美國雅培 (ABT) 2021 Q4 法說會逐字稿

Good morning and thank you for standing by. Welcome to Abbott's Fourth Quarter 2021 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 express written permission.

早上好，感謝您的支持。歡迎參加雅培 2021 年第四季度收益電話會議。 （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，不得對其進行錄製或重播。

I would now like to introduce Mr. Scott Leinenweber, Vice President, Investor Relations, Licensing and Acquisitions.

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 will 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。根據他們的意見，我們將回答您的問題。

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 for the year ended December 31, 2020. 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，今天做出的一些陳述可能是 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 2020 年 12 月 31 日的 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前瞻性陳述作為後續事件或發展的結果，除非法律要求。

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. 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。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, and good morning, everyone, and thank you for joining us. Today, we reported another strong quarter and highly successful year for Abbott. For the year, we reported organic sales growth of 23% and ongoing earnings per share of $5.21, which reflects more than 40% growth compared to the prior year and exceeded the original EPS guidance we set last January.

謝謝，斯科特，大家早上好，感謝您加入我們。今天，我們報告了雅培又一個強勁的季度和非常成功的一年。今年，我們報告了 23% 的有機銷售增長和 5.21 美元的持續每股收益，與去年相比增長了 40% 以上，並超過了我們去年 1 月設定的原始每股收益指引。

These last couple of years have truly been unique on many levels. The challenge throughout the pandemic has been the sheer breadth of its impacts. And for Abbott, it's reinforced the value of our diversified business model, which is uniquely balanced across multiple dimensions, including our business mix, customer and payer types, innovation cycles across our businesses and geographic footprint.

過去幾年在許多層面上確實是獨一無二的。整個大流行的挑戰在於其影響的廣泛性。對於雅培而言，它強化了我們多元化業務模式的價值，這種模式在多個維度上實現了獨特的平衡，包括我們的業務組合、客戶和付款人類型、我們業務的創新周期和地理足跡。

We've always said that our business model allows us more opportunities to win during the good times and makes us more resilient during the tough times, and never has this been put to the test more so than over the past couple of years. It's been tested by a major global pandemic and has proven to be highly resilient, delivering strong growth and returns for our shareholders.

我們一直說，我們的商業模式讓我們有更多機會在順境中獲勝，在艱難時期讓我們更有韌性，而且在過去幾年中從未有過這樣的考驗。它已經通過全球大流行病的考驗，並被證明具有很強的彈性，為我們的股東帶來強勁的增長和回報。

COVID testing has been a big part of this, of course. We delivered 1 billion tests last year and approximately $300 million in the fourth quarter alone and continue to play a significant role in the world's response to the pandemic. But just as importantly, we demonstrated Abbott's strength across our company, delivering strong growth across our businesses while continuing to expand our portfolio with innovations that will fuel our success for years to come regardless of the pandemic situation.

當然，COVID 測試一直是其中的重要組成部分。去年我們交付了 10 億次測試，僅在第四季度就交付了大約 3 億美元，並繼續在世界應對大流行病中發揮重要作用。但同樣重要的是，我們在整個公司展示了雅培的實力，在我們的業務中實現了強勁增長，同時繼續通過創新擴大我們的產品組合，無論大流行情況如何，這些創新都將推動我們在未來幾年取得成功。

Turning to our outlook for 2022. As we announced this morning, we forecast ongoing earnings per share of at least $4.70, which reflects nearly 50% growth compared to our prepandemic baseline in 2019. We forecast organic sales growth for our base business, excluding COVID tests, in the high single digits, and our guidance includes an initial COVID testing sales forecast of $2.5 billion. We're seeing very strong demand for testing to start the year with the recent emergence of the Omicron variant. And as you know, forecasting COVID testing demand for more than a few months at a time has been challenging. Therefore, our initial forecast compromises sales that we expect to occur in the early part of the year. And we'll update this forecast 1 quarter at a time over the remainder of the year.

