Coloplast A/S (COLOB) Earnings Call Transcript & Summary
August 31, 2022
Earnings Call Speaker Segments
Aleksandra Dimovska
executiveHi, everyone. Welcome to Coloplast. It is really, really great to see so many of you here in person, finally. And a warm welcome also to those of you joining us virtually for the plenary session. I am Alexandra, and I'm heading up the Investor Relations team at the moment. And before we start with the presentations, let me just go through a few verticalities for the day. So for those of you joining us virtually, you can ask your questions on the chat function throughout the whole plenary session. For the rest of you here, we have a very exciting day ahead of us. So after the inner session, there will be a lunch break just outside and after that, in the afternoon, we will split up into 4 groups for the breakout sessions. There are some information on your particular afternoon and how that's going to look like. It's included in the bag you received this morning. So please take a look at that before we go into the breakout sessions. There are also some product stands, as you have already seen. So feel free to drop by and look at some of our products during the lunch break as well. Then I would just add that if you have any questions during the day, feel free to reach out to myself or to Kristine and Margrethe and Otto over there. And on behalf of the Investor Relations team, I wish you a fantastic day ahead. With that, I will hand over to our presenters, our CEO, Kristian Villumsen and CFO, Anders Lonning-Skovgaard. Thank you.
Kristian Villumsen
executiveGood morning. It is a real pleasure that we're able to welcome so many people here at our headquarters in Humlebæk. We've been looking forward to this for a long time. I think the last time we had an event like this in person was back -- it's -- well, 3 years ago, I think, at this stage, in person. So welcome. We will spend some time here upfront just covering where the company is at the moment. And then the way we will play the first section of the day is I'll provide an update on the group strategy. I will hand over, once I'm done with that, after about 20 minutes to Nicolai Buhl Andersen, who looks after innovation in the company. Nicolai will give an update on innovation. And then Nicolai will welcome Caroline Rosenstand, who runs the Voice Respiratory Care business on to the stage. So you get to hear some of the important things that are happening at the company here in the plenary. And then what we've got planned are really 4 different breakouts, in the afternoon, where you will rotate across different topics. I'm sure many of those breakout session will pique your interest, and you have more detail about the things that are going on in the company and also get a chance to meet more of the leaders that run our company. With that, I think we dive into the first topic, which is really Q3. And if you zoom out for a second, I'd say the main message today is we're committed to this Strive25 ambition of 7% to 9% growth. You'll hear me talk about how the momentum is coming back into the company and also committed to an EBIT margin for the period of more than 30%. We are very focused. We'll try and run a company that has sustainable growth over a long time. We are part of a family in Coloplast, where the company has grown every single year for more than 65 years. So there's a legacy really to uphold here and we try with this strategy also to live up to that. If we move to Q3 for a second. We delivered 8% organic growth and an EBIT margin of 30%. And I'm very pleased with that number. On the organic growth side, the big highlight is Ostomy Care. For those of you who dialed in on the conference call, you'll know that we have very strong double-digit growth in the U.S., which, of course, means a lot to us since we have invested for that growth. We've won important places on the U.S. GPOs. We have expanded on the back of that, and we really believe this is the first time that we compete in the U.S. Austin market on an equal footing. Continence Care came in a tad lower at 5%. There's a bit of headwind from back orders and that, Interventional, [indiscernible] double digit, Wound and Skin Care around 5%. So region-wise, Europe is still very strong, and that is both for Chronic Care and for Wound Care, but also Interventional Urology, emerging markets, very strong. And we've had now a prolonged period of strong double-digit growth in our emerging markets region outside of China. And I'd also say U.S. when it comes to Ostomy Care very strong. On the Continence Care side, really, the pattern that we can see is that the patient inflow into the business has reached pre-COVID levels. But that inflow basically has to work its way through the numbers. So we expect that business also to continue to accelerate. I guess that's what I'll say on this chart, I hand over to you, Anders on margin.
Anders Lonning-Skovgaard
executiveYes. So thanks, Kristian, and hi, everybody. I will just talk a little bit to our margin development so far this year. So we delivered an EBIT margin of close to 31% and an EBIT increase of 8%. So that is something we are satisfied with. There are a number of moving parts. So on the gross margin, we actually see a little bit of improvement compared to last year. That is very much due to Atos Medical, so that's a part of our P&L. And Atos Medical is running with a gross margin in the level of 80%. On the more challenging side, we are starting to see the input costs impacting our business. So higher raw materials, higher freight cost and higher energy cost. But at least so far this year, we are a little bit ahead of plan from a gross margin point of view. As you can also see, our distribution costs are increasing quite a bit this year. It's a result of Atos amortization that is now included. It's also a result of our underlying costs, especially within sales and marketing are coming back to more normalized levels. We are starting to travel again. We are starting to have the marketing events, et cetera. So that's also a part of the reason why the distribution costs are increasing. That also includes part of our logistics costs. But overall, we are within our expectations from a margin point of view so far this year. When we look at the full year guidance, so we are maintaining the guidance for the year. So that's an organic growth between 6% and 7%, and a reported growth of around 15%, that includes currencies. So we have a tailwind from currencies this year, especially driven by the dollar, the sterling. And then on top of the currency, we also have the acquired growth from Atos and that is contributing with around 6%. So in total, we are expecting to hit around 15% in terms of reported growth. On the margin side, we are expecting around 31% before special items. And after special items, it's in the level of 28% to 29%. As you might recall, we included special items related to mesh in our second quarter. And also, we have included the integration cost for Atos as well. So in total, around DKK 450 million in special items this year. CapEx end is around DKK 1.2 billion for the year and tax rate, unchanged of around 23%. So that's how we see this financial year. And then we have included a little bit around next year and how we see the main moving parts for '22, '23. As you might recall, we are normally giving -- or we are giving our guidance for next year in November when we announced our Q4 results. But here, I'm giving you a little bit insight to some of the moving parts that we are currently working on. And if I start with the growth, we actually see good momentum across the majority of our business. So our European business is driving growth more than the market, especially driven by the U.K. So I would say we are on plan for Europe. Also, our U.S. chronic is picking up, driven by Ostomy Care. Emerging markets, ex-China, is also delivering a solid growth, solid double digits. That's also my expectation that we will continue to see that. Wound and Skin,, ex-China, is also within our expectations. And the same goes for Interventional Urology and our Voice and Respiratory Care. So many of our sales regions and business areas moving into next year are on plan with our expectations throughout the Strive25. The challenge we are having, that's China, and we have been talking to China many times throughout this year, and we are not expecting any improvements in China until -- or at least not this calendar year. So that's our main challenge and uncertainty moving into next financial year. So that's a little bit on how we see the growth. And then if we take the margin, there's no doubt, we have a lot of uncertainties currently driven by the energy. So energy prices are very volatile. We are hedged for 70% this quarter and the next one. But from '23, we are not hedged. So that also means that we have initiated a lot of activities in order to mitigate some of the challenges. So we have decided to increase prices across the group. We are expecting net price positive next year. We are very prudent on cost, also across the group. We are really evaluating where we're going to invest next year. So we are working on a number of things in order to manage the increased uncertainties that we are currently seeing. And we need to work through this before we guide the market in November. So I'm sure we're going to talk further to this later today, but those are the main moving parts that we are currently looking at for next financial year. So then back to you, Kristian.
Kristian Villumsen
executiveThanks a lot, Anders.
Anders Lonning-Skovgaard
executiveHere we go.
