Q4 2025 Smith & Nephew PLC Earnings Call

March 2, 2026

Speaker #1: All right. Good morning. Welcome to the Smith & Nephew Q4 and full year 2025 results presentation. I'm Deepak Nath, the Chief Executive Officer, and joining me is John Rogers, our CFO.

Deepak Nath: All right. Good morning. Welcome to the Smith & Nephew Q4 and full year 2025 results presentation. I'm Deepak Nath. I'm the Chief Executive Officer, and joining me is John Rogers, our CFO. I'm pleased to report a strong finish to 2025, delivering results at the high end of our guidance on revenue growth, margin, and free cash flow. For the full year, underlying revenue growth of 5.3%, importantly, all three of our business units grew by over 5%. Sports Medicine and ENT, and in particular joint repair within that, had another strong year. In Orthopaedics, we saw meaningful progress in our US recon business, particularly hips and in trauma. With those more work to do in US knees or OUS business, knees business has remained strong throughout the year.

Speaker #1: I'm pleased to report a strong finish to 2025, delivering results at the high end of our guidance on revenue growth, margin, and free cash flow.

Speaker #1: For the full year, underlying revenue growth was 5.3%, and, importantly, all three of our business units grew by over 5%. Sports Medicine & ENT, and in particular joint repair within that, had another strong year.

Speaker #1: And in orthopedics, we saw meaningful progress in our US recon business, particularly in hips and in trauma. And with those, there is more work to do in US knees. Our OUS business, the knees business, has remained strong throughout the year.

Speaker #1: So we had a record year of CORI placements globally and saw continued growth in adoption and utilization of our robot. Advanced Wound Management also had good performance in 2025, driven by growth in AWD and in Bioactives.

Deepak Nath: We had a record year of CORI placements globally and saw continued growth in adoption and utilization of our robot. Advanced Wound Management also had a good performance in 2025, driven by growth in AWD and bioactives. Innovation remains central to our strategy. With over 60% of our growth in 2025 came from products we've launched in the last 5 years. Innovations in all three business units delivered double-digit growth for the year, including Q-FIX, REGENETEN, FASTSEAL, LEGION CONCELOC, Catalyst CSR, EVOS, AETOS, PICO, and LEAF. On profitability, we saw 160 basis points of margin expansion driven by our enterprise-wide cost savings program and the benefits of all the work we've done in our Orthopaedics business dropping through to our P&L.

Speaker #1: Innovation remains central to our strategy, with over 60% of our growth in 2025 coming from products that we've launched in the last five years.

Speaker #1: And innovations in all three business units delivered double-digit growth for the year, including Q-Fix, Regeneten, Fast-Seal, Legion Console Lock, Catalyst Stem, EVOS, ATOS, PICO, and LEAF.

Speaker #1: On profitability, we saw 160 basis points of margin expansion, driven by our enterprise-wide cost savings program and the benefits of all the work we've done in our orthopedics business dropping through to our P&L.

Speaker #1: This includes optimizing our manufacturing network, improving productivity, introducing our new sales and operation planning processes, and portfolio rationalization. We expect to see further benefits from these initiatives combined with our Ortho 360 operating model and continued revenue growth that will drive us to more than 20% margin in Orthopedics by 2030.

Deepak Nath: This includes optimizing our manufacturing network, improving productivity, introducing our new sales and operation planning processes, and portfolio rationalization. We expect to see further benefits from these initiatives combined with our Ortho 360 operating model and continued revenue growth that will drive us to more than 20% margin in Orthopedics by 2030. We've also shown greater discipline around working capital management, bringing down days of inventory, and we reduced restructuring charges. Alongside growth and higher profitability, this has lifted free cash flow to $840 million, a 52.5% increase year-on-year. This enabled us to complete a $500 million share buyback program in the second half of 2025.

Speaker #1: The ones who have shown greater discipline around work and capital management, bringing down days of inventory, and we've reduced restructuring charges. Alongside growth and higher profitability, this has lifted free cash flow to $840 million, a 52.5% increase year on year.

Speaker #1: This enabled us to complete a $500 million share buyback program in the second half of 2025. This is a great way to finish off three years of incredibly hard work and focus under the 12-point plan, during which we've consistently delivered on our targets each year, and sets us up well for further acceleration of growth and returns as we go into the first year of our new RISE strategy.

Deepak Nath: This is a great way to finish off three years of incredibly hard work and focus under the 12-Point Plan, during which we've consistently delivered on our targets each year and sets us up well for further acceleration growth and returns as we go into the first year of our new RISE strategy. Turning now to 2026, we expect growth of under 6% revenue and around 8% trading profit growth, both on an organic basis and consistent with what we laid out at our capital market days in December, with trading profit growth ahead of our revenue growth. Since then, we've announced the acquisition of Integrity Orthopaedics. We're also now guiding the trading profit of around $1.3 billion, including the impact of the deal. John will cover guidance in more detail in his section.

Speaker #1: Turning now to 2026, we expect growth of 6% in revenue and around 8% trading profit growth, both on an organic basis and consistent with what we laid out at our Capital Markets Day in December.

Speaker #1: With trading profit growth ahead of our revenue growth. Since then, we've announced the acquisition of Integrity Orthopedics, so we're also now guiding the trading profit of around $1.3 billion, including the impact of the deal.

Speaker #1: John will cover guidance in more detail in his section. So let's now round out our financial performance over the last three years under the 12-point plan with actual numbers.

Deepak Nath: Let's now round out our financial performance over the last three years on the 12-Point Plan with actual numbers. We've moved Smith & Nephew from a historically low single-digit revenue growth company to mid-single-digit growth, delivering 5.7% CAGR from 2022 to 2025. We've expanded trading margin by 240 bps from 17.3% in 2022 to 19.7%, despite facing significant headwinds from VBP in China, FX volatility and higher inflation. If we exclude the total impact of the Sports Medicine VBP over this period, our 2025 margin would have been 20.9%, 120 bps higher than we've reported.

Speaker #1: We've moved Smith & Nephew from a historically low single-digit revenue growth company to mid-single-digit growth, delivering 5.7% CAGR from 2022 to 2025.

Speaker #1: And we've expanded trading margin by 240 bps, from 17.3% in 2022 to 19.7%, despite facing significant headwinds from VBP in China, FX volatility, and higher inflation.

Speaker #1: If we exclude the total impact of the Sports Med VBP over this period, our 2025 margin would have been 20.9%—120 basis points higher than we've reported.

Speaker #1: Our increased focus on cash and capital returns has yielded a 15-fold increase in free cash flow, and ROIC has increased by 170 basis points from 6.6% to 8.3%, or by 330 basis points excluding the 160 basis points headwind from the impact of portfolio rationalization.

Deepak Nath: Our increased focus on cash and capital returns has yielded a 15-fold increase in free cash flow, and ROIC has increased by 170 bps from 6.6% to 8.3% or by 330 bps, excluding the 160 bps headwind from the impact of portfolio rationalization. I'm incredibly proud of what the whole team here has achieved over the life of the plan and excited about what we can deliver over the next three years under our new strategy, RISE. I'll come back to talk about this next phase of our growth later, but for now, I'll pass you over to John to take you through the detail of our results. John?

Speaker #1: I'm incredibly proud of what the whole team here has achieved over the life of the plan, and excited about what we can deliver over the next three years under our new strategy, RISE.

Speaker #1: I'll come back to talk about this next phase of our growth later, but for now, I'll pass you over to John to take you through the details of our results.

Speaker #1: John?

Speaker #2: Thank you, Deepak. Good morning, everyone. Revenue for Q4 was $1.7 billion, representing 6.2% underlying growth and 8.3% reported, including a 210 basis point tailwind from foreign exchange.

John Rogers: Thank you, Deepak. Good morning, everyone. Revenue for Q4 was $1.7 billion, representing 6.2% underlying growth and 8.3% reported, including a 210 basis points tailwind from foreign exchange. We had 1 extra trading day year-over-year, and on an average daily sales basis, growth was 4.5%. Growth was broad-based across business units and regions. The US growth grew 5.6%, other established markets 7.2%, and emerging markets 6.4%. Excluding China, underlying growth was 7.2%. I'll now move on to the details by business unit, starting with Orthopaedics, which grew 7.9% on an underlying basis and delivered the strongest quarterly growth for more than two years.

Speaker #2: We had one extra trading day year on year. On an average daily sales basis, growth was 4.5%. Growth was broad-based across business units and regions.

Speaker #2: The US growth grew 5.6%, other established markets 7.2%, and emerging markets 6.4%. Excluding China, underlying growth was 7.2%. I'll now move on to the details by business unit, starting with Orthopaedics, which grew 7.9% on an underlying basis and delivered the strongest quarterly growth for more than two years.

Speaker #2: One extra trading day helped, but even if you normalize to that by looking at average daily sales, growth was still strong and accelerated nicely ahead of Q3.

John Rogers: One extra trading day helped, but even if you normalize for that by looking at average daily sales, growth was still strong and accelerated nicely ahead of Q3. In the US, we saw a third consecutive quarter of above-market growth in hips, acceleration in knee growth, and continued strong trauma and extremities growth. Hip performance continues to be driven by the uptake of Catalyst Stem, and we are seeing good competitive conversions, and we plan to increase our Catalyst Stem set deployments to support growth in 2026. US knee growth improved during the quarter following the launch of LEGION MS, which enables us to benefit from the market shift to medial stabilized inserts. We are pleased with our competitive wins with the product and continue to receive positive feedback from existing and new users.

Speaker #2: In the US, we saw a third consecutive quarter of above-market growth in hips, acceleration in knee growth, and continued strong trauma and extremities growth.

Speaker #2: HIP performance continues to be driven by the uptake of Catalyst stem, and we are seeing good competitive conversions. We plan to increase our Catalyst stem set deployments to support growth in 2026.

Speaker #2: US knee growth improved during the quarter following the launch of Legion MS, which enables us to benefit from the market shift to medium stabilized inserts.

Speaker #2: We are pleased with our competitive wins with the product and continue to receive positive feedback from existing and new users. In OUS, knees, hips, trauma, and extremities all deliver strong performance, except for some localized weakness in hips in certain distributor-led markets.

John Rogers: In OUS, knees, hips, trauma and extremities all delivered strong performance, except for some localized weakness in hips in certain distributor-led markets. Following the launch of Catalyst Stem in Japan, we see growth improving in OUS hips over the coming quarters. In trauma and extremities, we continue to see good growth from our TRIGEN MAX tibia, EVOS Plating System, and AETOS shoulder. Other recon grew 40.8%. We're pleased with increasing CORI placement in teaching institutes and with the percentage of CORIs deployed in competitive accounts. We also deployed 45% of CORIs in ASCs in the quarter. CORI deployment is important because knee growth is 850 bps higher in accounts where CORI is established, underscoring the potential for further improvement in knee growth as penetration and utilization of CORI continues to grow. I'll take a moment to look more closely at US recon growth.

Speaker #2: Following the launch of Catalyst Stem in Japan, we see growth improving in OUS hips over the coming quarters. In Trauma and Extremities, we continue to see good growth from our Trigen Tibia, EVOS plating system, and ATOS shoulder.

Speaker #2: Other recon grew 40.8%. We're pleased with increasing CORI placement in teaching institutes and with the percentage of CORIs deployed in competitive accounts. We also deployed 45% of CORIs in ASCs in the quarter.

Speaker #2: CORY deployment is important because knee growth is 850 bps higher in accounts where CORY is established, underscoring the potential for further improvement in knee growth as penetration and utilization of CORY continue to grow.

Speaker #2: I'll take a moment to look more closely at US recon growth. In HIPS, you can see consistent improvement in growth, both standalone and versus the market, since the beginning of 2024.

John Rogers: In hips, you can see consistent improvement in growth standalone and versus the market since the beginning of 2024. We've grown above market for the last 3 quarters of 2025. This is driven by the changes we've made to our commercial engine, product availability, and our portfolio with the launch of Catalyst Stem, which addresses the fast-growing direct anterior segment of the market. In knees, we have also been narrowing the gap versus the market. We had a good quarter in US knees in Q4. We recognize quarterly performance has not been as consistent as we would like. In 2026, we expect to continue to close the gap versus US recon market growth.

Speaker #2: And we have grown above market for the last three quarters of 2025. This is driven by the changes we've made to our commercial engine, product availability, and our portfolio with the launch of Catalyst Stem, which addresses the fast-growing direct anterior segment of the market.

Speaker #2: In knees, we've also been narrowing the gap versus the market. We had a good quarter in U.S. knees in Q4, but we recognize quarterly performance has not been as consistent as we would like.

Speaker #2: In 2026, we expect to continue to close the gap versus US recon market growth. We expect US HIPS to track in line with, or ahead of, the market growth, and expect US knees to start off with a softer first quarter, reflecting our continuing and deliberate trade-offs on balancing growth, profit, and asset efficiency.

John Rogers: We expect US hips to track in line with or ahead of the market growth, expect US knees to start off with a softer Q1, reflecting our continuing and deliberate trade-offs on balancing growth, profit, and asset efficiency. We will build towards market growth in Q4, supported by the launch of the cementless version of our new LEGION CONCELOC knee in the second half. LEGION CONCELOC brings the proven clinical benefits of our knee portfolio into a single platform that combines advanced kinematics with the next level of personalization, robotic enablement, and ease of implantation, while unlocking capital efficiency by leveraging existing instrumentation. LEGION CONCELOC will also feature best-in-class tray efficiency, making it particularly suitable for ASCs. Turning now to Sports Medicine in ENT, which grew 7.3%, driven by double-digit growth in joint repair as we annualize the impact of China VBP.

Speaker #2: We will then build towards market growth in Q4, supported by the launch of the cementless version of our new landmark knee in the second half.

Speaker #2: Landmark brings the proven clinical benefits of our knee portfolio into a single platform that combines advanced kinematics with the next level of personalization, robotic enablement, and ease of implantation, while unlocking capital efficiency by leveraging existing instrumentation.

Speaker #2: Landmark will also feature best-in-class tray efficiency, making it particularly suitable for ASCs. Turning now to Sports Medicine and ENT, which grew 7.3%, driven by double-digit growth in joint repair as we annualize the impact of China VBP.

Speaker #2: We reached an important milestone this year, with our joint repair business surpassing $1 billion in revenue for the first time. Growth continues to be driven by regenerative and QFIX Knotless, along with strong performance in small joint outside of China.

