Good afternoon, everyone, and thank you for joining us. My name is Lisa Gill, and I head up the Healthcare Services team here at JPMorgan. It is with great pleasure this afternoon that I have with me to my left Adam Schechter, who is CEO of Labcorp. And to Adam's left is their newly appointed CFO, Julia Wang. Thank you both so much for being here. Adam, it's so great to see you.
It's good to see you again too, Lisa. It's a pleasure.
You know, let me start, you know, with a few things. One, when we think about performance thus far in 2024, labs have been very solid.
Yeah.
It's been a great place for investors to invest in 2024, and when we think about our coverage universe, you know, there's been many developments, both positive and some negative, impacting healthcare services in the last year. How do you think about yourself being positioned going into 2025 after being so well positioned in 2024?
Yeah, terrific. Well, I'll answer that question directly in just one second. I just wanted to take a moment before I get started and personally thank Glenn Eisenberg, who's been the CFO of Labcorp for the past 10 years. He's here in the audience. Glenn has been an outstanding CFO, has created so much shareholder value, and he's just been a great partner for me as I became CEO, worked with him the last five years. To that end, we have Julia. When Glenn told me about a year ago, Lisa, that he wants to think about retiring, he said he didn't have a date yet or a time yet, but it was time to actually start to think about it. He and I worked side by side to figure out who was the right successor for him. We had very strong internal candidates.
So we said, if we're going to have an external candidate, they had to have, it's almost like a unicorn. They had to have strong diagnostic skills and capabilities, been in diagnostics. They have to have strong drug development skills and capabilities, and it has to be a sitting CFO for a meaningful period of time. So we found that unicorn with Julia. Julia worked for one of our competitors in North America in the diagnostics area. She's worked for three pharmaceutical biopharma companies, including the last company where she was the CFO for many years. So I just wanted, before I answer your question, I promise I will.
No, I know you will.
Personally say thank you to Glenn and welcome to Julia. And if it's okay, I'm going to just see if Julia wants to say a few words.
Yeah, absolutely.
Is that okay?
Yes. Welcome, Julia.
Thank you, Adam. Hi, Lisa. Great to see you, and I'm really excited to be here. As Adam just shared, I have had the good fortune of having worked in the broader healthcare space for the majority of my career, including the diagnostics industry, as well as the pharmaceuticals and biotech. When this great opportunity with Labcorp initially emerged, I was immediately intrigued. Now, given my past experience of working in the diagnostics industry, I appreciate firsthand how the labs can really inform the doctors and the patients in their healthcare decisions, but as I spend more time with Adam and the leadership team, I'm really impressed by the passion and the quality of the team, in addition to the market-leading position of the company in an extremely impactful industry.
I also would like to share that I like the fact that we are headquartered in North Carolina because I went to Duke University for my MBA study years ago. So when you look at it in totality, I would say that joining Labcorp at this juncture in my career feels very much like homecoming. Now, month number two on the new job, the team has indeed made me feel being at home, not to mention that Glenn has been a tremendous resource as I continue to transition to the company. So thank you so much, Glenn. Once again, I'm thrilled to be here and I look forward to working with you, Lisa, as well as the broader investor community.
Great.
So now I'm going to answer your question.
Okay, great.
Okay. 2024, you know, we had significant momentum. If you look at the third quarter, we reported revenue growth of 9% in our Diagnostics business, and more than half of that came from volume. If you look at our Central Laboratory business, that also grew 9%. If you look at those two businesses, they represent 94% of our revenue, even more than that if you look at operating income. Our Early Development business was down 11% in the third quarter, but that was better than the quarter before, and as I said in the third quarter, we expect our Early Development business to grow in fourth quarter, which we'll report in February.
Okay.
So it gives us a lot of momentum and a lot of strength as we come into 2025. I feel good about the underlying dynamics and the underlying performance of our businesses. And I also feel good about the potential for additional hospital, local, regional laboratory partnerships and deals as we come into 2025. The pipeline remains strong. So we've got momentum, and we're going to continue that momentum. We'll give our guidance for 2025 when we have our earnings in February.
Great. You know, there's a lot of talk. The inauguration is less than a week away. We're going to have a change in administration in DC. When we think about, you know, regulatory environment, obviously, you know, this is top of mind of many people that are here today. What are some of the things you're watching for in DC that potentially could impact your business?