Kristian Villumsen
executiveAll right. So let's dive into the content around group strategy. My main message today is that we're making really good progress on Strive25 and that I'm very pleased with the progress, particularly because the environment that we're operating in has become way more complex than we imagined when we made the strategy. If I start with innovation, the key thing to note today is that the clinical performance program is on track. We are going to see the first major platform launch next year. Two out of 3 programs are moving into what we call the commercialization phase. And we've also done some realized work that talk to the new direction and our new direction for innovation and market development beyond the strategic period. We call this Personalized Care and it fits like hand-in-glove with the type of company that we'd like to build. Of course, one of the big events of this strategic period was the acquisition of Atos Medical. My view is that we've added a high-quality mini Coloplast, it's a chronic care growth compounder. And the key message today is that it is on track and we really like what we see. On the whole, the Chronic Care business is in good shape. Our Chronic Care business is in good shape. We take share across the geographies in which we compete. And the only place where we've really had a significant headwind from COVID is China, and I'll speak more to that later. Interventional Urology has also largely come out of COVID and we are going to show you later today, Steve Blum and [ Tommy ] [indiscernible] here for one of the breakout sessions. We'll also show you what we've got going on the innovation front on the Interventional side. For all of the things that relate to what we call key growth enablers, so all of the important work that we do around efficiency, all of the important work that we do around sustainability and our people agenda, those initiatives are on track. So really the uncertainty that we're left with is the uncertainty that I know thousands of other companies around the world are looking at around inflation, input costs and all of the repercussions of the war in Ukraine. Now I want to start with the kind of company that we are. This company is more than 65 years old, and it was founded on an idea to help someone with an intimate health care need liver better life. Since then, this has been the mission of the company. This is where I start all my quarterly updates to our company. We talk about the people that we help. We show the stories of the people whose lives we change with the work that we do. Today, the company helps millions across the world. We sell our products in more than 140 countries around the world. We have our own subsidiaries in more than 30. But we also know very, very clearly that many, many more millions out there should have access to better products, better technology and better service. And that it's our job to do it. Nobody is going to come around and build better health care standards, it takes somebody who's going to take the fight and that's us. And the wonderful thing about working in a company like that is that the more successful you are, the more you grow, the better the performance of the company, the more you live the mission of the company. And we call this deliver with purpose. This is the single thing in all of the engagement surveys that we do that scores the highest. This is what keeps people in the company that we stand for something fundamentally good. We're also trying to build a company that speaks to where health care needs to go. And we've given it a very lofty title here. We call it the Consumer Healthcare Company of the Future. But I probably don't give any big news away when we think about the macro trends that are happening in health care, and everybody knows that health care is changing. But the implications of that change, we believe, are very, very profound, right? So the demographic pressure that's coming into health care systems across the world, more demanding consumers, the resulting increase in demand, pressure on prices and consolidating channels, that puts pressure on all health care companies around the world. And essentially, all health care systems must answer. A key question is how are you going to meet that increased demand without breaking the bank. And so if you look at demographic projections for places like China, places like South Korea, Japan, all major European markets, we're going to have some decades now where you're going to have generations floating through the health care systems that will be consuming much more health care than we've ever tried before. And what this means is you have to find a different way to meet that demand. If you want all these people to go into a hospital, this thing is going to blow up. And so at the core, what we're trying to do is basically build a company that can take a different role in the care continuum, make sure that people get treated at home, and we basically try and take that role and define it in the care continuum around the patient. So of course, I'm not also giving away anything here. The health care systems are not designed around patients, right? They're designed around disease areas and budgets and things like that. But we try and do this and design it around patients. And it really has these 5 components that we've invested in and that we're going to come back to through the program today that it starts with products, right? For a health care system, to basically reimburse your offering going forward, you must make products that matter. And they must matter clinically and you have to prove it. Nicolai will be back here and talk about where we are on the clinical performance program in the next session but this has been an investment area for the company for the last 4, 5 years, and we will continue to do that. We have also -- ever since we listed our company back in 1983 on the Copenhagen Stock Exchange, invested in building long-term relationships with health care professionals. These are long commitments, ladies and gentlemen, and they're long because their investments in building better health care standards and investing in the gatekeepers of those health care standards. Those are the health care professionals. And we believe there's still going to be the health care -- that's still going to be the gatekeepers going forward. So multi-decade long commitments of partnership. And we continue to do that. It's part of all the work that we do also around innovation. It's not enough to build a great product. You need health care professionals, along with that journey, who use your product, try it out. Ideally try it a lot more, like it, fall in love with it and will become advocates of your brands. But we also know that a lot of the people who have gone through a hospital, gone through a surgery, will be discharged and will have to live with their condition once they get home. So we've invested in building a direct-to-consumer channel building patient support programs in more than 30 countries around the world. By the way, we built every single one of those patient support programs with those health care professionals. And they only did that with us because they trusted us. So those were, again, back to why you want to have long-term commitments and trust. So you really have a particular way of thinking about driving demand in this environment and where increasingly now, you're going to have to prove to the health care system, to the payer, be it private or public, that the role that you're taking in the care continuum is actually worth their money. That requires data and requires investment into digital tools. You will also hear more about that. The company operates in a number of different growth markets that you're all familiar with. The 3 first I'll -- all have the same similar type of chronic characteristics. We are clear market leaders. I'll remind everybody that the existing market size for the Voice and Respiratory Care market does not represent the potential of that business. Of course, the potential of that business is to eliminate the white space that is out there, and you will see much more about how we think about that when Caroline gets up here and talk about the strategy and the lighthouses that we've defined for that business. In the 2 smaller business area of the company for Interventional Urology and Wound Care, we have really good businesses, but they are, if you will, attack at positions. So we have to have a more focused agenda. Now we are investing in developing both of them, and you'll hear Steve and [indiscernible] talk about the moves that we've made into adjacencies for Interventional Urology will roughly double the addressable market for that business. So lots of good things going on, but nothing in our mind that changes the fundamental underlying attractiveness of the growth rates in these markets. So I already said that the key message today is that we're committed to the 7% to 