美國雅培 (ABT) 2023 Q4 法說會逐字稿

Good morning, and thank you for standing by. Welcome to Abbott's Fourth Quarter 2023 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.

早安，感謝您的支持。歡迎參加雅培 2023 年第四季財報電話會議。 （操作員說明）此通話由 Abbott 錄音。除了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）的資料均受 Abbott 版權保護。未經雅培明確書面許可，不得對其進行錄製或轉播。

I would now like to introduce Mr. Mike Comilla, Vice President, Investor Relations.

現在我想介紹一下投資者關係副總裁麥克·科米拉（Mike Comilla）先生。

Good morning, and thank you for joining us. With me today are Robert Ford, Chairman and Chief Executive Officer; Bob Funck, Executive Vice President, Finance; and Phil Boudreau, Senior Vice President, Finance and Chief Financial Officer.

早安，感謝您加入我們。今天與我在一起的有董事長兼執行長羅伯特福特 (Robert Ford)； Bob Funck，財務執行副總裁； Phil Boudreau，財務資深副總裁兼財務長。

Robert and Phil will provide opening remarks. Following their comments, we'll take your questions. 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 2024.

羅伯特和菲爾將致開幕詞。根據他們的評論，我們將回答您的問題。在我們開始之前，今天發表的一些聲明可能具有前瞻性，符合 1995 年《私人證券訴訟改革法案》的目的，包括 2024 年的預期財務表現。

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 for the year ended December 31, 2022.

雅培警告說，這些前瞻性陳述存在風險和不確定性，可能導致實際結果與前瞻性陳述中所示的結果有重大差異。我們截至 2022 年 12 月 31 日的 10-K 表格年度報告的第 1A 項「風險因素」中討論了可能影響雅培營運的經濟、競爭、政府、技術和其他因素。

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. 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.

除法律要求外，雅培不承擔因後續事件或事態發展而公開發布對前瞻性陳述的任何修訂的義務。在今天的電話會議上，與過去一樣，將使用非公認會計準則財務指標來幫助投資者了解雅培目前的業務表現。這些非 GAAP 財務指標與今天起的收益新聞稿和監管文件中的可比較 GAAP 財務指標進行了調整，這些數據可在我們的網站 abbott.com 上取得。

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 is defined in the press release issued earlier today.

請注意，雅培尚未提供前瞻性的有機銷售成長的公認會計準則財務指標，因為該公司無法預測未來匯率的變化，這可能會影響報告的銷售成長。除非另有說明，我們對銷售成長的評論指的是有機銷售成長，這是在今天早些時候發布的新聞稿中定義的。

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

現在，我將把電話轉給羅伯特。

Thanks, Mike. Good morning, everyone, and thank you for joining us. Today, I'll discuss our 2023 results as well as our outlook for this year. But before I do that, I think it's important that we take a moment to look back at the challenging environment that we all faced over the last few years and how our actions during that time have positioned the company to be in an even stronger position today than before the start of the pandemic.

謝謝，麥克。大家早安，感謝您加入我們。今天，我將討論我們 2023 年的業績以及今年的展望。但在此之前，我認為重要的是我們花點時間回顧過去幾年我們所面臨的充滿挑戰的環境，以及我們在那段時間的行動如何使公司今天處於更強大的地位比大流行開始之前。

In the 2 years preceding the start of the pandemic, Abbott delivered organic sales growth of more than 7%, which was considered top tier given the large size of our company. We expected growth in 2020 to be in the similar range, but then COVID-19 arrived and disrupted that trajectory. And while our procedures-driven businesses such as Medical Devices and Routine Diagnostic Testing experienced a slowdown due to the healthcare systems around the world shifting their focus, our Branded Generics Pharmaceutical business was able to stay the course and our Nutrition business accelerated as people around the world place a greater emphasis on protecting their health.

在大流行開始前的兩年裡，雅培的有機銷售額增長超過 7%，考慮到我們公司的規模，這被認為是頂級的。我們預計 2020 年的成長將在類似的範圍內，但後來 COVID-19 的到來擾亂了這一軌跡。雖然我們的醫療器材和常規診斷測試等流程驅動型業務由於世界各地的醫療保健系統轉移重點而經歷了放緩，但我們的品牌仿製藥業務能夠堅持到底，而我們的營養業務則隨著世界各地的人們的發展而加速。世界更重視保護他們的健康。

While some companies saw their entire portfolio suffer during the pandemic, Abbott's diversified business once again proved to be resilient. It was also during this time that we created a multibillion-dollar COVID testing business in just a matter of months that helped play a role in reducing the spread of the virus around the world. COVID testing grew to become a significant part of our portfolio, representing nearly 20% of our sales in 2021 and 2022. And given the important role that these tests had on society and on our financial performance, COVID testing temporarily altered our identity and became a main point of focus to the general public, our investors and other stakeholders.

儘管一些公司的整個投資組合在大流行期間受到影響，但雅培的多元化業務再次證明具有彈性。也正是在這段時間，我們在短短幾個月內創建了價值數十億美元的新冠病毒檢測業務，為減少病毒在全球的傳播發揮了作用。 COVID 測試逐漸成為我們產品組合的重要組成部分，佔2021 年和2022 年銷售額的近20%。考慮到這些測試對社會和我們的財務業績的重要作用，COVID 測試暫時改變了我們的身份，並成為公眾、投資者和其他利害關係人的主要關注點。

But we knew that the pandemic would not last for ever, so we planned ahead. We pulled forward or accelerated investments in several areas across the company when the demand for COVID testing was at peak levels, knowing that we would scale these investments back down when the eventual decline in demand for COVID testing occurred. And the experiences we gained in creating the COVID testing business and then managing the rapid scale-up and subsequent scale down of that business will have a lasting positive impact on our company.

但我們知道這種流行病不會永遠持續下去，所以我們提前做好了計劃。當新冠病毒檢測需求達到高峰時，我們提前或加速了對公司多個領域的投資，因為我們知道，當新冠病毒檢測需求最終下降時，我們會縮減這些投資。我們在創建新冠病毒檢測業務以及管理該業務的快速擴大和隨後縮小規模方面獲得的經驗將對我們公司產生持久的積極影響。

Our R&D pipeline was one of the areas we targeted for the accelerated investments, and we're seeing those investments pay off. In the last 2 years, we have announced more than 25 new growth opportunities, which include a mix of new products, new indications and geographic and reimbursement expansions. And this level of pipeline activity is occurring across the entire company. In EPD, for example, we announced an agreement to commercialize several biosimilars in emerging markets.

我們的研發管道是我們加速投資的目標領域之一，我們看到這些投資得到了回報。在過去 2 年中，我們宣布了超過 25 個新的成長機會，其中包括新產品、新適應症以及地理和報銷擴張。這種水平的管道活動正在整個公司範圍內進行。例如，在 EPD 中，我們宣布了一項協議，將在新興市場將多種生物相似藥商業化。

In Nutrition, we continue to invest in science-based solutions to address emerging medical needs with particular emphasis on the fast-growing Adult Nutrition segment. In Diagnostics, we announced approvals for new tests, new instruments and a new laboratory automation solution. And in Medical Devices, we announced 10 new product approvals along with several new opportunities to further improve the growth outlook of the existing portfolio. These new opportunities are well balanced with each of our 7 Medical Device businesses accomplishing at least one significant pipeline-related achievement.

在營養方面，我們持續投資以科學為基礎的解決方案，以滿足新興的醫療需求，特別關注快速成長的成人營養領域。在診斷領域，我們宣布批准新測試、新儀器和新實驗室自動化解決方案。在醫療器材領域，我們宣布了 10 項新產品獲得批准，以及多項新機會，以進一步改善現有產品組合的成長前景。這些新機會與​​我們的 7 個醫療器材業務中的每一個都實現了至少一項與管道相關的重大成就的良好平衡。

Looking back at our performance in 2023, it is clear that these new opportunities contributed to an acceleration in our growth, both our sales and earnings growth exceeded the expectations we communicated at the beginning of last year. Sales, excluded COVID testing grew double digits every quarter last year and finished the year up more than 11% higher than our original guidance of high-single-digit growth.