Yeah, so there's two things that we're watching very closely, and a lot of it's being watched by our trade group, the ACLA. The two things I'd say specifically are, one, LDT regulations, and two, PAMA.
Right.
If you look at LDT regulations, I just believe that they're trying to take legislation that was fit for purpose for one industry and apply it to another industry, and I just don't think it's the right answer. I'm not against the FDA having additional oversight of LDTs where it makes sense, but it has to be in the right way and fit for purpose for the diagnostic industry. The thing I'm most concerned about with the LDT rules is not the cost. I mean, we already submit the vast, I'd say all of our LDTs to the State of New York, which would be enough to get the LDTs approved even with the new legislation. We'd have to add some monitoring and some things that we have to do to track side effects from testing and so forth, but we can do all that.
Right.
I'm much more concerned about patients. I think it will slow down the availability of LDTs. I think it'll be overwhelming with the legislation of where it is for all these LDTs to have to go through approval. And then the second thing is I think it creates healthcare disparities. So academic medical centers will be able to use LDTs in their institution. So if you're near an academic medical center and you have a child that has a disease, they could have access to an LDT that somebody in the middle of Wisconsin or someplace else where there's not necessarily a medical center with that test would not have the same access. So for me, it's more about what's the right thing to do for patients.
ACLA will continue to work with the new administration to see if there's a path forward that makes more sense than the current path forward. Separate and distinct from that, PAMA has been a bane of my existence for the five years that I've been in this job. It is the wrong thing for the industry. I don't think that it supports innovation. And we've been trying to get good legislation in place. It's been called SALSA that would actually fix the way it's even calculated, which we don't believe is correct. Now, we've had bipartisan support for a long time. You and I have talked about this five years in a row now, I think.
Exactly.
But we haven't been able to get the legislation over the finish line. And I think it's because anything that's been a cost add, even if it's a small cost add, has been very difficult to get legislation approved. So we continued to have PAMA delayed, and it was delayed again not to come in 2025.
Right.
In my forecast, in my base case, I assume it comes in 2026.
Right.
Because I don't think hope is a strategy, and I don't think we can hope it's going to be delayed again. We have to get a long-term solution to the PAMA, and whether or not that happens is very difficult to know, but that's something that ACLA and all of us will work with the new administration to see if possible.
And you talked about there being a cost associated with moving to SALSA versus PAMA, and I think this administration is talking about trying to pull out billions of dollars. And so something that's on the cost side. But at the same time, do you feel like SALSA really solves for all the issues that initially came with PAMA? I mean, we've talked so many times about the data collection and the way that they were collecting the data.
Yeah, I don't think there's any perfect answer. I think there are lots of parts of SALSA that make sense and make it more logical and more thoughtful. I think there might be pieces that we can pull out if we can't get all of it approved, but we have to find a long-term legislative solution. You know, continuing to hope for delays each and every year, I don't think is a sustainable strategy.
Then just going back to the LDTs for a second, when we think about potential changes there, would there be any cost from that side? Again, if we think about this administration and think about what potential changes could come on that side.
So for us, there would be some increased cost, but not enough that I would actually call it out. As I said, we already submit our tests to the New York State. So therefore, we're doing the studies and the trials, and we're collecting the data that you would need to have an LDT approved. The cost would come from some additional monitoring that we would have to do, and we'll put that in place. We're preparing for it as we speak. I think there'll be other laboratories, particularly smaller laboratories that are not necessarily in New York that don't necessarily submit their LDTs. And it's going to be harder for them because they don't have the people, they don't have the capabilities to do those submissions. So they might really pick up some additional costs, which will be very difficult for them.
My fear is it might prevent some of them from actually developing LDTs. And I don't think we want to do anything that prevents people having new, important life-saving tests available. So, you know, I think we have to find ways to get that much more rational than it is today.
Just shifting to the diagnostic business for a minute, utilization has been very strong in the last couple of years. We recently did an employer survey. It's expected that medical costs will increase by 8% again in 2025. When I think about how important lab is and diagnostics are, I think, you know, for any of you that are generalists, it's only about 2% of healthcare costs, but make up 90% of healthcare decisions, right? It helps to drive 90% of healthcare decisions. So as I think about 2025, and I know you'll give guidance in February, but as I think about the setup going into 2025, how do you think about setting yourself up for that 2.5%- 4.5% organic growth and the 1.5%- 2.5% inorganic growth, you know, 2025, 2026, et cetera?
