Great. I'm Rich Newitter, MedTech analyst at Truist Securities. Thanks to everyone tuning in to join us and everyone in the room. Our next fireside chat is going to be with Integer, and we are very fortunate to have Integer's CEO and President, Payman Khales, and CFO and Executive Vice President, Diron Smith. Welcome to both of you.
Thank you. Hey, good morning, and thanks for having us.
A lot of topics to cover, Payman, but I thought a good place to start, just since it's the freshest and newest area and we're all focused on it's been about six weeks since the announcement that there's a strategic review. We're not asking you to get ahead of the process, but would love to just hear, has the breadth or the composition of the interested strategic parties that you had referenced on the 1Q call, is that skewing strategic, financial, PE, both? Is there anything you can tell us about that and any updates since the announcement?
Yeah, sure. Again, thanks for having us, Rich . What I can comment on in general is what we'll be publicly disclosed in April, and that's the fact that, given the heightened level of interest in Integer, our board is doing their fiduciary duty to make sure that they are looking at exploring all options to maximize shareholder value, which is the reason why we announced a strategic process. We made the announcement public, because given the number of interested parties, we recognized that it would be difficult, if not impossible, to keep this confidential. We wanted to put it out there so that we could talk about it. We also said that we're not going to provide interim updates. What I can say is that our process has begun, and we said that the duration of it is not measured in years.
Something like this is more in months. We won't have any further updates, unfortunately, Rich, until such time that there is.
Okay. Can you maybe give us just some broad strokes parameters, because this is a question that's come up in the last six months as well, when you had some of the first signs of needing to reset based on visibility on ordering patterns in the fall of last year. Should you be a public company? Can you do this as a standalone as optimally as you could as a private company? I guess the question here is what's the framework that anchors the decision of go it alone, standalone versus doing something else and why now, if you will?
Yeah, I mean, the framework, ultimately, again, the board of a public company, their responsibility is to make sure that they look at all options to maximize shareholder value. That could be in a public setting, that could be in a different type of setting. Our board is going to explore and see whether there is another path, and they'll make the decision accordingly. The answer as to the why now is really because of the amount of interest that we have received in Integer in recent months that again, our board is doing their duty, are exploring any other options.
That's helpful. Then maybe just one last one. I'm not even sure if this is the right question to ask, is there any consideration or how are you protecting your customer base and key talent? Just they read all the same headlines and any time there's a change-
Yeah.
Of this type of magnitude, or transaction pending or something like that, there's always risk. What can you tell us about your ability to preserve continuity-
Yeah.
Under the headlines?
It's a great question, and it's a thoughtful question, obviously to the point that you made any time there's change. Let me just start with change in our industry is not unusual. Companies go through changes, whatnot, and our customers and employees recognize that. We, and I in particular, have been very open with our employees as to the reasons why we might be doing this and making sure that they recognize that we have a strong business and that no matter the outcome of this process, our first obligation is to the patients and then the customers that we serve. This is how we deliver value irrespective of the form and shape that we're in. They all understand that and recognize that. We've had similar conversations with our customers.
Again, we deliver value to our customers if we can help them solve the problems that they need to solve to deliver value to their customers and the patients that they serve. We've communicated to them that nothing is changing from that in that regard, and we have not received any expressions of concern or otherwise.
Business as usual.
Business as usual, absolutely. Yeah.
Let's get into the business. There's been some moving parts over the last six to nine months. Maybe just you can help the audience understand you had two guidance changes, one on the third quarter call November of last year, and then a second one on the 1Q update here in 2026. Just help us understand what your broader growth algorithm is, and then what led to the revisions and how they're different from the November 1 to the 1Q.
Sure. At our third quarter earnings in October of last year, we provided a preliminary guidance for 2026. That was as a result of the visibility that we had at the time that we had received that three products that had a strong ramp in 2025, were going to have a sizable decline in 2026. Although we normally issue guidance for the current year in the February of this year, we viewed it as a responsible thing to do and the transparent thing to do for us to provide that guidance early. Those three products, two of them were in the electrophysiology space and one of them was neuromodulation. The reason behind the decline was not because of any change in our supply arrangement with our customers. There was no insourcing, no competitive loss or share shift, et cetera.
It purely had to do with the rate of adoption in the market of the three products. Our customers had anticipated a higher rate of adoption, but once the products were in the market for some time, they realized that that was not the case and hence they adjusted their forecast accordingly. The change in April of this year was also primarily because of some products in EP, although different products and not ablation products. The primary reason for these two events that you're talking about, Rich, are because there's been a lot of change in the EP space over the past couple of years. When PFA was launched, started ramping, say, two and a half years ago, the landscape changed very quickly.
