All right, good morning, everyone. I'm Larry Biegelsen, the medical device analyst at Wells Fargo, and it is my pleasure to host this session with the management team from Zimmer Biomet. With us, we have the new CEO, Ivan Tornos, the CFO, and I know also expanded role and title, Suketu Upadhyay. What's your expanded role and title?
I also now have operational supply chain.
Got it.
Thanks, Larry.
From Investor Relations, Keri Mattox, Chief Communications Officer, and Zach Weiner, Director of Investor Relations. Format's gonna be fireside chat, and if anybody has a question, please raise your hand. So, Ivan and Suketu, thanks so much for being here.
Thank you.
Thanks, Larry.
Congratulations again, Ivan.
Thank you.
So Ivan, a lot of questions for you. I'm sure people would love to hear, you know, from you, you know, how you're thinking about the business. Maybe before we jump into the tougher questions, I'd love to hear from you, kind of your experience at Zimmer and, you know, what you're most proud of accomplishing over the past five years.
Sure. Thanks, Larry. Good morning, everybody. So, I've been with Zimmer Biomet about five years, and I could give a fairly lengthy speech in terms of what are the highlights of my five years here. If I were to give you a short sentence, I would say the transformation of the company. Really proud of the transformation of the company. And there's a lot of things to unpack. Maybe I'll make this a lengthy answer, and then we'll make our time later, but I'll leave you with five key areas of that transformation: strategy, operations, culture, innovation, and finances. So on strategy, I will tell you, five years ago, we didn't have clarity on strategy.
And this is not to diminish the work that, the previous management team, did prior to, some of us joining the company, but, but we did it. We doubled down on low-growth markets, Zimmer and Biomet. We were in multiple areas. We failed to say no. We came out with a very clear strategy around where to invest, where not to invest. Along came growth drivers, along came, investment innovation around data technology solutions, along came a lot of staff from a strategy standpoint. Operations, one word, remediation. This is a company that, back in 2017, 2016, and to a lesser degree, 2018, was flagged with all kinds of operational issues.
Whether we're talking FDA warning letters, whether we're talking compliance issues with a monitorship with the Department of Justice, whether we're talking a poor operations manufacturing strategy, I can go on and on. We changed, we turned that around. One FDA warning letter left. Can't wait for the FDA to come to Warsaw. Zero challenges from a compliance standpoint, zero challenges from an FDA standpoint. A trusted partner with key stakeholders. Again, it's a different company from an operations standpoint. Culture. We globalized the company, we created a totally different culture at Zimmer Biomet, a culture of winning, a culture of accountability, a culture of high engagement. We used to have 20, 25% turnover. People leaving, 20, 25% turnover, meaning like, you know, one of every five employees was leaving the company.
We have some of the lowest turnover rates that I've seen in 30 years in med tech around the world. Innovation. Once we close the remediation gaps, we move into innovation. Our pipeline today is twice what it used to be in 2018. What I mean by twice is twice the value. So we don't disclose externally what the actual revenue is, but we're talking $ billions. So the pipeline in 2018, fast-forward to 2023, twice the revenue. Those are products that we're going to be launching over the next, call it, you know, 2 to 3 to 5 years. These are products that in most categories, are going to be number one, number two in the markets where we play. 80%-85% of these new products are going to be in 4+ market growth segments.
And most important, they're very mission-centric products. So I tell people, and you've asked me before, our innovation, it truly is the competitive advantage of Zimmer Biomet. And then the fifth and final component of this lengthy answer is around the results. We have established a track record of saying things and doing things. We're gonna deliver this year, 7%-7.5% growth. Second consecutive year with a mid-single-upper single digit growth, delivering at midpoint, 100 basis points of margin expansion, three years in a row, committing to delivering margin expansion again in 2024. So I will tell you, those five key areas have been truly the pillars of this transformation.
That's super helpful, Ivan. And I hope this is the last time you're asked this question, but I think this is your first webcast.
Sure.
... as a CEO. So the question is about, you know, Bryan leaving, and the signal it sends.
Sure.
Some people see it as kind of a lateral move. I don't know what you can say-
Sure.
It's hard for you to get inside his head, but anything you can say would be helpful, and how you're just feeling about the business-
Yeah.
Probably more importantly.
