I see the back of the right side on stage, BofA, and we have Joel Grade, EVP and CFO, and Clare Trachtman, who everybody knows too. I guess, head of investor relations, right?
Yeah.
Official title?
Yeah, sure.
I guess just to start out, there was some news this morning about Saudi investing $5.8 billion in Michigan for a high-capacity IV fluid facility. I just wanted to bring that up first and kind of get your take on that.
I'd say take number one is good luck with economics on that. Number one. I guess number two, this is something obviously going to take a number of years to build. A lot to learn there is, I guess, the way I'd say it. I mean, obviously, we've had competitors that have actually tried to build plants. That's probably enough to 10 years ago, I'd say, that are still trying to get it figured out. Again, more to come, obviously. We'll have to understand more about what that looks like as it evolves. At this point, that's really nothing else to say, I would say, other than, again, that's a tough economic thing because I can tell you when you're at the price that you sell the IV bags at, that level of investment is hard to get your head around.
The only other thing I would mention too is, obviously, as you're aware, we did just re-sign our GPO contracts that are multi-year contracts in length. Obviously, there's limited ability for anyone to come in kind of within the next three to five years in two-thirds of the business. Our next one's up for renewal in, obviously, negotiations in 2026 for implementation in 2027. Again, from the time it takes, just looking at previous investments in capacity and IV capacity, it's at least three years before they're even up and running and likely longer. It's probably even closer to three to five years where they're at.
Okay. Super helpful. Maybe just to kind of start out, you kind of think about Baxter's a little bit at this transition period, just had basically the portfolio transformation, CEO change. Where do you see Baxter at kind of now? Where's the benefits of the last transformation going to show up kind of going forward?
Yeah. I'd say in a number of different areas. I would start with what I always pegged as the real strategic reason for actually selling kidney to begin with. That really starts with our capital allocation. That business, when it was within our company, number one, it was about half the return on invested capital that the entire company was. It was very capital-intensive, required a lot of cash, and ultimately went to projects that did not generate the returns that we would like them to have. The ability to prioritize and focus investments for both companies, frankly, but specifically now for Baxter, in terms of those areas that are actually going to drive higher growth, higher returns, is certainly one of the really key elements of that. You've heard us talking about that really as kind of come out of this.
I'd say the second part is just what I'm going to refer to as general simplification of our company. I'm certainly not going to go all the way to us being simple. The reality of it is that there were a lot of things that were very intertwined between the kidney business and particularly our solutions business. That kind of disentanglement allows for a lot cleaner view on our three vertical segments that have a very much clearer kind of end-to-end. Our ability to execute more efficiently. I'll give you just an example of what does that look like. Our distribution network with kidney was there's a big part of that business that was actually home deliveries. The last mile was very expensive. It was also very complicated.
We had up to, let's call it, close to 50 distribution centers in the United States. The post-Baxter world in that is going to require substantially fewer distribution centers, allowing us to have, again, fewer roofs, therefore less expense, better management of our ability to move inventory around, etc., etc. I'd say the simplification part is really the second one. I would just say third, again, as we now head into a world where it actually allowed us to pay down a large part of the debt that remained on our balance sheet, by the end of this year, we're targeting three times net debt to EBITDA leverage.
That now allows us then to really refocus our kind of, I'll call it, capital allocation at a macro level that both focuses on our organic investments, again, our R&D spend, but also the opportunity over time for Folden, Tucker, and M&A deals, the ability to restart a buyback program that both gives us a one-time opportunity to kind of, I guess I'll say, recapture some of the dilution that occurred over the last few years where we haven't bought stock back, but also have a regular program in place. That is really the third part that allows us to really reset that. More innovative, faster growth, more nimble, and really to actually have a really effective capital allocation strategy.
Where do things stand on the CEO search?
Continued good progress. I think our board is running a very, again, I'll say, thoughtful, diligent, but also expedient process. I'd say it's progressing well. I have a lot of high degree of confidence we're ultimately going to get the right person for the job.
What's the board kind of characteristics the board's looking for? How are they evaluating kind of internal versus external candidates in terms of kind of big picture?
Yeah. Yeah. I think if I had to summarize the characteristic they're looking for, it's somebody that can drive a culture of innovation, a culture of operational excellence into the organization. I think ultimately that's consistent with how we just think about the company going forward. I would say it's a balanced perspective between considering candidates internally and from the outside.
