美國雅培 (ABT) 2022 Q3 法說會逐字稿

Good morning, and thank you for standing by. Welcome to Abbott's Third Quarter 2022 Earnings Conference Call. (Operator Instructions) This call is being recorded by Abbott. With the exception of any participant's questions asked during the question-and-answer session, the entire call, including the question-and-answer session, is material copyrighted by Abbott. It cannot be recorded or rebroadcast without Abbott's expressed written permission. I would now like to introduce Mr. Scott Leinenweber, Vice President, Investor Relations, Licensing and Acquisitions.

早上好，感謝您的支持。歡迎參加雅培 2022 年第三季度收益電話會議。 （操作員說明）此通話由 Abbott 錄音。除了在問答環節中提出的任何參與者的問題外，整個通話（包括問答環節）的材料版權歸雅培所有。未經 Abbott 明確書面許可，不得錄製或重播。我現在想介紹投資者關係、許可和收購副總裁 Scott Leinenweber 先生。

Good morning, and thank you for joining us. With me today are Robert Ford, Chairman and Chief Executive Officer; and Bob Funck, Executive Vice President, Finance and Chief Financial Officer. Robert and Bob will provide opening remarks. Following their comments, we'll take your questions.

早上好，感謝您加入我們。今天和我在一起的是董事長兼首席執行官羅伯特福特； Bob Funck，財務執行副總裁兼首席財務官。羅伯特和鮑勃將致開幕詞。根據他們的評論，我們會回答您的問題。

Before we get started, some statements made today may be forward-looking for purposes of the Private Securities Litigation Reform Act of 1995, including the expected financial results for 2022. Abbott cautions that these forward-looking statements are subject to risks and uncertainties that may cause actual results to differ materially from those indicated in the forward-looking statements. Economic, competitive, governmental, technological and other factors that may affect Abbott's operations are discussed in Item 1A, Risk Factors, to our annual report on Form 10-K the year ended December 31, 2021. Abbott undertakes no obligation to release publicly any revisions to forward-looking statements as a result of subsequent events or developments, except as required by law.

在我們開始之前，今天發表的一些陳述可能是 1995 年《私人證券訴訟改革法案》的前瞻性陳述，包括 2022 年的預期財務結果。雅培警告說，這些前瞻性陳述可能會受到風險和不確定性的影響。導致實際結果與前瞻性陳述中的結果大不相同。可能影響雅培運營的經濟、競爭、政府、技術和其他因素在我們截至 2021 年 12 月 31 日止年度的 10-K 表年度報告的第 1A 項風險因素中進行了討論。雅培不承擔公開發布任何修訂的義務除非法律要求，否則因後續事件或發展而作出的前瞻性陳述。

On today's conference call, as in the past, non-GAAP financial measures will be used to help investors understand Abbott's ongoing business performance. These non-GAAP financial measures are reconciled with the comparable GAAP financial measures in our earnings news release and regulatory filings from today, which are available on our website at abbott.com. Note that Abbott has not provided the GAAP financial measure for organic sales growth on a forward-looking basis because the company is unable to predict future changes in foreign exchange rates which could impact reported sales growth. Unless otherwise noted, our commentary on sales growth refers to organic sales growth, which excludes the impact of foreign exchange.

在今天的電話會議上，與以往一樣，非公認會計準則財務指標將用於幫助投資者了解雅培的持續經營業績。這些非 GAAP 財務指標與我們今天的收益新聞稿和監管文件中的可比 GAAP 財務指標相一致，這些指標可在我們的網站 abbott.com 上找到。請注意，雅培未在前瞻性基礎上提供有機銷售增長的 GAAP 財務指標，因為該公司無法預測可能影響報告銷售增長的未來匯率變化。除非另有說明，我們對銷售增長的評論指的是有機銷售增長，不包括外彙的影響。

With that, I will now turn the call over to Robert.

有了這個，我現在將把電話轉給羅伯特。

Thanks, Scott. Good morning, everyone, and thank you for joining us.

謝謝，斯科特。大家早上好，感謝您加入我們。

Today, we reported results of another strong quarter, including ongoing earnings per share of $1.15. Based on our performance through the first 9 months of the year, we increased our full year adjusted earnings per share guidance to $5.17 to $5.23, which is more than 10% higher than the initial guidance flow we provided back in January.

今天，我們報告了另一個強勁的季度業績，包括每股 1.15 美元的持續收益。根據我們今年前 9 個月的表現，我們將全年調整後每股收益指引上調至 5.17 美元至 5.23 美元，比我們在一月份提供的初始指引流量高出 10% 以上。

As you know, the macroeconomic conditions remain challenging. Inflation continues to be a stubborn force globally, but we've started to see some moderating impacts in certain areas of our businesses compared to earlier in the year. At the same time, the U.S. dollar has continued to strengthen, including throughout the most recent quarter. COVID remains as unpredictable as ever with intermittent surges continuing throughout the world. And lastly, global supply chain dynamics, staffing shortages continued to impact our health care markets, though we're seeing steady signs of improvements.

如您所知，宏觀經濟狀況仍然充滿挑戰。通貨膨脹在全球範圍內仍然是一股頑固的力量，但與今年早些時候相比，我們已經開始在我們業務的某些領域看到一些緩和的影響。與此同時，美元繼續走強，包括整個最近一個季度。隨著世界各地持續出現間歇性激增，COVID 仍然像以往一樣不可預測。最後，全球供應鏈動態、人員短缺繼續影響我們的醫療保健市場，儘管我們看到了穩定的改善跡象。

Over the last few months, we've made progress in several important areas following the temporary shutdown of our infant formula manufacturing plant in Sturgis, Michigan earlier this year. We restarted production at Sturgis in July with a focus on our EleCare and other specialty infant formulas. And in September, we began production of several Similac products, which we expect will begin to reach retail store shelves over the coming weeks.

在過去的幾個月裡，繼今年早些時候我們在密歇根州斯特吉斯的嬰兒配方奶粉製造廠暫時關閉後，我們在幾個重要領域取得了進展。我們於 7 月在 Sturgis 重新開始生產，重點是我們的 EleCare 和其他特種嬰兒配方奶粉。 9 月，我們開始生產多款 Similac 產品，我們預計這些產品將在未來幾週內開始上架零售商店。

We also boosted production in our global network to increase infant formula supply to the U.S. In fact, we delivered roughly the same volume of formula to our U.S. customers this past quarter as we did during the 3 months prior to the recall. Our #1 supply priority was to the WIC, Women, Infant and Children, federal food assistance program to ensure that underserved participants would have access to infant formula.

我們還提高了全球網絡的產量，以增加對美國的嬰兒配方奶粉供應。事實上，我們在上個季度向美國客戶交付的配方奶粉數量與召回前 3 個月大致相同。我們的第一供應重點是 WIC、婦女、嬰兒和兒童、聯邦食品援助計劃，以確保服務不足的參與者能夠獲得嬰兒配方奶粉。

During the quarter, we also made leadership changes, both at our Sturgis site and in our prior organization, and we concluded a month-long investigation into the accusations that were made by a former employee. The investigation, which included extensive document reviews and interviews, concluded that the allegations about quality were unfounded. And during the quarter, the same former employee dropped the federal OSHA complaint.

在本季度，我們還在 Sturgis 工廠和之前的組織中進行了領導層變動，我們結束了對一名前員工的指控進行為期一個月的調查。調查包括廣泛的文件審查和採訪，得出的結論是，有關質量的指控是沒有根據的。在本季度，同一位前僱員放棄了聯邦 OSHA 的投訴。

And lastly, we conducted an analysis of the U.S. infant formula market and concluded that this country would benefit from more manufacturing capacity and redundancy. As such, we're moving forward with plans for a $0.5 billion investment in a new U.S. nutrition facility for specialty and metabolic infant formulas. We're currently in the final stages of determining the site location and will work with regulators and other experts to ensure this facility is state-of-the-art and sets a new standard for infant formula production. We recognize there's more to do, but feel confident in the progress we're making, and I want to thank all the Abbott employees that have been working around the clock on this matter.

最後，我們對美國嬰兒配方奶粉市場進行了分析，得出的結論是，這個國家將受益於更多的製造能力和冗餘。因此，我們正在推進投資 5 億美元的計劃，在美國新建一家營養設施，生產特殊和代謝嬰兒配方奶粉。我們目前正處於確定場地位置的最後階段，並將與監管機構和其他專家合作，以確保該設施是最先進的，並為嬰兒配方奶粉生產設定了新標準。我們認識到還有更多工作要做，但對我們正在取得的進展充滿信心，我要感謝所有在這件事上日以繼夜工作的雅培員工。

I'll now summarize our third quarter results for our remaining businesses in more detail before turning the call over to Bob. And I'll start with Established Pharmaceuticals, or EPD, where sales increased more than 12% in the quarter. Strong performance was led by double-digit growth across several countries, including India, China, Brazil and Vietnam, along with broad-based strength across several therapeutic areas. EPD has now achieved double-digit organic sales growth since the beginning of last year, fueled by a steady cadence of new product launches and strong commercial execution. And EPD has also expanded its profitability profile over the same time period, which is quite unique given the current macroeconomic headwinds.

