Siemens Healthineers AG (SHL) Earnings Call Transcript & Summary

Before we begin, I would like to draw your attention to the safe harbor statement on Page 2 of the Siemens Healthineers presentation. This webcast may include forward-looking statements. These statements are based on the company's current expectations and certain assumptions and are, therefore, subject to certain risks and uncertainties.

We pioneer breakthroughs in health care for everyone, everywhere for 66,000 Healthineers in 75 countries around the globe. This is what gets us up in the morning. This is what drives us every day, and this is what keeps us up at night. This is the purpose we defined for ourselves after Siemens Healthineers and Varian became one. And this is what we ask you to measure us against. The pioneer breakthroughs in health care for everyone everywhere. Ladies and gentlemen, on behalf of the entire Siemens Healthineers team, I warmly welcome you to our first Capital Market Day. In the next minutes, I will give you a short overview on what we have achieved during the upgrading phase and explain why it's time for the next chapter, our new ambition. I will share our midterm financial targets and illustrate what makes us so unique. I will lay out how we leverage our uniqueness to achieve our new ambition goals and finally introduce the team that will drive the execution of new ambition. In the past 2 years, in the midst of a historic pandemic, the Healthineers team delivered nothing short of spectacular results. Be it operational or strategic, the team delivered. We achieved -- actually, overachieved our financial targets. We closed the transformative combination with Varian. We launched breakthrough innovations and realized further market share gains. We further grew our value partnerships with leading customers worldwide. We developed an ambitious ESG program. The team was and is tireless in the frontline of fighting the pandemic, by keeping the supply chain running, by delivering uninterrupted highest quality service, by quickly seizing new opportunities like with the rapid-antigen tests. In parallel, and almost immediately after the closing of the Varian transaction, a joint team of variant and Healthineers leaders came together to chart out the strategy for the combined company until 2025. We call this next chapter, our new ambition, and it will be a chapter of accelerated growth, a chapter of growth in revenue with a CAGR of 6% to 8% for the fiscal year of '22 to '25 and a chapter of even stronger growth in EPS with a CAGR of 12% to 15%. In the following and in the presentation of my colleagues, all we will do is explaining how we will achieve this and why we are very confident about meeting these targets. At the core of new ambition are the unique capabilities we have systematically built in the past years and which we keep strengthening every day. Patient twinning, precision therapy and digital data and AI. I am deeply convinced that mastering these 3 capabilities, getting stronger in these 3 capabilities and creating more and more interconnections between these 3 capabilities is right at the core of us transforming health care for the better. Patient twinning means adding more and more and better and better ways to accurately describe the state of an individual patient, having the ultimate vision of a digital copy in mind on which diagnosis, therapy selection and response control can be based. This is why we drive imaging to new levels of insights. This is why we develop new diagnostic tests. This is why we work on making imaging and diagnostics more productive and more accessible. Precision therapy means using cutting-edge technologies to deliver individualized therapies, often with submillimeter, millimeter accuracy, whether it's cancer, stroke or cardiac disorders. This is what Varian is so unique at in cancer therapies. This is what Advanced Therapies is focusing on by developing image-guided and robotic-assisted procedures. Our third strength is our unique competence in digital, data and AI. It is key for scaling the application of technical advances, for having the next patient benefiting from the knowledge generated by diagnosing and treating millions before for connecting patient twinning with precision therapy. Now to sum this description of our core might sound a bit nerdy, abstract or overly simplified. Therefore, let me show you some real-life examples. In Imaging, we are always out to find new ways to understand the human body, like in this sodium image of a patient with a brain tumor. Besides the anatomical information of where the tumor sits, it adds the metabolic information, how active the tumor is. It is often elementary to choose the right treatment. We are leading in this field, as in so many others, and it is one of ours -- one more step towards the patient twinning. In Diagnostics, we do very similar steps. This summer, we were granted FDA de novo marketing authorization for our enhanced liver fibrosis or ELF blood test. Liver fibrosis is caused by scar tissue due to illnesses or damages of the liver. It often leads to liver failure and death. By 2030, nonalcoholic steatohepatitis, or NASH, will be the #1 most frequent reason for liver transplants in the U.S. The ELF test measures 3 serum biomarkers, which measure direct markers of fibrosis and can indicate the risk of disease progression for NASH patients. Now let's look at examples of precision therapy. This is a patient with a brain tumor with multiple metastases. Standard treatment is applying radiation therapy to the entire brain. Yet if you do that, the risk of damaging the hippocampus, marked in blue in the center of the skull, is almost unavoidable. The hippocampus plays a decisive role in our memory and therefore, our personality. The laws of physics make it challenging to treat the outside edge, but not the middle, like a donut, but it is even more complex than that because this is like 2 donuts next to 1 another. Treatment planning for such patients, well over 1 million cases worldwide, by the way, is extremely difficult and time-consuming. [indiscernible] developed a machine learning tool that can bring these several days process down to just a few minutes. And here is another example of precision therapy. This video shows a Corindus robot-assisted intervention. In this case, it's crossing a lesion. Currently, minimally invasive procedures are very operator dependent and can be very time consuming. We created algorithms based on the knowledge and expertise of highly skilled operators. In other words, we created a digital summary of the years and years of human experience and put them into an automatic robotic intervention. Through procedural automation, lesions can be quickly and easily crossed to arrive more quickly at the area where the intervention is needed. And here are some more examples for our work in digital, data and AI. In addition to fighting the tumor, preserving healthy tissue is elementary in cancer therapy to accelerate and improve treatment planning, we introduced an AI-based solution that is automatically contouring 71 organs at risk when planning for radiation therapy in the upper body, a perfect example for how AI brings our strength in imaging and in Varian together. My final example shows how we support radiologists by dealing with diagnostic questions around COVID-19. Given the still very high number of COVID-19 cases, it is essential to identify as quickly as possible if a specific patient is suffering from COVID-19 pneumonia or if the pneumonia has a different cause. And this is what this rapidly developed AI-based algorithm does, by automatically quantifying airspace opacities associated with COVID-19 pneumonia. Ladies and gentlemen, these were just a few real-life examples that underscore what we mean when we talk about our unique capabilities in patient twinning, precision therapy and digital data and AI. Now let's switch gears and look at the business side of things. Our 4 leading businesses are grouped around the unique capabilities, which I just mentioned, Imaging and Diagnostics forming the left side, Varian and Advanced therapies, the right side of the triangle. Imaging is a EUR 9 billion business operating at industry-leading margins of around 21%. Due to long-term service contracts, 40% of revenues are recurring. Diagnostics stands currently at EUR 4.4 billion revenues with a margin of 13%. As you know, fiscal '21 saw an extraordinary positive impact from the sales of COVID-19 rapid tests in both top and bottom line. Diagnostics recurring revenues are at around 90%. Varian contributes around EUR 3 billion in revenue at a margin between 15% and 17%, about half of its revenue is recurring. Advanced Therapies' annual revenues amount to EUR 1.7 billion and an overall margin of 15%. Around 40% of revenues are recurring. All in all, you look at a company of EUR 18 billion revenues and overall margin of 17.4%, an innovation and market leader in most of its businesses with recurring revenues north of 50%. Our setup is designed to enable both focus and scale. When needed, the segments apply laser-like focus on the specialty customer group they address and the particular competitors they are out to win against. They are possible. We use our unique scale when we leverage the breadth and the depth of the global Siemens Healthineers organization to provide holistic and tailored solutions, such as our long-term value partnerships, when we use our joint service team and digital expertise or when we use synergies in purchasing and manufacturing. Siemens Healthineers has direct operations in 75 countries and is active in more than 100 countries around the globe, making us the local partner of choice with global scale for our customers wherever they are. We have R&D production service and sales capabilities in all hemispheres. We have deep roots in emerging countries. We have almost 3,000 software engineers in India and strong R&D, manufacturing, sales and service capabilities in China. That's the global perspective. Let's look at the perspective of an individual customer. When we take a look at how our customers are typically set up, it becomes obvious, we are the holistic partner for the C-suite of an ever consolidating and transforming customer base. Through the breadth of our portfolio, we provide offerings for virtually all critical departments. Our service offering ranges from highest-rated product-related service to consulting, to comprehensive value partnerships. In the meantime, our backlog from long-term value partnerships is bigger than EUR 3 billion. With this, I turn to another of my favorite topics, our ever-accelerating stream of breakthrough innovations. Let's look at some of the most recent examples. Our MAGNETOM Free.Max is our lightest, smallest and most cost-effective MR system and is designed to bring MR imaging to places it has not been possible until today. Atellica CI1900. Atellica Solutions little sister is targeted towards midsized labs, hub-and-spoke settings and the emerging countries. It brings the Atellica philosophy of combining quality and throughput to even more customers worldwide. NAEOTOM Alpha is the first FDA-cleared photon counting CT on the planet. We have been working on this breakthrough for 18 years. And our customers confirm that photon counting technology has the potential to become the global technical standard in CT in the decades to come. Turning the page over to precision therapy. Ethos, our AI-driven adaptive radiation therapy system exactly does what I illustrated a few minutes ago: data-driven personalized cancer care with maximum impact while minimizing side effects. And with CorPath, we are on the way to advance endovascular robotics to better and more accessible state-of-the-art stroke treatment. All of this is enabled by the bloom of digital, data and AI like our AI-Rad Companion for Varian's oncology as a service offering. Ladies and gentlemen, we enter the new ambition phase with 2 convictions. While it became fashionable to speak about the challenges of health care, we are convinced health care is full of opportunities. While we could be proud of the history of our company, we are convinced Siemens Healthineers is just at the beginning. Why is health care full of opportunities? Because of the unrealized opportunities to fight the most threatening diseases, because of the untapped potential to improve provider efficiency, because of the currently uneven access for billions of people. Why is Siemens Healthineers just at the beginning? Because whether it's fighting the most threatening diseases, enabling efficient operations, expanding access to care, our technologies and competencies are tackling exactly these opportunities. Thus, we will tirelessly strengthen them further. As a result, we will have even more impact on global health and accelerated growth. While we pursue these 3 company-wide growth vectors, each segment will keep razor-sharp focus on its respective targets. For imaging, this means expanding the #1 position and creating new markets. For diagnostics, it is accelerated growth and margin expansion. For Varian, accelerating the cancer care impact now together as one. For advanced therapies, it is growing and disrupting procedures in cardio and neuro. The segment heads will provide more color on how they will contribute to our new ambition targets in a moment. Each segment will benefit from and contribute to our 3 company-wide growth vectors of fighting the most threatening diseases, enabling efficient operations and expanding access to care. And this is how we will achieve the midterm targets I laid out in the beginning. Before I come to an end, let me introduce to you the team that will play the decisive roles in Siemens Healthineers next chapter. Since February, Darleen Caron is our CHRO. Darleen will speak about how essential company culture is for us and about the progress of our sustainability program. Most of you know Jochen Schmitz, our CFO, who will speak after Darleen. Yesterday, we announced that Elisabeth Staudinger will become a member of the Managing Board as of December 1. Elisabeth will be responsible for the AP region for our Global Customer Service business as well as our Technology Excellence unit, which covers shared R&D and manufacturing. We also announced that Christoph Zindel will leave the company for personal reasons end of March '22. I want to take the opportunity to thank Christoph for all he has achieved for Siemens Healthineers over so many years. André Hartung will speak about imaging, Deepak Nath about diagnostics, Chris Toth about Varian and Carsten Bertram about advanced therapies. Carsten has taken over from in the third quarter of the last fiscal year. In scaling up our business, the regions play an elementary role, yet their representatives will not speak today. Nonetheless, let me introduce to you Dave Pacitti, who is responsible for the Americas; and Bernd Ohnesorge who is responsible for Europe, Middle East and Africa. Until we have a successor for Elisabeth in the AP region, she will hold the position as a region head on an acting basis. So that's the team. I have the privilege to be part of. And with that, I hand it over to Darleen. Very warm welcome to you.

Thank you, Bernd, thank you. So good morning, good afternoon, everyone. You've heard from Bernd how the combination with Varian offers a clear competitive advantage through our unique capabilities, unmatched global footprint and customer proximity. There's another angle to that competitive advantage that perhaps does not meet the eye, and that's how we have so much in common, Varian and Siemens Healthineers. And this is of particular relevance when considering that most M&A transactions fail not because of the strategy, but because of the culture. Let's take a look at what we have in common. Two global leaders with a rich heritage, pioneers in their field. Two organizations that are very purpose-driven with people that share a deep sense of pride and high levels of commitment. Building on that foundation, we jointly defined our purpose and core values that would unify 66,000 Healthineers. We anchored ourselves in our strategic and financial ambitions and brought together leaders and countless employees from both organizations to define what do we need to keep and what needs to evolve to make us even stronger. All along, we stayed connected to the voices of our customers and patients, and we heard very moving and true stories that inspired us even more. So to quote Chris Toth, yes, Chris, take a bow. Culture is not the soft stuff, it's the stuff. Defining the purpose and values was an important step. But the real work begins now as we are bringing our shared culture to life. So we're embarking on what we call the embedding phase. And to support that, we articulated a clear road map. And let me take you through 4 of the core elements. For one, continuing to promote skilled and diverse talent and then making sure that we, what we call, cross-fertilize, which means bringing talent across organizations; then building agility in the way we operate, so be it our operating model or our strategies for go-to-market, preserving that agility is considered essential. And finally, aligning our incentives, so that all of us turn our heads to winning together. We take culture very seriously. We're convinced that it's as important as our strategic vectors and our financial ambitions. And we have and will continue to invest time and resources to become one unified company. We pioneer breakthroughs in health care for everyone, everywhere. That's our North Star. But to guide our daily actions and behaviors, we carefully crafted 5 very simple values, and I'd like to take you through them. One, we listen first. You heard Bernd about our ambition to build unmatched C-level relationships. Listening to their needs is a start point. Listening to one another is also the best way to leverage the rich diversity we have in the organization. We win together, our unique capabilities in patient twinning, precision therapy and digital data and AI are only as powerful as our ability to work across domains and organizational boundaries and leverage our scale. Third, we learn passionately. There is no innovation without learning. And we embrace learning in our daily work as a means to continuously improve. We step boldly, not because we're arrogant, but because we are confident that thanks to our capabilities and people, we can make a difference in 8 billion lives. And last, but not least, we own it. It's personal. When we make commitments, we don't find excuses, we deliver, we own it. So those are the 5 values that guide us. So we pioneered breakthroughs in health care for everyone, everywhere. You will have heard this a lot of times, I'm sure you will be able to recite it by heart, but it says it all. And increasing quality of care and expanding access to care is not only 1 of our 3 strategic growth vectors, as illustrated by Bernd. It's also anchored in our sustainability framework. On this page, you see several examples of how we illustrate how we want to bring health care. But let's focus on Vietnam. So in this country, there are almost as many acute strokes each year as in Germany, but with much worse patient outcomes. Siemens Healthineers has entered into an 8-year partnership with the local stroke international services with advanced medtech solutions provided by Siemens Healthineers. SIS aims to bring internationally acclaimed stroke treatment standards to this part of Asia, while becoming an education hub for Southeast Asia. This includes robotic-assisted remote stroke treatment. So imagine how in a not-so-distant future, a patient with an acute stroke could be treated quickly at the nearest hospital instead of being transported for hours on the speedboat that you see on the top left corner across the Mekong River Delta. In several cases, those precious hours are the difference between life and death. If we turn our heads to diversity, it's an integral part of our culture, and we have woven D&I in every 1 of our 5 values that I presented earlier. Diversity of gender, nationality and thought makes us a better, more sustainable company. If we take a look at carbon footprint, my example here is very simple. All our new buildings will operate carbon-neutral, be it our high-energy photonics center in Forchheim, by the way, is directly adjacent to our headquarters where we just celebrated the topping out ceremony 10 days ago or our new campus in Bangalore where thousands of software engineers will develop digital solutions, climate-friendly, no exceptions. Our commitment goes far beyond anecdotal evidence. We've set ourselves clear, measurable targets, and you certainly have seen some of them. But what have we achieved so far? Let me draw your attention to access to care again. At least 1/3 of the world's population has no access to safe, affordable, and even basic health care. We're convinced we can help change that. We measure our progress through the increase of patient touch points in 90 underserved countries that the World Bank defines as low or medium level income. Touch points can be, for instance, imaging exams on installed CTs or x-ray machines or blood tests on our lab analyzers. And since we started, we've added 30 million touch points. You heard me talking about carbon-neutral buildings, that's only one lever to achieve our target of 130 kilotons of CO2 emissions by 2025. We've already achieved a significant reduction of 52 kilotons in fiscal year '21, but we're not going to stop at Scope 1 and 2. last October, we took the next ambitious step and committed to 13.5% reduction of Scope 3 emissions by 2030 over 2019. And this, in alignment with the science-based targets initiative who accepted our approach and targets. And I do want to mention, I have to say a word about diversity, we're committed to seeing more women and leadership and today's announcement is yet 1 additional proof point of that, and we are very optimistic that we will achieve our target of 26% by 2025. Our efforts, we believe, have paid off. Sustainalytics has raised our rating significantly. As you can see, we're in the top 5. Definitely, huge strides have been made and you will hear much more about it when we proudly launch our first stand-alone sustainability report in 9 days. And of course, we will proactively reach out to our investors and take you through all of that. Speaking of investors, let me now hand it over to Jochen Schmitz, our CFO, who will take us through all the details around the financial ambitions. Jochen?