John Rogers: We reached an important milestone this year with our joint repair business surpassing $1 billion in revenue for the first time. Growth continues to be driven by REGENETEN and Q-FIX, along with strong performance in small joint outside of China. We saw further acceleration of AGILI-C, albeit still off a small base. AET delivered strong growth led by FASTSEAL and patient positioning with strong growth in our US markets, ex-China. Despite continued softness in the US tonsil and adenoid market, ENT saw good growth with double-digit growth in those, as well as strong international growth, again ex-China. We have AET and ENT China VBPs ahead of us, but the headwinds in 2026 will be much smaller given the relative size of these businesses. We are already proactively managing our inventory ahead of implementation. Advanced Wound Management grew 2.8% in the quarter.

Speaker #2: We saw further acceleration of agility, albeit still off a small base. AET delivered strong growth, led by FastSeal and patient positioning, with strong growth in OUS markets ex-China.

Speaker #2: Despite continued softness in the US tonsil and adenoid market, ENT saw good growth, with double-digit growth in nose as well as strong international growth again, ex-China.

Speaker #2: We have AET and ENT China VBPs ahead of us, but the headwinds in 2026 will be much smaller given the relative size of these businesses.

Speaker #2: We are already proactively managing our inventory ahead of implementation. Advanced Wound Management grew 2.8% in the quarter; within that, Advanced Wound Care grew 4.4%.

John Rogers: Within that, Advanced Wound Care grew 4.4%. We are very early in our launch of ALLEVYN COMPLETE CARE, but we're pleased with performance so far, and we expect momentum to grow over the coming quarters as we roll out the product across the US. Moving on to Bioactives and devices. It's important to remember that both had very strong prior year comparatives of over 20% growth. Bioactives declined by 0.5%. We saw softness as we lapped the GRAFIX PLUS launch in Q4 of 2024, and we also saw a slowdown in skin subs in the physician office and outpatient setting prior to the CMS reimbursement changes that came into effect at the start of this year. Advanced wound devices grew 5.4%. LEAF and PICO both performed well, reflecting strong demand.

Speaker #2: Bioactives and Devices—it's important to remember that both had very strong prior-year comparators of over 20% growth. Bioactives declined by 0.5%. We saw softness as we lacked the Graphics Plus launch in Q4 '24, and we also saw a slowdown in Skin Subs in the physician office and outpatient setting prior to the CMS reimbursement changes that came into effect at the start of this year.

Speaker #2: Advanced wound devices grew 5.4%. LEAF and PICO both performed well, reflecting strong demand. PICO growth continues to demonstrate strong market demand and reflects our efforts to improve penetration in the surgical setting.

John Rogers: PICO growth continues to demonstrate strong market demand and reflects our efforts to improve penetration in the surgical setting. US RENASYS continues to be impacted by softness in the acute care channel, while performance outside the US remains strong. Now I'll move on to the full year financials. For the full year, revenue was $6.2 billion, up 5.3% on an underlying basis, ahead of our guidance of around 5%, and up 6.1% on a reported basis. Excluding the headwinds in China, growth would have been 7% on an underlying basis. Note also that 2025 had one fewer trading day versus 2024. Performance was broad-based, with all three reporting segments delivering growth of above 5%.

Speaker #2: US RENESIS continues to be impacted by softness in the acute care channel, while performance outside is strong. Now I'll move on to the full year financials.

Speaker #2: For the full year, revenue was $6.2 billion, up 5.3% on an underlying basis—ahead of our guidance of around 5%—and up 6.1% on a reported basis.

Speaker #2: Excluding the headwinds from China, growth would have been 7% on an underlying basis. Note also that 2025 had one fewer trading day versus 2024.

Speaker #2: Performance was broad-based, with all three reporting segments delivering growth of above 5%. Orthopaedics grew 5.1%, Sports Medicine & ENT grew 5.2%, and AWN grew 5.6%, all on an underlying basis.

John Rogers: Orthopaedics grew 5.1%, Sports Medicine and ENT grew 5.2%, and AWN grew 5.6%, all on an underlying basis. Overall, a good set of growth figures, particularly good to see that more than 60% of our growth comes from products launched in the last 5 years, as Deepak covered, giving us confidence coming into 2026. Let's now take a moment to look at our underlying revenue growth, excluding China over the last few years. You can see that growth ex-China has been greater than 6% since 2023, and that China headwind peaked in 2025 at 170 bps.

Speaker #2: Overall, a good set of growth figures, and particularly good to see that more than 60% of our growth comes from products launched in the last five years, as Deepak covered, giving us confidence coming into 2026.

Speaker #2: Let's now take a moment to look at our underlying revenue growth, excluding China, over the last few years. You can see that growth ex-China has been greater than 6% since 2023, and that China headwind peaked in 2025 at 170 bps.

Speaker #2: China was just over 2% of group sales in 2025, and although we still face VBP headwinds in '26, as I already mentioned, these headwinds will have a much smaller impact at the group level.

John Rogers: China was just over 2% of group sales in 2025. Although we still face VBP headwinds in 2026, as I already mentioned, these headwinds will have much smaller impact at the group level. Moving on to the summary P&L. Underlying gross profit was $4.4 billion, with a gross margin of 70.9%, an increase of 60 basis points. We were able to more than offset raw material inflation with price increases across our portfolio and productivity measures in manufacturing procurement. Trading profit was $1.2 billion, an increase of $162 million, resulting in 160 basis points of trading margin expansion to 19.7% for the full year at the high end of our initial margin guidance.

Speaker #2: Moving on to the summary P&L. Underlying growth of 70.9%, an increase of 60 bps. We were able to more than offset raw material inflation with price increases across our portfolio and productivity measures in manufacturing and procurement.

Speaker #2: Trading profit was $1.2 billion, an increase of $162 million, resulting in 160 basis points of trading margin expansion to 19.7% for the full year. At the high end of our initial margin guidance.

Speaker #2: This was driven by positive operating leverage, our cost savings program, and, in particular, margin expansion in our Orthopedics business unit. Moving further down the P&L, adjusted earnings per share grew by 21% to $1.02.

John Rogers: This was driven by positive operating leverage, our cost savings program, and in particular margin expansion in our Orthopaedics business unit. Moving further down the P&L, adjusted earnings per share grew by 21% to $1.02. That's above trading profit growth, primarily reflecting the $500 million buyback we completed in the second half, which more than offset a slightly higher tax rate year-over-year. Our tax rate was 19.4%, in line with our guidance of 19% to 20%. Basic earnings per share grew significantly faster, primarily driven due to lower restructuring charges and lower acquisition and integration costs. Our restructuring charges were $47 million, down from the $123 million in 2024. We had $32.7 million acquisition and integration costs compared to $94 million in 2024.

Speaker #2: That's above trading profit growth, primarily reflecting the $500 million buyback we completed in the second half, which more than offset a slightly higher tax rate year over year.

Speaker #2: Our tax rate was 19.4%, in line with our guidance of 19 to 20 percent. Basic earnings per share grew significantly faster, primarily driven by lower restructuring charges and lower acquisition and integration costs.

Speaker #2: Our restructuring charges were $47 million, down from $123 million in 2024, and we had $32.7 million in acquisition and integration costs compared to $94 million in 2024.

Speaker #2: The full-year dividend is proposed to be 39.1 cents per share, an increase of 4.3% year-on-year. This slide shows a more detailed trading margin bridge.

John Rogers: The full year dividend is proposed to be $0.391 per share, an increase of 4.3% year-over-year. This slide shows a more detailed trading margin bridge. We absorbed headwinds of 250 basis points from cost inflation, China VBP, and tariffs, with FX impact being broadly neutral. These were more than offset by 180 basis points of revenue leverage from price and volume, and 240 basis points of productivity improvements, delivering 160 basis points of margin improvement for the year. Drilling down into the details of the efficiency savings, we remain on track to deliver on the 12-Point Plan and zero-based budgeting savings we laid out at our interims in 2024 of $325 to 375 million of savings by 2027.

Speaker #2: We absorbed headwinds of 250 bps from cost inflation, China VBP, and tariffs, with FX impact being broadly neutral. These were more than offset by 180 bps of revenue leverage from price and volume, and 240 bps of productivity improvements, delivering 160 basis points of margin improvement for the year.

Speaker #2: Drilling down into the details of the efficiency savings, we remain on track to deliver on the 12-point plan and zero-based budgeting savings we laid out at our interims in 2024 of £325 to £375 million of savings by 2027.

Speaker #2: We've achieved $280 million in cumulative savings to the end of 2025, with further savings to come through in '26 and '27. We continue to anticipate total savings of about $150 million in 2026—half from these 12-point plan zero-based budgeting savings, and half from other opportunities above and beyond this, across procurement, manufacturing, sales and marketing, and business support.

John Rogers: We've achieved $280 million in cumulative savings to the end of 2025, with further savings to come through in 2026 and 2027. We continue to anticipate total savings of about $150 million in 2026. Half from these 12-Point Plan zero-based budgeting savings, and half from other opportunities above and beyond this. Across procurement, manufacturing, sales and marketing, and business support. Our 2026 guidance is that 8% reported trading profit growth on an organic basis, and for around $1.3 billion of trading profit, including some dilution from the Integrity acquisition. We laid out some extraordinary headwinds to profit in 2026 at our London Capital Markets day. These include inventory revaluation, tariffs, the impact of changes to reimbursement in our US AWN business, and ENT VBP in China.

Speaker #2: Our 2026 guidance is for 8% reported trading profit growth on an organic basis, and for around £1.3 billion of trading profit, including some dilution from the Integrity acquisition.

Speaker #2: We laid out some extraordinary headwinds to profit in 2026 at our London Capital Markets Day. These include imagery revaluation, tariffs, the impact of changes to reimbursement in our US AWM business, and ENT BBP in China.

Speaker #2: There are no changes to any of our assumptions regarding these headwinds. We still expect a $60 million impact from tariffs, compared to $17 million in 2025, and a $20 to $40 million incremental impact from changes to wound reimbursement.

John Rogers: There are no changes to any of our assumptions regarding these headwinds. We still expect $60 million impact from tariffs compared to $17 million in 2025, and $20 to 40 million incremental impact from changes to Wound reimbursement. We expect revenue leverage and operational savings to more than offset these headwinds to drive trading profit growth ahead of revenue growth before the impact of any M&A. Coming now to trading margin by business unit. We saw a 340 basis points increase for Orthopaedics to 14.9%. 20 basis points decrease for Sports Medicine in ENT to 23.8%, and 120 basis points increase for Wound to 24.9%. Broadly speaking, expansion came from OpEx savings and leverage across all three business units.

Speaker #2: We expect revenue leverage and operational savings to more than offset these headwinds, to drive trading profit growth ahead of revenue growth, before the impact of any M&A.

Speaker #2: Coming now to trading margin by business unit. We saw a 340 bps increase for Orthopaedics to 14.9%, a 20 bps decrease for Sports Medicine & ENT to 23.8%, and a 120 bps increase for Wound to 24.9%.

Speaker #2: Broadly speaking, expansion came from OPEX savings and leverage across all three business units. Within Orthopedics, the increase is driven by favorable price mix, manufacturing savings from network optimization, ongoing productivity initiatives, and disciplined cost control.

John Rogers: Within Orthopaedics, the increase is driven by favorable price mix, manufacturing savings from network optimization, ongoing productivity initiatives, and disciplined cost control. We expect further margin expansion to 2028 and beyond in this business unit. This will be driven by continued growth in revenues, the impact of actions already taken to right size our manufacturing capacity, and our Ortho 360 operating model, our Way to Win to balance growth, profit, and returns. In Sports Medicine and ENT, the margin decrease was driven by the impact of China VBP, which more than offset revenue leverage, operational efficiencies, and good cost management. Margin expansion in AWN was driven primarily by favorable product mix and productivity gains in operations.

Speaker #2: We expect further margin expansion to 2028 and beyond in this business unit. This will be driven by continued growth in revenues, the impact of actions already taken to right-size our manufacturing capacity, and our also 360 Operating Model—our way of running the business to balance growth, profit, and returns.

Speaker #2: In Sports Medicine and ENT, the margin decrease was driven by the impact of China VBP, which more than offset revenue leverage, operational efficiencies, and good cost management.

Speaker #2: Margin expansion in AWM was driven primarily by favorable product mix and productivity gains in operations. As you know, inventory has been a key focus under the 12-point plan, and you can see here the development of DSI, days sales inventory, over the year, both for the group and for each of the business units.

John Rogers: As you know, inventory has been a key focus under the 12-Point Plan, and you can see here the development of DSI, day sales inventory, over the year, both for the group and for each of the business units. Group DSI fell by 21 days, excluding the impact of portfolio rationalization that we announced at the end of last year, and by 51, including this. The biggest reduction came from Orthopaedics, reflecting continued efforts to reduce the number of units in inventory. As covered at our capital markets day, we expect inventory value to reduce further in 2026. We also saw a reduction in Sports Med DSI, including and excluding portfolio rationalization, albeit to a lesser extent than in Orthopaedics. Both Sports and Wound are already much closer to industry benchmark DSIs.

Speaker #2: Group DSI fell by 21 days, excluding the impact of portfolio rationalization that we announced at the end of last year, and by 51 days including this.

Speaker #2: The biggest reduction came from Orthopaedics, reflecting continued efforts to reduce the number of units in inventory. As covered at our Capital Markets Day, we expect inventory value to reduce further in 2026.

Speaker #2: We also saw a reduction in Sports Med DSI, including and excluding portfolio rationalization, albeit to a lesser extent than in Orthopedics, and both Sports and Wound are already much closer to industry benchmark DSIs.

Speaker #2: We've made good progress in our delivering a 90 basis point increase in ROIC to 8.3% at a group level. The improvement is being driven by trading margin expansion, lower restructuring charges, inventory reduction, and overall better asset utilization.

John Rogers: We've made good progress in our ROIC, delivering a 90 bps increase in ROIC to 8.3% at a group level. The improvement is being driven by trading margin expansion, lower restructuring charges, inventory reduction, and overall better asset utilization. Excluding the impact of portfolio rationalization that we announced in December, ROIC was 9.9%, exceeding our cost of capital for the first time in several years. All business units contributed to ROIC improvement, including a more than doubling of Ortho ROIC in 2025, helped by trading margin expansion and lower inventory. We expect a further step up in group ROIC in 2026, driven by a continuation of these trends. Moving on to cash flow. Trading cash flow was $1.236 billion for the year, reflecting a 102% conversion.

Speaker #2: Excluding the impact of portfolio rationalization that we announced in December, ROIC was 9.9%, exceeding our cost of capital for the first time in several years.

Speaker #2: All business units contributed to ROIC improvement, including a more than doubling of ROIC in 2025, helped by trading margin expansion and lower inventory.

Speaker #2: We expect a further step up in group ROIC in 2026, driven by a continuation of these trends. Moving on to cash flow, trading cash flow was $1.236 billion for the year, reflecting 102% conversion.

