Okay. Good morning. Welcome to day one of Baird's Global Virtual Healthcare Conference. My name is Mike Polark. I am a med tech analyst at Baird.
I'm pleased to be joined in this session by Sotera Health. Representing the company, we have CFO, Scott Leffler and Treasurer, Jason Peterson. For those that may be less familiar, Soterra is a leading global provider of sterilization, lab testing and advisory services. The company is also a leading global provider of access to Cobalt 60 finished sources, which is a key product input for industrial scale sterilization and also some medical applications. I'm going to turn the floor over to Scott, who is going to further set the stage and introduce Zotera with a few slides.
And then after Scott's remarks, we'll jump into some Q and A that I will lead. So with that, Scott, welcome, and thanks for being here, and I'll hand it over to you.
Thanks, Mike. Let me start out by thanking you and the Bayer team for hosting us in this event here today. And also, thanks to all of you for joining us and for your interest in learning more about Sutera Health. I'm just going to start out with a couple of brief comments. Just a reminder that some of the statements I make today may be considered forward looking statements and are subject to risks and uncertainties that could cause actual results to differ materially from those projected or implied.
You can refer to our SEC filings in this slide for a description of these risks and uncertainties. The company assumes no obligation to update any such forward looking statements. There will be a discussion in this presentation of certain non GAAP financial measures, including adjusted EBITDA. You can find a reconciliation of these measures in the appendix of these slides.
And copy of this presentation. Scott. You're coming in and out a little bit with audio. I don't know if you can Sure.
Let me, pull the mic a little closer. Is that is that better, Mike? Is that better, Mike? Can you hear me okay?
I'm better. Yeah. Okay. Yeah. It sounded better.
Okay. Great. I'll I'll assume that that you guys at least heard, well enough, the comments I made a second ago, but I was just finishing up with a reminder that a copy of this presentation will be posted to the IR section of our website at www.soterahealth.com. So let me just jump into the presentation then. At Sotera Health, our mission is safeguarding global health, and we do that through our sterilization services, lab testing, and advice services.
We go to market through our three business segments, Sterigenics and Nordion and Nelson Labs. Sterigenics and Nordion fall under the vertical relating to sterilization services. Sterigenics is a global provider of terminal sterilization services, primarily serving the medical device and pharmaceutical spaces. They provide a global network of facilities to our partners around the world with a leading position in terminal sterilization in all of the major modalities of sterilization, and that includes sterilizing using ethylene oxide gas, gamma radiation using cobalt 60, and using a machine called an e beam, which generates machine generated radiation to sterilize medical devices. Now I mentioned those three modalities, and one of them was sterilization using gamma radiation that's generated by cobalt 60.
And that's where our second business unit, Nordion, comes in. Nordion was acquired in 2014, and it allowed us become the only global vertically integrated sterilization solutions provider relating specifically to the modality of sterilizing using gamma radiation via Cobalt 60. Nordeon, as Mike indicated earlier, is the world's leading global supplier of cobalt 60, which has a number of applications, but primarily for use in the sterilization industry for that particular modality. And then our third business unit, Nelson Labs, is a is a global leader in microbiological testing, servicing primarily the medical device and also pharmaceutical spaces across the life cycle of pharmaceutical and medical device products. What we do is important, but how we do it is every bit as important.
We are providing mission critical services to blue chip customers. We do business with 40 out of the top 50 medical device manufacturers and eight of the top 10 pharmaceutical companies. For Sterigenics and Noreon in particular, a lot of that business is done over long term contracts. Seragenics and Nordeon generate over 90% of their revenue under long term contracts. Our services are provided to our customers via a comprehensive global network across all three of our businesses.
We have 64 facilities around the world. Serigenics, in particular, has 48 facilities around the world representing all of those major modalities of sterilization that I mentioned earlier. We believe that the cost to replicate our network is over $1,500,000,000 We operate all three of our businesses operate in a very highly regulated industry with a trend towards increasing regulation over time, and we believe that our ability to comply with an increasingly burdensome regulatory environment is a competitive differentiator for us. In terms of our growth strategy, we look at both organic and inorganic growth opportunities with a successful track record of delivering growth from both of those areas. All of that is grounded in a values based culture.
