We're going to get going. Thank you. Next up, we have IDEXX Laboratories, the worldwide leader in animal health diagnostics, and joining me on the stage is the company's relatively new CFO, Andrew Emerson. Thank you for joining us for the first time.
Thanks for having us.
Dr. Tina Hunt, EVP Global Strategy and Commercial. I'll start with some higher-level CFO questions, and then I think we can get just more granular in and out on guidance and a couple of other things. So, Andrew, I'll just kick it off and say, why was it the right time for IDEXX to accelerate the share repurchase relative to the past couple of years, which you guys stepped up pretty notably here in 2025?
Yeah. So I think in the past, or more recent history, in the past few years, we had kind of adapted our share repurchase approach really to pay down some variable borrowings that we had at a higher interest rate environment. So we had taken a little bit more of a conservative kind of flair to that. I think where you saw us end the year from a 2024 perspective was about a 0.7 x gross leverage ratio. And so at that point, I think we were just looking at, again, what's our plan going forward? It was largely fixed rate debt at that point as well. So that was part of our consideration. We have really high confidence in kind of the long-term trajectory of the business and the potential that we have here.
And we're certainly on the front edge of a ramp of innovation with recent launches of InVue Dx, as well as our Cancer Dx platform, starting with canine lymphoma. So I think the way we look at it is we have high cash flow coming off a recurring durable revenue stream, strong gross margins, and ultimately strong profitability and free cash flow. And if you look at how we guided in our initial guide back in our Q4 call, what we said was we planned for about $1.5 billion in share repurchases for this year. Part of why we signaled that was just we would see a step up in our interest rate level. We wanted to give some clarity around how we were thinking about that, as well as we gave a range of 2%-3% on diluted share count reduction for the year.
So just giving some parameters to think about the financial model this year. But ultimately, if you play that out, given our strong cash flow levels, we're really assuming a fairly consistent gross leverage ratio for how we're going to end 2025 with how we ended 2024. And so it's not really a change or a signal of a change in our capital allocation or structure approach. It's really consistent. Share repurchases have worked well for us as a way to return excess cash to shareholders over time. And that's really still our plan, is we want to make sure we're investing in the organic growth potential of the business. And then we deliver excess cash back to the shareholders, and we view share repurchases to do that.
And if I can just add quickly to that, John. So we do look at from a capital allocation perspective where there may be opportunities for us, a space that we do invest in and continue to see opportunities as software. That's a strategic focus for us, especially as we look at how we can help with automation, digitization, as well as communication. So we made an investment in ezyVet a few years ago. Greenline was another acquisition last year. And we also, just to add to that, are always looking to see if there are technologies that we can in-license that would accelerate our innovation and go-to-market agenda. So we do look at capital allocation from that perspective also.
Okay. That's helpful. And that's a great point. I was saying in the prior company presentation, I would think about IDEXX in the past as maybe buying a reference lab here or there, but that was probably several years ago. More recently, Dr. Hunt, to your point, it's been more software-based.
That's right.
I want to shift gears, and I'll just jump into the 2025 guidance and the moving parts. And so bear with me for a little bit as I try to set the stage. 1Q25 CAG Dx recurring was 4.5%, but it was 6% when adjusted for days. And the midpoint of the guidance for the year is 6.5%. But I feel like you guys get about three or four modest tailwinds for the balance of the year, right? First is you get greater price realization once you lap the renewal headwinds from the corporate contract. You'll get something on InVue. You'll get something on Cancer Dx contribution. And then I believe, Andrew, the visit assumption for the year is negative two, and it was negative 2.6 for 1Q.
So first, am I thinking about that correctly on those four, call it modest contributors for the balance of the year relative to 1 Q?
So I think you've captured it really well in terms of how we think about it. Maybe just to expand on a couple points there. I think, again, the underlying CAG Diagnostic recurring revenue growth profile, you captured that right. Q1 had a days adjustment of about 1.5%, and that's just equivalent days within the period there. So when you do adjust for that, it is about 6%. And our midpoint is 6.5% for the full year on CAG Diagnostic recurring revenue on an organic basis. So how we've been thinking about that is the first half, second half is fairly consistent on an underlying trend perspective. We did note last year that we had signed three large corporate groups or large entity groups contracts that were playing a role within our pricing.