回顧我們2023年的業績，很明顯，這些新機會促進了我們的成長加速，我們的銷售額和獲利成長都超出了我們去年初傳達的預期。去年，不包括新冠病毒檢測在內的銷售額每季都達到兩位數成長，全年增幅比我們最初設定的高個位數成長預期高出 11% 以上。

Adjusted earnings per share finished the year at $4.44, which was above the midpoint of our original guidance range despite COVID testing sales coming in much lower than originally forecasted. And this is a testament to the strength of the Abbott portfolio and a strong indication of the top-tier sustainable performance we are positioned to continue to deliver as we move past the pandemic.

儘管新冠病毒檢測銷售額遠低於最初預測，但調整後每股收益全年收於 4.44 美元，高於我們最初指引範圍的中點。這證明了雅培產品組合的實力，也有力地表明了我們在度過疫情後將繼續提供頂級永續業績。

Turning to our outlook for 2024. As we announced this morning, we forecast sales growth excluded COVID testing to be in the range of 8% to 10%, which equates to generating organic sales growth of more than $3 billion. We forecasted adjusted earnings per share of $4.50 to $4.70, which contemplates double-digit earnings growth on the base business.

談到我們對 2024 年的展望。正如我們今天早上宣布的那樣，我們預測排除新冠病毒檢測後的銷售成長將在 8% 至 10% 之間，這相當於產生超過 30 億美元的有機銷售成長。我們預計調整後每股收益為 4.50 美元至 4.70 美元，預計基礎業務收益將實現兩位數成長。

I'll now provide additional details on our 2023 results by business area before turning the call over to Phil. And I'll start with Nutrition, where sales increased 14% in the quarter. In Pediatric Nutrition, double-digit growth in the U.S. was driven by continued market share capture in the U.S. and from formula business, where we are once again the market leader.

現在，我將按業務領域提供有關 2023 年業績的更多詳細信息，然後再將電話轉交給 Phil。我將從營養品開始，該季度的銷售額成長了 14%。在兒科營養領域，美國的兩位數成長得益於美國和配方奶粉業務的持續佔領市場份額，我們再次成為該領域的市場領導者。

International growth of 18% was driven by growth coming from both infant formula products and our PediaSure toddler brand. In Adult Nutrition, sales for the full year surpassed $4 billion and grew 13.5% in the quarter, driven by strong demand for Abbott's market-leading Ensure and Glucerna brands.

嬰兒配方奶粉產品和 PediaSure 幼兒品牌的成長推動了 18% 的國際成長。在成人營養品領域，受雅培市場領先的 Ensure 和 Glucerna 品牌強勁需求的推動，全年銷售額超過 40 億美元，本季成長 13.5%。

Turning to Established Pharmaceuticals, or EPD, where sales increased nearly 9% in the quarter and 11% for the full year. This is the third consecutive year that EPD sales have grown double digits. Our unique business model of offering broad product portfolios across a targeted set of therapeutic areas that are tailored to the local needs of each emerging market we operate in continues to deliver outstanding results.

至於老牌製藥公司 (EPD)，該公司本季銷售額成長了近 9%，全年銷售額成長了 11%。這是 EPD 銷售額連續第三年實現兩位數成長。我們獨特的商業模式在一系列有針對性的治療領域提供廣泛的產品組合，這些產品組合是根據我們經營的每個新興市場的當地需求量身定制的，繼續取得出色的成果。

Moving to Diagnostics. Growth in Rapid Diagnostics was impacted by seasonality related to the respiratory virus testing. The flu season arrived later this year than last year, which caused sales of flu and other respiratory tests to be lower in the fourth quarter compared to that of the prior year. But in Core Lab Diagnostics growth of nearly 10% continues to be driven by the success of our Alinity suite of systems paired with our broad test menu offering.

轉向診斷。快速診斷的成長受到與呼吸道病毒檢測相關的季節性的影響。今年的流感季節比去年晚，導致第四季度流感和其他呼吸道檢測產品的銷售額低於去年同期。但在核心實驗室診斷領域，我們的 Alinity 系統套件與我們廣泛的測試菜單產品相結合的成功繼續推動了近 10% 的成長。

Alinity continues to drive high contract renewal rates and competitive win rates. We recently announced that we received FDA approval for our new lab automation system that offers cutting-edge technology to help laboratories increase performance and improve the overall quality of their operations. The system has been available in international markets, and we look forward to offering this to customers in the U.S.

Alinity 繼續推動高合約續約率和有競爭力的獲勝率。我們最近宣布，我們的新實驗室自動化系統獲得 FDA 批准，該系統提供尖端技術，幫助實驗室提高效能並提高其營運的整體品質。該系統已在國際市場上市，我們期待向美國客戶提供該系統。

I'll wrap up with Medical Devices where sales grew more than 15% in the quarter, led by double-digit growth in 6 of our 7 Medical Device businesses. In Diabetes Care, fourth quarter sales of FreeStyle Libre, our market-leading continuous glucose monitoring system grew 24% and ended the year with global sales surpassing $5.3 billion. In terms of sales dollars, Libre has become the most successful medical device in history, and it has outpaced market growth in 13 out of the last 16 quarters.

最後，我將介紹醫療器材業務，本季銷售額成長超過 15%，其中我們 7 個醫療器材業務中的 6 個業務實現了兩位數成長。在糖尿病照護領域，我們市場領先的連續血糖監測系統 FreeStyle Libre 第四季銷售額成長了 24%，年底全球銷售額超過 53 億美元。就銷售額而言，Libre 已成為歷史上最成功的醫療設備，並且在過去 16 個季度中有 13 個季度超過了市場成長。

In Electrophysiology, sales growth of 21% was driven by double-digit growth across all major geographic regions, including more than 20% growth in Europe. In Rhythm Management, growth was led by double-digit growth in pacemaker sales led by Aveir, our recently launched leadless pacemaker that can be used for both single-chamber and dual-chamber. In Structural Heart, double-digit growth in the quarter and full year was led by MitraClip, as well as several recently launched new products, including Amulet, TriClip and Navitor. For the full year, MitraClip sales grew high teens internationally and 10% on a global basis.

在電生理學領域，所有主要地理區域的兩位數成長推動了 21% 的銷售額成長，其中歐洲超過 20% 的成長。在節律管理領域，成長主要得益於起搏器銷售額的兩位數成長，其中 Aveir 是我們最近推出的無引線起搏器，可用於單腔和雙腔。在 Structural Heart 領域，MitraClip 以及最近推出的幾款新產品（包括 Amulet、TriClip 和 Navitor）引領了本季和全年的兩位數成長。全年，MitraClip 的國際銷售額成長了 10%，全球銷售額成長了 10%。

In Heart Failure, sales grew more than 15% in the quarter and 12% for the full year driven by continued adoption of both chronic and acute circulatory support devices. And lastly, in Neuromodulation, sales grew nearly 19% driven by the recent launch of Eterna, our first rechargeable neurostimulation device for pain management.

在心臟衰竭領域，由於慢性和急性循環支援設備的持續採用，該季度銷售額增長超過 15%，全年銷售額增長 12%。最後，在神經調節領域，由於最近推出了 Eterna（我們首款用於疼痛管理的可充電神經刺激設備），銷售額成長了近 19%。

So in summary, we exited the pandemic in an even stronger position. 2023 was a very successful year. We outperformed our initial expectations on both the top and bottom lines. The pipeline is generating a lot of new opportunities for growth and we're forecasting this positive momentum to continue and contribute to the strong growth we're forecasting for 2024.