The company's values are our core values are safety, quality, accountability, and excellence. That's how we do it, and the result is strong financial performance. Revenue growth every single year on record. We pulled numbers back to 2,005 in order to validate that, obviously, but I think our view is that is that that history goes back even further. In particular, when you look at the more recent periods of of macro disruption, the financial crisis, 02/2008, 02/2009, and and probably most importantly and most recently, of course, the pandemic and and during the worst points of the pandemic in 02/2020, we delivered revenue growth in every single one of those years.
We have an adjusted margin profile that is very attractive with over 50% adjusted EBITDA margins. And importantly, there's plenty of runway for growth with an addressable market of around $33,000,000,000 that we believe we can continue to tap into over time. Consistent track record of cash generation, and obviously, we're exposed to macro end markets with strong secular trends. And importantly, for anyone that wants exposure to the health care space without payer reimbursement risk, then we're an attractive opportunity. Now I think given how new we are to the marketplace, there's still a lot of investors out there that have trouble visual exactly what we do or how we interact with different medical devices.
So what we're trying to do here is just to give you examples. And bear in mind that Sterigenics has almost 3,000 customers. Muscle and Axle has almost 4,000 customers, and they're obviously providing services across a massive range of product categories. So this is just a small sampling of the product categories that we interact with. On the left side, medical device examples, and on the right side, pharmaceuticals.
And just to give you a couple of examples of how we might interact with these products, Across the top, cardiovascular implants or orthopedic implants. At any given point in time, if you were to walk through some of our gamma radiation facilities, there's a very good chance that you might see boxes of these medical devices that are being sterilized using gamma radiation. In the second row, you see collection swabs, particularly relevant in the pandemic environment where Sterigenics has been instrumental in providing sterilization services. Many people that follow the company are aware of comments we've made around how we touch the world of personal protective equipment, where there's a certain amount of sterilization, but really the larger storyline there has been the tremendous contribution that Nelson Labs has made in testing around personal protective equipment used by caregivers in treating treating patients during the pandemic. And then on the right side, I'll I'll just give one example on the pharmaceutical side that that we often reference.
You see an image on the upper left of someone holding an asthma inhaler. And this is a is a special one for us because in 02/2017, we acquired a leadership position via acquisition in a specific category of testing called extractables and leachables testing. And so the idea is if you look at the person in that image that's about to inhale a pharmaceutical product to treat their asthma, how do they know that that pharmaceutical product hasn't there hasn't been any harmful contaminant that's leached into the pharmaceutical product from the plastic or metal container? And this particular category of testing, where we're now an industry leader, is the is the leading solution for identifying those types of risks. So just a few examples.
Again, I think I mentioned earlier that we are touching products across really the entire life cycle of medical devices and pharmaceuticals and small sampling of that here. What does that translate to in terms of our financial performance? Here, we're looking at our financial performance from 2019 to 2020, delivering 8% top line growth in 2019 and importantly, during the pandemic, delivering 5% revenue growth. Importantly, during that time, we took already strong margin performance and expanded them by over four fifty basis points, culminating in 2020 margin profile of 51.3% and obviously delivering double digit bottom line growth. Robust earnings performance during that time period as well.
You see a little bit of a blip in 2020 that is related to financing activities that took place, not reflective of the material change in our capital structure since going public we'll talk about a little bit later that's resulted in a significant reduction in overall debt levels and interest expense. Next and more recently, looking at 2021 performance, and I'll focus on the right hand side of the slide talking about our year to date performance. We've delivered 16% revenue growth, 16% adjusted EBITDA growth and 83% adjusted EPS growth. Obviously, our organic performance is being complemented by some acquisition activity as well as the optimization of our capital structure that I mentioned a second ago. We've been a public company now for three reporting cycles, threefour of the reporting cycles, and we have delivered double digit growth in every single one of those quarters.
Finally, and I already referenced it a couple of times, we're proud of the optimization of our capital structure since going public. As a privately held company, obviously, we had a different philosophy as far as the capital structure we've maintained. But we have now reduced our net leverage from 7.5x pre IPO to 3.8x as of the most recent reporting period, obviously, with more opportunity for further reduction from there. People that follow the company's news may have read that a couple weeks ago, we used cash generated from operations to pay off our highest cost remaining debt on our on our balance sheet. And so our new run rate for interest expense is down to $70,000,000 and that compares to $215,000,000 in interest expense for the last year.
So obviously, a material reduction in interest expense to accompany the leverage reduction, and that just increases the cash flow potential for the company at the time. Finally, just to wrap up, and then I'll turn it back over to Mike. You know, we feel that the company has a very robust underlying operating model. You can see that in in the strong financial performance in terms of top line growth and bottom line performance. Large addressable market, plenty of runway for incremental growth, sitting in an industry that's been very attractive.