Yeah, well, I'll start with the second part of the question. Obviously, I'm very excited about where we are today. We can talk about the last five years and the next five years as we get into the Q&A, but very excited. Innovation, truly a strength. Commercial execution is happening. The macro environment is getting better. So really, really excited. In terms of Bryan leaving, look, it's a question at some point you guys need to ask Bryan. I'm very close to Bryan. I consider him a close friend. I knew when I joined the company five years ago that he had thoughts around doing something else. We always talk about at some point being five years. It was kind of like a gentleman's agreement, if you will. That's not to say that the deadline came and he left.
You know, he's got a great opportunity at 3M. Bryan loves doing transformations in the earliest stages of the transformation. Go back and look at his resume. You know, he was part of Tyco becoming Covidien. He was part of Covidien becoming Medtronic, and he joined Zimmer Biomet when we were frankly two different companies, Zimmer and Biomet. He was the architect of a lot of the stuff that I talked about, and now he's got a great opportunity at 3M, which is gonna be very compelling from a financial standpoint, and that's why he chose to go there. He doesn't see that as a lateral move, and once the proxy is out, I think you'll agree with me that it's a great opportunity for Bryan and for 3M, by the way. So excited about Bryan being at 3M as well.
That's helpful. How about strategy? You know, Bryan talked about a three-stage process at Zimmer. When he became CEO, he talked a lot about being in stage three today. How does the strategy change under your leadership?
Yeah. So let me maybe start quickly, 10-second summary on the three stages. So stage one was what I call hearts and minds, hygiene level factors. You know, let's clean up all the culture issues, the quality remediation, innovation part that I described. Stage number two was putting the strategy in place. What are we gonna do? What are we not going to do? And that was the divestiture of Spine, Dental, that was prioritizing the growth drivers of the company. And then stage number three, which is where we are right now, is deeper portfolio transformation. And we are in stage three, and we are gonna execute on stage three. So the second part of your question, how is the strategy gonna change? It's not. Evolution versus revolution.
We will go faster in executing stage three because we done all the cleanup already, but thematically, the strategy is not changing.
That's helpful. So, Ivan, what does success look like in 12 months for you?
Sure. Execution. You know, we say things, we gotta deliver on things. We made financial commitments, we gotta deliver on those financial commitments. Personally, I don't want us to be four plus mid-single digit grower. That's the commitment we're making for 2024. But if you ask me, I want us to be a company that is mission-centric, that is winning in the markets where we partake, growing above market, delivering top line, and expanding EPS at a meaningful rate. So that's winning from a financial standpoint. Beyond that, continue to be thought of as a trusted partner with the key stakeholders, and truly transform not just Zimmer Biomet, but an entire industry, and I think we can do that.
Given some of the innovation pathways that we have, given some of the talent that we got, I think this company can not only just impact the company, Zimmer Biomet, but truly transform an entire industry. I don't know if that's gonna happen in 12 months, but definitely an aspiration.
The 4%+, you know, not being satisfied for that caught a lot of, I think, investors' attention, after, you know, you did a sell-side call and people wrote notes about it. The current M&A portfolio, can it get you there, or do you need to, you know, increase your M&A growth?
Yeah. I, I'm not gonna elaborate too much on 2024. We'll give guidance at the right time, but we said in the earnings call that 2024, the commitment is 4+, even mid-single digit. In that commitment, that's an actual commitment, we think in macro and micro factors, and we feel very confident we can deliver on, on that commitment. But as we get closer into, guidance time, we'll be talking about all the different variables in, in that regard.
I think you're not being satisfied with 4%+, I thought was more of a long-term aspiration, not-
Uh.
... not a 2024 comment.
We'll see. We'll see.
Okay. Fair enough. Ivan, I wanna ask you a question on culture, because I know you and Bryan are different people, obviously. And what we hear about you, and you talked about it today, you know, as you know, being demanding and holding people accountable, which are good things, I think. Culturally, how do you see Zimmer changing under your leadership?
Yeah. So first of all, Bryan and I are different. He's blonde, blue-eyed, speaks impeccable English. But beyond that, I would say that Bryan and I are very similar. We both are very mission-centric. We both believe that culture needs to come before the strategy. And again, we both worked together for five years, and we built the culture together. So I don't see a change in that regard. We'll continue to manage the company with focus, with accountability, and with a deep sense of teamwork. I tend to be more involved in the details. I was the operator of Zimmer Biomet for five years. I like data, I like processes, I like systems, I like accountability, as you highlighted. I like focus. So I would say probably that's not gonna change. I would say the culture is not gonna change.
