All right. Good morning, everyone. Very happy to start our, I think, our next session, which features management from Baxter, Joel Grade, Executive Vice President and Chief Financial Officer, and Clare Trachtman, Senior Vice President and Chief Investor Relations Officer. As I said in all these sessions, happy to open it up to questions from those participating in the audience. If you do have a question, please just raise your hand, and we'll get a mic over to you so people on the webcast can hear that interaction. Maybe we'll start with, I think we've done a lot of questions about CEO search. Maybe give us an update on how that's progressing and any clarity that you're able to provide with respect to timelines.
Yeah. First of all, good morning, everyone. Thanks for your interest in Baxter. Yeah, David, nothing really new to report other than I would say we're continuing to make good progress on the search. I think the board's doing a very diligent process and balancing both being expeditious from a timing standpoint, but also making sure they're taking the right amount of time to get the right person. Nothing really new to report other than, again, I feel comfortable with the progress they're making and look forward to reporting something when we can report.
I think the only other question to ask is on the fourth quarter call when Brent participated, I think he made a comment that was really what we're looking for is consistent, reliable, strong performance. I think maybe that's at least close enough to, I think, what his outline was for what some of the objectives were with respect to the search. Any thoughts on just the profile of individual that you're seeking or maybe any further interpretation of those comments that he made on the call?
You know, I would say this. I mean, I think it really comes down to a few things. I mean, obviously, as we've talked about as a company, we're looking to accelerate growth over what we have had historically. We talked about this 4%-5% growth target, and that obviously is going to come in part from innovation and from the opportunity to drive R&D investment in those areas that are going to drive growth. I think that's certainly part of the profile as well. I think you talk about execution. We have an opportunity as a company to become even more streamlined and operationally effective and consistent in terms of how we perform. I think there's that element of the profile.
I do think that part of our growth story over time is also going to be, again, in a fold-in, tuck-in way, inorganic opportunities that supplement our existing portfolio. I think all wrapped up in someone who really can drive culture and the elements of all that through really into the DNA of the organization.
I want to jump into the business in a second, but if I kind of reflect on the past couple of years at Baxter, a lot of the focus has been, for lack of a better way to put it, cleaning up the balance sheet, streamlining the business. You had the BPS sale, you had the Vantive sale, and you haven't really had an opportunity to sort of lay out what post-Vantive Baxter is going to look like. Admittedly, this will probably change or evolve as a new CEO comes into the picture. How would you kind of just quickly frame the identity of the company now post-Vantive, post-BPS, post-paying down debt? Are we at a reset foundation? Give us a flavor of where we are just in the overall strategic evolution.
I'd say a few things. Number one, I would say the words looking to be more agile and nimble would be one word. I think, again, I wouldn't go all the way to simple, but simplified based on the, again, there is a lot of complexity that brought into our company, having a lot of the intertwined manufacturing and a lot of things. The other part I'd add, the verticalization of the business, and again, back to this nimble and agile point, now really allows a very clean set of verticals in the organization. I think that's one thing. I think the second thing is more innovation.
I think over the last number of years, obviously since the transformative acquisition we did, but then also the work that was done, again, you said it, BPS, verticalization, sale of Vantive, and some of the supply chain challenges we had, the innovation levels were not necessarily at that, what we would like to aspire to be. I think as a company today, really focusing on our capital allocation efforts, focusing on those things and driving innovation and, again, accelerated growth, expansion of margins, generating more cash that then gets reinvested back into the business, as well as a balanced return to our shareholders.
Okay. Maybe using that as kind of context here to talk about the business. One came in better than I think most had expected, including relative to your guidance. Maybe just to help us understand the underlying trends that materialized throughout the quarter that supported the 5%+ growth.
Yeah. Yeah, I'd say there's a couple of things. I mean, one of the good news stories that I haven't had a chance to say for a while is it was really led by HST. We had, obviously, there were some good favorable comps, but also some positives from an order book standpoint and CCS in particular. Again, that business grew at a 7% rate and our front line care grew 5%. We had a very balanced view across our HST portfolio. That was nice to see. MPT was really driven by a few things. Certainly, continued progress from Novum. We've had strong growth in our pump sales, and that continues to be a driver. We also had, I'd say, a larger than expected restocking from our distributors, which is probably a little bit of where we came in ahead of where people expected.
