Good day, and thank you for standing by. Welcome to the joint Globus Medical and NuVasive announcement. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question-and-answer session. To ask a question during the session, you need to press star one one on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 11 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Brian Kearns, Head of Investor Relations. Please go ahead.
Thank you, Victor, thank you everyone for being with us this morning. Joining today's call from Globus Medical will be Dan Scavilla, President, CEO, Keith Pfeil, Chief Financial Officer, David Paul, Executive Chairman, and joining from NuVasive is Chris Barry, CEO. This review is being made available via webcast, accessible through investor relations section of the Globus Medical and NuVasive websites at globusmedical.com and nuvasive.com. Before we begin, let me remind you that some of the statements made during this review are or may be considered forward-looking statements. Our Form 10-K for the 2021 fiscal year and our subsequent filings with the Securities and Exchange Commission identify certain factors that could cause our actual results to differ materially from those projected in any forward-looking statements made today. Our SEC filings, including the 10-K, are available on our website.
We do not undertake to update or any forward-looking statements as a result of new information or future developments, or events. Our discussion today will also include certain financial measures that are not calculated in accordance with generally accepted accounting principles or GAAP. We believe these non-GAAP financial measures provide additional information pertinent to our business performance. These non-GAAP financial measures should not be considered replacements for and should be read together with the most directly comparable GAAP financial measures. Reconciliations to the most directly comparable GAAP measures are available in the schedules accompanying the press release and on the investor relations section of the Globus Medical and NuVasive websites. With that, I'll now turn the call over to David Paul, our Executive Chairman.
Thank you, Brian. Thank you all for joining us on this call on such short notice. Today, I'm excited to announce to you the transformative combination of Globus and NuVasive. Through this transaction, we combine two of the most well-regarded, fastest-growing technology companies in the musculoskeletal industry. Together, we will accelerate innovation in the space, help even more patients and surgeons, and further our shared vision of relentless pursuit of solving unmet clinical needs. Medical care is in the midst of rapid evolution, in which using Intelligent Surgery throughout the continuum of care is leading to better clinical outcomes. We are at the forefront of this frontier and look forward to our combined expertise to substantially improve patients' lives. What makes this merger compelling is that it builds on all our work to provide better support to surgeons, healthcare providers, and patients.
Together, we can strengthen our mission of becoming the preeminent musculoskeletal company in the world. I would like to thank both the Globus and NuVasive boards of directors for their unanimous support and shared vision for this transaction. Dan and Chris will begin today's call in tandem with a summary of the transaction and explaining why we are so excited about the combination. Keith will share additional details on the financial benefits. We will answer your questions. I'll now hand the call over to Dan.
Thanks, David. Good morning, everyone. Starting on slide five, this transaction accelerates our strategy of becoming the preeminent musculoskeletal technology company. We're excited by the opportunities for growth across the business with an expanded portfolio, increased geographic and commercial reach, and additional surgeon relationships. This deal is a positive for all stakeholders. For patients, we maintain our focus on improving outcomes with access to our best-in-class portfolio and our combined resources driving future innovation to solve unmet clinical needs. For surgeons, we expand our offerings in both procedures and enabling technologies. They'll benefit from access to industry-leading research and our data registry, as well as our global education and research program. For our employees, we're combining two organizations with a shared commitment of patient-focused innovation. We recognize whenever you combine two companies, there may be differences in culture.
We're confident that our employees' passion, sense of urgency, and commitment to changing patient lives will provide the strong foundation of values moving forward. There's a great deal of growth opportunity to fuel our employees' careers. Finally, for our shareholders, we see many opportunities to create sustainable value, outpacing the market in sales growth, delivering mid-thirties EBITDA, driving strong cash flows, and accelerating EPS growth. This transaction is the best path forward to deliver value for all of our stakeholders. Slide 6. Our initial reviews show that we have a highly complementary commercial footprint in the U.S. and international markets with minor overlaps. This will allow us to focus on our surgeons without disruption. Combining our product portfolios will create the best-in-class offering to our surgeons in spine and trauma. Bringing together two highly innovative product development teams will create focus and impact on future offerings.
The operational footprint fits perfectly with our expansion needs. The Globus financial discipline and NuVasive drive for growth will create strong results in sales, EPS, and cash flow to benefit our shareholders. Turning to slide 7, an overview of the transaction. This is a stock for stock merger. NuVasive shareholders will receive 0.75 shares of Globus Class A Stock for each NuVasive share that they own. Following the close of the transaction, Globus shareholders will own approximately 72% of the combined company, and NuVasive shareholders will own approximately 28% on a fully diluted basis. The combined company will have an 11-member board consisting of all 8 Globus directors and 3 new board members from NuVasive. David Paul will serve as Executive Chairman. I will serve as Chief Executive Officer and member of the board.
Keith Pfeil will serve as Chief Financial Officer. Chris Barry, NuVasive CEO, will support our integration planning efforts. Corporate headquarters will be in Audubon, Pennsylvania, where Globus is headquartered. We will maintain operations in San Diego, California, Memphis, Tennessee, and West Carrollton, Ohio, in addition to other key cities and geographies. We expect the transaction to close in the middle of 2023, subject to the approval of both company shareholders, regulatory approval, and other customary closing conditions. On slide 8, what's unique about Globus and NuVasive is our shared history of innovation and growth going back more than 2 decades. No 2 companies have developed more innovation to shape procedures and improve outcomes. NuVasive and Globus have among the most innovative products in the industry. Together we will continue to offer comprehensive musculoskeletal solutions, enabling technologies to better serve the full continuum of care.