Speaker #2: The improvement came primarily from lower working capital costs, particularly from inventory and payables. Capital expenditure was $433 million. Working capital remains a focus for 2026.

John Rogers: The improvement came primarily from lower working capital costs, particularly from inventory and payables. Capital expenditure was $433 million. Working capital remains a focus for 2026. Free cash flow also improved to $840 million, growing 52.5% year-over-year. This includes a $26 million one-off property transaction and a $58 million reduction in restructuring, acquisition, legal, and other costs. The $840 million was well ahead of our initial guidance for over $600 million. We expect free cash flow in 2026 of around $800 million.

Speaker #2: Free cash flow also improved to $840 million, growing 52.5% year on year. This includes the $26 million one-off property transaction and a $58 million reduction in restructuring, acquisition, legal, and other costs.

Speaker #2: The $840 million was well ahead of our initial guidance for over $600 million. We expect free cash flow in 2026 of around $800 million.

Speaker #2: We expect the usual increase driven by profit growth, offset by a small, temporary increase in restructuring costs. This is driven by further optimization of our manufacturing network with the closure of our Warwick site, sourcing more into Memphis, and winding down manufacturing activities in Hull as we build our new wound facility in Melton.

John Rogers: We expect the usual increase driven by profit growth, offset by a small temporary increase in restructuring costs, driven by further optimization of our manufacturing network with the closure of our Warwick site, insourcing more into Memphis and winding down manufacturing activities in Hull as we build our new wound facility in Melton. Overall, our cash generation and returns profile is now in a much healthier position, and there is more improvement to come as we execute our RISE strategy. Net debt increased slightly during the year to GBP 2.76 billion, an increase of GBP 50 million. We finished 2025 with a leverage ratio of 1.7 times adjusted net debt adjusted to EBITDA, which is within our target of around 2 times.

Speaker #2: Overall, our cash generation and returns profile is now in a much healthier position, and there is more improvement to come as we execute our RISE strategy.

Speaker #2: Net debt increased slightly during the year to $2.76 billion, an increase of $50 million. We finished 2025 with a leverage ratio of 1.7 times adjusted net debt to adjusted EBITDA, which is within our target of around two times.

Speaker #2: In terms of capital allocation, we continue to prioritize organic reinvestment in our business and M&A execution in order to drive top-line growth. We'll maintain our dividend ratio of 35 to 40 percent, and we'll then consider returns to shareholders in the form of buybacks, subject to our target two-times leverage ratio.

John Rogers: In terms of capital allocation, we continue to prioritize organic reinvestment in our business and M&A execution in order to drive top line growth. We'll maintain our dividend ratio of 35% to 40%, and we'll then consider returns to shareholders in the form of buybacks, subject to our target 2x leverage ratio. Including the 2026 acquisition of Integrity Orthopaedics, our leverage still remains below 2x adjusted EBITDA. Now I'll finish with our outlook for 2026. We continue to expect around 6% organic revenue growth. That includes continued good growth in Orthopaedics, Sports Medicine, excluding AED and ENT in China, and Advanced Wound Management, particularly in AWC and AWD.

Speaker #2: Including the 2026 acquisition of Integrity Orthopedics, our leverage still remains below two times adjusted EBITDA. Now, I'll finish with our outlook for 2026. We continue to expect around 6% organic revenue growth.

Speaker #2: That includes continued good growth in Orthopaedics, Sports Medicine, excluding AET and ENT in China, and Advanced Wound Management, particularly in AWC and AWD. Whilst we expect headwinds in our skin substitutes business, we still expect AWB to grow, supported by the ongoing strength of Santol and growth in skin substitutes out of the physician office and mobile channel.

John Rogers: Whilst we expect headwinds in our skin substitutes business, we still expect AWB to grow, supported by the ongoing strength of SANTYL and growth in syn-in skin substitutes out of the physician office and mobile channel. We expect around 8% trading profit growth before M&A. As I've already mentioned, we face a number of extraordinary headwinds in 2026. We still expect trading profit growth ahead of revenue growth, driven by revenue leverage and operational savings. Since providing our provisional guidance, we've also completed the acquisition of Integrity Orthopaedics. This acquisition is expected to be marginally diluted to trading profit in 2026, broadly neutral in 2027, and accretive in 2028. Including this dilution, we expect trading profit to be around $1.3 billion.

Speaker #2: We expect around 8% trading profit growth before M&A. As I've already mentioned, we face a number of extraordinary headwinds in 2026, but we still expect trading profit growth ahead of revenue growth, driven by revenue leverage and operational savings.

Speaker #2: Since providing our provisional guidance, we've also completed the acquisition of Integrity Orthopedics. This acquisition is expected to be marginally dilutive to trading profit in 2026, broadly neutral in 2027, and accretive in 2028. Including this dilution, we expect trading profit to be around $1.3 billion.

Speaker #2: We thought it would be helpful to set out these two measures of trading profit so that you could see the performance of the business on an underlying basis, as well as the total trading profit, including the impact of the acquisition.

John Rogers: We thought it would be helpful to set out these two measures of trading profit so that you could see the performance of the business on an underlying basis as well as the total trading profit, including the impact of the acquisition. We expect around $800 million in free cash flow and greater than 10% ROIC excluding Integrity. We expect a stronger second half compared to the first half for both sales and profit growth in line with the typical phasing we see. We also expect ALLEVYN COMPLETE CARE to ramp up over the year and the launch of Landmark will benefit the second half. We have one fewer trading day in Q1 versus 2025 and one more in Q4. As a reminder, trading days have a more pronounced impact on our orthopaedics business. With that, I'll hand back to Deepank.

Speaker #2: Finally, we expect around $800 million in free cash flow and greater than 10% ROIC, excluding Integrity. We expect a stronger second half compared to the first half for both sales and profit growth, in line with the typical phasing we see.

Speaker #2: We also expect Leaving Complete Care to ramp up over the year, and the launch of Landmark will benefit the second half. We have one fewer trading day in Q1 versus 2025 and one more in Q4.

Speaker #2: As a reminder, trading days have a more pronounced impact on our Orthopaedics business. And with that, I'll hand back to Deepak.

Speaker #1: Thank you, John. So, the launch of RISE, our new strategy—which I laid out for you at the Capital Markets Day in December—our ambition is to accelerate growth and improve returns.

Deepak Nath: Thank you, John. With the launch of RISE, our new strategy, which I laid out for you in the capital market days in December, our ambition is to accelerate growth and improve returns. It's been great to see how well this new strategy has resonated internally, with this focus on reaching more patients, driving innovation, scaling through investment, and executing more efficiently. We're building on the behaviors embedded through the 12-Point Plan with our Way to Win, our program to be better every day through our continuous improvement mindset and behaviors. Let me now highlight the key drivers shaping our performance in the first year of RISE, and I'll start here with Sports Medicine. First, the China joint repair VBP headwinds have now fully annualized, which means our underlying joint repair growth will improve this year.

Speaker #1: It's been great to see how well this new strategy has resonated internally, with this focus on reaching more patients, driving innovation, scaling through investment, and executing more efficiently.

Speaker #1: We're building on the behaviors embedded through the 12-point plan with our Way to Win. Our program is to be better every day through our continuous improvement mindset and behaviors.

Speaker #1: So let me now highlight the key drivers shaping our performance in the first year of RISE, and I'll start here with Sports Medicine. First, the China joint repair BBP headwinds have now fully annualized.

Speaker #1: Which means our underlying joint repair growth will improve this year. And, importantly, we expect the upcoming AET and ENT BBP processes to be significantly less material, given the relative size of those businesses.

Deepak Nath: Importantly, we expect the upcoming AED and ENT VBP processes to be significantly less material given the relative size of those businesses. Second, we're continuing to build on the strength of our shoulder portfolio with our acquisition of Integrity Orthopaedics, and we look forward to driving adoption of TendonSeam across our customer base. I'll come on to this in a moment. Third, we are awaiting FDA approval of TESSA, our first in industry spatial surgery arthroscopic platform. This represents a major step forward in how surgeons visualize and execute procedures. Finally, we're also seeing ongoing growth in REGENETEN. The recent AAOS guideline support for the use of bioinductive implants in rotator cuff repairs is reinforcing clinical confidence and expanding usage.

Speaker #1: Second, we're continuing to build on the strength of our shoulder portfolio with our acquisition of Integrity Orthopedics, and we look forward to driving adoption of Tendon Seam across our customer base.

Speaker #1: So I'll come on to this in a moment. Third, we're awaiting FDA approval of Tessa, our first-in-industry spatial surgery arthroscopic platform. This represents a major step forward in how surgeons visualize and execute procedures.

Speaker #1: And finally, we're also seeing ongoing growth in Regenitin. The recent AAOS guideline support for the use of bioinductive implants in rotator cuff repairs has reinforced clinical confidence and expanding usage.

Speaker #1: I'd like to spend a few minutes on our acquisition of Integrity Orthopedics, an asset we believe has the potential to become a key growth driver for our Sports Medicine portfolio.

Deepak Nath: I'd like to spend a few minutes on our acquisition of Integrity Orthopaedics, an asset we believe has the potential to become a key growth driver for our Sports Medicine portfolio. We announced the deal earlier this year for total consideration of up to $450 million, including performance-based payments. Integrity Orthopaedics was co-founded in 2020 by Tom Wissing, who also founded Rotation Medical, the company behind REGENETEN, which we acquired in 2017. REGENETEN's growth is evidence of a proven track record of successful commercial execution, scaling an innovative shoulder product with our dedicated sales force, and building the clinical evidence to drive adoption. Integrity has developed TendonSeam, an innovative rotator cuff repair system that received FDA approval in 2023, and addresses the $875 million biomechanical repair market.

Speaker #1: We announced a deal earlier this year for total consideration of up to $450 million, including performance-based payments. Integrity Orthopedics was co-founded in 2020 by Tom Wesling, who also founded Rotation Medical, the company behind Regenitin, which we acquired in 2017.

Speaker #1: Regenitin's growth is evidence of a proven track record of successful commercial execution, scaling an innovative shoulder product with our dedicated sales force and building the clinical evidence to drive adoption.

Speaker #1: Integrity has developed Tendon Seam, an innovative rotator cuff repair system that received FDA approval in 2023 and addresses the $875 million biomechanical repair market.

Speaker #1: Rotator cuff repair is a large and growing category, with around 500,000 procedures performed annually in the United States. Despite the scale, surgical techniques have seen little meaningful innovation in over two decades, leaving patients with retear rates of between 20% and 40%, and long recovery times.

Deepak Nath: Rotator cuff repair is a large and growing category with around 500,000 procedures performed annually in the United States. Despite the scale, surgical techniques have seen little meaningful innovation in over two decades, leaving patients with re-tear rates of between 20 and 40% and long recovery times. As a result, this remains a segment with significant unmet need and where meaningful innovation can shift share. TendonSeam introduces a fundamentally novel biomechanical approach designed to distribute load across the entire tendon rather than concentrating stress at fixation points, resulting in stronger, more stable repair. Early clinical data is promising, showing potential for lower re-tear rates and accelerated patient recovery, while offering a shortened and easier surgical procedure compared to the current standard of care.

Speaker #1: As a result, this remains a significant segment with significant unmet need, and where meaningful innovation can shift share. Tendon Seam introduces a fundamentally novel biomechanical approach designed to distribute load across the entire tendon, rather than concentrating stress at fixation points.

Speaker #1: Resulting in stronger, more stable repair. Early clinical data is promising, showing potential for lower retear rates and accelerated patient recovery, while offering a shortened and easier surgical procedure compared to the current standard of care.

Speaker #1: The acquisition is fully aligned with our RISE strategy to accelerate growth through strategic investment by deploying capital into high-growth, high-value clinical segments where we already have a strong presence.

Deepak Nath: The acquisition is fully aligned with our RISE strategy to accelerate growth through strategic investment by deploying capital into high growth, high value clinical segments where we already have a strong presence. That's underpinned by our strong balance sheet. The deal is expected to be dilutive to trading profit in 2026. As John mentioned, broadly neutral in 2027 and accretive starting in 2028 as the product scales. While still early, integration is progressing as planned. We're focused on executing the same disciplined playbook that drove REGENETEN success. TendonSeam is highly complementary to Smith+Nephew's extensive shoulder portfolio. With this novel and disruptive technology, it strengthens the initial repair construct in rotator cuff tears. REGENETEN then builds on that strength by promoting biological healing over time.

Speaker #1: And thus underpinned by our strong balance sheet. The deal is expected to be dilutive to trading profit in 2026, and as John mentioned, broadly neutral in 2027 and accretive starting in 2028.

Speaker #1: As our product scales, while still early, integration is progressing as planned, and we're focused on executing the same disciplined playbook that drove Regenitin success.

Speaker #1: Tendon Seam is highly complementary to Smith & Nephew's extensive shoulder portfolio. With this novel and disruptive technology, it strengthens the initial repair construct in rotator cuff tears, and Regenitin then builds on that strength by promoting biological healing over time.

Speaker #1: Together, they create a differentiated end-to-end solution that addresses both the mechanical and biological drivers of successful rotator cuff repair. The total combined TAM for the two products is just under $1.2 billion, and today we have about 25% share.

Deepak Nath: Together, they create a differentiated end-to-end solution that addresses both the mechanical and biological drivers of successful rotator cuff repair. The total combined TAM for the two products is just under $1.2 billion. Today, we have about 25% share with opportunity to grow. Within fixation, we have the market-leading instability solutions, including our Q-FIX all suture anchor portfolio, which has 10 years of proven performance. In shoulder arthroplasty, our AETOS Shoulder System, launched in 2024 with anatomic, reverse, and stemless options, is positioned for the high growth replacement segment with estimated 250,000 procedures annually in the US in 2025.

Speaker #1: With opportunity to grow. Within Fixation, we have the market-leading Instability solutions, including our Q-Fix all-suture anchor portfolio, which has 10 years of proven performance.

Speaker #1: In shoulder arthroplasty, our ATOS shoulder system, launched in 2024 with anatomic, reverse, and stemless options, is positioned for the high-growth replacement segment, with an estimated 250,000 procedures annually in the US in 2025.

Speaker #1: We will soon have a powerful new offering with the launch of CORI Shoulder that will enable our handheld robotics to be used in the preparation and execution of shoulder replacement with ATOS, building on what we already have with choreographed pre-op planning.

Deepak Nath: We will soon have a powerful new offering with the launch of CORI SHOULDER that'll enable our handheld robotics to be used in the preparation and execution of shoulder replacement with AETOS, building on what we already have with CORIOGRAPH pre-op planning. We now have one of the broadest, most advanced portfolio for managing shoulder pathology, spanning replacement and repair via both mechanical and biological healing technologies across our Orthopaedics and Sports Medicine businesses. Turning to Advanced Wound Management. In wound bioactives, we have plans in place to navigate CMS reimbursement changes to skin subs in the physician office and mobile setting and to grow outside of those channels.