In Q1 specifically, we had about 4% global price realization, but it was about 3.5% in the U.S. For the full year, we anticipate 4%-4.5%. There will be a bit of a benefit ramping of the year on price. The more exciting piece of that is actually the longer-term relationship we have with those customers. Those were expansions and extensions. It's both a time duration that we have relationships now with these larger groups and expansion of products and services that they may not have been using or we felt like they had an opportunity to use more of over time. We always have those negotiations going on with our customers. Innovation, I think, is another really exciting category.
So both InVue Dx in terms of the recurring ramp that we'll see, we're certainly going to benefit on the capital placement side of the house. We've highlighted about $50 million on just the instrument revenue associated with that in 2025. So it's a key contributor to our overall organic revenue growth. But the recurring durable revenue stream that comes off that will play a role and will ramp over time as we place more instruments. Cancer Dx is also exciting, but we've also had other innovations like our Pancreatic Lipase Test that we launched last year in Q4, as well as SmartQC. So we have a really nice menu of new products and services that we're bringing to the table, and that's certainly going to be a tailwind for us.
I'll just go back and use, I think it was your words, and you sort of said that you sort of view it as growth consistent in 1 H/2H. I just get a lot of incoming, and it's back and weighted. Visits aren't improving. Visits need to improve, but from what I laid out there, you feel like it's somewhat equal.
Yeah. I think the underlying is fairly consistent, and certainly it's a range still, right? I think the macro can play a role in things like clinical visits, but you have to look at the last four quarters in particular. We had about just over a 2% decline in clinical visits, and that's really what we're planning for the full year as well.
And then let me push on the 2025 guidance and sort of say benchmark it to coming out of one Q. The assumption on the euro was 108. So you got a little bit of a wiggle room there. And then most of my companies did report prior to the Washington, D.C., China tariff news. And so maybe walk us through. The 108 on the euro is pretty straightforward. That's a tailwind as long as we stay with current spot. What about what that does mean, if anything, on the updated news U.S.-China relative to when you reported?
Sure. So maybe I'll hit the foreign exchange piece just to give you a sense too. We use planning rates, but we publish those in our press release. So if you look at our Q1 earnings press release, you'll see the details of the currencies that we've included there for our outlook. Just to give you a sense for it, a 1% change in those rates would actually have about an $11 million impact on the top line or revenue and about a $4 million impact on our operating profits. So that gives you kind of a way to think about the foreign exchange component of that. It is a planning rate. It's been very volatile, and we certainly aren't in the market to predict foreign exchange trajectories here.
We do try to be transparent about that, but certainly not something we're going to be able to control as part of our business. When we think about the tariff implications, I think fundamentally we're in a relatively good spot as an organization. About 65% of our revenues come from the U.S. specifically, and our CAG industrial footprint is largely U.S.-based as well. From that perspective, we have a fairly good foundation that's U.S.-specific, U.S.-based. China itself is less than 1% of our overall revenues. On a CAG or CAG Diagnostic recurring revenue basis, it's even less than that. We feel like we're well positioned from that perspective, both in terms of our supply chain as well as how we have our revenue streams coming in. Certainly, tariffs have been volatile.
We haven't quantified anything specifically, but I would just note that our primary focus is on making sure our customers have continuous supply of products. We'll certainly leverage our balance sheet where we need to to make sure we have access to product and supply continuity from a customer basis. And fundamentally, we're still delivering operating profit on a comparable basis. Operating profit margin improvement ultimately of 30-80 basis points is our outlook, so we believe we can deliver that in 2025, even in light of some of the headwinds on tariffs and impacts from things like the InVue Dx placement, which tend to be lower margins.