We may do things a bit faster, evolution versus revolution, but I like to go faster in some areas.
That's helpful. Maybe why don't we get the capital allocation question out of the way here? How does it change under your leadership? And maybe, Suketu, you can chime in and just remind us of the kind of M&A strategy.
Maybe I'll do the first part, and then, Suketu-
Yeah.
You can elaborate. The first part is that it hasn't changed. Again, we, as a management team, it wasn't Bryan, came out with the M&A strategy. Financially, we wanna have the right metrics. Those are not gonna change. Acquisition price up to $2 billion. That's not to say we're gonna do a $2 billion deal, but we like the optionality, given the balance sheet that we got, to do up to a $2 billion deal. Willing to take dilution up to 24 months. You know, we may or may not make an exception based on how compelling specific asset is, but that's kinda like the North Star. In terms of the key areas that we wanna focus on, it's really like a 3-step type of approach. Step number 1, we like certain spaces within orthopedics.
We are the number one company in the world in knees and hips. We are a fast grower in robotics. There's a lot of spaces within orthopedics that are very attractive. High growth, great margins, we got great presence, will be a seamless integration. So that'll be leg number one. Number two is SET. You know, higher growth segments in sports medicine, in upper extremity shoulder, in our CMFT, craniomaxillofacial thoracic business. So that's kind of like the second stage, if you will. And then number three, site of care. We have a great presence in the ASC. A large amount of cases are moving to the ASC, ambulatory surgical centers, and we want to leverage that call point and think about all the adjacencies in that call point.
That can be anything from anti-infective plays. That can be a lot of things in that, in that category.
I'd say from the capital allocation standpoint, it's really centered on three principles. The first is to ensure and protect the liquidity of the company. Two is to maintain strategic optionality and flexibility. And the third, underpinning all that, is to maintain investment grade. So as we think about how do we deploy in the backdrop of what Ivan just said, top priority is make sure we invest against the assets we already have. We've got to optimize those assets, make sure we got the right capital behind them, make sure we have the right investment to optimize those organic opportunities. From there, we're going to maintain our dividend on a $1 per share basis. We're not, we're not looking to increase that, or, or take it away in any way.
After that, our third priority then is that flexibility to do M&A, to accelerate our growth rate above that mid-single digit profile that Ivan talked about earlier. And then the last is, you know, return of capital to shareholders through share buyback. So that's how we think about deploying our capital. Very consistent with where we've been for the last few years.
And ROIC, I believe-
Yeah, so when we think about deals, you know, I think Ivan talked about, first of all, the sizing of that, but inside of that, we have a number of strategic variables. The financial variables we look at are obviously NPV, IRR. We look to maintain dilution inside of 24 months, and then we would look for ROIC to be accretive to cost of capital, high single digits, low double digits by year 5.
Just one clarification. You, Ivan, you talked about stage one, two, three. Sometimes people think about stages as, you know, you know, chronological. I don't think you meant it that way.
Yeah, no.
Those are the three-
Let me, let me clarify that. English is not my first language, so when we think about priorities, you know, we like spaces within orthopedics that are higher growth because again, it's a seamless integration. We have the right to win in those categories. So priority number one. Priority number two, SET. Priority number three, ASC site of care opportunities.
Got it. That's helpful. And one other big picture question. GLP-1s have been very topical.
Yeah.
Concerns about, you know, GLP-1s, reducing the rate of obesity. obesity-
Yeah.
Is a big driver of osteoarthritis, but there's also the potential benefit to your business.
Yeah.
- because a lot of patients are too obese to undergo a hip or knee procedure. How, how are you guys-
Yeah.
thinking about that?
You know, it's a great topic, and, and, and this came up, I don't know, 5, 6 months ago. We didn't pay that much attention. We're paying attention now. We're getting educated. I'm going to throw a couple of data points, and, and by all means, do the channel checks. You know, check with Rothman Orthopaedics, the guys here at MGH, Cleveland Clinic. I, I think you're gonna hear a very consistent message. Number one, in the short term, we believe this is definitely a tailwind. You got a large percentage of patients in the U.S. that don't have the right BMI threshold to go through a surgery, which is around 30-40%. As a matter of fact, the number is 10%. But let me say that again.