As you see from slide 8, each company brings demonstrated product innovation and success. We are confident that through this transaction, we'll focus our product development engine to create better solutions for unmet clinical needs. Importantly, this transaction will position Globus to capitalize on multiple high growth levers in the $50 billion musculoskeletal market. As shown on slide 9, this includes joint arthroplasty, trauma, enabling technologies, and power tools. With expanded commercial reach as a combined company, we see significant opportunities to further penetrate existing and future markets and continue each company's track record of above-market net sales growth. Chris?
Thanks, Dan. Turning to slide 10, as Dan mentioned earlier, the combined company will have complementary U.S. commercial organizations with limited customer overlap. This will enable our exclusive U.S. commercial sales force with strong presence coast to coast to reach more surgeons, and most importantly, serve more patients. We're confident the combination of our commercial organizations will create meaningful cross-selling opportunities. Turning to slide 11. Important to both organizations has been our focus on globalization, and we believe this transaction accelerates globalization strategies to target and win in high growth markets. We'll have a combined presence in more than 50 countries, complementary international footprint in key markets, and this creates immediate scale globally and an ability to effectively invest in high growth markets with meaningful cross-selling opportunities around the world.
Thanks, Chris. Moving to slide 12. The combined spine portfolio will be exceptional, with complementary and clinically proven solutions. For example, Globus' expandable portfolio with NuVasive's X360 and C360 systems, creating a comprehensive procedure portfolio. Globus' enabling technologies and NuVasive's Pulse platform, creating a strong foundation for the future of spine care and Intelligent Surgery . Most importantly, these innovative technologies will help us better support surgeons and healthcare providers and promote healing in patients. Our intent is to continue to serve our surgeons by offering our complete product lines. The deal synergies do not depend upon product rationalization. However, we will work together to shape the best product offerings for our customers as we move forward. Moving to slide 13.
The combined orthopedic portfolio will also be exceptional, with complementary and clinically proven solutions and a rapid expansion by combining the Globus trauma sales force with the NuVasive NSO team to accelerate penetration and growth as a combined team.
Turning to slide 14, I'm very excited about the combined Globus Medical and NuVasive portfolio and our ability to serve the full continuum of care, from planning to execution to postoperative data. In pre-op, to support patient assessment and optimization, as well as procedure selection and planning. In intra-op, solutions for procedure execution and verification, and in post-op, to support healing and recovery, monitoring, as well as outcome evaluation and continual learning. Turning to slide 15, complementing our innovation, our commercial organization, and our global scale is our shared continued commitment to surgeon education and research. The combined organization has trained over 2,500 surgeons in the last year. We've amassed over 800 peer-reviewed publications and have over 70-plus ongoing clinical studies. Both organizations have and will continue our long-standing society research partnerships supporting the overall advancements of care.
On slide 16, this highlights the expanded operational strengths of the combined company. Our ability to increase in-house production and leverage supply chain networks will drive savings and improve cash flows in all of our businesses. The fit is strong. In Globus, we were seeking to invest and expand our manufacturing and logistics footprint. With this combination, we can utilize the facilities and team NuVasive brings to the table for better outcome.
Lastly, but surely not least, is a focus on the employees. I'm excited about the shared commitment to patient-focused innovation that I see within both of these organizations, the strong sense of urgency, and ultimately the passion these workforces bring to the table.
Yep. I'll go off script here to say, having worked with both the field and in-house employees in NuVasive, I am really impressed with the level of talent that both Chris and his team have built. This will be a great strong add to us as a company going forward. Keith?
Thanks, Dan. Turning to slide 18, I want to make a few brief comments regarding the transaction and its compelling financial profile. As was mentioned earlier, following a transaction close, we see undeniable opportunities for cross-selling. While doing so, we intend to maintain a focused and disciplined approach to managing costs and the combined company cost structure. Following the close of this transaction, we anticipate above market mid to high single-digit revenue growth. We expect to achieve mid-30s EBITDA margins by year three. We expect approximately $170 million in identified cost synergies to be achieved over three years. We anticipate the transaction to be over 20% accretive to non-GAAP EPS in the first year post-close. We expect ROIC to exceed the cost of capital by year three. With that, I'll hand the call back to Dan to close.
Thanks, Keith. Slide 19 has an initial view of our vision as a diversified combined company. We expect to have thought and industry leadership in spine. We will continue to innovate in imaging, navigation, robotics, and invest in power tools and regenerative biologics. In addition, we'll build a strong foundation in trauma and total joint arthroplasty while expanding in other musculoskeletal areas, including regenerative biologics, sports medicine, and extremities. Together with NuVasive, we meaningfully advance our mission to create an innovative musculoskeletal technology company, and in doing so, help support more patients around the globe with leading innovation. That concludes our prepared remarks. Operator, please open the line for questions.