Yeah, no, it's the right question to ask. And I feel very good about the underlying growth that we've experienced in 2024 and the momentum that we have going into 2025. And there's three things that I would look at. Number one is we are continuing to see an increased utilization. Some hospitals have actually seen that decline. You haven't necessarily seen that in the diagnostic business, but I don't count on that. I assume that at some point in time, we'll go back to the historical rates of growth of volume of 1%-2%. But there are three other ways that I expect we will continue to grow Labcorp. Number one, with the hospital acquisitions that we do and what happens in the surrounding geographies of those hospitals after you acquire their business, we should gain share and continue to gain share.
Number two, we're going to continue to see the esoteric test and business grow faster than the routine business. And, you know, it's hard to see that because we do 650 million tests per year, so it takes a lot to move the needle. But we are certainly seeing our esoteric business grow faster than our routine business. And then the third thing is there's four therapeutic areas that we're hyper-focused on: women's health, oncology, neurology, and autoimmune disease. In those four areas, we're seeing growth rates that are two to three times the typical growth rate in the market. So as I look at the future and I think about Labcorp, we should have underlying growth of 1%-2% volume, which has happened historically. It's a little higher than that right now, but it might go back to 1%-2%.
We're going to continue to gain some market share. We're going to continue to move things from routine to esoteric as a % of our total. And we're going to continue to look for ways to really capitalize on the fastest growing parts of diagnostics. And that's what gives me the confidence in the numbers that we have in our longer-term guidance.
You know, we've heard some of the companies talk about growth in oncology. And part of that, some of the managed care companies, as well as some that serve managed care companies talking about later diagnoses for oncology. Are you generally seeing that in your book of business as well? And when I think about, you know, incremental opportunities around oncology specifically, you know, what do you see around testing and opportunities?
Yeah, no, I think it's an important point. I think during COVID, people put off a lot of their routine checkups, and therefore people were beginning to misdiagnose, not misdiagnose, but not catch diagnoses of oncology as quickly as they had in the past. So everybody has kind of seen that, unfortunately. As I think about oncology for our business, we have our esoteric testing. We have things like liquid biopsies. They will be important parts of our business, but they're important for a reason that's different than what you might think. It's important on its own, but we want to be the one place you come to for all the tests that you could need for an oncology patient, and it's not just us having something like a liquid biopsy.
It's the fact that when a person has a liquid biopsy, they also have their WBCs, RBCs, ALTs, ASTs, Alks, and a whole host of other tests that are run. We want to be the place that an oncologist can come to to do all the testing for the patient, so they'll get one report with all the results on one report and have it on one report.
Yeah.
Now, with that said, when I think about the future of oncology testing, there's four things I look at. Number one is screening. The best way we can reduce cancer in the future is to diagnose it earlier and to screen. I think that's going to take a long time to get reimbursement exactly the way we'd like it. The second thing is how do we determine who needs what when? Like, what's the right drug for the right patient at the right time? We're already seeing a good uptake in our business to help do that. Then the third thing would be minimal residual disease. Once a patient is cured from their cancer, how do you monitor them over time to ensure it doesn't come back?
Right.
Then the fourth is people wanting to do a lot themselves with genetic testing and understanding their genealogy. That's more in the, you know, patient paying for it out of their pocket. In each of those four areas, we're developing our pipeline of products. We want to have a holistic approach, and we want to be a one-stop shop where you come for all of your oncology tests.
Same, would you say the same for the other four areas that you're talking about?
Yes, yeah.
There was just a panel that I came from for women's health, a big area where employers are looking at women's health, employers looking at fertility and other things. Maybe just spend a minute and talk about women's health and some of the initiatives that you have.
Yeah, there's no doubt that we have to continue to develop tests for women's health, and if you look, for example, what we did, we acquired a company called Invitae.
Yes.
And maybe at the end, Julia, you can talk a little bit about the way we think about capital allocation.
Yeah.
I'm sure you'll get there anyway. But when you look at Invitae, their valuation was $10 billion. We looked at the tests that they provide in women's health. We thought they were great. We looked at their patient experience. We thought it was terrific. We just couldn't find a way for their justifying the cost of the company. When it became $5 billion, we looked at it again. We still couldn't get from here to there. When we were able to acquire it for $239 million in bankruptcy, we said, boy, this is a great addition to our women's health franchise. And we were able to capitalize on that at the time. I don't like to do dilutive deals. It was dilutive in 2024 by $0.40, but we expected to be slightly accretive in 2025.
