I mean, the balance sheet's in a great place. We could do something considerably larger. It's just not typical. There aren't that many assets that look like that in our space. Typically, we're much more interested in the technology side of this. We've made a lot of small bets into a lot of startup and small companies to watch and see what happens. As those mature, we see kind of opportunities along the way, very much like what happened with Aurion Biotech. We like to kind of find our way into those. Typically, that's been in that $50 million-$500 million. Not to say we couldn't do it or wouldn't do it, just simply that it's not a very common target.
Got a couple online. One was on gross margin development over the midterm. What should we plan for that? Another one just about kind of softening economy, weakening consumer confidence. What are you guys seeing? What are your customers telling you?
I think on the gross margin, that is going to be a piece of the overall margin expansion. I don't think it's going to be too dissimilar to what we've talked about in the past. I think if you look at that expansion, I'd say 70%-80% of that is going to be operating leverage as we continue to leverage the capabilities I spoke about earlier.
We will get some gross margin improvement as we mix up in some areas as we continue to get efficiencies, particularly in vision care with the DSM flex lines. I'd think about it as maybe 20%-30% of the overall margin rate expansion. Markets?
Oh, yeah. I mean, the third and fourth quarter of last year were a little bit softer, and we do not see much difference in the first quarter. I think directionally, we would expect that over the long haul, the markets normalize. Again, you are going to see some ups and downs as we go through this. If you kind of look over the long haul on this, it just continues to come back to the same mid-single digit numbers. Whether the consumer is weak or strong is more of a—the only part of our business that really reacts to that, I would say, is refractive surgery. Most of the rest of it normalizes relatively quickly. Clearly, there has been a softening of the markets in the back half of last year.
Larry.
Is this okay?
Yeah.
Thanks, Larry Biegelsen, Wells Fargo. Just for Tim on the LRP goals, I did not see a timeframe there. Confirm that it excludes M&A and any color on dilution from Aurion Biotech, please.
Yeah, I think I would say look at it as a five-year horizon as we have done in the past. That is kind of the timeframe I take it out to, so call it 2029. As far as Aurion Biotech, we will give you some more color. We are still working through some things. We will give you more color on the earnings call. Again, it's going to be heavy on the R&D upfront, and that revenue doesn't really start kicking in until 2028- 2029. We'll give you some more details on the earnings call in a couple of weeks. M&A is excluded.
It is excluded.
Yes, it is excluded from there.
Yeah, right here.
Oh. Thank you so much. It's Issie Kirby from Redburn Atlantic. I wanted to ask about two areas of quite a lot of uncertainty and volatility right now, one being tariffs and supply chain and how you're really considering that in particularly your margin forecasts. The second point really around Medicare and Medicaid exposure and any risks you really see around budget considerations there. Thanks.
On the second one, I think we anticipate generally some reduction in physician fee and facility fees have generally been pretty stable.
I think facility fees actually went up last year in cataract. Physician fees have consistently come down a little bit year on year. I think that's generally a trend that we would attribute inside the plan. I don't think there's any real change in that. The Medicare pharmaceutical business, obviously in the Medicare carriers, is a big part of our business in the dry eye business. We'll be very interested in working with those payers. That does take a little while. When you think about 512, for example, you'll need to think about that revenue. About half of the dry eye market is seniors, most of which are in some form of Medicaid or, sorry, Medicare. That will probably be a submission that we make later this year, but doesn't really kick in till 2027.
Part of that market will be developing over some stretch of time. On the tariff piece, we're fortunate in that we generally make product inside of the regions that we operate. We make U.S. product generally for the U.S.. We make European product in Europe for Europe. Asia a little bit more mixed, but we do make a lot of product out of Singapore for Asia. We have the ability to move product in certain locations, finished goods that way. There are elements of our U.S. business that are made in Mexico. We have an exposure to assembly across the border. We'll see what happens there. Again, something that we can manage and also move if we need to.
I think directionally, we are very interested in what the subsuppliers are because it's really probably the bigger issue is chips and electronics and resin and things that are input costs, which may get tariffs. We're staying very close to it. We're also very interested in what the MedTech industry is doing right now around trying to exempt MedTech products from the tariffs, whether that survives or not or whether that works or not. It's hard to tell. This is a very fluid situation. We're staying close to it.
Brett?
Hey, Brett Fishbin from KeyBanc Capital Markets. Just one question on the contact lens market assumption of 5%. Seems like you guys and really the rest of the industry have been doing quite a bit better over the past couple of years. You guys double-digit growth looking back four years. Maybe just unpack some of the assumptions that you're making around the market and what might be changing over the next few years. Thank you.
We really don't see much changing. The market has typically been kind of a third price, a third volume, and a third mix. I think that's still how we see it. The move from reusables to dailies adds mix value. There's always some price every year. Of course, we're always trying to move new patients in. I think the idea on the contact lens market for us has been innovation has driven share gain. It's been a very positive mix because we've entered spaces that have high margin for us. If you look at where we're under-indexed in mix, we'll cover this in a little bit. We were under-indexed in toric. We were under-indexed in multifocal.
We were under-indexed in reusables. We believe that when we launch products there that have real value for consumers, that we can raise that share to what would be kind of our fair share, if you will. In dailies, we're 30-something share. I think in the other markets, we're probably in the 20s. We have made a big move, for example, in torics, which you'll see in a little bit, which I think is really a function of a great lens that has a unique design, but then us spending time on it. For us to overachieve or to beat the market growth, it really is dependent on us continuing to put out products that patients want and that docs like. Precision 7 is a really exciting product. We're getting a lot of good feedback on it right now.
That's a $1.4 billion market that's been untouched, really, for a long time. Interesting to, again, we continue to build on that. We'll talk more about it.
We're kind of running towards the end. I think we got time for one more question. We'll have another Q&A after this. You guys will have an opportunity to ask additional questions.
Fire away.
All right. Great. Thanks. Steve Lichtman, Oppenheimer. Tim, again, given the focus on EPS growth rather than just op margin, I wanted to follow up below the op line on a couple of things. First, given the strong cash conversion, might we see share repurchase tick up even more in the LRP? And then second, I saw the 20% tax rate assumption, but any potential drivers to bring that down as upside potential? Thanks.
I would say as far as future share repurchases, again, we evaluate that every year with our board as when we go through our strategic plan. I would say for right now, I would just stick with the $750 million share repurchase that we have in place. We're very committed to executing that. When we get past that and complete that, we will evaluate what we need to do. Again, that's going to be a combination of what opportunities are out there, what organic investments do we want to make, and that type of stuff. As far as the tax rate, there are some opportunities that we're looking at. We look at your traditional intercompany financing and things of that nature. I wouldn't expect that to move that much at this stage given the structure.
I mean, we're not going to have any significant structural changes. I wouldn't anticipate that would drive that one way or the other. I would just stick with the 20% for now.
All right. That concludes the first Q&A session. We'll move on to our break. Thank you.
Thanks, everybody.
Our program is about to begin. Please take your seats. Our program is about to begin. Please take your seats. Our program is about to begin. Please take your seats.
In a world where vision is key to opportunity, millions in Africa still face preventable blindness. One year ago, Alcon began its journey to change that.
If there's one thing that unites all of our 25,000+ associates, it is our purpose and our mission to help people around the world see brilliantly. It is this belief that led to the birth of the Phaco Development Program over 15 years ago. Through this program, we have trained over 6,000 surgeons who have, in turn, performed over 10 million surgeries, benefiting over 5 million patients.
Over the past year, we've trained 61 eye care professionals across South Africa, Kenya, and Zambia, and aim to train 450 others by 2029. The program has positively impacted over 1,000 patients in the last one year.
I know so much more that I will use to perfect my skills and then pass on to my fellow colleagues who are at the hospital. My hopes for the program is that we provide quality eye health services, and these eye services should be accessible to everyone.
With support from local and international teams, the Phaco Development Program has provided in-field support calls and virtual coaching sessions. Together, we've enhanced patient outcomes and created a brighter future for countless individuals to help them see brilliantly. This year also marked the launch of the RCS program in South Africa, offering advanced virtual courses to improve outcomes for patients and surgeons alike.
I found out that I had the cataracts, and I thought I was, you know, bewitched. Now, after removing the cataract from my left eye side, now I see. I can now see clearly, and I recognize people by their face again. I'm able to see with a lot of light in my eyes.
In just one year, the Africa Phaco Development Program has empowered surgeons, transformed lives, and strengthened communities.
It is my hope that through this program, we help more patients in South Africa and in the continent of Africa see brilliantly.
I'm really excited that we're now scaling Africa.
By Africa,
for Africa.
Celebrating one year of advancing eye care in Africa.
Please welcome General Manager Surgical, Sean Clark.
All right. I really love that video. You know, David shared the video on the Children's Vision Program earlier. That's just another great example of how at Alcon we're really committed to helping everybody around the world see brilliantly and making sure that people that really need care get the access that they deserve to have. Welcome back from the break. My name is Sean Clark. I lead the surgical franchise here at Alcon. I've been with the company since 2008. I've had the opportunity over that time frame to work on the vision care business, work on the surgical business, spend a lot of time in the U.S., had an opportunity to work in Japan. I'm really excited to spend the next four hours with you unpacking the surgical business.
No, just kidding. We're going to do it in about 20-25 minutes. We have a lot of ground to cover, though. A lot of really interesting material for you. It was great to get to spend some time with a lot of you last night. You know, I've listened in on a lot of conference calls over my time with Alcon. It was really great to start putting faces with what up till now, to me, has just been names and voices. That was a really fun evening. You know, last time I worked on the surgical business, we were in the midst of launching Centurion. You know, we had other things that were coming out. We had other launches. The pipeline was good, and the response that we were getting from our surgeon customers was really positive.
Coming back to the business, one of the big questions on my mind was sort of, well, I know we have a lot of things in the pipeline, but how are people going to respond to this? Are we going to be able to go beyond what we had done in the past? You know, the products that we have out there now, the legacy portfolio, is really great. Are we going to be able to top that? I've spent the last year, you know, talking with our customers, sitting in on wet labs, listening in on ad boards. One of the things I've been really delighted by is the response that we've gotten to what we have coming in our pipeline and the products that we're going to share with you here this morning.
You know, I hope that at the end of this conversation, my desire is that you walk away as confident as I am that Alcon has the most comprehensive pipeline coming and that these are the things, you know, as David mentioned, that are going to help us keep growing faster than our competition and faster than the markets where we compete. Today I'm going to go through and we're going to level set a little bit just on the market again, just to recap that. Then I'm going to go through sort of by therapeutic area, and we're going to talk about what's new in the short to medium term on the surgical business and some of the things that you should expect to see us launch over the next couple of years. Let's go ahead and jump in.
Again, to recap, you know, David shared the macro slide for all of Alcon. If you just look specifically at surgical and the markets that we define where we play, it's about a $13 billion market. If you look at the chart on the left, what you see is, you know, we have the strong leadership position in these markets. We're over three times the size of our next closest competitor in these areas, which is ZEISS. If you look at the right-hand side, we talked about this a little bit before. You know, we report our business in implantables, consumables, and equipment. When you look at each three of those sectors, we feel really good about the mid-single-digit growth rates that we should expect to see there over the next five-year time horizon. They're all relatively right in that same range.
We have good tailwinds on the business in each of these areas that we can tap into. Now, when you think about our portfolio, again, the way that we report the business is implantables, consumables, and equipment. I want to make a couple of really two really critical points on this slide. The first is we have had a lot of success in implantables. We are going to continue to invest there. We are going to continue to grow there, and we are going to continue to innovate there. When you think about the $5.5 billion of revenue that we did on the surgical business last year, 70% of it is tied up in consumables and equipment. It is really the bigger portion of the business. The other point I want to make here is that consumables do not happen without the equipment. They almost go together.
They're like a peanut butter and jelly sandwich to a certain degree. When we sell the equipment into the OR, many times the consumables that flow behind that, the majority of the time, are bespoke to that equipment, and it creates an annuity stream for us over a long period of time. We want to spend some time this morning talking about, you know, our next generation of launches on the equipment side. These are going to come under the brand name Unity. You're going to see a lot of Unity launches over the next several years. Obviously, I think many of you know about Unity VCS and CS. Hopefully, you had a chance to engage with our team and kind of look at the equipment last night. We're going to spend some time talking about that.
I want to actually spend a few minutes also going into a little bit more depth on the consumable side and what that looks like. Then we're going to spend a few minutes talking about the connected ecosystem and what you should expect to see beyond just the Unity VCS/CS launch. When we think about Unity VCS/CS, right, this is our new generation vitreoretinal cataract system/cataract system. VCS is a dual-purpose system. It will do vitreoretinal surgery and cataract surgery. CS is a cataract standalone for the markets where that's an important attribute to have. These things replace our legacy portfolio of Constellation and Centurion. Constellation is about 16 years old at this point. Centurion's, I think, 12 years old at this point. We've got a really big installed base out there.