9% and more than 30% EBIT margin for the period. And what I'll do for the rest of the presentation is walk through the different elements of the strategy. I want to start with innovation. I want to start with innovation, and talk about just headings-wise where we are with the clinical performance program because we are now moving into a period of time where we are going to launch. And the first thing that you'll hear more about today is the new catheter platform. Nicolai will reveal both brand name and a lot of the thinking that we have going in on the clinical side and how we take this product to market. We're also very excited about the new digital Ostomy platform. We call it Heylo. We've got good pilots running in the U.K. and Germany. You see some of the data and the customer feedback. And you should think of this not just as 2 pilots for Ostomy -- for a digital Ostomy appliance, but that the company is now building a technology platform where we will use sensor technology at the patient level, and we will build a digital capability around extracting and working with that data that we can play it back to the consumers, the health care professionals and the health care system. So it's much bigger than the 2 pilots. But of course, we don't have anything if we can't make the pilots work and get reimbursement. So that's our focus. And then finally, the new Ostomy platform, we've got positive clinical data. So all in all, good progress, and we're starting to approach a point in time where we're going to launch. We continue to innovate within existing technologies. Right along here a couple of examples. We are in the middle of launching a SpeediCath Flex set, so basically a set version to the Flex portfolio. And we've also launched an updated version to our bowel management offering that we call Peristeen Plus, all of -- both doing well. Nice contribution to organic growth, and we will continue to do that type of work. The 2 examples of options coming into the pipeline are both from the Interventional business and [ Tibial ] is the product name for the technology that we bought from Nine Continents, and I'll allow Steve to talk about that later. But for that and the [ thulium fiber laser ], basically, these are entries through technology and product into new segments that roughly doubles the addressable market size for the Interventional Urology business. So we are really committed to finding more growth in urology. And then you'll also hear in one of the breakout sessions from Christian Bo Petersen, the work that we are doing on what we call market development. This is about building access to technology. And often, this is -- this boils down to whether there's reimbursement or not. Christian will share examples of how we've done that in some markets and also show you how large the portfolio project is that we're working on at this time to build access for more users out there. On the growth side, I already talked about the momentum coming back into the chronic business. I'm really pleased that the, if you will, the growth footprint in the core of the company is very competitive. And to me, it is a -- an enormously important milestone for the company that we're growing strong double digit in Ostomy U.S. after we won Vizient, Premier, and we've done sales force expansion. And we've done a number of things to develop that area of the company and Manu is here, and we'll tell you about how we're thinking about that. And we'll also, I think, give you a good reason to be optimistic that growth is going to come back in Continence Care. Wound Care, solid momentum in Europe. Remember, this is mostly a Europe and China business and Coloplast, of course, hit by China, but really good momentum in Europe around the core product categories. I spoke to Interventional Urology and then Voice and Respiratory Care, I'll say, so far so good. The business is doing well, growing well, and we know what we want to do with it. On the efficiency side, also very good progress. The Global Operations Plan 5. One of the core themes in that strategy is automation. Now I'll just remind you that the job for the operations team is basically to absorb all the growth that's coming out of the company for the first 3 years of the strategy, which corresponds to, if you will, not hiring 1,000 people. Allan will show you more about that. It's also a big milestone for us that we've opened a new site in Costa Rica. This is really about diversification of the network, derisking of the network, the transfer is on plan. And I'm very, very happy that we now have Costa Rica in the network. It has a lot of advantages, not least from a sustainability point of view. And then we still have in the company, and please don't forget that a strong core of scalability. We've invested for 10-plus years to get a unified IT infrastructure that's global. And we've invested also for more than 10 years to build a very strong shared services set up running out of Poland. That provides scalability to the growth. And it continues to do so. So whenever the company is humming away at above 5% growth, scalability sets in. Healthy engagement and on sustainability, actually, we didn't put on here, maybe the most important achievement is that the emissions in the company are going down. So of course, we're growing, but the emissions are going down. We take good progress on waste recycling on the whole, I'm very pleased with how that whole initiative is progressing. Challenges, of course, from the environment. COVID-19, really, it's about China at the moment. And our position really is to wait and see. We've got a very stable organization. We've got a very strong setup, a very highly digital business, well-established, very strong online share, channel share but we're not investing in China at the moment. We're holding our horses. And hopefully, we're going to see some improvement in China, but we are not seeing any signs of that this year. Inflation, Anders already talked to price. We've done a ton of work on price. This year, that we're going to close at the end of September, we're going to be net ASP-positive in the group. And this is a raw price effect, not mix. This is price. And we project, at least, the same for the coming year, a ton of work going into that. And then, of course, in looking ahead, looking at both inflation on raw materials, energy and wages, we are also tightening the belt on the development that we want to see on the operation -- on operating expenses side. One of the things I am particularly proud of is how robust our supply chains have been. Throughout COVID, even in the darkest areas. We've been able to supply. And really, it's only been this last quarter where we've had a bit of a hiccup on our Collecting Devices business that we haven't been able to. You will still see that this quarter, but I expect that we're going to come out of it. You'll also see in our numbers that we have made significant investments in building higher inventory for key raw materials essentially to take risk out and ensuring that we can continue to supply. All things told, we keep guidance for the year of 6% to 7% and an EBIT margin of 31% and say that our long-term guidance, in our view, remains intact. Now -- how about that top line and where is acceleration going to come from? So that 6% to 7% number that you see on the left-hand side, there's a lot of good things happening in that 6% to 7%. The strong Europe in there, the strong EM in there, the strong Interventional Urology, strong Atos Medical, strong U.S. Ostomy. And so really, the acceleration from here to the higher end of this range will come from 4 things. One, we need Continents to come back in the U.S. and I'm optimistic that, that's going to happen by a function of the patients simply coming back into the market at a normal clip. We need innovation to contribute. And then from February, Atos will be part of the organic growth profile of the company. It is growing faster than the group, so it will also contribute. And so the -- if you will, the highest uncertainty at the 4 here right now, we attach to China. So that's really what I had to say to you, ladies and gentlemen. I'd say as the CEO of the company, I'm pleased with where we are. I'm really happy that we're approaching the point in time when we're going to be launching exciting new things into the market that we've been working on for a long time. I'm extremely pleased with the progress of the Atos Medical acquisition. You will hear from Caroline, just what a great business this is. And of course, that the core in the company continues to be healthy and competitive, and we're getting momentum back there. Smaller business areas are doing well. And so really, most of the challenge is coming from the outside world into -- mainly into operations and the gross margin of the company, and that what drives uncertainty. But that was it. Thank you for your attention. And then I'll hand it over to Nicolai, who will talk to innovation.