There was some offset to that, though, based on some of the conservation that's happening that had happened in the first quarter, and we expect to continue to some degree in the second quarter and, of course, to some degree throughout the year. Those were, again, some of the key drivers, MPT, as well as, again, strong advanced surgery, strong nutrition. From a pharma perspective, we had injectables was strong outside the U.S., but not so much in the U.S., and our compounding business was softer. Those are a few puts and takes. Overall, again, it was a strong quarter. As I like to say, we came out hot, and I think overall some positive trends there.
Yeah, but then you popped the balloon here with this Q2 guidance. What happened here? It's like you had a good Q1, everyone took a few weeks off, so you guide 1%-2% for Q2. Help us understand the guidance for Q2.
Yeah. First of all, I wouldn't go all the way to pop the balloon, but what I would say is that if you actually look at H1 and H2 for the year, we came in a little better in Q1 than we anticipated based on, as I mentioned, the distributor restocking, which we had actually projected internally in Q2 more than it was. I think, if you look at the first half of the year and the second half of the year, it's pretty consistent with what we had anticipated happening. That's one thing I would say.
Number two, part of the impact in the second quarter that we're seeing, and by the way, the second quarter was always going to be our softest quarter. The reasons were primarily driven by some of the conservation that we're seeing in MPT, and we anticipated some of that happening. The third thing really is just, I guess, again, I'll say a little bit of conservatism around the results from HST, and that sort of factors into the quarter, but also some of the guidance for the year. I think you'd probably forgive us for being a little conservative on that front, but we haven't seen impacts from a capital spend at this point, again, factoring a little bit of conservatism.
It wasn't like you came off the first quarter and then in May you saw the business, or April, excuse me, you saw the business really deteriorate and you wanted to reflect that in the outlook?
Not at all. I would just go back to the point earlier. It's an H1, H2 thing, and some of the conservation that we anticipated seeing in Q2, we have seen, and we do expect that. One of the other things I would just keep in mind is that we had continued to have hospitals on allocation really for the most part through the end of May. We have only recently released that allocation. I would say it's still a little bit to be determined how that's going to play out because obviously prior to that, a hospital would only be able to order up to their allocation. If they tried ordering more, they could not.
That's now been released in full, and again, we're going to see how that kind of plays out, but we haven't necessarily contemplated anything upside-wise related to that.
How do you kind of contrast conservation efforts with now having full supply? Why would hospitals not say, "Hey, we've survived this long, let's just keep doing what we're doing"?
Yeah. I mean, I'll start and then Clare can chime in. I think the way I would phrase that is they get out of regular habits and get into new habits, and it takes some time to get back to old habits. I think back even in 2017, 2018, when Hurricane Maria hit, it took the better part of a year for hospitals to get back to kind of what would be a normal buying pattern. Now, that's a generalization. Obviously, every system is a little bit different, but I would say generally speaking, that's probably why. In fact, just some of the things that they got used to doing, there's just it'd take a little bit of time to evolve back to their normal patterns. Anything you'd add to that?
Yeah. The only thing I would add is that one of the things we can do too now that we're off allocation is have our sales reps and medical affairs work with the hospitals because some of the methods that they were using for oral rehydration are actually going to end up being more expensive than using an IV bag. When you're on allocation, we're not going to have those discussions. That gives us the opportunity to kind of go back, have those discussions, remind them that we now have adequate supply. I think that's piece number one. Obviously, these are volume-based commitments. If they do not order up to their volume, they do not really earn the same price that what they think they're getting at. Those conversations will now start happening.
I think to Joel's point, unfortunately, we have had experience with this before. We know it does take time to get back there, but our reps will be out there having those discussions now. I think the key is for the second quarter, kind of to circle back to where you're at. One, Joel referenced this, but Q2 was going to always be our most difficult comp as well. We had the highest growth Q2 of last year, so it was going to be. The key is, as he said, the first half is in line with what we thought. And we basically pulled through that same level of conservation, and we have access to that because we get end user data. That is what we're looking at when we do this is on the end user data.
We see that, and we basically said, "We're not going to assume it gets any better in the second quarter as to what we saw, but we won't have that benefit of the inventory rebuild at the distributor level." Now that we're off allocation, we think we'll see a gradual improvement going forward. I think that's the key. We said it's going to take some time. Eventually, it will get back, and we'll start the education, but let's not assume that all of a sudden we lose this and hospitals go back to historical practices.