在將電話轉給 Bob 之前，我現在將更詳細地總結我們剩餘業務的第三季度業績。我將從已建立的製藥公司或 EPD 開始，該公司本季度的銷售額增長了 12% 以上。印度、中國、巴西和越南等多個國家的兩位數增長以及多個治療領域的廣泛實力引領了強勁的業績。自去年年初以來，環保署現已實現兩位數的有機銷售額增長，這得益於新產品發布的穩定節奏和強大的商業執行力。環保署也在同一時期擴大了其盈利能力，考慮到當前的宏觀經濟逆風，這是非常獨特的。

Moving to Diagnostics, where COVID test sales of $1.7 billion were significantly higher than expectations but lower compared to last year, which resulted in a modest decline in sales growth overall. The decline in COVID test sales compared to last year was driven by lower demand for laboratory-based tests. Whereas demand for our rapid tests, which include BinaxNOW, Panbio and ID NOW continues to be strong, with sales this past quarter at a similar amount to the third quarter of last year.

轉向診斷，其中 17 億美元的 COVID 測試銷售額顯著高於預期，但低於去年，這導致整體銷售增長略有下降。與去年相比，COVID 測試銷售額下降的原因是對基於實驗室的測試的需求下降。鑑於對我們的快速測試（包括 BinaxNOW、Panbio 和 ID NOW）的需求持續強勁，上一季度的銷售額與去年第三季度相似。

Rapid tests have proven to be very important and highly practical tools. They provide a quick and affordable way to test COVID almost anywhere and at any time, whether you're experiencing symptoms or just want to know your status before attending events or gatherings. Excluding COVID testing revenues, sales of routine diagnostic tests grew 6% in the quarter overall and even faster internationally, fueled by the continued global rollout of our Alinity instrument for immunoassay, clinical chemistry and molecular testing.

快速測試已被證明是非常重要且非常實用的工具。無論您是出現症狀還是只是想在參加活動或聚會之前了解自己的狀態，它們都提供了一種快速且經濟實惠的方法，幾乎可以隨時隨地測試 COVID。剔除 COVID 測試收入，常規診斷測試的銷售額在本季度整體增長 6%，在國際上甚至更快，這得益於我們用於免疫分析、臨床化學和分子測試的 Alinity 儀器在全球的持續推廣。

Lastly, I'll wrap up with Medical Devices, where sales grew 6.5% in the quarter globally. In the U.S., sales growth of approximately 11.5% was led by strong double-digit growth in Electrophysiology, Structural Heart and Diabetes Care. During the quarter in the U.S., cardiovascular procedure volumes were somewhat soft in July before strengthening in August and September. Internationally, in addition to similar procedure volume trends, sales were negatively impacted by intermittent COVID lockdowns in China as well as supply constraints in certain areas, most notably in Electrophysiology.

最後，我將總結醫療設備，該季度全球銷售額增長了 6.5%。在美國，約 11.5% 的銷售額增長主要得益於電生理學、結構性心臟和糖尿病護理領域兩位數的強勁增長。在美國的這個季度，心血管手術量在 7 月份有所下降，然後在 8 月和 9 月有所加強。在國際上，除了類似的手術量趨勢外，銷售還受到中國間歇性 COVID 封鎖以及某些領域的供應限制的負面影響，尤其是在電生理學領域。

In Diabetes Care, sales of FreeStyle Libre exceeded $1 billion in the quarter, and our user base expanded to approximately 4.5 million users globally. In the U.S., where sales grew more than 40%, we initiated the full launch of Libre 3, which automatically delivers up to the minute glucose readings with unsurpassed accuracy in the world's smallest and thinnest wearable sensor.

在糖尿病護理領域，FreeStyle Libre 本季度的銷售額超過 10 億美元，我們的用戶群擴大到全球約 450 萬用戶。在銷售額增長超過 40% 的美國，我們啟動了 Libre 3 的全面發布，它在世界上最小和最薄的可穿戴傳感器中以無與倫比的準確性自動提供最新的葡萄糖讀數。

Internationally, organic sales growth was impacted by a couple of transitory items, including supply constraints on Libre 1 in certain emerging markets, which we expect to improve over the next couple of months. And secondly, a strategic choice we made in Germany to rapidly transition our large existing user base to our latest generation Libre 3 system, which temporarily reduced our focus on new user additions during the quarter in that country. We already transitioned well over half of our users with the vast majority of the remaining users expected to move to Libre 3 by year-end.

在國際上，有機銷售增長受到一些暫時性因素的影響，包括某些新興市場對 Libre 1 的供應限制，我們預計未來幾個月會有所改善。其次，我們在德國做出的一項戰略選擇是快速將我們龐大的現有用戶群轉移到我們最新一代的 Libre 3 系統，這暫時降低了我們在該國本季度對新增用戶的關注。我們已經轉換了超過一半的用戶，而剩下的絕大多數用戶預計將在年底前遷移到 Libre 3。

This move strategically fortifies our leadership position in the second largest continuous glucose monitoring market in the world and further enhances our already strong strategic position as we work to bring the benefits of Libre to more and more people, including those with type 2 diabetes that are not reliant on insulin to manage their disease.

這一舉措戰略性地鞏固了我們在全球第二大連續血糖監測市場中的領導地位，並進一步增強了我們已經強大的戰略地位，因為我們致力於將 Libre 的好處帶給越來越多的人，包括那些患有 2 型糖尿病的人。依靠胰島素來控制他們的疾病。

So in summary, despite the challenging environment, we achieved another strong quarter that significantly surpassed expectations which reflects the strength of our diversified business model and execution. And based on our strong performance for the first 9 months of the year, we're once again raising our EPS guidance for the year.

因此，總而言之，儘管環境充滿挑戰，我們還是取得了另一個顯著超出預期的強勁季度，這反映了我們多元化業務模式和執行力的實力。基於我們今年前 9 個月的強勁表現，我們再次提高了今年的每股收益預期。

I'll now turn the call to Bob. Bob?

我現在將電話轉給 Bob。鮑勃？

Thanks, Robert. As Scott mentioned earlier, please note that all references to sales growth rates, unless otherwise noted, are on an organic basis, which excludes the impact of foreign exchange.

謝謝，羅伯特。正如斯科特之前提到的，請注意，除非另有說明，否則所有提及的銷售增長率都是有機的，不包括外彙的影響。

Turning to our results. Sales increased 1.3% on an organic basis in the quarter. COVID testing-related sales were $1.7 billion, which while stronger than anticipated, reflect a year-over-year decline versus sales in the third quarter of last year. Additionally, organic sales growth was negatively impacted by a temporary shutdown of manufacturing at our nutrition plant in Sturgis, Michigan earlier this year. Excluding COVID testing-related sales and the U.S. sales impacted by the temporary manufacturing shutdown, total Abbott sales increased 6% on an organic basis in the third quarter.

轉向我們的結果。本季度銷售額有機增長 1.3%。與新冠病毒檢測相關的銷售額為 17 億美元，雖然強於預期，但與去年第三季度的銷售額相比出現了同比下降。此外，今年早些時候我們在密歇根州斯特吉斯的營養工廠暫時停產，對有機銷售增長產生了負面影響。不包括與 COVID 測試相關的銷售和受臨時停工影響的美國銷售，雅培第三季度的總銷售額有機增長了 6%。

Foreign exchange had an unfavorable year-over-year impact of 6% on third quarter sales. During the quarter, we saw the U.S. dollar continue to strengthen versus several currencies, which resulted in a slightly more unfavorable impact on sales compared to exchange rates at the time of our earnings call in July.

外匯對第三季度的銷售額同比產生了 6% 的不利影響。在本季度，我們看到美元兌多種貨幣繼續走強，與 7 月份財報電話會議時的匯率相比，這對銷售產生了略微不利的影響。

Regarding other aspects of the P&L, the adjusted gross margin ratio was 55.9% of sales, which reflects the impacts of the nutrition manufacturing disruption and inflation we've experienced on certain manufacturing and distribution costs across our businesses. Adjusted R&D investment was 6.1% of sales, and adjusted SG&A investment was 25.9% of sales in the third quarter.

關於損益表的其他方面，調整後的毛利率為銷售額的 55.9%，這反映了我們所經歷的營養品製造中斷和通貨膨脹對我們業務的某些製造和分銷成本的影響。第三季度調整後的研發投入佔銷售額的6.1%，調整後的SG&A投入佔銷售額的25.9%。

Lastly, our third quarter adjusted tax rate was 18.1%, which reflects an adjustment to align our year-to-date tax rate with our revised full year effective tax rate forecast of 15.5%. The revised full year forecast is modestly higher than the estimate we provided in July due to a shift in the mix of our business and geographic income.

最後，我們第三季度調整後的稅率為 18.1%，這反映了調整我們的年初至今稅率與我們修訂後的全年有效稅率 15.5% 的預測。由於我們的業務和地域收入組合發生變化，修訂後的全年預測略高於我們在 7 月份提供的估計。

Turning to our 2022 outlook. For the full year, we now forecast ongoing earnings per share of $5.17 to $5.23, which is comprised of our year-to-date results through September, plus ongoing earnings per share guidance of $0.86 to $0.92 for the fourth quarter. We forecast total company organic sales growth, excluding the impact of COVID testing-related sales, to be in the mid-single digits for the fourth quarter.

