Introducing Chirag, who will be presenting today. Just a reminder, this presentation will be 20 minutes and five minutes Q&A at the end. Handing it to you.
Thank you very much. Good morning, everyone, and thank you for joining us. My team is here, CFO Tasos, our Head of IR, Tony, and we welcome you to Amneal's presentation. Lovely morning in London. It was a nice, brisk walk this morning, and weather is very nice. So let me tell you the fascinating story. Before we start, I'd like to introduce myself, Chirag Patel, Co-Founder, Co-CEO of Amneal. Along with my brother and father, we founded Amneal in 2002. We migrated to United States in 1987, studied there, worked hard, American story, American entrepreneurial spirit, entrepreneurial system, helping companies to be built if you work hard and stay to your course and take care of your people. And that's exactly what we did, and today we're proud to have built the fourth largest.
We call it affordable medicine company and destined to be number one in the United States, and I'll walk you through how we get there. That's my introduction. And my brother is younger than me, and we still work together. So let me see if this is. There you go. It's a little slow. All right. So I want to start out with the micro trends, which most of you are familiar with this. It is obviously a line for our industry, which is affordable medicines. You can call it generics, you can call it injectables, you can call it biosimilar, whatever you like. Our job is to provide access and affordability to the world's population. We play in United States mainly. Now we are venturing out to international markets.
So today, 99.9% of all our revenues are from the United States. In the U.S., the prescription need is unfortunately high. Like, 22% of the population take five plus Rx, TRx every day. We also play in the Parkinson's category, where we have a leading drug, which is one million patients every year, about 90,000 new diagnoses just in the United States. Europe even has probably bigger than one million PD patients. And, as you know, in the United States, 92% of prescriptions are filled by generic drugs, which is why this industry is here to stay. The U.S. generics business is a good business. I don't buy the argument that it is just not a good business. It is a good business if you can make it work.
Yes, it is competitive in tablets, capsules, but not competitive if you have a broader portfolio. Competitive, but not the level of tablets and capsules. It is essential. It's a recession-resilient business because everybody needs prescription, and it's growing. $141 billion of drugs coming off patent, and it is the largest market by far than any other country or entire EU. So U.S., we actually feel very fortunate to be the leading company in the U.S., and now coming to Europe and going to Middle East and Southeast Asia, China. As Amneal's value proposition is, all our products are obviously FDA- approved. It starts from U.S., some are manufactured in the United States as well, in Ireland, in India, so global manufacturing, and then those assets have more value internationally.
So let me walk you through on how the markets are shaping up in the United States. So this is large market, and companies like us is poised to grow because we play in all four of these segments. So let's start out with retail generics, where we are ranked number fourth, going to number three in value and volume both. So it's we are not a volume play. We're more of a value play with a large pipeline, seven different dosage forms. So technology platforms we have, and this is what providing the growth, that in even highly competitive times, we were able to grow. And that business is solid and now growing at more than low single digit. And I'll show you the growth we had.
Institutional injectables, which are, w e entered the market in 2016, and we're moving up the value chain. We're ranked number ninth in the nation in value, and we have invested heavily now, and I'll walk you through why we are so excited on injectable portfolio. And this is all United States number, and market's growing. So today is about $50 billion-$60 billion market be doubling in seven years. And biosimilars, that's where the biggest growth coming for the United States and also for Europe as well as other global markets. And biosimilars, it's not easy. You have to invest over time, and it is a large investment, and it is a competitive market. You have to have a commercial presence as well, unlike generics.
So, a lot of our competition from India and China are not there because of that reason. That leaves out only good eight to 10 competitors, and it's shrinking fast. Because of millions of dollars, it gets into billions of investment in manufacturing, R&D, and also have to take the risk of getting a regulatory approval. FDA's inspections are tough. We have gone over all those things over the last 10 years, have invested through our partner, in considerable investment to, now proudly say we have three launch products, and they're doing extremely well. And we also do commercial well, R&D well, and commercial well, and we captured 6% market share in our Avastin product within first six months, beating Pfizer. We're not afraid of competing in biosimilars. We are committed.
Somebody has to be committed and have to be nimble, and has to come up with a much more faster approvals than what it used to be, and cannot spend $200 million-$300 million. It should be now around, on average, about $100 million-$150 million development costs, and these are global costs. Markets will keep developing it. And specialty where we play, this is just our market, where we play in Parkinson's and endocrinology. That is also growing. So we're set. As markets grow, we grow, and we should be able to get a bigger chunk out of it. This is we are at a glance today. Highly diversified company than five years ago, and I'll show you the comparison, what we were able to do from 2019 to today.