The technologies used. Two and a half years ago, there was very little, no PFA used, but now in the U.S., 80% of the procedures, give or take, are using PFA. The whole industry went through a very rapid change, which made it a little bit more unpredictable than usual and that's kind of the result of what we're seeing. Specifically, the few EP products that we're talking about this year in April, were as a result of our customers during this period of uncertainty, buying a little bit more product so that they have more products on hand to make sure that they're not losing any procedures. We learned that as things are stabilizing, they're now realizing that they might have a little bit too much inventory in hand, and they're adjusting it accordingly.
Got it. Is there any overlap of the actual customers, not the products, but the customers, from the November to the April? Is it possible that it's the same customer, or is it different customers?
In October, we said customers, and in April we said customers, so an overlap is possible.
Okay. Got it. Then I guess one of the things you said, well, actually, Integer had been viewed, yes, quarter-to-quarter, you could always have some lumpiness in any given part of the business, but there were always offsets elsewhere.
Sure.
When you looked over a multi-quarter period, things smoothed out, and you were what I have characterized as a fairly steady eddy within the context of that near-term lumpiness, that smoothed out. I guess, has something changed structurally just in the business? You guys have been grooming the portfolio, you're more concentrated, faster-growing subsegments in certain markets. Is there something that just inherently makes the business more susceptible to this type of thing going forward?
There's nothing that has structurally changed. We've communicated, and that continues to be the case that most of our revenue, we have visibility to through some sort of a forecast, typically a 12-month rolling forecast that we get from our customers. We've also communicated that our order book, which we refer to as backlog, was and has been at the end of April and has been for a number of quarters in the kind of $700 million range. If you do the math, that's about 1/4 and 1/2 of orders, that gives us good visibility. That visibility has not changed. Going back to some of the dynamics that I highlighted within the EP space, I think that's been the primary driver of some of this variability.
Again, if you think about when PFA was launched, how quickly the landscape changed and how quickly the technology changed, even the players, in terms of who's now the primary versus whatnot, that's really what's behind most of some of this variability that we've seen. We don't expect that to continue. To the point that you made, in terms of it being a steady eddy and whatnot, we hope and expect to go back to a more normal, if you will, cadence. I would point to some of the changes in the EP market for some of the variability that we've seen primarily.
You basically pushed out a return to market growth by a quarter. You originally entered the year with a, "Hey, we're going to start to get back to market growth in the back 1/2 of 2026." Now, you've pushed that out a quarter. Now it's the 4Q, right, not the back 1/2. Then there's a return above market at some point still in 2027. What I would guess, maybe that got pushed out by 1/4 too. I guess my question is, why is a 1/4 pushout for those objectives the right amount? Because when we had the original guidance reset in November, I remember asking the same question. How have you handicapped to make sure that you've captured this and you have the confidence that you'll get back to the reacceleration trajectories when you do, and it sounded pretty confident at the time.
Things don't always go to plan. You pushed it out 1/4 , How do we handicap for what you don't know over the next three months, and could there be something else? How have you either changed your philosophy or approach to the guidance knowing that this happened within a 1/4 ? How can you give us confidence that it's not going to be, "Well, we were off by a 1/4, and it's a 2/4 push out?
Just going to recap what you said. We've said that we expect to get to organic growth of market in the fourth quarter when adjusted for production days. That's what we've highlighted. Again, the visibility that we have is based on the forecast and the order books, and we do risk adjustment. To the point that you made, there was some forecast reduction that we talked about for EP that was primarily the reason why we adjusted the guide down for this year. We also mentioned that, again, given this variability that we've seen primarily in the EP space, we added a little bit more risk adjustment in our April guidance just to make sure that if there are any unforeseen events which we don't have visibility to, which we said we don't have visibility to, that is accounted for.
Okay. That's helpful. There is a, quote, "placeholder" for what you don't know on some level incrementally.
There's some.
Okay.
Within reason, yeah.
Got it. Just to be clear, nothing you're seeing that suggests there's something more structural at the end market level from your customers, whether it's EP or elsewhere, or even kind of an in-house manufacturing to outsourced manufacturing. There's no bigger structural changes that could be at play here?
No. We don't see a trend towards insourcing. We continue to believe that the trends toward outsourcing continue to be favorable, again, as evidenced by the pipeline that we continue to foster and grow. We've communicated our product development sales, which is an indicator of that continues to grow. That highlights that our customers are coming more and more to us to do that kind of thing. We don't see any structural changes. You mentioned EP. Obviously, the EP market has gone through this transformation, but even with the slowdown, the projections are that the EP market's growing somewhere in the mid to high teens, which is a very strong growth rate. There are some pockets, I think, out there. For example, some companies like sleep apnea has some headwinds and whatnot.
