Sotera Health Company (SHC) Earnings Call Transcript & Summary

Okay. Good morning. Welcome to day 1 of Baird's Global Virtual Healthcare Conference. My name is Mike Polark. I am a med tech analyst at Baird. I'm pleased to be joined in this session by Sotera Health. Representing the company, we have CFO, Scott Leffler; and Treasurer, Jason Peterson. For those that may be less familiar, Sotera is a leading global provider of sterilization, lab testing and advisory services. The company is also a leading global provider of access to cobalt-60 finished sources, which is a key product input for industrial-scale sterilization and also some medical applications. I'm going to turn the floor over to Scott, who is going to further set the stage and introduce Sotera with a few slides. And then after Scott's remarks, we'll jump into some Q&A that I will lead. So with that, Scott, welcome, and thanks for being here, and I'll hand it over to you.

Thanks, Mike. Let me start out by thanking you and the Baird team for hosting us in this event here today. And also thanks to all of you for joining us and for your interest in learning more about Sotera Health. I'm just going to start out with a couple of brief comments. Just a reminder that some of the statements I make today may be considered forward-looking statements and are subject to risks and uncertainties that could cause actual results to differ materially from those projected or implied. You can refer to our SEC filings and this slide for a description of these risks and uncertainties. The company assumes no obligation to update any such forward-looking statements. There will be a discussion in this presentation of certain non-GAAP financial measures, including adjusted EBITDA. You can find a reconciliation of these measures in the appendix of these slides. A copy of the...

Hey, Scott, you're coming in and out a little bit with audio. I don't know if you can...

Sure. Let me hold the mic a little bit closer. Is that better, Mike? Is that better, Mike? Can you hear me okay?

Sounds better, yes. Yes, it sounds better.