We have leadership positions on the installed base on both of these pieces of equipment, about 30,000 of these out there that we can tap into and upgrade over time. If you think about the typical, you know, launch cycle of a new platform like this, it's about 10 years. If you did the math, it's about 3,000 a year. Obviously, there's probably with any, you know, diffusion of innovation curve, you're going to start to see people kind of adopt, you know, faster, and then you'll get to the long tail near the end of it. We have an installed base that in many cases have many customers that have equipment that's seven or eight years old at this point, and they're sort of ripe for that upgrade. That's a really good place to be.
While we still have the opportunity to grow market share, you know, again, with the leadership that we've got in this area, it's really more about, you know, upgrading the installed base that we have already. Now, you heard David talk about this. I think we talked about this at JP Morgan as well. The main value proposition for Unity VCS/CS is efficiency. Being able to do a Phaco procedure faster, being able to get the OR set up and tear down faster, being able to, on a vitreoretinal surgery, cut at a faster speed if you're doing a core vitrectomy and get into and out of the eye more quickly. These are some of the key attributes that this new system brings to the table. This is really important for our customers.
In a few minutes here, I'll show you why that's important to them and the benefits that accrue to them. Now, it's one thing to talk about speed. It's another thing to kind of show you a demonstration of speed. I'm going to roll this video here in a second. What you're going to see on the left-hand side is our new 4D Phaco handpiece and Phaco tip attacking a cataract. What you're going to see on the other side of the screen is our existing Centurion platform with torsional Phaco. You know, right now, Centurion is really best in class. If you went and talked to an average surgeon, they would tell you that this is a really great product. You're going to see in this video exactly how much faster and more efficient our new system is going to be. Let's go ahead and roll that video.
This bench test helps demonstrate what is happening in the eye during cataract removal. It compares performance of Unity 4D versus torsional ultrasound in an artificial eye with a grade 4 plus cataract and minimal fluidics. Unity 4D Phaco was shown to be 48% faster than torsional ultrasound, with 41% less energy delivered into the eye and 48% less dissipated energy at the incision site.
You can see exactly how much faster that is. That's just one element of a total procedure when it comes down to it. We've had really great feedback from KOLs that we've been able to test this product with. In fact, one of the customers that we were with last year, he really described it as, you know, Centurion was a great sports car.
It was a really fast sports car, but it was like a gas engine sports car, right? It was sort of visceral in nature. You had the revving of the engine and you went through the gears and everything. Whereas Unity 4D Phaco, you know, from Unity is really more like a high-performing electric car where you just step on the accelerator and that thing just takes off. That's just one example that they've been able to share with us. I think broadly, as we've been doing user experience testing on this product, the feedback that we've gotten has been resoundingly positive. I think there's a lot of excitement and enthusiasm for this launch in the marketplace. If that's really the console and the equipment itself, again, I want to touch on the consumable side because consumables are required in every single cataract procedure.
The 5 million cataracts that are done in the U.S., the 30+ million cataracts that are done globally, you have to have a consumable element with every one of these. Once you set the equipment in the OR and get it there, it's a little bit of an anchor for us, right? The consumables flow through behind it. In most of the cases, these consumables are bespoke to the equipment. There are some things that can be switched out, but a lot of it is actually bespoke to the equipment that's actually been sold. What you see here on the left-hand side of the page is our new suite of cataract consumables that will come with the Unity launch and be used on every procedure. On the right-hand side, you see the same thing for our vitrectomy procedures.
You know, the instrumentation on the right-hand side, you can also look at, right? These are going from 25-gauge instrumentation as sort of the standard today to a thinner 27-gauge instrument. Doctors like that because it's less invasive in the eye. We're moving to things like a 30,000 cut per minute speed on a vitrectomy, which is one and a half times faster than we are today, which allows you to, you know, think about, you know, the eye, the ability to do that fast laser today. The ability for a surgeon to get into and out of the eye faster. We're getting anything around patient safety and the outcome of the procedure. On the side of the page, you know, we've done some bench testing internally. We're validating it now with actual time and motion studies.
We've been able to look at what does this mean for an average OR over the course of a year. Based on the bench testing and the efficiency that we're driving, we think the average OR that's doing vitreoretinal surgery can do 150 incremental cases a year. The average cataract OR can do 200 incremental cases a year. You know, this is a U.S. example. When you take that times the reimbursement, the facility reimbursement rate for both of those types of cases, what you can see is on a vitreoretinal side, you know, whether you're in an ASC setting or a hospital setting, that could be $300,000 of incremental reimbursement all the way up to $600,000 in a hospital setting. On the cataract side, it's about a $0.25 million per OR incremental in reimbursement.
You know, the benefits are really there for them, you know, if they're able to take advantage of the efficiency that we're bringing to the table. Now, what does it mean for Alcon? If you look at the other side of the page, the right-hand side of the page, what you can see is an example of how, you know, our existing, if you look at the left-hand side, it's our existing equipment sales and consumable sales for our legacy platform. The dark gray is the equipment, the light gray are the consumables that flow through with it. You can see as the, you know, sort of light blue group grows over time or plays out over time, that's us growing the installed base of this new platform. You can see how the dark blue grows behind that.
As we build out that installed base and we have more people using consumables on this new platform over time, that grows to be a significantly bigger portion of our total. You know, obviously, as you get to the tail end of this, it's a much bigger number than we started with, right? What's driving that? It's really two things. We've talked about procedure growth and some of the fundamental, you know, underpinnings of what drives demand in this market. Yes, cases are going to continue to grow 3%-4% a year. The flip side of it is that we're actually able to capture a higher value per procedure by bringing some of these new products to the table.
Think about the efficiency benefits that we're providing to the practice that gives us the opportunity to come back and actually capture value on the consumable side of it and grow that to be a bigger dollar per procedure over time. We talked about the equipment piece. We talked about the consumables. We talked about the benefits. I really want to give you also a view as to what's coming beyond just this first launch with Unity VCS and CS. As I mentioned before, we're going to have a whole suite of products launching under the Unity name over the next several years. I wanted to spend a few minutes kind of talking about what's coming over the next two to three-year time horizon on that front. First up is going to be Unity M. Unity M will be our new microscope.
It provides novel benefits and some new features that aren't resident on our current microscope: greater magnification, tunable light sources, which is really important for visualizing different, you know, different types of tissue in the eye; the ability to have motorized tilt, which is important for doctors who are doing MIGS surgery; bringing integrated image guidance into the microscope; adding things like digital oculars that will give a better and more ergonomically friendly and a better view of what the actual image is that's coming through the microscope for the surgeon who's viewing it; bringing our own unique wide-angle viewing system to the table, which again is an important attribute for somebody who's doing retinal surgery. Now, that was the OR. Let's switch gears and talk about the clinic for just a second. Unity DX will be our all-in-one diagnostic that we'll bring to the clinic.
I think we've talked about this in the past. This is a great device that will take the full suite of measurements that you need to do, especially to do an ATIOL case or decide if somebody's a good candidate for a PCIOL, all in one setting. If you think about the efficiency benefit here, being able to set somebody in front of one device and capture multiple measurements in one setting versus having to, like, rotate somebody through different stations in a clinic and have them maybe potentially wait for the machine to open up, this actually provides a lot of efficiency benefits in the clinic setting. Now, knitting that all together is something that we call Adi. Adi is our new umbrella name for everything that we're doing in the surgical digital health space.
I think many of you are familiar with Smart Cataract, which is what we've launched here to [Fort]. Adi Planner will actually sort of be the upgrade to what we've done with Smart Cataract. This will take all the information from the clinic. We'll put it into a surgical plan. We'll have all the great formulas that doctors are used to using. Eventually, we'll have our own unique AI-powered Alcon formula. We'll take that plan and import it seamlessly into the OR. It'll show up on image guidance on the new microscope as an example. Now, if you went back 20 years in cataract surgery, what would happen is on the day of surgery, somebody would show up with a stack of charts and papers, and they would have to walk in, and they'd have to do the plan that way.
Now everything can actually port seamlessly digitally from the clinic to the planner into the OR. Again, another efficiency benefit. There's a second piece to Adi. Smart Cataract does a lot of the planning today. Adi will take it to the next level, but there's more coming under the Adi name. One of the things I want to talk about is Inventory Manager. This is a device that we'll be able to use to help the OR or the ASC actually manage the flow of the products that they need to do each of the surgeries. This is going to help them make sure that they've got the right package of consumables in the right place at the right time, the right IOL in the right place at the right time.
As these things are being consumed out of their inventory, it's triggering automatic replenishment for these things to make sure that they're getting the right product in there. The last thing that we ever want to see is somebody not being able to do surgery because they don't have the right IOL in the right spot or that they don't have the right custom pack in the right spot. Now, underpinning all of this is Alcon's best-in-class technical service capability. I want to spend just a couple of seconds talking about this. I think if you talk to any ophthalmologist out there today, I think without a doubt they would tell you that Alcon consistently rises to the top on this front. Our ability to make sure that our equipment is functioning at its peak, you know, performance all the time is something that's really important to them.
We're going to continue to invest in this area as we go forward. Now, what does that mean? Part of that is going to be having the right number of people in the right markets with the right skill sets. Beyond that, we're introducing something called Intelligent Services. This is going to be a way to digitally link the equipment to Alcon itself. We'll be able to understand how the equipment's being used. We'll be able to better predict when equipment is about ready to fail so we can proactively put our field service engineers into the OR and make sure that the equipment stays up so that hopefully we defray downtime on all the equipment. Now, all of this, when you think about it, is an ecosystem, right? We've talked a lot about the efficiency benefits.
All of these things are designed to improve overall OR efficiency and make sure that people are getting the most out of the investment that they're making in the equipment and the consumables that they're leveraging. Now, probably, I guess if you've been keeping up with us this week, and I imagine you all have, you've seen news about the LENSAR acquisition. This is another very exciting thing for us. There's a little bit of a limit on what we can talk about at this point, given that the deal hasn't closed. Alcon has been a leader in the femtosecond space since we bought LenSx years ago. We're really excited about what [Ally] brings to the table. It's got some novel benefits. It's a smaller, more flexible platform.
It's much easier for somebody to use it actually in the OR setting so they don't have to have a dedicated laser room if they don't want it. It's a more seamless experience for the patient if the femto treatment is actually happening right in that same room where they're getting their Phaco treatment. It does some unique things from an astigmatism management standpoint, and the total procedure time is slightly faster than you'd see with some of the older equipment in this particular space. More to come on that as the deal gets closer to closing, but it's something that's a very exciting opportunity for us. Let's switch gears and talk about the IOL portfolio. I imagine that it's an area of a lot of interest for people still. We're excited about what we have coming over the next couple of years in innovation here as well.
If you look here, you'll see PanOptix Pro on the far left side of the page. This is a product that we're going to be launching in May of this year. I'm very excited about that. I'm going to unpack a little bit more about that product here in a minute. About a year after that, we're expecting to have an upgrade to our monofocal toric platform that's going to bring enhanced intermediate vision. Think of this as something that's going to compete with and go beyond what some of the competitive lenses like Eyhance have done in the space. About a year after that, an upgrade to our Vivity platform. EDOF lenses have done really well in the marketplace. Vivity has been a real hit for Alcon.
The, you know, the benefit of an EDOF lens, if you're not aware, is that you get very minimal visual disturbances. You get great distance vision, you get great intermediate vision, and you get sort of functional near vision. We are looking at upgrades in this arena that are actually going to be able to dial up the amount of near vision that you get from an extended depth of focus range lens and be able to provide, think of this as going from 20/32 vision at near down to 20/25 vision at near. A real benefit for the people that are looking to have that, you know, crisp, close vision. A little bit more about PanOptix Pro, right?
The big idea with PanOptix Pro is actually using more of the available light coming into the lens and scattering less of the light that is coming into the lens. If you went and talked to an average surgeon, they would tell you that the benefit from less scatter, or one of the benefits from less scatter, is that it should lead to lower visual disturbances, right? The more light that you're actually using effectively across the spectrum of different focal points, the less light's getting wasted, the less light that's going to contribute to things like visual disturbances. That's the real win here with PanOptix Pro. We've been able to reduce the amount of light that's being scattered by this lens by 50% over PanOptix Pro. That's an important comparison because PanOptix Pro is the gold standard in this space, right? PanOptix Pro is the leader in this space.
