Well, good morning, and thank you for joining us for our Bausch Fireside Chat. My name is Scott Rovin, and I'm a high-yield healthcare analyst at Barclays. Participating from Bausch today we have Will Woodfield, Will Woodfield, and Garen Sarafian. Thanks so much, guys, for joining us, and great to see you down in Austin again.
Yeah, thanks for having us. It's a pleasure to be here
Good to be here.
Yeah. you know, with, you know, 12 consecutive quarters now with growth in revenue and EBITDA, maybe we can start by just talking about worked so well for the company in general and more recently in particular.
Happy to talk about that. We are extremely proud of our record of 12 quarters in a row of top line and bottom line growth, and we hope to continue that streak moving forward. We have been really focused on top line growth, even better bottom line growth, and even better cash flow, t hat's how we view the company. A large part of that has been to do with performance, especially in our Salix and XIFAXAN business, as well as our Solta business and also international. We can get into all of those when we talk today. I would start with Salix especially.
Salix has been also on a streak where it's been nine quarters now with this quarter behind us of organic revenue growth, largely driven by XIFAXAN. XIFAXAN itself grew 21% this past quarter, which is fantastic, and we'll unpeel that in a second. Salix as a whole grew 18% this quarter.
I thought, you know, we were sitting here this time last year, 6% Salix growth. I thought that was pretty good. 18%.
Yeah. No, it's fantastic, and we should get into that a little bit because, you know, it's higher than normal, obviously. There's a number of reasons why that should be. XIFAXAN was 21% growth. I would ascribe that to three factors. First of all, the volume growth in our remaining channels that we're in, which is Medicare, commercial managed care, not Medicaid, where we grew very solidly, about 6% on a TRX basis on volume and demand, which for us is the most important thing of all. Second is the usual year-over-year list price increases.
Yep.
that you would expect to see, of course, every quarter. I mentioned that we were not in Medicaid anymore. As most of you know, we exited Medicaid in 340B in October of last year. We expected sales to go to zero. They've actually hung around a little bit in a much lower basis, and those sales are higher quality in terms of the net realized price that is subscribed to them because we're not paying the rebates on the Medicaid anymore. There's still a hunk of sales in Medicaid that have been hanging around for this quarter. When you combine those three factors, you get the 21% growth. We don't expect, again, that Medicaid piece to continue into the future.
Got it. Well, I'm sure we'll have a little bit more to say about XIFAXAN later in the program. I think Solta continues to also grow rapidly, right? I mean, maybe we can unpack what's been, you know, driving that strength, particularly in Asia.
Yeah, sure. Well, actually, I'd like to say a little bit more about XIFAXAN.
Okay
It's just worth exploring a little bit more why it's been growing so well for 9 quarters at this point.
Absolutely.
Certainly the volume and the demand is what it's all about, and w hy has that been doing so well? One is our consumer insights engine, which we've been talking about for a while. This has been AI generated. We've been using it since 2023. Like I said, since 2024, we've seen an unbroken streak of growth for Salix. That allows us to surgically target appropriate prescribers for the product. We've also been focused for a little while now on new to brand prescriptions, like new patients that are using XIFAXAN for their first time.
That's been a key KPI for us that's been very important and in fact, our sales force is compensated on the amount of take-up we get on the new to brand prescriptions. It was 3% this quarter when you exclude the value of Medicaid. We think that's great, and that's very important to us. In fact, since we've been focused on new to brand prescriptions, we've generated over 700,000 of such prescriptions. Between that and the consumer insights engine and just our continued focus on direct to consumer advertising and to physician targeting, we think that's allowed that consistent growth in XIFAXAN that we hope to continue for the rest of the year as well.
It's amazing that such a mature product can, you know, maintain that growth trajectory.
No, we're very proud of it.
Awesome.
Solta-
Yeah. Pivoting on to Solta, another, you know, pretty, spectacular grower. That market is a little bit different for some folks, you know, myself included, and it would be great to get your perspective on how that business operates and the stability and the sustainability of the Asian markets.