轉向我們對 2022 年的展望。正如我們今天上午宣布的那樣，我們預測每股持續收益至少為 4.70 美元，與 2019 年大流行前的基線相比，這反映了近 50% 的增長。我們預測我們的基礎業務的有機銷售增長，不包括 COVID測試，在高個位數，我們的指導包括 25 億美元的初始 COVID 測試銷售預測。隨著最近 Omicron 變體的出現，我們看到今年開始對測試的需求非常強烈。如您所知，一次預測幾個月以上的 COVID 測試需求一直具有挑戰性。因此，我們最初的預測會影響我們預計在今年年初發生的銷售額。我們將在今年剩餘時間內一次更新 1 個季度的預測。

I'll now provide more details on our 2021 results before turning the call over to Bob. And I'll start with Nutrition, where sales grew nearly 6% in the fourth quarter and over 7.5% for the year. Adult Nutrition delivered 9% growth for the quarter and double-digit growth for the year, led once again by Ensure, our market-leading complete and balanced nutrition brand; and Glucerna, our leading diabetes nutrition brand.

現在，在將電話轉給 Bob 之前，我將提供有關我們 2021 年結果的更多詳細信息。我將從營養學開始，第四季度銷售額增長近 6%，全年增長超過 7.5%。成人營養品本季度實現 9% 的增長，全年實現兩位數的增長，由我們市場領先的全面均衡營養品牌 Ensure 再次引領；以及我們領先的糖尿病營養品牌 Glucerna。

In Pediatric Nutrition, U.S. sales growth of more than 10% for the year was led by strong growth of Pedialyte, our oral rehydration brand; and market share gains for Similac, our market-leading infant formula brand. During the past year, we continued to expand our Nutrition portfolio with several new product and line extensions, including the launch of Similac 360 Total Care in the U.S. and continued global expansion of our PediaSure, Glucerna and Ensure brands with line extensions such as plant-based, lower-sugar and high-protein products.

在兒科營養方面，我們的口服補液品牌 Pedialyte 的強勁增長帶動了美國全年銷售額增長超過 10%；和市場領先的嬰兒配方奶粉品牌 Similac 的市場份額增加。在過去的一年裡，我們繼續擴展我們的營養產品組合，增加了幾款新產品和產品線，包括在美國推出 Similac 360 Total Care，並通過植物-以低糖和高蛋白產品為主。

Turning to Medical Devices, where continued recovery from the impacts of the pandemic and strong growth in Diabetes Care drove sales growth of 16% in the quarter and nearly 20% for the year. In Diabetes Care, sales growth of nearly 30% for both the fourth quarter and full year was led by FreeStyle Libre, our market-leading continuous glucose monitoring system. Rebased Libre sales grew over 35%, which translates to year-over-year growth of $1 billion to a total of $3.7 billion in 2021.

轉向醫療器械，從大流行的影響中持續復甦和糖尿病護理的強勁增長推動本季度銷售額增長 16%，全年增長近 20%。在糖尿病護理領域，第四季度和全年的銷售額增長近 30%，這得益於我們市場領先的連續血糖監測系統 FreeStyle Libre。 Rebased Libre 的銷售額增長了 35% 以上，這意味著到 2021 年，銷售額同比增長 10 億美元，達到 37 億美元。

This past year, we continued to strengthen our Medical Device portfolio with several pipeline advancements and launches. In the U.S., expanded Medicare reimbursement coverage for MitraClip will make it possible for more people to benefit from this life-changing technology. We launched NeuroSphere Virtual Clinic, a first-of-its-kind technology that lets patients communicate with physicians and receive new treatment settings remotely. We received U.S. FDA approval for our Amplatzer Amulet heart device, which treats people with atrial fibrillation who are at risk of ischemic stroke. And we received U.S. FDA approval of our Portico heart valve replacement system for people with severe aortic stenosis; and CE Mark for Navitor, our latest-generation transcatheter aortic valve replacement system.

在過去的一年裡，我們繼續加強我們的醫療器械產品組合，推出了幾項管道改進和發布。在美國，擴大 MitraClip 的醫療保險報銷範圍將使更多人能夠從這種改變生活的技術中受益。我們推出了 NeuroSphere 虛擬診所，這是一種首創的技術，可讓患者與醫生溝通並遠程接收新的治療設置。我們的 Amplatzer Amulet 心臟裝置獲得了美國 FDA 的批准，該裝置可治療有缺血性中風風險的心房顫動患者。我們的 Portico 心臟瓣膜置換系統獲得了美國 FDA 的批准，用於嚴重主動脈瓣狹窄的患者；和 Navitor 的 CE 標誌，我們最新一代的經導管主動脈瓣置換系統。

Moving to Established Pharmaceuticals, or EPD, where sales increased nearly 6% in the fourth quarter and over 10% for the full year. Strong performance was broad based across several countries, led by India, Russia and China. EPD has performed well throughout the pandemic, fueled by strong execution and a steady flow of new product introductions in our core therapeutic areas.