10% of patients that could get an implant today are not getting one because they're too obese to go through the surgery. When you put that in perspective, you know, it's a large number. It's a large number. We're talking millions of patients. So in the short term, it's a tailwind. Now, the second part of the question here is, well, do you guys think that volumes are going to get reduced as these GLP-1s start to work and people get skinnier? Look, I'll tell you, go back to bariatric surgery in the U.S., you know, 20 years ago. Bariatric surgery has been around two, three decades. Volumes in orthopedics have constantly gone up year after year after year. You're not seeing a reduction. So we think it's a tailwind in the short term.
We don't think it's a major headwind in the long term. The data that we're reading shows that, you know, genetics is a bigger factor. Most are factors that, weight. The data we're getting is that these GLP-1s are really not reducing pain as much. Obviously, you lose the weight. The data shows very, clearly that, the weight loss may not be sustainable, you know, after a certain period of time. Economically, I don't see how the healthcare system can pay, you know, $2,000 per month per patient for life, for people to stay, quote, unquote, "skinny." So we're not, terrified about that was going to happen here.
That's helpful. All right, so let's, let's switch gears, talk about, you know, the business today. You know, maybe get direct this to Suketu. How would you describe the operating environment now compared to this time last year? What's getting better? What's still a headwind?
Yeah, I'd say overall, it's a net positive. So far in the second half of the year, we're progressing as expected. We're very pleased with how the third quarter is playing through. All of our key assumptions are actually coming through. One of those being COVID being a non-factor, whether that's infection surges, hospital capacity, or staffing. So we're seeing that play out as expected. Overall, the pricing environment has been relatively stable to the first half of the year. It's another major proof point for us. So overall, demand remains very strong across all of our categories, so we feel really good about that. We still continue to see some supply challenges being somewhat of a governor to growth, but that's improving.
It's improving every week, and that was one of our expectations as we came into the second half of the year. So overall, very pleased with how the third quarter is progressing, very confident in the guidance that we provided for the full year.
... and the summer seasonality, we all hear about, you know, pent-up demand for vacations, but I think that was a factor last year.
Yeah.
Anything unique this year?
No, nothing structural. We're seeing a similar seasonality that we saw pre-COVID, so it's playing out as expected.
And the guidance, just to follow up on that, you know, 9%+ constant currency growth, very strong in the first half of the year. So the guidance implies mid-single digits, 5%+.
Yeah.
in the second half. Is that just a function of the comps getting tougher?
It really is, because if you look at the first half of the year, remember, you're comparing against the first half of 2022, obviously, which was plagued with Omicron, right? So you've got a comp benefit there. The second half of the year is a lot cleaner when it comes to comps, and if you think about our implied guidance of 5%+, I think that's actually a good proof point validation of where we are as a company from an execution and market standpoint.
Suketu, on leverage, you've talked about, I think, about 100 basis points this year.
Yep.
Next year, you've talked about this 4% plus, you know-
Yeah.
-organic growth, with some operating leverage. How, how are you thinking about just kind of leverage earnings in general for the company? And I think the biggest kind of concern is around how you get that leverage next year, given kind of the FX-
Sure.
kind of headwind.
Yeah. Yeah. So first, I thank you, Larry, for pointing out, in 2022 and 2023, the company's done a great job. The team's done a fantastic job of expanding margins in an incredibly difficult environment, especially if you think about inflationary pressures. I'm not sure a lot of our peer group can say that, but we've managed to do that over the last two years. Now, some of the tailwind we have this year from FX hedge gains will drop off, or won't be as pronounced in 2024 as they were in 2023, but we still believe we can grow operating margins into 2024. Maybe not at the 100 basis point level that we saw this year, but we can still get some acceleration. Building blocks are simple. There's three of them.
If you think about gross margin, we would expect to see about a 50- to 100-basis point headwind in the next year. Combination of pricing and the FX hedges falling off. That'll be somewhat abated or mitigated by continuous efficiencies and COGS, site optimization, et cetera. So if you just start with 50 to 100 basis points, again, that could change based on FX rates, mix of the business, et cetera, but that's, that's a starting point. From there, if, if you just think about how we've talked about revenue next year, 4+ or even mid single digit, just using sort of the middle of that range, 5%.