Nicolai Andersen
executiveThank you, Kristian. Good morning, everybody. As you can see in the slide, my name is Nicolai Buhl. I have been with the company since 2005. And for the last 2 years, been heading up our new unit that we call Innovation. And as you also can see, my session has been titled Innovating Towards Personalized Care because in the next 15 minutes, I would like to give you some insights to where we would like to take the way we think and act around innovation. And of course, as part of that, I will also be doing some double clicking on some of the existing projects we have within the pipeline to show you how we contextualize them under this new theme that we call Personalized Care. But I do know that you would like much more than 15 minutes with me here on stage with regard to the clinical performance program, [ Veronica ] had approached me and said I have so many questions to you. So the good news is that what you can see here is we're going to host a dedicated breakout session. where I'm joined by our new SVP of R&D, [ Anders Lonning ] and Christian Bo Petersen, who is SVP for Payers & Evidence where we going to take you through each of the 3 projects that we are attaching to the clinical performance program, but also give you an update on what we're doing within market development. So 15 minutes now and then much more to come in the breakout. But let's go back to some of the stuff that Kristian also talked about. Why are we here? And I think you are very acquainted with our mission because it's pretty clear. But what is also very clear for us is that even though we have been bringing a lot of new innovation to the market for many decades, we are still seeing that people with [ intimate ] healthcare needs still have many unmet needs. There's a bucket of unmet needs that are related to the fundamental clinical challenges with intimate healthcare. There's also a bucket of challenges that are related to the world being or the mental health of having intimate healthcare. And then last but not least, there's actually a lot of practical issues still attached to using our innovation. That's what we know. What we also know and you know it is that health care is changing. And health care is actually changing pretty fast. Even after COVID, we have seen some pretty big things driving the changes. So some of the shifts that we believe we need to relate to when we talk about innovation, are these 5 buckets you see up here because we believe they are going to shape the future of health care. First of all, we are seeing growing demand that you need to provide health care. They're not just a catering for the physical needs but also the mental and the well-being. So mental health is a big push that is happening right now. Mobile health is also a big push that we are seeing. We are seeing both clinician and consumers requesting that we are providing innovation that delivers basically evidence and data 24/7. Then we also see sustainability. Kristian just mentioned that this is an enterprise theme. Sustainability is also a key theme among our key stakeholders. So of course, they are also pushing and asking for us in terms of delivering innovation that also is taking the right steps in terms of sustainability. And then we also live in a world where everybody now are expecting to be met at their level with their needs and their situation, be it clinicians or be it consumers, they are expecting that we now are able to deliver solutions that fits their individual needs. And then we see a health care system under pressure. A health care system that after COVID actually have been under even bigger pressure. Right now, it's estimated that we are lacking somewhere between 5 million to 7 million nurses. 5 million to 7 million nurses are missing in health care system right now. And we are also seeing a lot of health care system under pressure. So we, of course, need to reflect upon that there's still unmet needs and there still are these significant shift happening. And to us, it means that the way we need to think about innovation needs to be based upon 3 core principles. First of all, we need to make sure that when we think about innovation, we need to think about solutions that is embracing the whole person, and not just parts of the unmet need, we need to take a much more holistic approach. And particularly in our categories, we need to drive our innovation that is enabling self-care. And then as mentioned, what we need to ensure also through our innovation is that we are providing solutions to consumers as well as clinicians that are meeting their personal needs. This whole concept we are calling Personalized Care. So innovating towards Personalized Care. And to be more specific, we believe that if you want to be able to cater better for Personalized Care, you need to make sure that the innovation you bring out not -- are stand-alone. They have to be integrated solutions. We call it an ecosystem of innovation. And if you take those categories we are in, we believe that your innovation needs to have 3 types. First of all, you need to have some very strong core product offerings. Core products that are catering for the key unmet needs. This could be -- since you are [indiscernible] or it could be a speedy cat to our platforms. And then you need to surround your core products with what we call extended solutions that either are supporting the core products in delivering the unmet needs or addressing different unmet needs than your core product. And then as you can see, these types of innovation are also then triggering or potentially triggering services that you then can offer either to the consumers, to the clinicians or even potentially to the payers. So of course, we also need strong service offerings. So this is the way we're going to talk about innovation going forward that for each business area, we need to have an ecosystem of solutions that are catering within these 3 areas. So let's talk a little bit about where we are and how we see our ability to become better in catering for Personalized Care. I think we believe that we have a pretty strong point of departure. We have a very strong innovation, culture and capability in the company. We have strong skills and competencies that makes us distinctly different. As you all know, we continue to invest in innovation. And we have a very strong discipline around how we want to cater for our pipeline and our portfolio with very distinct financial as well as strategic metrics. And we are investing because, of course, we want to expand the value of our pipeline. And as part of that, as you can see here, we are also investing in new competencies and skills. As you all know, we are investing to ramp up our capabilities and skills within the clinical area, but we are also ramping up within our digital areas. In particular, we are also now investing into more skills and competencies towards embedded technologies. And as a consequence of that, we are also ramping up when it comes to our service, capabilities and skills. And as you also will hear, we strongly believe that we also have a lever, which is called market development or market expansion that we would like to do more of. This is also reflected in our pipeline. And the pipeline from now on will be reflected according to this new ecosystem within personalized care, core products, extended solutions and services. So we believe we have a solid existing pipeline of projects that will enable us to deliver more personalized care, but we do also have a long list of things we would like to bring into the pipeline to make sure we expand the value. But as you also can see, since we have launched Strive25 back in October of '20, we have, of course, also launched new products to the market. So let's talk a little bit about some of these launches and Kristian spoke to them. So when we should take 2 examples of 2 new recent launches that has strengthened our position within our core product offerings. As you can see here, we have recently launched Peristeen Plus, which is new and improved and innovative solution for our power management business. And then on the right side, you can see here on your left side, you can see that we also have now expanded our key brand within our IC business, the SpeediCath Flex portfolio, now with a set solution that we are rolling out around the world. One of the things we are extremely excited about is that we soon are going to build and launch a new platform within IC. This will be called Luja And with Luja, we believe we can set a new standard within IC. We believe that Luja is a new generation of IC solutions, and we are very excited about Luja. We're excited because we can see that with Yucca, we are going to address the key [indiscernible] risk factors. As you all know, UTI is one of the key burdens with IC today. And we have actively been able to prove that through a very comprehensive piece of clinical work. And we're going to go into much more details with that during our breakout but we are confident and we are pleased, and we believe with Luja, we can set a new standard. We are going to roll out Luja during the second half of the coming financial year. Now within Extended Solutions. We are also bringing new innovation to the market. And I would like to highlight Heylo. Heylo as you have heard and is actually also being demoed up here if you want to get your hands on experience with it. Also with Heylo, we believe we can set a new standard. We believe we can create a new category of offerings within the OC area with Heylo. Heylo is the world's first leakage detecting system. And we want to create a new category with Heylo. And that's exactly why we also right now are doing clinical trials together with the authorities in Germany and in the U.K. to ensure that we establish this new category for Heylo within the OC area. You will also see much more in the breakout but we are also ensuring that we are doing a proper piece of work when it comes to evidence for Heylo. And so far, we are actually very pleased with the results that we are seeing, both in terms of the feedback we're getting from the clinicians, but most importantly, we can see there is a big demand from the end users to Heylo. Now the third leg. We need to ensure that our ecosystem is standing on our services. We have 2 fundamental service offerings in our company, Coloplast Care for consumers and Coloplast Professional for health care professionals and clinicians. We are, of course, investing in these 2 areas because we want to ensure that our customer engagement is improved and expanded. But secondly, we are, of course, also using these 2 service offerings as a way of reaching out to more. And this is, of course, where the digital opportunities play a critical role. You can also here see a couple of things we have done in terms of strengthening our offering in this space. So this is also a key component when we talk about innovation. Now I took a point of departure in terms of unmet needs among the end users as well as what we are seeing in terms of demands for new innovation among clinicians and health care professionals. But the whole concept about personalized care is also something we can see that the authorities and the payers actually are requesting. Here, there is an example of a recent published piece of research from this Danish Minister of Health, where they actually are exemplifying why a health care system needs more innovation within the space of Personalized Care. So this is not just something we would like to do on behalf of our end users and clinicians, this is also key from a payer point of view. So a summary from my side. Personalized care is the way we want to think and act around innovation going forward. Personalized care means you need to have an ecosystem consisting of these 3 types of innovation, core products, extended solutions and services. As you all know, we are committed to innovation, and we continue to invest in innovation to drive up the value of our pipeline. But of course, we are also super focused on ensuring that things get out of the pipeline. And therefore, we are thrilled and excited and confident around that we now are bringing 2 of our 3 clinical performance projects to the market. But much more details, right, Veronica on these clinical performance programs and the evidence in the breakout. So with that, thank you for your attention. Look forward to the breakout session. And then I would like to welcome Caroline on stage. Thank you very much.