If you look at this chart, this is something we call a point spread function. What it basically shows you is if you go left to right, it's showing you the intensity and the amount of light being used at different focal points. On the left-hand side, you get sort of far distance all the way going to kind of close near on the right-hand side. You can see how PanOptix Pro builds upon PanOptix Pro even and is much better at utilizing light across the entirety of the spectrum. Not only do you get the benefit of less light scatter, but you also get a more seamless transition between distance vision and intermediate vision here. Again, you see how this stacks up to a couple of our key competitors in the space. We are very excited about the opportunity to launch this lens.
As I mentioned before, this will be coming out in May of this year. I think we had some questions before around ATIOL penetration. I think the interesting thing here is while, you know, if you look at this chart, we've made some really good gains as an industry going back to 2018, really being able to build ATIOL penetration globally. Just as a reminder, each point of ATIOL penetration for Alcon is about a $100 million revenue opportunity to our current shares. It's a big opportunity for us to continue to push in that arena. The good news here is that, you know, even as we ended last year up at about 15.2%, we still have opportunity to continue growing in this arena. When we talk to patients, about 40% of patients say that they're willing to pay for an advanced technology IOL.
While you'll never realize 100% of that potential, there's obviously a huge delta still between 15% and 25% that's available for us to capture. We continue to invest in this area to do that, right? It's not only bringing new IOL technology to the table, but everything else that we can do, training the surgeon, providing the best diagnostics, helping them with their surgical plan to elevate their confidence and, you know, taking money from a patient and then actually giving them a really good outcome at the end of the day. We're going to continue to invest in this area to continue to drive ATIOL penetration. The last thing I want to talk about is white space. I'm going to talk specifically just about one here.
I think you're going to hear from Jeannette in a little bit on some other opportunities in surgical white space. I want to spend a few minutes talking about surgical glaucoma. You know, over the past several years, if you've kept up with this, you've seen that we've had a really good launch of Hydrus. Before that, we had Opti-Free Express in the marketplace. You know, obviously, if you think about the mild to moderate sufferer, we've now increased our ability to provide pharmaceutical therapy in that area. Now we're bringing SLT to the marketplace, DSLT to the marketplace. SLT is Selective Laser Trabeculoplasty. It's basically stimulating the trabecular meshwork to actually help improve flow of aqueous humor. SLT is becoming more and more recommended all the time as frontline therapy.
In fact, the American Glaucoma Society last year came out and recommended it as sort of first-line therapy in this area. The issue with traditional SLT has been it's an unpleasant thing for the patient, and the doctors don't really like doing it. Why is that? You need to use something called a gonio lens to get the right visualization on the eye. You need to set a patient in front of a slit lamp and fire a laser 100 times, you know, as you go around the circumference of the trabecular meshwork to actually deliver the therapy. That's been one of the main issues. DSLT and Voyager DSLT actually takes all of that out of the equation. You can sit a patient in front of this device. Hopefully, you got a chance to see it last night.
It has an automatic eye tracking system that actually registers the eye, figures out where the laser needs to aim, and then will fire that laser in a matter of seconds. The patient has a much more user-friendly experience. The doctor, it's much simpler and straightforward for them to actually execute the therapy as well. Why this is a big idea is if you think about, you know, again, just using the U.S. as an example, there are 6.5 million sufferers out there who are using a pharmaceutical drop for glaucoma today. If you look at the usage of SLT today, traditional SLT and now DSLT, it's about 600,000 patients. There is a huge opportunity for us to continue to grow this marketplace, and we're really excited about this product. You know, it taps into an existing reimbursement model in the U.S.
It's about $240 an eye. The nice news here is it's not just a capital component. There's a recurring revenue stream. There's a treatment pack associated with each of the different times that the machine is used. Yes, we sell the capital, but there's a recurring revenue stream that comes with every single use of this. We think, you know, the revenue potential here is, again, it's a great white space opportunity for Alcon. The early response that we've gotten from people who have bought this and incorporated it into their practice and into their flow has been overwhelmingly positive. I hope that over the last few minutes, I've been able to kind of give you the same level of confidence that I have that we have the most comprehensive pipeline.
These are the things that are going to help us be able to grow faster than our competition. We talked about everything we have coming in the Unity area, the equipment portfolio that we have coming just over the next three years even. I was able to show you a little bit of that. We're going to continue to invest in ATIOLs to maintain our leadership position there. We've got great opportunity in white spaces to capitalize on that. Again, Jeanette will share more about that when she gets to her part of the presentation. We'll continue to invest on the digital front to, again, increase that overall clinic to OR ecosystem efficiency. You know, underlying all of this remains our best-in-class technical service, which is not to be underestimated.
In fact, when you look across all of medical device, we typically end up in the top quartile. We have been consistently in the top quartile versus all medical device companies for the last three plus years. That is a real benefit and a strength of the company as well. Thanks for your time and attention. I am going to turn it over to my colleague, Max Wolf now, who is going to kick off the vision care section and is going to share a little bit more about what is coming on the contact lens business. Thanks.
Please welcome General Manager Contact Lenses, Max Wolf.
Always great to listen to surgical, but let us talk contact lenses this morning. Twenty-four months ago, many of you were actually here in the room with us or online. We talked about the contact lens business.
You may recall I shared with you how Alcon is uniquely placed to grow ahead of the contact lens market. As you know our results, we did exactly that. My guess is this morning, you're not here with us because of the history. You're here with us because you want to hear about the future of the contact lens sector and what we have in the shed, so to speak. Hopefully I can answer those questions. I'm going to cover very briefly the market, the main dynamics in the market, and the plans that we have, of course, within that market. I started my career here in Alcon about 13 years ago, actually in contact lenses. You know, thinking back over all the years, a few things stand out for me.
One thing really stands out for me, and that is today, more than ever in this category, more than ever, innovation, the quality and the quantity of innovation matters. I'm sharing that with you because it underpins the main point I have for you today. The main point is this: as Alcon, we continue to be uniquely placed to grow ahead of the contact lens market in the future. Let's jump right into it. Briefly covering the market here on the left, you have heard earlier from David and from Tim, the vision care market overall, $22 billion. It's a large market, very stable. As Alcon, we have a strong position in that market. On the other side of this slide, you see the market broken down in its main components. As you see, you see contact lenses are $11 billion.
We expect that market to grow roughly 5% over the next couple of years, which is great. The other half is what we call Ocular Health, select OTC and Pharma products. Later on, Jonathan Balch is going to cover that and go into the details. As for this $11 billion contact lens market, there are a few really important dynamics that I'd like to share this morning. Some of you who have been following us for a while are probably familiar with them, but they're so essential to our strategy that it's important that we talk about it. The first one you see here on this slide on the left, this looks at this $11 billion market, and it cuts it by lens design.
What you notice is that specialty lenses, so multifocal lenses for presbyopia and toric lenses for astigmatism, are actually growing double digit. These are premium lenses, therefore very attractive for us, of course. What's most exciting about this segment is they're under-penetrated today. There's ample room for growth in specialty lenses in the future. That's going to drive our plans. The second, bless you, the second trend that you see here, you see here in the middle, this looks at the contact lens market by what we call equalized units. Equalized units are a great proxy to look at the percentage of contact lens wearers in each segment. In this particular case, daily disposable and reusable lenses. You see that there is over time a trend from reusable wearers into daily disposable wearers.
Much so that today, a third, more than a third actually, of the wearers are already in daily disposable lenses. That one third of wearers represent almost two thirds of the value. You see that on the right because daily disposable lenses command a significant premium. What that means is there is ample room for more growth for trading up reusable wearers into daily disposable contact lenses and drive market expansion in terms of value. The other implication is that the reusable market is still very sizable for us, and I'll cover it a little later, why we're excited about that. These were the first two dynamics there.
Before I get into market share and how we're doing in the market, there's one more dynamic that is not on this chart, but I thought it'd be important for you to be aware of as you think about this category in particular. That is this: contact lenses for all manufacturers in aggregate, market share moves slowly but steadily. That's because this is mainly a repeat purchase business where a contact lens wearer is in a contact lens for about five years on average. If the product is great, a little longer, and if it's not as good, maybe a little shorter. At some point, folks switch into the next product. When they switch, about half of them stay with the same manufacturer and upgrade the product. Half of them change manufacturer.
As a result, compared to other consumer healthcare product categories, market share moves slower but more steadily. That makes this actually a very stable and very predictable market for us and a very predictable growth opportunity. As for our market share, you see this on the graph here on the left. We have been doing well over the last couple of years. We have added over 200 basis points of share, and we're now sitting at around 26% market share. To put it in perspective, each share point is about worth $110 million to us. A share point definitely matters. We're now at 26%. That's the highest market share we've ever had. What gets me excited about this is there's a lot of room for more market share growth for us. That's the plan.
Now, before any of you with eagle eyes ask me about the drop in share in the fourth quarter, I see you squinting. Great. There is a pattern. We see this every fourth quarter as another manufacturer that shall remain unnamed likes to put out inventory deals that favor them in the fourth quarter. They have to chew on that for the next couple of quarters. We tend to bounce right back in the first quarter if we look closely. What really matters, what really matters in this category is the long-term trend of the market share. What has been driving our market share over the last couple of years has been what? Innovation, innovation, innovation, innovation. Most recently, Total 30 for astigmatism and Total 30 Multifocal. Just a few weeks ago, I was at the conference, the large U.S.
conference with optometrists connecting with many of our customers. What I learned is that when it comes to innovation, many, many, many of them clearly see Alcon as the leader of the pack, the one player that is bringing the most meaningful innovation to this category. We have been doing well as a result of this innovation. As you see here in the upper right, if you look at this over a two-year period, market grew 13%. Alcon grew 17%. Look over a longer period of time of four years here in the lower right, market grew 33%. We grew 45%. Historically, we have been doing very well. More importantly, and probably more relevant for you this morning, is we expect to continue to do well. Of course, your question is how. Let's look at that.
At the core, it comes down to two levers to continue to grow ahead of the market. The first lever is really to build the most innovative portfolio of high-performance contact lenses. The second one is about winning in specialty lenses. I'm going to double-click on both of these now. As for building the most innovative portfolio of high-performance lenses in the daily segment that you see here in light blue, that is worth $7 billion as a market, we have been doing very well. We have a 29% market share, and each share point is worth about $65 million. We have a best-in-class portfolio. We have Dailies TOTAL1, and we now have Precision1, which has been doing particularly well for us. We are really well placed in this daily segment to continue to do well in the premium segment as well as in the mainstream segment.
There is this almost $4 billion reusable market here on this chart in dark blue and the light gray. In that segment, we have a 22% share at the moment. Why is that? Historically, we have only participated in this market with a monthly replacement lens. This market is interesting. It is still big. A share point is worth $45 million, so attractive. There is room to trade up people within that market. What is most exciting is the margins on reusable lenses are similar to intraocular lenses, very, very profitable. Furthermore, over the last couple of years, there has not been a lot of innovation in this market. It has been underserved. It does create an opportunity for us to get at least our fair share in a very, very profitable segment.
In the subsegment of reusable lenses, the monthly lenses, we have now introduced a complete new family called Total 30. This is the first and only reusable lens that has a water gradient surface, a technology that only Alcon can bring to the market. As you may recall, at the last Capital Markets Day, I shared with you we were in the midst of launching the toric version for astigmatism. We have completed that launch. In the meantime, we have added the multifocal product. Our plans here are to complete this family by adding a multifocal toric version sometime next year. For this bi- weekly subsegment, we have been absent till now. This very quarter, as you all know, this very quarter started the full commercial launch of Precision 7 Sphere and Precision 7 Toric in the United States.
Very first time a manufacturer is actually launching Sphere and Toric at the same time. We expect greater velocity from that. Also, the very first time for us as a company to introduce a brand new category, the one-week lens. Our plan is to complete this family by adding a multifocal version for presbyopia in the future. As for the product, you've probably all heard about it, so let me be brief. What you really need to know here is that even today, surprisingly, even today, more than half of the contact lens wearers entering the category enter in a reusable lens first. That is despite the fact that almost 9 out of 10 eyecare professionals would love to put every single wearer into a daily disposable SiHy lens. Why is that? It comes down to the price.
That's exactly where we see Precision 7 come in. We see Precision 7 as the very first and best choice for any contact lens wearer that cannot get into a daily disposable SiHy lens. As a result of that, reusable wearers can now start and end every week fresh, something they could not do before. Now they can, thanks to Precision 7 and thanks to the ACTIV-FLO technology. Of course, you are going to ask me, what is the size of the opportunity? We range it somewhere peak revenue between $250 million-$350 million. I had some people ask me yesterday, what do our customers think about this? Let's hear it directly from our customers.
Welcome to the dawn of a new contact lens era. Introducing Precision 7, the new one-week contact lens for when daily disposable contact lenses are not an option. Let's hear what eyecare thought leaders are saying.