So it was a short term, but it actually rounded out our women's health franchise in a very good way. We have strong NIPT testing. We have very strong testing for preventive disease, BRCA testing. And we also have very strong testing for things like preeclampsia, which is a new test that we launched for women's health in the marketplace. So we have a whole team focused on women's health, and we're going to continue to develop tests. We launched in total about 80-85 tests last year, and many of those were in the four therapeutic areas we talked about.
When I think about, you're talking about inorganic growth with Invitae. When I think about opportunities that you're seeing in the market today, the outreach acquisition pipeline remains very strong. How will you balance integrating closed deals and continuing to deploy capital around deals going forward?
Yeah, so we'll talk about that, and I'm going to ask Julia to jump in. As I think about our deal structures, most of our deals with the hospitals are regional in nature, and we have a regional infrastructure. So no one part of our company in any region is overwhelmed at any point in time. And we can do a lot of deals because we found ways to actually spread it out across the country. So I feel like we can do as many local hospital, local laboratory, regional laboratory deals as we can find. The pipeline's good. We did 10 deals last year. It's hard to know how many you'll do in any given year because sometimes they take three months, sometimes they take two years. But the pipeline looks good, and we remain excited about that. After those deals, we look at. We're committed to our dividend.
Right.
We're looking at share repurchases. And in very rare instances, we look for ways to enhance our four core therapeutic areas. So for example, we bought a test called Vectra last year for rheumatoid arthritis to fit into autoimmune disease very nicely. So that's how we kind of think about the capital allocation, but maybe you can add some thoughts there too.
Yeah, definitely. In terms of the capital allocation, I believe we are well positioned to pursue an attractive capital allocation strategy. So if you think about the sources of our funding, to begin with, we have been generating very strong free cash flow. In addition to that, we have a strong balance sheet. So that provides additional capacity should there be value-creating opportunities to pursue. And then in terms of the capital allocation approach, I think we have been fairly balanced. First and foremost, as Adam has already alluded to, we have been working very, very actively in the M&A space in ensuring that we do those transactions that support our strategy and augment our organic growth. And then in addition to that, we, of course, have two multiple ways to return the capital to the shareholders, inclusive of the share buyback program, as well as the dividend.
And just for perspective, in terms of the dividend, we have been really indexing that at about 15%-20% of our adjusted earnings. So all in all, I feel very, very good about our capital allocation strategy.
Right. You know, Labcorp continues to pursue the specialty market growth. We talked a little bit about this, but as I think about the pipeline and I think about specialty testing going forward, any specific areas of interest as we move into 2025 beyond what we talked about?
Yeah, I would say, you know, the four core areas is where I'm really focused. But what's important to note in those areas, women's health, oncology, autoimmune, and neurology, we have a very strong pipeline, and we develop tests ourselves. I'm also open to licensing tests where it makes sense because I want to have the broadest portfolio of tests that I can bring to market. And then in rare instances, I'm open to acquiring a specific test or a certain test. So we're really agnostic to some degree as how we get the best test in our portfolio. The thing that's most important is how do we have the most complete portfolio in those four therapeutic areas?
We touched on Invitae, and we know it was a dilutive transaction in 2024. I think our expectation is that there'll still be somewhat of a headwind in the first half of 2025, but should I start to think that it's accretive in the second half of 2025?
Yeah, yeah, it'll start to, you know, it'll be accretive for the full year, slightly accretive for the full year, but we're still working our way through. So there's two questions that if I were you, Lisa, I'd be worried about with me. The first one is, are you keeping the core of what you acquired, the great tests, the innovative nature of the company, their ability to interact with customers in a way that was, frankly, better than what Labcorp was doing? And, you know, are you like kind of keeping that? And the answer is yes. We've been very deliberate to ensure that we're admiring and we're respecting the culture of the company that we think is very strong. Then the second question is, can you get the costs out, and are you going to get them out fast enough?
Right.
What I would say with the cost, the reason it's taking us time for it to be accretive is we're being very thoughtful. If they have an MRD program that they were working on and Labcorp had an MRD program, we're going to do the best of the best. We're going to evaluate both. We're going to say which one's furthest along, which one's scientifically best, which one has the best, you know, margin profile, and we'll be agnostic to which one we keep based upon those things. When you do an integration that way, it's a lot harder, and it takes a lot more time to do it right.