Speaker #1: We now have one of the broadest, most advanced portfolios for managing shoulder pathology, spanning replacement and repair by both mechanical and biological healing technologies across our orthopedics and sports medicine businesses.

Speaker #1: Turning to Advanced Wound Management, in wound bioactives, we have plans in place to navigate SEAM burst CMS reimbursement changes to skin subs in the physician office and mobile setting, and to grow outside of those channels.

Speaker #1: As a reminder, CMS has introduced a pricing cap starting from January 1, 2026, with the aim of reducing historical distortions in the market that have incentivized a significant number of players.

Deepak Nath: As a reminder, CMS has introduced a pricing cap starting from the 1 January 2026, with the aim of reducing historical distortions in the market that's incentivized a significant number of players, often operating in the mobile setting, to charge very high prices. We expect a reduction in non-surgical volumes, particularly in mobile, now that incentives have changed and certain skin subs offerings are economically less viable to many of these players and providers. Although this will drive a value reset short term, it also creates a more sustainable, patient-focused, and evidence-based market going forward with a long runway for growth. We see opportunities to benefit as the market normalizes. At the very end of last year, CMS also withdrew the skin subs local coverage determinations or LCDs.

Speaker #1: Often operating in the mobile setting to charge very high prices. The expected reduction in non-surgical volumes, particularly in mobile, now that incentives have changed and certain skin sub-offerings are economically less viable to many of these players and providers.

Speaker #1: So, although this will drive a value reset short term, it also creates a more sustainable, patient-focused, and evidence-based market going forward, with a long runway for growth.

Speaker #1: We see opportunities to benefit as the market normalizes. At the very end of last year, CMS also withdrew the skin subs local coverage determinations, or LCDs.

Speaker #1: We have always seen this as being broadly neutral to the business, and so this has no impact on our 2026 guidance. Even without the LCDs, we believe that clinical evidence will continue to be an important factor in this market.

Deepak Nath: We always saw this as being broadly neutral to the business, and so this has no impact to our 2026 guidance. Even without the LCDs, we believe that clinical evidence will continue to be an important factor in this market. Towards the end of 2025, we launched ALLEVYN COMPLETE CARE, our newest 5-layer foam dressing, which addresses both chronic wound healing and the pressure injury prevention market. It has 51% superior exudate management, and with the new silicone adhesive, stays in place more frequently than competitive products, making it a superior product for chronic wound healing. It also has a 55% greater reduction in strain relative to competition, making it ideally suited for pressure injury prevention. I'm confident that as we roll out ALLEVYN COMPLETE CARE to the market, we will capture market share in the largest and fastest-growing segment of wound dressings.

Speaker #1: Towards the end of 2025, we launched a leave-in complete care, our newest five-layer foam dressing, which addresses both chronic wound healing and the pressure injury prevention market.

Speaker #1: It has 51% superior exit management, and with the new silicone adhesive, stays in place more frequently than competitive products, making it a superior product for chronic wound healing.

Speaker #1: It also has a 55% greater reduction in strain relative to competition, making it ideally suited for pressure injury prevention. I'm confident that as we roll out a leave-in-complete care to the market, we will capture market share in the largest and fastest-growing segment of wound dressings.

Speaker #1: We'll also continue to drive the portfolio in high-growth areas with unmet need, like Santel in wound bed preparation, and access new patient populations, like those at risk of surgical site complications or pressure injuries, with PICO and LEAF.

Deepak Nath: We'll also continue to drive the portfolio high in high growth areas with unmet need, like SANTYL in wound bed preparation, and access new patient populations like those at the risk of surgical site complications or pressure injuries with PICO and LEAF. Moving now to orthopedics. We'll continue to drive procedure growth across all joints with our CORI platform, supported by the launch of our shoulder execution capability. CORI remains a core differentiator for us. Handheld robotics are increasingly popular, and CORI's size, mobility, fast setup, and low cost of ownership make it well-suited to both hospitals and to ASCs. In knees, we'll continue to build out a portfolio in 2026. We've already launched our LEGION medial stabilized knee to meet the needs of a fast-growing segment, and we are pleased with the early momentum we've seen so far.

Speaker #1: Moving now to orthopedics, we'll continue to drive procedure growth across all joints with our CORI platform, supported by the launch of our shoulder execution capability.

Speaker #1: Corey remains a core differentiator for us. Handheld robotics are increasingly popular, and Corey’s size, mobility, fast setup, and low cost of ownership make it well-suited to both hospitals and to.

Speaker #1: ASCs . It needs . We will continue to build out a portfolio in 26 . We've already launched our Legion Medical stabilized knee to meet the needs of a fast growing segment , and we're pleased with the early momentum so far .

Speaker #1: The next leap comes in the second half of the year, when we launch Landmark, our most differentiating knee system yet. That will be available first in cementless and then in cemented versions.

Deepak Nath: The next leap comes in the second half of the year when we launch Landmark, our most differentiating knee system yet. That will be available first in cementless and in cemented versions, and with the best-in-class tray efficiency that's particularly suitable for ASCs. As the ASC channel starts to grow or continues to grow, we're well positioned to expand further, supported by a suite of tray efficient implants like AETOS, Catalyst Stem, and Landmark together with CORI. In fact, 40% of all CORIs placed in 2025 were in the ASCs, underscoring the platform's fit for this high-growth setting. We also capture further efficiencies with our Ortho 360 program. This is our global operating model designed to eliminate past inefficiencies by replacing fragmented region-driven decisions with unified goals, integrated metrics, and disciplined portfolio management.

Speaker #1: And with the best in class tray efficiency . That's particularly suitable for ASCs . As the ASC channel starts to grow or continues to grow , we're well positioned to expand further , supported by a suite of tray efficient implants like , catalyst , Stem and together with Corey .

Speaker #1: In fact, 40% of all Coreys placed in 2025 were in the ASCs, underscoring the platform's fit for this high-growth setting. We also capture further efficiencies with our Ortho 360 program.

Speaker #1: This is our global operating model designed to eliminate past inefficiencies by replacing fragmented , region driven decisions with unified goals . Integrated metrics , and disciplined portfolio management .

Deepak Nath: By maturing our sales and operation planning processes into fully integrated business planning process or IBP, simplifying the portfolio, reducing inventory, and enhancing capital efficiency, this should drive profitability, improve ROIC, and stronger cash generation in this business unit. I'll now give an outlook for innovation over the life of RISE, given its importance to our growth both historically and looking forward. Looking ahead, we are stepping up our R&D investment in sports and in Wound, while maintaining a robust front-loaded pipeline across all areas of the group from 2026 and to 2028. Over the last 3 years, we successfully launched 44 products, largely on time and within budget, and we plan to increase launch cadence going forward. We launched 14 new products in 2024, 15 in 2025, and we expect to launch 16 in 2026.

Speaker #1: By maturing our sales and operation planning processes into a fully integrated business planning process, or IBP, simplifying the portfolio, reducing inventory, and enhancing capital efficiency.

Speaker #1: This should drive profitability, improved ROI, and stronger cash generation in this business unit. I'll now give an outlook for innovation over the life of RICE, given its importance to our growth, both historically and at S&N looking forward.

Speaker #1: Looking ahead, we are stepping up our R&D investment in Sports and in Moon, while maintaining a robust, front-loaded pipeline across all areas of the group.

Speaker #1: From 2026 and to 2028 . Over the last three years , we successfully launched 44 products , largely on time and within budget , and we plan to increase launch cadence going forward We launched 14 new products in 24 , 15 and 25 , and we expect to launch 16 in 2026 .

Deepak Nath: We're also building on our two major scale, scalable technology platforms, MedTech and Biologics. In MedTech, we'll be launching TESSA and LUMINOS in Sports Med and our next generation LEAF monitors for pressure injury prevention in wound. We also have a rapidly evolving robotic platform to drive procedure innovation across all joints in Orthopaedics. In Biologics, we'll build on our existing products with launches like next REGENETEN, our next generation of REGENETEN. Before I finish, I'd like to remind you of the midterm financial targets that our strategy will deliver. Through continued innovation and execution, we'll deliver organic revenue CAGR of 6% to 7% that's above our market.

Speaker #1: We're also building on our two major scalable technology platforms, MTEC and biologics. In MTEC, we'll be launching TESA and LUMOS in Sports Med, and our next generation LEAF monitors for pressure injury prevention and wound care. We also have a rapidly evolving robotic platform to drive procedure innovation across all joints in orthopedics, and in biologics.

Speaker #1: We'll build on our existing products with launches like next , Next Gen Our next generation of regeneration . So before I finish , I'd like to remind you of the mid-term financial targets that our strategy will deliver through continued innovation and execution .

Speaker #1: We'll deliver organic revenue of 6% to 7%. That's above our market. And our continued focus on productivity, further operational efficiencies, and capital discipline will drive 9% to 10%.

Deepak Nath: Our continued focus on productivity, further operational efficiencies, and capital discipline will drive 9% to 10% trading profit CAGR, more than $1 billion in free cash flow in 2028 and 12% to 13% ROIC. Coming back to the near term, we've delivered on 2025 in terms of revenue growth, margin, free cash flow, and ROIC, and we're looking ahead to another good year. On revenue, we're accelerating growth, launching new products, and driving leverage through our P&L. We continue to be disciplined on our cost base to drive trading profit growth ahead of revenue growth on an organic basis. Our free cash flow generation remains strong and will deliver another step-up in ROIC, significantly exceeding our WACC in 2026. With that, will now take your questions. Jack.

Speaker #1: Trading profit . Keger more than 1 billion in free cash flow in 2028 and 12 to 13% growing . Coming back to the near term , we've delivered on 2025 , in terms of revenue growth margin , free cash and ROE , and we're looking ahead to another good year on revenue .

Speaker #1: We're accelerating growth, launching new products, and driving leverage through our P&L. We'll continue to be disciplined on our cost base to drive trading profit growth ahead of revenue growth on an organic basis, and our free cash flow generation remains strong.

Speaker #1: And we'll deliver another step up in ROE, significantly above our WACC in 2026. So with that, I'll now take your questions.

Speaker #1: I will now take your questions, Jack.

Jack Reynolds-Clark: Hi there. Jack Reynolds-Clark from RBC. Thanks for taking the questions. The first is on revenue guidance in 2026. Could you kind of break down what your expectations are for market growth, how much launches contribute to that growth guidance and what contingency is baked in to that guide? Could you just run through the phasing through the quarters for revenue guide? Could you remind us of your expectations for timing of the CORI SHOULDER? Sorry, shoulder ability in, on CORI.

Speaker #2: Hi there . Jack . From IBC . Thank you for taking the questions . The first is on revenue guidance for 2026 . you break down what your expectations are for growth ?

Speaker #2: How much launches contribute to to that to that growth guidance and what contingency is baked in to that guide ? And then could you just run through the phasing through through the quarters for revenue guide .

Deepak Nath: With 26, and actually right through RISE, one of the benefits of the program we have is the multiple sources of growth. We're not dependent on any one business unit or any one product to carry us through. And to remind you, we've exited 2025 meaningfully above our historical levels of low single digits. We've now navigated to above 5%, and when you take the impact of China VBP out of it, we were actually above 7%. What we're driving to the 6% to 7% growth for the next 3 years. Within that, 26 will be at around 6%, which will be above our market, and each of our business units will contribute to that. Innovation will be continued to be a key part of it.

Speaker #2: And then could you remind us of your expectations for timing of the quarry shoulder or sorry shoulder ability in on quarry . Thank you

Speaker #1: So with 26, and actually right through RISE, one of the benefits of the program we have is the multiple sources of growth.

Speaker #1: So we're not dependent on any one business unit or any one product to carry us through. And to remind you, we've exited 2025 meaningfully above our historical levels of low single digits.

Speaker #1: So we've now navigated to above 5%. And when you take the impact of China GBP out of it, we were actually above 7%.

Speaker #1: So what we're driving to is 6 to 7% growth for the next three years. Within that, '26 will be at around 6%, which will be above our market.

Deepak Nath: As I said, in 2025, we're about 60% of our growth comes from new products. To remind you, in 2024, we were above 50%, and in 2023 we were still above the 50%, around about 60%. We've been consistently above the 50% mark in terms of new products driving growth. In 2026, as I indicated, we'll have 60 new products. I mean, you can measure that all in different ways, but we expect that new products will continue to deliver above 50% growth into 2026. Around 6% growth ahead of market. We'll see growth coming from each one of our business units, and we'll have innovation that continue to fuel our growth. That's the overall kinda revenue story. In terms of our... anything to add, John?

Speaker #1: And each of our business units will that . Innovation will be continue to be a key part of it . As I said in 25 , we're about 60% of our growth comes from new products .

Speaker #1: To remind you , in 24 , we were above 50% . And in 23 we were still above 50% . Around about 60% .

Speaker #1: So we've been consistently above the 50% mark in terms of new products driving growth. In '26, as I indicated, we'll have 16 new products.

Speaker #1: I mean, you can measure that in different ways, but we expect that new products will continue to deliver above 50% growth into 2026.

Speaker #1: So, '26, around 6% growth ahead of the market. We'll see growth coming from each one of our business units, and we'll have innovation that continues to fuel our growth.

John Rogers: I can give a little bit of shape around the phasing if that's helpful.

Speaker #1: So, that’s the overall kind of revenue story. And in terms of our—anything to add, John?

Deepak Nath: Yeah. Yeah. Phasing's great.

John Rogers: As we said in the presentation, sort of weighted towards the second half. Q1 will be softer. Obviously there's 1 fewer trading day in Q1. We think US knees will be a little bit soft in Q1. We think that will build into Q2. We're expecting the first half to outturn somewhere between, say 4.5% to 5% top-line growth. Q3 and Q4 will be stronger as we obviously introduce Landmark and ALLEVYN COMPLETE CARE grows through the year. Q3 and Q4 will be stronger. Q4 also has 1 more trading day, so that's a little bit of a boost. We'd expect the second half to deliver growth of somewhere between 7.5% to 8%.

Speaker #3: I can give a little bit of shape around the phasing.

Speaker #1: If that’s phrasing, it is great.

Speaker #3: So, as we said in the presentation, it's sort of weighted towards the second half. So Q1 will be softer. Obviously, it's one fewer trading day in Q1.

Speaker #3: We think US knees will be a little bit soft in Q1 . We think that will build into Q2 . So we're expecting the first half to outturn somewhere between , say , four and a half to 5% top line growth .

