Teleflex Incorporated (TFX) Earnings Call Transcript & Summary

All right. Good afternoon. Welcome to day 2 of the Raymond James Institutional Investors Conference. My name is Jayson Bedford. I cover the med tech sector here. It's really our pleasure to have with us the management team from Teleflex. We have the company's Chairman and CEO, Liam Kelly; as well as Vice President of Investor Relations and Strategy, Larry Keusch. So with that, I think we're going to do a quick presentation, take your time, and then we'll engage in some Q&A.

All right, Jayson, thank you very much. Jayson tells me to take my time because I got an accent and you wouldn't understand me if I went too fast. So I'm going to go through an overview of Teleflex. And thank you very much for joining me today. We are pleased to be attending the Raymond James IIC, and we appreciate your interest in our company. Before I begin the presentation, I'd like to remind you that some of the matters discussed today will contain forward-looking statements regarding future events. I wish to caution you that such statements are, in fact, forward-looking in nature and are subject to risks and uncertainties and that actual events or results may differ materially. So today, Teleflex is a company with global scale that is built on innovation and brand power. We have over 23,000 products across 7 clinical areas, providing scale and depth, and we employ more than 14,500 employees in over 30 countries around the world. Our 2023 revenue was nearly $3 billion, and we serve more than 80,000 customers each day worldwide. We also have industry-leading brands that are highly recognizable by health care providers around the globe, including Arrow, LMA, QuikClot and UroLift. Our portfolio adds value to highly relevant clinical areas. We have products with category leadership in 7 key clinical verticals, including vascular access, interventional cardiology and radiology minimally invasive surgery, interventional urology, emergency medicine and anesthesia. Our portfolio is diverse and its construction has been purposeful over the years. To provide a sense of our financial progress over time, we've been able to consistently generate healthy constant currency growth through our diversified product portfolio. Even though our growth slowed temporarily during the pandemic, we continue to build on our durable core -- our durable growth objectives. We achieved a 6.1% revenue CAGR over the past 13 years and believe we are well positioned to execute going forward. Regarding profitability, we have driven significant improvements with adjusted gross margin increasing by almost 1,200 basis points and adjusted operating margin expanding 750 basis points for the year ending 2023 as compared to the year ending [ 2021 -- 2011 ]. Product mix shift, restructuring benefits, operating efficiencies and price have all been drivers of the gross margin expansion over the past 10 years. We have also realized strong operating expense leverage as we streamlined our management and reorganized our sales force structures and leverage shared service organizations. Indeed, over time, we have built a stronger Teleflex and have executed against our strategic initiatives. And as I reflect in our past successes, I believe that we remain well positioned for the future. Our corporate objectives remain focused on driving sustainable constant currency revenue growth, achieving adjusted margin and earnings expansion, optimizing our product portfolio and advancing corporate social responsibility and an inclusive culture. So let me expand on strategic priorities that will enable us to deliver on our long-term objectives. The first strategic priority is to drive sustainable constant currency revenue growth. As we look into the future, we are excited about the opportunities in front of us. Our combine -- our combination of growth drivers and diversified portfolio will help provide consistency in growth, while our continued focus on margin expansion and our revenue base will drive attractive free cash flow generation. This will be prioritized for internal growth drivers and inorganic opportunities. Our high-growth portfolio is expected to be a key contributor to our revenue growth algorithm and continued product diversification. This portfolio has many of our most exciting products, and we believe there is a long runway for market penetration. Our durable cohort is expected to show steady growth due to share gains, underlying market expansion and our category leadership. Of note, our durable core includes franchises with healthy growth, including Interventional, Vascular, Surgical and OEM as well as Asia from a geographic perspective. We intend to grow the percentage