Okay. Then to kind of wrap this together on IVs, where does pricing fall into all this? Are you seeing the benefit of the GPO price roles? How long does it take to go from winning the GPO contract to the IDN level to the hospital level? To what extent did price contribute in Q1, and how should we reflect that through the balance of the year?
Yeah. I mean, we are seeing that benefit, although it started in Q1. It started, I'd say, more in February than it did through it was not right exactly in the beginning of the year. I would say to some extent that phased in, if you will, in the first quarter. We do anticipate seeing a full benefit of that as we had anticipated. You'll recall last year we called out as an enterprise about 100 basis points of improvement from a pricing standpoint. That was primarily driven by the GPOs. Again, that's on track, again, but phased in starting in February of this first quarter.
Okay. So we should see a full impact starting in Q2, or?
Yes.
The 100 basis points is for the full year, but you saw less than that in Q1?
Yes. Correct.
Okay. So that would just, if I was again look at the Q1 to Q2 or even first half to second half, that that does imply some volume worsening.
Yeah, again, but anticipated volume worsening was some of what we anticipated.
It's really the IVs. I mean, it's basically just conservation, not offset by the rebuild at the inventory. That's the volume. You're exactly right. There is a volume impact.
Okay. I guess I do not want to belabor Q2 too much, but just on the philosophy of guidance, one of the things that go back and reflect on Brent's comments from the fourth quarter call about consistent, durable, reliable performance, how are you thinking about just the philosophy of setting guidance both on a quarterly and annual basis now?
I think in general, certainly some of the best words in the English language, beat and raise, is something that's always been part of the philosophy that I've had and that we've had. I think the reality of it is that we're going to have some fluctuations on a quarterly basis. I think we obviously set our annual guidance to a point we feel confident in, both on a top line, and obviously we had an adjustment on the bottom line from the 16% to 16.5% . Certainly in all those areas, again, in a place that we, despite some quarterly fluctuations, again, we feel confident in our guidance for the year.
If I just kind of take a step back and look at the 2025 outlook of 4%-5%, that does include two quarters where you have pretty easy comparisons, 1Q on HST and 4Q on the IV business within MPT. How do we kind of think about the normalized growth rate versus the comp benefit growth rate of the business?
I'd say a couple of things. We also, though, recall, as we just talked about, have a conservation element in there that's obviously a headwind. I mean, I think there's always going to be, I look at this, there's always puts and takes in a given year. We certainly view ourselves as this 4%-5% is a good way to think about our company in terms of annual growth. I think that'll play out as we anticipate this year. As we've talked about going forward, that somewhere is a good basis to think about the organic view of our company.
Maybe we could go into some of the individual segments. I think if you look at MPT, you talked about Novum, you talked about nutrition, you talked about advanced surgery. I mean, the IV dynamics, I think we understand. Any other product lines or businesses you want to highlight within MPT, and then we'll talk, then we'll go to HST?
I think that's the main stuff. Maybe the only thing I would add is just a couple of builds on a couple of those points. Again, from a Novum perspective, we certainly, again, that launch has gone really well. The product is performing really well. We are in an upgrade cycle that is causing lots of customers to be able to have conversations about those things. We've had a lot of opportunities for both competitive wins and obviously changing out the spectrum, but both. I think we've talked about the fact that our share gains with Novum, we believe, have doubled from where we were in the past. We're adding about 1% a year, and we think that's healthy. Is that about 2% a year in terms of that? That's one point I'd make.
On the nutrition piece, one of the areas that we've had some success in now is in the alternative space. I think this is one of those things where we've had some focus on and investments in the ASC space. Nutrition has been one of those areas we've had some nice success. That mid-single digit growth you're seeing there is in part due to our presence and our penetration into that space. I guess the other thing I would just say, the demand in our advanced surgery, in particular U.S., but in general, has been quite strong. I think all really across those areas, I mean, we've had some good performance. That's maybe the one couple of adds I just make to that point for MPT.
Okay. And then within HST, I mean, this is a business that actually has a lot of parts to it, but I think very frequently we, speak for myself maybe, think about it as you got beds in CCS and you got well-shallow and stuff in FLC. I think there's probably more moving parts to that franchise. Maybe help us think about how things are progressing within maybe a little bit more detail under the hood within those subsegments.