總而言之，我們在疫情結束時處於更有利的地位。 2023 年是非常成功的一年。我們的營收和利潤都超出了我們最初的預期。該管道正在創造許多新的成長機會，我們預測這種積極勢頭將繼續下去，並為我們預測的 2024 年強勁成長做出貢獻。

I'll now turn over the call to Phil. Phil?

我現在將把電話轉給菲爾。菲爾？

Thanks, Robert. As Mike mentioned earlier, please note that all references to sales growth rates, unless otherwise noted, are on an organic basis. Turning to our fourth quarter results, sales increased 2.1% on an organic basis, which, as expected, reflects the impact of the year-over-year decline in COVID testing-related sales. Excluding COVID testing sales, underlying base business organic sales growth was 11% in the quarter.

謝謝，羅伯特。正如麥克之前提到的，請注意，除非另有說明，所有提及的銷售成長率都是有機的。轉向我們第四季度的業績，銷售額有機成長 2.1%，正如預期的那樣，反映了與新冠檢測相關的銷售額同比下降的影響。不包括新冠病毒檢測銷售額，本季基礎業務有機銷售額成長 11%。

Foreign exchange had an unfavorable year-over-year impact of 0.8% on fourth quarter sales. Regarding other aspects of the P&L, the adjusted gross margin ratio was 55.9% of sales. Adjusted R&D was 6.1% of sales, and adjusted SG&A was 26.3% of sales in the quarter. Lastly, our fourth quarter adjusted tax rate was 14%.

外匯對第四季度銷售額同比產生了 0.8% 的不利影響。至於損益表的其他方面，調整後的毛利率為銷售額的55.9%。本季調整後的研發佔銷售額的 6.1%，調整後的 SG&A 佔銷售額的 26.3%。最後，我們第四季調整後的稅率為 14%。

Turning to our outlook for 2024. Today, we issued guidance for full year adjusted earnings per share of $4.50 to $4.70, which includes an adjusted earnings per share forecast of $0.93 to $0.97 for the first quarter of 2024. For the year, we forecast total underlying base business organic sales growth, which excludes COVID testing sales to be in the range of 8% to 10%.

談到我們對2024 年的展望。今天，我們發布了全年調整後每股收益4.50 美元至4.70 美元的指引，其中包括2024 年第一季度調整後每股收益0.93 美元至0.97 美元的預測。對於今年，我們預測總計基本業務有機銷售成長（不包括新冠病毒測試銷售）在 8% 至 10% 範圍內。

Based on current rates, we would expect exchange to have an unfavorable impact of a little more than 1% on our reported full year sales, which includes an unfavorable impact of approximately 2% on our first quarter reported sales. We forecast nonoperating income of approximately $130 million and an adjusted tax rate of 15%.

根據目前的匯率，我們預計匯率將對我們報告的全年銷售額產生略高於 1% 的不利影響，其中包括對我們報告的第一季銷售額約 2% 的不利影響。我們預計營業外收入約為 1.3 億美元，調整後稅率為 15%。

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

至此，我們現在開始提問。

(Operator Instructions) And our first question will come from Larry Biegelsen from Wells Fargo.

（操作員說明）我們的第一個問題將來自富國銀行的 Larry Biegelsen。

Congrats on a nice end to the year here. So Robert, pre-COVID, Abbott was growing 7% to 8% organically as you mentioned, you're guiding to 8% to 10% today for 2024 off of a higher revenue base. What has changed? And what is giving you the confidence to guide that high to start the year? Maybe talk about the key assumptions, and I'll leave it there for my one question.

恭喜您在這裡度過了美好的一年。羅伯特，正如您所提到的，在新冠疫情爆發之前，雅培的有機增長為 7% 至 8%，您今天的目標是在更高的收入基礎上實現 2024 年的 8% 至 10%。發生了什麼變化？是什麼讓您有信心在年初達到如此高的水平？也許談談關鍵假設，我將把它留在那裡以解決我的一個問題。

Thanks, Larry. I mean, as I said in my prepared remarks and quite frankly, as we talked about throughout most of 2023, the impact of the strategy we took to take some of the COVID revenue and reinvest in the base business. I think ultimately, that's really the factor here. I mean, we operate in these 4 business segments and their underlying attractiveness still is very sustainable.

謝謝，拉里。我的意思是，正如我在準備好的發言中所說，坦率地說，正如我們在2023 年的大部分時間裡所討論的那樣，我們採取的部分新冠疫情收入並再投資於基礎業務的策略的影響。我認為最終，這才是真正的因素。我的意思是，我們在這四個業務領域開展業務，它們的潛在吸引力仍然非常永續。

So strengthening our positions that were already pretty strong in each of these 4 segments was absolutely the right strategy here because we believe that these are important areas of healthcare to be in. So I'd make the case here that all 4 of our major businesses are actually in a better and stronger shape than when we were pre-pandemic, which was about $10 billion less and growing at that 7% to 8% range.

因此，加強我們在這 4 個細分市場中已經相當強大的地位絕對是正確的策略，因為我們相信這些是醫療保健領域的重要領域。因此，我在這裡說明，我們的所有 4 個主要業務事實上，我們的狀況比疫情前更好、更強大，當時減少了約100 億美元，但成長幅度在7% 到8% 之間。

If you look at EPD, as I said in my comments, I mean, these are 3 consecutive years of double-digit organic sales growth. This is probably one of our best commercial teams. They operate in a very challenging geographies in different markets and they've done an exceptional job at growing the top line and expanding the bottom line. I think even with all the FX and all the challenges that we've seen in those markets, they have expanded their op margin profile by 300 basis points. So a pretty strong position, strong team. And then we layered in that now a new growth vertical by adding biosimilars, which historically hasn't been a platform that's been readily available in emerging markets. It's probably been more of a developed markets play.

如果你看看 EPD，正如我在評論中所說，我的意思是，這是連續 3 年實現兩位數的有機銷售增長。這可能是我們最好的商業團隊之一。他們在不同市場的極具挑戰性的地區開展業務，並且在增加收入和擴大利潤方面做得非常出色。我認為，儘管我們在這些市場上看到了所有的外匯和所有的挑戰，他們的營運利潤率還是擴大了 300 個基點。所以這是一個相當強大的位置，強大的團隊。然後，我們透過添加生物相似藥來形成新的垂直成長，而生物相似藥歷來都不是新興市場上容易獲得的平台。這可能更像是已開發市場的遊戲。

So I think that's going to provide a new growth vertical for us there. Nutrition I think did an incredible job here. As we said at the beginning of last year at regaining our leadership position here in the U.S. I think it speaks a lot about the trust that our users and customers have for our product. But even Adult -- our Adult Business, our Adult Business has increased $1 billion since pre-pandemic, and it's just strengthening and getting stronger. I mean it's $4 billion, growing high-single digits. There's a lot of med tech businesses, Larry, that command very strong premiums in terms of the valuation just by having those kind of growth rates and sizes. So -- and we're making investments in that channel also.

所以我認為這將為我們提供新的垂直增長。我認為營養在這裡做得非常出色。正如我們去年初在美國重新獲得領導地位時所說的那樣，我認為這充分說明了我們的用戶和客戶對我們產品的信任。但即使是成人業務——我們的成人業務，自大流行前以來我們的成人業務也增加了 10 億美元，而且還在不斷加強和變得更強。我的意思是它是 40 億美元，並以高個位數成長。拉里，有許多醫療科技企業，僅憑藉這樣的成長率和規模，就估值而言就獲得了非常高的溢價。因此，我們也在該通路進行投資。

So diagnostics has got a great track record here. Our Core Lab business has done very well. I've talked about our algorithm and formula here and framework for growth. We've gotten some recent very large account wins globally here. I think that's the result of our portfolio. And quite frankly, the trust that these customers have in Abbott and our ability to execute.