As a reminder, to ask a question, please press star one one on your telephone and wait for your name to be announced. To withdraw your question, just please press star one one again. Please stand by while we compile the Q&A roster. Our first question will come from the line of Matt Miksic from Barclays. Your line is open.
Hey, good morning. Listen, thanks for taking the questions and congrats to both teams. I wanted to maybe drill into a couple of opportunities here, and it seems like there's a lot of them. If you could talk about on the sort of commercial organization, you mentioned cross-selling across your customer base and product lines. Maybe talk about the geography within the U.S. and sort of where in the portfolios you see the most opportunity for cross-selling, and then I have one follow-up.
Thanks, Matt. You know, again, early stages, we signed yesterday. We'll go deeper now that we have this en route. The initial view, I think we're all very pleased with how well the U.S. was a complementary fit. There's very little overlap. We'll fine tune those numbers and release them. You know, think of kind of low-to-mid single-digits % of an overlap that we can easily work through with this. That in itself was really a benefit. Obviously, combining these and opening up the NuVasive territories to our enabling technologies can be a significant gain for both. As you could imagine, updating our software and our ability to put all of those great NuVasive products through our enabling technology can be an amazing gain that way.
Outside of spine, and obviously, it's predominantly a spine move, but outside of that, I'm really excited about NSO and bringing that into the group. We have a fantastic, as you know, trauma offering. Adding that to that and bringing that sales force in will be a meaningful step forward on an accelerated basis for us in that market.
That's excellent. Then a couple on sort of the sort of back-end synergies or operating synergies is, obviously, you know, you're going to be able to fold, you know, all of the efforts and spend that NuVasive has been putting into, you know, the robot into your, you know, existing organization, you know, and successful robot on the Globus side, which is great. In terms of manufacturing, you know, Globus has been a fair way, you know, ahead of NuVasive in terms of this insourcing manufacturing strategy you both sort of went after several years ago. How do those two organizations come together? You know, what opportunities do you see there?
Yeah. Thanks, Matt. Again, you hit the second thing that got me most excited with this beyond the commercial fit. I really look at operations, and as I mentioned, we're expanding rapidly within our manufacturing site. In fact, we're looking for another building to get into. The NuVasive site location team is a perfect fit. They actually have space that will allow us footprint, that will allow us to expand out fast. We can pull more products in at a rapid rate using our cash to invest in the equipment there. Their Memphis facility is outstanding. It's a great fit for where we're going and what we're doing. For us, it's actually an investment avoidance.
We can free up that cash to go do other things and drive the business, leverage this out for both sides to actually benefit at a faster pace.
I'll leave it there, but congrats again.
Thanks, Matt.
One moment for our next question.
Our next question will come from the line of Vik Chopra from Wells Fargo. Your line is open.
Hey, good morning. Thanks so much for taking my questions. Congrats on the deal. Two for me. I guess the first one is, what do you see as the biggest differences between the margin structures, and how do you close that gap without hurting the culture? I had a follow-up.
Thanks, Vik. One of the things you'll see as we put the data out is this is not a deal that needs to be driven by synergies. We don't need to get into a slash and burn to make this work. It works pretty easily. While we certainly need, and we'll look at some synergies that will naturally occur, it's not a high risk product, project to get this going. That again means that we don't have to destroy infrastructure and culture and ram and jam to get to a number. I think by the fact that we get positive in our IC by year three, just by the natural move that we're doing will allow us to be prudent and smart in our investments to get where we need to go.
Again, there's obvious combinings that things will come out and we'll get more benefit. We're gonna obviously use that funding to expand manufacturing capabilities, to buy more sets, to make sure that we fuel new products out there to further drive that way.
Great. Super helpful. My follow-up question was, how is the team thinking about the progression of investment in innovation over the next couple of years, given this deal specifically as it relates to Pulse and the Globus' Recon robot? Thanks so much.
No, I appreciate that. You know, again, keep in mind, Globus by itself, we've always invested without hindrance. The joint robot will progress without any issues. We'll keep that on path. Truthfully, it's too early for us to say we know how best to fit the Pulse technology into our enabling technology. It's one of the next steps, and when we get into the closing, we'll have a better feel for that. Again, let's recognize they're both valuable and we're gonna look and see how do we optimize now that we can look at them through a different lens.
Thank you. One moment for our next question. Our next question will come from the line of Shagun Singh from RBC Capital Markets. Your line is open.
Great. Thank you so much for taking the question and congratulations. I was just wondering if you could provide a little bit of background on how this transaction came about. You know, why now? You know, what changes are you seeing broadly in the healthcare environment? You know, if there were any other companies involved. I guess with respect to my second question, you know, I just looking back at spine transactions, historically, they have been pretty challenging. And a lot of that has to do with culture and also the customer stickiness. How are you thinking about, you know, those items, you know, as you look to close the deal? Thank you.
Thanks, Shagun. I would tell you that the deal came about naturally just through conversation. You know, I think both of us had always looked at each other and realized that the combined is stronger than the individuals. It was really just a conversation that I had had with Chris that sort of progressed through and said, "Let's go further." The more we looked at this and understood the complementary nature, I think the more both Chris and I got into realizing this is a deal. The boards got involved and went. I would tell you that in our transactions, our conversations, there were no other parties involved. It was simply just us going through and saying what's best for our companies, what's best for our patients and surgeons and our shareholders came about that ourselves.