轉向我們的 2022 年展望。對於全年，我們現在預測每股持續收益為 5.17 美元至 5.23 美元，其中包括我們截至 9 月的年初至今業績，以及第四季度持續每股收益 0.86 美元至 0.92 美元的指導。我們預計第四季度公司總有機銷售增長（不包括與 COVID 測試相關的銷售的影響）將達到中個位數。

Excluding U.S. sales impacted by the temporary manufacturing disruption, we forecast fourth quarter organic sales growth to be in the mid-to-high single digits for the remainder of our combined businesses, which includes Medical Devices, Established Pharmaceuticals, Diagnostics, excluding COVID testing-related sales, and areas of nutrition, not impacted by the disruption. We forecast COVID testing-related sales of approximately $500 million, which does not assume a COVID testing surge in the fourth quarter. And lastly, based on current rates, we expect exchange to have an unfavorable impact of approximately 7% on our fourth quarter reported sales.

不包括受臨時製造中斷影響的美國銷售，我們預測第四季度我們合併業務的其餘部分的有機銷售增長將達到中高個位數，其中包括醫療器械、成熟藥物、診斷，不包括 COVID 測試-相關銷售和營養領域不受此次中斷的影響。我們預測與 COVID 檢測相關的銷售額約為 5 億美元，這並不假設第四季度 COVID 檢測激增。最後，根據目前的匯率，我們預計交易所將對我們第四季度報告的銷售額產生約 7% 的不利影響。

With that, we'll now open the call for questions.

有了這個，我們現在開始提問。

(Operator Instructions) And our first question comes from Robbie Marcus from JPMorgan.

（操作員說明）我們的第一個問題來自摩根大通的 Robbie Marcus。

Great. Congrats on the quarter. Robert, maybe we could start, we're already towards the end of 2022. And I think people's attention are really shifting to next year. Just with so many moving pieces, both in revenues and down the P&L with currency and inflation and COVID testing assumptions and so on. So I was hoping sometimes at this point in the year, you might give us some early thoughts on next year. Anything you can provide to help us narrow the range of outcomes would be great.

偉大的。祝賀本季度。羅伯特，也許我們可以開始了，我們已經接近 2022 年底了。我認為人們的注意力真的轉移到了明年。只是有這麼多的變動因素，無論是在收入方面，還是在貨幣和通貨膨脹以及 COVID 測試假設等情況下降低損益。所以我有時希望在今年的這個時候，你可以給我們一些關於明年的早期想法。您可以提供任何幫助我們縮小結果範圍的東西都會很棒。

Sure. I mean, with all those topics, we could spend the whole call on it, right? So I'll provide as broad framework that I can give you here. Obviously, the macro conditions are going to remain challenging, right, Robbie. I don't think that anybody right now as we're planning going into next year, is forecasting that this is just going to ease up, right? So specifically, I would say probably inflation, I don't expect to get better.

當然。我的意思是，對於所有這些主題，我們可以把整個電話都花在它上面，對吧？因此，我將提供我可以在這裡給您的廣泛框架。顯然，宏觀條件仍將充滿挑戰，對，羅比。我不認為現在我們計劃進入明年的任何人都預測這只會緩解，對吧？所以具體來說，我會說可能是通貨膨脹，我預計不會好轉。

And I'd say the currency headwinds are very much kind of in play here for next year, right? Those are probably 2 of the big kind of macro kind of impacts for us. But I still see a lot of opportunity for growth as I have been talking about our business and our portfolio. There's a clear path in my mind here for top line growth of high single digits. And you can get there with a variety of looking at across our businesses.

我會說明年的貨幣逆風在這裡很重要，對吧？這些可能是對我們產生的兩種重大宏觀影響。但我仍然看到很多增長機會，因為我一直在談論我們的業務和我們的投資組合。在我看來，這裡有一條清晰的道路，可以實現高個位數的收入增長。您可以通過對我們業務的各種了解來實現這一目標。

So in Medical Devices, we've got a lot of upcoming launches and products that we have launched. So Libre 3, Amulet, Aveir, CardioMEMS, Navitor, we expect to be launching next year here in the U.S. EnSite X, our mapping system, launching a new ablation catheter into the market globally next year also.

所以在醫療器械方面，我們有很多即將推出的產品和我們已經推出的產品。因此，Libre 3、Amulet、Aveir、CardioMEMS、Navitor，我們預計明年將在美國推出 EnSite X，我們的測繪系統，明年還將向全球市場推出一種新的消融導管。

I'm probably sure there's more that I could kind of rattle off here in terms of devices. So I think the device portfolio looks very strong as we go into next year. I expect the same kind of growth rate that we're seeing in EPD. I expect to see continued share capture that we're seeing in core diagnostics and then obviously, a strong recovery in U.S. infant nutrition.

我可能確信在設備方面我可以在這裡喋喋不休。所以我認為設備組合在我們進入明年時看起來非常強大。我預計與我們在 EPD 中看到的增長率相同。我希望看到我們在核心診斷中看到的持續份額捕獲，然後顯然是美國嬰兒營養的強勁復甦。

So like I said, you see that high single-digit growth in the clear path just based looking at how those businesses will perform and how they're performing and the launches that we got upcoming. Then you mentioned COVID, right? And that's the other piece of the business. So high single-digit growth, excluding COVID. COVID is an interesting one, Robbie, where I think over the last couple of years, we've been talking about the sustainability of COVID.

所以就像我說的那樣，你會看到清晰的路徑中的高個位數增長只是基於查看這些業務的表現以及它們的表現以及我們即將推出的產品。然後你提到了COVID，對吧？這是業務的另一部分。如此高的個位數增長，不包括 COVID。 COVID 是一個有趣的問題，Robbie，我認為在過去的幾年裡，我們一直在談論 COVID 的可持續性。

Many of you writing that COVID testing will probably go away. And here we are in the third quarter, in the summer months, with a $1.5 billion, $1.6 billion number here in the third quarter. So I think that as we look -- I want to see how the next few months look like. I think Bob made a comment in terms of our forecast for Q4. We haven't really planned for a big win to surge. It's more of an endemic-like forecast for Q4. And I think that's the kind of endemic forecast that we'll see going into 2023.

你們中的許多人寫道，COVID 測試可能會消失。我們在第三季度，在夏季的幾個月裡，第三季度有 15 億美元，16 億美元的數字。所以我認為，正如我們所看到的——我想看看接下來幾個月的情況。我認為鮑勃就我們對第四季度的預測發表了評論。我們還沒有真正計劃好一場大勝利來激增。這更像是對第四季度的流行預測。我認為這就是我們將在 2023 年看到的地方性預測。

But I think it's -- right now, it's looking like COVID test sales are stickier than most have assumed. So those are the components on the top line. Down the P&L, as I've said, we're going to be taking a close look at our cost structure. We have been. We've increased that over the last couple of years, made the investments. We talked about those investments. And I'm looking to be able to get a lot of leverage out of those investments that we've made historically.

但我認為，現在看來，COVID 測試銷售的粘性比大多數人想像的要高。所以這些是最重要的組件。正如我所說，在損益表中，我們將仔細研究我們的成本結構。我們已經。在過去的幾年裡，我們增加了投資，進行了投資。我們談到了這些投資。而且我希望能夠從我們歷史上所做的那些投資中獲得很大的影響力。

And at the top line, the way it's kind of laid out comes through and the leverage falls through, you're going to see that sales growth falling through at, I'd say, pretty healthy margins. Rob is going to invest in the areas that we know we've got good growth and high growth. Those get the investment dollars. I think in the past, a lot of you have written about the big 3 of Abbott, where there was Libre, Alinity and MitraClip and those are still a big contributor to drive a growth.

最重要的是，它的佈局方式通過並且槓桿率下降，你會看到銷售增長下降，我會說，相當健康的利潤率。 Rob 將投資於我們知道我們有良好增長和高增長的領域。那些獲得投資美元。我認為在過去，你們中的很多人都寫過關於雅培三巨頭的文章，其中有 Libre、Alinity 和 MitraClip，它們仍然是推動增長的重要因素。

But we've got a new class of products, I guess, I would call them the Fab 5, looking at TriClip, Aveir, Navitor, CardioMEMS and LAA. These products combined are an annual run rate of about $0.5 billion, growing 50% and those will also receive the kind of investments to be able to kind of drive their growth since I think they're, again, in the early innings of growth for us.

但是我們有一類新的產品，我想，我會稱它們為 Fab 5，看看 TriClip、Aveir、Navitor、CardioMEMS 和 LAA。這些產品加起來的年運行率約為 5 億美元，增長 50%，而且這些產品也將獲得能夠推動其增長的投資，因為我認為它們再次處於增長的早期階段我們。

So we'll look at managing the P&L and our investments in our structures and choosing the areas where we're going to continue to invest. And then other areas, we'll see some of the leverage from the investments that we've made in the past. So as we go into 2023, to say that everything is -- fundamentally nothing has changed. I'd say, true, our markets are still very attractive.

因此，我們將著眼於管理損益表和我們對結構的投資，並選擇我們將繼續投資的領域。然後在其他領域，我們將看到我們過去所做投資的一些影響力。因此，當我們進入 2023 年時，可以說一切都——基本上沒有任何改變。我會說，真的，我們的市場仍然非常有吸引力。

We've got leading positions in these very large, high-growth markets. I like the pipeline, and we've got a lot of ongoing and upcoming launch activity. So that, I'd say, hasn't really changed. We're going to have to be mindful, obviously, of the cost structure of some of the inflation pressures and FX challenges we have. And then on top of that, we have a strong balance sheet. And we've talked about that and that provides us a lot of strategic and financial flexibility as we go into next year. So that's probably my best characterization here in the condensed version of 2023.

