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J.P. Morgan 42nd Annual Healthcare Conference 2024

Jan 9, 2024

Robbie Marcus
MedTech Analyst, JPMorgan

I'm Robbie Marcus, the MedTech Analyst at JPMorgan. Really happy to introduce our next speaker, Robert Ford, the CEO of Abbott. We'll do a little bit of presentation, and then I'll join him up here for a Q&A. Robert?

Robert Ford
Chairman and CEO, Abbott Laboratories

Thanks. Okay, thanks, Robbie. Good morning, and thank you for being here and joining me today. Before I begin, let me start with forward-looking disclosure statement. At Abbott, our mission is to help people live better lives, fuller lives through better health. We help keep your heart healthy, we help nourish your body, we help you feel better and move better, deliver medicines and information you need to best manage your health. We've done it for the last 135 years, improving people's health at all stages of life by tackling some of the world's most pressing healthcare challenges with our innovative suite of products and technologies.

We have an ambitious goal, and that is to help improve the lives of 3 billion people by 2030, and that's 50% more than where we are currently today. We aim to accomplish that goal by staying relentlessly focused on our vision and our mission to bring forward innovations that are more personal, more precise, more convenient, and more importantly, broadly accessible by more people around the world. Our origin story started back in the late 1800s with Dr. Wallace Abbott, building medicines with his own bare hands. As one of the pioneers in modern healthcare, we've consistently delivered breakthrough innovations in multiple areas of healthcare, and we've done it for generations.

In fact, we're one of the few one of the 49 companies that are part from the original Fortune 500 list, and today we are a global high-tech healthcare leader. We have over 115,000 Abbott colleagues around the world, helping people in over 160 countries, and we have a proven track record that's built from a portfolio of well-known, trusted brands that deliver annual sales of more than $40 billion and have doubled in the past 10 years. While the makeup of Abbott has changed over years, we've remained committed to a proven framework that has delivered long-term value for our Shareholders. That framework consists of balance, relevance, global presence, and performance. We're intentional about maintaining an appropriate balance across the portfolio, across the geography, across different types of payers.

We build leadership positions and businesses that are aligned with major healthcare trends and broader global economic environment to ensure that we remain relevant in our chosen markets. With more than half of our revenue coming from overseas, outside the United States, and a third of it coming from emerging markets, we are, without doubt, one of the most globally recognized healthcare companies in the world. That strategic framework has played a pivotal role in our financial performance. It serves as a platform to deliver sustainable top-tier growth for expanding margins, generate strong cash flows, and increase in return to our shareholders. That portfolio is comprised of a diversified set of market-leading businesses that span the Healthcare Spectrum, and those four businesses are medical devices, nutrition, diagnostics, and medicines. In medical devices, we have a market-leading positions in cardiovascular, neuromodulation, and Diabetes care.

In the cardiovascular care, which is one of the largest and most innovative areas of healthcare, we hold leadership positions in large, fast-growing segments, including cardiac rhythm management, heart failure, electrophysiology, structural heart, coronary, and peripheral vascular. In neuromodulation, we, which is using electrical stimulation to help treat people with chronic pain and movement disorders, we're a leader in that area. In Diabetes care, Abbott has had a long-established presence in Diabetes care. Our market-leading continuous glucose monitoring device, FreeStyle Libre, has fundamentally changed the management of Diabetes. In nutrition, we hold the number one and number two positions, market share positions in many countries, markets that we participate in, with a broad portfolio that addresses the unique nutrition needs for people of all ages.

In diagnostics, our comprehensive suite of systems and tests allow laboratories and hospitals to test for more conditions, more frequently and more efficiently than ever, while at the same time providing consumers themselves the opportunity to perform diagnostic tests at home, where they can easily get care, when and where they need it. Lastly, our medicines business, our established pharmaceuticals, offers high-quality branded generic pharmaceuticals to those living in emerging markets. 2023 was a pivotal year for us. We successfully transitioned back from the impacts of the pandemic, which temporarily distorted our performance for a few years. Given the COVID testing, a business that we built so quickly, and it became such a large part of the company. Today, that is no longer the case. Following the significant decline in demand for COVID testing.

