Well done. Amazing. Thank you so much and welcome, everyone. Before we start, I get the fun disclosures. morganstanley.com/researchdisclosures. I'm just typing this right down. Go there. I'm sure you all will. Or you can reach out to your MS sales rep. Patrick Wood, U.S. MedTech team, you know, and welcome everyone. Big thank you, of course, the entire BD team. You know, obviously, we've got Chris, we've got Mike, and we've got Dave, across the head of Medical segment, across Life Sciences, and of course, as CFO. Thank you so much for joining us and agreeing to do this. What we'll kick off with, how about 2024 margins? You guys are running a little bit ahead. You know, I would say, let's see how the year closes, but of maybe where you are hoping to be on the margin structure side of things. How are you thinking about the interplay between reinvestment and margins going forward?
Yeah. Yeah, no, I appreciate the question. Thanks for having us. Good morning, everyone. So, yeah, I guess one stepping back, a couple of years ago, we outlined our BD 2025 strategy. Really, the core of the formula, right at the end of the day, was we declared that we see ourselves as a durable 5.5%+ on the top line. We've been really focused on driving the plus side of that, right? Our two-year growth rate, organic, is about 7%, so delivering strong results there. And then we wanted to deliver double digits, or call it 10% FXN, on the bottom line. That's kind of the formula we drive to. As part of that, we made a commitment on margins to...
We actually increased the commitment, by the way, versus our first investor day. So we were tracking ahead of it. We actually increased it once, but the goal is to get to 25% by 2025. We've had two strong years of execution, and that execution is showing up both in top line and on bottom line. So to your point, we're 70% towards our margin goal, two years in, as we think of sort of how we would exit this year. So really strong performance. That's on top of obviously an extremely, you know, complex macro environment. Inflation, two-year inflation, has been over 200 basis points of outsized inflation. So we're delivering that while also solving for the inflationary dynamics.
As you think of the balance, it gets us to a point where you need roughly, call it 50-75 basis points of margin improvement, over the next 2 years, consecutively. I would point back to the formula. The way we always think of it is, it's a nice place to be tracking ahead. One is if you can continue to deliver on the plus side of the 5, 5 on growth, you get natural leverage that just drops by maintaining your kind of cost structure and being very disciplined from that standpoint. So we'll look to continue to do that. Plus, we have a strong pipeline of initiatives that are actually well under the execution, and they start delivering more value.
Project Recode is a good example, where the front-end work is largely done in many areas. We're gonna keep doing that through this time period, but you start getting outsized benefit. So we have a strong portfolio of initiatives that are actually already committed, that you'll actually have a natural efficiency. The key to drive the plus side of the growth, which I'll go back to, though, is just to make sure two things: One, you're driving simplification to create capacity to reinvest in growth, and to also be able to manage, you know, headwinds. Things happen every year, puts and takes. What we've been trying to do is being committed to be the company that can, you know, be that steady ship, deliver strong performance, while navigating both of those.
The margin becomes kind of the moderator to that equation on the top and bottom line, and certainly, you know, and these guys can share some examples. There's plenty of opportunities for investment that come my way. The way I would frame it at the higher level is continuing to drive organic growth in R&D. Obviously, those, by definition, have a little bit of a longer-term payback. I think we have strong go-to-market opportunities. Digital is a key area. There's an anchor against kind of those three irreversible forces. We're focused on connected care, new care settings, chronic disease. We have a strong portfolio of products that, at the end of the day, they bring solutions that simplify things, make them safer, and simpler in the healthcare system. So I think there's a lot of growth opportunities there, and we'll continue to actually invest in our capabilities that will actually further drive the flywheel of simplification. So manufacturing excellence is an example where we're rolling out Kaizen capabilities and a mindset throughout our manufacturing organization, so you keep that momentum going. So that's the way we think of it as a bigger picture.
I guess, you know, Dave and Michael, if you can think of, I don't know, one or two pet projects, they don't even have to be the biggest ones, but things that you're kind of excited about yourselves within.
Yeah
The businesses.
Yeah, I mean, I'll go first. So good morning, everybody. Dave Hickey, Head of Life Sciences. And I think I look at it in two frames, Patrick. I think of, you know, what are some of the landmark projects that we have just commercialized or just launched that is sort of, you know, the sources of growth for the segment today. So, you know, I think you've heard us reference this super cycle of innovation in Biosciences. In fact, just last week, we had a great session with the president of Biosciences and the head of R&D, Steve and Eric, respectively, where we talked about three new platforms, both on the clinical diagnostic side, where now you've got the only sample-to-answer walkaway consolidated platform for HIV, leukemia, lymphoma testing. A step up in our presence and relevance in single-cell multi-omics with the launch of Rhapsody HT Xpress, and then obviously the flagship launch of the FACS Discover S8, which is a very new high-end sorter that brings new to world really research capabilities to start discovery and initiate translational research.