Yes. Thanks, Darleen, and also a very warm welcome from my side. I structure my presentation in 2 main parts. We talk about the midterm guidance in more depth and breadth as a second part of my presentation, and I would like to start with our financial framework first. I have structured it into 4 pieces: First, driving innovation and growth; secondly, fostering profitability; third, strengthening our financial soundness; and fourth, obviously, last, but not least, focused capital allocation. Let me kick it off with driving innovation and growth. Our high R&D and SG&A intensity is key for our growth agenda. We are currently spending around 9% of revenue for R&D and 17% of revenue for SG&A. We will stay at these peak levels in the current year and maybe also in the next year because we are currently in a phase where we significantly invest into, for example, on the R&D side, future revenue synergies on the Varian combination. We're also investing on the SG&A side heavily into new growth markets and in developing market activities. Over time, there might be some conversion coming, which brings us into an 8% to 9% arena of R&D intensity and 15% to 17% arena due to leveraging our scale advantages. With this investment in R&D and SG&A, we fuel our industry-leading margins, which I want to talk about now. We have industry-leading margins in 3 of our 4 segments already, and this is due to the fact that we have a significant scale advantage as we are a market leader in those businesses. Secondly, we have a very, very clear productivity culture in the company. We deliver every year 4% to 5%, sometimes even more than 5% of productivity of our total cost. Thirdly, we have really strong price discipline and pricing strength due to our innovation leadership and our strong go-to-market. This will cater also in the future for potential tailwind -- headwind from higher inflation. Now talking about high R&D investments, fueling the growth agenda, industry-leading margin, another very, very important aspect is the resilience of our business. 55% of our revenue today is coming from recurring sources. And our ambition is that we grow the recurring revenue at the same speed as the nonrecurring one. We will add new recurring revenue streams, for example, by expanding into digital and tech-enabled services, for example, in oncology-as-a-service. We will foster our service and software revenues in imaging, wearing and advanced therapies as well as our reagent revenue streams over time. Thirdly, on the value partnerships, we kind of transform nonrecurring revenue streams classically in the product business into kind of recurring revenue streams due to long-term partnerships. And even on the nonrecurring side, there is high level of resilience due to the fact that our demand or the demand for our products and services is based on a secular and stable procedure growth on the one hand and secondly, our strong global reach compensates for certain short-term volatility in certain regions over time. Talking about resilience, the next topic which is strongly supported by a resilient business is free cash flow generation. We will deliver 0.7 to 0.9 cash conversion rate over the planning cycle. Our 3 segments imaging, wearing and advanced therapies will be at the upper end of this range throughout the cycle. And diagnostics is still in transition to reach its steady-state level, which is a bit below the upper end, more in the 0.8 arena because of structural differences with regard to this KPI cash conversion rate because we invest in future growth in diagnostics via seeding, wiring, operating lease, which eats up some of the free cash flow, and we also to more capitalization of R&D, and the capitalization period is significantly shorter than the amortization period. One word on CapEx intensity. Our business is not very CapEx intense. We spend about 3.5% to 4.5% of revenue on CapEx. You'll see that where we were in the midpoint of this range over the last 3 years. We might move up a bit to the upper end over time in the next -- this year and next year due to the fact that we have to do necessary capacity expansion due to our significant growth agenda. This now leads me into the topic of capital allocation. And here, I want to reconfirm our M&A principles. They remain transparent and unchanged. Everything is based on strategic fit. This is the fundamental of anything. Is M&A an help to accelerate our strategic direction, yes or no? This is a prerequisite for everything we do in M&A. Secondly, we obviously look at financial accretion. And thirdly, we are opportunistic. We look for availability of the targets and for the right timing. Think about the Varian transaction, I think, a perfect example of a well-executed opportunistic window. And when you think about the M&A types, we stick to our structure of seat, small, adjacent mid-portfolio large acquisitions with here displayed kind of stereotype accretion profile, which is not always fully adhere to. When you look at the examples of Corindus, for example, I think it's an acquisition which was on the edge between seed and adjacency. Adjacent seed because of the size, yes, it was midsized, I would say. And from an accretion standpoint, more on the seeding side, Varian obviously, a clear portfolio-type acquisition, transformative in nature, large and immediately EPS-accretive. Another area of capital allocation, I want to focus on now as my final slide on the financial framework, is about 2 main KPIs, which both go into the wrong direction if you do significant R&D initially -- M&A, sorry, not R&D, M&A. The 2 KPIs are one on leverage, one on return on capital employed. On leverage, we will stick with our policy that we want to stay in solid investment-grade rating territory as a minimum. And we see 4x net debt over EBITDA as the upper limit of what is possible under this regime, knowing that we have the ability to deleverage very, very quickly as we have shown in fiscal year '21. By the way, we will also stick to our dividend policy of distributing 50% to 60% of net income every year. One word on return on capital employed: in our industry, in our sector, due to the long-term growth characteristics, multiples and prices are, relatively speaking, high and they drive initially return on capital employed down. But our clear ambition is with every deal we do, to improve return on capital employed over time in the long term, and this is the clear ambition of Siemens Healthineers, with M&A. So with this, let me now move to the outlook section. And let me briefly repeat what we have disclosed on November 4 for this fiscal year. Ex antigen, we will grow revenue by 5% to 7% and adjusted basic earnings per share by 17% to 23%. Remember, last year, revenue from antigen of EUR 1.1 billion. The assumption for this year is EUR 200 million. The delta represents almost exactly 500 basis points, which explains then the 0% to 2%, which is exactly in line with the 5% to 7% ex antigen. Just to repeat this, and now I come to the midterm guidance. And here, I talk -- start with one very, very important topic and that are the synergies with the Varian combination. We have raised our synergy target to more than EUR 350 million by 2025. This will drive the Varian margin well above 20%, even with only 80% of the -- more than EUR 350 million will show up in the Varian segment, the other 20% will show up, so to say, in the rest of the entire portfolio of Siemens Healthineers. We will also -- we also updated slightly our guidance on the cost synergies because we said beforehand we will be around EUR 150 million. Now we say it is more than EUR 150 million on cost synergies and more than EUR 200 million on revenue synergies. All of those synergies are now well defined and in execution phase. As you know, the cost synergies will kick in earlier. And we will reinvest a significant portion of the cost synergies into exciting future revenue synergies. The cost synergies will come primarily from procurement, back office and infrastructure consolidation, the delisting of Varian, just to name a few areas. Chris will later talk in more detail about the revenue synergies. And what is also important, all, everything we talk about with regard to midterm guidance include those more than EUR 350 million of synergies from the Varian combination. Why is this important? Because we believe it is the more meaningful way that we show you fully synergized plans for Siemens Healthineers overall as well as for the segments so that we do not need to artificially, in particular, in the outer years, to differentiate what is stand-alone and what is synergies, yes? So again, the midterm guidance is fully synergized. Let me move with this to the midterm guidance in more detail. You have heard from Bernd the 6% to 8% growth per annum. How is this fueled by the segments? Let me start with imaging. The imaging growth is -- will be between 5% and 8% on the back of market and innovation leadership in this business. We will bring new products to market. You have heard about photon counting, you have heard about MAGNETOM Free.Max. We will definitely optimize the workflow of radiology, think about the product of single carbon, which we also brought to the market. And thirdly, we will leverage our unparalleled imaging AI capabilities and think about the product AI-Rad Companion just as an example. This will fuel the growth agenda. On top comes based on our strong success in the last years, a significant growing installed base, which will drive our very, very stable and resilient service growth in imaging to a 6% per annum. Let me move now to Diagnostics. The diagnostic growth will be progressing towards 4% to 6% until 2025. This is on the back of a clear focus on workflow excellence coming from a much more stable Atellica Solution platform, Atellica CI1900, and very meaningful innovations in the point-of-care side, take as an example, Atellica Lifeline. Secondly, we will also beef up significantly the clinical value of our reagent portfolio, and we will further invest in our digital offerings in the lab. And when I look back to the performance of the core business in Diagnostics, in particular, in the lab space over the last 2 years, I saw already a clear improvement relative to main competitors with regard to growth rate, and this gives me a strong confidence that we will get to mid-single-digit growth rates over the planning cycle and beyond. Varian, very exciting growth at 9% to 12%, backed up by their market leadership position in radiation therapy as well as in proton therapy. And on -- in addition, they entered very attractive growth fields in interventional oncology as well as in multidisciplinary software and oncology-as-a-service. And obviously, revenue synergies come on top, yes? So 9% to 12% fully synergized on Varian every year. Advanced Therapies, 5% to 8% every year. And this is based on a fundamental trend in the health care sector, on which the Advanced Therapy business sits on, so to say. It is minimal invasive procedures. The procedure growth is fueling this growth, and we have leading image guidance equipment, which enables such procedures, on the one hand. Secondly, we will make robotics, Corindus, a clinical routine in endovascular procedures when they are complex. And thirdly, service. The service growth will be fueling this 5% to 8% with 5%-plus growth every year. With this, let me move to bottom line. You've heard from Bernd, the 12% to 15% adjusted EPS growth every year. The imaging margin, no news on this, will expand by 20 to 80 basis points on an industry-leading basis already every year. The bandwidth of 20 to 80 is primarily driven by mix impacts. In a year with a more favorable mix, it is more towards the 80. In a year with less favorable mix, it's more towards the 20. But the growth will fuel further margin expansion on an already leading -- industry-leading position. Diagnostics margins will progress towards the mid-teens in 2025. This -- I mean, you should see this the following way, yes? We have invested a lot into the business with -- primarily with the rollout of Atellica. Therefore, we have already built up a significant cost base. And with a constant growing reagent revenue stream and the respective contribution margin, we will, so to say, outgrow this cost base. And the consequence is that the margin progression will be skewed a bit towards the end of the planning cycle until 2025, but full confirmation of what we have guided for in the upgrading phase. On Varian, margin will progress to well above 20% in 2025. And also here, we will see good margin improvement for the first 2 years, means the current year and next year, but we will see an even progressing margin expansion in the outer years due to the fact that we currently reinvest significant portion of the cost synergies for future revenue synergies and their respective P&L impact will kick in at scale in the years 2024 and 2025. On Advanced Therapies, margin will also progress towards the 20% territory back in 2025. Here, we also see most a bit skewed towards the outer years due to the fact that we will see then a significant limited or lower dilution from the Corindus investments in the outer year; and secondly, we will see more and more tailwind also coming from the healthy growth in the Advanced Therapy business without Corindus. So with this, let me summarize briefly, yes? We have heard now -- or you have heard now in much more detail about our midterm guidance, and you will hear later by the business area heads about how they want to go about it and you have learned about our very, very consistent financial framework. And now it's time for the first round of Q&A. Marc, please join me on stage.

Thank you, Jochen. And also thank you, Darleen and Bernd, for your very interesting presentations. I am Marc Koebernick, Head of Investor Relations. As your host of the day, I'm very excited to be sharing with you our Capital Markets Day 2021. I have to say, believe me, CMD preparation sometimes feels like a marathon and that means sometimes it's also painful. But right now, as I'm standing here, I feel very proud that all the work was worth it, especially since we're now heading for the first Q&A session with you, by the way, can already register for. Before we start with the latter, I will do a bit of housekeeping. While I will be accompanying you on stage throughout the whole event, we have a team in the back end who is supporting you with any kind of technical issues that you might have. It could also be lock-in issues, these kind of things. In order to get that help that you might need, you click on the help desk that is on the top right of your screen. First of all, in terms of housekeeping I have to make you aware of our Virtual Expo where we are basically showcasing in a 3D environment, some of our breakthrough innovations across the segments. So I really think it's worth to click yourself through this. You find it in the tab bar. Secondly, in the web environment that you are in, you will also be -- this will be your hub for the whole day, yes? So next to the already referred to Expo, you find the downloads of the presentations, and you will also be able to refer to the segment presentations and recordings of this and also Bernd's & Jochen's later on. If you are on an IR distribution list, which I hope you are, you already received our presentations and the press release by e-mail in the morning. For any other request, the IR team is always happy to help. Thirdly, I would like to get your eyes to the safe harbor statement that is in the second page of both of the presentations that we've sent around this morning, so that we are on the safe side here with regards to all legal matters. And finally, I would like to clarify the setup of the day. As just said, we will be starting with the first Q&A in a very few seconds, yes, Bernd and Jochen already are with me on stage. In total, we will have 6 Q&A sessions; 4, with the segment heads, 1 right now with Bernd and Jochen and 1 at the end of the day, where you basically can come up with your final questions that you have. The 4 segment presentations come in 2 blocks of 2. Between them, they will always be before and after breaks between -- after the first segment block, there will be a larger break of 30 minutes, so you can plan for your lunch, which will be around about 12:50, yes? Don't get me wrong. We are actually a bit ahead of time already now. So now it's time to start with the Q&A.

If I look at my screen here, yes, the first person on the line would be Patrick Wood, yes? And I think he's also with us by video. So I would say, hey, Patrick, I hope you're fine, ready to receive your questions.

Perfect. Hopefully, you guys can hear me. Can you hear me okay?

Yes.

Excellent. Fabulous. Awesome. I'll keep it to 2, please. Slightly more big picture, I guess, more and more of the business on the imaging side and elsewhere is becoming software-driven. And I'm just curious, as you can push down innovation to customers on the software side, does that change the replacement cycle or indeed the innovation cycle on the hardware side over time as more and more improvements can be delivered through software? So that's the first question. And then the second question is it seems to me, and correct me if I'm wrong, that there's more of a focus on the therapeutic direction of the business in terms of looking at things, whether it's neuro or cardiovascular, does that inform how you're thinking long term about M&A and innovation and about whether you'd be more focused on looking at it through those areas or more around, let's say, robotics as a holistic area. So is it more therapeutic driven or sort of solutions driven, I guess?

Okay. Thank you, Patrick. So the software question, well, it's actually a very, very good one as always. I mean on the one hand, the higher software content, of course, helps us, I mean, from -- because we are developing more and more into a software P&L, yes, when it comes to gross margins and so on, yes. We -- you know that when it comes to new business models, health care is a little bit conservative, yes? We are also driving the digital enabled services and so on. But the core of your question was whether it is slowing down the hardware "cycle?" And I wouldn't see that really because what we do, and you will see this in André Hartung's presentation, yes, is extremely very much about having that dedicated software interacting exactly with the specialized hardware. I mean, photon counting being one very, very prominent example, yes, which is a software-powered hardware disruptions. But typically, when you go to the next level, you need to go hand in hand, yes? I mean a little bit of a trivial analogy, when you compare ourselves with the smartphone business, in Apple, you see that there is a stream of hardware innovations or hardware advancements, which is accompanied by software and the hardware makes things possible, the software is exploiting and vice versa. On the M&A side, I would recommend look at the triangle, which I explained yes, because this is from a core technology point of view, where our strength is, where our core belief is here to be super strong in the corners of the triangle, but in the interplay and whatever makes us stronger there from a clinical and technical point of view is what I would call a technical adjacency, technical medical adjacency. When it comes to more of the business, in fact it's worthwhile to look at the 3 growth vectors we talked about, yes? So the disease focus with the cardio, onco, neuro, the tech-enabled services and also what brings us more to access to care. But I think what you also saw is that the -- especially the combination with Varian made us a more disease-focused company and made us more relevant and is allowing us to up the game. So looking at technology-enabled therapy certainly is our focus.

And maybe one brief addition to your question, to your first question, Patrick, for example, think about photon counting and the combination of, I would say, a physical breakthrough with necessary software advancements to make this work from -- just from a sheer data volume. This might even trigger faster turnover cycles just because of the additional quality of the systems and that you just need to have it, otherwise you are so far behind. It can even have the opposite effect, in theory.

I mean so you make us talk with your question. I mean the opposite question to your topic is the MAGNETOM Free. We have the software and the interplay of our hardware, which is designed to be more affordable is key, but that means that you need to keep innovating also here on both sides of it.

Great. Thanks, Patrick for your questions. So now we head over to the next person on the call that will be Scott Bardo from Berenberg is also with us by video. So Scott, get ready, you'll be visible in a few seconds.

Thanks also for the confident message and outlook today, guys. So a couple of questions, please, if I may? The first question, I think somewhat emanating from the COVID pandemic. There certainly seems to be global shortages of staff for hospitals and care institutions, and obviously, inflationary considerations for, for everybody. So I wonder, Bernd, if you could perhaps talk a little bit to your products and solutions and the capital side of the business and how that may be part of the solution to some of these ongoing or overriding problems faced by the health care system? The second question, please. I just wonder if you could give us a little bit of an update as to the enterprise service element of the business and help us understand whether the group performing dedicated targets by 2025? And whether the picture and outlook changes here with respect to the Varian integration?

Yes. Thank you, Scott. I mean when it comes to solving really these bigger customer challenges you talk about. I mean when I talked about the 3 growth factors and opportunities behind them. I mean I said about unlocking the potential of efficiency on the provider side, which is triggered by, on the one hand, I mean, there is cost pressure and so on and so on. But one big topic is staff shortage and staff shortage is a problem in the developed world. And it is a challenge when it comes to developing a health care system. So we are very, very focused in a focused way, and that is why you saw also many of these AI examples to help take over the routine tasks, to make the existing staff more productive or on the other hand, help in the emerging countries that were certain specialties are not really established that AI helps do this stuff or that we develop a remote way of doing things like we do with oncology-as-a-service. And this is why this tech-enabled services is one of the big topics. Sometimes, it's in the product and the software around it, but we are very much focusing on developing also service models. On Enterprise Services, I mean, this is a great success story for us, but I'm also here as for the entire company convinced we are just at the beginning. Because what this does is the more our customers consolidate, the more they need to look at managing their institution, which is often an institution with 50,000 employees. Specialty, it's a very personnel-intensive business, and it's about managing payers, managing patients stream, managing physicians and so on. Having a strong technology partner, helping them to shape medicine, showing what's possible and so on, it becomes more and more a need. So the combination of what we have here of a super strong but also broad portfolio, plus the consulting capabilities we have built, plus the excellent reputation we have in service play exactly in that area and with Varian, it makes us even more relevant. And on the other hand, it helps the Varian business because it gives them access -- or our Varian business, access to the to the C-level conversation, which so far was sometimes a bit tougher simply because they played on the departmental level, mainly.

And maybe there is also one other aspect. All the services we provide, they all evolve our domain at the end of the day out of the triangle. Therefore, it's still a very integrated aspect to what we do. And therefore, from just from a reporting standpoint and from a target standpoint, it is built into our segment guidance. And I would not see this changing, at least not in that planning horizon that this will become an independent thing from you. Maybe it changes in the future, but not in that new ambition phase from my standpoint.

Great. Thanks, Scott. Now we head on to Falko Friedrichs from Deutsche Bank also with us via camera as far as I see. So Falko floor is yours.

Can you hear me now?

Yes.

Excellent. I also have 2 questions, please. And the first 1 is you mentioned that you aim to invest some of the R&D expenses into creating revenue synergies with Varian. Could you maybe elaborate a little bit on that and give us a flavor how the variant product might be synchronized with the products in your other businesses? And then the second question is on M&A. Your leverage obviously a relatively high at the moment, but it looks like it can come down quickly again. So what would be some of your areas of most interest for further additions over the planning period?

Yes, Falko, thank you. You -- on the reinvestment into revenue synergies, some examples you saw in my presentation, where you saw how we use AI capabilities to connect imaging to better radiation therapy, so it shows what our potential is to optimize the triangle, not the individual corners, but to make the 3 things work together. You will hear Chris talk about a nice challenge. We have given ourselves in Varian the 2/2/2 challenge here to go from 2 weeks to 2 hours when it comes to starting the treatment after diagnosis, which requires a lot of integration of the imaging and digital capabilities with radiation therapy. And you will hear Carsten Bertram and Chris talk about the integration of the image guidance systems with the Varian interventional oncology, plus also the Oncology-as-a-Service opportunities will be accelerated by further R&D investment. So I hope that explains it, but I'm sure that in Chris' but also Carsten's presentations, you will -- it will get even more tangible. On the M&A side, again, very similar answer. I would recommend look at the triangle, whatever helps us to understand the human body better and helps to guide treatment, but on the other hand what helps us to make the therapy even more precise ideally by combining it with the digital information we provide with the other businesses is more the medical technical story. I mean whenever I could not really imagine that we do something doesn't fit to that core, core, core [indiscernible] picture. And then when we look at the growth vectors, the topic of the focus of the 3 disease areas, which are the major killers on this planet and when it comes to the noncommunicable diseases, plus the topic we just had when it comes to enabling efficient operations moving, so to say, a bit forward in the value chain, not by taking over what our customers do, but by scaling certain aspects of their value chain in order to create a win-win situation.

And Falko, when you think about what I wanted to say with the 2 slides, the 2 final slides on the financial framework with regard to M&A. First of all, what I wanted -- or what we wanted to get across is with Varian, with the combination with Varian, it is not over. There is a future, and there might also be M&A coming in the future. But under clear boundary conditions, which -- where they laid out in the second slide, where we said, okay, solid investment-grade rating, 4x net debt over EBITDA as the absolute maximum of leverage we want to have. And therefore, when you think about timing, it's not content timing, you can -- you will not expect us making a portfolio move in the near term, but we might be in a position to do smaller things already relatively near term. That doesn't mean that we do this, I'm just saying what we can do. And our position is we want to be in the position to do things because, as I said, opportunistic -- driving M&A opportunistically is a very important topic because that -- if you -- and this is only possible if you have the ability to do so in the right timing window. And therefore, I think this is key, and that is what I wanted or we wanted to get across with the financial framework.

Okay. So thank you, Falko. I think we lost you on the way. Anyway, not too bad. We still have 2 people in the queue. [Operator Instructions] So next one in line would be David Adling from JPMorgan. David, you should be live now.

Can you hear me?

We hear you.

Great. Two questions, please. So firstly, just in terms of the 5% to 8% growth in imaging, I just wondered if you expect that to be relatively even over the time period or given that the products you're introducing we might see some years a bit stronger than others? And then secondly, just interested to hear you talk about recurring revenues growing at about the same pace as the overall revenues. We would normally expect in a business like yours as the installed base increases, we'd expect recurring revenues as a percentage of sales to increase. Maybe you could just talk to the dynamics of that? And if that correlation of increasing recurring revenues has broken down or whether it's just a factor based on your new product introduction, would you expect that to return at some point in the future?

