Stryker Corporation (SYK) Earnings Call Transcript & Summary

I'm Larry Biegelsen, the Medical Device analyst at Wells Fargo, and it's my pleasure to host this fireside chat with the management team from Stryker. With us, we have Andy Pierce, Group President, MedSurg and Neurotechnology and Jason Beach, Vice President, Investor Relations, the format is going to be fireside chat, as I mentioned. By way of background, MedSurg and Neurotech account for about 63% of total Stryker sales or about $15 billion in revenue. Andy, Jason, thank you for being here. Jason, thanks so much for being a supporter of this conference for many years. I appreciate it.

Thanks for having us.

Yes. Thanks for having us, Larry. .

So Andy, so Stryker's MedSurg and Neurotech business has grown over 11% organically for the past 3 years. Year-to-date, it was over 11% as well. What do you estimate your WAMGR is? And how do you consistently grow above your end markets, which I assume aren't growing at 11%?

It's a good assumption. They're not, but we are. And the unique thing about our MedSurg and Neurotechnology business in Stryker at least is we're 15 individual businesses. So they're diverse, both in terms of the categories that they play in, the types of technologies that they represent, but also in terms of call point. whether it's a surgeon call point or it's an administrative call point or even pre-hospital, which we have in our Medical division and emergency care. Each of these businesses, when we talked about this in our last Analyst Day, each of these businesses has a WAMGR that's between kind of that mid-single-digit growth all the way up to upper single-digit growth. And as you know, our stated expectation as a company is to grow 200 to 300 basis points faster than our markets. We certainly have that expectation in MedSurg and Neurotechnology. And if you look across the organization, we typically do that. Diverse businesses, like I mentioned, very focused, very specialized, which means they have their own dedicated R&D, marketing, sales, and they actually have their own dedicated M&A teams as well. So they develop deep expertise in customer and in category. They learn customer needs where you might have an unmet or undermet need, and then we figure out, of course, how to properly serve that. So very focused, very specialized organization. We also, as many of you know, do a good job of leveraging M&A. I talked about our specialized M&A teams that sit inside of our businesses. So we are very active across MedSurg and Neurotechnology on the M&A front. We have been busy this year. You don't see as much of that, but we will start to see some of that coming forward. We were pretty busy last year. And over time, we've been very busy. We are prolific innovators in our respective markets, particularly in our power brands. We are in the vast majority category leaders. So a strong #1 or #2 player in each of the markets. We have high expectations. We will continue to have high expectations both for performance, but also how we innovate, how we show up for our customers and you can expect that we'll continue to provide outsized growth for Stryker Corporation.

That's helpful. How are you thinking -- I know you don't guide by segment, but how are you thinking about the momentum in the second half of the year for MedSurg?

Sure. Yes. I think Jason and Kevin did a good job in the last call of taking up our guidance both in terms of the top line, but also the bottom line as well. And given -- I didn't know the precise number was 63% of the company that is MedSurg, you can't have a successful Stryker Corporation if you don't have a fast-growing MedSurg. So I think it's a pretty good sign when they take up the numbers that we're likely going to have a pretty solid second half in our world.

That's helpful. Investors are always asking what comes next for Stryker in terms of new products. I know as a company, Stryker keeps things pretty close to the vest. Any color hints that you can share with us? Or maybe you can talk about some of the new product launches right now like LIFEPAK?

Sure. Yes. We have a pretty consistent strategy, and we have for some time. It's wrapped around our power brands. And if you look at what we've done over the last few years, you mentioned a couple of those product launches that we've had. They are in our power brand categories of visualization that would be to 1788 or big professional defibrillator, LP 35, our ProCuity Bed, et cetera, et cetera, a number of key product launches System 9 on the power tool side and that's part of our offense. So you've seen and you can expect to see over time that in that kind of every 3- to 5-year range, you're going to see refreshes around those power brands. And the ones that we've just mentioned have had a strong impact on the market. Say, by and large, they're kind of mid-cycle in their life -- launch cycle rather. So we have some legs left on those product launches. But you can bet that right behind those. We have those next-generation products that will be coming in those power brand categories. As we get bigger, as we add more businesses from an M&A perspective, wash, rinse, repeat, power brands, you'll see us maintain that regular cadence of innovation and ensure that we're leading in the marketplace.

That's helpful. And Andy, any changes to the hospital capital equipment environment since the Q2 call?

