Hello, and good morning, everybody, to day two of the Citibank Global Healthcare conference here in Miami. And I am Joanne Lynch, the medical technology analyst here. And I'm thrilled that we're going to start this session with the management of Bausch + Lomb . Brent Saunders is Chairman and CEO, and Sam, oh, I'm going to call your last name. I'm sorry.
Eldessouky.
Wow. See, I feel like with Lynch, I get away with doing that. Anyway, I remember when Bausch + Lomb was spun out several years ago in its IPO, and a lot has changed, and we were just talking before we started this presentation about your analyst day, which sort of gave us the catch-up speech, but I'd like to get each of your opinion on what you're seeing of the company today and how it's evolved.
Yeah. So great question. I came back as CEO in, I think it was February of 2023, so what was that, about nine months or 10 months after the separation from BHC. And what I saw was a company that I knew well because I'd been CEO before and a space I knew well because ophthalmology, even Allergan, was a big player. But that kind of was stuck in neutral. So it wasn't necessarily a turnaround, but it was a revival. And so by design, in my head, I said, "The first thing we need to do is really focus on a couple of quick things. We have to focus on selling excellence and get to growing faster than the market. We need to focus on operational excellence because our supply chain was a big problem for us, particularly coming out of COVID and some of the supply disruptions.
And when you can't supply your products, it's hard to have selling excellence." And then third was build innovation. The cupboards were bare. There wasn't much in the pipeline, and the lifeblood of any healthcare company is innovation. And so we focused on those for the first two and a half, three years, and you saw some of the output of that in the presentation. And so what I would say is I'm very proud of what we've accomplished in transforming Bausch + Lomb into a high-performance competitor. But the last piece of the puzzle is financial excellence. And we do need to get our margins, and more specifically our EBITDA margins, in line with our competitors or even better than our competitors.
At the beginning this year, we started our Vision 27 program, which was a very massive program encompassing hundreds of programs and projects around the company, thousands of people working on it to really improve OpEx, improve gross margin, and thereby improve gross margin. Sam can walk you through how we're thinking about that. We're also very pleased to announce a three-year plan at our analyst day that shows a very thoughtful story around margin improvement, sales growth faster than the market, and a deep innovation cycle. If we can pull off all those things, which I'm highly confident we will, then I think Bausch + Lomb can start to argue that we're the most dynamic, exciting company in the eye health space. I think we've come a long way.
We have a lot more work to do, but I feel really excited and positive about where we are. I don't know, Sam, would you?
No, I completely agree with you, Brent. And I think the work that happened over the last couple of years, especially this past year in 2025, we put in the building blocks for what we need to accomplish going forward to 2028. And I think that was with the kickoff of Vision 27, which really was focused on how we can manage our fixed costs within the P&L, how you can drive leverage in the P&L. And really, that transition, as we saw in Q3 with the margin expansion we saw in Q3, puts us in a very strong position to be able to push that forward into the rest of this year and into 2026 and beyond.
But I think, Joanne, to one more point I'd make, some people may say, "Well, why didn't you start financial excellence when you started?" And in my experience, and maybe the people have other answers, but it's really hard to get people to focus on cost-cutting when you don't have growth. It's much more dynamic and exciting for the 13,000 colleagues to have the wind at their back in terms of selling excellence, the supply chain working, and of course, getting really excited about innovation in the future, and then say, "Okay, guys, now that's all lock arms," and really get disciplined around how we spend.
I think my early notes on the company referenced it as crawl, walk, run, and I don't hear you using those phrases now, which tells me you're well past crawl and maybe moving somewhere between walking and running at this stage.
I think that's accurate. And my hope is in 2026, you'll start to see us jogging and moving to running, right? Because you're starting to see some of the real output, right? You see a pipeline that's deep and diverse, filled with really great opportunities to change the standard of care across all of our businesses. You see the sales growth now for several quarters being faster than the market, and you're starting to see that margin improvement. You saw really good signs of that in the third quarter. We expect you'll see it in the fourth quarter and so on and so forth, so you're starting to see actual output. It's not just us saying it. It's actually happening.