Yes, I kick it off. Dave, I think good question. The 5% to 8% will it be evenly spread over the planning cycle? Difficult to say. I think we have a -- we can expect a strong start. I mean we have counting in the rollout phase in imaging of very, very important innovations. But when we gave us this corridor to be on the safe side and to have some leeway. It's always difficult to say because there are also some exogenous factors, which can play a role and things like this. So bear with us, 5% to 8% is what we commit to. And as we did not qualify further, using the midpoint for model might be a meaningful way for now. And then we will update you, as you know, on a yearly basis, what we expect in more detail for the current year as we did for this fiscal year, for example. On your second question, yes, it might sound a bit odd that we just want to grow the recurring portion of the revenue stream at the same speed at the nonrecurring one. First of all, with 55%, we are super resilient, and we have a significant recurring revenue stream already. Secondly, we intend to be very, very successful on the nonrecurring part of the portfolio means equipment. And then the question is, how do you sort of say, assign the value partnerships and the equipment we sell via value partnerships, do you send that now to recurring and nonrecurring, yes, you can argue until the cows come home. But I would say we have that so far in the nonrecurring section assigned to. And if you take the midpoint of the top line guidance, we grow both things with 7%. Will it be maybe skewed towards to the end of the cycle, more towards the recurring piece? Maybe. But I did -- I cannot commit now to more than this because I also want to not steer-lead the business wrongly because I have nothing against strong growth on the nonrecurring part, to be honest.

And David, it's a very fair question. There's also an aspect of -- I mean, you need to know how really the installed base grows, what is replacement revenue, what is replacement business, what is business which comes on top. And we continue to, to grow massively the installed base plus we create new markets. Over the period here, there is also -- you need to bear in mind there is typically also a warranty period, when you see that the growth of -- and the installation and so on happening, then it doesn't add immediately additional service contracts. And so which is why the service growth follows. I mean, Jochen mentioned in his presentation, the 5% roughly, I mean it comes through the service costs. Can this go up towards the end of the cycle, yes, by a percentage point potentially, yes.

Yes. And in imaging, we are already at 6-ish, and in advanced therapy is 5-plus. But there's also 1 from a modeling standpoint, 1 technical aspect. The business with the highest recurring revenue piece is, within our portfolio, not the fastest growing one. Therefore, there's also a mix topic in there, which hinders, so to say, a significant improvement on the recurring piece overall, just for your modeling. That's also a mixed topic in there.

Great. Thanks, David, for your questions. So we head on to Veronika Dubajova from Goldman Sachs. Veronika, you should be live on screen in a few seconds.

Hope you can hear me okay. Thanks so much for having us. Two questions for me, please. The first one is on the Varian growth ambition of 9% to 12%. Obviously, this is substantially higher than what the company talked about in the proxy statement and what they've guided for historically. So I would love to get some color from you on sort of what has changed? Do you have different assumptions around market growth? Or is this really all coming for share gains? And I guess, given the size of the business and the market share that it already has, that is a very ambitious growth target. So maybe you can give us some insights as to what exactly is driving that? Is that selling and marketing execution? Is that R&D? And maybe just the shape of that growth, is that 9% to 12% every year or does it accelerate through the time? I know there's quite a lot in there, but it's a big change from what we've heard from Varian in the past. So I think it's worth spending some time on that. And then my second question is just to circle back to some of the sort of software piece of the revenue pie that you were talking about. Just curious if you can give us a little bit of a flavor for how large the software revenues are today. And then as you think about forward, what would you expect the number to be by the time we get out to 2025? I know this is quite hard to quantify in some of your businesses, but even just a rough ballpark would be helpful.

Yes, Veronika, thank you. I mean on the Varian side, first of all, you will have 30 minutes of Chris Toth presenting the plan plus a Q&A, so where we will go very much into detail. But main headline, what is triggering the growth? I mean on the one hand, there is in the classic business on what comes on top to the Varian growth ambition from -- as from a proxy filing? On the one hand, it is the cross-selling, if you wish, opportunities utilizing the channel we have, the areas where Varian is not -- has not been as strong as Siemens Healthineers in second-tier emerging countries, certain areas in Europe and so on, but also when it comes to really utilizing the C-level contact. And this is happening as -- not only as we speak since day 1 of the combination, there is a lot of excitement in finding these joint opportunities to accelerate -- to even accelerate the share gains in the classic radiation oncology business. Then come the new offerings in the classic radiation oncology business. But then there are to additional growth engines in Varian, which also benefit strongly from the combination. One is the CTSI business or a multidisciplinary oncology with this Oncology-as-a-Service, which fits like hand-in-glove to our value partnership approach to our enterprise services business to the C-level relationships we have because this type of business typically is a C-level conversation. And the other growth engine is the interventional business, in the interventional oncology, where we can really play the strength of the triangle, so to say, here is the image Here's the image guidance and here is the therapy we can deliver for an interventional oncologist. This is a dream coming true the leader in imaging and the leader in cancer care team up to build that fourth column of cancer treatment. Software business, do you want to...

Sure, Bernd. Veronika, this is a very good question, obviously. Our current revenue stream in the software business is EUR 500 million-plus as a company. It's clearly above this. On the other hand, we sell today software in the majority still at the point of sale of equipment. So it's not the classical Software-as-a-Service business model and so on. This is relatively tiny still. Because the customer behavior has not changed in this regard. And due -- I would say, due to the situation we are in with relation to our customer, we are -- we don't want to force it to up to them. There's no need to do this, for now? Secondly, I think this is also an important topic, why we're also shying away from further segmenting our revenue streams is that software is a key enabler or digital for a tech-enabled services. And now the question, is it now software business or is it service business? How do you want to quantify that? Maybe we do not sell service, but we -- we sell software so that the customer does it on its own? Or are we provide service by utilizing our own AI capabilities in the future, this is something which is currently, so to say, developed and starting to find its way into the marketplace and how this exactly will pan out is still a bit open. And therefore, I think it would not be meaningful now to segment the revenue lines further. But this might change over time. But we have high expectations towards this. What software and digital can enable either on the service side as well as on the stand-alone software side.

That's helpful. And can I just ask a quick follow-up for the revenue growth and the EPS growth targets that you've given? Would you expect each of the divisions and the group to be in that range in each year?

I mean that is how we displayed it. That would be what we love. But you -- generally speaking, everywhere where we said P point, A point, there we -- this is the expectation. You find some formulation where we said progressing towards, for example, in diagnostic towards 4% to 6%. And for example, for this year, we have a guidance out there ex antigen 2% to 4%, not 4% to 6%. So you need to read it. Where everywhere, whereas P&A in the other per annum, it's per annum every year. And then we have given guidance clearly on where we see it progressing towards the end or the outer years, where we use the word progressing. I think that should describe it, hopefully correctly.

Great. Thanks, Veronika. And thanks also to the other analysts for asking their questions. Basically, this brings our first session, Q&A session to an end. We now have a 15-minute break, so you can refresh yourself and for your mind, get some fresh air, that's what we will clearly do. And then we have the first block of segment presentations with André Hartung, for imaging and Deepak Nath for Diagnostics, where you also will have the chance to ask questions. And if you haven't already found that bottom to request your question, maybe you can let yourself be helped by the IR team in the back end. So see you then. Thanks, Jochen; thanks, Bernd, for this first round. Back in 15 minutes. [Break]

Welcome back. I'm very excited to announce the first segment presentation for you right now, Imaging.

Welcome to the Capital Market Day 2022 from the Imaging side. Imaging is indispensable, and there is a great example that illustrates why. This heart has been imaged with the latest breakthrough innovation, the Naeotom Alpha, the world's first photon-counting CT. And what -- and it was performed in order to rule out coronary artery disease, the killer #1. And when you look at this image, then you see it reveals a very severe calcified plaque on the left main coronary artery. If this causes a stenosis, it may result in a serious myocardial infarction. However, with a conventional CT with such a calcified plaque, the examination basically would be inconclusive. You would have to perform an additional interventional procedure in order to make sure that you can do a safe diagnosis. With photon-counting CT and the spectral information related to this, this is changing because all of the sudden, you can isolate the plaque and you can remove it without removing any other tissue. And all of the sudden, you see there is no severe stenosis in the left coronary artery and you saved for this patient an interventional procedure. So let's have a little bit a look into some of the business figures. Since the IPO, we did significantly increase market share, being #1 in all large modalities, MR, computed tomography, conventional X-ray, molecular imaging. We have increased our installed base, so adding scale. We have a very strong top line with close to EUR 10 billion in revenue, and we have industry-leading margins. The revenue contribution is equally distributed throughout the 3 geographies. And the good thing is imaging is on the rise. And we are at the beginning of this. There are more and more diseases that drive imaging. Just Alzheimer's lately, there is a new drug introduced, MR being needed in order to monitor the drug therapy. Think about oncology and therapy response monitoring. So there are more and more diseases that are subject to imaging. At the same time, there's a severe topic with access. As Bernd mentioned in his presentation as well, when you look into the low-income countries, then you see that 2/3 of the population don't have access to imaging technology. And this gets together with a lack of staff. I'll just put up this one figure: 15,000 radiologists are already missing as of today in the United States. And at the same time, chronical diseases and severe diseases, the most threatening diseases, are on the rise due to the aging population. So there is an ever-growing demand for imaging. And this is why we as a leader feel very well positioned to shape this imaging market along our strategic pillars. The first is about intelligent imaging, so making devices smart, make them easy to operate, connect them. And with that, we address a very resilient EUR 15 billion market that we are about to expand as well on top. The second is streamlining operations, so making sure that we improve the operational efficiency of our customers to enable them to do more with less. This is necessary as well to cope with the staff shortages. And we have a very strong unparalleled footprint in the field of artificial intelligence-driven clinical decision-making. And there, we do help our customers to perform even better than of today -- than as today on the area. It's important then to put this as well in the context of the most threatening diseases to really understand what is the diagnostic information needed in order to facilitate the precise treatment later on. So we focus on cancer, neurovascular and cardiovascular diseases on top of this. When you look into the boundary conditions, we are really in a great situation right now. First of all, all the major markets after COVID or still in the managed COVID situation are back to growth. We have an extremely strong portfolio pipeline. We have the additional chances now with Varian being one company with us. And as mentioned, there's a steady growth in demand. So let's have a look into one of the recent innovations in the field of intelligent imaging, and this is about creating access. It's about creating access to new markets with the MRI MAGNETOM Free. Last year, we introduced the first version from it, the Free.Max. Now we already introduced the second version, bringing the TCO, the total cost of ownership, for our customers even further down, at the same time, have a very small footprint and a very easy-to-operate system, basically a push-button scanner. Our plan is to not sell this predominantly only in the radiology field but to really look into new fields where MR hasn't been before. So on the one hand, developing countries that can't afford an MR today, most likely now, will get the first-time access to this technology. At the same time, we open up the field into new clinical innovations. For instance, in pediatrics, for instance, in the emergency department and in the orthopedic arena. And it's not only about access to new fields and access to areas where MR wasn't available before. It's as well the way we commercialize it because it's not only the scanner. It's as well the services around the scanner that sometimes is necessary on top. So we have a portfolio that enables us to remotely scan and as well to remotely read. So we can offer the entire diagnostic service as a digital-enabled service, MR as a service to our customers. Let's have a look into what is really a breakthrough innovation and very close to my heart, I have to admit. I was part of this journey that took longer than 15 years from the very beginning. And I tell you, it's very rewarding, very rewarding to see that the FDA released a press release -- that's not what they typically do, stating that this is the first major imaging device advancement for computed tomography in a decade. So now it's about photon counting. And photon counting brings really or sparks a new era in CT imaging. You will see just when you look into the technical parameters, 2x the resolution, 40% less radiation dose, at the same time as well saving of contrast agent that we get here into a new league. But more important, though, is the impact on the clinical arena. And you recall the case that I've shown you at the beginning with the removal of the calcified plaque. At the same time, it will bring significant advances in the field of oncology. I put another case down there where you see the jaw of a patient imaged with photon-counting technology. And as you always have the spectral information with every scan you perform, you can see that the tumor in the jaw actually has blood flow. So it's a vital tumor. We create a lot of data. But data in hospitals do sit in various silos, and you have thousands of data points. But basically, for the clinical decision, you need maybe 50 to 60 critical ones. Radiologists sometimes take hours in order to collect the data for conferences out of the various silos. This we address with Syngo Carbon. We basically unify in one front end all the information from the very beginning of a radiology process to the final reporting into one solution, which is called Syngo Carbon. And the great thing is we have 20,000 syngo sites as of today that are potentially subject to upgrade to this type of technology in the field of enterprise imaging. I mentioned the example of MR, offering MR as a service. And that makes perfect sense because as I mentioned, shortage of staff associated with high labor costs at the same time is a key challenge in all health care systems around the world. So if we are able now to support our customers there in order to fill experience gaps and/or staff shortage by offering scanning and reading solutions, we tap into a new era as well of services. Artificial intelligence-powered reading is going to be key in the next couple of years. When you look into the high volumes that our customers have to cope with, from my point of view, in the next couple of years, there's no way around to invest in artificial intelligence-driven reading support. We have a very, very strong footprint there. We have already today more than 60 offerings around that field. We have access, which is key to a huge data -- huge clinical data sets in order to train our algorithms. We have protected ourselves very well with a leading patent portfolio in that field, and we become more and more a software company. Today, we can cover 35% of the human anatomy. And just giving you some of the latest examples on the right, yes, where we just launched the MR AI-Rad Companion Brain, in particular, right in time now when I think about the news around Alzheimer, then about to come in the close future the Rad Companion for cardiac CT. And it opens as well great opportunities in collaboration with Varian because with the AI-Rad Companion Organ RT, we connect basically the diagnostic field with the therapeutic field in order to support this artificial intelligence radiation therapy planning. So we are today at 35%, and our aim is to be at 85% by 2025. And that makes a big difference because you don't want to work with 10, 15 different solutions. You want to have somebody who is going on a journey with you in order to develop our portfolio and have an integrated workflow, integrated solution. So in order to get all -- to all this innovation, you need to have a strong fundament, and we have a very strong global footprint. We are present in all the geographies, be it in the United States, Germany. We are present in India, in China. We have access to the talent pools, we have access to local sourcing opportunities, and we have a lot of great market proximity. And in particular, in China, we are one of the leading medtech employers, multinational medtech employers. We have a very strong footprint, we have a very strong installed base, and we have great sourcing opportunities. And we move as well into new types of partnerships like public-private partnerships, with the Shanghai Innovation Center we recently launched, having a partnership with local authorities, local companies and local clinical players, and look there for targeted Chinese innovation as well, in particular on the digital field. So having now all this innovation, how is the business mechanic about? So what is fueling basically our wheel to success? And when you look how we translate innovation leadership, then you see 70% of the revenue from innovations as of today are from innovations introduced in the last 3 years, so more than 2/3 of our business. By leading innovation, we are about to gain market share, yes, just from '20 to '21, 150 basis points. This is translated as well then in a very strong recurring service business because all these new devices being installed typically come with a multiyear service agreement. So that as well today, 40% of our revenue is recurring and very resilient. We get innovator margins, so we have industry-leading margins around this that we steadily improve over the course of time. And that enables us to invest a significant amount of our revenue into the new innovations to further fuel the wheel. So to summarize, I have shown you that we are fighting the most threatening diseases, and what a different photon counting can make in that context. We have seen that we can enable efficient operations, talking about Syngo Carbon but as well digital-enabled services. And we are expanding access to care, giving you the first example with MR, and there is more to come. Leads to a midterm guidance for imaging until 2025 between 5% to 8% revenue growth and an adjusted EBIT margin between 20 and 80 basis points improved. Thank you very much for your attention. And with that, the floor is open for questions.

So thank you, André. That was very inspiring and interesting, probably also for our analysts and investors who are anxiously waiting for the first segment Q&A that's just about to start. Just maybe let me remind you out there asking the questions that we have in these segment Q&As our business leaders here. So maybe you might refrain from asking too detailed financial questions in this session but rather reserve them for the last slot that we have together with Jochen and Bernd. [Operator Instructions] And we will start the Q&A now. The first caller in line for me here is Will Mackie from Kepler Chevreux.

Great, great presentation. I wanted to dig into 2 areas first. When we talk about the growth ambitions across your segments, could you dive a little deeper into how you see the variances of growth perhaps by region and also by particular business area, whether it's service and products and the contribution that we might expect from the new innovations you've mentioned? So that's a general question on the growth across the group -- segment. The second relates to the exciting innovations around AI and the application of AI. Can you perhaps discuss how you are able to sell the value proposition of AI to your customers? And particularly when you're working with your AI algorithms, are they able to utilize data from different competitor machines? Or is this typically a closed system?

Yes. Thank you, Will, for raising that question. So let me start with the first one. I mean we gave the guidance of 5% to 8%. We don't break it further down into various years or into respective service revenue portion. I mean of course, you can calculate, we have 40% service revenue, so that kind of translates into something, but we don't give there more details on that one. When it gets to artificial intelligence, the value proposition is basically that you need to do or that we enable our customers to do more with less. When you look into these high-resolution data sets that we produce today, then sometimes it's thousands of images. When you look into, for instance, the case of photon counting, it can be easily 4,000 images for a larger study. There's so much information in there so that there are various aspects. The one thing is you want to be sure that you don't miss anything. The second thing is you want to be sure that you don't spend too much time on single cases. So it's really about speed, and it is as well about quality. We are not limited to the data from our systems, so our AI solutions can work with data from all vendors. However, when you look into the workflow embedment, then it's important, of course, when you look into this, and it will be perfectly embedded in the future in Syngo Carbon so that you really have a completely un-disruptive workflow, and there is then a proprietary advantage as you would use it with different systems.

So next one in line would be Veronika Dubajova from Goldman Sachs. So then we go over to Scott Bardo from Berenberg.

Can you hear me okay?

Yes. Thanks. We hear you.

Perfect. Sorry, yes, you've also gone to mute on my system now. So maybe just a couple of questions if you can hear me. So you can. Thanks, Marc. So first question, please, André. I wonder if you can give us a sense of how big the high-end CT market is within the current CT market. And therefore, how much market share do you anticipate taking with the photon-counting CT? Or how do you expect that segment of the market to grow? That would be very helpful. And perhaps a similar question please on the MAGNETOM Free.Max. Again, MRI, very successful franchise for Healthineers. Can you give us some sense of addressable opportunity for that sort of approach into some of the verticals you highlight?

Yes. Okay. Scott, thank you very much for the questions. Great questions. So let's start with the high-end market, yes? So when you look into photon counting, what is going to happen is that it will be very attractive in particular in the first years for academic centers. And you will see that there will be a lot of activities in order to raise third-party funds as well, yes, and so on in order to get access to these type of systems. So to some degree, this is really adding to the high-end markets and not cannibalizing it. And you think about that, there are a few thousand academic institutions out there. I think this alone already is a great opportunity. And everybody wants to have access to the research opportunities that you have with this system. And from that point of view, we expect a little bit of an extra drive in this high-end segment that we already today lead. We are in a range of 40-plus percent market share in that arena, and certainly, there is then additional opportunity when we think about Naeotom Alpha. On the MR side, we are really looking for places where in the past, budgets have not been allocated for MR because basically, it wasn't affordable. So I believe that will spark new thoughts in the customer base. They will think about now as MR becomes in their reach, they will think about how to fund it, yes, and maybe as well redirect funds from non-imaging, from non-imaging investments into the imaging arena. So we see that in particular in spaces like orthopedics. We see that in the arena of ICU. We see that in the arena of pediatrics. In the future, we believe there is as well a good chance on more specific niches, yes, when you look like dental, for instance, for MR. So there is a lot of clinical areas where MR now becomes attractive and where we believe there will be funds made available in order to get access to the technology.

Thanks for your questions, Scott. So now we give it a second try with Veronika. So we've sorted out your audio problems, and you should be live on screen. Can we hear you?

Can you hear me?

Yes.

Veronika, yes. Loud and clear. Perfect.