Our Q2 call was just a few weeks ago. And I think over that period of time, we have not seen any changes. The hospital capital environment is stable. Our order book is stable. If you look at our backlog as a business, it's quite strong. So our customers are feeling pretty good. They're liquid. They are prioritizing and investing in our types of products. So we feel good about the capital market.

That's good to hear. Jason, you have an Investor Day in coming up in November. What can we expect at the Investor Day this fall. Can you disclose which areas you're going to focus on? Typically, you focus on a few areas. And can we confirm that we will get an update on the long-term financial goals.

Sure. I'm not going to spoil it for you Larry. I want to make sure that you show up on November 13, but I would say a couple of different things. Certainly, we are going to get into areas of growth as you think about the future for Stryker and then we'll obviously update the long-range financial plan versus what we said back in 2023 and how we see the next few years going forward.

Okay. Got it. sounds good. M&A, Andy, you talked about as one of your core competencies. Where do you see interesting opportunities for M&A in MedSurg and Neurotech?

Yes. So we have 15 individual businesses, each of them maintains a list of interesting opportunities. Of course, we can't do them all. All of our businesses would like to, but that is a great problem to have when you have amazing opportunities to go out and execute on. And you have such a big, diverse company to be able to choose off of those lists. So although we have not been as active in the last months in terms of deals that we've announced publicly, of course, Inari being a big one that we did earlier this year, we are continuing to be active all across our businesses with those interesting opportunities that we have. And we've talked in the past about spaces that we're interested in from a large adjacency perspective. Two of those, we've done a pretty good job of getting into over the last few years. I mentioned the one with Inari in Peripheral Vascular. But also an important space for us that you'll see us continue to invest in healthcare IT. We first entered into that space just a few years ago with Vocera. We followed it up last year with care.ai and I think you can expect more from us in those categories as well. And I think you may know a few others as Kevin has mentioned over time.

That's helpful. Robotics is an area...

That is one of them.

Kevin has mentioned. Obviously, you're a market leader in orthopedic robotics. How are you thinking about soft tissue robotics and robotics more broadly. There's lot of areas of surgical robotics that are interesting. How are you thinking -- how are you approaching that? And I think one area that -- the one investor concern is that it's an expensive area. And if you do a deal in that area, people are concerned about potential dilution. How do you balance that?

Yes, yes. Well, let me just be very clear. We love robots at Stryker. We have a pretty good one in Mako, as he mentioned. And the reality is robotics, whether it's in soft tissue or h tissue is only going to continue to grow. The applications, the impact on the user, on the patient is positive and will only continue to get more and more positive. So we're very interested in the robotic space in general, as you mentioned, Larry, and of course, Kevin and Jason talk about that publicly. Soft tissue robotics, in particular, is an interesting space only because over time, we believe, as I noted, that we can provide really good medicine there. Now is it right for Stryker today? Is it right for Stryker tomorrow? We will determine that over time, and I'll get to your economic part of that question here in just a second, but I will say that we are very active as a company in assessing, deeply assessing the opportunities that are out there from a start-up perspective, and maybe some more mature robotics organizations that you might see in the market or hear about in the marketplace today that maybe someday could be for sale. Are they right for us? TBD. We will continue to evaluate those. Now that being said, there are other opportunities, as you mentioned, Larry, in specialized robots. So we're also looking deeply into those opportunities. And again, are they the right fit for us? I will say that should you 1 day see Stryker decide to enter into spaces outside of hard tissue robotics that you can believe that we've done our homework. And we've gone in eyes wide open with what that means from an investment perspective, and we firmly believe that, that's going to be the right decision for Stryker. We get all of those concerns I would say those aren't necessarily concerns of ours, they're realities of the marketplace, and we have to synthesize those realities with what's right to first Stryker Corporation.

That's helpful. So let's transition to the individual businesses. I think it would be helpful for people to unpack them a little bit. Starting with Endoscopy, star performer in the first half of the year, 15% organic growth. endoscopy is comprised of a few different segments you've disclosed out in the past. Help us understand which segments are driving the growth there?