因此，診斷在這方面有著良好的記錄。我們的核心實驗室業務做得非常好。我在這裡談到了我們的演算法和公式以及成長框架。我們最近在全球範圍內贏得了一些非常大的客戶。我認為這是我們投資組合的結果。坦白說，這些客戶對雅培以及我們的執行能力的信任。

And our Rapids portfolio has done very well in terms of placing a lot of new instruments out there, for decentralized testing, and we've been making investments on new assays to be able to go through those instruments. And then Medical Devices historically was in that high single-digit growth. I think what's changed there to become now a double-digit grower for us on a very large-size business is that you have historically double-digit growth businesses like Heart Failure, EP, Structural Heart, EDC, I mean, those are continuing. I think what's changed here is that we've taken a strategic look at about 40% of the revenue in Medical Devices, our CRM and Vascular businesses, that we're showing very little growth historically and made investments in them to accelerate their growth rates. I think you saw that in Q4 with CRM. I'd say it's predominantly been an organic play with our leadless platform and technology.

我們的 Rapids 產品組合在放置大量新儀器進行分散測試方面做得非常好，並且我們一直在投資新的檢測方法，以便能夠通過這些儀器。然後醫療設備歷史上一直處於高個位數成長。我認為，現在我們在一家規模非常大的企業中成為兩位數成長者，所發生的變化是，歷史上有兩位數成長的業務，如心臟衰竭、EP、結構性心臟、EDC，我的意思是，這些業務仍在繼續。我認為這裡發生的變化是，我們對醫療器材、CRM 和血管業務約 40% 的收入進行了策略性審視，歷史上我們的成長很少，並對它們進行了投資以加快它們的成長率。我想您在第四季度的 CRM 中就看到了這一點。我想說，這主要是我們無鉛平台和科技的有機發揮。

On Vascular, it's been a combination of adding inorganically to the business and organic plays to reposition some of the portfolio to higher growth segments. So I think that's really in a nutshell across all these very 4 attractive segments. We've spent the last couple of years strengthening it. And I think you're starting -- you saw that last year, every year, double-digit growth and they've gotten stronger and they've gotten better and they've gotten more growth opportunities with them.

在 Vascular 上，它結合了無機業務和有機業務的結合，將一些投資組合重新定位到更高成長的細分市場。所以我認為這實際上是所有這 4 個有吸引力的細分市場的概括。過去幾年我們一直在加強它。我認為你已經開始了——去年，每年，你都看到了兩位數的成長，他們變得更強大，他們變得更好，他們獲得了更多的成長機會。

So I think that's really the driver there. I mean if you -- I've gotten some of the headlines here about accelerating sales, but not seeing maybe that come through in the -- on the earnings. Again, this is another one where you look at the impact that COVID had on us and the clouding of it. Our Core business grew EPS last year, 40-plus percent. We're forecasting double-digit earnings per share growth this -- at the midpoint, double digit this year. We've got a range around it. I mean there's a lot of volatility in the world, Larry. So I'd say, yes, I don't have to list all those out in terms of macro and geopolitics. But we've proven to be pretty resilient there. And I think the range captures the opportunity that we have on the earnings side. I'd say there's probably more upside than downside in that range, but it's only January. So I think this is a good starting point.

所以我認為這才是真正的司機。我的意思是，如果你——我在這裡看到了一些關於加速銷售的頭條新聞，但沒有看到這可能會在——收益方面實現。再說一次，這也是你觀察新冠疫情對我們的影響及其影響的另一件事。我們的核心業務去年每股收益成長了 40% 以上。我們預計今年每股收益將實現兩位數成長——中間值是兩位數。我們有一個圍繞它的範圍。我的意思是，世界上有很多波動，拉里。所以我想說，是的，我不必從宏觀和地緣政治角度列出所有這些。但事實證明，我們在那裡具有相當的彈性。我認為這個範圍抓住了我們在獲利方面的機會。我想說，在這個範圍內，上行空間可能大於下行空間，但這只是一月的情況。所以我認為這是一個很好的起點。

Our next question will come from Joshua Jennings from Cowen.

我們的下一個問題將來自考恩的約書亞詹寧斯。

Congratulations on the strong finish to the year. I was hoping to just follow up on your comments there, Robert, on just the earnings power and just the margin expansion trajectory. I know Abbott is a unique story relative to peers because you didn't have the margin headwinds during the pandemic due to the COVID Testing business that you developed internally. But was hoping to just -- thinking about the pre-pandemic margin expansion trajectory of the business in that 30 to 50 basis point range. And I just hope if you could just give us a little bit more color on some of the drivers of market expansion and how your team sees that trajectory going forward in '24 and into the outyears?

恭喜您今年圓滿成功。羅伯特，我希望只是跟進你對盈利能力和利潤擴張軌蹟的評論。我知道雅培相對於同行來說是一個獨特的故事，因為由於內部開發的新冠檢測業務，雅培在大流行期間沒有遇到利潤逆風。但我們希望只是考慮一下大流行前該業務的利潤率擴張軌跡在 30 到 50 個基點範圍內。我只是希望您能給我們更多關於市場擴張的一些驅動因素的信息，以及您的團隊如何看待 24 年以及未來幾年的發展軌跡？

Sure. I mean, listen, we hear a lot of companies talk about working here to recover to their operating margin and try to get back to their op margin pre-pandemic. We're in a pretty unique position, I'd say, versus our peers here. Our op margin profile is already at -- is already at the pretty pandemic level. And I think what you saw us do there, Josh, and I talked a little bit about it in my comments, is I think we managed very well strategically the spending piece of it. We accelerated the spending investments when we were at our -- COVID sales were at their peak levels a few years ago. And then we held that spending flat these last couple of years, even though our top line was growing pretty significantly here.

當然。我的意思是，聽著，我們聽到很多公司談論在這裡工作以恢復其營業利潤率，並試圖恢復到疫情前的營業利潤率。我想說，與我們的同行相比，我們處於一個非常獨特的位置。我們的營運利潤率已經達到了相當大的水平。我認為你看到我們在那裡所做的，喬什，我在評論中談到了一點，我認為我們在戰略上很好地管理了其中的支出部分。幾年前，當我們的新冠肺炎銷售額達到高峰時，我們加快了支出投資。然後我們認為過去幾年的支出持平，儘管我們的收入成長相當顯著。

So I'd say our biggest opportunity for margin expansion really is on the gross margin line. And that is, if you think about our big 5 activities this year at the company, and we could do all 5 in the same time. But I'd say gross margin is pretty high up there in our priority. We're forecasting a pretty nice step-up in our gross margin profile this year, roughly around 75 basis points. And there's a combination of factors that are helping to drive that margin expansion, that profile expansion. We've got a pretty strong track record here of executing on internal margin improvement program. So every business has got their programs. We manage those on a monthly basis. They all get reported out. So there's a high degree of visibility and inspection to those programs.

所以我想說，我們利潤率擴張的最大機會其實是在毛利率線上。也就是說，如果你想想我們今年公司的 5 項大活動，我們可以同時完成這 5 項活動。但我想說，毛利率在我們的首要任務中相當高。我們預計今年的毛利率將大幅提升，大約在 75 個基點左右。有多種因素共同推動利潤率擴張和形象擴張。我們在執行內部利潤改善計劃方面擁有相當出色的記錄。所以每個企業都有自己的計畫。我們按月管理這些。他們都被檢舉了。因此，這些計劃具有高度的可見性和檢查。

Some of the headwinds that we faced, I'd say, over the last couple of years are starting to turn a little bit into tailwinds. So whether it's commodity costs, freight and distribution, all those elements seem to be, let's say, right now and given our visibility for the year as we stand here today, turning into tailwinds, so that helps.

我想說，過去幾年我們面臨的一些逆風正開始轉變為順風。因此，無論是商品成本、貨運和分銷，所有這些因素似乎現在都在，考慮到我們今天站在這裡對今年的能見度，都變成了順風車，所以這會有所幫助。

And then the other part here is just, I'd say, portfolio mix. So as some of the Device businesses continue to outpace and continue to grow those are higher-margin businesses and they provide that mix element in that gross margin expansion. So I think this provides a nice opportunity for us this year. But I expect over time, we'll get back to our pre-pandemic gross margin profile. It's -- for me, it's not a question of if -- it's just a question of when we could target 50, 75, I mean it's never going to be as linear as we always would want, but that kind of expansion for us, I think, really provides a good opportunity to drive earnings growth over the next couple of years.