Also, that's on the Biosciences side. On the IDS side, the diagnostic side, the growth is really one of the growth drivers, is our molecular platform. So obviously, with the recent approvals of BD COR, the high-volume molecular platform in the U.S., the BD MAX, and obviously, which saw a 60% installed base growth through COVID, and how we're now leveraging that BD MAX to put new, you know, new regular IVD tests onto that. They're big drivers of growth, you know, in terms of the segment today. And then if I just look forward to what's tomorrow, a couple of things we've talked about.
You know, we are under FDA review for a very unique and novel platform to collect capillary blood for people that have got sort of venipuncture phobia, so to speak, and that will really give access in retail decentralized settings. That's the BD MiniDraw. And then also, we're very vested in maximizing our HPV franchise. So obviously, we've got very specific claims around human papillomavirus as the new standard of care for cervical cancer. But the work that we're doing in genotyping there, and also the work that we're doing to enable self-collection, where we're already up and running with self-collection for people and females that sort of want to maybe take samples in the privacy and at the time of their own home. And then again, we'll be working towards an FDA submission here before the end of the calendar year.
Sure. So for medical, there's a lot that I'm excited about, whether it's in Pharm Systems or wearables program for, you know, long-term drug delivery for patients, or in MDS, where we have One-Stick Hospital Stay and improving the quality of life for patients that are in the hospital, so they can sleep through the night. But probably the thing that is most relevant in the near term and has the most impact, given the state of healthcare right now, is our connected bed management strategy in MMS. So there, you know, the concept is that you have, you know, medication being stored in a Pyxis cabinet. You've got the electronic medical record of the hospital.
We've got software that then connects our transactions that are occurring in the pharmacy to the cabinet at the point of care, up through to the infusion pump, which was recently cleared by the FDA. And so that the nurse at the point of care, instead of having to manually program, now has the ability to just automatically confirm the physician order and infuse the patient. And all that data then flows back to then replenish for inventory, give incredible data analytics to the hospital about patient acuity, physician efficiency, in terms of inventory management, diversion, and controlled substance management.
So the ability to connect all that data to the hospital and improve both patient safety, clinician efficiency, and the cost efficiency of the healthcare system, yeah, that's the part where I'm really excited because there's both very immediate near-term benefits, but as a platform for innovation, you know, customers come to us with interesting ideas, and we can very rapidly innovate on the software platform to pilot it, test it, and then, you know, refine it. So that's probably what makes me most excited.
Then, inevitably, the Alaris question, I guess, for, you know, Mike and Chris. How has reception been? I know it's still fairly early, but of the return of the market, and maybe unfair question, but is $200 million still the right number for next year?
Yeah, I mean, it's still the right number. The reception's been really positive. You know, the day we got clearance, we published a press release. You know, customers were, you know, sort of calling us and congratulating us and, you know, pleased to hear that the product that they had been using for the last 3.5 years and relying on during COVID and, you know, a number of healthcare crises, you know, was now cleared for use. They were excited to learn, and they wanted to learn, set up time to learn about the, you know, what's new in the product, the clinical workflow improvements, the cybersecurity improvements, the patient safety improvements. So, you know, we've contacted 100% of our customers at this point. I'd say they fall... You know, there's 3 buckets.
Yeah, I'd say this is a hypothesis kind of going in as we have these conversations with the customers. There's a group that's that sort of, "I want to be first." You know, they're the ones that called us, the ones that scheduled meetings immediately. They want to refresh their fleet, you know, right away. And these are archetypes. I wouldn't say there's any, you know, real hardcore market research analytics around it. The second group, you know, they're probably a little bit more complex. They've got an Epic upgrade or a Cerner upgrade. They wanna get this on the roadmap for them, and so they probably also have multiple hospitals, maybe with a lot of different ages of pumps and things like that.
So they may have some that are gonna be field remediated, you know, by our staff and some that'll be purchased, you know, and replaced. And then there's probably a group that's saying: "You know, I actually don't want to be first. I have a complex issue. I've got some, you know, other things on my plate and, you know, can we schedule for this? And let's make sure that we line everything up. I can get the labor in place. I can get my capital appropriations in place, things like that." So there's probably, like, three archetypes like that that are coming through. You know, they've had 3.5 years, and the customers have stayed with us, and, you know, our posture towards it is that, you know, we really, really appreciate that, and we're gonna take care of our customers. So, you know, we're looking to.