轉向成熟製藥公司 (EPD)，其第四季度銷售額增長近 6%，全年增長超過 10%。以印度、俄羅斯和中國為首的多個國家表現強勁。在我們的核心治療領域強大的執行力和源源不斷的新產品推出的推動下，EPD 在整個大流行期間表現良好。

And I'll wrap up with Diagnostics, where COVID testing was a big part of the story but far from all of it. COVID testing sales were $2.3 billion in the fourth quarter with rapid testing platforms, including BinaxNOW in the U.S., Panbio internationally and ID NOW globally, compromising approximately 90% of those sales. Demand for testing continues to remain strong, and we remain committed to help ensure broad access.

最後，我將介紹診斷，其中 COVID 測試是故事的重要組成部分，但遠非全部。第四季度 COVID 測試銷售額為 23 億美元，包括美國的 BinaxNOW、國際的 Panbio 和全球的 ID NOW 在內的快速測試平台，約佔這些銷售額的 90%。測試需求繼續保持強勁，我們將繼續致力於幫助確保廣泛的訪問。

Since the start of the pandemic, we've invested significantly to build both U.S. and international manufacturing supply chains, and we're working to expand our capacity further to meet global demand. Excluding COVID testing sales, worldwide Diagnostics sales grew over 8% in the fourth quarter and 13% for the year. We continue to roll out Alinity, our innovative suite of diagnostic instruments, and expand test menus across our platforms. During the year, we placed more than 3,000 Alinity instruments for immunoassay and clinical chemistry testing, with approximately 2/3 of those placements coming from share capture. And in Molecular Diagnostics, excluding COVID testing, sales grew double digits in both U.S. and internationally as we continue the rollout of our Alinity m instrument for molecular testing.

自大流行開始以來，我們已投入巨資建立美國和國際製造業供應鏈，我們正在努力進一步擴大產能以滿足全球需求。不包括 COVID 測試銷售額，全球診斷銷售額在第四季度增長超過 8%，全年增長 13%。我們繼續推出創新的診斷儀器套件 Alinity，並在我們的平台上擴展測試菜單。在這一年中，我們放置了 3,000 多台 Alinity 儀器用於免疫測定和臨床化學測試，其中大約 2/3 來自份額捕獲。在分子診斷領域，不包括 COVID 檢測，隨著我們繼續推出用於分子檢測的 Alinity m 儀器，美國和國際的銷售額均增長了兩位數。

So in summary, 2021 was another highly successful year for Abbott. We continue to play a vital role in combating COVID-19 as a result of our massive scale we've built in rapid testing capacity. All 4 of our major businesses delivered strong performance this past year and are well positioned for continued success going forward. And we continue to strengthen our overall strategic position with a steady cadence of important new products from our pipeline in several attractive growth areas.

綜上所述，2021 年對雅培來說又是一個非常成功的一年。由於我們建立了大規模的快速檢測能力，我們繼續在抗擊 COVID-19 方面發揮重要作用。在過去的一年裡，我們所有的 4 項主要業務都取得了強勁的業績，並為未來的持續成功做好了準備。我們將繼續加強我們的整體戰略地位，並在幾個有吸引力的增長領域以穩定的節奏從我們的管道中推出重要的新產品。

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

我現在將把電話轉給 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 for the fourth quarter increased 7.7% on an organic basis, which was led by strong performance across all of our businesses, along with global COVID testing-related sales of $2.3 billion in the quarter. Excluding COVID testing sales, organic sales growth was 10.3% versus the fourth quarter of 2020 and 10.8% compared to our prepandemic baseline in the fourth quarter of 2019. Foreign exchange had an unfavorable year-over-year impact of 0.5% on fourth quarter sales, resulting in total reported sales growth of 7.2% in the quarter.

轉向我們的結果。第四季度銷售額有機增長 7.7%，這得益於我們所有業務的強勁表現，以及本季度全球與 COVID 測試相關的銷售額 23 億美元。不包括 COVID 測試銷售額，與 2020 年第四季度相比，有機銷售額增長 10.3%，與我們在 2019 年第四季度的疫情前基線相比增長 10.8%。外匯對第四季度銷售額的同比不利影響為 0.5% ，導致本季度報告的總銷售額增長 7.2%。

Regarding other aspects of the P&L for the quarter, the adjusted gross margin ratio was 57.7% of sales, adjusted R&D investment was 6.3% of sales, and adjusted SG&A expense was 26.2% of sales. Our fourth quarter adjusted tax rate was 16.9%, which reflects an adjustment to align our tax rate for the first 3 quarters of last year with our revised full year effective tax rate of 15.5%, which is modestly higher than the estimate we provided in October due to a shift in the mix of our business and geographic income.