As an illustration, I'm not saying that's what it is next year, but as an illustration, given our flow-through and our drop-through over our business, that, that can be about 100 basis points accretive to operating margins in and of itself. Okay? That, that can change based on mix of the business, investment profile, et cetera, but that effectively offsets that headwind that you see in gross margin. And then the third building block that we have from there is we, we still, in some areas, have a target-rich environment when it comes to driving efficiencies. We've done this for four years now consistently. There's more to go, more work to do in G&A functions, which some of our functions still operate at a higher cost profile versus our benchmarks. So that tells us there's opportunity there.
There's still opportunity in some of our commercial go-to-market models in many markets, that are just not performing at company average or better relative to operating profit cash flow, and we're gonna continue to work on restructuring those businesses. But we think we've got efficiencies for many years to come, which, if you put all three of those together, gives us confidence we can continue to grow margin.
That's helpful. Suketu, I forgot that you still have the warning letter at the North campus.
Yeah.
It's been so long, Ivan brought it up. We're ready for reinspection. You know, that was one warning letter that actually did have kind of a negative impact-
Yeah.
on gross margins, you know, when it happened.
Sure did.
Five, six years ago. My question is, is there still opportunity to improve the gross margin when you lift the warning letter? Is there any? Are there any costs that go away?
Potentially, Larry. Potentially. I don't think they're significant. I think, the, you know, what gave rise to those warning letters was a pretty big underinvestment. And so now we've gotten quality where it needs to be. You know, we don't want to be penny-wise, pound-foolish when it comes to quality, because you can't sell product if you can't make product. So, we'll see. Potential opportunity, could be a potential tailwind, but we don't want to get too far out of our skis. Let's get through the warning letter, which we feel very confident we'll do, and then we'll go from there.
And right now, you're just waiting for reinspection?
Yep. And I wanna make it very clear, there's zero issue from a product delivery standpoint. I mean, this is a warning letter that has been around for a while.
Okay. That, that's helpful. Couple of hot topics here. Why don't we just get the China one out of the way? You know, obviously, the question is around the anti-corruption policies that are going in place. China's 2%-3% of your sales now?
Yes.
So relatively small, but just interested to get your, you know, your input here on what impact it could have.
Yeah, I can start and elaborate here, Suketu. We're not seeing a headwind today, so we're not seeing anything that is telling us we need to change guidance or we got a headwind as we speak. We're monitoring the situation. I spoke with the Chief Compliance Officer of the company late last night, early this morning, to make sure that as the question came up, we're not saying something inaccurate. She actually... And she was based in APAC for many years. She actually feels like this can be also a tailwind in the short term, in the sense that the Chinese government is prioritizing first local companies, and then they're gonna go into multinationals and whatnot. They're looking at pharma first, and then they're gonna get into medical devices.
Because of all the work we've done closely with the Department of Justice to resolve the, the monitorship that we had, we have built, through $ millions of investments, a, a best-in-class culture, and governance around compliance. So I would put our compliance program in China, globally, as leading best-in-class. So we know that we're doing the right things in China. We believe it can be a competitive advantage, you know, in, in that market. But again, if things do change, we'll update you guys. Right now, 2%-3% of sales, but, no headwind whatsoever.
Post VBP, two-thirds of sales, even less on operating profit. So that'll change over time, but in the near term, as Ivan said, we don't see this as a major headwind, but we're watching it closely.
One tailwind for you guys has been this backlog. We, you know, if you look at just the area under the curve, it's about $5 billion. I know we've talked about it, it's difficult to quantify. I think people are curious to know kind of how long you think it lasts.
You said $5 billion, I didn't say $5 billion. Here's, here's what I tell people. I've been fired from the backlog analytics team, like, five times already, so I, I got it wrong every time. So here is what I know. I know that it's sizable. I don't know if it's $5 billion, I don't know if it's $7 billion, I don't know what it is, it's sizable. So that's number one. We know that it's gonna be with us at least through the remainder of 2024. So we know that. You know, as I hear from another call it, you know, six quarters, at least, at least six quarters. We also know that we're not a backlog-dependent type of company. We know that because of all the macro dynamics and micro dynamics around commercial execution innovation, the data backlog is gone.
We're gonna continue to be growing at the pace that we need to be growing. So how big is the backlog? I have no idea.