One of the things that comes up very frequently as I'm talking with investors is the ownership structure of Bausch + Lomb. I'm the 88% that's owned by Bausch Health. Very frankly, I would have thought that would have not been 88% these years later. How should we think about that liquidity increasing?
Yeah, so I agree with you. I didn't think it would be either. That being said, I think both companies and both boards are committed to solving it. The timeline is really out of our control. It's more of a BHC board question, but I think they're a good board. They're very serious about trying to solve for it, but I think they need some more time still.
Okay. I want to talk about the financial slides, which you put up, and the 5%-7% revenue LRP. What were the components that got you there? Because some of the investor pushback that I received was like, "They're already there," as if it was like, "That was easy. They already got there." But I'm curious, what went into that number or that range? And is that a stretch goal, or is that just sort of something you're quite comfortable with?
Yeah. So maybe I'll start and then Sam can. So obviously, when you do a three-year LRP, it's hard to predict the future with perfect accuracy. We know what we can control. What we don't know is what we can't control. A good example is economic environment, things like tariffs and other things that we dealt with this year that throw us curveballs. But based on what we know today, we feel pretty confident about what we gave. I think it's very balanced as a way to think about it. And then, of course, it's not mutually exclusive. We're going to give annual guidance every year in the normal course. And that could be at the higher end, hopefully, if the world is working the way we anticipate it working, or it could be in the middle of that range. I don't suspect we'll see us towards the low end of the range. I don't know.
Yeah. And Joanne, I think when you have to think about the 5%-7%, you also have to put it in perspective with the market, overall market, right? We're a market that's growing at mid-single digits percent. And the work and the strategy that Brent outlined for us in the last couple of years was, how can you grow faster than the market? And I think what you see in the 5%-7% is a demonstration of the execution around growing faster than the market. Really, our guidance, and you've seen it in how we gave guidance in the last two years, we're quite balanced with our guidance. So we try to put a guidance that we understand that there's always opportunities that you see. You look at this guidance and say, "There's different parts of the business." We have four businesses.
Each one of those businesses has opportunities to be able to outperform from their respective point of view, and I think, again, it's a long-term guidance, so I think we'll take it as we go along for the next three years, but it's a very well-balanced guidance.
So, one of the things which you've also been doing over the last couple of years is very selective tuck-in M&A. And I'm curious your philosophy of what is tuck-in, what is M&A, and at what stage, given the pipeline that you do have that we saw unveiled at the November 13th analyst meeting, do you really need much more, or how do you think about that?
Yeah, so I would say right now, we don't need anything, and in fact, the three-year plan we provided contemplates no M&A. This is all organic. Anything we did would be additive to that. Look, we also want to improve our balance sheet, and that's important, and we hope to be at three and 0.5x net leverage by 2028 as well, or frankly, better. And so that's also a consideration that we have to play into it. I think to the extent we do tuck-in, the way I think about tuck-in is one of two things. It's something that, frankly, is smallish, and it's something we can drop right into our infrastructure and get leverage and accretion almost immediately, if not immediately, or it's intellectual property that helps make the pipeline that much stronger.
So, for example, we did a deal with a very small deal, but an important deal with Ripple Therapeutics to get access to a drug delivery technology to use our alpha-2 agonist potentially for geographic atrophy. That's an IP tuck-in for R&D. We bring a great technology, great expertise in sustained delivery, and we don't have to build it ourselves internally. We leverage a great partner like Ripple.
And when you think about investing in that situation, it was more in the pharma family. How do you think about which area to put your money to work in?