本季度其他方面的損益，調整後的毛利率為銷售額的57.7%，調整後的研發投入為銷售額的6.3%，調整後的SG&A費用為銷售額的26.2%。我們第四季度調整後的稅率為 16.9%，這反映了調整我們去年前三個季度的稅率與我們修訂後的全年有效稅率 15.5% 的調整，略高於我們在 10 月份提供的估計由於我們的業務和地域收入的組合發生了變化。

Turning to our outlook for the full year 2022. Today, we issued guidance for the full year adjusted earnings per share of at least $4.70. For the year, we forecast organic sales growth, excluding the impact of COVID testing-related sales, to be in the high single digits. We forecast COVID testing-related sales of approximately $2.5 billion, with a significant portion of these sales expected to occur in the early part of the year. We'll update our COVID testing sales forecast 1 quarter at a time throughout the year. Based on current rates, we would expect exchange to have an unfavorable impact of approximately 2% on our reported sales.

轉向我們對 2022 年全年的展望。今天，我們發布了至少 4.70 美元的全年調整後每股收益指引。對於這一年，我們預測有機銷售增長（不包括與 COVID 測試相關的銷售的影響）將達到高個位數。我們預測與 COVID 檢測相關的銷售額約為 25 億美元，其中很大一部分預計將發生在今年年初。我們將在全年一個季度一次更新我們的 COVID 測試銷售預測。根據目前的匯率，我們預計匯率會對我們報告的銷售額產生約 2% 的不利影響。

We forecast an adjusted gross margin ratio of approximately 58.5% of sales for the year, which reflects our forecasted business mix, underlying gross margin improvement initiatives across our businesses, along with the impact of inflation on certain manufacturing and distribution cost.

我們預計全年調整後的毛利率約為銷售額的 58.5%，這反映了我們預測的業務組合、我們業務的潛在毛利率改善計劃，以及通貨膨脹對某些製造和分銷成本的影響。

For the year, we forecast R&D investment of around $2.7 billion and SG&A expense of around $10.8 billion, which reflects investments to support several ongoing and upcoming new product launches and strategic growth initiatives. We forecast net interest expense of around $500 million, nonoperating income of around $375 million and a full year adjusted tax rate of approximately 14.5% for the year.

全年，我們預計研發投資約為 27 億美元，SG&A 費用約為 108 億美元，這反映了為支持若干正在進行和即將推出的新產品發布和戰略增長計劃而進行的投資。我們預計全年淨利息支出約為 5 億美元，營業外收入約為 3.75 億美元，全年調整後稅率約為 14.5%。

Turning to our outlook for the first quarter. We forecast adjusted earnings per share of at least $1.50 and organic sales growth, excluding the impact of COVID testing-related sales, to be in the high single digits. Lastly, at current rates, we would expect exchange to have an unfavorable impact of approximately 3% on our first quarter reported sales.

轉向我們對第一季度的展望。我們預測調整後的每股收益至少為 1.50 美元，有機銷售增長（不包括 COVID 檢測相關銷售的影響）將達到高個位數。最後，按照目前的匯率，我們預計交易所將對我們第一季度報告的銷售額產生約 3% 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 Larry Biegelsen from Wells Fargo.

（操作員說明）我們的第一個問題來自富國銀行的拉里·比格爾森。

Congratulations on a really strong finish to a strong year. Robert, can you talk about how you thought about the 2022 guidance? Why is $2.5 billion for COVID testing the right starting point? And how are you thinking about reinvesting the upside from COVID testing implied in the $4.70 EPS guidance? And I have one follow-up.