Our core business, our base business, which excludes COVID testing, is once again the driving force of our success. The chart in the slide shows the performance of our core business, our sales momentum, and how it's been building over the last few years. This includes double-digit organic sales growth in each of the first three quarters of 2023. The strong performance has been driven by a combination of factors: market conditions, strong execution, and an acceleration of the contribution of our new products. As we look forward to 2024, we expect to continue delivering that sort of growth at a top-tier level. If you look at our pipeline, as I mentioned, this is an area where it's been, we've been highly, highly productive, and it reflects an excellent balance between iterative and transformational opportunities.

In our medicines and nutritional business, we continuously expand and refresh our portfolios with a very steady cadence of new products and line extensions. In diagnostics, the global rollout of our latest suite of diagnostic systems, called Alinity, continues to go very well and nicely complements our success in expanding our available test menus. Given the highly innovative nature of our medical device business, pipeline activity here remains at a high level at all times. I'm going to highlight a few of our medical device products that I expect, we expect, to contribute meaningful in terms of our growth in the near term. I'll start with FreeStyle Libre, which is our market-leading wearable glucose sensor, and that, like I said, has transformed the way Diabetes is managed, eliminating the need for finger sticks.

There are now more than 5 million users of Libre around the world, with 2 million in the United States. Our strategy was to target the mass market, and that has been extremely successful. The market needed a pain-free, highly accurate, easy-to-use, and cost-effective system, and Libre hit on all of those dimensions. Libre sales are now annualizing at more than $5 billion. But despite our success, there's still a lot of opportunity in this area. There are more than 500 million people with Diabetes worldwide, so we have just begun to scratch the surface, and there are several new growth opportunities for us on the horizon. Payers around the world increasingly recognize the value that Libre has for the patients, for the providers, and for the healthcare systems.

This recognition often comes in the form of expanded reimbursement coverage, providing greater access to Libre to a greater number of people. The most recent example of this is a developing trend to expand coverage to more people with Type 2 Diabetes, who rely primarily on taking basal insulin to treat their condition. This is a global trend, and CMS starting to offer this new coverage in the U.S. last year. Most U.S. commercial payers now offer this expanded coverage as well. Internationally, this broadened coverage is available in certain major markets, such as France and Japan, exclusively for Libre, and I expect this trend to continue internationally. Another growth opportunity comes from a recent development effort that now allows Libre to connect to automated insulin dosing pumps.

This new opportunity is a result of several collaboration agreements we have with leading insulin pump manufacturers, and this is an exciting new development for those who choose to receive their insulin through a wearable pump. And finally, we're taking this wearable technology and moving it beyond Diabetes and into the personalized consumer health market. Ultimately, we want this technology to be available to everybody. We recently completed a pilot launch in the United Kingdom to validate this go-to-market strategy. This strategy is based on a direct-to-consumer model that does not require a prescription and requires no involvement from insurance companies or other institutional payers due to the simple cash pay aspect of our offering. We call this product Lingo, and the early feedback from users has been very, very encouraging.

Users find Lingo to be engaging, enjoyable, educational, but more importantly, life-changing by helping them make positive lifestyle and behavior changes that improve the way they feel and perform throughout the day. We're excited about the opportunity to bring Lingo to the U.S. market soon. TriClip is the world's first minimally invasive clip-based repair device used for the treatment of Tricuspid Regurgitation or a leaky Tricuspid Heart Valve. Tricuspid Regurgitation is a disease that affects more than 5 million people globally, and unfortunately, prior to TriClip, lacked effective treatment options. TriClip has been available in Europe since 2020 and is currently being reviewed by the FDA for U.S. approval. AVEIR is our leadless or wireless pacemaker used for treating people with slow heart rhythms.