mix of our high growth portfolio over time through multiple organic drivers, including new product introductions and market expansion. Importantly, we will continue to preferentially direct investments to our high-growth portfolio. To sustain our momentum, a key building block of Teleflex's long-term growth investment strategy will be to transform our internal development capabilities resulting in an improved new product launch cadence and associated increase in our new product revenue over time. We are building on our new product development pipeline with a focus on a disciplined approach to advancing our projects. We are also actively engaged in strategies to accelerate time to revenue of our new product development. Although still early, we are confident that we can drive increasing momentum in our new product cadence over the coming years. We are off to a good start and had a number of new product launches in 2023, including a new Navigation and PICC Stylet in our vascular business and the Wattson dual guidewire and pacing wire in our interventional business. We also received an important expanded cardiac indication for QuikClot in our anesthesia business unit. Now turning to our second strategic priority. We will continue to focus on opportunities to drive adjusted margin and earnings expansion. We are confident that there are several layers -- levers to pull that will enhance our margins over time. Importantly, we have a slate of margin expansion drivers that are already in place and complement our methodical approach to consistent productivity initiatives. Mix shift towards our portfolio of high-growth drivers would be the primary driver of adjusted gross margin expansion over the coming years as the percentage of total sales increases. The Palette acquisition added yet another high-growth driver to our portfolio, which is accretive to gross margin growth. In addition, our existing restructuring initiatives will be another incremental driver of margin expansion as well as other operating efficiencies, including distributor to direct sales conversion. Purposeful and disciplined incremental investments to maintain our current momentum will be offsetting a portion of our margin expansion over the coming years. We will allocate investments to drive global product launches, expand our geographic footprint and develop new products. Although these directed investments will increase operating expense as a percent of sales over time, we will be targeted in our spend. We are confident that our strategy is prudent and we'll continue to position Teleflex for durable growth. Our third strategic priority is to optimize our product portfolio through new product introductions, continued M&A and thoughtful divestitures of noncore assets. We have a history of successful acquisitions across our business units. From 2011 to 2023, we completed over 80 M&A transactions while deploying $5.4 billion in capital. As we look into the future, we will continue to pursue a steady cadence of acquisitions to help augment our high-growth portfolio and create shareholder value. We will continue to optimize our portfolio through a disciplined review process focused on M&A as well as divestiture opportunities. We are looking for assets with category leadership, obvious clinical benefits, the ability to lower the overall cost of care and strong intellectual property protection. We also pay close attention to opportunities that allow us to leverage our infrastructure and expand our geographical footprint. From a financial perspective, we are looking for assets that are accretive to growth and margins with a focus on exceeding our weighted average cost of capital in a reasonable period of time. Our fourth strategic priority is to systematically advance corporate social responsibility and an inclusive culture while remaining true to our core values as a company. We believe that fortifying our culture, creating a welcoming work environment and looking out for the safety of our employees is foundational for Teleflex. Moving to our capital allocation priorities. We are focused on 4 key priorities for our cash generation. First, we will continue to invest in the business with the potential for capital investment to execute on footprint consolidation and other productivity initiatives. Second, portfolio optimization remains a priority with a focus on M&A. Third, we will pay down debt when appropriate. And fourth, we will maintain our dividend. We will continue to prioritize our capital allocation to enhance our returns while retaining flexibility should business conditions change. Thank you very much for your time and attention today. Now we're going to go into a Q&A session. Thank you.