Your second question's a great one because I know there is some mindset out there that these things don't work, they tend to fail. you know, I can think we could all point to a few that worked really well. Factor in number one positions and others that may not have. Keep in mind that we are spine companies and our primary focus is spine companies, and we're both innovative share taking companies going this way. While there'll be natural cultural differences, the complementary nature of everything that we have really, I think, is going to put us in a stronger spot. The fact that we are primary spine companies and other acquisitions may have been adjacencies, I really do think put us in a stronger spot. We're not looking to untangle overlapping sales forces. We're not looking to untangle overlapping buildings.
There's a lot there that is really going towards us to make this a successful outcome.
Thank you.
One moment for our next question. Our next question comes from the line of Matthew O'Brien from Piper Sandler. Your line is open.
Great. Thanks for taking my question. Maybe I can just follow up a little bit on Shagun's question there on this transaction. I mean, you know, Globus historically has really been known as more of an engineering company and NuVasive more of a marketing company. Again, a lot of these deals in the space, you know, recently, especially like maybe AKC, just haven't worked real well as they're getting these deal organizations together. Why should investors think this is gonna be different, Dan? I mean, what can you guys do from a, you know, retention perspective, keeping these reps? I mean, they tend to move around quite a bit already. What can you do to ensure that that's not gonna be the case this time? Because we just really haven't seen that very often.
Thanks, Matt. It's a great question. Look, a couple of things. I mean, I would tell you NuVasive is incredibly strong as a marketing and a training company. I'll tell you they're also an engineering company. Don't underestimate that. You're right, we are primarily an engineering company, and that's why we've got some of the best products there. Think about it from a sales rep side.
You're about to get at your fingertips the best of both companies in your bag. You can choose with your surgeon whichever products you want because we're not rationalizing them or forcing anyone to make a decision. We have the leading enabling technology in the world, we're now putting that at their fingertips. We're going to build the software in to do that. We've got the cash flow and the investment strength to continue a strong pipeline of product portfolio outputs. Why would anyone want to go anywhere else and not take advantage of that? That, that's a personal call on their side, but this is the place to be, I know that our sales force, I know the NuVasive sales force knows that.
Okay, fair enough. Just maybe a couple for Keith. What happens to the, what happens to the NuVasive converts? What are you guys gonna do there? On the synergistic side, where is that coming from? You know, are you gonna shut down the, training facility in out east for Nuva? Are you gonna cut back on, you know, some overlapping sales? I mean, where is that synergistic benefit come from? How quickly can you get there? Thanks.
Okay. No, thanks. Great question. The converts, first question. 23 convert is due in a couple of months. That will roll off. The 25 convert, we're expecting to roll that in when the transaction closes, but we'll have more updates as, you know, as time gets closer. What I would say is when you step back and look at it, carrying the convert, we're preserving balance sheet flexibility with our cash balance. Your next question really talking about synergies and how we get them, really a combination of things. When you think about the top line, think about the things that Dan and Chris said. They really talked about cross-selling opportunities. They talked about technology. They talked about bringing the best of both portfolios together.
As the sales reps get the complementary products from each other's company in the bags, that's gonna help drive some of the sales growth. From a back-end perspective, from a cost structure, it really goes back to us being prudent in managing the company. You know, you said earlier, Globus is known as an engineering company. I think that that continues. But as Dan said, you know, NuVasive has a facility in Memphis. They have manufacturing in Ohio. We manufacture, we've worked to get vertically integrated. I think all of that continues. Really, as Dan said earlier, it prevents us from having to go out and invest on our own. On the back end, you're also gonna look at costs within SG&A, but we, you know, you'll identify areas of duplicative costs.
You know, that's generally speaking what we're thinking about. From a timing perspective on $170 million, it's really, 50% we expect to achieve by the end of the first full year, 75% by the end of the second year, and achieve a full 100% by the end of the third year.
Perfect. Thank you.
One moment for our next question. Our next question comes the line of Matt Taylor from Jefferies. Your line is open.
Hi. Good morning, guys. Congrats. Thanks for taking the question. I wanted to just explore this commentary that you made about the minimal overlap, because I think that's key, and that's something that's been a challenge for some of the other spine deals in the past that you referenced. Could you talk a little bit more about how you've analyzed the customer and geographic overlap and why that's so complementary and not at conflict? What are the good spine deals that you're thinking about that are a model for us to look at, to think about why this could be successful?
Yeah, I'll take that. I mean, we've been looking at this for some time, as Dan said, and just looking at where we compete. When we really dug in not even just at the customer level, at the surgeon level, what you see is it's a very complementary geographic dispersion of where our portfolio plays. you know, spine is not made up of 2 companies. It's several companies. We compete in several different fronts, it's just the natural, you know, evolution of these 2 companies has produced technologies that naturally are complementary, and that's played well in the geographic dispersion. That's not just a U.S. phenomenon. It's actually a global phenomenon.
We're excited about the very, we believe, minimal overlap and the complementary nature of the portfolio, and as we talked about, those meaningful cross-selling opportunities we look forward.