Speaker #3: Q3 and Q4 will be stronger as we obviously introduce Landmark, and obviously, AEVEN Complete Care grows through the year. So Q3 and Q4 will be stronger.

John Rogers: You combine that for 4.5% to 5% in the first half with the 7.5% to 8% in the second half, that gets you to your around 6% for the full year. That gives you a little bit of shape on the top line. Then I'll give you. You didn't ask for it, but I'll give it to you anyway because some people will probably ask. In terms of shaping on the bottom line, again, we've got that 8% growth in our trading profit for the full year. Again, it's naturally gonna be swayed to the second half given the revenue bias towards the second half.

Speaker #3: Q4 also has one more trading day . So that's a little bit of a boost . And so we'd expect the second half to deliver growth of somewhere between seven and a half to 8% .

Speaker #3: You can bind that for four and a half to 5% in the first half , with the seven and a half to 8% in the second half .

Speaker #3: That gets you to your around 6% for the full year. That gives you a little bit of shape on the top line, and then I'll give you a bit.

Speaker #3: You didn't ask for it, but I'll give it to you anyway because some people probably ask it in terms of shaping on the bottom line.

John Rogers: I'd expect profit growth in the first half to be of the order of 5.5% to 6%, something of that nature. Profit in the growth in the second half to be around 9% to 10%. The two combined gets you to your around 8%. Again, I'm not gonna break it down by quarter, but hopefully that gives you a little bit of a shape. Effectively building through the year, partly driven by the fact we've got one fewer trading day in Q1 and one more trading day in Q4.

Speaker #3: Again, we've got that 8% growth in our trading profit for the full year. Again, it's naturally going to be swayed to the second half, given the revenue bias towards the second half.

Speaker #3: So I'd expect profit growth in the first half to be of the order of five and a half to six percent—something of that nature.

Speaker #3: Profit in growth in the second half to be around 9% to 10%. The two combined get you to around 8%. So I'm not going to break it out by quarter.

Deepak Nath: Your question on CORI SHOULDER. The CORIOGRAPH, which is our planning platform, launched, I think, middle of last year. The key unlock is, of course, execution, and we're starting the year now that's launched. We've got a whole AETOS portfolio, Stemlin short stump, and CORI SHOULDER now planning and execution. The ability to do both reverse and anatomic, and the ability to do both glenoid and humeral and with CORI to do preoperative planning, intraoperative and postoperative kinda insights. Not only a complete solution, a highly differentiated solution that CORI.

Speaker #3: But hopefully that gives you a little bit of a shape. So, effectively building through the year, partly driven by the fact we've got one fewer trading day in Q1 and one more trading day in Q4.

Speaker #1: And your question on quarry shoulder , the choreograph , which is our planning platform , launched , I think , middle of last year , the key unlock is , of course , execution .

Speaker #1: And we're starting the year now. That's launched. So we've got a whole portfolio: stemless, short stem, and CORI shoulder now in planning and execution.

Speaker #1: So, the ability to do both reverse and anatomic, and the ability to do both glenoid and humeral, and with Quorri to do pre-operative planning, intraoperative, and postoperative kind of insights.

John Rogers: Thank you.

Deepak Nath: That's it, Jack. Veronika next. David.

Veronika Dubajova: Hi, good morning. Veronika Dubajova from Citi. Two questions from me, please. The first one, I just want to go back to joint repair. Obviously, Deepak, you said that the China headwind has annualized out now, but we've had it basically for eight quarters. I just want to confirm what's happening in joint repair China specifically, and what gives you the confidence this year that it's not going to be a drag to the overall joint repair number to the extent that we've seen. Obviously, the China improvement is a big part of the guide for the year. If you can talk about that, please. Then just a big picture question around the margin in organic and inorganic development.

Speaker #1: So, not only a complete solution, but a highly differentiated solution in children. Thank you, Veronica. Next, David.

Speaker #4: Yes .

Speaker #5: Hi . Good morning Veronica . From city two two questions from me , please . The first one , I just want to go back to joint repair and obviously , Deepak , you said that the China headwind has annualized out now , but we've had it basically for eight quarters .

Speaker #5: So I just want to confirm what’s happening in joint repair China specifically, and sort of what gives you the confidence this year that it’s not going to be a drag to the overall joint repair number, to the extent that we’ve seen. Obviously, the China improvement is a big part of the guide for the year.

Veronika Dubajova: Obviously, you know, very exciting to see organic margin improvement this year, but it is being eaten away by Integra. I don't know if you can maybe talk a little bit more broadly how you think about capital allocation and M&A sort of having an impact on the bottom line growth and to what extent that's sort of a favorable trade-off that you're willing to take, and maybe if there is anything else in the pipeline beyond Integra that we should be kinda looking at for this year? Thank you.

Speaker #5: So if you can talk about that , please . And then just kind of a big picture question around the margin and organic and inorganic development , obviously very exciting to see organic margin improvement this year .

Speaker #5: But it is being eaten away by Integra . So I don't know if you can maybe talk a little bit more broadly how you think about capital allocation and M&A , sort of having an impact on the bottom line growth , and to what extent that sort of a favorable trade off that you're willing to take .

Deepak Nath: Integrity.

Veronika Dubajova: Oh, Integrity. Sorry, Integrity. I'm so sorry. Clearly, my second cup of coffee hasn't kicked in yet. Thank you so much.

Deepak Nath: CORI and slip. Right. Let me talk about joint repair. As we mentioned, joint repair has annualized at this point. Going forward, have a clean kinda comp or rather joint repair growth unalloyed by China VBP. That is a key part of our growth story, as you as you highlighted. As we've called out a number of times, when you actually dissect our sports growth, it's been well balanced across geographies. You take China out of it, and we've actually grown high single-digit growth, not only across markets, but actually across categories. Which is one of the key features of our Sports Medicine, which is a balanced portfolio selling that we've undertaken.

Speaker #5: And maybe if there is anything else beyond Integra that we should be kind of looking out for this year. Thank you.

Speaker #1: Integrity .

Speaker #5: Integrity . Sorry . Integrity . I'm so sorry . Clearly , my second cup of coffee hasn't kicked in yet . Thank you so much .

Speaker #1: Right , so . So let me talk about joint repair . So as we mentioned , joint repair has annualized at this point .

Speaker #1: So, going forward, we have a clean kind of comp, or rather joint repair growth on Alloyed by China. And that is a key part of our growth story.

Speaker #1: As you highlighted, and as we've called out a number of times, when you actually dissect our Sports growth, it's been well balanced across geographies.

Deepak Nath: I feel very, very good about commercializing our portfolio and now the impact of China VBP and joint repairs going away. What is left though is AET, right? The AET part started last year. I think it will be Q3, right, John? Something like that, Q3 or early into Q4 by the time we fully lap AET. The impact to the group is relatively small at this point, right? The other part is we report ENT and Sports Medicine together. It is ENT that is not going through this, and it started kind of towards the later last year. We will fully annualize that towards the end of this year. Again, both of those, while important to those business segments at a group level, will now be a relatively small portion of the portfolio.

Speaker #1: You take China out of it , and we've actually grown high single digit growth , not only across markets , but actually across categories , which is one of the key features of our sports medicine , which is a balanced portfolio selling that we've undertaken .

Speaker #1: So I feel very, very good about commercially commercializing our portfolio. And now, the impact of China in joint repairs going away.

Speaker #1: What is left , though , is eat right . The eat part started last year . I think it will be Q3 . Right , John , something like that .

Speaker #1: Q3 or Q4, or into Q4. But at the time we fully lap EAT. But the impact to the group is relatively small at this point, right.

Speaker #1: And then the other part is we report ENT and Sports together. It's ENT that's not going through this, and it started kind of towards late last year. We'll fully annualize that towards the end of this year.

Deepak Nath: Overall, like I said, I feel very, very good about the continued momentum that the momentum we've built and capitalizing that momentum as we go into 2026. In terms of margin, as we noted, we've driven 240 bps of margin improvement over the life of the 12-Point Plan program. That's a combination of leverage and cost improvement and all of the work that we've done over the 3 years of the program. Not only deliver the 240 bps, but what's most impressive about that is the sheer scale of headwinds that we've overcome. If you just take China joint repair VBP, that's just 120 bps on its own. If you just add that to 19.7, we would be at 20.9.

Speaker #1: But again, both of those, while important to those business segments at a group level, will now be a relatively small portion of the portfolio.

Speaker #1: So overall , like I feel very , very good about the continued momentum that the momentum we've built and capitalizing on that momentum as we go into 2026 .

Speaker #1: In terms of margin, as we noted, we've driven 240 bps of margin improvement over the life of the 12-point plan program.

Speaker #1: That's a combination of leverage and cost improvement, and all of the work that we've done over three years of the program, not only deliver the 240 bps, but what's most impressive about that is the sheer scale of headwinds that we've overcome.

Deepak Nath: I'm absolutely proud of what we as an organization have delivered with focus not only on the top of margin. As we've said, going forward, the focus will be on revenue growth and driving sustainable above-market revenue growth and profit growth. That's kind of what we're orienting and guiding toward, recognizing that we'll continue to drive productivity, we'll continue to take costs out in order to, in effect, drive margin as well. In terms of capital allocation, our focus remains on investments in organic, right, to drive top-line growth above market to further accelerate our growth. That remains a key feature or the key priority for us in terms of capital allocation. What we've also said, of course, is that's a mix of R&D and M&A.

Speaker #1: If you just take China joint Repair , BVP , that's just 120 Bips on its own , and if you just add that to 1907 , we would be at 20.9 .

Speaker #1: I'm absolutely proud of what we as an organization have delivered with focus not only on the top of the margin . As we've said , going forward , the focus will be on revenue growth and driving sustainable above market revenue growth and profit growth .

Speaker #1: So that's kind of what we orienting and guiding toward recognizing that will continue to drive productivity . We'll continue to take costs out in order to , in effect , drive drive margin as well .

Deepak Nath: Within our RISE strategy, what we've said is we will undertake M&A that allows us to scale in areas where we have strength, and that's within Sports and within bone and areas where we see clear ability to build on what is a solid foundation. Integrity fits very squarely within that. As I've highlighted, the advantage of Integrity is within Sports Medicine, it allows us to be a clear leader in biomechanical repair, right? We were very positively impressed with TendonSeam and all that it has to offer in terms of an alternative to existing approaches. Together with what we have, I think it'll be a great complement, right, in terms of mechanical repair. What's most exciting is when you couple that with REGENETEN, where we clearly have market leadership in Biologics, that's a fantastic portfolio.

Speaker #1: In terms of capital allocation, our focus remains on investments in organic to drive top-line growth above market and to further accelerate our growth. That remains a key feature, or the key priority, for us in terms of capital allocation.

Speaker #1: What we've also said , of course , is that's a mix of R&D and and M&A . And within our strategy , what we've said is we will undertake M&A that allows us to scale in areas where we have strength , and that's within sports and within wound and areas where we see clear ability to build on what is a solid foundation and integrity fits very squarely within that .

Speaker #1: As I've highlighted, the advantage of integrity is within sports medicine. It allows us to be a clear leader in biomechanical repair, right.

Speaker #1: We were very, very positively impressed with tendon and all that it has to offer in terms of an alternative to existing approaches.

Deepak Nath: We should expect us to act as the leaders that we are in Sports Medicine. When we see an asset, unique technology that augments our position. Actually what's even more impressive is when you couple that with what we've got in arthroplasty with CORI and our full portfolio of AETOS, we are now very, very strongly positioned within shoulder. Just to remind you, there's significant channel overlap in shoulders. Surgeons who do arthroplasty also do soft tissue repair. That's what's most exciting about this. Integrity fits very squarely, as I said, in our RISE strategy, where we will make investments in order to shore up our position and to drive great growth.

Speaker #1: And together with what we have , I think will be a great compliment . Right . In terms of mechanical repair . But what's most exciting is when you couple that with Eugenitin , where we clearly have market leadership in biologics .

Speaker #1: That's a fantastic portfolio. And we should expect us to act as the leaders of ER in sports medicine. And we see an asset, unique technology that augments our position.

Speaker #1: But actually, what's even more impressive is when you couple that with what we've got in arthroplasty with CORIN and a full portfolio of Atos, we are now very, very strongly positioned within shoulder.

Deepak Nath: As it turns out, within this particular asset, it's the group that gave us REGENETEN, and you've seen what we've done, not only commercially, but actually investing clinically to develop the clinical evidence to drive adoption. That's what's most exciting about it, and hopefully it gives you a little bit of color on capital allocation.

Speaker #1: And just to remind you, there's significant channel overlap in shoulders. So, surgeons who do arthroplasty also do soft tissue repair. So that's what's most exciting about this.

Speaker #1: So integrity fits very squarely, as I said, in our strategy, where we will make investments in order to shore up our position and to drive great growth.

John Rogers: Maybe if I can just give you a little bit more color on China as well, because it's obviously a topic that comes up a lot in conversation. Just to sort of set the scene. In 2024, in sort of greater China, I think we've said this number before, we were doing around $210 million, $220 million or so of sales. In 2025, we saw broadly a sort of a reduction of a third as a consequence of all the impacts that we talked about. Roughly getting to us at about $160 million. Actually, when we look at 2026, it's actually a very similar number to 2025, so we're really not expecting to see much relative movement in our greater China sales, 2026 on 2025.

Speaker #1: And as it turns out , within this particular asset , it's the group that gave us Regeneron . And you've seen what we've done , not only commercially , but actually investing clinically to develop a the clinical evidence to drive adoption .

Speaker #1: So that's what's most exciting about it. And hopefully it gives you a little bit of color on capital allocation.

Speaker #3: Maybe if I can just it just give you a little bit more color on China as well , because it's obviously a topic that comes up a lot in , in conversation just to sort of set the scene in 2024 .

Speaker #3: In sort of Greater China . I think we've said this number before , we were doing around two , ten , two , 20 million or so of sales in 2025 .

John Rogers: Actually, you need to unpack that a little bit because it's a combination of a couple of factors taking place, one of which is we're actually expecting to see sports and joint recover a little bit. The reason why that's the case is because we've done a really successful job of managing channel inventory in 2025. We've taken inventory. Where we've had to, we've taken inventory out of the channel. We are confident, and we can see this start to come through in Q4 of last year, which is the reason that gives us confidence. We expect to see a little bit of a bounce in our sports business in China. Of course, for the overall number to be flat, that means there needs to be a negative somewhere.

Speaker #3: We saw broadly a sort of a reduction of a third as a consequence of all the impacts that we talked about . So roughly getting to about 160 , actually , when we look at 2026 , it's actually a very similar number to 2025 .