Yep. Absolutely. Solta I would say is one of our pillars of long-term growth for the company. It's unlike Salix and XIFAXAN, there's no notable LOEs. We expect it to continue to grow strongly for the foreseeable future. We do think it's capable of growing double digits for a while now. Obviously with a lot of growth in Asia, certainly, but we also have white space in North America, the U.S., EMEA, that we continue to see growth in, and we wanna expand that further and take more space in those areas. Obviously a big part of what happened this quarter was our Shibo acquisition, right?
Yep.
It's worth spending some time on that. As you know, in Q4 of last year, we acquired our Chinese distributor of Thermage and other, and other treatments through China, which was Shibo. We acquired it on December 1st, and we've been integrating it ever since to good effect. You saw that in Q1's numbers, where I believe it was over 120% growth in China, 52% volume growth in China. APAC as a whole was 22% organic growth. A lot of that did have to do with the Shibo acquisition. Why did we do Shibo? There's several reasons.
Number one, in acquiring our distributor, it gave us an important area of control over a part of our value chain, which is the distribution piece of it, and now we can interact directly with our customers, and it can be a two-way street of knowledge sharing and communication, promotion, things like that. That's number one.
Yep.
Number two is the fact that because now we effectively eliminated the middleman, we can take the economics of that middleman and incorporate them in our pricing effectively. We're now selling at the retail price to our consumers and keeping that margin, less of course the cost to operate the distribution.
That makes sense. I mean, we get a lot of questions on how should we value Solta. You know, this is a, it's a device company, but it's aesthetics, you know, has a, you know, large concentration in Asia. I mean, how should we think about valuation of that business?
That's very important again, considering, you know, as you think about what this company will be like when we lose XIFAXAN and at some point. The Solta will be one of the pillars along with international, which we'll talk about later. Solta, I would say again, it's very durable. Low LOE, n ot a lot of investment needed. We are putting in the investment, but it's not incredibly CapEx heavy. It doesn't have a lot of investment. We're appropriately investing in sales, advertising promotion, as well as R&D to keep the pipeline fresh, and we're also considering, of course, any business development that might make sense for us as well. When you factor those things in, let's start at the top line. Top line, you know, we are about 80% in Asia.
It's a little higher this quarter because of the one-time Shibo benefits. Strong presence in Asia. Korea's done well. It was 17% growth in Q1. China was massive. We do expect that to continue to grow for the reasons I said beyond for Shibo. We expect a lot of white space like I said in North America and EMEA, among other areas. As we continue to promote the product and invest in improved product offerings, that should continue to grow. Like I said, you know, we're hoping for double-digit growth on the top line, and again, without the LOEs. You have the appropriate promotion, the advertising, the selling, and the R&D.
When you're left, you still have a very profitable business, and you have fine profit. You have profitable margins both on the capital piece of it, which are the machines that are installed at the customers, and then those machines we use to sell, or those customers in turn sell our consumable products, through you know, to the ultimate patients, as treatments. They're highly incentivized to do that. You have these profitable installed base of machines, and then you have the profitable tips, which are used in each of the procedures by the customers. It's a razor-razor blade model where the actual razor is also profitable, and the razor blades are very profitable. You have about 75% split on the consumables, 25% on the machines.
Once you install the machines, they're just gonna have recurring revenue through each of those machines with hopefully more and more tips through to more and more customers. That's the basis for like the recurring nature of the revenue and the profitability that drops. We saw 40% operating income last year. Hopefully, you know, that'll stay in that zip code as we grow with more profitability, but at the same time invest appropriately. I mentioned the CapEx is quite low. When you combine those together, you have a lot of cash flow generated from this business. When you take that out and you've apply all of that, you know, we think it's a good multiple people should be thinking of for this business.
We've said, you know, mid-teens on an EBITDA basis could be appropriate even.
That's really helpful. I mean, I know back when the company had filed an S1 for Solta some time ago, their multiples were pretty robust, and if anything, the cash flows have been stable or and growing. You know, the performance has certainly been impressive.
No, thank you. Since then, I'd just like to add that Thermage FLX received regulatory approval in China.