Yeah, Matt, just on your second thing with the modeling itself, like I said, we still both have very rich product portfolios to still develop and launch to fuel growth. As Chris said, minimal overlap to untangle. What we're signaling to you is I don't feel any of us think that this is synergy heavy to get to where we want to be in the mid-30s% so that we don't have to go into slash and burn. I think when you look at all of those factors and the fact that spine is our primary focus, you know, we'll come in and do this. It feels like a very strong offering from what I see not only in cash flow, but EPS for the investors.
Great. Thank you, guys.
One moment for our next question. Our next question comes from the line of Ryan Zimmerman from BTIG. Your line is open.
Good morning. Thanks for taking the questions. I guess my question is really to David, to start, but, you know, as I think about Globus's history and the fact that the company has been moving away largely from spine into trauma, into imaging, into joint recon, why double down on spine essentially with this transaction? It speaks maybe to how this came together. You know, I'd love to get your thoughts on that, David. Then the second question is just a follow-up to Matt's question, I imagine that the bankers and the lawyers and everyone involved have looked at this from an FTC standpoint. You know, in this environment that we're in from an antitrust perspective, you know, just help us understand kind of what you would say to investors who are worried about antitrust issues here with this transaction.
Ryan, thank you for the question. You know, we've never gone away from spine, so I don't know how that feeling came about. We've always been focused on spine. That's been at the heart and core of our business. We have begun to diversify into the overall musculoskeletal market. If anything, today's announcement will underscore the fact that spine remains to be our chief and main focus. That's really, I would say a misnomer that we are going away from spine. The diversification that we've talked about for the last three, four years has been very deliberate and looking at a more longer range vision of where we want the company to go. As far as how did this come apart?
How can you resist when you can bring together two of the most well-regarded, fastest-growing technology companies in spine? We felt that this is a fit that is really made perfect by us coming together and offering our patients and surgeons better options. As I mentioned in my earlier comments, we feel like we're at an inflection point where Intelligent Surgery is going to be the future, and we feel NuVasive and Globus are at the forefront of this and pushing the boundaries of this and how we can improve outcomes. We again felt it was a very good match. As far as the antitrust and the FTC is concerned, our lawyers on both sides are working on it. As you well know, spine is a very robust, competitive environment with over 100 companies.
Lots of robust competition in spine. We don't see any issues of anti-competitive in nature. That is left to the lawyers and the FTC to decide.
Thank you, David.
One moment for our next question. Our next question will come from the line of Joshua Jennings from Cowen. Your line is open.
Hi. Good morning. Thanks so much for taking the questions and congratulations on the transaction. I was hoping to just better understand a little bit more, just the sales infrastructure for both NuVasive and Globus and the percentage of regions in the United States covered direct or with distributors. Just how you're thinking about where there is overlap, avoiding disruption. I think we've seen with other orthopedic and spine mergers, some of the distributorship decisions has led to some near-term, integration challenges. I just wanted to learn a little bit more about that or get reminded about that. Then secondarily, just the complementary product portfolios, I mean, understand a category like interbody spaces or cages you guys are competing head-to-head.
Maybe just to take that category and just help us understand how within that category the products are complementary, or are you talking more about the entire portfolio and just a lot of the different gaps in NuVasive portfolio are filled by Globus's and vice versa? Thanks for taking the questions.
Thanks, Josh. I'll actually kind of go first with that. Again, we just signed a merger agreement, and we need to go through a lot of filings and approvals and different items like that. It's a touch premature to get into specifics of what we'll do with direct sales forces and structures and distributors and items like that. What I would tell you is our intent is to preserve everybody, every territory that we have there. They fit well together. We're not looking to trim or do anything like it there. Let's get into the closing later on, in which case we'll have a more executable plan that we'd be glad to share. The first one, just a little bit too premature to get into depths with that.
You know, just your second one about the products, there's a lot, we would talk a lot about this, but taking our expandable technologies and putting them in the hands of our NuVasive reps will be an amazing thing. You look at the cervical disc now with a multi-level indication that they have that we can go put through our products and drive that way. Look at the strength of the lateral procedures that NuVasive has defined that we can enhance with the things we're working on. There's a lot of things like that that are just going to be an amazing lift and opportunity for all of us.
Again, putting those through the enabling technologies, making them part of our robot, building that onto the imaging system, all of that far outweighs having pedicle screws that might compete or, you know, a static interbody. That's no problem. All of those things have been launched. They've paid themselves off in full. We'll continue to utilize them and use them. Again, it's not gonna be any hindrance for us to drive growth going forward.
I'll just say that, you know, the multitude of technologies that exist between the two organizations, looking forward, not even just looking at the static view, but looking at what we can innovate and really the portfolio of technology that allows us to look at all the different things that we can put together to truly innovate and change patient care going forward. I think that's the heart of what we're excited about. Like I said, I couldn't be more excited about the opportunity.
No, that's helpful. Thanks so much.
Thanks, Josh.
One moment for our next question. Our next question comes line of David Saxon from Needham. Your line is open.
Hi. Hi, good morning, and thanks for taking the questions. Congrats on the deal. Maybe first, I wanted to follow up on a previous question and ask about just the impact this deal is gonna have on your hip and knee strategy. That's a larger market, so just wanted to kind of hear how you're thinking about the StelKast portfolio and the new knee robot, which I think is expected later this year, just given that, you know, there's gonna be at least some level of distraction.