Excellent. Fantastic. Second try, I'm lucky. I just want to follow up on Scott's question around the high-end CT market, and just would love to get your thoughts a little bit on sort of the age of the devices that are out there and whether you think there maybe might be a pent-up upgrade cycle and how significant that could be. I know it's a tough question, but obviously, you have been talking about this technology for a while. And so I suspect there might be some customers who have been holding off for a bit before going out there and purchasing another high-end CT. So that's my first question. And then my second question is on Monday in the Shape 22 event. You did mention a new MRI product called Free.Star. And so I'd just love to understand the differences between that and the Free.Max both in terms of capability and market opportunity and also maybe a little bit on pricing and profitability for you guys.

Yes. I mean let's start with the question regarding photon-counting CT, the CT high-end market. I mean you are right, yes. There are certainly a few people who did postpone some of the budgets in order to replace systems because they may have anticipated that something like the Naeotom Alpha is going to come. But I believe the stronger impact you will have due to the fact that this system opens so much additional opportunities, so from my point of view, what we'll see is we will see a strong catch-up at the beginning, and then it likely will stay on a pretty stable high level there. The second question around MR, first of all, the difference between the Free.Star and the Free.Max is the bore size. The Free.Star comes with a smaller bore, a 60-centimeter bore, but that enabled us really to bring the costs further down and make it even more affordable for entry-level segments. So that's the main difference there, but it's based upon the same platform. And the third aspect, you just need to help me, again, Veronika. The third aspect was on...

Pricing for Free.Star.

Yes. I mean this is really -- we look at it that way. I mean it is 30% less from a TCO point of view of what we had before with our entry-level systems. But it's tough to talk about specific prices. The configuration and variation of configurations, deep as well, too, a strong variation in price, and as well, there is a country element in there. So it's tough to unreel their dedicated pricing.

And would you think the Free.Star is more an EM product versus the Free.Max is more of a DM product, and that's kind of how you guys are thinking about it? Or am I sort of putting it too much in buckets?

Yes, I think both. Either way. Yes, it really depends on the requirements, yes. But I mean one thing is clear, due to the very favorable TCOs of the Star, we're going to expect this being in a lot of places, really the first MR and the first time that it gets into a reach of -- in terms of affordability.

Thanks, Veronika. So the next one online would be Lisa Clive from Bernstein.

Great. Yes, I struggled with the IT, so here I am. There has been a lot of investment into artificial intelligence and imaging over the past several years. I'm just trying to understand how much of that you're able to monetize today and if that will increase in the future. And I guess as a follow-on to that, is it fair to assume that if you reach the high end of your 5% to 8% imaging revenue growth target, that an uptick in mix will be a notable contributor?

I mean first of all, all the factors that I have been mentioning in the presentation will basically account for the growth in the range to 5% to 8%. And it's hard to predict to what extent exactly this is going to be. Yes, on the artificial intelligence side, that is in continuous investment fields on our end, but we don't break now the imaging P&L down to individual pieces and the software piece. You recall the Q&A from Bernd and Jochen, yes. Basically, what we aim for is that we turn more and more on the software revenue side from a more CapEx style of investment to a Software-as-a-Service style of investment. And this is what we have introduced with the AI-Rad Companion. And that is really one of the main areas where we want to get to, that we have more and more recurring revenue out of this, making us more resilient.

Okay. Then maybe to look at this another way, as we think about that 5% to 8% growth, what would be the growth rate just in machines? I guess trying to think of this in terms of volume and pricing mix software on top but just the growth of the -- of your imaging equipment specifically.

I mean obviously, the equipment side is going to be the major portion of it. But as I mentioned, we don't break it further down in the respective individual P&Ls.

Thanks, Lisa. So that brings us to, at least for the time being, the last one in the queue. That's Falko from Deutsche Bank.

Can you hear me?

Yes.

Yes, loud and clear.

Excellent. Two questions, please. The first one on photon-counting CT. How many years ahead of your competition with that technology? And when would you expect them to catch up and launch similar devices? And then secondly, on the AI reading support feature, do you have any data on the penetration in the field, meaning how many of your radiology customers are actually using this offering already today? And where do you expect it to go until 2025?

Yes. Let's -- starting with photon counting, yes. Sorry, I didn't get -- can you repeat the photon counting question?

Yes. How many years are you ahead of your competition in the technology?

Yes. I mean it's tough to really comment on competition, and we typically don't do that. I mean we invested 18 years as of -- 18 years of research basically in order to get there. And it was in between sometimes as well a bulky road, a rough ride in order to get there. We had all the ingredients, the entire value chain from the crystal growth until the final system integration in our hand, which makes us unique from my point of view. So clearly, we see us significantly ahead of competition. It's hard to quantify in years, but near term, I won't expect to see the first competitor solution. But certainly, we are aware that they are all investing in that field. AI, as mentioned, yes, I mean what you see is that the request for AI support is growing and growing and growing. There is no real good data yet to say how many customers are already using AI support as of today. But there is clearly the tendency to move stronger into this, in particular on those sites that have issues to read this massive amount of volumes. And that is what we feel as well, that we get more and more requests around artificial intelligence and reading support in order to do more with less.

Great. Thanks, Falko. So we have about 90 seconds left. So Will Mackie would be -- a short question left for you if we can quickly squeeze you in.

Okay. Can you speak about the evolution of value partnerships as a business development over the past 3 to 5 years and how you see that accelerating? And perhaps within the scope of the value partnerships, a short discussion on the proposition of imaging as a service enabled by AI and remote connectivity. How significant is that then the business mix now? And how could it grow?

Yes. When you look into AI and digital-enabled services around that, you -- we are basically now at the beginning, yes. But we take the elements, digital elements, including as well the scanner portfolio, combine that smartly in order to be able to take this or elements that the customer wants us to take from the value chain over and scale it. And of course, in value partnerships, this is going to be one of the key discussions because when we -- in value partnerships, the main themes are around operational efficiency and cost pressure but as well as medical advancements. And they are clearly -- with digital-enabled services, we may have an inroad like in CTSI with Varian, to offer services to the customer, leverage our scale and be more cost-efficient as well. So it's going to be a win-win situation for both sides. And yes, I do expect that in value partnerships, this is becoming a very, very relevant element.

Thanks, Will. So thank you for your questions. Thanks, André, for the great presentation and your time.

Thank you, Marc.

This brings segment -- the segment Imaging to an end, the presentation and the Q&A, not more. And we now head over to Diagnostics. And let me welcome to me here on stage Deepak Nath, straight in from Tarrytown, New York where our Diagnostics headquarters are based. Deepak, pleased to have you here.

Thank you. It's a pleasure for me to be here. Good day. Super excited. In vitro diagnostics was top of mind for the world over in a way that those of us in the industry could not have imagined even 2 years ago. At Healthineers, we're well positioned in this segment especially on the back of tremendous progress we have made on the turnaround plan that we previously communicated. I want to talk about 4 topics today. First, I want to talk about the market, how it's evolved and our place within it. I want to talk about Atellica Solution, our key driver of growth. I want to talk about the exciting pipeline that we have. And fourth, I want to talk about the plan that we're executing on that gets us to deliver the 4% to 6% growth entering into 2024 and the mid-teens margins that has been communicated by Jochen and Bernd earlier today. So with that, let's get right into it. In many ways, we are in a golden era of diagnostics fueled by COVID. It's an attractive segment. And in our addressable market, we see 5% growth over the planning period. There are 4 factors that are shaping this market. First is demographics with more people entering into the system, driving the need for testing. We see cost pressures manifest in different ways in health care systems around the world but with the imperative to do more with less. We see technological advances providing even more information to help in clinical decision support. And fourth, we see a broadening of access to testing in markets around the world. All of this is fueling a bifurcation in the market that began some time ago with more and more testing being done in near-patient settings, in decentralized settings; on the other end of the spectrum, testing being driven into networks of consolidated laboratories, hospital or reference laboratories. At Healthineers, we're well positioned in this bifurcated market. We've got a product portfolio in terms of our strategy to deliver workflow excellence, an area where we have been strong historically. At the same time, we're focused on delivering clinical value for our customers and, with our digital offering, bridging testing that's done in the point-of-care setting as well as in the core lab. So the portfolio we have on the point-of-care side allows us to provide quality testing at the point of need to enable fast, actionable results for therapeutic actions and to foster conversation between patient and provider. On the core laboratory side, we've got scalable solutions, highly automated systems for the larger laboratories and the integrated analyzers for low- to mid-volume settings. And we have a portfolio that expands our ecosystem particularly on Atellica both in point of care and in the laboratory. And we've got a development program that features assays to augment the clinical value that we provide to customers today. So how are we doing with this portfolio? 2021 was a strong year for us, as Bernd and Jochen shared earlier. We're able to deliver excess of EUR 5 billion on the top line at a 13-plus percent margin. Our rapid antigen tests were a key driver of this growth. But when you peel the COVID-related tests off this and look at just the core business, whether on the point of care or laboratory diagnostics, you see strength in our business, and our performance excluding COVID was right in line with our competitors. We today have a 14% share of the market. We are #2 in the point-of-care segment and #3 across all the segments in laboratory diagnostics, and we've retained our leading, market-leading position in the United States. So over the last couple of years, we've been able to stabilize market share in this area, and we have a great plan that gets us to build from this position. Now let me talk about Atellica, which is the second part of our presentation, which is a key catalyst for growth for us. Atellica is an unparalleled product in terms of bringing workflow efficiencies to the laboratory. It features a modular, scalable, flexible architecture, and it enables the highest throughput on the immunoassay side in the industry. It's built with AI capabilities on board, and it has 100-plus sensors that is built with -- that provide in real time an operational status of the instrument that enables, among other things, remote troubleshooting. The benefits it brings to the lab, as these statistics show very simply, is laboratories being able to operate with fewer operators, which is important in an environment there's a shortage of skilled labor; less hands-on time for the staff that are in the laboratory; and laboratories being able to accomplish what they need to do with fewer analyzers. We've gotten tremendous traction with Atellica so far globally. We've shipped over 6,000 analyzers to markets worldwide, covering large laboratories and medium-sized laboratories. Where we've had the greatest resonance is in the mega lab segment where our win rate is well over 80%. This video behind me shows Quest and Pardini, 2 of the largest laboratories in the world. They both feature more than 100,000 tests per day. The key to success here is, of course, Atellica. Without Atellica, these labs simply could not do what they need to do in terms of serving the needs of the P&L -- I think I'm in the wrong place. Thank you. The labs simply could not do what they need to do and benefits -- that benefits their P&L. The other star of the show is actually our people. The capabilities that have -- we've built and honed over time to take projects like this right from the blueprint stage through the design and construction and the reporting of patient results is simply unparalleled in the industry. Now turning now to the next part of the presentation. We acknowledged back in 2019 that we are -- we had some teething issues as we introduced Atellica to market, and we had our work cut out for us to deliver on the promise of Atellica. So we had outlined a 3-part action plan that we've been working hard towards. The first was to drive performance and reliability improvements. The second is to improve our cycle times from shipment to the reporting of patient results. And third is to sharpen our commercial execution. So I want to talk about the progress now we've made in each of these areas. In the first 2 areas, we've made tremendous progress in improving the reliability and stability of the systems. As measured by, for example, reactive service visits where over the last couple of years, we've reduced reactive visits by 50%, and the mean time between failures or mean cycles between failures has improved by a remarkable 150%. At the same time, we've made tremendous improvements in our cycle times. Over the last 2 years, the time it takes for us to go from shipment to the reporting results has improved by over 20%. And the mean time to go live -- sorry, the mean time to go live by 30%, and the implementation effort required has improved by about 20%. So tremendous progress in terms of maturing the platform, our experience with this platform, in terms of making it productive in the hands of our customer. At the same time, we've been hard at work improving our commercial execution. Our order book from the first full year of launch in fiscal 2018 to today has improved by over 50%. Of course, last year, fiscal '20 was a soft year given COVID, but we have improved our order intake during that time. Importantly, deal quality over this period of time has improved by 40%, and deal quality is measured by our variable contribution margin. And this -- the basis for this is pricing excellence. We've gotten better at configuring our systems, the amount of hardware required to run a laboratory and also the amount of assays that are loaded on to the instrument that we've contracted in the beginning. At the same time, we see a dramatic increase in the utilization of our instruments as laboratories integrate Atellica into routine use. And in fact, our cost base for Atellica now is on a par with our legacy platform, demonstrating the maturation of Atellica as a platform in our hands. So great progress for us over the last couple of years. On the back of this progress, I now want to talk about our pipeline. Over the next 3 years, we plan to introduce -- 3, 4 years, an unprecedented number of products. And we begin now a very exciting chapter in our history in terms of new product introductions. So let me talk about the instruments first, and then I'll talk about assays. On the instrument side, CI1900, as was referenced earlier, is our lead product. It allows us to take the power of Atellica and bring it into low- and mid-volume hospitals or spokes within hub-and-spoke kind of networks. It's built with the same technology, the same reagents and the same consumables as Atellica with a far lower cost structure. Secondly, we have Atellica Integrated Automation, which provides additional productivity tools in the same footprint as Atellica Solution to automate even more aspects of workflow, particularly the pre-analytical stages. And that, we introduce by module over the next 2 years, starting in fiscal 2022. And just to go back to CI1900, we plan to introduce that into the market in 2023. Then finally, in hematology, we plan to introduce a whole line of analyzers for low-, mid-, high-volume settings that is going to rejuvenate that franchise. And that cadence of introduction starts starting in 2023 and, based on geography, comes into line over the next couple of years. So a tremendous portfolio of instruments that expands the ecosystem of Atellica. Turning now to assays as we drive and bring additional clinical value for our customers. We've got an exciting pipeline of 50-plus assets. Actually, that number is 52 that we plan to bring forward over the next 4 years, 12 of those in 2022, 21 in 2023, 14 in 2024 and the residual in 2025. About 1/3 of those assays are in our focus disease areas that Bernd talked about, in oncology, neurology and cardiology, and the balance right across the spectrum in terms of disease states. 70% of these assays are new assays, with the balance being essentially improvements. And what we're seeking to do is bring forward the type of differentiated assays that Bernd mentioned, Enhanced Liver Fibrosis, which we're proud to be able to say we've got a de novo marketing authorization from the FDA that represents a culmination of 10 years' worth of work. We're now excited to enter into the neuro space with the neurofilament light blood test, which is an exciting new market to come along over the last 5 years particularly for neurodegenerative diseases, especially multiple sclerosis. So we plan to do with it what we've done with ELF. So the key here is for us to not only fill the gaps that we have in our menu, improve the depth and breadth but also bring forward truly unique and differentiated assays that we're super excited about. Now let me talk about point of care. And here, I've got a little show and tell. We have made tremendous progress on pipelines here, but our most exciting development program is Atellica VTLi. We achieved CE mark for this back in April. It has the power to put at a patient or provider's fingertips tremendous amount of information, so an immunoassay platform that provides unrivaled sensitivity and specificity. Our lead product with this is actually high-sense troponin. It's the only platform available on the market today that's able to provide high-sense troponin results from a fingerprint within 8 minutes. The potential for this is tremendous. Imagine this analyzer that I just demonstrated to you in a ambulance as a patient suspected of having a heart attack can get -- and the providers there can prick the patient's finger and get important information about the troponin levels. And those can be transferred now into a laboratory environment with the results being concordant as other tests get done on this. That's just the lead product. We have a huge pipeline behind it to develop other cardiac markers, other infectious disease markers and other critical care type of markers, particularly for sepsis. Exciting things to come in our point-of-care business. Now as we think beyond our imperatives over the next 2 to 3 years, go into a mode of shaping diagnostics, shaping the industry, we're excited about the possibilities they are. We have now established a new Center for Diagnostic Innovation that's led by a new leader, Dr. Ranga Sampath. And the idea here is to bring forward pioneering breakthroughs into diagnostics. Three areas. First, neuro -- first oncology. The combination with Varian provides tremendous opportunities for us to bring our advantages and our strengths in diagnostics, particularly in computational genomics that we have, together with the power of Varian around digital data and all capabilities in radiation oncology together to improve outcomes, whether it's in screening, in diagnosis or in radiotherapy. So very excited about the possibilities that we have to augment our oncology offerings and diagnostics. Neurology, I alluded to this with the neuro light filament, but we are continuing to make progress on that and enter into new areas such as Alzheimer's and other disease areas in neuro. A third and exciting area, thinking about the triangle that Bernd mentioned, is in digital, using our capabilities in AI and digital to gain new insights through a combination of markers rather than individual markers. And here, it's about putting to work the capabilities that we have, very unique, in order to bring forward a new set of offerings in digital. We pioneered this with COVID where we developed an AI-based COVID algorithm to help clinicians assess the severity of COVID in a patient. And this is in use, in investigational use in 3 or 4 centers around the world. It was a proof of principle for us to be able to bring forward new and unique sort of offerings in this space. Turning now to the right half of the slide, expanding our reach. We're making tremendous investments in China, expanding our manufacturing capabilities. We've been hard at work bringing a new factory online, an immuno-assay factory online, which will get fully operational in 2023 in the Chinese market. In addition, we're exploring opportunities to build on the success so far with rapid antigen tests to bring even more solutions forward in decentralized testing particularly in the area of rapid lateral flow technology. When you put these 2 together, a combination of what we're doing on the immuno-assay -- on the instrument side, on the assay side, our aspirations under new ambition to bring forward market-shaping diagnostics, there could not be a better time than now in diagnostics to begin a new chapter. Turning now to the third aspect -- actually before I go into this piece, I want to talk -- spend a moment talking about COVID where over the last 18 months, despite the imperatives we have in terms of our turnaround, we found a way to make a difference, to help society at a time of need through our product offerings, whether it's in the area of diagnosis, in the management of COVID patients or patients who are severely ill or in monitoring. And here, it showcases the power of Healthineers Diagnostics. On the one side, on innovation, where we had a couple of firsts. We were the first to bring forward a semiquantitative test in the United States market. In fact, the FDA did its own press release in this regard to highlight the importance of the offering that we had. We were among the first companies to recognize the importance of neutralizing antibodies based off of the spike protein and design our tests with that in mind. COVID also presented an opportunity for us to showcase our entrepreneurial spirit and demonstrate the power of our scale and reach with what the point-of-care team did, bringing forward the rapid antigen test to market in a number of important areas. And then finally, in terms of COVID management, we have a whole portfolio of 25 critical care tests, some of them highly differentiated, whether it's in the blood gas testing side or D-dimer, for example, that made an important difference in the care of patients who are severely ill. So we shipped well over 300 million tests in the last fiscal year across our different modalities. Turning now into the fourth part of my presentation, which is how do we plan to deliver the 4% to 6% growth by entering into 2024 and mid-teens margin by 2025. The first pillar of this is commercial excellence. I talked about the progress we've made in the context of Atellica to improve our commercial performance. It's all the things that I mentioned, pricing excellence, it's improved deal quality, it's driving higher instrument utilization in the way we construct our deals, but in fact, all the commercial activity that happens once the instruments are actually placed at an account. And importantly, with the cadence of products we plan to launch on the instrument and assay side in each of the next 4 years, executing flawlessly in terms of the launch of these key -- these products is going to be key to our success in terms of getting to the 4% to 6% corridor. And then the next 2 pieces are about tackling the big parts of our cost structure. On the service side, harnessing the capabilities of Atellica. I mentioned the 100-plus sensors that enables remote troubleshooting. That enables us to make come to life remote service delivery and really bring proactive service, a digitalized service to life. The imperative there is to hold our service costs flat even as our installed base grows by mid- to high single digits. And the complexity of our portfolio increases over the next 3 to 4 years as we bring new platforms on to market. On the supply chain side, as we convert more of our portfolio onto Atellica, we have an opportunity to reexamine critically our network. What we manufacture where in order to drive the next level of resiliency within our network and importantly, to make very, very significant improvements to our cost structure. That requires an investment, of course, but we have a plan in place that allows us to expand our margins to the mid-teens corridor as we enter into 2025. So we've got a robust plan that allows us to get there, but a plan is no good without having the right team in place. And over the last 2 to 3 years, we've invested heavily to build a competitive diagnostics organization. We've transformed the org structure particularly on the commercial side, where we now have 3 levels of management at a country, zone and region level who are 100% dedicated to diagnostics reporting into me. And that has allowed us to recruit the right caliber of talent and bring the right focus, discipline and sophistication and execution. Second, as we enable our strategy to bring more clinical value to our customers, we have invested to augment our medical, clinical and scientific affairs capability. We've also coalesced our disparate efforts into the Center for Innovation Diagnostics that I mentioned earlier to bring a greater intentionality and focus to our aspiration to bring breakthrough into diagnostics. And we've strengthened our R&D organization in critical areas. Our approach has been to build on the strengths and talents that we had at Healthineers and to go out into the market to recruit the best of the best in selected areas. The end result is we have a team that we've selected for seniority, for depth of domain experience and quality of experience in diagnostics, leadership and long and visible track records of success. The combination of which is we have a world-class, all-star team in diagnostics that's second to none in the industry. So finally, now, as we make our contributions as Healthineers to pioneer breakthroughs in health care and diagnostics for everyone everywhere, we've got the right products, we've got the right pipeline, we've got the right plan and importantly, the right people and leadership to deliver against our aspirations of 4% to 6% growth entering into 2024, mid-teens margin by 2025. Thank you very much. Marc?