You know, make sure that we engage them, we explain, you know, the advantages. We're really excited about helping with cybersecurity. We know that that's a key issue. That's what we've been hearing a lot. We're also hearing a lot about how beneficial interoperability for the Alaris and that ability to passively automate and document all the steps that a clinician would have to do at the bedside with the pump, now that's all automated. That was really beneficial during COVID. And with labor shortages and nurse staffing and things like that, a lot of our customers want to sort of convert to that. That takes a little bit longer and a little bit longer plan. It takes about nine months to do an implementation there, so we wanna make sure we plan that effectively.
Okay. And then there's obviously a lot of puts and takes for next year for growth. You've got some of the bolt-on deals that drop through into organic. You've got, you know, less of an impact from, you know, some of the business exits and things like that, but there's pricing. There's, you know, how should we begin to think about that sort of a process? Is like 6-7 number too aggressive or, you know, anything to help with the framework of thinking about next year?
Yeah. Yeah, no. So we... Last earnings call, we kind of outlined a frame for 2024. First, I would elevate back, right? Like, you know, 5, 5+ is sort of the target commitment. We've definitely been trying to drive the plus side of things, like I said before. We've been doing that. Our organic growth rate has been 7%, our two-year average. Yeah, but that's it. Every year is a little bit different. There's always dynamics. But we've systemically been driving enhancement to our WAMGR at the end of the day, right? And that's what you see coming out in this growth profile. So whether it be through what we've done from an organic R&D, increasing the productivity out of R&D, the amount of R&D dollars that are earmarked towards transformative solutions, now 60%.
We have a strong rhythm of new product launches expected. We had about 100 through this time frame. Almost half of those were $30 million or more, and half of that were actually $50 million more incremental sales opportunities. So really good progress there. Tuck-in M&A has been an important part of our growth. I think that's a new lever within BD. It's actually contributing about 30 basis points to our results year to date. This year, that's after anniversarying these acquisitions, so after they've gone through their first 12-month cycle. So we're gonna continue to drive that. I do think it's important to know. So what we're doing is we've enhanced our growth profile, but you still get that reliability and durability that comes with BD.
And then that comes because we have really strong leadership positions, where we've established strong capability in a little bit more mature category. So you get a little bit of this balance of stable with the outsized growth. You know, there's... So as we think of next year, what I outlined basically was. I know it's a little complex because there's all these dynamics still, whether it be COVID. But we did talk about with Alaris, that we see next year being about 6% base growth. Now, there is COVID-only revenue that we have. There'll be a small adjustment for that. We expect that to be not material next year. It already ratcheted back significantly this year, so there's about a 30 basis point adjustment for that.
So whether we want to just put that all in one bucket now and call it pace, right, it gets you closer to that 5.7% growth, which is again, very strong, but really the underlying base is 6%. We also did, as part of our simplify efforts, and are driving our kind of portfolio strategy, we did divest the surgical instrumentation platform, so there'll be an inorganic adjustment on top of that that's worth about 75 basis points for roughly three-quarters of sales that comes out. But again, that doesn't affect our organic underlying results. Importantly, on the bottom line, we're still targeting that about 10% FXN. You know, we'll see where currency goes, and we'll update where the quarter is.
And that does include then absorbing kind of the COVID-only reduced revenue and the divestiture, really. So when you think of kind of the base, I know we don't look at sort of EPS that way. It's actually stronger than 10%. So we think that's a good formula for next year. For where we are, we you know, we got a couple of months, obviously, to refine plans and you know, we're focused on continuing to execute against the things that will keep that momentum going.
There was a little bit of volatility maybe last week around some potentially misinterpretations around comments on China. I'm just curious, how are you feeling about, you know, the anti-corruption measures? Are you hearing anything from the field? Just any commentary on that would be helpful.
Yeah. So I guess a couple things. One, I'd make a few macro comments. One, again, BD, what we've done over the past two years is deliver this performance in very uncertain, challenging macro backdrop, right? Which included multiple factors, whether it be procedural dynamics, inflationary pressures. There's been pressure in China throughout the past two years, whether it be how they've navigated COVID and restrictions, whether it be port congestion. Through all those dynamics, we faced into sort of reality, and I think having an awareness and realistic posture about dynamics that play out in the market, and then approach it with a growth mindset to lead through that. So we've been outperforming in that market. It's only about 7% of our sales, to put it in context. So...