One area of study that fascinates me is the possibility of a lens that can elute wetting agents. That's why I'm so excited about the ACTIV-FLO system in Precision 7 contact lenses. First, it features a new SiHy material, senofilcon A. Next, a permanently bound water-loving moisturizing agent improves the hydrophilicity of the contact lens material. Lastly, what's really incredible about the ACTIV-FLO system is what Alcon has accomplished in terms of elution over time. The ACTIV-FLO system enables a proprietary replenishing agent to release gradually and continuously over the course of seven days, moisturizing the surface throughout the wear schedule. This allows patients to enjoy 16 hours of outstanding comfort and precise vision, even on day seven.
The response that we've gotten from patients has been really, really positive. It starts the moment they put the lens on the eye.
My experience with Precision 7 has been a game changer. A lot of patients are very interested in Precision 7. Patients love the very easy remember to replace the lens once a week schedule. It's very comfortable. It delivers great vision, and it's at a really affordable price point.
I got a text message from a patient that said, "Precision 7 is amazing." They were so excited. Just being able to hear that feedback from a patient and to see the lens perform is exciting.
At Alcon, we are always innovating the next great thing in vision care. Welcome to the dawn of a fresh new one-week lens.
As you can tell, our customers are pretty excited about the product. The product is pretty good. Actually, beyond the product and beyond Precision 7, I think this is a poster child example for the type and caliber of innovation that Alcon can bring to the contact lens market, thanks to our unique R&D capabilities. Just thinking about the next big thing that they're working on, quite honestly, gives me the goosebumps every time I think about it, but I get carried away. Let's shift gears. Let's talk about the second lever to continue to grow ahead of the market. The second lever is really to win in specialty lenses. As I shared at the beginning, specialty lenses represent the fastest growing segment in contact lenses today, particularly toric lenses.
Double-digit growth, premium priced, already more than 25% of the contact lens market today in value, but most importantly, ample room for more penetration because over 40% of the population has some form of astigmatism, including 40% of us here in the room. A very attractive opportunity. We have been doing very well in this segment over the last couple of years. If you look at the chart, we have added over 700 basis points of market share growth in the toric segment, thanks to innovation. We're now sitting at a 22% market share. Each share point is worth about $30 million. We believe it's more than realistic and reasonable to expect that we reach our fair share in the toric segment.
That's the same share that we have in the daily disposable sphere segment, which is roughly a third of the market, somewhere low to mid-30% in market share. You can do the math. This is a very sizable opportunity for us. We have been doing very well. We have launched Precision 1 for astigmatism. We have launched TOTAL 1 for astigmatism. We have launched TOTAL 30 for astigmatism. We expect to continue to see market share gains just from the products that we have launched. Of course, we expect additional market share gains from the next launches, in particularly Precision 7 Toric that is launching right now, which, by the way, we believe this is the very best toric we have ever made, hands down.
We expect more share gains from TOTAL 30 Multifocal oric that is launching sometime next year, which will be, by the way, the very first time that we introduce a multifocal toric as a manufacturer. This is a very exciting growth opportunity in specialty lenses, particularly in torics. We have been doing very well, but more opportunity lies ahead. In summary, as I said at the beginning, Alcon continues to be placed uniquely to grow ahead of the contact lens market by building the most innovative portfolio of high-performance contact lenses, including Precision 7, the first and only one-week lens, and by winning in specialty lenses, particularly the toric segment, as I just shared. With that, I conclude the contact lens portion of the vision care plans, and I am going to hand it over to Jonathan, who is going to cover ocular health. Thank you very much.
Please welcome General Manager Jonathan Balch.
Max. Thank you. That was exceptional, but I think it's time to get on with it. Thank you, guys, for hanging in there with us. We're really excited to share updates with you across the businesses. I'm Jonathan Balch. I'm the GM of the global ocular health and pharma business. I had the opportunity to speak with many of you just a couple of years ago at the last Capital Markets Day. What we said at the time for ocular health and pharma is we wanted to really do two things. One, accelerate innovation in our OTC business and to thoughtfully pursue our reentry into pharma. We've made pretty significant progress in both areas.
I spent around 20 years in big pharma, and I can tell you that I'm very pleased with the progress and the pace of the progress that we've made, especially post-spin in both of those areas. Also, just wanted to acknowledge I'm particularly excited about the news and the press release related to Arion that went out yesterday. Jeanette will pick up with some color on that news in her section. Let's frame ocular health and pharma quickly. We define, as David pointed out, the ocular health and pharma business as about an $11 billion achievable market. That is effectively the OTC markets in which we play, as well as the dry eye Rx market and the glaucoma Rx market. We project that that market that we've created in total is going to grow at about 4%. You can see the growth drivers that are included there.
Artificial tears, continued healthy growth over the period, dry eye Rx, healthy growth expected over the period, and allergy continuing to grow very well. Here is our portfolio on the right-hand side of the slide. We are participating in the artificial tears category, continuing to win behind the Systane brand. We have been very pleased with the performance of Systane. I will provide a bit of an update there. In allergy, Pataday continues to grow very nicely in the U.S., and we are actually seeing U.S. market expansion driven by our U.S. vision care team. In contact lens care, we are the largest player. Opti-Free and ClearCare enjoy number one share globally around the world. In pharma, of course, we are just getting started, but we are paying close attention to our inline glaucoma portfolio, as well as our dry eye assets, and then preparing for the launch of AR-15512.
You'll see throughout this presentation, I refer to the name Acoltremon. Acoltremon is the generic name for 512. The brand name has not yet been approved. We'll reveal the brand name when we get the feedback from the FDA. Let's take a quick look at the overall top three priorities for ocular health and pharma. One, continue to drive sustained growth. I'll show you in just a moment how the artificial tears markets are evolving and why we're leaning into that space. We want to continue to accelerate our reentry into pharma, but we want to do that in a thoughtful and deliberate way. Many of you, I said a few years ago, have become historians on Alcon. You know who you are. You know a lot about where we've been in the past.
It wasn't that long ago that the pharmaceutical business was a very large and profitable part of our core business. Of course, we're putting a lot of emphasis on preparing for a successful launch of AR-15512. Let's talk about artificial tears first. What we're seeing for Systane, I think Tim said a couple of years of double-digit growth. In 2024, Systane TOTAL brand grew 13% overall. That was the fifth year of double-digit growth for Systane. The multidose preservative-free formulations of Systane grew nearly 40%. What you can see in the arrows across the breadth of the slide is effectively that growth, especially for multidose preservative-free formulations, is coming from markets around the world. In addition, I'll focus your attention to the bottom or the right side of the slide, the pie chart. That is percent contribution by format in the international market.
When I shared an update on this at the last Capital Markets Day, or even last year, it's progressed. Unit dose preservative-free and contribution for total market. It's now about 80% in international markets. Compare and contrast that to North America, where it's less than 45%, but growing year over year. One point of penetration of preservative-free in the North American market is worth roughly $10 million to the market. We're really happy to be participating, and we continue to want to drive innovation in multidose preservative-free and play a leadership position in North America and a competitive position in international markets. You probably saw the news in February, press release related to the launch of our longest-lasting artificial tear yet, Systane Pro Preservative-Free. When we talk to artificial tear users, what they tell us they want is long-term symptom relief. Systane Pro Preservative-Free offers 10+ hours of symptom relief.
We'll have a 10-hour claim on the box immediately, and we're pursuing a 12-hour claim. It's the most comprehensive formulation that we have to date, with the nanolipids found in Systane Complete, the predecessor to Systane Pro, as well as hyaluronate, which stabilizes and thickens the tears, likely adding to the duration. When we talk to doctors and to consumers, they're particularly interested in this product, and the early feedback in the U.S. launch has been quite positive. I've used it. I like it. I like it better than anything else in our portfolio. You don't have to take my word for it. In your backpack, there's a trial of Systane Pro Preservative-Free, and on the plane ride back or the car ride or at your hotel, please give it a shot. Let's switch gears just a little bit and talk about the pharmaceutical business and our reentry there.
What we've said publicly is that we want to reestablish a meaningful third pillar of the business and that we want to regain leadership in OphthP harma. We believe that we've got a right to win. There were a number of questions about this at the reception last night. Why do you think you can play? How do you compete against big pharma? At the heart of what we do is we're really specialty-focused on eye care. The OphthP harma business is highly fragmented. There's a lot of assets that are less than $1 billion. We talked a bit about that earlier today. They're not particularly interesting to big pharma, but they are particularly interesting to us.
You could also argue that we're the largest and best capitalized in the specialty arena, and we've got deep Ophth expertise, of course, with rich R&D, manufacturing, and commercial capabilities, where we're mostly focused on later-stage development in the R&D space. Our progress to date, a bit of a progress update. We built an initial portfolio with Rocklatan and Rhopressa through the Aerie acquisitions. Simbrinza was the first brick in the house that we built. We've got Isovue, and we've made some targeted investments. Those targeted investments that we're making have very specific criteria, most of which we're looking for assets that have largely been de-risked and are later-stage ready for late phase two or phase three. The Aurion Biotech example would be a great example of an investment that we've made that we think fits that criteria. In terms of R&D build, this has been a real highlight.
Almost overnight, with the Aerie acquisition, we regained R&D scale. Again, mostly focused on development rather than early discovery, but we have 100 scientists in Research Triangle Park, North Carolina, dedicated to pharma R&D, and we've been very pleased with the progress they made. In fact, we have an emerging pipeline of products that came largely through the Aerie acquisition, and I'll show you in just a moment where we stand, or at least a bit of a snapshot on the pipeline. From a commercial execution standpoint, we have an established glaucoma sales force driving Rocklatan, Rhopressa, and Simbrinza. They are dedicated predominantly to focusing on glaucoma. With the launch of 512, we will stand up and are in the process of standing up a dedicated dry eye sales force in order to ensure that we drive the right kind of trial and exposure to the product early on.
Of course, we're particularly excited about the partnership in China with OcuMension, who is like-minded and has similar capabilities to Alcon. Let's look at the pipeline. Quick orientation to the slide. On the left-hand side of the slide, the y-axis, we've got the target therapeutic categories or a short list of the ones where we're conducting projects. On the x-axis, you can see stage of pipeline development. A bit of a cartoon, but this gives you a little insight into some of the key projects that are underway. In glaucoma and dry eye, we've got a couple of key life cycle management projects around Rocklatan and Acoltremon. It's never too early to start thinking about life cycle management. In dry eye, 512 is there. The PDUFA date is May 30th of this year, which we're anxiously awaiting feedback from the agency.
In redness reliever or whitener, we're pursuing our own whitener asset in the very fast-growing whitener category, which grew nearly 11% last year. I had a question about that at the break. In retina, combined with our delivery platforms, Jeanette will speak about this in a little bit more detail, but we've got a well-characterized molecule that we've paired with our Systane delivery technology that we refer to as Print for the indication of wet AMD that we're particularly excited about. Let's double-click on 512 and give you a little bit of an insight into what we're thinking about there. We're particularly excited about dry eye because we think there's significant unmet needs that remain in the market. When we talk to dry eye Rx users, what they tell us they want is speed and efficacy. Sounds pretty straightforward.
When we look at what's really happening today in the market, we see 90% discontinuation rates on average in less than a year. We see 60% of patients reporting mild to no improvement in their symptoms, and only about 13% feel like their dry eye is being well-managed. We believe that Acoltremon has an opportunity to step into that void. A little bit of background on Acoltremon, and I'm going to show you a video that gives you a bit more detail on the science and the mechanism of action. Acoltremon is a first-in-class novel TRPM8 receptor agonist, which rapidly stimulates natural tears. Effectively, it's doing that by stimulating the body's natural pathway for making natural tears. A few of the phase three clinical findings that you can see on the right-hand side deliver rapid onset as early as day one and sustained through day 90.
Up to 80% of patients had normal tear volumes on day one. We saw consistent reduction in symptoms at day 28. We've referred to it, I think, on this slide as a month. Overall, a very favorable safety profile. I've had a few questions about the most common AE, which is burning and stinging. In Rx dry eye, a sensation upon installation is quite common in the category. We believe, and what we see in the data is most patients, 98%, report that that's mild and transient. It's something that doctors are comfortable managing. If you look at the totality of our data, in four studies, a 2B study, and three pivotal phase three trials, 766 patients were on active drug, only five discontinued due to this AE.
We think that that's manageable and that the efficacy and the speed of the product will overcome any sort of concerns about the AE. Let's roll a video, and I'll give you a little bit more insight into the science.
Introducing Acoltremon, the only eye drop that rapidly increases natural tear production. Of the prescription dry eye treatments currently available, most are either anti-inflammatories or do not address the underlying disease state. Acoltremon is a novel first-in-class TRPM8 receptor agonist that stimulates nerve endings found on the cornea and upper eyelids. Stimulation of TRPM8 receptors directly activates the trigeminal nerve and the body's natural pathway for producing tears. This mechanism of action rapidly triggers the production of natural tears containing aqueous proteins, lipids, and mucin. In phase three clinical trials, Acoltremon demonstrated increased tear production as early as day one and sustained through day 90. Acultramon, PDUFA date, May 30, 2025.