As I mentioned, highly productive R&D engine. Manufacturing, one of the robust manufacturing plants, and most proud we are is our quality track record. Over 100 FDA inspections, over 18 years now, 20 years, and never had any, I mean, any warning letters, any official action indicated, and we proudly, I mean, we're so proud that we created that culture. That is what we believe in. It doesn't happen just by systems or technology. It happens by culture, and it starts from the top, that we take the medicine business absolutely seriously. My father is an industrial pharmacist, brother is an industrial pharmacist. My mother takes, unfortunately, five certain prescriptions. She only takes Amneal's prescription. So we see this as a, the family's taking the medicine, so how can we not have the best quality?
At any cost, we'll be number one in quality. The growth has been sustainable and now very well diversified. As you can see, we just upgraded the guidance, $2.4 billion in revenue for this year, approximately $540 million-$550 million EBITDA, so it's handsome EBITDA numbers. After investing almost $170 million in R&D. So this is not, we're showing you. We're not. We are investing more than the competitors and still making good EBITDA, because that is the reason. If we don't invest, we don't have great pipeline. And then operating cash flow is great, and it's getting better. And our CFO is here, can answer more questions. Our net leverage today is 4.6x. Our goal is below 4x and then go even below 3x.
Here is just what we have done in last several years, and it's in a highly competitive time, we were still able to grow our business. You can see how it's diversifying. You got the base business, which was $1.2 billion. It did not go to zero. That's what they talk about U.S. generics, that everything can go to low base. It doesn't. Actually, we grew our base business from last year to this year, 2022 to 2023. Because of, there's so much of shortages, so many shortages, so many companies getting into FDA issues, so we were able to grow and pick up volume. Of course, pricing pressures are there, but we're able to grow with volume on a base business. We introduced new products, which are almost now $600 million, and every year we're launching 30 new products.
So it's quite a great pipeline that is keep churning. And then distribution business, which is a value add value-added distribution, is growing, and I'll walk you through that, and, specialty business is growing. And international will add another bar in the future years coming up. And EBITDA, we invested in commercial infrastructure as well as R&D, and it's still growing, and it. Now we expect a high single-digit growth. Here's. Let me walk you through each of these segments. So generics, we also call it affordable medicines. We're trying to change the name to, for whole industry to start calling affordable medicines. When you, when you say, "What do you do?" In, in the plane with some stranger and you say, "We do generic drugs," it doesn't go well.
They're like: "Okay, is it good quality?" That's the first question comes back. The minute, and I've been testing this, the minute you say, "We're in the business of making affordable medicines." "Oh, wow! Great business. Great." So why not call affordable medicines rather than generics? Anyway, so retail is growing, as I said. The injectables, a lot of growth coming in because of 19 production lines, five manufacturing sites, ability to do microsphere peptides. We filed all the electrolytes bags and the cancer shortage products, so we're very, w e're a U.S. company, we're going to take care of U.S. So we're working to alleviate as many shortages as we can, and that, and then biosimilar is on top of it. So this segment now grows high single digit or even more because of these different catalysts.
If you look at our oral solid business, $637 million. That is where the irresponsible competitors, which should not be selling their drugs at penny a pill. Even FDA commissioner says, "You cannot do it, it's unsustainable, and you do not need to do it." So I hope they sober up, and otherwise, they cannot be in the business. You cannot make pharmaceutical products for penny a pill or a dollar a vial. It is unsustainable, and industry is changing. Hopefully, it changes for good. And government is with us, actually, because it's as you know, United States, they let the buyers consolidate big time, and three buyers buy 90% of the pharmaceutical products, and there are many sellers. So, we've been having great dialogues with the buyers as well to be strategic.
We're not. We refuse to sell at penny a pill or a dollar a vial. We're not gonna do it because we have a responsibility to sustain the markets. So this is going to grow. Let's say the specialty, IPX203, we're very excited. That's our new PD product, which is completely different formulation. Provides longer good on time, which if you, by any chance, have friends or family who have Parkinson's, they have to get by every day. And it's the only gold standard is CD/LD. Unfortunately, in Europe, the extended version is not available. We're working with our partner to bring it to Europe as well, and we expect the approval in second half next year.
We just have to perform a routine QT study, which has been happening, which is being under study is underway, and we should be able to file in first refile it in the first quarter. That was one FDA question. And then we have DHE auto injector, which is in a cluster headache, which is again emergency conditions that the it's a, it's a pain level is nine out of 10 for cluster headaches. So if you have something at home, auto injector, boom! You, you like, it's epinephrine kind of injection, rather than going to the emergency clinic three hours, having that cluster headache. They bang their head on the wall. It's that unbearable. And then we have a few other pipeline assets. This business, we love.
High contribution, almost 50%, and we would love to keep growing. We got distribution business. This is not a typical distribution business. We do not compete with McKesson, ABC, or Cardinal. We can't. They're so big. This is VA/DoD, so it's value-added. VA/DoD requires either made in America or TAA-compliant countries. So very few companies, due to the cost pressures, are remained in the United States. Allows Amneal having still three big plants to produce many products for our own VA/DoD. And we appreciate that somebody cares about made in U.S.A. And so that's our biggest pie of this business and growing because the population is aging within VA/DoD, so they're using more prescriptions, so demand is growing. Distribution, the 340B is not a big business for us.