Okay. Great. I'll assume that you guys have at least heard well enough the comments I made a second ago, but I was just finishing up with a reminder that a copy of this presentation will be posted to the IR section of our website at www.soterahealth.com. So let me just jump into the presentation then. At Sotera Health, our mission is safeguarding global health, and we do that through our sterilization services, lab testing and advisory services. We go to market through our 3 business segments: Sterigenics and Nordion and Nelson Labs. Sterigenics and Nordion fall under the vertical relating to sterilization services. Sterigenics is a global provider of terminal sterilization services, primarily serving the medical device and pharmaceutical spaces. They provide a global network of facilities through our partners around the world with a leading position in terminal sterilization in all of the major modalities of sterilization, and that includes sterilizing using ethylene oxide gas, gamma radiation using cobalt-60 and using a machine called an E-Beam which generates machine-generated radiation to sterilize medical devices. Now I mentioned those 3 modalities, and one of them was sterilization using gamma radiation that's generated by cobalt-60. And that's where our second business unit, Nordion, comes in. Nordion was acquired in 2014, and it allowed us to become the only global vertically integrated sterilization solutions provider relating specifically to the modality of sterilizing using gamma radiation via cobalt-60. Nordion, as Mike indicated earlier, is the world's leading global supplier of cobalt-60, which has a number of applications but primarily for use in the sterilization industry for that particular modality. And then our third business unit, Nelson Labs, is a global leader in microbiological testing, servicing primarily the medical device and also pharmaceutical spaces across the life cycle of pharmaceutical and medical device products. What we do is important, but how we do it is every bit as important. We are providing mission-critical services to blue-chip customers. We do business with 40 out of the top 50 medical device manufacturers and 8 of the top 10 pharmaceutical companies. For Sterigenics and Nordion in particular, a lot of that business is done over long-term contracts. Sterigenics and Nordion generate over 90% of their revenue under long-term contracts. Our services are provided to our customers via a comprehensive global network across all 3 of our businesses. We have 64 facilities around the world. Sterigenics in particular has 48 facilities around the world, representing all of those major modalities of sterilization that I mentioned earlier. We believe that the cost to replicate our network is over [ $1.5 billion ]. We operate -- all 3 of our businesses operate in a very highly regulated industry with a trend towards increasing regulation over time, and we believe that our ability to comply with an increasingly burdensome regulatory environment is a competitive differentiator for us. In terms of our growth strategy, we look at both organic and inorganic growth opportunity, with a successful track record of delivering growth from both of those areas. All of that is grounded in a value-based culture. The company's values are -- our core values are safety, quality, accountability and excellence. That's how we do it, and the result is strong financial performance: revenue growth every single year on record. We pulled numbers back to 2005 in order to validate that obviously, but I think our view is that, that history goes back even further. In particular, when you look at the more recent periods of macro disruption, the financial crisis of 2008, 2009 and probably most importantly and most recently, of course, the pandemic and during the worst points of the pandemic in 2020, we delivered revenue growth in every single one of those years. We have an adjusted -- a margin profile that is very attractive with over 50% adjusted EBITDA margins. And importantly, there's plenty of runway for growth with an addressable market of around $33 billion that we believe we'll continue to tap into over time. Consistent track record of cash generation. And obviously, we're exposed to macro end markets with strong secular trends. And importantly, for anyone that wants exposure to the health care space without payer reimbursement risk, then we're an attractive opportunity. Now I think given how new we are in the marketplace, there's still a lot of investors out there that have trouble visualizing, in fact, how we interact with different medical devices. So what we're trying to do here is just to give you examples. And bear in mind that Sterigenics has almost 3,000 customers, Nelson Labs has [ almost 4,000 ] customers. They're obviously providing services across a massive range of product categories, so this is just a small sampling of the product categories that we interact with. On the left side, medical device examples; and on the right side, pharmaceuticals. And just to give you a couple of examples of how we might interact with these products. Across the top, cardiovascular implants, orthopedic implants. At any given point in time, if you were to walk through some of our gamma radiation facilities, there's a very good chance that you might see boxes of these medical devices that are being sterilized using gamma radiation. In the second row, you see collection swabs, particularly relevant in the pandemic environment where Sterigenics has been instrumental in providing sterilization services. Many people that follow the company are aware of comments we've made around how we touch the world of personal protective equipment where there's a certain amount of sterilization but really the larger storyline there has been the tremendous contribution that Nelson Labs have made in testing around personal protective equipment used by caregivers in treating patients during the pandemic. And then on the right side, I'll just give one example on the pharmaceutical side that we often reference. You see an image on the upper left of someone holding an asthma inhaler. And this is a special one for us because, in 2017, we acquired a leadership position via acquisition in a specific category of testing called extractables and leachables testing. And so the idea is if you look at the person in that image that's about to inhale a pharmaceutical product to treat their asthma, how do they know that, that pharmaceutical product hasn't -- there hasn't been a harmful contaminant that's leached into the pharmaceutical product from the plastic or metal container. And this particular category of testing where we're an industry leader is the leading solution for identifying those types of risks. So just a few examples. Again, I think I mentioned earlier that we are touching products across really the entire life cycle of medical devices and pharmaceuticals and a small sample of that here. What does that translate to in terms of our financial performance? Here, we're looking at our financial performance from 2018 to 2020, delivering 8% top line growth in 2019 and importantly, during the pandemic, delivering 5% revenue growth. Also importantly, during that time, we took already strong margin performance and expanded them by over 450 basis points, culminating in 2020 margin profile of 51.3% and obviously delivering double-digit bottom line growth. Robust earnings performance during that time period as well. You see a little bit of a blip in 2020 that is related to some financing activities that took place. It's not reflective of the material change in our capital structure since going public that we'll talk about a little bit later that's resulted in a significant reduction in overall debt levels and expense. Next and more recently, looking at 2021 performance, and I'll focus on the left-hand side of the slide, talking about our year-to-date performance. We've delivered 16% revenue growth, 16% adjusted EBITDA growth and 83% adjusted EPS growth. And obviously, our outstanding performance is being complemented by some acquisition activity as well as the optimization of our capital structure that I mentioned a second ago. We've been a public company now for 3 reporting cycles, 3 quarterly reporting cycles, and we have delivered double-digit growth in every single one of those quarters. Finally, and I already referenced it a couple of times, we're proud of the optimization of our capital structure since going public. As a privately held company, obviously, we had a different philosophy as far as the capital structure we want to maintain. But we have now reduced our net leverage from 7.5x pre IPO to 3.8x as of the most recent reporting period, obviously with more opportunity for further reductions from there. People that follow the company's news may have read that a couple of weeks ago, we used cash generated from operations to pay off our highest cost remaining debt on our balance sheet. And so our new run rate for interest expense is down to $70 million, and that compares to $215 million in interest expense for the last year. So obviously, a material reduction in interest expense to accompany the leverage reduction, and that just increases the cash flow potential for the company at the time. Finally, just to wrap up, and then I'll turn it back over to Mike. We feel that the company has a very robust underlying operating model. You can see that in the strong financial performance both in terms of top line growth and bottom line performance. A large addressable market with plenty of runway for incremental growth, sitting in an industry that remain very attractive. We're a trusted partner for our customers where we have many customer relationships literally going back multiple decades. Plenty of opportunity from operational excellence as well. And importantly, a platform here for continued M&A where we're able to use inorganic opportunities to complement the robust organic performance. So with that, Mike, I think I'll hand it over to you.