Thanks, Deepak. I love the video from the Quest side, it really kind of shows what complexity our Atellica Solution is able to muster. So it's time again for Q&A. We have slightly less than 15 minutes for the questions in the field. I've seen that we have quite a queue already that has been registering. So I don't want to take too much time in talking. And I would call up Patrick Wood would be our first one to ask his questions. So Patrick?

I appreciate the questions. I have 2, please. Curious for any update, if you were to take a step back and look at your customer base, best guess, what proportion of your customers are now the larger, centralized reference labs with the high volumes relative to the sort of midsize, I don't want to say mom and pop, but you know what I mean, that shift of the customer base, how far through that journey are we? So that's the first question. And then the second question, interested on the ELF side of things. It's -- NASH is a space where in the Dx side, there's a reasonable amount of competition. You've got companies like Perspectum. I think they've got a partnership with GE on the scan side. I'm just curious, how do you view the competitive landscape and what the ultimate opportunity for that kind of a test is?

Sure. On the first part, in terms of proportion of test, it really does depend on where you are in the world. We do see the consolidation happening. I mean, I wouldn't want to hazard a guess in terms of what the number is. But what I can tell you is over the last even 3 years, we've seen an increasing number of testing -- a number of institutions accounting for larger and larger and more tests. So what's happening is reference labs acquiring either small laboratories or performing tests for hospitals, right, that factor at work. So it's hard to put a number there, Patrick, but I think what I can speak to is a trend that shows that more and more of that testing is being done in those settings, right? In terms of ELF, clearly, there's an alternative. And right now, the standard of care is ultrasound-based imaging, and you referenced those in the market. The potential we see now is a significant expansion where it's a simple blood test can provide a significant amount of information that has the potential not to broaden this pool, right? So now going into essentially a GP type of setting, for to be -- to educate either a gastroenterologist or a primary care physician to order these tests based on risk factors and then to kind of get into the care pathway from there on out. So the potential we see is less a head-to-head competition with what's out there today, more about actually growing of the pie with this unique and differentiated test. So that's the potential that we see. And obviously, as much work remains ahead of us in order for us to activate the potential and to capture the opportunity that exists with this and to bring forward a unique solution that impacts about 25% of the population, the adult population today.

Thanks, Patrick. Next one on the line would be Lisa Clive by phone again. So Lisa, we should be hearing you.

Great. A few questions from me. So first of all, the POC platform looks very interesting. You mentioned the finger prick test for troponin. Is this proprietary to Healthineers being able to use just the finger prick? And is it patented and for how long?

It is. It is proprietary to us. It is patented, and I'll have to get back to you on the duration of patent, Lisa. But absolutely, it is really a game-changing technology that we have literally in our hands.

Okay. And you mentioned Alzheimer's just in passing in your comments. But now that there's an FDA-approved drug testing in this area, it's clearly going to increase and the current sort of spinal fluid-based testing is clearly not ideal. Are you working on any Alzheimer's test either using mass spec or immunoassay, which seems to be the 2 approaches that are in development right now?

Yes. We're looking really more on the immunoassay side, Lisa. As you well know, it's not one marker in Alzheimer's. It's a complicated field with multiple biomarkers that we need to kind of go -- to go after in order to yield some insights there. But our focus is on the immunoassay side in terms of bringing forward solutions. We're in early stages here, Lisa. So I don't want to go into too much more detail, but the short answer, our focus is on the immunoassay side.

Okay. And then lastly, I've read a bit about your computational genomics platform, which you mentioned. But can you just explain to the layperson what this platform does? And it's particularly interesting because it appears that this is a way that Healthineers' IVD business can get involved in some of the diagnostics that are actually mainly getting done with various molecular platforms where you aren't much of a player. So would just love to hear more about this.

Yes. So it's less a platform, Lisa. It's a capability we have in computation genomics. It's the ability to now parse information to help with either biomarker identification or discovery efforts, or really where we are focused is on looking at combination of biomarkers. So it's less a platform, Lisa. And as you know, we're not significant players on the molecular side. So really here, what I'm alluding to is the ability for us to play a role in the identification of biomarkers on the discovery side of biomarkers.

Okay. Great. And then just lastly, a follow-up on the Alzheimer's testing. Are you looking at a tau or amyloid beta biomarker at the moment?

We're looking at tau, for sure, and we're also looking at other things, but definitely, I can confirm that we're looking at tau. That's my response.

Thank you, Lisa. So now next one in the queue is Scott Bardo. Scott?

Yes. So I think Asia Pacific is an important part of your business, around 20% of sales. And we're certainly picking up increasing nationalistic tones in that region or some evidence of provincial tenders and so forth. I wonder if you can make any comment to whether the growth opportunities in Asia are now inferior to history or whether this indeed represents a broad opportunity for a domestically present organization? So that's the first question, please, Deepak. And the second question, please. At the time of the spinout, I think the group communicated margin targets around 16% to 19% of the diagnostic business. And of course, the mid sort of teens margin you outlined today is still a meaningful step-up from where we are today. But I'd love to hear some thoughts about the line of direction. Do you still think those more ambitious targets are a realistic opportunity for the group at some point? I'd like to hear that.

Great. Scott, so thank you for the questions. So first off, we do -- I think your comments are aimed more at China, so I'll talk about that. So we remain very much bullish on the opportunity in China. There are, of course, fairly significant moves happening in market in terms of value-based -- volume-based procurement and things like this that are being rolled out from province to province. So there are fundamental shifts taking place. Having said that, we take a long view in China. We aim to be the partners of choice for the Chinese government. Today, we are not the market leaders in China. That presents an opportunity for us to grow and take share within that market. So with that long view, we're taking -- I mentioned the manufacturing side of things. We believe it's an important investment and an important signal to the Chinese government in terms of aspirations and how long term we're actually thinking, right? And it's an immunoassay plant, so fairly significant value that's going to be added in country. So we believe there's a significant investment that will make a difference. What I did mention, what I'll highlight here is in addition to manufacturing, we plan to bring forward late-stage asset development capabilities in country, which I believe will make an important difference. We already have an innovation center on the imaging side in Shanghai. And so capitalizing on our success so far in the imaging side of the business and bring forward those success stories into diagnostics. So we believe the demonstration of our long-term view, the demonstration through investment, our aspiration to be in the country long haul will make a difference. The third thing on the practical level, we are #3 in the market. There's plenty of opportunity that we see on the back of these investments and commercial execution to take share. And I mentioned having the right leadership team in place. We have in Kenny Lam a very seasoned leader who came from Abbott, who drove Abbott's success in China in the core lab and his subsequent investment banking experience where he led HSBC's health care investing efforts, and the combination of those things I do believe will make the difference in terms of taking our performance in market to the next level. So that's kind of in a nutshell how we look at the opportunity in China and how in the near term we plan to do better. The second question -- sorry, if you could remind me, again, Scott, I lost my train of thought there.

Yes, sure. It was just that the initial...

Yes. So the margin, yes, I got it. Yes, thanks. So first of all, the previously communicated targets, we do believe are achievable. Time shifted in time. We had previously articulated were about delayed a little bit in terms of our ability to get to those previously communicated targets. So over this planning cycle, as Jochen mentioned, we're going to be on the back end of that cycle to really hit the mid-teens number that was communicated. We believe the previously communicated target are within reach. And some of the initiatives we've talked about, particularly on the supply chain side, we believe are going to get us to those previously communicated targets. But it's going to take us some time to make progress on the initiatives laid out because those are, as you can imagine, not a short-term set of things that we've got to do there. But short answer is we do expect to get there. It's just time shifted in time and outside of the planning window that we've currently communicated.

Thank you, Scott. We are now heading over to Veronika Dubajova from Goldman Sachs. Welcome back, Veronika.

I just wanted to ask you, Deepak, a little bit about the service organization. I know that was also in the past one of the struggles that you have had in terms of customer retention. So maybe if you can give us an update on the kind of changes that you've made to that organization and whether you think the quality of service and the relationships that you have with customers have improved as a result of that and maybe how much further do you have to go on that front? So that's my first question. And then my second question is just a little bit of a confirmation. The CI1900, did you say the launch is 2023? I might be misremembering, but I thought that might have been on the cards for '22. So any delays there? Or am I just mistaken in my recollection?

Great. Thank you, Veronika. First of all, hello. So the first part of your question there in terms of -- so let me answer the second one first, the delays with respect to CI1900. You're not misremembering. We originally had 2022. The COVID has impacted our time line a bit here. So our ability to do some of the work in the context of the pandemic, which involved folks having to be on-site in front of the instrument to do some of the verification, validation work was -- has caused a delay that shifted it into the next fiscal year, which is why we've now communicated 2023 versus 2022. So that is indeed...

Sorry.

No worries. No worries. So that is indeed a factor in this. And the first part of your question was around -- sorry, I'm blanking here. Can you remind me again on the first part -- the first question?

So I know it was just a timing for Atellica and then the service organization.

The service organization, yes, so sorry. So first of all, the root of that was an inherent kind of instability and unreliability of the system at the time that we introduced this. It was less a factor of having the wrong folks in our service organization or an inherent weakness in service per se. It was that we weren't as well trained as we could have been. We weren't as experienced with the platform as we could have been. And so the combination of that plus the instability in the platform led to the kind of customer experience that you alluded to. So what have we done about it? First and foremost, some of the metrics that I've demonstrated in terms of the improved reliability of the system, that's the root cause of it. We've come a long, long way since you and I talked back in 2019 in terms of the reliability of the fleet. I mean, really a long way. And some of the metrics do it some justice in terms of what we've been able to accomplish. Second, we've also improved greatly the proficiency of our organization, just pure experience of our field teams to be able to work with the instruments, resolve issues. Our first-time fix rate, I didn't pull up that metric, has actually gone up by well over 50% during the same period of time. And that speaks to the growing experience level and proficiency with the platform. And then finally, on the organizational side, I alluded to the fact that we've now verticalized the organization where we have a diagnostics-oriented service or the core lab-oriented service folks reporting into the business. So a much, much closer tie between the commercial leaders in diagnostics and the service leaders who are responsible for executing on the service and the organization. And that level of collaboration between commercial and service, as you well know, Veronika, is kind of the industry standard or the standard of the in vitro diagnostics industry. So the combination, reliability, the proficiency plus this org construct, I believe, will stand us in very good stead as we go forward into this planning period.

So time has actually run out for a Q&A session. I think the day is going to be very long anyway. So I know there are a few people on the queue still. You know that we have a final Q&A session with Bernd and Jochen. We can try to take your questions in that session. And other than that, we can also, of course, try and take your questions off-line and solve this with the diagnostics organization, yes. So thanks, Deepak, for your time. Thanks for the detailed presentation and Q&A. Looking forward to seeing you back in Tarrytown when we are road showing in the U.S. And now it's really time for a longer break, yes. So we have 30 minutes for you to grab some lunch, for us to refresh, and then we'll be back with a new joiner in Healthineers, Chris Toth from Varian; and also, a bit of a new joiner in -- at least in the segment management team, Carsten Bertram, who will be presenting Advanced Therapies. So see you back in 30 minutes. Bye. [Break]

So welcome back to the second part of our Capital Market Day. We will have, again, 2 segment sessions now with attached Q&A. So welcome with me on stage, live on stage, all the way from California, Chris Toth from Varian. Chris, the floor is yours.