我想說，這裡的另一部分只是投資組合。因此，隨著一些設備業務繼續超越並繼續成長，這些業務是利潤率較高的業務，它們在毛利率擴張中提供了混合元素。所以我認為這為我們今年提供了一個很好的機會。但我預計隨著時間的推移，我們將恢復到疫情前的毛利率狀況。對我來說，這不是一個是否會發生的問題，這只是我們何時能夠以50、75 為目標的問題，我的意思是它永遠不會像我們一直希望的那樣呈線性，但對我們來說這種擴張，我認為，這確實提供了一個推動未來幾年獲利成長的好機會。

So I'd say that's our biggest opportunity. I think we did a really good job at leveraging spending. And I think you see that in our profiles. So our big opportunity here is gross margin, and we're all over it.

所以我想說這是我們最大的機會。我認為我們在利用支出方面做得非常好。我想你在我們的個人資料中看到了這一點。因此，我們在這裡的巨大機會是毛利率，我們全力以赴。

Next question will come from Marie Thibault from BTIG.

下一個問題將由 BTIG 的 Marie Thibault 提出。

I wanted to ask a little bit more about your Electrophysiology business. That segment has been very strong, and I've been impressed that you've been able to put up that European growth rate in the face of some competitive PSA launches. So I would love to hear what's going on behind the scenes there, how you're getting those growth rates and how you're thinking about the U.S. EP business as we see some PSA launches this year?

我想多問一些關於你們的電生理學業務的情況。這個細分市場非常強勁，令我印象深刻的是，面對一些有競爭力的標緻雪鐵龍的推出，你們仍能維持歐洲的成長率。因此，我很想聽聽幕後發生的事情，你們如何獲得這些成長率，以及當我們今年看到一些 PSA 推出時，你們如何看待美國 EP 業務？

Sure. Well, I think we've showed pretty strong robust growth in our EP business throughout all the year, even in the face of actual end market competition, it's been strong across the board. I don't think it's just been a Europe story. U.S. has been strong. China has been very strong for us this year, especially in VBP. I mean there were some price challenges throughout the year with VBP, but the volume we picked up, the market share we picked up more than offset that. So it's really been across the board here. And I think it really is about the strength of the portfolio. So not only having a strong mapping system with our EnSite X, I think is at the core, good mapping disposables and diagnostic disposals also. And I think launching TactiFlex, which is the flexible tip combined with the contact force. We've seen great results, great outcomes, whether it's outcomes to the patient or time of procedure. We've seen that consistently around the world.

當然。嗯，我認為我們的EP業務全年都表現出相當強勁的強勁增長，即使面對實際的終端市場競爭，它也是全面強勁的。我不認為這只是歐洲的故事。美國一直很強大。今年中國隊對我們來說非常強大，尤其是在VBP方面。我的意思是，VBP 全年都面臨著一些價格挑戰，但我們增加的銷售量、我們增加的市場份額足以抵消這些挑戰。所以這裡確實是全面的。我認為這確實與投資組合的實力有關。因此，我認為我們的 EnSite X 不僅擁有強大的測繪系統，而且良好的測繪一次性用品和診斷一次性用品也是核心。我想推出 TactiFlex，它是柔性尖端與接觸力的結合。我們已經看到了很好的結果，無論是對患者的結果還是手術時間。我們在世界各地都看到了這一點。

And then on top of that, I think we've got a great team, really a great team that is very close to our customers. And yes, we were able to see the adoption of new technologies. We've talked about some of the shortcomings that exist in those. So I think it's really the combination of our portfolio and our team that really has kind of sustained the growth as we look to more PFA systems that will be in the market this year in the U.S.

最重要的是，我認為我們擁有一支優秀的團隊，非常接近我們的客戶的優秀團隊。是的，我們能夠看到新技術的採用。我們已經討論了其中存在的一些缺點。因此，我認為，隨著我們期待今年將在美國市場上投放更多 PFA 系統，我們的產品組合和團隊的結合確實實現了持續的成長。

Listen, as I've said, I think it's a great technology. I think there are some challenges with some of these first-generation products. I do expect there to be uptake and usage of it. I think what's been interesting in observing the uptake in Europe is that it is first, at least from what we've seen, it is first seen to have broader adoption in the Cryo segment. And then from there, then kind of moving past that, so right now, I think -- I guess, that's my assumption in the U.S. until I see something differently that it will follow a similar pattern. And then the question will just be kind of the speed. But I think the team has done a really good job here on the ground with the technology.

聽著，正如我所說，我認為這是一項偉大的技術。我認為其中一些第一代產品存在一些挑戰。我確實希望它能被接受和使用。我認為觀察歐洲的採用情況的有趣之處在於，至少從我們所看到的情況來看，它首先在冷凍領域得到了更廣泛的採用。然後從那裡開始，然後就超越了這一點，所以現在，我想——我想，這是我在美國的假設，直到我看到不同的東西，它將遵循類似的模式。然後問題就只是速度。但我認為團隊在技術方面做得非常好。

And our next question will come from Robbie Marcus from JPMorgan.

我們的下一個問題將來自摩根大通的羅比馬庫斯。

Robert, maybe I could ask on Libre. This is the most successful medical device. At the conference just a few weeks ago in San Fran, you were talking about really robust growth rates moving forward and targets. Maybe you could help us understand where the growth is going to come from in '24 and beyond and one question I get a lot from investors is we see the IQVIA script data. It's the best we have. It seems like Libre sales or at least prescriptions are flattening out, yet the sales keep growing. How do we think about the discrepancy there? And how big is the Medicare DME business? And the growth we're getting there from basal.

羅伯特，也許我可以在 Libre 上詢問。這是最成功的醫療設備。在幾週前於舊金山舉行的會議上，您談到了未來真正強勁的成長率和目標。也許你可以幫助我們了解 24 年及以後的成長將來自哪裡，我從投資者那裡得到很多問題是我們看到了 IQVIA 腳本數據。這是我們擁有的最好的。 Libre 的銷售或至少是處方藥的銷售似乎正在趨於平緩，但銷售仍在增長。我們如何看待其中的差異？ Medicare DME 業務有多大？我們從基礎開始成長。

Sure. Strong growth in Q4 under $1.5 billion. U.S. was up 32%. And I'd say still haven't -- team hasn't even had to unleash L3 in the U.S. market in 2023, I think you'll see that now really hit in 2024. But being able to put those kind of growth rates in the U.S. without even having to launch L3 with a competitive new system. I think that speaks a lot about our position, our scale and our brand.

當然。第四季強勁成長，不到 15 億美元。美國上漲32%。我想說的是，團隊甚至還沒有在 2023 年在美國市場推出 L3，我想你會在 2024 年看到這一點。但是能夠實現這樣的增長率在美國，甚至無需推出具有競爭力的新系統L3。我認為這充分說明了我們的地位、規模和品牌。

The growth is going to come from -- I've been pretty consistent about this, Robbie, and then we've a lot of opportunities here for growth. I'm not going to list them all out here. But I'd say, okay, the basal is a big opportunity. It's a large opportunity for us. And I also think it's multiyear. So I don't think it's just a '24, '25. I think the penetration into the basal segment is definitely 2-plus years easily.

成長將來自——羅比，我對此一直非常一致，然後我們這裡有很多成長的機會。我不會在這裡將它們全部列出。但我想說，好吧，基礎是一個很大的機會。這對我們來說是一個很大的機會。我也認為這是多年的。所以我不認為這只是'24、'25。我認為滲透到基礎部分肯定是輕鬆兩年多的時間。

And Libre dominates in the pharmacy channel here. I mean you referenced IQVIA, Robbie. 7 out of 10 new scripts for this patient segment is Libre. And I think that's a testament to the strength and the value proposition that the product has, so it's becoming an increasingly strong growth contributor in the U.S. In Japan and in France, where that reimbursement is exclusive to Libre, that's also having a nice contribution on growth.