So you just fleshed out 25 pretty well, and I'll ask on 26. I'm not going to ask for the number, right? But I do want to just sort of get after the build a little bit. And so the Street's at roughly 6.2, I think 6.3 CAG Dx recurring this year, the midpoint 6.5. And they accelerate by about 200 basis points the following year to low 8s, 8.2. And so how do we think about we break it down into visits, price, and what we call the IDEXX premium. It would seem price probably normalizes a little further, right? You're still above your LRP on price. So if that's down 50 basis points, the ask is 250 basis points acceleration from visits and premium. How do you split that, right, at a high level?
I mean, is it, yeah, look, visits are going to have to get better by 100-150 basis points. And then there's the InVue Cancer Dx that could be the remaining 1150.
So just to maybe highlight it, we're not updating or confirming 2025, and we're certainly not setting a 2026 guide here today. But just to give you a way to think about it, we actually focus on the execution drivers, right? Clinical visits are a little bit outside our ability to control directly, although we are focused on how do we help clinics grow. We know they're interested in looking for ways to grow. And maybe Tina can talk a little bit about that. But at the end of the day, our execution drivers are still really focused on net new customer adoption, right? How do we continue to partner with clinics around the world? How do we drive utilization, the use of diagnostics? And one of the ways we do that is our focus on delivering new innovations, the ability to add clinical insight, clinical relevancy within this space.
Something like cancer diagnostics is a great opportunity for that. Certainly a category that has a lot of impact and a lot of emotion with customers that I think is going to be really helpful to drive our recurring revenue streams. And then to your point, net price realization in our long range potential we've highlighted is 2.5%-4% ultimately. And if you think about the 4%-4.5% for 2025 as part of our guide, we are kind of on the higher end of that range right now. But that 2.5%-4% is what we highlighted in our investor day last year. And we still think that's a good number that we should be thinking about.
And that CPI does dictate that to an extent for you guys. I mean, we've shown your price increases and overlaid that CPI and one exactly on top of the other one, but that's informing your decision on your price realization.
Do you want to talk a little bit about that?
Yeah. I'll take the pricing question, and just from a high level, we do have a very strategic approach to how we look at pricing. There is, of course, the price commensurate to the value that we bring to our customers. There are aspects of how we think about pricing, which is really about sector development and ensuring that we are enabling both access and adoption of a new menu, so if you think about Cancer Dx as an example, the way we have priced it is to really accelerate the adoption and access, and then there's inflationary impacts. I think some of what you're talking about is a reflection of the inflationary impacts.
So if you put all of those things together, we want to make sure that we are always on the right side of that equation, that we are ensuring that we're enabling our customers to grow, for pets to come in and get the care that they need. So that's like a little bit of the strategic approach that we have for pricing.
Okay. That's very helpful, and you guys talked about focusing more on your execution drivers. It's a good segue. Let's get after it, and I'll start with InVue Dx. We actually had a, I thought, a very upbeat doc call last week or maybe the week before where the doctor provided some early feedback on her experience with InVue. Andrew, maybe just to run back a couple of numbers, there were roughly 300 placements in the quarter, and there was the big step up in April to roughly 600 specific to April. So maybe just start there. Everyone was struggling with the 4,500 placements when you did 10, and then it was like, where are they going to go? A couple hundred, and then the April number. I think we're like, oh, I get it, so are we just extrapolating that out?
I mean, is it, hey, 600 and you got seven or eight more months to go? Is that a decent way to think about it? Or did you catch up on orders considerably? And that was more of a one-time catch-up.
Do you want to talk to InVue and maybe get a little context?
Yeah. Let me just talk about overall reception of InVue . So the exciting thing about InVue is that the customers recognize how impactful it's going to be. So we entered the year with a pretty large number of pre-orders. And as you mentioned, John, in Q1, we were still a little bit more in the control launch aspect of it. We wanted to make sure that the customer experience is exceptional, the way we want to ensure our customers experience our innovations. We opened that up for broad availability in April, and that's where you start seeing the 600. I'll talk more to why is there so much excitement about InVue . It hits on so many things that were pain points for customers. Let's just start with, from a workflow perspective, it is slide-free load and go workflow with very minimal hands-on time.