Thank you, Marc. Appreciate it. Hello, everyone. First, just before starting, I want to take a brief moment. I've had the fortunate opportunity to be with Varian for 21 years, starting as an intern, and throughout the course of that time, saw many meaningful innovations, achievements and breadth of expansion in cancer care. But I am standing here today in front of you 7 months into being a Healthineer, and I am very proud to be a Healthineer. In fact, I have never been more convinced that together as one company, we will save more cancer patient lives than we ever could apart. Earlier today, you heard from Bernd talking about the purpose statement of Siemens Healthineers. We pioneer breakthroughs in health care for everyone, everywhere. You also heard Darleen share about culture is not the soft stuff, it's the stuff. And I can share with you what I've seen over the 7-month period is a beautiful blending of the 2 organizations, not just in the context of what we can do in terms of new innovation to save lives, and there is plenty there, and I will share that with you to show why you've seen our ambitions increase with respect to financial performance. But it's also been about blending the 2 organizations together and taking the 11,000 Varian employees and the 55,000 Healthineers to come together to 66,000 Healthineers. In fact, within the Varian business area, prior to the combination, our vision was a world without fear of cancer, something we all hold deep in our hearts. We've seen that vision shift to the mission of the business area in service to we pioneer breakthroughs in health care for everyone, everywhere. Probably the moment that sticks out to me the most with respect to this cultural integration and trajectory forward is we had a kickoff of this joint purpose statement to our top leaders in the combined organization. And I have a long tenured Varian employee, who is a very strong leader in our organization, text me and she said, "Chris, this is so powerful. If we help a cancer patient live, but they die of a stroke, we have not done our job." So with that, I'd love to step forward and share with you a little bit more about cancer and specifically what we're going to do with respect to cancer as we look to the future. First and foremost, I think it's important to anchor in the fact that the cancer burden is growing globally. So we're not just participating in a market where we've got a strong market presence and leadership, but also a market where so many patients need our help. If you look at the left-hand side of the screen, you see in 2018, 18 million new cancer patients were diagnosed. This number is going to balloon to 30 million by 2040. To put that in context, that's almost a 67% increase in roughly a 2-decade span. But that's only half the story. The other half of the story, if you look at the icons and distinguish between the blue and the gray, blue represents those patients who have adequate access to care. Those in gray represent the patients that don't have access to care. And by the way, those patients that do have access have great heterogeneity in the available quality of care. So when we look to the right of the page, we see trends driving survivorship. There is optimism on the horizon as we move forward in creating a world without fear of cancer in service to driving breakthroughs in health care. If you look down in the bottom right of your page, the reality is there are true barriers that exist, capital budgets, clinical skills gaps, technology adoption, patient access. And looking at all the trends in the blue, within Healthineers, we represent the only med tech company that goes end-to-end in this regard. That's why we're accelerating into the future to help more patients live. And as you look at those below, what you'll hear from me as I take you through much of the picture of why we're so excited inside of Healthineers, you'll see how we're executing to address each of these barriers and challenges. But let me anchor you first with where we are. We are in an extremely strong position. Our radiation oncology business has had market leadership for decades, and that leadership will continue as we not only continue to take share but expand the market. And you will see some of those areas that will expand market as well as drive taking share. And this is both in conventional linear accelerators as well as proton therapy. We've had 2 additional very significant business lines emerge over the past 24 months. The first is in interventional oncology, and the second is in multidisciplinary oncology. And I'll seek to educate you a little bit more on how as these business lines grow, what you'll see is an expanded number of patients that we touch at accelerated growth rate. And when you look at the right-hand side of your page with the revenue split, both of those businesses, interventional oncology as well as multidisciplinary oncology are driven from recurring-type revenue streams. But before we dive in a little bit deeper to the businesses, I want to come back to something that Jochen shared with you today. We've seen such great progress with our teams. And watching what's been happening across each of the areas listed on the page, we've increased our expectations for our synergies by 2025 to EUR 350 million. And I'd like to take a few minutes and just walk you through some tangible, real examples that give us confidence in what was shared. I do want to emphasize as well a few notes from Jochen earlier today, the first of which is this is a growth story. And while we're seeing cost synergies that are extremely meaningful, we are using those cost synergies in '22 and '23 to fund new developments that will drive sustained long-term growth. So first, talking about scale. You heard Bernd talk about focus and scale, and this has really been the beauty of the combination. We've done a number of things to retain the focus within the Varian business area. But on the scale front, as we look at markets or geographies where we've been indirect and how to desire to go direct, we now have a different level of a platform to access. Not to mention, just think of basic things like procurement of software licenses to run the business or other type of things where we have new found purchasing power. And I've been so impressed with the Healthineers' capability around procurement. It's truly a core competency of the organization. Value partnerships. This has come up through all of my colleagues today. And what I've seen with value partnerships is relationships that exist at the C-level in an unparalleled fashion to what Varian had access to on an independent basis. Let me maybe give you a couple of examples. University of Missouri. I had the opportunity to join the Healthineers team and meet with the CEO of the University of Missouri. We talked about the picture of what Varian is creating as part of Healthineers and how we're seeking to accelerate new victories for cancer patients. Following that meeting, we've secured an Ethos adaptive therapy system that will be going in at the facility. I've had a chance to meet with many of the other CEOs across many of the institutions in the value partnership arena. Further to this, we have now seen opportunities where Varian has had strength in the cancer program, working with the Healthineers team to open new doors for value partnerships. So stay tuned. This is going to be an area where you'll see some exciting wins in not just onetime capital equipment wins but significant contract values with recurring type revenues in some of our emerging businesses. Market access. I referenced a little bit to this earlier around scale. But when we look at areas that were indirect and we look at the strength and breadth of the Healthineers' organization, what it has done for us is allowed to play at a different level with our strategy. Digital offerings and integrated solutions. This is where we start to see the power of the innovation inside of Healthineers. Looking at the artificial intelligence capabilities, what André shared earlier about AI-Rad Companion, the sophistication and the infrastructure of what's there for machine learning and AI has accelerated our programs in many different ways. In fact, AI-Rad Companion, we're just completing the process of interconnecting it to our 5,000-plus Eclipse sites. And then integrated solutions. Being at ASTRO, the large radiation oncology trade show this year, what I saw was a light bulb go off for our customers. Never before in radiation oncology has there been a leader, a vendor, a partner who goes end to end. And some of the conversations we had were incredibly inspiring, new ways of thinking about potentially bringing things like the MAGNETOM Free.Max into the radiation oncology department in the future. So much more to come, but we are extremely excited about the trajectory that we're on. And complementing this trajectory, as I referenced scale and I referenced focus, is the focused go-to-market customer channel that we have within the Varian business area. In fact, we made a very specific decision. The strength, especially in our radiation oncology business is one of the core assets of the Varian brand. And we have not only kept that Varian brand as we are Varian, a Siemens Healthineers company, but we kept our go-to-market approach. What you see depicted on the page are a series of different bullet points about all of the activities taking place across the globe with many, many needs falling in line with the trends that I shared earlier. And I'll simply say, as we are #1 in each and every one of the geographies you see depicted, the additional benefit has been access to key opinion leaders to bring knowledge back in for conversations like, as you heard André talk earlier with Photon counting CT, as we think about ways to deploy this in cancer, what a platform to leverage the focus channel and then think it scale across the organization. Now I want to orient you with our emerging and growth businesses. Personally, as I think about the future of the Varian business, Varian side of Healthineers, I want it to be marked with diversification and becoming a comprehensive cancer care business. We started much of this journey in 2019. But before I talk about some of the assets that we acquired in that journey, I do want to spend a minute on the radiation oncology market and the overall markets that we play in as a whole. The chart on the page shows in 2025, we anticipate that we'll be playing in over EUR 17 billion of total available market. Roughly half of that or just under half of that is in our radiation oncology business. Now in radiation oncology, we'll not only seek to gain share with many of the solutions I'll share with you, but we'll also seek to expand the market with things like adaptive therapy. And I'll give some better examples in a moment that will illuminate the possibilities that can exist for patient wins. But as we move to the right on the page, you can see by 2025, there's almost a EUR 7 billion market in multidisciplinary oncology software and digitally enabled or tech-enabled services. We made acquisitions in 2019 of CTSI and just prior of Noona for patient-reported outcomes. I am thrilled to stand here today and tell you that these assets that we've acquired are accelerating our impact, not only in business growth, but in quality of care for patients and enabling access to care. One such example happened in the Philippines with AC Health, an institution that was seeking to open a cancer center but didn't have the knowledge and the capabilities. We not only utilize CTSI in order to create the ability to drive services in what will be a multimillion dollar per annum services agreement, but we also created the opportunity for multiple millions of dollars in equipment sales. By the way, that same customer is now looking at expansion into imaging and what they need as that infrastructure solution. You can guess who their desired partner will be. The next area is around interventional solutions. We acquired a series of assets, 2 of which are listed here, Endocare and Alicon. And in interventional oncology or interventional radiology, this is a burgeoning discipline. You could see by 2025, this is a market that will be almost EUR 2.2 billion, and it's also growing at a double-digit rate -- growth rate. So as we enter and access this market, it's not just about the speed of growth, but it's a large, fast-growing market that's new growth on top for the Varian business area. And I'll share more with you some of the great advantages and opportunities we see in conjunction with advanced therapies to leverage some of the leading imaging technology to redefine this discipline or, potentially said better, define it for the future. And then lastly, an innovation that will be beyond even the cycle through 2025 is our CyberHeart acquisition from 2019 and looking at cardiac radioablation. I'm not going to give a spoiler, but I do have something for you as we get towards the end of this presentation that will show how we're not only bullish in the cycle through 2025, but we see acceleration well beyond. So going into radiation oncology solutions. Our radiation therapy devices are market-leading. Our software is market-leading. The intelligent diagnosis capabilities bring to market not only a market-leading set of solutions within the imaging suite but also an opportunity, an opportunity for us to integrate in new ways. Never before has there been the #1 player in radiation oncology and the #1 player in radiation oncology imaging as one in order to drive new opportunities. An example of this is what Bernd alluded to earlier today, something I'm personally very excited about. As we talked in the organization about what will mark, how we will change the lives of people we may never meet. We talked about this concept of 2 weeks to 2 hours. So let me anchor you for a moment. It generally takes 2 weeks from the time of consultation to first treatment for a cancer patient. Think about putting yourself in that position, how do you feel over that 2-week period? Well, my first question is, why? Why in 2021 with artificial intelligence, machine learning and now the combination of Siemens Healthineers and Varian and all of the platform stack available for integration, automation and new levels of innovation, couldn't we reduce this down to 2 hours? And so as we put this challenge into the organization, this will redefine care, both in developed markets as well as open up new doors in developing markets. Think for a moment about Africa. In Africa, they never use the landline. They jumped straight to cellphones. Why not the same thing? Why not start where it's 2 hours from diagnosis to treatment. And we've got a few other tricks up our sleeve as well, such as creating an integrated radiation therapy device that can also do diagnostic imaging on the system in order to diagnose a disease and then treat all in one. But much more to come over the years to come in this regard. But this focus of 2 weeks to 2 hours will not only unlock new growth, but more importantly, it will save many more lives. Further, I want to turn your attention to adaptive therapy. Just 2 short years ago, we launched the Ethos platform. At the time of launch, Ethos was the world's first AI-powered linear accelerator. And Ethos is focused on revolutionizing and transforming adaptive therapy. I still remember standing in Chicago at our users meeting and then at the booth launching this product to the community and thinking how over 2 decades of experience in radiation oncology, we were always seeking to adapt. Because when you think about a tumor, you're trying to avoid all of the healthy tissue around it. And during the course of treatment, a tumor's shape and size can change. So why are we still irradiating with the same treatment plan? This is what you heard as MR-Linacs became available as the exciting new innovation and unlock. But it wasn't about MR-Linac. It wasn't about a conventional Linac. It was about the capability sets to do this in a repeatable high-quality way. And we, at Varian, sought to democratize adaptive radiation therapy, and in doing so, as we launched in 2019, created a multi-modality console that allowed to see various levels of images. Well, now as part of Siemens Healthineers, in just these few short months since closing, we've begun to see new ways to unlock different types of imaging that come into the console area. So simply stated, very excited for the trajectory of the product. But it's also about clinical evidence. We've got almost 100 studies ongoing in clinical evidence. This dwarfs the combination of all of what competition in the adaptive therapy space is seeking to do. And we are investing heavily here because the evidence generation that shows we can reduce toxicity will increase adoption as well as generate the potential for reimbursement. And as we look at clinical adoption, we have over 40 units installed, over 100 orders received and over 12,000 adaptive fractions performed. Turning our attention to interventional oncology and interventional radiology. Within the Varian business area, we have embolics looking at both bland and drug-eluting beads. We also have microwave and cryoablation. We have begun funding around next-generation microwave and cryoablation products. But more importantly than just the next-gen products, what we began looking at is integration across with the advanced therapies leading imaging systems. This will drive standardization. This will drive scale in interventional oncology and interventional radiology. Going back to the ASTRO meeting that I referenced earlier, the Society of Interventional Oncology leadership came to meet. As we sat down at the booth together, they said the single most exciting thing for the discipline has been the combination of Siemens Healthineers and Varian. Because now we're going to integrate workflows, we're going to reproduce capabilities and create the opportunity to democratize care globally for this very specialized discipline that can help many, many patients. Going to multidisciplinary oncology. This is what I discussed earlier as software solutions outside of radiation oncology and, in addition to that, technology-enabled or digitally enabled services. A simple example is remote treatment planning. COVID accelerated the tolerance and support for being able to utilize remote resources as we go forward into the future. At first blush, when we acquired CTSI in 2019, we looked at it very much as an emerging market opportunity where there were a lack of trained individuals, going back to my first slide, talking about the gap and the challenges with access. What we've seen since is not only a rapid acceleration in those emerging markets, but also developed markets coupled with the fuel of Value Partnerships and access to the C-suite. To bring this to life for a moment, CHRISTUS Health. CHRISTUS Health in Texas, we signed a 7-year $70 million agreements. This is a combination of annual services as well as an equipment refresh. And this is just the foundation that we can expand on. And there are many, many more in the pipeline like this especially leveraging the value partnership relationships that exist. So as I've taken you through so far, I painted a picture of how together, we will help save more cancer patients than we ever could apart. I've shown you a market that we're participating in that's going to double by 2025 from where we were prior to the acquisition of the assets in 2019. I've talked about the fuel that we're giving to the businesses to accelerate. And in addition to that, I've highlighted the synergies and how we're taking some of the cost savings to give fuel to these businesses. But I have 2 more things to share with you that I find incredibly exciting and really, potentially transformative for the future of care. And this is about what's even beyond 2025 and staying ahead of the innovation curve. The first is around cardiac radioablation. And if you think about cardiac disease and you look at what André shared earlier and some of the great opportunities we have for imaging and diagnosis, the reality is, still, cardiac disease and challenges and coronary artery issues result in the #1 killer globally. We have, with CyberHeart, acquired technology that allows us to look at cardiac radioablation. The picture you see on the screen here is of a patient who went through a standard EP ablation procedure. As you can see with all of the catheters and tubes, this is a highly, highly invasive procedure. Has all sorts of challenges, patients in the hospital can be up to 8 hours of OR time. Cardiac radioablation represents an incredible disruption to what can be accomplished in the future. Here, you see a gentleman who is exiting, who just had a radiosurgical procedure on a Varian linear accelerator for ventricular tachycardia and is walking out and will go have dinner with his family. We are starting with ventricular tachycardia. We see options beyond. We see the scale of Healthineers opening up many opportunities for us to look well beyond ventricular tachycardia. But most importantly, we will begin accruing patients on clinical trials this year for this product, and we've fully developed the infrastructure for a cloud-based solution for segmentation of the heart in order to facilitate these treatments. But then there's a second area that I want to highlight for you, which is around FLASH Therapy. And let me describe first FLASH Therapy. When you think of a way a cancer patient is normally treated within radiation oncology, that cancer patient is treated over multiple weeks. What FLASH does is take that entire course of therapy and distill it down to less than 1 second. And so just to repeat that, if you look at the entire course of therapy over multiple weeks and distilling down the beam time to less than 1 second, what is happening is incredible. And I'm going to use the example of the Zebrafish on the page to talk about toxicity because that's the real story here. So as you look to the left, there's a normal Zebrafish. As you look to the middle and you see conventional -- after a conventional schema of delivering radiation therapy, you can see a lot of healthy tissue damage. If you look at FLASH all the way to the right, you see some minor inflammation, but you do not see significant damage. This is potentially revolutionary in the way we think about care in the future and likely opens up radiation therapy well beyond the current clinical paradigms and could even further it as a quintessential noninvasive surgical procedure of the future. Most importantly, in addition to the reduction or almost elimination of normal tissue impact, we're seeing tumor control probability not wane. In fact, in some preclinical studies, we've actually seen it slightly improve. We just completed accrual of our first in-human trial. Now to be clear on this, this was an initial small group of patients that we work closely with the FDA on, but it represents the first in-human in the entire industry. We've amassed over 100 patents in this area. And as you think about FLASH and as you think about Siemens Healthineers, I'd encourage you to think of, as FLASH emerges, Siemens Healthineers and the Varian business area will lead. So as I've taken you through many of the examples of how we will pioneer breakthroughs in health care for everyone everywhere. I hope that you have seen the accelerating of our cancer care impact, the expanding of our addressable market and driving our innovative road map. And all of this culminates into what you have seen that was put forward earlier today, but I just want to reiterate and focus in on, which is our midterm guidance is 9% to 12% on the top line of revenue growth. And we realize this puts us in a strong market share gain position, but it's also about market expansion. Further to this, as we look at the bottom line margins, I've articulated this a few times over, but to emphasize, we need to invest in order to achieve the sustained growth rate. Those investments, as we look at costs coming out of the business due to the scale leverage, we'll be reinvesting back in, in '22 and '23. So thank you so much for your attention and time. And Marc, I'll hand it over to you for Q&A.

Thanks a lot, Chris. Incredible breakthroughs we have on our hands here. And if I look at FLASH, for example, it almost sounds a bit like science fiction, but it's not, yes. I mean these pictures are real that you just showed us. So we have another 15 minutes for Q&A now, and I would ask you to line up, and I see there are already a few people in the queue, which makes us ready to go, and I see that we have Julien Dormois, who had some trouble linking in, that's why it's also only via phone. So Julien, I think we -- I'm hearing you already in the background. So you can ask your questions, Julien.

Marc and Chris, it's quite exciting to hear about the FLASH Therapy first. Could you just maybe tell us realistically when that could be offered clinically? And maybe also what would be the share of cancer that could be addressed with this therapy? And my second question relates to the great emphasis that you have put on how we are now the undisputed #1 player in aging and in radiotherapy under the same roof. So does that indicate that you would have an appetite to develop an image-guided radiotherapy machine anytime soon? And basically, how long would that take and do believe that this is an attractive area for the future?

Thank you, Julien. Two wonderful questions. So first, starting with FLASH. Rather than speculate, I think I want to let the science continue to guide us. And specifically, when I say science, when we look at the biology and what we're learning about those in the preclinical work and then some of the early in-human clinical trials, this will inform better the technology development well into the future. I should denote that the Varian proton therapy system, the cyclotron of the device is a system that has the ability to accelerate to dose rate levels that allow us to penetrate for deep-seated tumors. So we know we're uniquely positioned. The first study was completed at Cincinnati Children's Hospital in a unit that was normally used for clinic. But then we also have the ability to do some of this research. So I'd simply say stay tuned. But keep in mind, those numbers that I shared with you did not include what FLASH could do as an accelerant well into the future and disruption. With respect to the aspect of how broad it could go from a care perspective, this is where by-disease site trials are necessary. And this is the capacity and competency we have within the business. It's something I'm excited to see thinking about. For example, lung cancer tumors on younger patients, where we want to think about what we would normally do a surgical intervention due to the fact that we have concern about toxicity to healthy lung tissue, we may learn that we can do this in a simple outpatient procedure. So a lot more to come there, but there's excitement in the background. With respect to the image guidance question, I think it's important to reference, Varian is the global leader in image-guided radiation therapy. All of the portfolio that we have today has received best-in-class awards with respect to the quality of images. In fact, what's been exciting is we've been looking at the IP portfolios in the combined company and thinking about how we may be able to apply different types of reconstruction algorithms and not only have it be on a new device but sell into the installed base. So one of the synergy pieces identified is around metal artifact reduction capabilities. and some of the algorithms that exist that we could put into our 5,000-plus installed base of TruV systems and roughly 1,000 unit installed base of Halcyon systems. So lots of opportunity in that regard. And certainly, we're leveraging the combined prowess of the entire organization.

Thanks, Julien. So the next one on the line would be David Adlington from JPMorgan.

You didn't talk that much, maybe with the exception of FLASH about Proton. And the last time we met, there was quite an interesting discussion between you and Jochen about the outlook for Proton. Just wondered if you could give an update there in terms of the path, maybe the better profitability, timing, thoughts and how integral FLASH is to that. And then just on FLASH. it might be my misunderstanding, but I think FLASH has been developed on both proton and electron style. Are you focusing on the Proton style only.

I'm going to start with the second question, and then I'll go to the proton question. We are doing both the electron-based FLASH capability set. Keep in mind, with electrons, your depth of penetration is very minimal. So it's going to be for skin type of lesions. And quite frankly, we think the tremendous unlock is for deeper-seated lesions, but there's really important research that will happen with electrons that will then translate over into protons. And beyond that, within our technology innovation office, we're looking at other types of ways to accelerate particles well into the future. I'd simply reemphasize my point around over 100 patents in this area and we are seeking to develop a very significant moat around technology differentiation. Around protons, since our last conversation, we are now at 88 rooms in backlog, 41 of which are installed. A significant number are going to be coming out of warranty. The services business is a really critical component of that path to profitability, primarily because each one of those rooms generates around $1 million of services revenue. And you've seen over time the difference in many cases with services profitability versus simply product, looking at the COGS on both sides of that equation. Furthermore, in protons, we've seen an acceleration in our market share position, winning some really key contracts in China as well as around the globe. And then lastly maybe, as I just sort of button-up around the financials question, all of what we shared with you in that guidance there includes everything all in. So some of those units coming out of warranty, going into services and getting the ongoing revenue from them as well as the installations as we seek to put the backlog units into operation.

Thanks, David. Now next call on the line would be Lisa Clive. So back to you, Lisa.

Great. You mentioned the $6.7 billion market size for multidisciplinary software and tech-enabled services, big market. Could you just give us an indication of what you think your market share is today in the segment? And who are your biggest competitors? And can you just articulate what Varian's competitive strengths are?

Yes. Wonderful question. I'd say we have less than 5% of that market today. It is, in many respects, a market-making or market-creation adventure, namely on the digitally enabled services side. What we saw when we decided to acquire CTSI in 2019 was that Varian is the strongest player in radiation oncology with deep insights to where we could increase quality, reduce costs for providers. And in developed markets, that's incredibly critical due to pressure on the health system. And in emerging or developing markets, it's the very gateway by which we can actually get access to care for patients. And so we have been embarking on that market creation effort. And I will simply say, with CTSI and the trajectory we've been on with the services, we're well ahead of any deal model we have put forward. We think COVID has been a tailwind for that business, mainly based upon what I denoted earlier. And if you were to break that $6.7 billion into the subcomponents, looking at digitally-enabled software solutions versus digitally-enabled services or tech-enabled services, it's roughly 50-50. I should also note that we've got a fantastic team leading multidisciplinary oncology. And we put both those digital assets and the services together because we wanted to not just go after anything and everything in the space. We wanted to be very precise and specific about what are the key problems for providers to solve, innovative solutions, offer a service, but then also offer a software product. And this is showing early dividends. This is also where a good portion of some of our early invests, as we look at cost synergies, will go into this business. And it's mainly being met with some great conversations with providers, especially within those value partnership context that I shared before.

Okay. And 1 more question. Just on the CHRISTUS Health deal, so $70 million over 7 years. You mentioned that includes advanced technology, clinical care services, tech-enabled solutions, but it also includes, I assume, just replacing and upgrading some machines. So could you quantify for us how many sort of LINAC unit sales are in that amount? I'm just trying to understand -- and what specifically is the value of the LINAC sales alone? I'm just trying to understand how much you're getting paid for sort of all the other stuff that you've been able to develop and package into something for customers.

Yes. Perfect question. Thanks for asking it. Simply stated, it's roughly 50-50. So roughly 50% of that $70 million agreement is for technology-enabled services. And it should be noted, with the agreement we've structured and how we're helping with tech-enabled services, digitally-enabled services in their operations, we're actually reducing their annual operating costs by roughly $1 million per annum while creating this revenue stream for ourselves. So it had a multiplication impact in this instance. That's why we announced it or talk about it together, is simply the fact that it's a very significant standalone services agreement where we're being paid adequately and appropriately for those services. We are not going to lead with giving these away. These services unlock new levels of quality, while also creating new efficiencies. But at the same time, by generating operational efficiencies, we actually freed up some additional funding to add some further replacements into the mix.

Thanks, Lisa. So we have 3 people in the queue still. I would ask you now to limit yourselves to one question each. So the next one would be Veronika from Goldman Sachs. Veronika?

Hope you can hear me fine. I'm going to just go back. I asked the question to Jochen in the morning, and I'm sure you've heard it. But the 9 to 12, can you decompose it a little bit for me in terms of the old RT business and then all the other contributors? How important do you think each of them is towards that 9 to 12? And maybe just to push you, I think it's a very ambitious growth strategy that you have. What's the kind of the biggest risk that you see to that?

Yes. Wonderful question. Thanks, Veronika. I did hear it earlier, so I appreciate a little bit of foreshadowing. But it's a simple answer, it's the same as what it would have been this morning. We've been on a journey. The journey is to become a comprehensive cancer company. And what I would say is, I'm sure you're well aware of the guidance of the other players in the radiation oncology space. We're going to take share with our plan. And with what I shared is in the portfolio even before some of the new items that we're going to be innovating, that we have access to in this combination and new levels of capabilities that we have access to, we were going to be taking share. So you can use that as a baseline. And then the others are on top. They're on top with very significant growth from those businesses. I think probably the biggest risk is, I think, at this point, is really looking at, from a global perspective, how do we maximize the communication of this broader value proposition that we have. And this is where I go back to the scale of the combined company. Just sitting with the geography leaders in the Varian business area and seeing the relationships that they've been forming with the Healthineers' region leaders gives me that confidence in what we shared with you. And if I looked at the one area in the early win I talked about upfront, the purpose statement. And really, I'm personally extremely inspired by it, but I've also seen culturally among our teams, the teams coming together. And so that scale is really accelerating the opportunity to get this message out faster.

Thanks, Veronika. So next one coming in via phone and without image, I think, would be Sezgi. So I think -- I hope we hear you.

Yes, I can hear you. I hope you can hear me as well.

Yes, perfect.

Perfect. Okay. Since I'm going to have to limit to one, I'm choosing one question that I had. Can you give color about the competitive picture in China? I know you're producing your LINACs there. And I know China has the policy of Made in China. So does this prove your strong competitive advantage? And also, does China -- like are there plans to go with tenders in LINACs there as well? Are you facing any pricing pressures or foreseeing any for the midterm ahead?