Thanks, Liam. Thanks. Good job. I guess maybe -- we have a broad audience here. Maybe just to start, how fast do you think your end market is growing? I appreciate it's difficult in that you have, what, 23,000 products. But how fast do you think your end market is growing?

So I think it's dependent within the segment, to your point, we have 7 business units. I think some of the faster-growing markets that we're in is interventional cardiology and radiology there, you'd be expecting to -- the end markets to be growing in around the 5% range. And then in the slower end of the market would be the European drainage business and the anesthesia portfolio, which will be growing in that 1% to 2%. As we take a step back and look at our overall portfolio, I think on average, across many different segments, it's growing at around that 3%. Now within the high-growth portfolio, they are purposely selected within markets that are higher in growth. So clearly, the spacing market where we just acquired Palette Life Sciences, that's a faster-growing market for Teleflex. The Hemostatic market is a faster-growing market for Teleflex. And within OEM, where we acquired HPC, that would be at the upper end of that over 3% market growth as well. So some of our key acquisitions have been focused in on areas where we get faster growth within the market.

So if we stir it all together, is it mid-single-digit end market growth?

So if you stir it all together, just 3% to 4% would be the average market growth for the entirety of the Teleflex portfolio.

Okay. And then I guess just as you think of the growth in your LRP, you kind of alluded to it, but which segments would you expect to grow north of 6% and which would be south of 6%?

Yes. So a key element to our hypothesis for the 6% CAGR is really in 2 main buckets. You've got the high-growth portfolio. And within that high-growth portfolio, we're expecting that to grow approximately 12%. Within that, you have some key product drivers that are going to drive that. The Interventional Urology business unit, which Palette Life Sciences sits within, you have the PICC market, where we continue to take share within that space, and that's been growing quite aggressively for us in the mid-teens. You have the hemostatic portfolio that came through the Z-Medica acquisition. You have the intraosseous portfolio that continues to penetrate the markets, both domestically in the United States, and now we're starting to penetrate markets overseas with that portfolio. You obviously have MANTA within the interventional portfolio that continues to penetrate the large [indiscernible] closure market. And of course, you've got Titan, and we do expect the Titan product to grow this year. And then in the durable core, we expect the durable core to grow at 5% over the LRP. Now that -- in all transparency, last year, the durable core did better. Overall, Teleflex did better than the 6% we were expecting. We [ actually produced ] 6.5%. And a key part of that was the durable core doing better. And as I said a little earlier, there's some key franchises within that. You have the Interventional portfolio that is excluding MANTA and the intraosseous and you also have OEM within their surgical portfolio. And Asia Pacific, which is 11% of total Teleflex, are growing at well above market. So geographically, that's one of the key geographic areas to drive in excess of the market growth.

Just remind us exposure to China, and what's the growth rate been there?

So within China, China is approximately 4% of our total revenues as a company. And last year, China grew strong double digits. And we were -- we continued to invest behind the China market. We have seen some volume-based procurement and there's some volume-based procurement in our run rate as we go through 2023. Every company has a different strategy how to deal with that. We have ours. We think it's been working pretty effectively for us. And I think it's important for investors to know, we only sell the most differentiated part of our portfolio in China in order to somehow -- in some ways, protect ourselves from volume-based procurement because there aren't that many local competitors to that portfolio that has good, strong intellectual property.

I'm so sorry, contemplated in the '24 guide is some BVP pressure in China?

Yes, absolutely. We have some in '23, and we do anticipate that there will be some within '24. But we still expect that China will grow -- or Asia in general, will grow double digits in 2024.

Got it. Okay. Palette, it's been in the house for 5, 6 months now. What's gone good and what's gone bad in terms of either the integration or market reception based on your initial deal?

So we're very excited about the Palette acquisition. My mother, god rest her, used to say, a good start is half the battle. And we've had a good start with Palette. We expected it to do $56 million pro forma in 2023, and it modestly exceeded that. So that's a good positive start. We expect the asset to do $66 million to $68 million in 2024. As I sit here today, I feel comfortable in the asset's ability to deliver that number for Teleflex. What we really like about the Palette acquisition is the margins to Palette, it's not alone accretive to Teleflex, it's not alone accretive to the high-growth gross margin but it's also accretive to UroLift gross margin. So every dollar of growth within Palette is a good dollar for Teleflex. The integration so far has gone very well, one quarter in. We -- in December, we began the training of our UroLift sales force that are going to be dual bagged. There's 50 salespeople that are going to be dual bagged from the existing UroLift staff. We began the training in December, January and February, those individuals were doing field-based training and proctoring cases, observing cases. And we expect from Q2 on that they will be fully active within the field. No negative surprises, 5 months in, which is very encouraging. And I think that the asset will continue to perform, and I believe this will be a really nice fit for Teleflex.

And just the growth strategy, my sense is it's more focused on expansion of users complemented by existing -- growth from existing users. Is that fair?

Yes, that's very fair. I mean this asset fits so well into Teleflex. 97% of urology that treat BPH also treat prostate cancer. Only 20% of our current UroLift users use Barrigel today. So we have a lot of white space to go after. The overall market is $320 million to $330 million, and there is a potential to expand that market with new indications. And indeed, we have already begun the clinical pathway to expand the indications for Barrigel beyond its current application. There are just shy of 300,000 new cases of prostate cancer diagnosed every year. So growing into that white space is really important. We have a lot of runway within our existing base. And then we have the potential to expand the use of the product overseas and in particular, to Japan, which is a market with good strong reimbursement, and that should happen over the next 12 months or so.