我們在這些非常大的高增長市場中處於領先地位。我喜歡這個管道，我們有很多正在進行和即將推出的活動。所以，我想說，並沒有真正改變。顯然，我們必須注意我們面臨的一些通脹壓力和外匯挑戰的成本結構。最重要的是，我們擁有強大的資產負債表。我們已經討論過這一點，這為我們提供了很多戰略和財務靈活性，因為我們進入了明年。所以這可能是我在 2023 年精簡版中最好的描述。

That's really helpful. And maybe one for Bob. The fourth quarter implied EPS guide came in a little bit lower than the Street. We also saw a much bigger FX headwind. So how should we be thinking about the impact to the bottom line in third quarter? What's implied in fourth quarter? And if we start thinking about our models for next year, Robert gave us the top line considerations. How do we think about FX at current rates heading into next year?

這真的很有幫助。也許一個給鮑勃。第四季度隱含每股收益指引略低於華爾街。我們還看到了更大的外匯逆風。那麼我們應該如何考慮對第三季度利潤的影響呢？第四季度意味著什麼？如果我們開始考慮明年的模型，羅伯特給了我們最重要的考慮因素。我們如何看待以當前匯率進入明年的外匯？

Yes, certainly. So we've seen the dollar significantly strengthened this year, including throughout the third quarter. And the biggest moves have been really in developed market currencies, the euro, the pound, the yen. So this is something that most, if not all, multinationals are dealing with and certainly not unique to us. And I think, Robbie, maybe these headwinds are a little bit underappreciated in terms of the impact here.

是的，當然了。因此，我們看到今年美元大幅走強，包括整個第三季度。最大的波動實際上是發達市場貨幣，歐元、英鎊、日元。所以這是大多數（如果不是全部）跨國公司都在處理的事情，當然不是我們獨有的。我認為，羅比，就這裡的影響而言，這些不利因素可能有點被低估了。

We always are looking to mitigate as best we can, but there's certainly going to be a limit here in terms of what can be done. We try to match our cost, hedging program and take price where appropriate. This year at current rates, our full year headwind is a little bit more than $0.15 in terms of earnings. But about $0.10 of that is happening just in the fourth quarter alone. And so while there are certainly other moving parts, that fourth quarter impact should give you a pretty good feel for the magnitude of headwind that's flowing into next year, particularly in the first 2 to 3 quarters of the year. We'll provide our earnings guidance in January as we always do, and we'll contemplate currency rates at that time.

我們一直在尋求盡我們所能減輕壓力，但就可以做的事情而言，這里肯定會有一個限制。我們試圖匹配我們的成本、對沖計劃並在適當的情況下採取價格。今年以目前的匯率計算，我們全年的收益略高於 0.15 美元。但僅在第四季度就發生了大約 0.10 美元。因此，雖然肯定還有其他活動部分，但第四季度的影響應該讓您對明年流入的逆風幅度有一個很好的感覺，特別是在今年的前 2 到 3 個季度。我們將像往常一樣在 1 月份提供收益指導，屆時我們將考慮匯率。

Our next question comes from Larry Biegelsen from Wells Fargo.

我們的下一個問題來自富國銀行的拉里·比格爾森。

Two product-related questions for me. First, I wanted to start with Libre. A lot going on there, Robert. Obviously, the exciting news this quarter was the type 2 basal LCD from CMS. So I'd love to hear your thoughts on that opportunity. Our back of the envelope math suggests that could be a $1 billion opportunity for Abbott in 5 years. I'd love to hear if you agree. And just lastly, on the vitamin C timing of that resolution and any color -- any additional color you want to provide on Libre. And I did catch in your prepared remarks, you talked about non-insulin patients that was interesting. And I did have one follow-up.

我有兩個與產品相關的問題。首先，我想從 Libre 開始。那裡發生了很多事情，羅伯特。顯然，本季度令人振奮的消息是來自 CMS 的 2 型基礎 LCD。所以我很想听聽你對這個機會的看法。我們粗略的計算表明，這可能是雅培在 5 年內獲得 10 億美元的機會。如果你同意，我很想听聽。最後，關於該分辨率和任何顏色的維生素 C 時間 - 您想在 Libre 上提供的任何其他顏色。我確實注意到你準備好的評論，你談到了有趣的非胰島素患者。我確實有一個後續行動。

Sure. That's the catch-all Libre question. Let me take the CMS one. So it is very exciting. And if I think about your model, you're probably more aligned maybe to my team, but I think my team is cutting it short in terms of what we could actually do with this indication, and I'll tell you why in a second. But it is pretty significant. I mean, you got 4 million basal patients in the U.S., about 1/3 of them are covered by CMS.

當然。這是包羅萬象的 Libre 問題。讓我拿一個CMS。所以這非常令人興奮。如果我考慮一下你的模型，你可能更符合我的團隊，但我認為我的團隊在我們實際上可以用這個指示做些什麼方面縮短了它，我會告訴你為什麼.但這非常重要。我的意思是，你在美國有 400 萬基礎患者，其中大約 1/3 由 CMS 覆蓋。

So this is probably going to be in terms of the timing of public comments and amount of time it's going to take for CMS to make the decision and then the implementation date, et cetera. So this is probably more of a second half 2023 item, I would say, but it's pretty significant. It's going to expand CGM coverage by about 1.5 million patients on CMS. And as you probably know, Larry, one CMS makes that determination then there's a natural flow that will then move into the private commercial market.

因此，這可能與公眾意見的時間、CMS 做出決定以及實施日期等所需的時間有關。因此，我想說，這可能更像是 2023 年下半年的項目，但它非常重要。它將在 CMS 上擴大約 150 萬患者的 CGM 覆蓋範圍。正如您可能知道的那樣，拉里，一個 CMS 做出了這一決定，然後自然而然地就會進入私人商業市場。

So I'm looking at the opportunity of ultimately 4 million patients that will have potential to get some sort of coverage and benefit from the technology. Listen, I think that we've -- it's not surprising from the perspective of this coming up because we've been leading in the generation of data and evidence to support this proposal.

因此，我正在尋找最終有 400 萬患者的機會，他們有可能獲得某種覆蓋範圍並從該技術中受益。聽著，我認為我們已經 - 從這個即將出現的角度來看這並不奇怪，因為我們一直在引領數據和證據的生成以支持這個提議。

I think if you do a lit search on all the studies that have been done on CGM and then segment them between pump studies and basal studies and type 2 studies and type 2 with non-insulin studies, you're going to see that Libre's at the head of all of those type 2 study. So I think this is part of the investments that we've been making clinically to be able to show the evidence and how this benefits a broader population.

我認為，如果你對 CGM 所做的所有研究進行簡單搜索，然後將它們劃分為泵研究和基礎研究以及 2 型研究和 2 型非胰島素研究，你會看到 Libre 在所有這些 2 型研究的負責人。所以我認為這是我們在臨床上進行的投資的一部分，以便能夠展示證據以及這如何使更廣泛的人群受益。

And then with the value proposition that Libre has, it provides us I think I know what your model is saying. I just think that we'll have a disproportionate share of that. This is a market where, whether it's in the U.S. or in Europe, it predominantly drives around primary care, primary care call point, primary care scale, specifically in the U.S., DMEs.

然後是 Libre 的價值主張，它為我們提供了我想我知道你的模型在說什麼。我只是認為我們將在其中佔有不成比例的份額。這是一個市場，無論是在美國還是在歐洲，它主要圍繞初級保健、初級保健呼叫點、初級保健規模進行驅動，特別是在美國，DME。

And this is a segment where we do very well. If you do an audit of prescriptions by physician class, Libre has taken about 80% market share of the primary care Rx. So the team has been working on that. So I think it's a great opportunity. And I think this kind of fuels into this notion of this is a much larger market than has historically been contemplated as part of CGM, and that's what our strategy from the moment we enter the market has been thinking about it, right?

這是我們做得很好的部分。如果您按醫生類別對處方進行審核，Libre 已經佔據了初級保健 Rx 約 80% 的市場份額。所以團隊一直在努力。所以我認為這是一個很好的機會。我認為這種概念助長了這個概念，這是一個比歷史上作為 CGM 的一部分設想的更大的市場，這就是我們從進入市場的那一刻起就一直在考慮的策略，對吧？

We're not looking at sprinting quarter-to-quarter, we're looking at this over the long term and making the investments to be able to sustain this kind of growth rate. We announced manufacturing capacity expansions also in the quarter for Diabetes Care because we believe this is a $10 billion franchise by 2028. We believe that we've got pathway between 15 million and 20 million users on this product.

我們不是在考慮按季度衝刺，而是從長遠來看，並進行投資以維持這種增長率。我們還在本季度宣布擴大糖尿病護理的製造能力，因為我們相信到 2028 年，這將是 100 億美元的特許經營權。我們相信，我們已經有 1500 萬到 2000 萬用戶使用該產品。

So we're resourcing our manufacturing, our scale, our commercial infrastructure, our service, our clinical investments to be able to support what I believe is a significant growth opportunity, and we intend to lead that. I think your other question was on vitamin C. Yes, we have completed the clinical work on the vitamin C. I'll provide updates at the appropriate time.

因此，我們正在為我們的製造、我們的規模、我們的商業基礎設施、我們的服務、我們的臨床投資提供資源，以便能夠支持我認為是一個重大的增長機會，我們打算引領它。我想你的另一個問題是關於維生素 C。是的，我們已經完成了維生素 C 的臨床工作。我會在適當的時候提供更新。

I do recognize that this is an important, I would call short-term, medium-term kind of growth driver for us. If you think about our franchise, it's going to be about basal, type 2 and pump integration. So think of that in the next kind of 2, 3 years of key core growth drivers. And then I'd say, more longer term to get to those numbers, I made an announcement beginning of this year regarding looking at this outside of diabetes on our Lingo franchise, and that will then sustain our growth going forward.