Great. Great question. China is a huge growth market. There's tremendous opportunity, especially namely in the fact that you've got the primary concentration of care in 4 major cities and there's a push to get out to the county level. And when I say county level, let's not be confused. This is populations of 5 million-plus in many instances. We have taken a really active approach starting back in 2018 where we want it to be a multi-domestic company. We wanted to be viewed in China as being a local company. And to this end, we start up our manufacturing operations there. We have, to date, built almost 800 linear accelerators locally. We've developed great relationships in China, not just with KOLs, but across all tiers that you could imagine. Further to that, we are in the process of securing how we will enter into the market with those digitally enabled services in the CTSI business. And we're thrilled about that'll mean, especially as we go to the county level. And we've been seeking through the Cancer Foundation of China to educate hospital presidents in the county setting about what does it take to really have radiation therapy. So I bundle those together and I'd simply say, while you may have some local manufacturers, they have not gotten to the point of having reliable systems nor, more importantly, have been as in tune with the market needs of what it takes for cancer care as Varian has. And this is shown up in our market share. We're, by far, #1 in the country.

So we hand over to the last call, and the last question coming from Scott Bardo from Berenberg.

So Chris, I think last time we spoke, you highlighted optimism of a singular reimbursement for adaptive radiotherapy and appreciate the progress you've now shown us with the Ethos system. Of course, your competitor in adaptive radiotherapy is trying to push for a separate premium reimbursement for MR Linac. So I wonder if you could help just share any thought development in this regard, whether your discussion in and around ASTRO are leading more from one to the other.

Yes. No, perfect. Happy to do so, Scott, very nice to see you again as well. So let's also be careful, let's just not only talk about the United States, because as we think about reimbursement, we want to look in each global market. And what I shared with you around the studies to be performed is to generate a composite view or synthesis of clinical evidence that's going to show a demonstrable difference in quality of life or other benefit. what I showed on the slide would represent the most complete dossier of adaptive therapy clinical evidence across the industry. And we will begin to see many of the fruits of that in late '22, based on where studies are accruing, well into '23 and into 24. So we have a nice march of evidence coming. In the Netherlands, a modality-specific code has been denied multiple times. In the U.S. and in discussions with ASTRO, it's very much been -- it's about adaptive therapy. So no real change from what I shared last time. But I would say, when you look at what we have with Ethos, which is an AI-powered device that treats in 15 to 20 minutes, has a price tag at roughly the cost of an MR-Linac, installs in just a few weeks as opposed to 6 to 8 months, requires minimal room renovations in order to achieve, this is about accelerating adaptive therapy into the mainstream. And so while we'll continue down that reimbursement path, you should think about the big opportunity that exists for the business with Ethos, as evidenced by a strong order book.

Great. Thanks, Scott. And thanks, Chris. Looking forward to working together. I think we have a great opportunity at our hand here together. And I would now hand over to the next presentation, that's coming from Advanced Therapies. An emotional introductory movie first, and Carsten Bertram will then take you through our new ambition at Advanced Therapies. So curtains up. [Presentation]

Yes, like Stefan, 15 million people per year suffer a stroke and very few of them receive thrombectomy, and that has dramatic consequences for the individual patients up to permanent disability. And for society, it means high cost and high burden. And Advanced Therapies is here to make better care available, not only to Stefan, but to everyone everywhere. My name is Carsten Bertram, and I have to smile a little bit when Marc introduced me as being the newcomer, which I am. On the other side, I have been with Siemens Healthineers for 30 years now in multiple roles, being responsible for businesses on the imaging and on the software side in Europe, Asia and the U.S. and now for Advanced Therapies. We -- in Advanced Therapies, we focus on changing the way therapy is delivered to enable better care for more patients. And by doing so, we -- as Advanced Therapies, we will continue to expand our position as one of the world's leading providers of innovative technology for minimally invasive procedures. So what are we here for? We are here to address the most threatening diseases globally. And what you see here is on the left side, cardiovascular care, with the #1 cause of death globally, which is coronary artery disease. And we talked about neurovascular care, where 15 million people worldwide will have suffered stroke. 1/3 of them will die and 1/3 of them will be permanently disabled. And then last but not least, cancer care, where if you listened to Chris, he talked about that 18 million people will be diagnosed with cancer in 2018, and that number goes up to 40 million going forward. So I think this is also -- the message you see here is looking familiar from the earlier presentation that were given by André on imaging, Chris for Varian and Deepak by -- for diagnostics, because we, as the Siemens Healthineers teams, we are focused on fighting these diseases with the entire portfolio that Siemens Healthineers brings to the table across the whole clinical care path for the patient. And now if you look at what is changing on the -- now let me take you to the world of Advanced Therapies, and let me show you how innovative minimally invasive procedures changed the way that care is delivered. Let's start again with cardiovascular. Innovative, minimally invasive procedures, they grow double digit every year. And why is that? So what you see here is how these procedures are growing. And why are they growing? Because we are bringing new and better treatments out each and every day. They are -- excuse me. So we have growth on the cardiovascular side. We have growth in neurovascular side. And we have growth on the cancer care side. The innovations that you see here are being brought forward. I'm sorry, right now the -- it's not working, so I'm trying it slightly different. The procedures you see here are growing. And why are they growing? Because we have new and innovative technologies that are changing the way that these procedures are being done. We have more complex procedures. And we are bringing out new -- new devices are being available each and every day. Okay. Okay. But the clicking doesn't work, I'm sorry. Okay. So we have innovative treatments. We have innovative devices. And all of them can only be brought forward because image guidance is the key to bring all of these innovations into clinical routine. And we, as Advanced Therapies, with the strong portfolio we have in terms of image guidance products, in terms of endovascular robotics and digital solutions, we are in the right place to translate that trend into sustainable business growth. Let me now give you a quick overview about Advanced Therapies and our performance in fiscal year '21 and how we have done. So Advanced Therapies offers, which you see on the right, fixed and mobile C-arms, and we have been pioneering endovascular robotics for 2 years now. We grew our business by more than 8% in fiscal year '21. And then that something I'm super proud is of we have extended our market share to 35%. Our profitability in fiscal year '21 declined as COVID-19 significantly delayed the growth of our endovascular robotics product lines. At the same time, we saw currency headwinds, higher incentive provision and negative mix effects that weighed on our fiscal year '21 results. And yet, fiscal year '21 was a very successful year for our ARTIS icono platform. We strengthened our #1 position in neurovascular care, clearly proving that the continued invest in this area pays up for us. And we have shown resilience throughout the last 2 fiscal years. And I think our Q4 numbers already show the positive trend. And we, as Advanced Therapies, we are fully committed to further improvements in top and bottom line in the coming years. And now let me take you back to the preclinical season, let me depict strategic highlights for each clinical field. So let me start with cancer care. One in 2 men and 1 in 3 women will develop cancer at some point in their lives. And the 5-year survival rate for liver cancer is still below 16 degree, and we, we want to change this. And we are now in a unique position to change that for interventional oncology because we can combine the Advanced Therapies image guidance portfolio with the interventional solution portfolio of our Varian colleagues that Chris just introduced. And we combine it, and that's the cool thing for the whole therapy pathway for less complications, for better outcomes and for higher life expectancy. And Chris talked a little bit about the feedback he was getting at the ASTRO, and I can only echo this. Our customers are thrilled about the combination of the leader in interventional solutions and our interventional imaging portfolio leadership. By bringing them together, we can create new solutions. And to make this slightly more tangible for you, we can already now use the advanced image guidance software, myNeedle Companion. And increase, with this, the precision of the microwave and cryoablation therapies, as they are provided by Varian. So with integrated solutions like these, we do 2 things: we increase our total addressable market, and we create new value for our customers. And with that, we position ourselves firmly as the partner of choice. So the opportunities are there. And we, together with our colleagues from Varian, we will address them together. Now let's move to cardiovascular, neurovascular care, the other 2 fields I mentioned before. We will grow our share in cardiovascular care and strengthen our #1 position in neurovascular care. So how are we doing this? I mean what you see on the left are the most prevalent cardiovascular clinical procedures. And what you see is they are growing, and they are growing very fast. And we invest into and we provide the technologies that allow our customers to, not only grow with the trend, but rather shape the trend. So we provide the key enablers that you need to successfully do minimally invasive cardiovascular procedures. And you see them at the bottom of the slide here, you see it's our ARTIS image guidance platforms, it's our Corindus endovascular robot and it's our digital solutions that connect, complement and optimize the 2. And if you now go over and look towards the right, you see the same happening on the neurovascular side, yes. The number of neurovascular procedures is growing fast. And if we go back to stroke and if you remember the story of Stefan, stroke is the most prevalent neurovascular disease today with 15 million cases per year. If you look at the patients that received thrombectomy, 48% of them can live independent life, which makes the difference between life in a wheelchair and walking on your own legs. The problem, there are just 200,000 thrombectomy delivered every year. But good news, and that's really, really good news, the number of procedures is growing very, very fast. And our ARTIS icono biplane system has proven that this is the system for mechanical thrombectomy. This leads to consistently high sales numbers since our very successful launch in 2020. So again, with ARTIS, with Corindus and with our digital solution, we will gain market share and strengthen our #1 position in neurovascular care worldwide. I have been in this industry for a long time and what still really fascinates me is our ability to change the way care is delivered. Let me now share a couple of examples on the clinical side, how we transform cardiovascular and neurovascular care. Let's start with cardiovascular and the most common minimally invasive procedures treating coronary artery disease by placing a stent to restore blood flow. And our solutions and data solutions and image guidance in robotic precision and in intelligent digital solution improves each step of the procedure, making it faster, more precise, less costly and providing better outcomes. So let me show how our solutions differentiate us here. Let's start on the left. This is about assessing the degree and impact of the stenosis on blood flow. What you would typically do today is you're using a separate device, a pressure wire to assess the stenosis. We already, today, offer a solution, a digital solution, where the assessment is now digitally and is done seamlessly integrated within the procedure, the so-called angio-based virtual fractional flow reserve. So you have a solution that's less invasive, that's faster and that is less costly. Now let's move to step #2 and 3, which is the treatment. And if you remember the picture in the slide that Bernd showed earlier about the Corindus robot, this is what we are talking about. With the Corindus robot, we are able to really crush the lesion fast and at the same time use the smart automated movements to help precisely -- to position the stent where it's needed. Then if you look at the last step, was the procedure successful? Has blood flow improved as planned? You can again use the same digital solutions from the start to assess if the procedure has worked out. So in summary, our solutions enable faster, more precise, less costly procedures and provide better outcomes. For us, it means we address new markets and generate additional business opportunities. So now let's move to neurovascular care, and let me outline how we change the way brain aneurysms are treatment -- are treated, minimally invasive and how our solutions make a clinical difference. So what you see here is a brain aneurysm, stealthy, often silent abnormality that can be deadly if left untreated. if the weakness in the brain vessel wall, a bulge ruptures, it interrupts blood flow to critical areas of the brain. And you treat it by closing off the aneurysm minimally invasive. You insert tiny platinum coils into the bulge. Now our solutions improve each step of the procedure, making it faster, less complex by using smart digital solutions and more precise with robotic assistance. Second -- second step or step #1, you look at the analysis. If you want to understand how an aneurysm works, what is the -- how to best treat it, you can get a complete and detailed analysis with our ultra-high-resolution 3D imaging in less than a minute. Now talking about the digital solutions, step #2, you can really do a complete virtual planning and placement of the stent in 3D with our solutions. And we are talking about a rather long and complex procedure. So the outstanding image quality of the ARTIS icono is key to easily guide and precisely maneuver all devices into place during the intervention. And then looking at the last point in the procedure. Again, you want to understand, has the procedure been successful? Has the aneurysm been successfully sealed off? And we offer the digital solution to easily compute and compare inflow and outflow of the aneurysm before and after the treatment. Again, in summary, it's all about faster less complex, more precise procedures and then, at the end, better outcomes. So now, let's have a look at a typical -- because I talked a lot about imaging and robotic, let's have a short look at how this typically looks like. What you see here is on the left, the ARTIS icono. You see the CorPath GRX mounted to the end of the table on the right. And you see at the front, the remote console from which the physician will conduct the intervention, all integrated in 1 solution. And now given the fact that I talked a lot about Corindus, let's have a look at where we are right now. The investment into Corindus starts to pay off. The CorPath GRX has now been sold into more than 20 countries and the Chinese authority granted us fast track approval for innovative medical devices, a first for a medical imaging company. For us, it means a unique opportunity to get system approval in China in less than a year. Our orders more than doubled compared to last fiscal year. And our business model with the 3 revenue streams, equipment, service and consumables, is working. But yes, the business has been hit by the global pandemic. Access to physicians was extremely restrictive. Health care providers were prioritizing the fight against COVID-19. And as the endovascular robot is the first of its kind solution, physicians need to try and test it. At the same time, we need to conduct clinical studies to build clinical evidence. All of that was very difficult and limited during the pandemic. But we will and we are overcoming these hurdles. Started in cardiovascular, now we have the first sites installed on the aneurysm treatment side. And we are working in parallel on the next-gen robot aimed at stroke treatment. So we believe in and we are fully committed to make endovascular robotics part of the clinical routine for minimally invasive procedures. Now talk briefly about better care for more patients everywhere. The best way to make this happen is if health care providers and us, we join forces and work closely together. We call these collaborations, Value Partnerships. With Value Partnerships, we are able to accelerate our growth through higher customer intimacy and create additional revenue streams based on long-term commitments. So how are we doing it? By delivering measurable outcomes that benefit patients, staff, and hospitals. And for this, we bring together the customer expertise in clinical care and couple it with our engineering innovations and workflow improvement capabilities. Let me now show you two examples where we play a pivotal role in these Value Partnerships. The first one is a site in Portugal where we're working together for 3 years and the result of our Value Partnerships, we have been able to double the cath lab capacity and identify substantial time savings through optimizing workflow. And the second one in the U.S. and you will see, this is the nation's stroke belt. Target is clear, we have to reduce the time it takes for severe stroke patients to receive treatment. We have a common team that works on setting industry wide standards for advanced stroke care. And after just 1 year, initial results are very encouraging. So Value Partnerships, for us, it's about moving our business from transactional to long-term partnerships. Now let me summarize the strategy of Advanced Therapy in new ambition in a few sentences. We provide pioneering solutions for minimally invasive procedures that solve key challenges of our customers. And these solutions are centered around three core areas: we leverage our image guidance leadership; we scale our digital solutions; and we establish robotics and clinical routine, all with 1 clear goal, better treatments for more patients. And by doing so, we will continue to position ourselves for the future as one of the world's leading provider of innovative technologies for minimally invasive procedures. And based on this strategy, we will achieve high to mid-single-digit growth of our business and increase the profitability in parallel. And as Advanced Therapies, we are an integral part of the new ambition phase of Siemens Healthineers. Jochen said earlier, new ambition for Siemens Healthineers is about addressing the greatest opportunity in health care. For us, in Advanced Therapy, the greatest opportunity is fighting the most threatening diseases in cardiovascular, neurovascular and cancer care, and we will make full use of these opportunities. We will utilize our unique capabilities to offer innovative technology for minimally invasive procedures, expanding image guidance, digital solutions and robotics further into cardiovascular and neurovascular care. And with this, embedded and fully integrated into new ambition, we, as the Advanced Therapies team, will grow our business by 5% to 8% per year and we'll progress towards 20% margin by fiscal year '25. Thanks for your attention. Sorry for the technical problems at the beginning, and I'm now ready to take your questions.

Thank you, Carsten. And also, I think a bit sorry from our side there have been real technical problems, and you mastered it brilliantly, really. So it would have totally throw me off track, I would say, normally. So we would be asking you to register for your questions right now. So if you just press the call request button, that would be great. And we have not seen anybody coming in. So I don't know if there's maybe a technical issue on the back end. Now there's people appearing, great. So the first one -- first question coming in from Veronika. And you're not limited to 1 or 2 questions. Go ahead.

Marc, you know me. I have an endless number of questions as always. Maybe my first one is just sort of conceptually. Obviously, I think you're heading in the similar direction as we see some of your competitors, which is really integrating purely imaging to an interventional state. And I'm just kind of curious, what else do you think you need in your portfolio to complete that journey? Or are you happy with what you have today and you think you can be successful? And maybe we can start with that and then I'll ask my follow-up after that.

Okay. Yes. Thanks, Veronika. To answer your question, I'm super happy with the portfolio we have. We have the image guidance platforms with the ARTIS icono that we are -- that we continue to expand both in breast, that means adding more system variants; at the same time, we will add clinical depth by adding new clinical features to the system. We also have, and I talked about this now with the Corindus endovascular robot, a complete new groundbreaking solution available. Yes, it's one that will take time because we have to create the market. This is one where we will take time because customers need time to understand how systems work. Customers need time to play and to work with the system before, and that makes the sales cycle significantly longer. But I think as I have shown, we are up to a good way there. And then we have our digital solutions that, couple and combine all of this, and with this, I think we have a very strong portfolio on the cardiovascular side, on the neurovascular side, but also on surgical oncology, interventional oncology. And what you can add to this is that we are actively collaborating with multiple other companies in the field, so expanding our solutions by making sure that our products are seamlessly integrated with the offer that other companies in this area are providing.

Okay. That's helpful. And obviously, you cited that statistic about over 200,000 thrombectomies against 15 million strokes being performed, sorry. I'm just curious how you think about what needs to change for that 200,000 number to grow. Is it awareness? Is it education? Is it technology? Is it reimbursement? And what you can do to help accelerate that process?

Yes, that's a great question. I mean, on the one side, I mean, I think as I showed, the number is already growing, and it's growing really, really fast. We're talking plus 20% here. The other -- on the other side, definitely providing even better tools, both on the image guidance platform, on digital solutions, but also on the Corindus side will help. And then over time, and I think this has been the Holy Grail for our Corindus acquisition is that, over time, when we advance and expand the Corindus robot and we're calling that the next-gen robot for stroke treatment, that will help then to make that kind of treatment because you need to have a very, very good physician there to do that. And these kind of physicians are not available everywhere. So over time, when we bring the next-gen Corindus robot to the market, coupled it with remote capabilities, I think you will see that this life-saving technology, this life-saving procedure will become available to more and more patients and therefore, will really help to broaden, on the one side, the number of procedures, while at the same time, close the gap between the 15 million, and not all of them will be -- can be eligible for thrombectomy, but a significant part is the 200,000 that discussed.

Thank you, Veronika. So next question in line would be Scott Bardo. Scott, you should be going live just about now. Here you go. Hi, Scott.

Hi, Scott.

So forgive me, Carsten, if you mentioned it, but could you provide perhaps some time frames of when you expect the stroke indications on the Corindus robot and the launch of the next-generation system? Perhaps detail a little bit further, whether you need to have a separate clinical study for the next-generation system? I'm just trying to understand the building momentum in your base here. That would be helpful.

Yes. I think there are multiple steps we are talking about here. I mean, the first one is the one that I just talked about, that we have expanded the CorPath GRX into the first neuro application, which is the brain aneurysm treatment. So this is the first important step because it also adds the advanced cassette, which has the capability to provide microcatheters and more catheters to the system, which is super important for what is required there. And then at the same time, we have clinical -- we will go into trials for the remote capability, while at the same time, in parallel, working on the next-gen robot. And when all of these developments merge in the midterm, I think at that point in time, we will be able to provide a clearer time line and a more precise definition on when the system will become available, at what point in time and in which configuration.

And is it fair to say that, that is likely within this planning period or something more likely outside of this planning period?

I think certain steps of it will be in that planning period.

Okay. Very good. And maybe just last question, Marc, if I may, just could you give us an update on the ARTIS pheno system? I know there's a heavy focus on the icono platform. But I think you have quite some differentiation with the KUKA robot there. How is that system performing? Are there next-generation iterations to follow?

I think the -- and Scott, first of all, thanks for bringing it up, because I didn't talk about surgery at all today. And as you rightly pointed out, it's a very important part of the Advanced Therapies business. I mean, the ARTIS pheno is doing extremely well in the market because of, as you said, features that very much differentiate us from the competition. What we see is, very clearly, an interesting move that the system is nowadays not only used for hybrid OR, but we see more and more of a multidisciplinary use on the system which drives up the utilization and makes the system even more attractive to more customers because now you can build a better business case on how using it. So as I said, very important part of the portfolio and a part of the portfolio that we will continue to develop further.