Okay. Did want to kind of move towards the Q1 results that you just reported. There was 5% growth in the quarter. You called out 150 basis points of kind of one-time thing, so 3.5% underlying. How did the quarter shape up versus expectations? How are you thinking about the pull forward from Q2? Maybe remind us exactly what that was and why it was pulled forward and confidence that it was really pulled forward.
Yeah. I can start with a couple of things. Number one, I think there are a number of things that went really well in the first quarter. I'm going to start with HST. I haven't had the opportunity to do that that often, so I'm going to today. That business actually had a strong first quarter. Obviously, they had some favorable comparisons, but they also had a couple of things going for it. Number one, the CCS business actually had a 7% growth in the quarter. PSS US had 14% growth. Our capital orders, whether we talked about a strong order book as we headed into the latter part of the end of last year and into this year, we saw the results of that. That continues to remain strong. I think in a really solid place. Balanced with that, our FLC grew 5%.
Again, we had a nice balance between the two. I think you see some stabilization in the primary care markets. Those are all positives. The Novum pump continues to demand for Novum continues to remain strong. On the MPT side, which also grew 6%, was, again, continued source of strong growth there. What you are referring to as a pull forward was some of our distributors on the MPT side actually, I would say, started to restock themselves. That was something that, say, happened a little earlier than anticipated. That was some of the impact that you are referring to in Q1. Those things all offset, I would say, some of the softness you saw with some of the conservation, as well as a bit of softness, particularly in compounding on the pharma side. That is a little bit of a summary.
The one thing I would point out, though, is that even as you refer to the pull forward, again, primarily related to MPT distributor restocking, the first half of the year remains very consistent with how we had anticipated it playing out. While there was a bit of a pull forward there, and we've had some questions at our Q2 guidance, which I'm sure you'll get to, that H1 is something that is very consistent with how we anticipated it playing out.
Yeah. Do you have anything to add?
No, I think that part of that was exactly right. Yes.
Yeah, the follow-up is, I think the Q2 guide kind of surprised some people because three and a half this quarter and guiding to one to two in Q2. What was kind of the big reason for that one to two in Q2 and how much of that's conservatism kind of built in?
Yeah. I mean, I would say a couple of things there. I mean, number one, Q2 was always anticipated to be our lowest quarter, and particularly as we anticipated some of the conservation from fluids actually kicking in there. We have got some of that built into this forecast. I would say we also, I think, took a, I'd say, degree of conservatism as it relates to HST. We continue to, again, feel good about that. Obviously, as we sort of built that into the continued full year guidance for them and as well as in the second quarter, we need to be conservative as it relates to that. Finally, the pull forward piece, again, that certainly did impact as we just talked about the second quarter relative to the first. Again, just to reiterate, H1 is consistent with how we anticipated.
Yeah. I mean, I think from a comp perspective too, but kind of to your point, Q2 of last year was our highest growth for the year. We knew coming into that Q1, obviously, given HST was a little bit lower. There is that comp issue as well. I think going back to this first half, as we looked at it, it basically was in line with where we were at. I think that we knew there would have to be a distributor build because of what happened in the fourth quarter with Hurricane Helene and distributors obviously depleted their inventory. The timing of that did shift. In general, one of the things we did was held that conservation in the second quarter, as we talked about on our earnings call. We do expect to remove the allocations this month.
That is our plan, is to remove the allocations, which we do think will likely lead to some accelerated purchases. We just did not build any of that in. We kind of just said, "Let's hold to the conservation level we saw in the first quarter. Let's remain that." We did, as you heard Heather say on the call, we expected to wane over the course of the year, but actually, we're keeping that conservation, a level of conservation throughout the year, somewhat in line with what we saw during Hurricane Maria. We are kind of taking, obviously, the lessons learned from Hurricane Maria and knowing that it does take some time for those, I'd say, practices to return to their normal levels.
I just want to make sure it's clear to everybody too, just to maybe explain the IV. There was a shortage with the hurricane back last year. Hospitals have changed practices. You're using less IV solution. Now the IV is coming back. It's not like they're going to go back to old practices right away. I think that's with the conservation that you're talking about here.
We had to incur. When the hurricane happened, obviously, Baxter is a key supplier for IV solutions in the United States, and it is our largest facility. We actually had to encourage our hospital customers, kind of some efforts to conserve fluids. One of the things, one of the methods they can use is oral rehydration, which in essence involves taking Gatorade. That is something we will look at as well because once we go off allocation, we can actually go to our customers and just educate them that at times the cost of that Gatorade bottle is actually more expensive, actually a lot more expensive than just the IV bag. You are not necessarily seeing that.