As we even entered this year and we gave our kind of guidance by segment, one of the things we talked about is the fact that we anticipated a more balanced view between our injectables and anesthesia and the compounding business. From a mixed perspective, there is, I would say, some conscious view on having some of that be a little more leveled out versus last year where compounding was in the teens in terms from a growth standpoint. I will say this, again, it is a lower margin business, but it is a fairly large business. There is a fair amount of absorption that happens from a leverage and fixed cost standpoint there. I will agree to your point. It is something we have looked to balance out some.
I anticipate it was softer in the first quarter than it will likely be the rest of the year. We do anticipate that leveling out some. The other thing I would just say too is from an anesthesia standpoint, I know you did not ask this, but just to add to that, again, that is a business that we have had certainly some tail or some headwinds on over the last couple of years. That business is starting to stabilize, and again, it is also a good margin profile in that business. We do anticipate that continuing to get better.
Okay. That's very helpful. Maybe let's turn over to the P&L here and we were remiss not to touch on tariffs. A lot has changed since you issued guidance, and it continues to be an evolving dynamic. How should we, maybe just remind us, within the $60 million-$70 million, I think, how big was China as a percentage of that, and what's the impact of this recent de-escalation?
Yeah. I mean, China was actually ended up being about half of it. The interesting part of that is that when what seems like forever ago, we started the tariff conversation, our original commentary was that China is not a really significant part of our business. I had anticipated at that time it was more Canada, Mexico, and obviously lots evolved since then. The reality of it is then China became a larger issue for us just because of the sheer magnitude of the tariff. The net effect of the 60-70 we have talked about is really the net effect of tariff risk and in addition to offset by some of the things we are doing, both from a supply chain standpoint and I will call it targeted pricing standpoint to offset that.
Yes, there was this kind of a 90-day, if you will, hold pattern on what is happening with the whole thing with China. We are holding where we are right now in the 60-70 because obviously as the tariffs go down, some of the mitigation activities go down as it related to that specific business. I would just say this, this thing is constantly evolving. We are comfortable where we are as of today. Five minutes from now, something else might change. I am not sure, but we are going to continue to adapt. The good news is a lot of the things that we are doing in terms of reevaluating our shipping lanes, reevaluating some of the things that are both kind of short and medium-term opportunities, are something we are certainly continuing to be focused on as this thing evolves.
Maybe we talk about the overall market, the 16% to 16.5%. I think we'll understand why the adjustment from the approximately 16.5% that you had issued previously. Looking at Q1, there's a pretty big ramp from your Q1 gross and operating margin to meet the full year targets. What are some of the drivers on both gross margin and then operating margin that get you from where you started the year to average out to where your guidance now sits?
Yeah. So I mean, really a few things. I mean, one, we'd already talked about the pricing. There's kind of a partial impact, if you will, in Q1 relative to the GPO pricing. I'd say another thing is really related to the impacts of our TSA income and stranded cost implications. You'll recall in Q4 of last year, there was a large stranded cost number that was included as part of the 13.9 that we ended the year at. As we now head into this year, we've obviously talked about the fact that our TSA income, which again is ramping, and again, the deal closed January 31st, and so some of those same effects were in Q1 of the stranded cost. Obviously now the TSA income and some of the cost mitigation activities are starting to kick in.
That's also certainly a sizable part of that as we go into the year. Just generally, there's some seasonality to our business where our margin profile, as volume goes up, we do get more leverage out of that. Our year does increase that way. I think obviously, I think we feel like we're in a pretty good place there, but those are a few of the key drivers there. Is there anything you'd like to add to that?
Exactly. Yeah. I think the key is the cost initiatives ramp over the course of the year. Our margin progression normally just improves every quarter, just as our sales volume, and we get better leverage. I'd say those are the two big drivers.
Were there any hangover effects on the gross margin line in Q1 from North Cove in Q4, whether that was, I don't know, capitalized inventory or any dynamics in Q1 that were shown in the P&L in Q1, but a reflection of things that happened in prior periods?
Do you want gross margin or?
Yeah, gross margin.
I mean, there's probably a little bit of that. Again, as I mentioned, the pricing didn't kick in in Q1. The other thing I would just remind you of, though, is on the gross margin line in general, our TSA income, the way the accounting works for this is that our TSA expenses, some sit in COGS, some sit in SG&A, and the income itself sits on a separate line, if you will, over and above our operating income line. As we've talked about the fact that our TSA income is going up from where we had originally anticipated, that's not just a, "Hey, that sounds like a good news story." That also means the expenses are going up that are being covered by the TSA income.