So for something as important as this, where we think they have really strong science, really strong data people, we want to be very thoughtful about how do we integrate this in a very different way than we would do with the typical kind of laboratory acquisition. There we just kind of swallow it up into our infrastructure. Here it's really best of best, and that's why it's taking so long.
Earlier we talked about esoteric testing and talked about growth being faster in esoteric testing. You talked about that on the third quarter. Is that a shift, you think, in the business? Did you continue to see that going into the fourth quarter? So is there a big shift going on here? Was it, you know, just something specific to the third quarter? How do I think about esoteric testing going into next year?
Yeah, so over time we see it continuing to grow at a rate that's faster than the routine testing.
Yeah.
So I don't think it's been a significant shift. And the problem is that when you do 650 million of anything, it takes a lot to move the needle. So even like a 0.1% or 0.2% shift in that business is meaningful over time. So I think we'll continue to see an asymptotic shift towards that business. The four therapeutic areas that we're focused on, a lot of those are in the esoteric test areas. Those are growing two, maybe three times faster than the underlying diagnostic market. So even that alone should cause additional kind of faster growth in that area than routine. But you stumped me. It was a couple of years ago when you first came back, and you said, Adam, you've been talking about your market share growth for a long time. Do you remember this?
He goes, "How come I don't see you getting five share points?" And I had to think about it. I'm like, "It's an $80 billion market." I was like, "Do you know how many, like how much money five share points is, Lisa?" I said, "It takes time.
Okay, so that was my fault. I didn't do the math.
No, you stumped me that day. I'm thinking, why didn't we go back to the team? Why aren't we seeing more market share growth?
It was obviously Glenn's fault.
It was Glenn's fault, yeah. It was all Glenn. But it's just, it's just big numbers. Small changes make a big difference.
Thinking about changes, managed care contracting. There's been talk for a number of years around value-based care, value-based care contracting. You've sounded more positive on your contracts with managed care over the last 12- 18 months. So can you maybe just talk about contracting with managed care and how you see the future?
Yeah, I'm going to start kind of big picture and then I'll drill my way down a bit. Healthcare costs in this country are too high and are growing too fast. And you can probably say that in almost any country in the world. I think diagnostic testing can be part of the solution to that if we do diagnostic testing in the right way at the right times. Working with managed care, I would love to do more value-based contracts. I think it's just the right way to help reduce cost over time. But no one part of the healthcare system can really do it itself, and it takes a lot of different pieces coming together. And that's why I think it's been slower than I ever would have thought.
Right.
And it continues to be slow, although I would like it to go faster. Separate and distinct from that, our ability to work with our payers and managed care customers continues to be strong. And we are a low-cost provider, and we provide high-quality results. That's what they're looking for. That's what's important to them. We also have been able to show the payers that when we do hospital acquisitions, they have a very significant savings very quickly. And that helps. And they would like us to do more of those. That helps us also in our discussions with them when we're looking at contracts to say, look, we're continuing to do this. You're having savings here. Can we get some savings there? Shouldn't we have increased coverage here? Maybe not there. So when we negotiate these contracts, there's a lot of different things that we negotiate.
Net net, I would say it's been about neutral, which is better than it's historically been. I think a big part of that is the fact that we are doing so many hospital deals, and they can actually see and feel the benefit of those.
Just on value-based care, you said you'd like to see more contracts on the value-based care side. So should I think about that as, you know, diagnostics are so important to outcomes and doing early testing, et cetera, can help to drive better outcomes where potentially you would get a piece of that, maybe, you know, the cost savings or the upside or?
That's exactly right, and if we can help determine who needs what when, like, you know, if somebody's never going to respond to a chemotherapy and should go on a PD-L1 therapy, if we can know that right from the beginning, think about how much money you save because the patient from chemotherapy or radiation won't end up in the emergency room or they won't end up having as severe side effects. It might cost them more for the drug right away, but it's going to be worth it in terms of overall cost, so if people start to look at their overall cost, diagnostics is one of the most cost-effective things you can do. If you just look piece by piece by piece, well, then you can argue that anything's not cost-efficient enough.
Right. When we think about the consumer, right, Labcorp OnD emand, are there areas for the consumer you'd like to expand into as we think about 2025?