Oh, right. Yeah.
at the time of the S1. We, of course, acquired Shibo. That's another step function of improved profitability and growth as well.
Allow you to control your own destiny in China.
Correct.
Excellent. Maybe or even we mentioned organic, y ou know, sales were flat there, but there's probably a little bit more to unpack than just the flat organic sales there.
Yeah, for international?
Sorry, international, yes.
Yes. International like I said, along with Solta, is one of our pillars of growth and value in a post-XIFAXAN world. We love our International business. It's profitable, it's extremely diverse. It's diverse in terms of geographic areas, customers, brands, therapeutic areas, they're all areas where we think we have a lot of value already. We're in highly growing areas of the world in Eastern Europe, Latin America. We have branded generics, which means they're products, you know, don't have LOE exclusivity on them. There's not the patent cliffs associated. They are available in generic versions. The teams in those markets have built brands around these products. They promote these products. They have sales forces. They have marketing, they're able to price accordingly for that.
We find it's a great business for the long term. We expect it to grow mid-single digits, you know, generally as a basis. Even though we saw, you know, puts and takes this time around, we do see lots of future in this business.
Great.
I'm happy to go through the different components of it.
Yeah, you know, if there were a couple, I think, like, Canada was an area where there was some movement this quarter. You know, anything you wanna call out there would be helpful.
Yeah. Canada is something that we called out last year, even as having a benefit that we had in Q1 of 2025 in terms of we sold more of our WELLBUTRIN product there, thanks to competitors having stocked out back in Q1 of 2025. We aren't able to lap that. You know, we just didn't have the same competitor stock-out situation we had this quarter in Canada that we had last year in Canada. Our promoted portfolio did grow 18%.
Yeah.
We won't have those types of headwinds from prior year growth, one-time growth in the future. We do expect growth to return to Canada going forward.
Okay.
Just to round out the segment on the Europe side, on the EMEA side, we love the EMEA business. Like I said, it's Eastern Europe. It's across multiple geographies and product areas. It grew 3% on an organic basis, and that was across our three largest markets, which were Poland, which were Serbia, Montenegro, and which were Russia, and it did very well. It was our 13th quarter of uninterrupted growth for that business. We expect to see further growth the rest of this year and going forward with about 30 new products that are coming online. You know, that's another important part about this international business.
It does not require a lot of R&D or a lot of BD to add incremental products into it that will grow over time, you know, when you start to stack them up the way we're starting to do so, this year.
Awesome. We'll touch on the BD in a second.
Yeah. Oh, can I just finish with LATAM?
Absolutely.
LATAM is, it was flat from an organic perspective. On the one hand, especially in Mexico, we have a very strong, I would say, you know, commercially available suite of products led by, What's the name of the product?
VYZULTA.
VYZULTA. Thank you. That's done very well for the quarter. On the other hand, we did have a timing miss on the government side when a tender we had won was not realized in Q1. We expect that tender to realize itself later in the year, and we'll see a benefit from that. We're also rolling out cardiometabolic products this year. Started last year, we continue to roll out this year, which will be another source of growth. We expect to see growth in LATAM for the rest of the year and going forward as well.
Okay. Maybe we could just like round out the business line with diversified. I know diversified saw some organic declines based on volumes in neuroscience. I know, like, neuroscience is an area you've actually highlighted as a core competency for the company. I don't know. Is there anything you wanna call out there? Maybe as a segue, talk a little bit about some of the, you know, the business development initiatives that the company has been undertaking.
Sure. Absolutely. Neuroscience is a big part of our diversified portfolio. It makes up about 60% of the revenue of that segment. We do expect it to decline over time without any business development or pipeline products. Why is that? Because WELLBUTRIN, which is our flagship product, has been off patent for many years and has already significant competition. It's hung around very well, it has declined every year. It did decline in Q1, which is part of the reason why you're seeing the volume decline.
Yeah.