Speaker #3: So we're really not expecting to see much relative movement in our Greater China sales . 26 on 25 . Now actually , you need to unpack that a little bit because it's a combination of a couple of factors taking place , one of which is we're actually expecting to see sports and joint recovery recover a little bit .

Speaker #3: Now, the reason why that's the case is because we've done a really successful job of managing channel inventory in 2025. We've taken inventory.

John Rogers: Of course, the negative exists in the AED and in the ENT. That we haven't really seen the impact of that in 2025. It's gonna really come through in 2026. That's the negative. Overall, those two play a draw to be neutral on the top line. When you look at the bottom line, profit again for 2025 was, let's sort of call it around $50 to $60. We will expect to see a $15 to 20 million reduction in that profit year-on-year into 2026, and that's being driven again by the VBP on AED and ENT. Again, we've done a really good job of managing the channel inventory on ENT. Again, we can be reasonably comfortable with that number.

Speaker #3: We've had to we've taken inventory out of the channel . So we are confident and we can we can start to come through in Q4 of last year , which is the reason that gives us confidence .

Speaker #3: So we expect to see a little bit of a bounce in our Sports business in China. Of course, for the overall number to be flat, that means it needs to be negative somewhere.

Speaker #3: And of course, the negative exists in the ortho and in the ENT that we have. We haven't really seen the impact of that in '25.

Speaker #3: It's going to really come through in '26. That's the negative. But overall, those two-point player draw to be neutral on the top line.

Speaker #3: When you look at the bottom line, profit again for '25 was, let's call it, around $50 to $60 million. We will expect to see a $15 to $20 million reduction in that profit year on year into '26.

John Rogers: As we've very clearly stated, China will not be in 2026 a drag on the top line in the way that it has been historically. It will be a drag on the bottom line, but to a much more limited extent, call it $15 to 20 million, which is what we set out at the capital markets day in December and what we're reiterating today in terms of the impact of VBP, AED, and ENT for 2026. That's absolute clarity. That's the thing that gives us confidence. You know, when you look at our growth, ex-China for 2025, we were at 7% growth. We're no longer seeing that drag come through in 2026, that's what gives us confidence with regards to our around 6% growth at the top line of business.

Speaker #3: And that's being driven again by the BPP on. So again, we've done a really good job of managing the channel inventory on ENT.

Speaker #3: So again, we can be reasonably comfortable with that number. So as we've very clearly stated, China will not be in 2026 a drag on the top line in the way that it has been historically.

Speaker #3: And it will be a drag on the bottom line, but to a much more limited extent. Call it $15 to $20 million, which is what we set out at the Capital Markets Day in December.

John Rogers: Notwithstanding some of the headwinds we've clearly talked about.

Speaker #3: And what we're reiterating today in terms of the impact of GBP 80 and ENT for 26 . So that's . Absolute clarity , and that's the thing that gives us confidence .

Deepak Nath: David.

John Rogers: Morning. Morning, David Adlington from J.P. Morgan. You've seen two or three of your competitors in skin substitutes downgrade their guidance expectations in the last few weeks. You've maintained yours that you had before Christmas. Just wondered if you could talk about what you're seeing in the markets and your assumptions around price and volumes for this year. Second one more for John. In the inventory write-down, $159 million, is that all coming from the portfolio rationalization or is there anything more underlying in there? Is that now complete or should we expect more changes coming through?

David Adlington: Morning. Morning, David Adlington from J.P. Morgan. You've seen two or three of your competitors in skin substitutes downgrade their guidance expectations in the last few weeks. You've maintained yours that you had before Christmas. Just wondered if you could talk about what you're seeing in the markets and your assumptions around price and volumes for this year. Second one more for John. In the inventory write-down, $159 million, is that all coming from the portfolio rationalization or is there anything more underlying in there? Is that now complete or should we expect more changes coming through?

Speaker #3: You know, when you look at our growth ex-China for '25, we were 7% growth because we're no longer seeing that drag come through in '26.

Speaker #3: That's what gives us confidence with regards to our around 6% growth at the top line in our business, notwithstanding some of the headwinds we've clearly talked about, David, and

Speaker #2: Morning, David Addington, JP Morgan. You've seen two or three of your competitors in skin substitutes downgrade their guidance expectations in the last few weeks.

Deepak Nath: Yeah. In terms of skin subs, we are seeing the, the channel adapt to the, to the changes that are coming. Just to remind everyone, it's really in the physician office and the mobile channels where we're seeing most of the impact, and within that mobile is more impacted than physician office or the hospital outpatient segment, right? In the surgical segment, we're continuing to see growth. In terms of parsing what different players have said, it really has to do with the mix of our business. Is how much of our business is in each of those channels. The other factor within that is the, the type of products you have within each segment, right?

Speaker #2: You've maintained yours. They had before Christmas. I just wondered if you could talk about what you're seeing in the market and your assumptions around price and volumes for this year.

Speaker #2: And then secondly , more for John inventory . Write down 159 million . Is that all coming from the portfolio rationalization , or is there anything more underlying in there ?

Speaker #2: And is that now completed, or should we expect more changes coming through?

Speaker #1: Yeah . So in terms of skin subs , we are seeing the channel adapt to the to the changes that are coming . So just to remind everyone it's really in the physician office and the mobile channels where we're seeing most of the impact .

Deepak Nath: You've got products that you can segment both from a customer standpoint and from a price standpoint. Put all these pieces together, what we're seeing is definitely impact in terms of price that is hit. To remind everyone, typically within the physician office segment and mobile segment, the payment terms or reimbursement levels or cycles are between 40 and 45, 30 and 45 days. We're now heading into a period where the first tranche of reimbursements have gone in and physician offices are starting to see just what comes through from CMS around that.

Speaker #1: And within that mobile is more impacted than , than physician office or the hospital outpatient segment . Right . So but in the surgical segment , we're continuing to see growth .

Speaker #1: So, in terms of parsing what different players have said, it really has to do with the mix of our business—how much of our business is in each of those channels.

Speaker #1: The other factor within that is the the type of products you have within each segment , right ? You've got products that that you can segment both from a customer standpoint and from , from a price standpoint .

Speaker #1: So put all these pieces together . What we're seeing is definitely impact in terms of price . That is hit to remind everyone typically within the the physician office segment and mobile segment , the payment terms or reimbursement levels are cycles are between 40 and 45 , 30 and 45 days .

Deepak Nath: There's still a fair amount of uncertainty in the channel in terms of not only utilization, but how these products get reimbursed and the mechanism under which the CMS is actually reimbursing those products. What we've said is, the guidance we've provided for our business in terms of how we're impacted, hasn't fundamentally changed from last year. Longer term, David, I'm very, very bullish on the segment. Once we get through this period of adaptation, we believe that the clinical unmet need is there. There will be a drive towards using products that have clinical evidence. As you know, we've invested considerably over the years to develop not only products, but clinical evidence to drive the appropriate use of those products.

Speaker #1: So we're now heading into a period where the first tranche of reimbursements has gone in, and physician offices are starting to see just what comes through from CMS around that.

Speaker #1: So there's still a fair amount of uncertainty in the channel, in terms of not only utilization, but how these products get reimbursed.

Speaker #1: And the mechanism under which this CMS is actually reimbursing those products . So what we've said is the the guidance we've provided for our business in terms of how we're impacted , hasn't fundamentally changed from last year , but longer term , the David , I'm very , very bullish on the segment .

Deepak Nath: That combined with the growing unmet need based on demographics, right, makes this an attractive channel over the long term. Inventory, I'll take that.

John Rogers: Well, I was gonna say, just maybe give a little bit of color around the how do you get to our 20 to 40 impact on the bottom line. I mean, we said before that, you know, our skin subs business is around a couple of hundred million USD. You know, we think that from a pricing perspective, we think for our portfolio, we'll see a sort of price reduction of around sort of 20%, 25% or so. Now, that's a lot lower than the overall industry will see because we haven't necessarily participated in quite the same high price points as the industry average. We will expect prices to come down a little bit.

Speaker #1: Once we get through this period of adaptation, we believe that the clinical unmet need is there. There will be a drive towards using products that have clinical evidence.

Speaker #1: And as you know, we've invested considerably over the years to develop not only products, but clinical evidence to drive the appropriate use of those products.

Speaker #1: And that, combined with the growing unmet need based on demographics, makes this an attractive channel over the long term.

Speaker #4: Okay .

Speaker #1: And inventory, you want to take that? Well.

Speaker #3: I was going to say, I just maybe give a little bit of color around the how do you get to our 20 to 40 impact on the bottom line?

John Rogers: At the same time, we would expect our volumes to be broadly neutral, maybe even a little bit positive as we grab a little bit more share from the channel. Overall, a sort of 15% to 20% reduction in our revenues. If you work out that on the $200 million and drop that through as a margin, that gives you your 20% to 40% impact on our bottom line that we've put in our margin bridge. You know, there's lots of assumptions that build into that, lots of uncertainty around that, but that's just the basis on which we give the guidance. We haven't seen anything in the market to date that would contradict that guidance. That's a broad, you know, reasonably broad range from that $20 million to $40 million.

Speaker #3: I mean , we've said before that , you know , our skin subs business is around a couple of hundred million . If you look at the , you know , we think that from a pricing perspective , we think for our portfolio we'll see a sort of price reduction of around 20 , 25% or so .

Speaker #3: Now, that's a lot lower than the overall industry. We'll see, because we haven't necessarily participated in quite the same high price points as the inventory average.

Speaker #3: So we will expect prices to come down a little bit at the same time , we will expect our volumes to be broadly neutral , maybe even a little bit positive as we as we grab a little bit more share from the channel .

John Rogers: In terms of the inventory and the portfolio rationalization, we see this as being a really positive thing. You know, we're taking this opportunity to accelerate the rationalization of our product portfolio. It means a circa two-thirds reduction in our Ortho SKU count, a circa 10% reduction in our Sports SKU count. These only represent, you know, in 2026, probably about 7% of our sales. It's a huge number of SKUs representing a very small percentage of our sales, which we will expect over the next 2, 3 years to roll off. This is an opportunity for us to simplify the portfolio, offer our customers our latest products.

Speaker #3: So overall, a sort of 15 to 20% reduction in our revenues. If you work out that on the 200 and drop that through as a margin, that gives you your 20 to 40%.

Speaker #3: Impact on our bottom line that we put in our margin bridge. So there's lots of assumptions that build into that. Lots of uncertainty around that.

Speaker #3: But that's just the basis on which we give the guidance. And we haven't seen anything in the market to date that would contradict that guidance.

Speaker #3: And that's a reasonably broad range, from $20 million to $40 million. In terms of the inventory and the portfolio rationalization, we see this as being a really positive thing.

Speaker #3: You know, this is an, you know, we've taken this opportunity to accelerate the rationalization of our product portfolio. It means that it's circa a two-thirds reduction in our Ortho SKU count, and a circa 10% reduction in our Sports SKU count.

John Rogers: It's very much building on the work that was a portfolio rationalization work that was kicked off at the very beginning of the 12-Point Plan. This is the second wave of that. We're a little bit more focused on trauma. The initial plan was more focused on knees and hips. We see this as being a really positive thing. We don't, by the way, we don't anticipate any further changes. To devoid of doubt, the GBP 159 million charge is just the portfolio rationalizing. We haven't hidden anything else in there. It's simply what it is. We think it's a very positive thing for the business.

Speaker #3: And these only represent , you know , in 2026 , probably about 7% of our sales . So it's a huge number of SKUs representing a very small percentage of our sales , which we will expect to over the next 2 to 3 years to to roll off .

Deepak Nath: Just to reinforce something here, which is we've called out Ortho 360 a couple of times today. We've mentioned that actually on a couple of market days. It's really important to emphasize how we're running this business better than we have historically. Balancing capital deployment, you know, growth and margin to achieve a better balance across those things than we've historically done is an important part of how we operate this business. It's not chasing growth at all costs, but rather to drive the right kind of balance. We've historically been not as disciplined around deploying capital in this business, which has led to some of the challenges around ROIC and inventory that we've seen.

Speaker #3: And this is an opportunity for us to simplify , simplify the portfolio , offer our our customers our latest products . And it's very much building on the work that Failure rationalization work that was kicked off at the very beginning of the 12 point plan .

Speaker #3: This is the second wave of that with a little bit more focus on trauma . The initial plan was more focussed on knees and hips , but we see this as being a really positive thing and we don't , by the way , we don't anticipate any further changes .

Speaker #3: And for the avoidance of doubt, the $159 million charge is just the portfolio rationalization. We haven't—we haven't hidden anything else in there.

Speaker #3: It's simply, simply what it is. But we think it's a very positive thing for the business.

Deepak Nath: It's really important to emphasize that we're operating this business better in a more disciplined way than we historically ever have done. Question here. The last question in the room, and then we go to questions, we go to the phone.

Speaker #1: Just to reinforce something here , which is we've called out ortho 360 , a couple of times today . We've mentioned that actually in a couple of market days , it's really important to emphasize how we're running this business better than we have historically .

Richard Felton: Thank you very much. Richard Felton from Goldman Sachs. 2 questions please, both on shoulders. I think it's 13 or 14 consecutive quarters where REGENETEN has been called out as a strong contributor to growth. Could you help us with roughly how much that product contributes to your Sports Medicine business today? On the AAOS guidance, what does that change in practice? Is it because of that guidance that shifts reimbursement conversations? Does that guidance have a material impact on surgeon behavior? Anything you can help us with to frame how material that shift in guidance is, would be really helpful. The second one, also on shoulders, Deepak, I think you referenced REGENETEN and Integrity addresses a TAM of $1.2 billion. How do you get to that $1.2 billion?

Speaker #1: So, balancing capital deployment, you know, growth, and margin so we achieve a better balance across those things than we've historically done is an important part of how we operate this business.

Speaker #1: It's not chasing growth at all costs But rather to drive the right kind of balance . So we historically been not as disciplined around deploying capital in this business , which has led to some of the some of the challenges around Roe and and inventory that we've seen .

Speaker #1: So it's really important—important to emphasize that we're operating this business better, in a more disciplined way, than historically we ever have done.

Speaker #1: Question here. The last question in the room. And then we go to questions. We go to the phone.

Speaker #2: Thank you very much .

Speaker #6: Richard Watson from Goldman Sachs . Two questions please , both on shoulders . So I think it's 13 or 14 consecutive quarters where regeneration has been called out as a strong contributor to growth , could you help us with roughly how much that product contributes to your sports medicine business today ?

Richard Felton: Is that all rotator cuff? Is it a subset of rotator cuff that are done with bioinductive implants today? Any parameters to provide color around that and how fast it's growing? Thank you.