Sure. Yes. So A long-term high performer for Stryker Corporation are in the Endoscopy division. It's an interesting business in that it has 4 unique franchises, who I talked about those 15 businesses. 4 of them sit inside of our Endoscopy division, starting with our core visualization business unit, what we call our Endoscopy business unit. That business has our 1788 and you can, of course, imagine that 1788 has been a strong growth driver for that individual business unit and for the division. We are kind of in that 2-year mark post-launch, we're pretty much right there, and we expect to continue to get some legs out of our 1788 launch particularly around the world, but also in the U.S., we have plenty of opportunity for ongoing upgrades of existing customers, but also it has been a terrific product for us to go out and take share. Our Communications business unit is also in our Endoscopy division. That's our hospital infrastructure business, operating room infrastructure business. booms, lights, tables, OR integration products for audiovisual integration inside the operating room. That has been a strong grower for us over the last several years as you've had more and more new builds on the ASC side, but also new build and expansion on the hospital side. So that fits in well from a trend perspective with where we are with that business, strong growth. Our sports medicine business has been a very strong accretive grower for now many years, a small business once upon a time that now is growing into a more material business for the corporation, where we've been prolific in innovation. We've launched 6 new products in the last 18 months in the shoulder alone. We have a strong position in the hip. We're growing fast in the knee as well. That is a terrific business for the company. And then lastly, our reprocessing business, which I think you're all familiar with is our fourth business unit, which has been a consistent grower for us over time and is a great brand builder for the company.

That's super helpful. So Medical, there's a lot to cover. So we could spend a lot of time just on Endoscopy. I know that. And I had follow-up questions, but I want to make sure we get to other businesses that people are interested in. LIFEPAK 35 is in Medical. And so is Vocera, I believe. Medical has been -- the growth has been good, not -- I wouldn't say above the average. You have had, I think, some supply issues there. You're launching LIFEPAK 35 outside the U.S. now. How is the LIFEPAK 35 launch going? I think you said the installed base is over 100,000 units globally. And could the OUS launch kind of accelerate the medical growth.

Last part of the question, yes. So today, we are now launching in Europe. EU MDR means that some of these launches have a little bit of a lag to them relative to the U.S. for the regulatory requirements. But we are in Europe now. We've been there for a couple of months. And you can expect as we move into the next year or 2, 3, that you'll start to see the impact of LIFEPAK 35 in that market, so internationally as well in total. In the U.S., we've been about a year on the market with LIFEPAK 35, and it's been every bit as successful as we hoped it would be. Of course, we build business models around each of these product launches, and we have exceeded what we expected from an impact of LIFEPAK 35 here in the U.S. We're upgrading existing customers. You talk about our 100,000-plus installed base. The majority of that is here in the U.S. We're upgrading those customers. That will have a long tail as these upgrade cycles can be longer with a defibrillator and we're taking business from competitive customers as well. So we feel great about it. It's a unique technology. Our customers love it. It's durable. And we are out there saving lives with LIFEPAK 35 and pretty excited about that.

And is it the supply issues that have held you back? Growth's been good, not stellar.

Yes. So our Medical division, you mentioned that there's a lot there. There's a lot in all of these big divisions of Stryker and that they're very diverse. So 3 individual business units inside of Medical, our Acute Care business, our Emergency Care business, and our Sage products business inside of our Medical division. So some of those products, particularly the large capital, have complex supply chain. So at times, you will see some disruption in supply from our position. The great thing is that we do have enough diversity to oftentimes cover those challenges. But from quarter-to-quarter, you might see some fluctuation based on that. We have stated and we are optimistic that, that will be a double-digit grower, that division, Stryker Medical for the company this year. So we expect strong performance. Our ProCuity Bed, our stretchers, LIFEPAK 25 all strong contributors as we deal with some challenges on the supply chain front.

That's helpful. And Vocera...

And by the way, LIFEPAK 35 is not one of those challenges in terms of supply chain.

Got it. And Vocera? So far, so good?

We are extremely excited about Vocera. We're excited about it today. Our customers love the Engage platform, the middleware that we offer the communication and care coordination that we provide through Vocera. We're just as excited about how we continue to integrate all of these technologies that have a digital integration potential across Stryker, whether that's beds or ProCuity, which we have integrated into Vocera today or some day, maybe even a Mako robot that is pushing data through the Vocera platform. And also that tie in from a platform perspective to care.ai. So sensors in the room, voice on the badge and how all that works from an AI perspective. Workflow simplification, better patient care, better experience for nursing, of course, we know, are under an incredible amount of stress, and we have a nursing shortage. So much more efficient care. We're extremely excited about Vocera, but more so, I'll just say it one more time, excited about our entire digital vision that we have for the company.