我確實認識到這對我們來說是一個重要的，我稱之為短期、中期的增長動力。如果您考慮我們的特許經營權，那將是關於基礎、2 型和泵集成。因此，請在接下來的 2、3 年關鍵核心增長動力中考慮這一點。然後我想說，從更長遠的角度來看，為了獲得這些數字，我在今年年初宣布了關於在我們的 Lingo 特許經營中關注糖尿病以外的問題，這將維持我們未來的增長。

So we've made the study. We feel good about the results, and I'll be updating once we have something to update there. We are working on pump integrations outside the United States and we'll have a pump integration launch by end of this year, beginning of next year into Europe with 1 of our pump partners. And I think they're going to benefit a lot from our user base that we have in those countries.

所以我們進行了研究。我們對結果感覺很好，一旦我們有東西要更新，我就會更新。我們正在美國以外的地方進行泵集成，我們將在今年年底推出泵集成，明年年初與我們的一個泵合作夥伴一起進入歐洲。而且我認為他們將從我們在這些國家/地區擁有的用戶群中受益匪淺。

Robert, that was super helpful. Just for my follow-up, I'd love to get your reaction to the PASCAL data at TCT and the launch in the U.S. specifically, your thoughts on the greater durability effect they showed with PASCAL. I know we haven't seen that in the MitraClip registries. And just any update on the locking issue we heard about this quarter.

羅伯特，這非常有幫助。就我的後續行動而言，我很想听聽您對 TCT 的 PASCAL 數據以及在美國的發布的反應，特別是您對 PASCAL 顯示出的更大耐用性效果的看法。我知道我們在 MitraClip 註冊表中沒有看到這一點。以及我們在本季度聽到的有關鎖定問題的任何更新。

Yes. So it wasn't unexpected. Every time at TCT, there's always an expectation of a landmark study or an approval. So that wasn't unexpected. They got approval for DMR. That's one of the smaller indications, about 1/3 of the market. We've competed with PASCAL internationally already for a couple of years. I expect to see some trialing in the U.S. And the question is going to be how much it is going to stick.

是的。所以這並不意外。每次在 TCT，總有一個里程碑式的研究或批准的期望。所以這並不意外。他們獲得了 DMR 的批准。這是較小的跡象之一，約佔市場的 1/3。我們已經在國際上與 PASCAL 競爭了幾年。我希望在美國看到一些試驗。問題是它會堅持多少。

Internationally, MitraClip has done very well, and we've held on to a good portion of our share. I think in Europe, we're kind of at that 80-20 split. So I think -- I expect some of those dynamics to play out here in the U.S. And I think MitraClip is going to do very well. Regarding the data set, yes, I mean it was -- I think it was 117 or 120 patients. I think it was maybe versus 63 of MitraClip.

在國際上，MitraClip 的表現非常好，我們已經佔據了很大一部分份額。我認為在歐洲，我們的比例是 80-20。所以我認為 - 我希望其中一些動態會在美國發揮作用，而且我認為 MitraClip 會做得很好。關於數據集，是的，我的意思是——我認為是 117 或 120 名患者。我認為這可能與 MitraClip 的 63 相比。

I mean we've done over 150,000 implants, Larry. And we've got great data on our products. We do have over 1,000 patients in the registry. I think the data set is pretty small right now. So we're working on our side. We're doing our investments in our clinical trials, investments in product advancements, in MitraClip.

我的意思是我們已經完成了超過 150,000 次植入，拉里。我們擁有關於我們產品的大量數據。我們確實有超過 1,000 名患者在登記處。我認為現在的數據集非常小。所以我們在我們這邊工作。我們正在對 MitraClip 進行臨床試驗、產品改進投資。

I think right now, I think the biggest opportunity is market expansion, and we're going to be driving a lot of that with the FMR indication. I think I said this in the last call, I think that one of the biggest impacts we have, for me, as I looked at our portfolio was regarding COVID was not being able to benefit the FMR indication and the NCD. So I think that's the biggest opportunity we have is market expansion and working to get those referrals network set up and driving that demand for further expansion. So I think it' a locking mechanism -- yes, I think we had -- we took a field action and I think that's so far going okay. I haven't had any kind of issues, supplies back to normal.

我認為現在，我認為最大的機會是市場擴張，我們將通過 FMR 指示推動其中的大部分。我想我在上次電話會議中說過這一點，對我來說，當我查看我們的投資組合時，我認為我們產生的最大影響之一是 COVID 無法使 FMR 適應症和 NCD 受益。所以我認為這是我們最大的機會是市場擴張和努力建立這些推薦網絡並推動進一步擴張的需求。所以我認為這是一種鎖定機制——是的，我認為我們有——我們採取了現場行動，我認為到目前為止一切正常。我沒有任何問題，供應恢復正常。

And our next question will come from Joanne Wuensch from Citibank.

我們的下一個問題將來自花旗銀行的 Joanne Wuensch。

I'd like to jump off a little bit from the MitraClip conversation and try and peel apart the double-digit growth in Structural Heart this quarter a little bit stronger than we were looking for. How much of that is MitraClip versus demand for Portico versus maybe something else? And how do you think about developing that segment a little bit further?

我想從 MitraClip 對話中跳出來一點，並嘗試剝離本季度 Structural Heart 的兩位數增長，比我們預期的要強一些。其中有多少是 MitraClip 與 Portico 的需求與其他東西？您如何看待進一步發展該細分市場？

Sure. Well, I mean, I think we've talked about how important the Structural Heart portfolio was for us even when we go all the way back to the acquisition of St. Jude and really building this franchise. So we've been intentional about doing that. MitraClip had a good quarter. We had a growth of about 6%. That was impacted a little bit in the U.S. but we had double digit -- almost double-digit growth internationally.

當然。好吧，我的意思是，我認為我們已經談到了 Structural Heart 產品組合對我們的重要性，即使我們一路回到收購 St. Jude 並真正建立這個特許經營權。所以我們一直有意這樣做。 MitraClip 有一個很好的季度。我們的增長率約為 6%。這在美國受到了一點影響，但我們在國際上實現了兩位數——幾乎是兩位數的增長。

So if you kind of then back into that, you could see that some of the other parts of the portfolio are now starting to kind of -- as they're gaining in scale, Joanne, they're starting to have a stronger impact on the portfolio. So Amulet and Navitor internationally, I know you mentioned Portico, but I'd say it's probably more Navitor in Europe that did very well for us, and it continues to do pretty well.

所以如果你再回到那個時候，你會看到投資組合的其他一些部分現在開始有點——隨著規模的擴大，喬安妮，他們開始對投資組合。所以國際上的 Amulet 和 Navitor，我知道你提到了 Portico，但我想說歐洲的 Navitor 可能對我們做得很好，而且它繼續做得很好。

We've -- as I say, we acknowledge that we're behind 2 market leaders here, but we're making the investments and it's done pretty well. In Europe, I'd say we've got about an 8%, 9% market share in Europe and the accounts that we actually have Navitor in we're close to kind of mid-teens. So that product is very competitive, and we're looking forward to bringing that here to the U.S.

我們已經 - 正如我所說，我們承認我們落後於 2 個市場領導者，但我們正在進行投資並且做得很好。在歐洲，我想說我們在歐洲擁有大約 8% 到 9% 的市場份額，而我們實際上擁有 Navitor 的賬戶接近十幾歲。因此，該產品非常具有競爭力，我們期待將其帶到美國。

We filed it with the FDA and we expect to bring this to the market here in the first half of next year. Scott, maybe you can talk about kind of Amulet and what we're seeing there also.

我們向 FDA 提交了它，我們希望在明年上半年將它推向市場。斯科特，也許你可以談談護身符的種類以及我們在那裡看到的東西。

Yes. I'd say, Joanne, as Robert mentioned, it is kind of the remaining basket of that Structural Heart business that's driving a lot of the growth there, Amulet, being a component of that. Launched in the U.S. continues to go very well, nice traction. In particular, I would say, in the early adopter accounts as it started late last year. Our share in those accounts is around 40% now at this point.

是的。我想說，喬安妮，正如羅伯特所提到的，正是結構心臟業務的剩餘籃子推動了那裡的大量增長，護身符是其中的一個組成部分。在美國推出繼續非常順利，很好的牽引力。特別是，我會說，在去年底開始的早期採用者帳戶中。目前，我們在這些賬戶中的份額約為 40%。

It just shows you kind of once you get in there and get experience and have an opportunity to drive some deeper penetration that you can really achieve a strong share position, and we're doing that in those early adopter accounts. So as we've added accounts over the first portion of this year, we'll look to do the same thing with them as we go forward. So a great opportunity to build, seeing nice growth there. And like I said, like Robert said, kind of a handful of the other items along with TriClip, Navitor and Amulet here that are driving growth in addition to what you're seeing and now is the long-term opportunity for MitraClip.