Unlike traditional pacemakers, AVEIR does not require an incision on the chest, and it also is the world's first leadless pacing system that offers dual-chamber pacing, which is the most common form of pacemaker treatment needed. We ultimately believe that this highly innovative technology has the ability to revolutionize this multi-billion-dollar pacing market. An overview of our capital allocation. We have a very balanced approach as we allocate capital. And this is an important area for us. We have a strong and consistently growing dividend, and that's an important part of our identity. Last month, we announced the 400th consecutive quarterly dividend payment, which has now increased 50% versus where it was in 2020.

We also make investments, capital investments, internal capital investments, such as capacity expansions, that are an important part of our strategy 'cause they sustain our future growth and generate an attractive return on investment. We also have a process for continually assessing opportunities for share repurchases and M&A opportunities, which we pursue when they make sense strategically. Our ability to execute this balanced approach is ultimately a result of our fortress balance sheet that we have built. Our cash position and debt ratios are at extremely healthy levels, which allow Abbott to achieve our multiple capital allocation objectives. And finally, the promise of AI and the promise of AI in healthcare, the obligatory AI slide, I guess. AI has been used in healthcare for decades in increasingly useful ways. But last year, we saw the interest level in AI reach a completely different level.

We've identified three areas where we believe AI will play a major role in healthcare. In diagnostics, AI will allow us to identify conditions earlier and more accurately. In fact, even potentially identifying conditions that we don't even know yet that we need to identify. We have access to vast data that can guide personalized care, giving physicians actionable insights for individuals. In treatment, AI will assist in the discovery of new therapeutics. Without a doubt, we hear a lot about that in today's conference. But also across medical devices, pharmaceuticals, and nutritional products, making the process much more efficient and predictable. AI can more rapidly explore hypothesis, examine alternatives, and play out scenarios, resulting in increased innovation.

AI also holds the power to empower consumers by allowing us to engage more deeply with the healthcare products that we use, which helps improve adherence to treatment, which then leads to better outcomes. We've been using AI for many years. We use AI in our Diagnostic Systems to help predict routine service requirements and enhance both the performance of the systems that run the tests. In medical devices, our portfolio of cardiovascular products includes technologies that monitor the health of your heart, adjust therapy based on the data, and in some cases, help predict potential Cardiac events. Our Ultreon Vascular imaging software uses AI to automatically detect calcium levels in the vessels to help guide physicians in making more accurate treatment decisions.

In our Diabetes business, we have access to more than 50 billion hours of glucose monitoring data, which provides visibility to broad population trends and helps us see how Libre is being used and the value it provides to our customers. We'll continue to explore ways to incorporate AI across our company in order to benefit our customers. With that, I'll conclude my presentation and take any questions.

Robbie Marcus
MedTech Analyst, JPMorgan

Well, great. Thanks, Robert. Maybe to kick it off in regards to Libre, you mentioned in the past that you felt Libre could achieve $10 billion in annual sales by 2028. There were a lot of good updates up there, but maybe talk about how you're feeling about those targets, and are they still achievable?

Robert Ford
Chairman and CEO, Abbott Laboratories

Sure. If you look at Libre, annualizing at roughly around $5 billion, I cannot think of any MedTech that has MedT ech product that has reached this level of success. Libre is definitely the most MedTech product in history, at least in terms of revenue. So we're very bullish about the opportunity that's ahead of us. I put a target of $10 billion by 2028. That equates to about 15% CAGR. Obviously, you know, we will shoot to do better than that, and we have been doing better than that. And it's really predicated on really a few different areas that we're focusing on.

I'd say first part of the strategy is to really look at the insulin user, especially the intensive insulin user or the pumper, and we've developed a suite of products that will help us gain share in that segment. We have a very low market share with that insulin pumper, and we've started our strategy to begin connecting our systems to insulin delivery pumps, but also starting to focus at how do we leapfrog that, and we've been public about the development of a dual analyte sensor that will measure both continuous Glucose and Ketones. The feedback that we've received from the KOL community regarding the availability of that sensor and the connection of that to a pump provides a lot of value to the users.