Okay. Is there any structural reason why you can't have 50%, 60% of your UroLift physicians also using Barrigel?

Well, I think the only restriction is training and education. We need to educate the urology and radiation oncology community about the benefits of spacing. About 80% of the placement is done by urologists and about 20% approximately is done by radiation oncologists. And as I said earlier, 97% of urologists that do BPH also treat prostate cancer. So there should be no limitation for education and knowledge of the technology to assist in expanding that market into that white space. And Jayson, that's why we're so focused on the 60% of our current user base that don't use any spacing because that's just a question of education.

Okay. And if we're going to see any type of halo effect from Palette on UroLift, is there a time frame where you'd expect to see that, meaning in the next couple of quarters, is it more years?

So I think it's too early right now. And just to be clear to all the investors in the room, we did not build a halo effect into the model. So we didn't build any UroLift revenue synergies into the model when we acquired Palette Life Sciences. Do we anticipate there could be a potential halo effect? Absolutely, we do. And we think that's a real potential. I think that the [ air lease ], we're going to see it, Jayson, is by the end of this year. You want the reps out there for a couple of quarters to get at least an early indication as to whether there will be a halo effect. And with 50 reps hitting the ground in the month of March, dual bagged we'll obviously be monitoring that interaction very closely. Our existing customer base obviously uses UroLift and has the potential, but there's also a customer base that does spacing that doesn't use UroLift. And we will be going after that market segment as well. And it is an opportunity for us to talk to these urologists that have never had any exposure to UroLift or maybe had an early exposure to UroLift, and perhaps didn't have the best patient -- or didn't have the best reimbursement outcomes because the product wasn't reimbursed, and it's an opportunity for us to go back and reeducate those individuals.

And I know we've addressed this in the past, UroLift, but just for the sake of the audience here, it used to be 13% of sales, growing 20% plus pre-COVID. It's now sub 10% of sales. Growth is a bit more challenged. Can we assume you're still confident in the performance of the device? There's no additional data you need to present or modifications to the product? And maybe just in answering that kind of expand on what you see in the market today and how that could change?

So the product is performing exceptionally well. And I think that we addressed there was one question about the durability of the procedure. So just in the last couple of quarters, we've produced a 40,000 patient study that address durability of some of the main procedures. And I want to demonstrate is that still the gold standard is TURP. At 5 years, the retreatment rate for TURP was in or around that 7%. UroLift and GreenLight were statistically significant in the retreatment rates with UroLift coming in at around 11% or 12% revision rates at 5 years. Interestingly, the lowest complication rates of any procedure at year 1 was UroLift. The highest complications at year 1 from a procedure was actually resumed with this data, which is compelling. So the product is performing well. And structurally, I think having the product performing well means that there's a great opportunity for us to get this back to growth. The UroLift is growing in the hospital side of service and grew in the hospital side of service last year. The area that has been challenged has been the office side of service. And we have done a few things to help augment that. We've trained an increased number of surgeons in 2023 versus 2022. And an actual fact, we've trained as many as we trained at the peak in 2018 and '19. So that's a positive for us that surgeons are putting their hands up to get trained on this product and they want to adopt the technology. We have also implemented a program where the surgeon in the office can get a preauthorization just to make it easier for them to make sure that they get paid and they do the procedure. And we've also rolled out a volume rebate program for our key customers in order to ensure there's an incentive for them to do additional procedures. So I think that the product is performing well. The data supports the ongoing adoption of the technology for the treatment of BPH. It is still the best minimally invasive treatment for BPH. It's the only technology out there with proven 0 sexual dysfunction for a minimally invasive therapy, and it has longevity now demonstrated in the revision rates from that clinical study that we did.

Just the pre-auth and the volume rebate programs, when were they implemented?

So the pre-auth was last year, halfway through the year, the volume rebate began halfway through last year, and we've just augmented it in the first quarter.

Okay. Okay. We've got about 5 minutes left here. But just on margins, certainly, times have changed since the LRP was disclosed. Is there anything holding you back structurally from hitting 29% op margin?