We've had APLENZIN, which is our second-largest product in that space, that APLENZIN has done well. We do expect to lose its exclusivity in July of this year, and that's factored into our guidance, of course. That will be another downdraft for the back half of the year and going forward. We have a lot of other products which have lost their exclusivity and are facing downward pressure. Again, that's driving the volume decrease. I would just be remiss not to point out that we exited again, you know, Medicaid last year. That means that we're not selling through that channel, and that's further volume decrease. That's why you saw the results you did in neuroscience.
To go to your question about why we think that could be a good opportunity for business development, we own the WELLBUTRIN XL space. It's performed way better than it should have considering, you know, losing its exclusivity. We have been promoting very well, we think, WELLBUTRIN XL as well as APLENZIN. We have a sales force in place, w e know the space very well. We've done the regulatory work around keeping those products online.
That's something where we could see some good opportunities in the area of BD in terms of neurology, where it could be the right fit for a product or business that we could, that we could take either from, you know, the near-term R&D perspective or for the commercial perspective, and that would lend itself very well to our neuroscience franchise. I think to, you know, the same logic could be applied to GI. Again you know, with the knowledge that we have, from certainly from Salix, from larsucosterol, which is now in phase III trials.
Right.
You know, that's a prime example of the type of BD we could certainly consider, where it's a tuck-in, and it's near term, and we can guide it. We shepherd it through the remaining R&D processes and then launch it in the medium term, near to medium term. That's like a good template, a good template for the type of BD deal we could certainly do. Dermatology and Solta could also be areas where we're focused on those, on those indications. Again, we have the expertise in the R&D side and the commercialization side.
What's the market opportunity for larsucosterol?
We haven't really talked too much about that.
Okay.
We just think it fits in very well into the space that we know about, and we think the AH market could be good.
Okay.
Appreciate the question on 2029. Thank you.
Fair enough. Well, I'm sure that people are gonna be excited to talk about the next list of topics here.
Yeah.
A lot of these topics are somewhat intertwined, but, you know, maybe we could shift gears to BLCO.
Sure.
My personal favorite topic. You know, you can imagine we get all sorts of questions about BLCO. Operations, valuation, M&A, monetization. I realize you're not the management team that runs that company, but as owners of that business, I would think you'd have a very good perspective that you could share with us and with me. High-level thoughts in terms of some of these matters would be really helpful for us.
Yeah, absolutely and we love the B&L business, we are very excited by the management team we have in place and the good work that they're doing. We fully stand behind their Investor Day projections that they made in November of last year. One of our corporate goals is to make sure that we give them every opportunity to realize those projections and to help them along any way we can. I didn't wanna go through a blow-by-blow of their different segments and performance.
Yeah. No, just a high-level observations.
Yeah
You know, there are a lot of facets to the business for sure. You know, like I know that like, for example, your business, like you put up a $1 billion of cash flow. I think, are we at the precipice of, you know, seeing some real cash flow and some operating leverage at BLCO?
Yeah, I think we're seeing definitely good progress from them, as you saw from Q1, certainly the goals that they put out there, we think are entirely realizable in terms of their certainly their top line. They've already shown that, we've started to see already some margin expansion, we, you know, look forward to seeing more of that. I think by the time we get into 2027, 2028, we expect to be at those projections they put out there. We think at that point, that's when we can start thinking about starting to monetize our investment in them.
We've said all along, we expect in order to address our cap structure to get it to a somewhat more normalized level, we have to monetize assets, and that the asset most likely to be monetized is our 87% stake in B&L. Which as of today, you know, adds a lot of value to our balance sheet, but we're not getting necessarily the cash from it. They're keeping the cash to themselves and which is absolutely fine 'cause they're, you know, investing in their business. Our goal is to give ourselves the runway to monetize later rather than sooner, that B&L stake when those objectives from their Investor Day last year are more fully realized, when hopefully the market will be giving them the credit they deserve for that performance.
At which point, you know, we expect them to be substantially more valued than they are today in terms of their share price. Then, you know, the shares that are backstopping the debt we raised last year with you guys and the uncommitted shares that we still have of theirs, that'll be worth more. So, it'll be a win for us and all of our debt and shareholders, you know, when we do realize it when the time comes.