Remember that our portfolio is very diverse, and we participate in a wide range of therapies, and no one specific product makes up more than a couple of 2%, 3% of our revenues. Given that diversification and given the visibility that we have to the underlying base core business and the new product launches, we feel confident about the projections that we have.
It's interesting. It sounds like EP was a little bit about which players you happen to be tied to and their forecast horizons in a growing market. That can be a little more idiosyncratic to you without the EP market going broadly through some massive deceleration phase. There are some other MedT ech markets that have actually seen some actual slowdown, like urology, neuromodulation, you mentioned hypoglossal nerve stimulation, WATCHMAN, left atrial appendage closure. Can you quantify, even if directionally, your exposure to any of these other categories?
I can say that we have exposure to them, again, given the broad range of therapies and the broad range of customers that we have relations with. We have exposure, again, net-net, when we look at the total portfolio, the new product launches, and we balance out what some of the headwinds might be, we believe-
Mapping easier comps from 2026. How much of it's actual will be realized. We are-
It's a little bit of a combination of everything that you said. Let me try to break it down for you. In terms of the comps getting easier, we had a strong ramp of these three products in the H1 of 2025. The comps are the most difficult in the H1 of this year. As we navigate 2026, the comps become sequentially easier. As we enter 2027, we don't expect those comps. As it relates to the three products, we're also not counting on any meaningful growth from these three products in 2027. We don't anticipate that all of a sudden they're magically going to get back to growth.
You assume they stop getting deteriorating.
Yes.
You have stabilization.
The information that we have suggests that these products are not going away, that they have a place in the market, but we're not counting on any meaningful growth from them.
Okay.
Certainly not the type of growth that we saw in 2025. When you think about the underlying business that we have as we get into 2027, which our WAM growth is about 46%, you add to that the product launches that we have scheduled in the H2 of 2026 and during 2027, we expect to get back to 200 basis points over market in 2027.
Got it. Okay. I'm just curious because one newer market that maybe isn't quite inflecting at the moment, but has the potential to, is renal denervation. Just curious. Can you quantify or size your exposure to that emerging market in any way? How significant could that be?
Yeah. As we've said over time, we have exposure to RDN, and we believe that this has potential over the long term. The market size potentials have kind of varied a little bit based on different estimates, but a key player recently mentioned that they view that market as being about $100 million. Consider that our opportunity is based on the COGS of our customers.
Yep.
It's a smaller portion of the total market. We have participation in it. It's not a meaningful part of our portfolio. While we believe that this is something that can potentially give us tailwind, it's not something that's going to move the needle necessarily in the immediate future.
Helpful. Diron, maybe we can pivot to you a little bit. Given the amount of the revenue outlook reduction that we saw on the 1Q, I was actually pretty impressed. The EPS reduction was disproportionately better or less bad than at least we would have expected. What's allowing you to do this? Is the risk at all that you've eaten into some of the margin cushion or cut into muscle?
Yeah. Thanks for the question. I think first and foremost, we've talked about managing through this air pocket that we have. One of the things that we've talked about is, we run the business for the long term. We see this as a short-term headwind. We are not going to make any significant structural changes that are going to impact our ability to return to market growth in the fourth quarter or above market in 2027. From that perspective, no, we don't believe we've cut into any muscle. We've been very conscientious of that and making sure that where we're maintaining our cost discipline, it's in the right areas and continuing to invest in the areas that are extremely important to that growth algorithm.
One of the things that we do have in our favor is our remaining quarter of interest expense savings from the convertible note that has also helped to offset that. Then just overall cost discipline in the areas that are less impactful to that growth algorithm. That balance, we believe, is what's contributing to our ability to mitigate the impact. Obviously, it's not where we'd want to be on the profit side, we think we're mitigating it to the right level.
Got it. Then maybe just help us think about, you've talked about operating profit growth 2x the top line level as your broad strokes kind of target. Clearly, that's not going to apply as you're going through this transition period. When can we expect that kind of operating leverage algorithm to kick back in?
Yeah. I'll first state that that's our strategic objective, is to have our operating income grow at twice the rate of our sales growth. That remains our strategic objective. As you've said, 2026 is not a year where we're going to see that given the sales decline. We have not formally given any guidance on 2027 and are not prepared to do so here today. What I will point to is in recent years, we have achieved that 2X in certain years, and in the years we haven't, we've been 1.5, 1.6x , 1.7. As we look forward, it's going to remain our strategic objective. I would say some years we're going to invest differently, and we may be a little short of that. Other years, we expect to be able to deliver on that.
Okay. Again, I heard you did not provide official 2027 guidance, but it sounds like there should be some comfort that if it's not 2x , maybe it's a floor-ish of 1.5-2x or something like that.
I think what I would point to is, again, the cost discipline that we've put in place this year. We expect to maintain that cost discipline to enable us to maximize what that operating income would look like on the return.