Libre 在這裡的藥房管道中佔據主導地位。我的意思是你提到了 IQVIA，羅比。針對該患者部分的 10 個新腳本中有 7 個是 Libre。我認為這證明了該產品的實力和價值主張，因此它正在成為美國日益強大的成長貢獻者。在日本和法國，報銷是 Libre 獨有的，這也對生長。

I think right now in the U.S., most of the population is now covered, whether it's in Medicare or whether it's in private -- private commercial Medicare represents about 1/3 of the market. So I think there's great opportunity here. We just got to build the awareness, build the traveling experience with primary care. And that's what we're doing. That's what we have been doing, quite frankly, for some time.

我認為現在在美國，大多數人口都得到了覆蓋，無論是醫療保險還是私人醫療保險——私人商業醫療保險約佔市場的 1/3。所以我認為這裡有很好的機會。我們只需建立意識，透過初級保健建立旅行體驗。這就是我們正在做的事情。坦白說，這就是我們一段時間以來一直在做的事情。

So it's a nice opportunity, and it's a great growth opportunity for us, and like I said, easily 2-plus years. I think the other part of the opportunity we have, Robbie, is looking at a segment that really hasn't been -- we haven't been able to access which is that of pump connectivity. I think this represents a great opportunity for us. If you look at basal as being a market expansion opportunity, I think the pump connectivity becomes a market conversion opportunity for us. You got 150,000 to 200,000 I guess, new pumpers every year, and that patient segment has -- we haven't been able to target it, but now that we've got the regulatory clearings and list and connecting to all the different pump manufacturers. I think this is a great opportunity for us. And I think it's good for patients. I think it's going to be good to have a different option especially for this patient population, where insulin delivery and the whole connected system is important, right?

所以這是一個很好的機會，對我們來說也是一個很好的成長機會，就像我說的，很容易就能持續兩年多。羅比，我認為我們擁有的機會的另一部分是著眼於一個實際上尚未出現的領域——我們無法訪問泵連接的領域。我認為這對我們來說是一個很好的機會。如果你將基礎視為一個市場擴張機會，我認為幫浦連接對我們來說成為一個市場轉換機會。我猜每年都會有 150,000 到 200,000 個新的泵，而患者群體已經——我們無法瞄準它，但現在我們已經獲得了監管許可，列出了並連接到所有不同的泵製造商。我認為這對我們來說是一個很好的機會。我認為這對患者有好處。我認為有一個不同的選擇會很好，特別是對於這個患者群體，胰島素輸送和整個連接系統很重要，對吧？

Recently, there was an independent third party study. I think this is the first time we've seen an independent head to head study that was published a few weeks ago, showing that Libre 3 is superior to the recently launched product from our competitor across a variety of different metrics, whether it's bias, whether it's MARD. So I look at that and I say, okay, through a pump company, and you're wanting to provide the best solution to users, that's an important aspect, especially for this segment.

最近，有一項獨立的第三方研究。我認為這是我們第一次看到幾週前發布的獨立的頭對頭研究，表明 Libre 3 在各種不同的指標上都優於我們競爭對手最近推出的產品，無論是偏見，無論是MARD。所以我看著這個，我說，好吧，透過一家泵公司，你想為用戶提供最好的解決方案，這是一個重要的方面，特別是對於這個細分市場。

So I look at the basal, I look at the pump, it's probably good drivers for us in '24, '25, but we've got multiple growth verticals here on this platform like I've said.

所以我看看基礎，我看看泵，這可能是我們在 24 年、25 年的良好驅動力，但正如我所說，我們在這個平台上有多個垂直增長。

To your question on IQVIA, I think anybody who kind of follows Pharma and is more attuned to pharma knows that IQVIA doesn't pick up the entire market. So the pharmacy channel in the U.S. gets picked up by IQVIA, but there are other segments in the market that drive adoption that don't get picked up by IQVIA. So maybe that's what you're seeing.

對於您關於 IQVIA 的問題，我認為任何關注製藥業並且更了解製藥業的人都知道 IQVIA 並沒有佔領整個市場。因此，美國的藥局管道被 IQVIA 收購，但市場上還有其他推動採用的細分市場沒有被 IQVIA 收購。所以也許這就是你所看到的。

Our next question will come from Danielle Antalffy from UBS.

我們的下一個問題將來自瑞銀集團 (UBS) 的丹妮爾·安塔菲 (Danielle Antalffy)。

Congrats on strong end to the year and strong guidance. Just, Robert, since the story seems to be very much about top line growth. I haven't heard you reference the Fab 5, one of my favorite analogies in a long time. So just wanted to -- and maybe I just missed it, but I just wanted to get an update on those 5 products or where you think you guys are in launch trajectories, revenue contribution for each of those products. Do you still think there is a Fab 5? And where -- how they sort of factor into the growth, the 8% to 10% organic growth for 2024?

祝賀今年的強勁結束和強有力的指導。只是，羅伯特，因為這個故事似乎與收入成長密切相關。我很久沒有聽到你提到 Fab 5，這是我很長一段時間以來最喜歡的類比之一。所以只是想——也許我只是錯過了，但我只是想了解這 5 種產品的最新情況，或者你們認為你們處於發布軌跡中的哪個位置，以及每種產品的收入貢獻。你還認為還有Fab 5嗎？他們如何影響成長，2024 年 8% 到 10% 的有機成長？

Yes. Thanks. I don't know if I regret using that terminology or not now, Danielle, but I guess I would say, yes, they are great products, and we didn't think about calling them that because they were going to be a flash in the pan for 1 or 2 years. We look at these as really long-term great growth opportunities that we have that will significantly add to the company over the next few years. And quite frankly, they have added a good amount of growth for us this year, and they'll accelerate.

是的。謝謝。我不知道我現在是否後悔使用這個術語，丹妮爾，但我想我會說，是的，它們是偉大的產品，我們沒有考慮這樣稱呼它們，因為它們將成為一個閃現平底鍋1或2年。我們將這些視為真正長期的巨大成長機會，將在未來幾年為公司帶來顯著的成長。坦白說，他們今年為我們帶來了大量成長，而且還會加速。

So I think this year -- sorry, in 2023, those 5 products represented about 0.5 point of growth. I expect that to increase in 2024 to about 1 point of growth, total Abbott contribution. So they're definitely stepping up and I'd say some of them, I would call market creating opportunities, tricuspid I would put over there, CardioMEMS over there, generating the clinical data, generating the data for reimbursement, generating referral pathways. We know how to do this, and we all want things to go pretty fast, especially with med tech products, right? But with products like this that have such significant growth opportunities, there's a certain amount of work that you need to do regarding clinical work as it relates to market expansion, development -- and market development.

所以我認為今年——抱歉，到 2023 年，這 5 種產品代表了約 0.5 個百分點的成長。我預計雅培的總貢獻將在 2024 年增加約 1 個百分點。所以他們肯定會挺身而出，我想說其中一些，我會稱之為市場創造機會，三尖瓣我會放在那裡，CardioMEMS在那裡，產生臨床數據，產生報銷數據，產生轉診路徑。我們知道如何做到這一點，我們都希望事情進展得很快，尤其是醫療技術產品，對吧？但是，對於具有如此重大成長機會的此類產品，您需要在臨床工作方面做大量工作，因為它與市場擴張、開發和市場開發相關。

I'd say some of the other products on that list, I'd say, are probably more market conversion, and these are already attractive -- large attractive growth segments that we're targeting with our technologies, Navitor in the TAVR space, Aveir in the CRM side. I mean these are large segments that were coming in, and will have different value propositions. I think Aveir has got a tremendous opportunity. It's a $3 billion global pacing market and the value proposition for Aveir I think is second to none in terms of its proposition to the implanter, to the patient. So -- we -- I expect a lot from Aveir in terms of growth. I expect a lot from Navitor. And we're going to be expanding. So we'll have 2 new line extensions to Navitor this year, Navitor Vision and Navitor Titan. And so we're investing in those areas. And yes, they're still great products. They'll still have the Fab 5 on it. And they continue to increase. They'll grow 50%, at least we're forecasting a 50% growth next year and they will contribute about 1 point of growth to the overall company.