Yeah. I mean, I guess like, again, bigger picture-wise, when you think about, you know, that ultimate realization event, do you think about that in like one fell swoop? Do you think about that as like, you know, there are a number of different businesses operating, you have surgical products, pharma, and each of them has their own sort of, you know.
Yeah
Nuances and growth,
Yeah
Opportunities and then as we think about the potential buyers of those businesses, you know, competitors, private equity firms, I mean, how do you guys think about the ultimate monetization? Is it like sort of one sort of target? Is it a moving of a variety of different options? I mean, is any kind of high level thoughts in that area would be helpful.
Sure. The short answer is, we are open to lots of different options here. I don't think there's one size fits all. I think we'll see how things progress over the next few years, a nd see what makes the most sense given the situation at hand and the opportunities at hand. The good news is, thanks again to the series of refis we did last year with some folks in the room, we're able to give ourselves that operating flexibility to get through 2028, assuming a, you know, a 2028 LOE on XIFAXAN.
We can get through our 2028 maturities, we believe between the over $1 billion of cash we have on hand, the several billion dollars of cash flow we expect to generate in 2026 to 2027 going into 2028. We expect to get through our 2028 maturities, and then only in 2029 would we need to do something extra beyond just apply cash to our debt.
All of that will give us time to, time for B&L to perform and meet its goals and, time for us to figure out what's the best way to monetize, whether it's any of those options, whether it's, you know, an auction, like what we looked at a couple of years ago versus selling into the market over time versus some combination thereof.
Yeah. Sounds, like you wanna keep your options open.
Yeah
Which makes sense. Now good segue into XIFAXAN. In the most recent earnings call, I think the company largely maintained the party line about the LOE in January of 2028. You know, that said, I know there are some potential wrinkles that could possibly change that timetable. Again, without going into too many nuances of the different changes that could take place, at high level thoughts on maybe what we could expect to see reasonably unfolding in 2026 and, you know, some of the things that, you know, may give you pause in terms of, you know, possibly adjusting that timetable to some degree.
Sure. There's many ways that this could go.
Yeah
We're gonna stick to the kinda high level facts on the ground and, you know, without going into too much speculation. As, as it stands now, we have settled with four generic competitors, and that settlement involves the first generic of XIFAXAN going out on the 1st of January 2028. That's, that's a fact. Secondly, we believe, as does the FDA and as does Teva, that Teva has the first filer rights that would grant it 180 days of exclusivity, you know, as the after launching their transaction.
You know, that was challenged by Norwich when Norwich sued the FDA for failing to grant Teva full approval, or filing or because to not grant Norwich full approval because Teva should have forfeited its first filer right. That case was dismissed. Norwich appealed, and now it's in appeal court, and we're waiting to see what the answer is. We check every Tuesday and Friday. Nothing today. But it could happen any time. Basically the situation is that the FDA believes that Teva's retained its first to file. Teva has and so do we.
In fact, you know, this, a few months ago, Teva did receive a full approval, a final approval on its version of rifaximin, which we think further strengthens the case.
I mean, does the base case assumes that there's no changes or that if that for some reason decision perhaps was remanded back to FDA, obviously like that timeframe could effectively be like 2028 maturity. Again, I know there are different possibilities, but your base case is that?
Well, without going into cases, I would say that the, you know, original court found in favor of the FDA and Teva.
Yeah.
You know, we're waiting to see what happens here. There's also the thirty-month stay component of it, which we think also should apply in this situation since Norwich, you know, did its second ANDA, its skinny ANDA, you know, the Norwich two scenario.
Yeah.
That would delay anything until later this year anyway.
Yeah.
There's, you know, steps after that would have to happen as well.
Yeah.
There's also the IP litigation that we expect end of summer that's separate, that's still out there with no case, date yet.
Right. Understood.
Yeah, you're talking about the Amneal-
That's the Amneal. That's separate.
That's at the end of the summer.
Exactly.
Well, there's no trial date set.
We think it's gonna be in the summer.
Basically it's gonna be in summer.