Yeah. So obviously, we want to support all of our businesses. I think the ones that require the most outside help are probably pharma and surgical. Contact lenses, like we discussed with Project Halo, we have a deep R&D from beginning to end, fully vertically integrated. We can do that ourselves. And then consumer, we can do ourselves. And so I think, to be fair, you tend to want to look at supporting the businesses that can really thrive from external partnerships and relationships and can build a broader portfolio and service our customers, most importantly, as robustly as they can. And surgical and pharma are probably the areas we tend to bias towards a little bit more there.
We'll start with contact lenses. You do have a couple of products that are in there. The new material that you're excited about, is there anything that you can flesh out about the timing of bringing that to market? What makes this new material so special?
Sure. We announced Project Halo, and so this is a bioactive platform. What our scientists were able to do was to create a novel material, first time in 25 years, that can deliver enzymes or proteins to the eye that are beneficial via the platform. We're starting with hyaluronic acid, but there are other ones that are sitting behind it. What we found is one of the biggest problems in contact lens wearing is 70% of contact lens consumers report end-of-day dryness, and so that's important to solve for if it's that big of a problem, right? It's not just because we want to create the best product, which we do, but it's also about expanding the market because you have a lot of dropout because of that end-of-day dryness.
So if we can solve both of those things, I think that's a win for us, and it's a win for the practitioners, the ECPs, as well, to keep people in their contact lenses and expand the market. What we love about this product is that end-of-day comfort. The way that the hyaluronic acid works with the enzymes in the eye creates this environment in the eye that has continuous release of HA that's interacting with your ocular enzymes to create comfort throughout the day and even at the end of the day. The data is compelling. We've done about 10 internal clinical studies on patients, and the data was great. We're in the full external study right now, and we should have data by mid-next year.
And then we'll do the registration claim study and launch in 2028 or perhaps maybe a little earlier if we can keep the enrollments going really well. So far, so good.
When you bring a new product like this to market, my memory is the last time we had a big step up in material was the introduction of silicone hydrogel. That was 20 years ago.
Yeah. And we never want to do that again. So to be fair, my second day when I returned in February of 2023, I went up to Rochester to meet with the contact lens R&D team. They're a great team. And they did a poster session for me during lunch where I walked around, and a lot of the scientists presented what they were working on via a poster. And I spent 10 minutes at each poster. And I got to the one on the bioactive platform, and I immediately called our head of R&D, and I said, "This is really cool. Can we do this?" And so we got everybody together the next week. And I said, "But here's the deal. We'll greenlight this, and I'll support it, and I'm going to meet with you every other Friday and review progress.
But you have to be able to make it on an existing platform. We're not going to spend another $1 billion+ on capital." And to their credit, and you heard Brian Reed at Investor Day say that made the challenge monumental, right? Because normally, when you have a new material, you have to create a whole new manufacturing environment. But to their credit, they cracked that code. And so we can make this on our existing lines. The capital expenditures here will be minimal. And what that means for us is a high-margin lens from the get-go. And we shouldn't have capacity constraints at the get-go. And so this will be the first time we can launch a lens in a robust way at a very high margin in 2028. So it's super exciting from that perspective.
The contact lens market has slowed. We look at our contact lens market model. It looks like in the first half of the year, it was about 4%. Waiting for the last one tomorrow night to close out the third quarter. Why has it slowed?
Yeah. I think it's a complicated story. I agree with you. It's probably in that 4%-ish range. We're growing obviously faster than that. I think it's coming from a variety of different things. I think one is you see a little bit of a slowdown in Asia, Southeast Asia, and China in particular. Those are still very strong, viable markets for the future. I think they're just going through some economic difficulties. If you look at October data from China, growth was 2.9% in October, off of a year that's going to be about 4%. So it's growing, but it's slowing, right? Consumer sentiment in China still remains pretty robust. But if you look at it more globally, you're seeing a bifurcation where the lower-end consumer is feeling more strapped, and the middle and the high are still spending robustly.