Carolina Vagner Rosenstand
executiveThank you, Nicolai. Thank you. All right. Good morning, everyone. It's good to see you all. For those of you I haven't met before, my name is Caroline, I've been with Coloplast for 7 years. Started up with heading up our Corporate Strategy and Development team, moved to the U.S., work with the Chronic business, work with Interventional Urology, a couple of years in our emerging market regions. And then from February this year, have been heading up Atos Medical. So here we go. Overall, we can confirm the rationale behind the acquisition of Atos Medical. We see a strong strategic fit. Atos Medical is a strong chronic business with category leadership and also extremely strong relationships with our consumers through our DTC, our direct-to-consumers channel and health care professionals. We can also confirm the growth ambition of 8% to 10%, with high single digits to low double-digit growth for the laryngectomy business area and mid-single digits for tracheostomy. Integration is progressing as planned. We are tapping into the good and strong infrastructure of Coloplast, where it makes sense and also tapping into the capabilities and competencies that Coloplast has. And that, by the way, also goes the other way, Coloplast tapping into Atos. Key people have been retained, both in my leadership team but also generally in the organization. Before we get into the details of the strategy and the company and everything, let's start with what business is all about the patients. So in the movie that I'm just about to show, you will see Morten. Morten got a total laryngectomy back in 2020 and is today one of our Provox life users. So enjoy. [Presentation]
Carolina Vagner Rosenstand
executiveVery inspirational movie, if you ask me. So let's take a look at the numbers before we dive into the details. We have historically delivered around 8% organic growth, very much driven by the laryngectomy business area, obviously. You can see that in 2021, tracheostomy is partly -- the numbers of tracheostomy's partly reflecting the acquisition of Tracoe that was done quite late in the calendar year last year. So the split of the 80/20 between tracheostomy and laryngectomy is also going to be slightly increased from the tracheostomy when we reflect the full year effect of Tracoe in those numbers. Europe is really our home turf. That's where we started. That's where we have good penetration, which means that we have a lot of potential to go for outside of Europe. D2C or the direct-to-consumer is a key channel for us within the laryngectomy business area, it's about half of all our sales that we sell directly to the patient or the end user. Good. So -- some of you may be familiar with our strategy called Living Well, which we are executing on. In addition to that, we have identified 4 strategic lighthouses that goes beyond the 2025 time horizon and they can also help to supercharge the strategy. So we have 2 for lary, 1 for trach -- 2 for laryngectomy, 1 for tracheostomy and 1 for people and culture. The first one for lary is about eliminating white space. And by white space, I mean that today, there are a lot of patients worldwide who do not have access to our products or who do not use our products compliantly. So this is very much about rolling out the model that we already have to perfection, to make sure that everybody have access, and that they use products compliantly. Designing our future user ecosystem is about combining already existing elements that we have across products, services, support, digital into a more cohesive experience. By experience, I mean, the experience at a health care professional or end user have when interacting with Atos. This is what we'll do in the short term. But longer term, this is also where the more radical moves would be. So for instance, the ambition should be that you're standing in front of a person who has gotten the total laryngectomy but you're not able to see it. There's nothing coming out of the neck, and you're not allowed -- and you're not able to hear it on the voice either. So that's a nice ambition to pursue. Third lighthouse is about tracheostomy. We already have a good tracheostomy business today. We want to grow and develop that even further by tapping into those chronic and community elements that we see in the tracheostomy market, but that today are very much underpenetrated and underdeveloped. So this is work that's ongoing and where we will be merging elements of the laryngectomy model with the tracheostomy model to create something that's uniquely tailored for the tracheostomy market. Last but not least, we have a good growth culture in Atos. We want to protect and preserve that while also adding in new elements that will allow us to execute on the strategic lighthouses going forward. So today, I'll be talking about the first and the third lighthouse in a bit more details on the following slides. But first, let's just take a step back and talk about what laryngectomy actually is. So if you get a total laryngectomy, it's an irreversible procedure. You're cutting off your upper and your lower airways and you're removing your voice box. This will impact the way that you are smelling, speaking, swallowing, breathing and talking because now you no longer breathe through your nose in your mouth, you breezed through an opening in your neck called stoma. You typically get a total laryngectomy as a consequence of having laryngeal or hypopharyngeal cancer. And there are about 50,000 total laryngectomy procedures done on a global scale every year. We see that number to be flat to slightly increasing. It is slightly decreasing in developed markets, but slightly increasing in developing markets. There is a very high correlation with alcohol consumption and smoking to getting these types of cancers. About 1/3 of these 50,000 annual total [ [ laryngectomies ] have access to proper care. The rest are with our products or services to support. The life expectancy is 8 to 10 years, can vary quite a lot. So we estimate that the total community base out there, the patient group is about 250,000 patients globally. And about half of these are in the markets where we are present today. Patient value is about DKK 20,000 to DKK 30,000 in developed markets, but it does vary quite a lot. Even in developed markets, you can have countries like the Netherlands, where it's closer to DKK 50,000 but you can also have countries where it's a lot lower. And in developing market, it typically also is a lot lower. So let's move to the products. broader a few here, and there's also a booth outside where you can take a look. The first bucket, the heat and moisture exchangers. So this is -- this is actually your nose because if you're cutting off your airways and you no longer breath through your nose and your mouth, the air goes directly without any filtration, humidification or heating directly into your lungs from here. And that's not good for your pulmonary health. It creates a lot of mucus. It creates secretion and you increase your probability or your risk of catching pneumonia. So that's why you use this one, which humidifies and heats the air before it passes into your lungs to increase your pulmonary health. You attach the HME to an adhesive. So you put the adhesive over your stoma and you attach the HME to it, and then you're good to go. You'll do that -- recommended use 3 to 4x per -- or 3 to 4 [indiscernible] per day and 1 to 2 adhesive per day. Then you have your -- the voice prosthesis, which is this tiny thing that you probably can see much better out there. Basically, this is a one-way valve that is placed just below where your voice box used to be, creating a passage from your trachea to your esophagus or your wind pipe to your food pipe. So allowing air to breathe -- to flow from your lungs through the one-way valve, up into your esophagus, and then you can be trained to get your esophagus to vibrate and thereby creating sound and speak. So before, you used to have your voice box, which is approximately the size of my hand, that would vibrate, create sound, you speak. Now you have the small device to help you speak. So pretty cool invention. Then we also have various types of accessories. It can be products that you use when you are applying or removing your adhesive. It can be laryngeal tubes and it can be a couple of other things as well. So that's sort of the main products that we're using. I should mention that the voice prosthesis, you change that 3 to 4 times per year in a hospital setting. You don't do that at home. Good. So we -- looking at the first lighthouse, eliminating white space. Today, we estimate that the market value is about DKK 1 billion to DKK 1.5 billion, growing around 10%. We have about 80% market share. We have the 80% market share because basically, we're the ones who have developed most of the markets from scratch from basically nothing. That also explains the discrepancy between the 10% growth that we have seen historically and the [ flats ] or the stagnant to slightly increasing number of total laryngectomies per year, 50,000 because the growth comes from continuously penetrating the white space, opening up new markets, ensuring compliance and so on. And -- but why do we see this big white space out there? Well, there are 3 primary reasons for that. First of all, there's a lack of clinical standards. Nobody knows about this, really, in particular, in countries outside Northern Europe. They tend to be very, very low knowledge. Patients are not compliant in their use. And then there's a general lack of reimbursement in most developing markets. So there's a lot of opportunity here to tap into. So these are some of the things that we will focus on, and I'll dive into each of these on the following slides. But to eliminate the white space, we, first of all, we need to really focus on building the markets by setting the clinical standards and by increasing penetration, basically in all markets, to be honest, but in particular, outside Northern Europe, U.S. is a really good