Thanks, David. And by the way, great question. Thanks for asking. Just for clarity, this deal and the fact that it's an all-stock activity preserves the cash we need to remain focused on investing in our orthopedic strategies for both trauma and joints. I am really excited to bring that robot to market. I think there's genuine value in where that's going to be and what it's going to do. We continue to invest unabated in our joint portfolio. For me personally, we can't bring it to market fast enough, so we're gonna continue to push on that. There'll be no letting off on that area. I would say the same with trauma, that there's plenty of development there.
None of this will impact how we change or look at that as it goes forward, as we integrate these two companies primarily on the spine side. As I said, a great add with the NSO team joining into the trauma team.
Okay, that's helpful. Then maybe for Keith, sorry if I missed this, but the $170 million in cost synergies, where on the P&L is that coming from? Thanks so much for taking the questions.
I would say the $170 million, we feel good about achieving it. It'll be throughout the P&L. We'll have more details as time draws closer. I'll just reiterate that we expect 50% of them after the first year, 75% after the second year, and then fully realize them by the third.
Got it. Thanks, guys.
One moment for our next question. Our next question comes from the line of Kyle Rose from CGF. Your line is open.
Great. Thank you very much for taking the questions and congratulations on the announcement today. Keith or the Globus team, I guess the real question I have was just about the difference from an operating profile in both companies. You know, I think if we look back at NuVasive, you know, NuVasive has always had, you know, great branding and presence in the market, but they've really struggled to make up that, call it, 1,000 basis point gap from an operating margin perspective, between, you know, where they're at now and where, you know, Globus' legacy is. I guess when you look at the company, what do you see that you can do differently to close that gap sooner rather than later?
How do you do that in a way that doesn't, I guess, change, you know, the culture and the branding, you know, that's already there? Is it just purely a scale position you're adding on, you know, more, or is there something structurally or culturally different that you're going to bring to this?
Hey, Kyle, it's Dan. I'll just answer that one first. You know, again, at the end of the day, it's not a race for us to say, how do we slash to get to a number? I think as Keith said, we're going to do it in a meaningful way over three years to get where we need to go, making sure we're not having undue disruption for the sake of chasing a number. There's no doubt about it. I since I've been here for eight years, I've looked across the country over at NuVasive and have been marveled at their marketing and their training skills. Combining that into us only makes the entire group stronger, okay? I think that's really one of the great things with it. As I say, don't underestimate the engineering prowess of that team. It's great.
Again, combining those, we're just going to be in a much stronger position that way. Listen, we're two publicly traded companies. You combine, there's just natural public costs that you don't need. There's different things you can go through that will just happen naturally. Where I think we can get to those targets in many different ways, as Keith said, that's why we're not laying them out now. We've got many different ways to get to something like that. We want to do it in a way that is intelligent and preserves who we are and gets us going in a way that just gets us in a strong position. I don't know if, Chris, you want to add anything to it?
No. You know, as I laid out our latest LRBP some time ago at the Analyst Day, we were targeting, you know, to take the margin profile up. We've still got, as Dan said earlier, insourcing opportunity within our West Carrollton facility. We believe between the two organizations, we can accelerate those plans. I'm very confident that this transaction actually accelerates our strategic plan, which had profitable growth as the underlier of all the key three strategies we talked about.
The only thing I'd add to that, to what Chris and Dan said, is it really comes back to managing the business, for cash, manage it for cash flow and cash profits. That's really how we look at this moving forward.
Then just the second question I had as a follow-up is, you know, a lot of the times we see these deals, you know, stumble or take longer to play out. It's not necessarily year one, it's year two, when you're starting to digest the actual organization and from a sales and an operational perspective. I guess, how do you think about the midterm guidance from a combined perspective in ensuring that, you know, after you lock up the sales forces during the transition period that we don't see dis synergies or a slowdown in years two and three? What processes do you plan to put in place to kind of make sure that that doesn't happen?
This is Keith. I'll take that question. Dan, Chris, add on. Really, at the end of the day, you know, we're announcing today, when this deal closes and we move forward, you have to go fast. You know, you have to go fast. You have to identify what are the things that we can do to drive the business forward. I think Dan, Chris, and David. David spoke about the strategy. Dan and Chris really talked about cross-selling. We talked about operational opportunities. There's things that we've already seen and identified that we really want to move forward with.
Once this deal closes, we want to be ready to achieve those and really get started strong because, you know, as you get into year two, year three and beyond, it really all comes back to how you got off in the very beginning. Because if you start strong and you push to get through it, you could be successful on the other end.
Yeah. One thing, too, that I would add and just, you know, put it out there, deals are complicated and stumbles will happen. It's just what's going to be there. It's the job of leadership to unstumble and get up. We're moving forward. We'll see where we are. We're going to adjust as needed. There's no doubt there'll be challenges, but you've got a team around the table that's going to overcome those challenges.
Thank you. One moment for our next question. Our next question comes from the line of Richard Newitter from Truist. Your line is open.