When we share the video with thought leaders and other customers and investigators that have been exposed to the data, what they're particularly excited about is the unique mechanism of action and the ability to directly produce natural tears. If you think about it, at the heart of dry eye is tear deficiency. We are really excited about this opportunity. I'll show you just a bit of the phase three pivotal efficacy data. For the sake of time, we could not go through the breadth of the robust data package that we've submitted to the FDA. On the left-hand side of this slide, you'll see the primary endpoint, which is the Schirmer score. This is % responders with greater than 10 millimeters of increase in Schirmer score, which is essentially tear volume.
The middle lane, day 14, middle bar is effectively the primary endpoint, and you can see statistical significance versus vehicle. What's really compelling about this chart is if you look at the key secondary endpoints, day one and day 90, also statistically better than vehicle, which is the gray bar sitting well below the blue bar. On the right-hand side, again, this is the pooled data for symptoms. Day 28 was the predefined or pre-specified key secondary endpoint, and you can see statistical significance when we look at the breadth of the data. There's also some really compelling data on ocular staining as well as some tertiary and exploratory endpoints, some of which we're pursuing additional data through some phase 3B trials that we hope to report out before launch. We are particularly excited about this and look forward to talking to you more about it.
In summary, start where we end where we left. Let's end where we started. We'll drive continued sustained revenue growth through a focus on our MDPF formulations overall, and then particularly leaning into Systane Pro Preservative-Free launch. We need to execute a world-class launch of Acoltremon, or as most of you know, AR-15512, and accelerate Alcon's reentry into pharmaceuticals. We'll do that thoughtfully, but we do see a big opportunity. Thank you very much for your time. Look forward to the Q&A. I think Jeannette Bankes is going to take over now.
Please welcome Senior Vice President, Global Franchises, Jeannette Bankes.
Thank you. Thank you. It's an absolute pleasure, first and foremost, to a lot of the familiar faces in the audience and online. I'll address online as well. This is my third Capital Markets Day.
For those that have chosen to invest in us, be a partner throughout this last five or six-year journey since SPIN, I'm looking at some of you in the faces. You can look up from your computers as you're reporting. A sincere thank you. For those, as Tim said, that are on the sidelines, I'm going to challenge you a little bit. Okay? We've shown you a historical performance. We've set expectations as a company, and we delivered on those expectations. I think I would say it would be hard to argue that Alcon doesn't have the most depth and breadth of pipeline fueling the next generation of ophthalmic needs. If you're standing on the sideline, I hope that we've sparked a little bit of energy and passion in you to think about partnering with Alcon.
For our shareholders that have made the money with us over the last six years, congrats. We're happy about that. I've been with Alcon for six years. I started in Shawnsville. I was the President of Surgical. Whenever you get to a certain age, you say how many years plus you've had. I've been 30+ years in healthcare. I started in the pharmaceutical business at Merck, spent a decade there. I then moved on to Boston Scientific in the good, the bad, and the ugly years. I would tell you that that 15 years of transformation was phenomenal. I joined Alcon a little bit earlier. I think I'm two weeks earlier than Tim, so I'm a little bit older than him. I joined at the SPIN, and I couldn't be more excited and proud.
While you've seen many of us present today, we're representing the 25,000+ employees that put their heart and soul and passion into this company for our shareholders. Let's say, more importantly, the patients that we may be someday or the patients that we think we serve every day. We have a breadth of folks sitting on this side and this side that represent Alcon. I will turn to them. We love our shareholders. It's the people at the company that make the company. Thank you. I'll give one more shout-out to my colleague, Head of R&D. Thank you, Franck Leveiller , for one of the richest pipelines in ophthalmology and for the passion of your R&D team, because that's what fuels growth. I have the pleasure the three franchise heads showed you in the short and intermediate term. What does that look like?
You may be short-term in memory and say, "You know what? I only care about the first three years." You should care about a continuous breadth and depth of pipeline. We have over 100 active programs in R&D, but we're going to try to sprinkle in some of the most exciting that, from an opportunity perspective across surgical and vision care, that really could make a difference in this company. I'll start out with premium lenses, ATIOLs. We'll talk about PowerVision and where we stand with that program. We'll then go on to our equipment capability, next-generation lasers. There's multiple disease states that actually can actually be treated with laser and robotic capability. We'll talk about that. We'll then get into the uniqueness in our contact lens business. What are we doing for that presbyo?
If I happen to be that person, a lot of you, I will judge your age, are in that category as well. What are we doing to actually maintain that population of contact lens wearers? I will continue into the pharma business, first with how do we expand? We are excited about Systane Pro. How do we continue to never arrive in dry eye? I will talk about therapies there. I will end with a splash on pharma. I get the pleasure of showing you what the pipeline could look like. We have a very solid foundation, but we want to grow that foundation as a company. Let's start with surgical first. Sean showed you PanOptix Pro. As we think about our long-term IOL portfolio and the ambition we have in front of us, it's really about delivering and moving the actual bar.
I would say I'd ask you to all challenge yourselves and ask, among the competitive landscape of IOLs, people are just trying to come close to what we consider best-in-class PanOptix and Vivity. That's a high bar to set. With the optical engineers and expertise at this company, we're moving the bar. Any good athlete would say, "Great, you ran the 10mi run. I'm running the 8mi/ min run." We want to move the bar. We look at two attributes we believe continue to be unmet needs in the marketplace. That's really visual disturbance profile and full range of vision. How do you continue to take the best-in-class PanOptix and Vivity and move that bar? Sean showed you, as you're investing in the company, in the near term, we're going to have a PanOptix 2.0. We're going to go to a 3.0.
Vivity, we're going to bring down that domain as well from a near vision capability because it has a very unique visual disturbance profile being an EDOF lens. I want Utopia. We at Alcon want Utopia. We believe that in order to meet that access on both visual disturbance and full range of vision, it is going to take something as close to a natural lens. That is our accommodating IOL program. When we look at our accommodating IOL program, it really is the only program that we are aware of. As David had said, we look at everything. We're Alcon. It is really the only program that has truly shown objective accommodation while having attunability, being able to tune to 2 diopters attunability. What we want to share is a video of the progress we have made on this program to date. Please play the video.
At Alcon, we are always looking to be on the cutting edge in new and innovative ways to help the world see brilliantly. In light of that, we are currently developing breakthrough technology for IOLs. This new lens aims to closely mimic the eye's natural function. It continually adjusts to the patient's visual demands using fluid-filled haptics that, when squeezed, change the power of the lens.
The AVAMS by Alcon is a custom-built instrument for the clinical assessment of objective accommodation. The AVAMS custom software enables the recording of objective accommodation data while performing real-time quality checks to ensure proper performance and data collection in a human clinical study. The custom hardware automates the presentation of the far and near targets, stimulating the eye's natural accommodative response, ensuring maximum change in objective accommodative power.
If needed, the setpoint for the distance vision can also be tuned post-operatively once healing is complete, adding to the surgeon's confidence and delivering a great outcome. To tune the lens, lasers are applied to treatment zones along the lens body. As sequential bursts of the laser are applied to the blue area, the lens power setpoint is decreased in a stepwise fashion. As sequential bursts of the laser are applied to the red area, the lens power setpoint is increased in a stepwise fashion. This allows the lens power to be tuned plus or minus 2 diopters after implantation.
An update on our IOL program, long-term accommodating lens. Number one, we've made significant progress. Where we stand is we're enrolling in a clinical trial this past year. We have robust clinical data that we've had produced with this lens. Second is tunability.
We showed you the video because not only do we have a robust clinical program, we have a capability to tune plus or minus 2 diopters. I think most importantly is how are we doing with the safety profile? We've proven safety across multiple clinical trials. The last bullet, as we think about this program and we went through the data analysis in 2024, late 2024, the majority of patients had happened exactly what we thought: a phenomenal safety profile with visual outcomes that we predicted. There was a small portion of the population, though, that did not get the visual outcomes that we expected. As R&D, both the clinical and technical teams took a look at why is it that there are a large majority of patients having a brilliant outcome, and we have this small subset that we did not see that.
They actually did a root cause analysis. What we've done is we actually extended the clinical program. We're enrolling more patients. What we found is we needed to standardize both the intraoperative and post-operative medical therapy, have a standardization. There was an anomaly among the patients. What we're doing is extending that clinical program through 2025. We're currently enrolling with the protocol changes, and we'll bring back and say, "Did we solve what we thought was the hypothesis on why some patients didn't benefit while the majority did?" We expect to report that data with you at the end of 2025 and continue to progress if we've actually proven out the hypothesis we think where patients will get the outcomes they deserve on this premium lens. Let's talk about long-term surgical and our equipment capability, in particular on lasers.
Sean showed you the breadth of equipment we're about to unveil or commercialize over the near and intermediate term. When you take a look at our capabilities, not only do we have a breadth and depth of optical engineers that know how to do IOLs, inclusive of our accommodating IOL, we have this breadth and depth when it comes to equipment, in particular laser capability. When you look across the different disease segments: retina, cataract, glaucoma, we know that with laser treatment up to robotics, we actually have unmet needs in the marketplace. We believe we can solve AMD. We believe we can solve floaters in retina. We know that being able to provide a channel in the trabecular meshwork in glaucoma will relieve IOP. When you look across these multiple programs, both our equipment, software, and laser capability, and you summarize that, that's about a $3 billion opportunity.
We wanted to show that to you because while in the near term, we're excited about Unity VCS and Unity CS, our next-generation microscope, and ADI, behind the next corner is a breadth of laser capability that could equate to a $3 billion opportunity. Let's turn to contact lenses. I love surgical. I happen to have a bias. I helped run it for a couple of years. I now love all the siblings in the house. We also have a unique capability in manufacturing, and we have some of our manufacturing folks. This is a beautiful competitive advantage compared to anybody in the space that competes with us. We talk about DSM flex, but if you really peel back the onion and understand, well, okay, so you can make better capacity, is that really important? Yes, revenue generation.
When it comes to innovation, and Max tapped into this, the winner has to innovate. We have to keep ahead of our competition when it comes to innovation. Our ability to change chemistry, materials, the way we do surface on contact lenses is going to put us at a competitive advantage. You like the capacity. We like the double whammy. We like the capacity, and we like the innovation cycle. As you think about innovation, I'm going to introduce a next-generation presbyopia lens. It's a big deal to us. We're able to, in a time-efficient manner, now take an innovative new chemistry out of Franck's team and put it into manufacturing faster to the point where the amount of prototypes we can fail fast or succeed fast is actually a competitive advantage. Lastly, as an investor in the company, you should care about our capital deployment.
This creates the most efficient capital deployment when you can take a modular approach, put lenses across one line, multiple lenses, and speed up innovation. You should care a lot about this slide, and it is a unique position that Alcon has. Let's tap into why you would invest in us or why you continue to invest in us. Number one, whether we like it or not, you will all become presbyopes. Great business model for Alcon. Okay? However, we lose as many contact wearers as you get older as when we have the young generation coming in and coming to us for that contact lens. The reason being is it's a limitation. I stand here in my Dailies TOTAL1s. I see halos and glares. I'm giving up my near vision. I happen to be a high myope.
I told somebody last night, "900, 800- 9 and - 8. I'm + 2.5, but yet I don't want to wear spectacles. I still have to wear readers because I'm trading off something in my vision. I cannot give up my distance vision, yet I know that I can't get my near with the current offerings." Number one, we're not meeting the need of the 40- 45 year old. Number two, it is not easy for the ECP as a manufacturer is trying to go low, medium, high add. Think about the fits for the ECP and the pupil dependency on those contact lenses. It's not easy for them either. Last, while we love that we put an actual Systane Pro in your bags, we're dry eye recipients. I would love a day where you can give me a more comfortable lens.
At 10:00 P.M., when I'm getting ready for you the next day, I don't see a glare over it because I have such a dry eye. These all three unmet needs really cause us to lose that patience. If we could just extend even 5-10 years of a contact lens wearer, that is worth billions of dollars for us in industry. The team took that challenge on with the optical engineers. Reminder, I have a surgical background. We do share our engineers with Franck and I. Those same brilliant optical engineers set out to say, "What if? What if we could take some of the optical things we did in things like Vivity and PanOptix and bring that to the next generation light utilization, wear, comfort?" The team is doing that.