And so I think you're seeing more of an impact on the private label. We're seeing it actually even in lens care. The private label is more challenged than the branded, which is very odd. And I think you see it in contact lenses as well. So it doesn't impact us as much, but it is an issue. I think it will get solved in time. Hopefully, 2026 will be a better year for the U.S. And Europe still seems pretty okay. But I suspect that 2026, we could see the contact lens market shift back to something higher than 4%. Maybe it's 5% or somewhere in between. But I think it's going to be in that zone.
What percentage of the market right now is private label?
Do you know that? I don't.
I don't have that percentage.
I'd have to get that for you too. I'm going to get it for you.
For a while, it was just like.
We don't participate in it. That's why I don't know.
There you go. Okay. That's a good one. I'm going to switch a little bit over to consumer then. And I want to ask about some of your brand name products. I mean, PreserVision has been around forever. Lumify continues to take strides. Outside of these two, am I missing a key product that you're like, "No, Joanne, make sure you focus on this"?
Blink.
Blink.
The Blink was brought in, and it has been a strong double-digit grower in our hands, and what we did with Blink is we positioned it a little bit differently than the market-leading lubricating drops, and it's designed more for the modern user, the younger user, the gamer, the social media, people staring, TikTok users, people staring at their screen, and our team's done a phenomenal job of driving real growth, and we have some innovation coming, not only the preservative-free formulations, but the new Beat the Blink delivery system. I'm an avid user of Blink. I use it 4x or 5x a day, but I'm a horrible dropper in the eye. It runs down my cheek. I miss.
Streaming like your car.
Yeah. And I've had many ophthalmologists and optometrists try to teach me how to do it better. I still stink at it. But Beat the Blink, I tried it. It is so cool. I think it's not going to work. I'm going to blink when I click it.
Is it like a spray?
It's a spray, and you just hold it right in front of your eye, and you click, and it does. It Beat the Blink every time. It goes right in seamlessly. So it's a really cool consumer experience upgrade. And ultimately, I think we can even use it in our pharmaceuticals. A little longer pathway there would be a.
So it's a delivery sort of.
It is, but for a consumer, it's a straightforward once-and-three kind of thing. For pharmaceuticals, we have to do some more clinical work.
How do you leverage the products that are more mature, the PreserVision of the world?
Yeah. So PreserVision is the market leader, very strong market share. But it's very limited to people with advanced AMD, is where it tends to get promoted and doctor-recommended, which is so important in that brand. And with AREDS 3 coming out next year, we open up to the all-comers. So we expand the market, but for us, by almost 3x to almost all 28 million AMD sufferers, no matter where they are in their journey. And so that's really a huge opportunity to expand the market and give people, right, with a very serious disease, something that they can do till they hit the advanced stage, and they have to get injections, right? And so that's why it's such an important part of the therapeutic regimen for patients with AMD. And really excited to have AREDS 3.
And Lumify?
Lumify has been a home-run product. It's probably our one product that's not technically just an eye care product. It's a beauty product, and we have done a lot. The team is really, to their credit, has really moved into the digital world with Lumify. It's now available on the TikTok shop. It's eligible for influencer, the system that they use for influencers to promote it in the TikTok shop, but we also have innovation coming, right? We finished the phase III study for Lumify Luxe, is the working title we're using till we get the brand approved, and adding HA changes the consumer experience. So we have a great eye whitener, the best eye whitener, right? And I use it. My wife uses it. All my friends use it, and it really makes your eye look beautiful and white.
But any really good beauty consumer product, which I have a lot of experience from Allergan doing, also should have a luxurious feel. And adding HA really creates that comforting, luxurious, silky smooth, is what we heard a lot from the study participants. And the data from the study was terrific. We hit every primary and secondary endpoint with strong statistical significance. So the NDA is being filed, and we'll get that out probably in about a year.
So Sam, I'm going to ask you before we get into some other products, how do you help work or manage your budget for research and development? Because there's a big pipeline here that I keep hearing about.