So we're doing a lot of work to be able to gain share in that segment. The second segment I talked a little bit about, which is the largest segment of the Diabetes space, which is the Type 2 basal population. And there, the penetration of CGM has been historically very low and traditionally been focused more on cash pay users. We've generated a lot of clinical data to be able to show the same benefits that somebody who's taking injections multiple times a day but is only taking one injection a day, that there's considerable benefit for that patient population, too. So you've started to see the clinical data have impact on reimbursement decisions, U.S., and several international countries.

We believe that has got tremendous opportunity for growth and tremendous impact for those patients that are living with Type 2 Diabetes. And then the third part of that growth strategy is to take the platform that we built in Diabetes and expand it out beyond Diabetes. And this is our strategy regarding Lingo. It benefits from the scale, the global presence, the capacity that we have, and now focusing on targeting people that actually are healthy. And that's not something that you hear a lot of Healthcare companies doing, which is targeting the healthy population so they can stay healthy, and that's what Lingo is intended to do.

So I think the combination of the execution across those three strategies will allow us to maintain, I guess, a similar trajectory or even an accelerated trajectory, for our Libre glucose platform, and moving it towards other areas. We're focusing on expanding also beyond glucose. Our first expansion there on a different analyte is measuring Beta-Hydroxybutyrate Ketone levels in the interstitial fluid. We also have several other programs, including a continuous lactate monitoring, and we'll start to talk a little bit about that as the research part of that product moves into more of a clinical stage. So we feel very confident in our ability to deliver that $10 billion by 2028. I'd like to go beyond that.

You know, I don't really think that this is a product that falls into the, you know, larger denominator, the percentage starts to go down. I think we can increase that denominator and keep a fairly healthy growth rate also.

Robbie Marcus
MedTech Analyst, JPMorgan

Great. Maybe, shifting around here, if I focus on the infant formula business. Back in early 2022, you had a recall. Over the course of the recovery on the earnings calls, you've given us updates on where you stand in terms of recovery back to, pre-recall levels. So wondering if you could give us an update today on market share and your view on, infant nutrition and Abbott's position in that market today?

Robert Ford
Chairman and CEO, Abbott Laboratories

Sure. Well, that was a difficult situation, and as a father myself, I cannot imagine how difficult that must have been for a lot of the families here in the country. I have been giving updates on a quarterly basis regarding our progress for market share recovery. I've included here the market share prior to the recall in the first quarter of 2022. And as you can see, the company has done a very good job at recovering the market share that was lost during the recall. That's a combination of utilizing our fairly extensive manufacturing network, not only here in the U.S., but around the world, to bring infant formula into the U.S.

But I think it also speaks to the trust that healthcare professionals, hospitals, and ultimately consumers have with our brand and with the company. I think the team has done a really strong job here. I think that we can continue to perform. It is an important market for us, but as I've said on our nutrition segment, we really affect nutrition across a broad spectrum, not only here in this country, but around the world, across all ages, infant, pediatric, and adult. So we'll continue to focus not only here on the recovery here in the U.S., but continue to drive innovation into our nutrition business.

You know, one of the things that we're looking at, I've been public about this also, is using our science-based nutrition, to address, or to at least help address some of the issues that, a lot of GLP-1 adult users face. As one of the side effects is muscle loss, we believe that we have an opportunity here to utilize our science, to be able to offset or, or partially mitigate some of those, some of those side effects.

Robbie Marcus
MedTech Analyst, JPMorgan

Got it. Moving on, Abbott has a diversified business model, and it puts you in a unique position. You've been able to, down the P&L on the operating margin line, sustain a profile that's in line or better than where it was before the pandemic, even with higher inflation and negative FX and so on. So maybe talk about how Abbott's been navigating the environment the last few years and the opportunity you see for future margin expansion opportunities.