Deepak Nath: REGENETEN, I think we haven't called out REGENETEN, have we, previously? I need to confirm what we've actually.

Speaker #6: And then on the guidance, what does that—what does that change in practice? Is it because of that guidance that it shifts reimbursement conversations?

Richard Felton: I think we've given some rough guidance. I think you can give.

Deepak Nath: A couple hundred.

Richard Felton: At least range.

Deepak Nath: Think multiple, $100 million.

Richard Felton: Yeah.

Deepak Nath: Okay. I've got to be careful of what I say. Scope. It's a key driver of growth, as you'd rightly note. It's been a fantastic story for us. As we've said, we took a relatively small, when it was launched, when we acquired it, kind of like Integrity, right? Early stages. What we've done is put it into our channel, our commercial sales organization. We've done more, right? We've invested in developing clinical evidence. We've in previous earnings calls, called out the wonderful data that have come out, right? At different time points, one year initially, and then two-year time points in terms of statistically significant reduction in re-tear rates, that we've seen with REGENETEN, right? That's been a great story.

Speaker #6: Does that guidance have a material impact on surgeon behavior? Anything you can help us with to frame how material that shifting guidance is would be really helpful.

Speaker #6: And then the second one, also on shoulders—Deepak, I think you referenced Regeneration & Repair at a time of $1.2 billion. How do you get to that $1.2 billion?

Speaker #6: Is that all rotator cuffs? Is it a subset of rotator cuffs that are done with bio-inductive implants today? Any parameters to provide color around that, and how fast it's growing?

Speaker #6: Thank you . Sure .

Speaker #1: So, regeneration. I don't think we have called that out, have we, previously? So I need to confirm what we've actually—

Speaker #3: I think we've given some rough guidance so you can give a.

Speaker #1: Couple

Speaker #7: Of each .

Speaker #4: So I think

Speaker #1: Multiple 100 million . Okay . So I've got to be careful with what I say . So so it's a key driver of growth as you rightly note , we've it's been a fantastic story for us .

Deepak Nath: It's not only the commercial channel strength, but also the evidence investment that leads to the kind of utilization that we've seen. What the guidance does is actually help surgeons determine the appropriate use. There's different levels of clinical evidence, right? This doesn't. Over time, you'll have this be reimbursed, right? Today, it's part of the kind of the DRG. There's not a specific reimbursement for REGENETEN. What it helps surgeons do is, you know, take all the clinical data they've seen in papers. Now that the society has now come up with guidance on the appropriate use of it's a way to further increase adoption is the way to think about it.

Speaker #1: And as we've said , we took a relatively small when it was launched , when we acquired it kind of like integrity , right .

Speaker #1: Early stages. And what we've done is put it into our channel or commercial sales organization, and we've done more. Right.

Speaker #1: We've invested in developing clinical evidence. We've, in previous earnings calls, called out the wonderful data that have come out at different time points.

Speaker #1: One year initially and then two year time points in terms of statistically significant reduction in retail rates . That we've seen with regeneration , right ?

Speaker #1: So, that's been a great story. So it's not only the commercial channel strength, but also the evidence investment that leads to the kind of utilization that we've seen.

Deepak Nath: The $1.2 billion market is about $875 million of it is mechanical, biomechanical repair, right? It's the sutures and anchors and everything else that goes into repairing the rotator cuff. That's all rotator cuff, Richard. The remaining bit of it is biologics. Within that, we are a large part of that. I mean, there's some other collagen-based implants, but we are the essentially the largest player within that space. You add the two together, $875 million, the balance, you get $1.2 billion. That's the market in which we participate. As I mentioned, when you combine the two together, we're about 1/4 of the market.

Speaker #1: What the guidance does is actually help surgeons determine the appropriate use . So there's different levels of clinical evidence . Right . So this doesn't over time will have this be reimbursed .

Speaker #1: Right. But today it's part of the kind of the DRG. There's not a specific reimbursement for regeneration. What it helps surgeons do is take all the clinical data they've seen in papers.

Speaker #1: Now that the society has now come up with guidance on the appropriate use of it, it's a way to further increase adoption—it's the way to think about it.

Speaker #1: The 1.2 billion market is about 875 million of it is mechanical , biomechanical repair , right . It's the sutures and anchors and everything else that goes into repairing a rotator cuff .

Deepak Nath: The potential we see now with TendonSeam is the ability to actually, you know, have a full solution. Actually now with TendonSeam, a very unique solution, biomechanical repair, right? That allows us to treat even more cases. What is important as I highlighted, is now to include biological healing, right? On top of when the repair is initially done. That's the real helpful part. What we see with TendonSeam is at time zero, right after the procedure, the anchors actually leave the tendon with twice the amount of strength that a traditional repair has. There's some intriguing possibility of faster recovery time for patients coming out of a sling quicker.

Speaker #1: And that's all rotator cuff. Richard, and the remaining bit of it is biologics. And within that, we are a large part of that.

Speaker #1: I mean , there's some other collagen based implants , but we are the the essentially the largest player within that space . So you add the two together , 875 .

Speaker #1: The balance you get 1.2 billion . So and that's the market in which we participate . And as I mentioned , when you combine the two together , we're about a quarter of the market .

Speaker #1: And the potential we see now with tendon seam is the ability to actually, you know, have a full solution—actually now with Tendon Seam, we're a very unique solution for biomechanical repair.

Deepak Nath: There's some great early experience around that that makes us think that this would be a very nice complement to what's out there, right? That's the Sports Medicine part of it. The other exciting thing, just as I reinforce within shoulder, is with AETOS. Right? We are a relatively small player in arthroplasty today within shoulder, but with AETOS, we now have a full solution that's, you know, stemless, short stem, anatomic, reverse anatomic. We've got a full range of implants. In the shoulder anatomy, a handheld form factor is particularly well suited for that anatomy. Robotics is. CORI, with its handheld form factor, is super well suited for that.

Speaker #1: Right. So that allows us to treat even more cases. But what is important, as I highlighted, is now to include biological healing right on top of when the repair is initially done.

Speaker #1: That's the real helpful part . And what we see with tendon seam is at time zero , right after the procedure , the the anchors actually leave the tendon with twice the amount of strength that the traditional repair has .

Speaker #1: So there's some intriguing possibility of faster recovery time for patients coming out of a sling quicker. There's some great early experience around that, which makes us think that this would be a very nice complement to what's out there, right?

Deepak Nath: Just to remind everyone, adoption of robotics in shoulder is very, very early stages today. Right? We see an opportunity now-CORI plus AETOS, where we start to take share within the orthoplasty market and together with the robust portfolio we've got in soft tissue repair within shoulder, we now have what we think is a very, very compelling offering in a fast-growing part of orthopedics. That's all of these different pieces to come together, Richard. Questions over the phone, I'm told.

Speaker #1: So that's the the the sports medicine part of it . The other exciting thing , just as I reinforce within shoulder is , is with Atos , right .

Speaker #1: We are a relatively small player in arthroplasty today within shoulder . But with Atos we now have a full solution that's , you know , stemless short stem anatomic , reverse anatomic .

Speaker #1: So we've got a full range of implants . And in the shoulder anatomy a handheld form factor is particularly well suited for , for , for for for that anatomy .

Speaker #1: So robotics is—and CORI, with its handheld form factor, is super well suited for that. And just to remind everyone, adoption of robotics in shoulders is at very, very early stages today.

Operator: Thank you. To ask a question, please press star followed by one on your telephone keypad now. When preparing to ask your question, please ensure your device is unmuted locally. Our first question comes from Graham Doyle from UBS. Graham, your line is now open. Please go ahead.

Speaker #1: Right . So we see an opportunity now Corrie plus Atos where we start to take share within the arthroplasty market and together with the robust portfolio , we've got in soft tissue repair within shoulder , we now have what we think is a very , very compelling offering in a fast growing part of orthopedics .

Graham Doyle: Morning, guys. Thanks a lot for taking the questions. I just went on skin subs and then on Landmark. On skin subs, the flat volumes assumption, it seems, it's quite a benign assumption versus what we're seeing in the market over the past sort of month and a half. How would you expect that to sort of flow in H1? Would you expect, you know, maybe down 50 plus 50 in H2? Then just on Landmark knee, could you just talk us through how you imagine the ramp would be? Are there things you need to do on inventory or getting people ready for that launch? You know, do the old factors sort of slow down for launch? Do you then ramp up quite quickly?

Speaker #1: That's how all of these different pieces come together. Richard, questions over the phone, I'm told.

Speaker #8: Thank you . To ask a question , please press star , followed by one on your telephone keypad . Now , when preparing to ask your question , please ensure your device is unmuted locally .

Graham Doyle: Just to get a sense when we're modeling that'd be really helpful. Thank you.

Speaker #8: Our first question comes from Graham Doyle from UBS. Graham, your line is now open. Please go ahead.

Deepak Nath: Sure thing, Graham. Let me start off with skin subs and John, maybe you can take the phasing of it, right. In terms of flat volume, and John kind of alluded to it in his remarks earlier. Fundamentally, when you double click, it has to do with parts of our portfolio we're actually seeing growth. OASIS, for example, in our portfolio, we're seeing very significant uptick in volumes and usage and utilization of that product. And price impacts that impact, you know, one or the other parts of the portfolio. In terms of volumes, it's both channels I said earlier, right, where the volumes are quite stable in the surgical channel.

Speaker #9: Morning, guys. Thanks a lot for taking the questions. I just went on Skin Subs and then on Landmark on Skin Subs.

Speaker #9: The flat volumes assumption—it seems it's quite a benign assumption versus what we're seeing in the market over the past month and a half.

Speaker #9: How would you expect that to sort of flow in H1 ? Would you expect , you know , maybe down 50 plus 50 in H2 and then just on landmark Knee , could you just talk us through how you imagine the ramp would be ?

Speaker #9: So is there are there things you need to do on inventory or getting people ready for that launch ? And you know , does the do the old factors sort of slow down the launch ?

Speaker #9: Do you then ramp up quite quickly, just to get a sense of when we're modeling that? That would be really helpful. Thank you.

Deepak Nath: When you look at hospital outpatient physician office and in mobile, the greatest impact actually is in mobile and physician office. Right. In terms of our mix of business, what we're seeing is gains in one area offsetting declines in another, right, as the channel adapts. The net impact of which we'll get to all. As I said, it's still early going yet. In terms of how the channel is responding to it, we're now in the first early stages of physician offices billing, right, from the utilization they've had in the early part of the year, and now in a position to see how CMS is responding in terms of reimbursement.

Speaker #1: Sure thing . Graham . Let me start off with and John , maybe you can take the phasing of it right . So in terms of flat volume and John kind of alluded to it in his in his remarks earlier , fundamentally , when you double click , it has to do with parts of our portfolio .

Speaker #1: We're actually seeing growth. And Oasis, for example, in our portfolio, we're seeing a very significant uptick in volumes and usage and utilization of that product.

Speaker #1: And and , and price impacts that impact one or the other part of the portfolio . So in terms of volumes , it's both channels .

Deepak Nath: That will help inform how the balance of the half goes and how H2 is kind of set up. Anything you want to color to that, John?

Speaker #1: I said earlier , right , where the volumes are quite stable in the surgical channel . And then when you look at hospital outpatient physician office and in mobile , the greatest impact actually is in mobile and physician office , right .

John Rogers: Not really. I mean, Graham, I actually thought we were being quite detailed in the guidance that we were giving for the year as a whole. In terms of the volume impact and the pricing impact, I don't think I want to get drawn into specifically quarter by quarter other than to say, you know, to Deepak's point, it's still working its way through as we speak. I expect half 1 to be a little bit softer, half 2 to be a little bit stronger as the market starts to normalize. I don't think we're going to get drawn on very specific guidance quarter by quarter on skin subs.

Speaker #1: And in terms of our mix of business, what we're seeing is gains in one area offsetting declines in another. Right. As a channel adapts.

Speaker #1: So the the net impact of which will be a draw , as I said , it's still early going yet . So in terms of how the channel is responding to it , we're now in the first early stages of physician offices billing right from the utilization they've had in the early part of the year .

Deepak Nath: Okay, good. In terms of Landmark, this will come in stages. In the second half, think end of Q3, Q4, we'll launch Landmark first on cementless, and then we'll bring forward cemented in the first half of 2027. The focus there is one platform that combines the best of essentially our existing platforms in terms of degree of personalization, ease of implantation, and preserving some of the benefits of kinematics, and the other benefits that we have within our existing portfolio. The other important kind of design considerations around Landmark is tray efficiency. We've brought this thinking in Catalyst CSR and with AETOS, 'cause what we're looking ahead to is ASCs, where space matters, and tray efficiency is super important.

Speaker #1: And now in a position to see how CMS is responding in terms of reimbursement. And that will help inform how the balance of the half, and how H2 is kind of set up.

Speaker #1: Anything you want to add to that?

Speaker #3: Not really . I mean , I mean , Graham , I actually thought we were being quite detailed in the guidance that we were giving for the year as a whole .

Speaker #3: So, in terms of the volume impact and the pricing impact, I don't think I want to get drawn into specifically quarter by quarter.

Speaker #3: Other than to say the defect point. It's still working its way through as we speak. I expect half one to be a little bit softer, half two to be a little bit stronger as the market starts to normalize.

Speaker #3: But I don't think we're going to get drawn on very specific guidance quarter by quarter on skin subs. Okay.

Speaker #4: Good .

Speaker #1: In terms of landmark , this will come in stages . So in the second half think end of Q3 , Q4 will launch landmark first on Cementless and then we'll bring forward cemented in the first half of 2027 , the focus there is one platform that combines the best of essentially our existing platforms in terms of degree of personalization , ease of implantation and preserving some of the benefits of kinematics and and the other benefits that we have within our existing portfolio .

Deepak Nath: We've built that thinking now into Landmark. Not only is it about the designs of the implant itself, but also making the procedure more efficient, you know, more efficient not only in terms of ease of implantation, but also the mechanics of getting through, getting to a case, less capital intensive. Right? Those are the features of Landmark. It also is, comes with Cementless and Cemented and with a medial stabilized kind of paradigm, which is where the market is going. Keep in mind, today, we've got Cementless on the LEGION platform and we don't have this on the JOURNEY platform. Landmark allows us to fill kind of the gap that we've got for JOURNEY today. Right?

Speaker #1: The other important kind of design considerations around landmark is tray efficiency . We've brought this thinking in catalyst stem , and with Atos , because what we're looking ahead to is ASC , where space matters and tray efficiency is is super important .