That's helpful. Ivan, let me... Yeah, so you talked about micro. And I guess when I think about your tenure at ZB, and I look back, you know, before you came, Zimmer was generally a share donor in the hip and knee market. In the last, you know, couple of years, you've been a share gainer.
Yeah.
What, what's changed? What's driving that, and how sustainable is that?
It is sustainable. As you can see, over the last two, three years, we've been gaining share in the key categories. Willing to take that bet with anybody. I don't know about backlog, but I do know about market share gains. We've been gaining share in the key categories for the last two, three years. It is sustainable. Frankly, I think we can accelerate it, given the low penetration we have on robotics, given the low penetration we have on cementless knees. You know, 15%, one five, of our knees are cementless. We believe we can do 50%-60%. That's a great opportunity to get new accounts. We're excited about the pipeline that I mentioned earlier. We're excited about the best-in-class commercial execution capabilities. It is sustainable.
That's helpful. There's a lot we can dive into there on cementless, but I'm curious. I wanna make sure we-
Sure.
... we hit that, because hips and knees, great, in Q2.
Yeah.
That flattish.
Sure.
That's supposed to be, you know, your fastest-growing category-
Yeah.
... long term.
Yeah.
How do we think about that going forward?
Yeah, first things first, we got to change the acronym because SET means nothing anymore. It used to be a sports extremities trauma. Today, SET for us is six categories. So we got sports, we got shoulder, we got CMFT, craniomaxillofacial thoracic. I can't believe I can pronounce that. Those are the three key categories. And then you got trauma, you got foot and ankle, and then you got restorative therapies, which is biologics, HA agents and whatnot. In the three key growth drivers, we've been growing upper single digit, you know, low, in the teens, depending on the market. So those are going really well. Trauma, foot and ankle, and restorative therapies, have been a bit of a boat anchor, for a variety of reasons.
We've said that once things were normalized around reimbursement in challenges in RT and other headwinds, we should be a mid-single digit or above growth type of company. We're there. We're there. We believe we're gonna continue to accelerate our SET performance as we exit 2023 and enter 2024. So really excited about that, that, that space. And by the way, in case you wonder why SET is being low growth or flat over the last, call it, you know, 5 years, remediation. We started to remediate the knees and hips from a factory standpoint, from a commercial execution standpoint. Now that that's behind and we're growing at a nice clip, you know, it's time to get SET going, and we are growing at the right pace moving forward.
Lower extremities is, even though it's the one of the underperforming subsegments, it's still a high priority for you. Is that correct?
The three growth drivers are Shoulder, Sports Medicine, Craniomaxillofacial Thoracic. We are deprioritizing the other three: Trauma, Foot and Ankle, and Restorative Therapies. That said, because they are high-growth markets, if we have an attractive opportunity to invest in one of those three, we will. But today, the three growth drivers remain Shoulder, Sports Medicine, Craniomaxillofacial Thoracic.
Okay. Because I think I remember in the past, you know, talking about foot and ankle being an area that you would like to improve and potentially inorganically.
Choices, right? I mean, that's, that's the one thing that I'll tell you, that we change dramatically here, choices. We're not gonna be in every country, we're not gonna be in every platform, we're not gonna be with every customer. Choices.
Okay, that's helpful. In terms of the pipeline products that, you know, I think people are interested in, one is obviously Persona IQ. Sounds like the full launch is still scheduled for early 2024. What needs to happen between now and then, and how are you thinking about the impact that could have?
We're ready. We said all along that 2023 was a limited market release, validate the clinical value proposition of the product, which we have. Get the right reimbursement dynamics, which we have. NTAP , we are submitting for TPT, understand the commercial payer angle, which we have. Locking the right contract with the right institutions, which we have. So now it's about execution in 2024.
You know, when we talked yesterday, you talked about being cautiously optimistic. What, what is driving your cautious optimism?
The input that we're getting from patients, the input that we're getting from physicians, the input that we're getting from payers, leads me to believe that this can be a groundbreaking product.
Remind me, can this be done on ROSA, or is that something that needs to-
It can be done on ROSA. Absolutely. We have generation one, which, as you know, is gonna be the, is the longer one. We're launching at some time soon, what we call the stubby. I didn't come up with the name, but that's the shorter stem. We are gonna have a cementless application before too long, and all of those are gonna be fully integrated with ROSA.