This is a process before InVue that was very laborious. It took a lot of time, but also it was very technique-intensive. You really had the doctor coming in and reading the slide. Now they just add the sample and they get the results. The results are available in the electronic medical record. They're quantifiable. We provide interpretation information. They can track the results so they can really get a full assessment of the pet's health, as well as the capturing the charges because it is all connected. Customers are super excited about it. While we're not breaking any of the quarterly breakdown, we're off to a great start. What we've indicated is 4,500 for the year and 20,000 over the next five years.
And then the other variable or important variable of that is $3,500-$5,500 per box. Can I push a little bit? How do you break that down between? Because I think that number is inclusive of FNA.
It is.
That's correct, right? So should we think, how are you breaking out the, let's just take the midpoint. The $4,500 in revenue per box, how do we break that down between your cytology, blood morphology, and FNA? And our diligence shows us FNA is what the vets are most excited about. So should we keep things a little bit more in check on revenue per box, at least in 2025, until you get a full year of FNA contribution in 2026?
So these are our large categories, right? So to your point, we've launched ear cytology and blood morphology, but these are large categories that they're doing testing manually today in the clinic. I think FNA is certainly an opportunity for us, and we're excited about that. We anticipate the launch of that to be later in 2025. So it's part of this kind of platform approach or broadening the menu over time. I think there's a lot of capabilities of our InVue Dx cellular analyzer. And so we certainly have a technology-for-life approach, and we'll continue to build that menu out. I think it's still a relatively good range, right? It's early in the launch, and we'll be calibrating that and providing some updates for how we think about that or how that evolves with our customers over time.
But it's both the adoption of how often they use it for each of these categories as much as how many times they use it in any given day or week or month as well. So we'll get a little bit more insight as we go for it. I think it's a good foundation for us to plan for. It is inclusive of FNA, which we'll launch later this year.
Okay. And then just to sort of have you sign off on the numbers at a high level, I look back at the SediVue ramp, and that was largely linear, right? You guys have discussed the 20,000. If this takes on a linear approach, it's what? When all is said and done, it seems like it's 50-60 basis points of growth contribution to CAG Dx recurring starting as maybe early as 2026, and that would remain pretty consistent if it's the linear uptake. Is that the right way to think about it on your current revenue base?
I think, again, if you look at maybe the comparability to a SediVue , certainly the amount of instruments that we can place globally, I think, is an important factor. The menu here is going to be different than what we offered on the SediVue analyzer. I would just come back to our longer-term algorithm that we provided in the summer of last year, which highlighted, again, utilization and innovation will contribute approximately 3.5%-4%. What we highlighted was about 2% of that would come from innovation specifically. We still believe that between these different launches that we have, the pipeline that we have, over time, we anticipate about a 2% benefit related solely to innovation, but we didn't necessarily quantify specifically the platform. It is much more extensible than what we have on our SediVue platform, however.
Okay, so let me try to build on that. If it's 200 basis points from innovation, and my math is 60 basis points on InVue on a linear uptake, it's, again, a good transition into Cancer Dx, right? When I was on the road with you guys, you guys talked about maybe an SDMA analog. Cancer Dx, what? Anyone can order it overnight, right? You don't need the razor-blade. So remind us a little bit quickly, if you don't mind, on the aid and diagnosis opportunity and the screening opportunity, but maybe even before we get there, should investors be conditioned of this is clearly the bigger of the two, where if you're doing the build to 200 basis points, if successful, this is likely a bigger contributor relative to InVue?
I think they're both really meaningful. Maybe I'll let Tina answer the opportunity for Cancer Dx specifically, but again, we'll benefit near-term from the instrument placements as that flywheel builds on the recurring revenue stream associated with InVue Dx, but I do think there's a really large opportunity. What we've highlighted is, again, 19 million ear cytologies are done manually today. Blood morphology, I think there's a real opportunity to continue to drive that. Two out of every three CBCs that are completed would benefit from blood morphology being added. It doesn't happen today given some of the constraints that Tina highlighted, but that alone would be another 20 million opportunities that we think about in terms of leveraging just for those two categories, and then FNA becomes, again, another large category for us to be continuing to grow that revenue base on.