Robert Ford
Chairman and CEO, Abbott Laboratories

Yeah, I mean, I think we all faced some challenges. A lot of companies faced some challenges during the pandemic. I'd say right now, our op margin profile is back to where it was pre-pandemic. I don't, I don't think a lot of our peers can say that. And we've done that through very disciplined drive in the top line and a good focus on our expenses and being effective and efficient with our investments. But one of the areas that we've had, and like I said, a lot of companies have had some challenges, and has been in the area of gross margin. You know, we've lost 200 basis points of gross margin versus where we were pre-pandemic.

And to the points that you've raised, Robbie, whether it's inflation and certain commodity input costs, freight and distribution, in our case, given our external and global presence, having some impact with the strengthening of the U.S. dollar. But this is definitely an area that we focus on a lot, and I think there's a lot of opportunity for us. We started to see as we're moving into the second half of last year, and as we go into 2024, opportunities that we have for margin expansion, specifically in the gross margin line. And this is really where me and the team have really focused a lot and will continue to focus a lot, especially during 2024. It's probably one of our top three areas of focus on.

So, we've got opportunities. We're seeing commodities come down, so that's good. Businesses like nutrition or some of our other businesses that rely on input costs, we're seeing those commodities come down. I think we've all seen freight and distribution costs normalize now. Allows us to, you know, especially with better inventory and inventory management, to move to, you know, whether it's, ocean, or just cheaper, more cost-effective ways of, of transporting our products. So those are all normalizing. Like I said, we have dedicated teams that are exclusively focused on, working on gross margin, gross margin improvements. They do this, you know, Monday through Friday, you know, every day. So those teams have all been revamped. And then favorable portfolio mix, right?

So as MedTech business, our medical device business, continues to outpace the growth of the total company, those parts of our business come with gross margin accretion versus the other parts of the business. So as that continues to accelerate, that will obviously help drive mix on the gross margin line, and we saw that during the last, you know, during 2023, at least first couple of quarters that we reported, an acceleration in the growth rate in our medical device businesses. So I think we've got a lot of focus. We've got a very sustainable top line, top tier, top line, and now the opportunity to work on the gross margin side.

I think one of the areas that also helped us was, I'd say, pricing, our ability to utilize pricing to offset some of those input costs, especially in our Consumer Businesses. On the Institutional Businesses, I think we've kinda held our prices, and as long as costs still remain elevated, even though inflation has come down, I don't see any reason for changes in that pricing strategy. So ultimately, a great opportunity here to focus on our COGS, and address and accelerate margin expansion through gross margin.

Robbie Marcus
MedTech Analyst, JPMorgan

Robert, if I think of the amount of cash you generated over the past several years, particularly on the back of COVID testing sales, you're now in the really enviable position with a nearly pristine balance sheet. So how do you plan to spend all that cash? Is it on M&A? Is it on share repurchase? Is it a mix? Is it Internal Investment? You know, what, what can we expect to see from Abbott with the cash pile?

Robert Ford
Chairman and CEO, Abbott Laboratories

I mean, I think if there's one kinda core principle on our capital allocation, it's not only a strong, but it is a growing dividend, right? And I think that's probably really at the core of our model. Outside of that, we're looking always at opportunities to best deploy the capital where there's a best return for our shareholders, both in the short term and long term. You know, you saw on the slide, during COVID, 2021 to 2023, we returned about $17 billion back to our shareholders in terms of dividends and buybacks, and it was appropriate for us to do that. We've got a process for looking at M&A. I get asked this quite a bit about, you know, what are we gonna do regarding M&A?

I feel that we're in a privileged position where our organic growth rate we can sustain our organic growth rate, you know, in those high single digits with the pipeline, with the organic pipeline, the opportunities we have in front of us. So I don't feel that, you know, we need to do M&A to be able to sustain, you know, our growth model, which is high single digits, you know, double digits, bottom line. So that puts us in a position to be a little bit more selective, a little bit more strategic. We made two acquisitions last year to augment our portfolio. But to your point, yeah, we're in a strategic position now where we can evaluate a lot of different opportunities. We've got plenty of firepower to do that.