What I draw your attention to is the two lines on the slide. The gray one is what I am every day. I'm giving myself distance, but I'm taking away my near every day with the options that we have in the market. As we do the fast prototyping I described in manufacturing, the team has actually developed early on technologies, and we're really extremely excited about this. We're in feasibility. That blue line is what the next generation presbyopia lens will allow us. We're also challenging in our product profile. Can you not have so many ads? Can we make it simpler on the ECP? Lastly, as you've heard, Max, with all of the capability to make your eye wetter, we're actually doing that as well.
We look forward to this opportunity, and I couldn't be more excited for the contact lens group, and thank you to manufacturing for the flexibility. Let's talk about dry eye. As you think about the next phase of innovation, Jonathan, I love your giving us 12 hours, but that's not enough. From a dosing perspective, we really have an aspirational goal that at the end of the day, if we understand the root cause, when we look at the mucin layer, the foundation of healthy tears, if we can somehow impact the residence time on the mucin with a tear, can we actually go to single doses in a 24-hour? This is what the team is doing.
When you look at what we're trying to do is a single dose, have great efficacy in a product, and allow a tear film therapy with the mucin interaction to have more residence time. Early prototyping shows us on the right-hand side that we're achieving just that. While we love the products that we have, we believe we have a meaningful innovation in both residence time and dosing for dry eye patients. Last two in pharma. Exciting. If I haven't gotten the sideliners excited for an investment opportunity, wait now. Okay? Wet AMD is a very, very large issue, very profitable as well if we're frank about the financials around it. As we on the acquisition of Aerie, we're actually able to pick up what we would consider a delivery mechanism.
As we think about wet AMD and where David said our investments are, where are we interested in, the unmet need, if you do not have a relative, family, or loved one that has wet AMD, it is not easy. My mom has it. I probably am a future patient. I am already dry AMD. At the end of the day, you have folks doing needles in their eyes every four to six weeks. Number one, that is a huge patient burden. It is a huge healthcare burden. You also have to maintain the efficacy and safety profile because at the end of the day, none of us want to lose our sight.
Can you imagine if we have a technology called Print that is a biodegradable platform that allows you to deliver a drug in a biodegradable manner that allows sustained release over at least, on our bench testing, 12 months, that allows you to go maybe once a year versus every four to six weeks? We could not be more excited about being able to enter in a meaningful way, wet AMD, in a truly patient-centric manner, a healthcare system manner, a delivery mechanism that allows sustained durability. My last highlight for pharma, you notice my passion gets even higher as I get to the end, is Aurion Biotech. Aurion Biotech is a unique proposition. David explained a little bit. I will go a little bit deeper.
Number one, if you step back and say, "What is standard of care today for patients that have corneal disease?" It is a corneal transplant. We happen to benefit, and I'm looking at everybody internationally in the United States, to have corneal banks. The U.S. has a lot of things that they have favorability. The rest of the world doesn't have a corneal bank in every country. Aurion Biotech's significant development and cell expertise has taken cells and did a combination with ROCK inhibitor. Not only did they take one donor to one patient, the passage of those cells and the combination of ROCK inhibitor actually allows us to be one patient to 1,000 doses. Dramatic global effect. Most importantly, as you look at the early data, their studies, number one, yielded a Japan approval. They're already approved in Japan for this.
They're in phase two, past phase two with really good clinical results, entering into phase three and a breakthrough technology designation with the FDA. As you can imagine, trying to mitigate the graft shortage, having a great safety profile that will potentially right now say could be safer than standard of care, which is DMEC and DSAC, could open up a breadth of new patients. Right now, physicians around the world preserve those grafts to the most severe patient because the more severe you get, the less sight that you have. Naturally, you're going to give it to the most severe patient. If we can open up this from a 1 to 1,000 dose, even the mild to moderate patients would benefit this from preserving sight. We look forward.
There'll be negotiations with the phase three trial design and ultimately commercialize in strat plan period, later part of it. We're excited about this technology, both in terms of its capability, but as David showed the video, Raj and team over in Africa, we have a responsibility to restore sight to those that don't even have an opportunity to get it currently. As I go into conclusion, I would tell you that we have one of the richest pipelines in industry. As an ophthalmic leader, we take it very seriously around our responsibilities to be able to bring the next generation of technologies for unmet needs. When you take a look at implantables, it is not easy to beat a PanOptix or a Vivity. We're best in class, and yet we're moving the bar. On the accommodating IOL lens, we've had significant progress.
We showed you on that video not just the technology, but the burden we place on ourselves to actually prove it clinically and then to regulatory agencies to show true objective accommodation. We are looking forward to progressing that program. From an equipment standpoint, the here and now is going to be beautiful. When you look at our install base, we are going to refresh ourselves. Again, from a laser capability and a robotic capability, we are invested internally and externally. On vision care, I would tell you that while we are excited about Precision 7, my age, I would really like to see contact lens wearers go longer and us create the next generation presbyopia lens. To end, we promised to increase our pharma portfolio.
We're doing just that, both with what's internal 512, but the acquisition and investments and things we picked up with AR-15512 on Print as well as Aurion Biotech is just beautiful for you as investors and us meeting the patient needs around the world. Thank you, and we look forward to the questions.
Ladies and gentlemen, please stand by as we prepare the stage for the Q&A session.
I really like that. You just permanently have your hand up. All right, all right, guys. What do you think? Everybody, you like the show? Thank you.
The show.
Just a couple of housekeeping items before we kick off. Just as a reminder, when you do ask a question, remember to state your name and the firm just so everybody on the webcast can ask any question. Lastly, I wanted to remind you that the first bus to take people to the airport leaves at 12:30PM, and then there's another one at 1:30PM. We'll have lunch immediately after this. With that, we'll go ahead and kick it off for Q&A.
Larry?
Thanks, Dan. Larry Biegelsen, Wells Fargo. One question for Jonathan, one question for Sean. Sorry, Max.
I'm glad.
Starting with Jonathan on AR-15512, just help us. Everyone's going to look at kind of, I'm trying to understand the adoption, and people are going to look at MiBo, the last big launch in the category, prescription sales, same quarter post-launch. Help us understand how you think 512 will ramp relative to that and why. A similar question for Sean on Unity. Help us understand the speed of the upgrade cycle. 30,000 machines out there. What's the average age? What % are over that seven to eight years that would typically be due for an upgrade? Thanks for taking the questions.
Thank you for the question. The first one on 512, I would just say first as a reminder, 512 is an investigational product, has not yet been approved, which leads to a couple of points. We need to see the final label. We need to see the final data package. I think my recommendation to you, if you're trying to model, would be to think about how much time it's going to take to gain market access. David alluded to this in his opening comments. There is a defined market access cycle for government patients, Medicare patients, and then commercial patients can move at a different pace. I would think that through. We believe in the profile of the product.
Our early response from payers and the engagements that we've had with them have been quite positive, the same with eye care professionals, but it's going to take us some time to gain traction.
I think on the Unity uptake, right, when you think about the age of the current install base that we've got on both Centurion and Constellation, and we've been continuing to sell these at a pretty brisk pace over even the last couple of years. You could probably think about two types of people getting on the train early, right? The early adopters who just love any new technology and want to have the latest, greatest new toy, and there's also the people that have the more aged platform. It's going to vary a little bit market by market, but a significant portion of the install base is over that seven to eight-year timeframe.
It'll vary a bit here and a bit there, but we expect that you're going to probably see more adoption early on, and like you would with most things, you'll see a longer tail as we get to the end of that 10+ year time horizon.
Second the questions, Jack. I'll be seeing. I've had one for Sean and one for Max. What is your view on maximum daily compensation?
Yeah, so I'll start on ATIOL penetration. I think we still have this thesis that we're going to continue to grow about 50 basis points per year, probably a little bit more driven outside the U.S. at this point. If you go back to the chart I shared, there's about a five-point gap between international and the U.S. in terms of the penetration today. We've seen faster gains in the more recent timeframes in international where we were starting from a lower base. There's probably a bit of catch-up that will happen there outside the U.S. compared to the U.S. In terms of what's the total upside potential, it really depends on how technology evolves over a five, ten-year timeframe, right? The theoretical upside is that 40%, right? That also depends on our ability to actually deliver against the proposition in a meaningful way as an industry.
When you think about some of the technology that we have coming in the near term, we think that does power that 50 basis point growth. If you think about the longer term, there are things like Jeanette Shared that have the opportunity to actually kind of turbocharge that, at least for a period of time as well. Sorry, repeat that part of the question again? Yeah. If you think about it again, probably more outside the U.S. in the shorter term than inside the U.S., but opportunities in both markets, quite honestly. Again, 50 basis points is going to equate to about a $50 million uptick.
On the daily penetration, that was your second question. Today we have, what, 37% of the contact lens wearers in dailies. Think of it like this, there are actually about 1% of reusable wearers shift over, one percentage point shifts over into dailies every year. Next year will be 38% and the year after 39% and so forth. In terms of where this will plateau, there is quite a long runway, very long runway actually. One proxy for you to consider is we have one subcategory that is presbyopia correcting lenses where dailies are at 60%. If you just do the math, then you are close to 25%, 25 years of continuous growth. There is quite a long runway for ample more growth for trading up people into daily disposables.
As I said earlier, the reasonable market is still sizable, and we're very excited also about trading up within that segment to Precision 7 for those folks coming into the category early on when they're teenagers and they may not yet be able necessarily to afford a daily disposable lens. Now you can get into a lens that is a weekly lens, which is great.
Great. Hi, David Adlington, JP Morgan. A few questions, please. Firstly, just on the Unity consumables, I just wanted to give us an idea on the price premium you're expecting to extract from that. Secondly, on the accommodating lens, just wanted to give us an idea of the percentage of patients that have seen that overcorrection and where you expect that to get down to with the expanded trial. Thirdly, you haven't mentioned today Chinese VBP. I just wanted to give you an update in terms of the dynamics you're seeing there in the market.
You want to do the first one?
Yeah, I'll take the first one around, sorry, repeat the question.
Price premium.
Yeah, so I think on the cataract side, obviously, where reimbursements are lower, we'll still be looking to achieve a price premium that'll be on a more modest end of the range. When you think about the vitreoretinal procedures, there's a bigger opportunity there. One, the total reimbursement envelope tends to be higher globally. Two, the variety of the procedure itself, there's a lot more different things that can happen in a retinal surgery versus a cataract surgery. It may be a little bit more cut and dry on cataract. We have a lot of different incremental innovation that we brought on the instrumentation side on the vitreoretinal portion of the business. Probably a little bit more of an opportunity to capture value on the VIT side today.
While the number of vitreoretinal procedures are lower globally than the cataract procedures, the actual value per procedure and the reimbursement procedure is much higher. I think there's opportunity on both, probably a little bit more on an absolute penny basis, maybe on the vitreoretinal side.
Do the distribution of-
Yeah. From an accommodating lens perspective, I don't know if we will report out the exact number. I can tell you the large majority of patients actually had the visual outcomes that we were experiencing. If you noticed in the video, we're looking at tunability as well. For us, the real solve is if we can get them, the patients that were an anomaly, into a distribution curve that allows us to adjust it with the tunable piece of this, we think we have a commercializable product. That's what we'll say at this point.
Exactly. On the VBP, we've got a really nice position there. It's growing nicely. We'll have a full year effect of that. I think the back half of last year is a pretty good representation of what we would see for the full year this year.
Thanks. Chris Pasquale, Nephron. Wanted to follow up on those two topics with Sean and Jeannette. First, Sean, for a certain segment of the customer base here, you're going to be replacing two machines with one. Just talk about how that changes the adoption dynamic and what happens to your customers that have machines of different ages from the legacy systems. For Jeannette, it sounds like you guys have made a fair amount of progress at this point on PowerVision. Talked about reporting out these latest results at the end of this year. What's left to do after that, and how should we think about the timeline to commercialization of that product?
Yeah, so it's probably worth even mentioning. There are two sort of market archetypes around the world. There are dual combo procedure markets that tend to have a higher development there, and then ones that look more like the U.S. where it's more isolated, probably. I think from an age of the install base standpoint, the Constellation equipment, which actually does have the ability to do Phaco as well, has been out there the longest. When you think about even the sequence that we decided to launch these in, I think there was some thought that went into it based on that. There is probably a little bit more pent-up demand, I guess, among the vitreoretinal surgeons on that front.
When you go to the markets where the combo procedure is more of a common thing, I think there's just a lot of interest in this just based on those are largely Constellation-based ORs today. That is really going to drive that phenomenon.
Let me just add, the retina market in particular is of high interest to us because it has a high value equation with this particular service. In particular, outside the U.S., where the ORs are shared, that will be a particularly effective market for a joint product. In the U.S., cataract surgery is typically done with a standalone cataract machine. You will probably see a difference between many of the international markets and the U.S. uptake, U.S. uptaking a little bit more aggressively on the CS product and the other markets really around the VCS.