Yeah, m akes sense. Again, it just seems like flexibility probably around these matters makes a lot of sense and that's exactly what I think the company said in their most recent earnings call. I think you discussed, in conjunction with some of these, you know, again, you can't predict the future entirely. You pointed to some aspects that were a little bit different in terms of exercising certain options of flexibility, and maybe we could talk about a couple of the things that you mentioned in your most recent earnings call.
Sure. I mean, if things were to go against us for whatever reason, I think it's the same strategy that we just laid out, we would have to accelerate it just for the fact that we would lose cash flow earlier than we otherwise would have.
Yeah
Versus the 1128 LOE case. In that case, we, you know, it would be harder to get through our 2028 maturities, and we would have to monetize B&L and/or other assets earlier than we otherwise would need to.
Right. In terms of like the earlier monetization of assets, I mean, if we just like, dig in there for just a second. Are you talking about maybe, BLCO shares or with BLCO in general or any other assets? Any perspective there would be great.
I mean, we're always evaluating everything. Everything's for sale at the right price, of course. BLCO shares, as we've said, are not granting BHC parent cash flow or any other benefit other than just the value of those shares. Those would be the logical target for monetization, w e would, you know, but a lso, we also have these other valuable assets that we've talked about, whether it's Solta or international. We would certainly not want to sell those unless it's at a great price, considering the long-term value that they would continue to accrete for the company. We just have to make sure that whatever situation we were in, we would find the most appropriate answer.
Certainly the BLCO shares would be the logical, kind of, area to approach in those situations.
Great. No, that makes sense. Just to, you know, kind of going back to the other sort of possibilities in terms of maintaining flexibility. The company mentioned potential business development initiatives.
Yeah.
Also mentioned refinancing of maturities through 2028. Maybe we could just, you know, in terms of like exercising what those options might be and how you might address those matters.
Sure. I think that there could be a connection between those two issues.
Yeah
As well, certainly. We've got a lot of liquidity right now. We have over $1 billion of cash on hand. We're generating lots of cash flow as you've seen, and as you've seen our guidance. We expect that to continue through the LOE of XIFAXAN certainly.
Yep.
That gives us firepower should we choose to pursue BD. We talked a little bit about BD, what that could look like, whether it's things like larsucosterol or slightly bigger or larger targets that would again fit into our wheelhouses in those, in those areas. I think in terms of the debt refinancing side, we obviously did a lot of great work with people in this room last year. We'd like to do more. Certainly we can cover our 2027s with cash that we can cover our 2028s.
If we're able to refinance some of those maturities that are coming up in the next few years, that would just give us more firepower that we could potentially use even more for business development, for example, or not using our B&L shares as early in terms of selling them and then letting that value accrete for when we do eventually monetize them later rather than earlier, which again, would be a win. That's how we think about it.
Right. you know, I guess that's a probably a good segue into capital structure.
Yeah.
I know, you know, we've been sort of building towards this and touching on it a bit, but I was just looking back at my notes since the last time we were here. In the last 12 months, you guys have generated at BLCO $1 billion of cash flow. You pushed out $10.8 billion of maturities through 2028. Boy, what a difference a year makes.
Yeah.
You know, maybe, you know, as it relates to those numbers, right? You have $700 million of debt maturing through 2027.
Correct.
$3 billion through 2028, and about a billion and a half dollars worth of liquidity today.
Yeah.
You know, again, I know we've kind of touched on it a bit, but let's talk about how we sort of bridge those two numbers.
Absolutely. Again, very, very happy with how things went last year, we're happy with where we are today. Like I said, we can cover the 2027s with cash on hand that we actually have sitting on our balance sheet today. 2028s, we can get through with that plus the cash on hand. When you're looking at the 2029s and later, we do have the B&L shares that are currently uncommitted to anything. That's about 28% of all of B&L shares, and it's about 98 million shares, actual shares.
Yep.
In a base case scenario where we don't do a refi, we don't do, you know, business development, that can be applied to the 2029 maturities, early 2030 maturities.
Right.