So it's certainly a meaningful launch for us. I wouldn't underplay kind of the expectations that we have for this and the value that it can bring to our customers. But if we transition to Cancer Dx.
Yeah. Maybe to Cancer Dx, because the goalposts seem to be up there for InVue for the most part when we have boxes and revenue per box. But the only metric we've gotten in Cancer Dx so far is the 1,000 users that I believe you disclosed in the 1Q call. So help us with those users and we ramp from there.
Yeah, so let me just back up and talk about what we're bringing to market just to make sure everybody is aware, so Cancer Dx, let me just talk about cancer. Cancer is a leading cause of mortality in both dogs and cats, and it doesn't get diagnosed early enough, so what we're bringing is a way to diagnose cancer much earlier, starting with lymphoma, and then we plan to build on the panel for the majority of the canine cancers, so what we have said is that over the next three years, we will add over 50% of the cancers, named cancers, and in some cases, like with lymphoma, we also go to the next level with whether it's a T cell or B cell, which is going to impact the prognostic, so with cancer, cancer is not just a serious disease. It's an urgent disease.
There is a need to detect it earlier so the treatment can start much earlier. Pets, they age 6x to 7x faster than humans. Cancer moves through them very quickly, so that early detection is very important. Now to answer your question, John, on how we're thinking about it, there are about 13.5 million dogs that we believe have cancer, and only about a quarter of them get diagnosed. As I mentioned, most of them get diagnosed much later. That's where the aid-in-diagnosis is going to be very helpful. A big opportunity is for the at-risk dogs. Where we see cancer going is that it becomes an important part of the wellness screen. There are about 20 million at-risk dogs in just North America alone. When I say at-risk, I'm talking about all dogs above the age of seven.
They have a high risk for cancer and certain breeds above the age of four. So if you put that together, that translates to about $1.1 billion opportunity for us with respect to the cancer screening. So the way we're thinking about cancer is there's two ways we look at the revenue. One is, of course, the direct revenue. We have offered it at $15 when included in a wellness panel, as Andrew mentioned. We don't want there to be a false choice between do I do wellness or do I do the cancer screening. And for a standalone or an aid-in-diagnosis, it's a $60 list price. So there's a direct revenue stream. What we believe is going to happen over time is the pull-through that this is going to have for overall wellness testing.
That's part of, like Andrew had indicated earlier, how are we thinking about influencing clinical visits? If you think about cancer, cancer is such an emotional thing for pet parents. They either know somebody with cancer or they may have had a pet with cancer, and there's a high interest in screening their pets earlier. Now, knowing that this is available to them, we're hoping this is going to pull more pet parents into the clinics. In addition to leveraging our software app, Vello, which is a communication tool that is between a veterinarian and a pet parent, that can also help with that.
So you believe this is going to help on the visit side, and this would also help on what? The DX utilization side or the frequency?
The utilization frequency, yep.
Okay.
Yeah. So from a utilization perspective, again, what we shared at Investor Day last year over the summer was every 50 basis point change in blood work inclusion increases our CAG Diagnostic revenue by about 2% overall. So that's been something that we've seen a very steady trend on over time. It's certainly part of our strategy ultimately is to continue to move the blood work inclusion up on clinical visits. That's why we think about adding new testing menu, new insights, new capabilities for the veterinarian to better understand the health of the pet as they come into the door. And it's also part of why we're excited right now. I know clinical visits have been a headwind more recently, but when we look at the actual quality of those visits, the frequency continues to improve, utilization continues to improve.
Pets and pet owners ultimately are willing to continue to invest in diagnostics, and they see the value within that. And part of the value we bring is new innovations in order to make sure that's more meaningful.