And I think there's a lot of great opportunities out there, and we continue to study all of them. You know, we'll, you know, I never liked saying where the puck is gonna go. I know I get asked that a lot. You're not gonna hear me say where the puck is gonna go, but what you can know is that we're diligent. We believe we're stewards of the capital that belongs to our shareholders, and we're gonna make deals that, you know, make sense strategically and financially.

Robbie Marcus
MedTech Analyst, JPMorgan

Maybe just to, to stay on that topic, you know, think of four legs of the stool: established Pharmaceuticals, Diagnostics, Nutrition, and the Medical Device business. Is there one of those four areas that you think might be more right for M&A? Or on the flip side, one that might be, you know, one you might look to prune a bit from Abbott?

Robert Ford
Chairman and CEO, Abbott Laboratories

Yeah, it's a parent's heart. There's room for everybody. So if there's opportunity across all those four areas that make sense for us in that framework, Robbie, then we'll, we've got the capacity, and we'll pull the trigger. I have been public about, you know, where we've been looking. Diagnostics and devices are definitely areas that I would say provide great opportunities to be able to kind a augment our portfolio, add to our portfolio. We tend to look at both areas where we can Synergize, but we also tend to look at white space also. And I think there's great opportunities in those two areas. Now, that's not to say that we don't look at nutrition, we don't look at established pharmaceuticals.

Like I said, if there are opportunities, then we've got the capacity and the global presence to be able to pull the trigger and, and capitalize on those. But I, I've been pretty public about those first two areas as being areas that we're primarily focused on.

Robbie Marcus
MedTech Analyst, JPMorgan

I think everybody in the room is pretty familiar with Libre and continuous Glucose Management and what it's done for Abbott, both on the top and bottom line. If you exclude Libre from the discussion, what do you think are the next several big, key new product launches you're most excited about that in 2024, 2025, we might see impacting the top and bottom line for Abbott?

Robert Ford
Chairman and CEO, Abbott Laboratories

Yeah, I mean, I think on the Cardiovascular side, I'm very excited about TriClip and tricuspid. That's building a whole new segment. There's no real treatment options. Surgery is complicated and risky, and there's no real kind of Pharmaceutical Treatment to assist that, so we're excited about that. AVEIR, with our leadless pacemaker, I talked about that. I mean, I think that is a tremendous opportunity here to completely disrupt how it's been done. It really hasn't changed over the last 50 years. And leadless allows us to do that, and we're the only company that has a dual chamber, so two independent devices implanted in your heart, talking to each other on a continuous basis and delivering therapy, you know, in milliseconds.

So I think there's a tremendous opportunity here for us to really shape that market. I've talked a little bit about entering into the TAVR space. We've been investing there, so I think Navitor has shown that from a profile perspective and its clinical data, it can compete with the market leaders, and we're focusing over there for sure. And I showed on the slide, you know, whether it's the Glucose Ketone, whether it's a rapid test for concussion, for TBI, whether it's our nutritional supplement, whether it's a new Alinity System, Alinity and that we'll be launching also, I mean, we've got a nice kind a cadence, as I said, of products across all of the businesses that we're excited about.

And that's not to say that we need those. I mean, we're still in the early stages of growth. I mean, Libre, like I said, is still scratching the surface. Alinity, MitraClip, these are all products that still have a long runway of growth and penetration. So, we're excited about the products that are currently in the market, the ones we've just launched, and the ones that we're gonna be launching in the next couple of years.

Robbie Marcus
MedTech Analyst, JPMorgan

If I shift a little bit, again, very diversified business model. You touch consumers, you touch hospitals, you touch some other parts of healthcare. Across the medical device spectrum, we've seen pricing come to the top of the discussion, whereas historically, it was a -2%-3% for the group annually. Now, it's something less than that, and we're hearing from a lot of your competitors that maybe a new paradigm might be in place where less negative pricing. What's pricing overall for Abbott, and what's your view on what pricing might look like in the next few years?