我想說的是，該清單上的其他一些產品可能會帶來更多的市場轉化，而且這些產品已經很有吸引力——我們的技術瞄準的是具有吸引力的大型成長細分市場，例如TAVR 領域的Navitor， Aveir 在 CRM 方面。我的意思是，這些都是即將進入的大細分市場，並且將具有不同的價值主張。我認為阿維爾有一個巨大的機會。這是一個價值 30 億美元的全球起搏市場，我認為 Aveir 的價值主張對於植入者和患者來說是首屈一指的。因此，我們對 Aveir 的成長抱有很高的期望。我對 Navitor 抱有很大的期望。我們將會擴大規模。因此，今年我們將推出 Navitor 的 2 個新產品線擴充：Navitor Vision 和 Navitor Titan。所以我們正在這些領域進行投資。是的，它們仍然是很棒的產品。他們仍然會擁有 Fab 5。而且它們還在持續增加中。他們會成長50%，至少我們預測明年會成長50%，他們將為整個公司貢獻約1個百分點的成長。

So that being said, I will say those are great products. They take a lot of focus, but we still have a lot in the chamber here, too, whether it's Lingo, whether it's our TBI test. We're going to be launching a nutritional drink for GLP-1 users this year. Also, we're doing a lot of work on (inaudible), which is our PFA solution. We put out some announcements already at the beginning of the year regarding our clinical trials.

話雖這麼說，我會說這些都是很棒的產品。他們需要很多關注，但我們這裡的房間裡還有很多東西，無論是 Lingo，還是我們的 TBI 測試。今年我們將為 GLP-1 用戶推出一款營養飲料。此外，我們正在（聽不清楚）做大量工作，這是我們的 PFA 解決方案。我們在今年年初就已經發布了一些有關臨床試驗的公告。

I talked about biosimilars in EPD, our dual analyzer sensor for Libre, we're developing a new Alinity system to target a segment of the Diagnostic market that we're currently not competing. So yes, Fab 5, a lot of great contributions, but there's a lot in the chamber here, and I think that's really what's going to sustain our growth beyond 2024 and 2025 is just having a robust pipeline.

我談到了 EPD 中的生物相似藥，我們的 Libre 雙分析感測器，我們正在開發一種新的 Alinity 系統，以瞄準我們目前沒有競爭的診斷市場部分。所以，是的，Fab 5 做出了很多偉大的貢獻，但這裡有很多貢獻，我認為真正要在 2024 年和 2025 年之後維持我們的成長，只有擁有強大的管道。

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。

Nice start to the year or nice end to last year, too. So here is a question I have in Nutrition, you've done a great job of sounds like returning to normalcy. I'm wondering if there are pockets that still need to sort of get back on track or whether we should think of this returning to sort of a mid-single-digit segment growth category.

今年的開局不錯，去年的結尾也不錯。這是我在營養方面的一個問題，你做得很好，聽起來就像恢復正常一樣。我想知道是否還有一些地方仍然需要回到正軌，或者我們是否應該考慮回到中個位數的細分市場成長類別。

Yes. I think kudos to the team here, we set out a target at the beginning of last year -- this time last year to get to market leadership in our October call, we had already confirmed that and let's say, over the last couple of months, that continues to expand in terms of our position versus the #2. Yes, I mean I think you'll now have the full year effect, Joanne, of having all of that share. And I'd say, given the strength of the portfolio of team and what we went through and the actions that we've taken, I'd actually expect us to actually surpass our pre-recall share. I don't know exactly when, but that will be my expectation on that.

是的。我認為這裡的團隊值得讚揚，我們在去年年初制定了一個目標——去年這個時候，在我們10 月份的電話會議中取得市場領導地位，我們已經確認了這一點，比如說，在過去的幾個月裡，與第二名相比，我們的地位繼續擴大。是的，我的意思是，喬安妮，我認為你現在將擁有所有這些份額，從而獲得全年的效果。我想說，考慮到團隊組合的實力、我們所經歷的事情以及我們所採取的行動，我實際上希望我們能夠超越召回前的份額。我不知道確切的時間，但這將是我的期望。

You'll have a little bit of a partial year impact there of some pricing that we took across the entire Nutrition portfolio. So I'd say we're probably above that 4% to 6% range that we used to have prepandemic, at least into 2024. As I've said, I think that we can be at the higher end of that range once everything kind of settles down. And I think a big growth driver for us going forward is really going to be the Adult segment, which is growing high-single digits and of which we've got very high market share positions across the globe. And this position with the brand we have, the science that we have, really aligns to, I'd say, a pretty sustainable demographic trend that we're seeing, which is just an aging population that is focusing on Healthcare and on Nutrition.

我們對整個營養產品組合的一些定價會對部分年度產生一些影響。所以我想說，至少到 2024 年，我們可能會高於大流行前的 4% 到 6% 的範圍。正如我所說，我認為一旦一切都發生了，我們就可以處於該範圍的高端。有點安定下來。我認為，我們未來的一個巨大成長動力實際上將是成人細分市場，該細分市場正在以高個位數成長，並且我們在全球範圍內擁有非常高的市場份額。我想說，我們所擁有的品牌、我們所擁有的科學的這一立場確實符合我們所看到的相當可持續的人口趨勢，即關注醫療保健和營養的人口老化趨勢。

So I'd say that's probably an opportunity for us to maybe break out of that higher end 6% range going forward. But I think right now, you'll see the impact of the share in the U.S., some partial year impact of the price allow us to be above that 6% range. And then as we move into next year, what's going to be the impact of some of the launches that we have planned for the Adult segment and what is that going to do for us?

所以我想說，這可能是我們未來突破 6% 高階區間的機會。但我認為現在，你會看到美國市場份額的影響，部分年份的價格影響使我們能夠高於 6% 的範圍。然後，當我們進入明年時，我們計劃為成人細分市場推出的一些產品將會產生什麼影響？這會對我們產生什麼影響？

And our next question will come from Vijay Kumar with Evercore ISI.

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

Robert, congratulations on a nice Q4 and a solid guide. I guess my one question is on M&A. Looking at the balance sheet phenomenal position, you at least have a minimum of $20 billion of firepower, Abbott hasn't done any large deals in the last few years. So my question is, how do you see the opportunity for larger-sized deals, what is Abbott's appetite for a larger-sized, more meaningful transaction?

羅伯特，恭喜第四季度的出色表現和可靠的指南。我想我的一個問題是關於併購的。從資產負債表驚人的位置來看，至少有200億美元的火力，雅培在過去的幾年裡沒有做過任何重大的交易。所以我的問題是，您如何看待更大規模交易的機會？雅培對更大規模、更有意義的交易的興趣是什麼？

Well, yes, we've got a strong balance sheet and provides us a lot of flexibility on our capital allocation plan. On the M&A side, Vijay, listen, I think it starts off with -- we've got great pipeline. We have great organic opportunities here to be able to kind of drive top-tier sustainable growth. So that ends up putting -- allowing us to be in a selective position here where we're not trying to use M&A as a way to kind of bulk up our top line or to cover any kind of top line gaps that might be there. So that allows us to be sustainable -- allows us to be more selective. And if there are opportunities that fit strategically and can generate an attractive return, then like you said, you've done the math, we've got the flexibility and the firepower to do that. But I'm not looking to acquire businesses simply to make the top line look good.