We're a trusted partner for our our to our customers where we have many customer relationships literally Plenty of opportunity from operational excellence as well. And importantly, a platform here for continued M and A where we're able to use inorganic opportunities to complement the the robust organic performance. So with that, Mike, I I think I'll hand it over to you.
Excellent. Great foundation, Scott. Good introduction. Thank you so much. We have just over fifteen minutes for some q and a.
I'm looking to start a lot of these conversations here about the environment. I understand we're inter quarter and you may not be able to comment. But in just the last week or so, a handful of public companies have commented that Delta variant is perhaps impacting procedural demand, ability to access health care. It certainly doesn't seem widespread like 2Q of last year, but pockets of strain. So in the context of your business, which for our listeners, Steregenics grew 4% last year in arguably the most challenging macro environment in recent past.
First quarter last year in Steregenics was low single digit growth, so proved resilience during the trials of last year. I'd be just curious for your take on the world as you see it here. We have obviously Delta variant. There was summer seasonality. Folks may be burnt out and needed to get away to the beach.
You had some hurricane and weather related disruptions. You know, from your perch, how do you view these these influences?
Sure. Well, I I think we can all use a trip to the beach, but, you know, I and thank you for the the comment about where we are in the earnings cycle because, obviously, it's so close to the end of Q3. I'd probably be better off anchoring myself to some of the comments that we've made in the past, particularly in our Q2 earnings report, which is just a reiteration of the fact that it is such a robust and consistent and resilient, your term, operating model. As I said earlier, over 90% of the revenue from Nortion and Sterigenics delivered under long term contracts. And as you said, we delivered growth as a company in every single quarter of last year, including during the worst of the pandemic related lockdowns.
Also working in our favor here is the diversification of the revenue model, where when you're talking about doing business with literally thousands of customers across thousands and thousands of product lines, then that really helps to insulate you against any macroeconomic volatility. And I think we certainly demonstrated that last year. Just we have every single year on record. And I think that gives you a sense for the the optimism that we, in general, feel around the resiliency of the revenue model even in a in a more challenging macro environment. And so, you know, I think in our q two earnings call, we made some comments about our our optimism around the company's ability to to continue to deliver robust results even in a challenging environment.
Yeah. We'll shift gears in double on Cerigenics. You know, a nice result in the most recent quarter. If I have the numbers correct, 12% growth in constant currency, organic for Terigenics revenue, which is, you know, probably in that, global network. I think when I, you know, hear those comments, that seems to be a signal that you expect growth ahead.
So, you know, level set here on on tensions underway. Six are expected to to be online by the end of this calendar year. You know, why are you investing? What gives you the confidence to expand your network capacity? And, you know, what is it you know, am I crazy to think that these double low double digit growth rates are, unreasonable here over the next handful of quarters as these projects come online and start to fill?
Sure. Well, so there's a couple perspectives maybe embedded in there. Some of it's more near term, and some of it's more medium term and longer term. So I'll try and approach it from a couple of different angles. But in terms of our outlook for this year, first of all, it's our general policy not to update or comment on our guidance between earnings calls.
But we did, in our earnings call, update our guidance for the year, which, obviously, if you look at our year to date performance as of Q2 and what that implies about the second half of the year, you can see that as of that time, at least there was a certain amount of comfort around what the second half of the year looked like. And I'll just say, I hate to keep reiterating the same point, but the consistency of the revenue model for Surgenics in particular, the diversification of the revenue stream as far as the number of customer new product lines, really means that you've got a business, and this applies to Nordion as well, that it's not that often that we have surprises in this type of business. You have a lot of visibility into the revenue stream over time. And then, you know, with respect to the capacity expansions, we have mentioned on our last couple of earnings calls that we have nine active capacity expansions with six contemplated to go live for this year. Bear in mind that the cycle for capacity expansions is not necessarily a reaction to immediate to the immediate demand environment.
It's more the result of what is often a multiyear commercial cycle, where we are deeply embedded with our customers in many cases in terms of their own product development plans. Just a reminder that while sterilization services typically represent less than 5% of the total cost of bringing a product to market, you can argue that they unlock 100% of the value because you're talking about a service that is often FDA mandated. And so for our customers that are in different phases of product development, it's absolutely critical for them to know that they're going to have sterilization capacity available to them. And so, again, back to these capacity expansions, these are the result, in many cases, of commercial negotiations that have been taking place for quite some time. And also, as we've said in the past, they're not necessarily representative of any change in the overall longer term trajectory of the business.