Regarding the accommodating IOL program, should our hypothesis test out positive when it comes to medical therapy and biological healing, we would then go into the next stage of clinical trials. What that does for us is it puts our commercial forecasting outside of strap-time period at this point, beyond 2029.
We have got a couple questions that have come in online. This one from Jeff Johnson to address to Sean. Can you help us better understand the reimbursement environment for SLT, which is pretty low, versus the capital and consumables cost to doctors? I think the underlying question is, is there enough profit margin left for the docs and the ASCs to do DSLT?
The short answer to that question is I think we firmly believe there's enough profit margin left. The reimbursement, I think, is $241 million in the U.S. And while there is a capital outlay that you have to put in place to acquire the machine, based on what we're charging on a per procedure basis, there's 75% plus of the reimbursement left to go to cover every profit margin in the practice and all the other costs that they've got associated with it. Our customers have actually done the math pretty quickly, and they've figured out that in many cases, it makes sense for them to buy not even just one machine, but multiple machines for different locations that they've got. We think that that's a healthy paradigm on that front.
Okay. We got another one on 512 or Acoltremon. You've talked a lot about, and this question's from Susannah at Bernstein. You've talked a lot about beefing up your sales force. Can you help quantify the investments that are required this year to launch this product, both from a sales force build-out and a marketing perspective?
Sure. We'll start with a dedicated sales force and a focus on the eye care professional. We've already staffed up the majority of the force that we'll put in place. We've also hired dedicated medical science liaisons who've been out doing some market development work. We've got a pretty robust market access team in the US market that's already engaged with all major payers. We'll start with the eye care professional and the payers. Once we get moving, we'll move on to direct-to-consumer advertising.
Thanks. Anthony from Mizuho. Sean, Max, and Jeannette, three quick ones. Sean, just maybe a little bit on training for physicians in the United States. How long is that going to take for Unity? For Max, I'm wearing these two-week J&J lenses that are very dry. I'm wondering if you have any Precision7 samples laying around. Actually, how much will they cost between two weeks and one week for a one-year supply? For Jeannette, just a phase three ORIEN study. When does that start? How long is it going to be? When should we expect an interim readout? Thanks.
Yeah. I'll start on the training for Unity. I think I don't want to belittle the fact that we will have to train, but I think this is going to be a relatively straightforward thing. There are some differences for the staff and the physician on how the machine operates, but we're not talking about a long throw from kind of how Centurion has operated. To the extent someone's familiar with Centurion and Active Century, the changes are relatively mild compared to where they've been in the past. There's probably some new functionality that we'll be able to open up for them depending on the parameters that they've been using and how they've been operating in the past. It should be a relatively straightforward thing.
We've actually started training our sales force even now on the things that they're going to have to do and go in and explain to the staff and to the surgeon on it. We are as prepared as we think we can be on that front.
One of the nice pieces just to add on that is we've had about a year of opportunity to kind of have this with surgeons and see what this transition when you port over from one set of settings to another set of settings. We are trying to move people from very high pressures in the eye down to physiological pressure, which is safer and is more comfortable for the patient. As you do that, it does require some adjustments and settings. We've done a really good job, and Sean's team's done a great job of training into the sales force, which is what we'll be spending a lot of time on in the very near term so that they can help make that transition smooth. It will take just a little bit of time to make sure we get that right.
Yeah. For Precision 7, if you're really seriously interested, which is great, thank you, maybe let's connect after the break and we find you an optometrist to get you fitted in the product.
We have a few around.
We have more than one in the crowd, I'm sure here. We'll get you some samples. I'm obviously not going to comment on pricing strategies of other players in the category, but we believe Precision 7 is pretty well priced, actually, on an annual supply basis, somewhere in the $400 million range, commiserate to the value that it brings to the market. Pricing actually is a pretty good pricing for the product, as you heard from customers. You'll see.
We have another question.
One more question regarding ORION, Anthony. They're going to commence their phase three right now. Timing is fall of 2025. As a reminder, this is a breakthrough designation. Considering enrollment, filing, etc., there's a forecast of 2028 commercial availability.
We have another question online. This is from Graham Doyle at UBS. Where are you on rolling adjustability or tunability across the IOL portfolio, even without the accommodating lens?
Yeah, it's a good question, Graham. Thanks for it. We obviously have a lot of technology that's wrapped into that one lens, and we are really interested in kind of doing the whole project as it stands right now. We obviously can use either technology, either the accommodating separately or the tunability separately if we chose to. We've done a little bit of work on it, but we really haven't initiated anything of a project that's really dedicated to moving forward yet. We're still working through this one.
Tom Stephan with Stifel. Maybe to stick with accommodative, excuse me, the tunability of two diopters, I think that was bench data you mentioned, Jeannette. Did you see similar results in the study itself? Maybe if you can talk about that bench data. Then pivoting to ATIOL penetration, I think in the U.S., the cataract surgery family is going to be up for reevaluation fairly soon. We saw it come down in, I think, 2020, messy year. Do we think about that as a potential U.S. tailwind to accelerating growth in ATIOL penetration if, let's say, standard monofocal reimbursement comes down? Thanks.
I'll answer the first question. From the accommodating lens program, the clinical trial we were running in 2024 was actually beadless, we'll call it. We were trying to test that the base lens could fit within that. You are right, it was bench testing on the bead form, but we saw phenomenal results on what we call a BAL lens that's no beads in it. As we think we have the hypothesis, we test it and it tests out, you then know that you have a solvable problem because the beads will go on top of it. It was a beadless clinical program that we saw those results in.
On the penetration element, what was the question again?
Tailwinds.
Tailwinds, yes.
On reimbursement.
On reimbursement, yeah. Like I said earlier today, I think every year we see reimbursement comes down just a little bit. I think that will be the continued downward pressure is creating, I think, a desire for surgeons to do more ATIOLs. I think that's part of the process. I'm not sure that it really accelerates it. Typically, what we've seen accelerate it has been new product entries. When you get more promotion around it, I think most recently you've seen a little bit of an uptick in the U.S. as the J&J folks and the B&L folks have gotten involved in this. Now, internationally, when we've made progress in China, that's helped the penetration work. I don't know that the reimbursement, which is kind of expected to come down every year as these surgeries get better and more efficient.
The good news on the facility fee is that it's typically gone up. Am I getting that right, Sergio? Typically. Yeah. Every year, they look very carefully at the facility fee, which matters because that's where actually the IOL is housed is in the facility fee. The surgeon fee, though, is coming down as they obviously get faster and better at it.
Hi, Steve Lichtman, Oppenheimer. A couple for Max. First on Precision7, can you talk a little bit more about how you're positioning marketing it in the field so it doesn't become more cannibalistic to your 30-day? And it is incremental. Obviously, you've mentioned going after the 14% that is biweekly. Secondly, can you talk a little bit about pricing overall, increased sensitivity on price in this market, just given the broader consumer dynamics? Thank you.
Yeah. So look, from a positioning perspective, as I shared, the core idea here is that we have a large group of contact lens wearers that cannot get into daily disposable SiHy lens today. The main reason is price. We see Precision 7 as the first choice for those folks who cannot get into a SiHy because of price, daily disposable. If then Precision 7 is still too expensive, that's where TOTAL 30 comes in. The idea here is for our portfolio that we have the best performing lens at every price point. Depending on where you are on that price point, we have the right solution for you.
A bit similar to what optometrists do today when they sell spectacles, quite frankly, when they start with the most premium glasses and then they take you down the ladder on price until they found the right price point for you. From a positioning perspective, it actually slots right into our portfolio into a nice gap. You had a second question on pricing generally. Yeah. Look, obviously, you all know we have quite an inflationary environment the last couple of years. In that environment, contact lens particularly, we're in a good position to actually take price pretty much in line with inflation. On balance, I believe, you'll judge, but on balance, I believe we've got it more right than some of our competitors. Some maybe have taken too much price. Some may have waited too long to take price.
I believe on balance, we were pretty much on the money in most markets with the majority of products. That will continue. We see that this is a place where certainly in line with inflation, we can take price on existing product. Of course, as we bring as an innovation powerhouse, better solutions, there is an ample opportunity to trade up people into more premium products. That is actually quite interesting. I did not cover it during my presentation, but if you think about it, today, how many hours do you spend in front of a screen compared to 10 years ago? That has an impact on your eye. You blink less, your eyes dry out much faster. That has an impact on contact lenses because the demand on durability and tear film stability on contact lenses goes up.
Lenses that were developed 5- 10 years ago are not fit for purpose 5- 10 years from now because the requirements are higher. That creates a tremendous opportunity for us to bring better lenses in the future and therefore command a higher premium. People are willing to pay for that because it is something they need every day. Hopefully that answers your question.
Hi guys, thanks for taking my questions. It's Issie Kirby from Redburn. Just wanted to hear any updated thoughts you had on the myopia management space, either on contact lens side of things, perhaps on eye drops, atropine. I know historically you've been a little bit more conservative around your appetite to enter that space. Similarly, obviously got a lot going on in equipment, but one thing I feel like we haven't really touched upon is the refractive suite. How are you thinking about your product portfolio, what you currently have there? Is that something where you're looking to perhaps upgrade or bring in any new offerings over the long range plan?
You can take the myopia once you take the refractive suit. On myopia, we follow everything in this space. Obviously, there's been a number of ideas, peripheral focus, peripheral defocus, atropine, Ortho-K. There hasn't been anything that has really intrigued us yet. I do think there's progress being made in some of those areas. I think it's our view as we have ideas in all of those spaces that if one of those were to get traction, meaningful traction, I think we could enter relatively quickly. We would probably choose to develop at that point in time once we see markets develop. Read that as we'd like to be a fast follower in that space and see how that plays out. I think we just haven't quite gotten a level of conviction to want to go after it yet.
There are some long-term projects that we're working on we really haven't talked about, but we have some of our own ideas on what other ideas might be more effective or could be more effective. Again, we'll lay those out over time as they play out or not. On refractive?
I mean we did not really have the bandwidth to get into it in detail in the presentation, but we are launching Wavelight Plus right now around the world. We are very excited about that. We got it out into the market last year in Germany, and I think we have sold over 80 site maps right now, which are the front-end device that actually captures the data that you need to go into the surgical plan for a LASIK procedure. It is exciting on two dimensions. One, it provides you a really great outcome, very high percentage of patients with 20/20 or better vision coming out of the procedure, but it does it in a much easier manner probably for the surgeon than our previous generation had done. It takes a little bit of the extra math out of the workload for them, which has been really well received.
The other thing that's interesting about Wavelight Plus for us is it's an opportunity for us to capture a per procedure fee outside the U.S. In the U.S., for a long period of time, we've had that model. Every time you fire the laser, we're collecting a portion of that revenue stream that the doctor takes is coming back to Alcon. We really haven't had that model outside the U.S., and this gives us that opportunity to introduce that into some of those select markets where we're starting to roll that product out. Longer term, more coming obviously in the refractive space just like there is across the rest of the portfolio.
We like the refractive space just directionally because it tends to be a large opportunity over time. I do think everybody's aware that of the few things that are sensitive in these categories, this is among the ones that when you see consumer confidence fall, refractive tends to fall. I think you can see that both in the China market, you can also see it in the U.S. market. Right now is not the greatest moment for refractive surgery, but again, it comes back pretty quickly and pretty predictably. As long as you can kind of live with a little bit of fluctuation on that, it tends to be a big opportunity, not yet really satisfied, and I think we will continue to look at it very carefully.
I think the point you made earlier is the longer-term macro trends there really support that business in the long run.
That's right.
Yeah. Just got another question online. This one's for Tim. On the cadence of CapEx over the next few years, where are you? What's that look like? How is it split between growth and maintenance? How should we think about kind of what a normalized CapEx to sales ratio should look like?
Yeah, you know I'm a big midpoint guy, so I would go with the 5%. I think there is still some more expansion in there, but it's going to be a much more normalized pace. If you recall, a few years ago, we were playing catch-up on the DSM flex investments. We'll continue to put DSM flex lines in, but we'll mirror that with the demand that we're seeing in the marketplace. We have our usual maintenance CapEx and that type of stuff. I wouldn't expect any big peaks or valleys. I would just probably load up 5% and run it out that way.
Hi, David Saxon from Needham. Thanks for taking my questions. One for Sean, one for Jonathan. Sean, just wanted to ask on Voyager. Been hearing from docs that they think it'd be great for retreatment. I do not think that's in the label yet. Is that an interest for you? What would it require, et cetera? My second question, maybe it's a combo for Jonathan and Tim. Jonathan, you talked about wanting late-stage de-risked assets. Tim, target M&A is $50 million-$100 million. How do you balance the two? Thanks.