Actually, there's been a lot of questions. I think a new question that emerged was sort of capital versus consumables. We don't have a big capital install base there, way under indexes against BD. BD actually, at a total level, only has about 15% of capital as part of our revenue model, so 85% of it is recurring revenue. China way under indexes versus that metric. So, one, think of BD as kind of we're a big business, managing puts and takes, but that's how we think of FY 2024, and that's been our mindset throughout. You know, again, the reality is, I think it would be, you know, there's been dynamics there. There's been dynamics in Eastern Europe. There's still inflationary dynamics, right? When we set up next year, we look at all these things and make sure that we're as best prepared to navigate what could change in that environment. We still have inflationary pressures. They've moderated, right? But they're still above normal levels, and, you know, we've contemplated that as well. I think on the positive procedures, BD's been less exposed to procedure - big procedure fluctuations.
But you're seeing the healthcare system in the U.S. certainly basically sort of back to normal, right? So there's puts and takes. As we look at the macro environment, that discussion was really more about total macro. And you know, we're gonna keep watching, you know, how China plays out. Again, I think a counterbalance to... It's clear there's dynamics playing there that happen maybe more to, like, a micro level, right? How they're managing their GDP dynamics, et cetera. The reality is, there's a ton of unmet need there from a healthcare standpoint. So I think the counterbalance is that they're always gonna wanna make sure they don't create an unintentional situation of patient backlogs and not supporting their citizens.
At the end of the day, we're well positioned to capitalize on opportunities in China. We certainly see it as a long-term opportunity. We have a strong kind of local capability, whether it be manufacturing, go-to-market, innovation. We've had a strong rhythm of innovation in that market. But what we've done is we've de-risked the rest of our book of business. We're not dependent on China from a finished goods manufacturing standpoint. We're not sourcing there for the rest of our business. So it's contained. It's contemplated in how we're thinking of things on a go-forward basis. I just, you know, again, shared the 2024 outlook, that's unchanged through our lens. We'll continue to watch it and, of course, you know, monitor and just make sure that we're performing, you know, leading performance within the environment that exists there, is the way... It's always been our posture.
I remember, last time I came out to see you was the day of the SELECT data. And now obviously, GLP-1s have cured every issue in healthcare, so that's good news. But within that context, like, where... You know, there are some aspects of your business that are potentially affected by it, you know, one way or the other. I mean, to pick out one, like pharmaceutical systems, potentially, I mean, what, 13 quarters of double-digit growth? Presumably, there's some-
14.
14, there you go. That's the one.
Who's counting?
Presumably, there was some, you know, contributing factor within that. But for overall BD and PS included, how should we think about the impact of GLP-1s?
You want me to take this, Chris?
No, no, go ahead.
Yeah. So we have some exposure to GLP-1s. I mean, our pharmaceutical systems business, we make primary container closure devices for drugs that are in a prefillable syringe. We sell the prefillable syringe to pharma companies. They fill it, and they provide it to their customers. You know, our capacity to serve that segment of the market is about six times the nearest competitor, and the technology that we've developed over time is pretty well suited, and it's really been designed to support the advent of biologic drugs that provide for more targeted therapy.
So the innovations that are actually, you know, enabled through the BD's business in Dave's area around identifying specific receptors and, you know, cell surface, you know, sort of, you know, the microbiology of life, that then the pharma companies develop targets to address particular cancers or Alzheimer's targets or, in this case, diabetes targets and, GLP-1s, those particular receptors. Those molecules then get developed into a therapeutic, and they get put into a primary container closure device, which we provide. So we have had some of that. Most of the GLP-1s come through pens or auto injectors. They're in a ready-to-use format for customers.
You know, we have a nice, you know, pen business, a little less on the auto injector business, but inside those plastic housings and the devices with the springs and everything to make the drug kind of shoot into the body, is a glass syringe, and so we have a portion of that. But we're not particularly beholden to only GLP-1, so there's a broad range of biologics. You know, more drugs coming to the FDA for approval through the drug device combination pathway are biologics in nature, as opposed to small molecules, things like that. So that's a... That has been a positive. The other positive has been vaccinations. If you think during COVID, you know, vaccinations into a ready-to-use format, you know, that's been...
You know, we've been able to help, you know, supply the market and help with that response. And then there were particular drugs that were used during COVID, anticoagulants, low-molecular-weight heparin, that come in a ready-to-use format. They've always been used to help whenever somebody's in the ICU, and they may be at risk of stroke, or they may be at risk of pulmonary embolism or some other circulatory system disease or comorbidity. And particularly with the manifestation of COVID, it was one of the therapies that was used to help protect those patients. So we're seeing a sort of a resetting of that particular market. So different dynamics. So GLP-1's definitely going up, positive, and I think a long-term positive trend as the clinical data continues to come out.