example of that. We need to increase compliance in all markets. And we will continuously open and develop new markets, just as we've done recently in Brazil, South Korea and what we're currently processing of doing in China. When we look across our markets, there's very high difference to the level of penetration that we see. So in certain Northern European markets, like the Netherlands, Germany, we see very, very high penetration. It's between maybe 95% and 100%. Just going a bit south, it's half, it's half of that. Going to the U.S., you take another slice out. Going to Rest of World, here is other markets where [indiscernible] are present where you take another slice out. So there's a lot to do here with penetrating these markets that we're already in today. You need to work with multiple stakeholders to do that. Some of the most important ones are health care professionals and KOLs. If you don't have their support, it's going to be really, really difficult to set the clinical standard. And we have a very long tradition and history of working closely with KOLs and HCPs. One example could be NKI, the National Cancer Institute of the Netherlands that we worked with ever since we created the first voice prosthesis together in 1990, so more than 30 years. We continue to work with them every year on new products. Some of you have probably also read the Gemelli study that came out this spring about Provox Life. That's another example of us working with these institutions and KOLs. We work very, very closely with health care professionals in all our markets. We have a digital Atos Learning Institute, where last year, we saw more than 1,500 HCPs participate in that, in webinars, guest lectures, knowledge sharing sessions and so on. So really a good community. If it's something that was founded during COVID, but we decided to keep it because it creates so much engagement and really good knowledge sharing. Patients and patient associations. I already mentioned that we are very, very close to our patients through our D2C channel. We, in most of our markets, work with what we call patient ambassadors, which are [ laryngectomy ] themselves who go out and train people who have just gotten a total laryngectomy. Talk about how to live their life afterwards and what they can do, tips and tricks, but they are also used to advocate for better care in a more structured way. We work very closely with patient associations. A lot of our patients because it's a smaller group of people need some really strong associations behind them. So in all our markets, we team up with the patients associations to advocate for better care. It could be Lary's Speakeasy, WebWhispers, or the NALC, which are a couple of the groups that we're working with in the U.S. and U.K. And then obviously, payers and governments are extremely important to get reimbursement. It's very, very difficult to penetrate a market if you do not have a reimbursement. So these are more data-driven and data-driven dialogues where you focus very much in the clinical evidence and the advantages, the benefits that you can bring to both patients, but also the payers themselves by using our products and services. An example of this was the reimbursement improvement that we saw in Norway last year as just before launching Provox Life, where we had a really good dialogue with the Norwegian authorities around the clinical benefits of the new products. Once you have access, you want to work with compliance. So as I previously said, 2 to 3 HMEs per day, recommended use, and 1 to 2 adhesives. That's sort of is the current recommended use. A key driver for compliance is the Provox Life launch. It was launched 2 years ago. We are now live in 14 markets with the products and are continuously adding more products as well, our markets as well. So we have launched Provox Life at a price premium in the markets where we have gone in. And we've been able to do that because we have really good clinical evidence about the superiority of Provox Life compared to legacy products. We're able to improve better humidification and better breathability, which are really 2 key parameters to track when you want to improve your pulmonary health. We also have the Gemelli study that I previously mentioned, which is a randomized crossover study of 40 patients. And in that, we were able to approve 36% -- 36% reduction in forced coughing, a 26% reduction in the number of days where the HMEs had to be removed for the patient to catch their breath, and a 39% reduction in average number of days with skin irritation. So really good results behind the Provox launch Life -- Provox Life launch, sorry. Another strength of Provox Life is that it opens up for situational use. So I'm going to use an analogy, shoes. You have different shoes for different situations. If you're at home, you want comfortable shoes, maybe you just wear socks. That's the same for the HME for Provox Life. You use your home HME, which has good breathability but -- and a very high humidification as well. At the other end of the spectrum, if you want to go running, then you put on your running shoes to maximize your performance and run even faster. If you want to go out and exercise when you use our products, you put on the energy HME, which is really optimized for breathability, very high breathability but then lower humidification. If you go into a construction site, you tend to wear your safety shoes. That's the same. If you wear an HME, you go into a dangerous environment. It could be COVID, pollen, [indiscernible] anything like that. You put on, you protect HME to protect your lungs. And at night, you just really want to be comfortable, here you put on your night HME, which ensures maximum humidification so that your lungs can restitute, recover from the day and be ready for a new day tomorrow, just like the rest of your body needs to be. So you can see that for -- when you have all these different situations, and you change your HME for this specific situation, you also increase compliance because most of us -- most people, they don't sit just at home all day and they go out or, at least, at one point in time, they sleep. So this is a really good way also to increase compliance. We also have the adhesives where you have different situations. You could have the night, which is very easy for the skin to breathe through the -- from -- breath through the adhesive. You can also have stability that many people tend to use when they speak hands-free where there is more pressure on the adhesive. So the combination of this increased price that we've generated at launch and also the increased compliance means that the overall patient value has seen a nice uptake with the launch of Provox Life. A fair -- well, actually, a bit more than half of all the patients in the countries where we've launched Provox Life have tried Provox Life and we're also sort of continuously tracking how many times does the patient order Provox Life so that we know when is the patient converted because you're not converted, if you just try it once. You have to try it, you have to order it a couple of times before we sort of say that, yes, now this person is a Provox Life user. And that trajectory is turning out really great. We talked a lot about existing markets. Let's move to some of the newer markets. In Atos, we work with having a continuous funnel of new markets that we move through the maturity curve sort of going from distributor to some sort of hybrid model to a subsidiary. So that we, all the time, have new markets that we can enter and that we can further develop. And some of the recent successes that we've seen on the reimbursement front has been South Korea, Brazil and Japan, where we've either seen reimbursement for the first time we've seen an improved reimbursement compared to what used to be. China is a really big opportunity, obviously. It's about 1/5 of both new and total laryngectomies. So there's a big market out there. But today, there are no products, no clinical guidelines, no treatments. So we're basically starting from scratch, right? We have gotten product registration on the HMEs, the heat moisture exchangers and the adhesives. We're doing the clinical trials on the voice prosthesis and the process to get the voice prosthesis is also pressing according to plan. Once we have the product registered, the real work begins, right? We will work very closely to the hospitals where we're doing the clinical studies today to develop a playbook for how to do [ lary ] in China because China is, obviously, a specific and different market with different drivers, and we need to make sure that we get the absolute right model before we scale it. So we'll work with the key hospitals first, roll it out to other key hospitals in Tier 1 cities, [indiscernible] 2 and so on. So good potential, but also a lot of work ahead of us to get this right. But all of this -- these new markets have in common is that you need to work with multiple stakeholders in order to get to where you are, where you have reimbursement and you can start penetrating the markets. KOL, HCPs, absolute key, as I mentioned before as well. But you also need to work with Ministry of Health, governments, patients, patients association, industry associations, embassy, church, conferences, everything basically. And this is where we see a really good advantage of tapping into the great market access and market development capabilities that Coloplast has. We're already working together, for instance, in Poland and in China on some very concrete initiatives. So this is a real benefit for us as well. So to sum up on the first strategic lighthouse about eliminating white space. Lots of potential, a lot of good opportunities, and we basically know what to do to unlock it. Let's jump to tracheostomy. So the -- getting a total laryngectomy is irreversible procedure, a tracheostomy is a reversible procedure because your airways are intact. Your voice box is not removed, but you do have an opening in your neck, the stoma, that you breathe through. So