Because we were on allocation, we did not want to go to the customers encouraging that because we wanted to ensure that we had healthy supply to go back to them prior to obviously engaging with that. Once we go off this month, we will start those discussions with them on that. Now that we are back to, and again, as we talked about, our North Carolina facility is back to pre-hurricane production. We are back fully operational there and obviously we will be in a position to remove those allocations here shortly.
When you saw the last hurricane, I think it was Helene, not Helene, Maria. Sorry. How long did it take customers to kind of get back to normal?
Great question. It was about a year. It was about a year that it took for customers to get back to that. I think, and I do not know if you recall, but we actually, if you go back and look at it, we had assumed that it would come back a little quicker, but it did take some time to. After about a year, we were back to just normal practices after that.
One question that comes up a lot is how are you sure it's utilization and conservation and not share loss at this point?
Yeah. What I would say on that is, one, we do obviously track our end user data. We get it. We either sell direct to a hospital or they will go through the distributors. The distributors give us the tracing data. One of the things that did happen, obviously, after the hurricane was we actually tried to pull all the inventory back in so that we could better manage it from an allocation perspective. Excuse me. We knew that distributors would need to rebuild those inventory levels. That is what we are seeing. It is just this natural rebuild, but we do have the end user data.
Now, the one thing I do want to go back to is, and this is where it can get a little confusing, so I'm going to try not to, but as we went through our GPO renegotiations that we just talked about earlier, we did assume that we would see some share shifts as a result of that. Nothing to do with the hurricane, but more just in general, obviously, given this is a long-term agreement, we were taking some price increases. Those, as we've talked about, were in line with what we were thinking. Actually, I think we ended up better than what we had thought we would be from a pricing perspective on that.
That's helpful. I guess in some sense that the restock that you saw in Q1 might actually continue, right? If there's the ability for this to actually go better than expected in Q2 again.
Yeah. One of the things we did see was the hospitals. Some hospitals operate more on just a just-in-time type inventory. Some hospitals actually do keep a level of safety stock. Those hospitals fared much better. We have had outreach from hospitals looking at potentially keeping and holding more inventory. That's not built into our forecast right now, but that's something we will look at as we go over the course of the year as well.
Yeah. I think that ties a little bit directly to the allocation piece that Clare talked about earlier, as we called out in our call that actually we're going to release our really full, no more allocations essentially in the month of May. I think that we'll see a little bit how that's going to play out once our allocation is.
That's a great point because they can only order up to basically 100% of their historical practices. They do not have ability to actually build any inventory at this point. They are limited and capped on what they can do.
They'll get a letter and say, "Hey, you're able to order it.
Exactly. The allocation's been removed, and then they can say 120%. So their order can go through at like 120 or whatever they want to order at. Yes.
Okay. Helpful. Maybe switching gears to tariffs. You guys did a good job offsetting it. I think that was a surprise to some of us. Good job at that, the $60-70 million in 2025. Now we've had some news on China, the rates going down. How do you think about the impact of the China trade negotiations over the last weekend?
Yeah. I can start and Clare can chime in there. I mean, so one of the things we talked about was that China was actually about half of our exposure. I mean, initially, when we started talking about tariffs, before all this went in, we said it was a fairly minor part of our ecosystem. Then the tariff obviously escalated to where it escalated to, and then all of a sudden it became basically half our issue. I mean, certainly, it's one of those things. Again, it's a 90 days. We'll see kind of how this thing plays out. It does have a, I'd say, a relatively disproportionate impact in a positive way in the event that that does shift permanently. We'll see how it goes. I mean, certainly, like I said, it's about a half our issue at this point.
Yeah. If you do the math, that's $35 million is China and adjust for the rates, probably a $15-plus million benefit just that alone this year. How do you think about the ability to let some of that flow through versus reinvest in some of the offsets that you had?
Yeah. I mean, if you recall in the last, certainly for our last call, we moved the range. We got a 16.5% OI. We moved that down to 16% again. There is certainly maybe some element of movement within that range as a result of that. At the same time, I think also part of the work that we were doing to offset potential tariffs was really tied to also the work that we are doing on cost savings related to the stranded costs that we had that obviously were left with the kidney care. I think I would say it is some combination of that would be the way I would like to think about that. I think that there is still work we need to do to eliminate costs, again, unrelated to the tariff that obviously factors into that. There is probably some of both.
Okay. How are you thinking about the pharma tariffs at this point?