Yeah, very good question on Voyager. I think that it is not in the label today, just to be clear, to do a retreatment. It is something that we're interested in. We're actually doing some legwork right now to figure out what the clinical pathway to support that might look like and be able to go back and get that added. More to come on that as we go, but it is definitely an area of interest to us. It's been something that doctors, our customers have asked about as well, obviously.
Yeah. On the balance of the opportunity, I'll take a stab at it, Tim. I think we're not doing a lot of discovery and early development work because that's very expensive. Buying something that's largely de-risked with a huge potential can also be very expensive. What we're trying to do is find that sweet spot where we can play early. Maybe we've got interest in a high-quality space where we see the scientific thesis that's really meaningful. We're trying to get in there early and have a seat at the table so that if the thing continues to go, we've got a good position to negotiate and potentially can win the asset.
Yeah, I think that's right. I mean, when you look at our capital allocation philosophy, M&A is obviously a piece of that. We're building a portfolio. It is really different assets that you're looking at are in different phases. Some are creative day one, some are dilutive day one. We look at it from an entire portfolio perspective with the long-term in mind of what we're trying to do.
Hi, guys. It's Sam England from Berenberg. Just one broader question. You mentioned earlier on in the presentation around improving R&D processes and efficiencies, but then we've obviously spent a lot of time during the day discussing the broad range of R&D focus areas across the business. Can you give some examples of where you see opportunities for improving R&D efficiency and functions? Is there an opportunity with AI to drive greater efficiency in your R&D function, maybe working on more projects simultaneously or doing things more efficiently and quickly in R&D?
Yeah, I mean, yes, in a really, really big way. I think part of that is just our own modernization process. I think a lot of people may be further down that road than we are. Everything from this kind of start to the finish, in silico modeling as opposed to kind of hard modeling is a big opportunity for us. Software co-piloting for writing software on machines is a very big opportunity for us. There's a great deal of work that's going on around how we move documents and scientific records. That's a really big opportunity for us. There's a series of tech transfer ideas that I think matter a lot, how we move from the research lab into the startup manufacturing facilities and how we manage that information. We have a lot of discrete systems.
We probably have five or six major systems that work independently, but the movement of data from one system to another, we're creating what we call a digital thread that moves that data so it doesn't have to be recreated or rediscovered. Particularly when you start doing iterations on products, if you have to start from scratch and go back and find a 10-year-old file that's in a box somewhere in a warehouse, which is not a crazy comment, it's really laborious and it takes time. We see a world where most of this is digitized and most of the records are much more easy to accept as you move kind of step to step going all the way through to manufacturing.
Franck will give you a long lesson on how all this works, but we've got, I think, 14 or 16 work streams that are basically designed to improve both the process and then using digital tools improve what we're going to do with those processes. We're excited about it. We think we can improve throughput meaningfully, and that's a big opportunity. Go ahead.
Hey, Brad Fishbin from KeyBanc Capital Markets. Just one for Sean and maybe Dave on the Lensar acquisition. I understand the deal is still in progress, but was just wondering strategically if you could discuss a little bit how you think Ally complements the existing portfolio and maybe whether you view it more as an upgrade or an alternative to the current offering.
Let me take a little bit of it, Sean will chip in but I think, look, LenSx has been a great product for us. It's also 15 years at this point. We know that that product is well-liked, but the boards are getting very difficult to replace. We are going to have to do something about it. As we look at LENSAR, we see something that's made some real progress that's available to us right now that we think is going to be a next-generation play for us. We think that's a natural step up. It's faster, it's mobile, it has some really interesting features in the way in which it works, it communicates well with its newest software. We like that product a lot, and it will be a nice add to what we would need to do one way or another.
Yeah, I mean, I think we're still committed to the femtosecond space, right? It's a very important thing for a lot of our more premium-oriented customers because there's a high degree of correlation between people that are in the ATIOL game and people that are in the femtosecond laser game, right? They like having that as part of their whole process. It's important for us to be able to keep innovating in this space and bringing new news to the table.
Thank you. Richard Fosun from Goldman Sachs. Follow up on China. Do you have any estimates on how much ATIOL penetration has increased to that market following the implementation of VBP? As that market potentially becomes more significant for Alcon, what is your stance on the potential for local manufacturing for ATIOLs in China?
I don't know if I've got the exact number. Maybe one of these guys does, but it's been meaningful. I would just say, I think in the 200-300 basis points improvement in the last year, it could be higher than that if I remember right. It's been a big move, partly because they're reimbursing at a level that is not too dissimilar to where the first ATIOL goes in. For example, toric lenses, I think, are falling underneath the DRG. There's very little cost to the patient. That's driving penetration in China. I would say that remember that the Chinese prices are relatively low. I mean, they're probably half of what the U.S. are.
Even if we're holding volume, which we are globally, we're losing the volume that we're losing to share in competitors in the U.S. is at a much higher price than the gain we're getting in China on the other side. That's the dynamic that's playing out with ATIOLs in the moment. What I'm excited about, though, really is that over time, you've got a stability coming in the U.S. and you've got kind of penetration driving all over the world. The U.S. continues to drive penetration. I think it's on a nice recent trend, and I think that will continue. We'll see. The rest of the world is doing really well. China was certainly the biggest, but Europe moved along positively as well recently. We're seeing a lot of people.
Part of that is that many of these governments have outsourced the backlog that they've got to private payers, which is unusual, I think, particularly for the Europeans. They have done it in Canada, they have done it in the U.K., they have done it in a number of Nordic countries. I think they are doing it in a number of places around the world now to try and get the wait time for cataracts down. What that has opened up is then an opportunity to see more ATIOL penetration because it is being offered by these private centers that is different than where it has been. That is a nice dynamic for us internationally. We always look at it, but it is not a high priority for us. I think scale is really important to manufacturing. We have two really great sites.
We have a terrific site in Huntington, West Virginia that supplies the U.S. and a lot of other markets. We have a Cork facility in Ireland that really supplies the rest of the world. Trying to keep those fully occupied and trying to generate leverage off of those is probably our primary interest.
Hey, guys. Middle way. Patrick and Morgan Stanley. Two quick ones. One, custom packs. No one ever asks about it, but good job, very stable business. Ability to take pricing. Is there anything going on in there? That's the first kind of bundle. Second one on Unity, a bit of a niche question, but I love those. Air gas exchange. You guys made a bit of a change on that side of things. That was the number one area for a lot of surgeons around malpractice claims. Was that to make things a little bit easier for them? What are some of the implications for the docs on that side? Thanks.
I'll do the pack thing. Packs are a great business for us. We have a very, very unique capability, and it's scaled. It is very hard to reproduce that. We make packs on a per-doc basis. It has the name of the surgeon, and it has exactly what that surgeon is going to use. Sometimes it has two and three versions for that surgeon depending on the procedure. We are able to customize that because we have a very unique setup down in Austin for the U.S.. and in Belgium for the rest of the world. We have gotten really good at it, but a lot of it is in our logistics and our planning and our packaging. There is a lot of automation in this now, and we are getting better at it every year.
The scale of that does afford us some real defense around what it costs other people to kind of come into that space. We feel good about our ability to defend there. Pricing is always sensitive, and it's mostly sensitive to the total reimbursement price. When you get all through it, there's a fixed amount that, particularly in the U.S., they're getting a price for, the facility is getting a price for the reimbursement. They have to afford the capital, the pack, the IOL, and anything else they use and their staff. They have to fit all that in there. When the facility fee moves up a little bit, we can sometimes take a little bit of price. We will, as we move into Unity, for example, on some of the packs that we do.
I think it's a tricky business because everybody's very aware of the cost per procedure. That includes everything from service to the IOL to the capital. Easier outside the U.S. at some level because it's a little bit more disjointed in terms of the way it gets reimbursed.
I think, go in your second. Do you want to take it?
Yeah. On gas delivery, that's something that we're in the process of launching right now, a new product called Unify that actually dials in the exact concentration of gas. It takes a lot of the, I want to say, guesswork, but risk of lack of precision out of the system. You've got a dial on the actual unit. You put what concentration of the particular gas that you're using, dial it in, it's ready to go. It's a disposable device, so one-time use, and then it's gone. That's something that we'll be launching here over the next several months to complement the Unity VCS launch.
Just a comment around that as well, Sean. I mean, if you're really looking at why Alcon would pursue a gas mixer like that, number one fear is blindness. If that mixture is wrong, you're blinding a person. That's both patient implication and legal implication. Our customers are used to doing consumables with us. The tech turnover as well. When you think about all the dynamics, first, patient safety, second, legal liability, and third, that tech thing, this is a natural consumable that they would pick up from us. It's a nice unmet need.
Thank you. Larry had a question.
Thanks for the follow-up question, Larry Biegelsen from Wells Fargo. Sean, one for you on implantables. You have a lot of new products coming in surgical, but on the implantable side, the next big breakthroughs outside of the planning horizon here. How do you see implantables? It was 2% in Q4, I think. How do you see that relative to the 6%, CAGR, you told us today, going forward over the next five years? Max, I didn't see anything on daily disposable penetration. I mean, I'm sorry, silicone hydrogel penetration in daily disposables and reusable on a dollars and units basis. Where do you see that going, particularly on the daily disposable side? Because that's been driving a lot of growth, right? The upgrade toSiHy . Thanks.
Yes. I mean, I think in the IOL space, we're confident in our ability to maintain a leadership position there. While the next sort of wave of totally breakthrough innovation may be a little bit further out, we still have room to continue to innovate within our two existing main technologies on PanOptix and on Vivity, and we will continue to do that. I think the situation will vary a little bit market by market depending on the competitive set and how fast other things launch or come to fruition there. On an overarching global basis, I think we're still really confident in our ability to maintain leadership in that particular area.
Yeah. On your question on daily disposable SiHy lenses and the penetration and the growth rate, think of it like this. We see the market grow overall 5%. Of course, dailies are growing faster because there is a shift. They are roughly in the 6%-8% over the next couple of years. Within that, the fastest growing segment is daily disposable SiHy. That is low to mid-single digits. We see that continue over the next planning horizon for sure, not slowing down anyway. Double digits, sorry. Did I say single digits? Yeah, I know that is wrong. Thank you. No, it is, yeah, somewhere between 12%-15%. Low to mid-double digits, to be exact. Yeah.
We've got time for a few more questions in the room. If not, I can jump in. This one's for Sean from Falko Friedrichs at Deutsche Bank with respect to the DSLT. I'm really impressed with the $75 million-$150 million revenue target you guys gave out for that. Is that within the current plan or current or medium-term plan? How do you expect that to phase in?
Yeah. I think that's sort of our outlook on peak revenue today and is probably more at the later end of the five-year time horizon. Now, that said, I would say we've been pleasantly surprised by the surgeon response that we've gotten to the device so far. We want to make sure that we're also looking at opportunities to expand that into markets where it doesn't have approval today. We will continue to work on that as we go forward.
Dan, if there's no more questions, maybe I'll just wrap it up.
Yeah, yeah. I think we got one more.
Sorry, one more.
Good. Okay.
It's Yong Lee from Jefferies. I guess two questions related to glaucoma programs you didn't really get a chance to talk about. First, thoughts on, I guess, the intracameral drug delivery market, i.e., eye dose, and also just on monofocals that can potentially deliver glaucoma drugs for a couple of years.
Yeah. We've watched those spaces very closely. I think what the Glaukos people are doing is a really great thing, and I hope they succeed with it. I think it would open up a market if they can find reimbursement consistently that makes sense for development in that space, I think we'd be excited about that. I hope they succeed. I think on the other front, we're a little bit less optimistic necessarily. We've looked at a lot of the ideas about IOL attachments to deliver glaucoma. Difficult technologies in our opinion. Again, we're always open to having other people break new ground. Again, we generally speaking can follow in with something that makes good sense for us. Both of those are very interesting.
Okay. I think that concludes our Q&A session.
Let me just wrap it up by thanking everybody. I'm going to just finish by where we started. We're excited about these markets. We live this every day, so we get kind of animated about the positives that we create in helping people see well. I think the part that matters is, of course, that these markets over the long stretch are resilient. They're underpinned by some really good fundamentals and some positive macro trends. We're excited about this next frame because, of course, we've kind of ended this very hard work that was to separate and kind of stand up and get everything organized and really reinvest. We spent a lot of capital for a long stretch, and I think we are now in a place where we're generating cash and we're in a much more mature phase.
You can see that we're moving now into this next phase of where we run operationally in a very excellent manner and try and build a great company. It comes down to, in the end, innovation. What you will have seen today, at least for a while, has been this notion of consistent product flow throughout the years. We've done that for the last four or five years. We see a really healthy portfolio in front of us. With that said, let me just thank you all for your time today. There are some terrific sandwiches, I think, outside. Good luck with that, and thank you for coming. Appreciate it.