So it's been interesting. I've learned a lot about the consumer market for diagnostic testing going through COVID. During COVID, people were looking for the fastest answer they could get. They didn't really care how much it cost, and they didn't really care how accurate it was. They just wanted to know, do I have COVID and can I go back out and go to a restaurant? That was not the typical dynamics. Typically, a patient is willing to wait one or two days for a result for cholesterol or diabetes as long as it's cost-effective and as long as it's highly accurate. So I think we have to be thoughtful about which tests we offer consumers when. Asymptomatic diseases, I think, are more difficult to offer patients. Symptomatic diseases, I think they are much more apt to jump on board very quickly.
You know, if you look at things like syphilis or syphilis test, people, if they don't want to go to their doctor or if they don't, you know, they're much more apt to order a syphilis test at home. So there's certain areas that we'll see really strong growth. Separate and distinct from that, people are taking a much more active look and control of their healthcare. And we see more people trying to stay healthy. So we're doing more and more tests to actually help people understand their health, their vitamin levels, their testosterone levels. And there's, you know, we have a women's health test, a men's health test. So we're trying to find ways to augment patients that are trying to think about their own health.
And then we're trying to think about areas where people will be more apt to actually order online to get the result themselves. I think those are the areas we'll augment.
If we think about biopharma lab services, BLS, as it's referred to, is a big piece of the organic growth story. Can you refresh us on your competitive positioning today, both in early development and central lab? And you talked about how in the third quarter, early development negative, right, but central lab continuing to be positive. How does this fit into the organic growth rate, again, of that, you know, 4.5%-7.5% target?
Yeah, and I did say expect early development to grow in the fourth quarter and as we go into 2025. If you look at those businesses, they're both market-leading businesses. Our Central Laboratory business is the market leader. It's a very global business. We have a very strong laboratory network across Asia and Japan and China and Singapore, very strong network across all of Europe. We have a good network in Latin America. We're increasing that a little bit, but if you're looking for a truly global central laboratory, we have a very, very strong position, and that will continue to be a good business. I said that that business grew 9% in the third quarter. In fairness, that was off of a relatively easy compare. In 2023, you might remember there was a nursing shortage. Sites could not enroll patients fast enough. They had a hard time retaining employees.
So 9% is not a typical type of growth for that business. It's typically in the mid-single digits. If you look at our early development, that was down 11%. That's not typical either. That's typically in the high single-digit growth. As we go into this year and we look at fourth quarter, again, it's a relatively easy compare because in 2024, we had significant things we were overcoming, but I expect that business to come back to growth as well. So with both businesses growing, we should be able to hit those numbers.
When we think about early development, you know, over the years, there's been cancellations, right?
Yeah.
There's been questions around funding, whether we think about early biotech, et cetera. How do you feel about the overall environment right now?
Yeah. No, it's a great question, Lisa. And I'd say there's three things I look at to understand the underlying dynamics of the Early Development business. The first thing is I look at the number of RFPs coming to us. I look at those in numbers, and I look at those in dollars. The RFPs have been relatively stable. The second thing I do is I look at our win rate of the RFPs that come to us. That's kind of a surrogate to me of a market share of the studies that come. Our win rate has been very stable and remains strong. And then the third thing I look at is cancellations. So somebody comes with an RFP, you win the trial, but they never start it. We've seen elevated cancellations, and we understand why. It was two reasons.
One was that when there was an NHP shortage, people got in line earlier. Number two, we saw a funding issue, and a lot of our business in early development is in the small biotech sector. As we looked at third quarter, we actually saw cancellations improving, not back to the level that we would expect them to be, you know, pre the issues with NHP and so forth, but it's definitely getting better. And that's what gives us confidence as we look at fourth quarter and we go into the next year.
Is that partially driven by the funding environment being better?
I think it's more driven by the cancellation rate being lower than it has in the past. A big reason studies were being canceled, where historically if you came to us and said, we want to do an NHP trial, we'd say we can start that in six weeks. During the shortage, we said we can't start that for six months. People got in line early. Then when it was their turn, six months later, a lot happens in early development. They either didn't have the funding, so they canceled. They killed the molecule, so they canceled. So there was a lot of reasons. We then started proactively going out to them before it was their turn. And then we even saw a greater acceleration of the cancellations. We've kind of worked our way through that, and that's why I feel pretty good about it.
As you think about areas of increased cost over the past few years, how would you characterize the current labor market? I mean, we've heard, we actually heard a hospital today come out and talk about that they were seeing increased labor costs again.