Thanks, Scott. That brings us to Delphine from SocGen. Delphine, I think you should be live now.

Just on the Corindus robotic. When I have a lot of questions with some of the vascular surgeons, they often said to me we need to be 2, even 3 surgeons, on the back of the robot and beside the patient. When I look at the Corindus, I see there's -- at the end from what I see, but I want to have a confirmation, 1 physician, which is open. So I was wondering at what stage of development and when do you expect? Is it by the end of the decade to have a robot that might be multifunctional, meaning that just not for cardiovascular or neurosurgery, but also for endovascular or any other GI surgery, for instance? What's the plan? What's the plan in terms of [ failure ] for the robot, in terms of application? And when do you see that? We have to think by 2030, for instance? Or would you say the development of Corindus will be achieved, let's say, by '25, you're going to be already at a very good stage?

I mean, first of all, thanks for the question. I think these are 2 very different types of robots we are talking about. One more in the surgical environment and the Corindus robot is definitely more on the endovascular side. I think if I look towards the future of Corindus, we are very much focused on pioneering and bringing that breakthrough technology to the market and creating the market for the endovascular side. And I think doing this, and making sure that we cover all of the clinical capabilities and opportunities that we see because I mean, that's something that I find really fascinating. Whenever I talk to a customer about the Corindus robot, there are additional ideas coming up on how to use it in an endovascular environment. So I think we will stay focused for the endovascular environment because we see so much opportunity there. I think what we have done so far, we just scratched the surface. And we will, therefore, continue to really drive down that road, the endovascular road for the Corindus robot.

Okay. Good. Thanks, Delphine, for the question. That basically brings our Q&A to an end. And thanks a lot for bearing with our technical problems and managing so greatly. We have another break now before we go into the final Q&A with Jochen and Bernd. So if you have any, let's say, bigger picture questions, et cetera, you can still ask them in this round in 15 minutes. And by the way, maybe if you haven't done so up 'til now, you can also have a look at the virtual expo, which we've prepared for you, still delivering some additional information on some of our breakthrough innovation. So thanks for staying with us. See you in 15 minutes. [Break]

Welcome back. So here we are again in our virtual studio. I'm accompanied now by Bernd and Jochen as we had it in our first Q&A. So welcome back, Bernd and Jochen. The lines are open for you to register as usual. So if you click the talk request button, we will have you in the queue. And the first one in the queue is Julien Dormois, really by phone this time again. So Julien, welcome back.

I would have 2. The first one relates to the very detailed financial framework that you have provided, and thank you for that. I have to say, and you may wonder whether that I'm looking into a very detailed thing. But I'm surprised about the regional split for SG&A spending, especially because it seems to be geared towards EMEA in the coming years and actually to the detriment of Asia Pacific, while the latter is making up nearly 30% of your group sales. And apparently, you are spending -- you are planning to spend only 20% of your SG&A expenses in the region. So I'm just a bit surprised because this is obviously probably the fastest-growing region. So I was wondering what's behind this guidance? And the second question I have is related to also something you put out on the slide, which seems to indicate that pricing headwinds at the group level have historically been between minus 1.5% and minus 2.5% per annum but have been decreasing in recent years, which again comes a little bit as a surprise. So I was wondering what is -- what are the drivers behind this reduced pricing pressure because you also indicate that this is what should help you offset cost inflation? So quite -- seem to get a few elements on that side, too, please.

Yes. Thanks for the question, Julien. Let me start with the SG&A spread around the world. First of all, this is not -- the spread around the world is not a guidance for the new ambition phase. It's just the view how the numbers were in fiscal year '21. And when you look at the distribution of SG&A, 1 significant driver, which is not fully, I would say, in line with the revenue share is -- or 1 driver behind it, is often the way how you get to revenue, do you do direct or indirect business. And in Asia Pacific, it is definitely a significant higher portion of indirect business because we are not as direct as, for example, in Europe. I think that's the main driver. When you look into the future, it's clear, and I said that also briefly in my presentation, we definitely will focus on growth markets, also from an SG&A investment, for example, in China. And I would expect that our share in Asia Pacific will grow over time. So that's an answer to that first question. Thanks for looking at the material very diligently, by the way, I like that a lot. No, that was meant seriously. On your second question, we have seen historically always a price decline around the 1.5% to 2.5%. And it also varies a bit by business. And we have, generally speaking, a higher price decline in Imaging where we, so to say, our biggest enemy ourselves by innovating out our own products, so to say, and the biggest enemy, price-wise, for your own product is the new product which you bring to market. For example, on Diagnostics side and also on the service side, pricing stability is much higher than in the equipment side of Imaging and Advanced Therapies, for example. We have started 3, 4 years ago, also an initiative internally to focus even more on pricing excellence. We see also the benefits of this. I think we have established new tools, also, I would say, new processes, how we interact between headquarter regions in this regard. And this is obviously also paying off, and that is also why we see a bit less price decline than we have seen historically or in the past. And with regard to inflation, I think that is more a natural process, which will take place when prices and costs inflate everywhere. It will push also -- it would also put, I would say, some tailwind to our pricing excellence in the field. That's more the rationale. I hope that answers your questions.

No, absolutely, it does. And just to make sure I understood you correctly. So it would be sort of the lower pricing headwinds are more related to your own execution than anything on the market themselves. Is that right?

Yes. Correct.

Good. Thanks, Julien. Next person online, and let me just remind you to press talk request button, if you want to be in the queue. So next one online would be Scott Bardo from Berenberg.

And thank you all of my questions today in the excellent event today. So maybe 2 questions, please. One high-level question for you, Bernd. I think we've seen since the spin out of Siemens Healthineers from the broader parent, a lot of evidence that being an independent-focused company can take market share and lead to a higher-performing business. So with this in mind, is there anything new to fear now that GE seems to be following your footsteps to have a single health care company competing in the market? So that's my first question, please.

Well, what is the -- the statement is that when you get copied, it is one form of flattering or whatever the exact English expression for this is. So I mean it shows that we are on the right track. And it's -- and I really think that what we have proven is that a company with a super strong focus, which makes up with the same intent in mind is our customers. Pioneering breakthroughs in health care for everyone everywhere makes a difference from a business point of view, but also from a psychological point of view. But just doing that is not doing the trick. I mean, there is more, especially in Asia, than being an independent company. I mean, you have an extremely strong position with leading businesses. We have an extremely rational portfolio. I mean, you look at the triangle and how things are interconnected and how we combine the patient winning the precision therapy, the strength in digital data and AI, this is something which is unique. And also, I think, and this is why it was very important to us and very important to me also when it comes to the culture piece why we decided that is also important that you hear from Darleen who we are and how we do things and so on. And this is something, which is much more than just the fact of being a listed company. So there is much more uniqueness in this. So -- and from that point of view, it is not a topic which we are scared about. I mean, we take competition very seriously. I mean we take GE very seriously, of course. And it will certainly help us to get even better.

And maybe then just the second question, and, Bernd, I appreciate you shared the thoughts in an analyst forum about this more recently. But for a broader audience, can you talk a little bit about some of the portfolio decisions for the group? I'm thinking particularly with respect to Ultrasound and how core that business is to the group? And also your determination on proton therapy, do you need to wait for this flash clinical study before making a decision about the relevance of that asset within the broader group?

Yes. Probably, in the smaller group you referred to, I mean, I basically described the portfolio as here's the center of the city, and there is -- there are some businesses which are maybe more in suburbs, but still belong to the larger context. Ultrasound is a business, which ticks differently than many of the other businesses or basically, all the other businesses. Why is that? It is very -- it has very different innovation cycles. It is a much more inexpensive device. And it is something, which, and this is maybe the biggest difference, all the other products or all the other segments are focusing on a specialty customer group. They are basically operating the technology, is almost what defines a professional. Operating a LINAC is the definition of radiation oncology to some extent. Operating MRI, CT and so on is what radiology does. Cardiology, you have [ price to ] think about, about interventional procedures and so on and so on and very similar in lab medicine. Ultrasound is a very broad tool, which is similar like an EKG or measure, and it's very -- it requires also a different sales channel or different sales channels so -- which is why we have decided to run this business, which, by the way, is 3% of our overall top line, as a company within the company because it needs its own innovation cycle and its own go-to-market approach. So that's the story about Ultrasound. Yes. It's a business. And I am very happy with the trajectory it's on. But on the other hand, I also want to say it is more on the suburbs side than right in the center of the triangle I described. On proton therapy, I mean, you heard Chris and including the exciting results not only on the Zebrafish, but also when it comes to the FLASH consortium, because, I mean, in the end, and here, I want to echo what Chris said in a little bit of a different context, this is about the science developing. This is about where will this really take cancer treatment. And is it -- will the next years show that the benefit is so great that it definitely will have its strong place and grow even further? Or will it stay a bit of a specialty topic, which currently it is more. We are very committed to drive that science forward. I mean, this is a super important field in cancer care to find out, but to some extent, the jury is out. But it's primarily a science and technology development topic and not a theoretical or a closed-room business decision, which we could make -- which we can make today.

Thank you, Scott, for all your questions today. And now we head on to Veronika, who's also been very active. So Veronika, the line is open for you. Are you mute?

Oh yes, muted again.

Red tab, I understand. Is that correct?

Not working? No.

Not working. I can't lip sync, that's the problem. Now, I hear something? No, I don't.

No.

Maybe you should dial out and come back. We'll wait for you. So in the meanwhile, if there's anybody else who wants to us to join in the call with a request? Other than that, I will just use the meantime to get your eyes to the fact that we will be road showing after this event. So let me just kind of continue with this and then we get Veronika back on. So we'll be road showing after this event, and we'll be virtually road showing the next 3, 4 workdays. And then we will be in really physical format. I almost can't believe I'm saying that, going on conferences to the Pennyhill conference in London. Hopefully, we will be going to the 2 New York conferences by [ Auto ] and by Berenberg Bank. And we will be at the JPMorgan Conference in San Francisco, hopefully. So that's the plan. So if you want to see us in physical form, you just heard where you can meet us. So let's try it again, Veronika?

All right. Let's see. Can you guys hear me now?

Yes. We hear you. Perfect.

Excellent. Sorry, it turns out that technology is not -- it's not my day today. I wanted to ask a short term one, and I apologize, I know this is sort of midterm outlook discussion. But I'm just kind of curious, we are hearing a lot about things like staffing shortages from hospitals, in particular, in the U.S. And I'm just curious, Bernd, if you can comment to what extent that's changing any of the conversations you're having on CapEx and purchasing decisions, either to the up side in terms of folks wanting to deploy more technology faster or to sort of hospital saying, hang on, we've got to pause because we have other problems to address? So I have a follow-on after that, but I'll let you answer them.

I think it's rather a positive for us, Veronika, because in the end, every piece of equipment in our portfolio is more productive than what people operate today and helps overcome staff shortage problems, whether it's about throughput in Imaging, or in a LINAC, or in Advanced Therapies, or in the lab. I think it was pretty impressive to see what Deepak showed when it comes these big installations in Quest and Pardini, but the same you can basically imagine in other parts of the closures. In the end, it shows, and it's a term I don't really like so much, but that this industrialization of health care delivery is real. So it's about how can we do more with less and the technology advancement very, very often goes into this direction. Plus, it helps us to accelerate what we do in digitally enabled services and in our Value Partnerships. What I have not heard is that people take a pause. Because of that, it's really the opposite. And it is -- but it is, as you rightfully say, it is on -- especially when you talk to the C level staff shortage. And more or less every hospital CEO you talk to, as well they say, we are currently looking for this couple of hundreds of people. And that is a big topic where we come to play, solving this productivity problem or enabling more efficient operations.

That's great. And then I think sort of the other outcome of COVID has really been decentralization of care. And obviously, you guys have done quite a lot here as I think about the MRI innovation. I'm curious if you're working on solutions in some of the other modalities that are similar to that? And if you could maybe give us a little bit of a flavor or preview of anything that is on the RM drawing board that would be more suitable, kind of CT, X-ray? I mean, ultrasound, not really the point here, but in more decentralized outpatient ASC settings?

Yes. I mean maybe it's a very good point. I mean, on the one hand, I mean, whenever and this is -- I mean, I start with Imaging. On the Imaging side, we always have 2 directions of innovation. One is going to the -- I mean, going to the next level of clinical performance, probably getting closer to the patient with -- and then with the Photon Counting as one of the most prominent example. But the other direction, which is as exciting and as challenging aspect in target of engineering is making more affordable what we have developed so far. And by not only making the product less expensive to build with real design-to-cost R&D creativity, but also looking at the entire TCO siting requirements, training requirements for the staff and so on and so on. So you see the MAGNETOM Free. But in CT, we do similar things. In X-ray, we do similar things. The Healtheon product in Varian is extremely following this very similar philosophy. And we do and will do the same also in Carsten's business because it is not only about the diagnostic piece, but it's also about delivering ambulatory therapies, whatever vascular interventions and so on, where it's not about hospitalization, where the real benefit of minimally invasive therapies come to play. You can think the Atellica CI 1900 is a product, which is for the hub and spoke for decentralized settings and what we talked about in point of care where we go in having, on the one hand, these strapped devices for a system but then having them connected with informatics. So it is -- it goes across the board here. And internally in our more -- let's say, more complete way of describing our growth factors, you even call it not only enabling better operations, but we also have this supporting networked care as a key paradigm.

And yes, another example on this, when you think about Corindus robotics, it's also an example for this, because the robotics allows people who are not as experienced to perform complicated procedures, which are normally only be possible if somebody is very experienced. And you can do this even remotely and other things that also increases in -- I would say, in a broader sense of the word, the access to care, kind of.

Yes. So now you -- I think you should maybe tell me what you do as an assisting or virtual cockpit, so how do you -- you have a hub-and-spoke model here of operating the Imaging. Same topic oncology as a service, Chris spoke about. It's not only about this decentralized equipment, but then also looking at how can you make sure that you don't have to deploy very rare medical specialties at remote places because that is often the problem, and here comes the digitalization into play.

That takes us to Lisa from the phone again. So Lisa, you should be live now.

Great. Just going back to questions around potential Alzheimer's diagnostics. Just pivoting to your PET business. You're a very strong player in that market, and I believe with the #1 position. So could we expect higher growth in installations in the U.S. in particular as there is more of a focus on Alzheimer's? And have you seen any sort of change in demand on that?

It's -- let's say, it's early in the ball game because typically, the PET CTs are not, let's say -- typically not on an absolute capacity limit when it comes to patient throughput. So that normally when we are in a situation like we are today where it's in the early innings of these type of diagnostic tests, it's not yet triggering this demand. On the other hand, it is certainly an upside. And when you look at the PET business, which wasn't so much in the focus today because we have so many other exciting topics, this is also when it comes to cancer treatment, a diagnosis but potentially also treatment options, a super important business where we are in the -- also, in the -- where there are very, very inspiring discussion also between the Varian teams and the -- our PET business.

Maybe there's also one other aspect where we see tailwind from this already is because we run the largest radiopharmacy network in the United States, a business we call PET Net. And obviously, the tracers are produced and then delivered to the hospital in this network. And here, we see definitely an uptake and a tailwind from the Alzheimer companion, so say, tracers, which are needed for this. But this is a smaller business. It will not fundamentally change our growth dynamic, but it's a nice upside to have.

Can you just elaborate on that a little bit more because just to be clear, you are not one of the companies that actually manufacture the PET tracers, but this is more around the distribution of them?

Yes. So this business, we are market leader in the United States in this business which we call PET Net, which is the distribution, on the one hand, the -- and this sounds more disrespectful than I want it to be the "bread and butter" business in that area is the production of FDG. That is the standard tracer, which is used in PET imaging. This is a radioactively labeled sugar, which is the tracer used for imaging basic cancer cells or typically, that's the mechanism. But the interesting thing here is that whoever comes up with a new tracer, which is some ways more a pharma-type development than the Siemens Healthineers' type of development, needs that distribution system because basically, this is a super complicated, on the one hand, production process, but then it's a logistics process because typically, the half-life of these tracers is, I think, 2 hours. So if you don't get the distribution right, the tracer is gone. So it is always -- we get a fair share from whoever comes up with novel tracers. So it is a good business to be in. But I mean speaking about suburb and center, this is more an -- it's an attractive suburb.

Yes. And to very precise, we produce tracer, as Bernd has said. We do have the chemistry, and we produce also the radioactive material in the cycle [ joint ] and then it gets to say mixed, and then it gets immediately transported into the hospitals. So that's production as well as the distribution.

Correct, yes. But we pay a license, so to say, to the owner of the IP for the respective tracer, be it prostate cancer, be it amyloid plaque, be it tau or whatever.

Thanks, Lisa. So it couldn't have been choreographed any better because the last caller of today is the first caller of the day. Now he's gone. Patrick. Here you go.

Perfect. Hopefully, you guys can hear me. I'll just have one nerdy one on Imaging. By application, you've got some areas where you're particularly strong. We all know you're very good in neuro. And I think you guys gave a kind of amazing stat behind closed doors about your share within radiation oncology with the Imaging side over the last -- I forget it was like last 7 years or something had gone from like 15% to 50% or something like that. I guess my question is 2 parts. Question one is, where are the white spaces where you feel by application you could grow and do a little bit better than you're currently doing? And two, where you are strong, are there other ways you can monetize that? So obviously, Varian is one way to monetize the strength in the Imaging side in terms of radiation oncology with the Imaging. I guess Corindus on neurology is good for the neuro imaging, but in other applications in Imaging, is there another way to monetize that high market share of imaging? So white spaces? And how can you monetize further, via therapeutics, the areas where you're strong?

Yes. Good question. I'll give you a nerdy answer, okay? So I mean, on the one hand, I mean, there is -- when you look now at core imaging and MR, CT, PET CT, and so on and so on, to some extent, I mean these are disease and ology agnostic products. So an MRI can do brain -- can image brain cancer, can do the knee, MSK imaging and can help you do cardiac imaging. And that is, to some extent, the strength of radiology as a department and the role of radiology as a department to answer whatever question comes in, whether it is the poorly traumatized motorbike accident or a follow-up scan after chemotherapy to confirm health. So this is one side, and this is the majority of the business in André's business. And then it's about developing a breadth of different applications and monetize the specialty of saying, hey, we have that cardiac package. We have the neuro package and so on and so on. But we currently, don't have too many instances yet, and I say yet, where the use of the product is a single-use application and is creating a new and additional footprint. This is different in imaging for radiation oncology where we did a very good job in the partnership with Varian, which we had before the acquisition, to have special products, which are not so much of diagnostic nature, but are used to do treatment planning. And with the path we are on of making of democratizing imaging and reducing the form factor, the whole TCO and so on, this is an area which will bring us -- which can bring us to areas where in orthopedics or even in -- for dentists and in all kinds of areas, specialty equipment can play a role. So this is, for example, a big topic in the development of MRI. And it will also help us to have better guided treatments. We're basically looking at areas, and Carsten spoke very much about x-ray-based interventions. But in the long run, there is the opportunity that minimally invasive therapies are also guided by MRI, for example. This is an area we are looking at. So these are the big topics we are looking into. In addition, there is the potential upside when looking at neurodegenerative diseases, and we touched only in the last year a little bit here with the first Alzheimer drug with all its, let's say, early stages. And this is a super important untapped potential, but the imaging only makes sense when there's a treatment. And to some extent, we will be for sure benefit from all the developments in the pharma industry when it comes to tackling neurodegenerative diseases, which are currently maybe, on top of cancer, the big, big, big challenges in terms of science.

Thank you, Patrick. And this now takes our first real CMD as listed DAX company to an end. We really brought together a very informative program for you, I believe, personally. Also, we'll be very thankful for any kind of feedback. So what remains to say is thank you, dear viewers. Thank you, dear presenters. And also, of course, very much thank you, dear team, in the back end, preparing the charts, running the event, running the cameras, so that's been really a great achievement. So bye. Stay healthy and see you soon.

Thank you, everyone.

Thanks. Bye.