How long for the cementless?
I don't think we have said that externally, so I, I'll keep it at soon.
You know, it's interesting, you talked about this mixed benefit for cementless, you know, mid-teens and ROSA mid-teen. Is one gonna go faster than the other or kind of in tandem?
I think they're gonna be pretty much in tandem. And you can look at what our peers did, and, you know, you probably saw that all their peers, you know, grew at pretty much the same pace. We're at 10, rather 15% cementless penetration, 15% ROSA, here in the U.S., and our goal is to get to 50-60% on both categories. And I think they're gonna go in tandem. And frankly, one is gonna feed the other, especially with the ASC dynamics.
The other pipeline product people are interested in is obviously the robotic application for shoulder.
Yeah.
Where are you in that process?
Sure.
What is the problem? Kind of with knees, it was, you know, the unsatisfied 20% of patients unsatisfied. What are we trying to solve for with shoulders?
Yeah. I've said that, I think I've said, like, 50 times, we're gonna be number one to market. So, 51, we will be number one to market when it comes to shoulder robotics. I'm pretty, pretty certain of that. So that's part A. Part B, what is the problem with solving? I would say it's three things: accuracy in the actual placement cuts, speed in the actual surgery, and shorter recovery. So eliminating the time that it takes to get recovered from a shoulder surgery. Those are the three key compelling, I guess, elements of the value proposition.
Have you talked about... I can't remember if it's the same capital or you need new capital?
No, it's gonna be the same platform. So it's software that changes, upgrades.
This is software. There's no, like, end effector.
You'll, you'll do some things, you know, potentially to the arm or whatnot, but overall, it's the same, the same capital.
Okay. And have you talked about, you know, anatomical, reverse, kind of what the priorities are?
You- we're gonna have both, in the right sequence, and I don't want to talk about that. We're also gonna have optionality of, inlay, onlay. We're gonna have, upgrades on the road, but, you know, it's... ROSA is very modular, so you can build a lot of different applications for different surgeries. That's one of the things that we like about ROSA.
How are you just kind of jumping around here, how are you thinking about kind of giving long-term financial goals or having some type of analyst meeting? I don't think you guys have had one in a while.
Some point, Keri, Suketu, and I were talking potentially 2024. You know, we haven't made a decision yet, but maybe in the first half, we'll let you guys know. But we're at a position that I love to share with everybody the long range plan, financial goals, but most importantly, just the innovation story. If I were to leave you one thing here today, this, this is a different company. It's unfortunate that through a variety of reasons, we haven't been able to showcase that, but I look forward to having that investor day and getting deep into not just the financials, but the innovation that we got going on, the transformation from a commercial execution, and a couple of other things.
A couple quick hits here. So your prior role, Chief Operating Officer, is there a plan to replace that position or how? What's the plan?
Yeah. We're gonna have... You know, obviously, I'm not gonna have both roles, so we're gonna have a group president that is gonna run some of these businesses. I plan to stay very much connected to the day-to-day. That doesn't mean I'm not gonna be the CEO of the company and focus on the right things, but I will be connected to the day-to-day. We had a press release yesterday that talked about how we elevated certain positions to the CEO level. All three regions are gonna report directly to the CEO, and the global head of innovation, or Chief Innovation Officer, is gonna report into the CEO to make sure that innovation continues to be a competitive advantage. But yes, we're gonna bring, you know, some talent to the company.
So, what-
Are you applying for the job?
The Chief Innovation Officer, you announced a new person yesterday.
It's not new. Dr. Nitin Goyal, a Rothman Orthopaedics surgeon, who's been with us for the last two and a half years. I give him a ton of credit for the innovation journey, and he's coming with me. He was reporting to the COO, now he reports to the CEO.
What's underappreciated about Zimmer?
The amazing pipeline that we have, the fact that, yes, the last five, seven years were rocky. Remediation, challenges, COVID, and I know everybody uses the excuse of COVID. You know, when you run an elective surgery company, it's more painful. So I would say now that we are in a normal environment, I think the future is great for us. The present and the future is great for us. So that's underappreciated.
All right, great. We're out of time. Thanks so much for being here.
Thank you.
Really appreciate you giving us the first-
Thank you.
- Fireside chat.
Thank you, Larry.
Thank you. Bye.