Hi. Thanks for taking the question. You know, most have been asked already, but I maybe want to just go back to where the Globus strategy and the growth, you know, the growth profile of the company and where you envisioned it, you know, over the last decade. You've always talked about, you know, high single digits and you strive to outperform that. You had moved into technological areas and advanced areas like robotics, and then tangential areas like trauma. You were growing double digits for a number of quarters in a row.
I guess my first part of the question here is, do you still aspirationally see the combined organization and that aspirational double digit sustainable growth rate, especially with where it felt like you were headed as you moved into 2023 and 2024 with some new platform technologies, you're moving into hips and knees, maybe. You know, it felt like that's where you were headed. Your guidance I think it's as a standalone is 7%-8% constant currency for 2023. NuVasive is a mid to high single digit grower. I guess, are you now more focused on scale and earnings accretion and driving that earnings number up, or are you looking to be more of a double digit top line grower over time?
Thanks, Rich. I would tell you know, we're always gonna put guidance out, and we're always gonna be conservative. You know that from what we've done for years now. Our aspiration is and will remain to be a share taker to outpace the markets in which we play. That's true with joints as it is with trauma, as it is with spine. We will go conservative in what we release now. There's a lot for us to do, but we're not signaling that all of a sudden we're big and slow. What we're saying is we're combining as two innovative companies to actually drive the ability to capture the market at a better pace. Again, there's always gonna be conservatism in what we put out there, and then we look to beat it.
I would tell you that there's nothing that you're seeing or hearing from us today that shifts who we are. I do think by the nature of combining, we have an opportunity to be accretive on the bottom line and perhaps get that at a faster pace than we have done as a standalone. Certainly, we'll all do that as well, and we'll just combine those through.
Okay. You know, if I can, you know, this is a larger size transaction, you know, especially compared to what you've done in the past. You know, one, there's the opportunity and potential for distraction to be there while you pursue that. Some of the future endeavors that you were focused on, particularly moving into large joints and robotic large joints at that, you know, that always, in investors' minds, has the potential to be a distraction too. It sounds like you could be having both of these happening at the same time.
What gives you the confidence that you can manage the potential stumbles, as you referenced, for both of those over the course of the next year and a half to two years, given that this is entirely new territory for you guys, from an execution standpoint?
A couple things. First off, the trauma and the joint teams are completely standalone, from the management of presidents through, whether it be the R&D portfolio and development, whether it's the sales forces all the way through. They can remain independent from us, and they'll execute unencumbered with what we're doing. We are primarily spine companies, and we have been spine companies, so it's not a distraction. It's our main focus. You know, we'll do that. Again, the highly complementary layout of the markets and of the portfolios and then the operations will eliminate or streamline a fair amount of things that may have plagued folks in the past with us. That's really where I am.
Again, with spine itself, we have enough firepower to make sure we stay focused on that and yet let those others run without being unencumbered.
Thank you.
One moment for our next question. Our next question comes from the line of Joanne Wuensch from Citi. Your line is open.
Thank you so much for taking the question. Congratulations on the merger. Briefly, you were quantified with the $170 million in expense synergies, and I'm curious if you can quantify the revenue synergies. It's a two-part question. Does that amount mean you're accelerating high single-digit revenue growth or sustaining it?
It's a great question. What I would say is that the revenue growth as you look out is really more of a sustain. You know, as Dan mentioned earlier, you know, we feel good about our business, and we don't feel any different about the Globus business than we did, the day before we announced this. We always said we were mid to high single-digit growers. We expect that to continue. You know, doing this combination with NuVasive, it obviously creates a little bit more scale. As we move forward, we're gonna identify the cross-selling opportunities, and we're gonna execute on them.
Dan mentioned earlier that, you know, there's a little bit of conservatism in our projections, but that doesn't take away from how we feel about the business in a combined fashion as we move ahead.
I'm sort of curious, I know it's early days, if you can comment on how you think about combining.
The Globus robotic technology along with that which has been being created at NuVasive as well as their Pulse and the other software applications that they have.
Joanne, this is Dan. That will take some time. We'll do that through, as we go further into our planning. I think there's some complementary nature there, but in order to do due diligence, we had to remain separate in those areas. We looked at it, we realized it shouldn't be a hindrance, but we'll know more data as we move into an execution planning phase now, we'll have a better answer for that.
Excellent. Thank you, and congrats again.
Thank you.
Thank you.
One moment for our next question. Our next question comes line of Jason Wittes from Loop Capital. Your line is open.
Great. Thanks for taking the question and congratulations. You know, as you mentioned, the spine market's very competitive and traditionally it's been very hard to grow. In fact, it gets very defensive to maintain share above 20%, 25%. You know, if I had asked Globus standalone kind of what their aspirations were, I think generally speaking, I think most people thought, you know, 20% was the upper limit of where Globus could go by itself. I understand, you know, combining with NuVasive, you're now 20%+ in market share, which again puts you in that defensive position. I guess the two questions related to that. One, you know, what dynamics do you see changing that could make your share go much higher than 20%, that 20%-25% range?
Two, you know, what would you see as the upper limit of kind of what a combined NuVasive Globus market share potential could be?