Deepak Nath: The way we expect to launch, as you know, this will be a build over time. We'll in this back half of the year with the Cementless launch, we'll have the initial foray into this. As we go into the first half of 2027, we'll have both Cemented and Cementless. It'll be the same instruments for Cemented and Cementless, right? Again, keeping that tray efficiency paradigm front and center in what we do. Hopefully that addresses your questions, Graham.

Speaker #1: So we've built that thinking now into landmark . Not only is it about the designs of the implant itself , but also making the procedure more efficient , you know , more efficient , not only in terms of ease of implantation , but also the mechanics of getting through , getting through a case less , less capital intensive .

Speaker #1: Right. So those are the features of Landmark. And it also comes in cementless and cemented options, and with a medial stabilized kind of paradigm, which is where the market is going.

John Rogers: And, and just to, just to-

Deepak Nath: No.

John Rogers: Just to build on the comment that we also made in the presentation, that we're also mindful, we're very mindful as to how we're deploying capital on our existing platforms in the build up to the launch of Landmark in the second half, because we want to make sure that we maintain our capital efficiency we've continued to build over the last couple of years. For that reason, we do expect the first half to be a little bit softer, therefore, on US knees as we grow. The Q1 will be a little bit softer because of the fewer trading day.

Speaker #1: And keep in mind, today we've got cementless on the Legion platform, and we don't have this on the Journey platform. So Landmark allows us to fill the gap that we've got with Journey today.

Speaker #1: Right . And so the way we expect to launch , as you know , this will be a build over time . So we'll in the back half of the year with the Cementless launch , we'll have kind of the initial foray into this .

Speaker #1: And then as we go into the first half of '27, we'll have both cemented and cementless. It'll be the same instruments for cemented and cementless.

John Rogers: We'll expect to see that grow a little bit in Q2. It's really Q3 and Q4 upon the launch of Landmark where we expect to see US knees grow and in line with the market by the end of the year. That's the sort of trajectory we're expecting of US knees.

Speaker #1: Right. So again, keeping that tray efficiency paradigm front and center in what we do. Hopefully that addresses your questions.

Speaker #3: And just to just to build on just to build . Sorry just to build on the comment that we , we also made in the presentation that we're also mindful .

Deepak Nath: This type of capital discipline, again, as part of Ortho 60, we've actually Ortho 360 we've displayed in how we've launched Catalyst CSR. It's very different to how we've done it. You've seen all the growth numbers, right? We are above market now. Again, in Q4 we exceeded the market in US hips, right? As important as that growth is, how we've achieved that is in many ways even more important, 'cause we've brought a high level of capital discipline in terms of how we approach that launch to market. You should expect the same with Landmark. It's a bit more complicated because we've got to straddle... you know, we've got multiple elements of our portfolio and needs that we have to navigate through, but we will strike a better balance in terms of growth, capital deployment, and margin.

Speaker #3: We're very mindful as to how we're deploying capital on our existing platforms in the build-up to the launch of Landmark in the second half, because we want to make sure that we maintain our capital efficiency.

Speaker #3: We continue to build over the last couple of years , and that and for that reason , we do expect the first half to be a little bit softer .

Speaker #3: Therefore , on us knees as we as we grow . So the Q1 will be a little bit softer because of the , the fewer trading day we'll expect to see that grow a little bit in Q2 , but then it's really Q3 and Q4 .

Speaker #3: Upon the launch of Landmark, where we expect to see US knees grow and in line with the market by the end of the year.

Deepak Nath: It's not just growth for the sake of growth, right? Super important to keep in mind. We'll take one more question online, and then we'll come back to the room if there aren't any.

Speaker #3: So that's the sort of trajectory we're expecting on us.

Speaker #1: And .

Speaker #4: This .

Speaker #1: Type of capital discipline . Again , as part of arthroplasty , we've actually three , 60 . We've we've displayed in how we've launched catalyst Stem .

Speaker #1: It's very different to how we've done it. You've seen all of the growth numbers, right? We are above market now. Again, in Q4 we exceeded the market in US hips.

Operator: Thank you. Our next question comes from Kane Flitzkin from Deutsche Bank. Your line is now open. Please go ahead.

Speaker #1: Right. So as important as that growth is, how we've achieved that is in many ways even more important because we've brought a high level of capital discipline in terms of how we approach that, launch the market, and you should expect the same with Landmark.

Kane Flitzkin: Morning, guys. Just on CORI, could you just talk a little bit on the competition you're seeing in the sort of smaller handheld space? We obviously recently had Mako announce their limited market release of their handheld. Just wondering what you're seeing there. Presumably, they're gonna be targeting the same sort of ASC space. Then just on J&J spinning out of its ortho business, I assume are we expecting sort of a bit of disruption in the market over the next sort of year or so due to that split up? If so, what are the sort of challenges and or opportunities you're seeing there? Just finally, I did notice there was a shortage of bone cement in the UK.

Kane Slutzkin: Morning, guys. Just on CORI, could you just talk a little bit on the competition you're seeing in the sort of smaller handheld space? We obviously recently had Mako announce their limited market release of their handheld. Just wondering what you're seeing there. Presumably, they're gonna be targeting the same sort of ASC space. Then just on J&J spinning out of its ortho business, I assume are we expecting sort of a bit of disruption in the market over the next sort of year or so due to that split up? If so, what are the sort of challenges and or opportunities you're seeing there? Just finally, I did notice there was a shortage of bone cement in the UK.

Speaker #1: It's a bit more complicated because we've got to straddle. We've got multiple elements of our portfolio and knees that we have to navigate through.

Speaker #1: But we will strike a better balance in terms of growth, capital deployment, and margin. It's not just growth for the sake of growth, right.

Speaker #1: Super important to to keep in mind . So we'll take one more question online and and then we'll turn come back to the room .

Speaker #1: There aren't any

Kane Flitzkin: I mean, I appreciate UK is probably small in your life nowadays, but yeah, any comments around that? Thanks.

Kane Slutzkin: I mean, I appreciate UK is probably small in your life nowadays, but yeah, any comments around that? Thanks.

Speaker #8: Thank you. Our next question comes from Qin Slutzkin from Deutsche Bank. Your line is now open. Please go ahead.

Deepak Nath: Yeah. CORI, it's important to keep in mind that when we talk about CORI ASCs, we said something like excess of 40% of our placements in 2025 have been in the ASC. It's important to remember that CORI isn't just for the ASC. While it is a handheld robot, fundamentally it's a robot across a whole range of settings, hospitals, ASCs. We've got quite a bit of focus on teaching institutions, and we've got great traction over the last couple of years in terms of the adoption of CORI in teaching institutions. It's important to keep in mind that CORI isn't just a handheld. It's a robotic system that happens to be handheld, right? It has resonance across a range of settings.

Speaker #10: Morning , guys . Just on quarry . Could you just talk a little bit on the competition you're seeing in the sort of smaller handheld space we obviously recently had Mako announced their limited market release of their handheld , so just wondering what you what you're seeing there .

Speaker #10: Presumably they're going to be targeting the same sort of ASC space. And then just on J&J spinning out of it.

Speaker #10: Also business, I assume. Are we expecting sort of a bit of disruption in the market over the next sort of year or so due to that split out?

Speaker #10: And if so , what are the sort of challenges and or opportunities you're seeing there ? And yeah , just finally , I did notice there was a shortage of bone cement in the UK .

Deepak Nath: Therefore, in terms of competition, you know, we feel very, very good about what CORI is, the features and benefits that it's got. It's one platform that can do knees, hips, and shoulders. The type of, kind of features and benefits we've brought on board over the last three years is absolutely impressive in terms of how quickly we've done it. That's the short answer to this. It's a robotic platform that happens to be handheld rather than us competing in one segment. In terms of J&J, look, we've got a very good set of priorities we're executing towards. You know, we feel very good about how competitive we've been in hips and how we've gone from basically lagging the market to when we've got a product, we've launched.

Speaker #10: I mean, I appreciate you guys are probably small in your life nowadays, but yeah. Any comments around that? Thanks.

Speaker #1: Yeah. So first, it's important to keep in mind that when we talk about Corey, ASCs, and we said something like excess of 40% of our placements in '25 have been in the ASC, it's important to remember that Corey isn't just for the ASC.

Speaker #1: And while it is a handheld robot , fundamentally it's a robot across the whole range of settings . Hospitals , ASCs . We've got quite a bit of focus on teaching institutions , and we've got great traction over the last couple of years in terms of the adoption of Corey and teaching institutions .

Speaker #1: So it's important to keep in mind that COREY isn't just a handheld, it's a robotic system that happens to be handheld. Right?

Deepak Nath: We've launched in a very disciplined way, now you see the benefits of that flowing through, not only in terms of growth, but the leverage that we're coming through with that. Trauma, that whole process started earlier on, you know, supply improving and us executing commercially with a great product portfolio of EVOS and now with TRIGEN MAX. We've had multiple quarters now where we've surpassed the market in our trauma and extremities. We expect to do the same with knees, right?

Speaker #1: And it has resonance across a range of settings . So therefore , in terms of competition , you know , we feel very , very good about what Corey is , the features and benefits that it's got .

Speaker #1: It's one platform that can do knees , hips and shoulders . And the type of kind of features and benefits we've brought on board over the last three years is absolutely impressive in terms of how quickly we've done it .

Speaker #1: So that's the short answer to this. It's a robotic platform that happens to be handheld, rather than us competing in one segment.

Deepak Nath: On the launch of a Landmark in the back half of the year, LEGION MS now that we recently brought to market, and of course, continued adoption of CORI, where we've, as we've said, we are pleased with the kind of uptake we've had in competitive accounts with CORI, right? Not to mention the traction in ASC. You put all of these together, we've got a set of priorities. We're executing to those priorities. In terms of J&J, we don't underestimate any competitor, and no matter what kind of they're going through. I believe with continued focus on what we're doing, we will be competitive and increasingly competitive within the market. In terms of shortage of bone cement in the US, as you highlighted, in the UK rather.

Speaker #1: In terms of JNJ . Look , we've got a very good set of priorities . We're executing towards . You know , we feel very good about how competitive we've been in hips and how we've gone from basically lagging the market to when we've got a product we've launched .

Speaker #1: We've launched in a very disciplined way , and now you see the benefits of that flowing through , not only in terms of growth , but the leverage that we're coming through with that trauma , that that whole process started earlier on supply improving and us executing commercially with a great product portfolio with Evos and now with Trigem Max , we're starting to , you know , now starting to we've had multiple quarters now where we've surpassed the market in our trauma and extremities .

Deepak Nath: UK is relatively small proportion of our market. It doesn't fundamentally impact any of our guidance or financially. I do believe now there's a solution in the market in the UK, the market should see some relief from that shortage in bone cement. It doesn't fundamentally impact any of our financials or guidance as a result of it. Thank you. I think that's the time.

Speaker #1: And so we expect to do the same with knees right on the launch of LEGION in the back half of the year. LEGION, miss.

Speaker #1: Now that we recently brought to market and of course , continued adoption of Corey , where we've , as we've said , we're pleased with the kind of uptake we've had in competitive accounts with Corey .

Speaker #1: Right. And not to mention the traction in ASC. You put all of these together, you've got a set of priorities.

Kane Flitzkin: Thanks.

Kane Slutzkin: Thanks.

Deepak Nath: Absolutely, Graham. I think that's all the time we have today. Just wanted to close by saying thank you for being here. Thank you for your time and attention. Just to recap now, 2025 was a very strong year for us of delivery. It marked the successful completion of the three-year 12-Point Plan. We've built momentum across the group, and as we enter 2026, we do so from a position of strength, and we're well aligned with our ambition to deliver the 2028 RISE targets. Looking ahead, what I'm really pleased about is the multiple growth drivers that we have over the next three years, including 2026, and the fact that innovation, just like it's been over the last three years, will continue to be a key to us delivering on targets.

Speaker #1: We're executing to those priorities in terms of J&J . We don't underestimate any competitor . And no matter what kind of they're going through , I believe with continued focus on what we've doing , we will be competitive and increasingly competitive within within the market in terms of shortage of bone cement in the US .

Speaker #1: As you highlighted , the in the UK , rather , UK is a relatively small proportion of our market . It doesn't fundamentally impact any of our guidance or our financially .

Speaker #1: I do believe now there's a solution in the market in the UK, and so the market should see some relief from that.

Speaker #1: Short of, it doesn't fundamentally impact any of our financials or guidance as a result of it. So, thank you. I think that's the time.

Deepak Nath: The investments we've made in R&D so far is starting to bear fruit, will continue to bear fruit. We're now pivoting to stepping up our investments in Sports Medicine and in Advanced Wound Management. That, combined with sharper commercial execution, positions us to accelerate revenue growth as we progress to market leadership in both Sports Medicine and in Advanced Wound Management. In parallel, the positive actions that we've taken in Orthopaedics, together with our focus on group-wide productivity and operational efficiency, will make sure that our top line growth actually translates into sustained trading profit growth as well. A strong cash generation underpins this progress and gives us the flexibility to pursue value-accretive strategic M&A. That will be further reinforcement of our success. We're confident in the year ahead. We look forward to updating you on progress as we through Q1 and beyond.

Speaker #1: Absolutely, Graham. I think that's all the time we have today. So I just wanted to close by saying thank you for being here.

Speaker #1: Thank you for your time and attention . Just to recap now , 2025 was a very strong year for us of delivery . It marked the successful completion of the three year , 12 point plan .

Speaker #1: We've built momentum across the group, and as we enter 2026, we do so from a position of strength, and we are well aligned with our ambition to deliver the 2028 RISE targets.

Speaker #1: So looking ahead , what I'm really pleased about is the multiple growth drivers that we have over the next three years , including 2026 , and the fact that innovation , just like it's been over the last three years , will continue to be a key to us delivering on targets .

Speaker #1: The investments we've made in R&D so far are starting to bear fruit. We'll continue to bear fruit, and we're now pivoting to stepping up our investments in Sports and in Wound.

Deepak Nath: Thank you very much for your time and attention today.

Speaker #1: And that, combined with sharper commercial execution, positions us to accelerate revenue growth as we progress to market leadership in both Sports and in Wound.

Operator: Thank you. This now concludes.

Speaker #1: Care . So in parallel , the positive actions that we've taken in orthopedics , together with our focus on group wide productivity and operational efficiency , will make sure that our top line growth actually translates into sustained trading profit growth as well .

Speaker #1: The strong cash generation underpins this progress and gives us the flexibility to value accretive strategic M&A, and that will be further reinforced as a reinforcement of our success.

Speaker #1: So we're confident in the year ahead, and we look forward to updating you on progress as we go through Q1 and beyond.

Speaker #1: So, thank you very much for your time and attention today.

Q4 2025 Smith & Nephew PLC Earnings Call

Request a DemoDemo

SNN

Smith+Nephew

Earnings