是的，我們擁有強大的資產負債表，並為我們的資本配置計劃提供了巨大的靈活性。在併購方面，Vijay，聽著，我認為這一切始於——我們有很好的管道。我們在這裡擁有巨大的有機機會，能夠推動頂級永續成長。因此，這最終使我們能夠處於一個有選擇的位置，我們不會試圖利用併購來擴大我們的營收或彌補可能存在的任何類型的營收缺口。因此，這使我們能夠可持續發展，使我們能夠更具選擇性。如果有戰略上合適的機會並且可以產生有吸引力的回報，那麼就像你說的，你已經做了數學計算，我們有靈活性和火力來做到這一點。但我收購企業並不是為了讓收入看起來不錯。

Profitability matters. Earnings matter. And when you get into these larger size deals, you have to have very strong conviction and understanding of that to be able to generate those returns and not just look at it as a top line play. I think they're harder nowadays. You look at what we did with St. Jude, and we have looked back at the deal model that we put together spot on in terms of all aspects there of how we thought this business would impact the company. So I'm not discarding anything like that. I'm just providing you the framework that says they're harder to make work if you want to look beyond just top line and you want to look at ROICs and all the right financial metrics here in terms of how you deploy capital. And -- but I don't feel that we need to do anything like that to cover a top line kind of gap.

盈利能力很重要。收入很重要。當你參與這些規模較大的交易時，你必須對此有非常堅定的信念和理解，才能產生這些回報，而不僅僅是將其視為頂線遊戲。我認為現在他們更難了。你看看我們對 St. Jude 所做的事情，我們回顧了我們在我們認為這項業務將如何影響公司的各個方面所整合的交易模型。所以我不會丟棄這樣的東西。我只是向您提供一個框架，該框架表明，如果您想要超越營收，並且想要查看投資回報率以及所有正確的財務指標，以了解您如何部署資本，那麼它們就更難發揮作用。而且 - 但我不認為我們需要做任何類似的事情來彌補頂線的差距。

If we ever did something like that, it was because it would be strategic and looking at the company kind of long term and not trying to feel a top line gap.

如果我們曾經做過類似的事情，那是因為它是策略性的，並且著眼於公司的長期發展，而不是試圖感受到收入差距。

Operator, we'll take 1 more question, please.

接線員，我們再回答 1 個問題。

And our last question will come from Travis Steed from BofA Securities.

我們的最後一個問題將由美國銀行證券公司的 Travis Steed 提出。

So some of the insurance companies are getting surprised by higher procedure utilization. Some of the tech companies are kind of calling out above-normal growth. So curious, Robert, if you look at your net device markets, are there areas where you think you're seeing some kind of above elevated catch-up still coming through? Or do you think this is kind of more normalized growth rates that you're seeing in 2024? Just kind of curious on some of your thoughts on the overall market.

因此，一些保險公司對更高的程序利用率感到驚訝。一些科技公司聲稱成長速度高於正常水平。羅伯特，很好奇，如果你看看你的網路設備市場，你是否認為在某些領域仍然會看到某種超越水平的追趕？或者您認為這是您在 2024 年看到的更正常化的成長率嗎？只是對您對整個市場的一些想法感到好奇。

Yes. I don't think that we're seeing kind of any kind of catch-up or pent-up or anything like that. I think what you're seeing here is more -- at least I can speak for our portfolio. I just think you're seeing more adoption of the technologies, right? So I think there was some disruption. We've talked about it in some parts of some procedures that require a little bit more preop planning or imaging before and imaging after. I mean I think those -- that combined with the labor shortages that occurred 2022. I think that, that probably slowed a few of them down, but I don't think that there was a bolus returning as a result of that.

是的。我認為我們沒有看到任何形式的追趕或被壓抑或類似的情況。我認為您在這裡看到的更多 - 至少我可以代表我們的投資組合發言。我只是認為您會看到更多的技術被採用，對吧？所以我認為存在一些幹擾。我們已經在一些手術的某些部分討論了這一點，這些手術需要更多的術前計劃或術前影像和術後影像。我的意思是，我認為這些——再加上 2022 年發生的勞動力短缺。我認為，這可能會減慢其中一些人的速度，但我認為不會因此而出現大量回報。

I just think we got back into a normal cadence here of being able to see procedures increasing. We saw that in structural heart procedures, saw that in CRM and EP procedures, not just here in the U.S. but around the world too. So seeing that also in routine diagnostic testing, Travis, a lot of our -- a good portion of the diagnostic business, our Core Lab business is actually in the hospital. So we also get to see that, too. And I didn't see a bolus of testing coming back. So we try and triangulate this. I just see this as procedures are returning back to normal. And because the -- because these technologies that are being developed and launched into the market are so -- it got such great opportunity to improve care, improve life of patients. I just think you're seeing the return to the adoption and the adoption curve. Some are faster than others, just given, I think, the market and market positions, et cetera. But I wouldn't account for it to be some sort of pent-up piece over here.

我只是認為我們回到了正常的節奏，能夠看到程序的增加。我們在結構性心臟手術中看到了這一點，在 CRM 和 EP 手術中看到了這一點，不僅在美國，而且在世界各地也是如此。因此，在常規診斷測試中，特拉維斯，我們的診斷業務的很大一部分，我們的核心實驗室業務實際上是在醫院。所以我們也能看到這一點。我沒有看到大量測試回來。所以我們嘗試對此進行三角測量。我只是看到這一點，因為程式正在恢復正常。因為——因為這些正在開發並投入市場的技術是如此——它獲得了改善護理、改善患者生活的絕佳機會。我只是認為您正在看到採用率和採用率曲線的回歸。我認為，有些比其他更快，只是考慮到市場和市場地位等等。但我不會將其視為這裡某種被壓抑的部分。

Okay. Well, I'll wrap up here. And like I said in the beginning, very successful year 2023, in many ways, it sort of represented this transition year regarding the coming down of COVID. I think we did a really good job at managing the scale up and the scale down, a lot of healthcare companies actually participated and -- in trying to solve the COVID problem and I think we did a good job here at being able to scale up and scale down.

好的。好吧，我就到這裡結束吧。正如我在開頭所說，2023 年是非常成功的一年，從許多方面來說，它在某種程度上代表了新冠肺炎疫情結束的過渡年。我認為我們在管理擴大規模和縮小規模方面做得非常好，許多醫療保健公司實際上參與了努力解決新冠病毒問題，我認為我們在擴大規模方面做得很好並縮小規模。

Our performance here is now transitioned from being driven by COVID testing to once again being driven by a broad-based strength across the entire company. We delivered double-digit organic sales growth on every base business every quarter. And we're clearly entering 2024 with a lot of momentum. The pipeline we talked a little bit about it, continues to be highly productive. And I'm forecasting here top-tier growth in 2024. And as you look at our range on the EPS guide, like I said, there's probably more upside to that than downside. But we're in January. So we're off to a good start and looking forward to executing this year.

我們的業績現在已經從由新冠病毒測試驅動轉變為再次由整個公司的廣泛實力驅動。我們每季的每個基礎業務都實現了兩位數的有機銷售成長。我們顯然正以強勁的勢頭進入 2024 年。我們稍微討論過的管道仍然保持著很高的生產力。我預測 2024 年將出現頂級增長。正如我所說，當您查看 EPS 指南上的範圍時，您會發現上行空間可能大於下行空間。但我們現在是一月。因此，我們有了一個良好的開端，並期待今年的執行。

Okay. Thank you, operator, and thank you all for 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 Investor Relations website at abbottinvestor.com. Thank you for joining us today.

好的。謝謝接線員，也謝謝大家的提問。雅培的電話會議到此結束。本次電話會議的網路直播重播將於今天中部時間上午 11 點後在雅培投資者關係網站 abbottinvestor.com 上播出。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。今天的電話會議到此結束。感謝您的參與。您現在可以斷開連線。祝大家有美好的一天。