Thanks, Jason. You know, maybe offline too, we can compare numbers, just 'cause I've got a different one than you and not a challenge. Just as I look at market, I look at what those two things are. I see us probably closer to the mid-teens in size, not a 20% player here. Again, let's just make sure we're there fact-wise.
Fair enough.
We'll use the same thing. I think if we combine that out, you know, we're not coming out as a giant by any stretch. I, you know, the upper limit, I think you're probably right. You know, I won't say I think we're a 20 or 25. Truth is, I don't know. We're gonna put innovation out there that changes the market, hits unmet clinical needs, adds value to the patients and surgeons. Let's see where we go to. I'm not gonna call that right now.
You know, I'll just add though that putting these two companies together doesn't change the growth opportunities either had. It actually, you know, it adds to those. We talked a lot about our opportunity in areas like cervical, where we're a low single digit player. We talk about the dynamics of the artificial disc and how that's shifting really the ACDF market. I think there's growth drivers embedded in both organizations that don't go away because you combine. Actually, I think they're potentially accelerated and enhanced by the combination.
Point's taken. If I could just ask a follow-up. Internationally, can you kind of describe the differences in footprint and overlap, that's occurring there? It looks pretty advantageous as well, but I'd love to get a little more color in terms of how the two companies stack internationally in terms of distribution.
Yeah. Jason, I think you answered it yourself. It looks really complementary. Again, remember we went into very light due diligence, making sure we didn't cross any boundaries unintentionally with that. We'll get into that planning at a different stage. Again, all of us, we're very pleased what we looked at, realized that these fit nicely together. There's obviously overlap, but it's minimal in the scheme of things, and that's promising, but more to follow as we go deeper in our planning structure. Okay?
I guess I can't push you on a % as you gave for the U.S. in terms of what the potential overlap is there?
You can always try, but no, I need a little more time before I call it.
Fair enough. Thank you very much.
One moment for our next question. Our next question comes line of Allen Gong from J.P. Morgan. Your line is open.
Hi. Thanks for the question. I'd had two quick ones. First, just thinking about, you know, overlap in the portfolio and, you know, the potential for divestitures or for, you know, rationalization of the portfolio. Are you able to provide more color on that? When should we expect to get more, if not?
It's a bit early to really call that out. You know, I think right now we're happy with what we have. We think all of these things can continue forward. We, of course, has to file for approval with the federal government. If they signaled something, then of course, we as a combined team would work to remediate that as best we can. There's nothing that we've looked at that we would anticipate could or should be a required divestiture at this point.
Got it. A really quick follow-up just, you know, on the quarter since I think, like, we've kind of touched on a lot of the facets of the deal. You know, it looks like sales for both of you came in a little bit softer than expected, even with currency being a little bit less of a tailwind. You know, there were some challenges that were highlighted heading into the print. We've already seen some peers posting a bit of a mixed quarter as well. I guess just like what are the kind of trends that you saw in fourth quarter and what's carrying over into 2023 to be incorporated into your respective guidance? Thank you.
Obviously more to follow as we both do our separate earnings releases. You know, what you've seen out being released with a little bit softer maybe at the end of the fourth quarter is true. And I think that it's out there as well. I don't think either company's off by guides by any significant amount. You know, one of the things we did as well is to just held back a little bit of revenue rec for our side, but we'll talk about that more as we get into the earnings release. I would say that there's nothing from the Globus side that we experienced in the fourth quarter that would cause me to be concerned with 2023. Chris?
Similar on the NuVasive side. We obviously had some currency headwinds throughout the back half of the year. That did continue somewhat into the Q4 timeframe. As I said before, you know, we just haven't seen the seasonality come back that we've seen in previous years prior to you know, the pandemic and other years. Fundamentally, though, felt very good about the quarter. Feel very good about 2023.
Thank you. One moment for our next question. Our last question will come from line of... Sorry about that. Mathew Blackman from Stifel. Your line is open.
Good morning, everybody. Thank you so much for squeezing me in. I just wanted to circle back to the why now is the right time for this, for this transaction and whether you're seeing or anticipating any structural or secular changes in the spine market that maybe contributed to the decision-making on this deal. Just any thoughts would be helpful. Thank you.
That's a great question, Matthew. I would tell you that there was nothing pressing from a macro environment where we said we need to react in order to blank. It was really more of just a conversation as I assumed the role and I got a chance to meet Chris, that we just looked at it, we looked at our companies, we realized we've always thought there was great synergies there. It was probably just the opportunity of me getting in the role, Chris and I crossing paths, having the conversation and going. I, you know, I'll kind of also pass it to Chris. There's nothing where we're saying there's an alarm, we feel we're at a competitive disadvantage or even, like I said, from a macro environment on my side.
I mean, to me, it all goes back to what I've been talking about, this idea of core growth. The complementary nature of our portfolios accelerates the Intelligent Surgery and the concept we've been talking about, I think independently and now collectively we'll be talking about as we look forward. The looking forward at potentially ways to go after new and exciting market opportunities and some of the diversification that David spoke of. Underlying that profitable growth, the combination, I believe, accelerates all four of those dimensions of the company. For those reasons, it just makes all the sense in the world to me.
All right. Thank you, everybody, and congratulations.
Thank you. With that, this will conclude our today's conference call. Thank you for participating. You may now disconnect. Everyone, have a great day.