Excellent. Great foundation, Scott. Good introduction. Thank you so much. We have just over 15 minutes for some Q&A.

I'm liking to start a lot of these conversations here about the environment. I understand we're intra-quarter and you may not be able to comment. But in just the last week or so, a handful of public companies have commented that Delta variant is perhaps impacting procedural demand, ability to access health care. It certainly doesn't seem widespread like 2Q of last year, but pockets of strains. So in the context of your business, which for our listeners, Sterigenics grew 4% last year in arguably the most challenging macro environment in recent past. Your worst quarter last year in Sterigenics was low single-digit growth, so proved resilient during the trials of last year. I'd be just curious for your take on the world as you see it here. We have obviously Delta variant. There was summer seasonality. Folks may be burnt out and eager to get away to the beach. You had some hurricane and weather-related disruptions. From your perch, how do you view these influences?

Sure. Well, I think we can all use a trip to the beach. But -- and thank you for the comment about where we are in the earnings cycle because, obviously, so close to the end of Q3. I'm probably better off anchoring myself to some of the comments that we've made in the past, particularly in our Q2 earnings report, which is just a reiteration of the fact that it is such a robust and consistent and resilient, your term, operating model. As I said earlier, over 90% of the revenue from Nordion, Sterigenics is delivered under long-term contracts. And as you said, we delivered growth at the company in every single quarter of last year, including during the worst of the pandemic-related lockdowns. Also working in our favor here is the diversification of the revenue model, where when you're talking about doing business with literally thousands of customers across thousands and thousands of product lines, then that really helps to insulate you against any macroeconomic volatility. And I think we clearly demonstrated that last year, just as we have every single year on record. And I think that gives you a sense for the optimism that we in general feel around the resiliency of the revenue model even in a more challenging macro environment. And so I think in our Q2 earnings call, we made some comments to that effect around our optimism around the company's ability to continue to deliver robust results even in a more challenging environment.

Yes. Let's shift gears and double-click on Sterigenics. A nice result in the most recent quarter. If I have the numbers correct, 12% growth in constant currency organic for Sterigenics revenue, which is [Technical Difficulty] in that global network. I'd say, when I hear those comments, that seems to be a signal that you expect growth ahead. So level set here on [Technical Difficulty] underway. Six are expected to be online by the end of this calendar year. Why are you investing? What gives you the confidence to expand your network capacity? And what is it -- am I crazy to think that these double -- low double-digit growth rates are unreasonable here over the next handful of quarters as these projects come online and start to fill?

Sure. Well -- so there's a couple of perspectives maybe embedded in there. Some of it's more near term and some of it's more medium term and longer term. So I'll try and approach it from a couple of different angles. But in terms of our outlook for this year, first of all, it's our general policy not to update or comment on our guidance between earnings calls. But we did in our earnings call update our guidance for the year, which obviously, if you look at our year-to-date performance as of Q2 and what that implies about the second half of the year, you can see that as of that time, it leads towards a certain amount of comfort around what the second half of the year will look like. And I'll just say -- I need to keep reiterating the same point, but the consistency of the revenue model for Sterigenics in particular, given the diversification of the revenue stream as far as the number of customers and product lines, really means that you've got a business, and this applies to Nordion as well, that -- it's not that often that we have surprises in this type of business. We have a lot of visibility into the revenue stream over time. And then with respect to the capacity of things that we have mentioned on our last couple of earnings calls that we have 9 active capacity expansions, with 6 contemplated to go live through this year, bear in mind that the cycle for capacity expansions is not necessarily a reaction to immediate -- to the immediate demand environment. It's more the result of what is often a multiyear commercial cycle, where we are deeply embedded with our customers in many cases in terms of their own product development plans. Just a reminder that while sterilization services typically represent less than 5% of the total cost to bring a product to market, you can argue that they own 100% of the value because you're talking about a service that is often FDA mandated. And so for our customers that are different -- in different phases of product development, it's absolutely critical for them to know that they're going to have sterilization capacity available to them. And so again, back to these capacity expansions, these are the results, in many cases, of commercial negotiations that have been taking place for quite some time. And also, as we've said in the past, they're not necessarily representative of any change in the overall longer-term trajectory of the business. We would characterize these as being representative of our routine cycle of investment in the business. We've said that we tend -- just from an optimization of ROI on our investments, we do have a tendency to run at very high capacity utilization levels. And so what that means is that we also have to have a routine program of capacity expansions in order to accommodate growth over time for the business.