它只是向您表明，一旦您進入那裡並獲得經驗並有機會推動更深入的滲透，您就可以真正獲得強大的份額地位，我們正在那些早期採用者賬戶中這樣做。因此，由於我們在今年上半年添加了帳戶，因此我們希望在前進的過程中對它們做同樣的事情。所以這是一個很好的建立機會，在那裡看到了良好的增長。就像我說的，就像羅伯特說的那樣，除了你所看到的之外，還有一些其他項目以及 TriClip、Navitor 和 Amulet 正在推動增長，現在是 MitraClip 的長期機會。

As my follow-up question, in Nutrition, one of the things we talk with investors about is, how do you think about the recovery in that segment once your supply is back up? Do you see yourself just returning to growth of the market rate or taking a good percentage of the share back? Or any guidance you could give us remodel forward would be helpful.

作為我的後續問題，在營養方面，我們與投資者討論的一件事是，一旦您的供應恢復，您如何看待該領域的複蘇？您是否認為自己只是恢復了市場增長率或收回了很大比例的份額？或者您可以給我們改造前的任何指導都會有所幫助。

Sure. I would say we've gone -- we've had a situation like this back in 2010, and we've seen other competitors have situations like this, Joanne, in terms of the share recovery process. I'd say there's a couple of key things in terms of consideration. And when you think about doing those modeling, it's looking at your share of the WIC program, your ability to continue to call on pediatricians and your share in the hospitals.

當然。我想說我們已經走了——我們在 2010 年就遇到過這樣的情況，而且我們已經看到其他競爭對手也遇到過這樣的情況，喬安妮，就份額恢復過程而言。我想說在考慮方面有幾個關鍵的事情。當您考慮進行這些建模時，它正在考慮您在 WIC 計劃中的份額、您繼續呼籲兒科醫生的能力以及您在醫院中的份額。

And I would say we've disproportionately focused in this quarter with our global supply network to focus on those channels. And one of the challenges with that the WIC channel is a lower priced channel than I would've call the non-WIC channel. So that's probably where we made a decision to take our -- take the volume that we had.

我想說，我們在本季度不成比例地專注於我們的全球供應網絡，專注於這些渠道。 WIC 渠道面臨的挑戰之一是價格低於我所說的非 WIC 渠道的渠道。所以這可能是我們決定採取我們的 - 採取我們擁有的數量的地方。

And like I said in my opening comments, we actually supplied to the market this quarter, what we supplied in the 3 months prior to the recall. It's just the mix of that supply was overly gated towards the WIC states and the WIC contracts that we had. We made a commitment to those states that they would not have backward supply shortages. So we focused on that.

就像我在開場評論中所說的那樣，我們實際上在本季度向市場供應了我們在召回前 3 個月內供應的產品。只是這種供應的組合被過度限制在 WIC 州和我們擁有的 WIC 合同中。我們向這些州承諾，他們不會出現落後供應短缺的情況。所以我們專注於此。

And I think by focusing on that, we not only live to our commitments and the contracts that we put in place but that's going to obviously be a base for us as we go into this quarter and into next quarter. So if you look at the Nielsen data, you do see share recovery, I'd say, we probably lost about 20 share points from the recall. And I think the last read that I saw in September was we got half of it back. And that is a mix -- this will go to the mix piece where on the WIC side, we've recovered all of our share. And now we're going to take our capacity and start moving it into the non-WIC channel with the non-WIC configuration.

我認為，通過專注於這一點，我們不僅能夠履行我們的承諾和簽訂的合同，而且在我們進入本季度和下一季度時，這顯然將成為我們的基礎。因此，如果您查看尼爾森的數據，您確實會看到份額恢復，我會說，我們可能從召回中損失了大約 20 個份額點。而且我認為我在 9 月看到的最後一次閱讀是我們收回了一半。這是一個混合 - 這將進入混合部分，在 WIC 方面，我們已經收回了我們所有的份額。現在我們將利用我們的容量並開始將其移動到具有非 WIC 配置的非 WIC 通道中。

So like I said, we've intentionally made these decisions in terms of how we're supplying the market. And I think by doing that, just naturally with the work that our teams are doing, we'll start to see the share recovery build month-over-month. So that's probably how to think about it.

所以就像我說的那樣，我們有意根據我們如何供應市場做出這些決定。我認為通過這樣做，自然而然地隨著我們團隊所做的工作，我們將開始看到每月的份額恢復。所以大概是這麼想的。

And our next question comes from Josh Jennings from Cowen.

我們的下一個問題來自 Cowen 的 Josh Jennings。

Robert, I wanted to ask about the COVID testing franchise and just the strength in 2022 and thinking about the comp for 2023. Is there anything you can share in terms of contracts that are in place for 2023 and what that base could look like where weather contracts in 2022 could roll over into 2023? I know it's impossible to forecast utilization or uptake of COVID testing next year, but if there's any base commentary you can provide, that would be helpful. And I just have 1 follow-up.

羅伯特，我想問一下 COVID 測試專營權，以及 2022 年的實力，並考慮 2023 年的比賽。在 2023 年的合同方面，你有什麼可以分享的嗎？這個基地在哪里天氣會是什麼樣子？ 2022 年的合同可以延期到 2023 年嗎？我知道不可能預測明年 COVID 測試的利用率或接受情況，但如果您可以提供任何基本評論，那將很有幫助。我只有 1 次跟進。

Yes, I think that's -- looking at the market between government contracts and nongovernment contracts is something that we spent a lot of time this year doing because obviously, those government contracts, they're high-volume and they ultimately skew a little bit of kind of the run rate as we're trying to kind of run rate this. So if you look at our Q4 number, our Q4 number that we're forecasting is really what I would call an endemic state, right?

是的，我認為這是 - 觀察政府合同和非政府合同之間的市場是我們今年花了很多時間做的事情，因為顯然，這些政府合同是大批量的，它們最終會稍微傾斜一種運行率，因為我們試圖對此進行運行率。因此，如果您查看我們的第四季度數字，我們預測的第四季度數字實際上就是我所說的流行狀態，對嗎？

So about $0.5 billion across the world, across all of our platforms, in a winter season without necessarily forecasting the kind of surge that we saw last year. In that number, we do not have any significant government contracts. Now what governments have realized is that they do need to make some investments and they do need to hold some level of testing inventory in their countries.

因此，在冬季，我們所有平台上的全球大約有 5 億美元，而不必預測我們去年看到的那種激增。在這個數字中，我們沒有任何重要的政府合同。現在政府已經意識到，他們確實需要進行一些投資，而且他們確實需要在本國持有一定程度的檢測庫存。

So we have active conversations with a lot of governments and they recognize and realize an Abbott's ability to scale up and scale up pretty fast. So we've got plenty of capacity, and they know that, they know the value of our product. They work very well with the -- in terms of determining COVID and the new variants, et cetera.

因此，我們與許多政府進行了積極的對話，他們認可並意識到雅培擴大規模並迅速擴大規模的能力。所以我們有足夠的能力，他們知道，他們知道我們產品的價值。在確定 COVID 和新變體等方面，它們可以很好地工作。

So we don't have any significant number in 2020 -- in Q4 of this year, we think that that's the kind of right -- kind of run rate from an endemic standpoint. And if there is a surge and if governments realize that they do need to procure more testing, we've got the product, we've got the reliability of the product and we've got the reliability of supply, and they know that. So we're in a good position there.

所以我們在 2020 年沒有任何顯著的數字——在今年第四季度，我們認為這是正確的——從地方病的角度來看，這種運行率是正確的。如果出現激增，如果政府意識到他們確實需要進行更多測試，我們就有產品，我們有產品的可靠性，我們有供應的可靠性，他們知道這一點。所以我們在那里處於有利位置。

Excellent. Just one follow-up on Libre. You mentioned just the path to achieving full iCGM status and understand there's a segment of the CGM that will open up for Libre, but I was wondering if you could just share your thoughts on the potential impact to clinician sentiment towards accuracy of the platform, payer sentiment in terms of whether there could be any formulary prioritization decisions considering the pricing? And then on the other side of that, how are you -- any new thoughts on pricing for Libre 3 particularly in this inflationary environment.

出色的。只是對 Libre 的一項後續行動。您剛剛提到了實現完整 iCGM 狀態的途徑，並了解 CGM 的一部分將為 Libre 開放，但我想知道您是否可以分享您對臨床醫生對平台準確性的潛在影響的看法，付款人考慮到定價是否有任何公式化的優先級決定？然後另一方面，你好嗎？關於 Libre 3 定價的任何新想法，特別是在這種通脹環境下。

Sure. Well, listen, this is an important segment, right? Obviously, the vast majority of CGM users and the vast majority of future potential users are people that are either injecting insulin with pens or syringes or not even using insulin, right? But we recognize that this is an important segment. So we're doing -- like I said, we completed the work on Libre 2 regarding the vitamin C. We'll be updating --we will be updating the market and our partners as we go through that process with the agency.

當然。好吧，聽著，這是一個重要的部分，對吧？顯然，絕大多數 CGM 用戶和絕大多數未來潛在用戶是用筆或註射器注射胰島素甚至不使用胰島素的人，對吧？但我們認識到這是一個重要的部分。所以我們正在做——就像我說的，我們完成了關於維生素 C 的 Libre 2 的工作。我們將更新——我們將在與該機構一起完成該過程時更新市場和我們的合作夥伴。

But we also believe that -- we also believe that there is potential to innovate even further in that pump integration, right? And we talked about this in last call. We announced this at the ADA in June which is the creation of a dual analyze sensor, a glucose ketone sensor. Everybody -- all the [capabilities] that I've spoken to that you're -- I guess you're referring to believe that this would be the go-to sensor for pump integration because the ketone functionality provides the added safety feature that would be required, right?