Yeah. And it's interesting because when you look back in the last couple of years, we didn't have that pipeline. So I think we were very deliberate about how we actually allocate investment in R&D for the last couple of years. And we spend a fair amount of time, Brent and I, talking and talking with Yehia, who's the head of our R&D, in terms of which programs you allocate also the funds to. So we've been running roughly about 7% or so of revenue in terms of R&D. We extended that up to about; now we're approaching about 7.5%. And as we touching the 8% or so to continue to fund those programs. So I think one of the key elements is we really focus on the science behind the program, the TAM, or the total addressable market that we're actually about to enter with the pipeline.
And more importantly, how are we going to be able to position this within our commercial team as we go forward? So a lot of discussions that goes on behind the scenes on those aspects. But really, we've been focused more of really how you can actually allocate where you're going to get your return, what's the science behind it, and are we anchored into science or no?
The other thing I would say, Joanne, is for Vision 27, R&D had to participate, even though their budget is expanding. And their goal was to move, if you think about or oversimplify how you think about an R&D organization, it's kind of the maintenance of business and infrastructure of R&D, and then it's programs. And their goal was to reduce the amount of money they spend on maintenance of business and the administration of R&D and shift their allocation more towards programs. And so that's a pretty meaningful shift inside of our R&D organization, using AI, using just better management and efficiency to reduce the burden on the day-to-day running of R&D and allocate more money towards actual programs, which become products, which become sales, right? And so that's where a healthy R&D organization should be overallocated towards programs and less to the administration side.
Excellent. I want to go back to products here and talk about dry eye. And we've spent a fair amount of time talking about Miebo and Xiidra. How do we think about those two different products ramping forward? And how do we think about the collective of what's really happening in the dry eye market? Because I can count on, well, probably two hands, but definitely one hand, different dry eye products, whether it's more mechanical or whether it's more drop-like pharmaceutical that are coming to market.
Yeah. I mean, I think, look, I've been in the dry eye space for a long time, having had Restasis at Allergan and now Xiidra and Miebo. I can tell you I think we have the best portfolio of products for patients. I think if you survey doctors, ECPs, they would say that for most dry eye patients, Xiidra and Miebo are the gold standard for solving or alleviating symptoms of the disease or treating the disease, I should say, is a better way of saying it. And so I think we're in the pole position. We're in the leadership position. Most dry eye disease is evaporative. We have the only evaporative drug in Miebo. And then inflammatory is the second biggest category. And we have the best inflammatory agent in Xiidra. So we have the best. I think when you look at the competitors out there, they're niche competitors.
They fill a smaller niche void like increased tear production or nothing's working, so let's just try something else kind of solution or cost, right? And so I think we're in a great spot. And then ultimately, what we announced with our phase II program on the combination of Lifitegrast and Miebo, I think is kind of the best in class because this is a multifactorial disease. Patients sometimes need both an anti-inflammatory and an anti-evaporative. It's hard for many ECPs to diagnose what's driving that dry eye disease. Giving people multiple drops leads to both cost and compliance issues, right, persistence and compliance issues. And so having a combination therapy for a multifactorial disease is what we've always done in this industry. And so this is the first of that kind. And we're super excited about it.
So if right now I go in with dry eye, am I walking out with two prescriptions?
Unlikely.
Unlikely. I'm going to walk out with one. It's going to work or not work. And then I'm going to go back, and they're going to give me a second one.
That's right.
And then if you offer a combination product, is that your third leg of it?
No, I think the position for the combination will be first-line therapy.
First-line therapy.
Because it's the easy button. It's going to provide instant, hopefully, well, I have to back it up with data, but it should, the product profile and what we believe from the scientists is it should provide immediate and enduring relief from dry eye.
Okay, and in the area of glaucoma, you have some products that you've sort of said you have, but without a lot of detail.