The other business that's been a star performer, Neuro Cranial, 20% growth in the first half. Most people probably I will admit, don't know really much about Neuro Cranial. We probably -- I don't get questions on it. Let's put it that way. Help us understand why that business, it's such a strong performer. I know you've talked about -- I think Vertos is down there, the Interventional Pain, Interventional Spine business. We'll talk about -- I want to talk about Vertos as well, but just help us understand why that business is so strong?

Yes. So there's 4 businesses that are part of our Neuro Cranial franchise. Our Interventional Spine that you mentioned, our craniomaxillofacial business, our CMF business is part of Neuro Cranial, our ENT business and our Neurosurgical business. So that makes up Neuro Cranial for the company. And you might imagine in the neuro space that the neurosurgeon in particular, has a lot of leverage with their hospitals. So they kind of get what they want. They're saving logs. They're treating very sick patients. So we're in that sweet spot of care. The IBS business, which you mentioned has been one of Stryker's fastest growers. It participates in the high-growth segments of spine, both on the pain side, but also in bone tumor ablation with our OptaBlate product. Vertos fits into that pain category. We're very excited. We can talk more, as you said, Larry, about Vertos. That's our Interventional Pain business. We acquired NICO last year, and Interventional Spine, once upon a time called Interventional Pain. I'm old. I've been around a long time. Our Interventional Spine business. Neurosurgical. That's where our NICO acquisition from last year is. So NICO is all about going after hard-to-reach tumors and stroke care. That's been a great addition to our Neurosurgical portfolio, helping to drive greater pull-through across that entire bag and raise our brand story in the marketplace. Neurosurgical think about tumor removal and bone removal. So whether that's in the cranium or in the spine or tumors primarily in the brain with that's mostly related to both NICO and our Sonopet Ultrasonic platform. very fast growth, very innovative business, a very competitive sales team in neurosurgical. CMF, long term, a great grower for us, out taking share, moving customers to customized implants or what we call patient-specific, CT-based, an implant specifically designed for you. That's been a great grower for us, and we continue to get traction in our ENT business, particularly as we've expanded our sales organization. We have launched some good new products there. but driving greater commercial excellence has led to a nice acceleration in growth in our ENT business as well.

Vertos, we're familiar with the company before Stryker acquired it. That's the mild procedure right?. Checks are very, very good. That turned organic, I think, in Q4. I assume that, that will be accretive to organic growth. Is that fair?

Both of those things are accurate. The deal closed at the end of Q3, so you'll start to see organic growth coming out of Vertos in the fourth quarter. And yes, that business is accretive to Stryker's growth, will be accretive to our growth overall and the other bit of good news is we're ahead of our model with Vertos, so performing very well.

That's good to hear Yes. I mean it's hard to sustain 20% organic growth, but we'll see. For a division, it's a good challenge. So let's switch gears, vascular, you renamed it. It's still kind of -- the organic growth there is still Neurovascular, right? We'll talk about Inari in a minute. But that's -- that was actually one of your software businesses in the first half. What are the trends in that business and what drives the acceleration?

Sure. Yes. So specifically in Neurovascular, Neurovascular is a strong global business for us. It's the one business in Stryker that we're bigger outside the U.S. than in the U.S. And we're particularly sensitive to BDP as we have a big China business. So you can see some movement there. in terms of our growth related to various BDP activities that many companies have experienced in China. We're not in into that in Neurovascular, in particular. That is a crowded space, particularly on the ischemic stroke side, and we have, frankly, been what we would consider to be below our standards in terms of our offering in ischemic stroke and we're right in the early, early innings of launching a new large core catheter called Broadway. We're very excited about it. Our customers have received the product well, but it's very early, and we expect that to be a growth driver for us going forward. Our sweet spot as a neurovascular business is on the hemorrhagic stroke side. We have a great coil business, but we also have a nice and growing flow diverting stent business, and we are also in the early innings a brand-new launch there called SURPASS Elite, our Elite system, and that is also being extremely well received by our customers, again, early innings, but we expect that to drive growth for us going forward. So overall, new products are the game in Neurovascular, when we get those new products, we drive that Stryker level of growth that you expect. And we're pretty optimistic about what we have coming in that business.

So Andy, one follow-up on Neurovascular. It's probably the most crowded space I can think of the med tech right now. I mean you can count 9 players or so, okay, private public companies. It's a nice market, but it's not huge. What are your thoughts on consolidation in that market? I mean it seems inevitable.