但我們也相信——我們也相信在泵集成方面有進一步創新的潛力，對吧？我們在上次通話中談到了這一點。我們在 6 月的 ADA 上宣布了這一點，這是一種雙分析傳感器，即葡萄糖酮傳感器的創建。每個人——我和你談過的所有[能力]——我猜你指的是相信這將是泵集成的首選傳感器，因為酮功能提供了額外的安全功能，將是必需的，對吧？

So if there's some sort of interruption in insulin delivery from the pump, what is understood clinically is that the ketone levels will rise earlier than the glucose levels and to be able to have that ketone level, that continuous ketone level measurement is an added safety feature for that pump environment.

因此，如果泵的胰島素輸送出現某種中斷，臨床上的理解是，酮水平將比葡萄糖水平更早上升，並且能夠達到該酮水平，連續測量酮水平是一項附加的安全功能對於那種泵環境。

And I think it does provide, I guess, a step ahead in terms of innovation, in terms of pump integration. Regarding the accuracy, I mean, I think it's commonly understood and the data is very clear in terms of Freestyle Libre 3 -- I mean even FreeStyle Libre 2, but FreeStyle Libre 3 being a definitive best-in-class accurate sensor. It's the only CGM sub-8 MARD. So I don't think we have that issue.

而且我認為它確實提供了，我想，在創新方面，在泵集成方面領先一步。關於準確性，我的意思是，我認為這是眾所周知的，而且 Freestyle Libre 3 的數據非常清楚——我的意思是甚至是 FreeStyle Libre 2，但 FreeStyle Libre 3 是一個明確的同類最佳精確傳感器。這是唯一的 CGM 低於 8 MARD。所以我認為我們沒有這個問題。

So it's an important segment, and we're going to be investing in it, and we're going to -- our goal is to actually provide something that's even more advanced and more beneficial.

所以這是一個重要的部分，我們將對其進行投資，我們將——我們的目標是實際提供更先進、更有益的東西。

Sorry, did you have another question on --oh, it' pricing. Yes, Libre 3 pricing, Libre 2 pricing, Libre 1 pricing, it's practically all the same, Josh. And the more volume we can get on to Libre 3, the more we can kind of lower those COGS.

抱歉，您是否還有其他問題 - 哦，它的定價。是的，Libre 3 定價，Libre 2 定價，Libre 1 定價，實際上都一樣，Josh。而且我們可以在 Libre 3 上獲得的數量越多，我們就越能降低這些 COGS。

But we have a parity pricing right now. And we think that, that pricing strategy as I said last year, as the international markets or even in the U.S., people have challenges either with co-pays in the U.S. or with formularies and reimbursement decisions internationally. I think that our value proposition is very strong, and it's going to prove itself out very clearly as single-payer systems start to look at how to fine-tune their budgets and get more done either with less or with the same amount.

但我們現在有一個平價定價。我們認為，正如我去年所說的那樣，作為國際市場甚至美國的定價策略，人們在美國的共同支付或國際處方集和報銷決定方面都面臨挑戰。我認為我們的價值主張非常強大，並且隨著單一付款人系統開始研究如何微調預算並以更少或相同的金額完成更多工作，它將非常清楚地證明自己。

So I think that our value proposition, consumer-friendly product with best-in-class accuracy, feature set that no real gaps and our pricing strategy, I think it's a complete value prop.

因此，我認為我們的價值主張、具有一流準確性的消費者友好型產品、沒有真正差距的功能集以及我們的定價策略，我認為這是一個完整的價值支柱。

And our next question comes from Vijay Kumar from Evercore ISI.

我們的下一個問題來自 Evercore ISI 的 Vijay Kumar。

Robert, maybe my first one for you. The headline organic ExCo within 3Q was 3%-ish low singles. When you back out some of these the supply chain impact, I think you mentioned Germany and Nutrition, what was the underlying organic growth? And when can we get back to an environment where there is no mismatch in the headline organic and underlying rate? It's a clean number. So maybe just talk about that cadence to normality.

羅伯特，也許是我給你的第一個。第三季度的主要有機執行公司是 3% 左右的低單曲。當您排除其中一些供應鏈影響時，我想您提到了德國和營養，潛在的有機增長是什麼？我們什麼時候才能回到標題有機率和基本率不匹配的環境？這是一個乾淨的數字。所以也許只是談論正常的節奏。

It was high single -- it's mid- to high single once you do all those exclusions. I don't like doing that. I mean I get that it's important to be able to isolate what the challenges are and what the issues are and are they more transitory or are they more kind of sustained issues in the business. I would say the issues that we've had, the challenges we've had in this quarter regarding supply chain, they're fairly, I'd say, from a Med Device perspective, they're pretty significant, and they kind of had the impact that we saw in our Med Device business.

這是高單曲——一旦你做了所有這些排除，它就是中高單曲。我不喜歡那樣做。我的意思是我明白重要的是能夠隔離挑戰是什麼，問題是什麼，它們是更短暫的還是在業務中更持久的問題。我想說的是我們在本季度遇到的關於供應鏈的問題，我們在供應鏈方面遇到的挑戰，我想說，從醫療設備的角度來看，它們非常重要，而且它們有點像產生了我們在醫療器械業務中看到的影響。

I think if you had look at the kind of back orders that we had, whether it was Libre 1 and some of the back orders that we had in EP, we would be high single digits. But if you back out these issues mid to high overall for the company. Yes, your question of when do we get into kind of normal organic? I think part of the challenge here is COVID -- COVID to play. And as that base becomes smaller than what it is this year, I mean, this year, we'll probably do very much close to the same amount of COVID test sales that we did kind of last year.

我認為，如果您查看我們的延期交貨單，無論是 Libre 1 還是我們在 EP 中的一些延期交貨單，我們都會達到高個位數。但是，如果您將這些問題排除在公司的中高水平。是的，你的問題是我們什麼時候進入普通的有機食品？我認為這裡的部分挑戰是 COVID-COVID 發揮。隨著這個基數變得比今年小，我的意思是，今年，我們可能會非常接近我們去年所做的相同數量的 COVID 測試銷售。

But as we move into next year, and that becomes smaller than this year, we'll see a little bit of an impact on that overall growth rate. But as I said, I think in Robbie's question, I see high single-digit growth once you back out of COVID. And so COVID will be just the determining factor there, but base non-COVID, high single digits next year.

但是隨著我們進入明年，並且比今年更小，我們會看到對整體增長率的一些影響。但正如我所說，我認為在羅比的問題中，一旦你退出 COVID，我會看到高個位數的增長。因此，COVID 將只是那裡的決定因素，但明年將是非 COVID 的高個位數。

That's helpful. And then maybe one on the financial side. I think when gross margins were down Q-on-Q. I'm wondering what was the FX incremental inflationary impact. I think Robert Funck mentioned $0.10 of FX impact in Q4. Should we annualize that to $0.40 of FX impact for next year? I'm not sure how to think about FX and inflationary impact for next year. And we didn't talk about Lingo. Shouldn't that be an incremental driver here and not '23?

這很有幫助。然後可能是財務方面的一個。我認為當毛利率環比下降時。我想知道外匯增量通脹影響是什麼。我認為 Robert Funck 在第四季度提到了 0.10 美元的外匯影響。我們是否應該將明年的外匯影響年化為 0.40 美元？我不確定如何看待明年的外彙和通脹影響。我們沒有談論Lingo。這不應該是這裡的增量驅動程序而不是 23 年嗎？

Let me -- Vijay, I'll take the exchange first. I mean, I wouldn't necessarily take that $0.10 impact in the fourth quarter and extrapolate that for the full year of next year. But certainly, through the first 3 quarters, you would expect to see that. But then in the fourth quarter, you're going to kind of be at those rates that we currently are at. So but again, it is going to be a significant headwind for us next year.

讓我 - 維杰，我會先進行交換。我的意思是，我不一定會在第四季度承受 0.10 美元的影響並推斷明年全年的影響。但可以肯定的是，通過前 3 個季度，您會期望看到這一點。但是到了第四季度，你就會達到我們目前的水平。所以，但同樣，明年對我們來說將是一個重大的逆風。

On inflation, definitely, we're seeing the impacts there. Like others, the biggest impacts we've seen is really around commodities, other manufacturing input cost and logistics. We've incorporated about another $100 million impact to gross margin in our current guidance. So that's about $1 billion for the year, so call it, maybe 240 -- probably a little more than 240 basis points on the gross margin.

在通貨膨脹方面，我們肯定看到了那裡的影響。與其他人一樣，我們看到的最大影響實際上是圍繞商品、其他製造投入成本和物流。在我們目前的指導中，我們已經對毛利率產生了大約 1 億美元的影響。所以今年大約是 10 億美元，所以稱它為 240 - 毛利率可能略高於 240 個基點。

As we -- as Robert said, we've seen a little bit of moderation in the rate of increase in the third quarter compared to where we were earlier in the year, and we're trying to take some price to offset that really more in our consumer-facing businesses. Kind of given the way that inflation has hit us over the course of this year, the inventory that we purchased and manufacture this year at these higher costs will definitely negatively impact us next year when that inventory is sold even if inflationary pressures start to come down kind of as we get into next year.