Therefore, some of those end up sitting in the gross margin line, again, where the TSA income sits below. That is some of what you are seeing as a dilutive effect on the gross margin as well.
Yeah. I think in particular, in the first quarter, we had some higher planning and logistics costs that impacted COGS, which impacted our gross margin then. TSA income was higher than we had anticipated, so it was just an offset, but it did impact that gross margin line because of those planning and logistics costs.
The planning and forecasting piece was part of what hit the COGS line, and that was related to North Cove.
Yeah. So those are okay. And then if I look at your guidance for Q2 and revenue dollars, it actually looks pretty similar to Q4 of last year, and you did have gross margin in the 44%-45% range. Why would not you get back to that level?
I think we just included the tariffs. The tariff, we would have, but we reflected the impact of the tariffs.
You started to see tariffs impact you in Q2 of this year?
Oh, in Q2 of this year?
Yeah. Yeah.
Yeah.
We should have slightly. It's more of a second half of the year, but no, not as much tariff in the second quarter.
Again, the gross margin impact, though, is a couple of different things. On the positive side, there's the pricing. On the other side of it, the MSA income has a dilutive effect on our gross margin.
That's like 10% gross margin.
Yeah. With the $310 million or so-ish, that actually has a dilutive effect on margins, as do, again, the TSA expenses that are going through there. There are a number of those lines.
You would say operating margin's a better vehicle to sort of value overall profit margin.
It is because the TSA income all sits in this other line.
In that other line. Okay. If we kind of just wrap this together, Q1, you had basically three months of full stranded costs, only two months of TSA income. There was a mismatch there between your costs and the TSA income, which depressed margins. I do not know if the costs are ratably 1/3 , 1/3 , 1/3 , but over the course of the quarter, that did have a significant impact. As you roll into Q2, you kind of have more, it is matched TSA income and.
Stranded costs.
Your stranded costs should start going down.
Yes.
Your TSA income should go up on a quarterly basis, sequentially.
The TSA income kind of remains flat-ish over the course of the year, but our stranded costs come down.
Yeah, but two months to three months, so it should go up sequentially.
Yeah. It's going to go up relative to Q1. Like our TSA income would go up relative to Q1.
Yes. Yes. It might stay a little bit the same just because we had elevated expenses to support Vantive in that. It's all dependent on what Vantive needs from us. That is the key. It's all dependent on what Vantive needs from us. Yes, to Joel's point, it likely will go up when you have the full three months, and it could be even higher if Vantive requires more services from us.
You charge them a markup?
A slight markup. Slight.
Okay.
Yeah.
Got it. As we cut, obviously, the tariff dynamic did throw off what seemed to be a pretty linear opportunity to expand your margins here. Still, 16%-16.5% versus 13.9% represents significant improvement year over year. I have asked you in the past, do you think normalized margins for this business can be in the high teens? Is that still an achievable number?
Yeah. I think I always like to rephrase that question slightly, and the answer is, the question is, is there something structural that would prevent us from getting to that point over time? And the answer is there's not. I think this is, let's say, it's something, again, I'm not putting a timeframe on that, but as a company, certainly we are committed to continue to expand our margins, and I don't think there's not something structural that would prevent us from getting to that point. I just want to say one thing you already added. I think it is very constructive to look at us on an operating margin basis this year with some of that noise in between the lines on the TSA income. Just to reiterate that point.
Okay. Very helpful. Maybe we'll just kind of close with the balance sheet and use of cash. You obviously paying down debt was a priority post the Vantive sale. Kind of where are we in sort of your leverage ratio, and when do you think you'll be in a point where you can start buying back stock beyond offsetting the dilutive impact of options?
Sure. Yeah. We are on target to hit our 3x net debt- to- EBITDA by the end of this year. I am very much looking forward to that too, so I can not have to tell you. I am just focused on paying down debt. We have this opportunity once we achieve that target leverage to reinstate a buyback program that includes both the offsetting dilution, but as well as, again, a consistent buyback program over the years. I think the other part of that then is that, as we talked about, the opportunity for fold-in, tuck-in M&A. Again, to be very clear, it is not large M&A deals. It is fold-in, tuck-in opportunities that supplement our product categories and that allow us to accelerate our growth rates.
Those are the types of things we look forward to doing in addition to the organic R&D investments and things we've talked about as a company.
Excellent. I think with that, we're at time. Joel and Clare, thank you for participating, and we look forward to seeing you later today.
All right. Thanks, everyone. Appreciate it.