Robert Ford
Chairman and CEO, Abbott Laboratories

Yeah, like historically, Abbott has really grown at that top tier level, 7%-8%, really through volume. We really haven't used price as a mechanism, one, because I think you have a little bit, historically, of friction there on the institutional side of the business. Throughout the last couple of years, I'd say, in certain parts of the business, prices contributed to the growth rate. On the device side, though, yeah, we've been able to be, I guess we'll use the term, less negative. But like I said in the comment there, you know, yeah, inflation has come down, but those costs aren't coming down. You know, those costs have gone up.

Unless there is a change in those costs coming down, you know, I don't foresee us returning to those kind of, let's say, pre-pandemic pricing dynamics in the institutional channel.

Robbie Marcus
MedTech Analyst, JPMorgan

Maybe just along those lines, you know, part of the equation, the health of the global hospital systems, that they're able to absorb, you know, new pricing dynamics. You know, what would you say, given your global look, the health of both the U.S. and outside U.S. Healthcare Systems are and their ability to pay for some of these new technologies that Abbott's bringing to market?

Robert Ford
Chairman and CEO, Abbott Laboratories

Yeah, I'd say, listen, every country deals with a very common challenge, which is a growing population, a growing elder population, and less resources, less funds, less people, less infrastructure to manage that. So we tend to focus a lot on how do we solve the problem of access? If all we're doing is bringing new technologies in and pricing at a level where we're kind a scratching the surface and Niching our Technologies, I think that's probably the paradigm from the past. The way we're thinking about it is, how do we use our technology to not only solve the medical and the clinical problem, but to actually solve what is an existential crisis in Healthcare, which is the access issue?

So a lot of the technology and the investment that we make and the technology that we're using is to find ways to, to bend the cost curve on the innovation, and then from there, be able to bring innovation that has an impact, to the population without necessarily needing to, you know, go out of, you know these budgets have to recognize that they're not gonna they're not elastic, they're not simply going to be able to grow. So I think a great example of that kind of thinking is Libre, where, you know, we priced the product, significantly lower than competitors, and all of a sudden, the entire market opened up, and it became less of a niche, and became more of a mainstream product. And we didn't do that by sacrificing profitability.

It's still probably one of our most profitable products in the company. So I think that's how we're thinking about, Robbie, is we actually have to solve two problems. Historically, it was just the clinical and the medical one. Now, we have to solve, together with that, the access and affordability issue, so.

Robbie Marcus
MedTech Analyst, JPMorgan

Great. Maybe with the last few minutes here, you've talked about acceleration from pre-COVID levels on the top line from about 7% to maybe something higher. Talked about operating margin expansion opportunities. Any thoughts you want to provide on 2024 and what we might be looking forward to from Abbott?

Robert Ford
Chairman and CEO, Abbott Laboratories

We'll give guidance in a couple of weeks, Robbie. What I would say is, you know, we worked during the pandemic to not only, you know, help society with our diagnostic pipeline and portfolio and get testing out there, but we also thought, Okay, how can we actually become stronger, bigger, better coming out of the pandemic? That's what we did. We invested. You know, we took a portions of those cash flows from COVID and invested in the business to ultimately be in a position where we'd be stronger. I think you saw that in first nine months of the year, last year, where our business grew double digits.

That was compared to where we were, like you said, prior to the pandemic, around 7%-8%. So I expect that momentum that we saw in the first nine months to continue. We'll report our Q4 in a couple of weeks, and I expect that momentum to continue, as we go into 2024. We'll definitely be, I'd say, growing faster than where we were prior to the pandemic. Looking forward to 2024.

Robbie Marcus
MedTech Analyst, JPMorgan

Great. We're out of time, Robert. Thanks a lot. Thanks, everyone, for joining today.

Robert Ford
Chairman and CEO, Abbott Laboratories

Thank you.

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