But just to be clear, the average pet owner probably doesn't know that, hey, this test is now available, this great test is now available from IDEXX unless you go out there and do a DTC. So it might not be as much of an adding visits as it is the diagnostic frequency. And then again, if you get a 50 basis point lift in that regard, that's what can translate to the 200 basis point.
And I think over time, it will. And this is another area where we can help. But also, one of the metrics we've shared is that there is 750,000 roughly calls coming into clinics from pet parents saying, "Is cancer screening available?" So right there, you can now answer.
Yes.
Yes.
In a firm manner.
Not the whole screen, but it's available. Yep.
I'm going to jump around. I might fast forward a little bit. Andrew, I think the beauty of it is CFO of an incredible company that maybe if there's any fallback, it's you inherited an LRP that has been consistently aggressive over the past handful of years. And we'll be going out to headquarters in August again in a couple of short months. But maybe just talk about you've now inherited this as we look forward. Is there a want or a need to right-size the LRP? And you guys have been incredibly successful. We're now dealing with just a base of bigger numbers. So we'd love some thoughts there.
Yeah. I think, again, we're really excited by the long-term potential of the business. And as much as I'm newer in this role, I've been part of the leadership team for 10 years. I've been working directly for Brian in a senior finance role for that entire period. And so I've had an ability to influence how we think about this, some of the ways that we apply our strategy. And we are a very data-centric organization. We really use data to inform and drive the strategy of the company. And so as we look at all the underlying drivers, the pet population, the human-pet bonds, the ability for people to make trade-offs ultimately, the improvement that we've had on the frequency and the blood work inclusion aspect of the business, our pipeline of innovations, I think we're just really excited by the long-term potential here.
And we'll certainly update anything that we feel like we need to as part of the next Investor Day. But I think I've been a part of this for a long period of time and still have high conviction within that plan that we have.
And in the minute or so that we have left, any additional thoughts or granularity on visits? I think on the most recent earnings call, Jay gave some metrics of the CAGR in pet populations actually up 3% since 2019, right? Obviously, that wasn't linear. We went through the COVID puppy boom and then on the back end of that. But still, the CAGR is up 3%. Yet the visit CAGR over that same period of time is probably down a similar amount, low single digits. So why that divergence? Why that discrepancy? And someone that is on the outside looking at this would say, "Was the pricing too aggressive? Have a subset of pet owners been priced out of the typical wellness visit?
Yeah. I think, John, the way we think about it is when, not if, clinic visits are going to get back to what we believe. We do have confidence in the long-term plus 3% annual clinical visit increase. And there are a lot of very, very strong tailwinds that point to that. We have talked about the pet ownership is at a high. Pets are living longer. Pets are being adopted by younger generations who are pushing out family formation because they want to have pets. And as pets age, the biggest, I think, now nobody has a crystal ball, but the biggest indicator is that that huge bolus of pet adoptions over the past three, four years during COVID, they're getting to an age where they're going to start coming in. They're young adults. They're seniors. They're going to start coming in.
So we do expect to see that increase in clinical visits and with a higher diagnostic intensity and utilization. So we're very bullish about the long-term trends.
Yeah. We know there's been a broader level of inflation, right? It's not just the veterinary sector themselves. At the end of the day, housing prices have gone up, gas prices, food prices. If you just look at a broader inflation and what the consumer is dealing with, yeah, we do believe in 2024 and in 2025, this is more of a macro impact that we're seeing. We went from probably some more constraints at the clinic level early on in 2022 and 2023 to a little bit more of a macroeconomic impact here at the margin. Folks may have to make some of those trade-offs. You may have a younger, seemingly healthy dog or cat. You're making some trade-offs given the higher levels of inflation more broadly that you're having to manage.
And I think we see that play out really in wellness and probably more on the elective side, things like dentals over time that people can make those types of choices. But fundamentally, the commitment behind continuing to spend and continuing to see pets as part of the family, I think, is really an important aspect that we look at. And it's part of why we, again, focus on the diagnostic frequency and utilization.
Very fair. Any last-minute questions for the team? All right. We're going to conclude. Guys, thank you very much. Appreciate it.
Thank you.