Yes. It's not unlike, I gulp a little bit when I say this, but the core spine market is also a very crowded space. And of course, you've seen consolidation like you're mentioning and that Stage 2 over time. And I'll talk about consolidation from our perspective. And you can imagine like we are, and we talked about earlier, very busy in that business, evaluating opportunities to consolidate as well. for a lot of those smaller players that are coming up or niche products that exist in neurovascular, but completely agree, crowded space, and it is ripe with opportunities for deals to happen.

Okay. And it's an area you're committed to, so you could participate in some of that consolidation.

Completely committed to it. It is absolutely on the right side of health care. It's great medicine. It doesn't mean it's easy. It is competitive, particularly on the ischemic stroke side, it's competitive, but 100% committed to neurovascular.

And Contour, which is available in Europe, which is a good reputation next year or 2 from the U.S.?

Sure. Yes. Contour is our intrasaccular device or one and done. You'll hear those technologies called and that's available in certain markets outside the U.S., you just mentioned in Europe. And we will -- coming to a theater near you have that in the U.S. We're not talking specifically about launch dates here in the U.S. for that, but we're excited about where we're going in Contour.

Great. So Inari, the growth in the second quarter based on your commentary, you didn't give exact numbers, but by our math, maybe slightly below 10%, but you expect an improvement in the second half of the year. What's giving you the confidence that you can accelerate so quickly?

Very excited about Inari. As you might imagine, we did our homework, and there were lots of options or at least plenty of options for us to evaluate in the market in the peripheral vascular space. And we chose Inari for a reason. We believe in their portfolio, we believe in their science. And we also believe culturally that they're a really great fit for Stryker overall. And in terms of their focus on the customer and their focus on technology. That being said, oftentimes, when we acquire companies, and this is not a new story, it's not just a Stryker story. You see some short-term disruptions when you're integrating companies. That is not something that we don't expect. We're experienced acquirers. We know that, that happens, and we expect that. In particular, in Inari's case, we felt like we had the opportunity to make some important upgrades on the commercial side of the business. They have a number of really exceptional sales professionals, but we have the opportunity to go in and add some Stryker level talent in many places. And we feel like we're through that. We feel great about sales organization stability today and where that's going to take us from a performance perspective going forward. We also, importantly, moved in Stryker leaders in key positions. So our division President announced on day 1 is Tim Lanier, who ran our very successful Trauma and Extremities business and happened to come to Stryker via an acquisition. He was running the shoulder business for Wright Medical. So he knows what it's like to go through an integration, and that's brought him a lot of knowledge and credibility with the Inari team as well. But he also had 6 years leading the sales organization of [ ED3 ]some moons ago. So we have an experience level in peripheral vascular as well. So Tim is there. We have a brand-new sales leader, not new to Stryker, and 20-year veteran that we moved from one of our other high-performance businesses to lead that sales force, building the right culture, the right incentive structure, the right talent. And we did the same thing on the marketing side where we took 1 of our high-performing star marketers and move them from 1 business of Stryker into Inari. So we feel great about the management team, and where we're headed with that business. And I think you can expect Stryker level performance out of Inari going forward.

Jason, you've said for the year for 2025, you've given a sales number right for Inari that implies growth of what low teens, something like that?

Yes, that's right. So in Q1 and again in Q2, we said we expect roughly $590 million of revenue for the 10 months that we will have owned them. And then to your point, it implies kind of teens growth for the year, this year.

And is that how you see Inari longer term, Andy? A double-digit grower?

The way we think about are is twofold. One is we mentioned at the very beginning that we expect all of our businesses. It doesn't matter if it's Inari or it's our premium craniomaxillofacial business or you name it, to grow faster than their markets. And we like to say 200 to 300 basis points faster at least, and we expect Inari to do the same. So the second part of that is you have tailwinds in market growth as you drive mechanical thrombectomy adoption in both pulmonary embolism and in DVT. So you're going to get a faster growing market spend that way, and you're going to get Stryker growing faster than that market. So you can imagine that, that would equate to a strong accretive business over time to Stryker's overall growth.

One follow-up on that. Obviously, so I guess the 200 to 300 basis points faster than the market. So it's a competitive market, not only with Penumbra who seems to be doing well. They disclosed some of their growth rates in that -- in the peripheral market, but you also have new competition coming. So it does seem like -- I agree the market growth is pretty strong, but growing 200 to 300 -- going faster than market seems challenging.