Again, I'll start here. I would say number one, still a little bit to be determined, but I would say we feel pretty good about how we're set up for those and for a couple of different reasons. One, the majority, a large part, I'll say, of what constitutes pharma in our world is actually manufactured in the United States or in Puerto Rico. And generally speaking, kind of manufactured where it's sold. There is some element of it that obviously is not. I think what we're doing, kind of in the spirit of what can we do about it, the same way that we've thought about some of the other opportunities for what we need to do for tariff impacts, thinking about what opportunities we may have from a pricing standpoint, very targeted, but a pricing standpoint in that way.
Thinking about supply chain opportunities with direct shipments versus shipping freight lanes that may go through a country that has tariffs, figuring out how to be able to move if there are opportunities to move production or move product into our country or into maybe from, again, from Costa Rica to Puerto Rico, for example. Those are the kind of proactive things, obviously, in addition to certainly working with our industry association on that. Again, generally speaking, I think we're decently positioned for it. To be clear, we have not factored in tariff impact from pharma into any of the conversations we've had. Is there anything you'd add?
Two things I wanted to add. One, to circle back to, I was thinking about the savings that we would have this year. Partly, I did want to make it clear, though, because you showed references earlier about innovation, like of things that were like, innovation is very critical for us. We recognize that is the lifeblood to drive accelerated growth. We have not lowered our R&D investments at all. If anything, we actually increased them this year. That was not one of the offsets we looked at. We actually still held the guidance range with actually meaningfully increasing our R&D relative to what we had originally expected there. On the pharma tariffs, I mean, I think pretty much we feel pretty well positioned with that.
The reality is that with the timing of it, the impact in 2025 would likely be pretty immaterial just from a perspective of when they actually would get implemented to when the inventory would roll and things like that. We would not expect a significant impact in 2025, but it is something we will have to continue to look for for 2026. Just so everyone understands, I think we hear pharmaceuticals. Our pharmaceuticals are typically obviously generic pharmaceuticals. It is slightly different. Most of those are specialty injectables. Business is manufactured a lot. We do a lot of that in Round Lake, Illinois. We do have a good facility there for a lot of our antibiotics and anti-infectives within Round Lake, Illinois. I mean, we will have to look at things with respect to it, but we feel pretty well positioned with that.
Actually, I just add one thing. Clare, you've often made an interesting point on also the fact that the majority of our business in that area is premix. And many of those products are actually premixed, if you will, for lack of a better word, again, in this country. We do not do nearly as much of vials that actually come from outside the U.S. I guess that's just one other aspect of our business that why we say, "Hey, we're fairly well positioned for that." That's just one other part that I would add.
Yeah. On margins, this year, you raised the guidance to 16.5% this year. How should we think about the cadence on Q2, like front half, second half, and margins? Anything to kind of call out for us to be aware of, puts and takes? I know there's a lot of moving parts with TSAs and MSAs and tariffs. I know this picture street models kind of get in the right place from a cadence perspective this year.
Yeah. I'll start it again. Clare can certainly chime in. A couple of things just to remember. I know this isn't your question. I'm going to say something here and I'll get back to your point. I mean, obviously, remember the one thing in Q4, we do have the easier comparison, if you will, with what happened in North Covid. There is a lot of just kind of general impact out of that that happens in Q4. From a margin standpoint, though, I think there are a couple of things. I mean, one, we called out the fact that our MSAs are coming a little bit lower than we'd anticipated, which obviously the MSAs themselves have a dilutive effect on gross margin. There is a little less effect on that.
On the flip side of it, our TSAs are actually coming in somewhat higher than we had anticipated. The way that manifests itself in our is that we do obviously get the TSA income or revenue, but it does not sit. Some of the expenses sit in a number of different lines of our company. Some of those sit in our SG&A. Some of them actually sit in our COG. Because of the fact that we are providing more services, we get more TSA income, but it does not always directly offset. Some of what you are seeing from a gross margin impact is actually somewhat impacted by this phenomenon as it relates to the TSA income. A couple of just key points there.
I mean, I think generally speaking, we do anticipate our margins to continue to pick up over the course of the year, that the second part, the second remaining part of the year is higher than it was in Q1. Other things you might.
Yeah. I mean, I think from a gross margin perspective, what I would say is I would expect the first half and second half to be fairly similar to each other because the impact of the tariffs, and obviously something we'll look at, but that impact of the tariffs will be primarily felt in the second half of the year. It would lower that. Now, we would expect, though, our OPEX to come down. We'd have nice leverage in the back half, which will drive a lot of that operating margin expansion. Every quarter, we should see that sequential step up in operating margin going forward.