Got it. Just anything else, there's been some macro changes, Middle East and the war there, or the conflict there. Anything on freight or fuel or anything that's crept in since the outlook you issued on the 1Q call?
Yeah. In the 1Q call, we had included and contemplated the conflicts and some of the impacts on the cost pressure. I'll remind the audience that our customers primarily manage their freight and logistics. A lot of any impact is actually going to be on that side. Any impact that we're seeing, I'll call it on the inbound freight or logistics or some of the raw materials, we've included that in our outlook.
Got it. I think you executed $100 million of the $200 million authorization during the fourth quarter and one first quarter period. I don't think you have further buybacks in your outlook. Is that correct?
Yes, that is correct.
I think you have insinuated that you think intrinsic value is higher than current market value for your shares. I'm just curious, is there just a pause here during the review process, or how should we think about buybacks as part of the capital allocation? To what extent does the review process influence that?
Sure. Yeah, let me start just what our capital allocation priorities are, because where they stand today is where they have been in the past. We prioritize first generating free cash flow that we believe is acceptable to run and support the business and its growth objectives and outlook. From that, our first priority is really around organic investment, so making sure that we have the right capital expenses and investments in either overhead or OpEx to support that growth algorithm and supporting our customers in delivering their products. That's always been our first priority, and we believe that we have the right level there. Our second priority has been our tuck-in M&A strategy, and that continues to be our second priority. We remain active in the space. It's still a very fragmented market, and there's still a lot of opportunities.
We stay very close to our target list and nurturing those relationships, and that remains a high priority for us. Although right now we're primarily focused on executing here as we manage through the air pocket. The third piece is the opportunistic share repurchase. I'll say that because when we announced the $200 million, we announced it as an opportunistic approach, and we still remain in that opportunistic mindset. At this time, we do not have any future share repurchases in the outlook.
Got it. Maybe just going back to the strategic review process. You've said multiple times, measured in months, not years. I guess, why put a time restriction on it? What-
I think the statement was an answer to the question.
Okay.
How long would that take? Obviously, look, we don't know how long these things make, but they typically don't last weeks. They typically don't last years. It's typically months, which is kind of the reason why we categorized it. We had not articulated a timeline. I think that was a response to the question.
Okay.
Yeah.
Got it. That makes sense.
Yeah.
This is a tougher question to ask you, but we're trying to ask all the companies that we have the opportunity to have a fireside with during this conference. We get mixed signals on what's going on in the underlying utilization procedure and med tech product consumption backdrop. There have been some negative anecdotal data points from hospitals on utilization trends. In the backdrop, we're all aware of ACA subsidy expirations and Medicaid cuts that we entered this year with. Most MedT ech companies aren't calling any major kind of procedural headwinds out. We had some weather in the first quarter, but I'd love to just hear, could you guys be a canary in the coal mine at times, given that you're getting forecasts from all the companies that we cover?
Anything that you're hearing or seeing that's brewing, obviously, EP had some inventory dynamics, but that's not necessarily end market issues.
Yeah.
Anything that you're hearing, seeing, without getting into any specific customers, that's alarming or suggestive of a utilization slowdown in a meaningful way?
No, nothing. Look, we read the same reports that you do, obviously, and we're connected with our customers, and that we have those discussions. Other than some events that are public, for some areas, like sleep apnea, for example, and some other things, which are, again, those are parts of our business, not the totality of our business. Going back to you kind of gave the answer in the question. The guidance that we have is really taking a balanced view of the forecast that we have from our customers, the order book that we have, and then doing some risk adjustments and looking at opportunity views and coming up with a range. This is our philosophy and because we believe we have good visibility, that's what the basis of our guidance is.
Are you seeing any other pockets in your customer mix or base where you're seeing maybe there was some excess inventory build and they're dialing it back or taking a pause on replenishing? I'm just trying to get a sense for whether there could be some signs of some slowdown coming and excess inventory is probably the most logical way to try to read that.
We're not seeing anything that's unusual. Obviously, inventory management was a bigger deal going back a couple of years, over the past couple of to three years, just going through the COVID era, people built some inventory. Although we believe that we managed that in a balanced way, at a time that supply and labor was a little bit more challenging. We were working with our customers very closely to make sure that we can meet the needs of the patients everywhere and not having one company, for example, build inventory while short-changing another one. We work very closely with our customers. We don't believe we were as affected by that inventory build, but there was some element of it that in recent years that we outgrew. As I'm looking at the inventory situation in 2026, we don't believe there's anything unusual there.
Okay. That's great. I think we're right at the marker here for time. Thank you, Payman and Diron. Really appreciate your participation.
Thank you, Rich.
Thank you, Rich.
Appreciate it. Thanks, everybody.