It is challenging. It's not unlike our Neurovascular business, and we have high expectations for our Neurovascular business, and they know it, and that team is accountable and there's improvements that we can make there. And Inari, we will not back off. It's not who we are growing faster than our markets. Yes, it's competitive. Yes, it's getting more competitive. And we have to make our way through that maze. It's tricky for sure, but we do the right things to control what we can control, both on the portfolio side, but also how we go to market and represent through our sales organizations, we feel like we can win in that space. And I think you can expect that we will not back off of our expectation that, over time, we grow 200 to 300 basis points faster than our market. In short-term periods, could you see that change based on some new product launch or other market dynamic? You could but over time, our expectation is that we are beating our market.

And Andy, you talked about building out the peripheral portfolio. It's a pretty heterogenous. How are you thinking about kind of building out that portfolio over time?

Right. Yes. If you look at our -- the whole total peripheral vascular universe and certainly as you include the arterial space, we're today really only playing in a small sliver of the total addressable market in peripheral vascular. So we, of course, are looking primarily at the faster-growing segments or categories of peripheral vascular. Many of you are aware of some of those that even have transacted in recent times. And we're also looking at opportunities to participate in those. So you can bet that back to this M&A story, where we have dedicated M&A teams, of course, working alongside our marketing teams that we are assessing essentially all of the opportunities that we can, the entire universe, and we are funneling those down into the right types of acquisitions for Stryker. You can expect that we will continue to do transactions in peripheral vascular. I won't give you exactly for competitive reasons where we're going, but you can bet that we're going to be busy there.

So you name the business Vascular. which neuro, some people would define it neuro, coronary and peripheral. Should we expect at some point in the future, Stryker to also to be in coronary, I'm not asking for time line.

It is named vascular. And today, we're focused on peripheral vascular. And I would...

And neuro.

And neuro of course. But neuro relative to coronary, you obviously have a near adjacency to peripheral vascular. Also similar types of technologies, oftentimes the Neurovascular, you're right about that, Larry. We're not getting ahead of our skis. We know what we need to do today and how we need to go out and win and prove ourselves, both in terms of ensuring that Inari was a great acquisition for our shareholders and for our customers. But yes, you can imagine over time, Stryker does find its way into new categories and segments, and we'll see where we go over time.

We didn't cover Instruments. And in case there's anyone from the Instruments business online listening, I don't want them to feel slided. So it doesn't get a lot of attention, but it is a consistent double-digit grower. I think it's mainly power tools and waste management. What's driving the growth there? And what's underappreciated about this business?

Very consistent long-term grower for Stryker. Thanks for to our friends that might be listening from Instruments for asking the question. Yes, we have really strong power brands in our orthopedic Instrument business, which primarily today is being led by our System 9 heavy-duty power tools, but we also have a launch in our next generation of Steri-Shield so the hoods and togas for personal protection, that's in that business and a handful of other categories that are there. High market share, high growth over time. On our Surgical Technologies business, it's sister business unit, inside Instruments. That's where Neptune Waste Management resides. Also, we've had incredible success over time in waste management, and we are, by far, the market leader in waste management. Also plays nicely from a trend perspective to trends in smoke management. So smoke evacuation business resides in our Surgical Technologies business, that trend, of course, is more and more regulations. And a lot of that have been put into place around particularly states in the United States around smoke evacuation and surgical smoke. That plays into our hand there. And then we have a great business for sponge counting with our SurgiCount+ system with Triton, which also helps to measure or quantified blood loss for patients, and that business is fast growing for us as well. So really some neat categories and product technologies that we have in our Instruments business that are helping to drive strong growth for us today and have really for a long time.

That's helpful. Look, I wanted to -- we're running out of time. I wanted to give you an opportunity to make some closing remarks, but maybe you could do that and also just -- obviously, you're not going to talk about MedSurg growth in 2026. It's just how you're feeling about the momentum. This has been a consistent double-digit grower for Stryker.

Yes. We have a pretty admirable growth profile as a company. You've mentioned the 11% growth over the last few years. I think most would love to have that. We don't take that for granted. We know it takes extremely hard work, great innovation, great M&A, great sales execution, taking care of our customers. We do not expect that to change. We will continue to innovate, we'll continue to buy companies. We'll continue to drive specialized sales forces, and we will expect to outgrow our competitors over time. We think that part of the battle to growing like that is having high expectations. We will not back off of those high expectations. You can expect that MedSurg and Neurotechnology over time will be accretive to Stryker Corporation's growth. We expect that, and we're very excited about the future.

Perfect. Thank you for being here.

Thank you.

Thanks, everybody.