Yeah. So we do have. We're repeating a larger robust phase II study for our glaucoma product. What we saw in the first phase II study, so we have data on this, is a very potent alpha-2 agonist that works differently than the others that are out there. And we explained that in the R&D day. I'm happy to dive deeper on that, or someone can watch the replay. But what we saw and what was so exciting about this is a game changer in the treatment of glaucoma is functional improvement. So most glaucoma patients, even when they control their IOP, still lose vision. And that shouldn't be, right? We need to stop just managing a symptom of the disease, intraocular pressure, and actually help preserve and provide some neuroprotection to preserve vision. And we saw about 15-line gains at low luminance in the phase II study.
We're actively enrolling in the broader phase II- B study, and if that data is replicated, this is a game changer, right? If you have glaucoma, this will be the best option for you.
It'll be an eye drop?
It'll be an eye drop.
That will replace other eye drops?
It will replace.
In theory.
Yes, because it controls IOP as well as the current therapies, but has the added benefit of what patients care about is their vision.
Right.
Right, and ECPs too, right? The whole community is built around preserving or restoring vision and symptoms.
When are we likely to see that data?
We should see that data towards the end of next year.
Okay. In 2026?
Yes. Back half of 2026.
Okay. Excellent. I want to spend a little bit of time on your surgical business. And I think it's funny that I'm coming to that business last when I think if you and I were talking a couple of years ago, that's where we would have started.
Yep.
Walk me through, you had a recall earlier this year. By all measures, from what we can gather, you regained footing very quickly. If you could just talk a little bit about the impact, what you learned, and where do you think you are now?
Yeah. So exactly right, so enVista has been around for 11 or 12 years, right? It's a great lens, glistening-free, very stable on the eye, and doctors do love the material. What we did was we wanted to move into the premium category, and so we launched enVista Envy, which was our trifocal. As soon as we launched it, we saw great acceptance. Doctors really fell in love with the outcomes, and then we had a recall. We saw a risk across the entire enVista platform, and we moved with speed and purpose to do the right thing. It was very difficult. It was one of the hardest things I was involved in in the last several years, but we were very committed to finding the root cause and getting back on the market. We did that, I think, faster than people expected.
It was a lot, a lot of work by a lot, a lot of people to get there. But I think it's not the reason we did it. Obviously, you never want to go through this. But I think we established a lot of trust that we're always going to do the right thing for patients. We're always going to put patient safety at the top of the list. And what you see now is doctors are coming back to enVista as quickly as they can because they trust the lens, they trust the company, and they get great outcomes with Envy. And so you saw in the third quarter, Envy was growing very quickly. I forget the exact number off the top of my head. But it was pretty high growth in the third quarter.
What we had said when we returned to market is we would be back to where we were in first quarter by first quarter. I think we can very confidently say that that's true today. Momentum is really good. The last piece of the puzzle is enVista Beyond, the EDOF. That trial has finished enrolling. So we expect to have that in about a year.
In the United States as well as the U.S.?
Yep.
What will enVista Beyond be?
The EDOF?
Just specifically, what will its parameters be? Or it'll be an IOL, but.
Yes.
Okay.
Yeah. And so if you think about a trifocal versus an EDOF, the easiest way to think about it is there are a number of ophthalmologists or cataract surgeons that like to do trifocals and feel very comfortable with a trifocal. But there's a much larger group of ophthalmologists who like an EDOF. And so I think Beyond, and you heard Eric Donnenfeld on our panel, a noted very respected ophthalmic surgeon, say he thinks the EDOF, he's in the study too. So he has a little advantage, right? But he's been around forever, and he's tried every lens out there. Said he thinks that enVista Beyond is going to be the best and biggest lens from Bausch + Lomb.
And so the growth in the IOL category, how do you think about that? I mean, is that just riding the aging population? Is that?
Yeah. It feels very consistent, right, and predictable. Does that not mean there'll be a little variability from quarter to quarter or market to market? Sure. Right now, you're seeing the U.K. cut reimbursement for cataract surgery. So those types of things are going to happen. But demand is very consistent with an aging population. And so I have no worries about demand. If you look at it on a two, three, five-year basis, it's very robust. You just have to think about reimbursement pressures as the variable there. But I feel very good at mid-single-digit growth there.