We would characterize these as being representative of our routine cycle of investment in the business. We've said that we tend, just from an optimization of ROI on our investments, we do have a tendency to run at very high capacity utilization levels. And so what that means is that we also have to have a routine program of capacity expansion in order to accommodate growth over time for the business.
Quest Scott, can you hear me?
Barely. I I don't know if it's apologies. I don't know if the technical issue is on my end or your end, but I I'm having a lot of trouble.
I think we're I think we're rolling now. I can hear you, and it sounds like you can hear me.
Sure. Okay.
Yeah. No. That was a good overview on the on the capacity expansions. I I think you know, so I think in summary, you're you know, maybe talk about what maybe talk about one of these projects. You know?
How do you bring it to your leadership team internally? How does the capital get approved? What sort of inputs go into that process, whether it be customer commitments or indications? You know? Because I think that is useful.
This is a business where you have to put up the box first before you can fill it, before you can grow. And I think in the past, you've provided some helpful context around how Solterra gets comfortable making such significant capital commitments. So maybe if you could comment on that as you think about the Steregenics network growth and the investments being made there.
Sure. And just back to a point I made a second ago, with these deep customer relationships, in many cases, we're going back decades. Our commercial team really does a great job, I think, of being embedded with our customers, in many cases, early in the product development cycle or at least early enough at the point where we can be part of the solution for them in terms of of giving them the confidence they need that they're gonna have the right capacity available and in the right place as they bring what what is often a very important product to the marketplace. And so, you you know, oftentimes, I think in a best case scenario, and we've said this before, we love it. We'd love to have customer commitments up front before we even put a shovel in the ground for a new capacity expansion.
So oftentimes, the internal discussion, it goes along the lines of looking at the actual customer commitments along with maybe even if it's not a commitment, looking at the rest of the commercial pipeline for a particular modality in a particular geography. And so we, you know, we look at that on an ROI basis, and we are making for 20% plus IRR returns on our core team of investments. We don't always have 50% capacity committed for an expansion, but certainly, it's it's nice to have that. That's a bogey. But in general, I think our commercial team does a great job of being in tune with the marketplace so that whether it's actual committed volume from a customer or a very robust and reliable pipeline, we're able to make a decision to make an investment in capacity expansions like the ones I've talked about and deliver a very strong track record of hit rates on those expansions.
So your service, is valuable to a wide variety of of customers and products. I don't wanna spend too much time on any specific category, but one that continues to get proactive mention is bioprocess. I think broadly single use consumables for the production of vaccines and biologic drug products. And and and I'd love you to comment on what you see in that product category defined broadly and kinda why why it seems to be quite buoyant and and growing. And I I think there's maybe a pandemic influence, but also more of a secular shift.
So, you know, what's what's Sotera's view on on the bioprocess category and that opportunity within, you know, stereogenics?
Yeah. Well, I mean, I think you hit the nail on the head in terms of just the the macro opportunity there. There there really is just a a tremendous emphasis and and growth tailwind in that area. Historically, it has not necessarily represented a huge part of our business, but I think that some of that relates to just the way that market worked. And as you said, this trend towards more single use inputs for bioprocessing is something that creates a commercial opportunity for us as well.
We talked a little talked about it a little bit on our Q2 earnings call. And without quantifying the opportunity in any way, we certainly believe that that's a very promising opportunity for us as well as the product line.
Maybe last one on stereogenics. I will ask briefly on the the litigation, not for written outcomes or anything of the sort, but just upcoming events. So one in New Mexico, I believe you were working on a monitoring agreement with the authorities there. What's the latest on that? Or when might investors be able to expect an agreement?
And then Illinois, you've been very clear. Jury trials year, first one, July. What happens between now and then? Is there anything investors should be digging into, or is it simply, you know, waiting for next summer?
Yeah. So in terms of the the personal injury cases in Illinois, you're right about the timing in terms of the first cases coming in trial in the second half of next year. And so so, really, barring any surprises, we wouldn't expect to have much in the way of updates on those. As you indicated, really, it's just more preparation in terms of our legal resources. And, you know, obviously, from the very beginning, we have felt very strongly about the company's position on these matters.