[Technical Difficulty] Scott, can you hear me?

Barely. I don't know if it's -- apologies. I don't know if the technical issue is on my end or your end, but I'm not having a lot of trouble.

I think we're rolling now. I can hear you, and it sounds like you can hear me.

Sure. Okay.

Yes. No, that was a good overview on the capacity expansion. So I think in summary, you're -- maybe talk about one of these projects. How do you bring it to your leadership team internally? How does the capital get approved? What sort of inputs go into that process, whether it be customer commitments or indications? Because I think that is useful. This is a business where you have to put up a box first before you can fill it, before you can grow. And I think in the past, you've provided some helpful context around how Sotera gets comfortable making such significant capital commitments. So maybe if you could comment on that as you think about the Sterigenics network growth and the investments being made there.

Sure. And just back to a point I made a second ago. With these deep customer relationships that in many cases, are going back decades, our commercial team really does a great job, I think, of being embedded with our customers, in many cases, early in the product development cycle or at least early enough at the point where we can be part of the solution for them in terms of giving them the confidence they need that they're going to have the right capacity available in the right place as they bring what is often a very important product to the marketplace. And so oftentimes -- I think in a best case scenario, and we've said this before, we love to have customer commitments upfront before we even put a shovel on the ground for a new capacity expansion. So oftentimes, the internal discussion goes along the lines of looking at the actual customer commitments, along with the -- even if it's not a commitment, looking at the rest of the commercial pipeline for a particular modality in a particular geography. And so we look at that on an ROI basis, and we are making for 20%-plus IRR returns on our organic investments. We don't always have 50% capacity committed for an expansion, but certainly, it's nice to have that as a bogey. But in general, I think our commercial team does a great job of being in tune with the marketplace so that -- whether it's actual committed volume from a customer or a very robust and reliable pipeline, we're able to make a decision to make an investment in capacity expansions like the ones I've talked about and had delivered a very strong track record of hit rates on those expansions.

So your service is valuable to a wide variety of customers and products. I don't want to spend too much time on any specific category, but one that continues to get proactive mention is bioprocess, I think probably single-use consumables for the production of vaccines and biologic drug products. And I'd love you to comment on what you see in that product category defined broadly and kind of why it seems to be quite buoyant and growing. And I think there's maybe a pandemic influence but also more of a secular shift. So what's Sotera's view on the bioprocess category and that opportunity within Sterigenics?

Yes. Well, I mean, I think you hit the nail on the head in terms of just the macro opportunity there. There really is just a tremendous emphasis and growth tailwind in that area. Historically, it has not necessarily represented a huge part of our business, but I think that some of that relates to just the way that, that market worked. And as you said, this trend towards more single-use inputs for bioprocessing is something that creates a commercial opportunity for us as well. We talked a little -- we talked about it a little bit on our Q2 earnings call. And without quantifying the opportunity in any way, we certainly believe that that's a very promising opportunity for us as well as the product line.

Maybe last one on Sterigenics. I will ask briefly on the litigation, not for written outcomes or anything of the sort, but just upcoming events. So the one in New Mexico, I believe you were working on a monitoring agreement with the authorities there. What's the latest on that? Or when might investors be able to expect an agreement? And then Illinois, you've been very clear of jury trials next year; first one, July. What happens between now and then? Is there anything investors should be digging into? Or is it simply waiting for next summer?