And then I think some of the other ones are more of a reset. So I think there's a little bit of both of those. And then long term, you know, the move for quality of life, moving from drugs, kind of coming from vials to pre-fills or going directly into a pre-filled device, but going to for more long-term wear at home, that's what I mentioned about. That's also exciting, is the wearables, on-body injectors, things like that, that would allow a patient, instead of having to go get back on a bus, go back to an infusion center, spend a day in a chair getting their drugs and medication, they would be able to take one of those products, put it on, you know, put it on as a wearable, and have that administration at home. We feel really good about that. Our Libertas device is available for clinical trials. You know, we have a number of clinical partners there, and we feel really good about that innovation.
And then maybe, switching a little bit into, some of the life sciences stuff, Dave. Firstly, I guess, curious about, you know, microbiology doesn't get a lot of questions necessarily, but actually there's quite a lot of technological potential change over time happening there. I think you guys have still got a partnership with Accelerate.
We do.
But also just there's NGS, there's a lot of different moving parts there. How are you viewing that market long term and any potential changes in technology?
Yeah. No, thank you. Thanks, Patrick. And I mean, if you think about it, the core essence of microbiology is this looking for infectious disease, right? So if you look, and it really is the core of the microbiology lab. So if any of us have an infection, what we really want to know is what is causing the infection, and then more, and then equally importantly, what was the right antibiotic to sort of treat it. And actually, if you take a step back, and to your point about it not being discussed a lot, there is a big global issue around antimicrobial resistance. And if you think about it today, either directly related resistance deaths or sort of, and/or deaths related to resistant infection is about 5 million deaths a year right now, globally.
There was a review commissioned, actually by the U.K. a couple of years ago, that suggested without improvement in diagnostics, without improvement in pharmaceuticals and antibiotics, AMR, so antimicrobial resistance, could be one of the world's biggest killers by 2050, with about 10 million people per year dying. So innovation in this space is really important. And if you think about it, today's microbiology typically takes about 3-4 days from somebody sending a sample to the lab and getting a result. Do I have an infection, yes or no, and what is the right antibiotic? Now, we've made some improvements, so if I think about the acquisition that we did with BD Kiestra, that now automates, fully automates and standardizes the clinical lab. So it also ties very nicely into BD's connected care strategy.
That has got that time frame down from about three days to about 1.5 days. You look at something like Accelerate, and the partnership we have there, which is a rapid susceptibility platform, where for certain clinical use cases like sepsis, you can now get an antibiotic insight within 5 hours. So, you know, every day, bit by bit, we're shortening that time to the clinical insight. And then, yes, there are what we call hunting grounds, where there are technologies that we are looking at, whether that is sequencing, whether that is predictive susceptibility screening using AI. That's just an area that we continue to look at. But if we are collectively as an industry gonna fight antimicrobial resistance, technology advancements in infectious disease and susceptibility testing are gonna be really important.
Then, Biosciences as a whole, you obviously have a wide selection of different customers, but some of them are on the sort of biotechy academic side, and there's always, you know, a hoopla made over, like, NIH funding and stuff like that, and there's the biotech funding. What are you hearing from your customers at the moment?
Yeah, so I mean, Patrick, it’s an area that we continue to watch. I mean, the good thing about Biosciences for us is, you know, we continue to grow above category, right? So we’ve said that the category, it’s about a $3 billion space. The category itself is mid-single digits. We’re exceeding that. We’re number one or number two in the areas that we play in. You know, obviously a lot of the instrument acquisition is capital, but I think the nice flexibility that we have as BD is there’s also a lot of dyes and antibodies and reagents that we sell around that. So we have demonstrated a lot of sort of flexibility in terms of the way we think about capital acquisition.
And then to build upon Mike's point, when he was answering the GLP-1 topic, is a lot of where the bioscience platforms go is very early discovery. So when you think about, you know, and particularly in this quest for, getting better at cancer therapy, cancer diagnostics, immuno- oncology, you know, we just actually recently sort of press released a collaboration with Navigate BioPharma on CDx. And the goal here is, you know, how do we get away from these historical treatments of chemotherapy, radiotherapy, which is typically slash and burn the cells, and be much more targeted in cancer diagnostics? So the fact that we're seeing much of our research application be so early stage, right now, we're not really seeing any remarkable difference on the business performance.
I mean, you've timed that perfectly. Chris, Dave, Mike, thank you so much for-