Certainly, feel that all of those claims are unfounded that are against the company, and our intent is is to vigorously defend ourselves against every one of those claims, and and we'll see the the results of that in the second half of next year. We don't have an update of any kind in terms of the Santa Teresa monitoring situation. As we mentioned on the Q2 earnings call, we had been going the the status quo of the situation right now is that we need to go back in front of the judge in that case and ask for a ruling in terms of the monitoring requirements, and and there's been no no change in that. We're waiting for the judge to give us a timeline for that ruling. In in the meantime, though, our position hasn't changed relative to what we mentioned on the Q2 call is that is that we're we wouldn't anticipate that that ruling would have any impact from an operational standpoint on that side.
Let's shift gears to Nelson Labs. I get this question a lot. What what does doTERRA envision Nelson being in five years forward? You know, I there you are, a a small fish in a very large pond. Lab serve lab services defined broadly as a massive marketplace.
It's heterogeneous. You know, what where is Nelson different today? And, you know, why why is SoTERRA an advantaged owner of this asset, and what's the vision, you know, over the next five years to to grow this business?
Well, I think if you go back to 2016 when we originally acquired Nelson Lab, the original thesis was really grounded in the significant amount of overlap that exists between the testing services that are provided by Nelson Labs, which specifically relate to the the sterilization process. And then, obviously, the the overlap with serogenics, which is delivering the the sterilization services. And so they there's you can lump those testing services into two general categories. There's one bucket that relates to routine testing for products that are already out there for routine production and distribution in the marketplace. There are generally a number of quality control or routine lot release tests that are done after the sterilization service is provided in order to validate the efficacy of the sterilization process.
And so there's a natural commercial and potentially operational synergy there. And then earlier in the product development life cycle, there's a lot of testing that goes on in order to design the sterilization protocol and then validate the efficacy of that protocol. And Nelson provides a lot of testing services in that area. And again, there's an obvious potential commercial synergy between Nelson Labs and Sarah Jennings on that front as well. And we've said we think even a few years into the acquisition, we think we're still in the early stages of realizing the the potential synergies associated with with those connection points.
But more broadly, obviously, we we couldn't have been more thrilled with Nelson even above and beyond those synergies with Sterigenics because they they just have such a broad universe of opportunity. We claim a $33,000,000,000 TAM for the company, and 29,000,000,000 of that is in the Nelson Labs space. But then 26 out of the 29 relates to pharma, which is really an area that we've gone out of our way to emphasize. Historically, Nelson Labs was almost exclusively a med device. And after identifying the just the material opportunity that is out there for testing services in the pharmacy, we've gone out of our way to emphasize both organic and inorganic investments with with a pharma bent to them.
And so where we sit today, Nelson Labs has gone from having very little pharma exposure to now being almost 30% pharma. A couple of our tuck in acquisitions had a specific pharma area that they were targeting along with with some organic investment as well. And so really, when you look at at Nelson Labs five years down, we think that there's plenty of organic opportunity out there, whether it's further penetrating the existing TAM on the medical device side, further penetrating the the large opportunity on pharma. And then in in a changing regulatory environment, that's where Nelson Labs really differentiates itself because their thought leadership, which we consider to be second to none, positions themselves positions them better than anyone to assist their customers in understanding and complying with a dynamic regulatory environment.
Yeah. That's a good overview. So we have twenty seconds, and I won't squeeze in the question on margin. But I will say, you know, one of the questions is, wow. These margins are so high.
How can they go higher? And I just would double click on your opening comment during your prepared remark, which is that you expect to strive for margin improvement from operational excellence, perhaps some price business mix. I have a lot of questions about that, but I think it's important just to reiterate that even though your margin is very high, you strive for for higher.
Absolutely. And, you know, we talked about three main drivers for our margin profile. We didn't get into it much on this call, but the company does have a successful track record of delivering some top line growth from price, including annual price escalators built into our contracts. And so that provides some amount of margin tailwind. Our businesses have a tremendous amount of operating leverage overall.
So as we ramp up the volume performance, then then that creates a margin tailwind for us. And to to your point, operational excellence is something that we really have embedded in the culture of the company and believe that there's plenty of opportunity out there to drive margin and bottom line performance from optic industry.
Scott, thank you so much. We're gonna have to leave it there, and thanks for working through the tough technical difficulties. I don't know. Somewhere in the ether, there was some, some excess traffic, but, we made it through. Thanks for being here.
Good luck today with the rest of your meetings, and and thanks, to everyone in our audience for for listening in.
Thanks. I really appreciate it. Have a day.
Have a good day.