Yeah. Some of that is leverage on growth. I'm sorry. Some of that's leverage on growth. Some of it's also some of the programs, the cost reduction programs that we've had in place related to the stranded cost. We talked about we anticipate that, obviously, taking it over the course of the year.
Q2 margins above Q1, Q3 above Q2.
You got it. That is more about ending the year at the highest.
Yeah. It seems to be kind of a positive sign for the go-forward margin expansion of this company kind of longer term. How are you still thinking about the opportunity to keep on the margin progress here? I don't know how much that's driven by stranded costs versus other cost savings initiatives kind of as you move forward kind of post-2025.
Yeah. It's really all those things. I mean, I think about number one, just to say it clearly, we do have a continued opportunity to expand our margins. As we think about the growth of this company, it's both growing, accelerating our growth on top, but also doing so in a way that continues to expand margins. I would think about that in a number of different categories. I would think about it, number one, you just kind of said it, that we anticipate continued leverage as our cost structure continues to, again, set based on the stranded cost work we're doing, both the cost takeout itself, but also the leverage on what we'll call the fixed portion of our cost continues to get better, which will drive operating margin. We continue to focus on mix.
It's one of the things we talk about a lot in our company is our mix of products, our mix of business, our mix of categories. As HST continues to evolve, as advanced surgery, as our injectables, these different areas of our business that are actually positive from a mix perspective, you'll also recall we've exited IV solutions in China, for example. Those are examples of things where we are thoughtfully and strategically exiting lower margin businesses that will ultimately, again, drive a positive. Our ISC, we continue to have opportunities within our supply chain related to margin improvement programs, things where we ultimately continue to implement these programs that impact our overall margins.
Then, as you said, the stranded cost work, again, our TSA income obviously will remain for a while, but as we go along, we are also continuing to do work that is already in flight on some of the cost reduction measures that ultimately reset our cost structure. Clare made a really important point. I just want to reinforce it. These programs I am talking about are not in any way incongruent with our desire to actually drive R&D costs and drive innovation. We will remain, we will continue to invest. We will continue to drive innovation. Based on the work that we need to do to eliminate stranded costs, we will continue to do that as well.
Still a path back to kind of the 19% plus operating margins for this business?
Yeah. The way I've always tried to frame this question up, I've been asked in a number of ways on this, is that is there something structural about our company that would not allow us to get back to that place in my overtime? And my answer is there's not. There's not something that would prevent us from doing that.
What if we move back into an inflationary environment at a point where we had a secondary inflation? How is Baxter better positioned at this point to mitigate inflation versus kind of where it was before?
Yeah. I think one of the biggest things is as part of the renegotiation of the GPO agreements, unlike where we were back in 2022, where we really did not have a lot of ability to move, we do have actually clauses and indices in the contracts that actually allow us to take, again, if certain costs go up higher, we have the ability to pass some of those costs along, as well as just, I will call, a broader range of opportunities within general cost increases on a year-over-year basis to take price.
I mean, the business is significantly streamlined as well post-Vantive. Vantive had a heavy logistical, and so that added a lot of cost during that time period as well. Not having that infrastructure definitely positions us better.
Yeah. It's actually interesting from a fuel perspective. One time fuel costs would go up, that part of the business had a much bigger impact.
I remember doing that math.
Yeah. Me too.
Every day.
Yeah.
Before we end here, I just wanted to ask on the 4-5% revenue growth, kind of the building blocks there. Some people are sometimes kind of surprised how Baxter's a 4-5% growth company and you've been putting it up. I want to just get kind of the durability of the top line here in your mind and we'll end.
I think it starts with what you've heard from us about new product development. I think one of the things that you're going to hear more and more from us is a consistent opportunity to grow and develop new products. I think, again, focusing on these categories and in these markets that are actually growing at a faster rate. I would just tell you, on top of that is, again, as we talked about the cap allocation earlier, over time, and this is really the four to five is really the base, but being able to actually work in hold and tuck and acquisitions as part of our growth strategy in those areas where we think it's better to build versus buy in space like that. Not large transformational deals, hold and tuck and opportunities that really supplement that.
I think there's, again, I feel very confident about our path.
Awesome. Great. Thanks a lot. I think we're out of time.
Thank you.
All right. Thank you.
Thank you.
Thank you.