they are also similarities, obviously. There can be multiple reasons why you get a tracheostomy. It can be trauma, an accident, be it cancer, swelling, infection, blocked airways, be it neurological, can be coma. So there's just a lot of reasons why you get a tracheostomy. That's why the number of tracheostomy has done for years is also a lot higher. It's about 1 million. Most of the tracheostomies are temporary, meaning up to 6 months. That's about 2/3, about 1/3 are long term or even permanent. So there is a lot of -- the patient pool is a lot more complex. We have people just being on the track for a short period of time versus people who live with it chronically or the rest of their lives. So in Atos, we have, for a long time, been debating are we in, or are we out in tracheostomy, but with the acquisition of Tracoe, we are firmly in. We also now have a 10% market share. So this is very much today, a B2B business, sold into the hospitals. The community segment, the chronic segment is highly undeveloped. It's not a focus area. So that means that also, it just is a big opportunity of tapping into the business model that we have on laryngectomy and the Coloplast also have to tap into this attractive segment of the chronic patients. So looking at the products. Tubes are the vast majority of sales, 60%. And that's simply due to the fact that you need a tube to have a [ track ]. If you remove your tube, your [indiscernible], you're not able to breathe. So there's 100% penetration of tubes when you have a Tracoe. HMEs, heat moisture exchangers on the other hand, very little penetration. But it's just as important for a tracheostomy for their pulmonary health to have an HME as it is for a laryngectomy because you need the air to be heated, filtered and moisture it before -- and humidify it before it reaches your lungs. So this is a big opportunity of setting that clinical standard of using HMEs as well. Then you have a number of accessories, speaking devices and so on that are also used for laryngectomies. For trach, we have currently 2 focus areas, integration of Tracoe that was acquired last year and then developing this new business model for tracheostomy that I've been talking about a bit. The integration of Tracoe is progressing according to plan. It's about integrating the Tracoe [indiscernible] into Europe entities into Atos. And it's also about forward integration in the markets where some of the markets where Atos have a subsidiary, but Tracoe have used distributors in the past, then we can take the distribution in-house. So developing the new tracheostomy business model is really interesting work because here, we're diving deep into the underlying drivers and the structures of the tracheostomy market to try to understand what should our business model look like, in order to serve these patients in the best possible way. Yes, there are similarities between laryngectomy and tracheostomies. But for a tracheostomy, you typically have a number of other comorbidities. Your health is either stagnant or declining. You also just really hope that this track, the tracheostomy that you have that is just temporary. You basically just want to get rid of it, right? You don't hope that you have it for the rest of your life. So there's not a lot of incentive for the patient upfront to really learn how to master having a track. On the hospital setting, you -- we see a lack of established clinical standards, and we also see that the expertise is spread out across the hospital. There are no sort of real centers of knowledge around this. So it would be naive just to say, "Hey, let's to take the [ lary ] model and put on top of track and then we have a good business model." I don't think that will work. But that doesn't mean that we should not take all the great elements of the existing DTC and chronic community lary model and incorporate that into the future tracheostomy business model. That has a lot of potential, a lot of complexity, but also just a lot of fun to do. So with that, I think we're off to a good start. We're well-positioned to execute on our strategic priorities, and we have identified numerous good opportunities and value pools that we can unlock. We have developed our 4 strategic lighthouses that will help us unlock them. And by that, we are happy to confirm or reconfirm the financial ambition of 8% to 10% organic growth per annum and mid-30s EBITDA margins. So I'll see you all in the breakout. But for now, I think we should open up for questions.
Aleksandra Dimovska
executiveThank you all. So now we're in the Q&A session. And for those of you in the room, please raise your hand and also we'll come with a microphone. I can see Martin already had a question.
Unknown Analyst
analystMartin [indiscernible] from ABG. Just I think it's for Anders and Kristian, just on the Strive25 plan. First, on the -- you were very kind to show this bridge for organic growth, and there was nothing on the margin bridge, and I understand that's [indiscernible] because you don't really know how to make it because it's so uncertain, but maybe you can share some thoughts on it anyway. And then just on the margin, we all maybe remember, at least some of us remember that when you reduced your margin back 5 or 6 years ago, because you want to invest more in organic growth initiatives, and you thought that margin guidance was inhibiting for you for doing that. Are we in the same situation now? Because now you don't mention anything about the 2 percentage point investing in additional growth initiatives. Are you now sacrificing that and we are back to the same situation back then, where you had to invest less in order to keep your guidance for the equity market.
Kristian Villumsen
executiveWhy I don't want to speak to the latter part of that question and then you can speak to the margin bridge. I think that's a great question, Martin. When you run a company, you run into something like what's happening in the outside world now. Of course, you aren't faced with more uncertainty than normal, right? And so there are some things that we think are just pretty straightforward to do and just common sense, right? So if you've got a Chinese market that's largely shut down, there's no growth in it. We're not going to invest. So we can't get people out there, we would not be able to get paid back. And then when it comes to all the other things that we would typically invest in, where it be innovation. U.S., it will be EM and Europe, different things, digital, all the other things that we've invested in to drive growth. I think our line of reasoning at the moment is we've invested quite a bit on pretty much all of those fronts. We're starting to see some payback, we hope on the investments that we've made in the U.S., but we also want to see continents come back, right? On innovation, we have now for 5 years, invested more over a single year. We are now moving -- you're going to hear more about this in the afternoon. We've got a couple of platforms that are moving into the market. Of course, we need to manage this in a way that we still have new things that come in, but we think there's a decent balance to be struck. And then if I look at investments going into Europe and going into EM, I'd say probably, right now, we are a little conservative with how we guide for that investment, and we want to have some -- basically some more miles behind us. But of course, that cannot persist and we don't believe this is going to persist. So at the high level, we will continue to invest in the business. But where we are right now, we're a little more conservative. And we think we're okay given what we've already invested in.
Anders Lonning-Skovgaard
executiveAnswer to the first question, I already talked to the moving parts in the opening. And yes, we see more uncertainties short term as a consequence of the higher electricity prices, the higher raw material prices, higher inflation. And that's also why we are working on our cost base. We are becoming more prudent moving into next year. We are double-clicking on the investment and the commercial activities we are going to do. And then we have focused a lot on the pricing. So we are going to see a higher -- or a positive impact from higher price increases also next year, under the assumption we are not going to have health care reforms. So we are working on a number of initiatives, but there's no doubt there is also. [Audio Gap] commit to the 30% EBIT margin.
Aleksandra Dimovska
executiveQuestion. [indiscernible] go ahead.
Veronika Dubajova
analystVeronika Dubajova from Citi. Two for me, please. Maybe just a follow-on on the financial midterm guidance. And I guess, a 2-parter. One, as you think about that 7% to 9% growth, should we think of this as accelerating through the period, so that we're ending up at 9% in 2025, but at 7% in the short term? That was sort of my impression from what you talked about, Kristian, but you can give some color to that.
Kristian Villumsen
executiveWe're closing a year of what we're going to do between 6% to 7% growth. And so to get to the higher end of that range, we have to accelerate. And what we -- I just wanted to illustrate with that chart is that the 4 key accelerators are U.S., China, innovation and Atos. So everything else, when we look at where are the other businesses at the moment, we think are in relatively healthy condition and contributing as they should. These are the 4 as where we would want to see acceleration and get to the high end of the range.
Veronika Dubajova
analystOkay. And then Anders, is it fair to interpret your last statement is you're committed to 30% margin every year through the Strive25 period?
Anders Lonning-Skovgaard
executiveSo rank, as I said earlier, we are seeing more headwinds in next year, 22%, 23%. So high energy prices, inflation, all the things I mentioned. So what I'm saying is that we're committed to the 30% over the period. That's what we are focusing on. The specific guidance for next year will be announced when we come out with our full year results in November.