Unit dose is growing. It's now run rating around $60 million-$70 million per year, and it's growing. We do unit dose distribution in hospitals. So this is a good business. We doubled it since we acquired, and we're gonna keep growing. And here's how I sum it up with everything, as we are calling the first segment as affordable medicines, $1.5 billion today, high single-digit growth, and we see this growth coming for many years, so not one or two years. This keeping in account all the competition that comes in every year. On top of that, we are growing, and also by continue to do the investments. Specialty, we reach comfortably 500+ or even more, and as we say, our investments will go in specialty and biosimilars. And AvKARE is growing beautifully.
Here, I want to, on a last slide, I want to focus on how we are focused on four priorities, right? So we have, and if you see in 2019, our OSD was 53% of total business. Today, 26%. In few years, it will be down to only below 20%. The financial performance revenue 2019, $1.6 billion, $2.4 billion. That's in during COVID time, during the massive competition, which is a little bit reduced now or, or it's good amount has been reduced in America. It's, we still grew, and, and we have completely differentiated portfolio, and we expect that to keep growing. EBITDA grew handsomely, and now we see even more acceleration in EBITDA. Cash generation is excellent, and more EBITDA to cash generation is even growing higher.
So, that is we're gonna keep working at it and then delevering by paying off debt, as well as, increasing EBITDA. So we see ourselves going below 4x, and then our goal is to below 3x at some point, and with this, we are well set. If you compare this chart from now to 2026, 2027, you see the revenue growth, which will be coming from the biosimilars, specialty, injectables, inhalation, international market. So it's strong, and EBITDA should improve from 23% to 25%+, because all these are high-margin business. And cash generation would be higher as we would have paid off debt, our free cash flow would be high. With that, there are a few slides in the back just to the journey.
At your leisure, you can walk through how we constantly innovate and do a lot of organic investment. So we're very bullish on our different platforms and constant innovation. So we don't sit and otherwise, we can't become a number one affordable medicine company in the United States. And we're in a great position because Sandoz is focusing on biosimilars only. Teva has a brand and less focus on GX. Viatris is out of GX business mostly. That leaves us and Indian companies. So we're way ahead for the U.S. market than Indian companies. And this is our footprint where we operate out of it and beautiful plants. We made all the new plants in India. And this is what we are doing internationally.
I didn't touch upon quickly is that India, we launch our label directly, and rest of the continents, we are partnering, and we already have signed the partnership. China, we got two products approved already. Our partner, Fosun Pharma, they're also a strategic investor in the company. And the other markets will start producing revenue.
Okay, now Q&A. I must give five minutes for Q&A. Thank you, and there's a bunch of products coming, so you can see we're not relying on any one product. Thank you very much. Okay.
Thank you, Chirag. We'll now take questions from the floor. Does anyone have any questions?
Hi, Chirag. Morning. Dan Nathan from Parsity Group. Really good to hear you.
Yeah.
Love the presentation. So you talked about the eroding of the biosimilars market shrinking. I think we see similar forecasts as well. You talked about Amneal being very good commercially as well. Is the plan to build a commercial front end in Europe for biosimilars, or will you go down the, the partner route?
Don't know that yet. The U.S., we have built it, so a natural step would be to building it in Europe.
Yeah.
Because I think the two margins will struggle in the long run.
Yeah. Thank you.
Thanks.
You mentioned in the U.S. that three buyers are responsible for 90% of the market. In terms of your suppliers, where do you think you have the greatest leverage to reduce cost? Is it in manufacturing of automated manufacturing? Is it in APIs? Is it in something else?
Yes. So we constantly work on reduction of cost. So API, we negotiate. As pressure comes to us, we try to negotiate with API vendors as well. Many times, they're good partners over the years. They do cooperate if they have space to go down, but we don't want to also have them do it at a very thin margin, right? Everybody has to have efficient margins. Then we did a proper allocation of where the products are made. So whatever the competitive products we were facing competition from India, now we manufacture pretty much all of them in India. So it's apples to apples with Indian competitors. We can be right there.
We constantly work on automation, so that really on the packaging lines or whether it's in the production lines, so that also gives us a better cost. We have maintained our margin. Hasn't gone up, but generics to have 42% in United States. I know some of my colleagues are sitting here from our other companies, but it's highest probably in generics alone. And it will grow because of our diversified portfolio. When you add biosimilars, injectables, it, the margin should grow. Yeah. We still have a minute and a half. We're not gonna force everyone to stay for 1 minute and 35 seconds. Oh, okay. Well, thank you very much. Really greatly appreciate you joining, and have a great day.