Yes. So in terms of the personal injury cases in Illinois, you're right about the timing in terms of the first cases coming to trial in the second half of next year. And so really, barring any surprises, we wouldn't expect to have much in the way of updates on those. As you indicated, really it's just more preparation in terms of our legal resources. And obviously, from the very beginning, we have felt very strongly about the company's position on these matters. Certainly, we feel that all of the claims are unfounded that are against the company. And our intent is to vigorously defend ourselves against every one of those claims, and we'll see the results of that in the second half of next year. We don't have an update of any kind in terms of the Santa Teresa monitoring situation. As we mentioned on the Q2 earnings call, we had been going -- the status quo, the situation right now is that we need to go back in front of the judge in that case and ask for a ruling in terms of the monitoring requirements. And there's been no change in that. We're waiting for the judge to give us a time line for that ruling. In the meantime though, our position hasn't changed relative to what we mentioned on our Q2 call, is that we're -- we wouldn't anticipate that ruling to have an impact from an operational standpoint on that side.

Let's shift gears to Nelson Labs. I get this question a lot. What does Sotera envision Nelson being in 5 years forward? There you are, a small fish in a very large pond. Lab services is defined broadly as a massive marketplace. It's heterogeneous. Where is Nelson different today? And why is Sotera an advantaged owner of this asset? And what's the vision over the next 5 years to grow this business?

Well, I think if you go back to 2016 when we originally acquired Nelson Labs, the original thesis was really grounded in the significant amount of overlap that exists between the testing services that were provided by Nelson Labs, which specifically relate to the sterilization process, and then, obviously, the overlap with Sterigenics, is delivering the sterilization services. And so there's -- you can lump those testing services into 2 general categories. There's 1 bucket that relates to routine testing for products that are already out there for routine production and distribution in the marketplace. There are generally a number of quality control or routine lot release tests that are done after the sterilization service is provided in order to validate the efficacy of a sterilization process. And so there's a natural commercial and potentially operational synergy there. And then earlier in the product development life cycle, there's a lot of testing that goes on in order to design the sterilization protocol and then validate the efficacy of that protocol. And Nelson provides a lot of testing services in that area. And again, there's an obvious potential commercial synergy between Nelson Labs and Sterigenics and Nordion as well. And we've said we think -- even a few years into the acquisition, we think we're still in the early stages of realizing the potential synergies associated with those connection points. But more broadly, obviously, we've been a bit more thrilled with Nelson even above and beyond those synergies with Sterigenics because they just have such a broad universe of opportunity. We claim a $33 billion TAM for the company, and $29 billion of that is in the Nelson Labs space. But then $26 billion out of the $29 billion is for pharma, which is really an area that we've gone out of our way to emphasize. Historically, Nelson Labs was almost exclusively medical device. And after identifying just the material opportunity that is out there for testing services in the pharma space, we've gone out of our way to emphasize both organic and inorganic investments with pharma then to develop that. So where we sit today, Nelson Labs had gone from having very little pharma exposure to now being almost 30% pharma. A couple of our tuck-in acquisitions had a specific pharma area that they were targeting along with some organic investment as well. And so really, when you look at Nelson Labs 5 years down, we think that there is plenty of organic opportunity out there, whether it's further penetrating the existing TAM on the medical device side, further penetrating the large opportunity on pharma. And then in a changing regulatory environment, that's where Nelson Labs really differentiates itself because their thought leadership, which we consider to be second to none, positions themselves -- positions them better than anyone to assist their customers in understanding and complying with the dynamic regulatory environment.

Yes. That's a good overview. So we have 20 seconds. And I won't squeeze in the question on margin, but I will say one of the questions is, "Wow, these margins are so high. How can they go higher?" And I'd just double-click on your opening comment during your prepared remarks, which is that you expect to strive for margin improvement from operational excellence, perhaps some price, business mix. I have a lot of questions about that, but I think it's important just to reiterate that even though your margin is very high, you strive for higher.

Absolutely. And we talked about 3 main drivers for our margin profile. We didn't get into it much on this call, but the company does have a successful track record of delivering some top line growth from price, including annual price escalators built into our contracts. And so that provides some amount of margin tailwind. Our business does have a tremendous amount of operating leverage overall. And so after we ramp up the volume performance, then that creates some margin tailwind for us. And to your point, operational excellence is something that we really have embedded in the culture of the company and believe that there's plenty of opportunity out there to drive margin -- our margin performance [ and other opportunities as well ].

Scott, thank you so much. We're going to have to leave it there. And thanks for working through the technical difficulties. I don't know, somewhere in the ether there was some excess traffic, but we made it through. Thanks for being here. Good luck today with the rest of your meetings. And thanks to everyone in our audience for listening in.

Thanks. Really appreciate it. Thanks a lot.

Have a good day.