Veronika Dubajova
analystOkay. Understood. And then maybe a bigger picture question, obviously, with some of the Atos initiatives, Kristian, curious how you're thinking about the size of the organization. Do all the pieces make sense that sit in it, and your desire to remain in the less chronic carry type of businesses.
Kristian Villumsen
executiveAre you thinking about the portfolio overall in the different businesses? Well, I mean, if the business and the portfolio need to contribute to the performance of the company. And clearly, I mean, if you -- at the high level, if you think about what are the similarities between an Ostomy Care, Continence Care and a Voice and Respiratory Care business, there are many more similarities between those 3 businesses than between any of them in an Interventional Urology business. I still think the Interventional Urology business makes a ton of sense in the portfolio. We're doing a lot of great things for that business that you'll see in the afternoon. But of course, we have strong capabilities around running Chronic Care businesses that we can leverage. We've chosen, as a very explicit decision, Veronika. We run this as voice respiratory care as a stand-alone unit. So we are integrated globally only when it comes to regulatory, quality, legal, finance and things like that, IT, of course. But we want a dedicated organization that when people in that team wake up in the morning, these are the patients they care about and that they serve. And so the growth is the priority. And we think getting that set up in a way where we continue to get momentum on lary. And we find out what the model should be around tracheostomy. The tracheostomy opportunity for many is a little counter-intuitive. And so if you just have a [indiscernible] look at the - I mean selling tubes into a hospital isn't that exciting, right? But it looks a lot like what you would find, if you looked at the catheter market that is now -- has been a nice growth business for our company for 35 years. If you look at what's going on with that category in a hospital, same thing. So we have to find the model where we can, if you will, extract the annuity effect and serve people once they leave the hospital.
Aleksandra Dimovska
executiveLet's continue with Oliver.
Oliver Metzger
analystIt's Oliver Metzger from ODDO BHF. First question on your cost station and you described as you are prudent. For the past decade, at the end, you always acted quite prudent. And if you look at the current situation, so for incremental cost savings, there is a trade-off between you don't invest in certain growth areas because you see them as less profitable? Or is it just a pure cost-cutting focus? So that's number one. Number two is on a comment on the channel consolidation. So you mentioned in your prepared slides with some mixed effects. Some years ago, it was a big topic. Now basically, you haven't talked a lot about that. Potentially, you could just remind how the current situation is. Is there any incremental pressure compared to the states some years ago?
Kristian Villumsen
executiveLet me just take the latter one. First, I'd say no. So the status of where the channels are, by and large, if you just go back a couple of years, no, it hasn't changed a lot. I'm talking about, if you will, in my presentation, just if you -- a tectonic shift in health care. That to basically get paid as a distributor in an environment where prices are going down, you have to become larger to make a profit. And -- or become forward-integrated with a manufacturer. That's, of course, also a solution, but we've not seen big shifts last 24 months.
Anders Lonning-Skovgaard
executiveIn terms of your first question around how we work with the cost base. Please remember this financial year, our cost is increasing more than the reported growth. So this year, we are investing quite a bit into the business. We have also, you can say, come back to more normal levels in terms of the travel, marketing events, et cetera. For next year, that's definitely something we will look further into. That's one thing. We will also be looking further into making sure that we get the savings out of the efficiency programs we are running. So we are running a big efficiency program within Global Operations Plan 5. That is to be finalized for next year. We're also working on getting the synergies out of the Atos acquisition. So there are a number of areas that we are really focusing on as part of managing our costs in an efficient way. And then you have the investments. And as Kristian mentioned earlier, we have invested a lot in the first couple of years of the Strive25. We have invested a lot into the U.S. We have invested into selected emerging markets innovation, et cetera. So we also are expecting that those investments are starting to give a return. So that's some of the examples of the things we're working on as we have more uncertainties due to the input cost increases.
Aleksandra Dimovska
executiveI think let's continue with the gentleman over there.
David Adlington
analystDavid Adlington, JPMorgan. Just with respect to the pricing environment. Obviously, you gave us 7% to 9% growth target some years ago, but that was probably with a 1 percentage point down in price every year. You're now looking at -- I'm guessing low single-digit increases. How should we think about that influencing that 7% to 9%? Is there an offset in terms of maybe China that you're giving at 7% to 9% with a more positive pricing environment?
Kristian Villumsen
executiveWell, so the way we work with this in the group is that we're really talking about a large portfolio of initiatives. So there's both initiatives that are around doing things with reimbursement and getting inflationary mechanisms and thought that we do together with industry associations, lots of tactical things happening. So we literally run 70-plus types of initiatives around the group. Of course, China is a drag on growth right now, right? So if -- normally, we would have a Chinese business that will contribute DKK 100 million to DKK 150 million every year in growth and has been doing that quite consistently. And price will compensate for some of that. But of course, we also have the pressure on the gross margin. But the -- what we're saying is that we are going to close this year, net ASP-positive. We typically tell you guys that we're up to 100 basis points negative. And we expect the same thing to occur next year unless we get confronted with the significant health care reform somewhere. We don't have any visibility to that at the moment.
David Adlington
analystJust on the pricing. Is that purely on the reimbursement side? Or are you increasing pricing to your distributors as well?
Kristian Villumsen
executiveBoth.
Aleksandra Dimovska
executiveSo the questions from the chat are very similar. So let's continue with the room.
Hassan Al-Wakeel
analystHassan Al-Wakeel from Barclays. I have 2, please. So firstly, could you talk a bit about how you think about reimbursement when it comes to Heylo and to what extent you think this data validates the required step change in cost? And how are initial discussions with payers trending? And then secondly, maybe a follow-up on costs. What is the margin impact from higher electricity costs based on current spot prices, assuming no hedging next year? And just to be absolutely clear, could you rule out margins being below the midterm guide in FY '23?
Kristian Villumsen
executiveNicolai, you want to talk the investment?
Nicolai Andersen
executiveSure. So first of all, thanks for the question. We will actually be speaking into this topic also during the breakout. But nonetheless, let's also elaborate upon it here. So first of all, as mentioned, we would like to establish a new category with Heylo. And that, of course, means that we're working with the authorities in U.K. and Germany right now. We cannot at this point, talk to specific levels of price. But of course, we are a company that operates with reimbursed products. So clearly, we are also, as you can see, investing quite substantially to get to where we would like to get, in terms of getting a new category and relevant pricing. And the results we are seeing, we believe, are confirming that our ambitions can materialize. Of course, we still have the final negotiations once we have concluded the data and the studies. But we remain confident that we can create a new category with Heylo.
Kristian Villumsen
executiveAll right, Nicolai. Then in terms of your second and third question, Hassan. So you -- I think the second question was around the energy prices and the current spot rates. Yes, there is a lot of volatility currently and the energy prices are significantly up. And as I said earlier, we are not hedged from '23 and onwards. So that is giving us a significant headwind of more than 1 percentage point given the current levels. But again, the volatility is high. In terms of your second -- or the third question, so I have -- I mentioned it earlier that over the period, we are, you can say, committed to the 30%, but we are seeing short-term challenges, energy, as I just mentioned. So that's how we see it.
Aleksandra Dimovska
executiveGood. So I think that's all we have time for in the plenary session. But you will have Anders, Caroline and Nicolai also in the breakout session, so you will get to ask more questions later on...
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