How do you think?
For the market.
For the market.
I think we'll do better.
You think you'll do better. Thank you. And then how do we think about sort of the economic environment and individuals' choice?
Yeah. I mean, I think to be fair, the aging population is more active than they've ever been, right? And they're using iPhones, and they want to be able to read, and they want to be able to watch TV, and they want to be able to drive at night. They want their independence, and they want spectacle independence. And so I think the amount of money that they have to pay for a premium IOL is a good investment. And I think many of them see it as a good investment to maintain an active lifestyle. And so I feel that that's not an impediment to our growth at all. In fact, I think there's some tailwinds there as well.
What do you think at this stage investors are missing about the Bausch + Lomb story?
I think they were missing a lot. That's why we did the investor day. I think people didn't realize the pipeline. I think that's becoming an emerging story about us. And we were talking with George and Sam earlier that we're going to start to do quarterly R&D deep dives. We'll ask you to host one, hopefully. But we want to start to educate our investors more about the opportunities in the pipeline because we quantified that as over $7 billion of potential revenue. It's pretty important. And I think it's a massive growth opportunity. That being said, the LRP or the three-year plan we gave really has very few pipeline products in it for growth. There's a few like IOLs or AREDS 3 or Lumify Lux, but there's not that many, right? And enVista Beyond. Those are the four that have to come through the 20-year period.
But it's really an exciting part. I think the second thing that was missing is that financial excellence component, that margin improvement. And Sam certainly can give some details, but we didn't just give you a hockey stick and say, "It's all coming in 2028." We tried to say, "Okay, roughly 200 basis points a year of consistent building of margin improvement throughout the next three years."
Yeah. And I want to emphasize a couple of points you made here, Brent, because the first part I'll emphasize is the building blocks of what we need to deliver on our financial targets to 2028 is already in action right now. So we're not waiting for a pipeline launch or waiting for something, a product or something that we don't have yet to be able to deliver those targets. So that's a very important aspect of that. And that's when you think about, again, the entirety of our financial excellence. We talked a lot about the 5%-7% growing price in our market. But what we didn't talk about is the couple of other areas, which is the margin and the 600 basis point improvement. And again, we're coming from a position of strength with that margin because we've seen already the actions we've taken throughout 2025.
We've seen the results already, early results in Q3. We are coming in from a position where we're seeing that momentum continue into 2026, and that's where we said there's about 200 basis point improvement on a year-to-year basis as you go into 2026 from our guidance, and then the 400 basis point is coming in gradual as you go into 2027, 2028, and the balancing of the margin part of it also, which is very important, it's not coming in from just one element or one driver. I think we've been seeing a lot of the product mix shift that we've been taking with the launch of the dry eye portfolio for us to push on our Daily SiHy.
And also many of the efficiencies we're doing in our manufacturing, which you see mainly in our surgical business, and that's driving that 250 basis point on the gross margin. On the Vision 27, which is a key element of managing our fixed cost and driving the leverage in the P&L, that's where you see the 400 basis point coming in through the SG&A. One element, which I mentioned it during the investor day, is as you think about that part of the SG&A, I think about it as probably two parts that split equally between selling and marketing and the G&A side.
And it's very important to think about it this way because we are exiting our two-year launch phase of the dry eye, which is really at the right time for us to be able to be very targeted with our selling and M&A, but also driving that leverage in the P&L and managing the fixed cost through Vision 27. So we feel very confident where we are. And I think we spend a fair amount of time preparing as we prepare for investor day about we are coming really from a position of strength in terms of how we're outlining our three-year targets.
Excellent. I think our time is up, so Brent and Sam, thank you so much for joining us, and I hope you have a great day.
Thank you for having us. It's been terrific.