Before you get to your term loan in October, when then, of course, you've got 60% of the BLCO shares supporting that term loan and the 2032 notes. You know, on a base case scenario, we would expect to start using the uncommitted B&L shares to help address the 2029s and early 2030s.
Right. I mean, have the company give any thoughts at all to more of like a global refi? I mean, I know you have like, a lot of, you know, smaller bonds trading at discounts.
Yeah
Is there any type of like global refinancing that the company might be considering?
Yeah. We think when the time comes, a global refi will be appropriate, and that's going to be, I think, when the confluence of several things happens. The first would be, of course, the B&L share price being at a level that we think is appropriate to monetize.
Yep.
At which point, of course, we could then monetize the 60% of the shares that are backstopping the 2030 term loan and 2032 notes, which that will pay off a lot of debt and, at which point our leverage will drop significantly, and we think that would be a good impetus to do a global refi, hopefully for, you know, a more normalized capital structure. That would be the target. It would be the B&L shares being at a good place and/or getting to 2030, whichever happens first.
Great. Maybe with the couple minutes that we have left, I mean, you know, we've kind of touched on business, we've touched on your big assets. We've touched on the capital structure. You know, maybe we could just, you know, discuss recent events within the world and see how maybe those matters affect the way you're operating your business today, the way you're planning for your business tomorrow. I know that like tariffs has been something that has driven a lot of conversation in the past, maybe not so much more recently, but any perspective in terms of some of the, you know, kind of the recent developments in the world and, you know, it's more expensive to, you know, ship products from point A to point B.
Like, how do these things affect the way you plan your business and your potential profitability going forward?
Sure. When we had our earnings call a couple of weeks ago for Q1, and we reiterated our guidance, we did call out, I believe, that, you know, we were taking into account the latest tariff developments, and there were some in that.
Yeah
in the Q1. There were some new tariff developments. We factored those in. Some of those are later in the year. Regardless, I would not call them material to our business. We are fortunate as a, as a largely pharma company or else a medical aesthetics company with good margins that, even though there are certainly costs added to our cost of goods sold and our manufacturing, our margins are such that we can absorb them without too much problem. It's not been, by any means, a major drawback for us as we manage our business. I would say, the energy crisis has largely not affected us. The tariffs have largely not affected us. I think, we're seeing very good growth in China.
People have been very focused on China's economy and what's going on there. It seems like we've hit the sweet spot of consumers who haven't been too affected by the property situation going on there, and we've seen robust demand from them, as you can tell from our numbers, and we hope to continue to see that going forward.
You've already kind of baked in the IRA impact in Q4 to what, you know, what may, you know, is ultimately gonna affect the price of XIFAXAN going forward.
That's right. Just as a public service announcement, we've talked about this a little bit, and I'm glad you brought that up. Yes, we've baked in the 2027 IRA impact for XIFAXAN. Just again, the public safety announcement is that we expect to have a hit at the very end of Q4 as we adjust what's in the wholesaler pipeline that's going to be sold to Medicare. We have to adjust the gross to net value of the higher rebate that's going to happen on January 1st, 2027. That's going to impact our results on the last day of 2026. That will be a bad guy.
Yeah.
We had kind of had a separate opposite situation when we exited Medicaid on October 1st. We had to make an accrual true-up in September 30th of last year to reflect the fact that we were no longer selling into that channel with those rebates, and we got a one-time benefit. This time, in the end of 2026, we're going to see a one-time detriment. We factored that all into our guidance.
Also for 2027, we also gave implied EBITDA guidance when we said that 2026 and the average of 2026 and 2027 EBITDA would be approximate to 2025, so that you have guidance for 2027 as well.
Correct.
Right, r ight.
That also includes a full year of IRA, obviously.
Right.
Thank you very much. Well, I think that's, I think that pretty much wraps it up, t hanks very much. Enjoy the rest of the conference, and we as always, appreciate your participation.
Thank you.
Thank you for having us.
Thanks again. Well, thanks, Garen.
Thank you, everyone.
Thank you.
Thanks for all of you who supported us.