So in order to hit 29% op margin, I think it all begins at the gross margin line. And I think that we have a clear path and visibility to be able to deliver on the gross margin expansion of at 250 basis points within our LRP. On the op margin line, there's nothing structurally. The biggest change that happened there was inflation was a little bit worse than we had thought when we launched our LRP. And also, we brought in a nice acquisition within Palette, that brought some OpEx with it. I think that 29%, 30% operating margin, they are the right numbers for Teleflex as a company. It's probably -- it's not going to happen probably in 2025. It will just take a little bit longer to get there. But those are the right types of numbers for Teleflex to be aspiring to. As a company overall, what we aspire to be is a good solid 6% top line grower, expanding our margins in the middle with good, high single, low double-digit earnings growth as a company. And I think that's a good aspiration for us over the next number of years.

Just on price versus inflation, I think you've talked about 50 basis points of potential price in '24. Is inflation more or less than the 50 basis points? And in inflation, I'm thinking more on the cost of goods side.

Yes. So pricing has not been enough to offset inflation for the past couple of years, and it won't be again in this year. Even though we do see some disinflation, and I think our team has done an outstanding job in modeling what's going to happen in this uncertain environment as we've gone through 2023. And to their credit, they nailed it in 2023. As we go into 2024, we still expect to see inflation, but we do expect to see disinflation rather than deflation. So we will see additional inflation year-over-year. We'll offset some of it with price, but it's not going to be enough to offset the total inflation on the gross profit line. We're still expecting to expand our gross margins at the midpoint of our guide by 90 basis points. And that's really because of the dynamics of exiting the MSA and bringing Palette in that the combination of those has helped even with what I just said, to expand our gross margins in 2024 over 2023.

That's helpful. Just in terms of capital allocation, going back to the investor event a few years ago, my sense was that there were some potential distributor to direct type of deals, I don't feel like we've seen many of those. Are they still on the table?

Yes, we still have 6% of our revenue that goes through distributors. And by distributors, for those of you not familiar with Teleflex, these are overseas companies that sell our product into the end market. We have done a couple of small distributor to direct over the last couple of years. We did a small one in Brazil. We did another one in Thailand. And there is potential for us to do more predominantly within Latin America and Asia Pacific. And we continue to monitor those and execute on them as they become potentials for us.

And then just deciphering your comments on the fourth quarter call around deals and capital allocation. My sense was the deals may be smaller in nature but more protective of earnings. Is that a fair conclusion?

That's a fair conclusion, especially the second part of that to be protective of earnings. Our underlying earnings per share growth if you exclude the MSA impact, if you exclude the Palette impact, the tax impact and FX, you add all of those together, and it's a pretty significant headwind. The underlying earnings per share growth is in the 7% to 10% underlying. But I think what's the state Minnesota?

No, Missouri.

Missouri. I think -- sorry, I always get those 2 mix up. So I think Missouri, I believe, is the Show Me state, if I read that correctly. So I think it's -- it would be nice for us to show that 7% to 10% earnings growth toward the investment community. And we're focused on that, Jayson, for sure. We're -- we acknowledge the fact that we've done some things that are in the best interest of Teleflex, and they're really good for Teleflex. Exiting respiratory is good for Teleflex, acquiring Palette is really good for Teleflex. But they are overshadowing the core earnings growth. And I think it will be important for us as we go into '25 and '26 to clearly demonstrate the ability of this company to drive real solid earnings growth.

All right. Outside of apologizing to everyone in Minnesota, do you have any final last words for the group?

No, I think having laid out our guidance for the year, we feel that the guidance covers a wide range of options for Teleflex. I think the guidance is prudent. I'm really happy with how we executed in 2023. We basically went -- rolled our sleeves up and at least beat or exceeded expectations each quarter. It's my expectation that we're going to do the same in 2024. We're going to just roll our sleeves up again. We did 4 for 4 last year on at least reaching, if not exceeding expectations. And I won't be happy until we've done 8 for 8 and then I won't be happy until we've done 16 for 16. So our goal is just to execute and to continue to demonstrate the portfolio we have within Teleflex and our ability to drive long-term shareholder value.

Well said. Thank you, Liam. The breakout session is downstairs in [indiscernible].

Excellent. Thank you.