Yeah. So if I look, you know, in our model, I think we've built in, Julia, a 3%- 3.5% for inflation for labor costs as we look out to the future. That's much more normal than what we've seen during COVID or just after COVID. But it's really important to note that that's not everywhere consistent across the organization. We've seen retention rates look mostly back to pre-COVID levels in all of our biopharma laboratory services business. In the Diagnostics business, we've seen many areas where our retention rate is back to pre-COVID levels. But we haven't seen it in the frontline employees, our phlebotomists, our couriers, some of our laboratory technicians. We still see a higher turnover rate than we would have seen pre-COVID. Definitely better than it was just after COVID, but it's still higher than we thought.
So those are the areas where you can't just give a 2% or 3% merit. Certain areas there you have to look to actually give a higher merit. And then there's other parts of the organization where we think we can give a little bit less of a merit increase. So I think we're doing much better than we were doing. But the honest answer in like accessioning and some of those other areas, it's still very, very competitive, and those wages are growing faster than you would think historically. So it doesn't surprise me that a hospital that has a lot of those workers would feel that.
Yeah. That's coming back again a little bit, right? Yeah.
I think for the frontline early, yeah, I think so. It's going to be interesting as a lot of companies are going back to, you know, five days in the office and those things. It's going to be interesting to see.
Julia's laughing. I heard of a little company that's going back to five days, right? We at JPMorgan, as everybody knows, Jamie was very excited yesterday to talk about the five days in the office.
Yeah, it's the five days.
I've been back five days since 2022, so.
Yeah. I was going to the office, even during COVID. We were in there most of the time.
You know, there's some talk about potential tariffs with the next administration. Is there potentially any impact on your business, whether it's supplies or other products that you might get from somewhere outside the U.S.?
Yeah. So we'll have to see what those tariffs are and where they're from and so forth. But the one thing that we learned during COVID was how to build a resilient supply chain that has multiple different ways of getting supply. If you, how many people remember when you couldn't find nasal swabs like really early in COVID? 95% of those nasal swabs were made in a little factory in Italy, Copan, Italy. And that's where everybody bought them from because they had such bulk. It was the cheapest place to go, and everybody went there. There were so many examples with reagents and supplies. We got very good at procurement, much better than we were prior to COVID. And we've really learned that you have to have duplicative supply chains.
So I feel comfortable if there's issues in this part of the world, can we go to that part of the world? If there's an issue here, can we go there? So we'll work through it and manage it best we can. I don't know what could come at us, so we'll see. But I feel like we're in a very good position now than we would have been prior to COVID.
I know we only have a couple of minutes left. I want to talk about, you know, just kind of big picture as we think about 2025, headwinds, tailwinds of things to keep in mind as we think about 2025.
Yeah. So again, I'll give the guidance in a couple of weeks and our call in February. I feel great about the momentum that we had in third quarter going into fourth quarter, coming into 2025. We'll give the fourth quarter in February as well. If I think about like big pushes and pulls, I'd say it's a relatively stable year versus other years where you and I would be talking about, you know, COVID tests and pricing of COVID tests, when it's going to come down and, you know, last second whether pneumonia is going to come or not come. So I feel good about the consistency. There will always be things unexpected with weather. My heart goes out to the people that are facing the fires. And it's just horrific what's happening there. We have some employees that have been impacted.
There'll be some things that you can't account for, but there'll be other things that are positive that you don't account for. So I don't see any really big swings as I come into 2025 as I have before in a significant way. I don't know if you've seen anything different that you.
You've covered it well in the comprehensive letter. I agree.
I guess lastly, in our last couple of minutes, Adam, you know, I like to turn it back to you to give people an opportunity to really think about what will they better understand or appreciate about Labcorp over the next 12 months that maybe they don't appreciate today.
Yeah. No, Lisa, I think that's important. I still believe that Labcorp is undervalued. I still believe that there are things that investors haven't yet understood about Labcorp. I'm hopeful that as we go through the year, people will see that all three of our businesses are performing well, meaning diagnostics, early development, and central laboratory. I think early development has taken up a lot more time and a lot more discussion than the 6% of revenue that it represents. So I'm looking forward to that returning back to growth. You'll have to find something else to pick on us for. But, and I think you'll see that we continue to do what we say we're going to do. That when we put numbers out there, we hit those numbers. When we put objectives and we put our guidance out there, that we continue to maintain our guidance.
I want to make sure that you continue to see a level of consistency of us achieving or beating our numbers as we move forward.
I think that's a great way to end. Thank you very much, everyone, for joining us this afternoon.
Thank you, Lisa.
Thank you, Julia. Thank you.