正如我們 - 正如羅伯特所說，與今年早些時候相比，我們看到第三季度的增長率略有放緩，我們正試圖採取一些價格來抵消更多在我們面向消費者的業務中。考慮到今年通貨膨脹對我們的影響，我們今年以更高成本購買和製造的庫存肯定會對我們明年出售庫存產生負面影響，即使通脹壓力開始下降就像我們進入明年一樣。

On your question on Lingo, Vijay, we have factored in a launch into next year. We have not factored that launch here in the U.S. So it is an international launch. It's a different business model, as I talked about it, more of a direct-to-consumer wellness subscription model. And we're on target here to come out of the gates to that in Q1. We are going to be launching into what I would call a little bit of a challenging environment.

關於你關於 Lingo 的問題，Vijay，我們已經考慮到明年推出。我們沒有考慮在美國的發射，所以這是一次國際發射。正如我所說，這是一種不同的商業模式，更像是一種直接面向消費者的健康訂閱模式。我們的目標是在第一季度走出大門。我們將進入我稱之為有點挑戰性的環境。

So we've taken that into consideration here. But I think that the long-term growth opportunity of building this kind of business, a wellness subscription-like model with the platform that we've built and the scale that we have, I think, is a great growth opportunity for us. We do have it factored in into next year probably launching in the beginning of the year and then building from there. But we'll be launching, like I said, in a challenging environment, but I still think it's the right thing to do from a long-term perspective.

所以我們在這裡考慮到了這一點。但我認為，建立這種業務的長期增長機會，一種類似於健康訂閱的模式，以及我們已經建立的平台和我們擁有的規模，我認為，對我們來說是一個很好的增長機會。我們確實將它考慮到明年可能會在今年年初推出，然後從那裡開始建設。但正如我所說，我們將在充滿挑戰的環境中推出，但我仍然認為從長遠來看這是正確的做法。

Operator, we'll take one more question.

接線員，我們再回答一個問題。

And we'll take our last question from Travis Steed from Bank of America.

我們將向美國銀行的 Travis Steed 提出最後一個問題。

I did want to ask on China, how do you see the recovery shaping up there. There's going to be another headwind next year and any new VBPs that you see coming up in China?

我確實想問一下中國，你如何看待那裡的複蘇。明年還會有另一個逆風，您認為中國會出現任何新的 VBP 嗎？

Yes. It is going to be a little bit of a headwind. You can think about it as either currency and VBP. We've gone through this in some other parts of our business. So we do expect this value-based procurement or pricing here to play out. I think the next area that we're looking at. We've gone through it with stents last year or 1.5 years ago, and the next area that we're looking at is probably on the electrophysiology side. That's probably the next category that's up.

是的。這將是一個逆風。您可以將其視為貨幣和 VBP。我們在業務的其他部分也經歷了這一點。因此，我們確實希望這種基於價值的採購或定價在這裡發揮作用。我認為我們正在研究的下一個領域。去年或 1.5 年前，我們已經用支架完成了它，我們正在研究的下一個領域可能是電生理學方面。這可能是下一個類別。

It's interesting, as we've been looking at this, there's definitely interesting impacts in terms of ranges of these pricing. We've actually gone through some of it in pharmaceuticals also. It will range from 30% to 80% in terms of pricing. And really, the magnitude here depends on whether it's a national or regional process. Some of the categories have been more regional. And they tend to be a little bit lower.

有趣的是，正如我們一直在研究的那樣，這些定價範圍肯定會產生有趣的影響。實際上，我們在藥品中也經歷了一些。就定價而言，它將介於 30% 到 80% 之間。實際上，這裡的規模取決於它是一個國家進程還是一個區域進程。有些類別更具區域性。而且它們往往要低一些。

And it also depends on the number of participants that exist in that category. So as I look at -- on the EP side, we've also seen that when there are more -- like a system-based approach, Travis. So think capital, think about the technical support and the infrastructure associated support that, those tend to be a little bit on the lower end of that range versus to be on the higher end of that range. So that's probably what we've got contemplated for VBP next year is more on the EP side.

它還取決於該類別中存在的參與者數量。所以當我看到 - 在 EP 方面，我們也看到了更多 - 比如基於系統的方法，Travis。所以想想資本，想想技術支持和基礎設施相關的支持，這些支持往往處於該範圍的低端，而不是處於該範圍的高端。所以這可能是我們明年對 VBP 的設想，更多的是在 EP 方面。

No. That's helpful. And I did want to ask about the M&A environment, too, since it hasn't come up yet on this call. And also kind of how it relates to your thinking of the device growth longer term, if you're still able to grow at the high end of med tech. And if the Fab 5, as you called, is enough to do that? Or if you need to augment device growth with M&A over time?

不，這很有幫助。我也確實想詢問併購環境，因為在這次電話會議上還沒有出現。如果您仍然能夠在醫療技術的高端發展，那麼它與您對長期設備增長的想法有何關係。如果你所說的 Fab 5 足以做到這一點？或者，如果您需要隨著時間的推移通過併購來增加設備增長？

No, I don't feel that I need to do M&A to be able to sustain that high single-digit growth that we've been posting pretty consistently on devices. I did say in the last call that we're interested and we're being prudent about that interest. The interest has increased and we actively assess all the opportunities here. But as I've said, just because we have a strong balance sheet, and we've got a lot of flexibility, we're still going to make sure that we're going about this from a strategic perspective and we're going about it from a financial perspective.

不，我認為我不需要進行併購來維持我們一直在設備上發布的高個位數增長。我在上次電話會議中確實說過我們有興趣，並且我們對這種興趣持謹慎態度。興趣增加了，我們積極評估這裡的所有機會。但正如我所說，僅僅因為我們擁有強大的資產負債表，而且我們有很大的靈活性，我們仍然要確保我們從戰略角度來解決這個問題，我們將繼續從財務的角度來看。

So obviously, valuations come down somewhat. And that helps on the financial modeling and attractiveness side from it. But I would say they probably need to stabilize a little bit of these valuations so that you can engage what I would call just meaningful discussions here. And I think as those stabilize, I think you'll see the environment pick up here in terms of M&A. So we're in a good position.

很明顯，估值有所下降。這有助於財務建模和吸引力方面。但我想說他們可能需要穩定一些估值，這樣你就可以在這裡進行我所說的有意義的討論。我認為隨著這些情況的穩定，我認為你會看到這裡的併購環境有所好轉。所以我們處於一個很好的位置。

Don't need to do M&A, but there's a lot of opportunities out there for us, and we're going to apply that consistent framework of strategic and financially disciplined in terms of how we look at that.

不需要進行併購，但對我們來說有很多機會，我們將在我們如何看待這一點方面應用一致的戰略和財務紀律框架。

So I'll just sum up here. Q3 was probably a very challenging quarter for us, probably our most challenging. Obviously, the impact of inflation and supply chain and some of the back orders that we encountered was a headwind. Some of the FX as we go forward also will be a headwind. But you saw the portfolio strength and the execution here coming through that, all those challenges and delivery, not only in the quarter but also for the full year, as evidence of our full year raise here also.

所以我就在這裡總結一下。第三季度對我們來說可能是一個非常具有挑戰性的季度，可能是我們最具挑戰性的季度。顯然，通貨膨脹和供應鏈的影響以及我們遇到的一些延期交貨訂單是逆風。我們前進的一些外匯也將是逆風。但是你看到了這裡的投資組合實力和執行力，所有這些挑戰和交付，不僅在本季度而且在全年，作為我們全年加薪的證據。

So it's also provided us an opportunity to make some strategic choices, to strengthen our business and to strengthen our position and build our momentum, I guess, to Robbie's comment in the beginning about how everybody shifting to 2023 and so are we. And we made some choices and decisions here to be able to prepare us and build our momentum and strengthen our position as we go into 2023.

因此，這也為我們提供了一個機會，讓我們做出一些戰略選擇，加強我們的業務，鞏固我們的地位，建立我們的勢頭，我猜，正如羅比在一開始關於每個人如何轉移到 2023 年的評論一樣，我們也是如此。我們在這裡做出了一些選擇和決定，以便在我們進入 2023 年時為我們做好準備並建立我們的勢頭並鞏固我們的地位。

I saw a nice recovery in the institutional businesses. And our pipeline here that we talked a little bit about is going to sustain that growth acceleration. There's a lot of organic growth opportunities that we've got in 2023. And I highlighted here how I see a clear path for high single-digit revenue growth. And then on top of that, we've got a strong balance sheet, and that's going to allow for a very balanced capital deployment to our shareholders and also allow us to fuel future growth.

我看到了機構業務的良好復甦。我們在這裡談到的管道將維持這種增長加速。 2023 年我們有很多有機增長機會。我在這裡強調了我如何看到實現高個位數收入增長的清晰路徑。最重要的是，我們擁有強大的資產負債表，這將為我們的股東提供非常平衡的資本配置，也讓我們能夠推動未來的增長。

So with that, I'm going to wrap that up. Thanks.

因此，我將結束它。謝謝。

Thank you, operator, and thank you for all of your questions. This now concludes Abbott's conference call. A webcast replay of this call will be available after 11:00 a.m. Central Time today on Abbott's Investor Relations website at abbottinvestor.com. Thank you for joining us today.

謝謝您，接線員，謝謝您提出的所有問題。現在結束雅培的電話會議。中部時間今天上午 11:00 後，將在雅培投資者關係網站 abbottinvestor.com 上重播本次電話會議的網絡直播。感謝您今天加入我們。

Thank you. This concludes today's conference call. Thank you for your participation. You may now disconnect. Everyone, have a wonderful day.

謝謝你。今天的電話會議到此結束。感謝您的參與。您現在可以斷開連接。大家，有一個美好的一天。