恭喜您在強勁的一年中取得了非常強勁的成績。羅伯特，您能談談您對 2022 年指導方針的看法嗎？為什麼 25 億美元用於 COVID 測試是正確的起點？您如何考慮將 4.70 美元每股收益指引中隱含的 COVID 測試的優勢再投資？我有一個後續行動。

Sure, Larry. I'd say at the beginning of the year, you're coming into the year and you're trying to find the right balance, right? You're trying to find the right balance on your long-term growth opportunities that Abbott has, which I think are pretty unique, and balancing that with, I'd say, probably some uncertainty. And I'd say every year, there's a little bit of uncertainty at the beginning of the year, but I'd say this year is probably a little bit more than usual. So you're trying to find that balance, and I'm pretty sure we'll talk about some of the long-term growth opportunities.

當然，拉里。我會說在年初，你即將進入這一年，你正在努力找到正確的平衡，對吧？您正試圖在雅培擁有的長期增長機會上找到適當的平衡，我認為這是非常獨特的，並且我想說，可能存在一些不確定性。我會說，每年年初都會有一些不確定性，但我會說今年可能比往年多一點。所以你正試圖找到這種平衡，我很確定我們會討論一些長期的增長機會。

But if you think about some of the challenges in forecasting right now, there's a lot of dynamics that are existing from a macroeconomic standpoint that are out there that, quite frankly, aren't necessarily unique to Abbott. But they're out there, whether it's the pandemic and the duration of the current surge, potential new waves and how long they will last, staffing shortages that we've seen for the hospital base kind of part of our business; quite frankly, patients' willingness to go in, to do a procedure during the surges. So that's probably one kind of big bucket to look at.

但是，如果您考慮目前預測中的一些挑戰，那麼從宏觀經濟的角度來看，存在很多動態，坦率地說，這些動態不一定是雅培獨有的。但是它們就在那裡，無論是大流行和當前激增的持續時間，潛在的新浪潮以及它們將持續多長時間，我們已經看到醫院基地的人員短缺是我們業務的一部分；坦率地說，病人願意在激增期間進去做手術。所以這可能是一種值得一看的大桶。

Another area, obviously, on the macro side is supply chains and inflation challenges that every company is facing, and obviously, kind of currency headwinds. So I'd say those are all challenges that are facing a lot of medtech companies, companies in health care, and quite frankly, a lot of companies outside of our sector.

顯然，宏觀方面的另一個領域是每家公司都面臨的供應鍊和通脹挑戰，而且顯然是某種貨幣逆風。所以我想說，這些都是許多醫療技術公司、醫療保健公司以及坦率地說，我們行業以外的許多公司都面臨的挑戰。

Probably what's a little bit different for us, another fact to consider in our forecast is just COVID testing and how is that going to play out throughout the rest of the year given the magnitude of what the testing could look like between it completely going away or it staying or increasing at this level.

可能對我們來說有點不同，我們預測中要考慮的另一個事實只是 COVID 測試，考慮到測試在它完全消失或它保持或增加在這個水平。

So factoring all those kind of elements over here, I think this was the right starting point for us, to start off like that. And I think this initial full year guidance is contemplating not only some of those challenges, but also contemplating on the flip side, a very strong underlying kind of Abbott base business, as I said in my comments, high single-digit growth. So there are definitely acceleration in a lot of our portfolio versus where we were prepandemic.

因此，考慮到所有這些元素，我認為這是我們的正確起點，以這樣的方式開始。而且我認為這個最初的全年指導不僅考慮了其中一些挑戰，而且還考慮了另一方面，正如我在評論中所說的，雅培基礎業務非常強大，實現了高個位數增長。因此，與大流行前的情況相比，我們的許多投資組合肯定都在加速。

We've got investment in this guidance to be able to support not only all of our launches that we engaged in towards the end of last year. Beginning of this year, we've got launches and opportunities. And that's all been contemplated and fully funded.

我們已經對本指南進行了投資，不僅能夠支持我們在去年年底參與的所有發布。今年年初，我們有發布和機會。這一切都經過了考慮並得到了充分的資助。

And the initial COVID testing forecast of $2.5 billion, I don't expect COVID to simply go to 0 starting in the second quarter. But the challenge of forecasting, the magnitude, I felt, is the right way to -- and quite frankly, I talked about this in October, we will be updating it as we go along. We've got a -- we've built a lot of capacity. You've seen that over this last 1.5 years, especially in rapid testing. So we have that capacity, and we'll be updating it.

而最初的 COVID 測試預測為 25 億美元，我預計 COVID 不會從第二季度開始簡單地變為 0。但是，我覺得預測的挑戰和規模是正確的方法——坦率地說，我在 10 月份談到了這一點，我們將在進行過程中對其進行更新。我們有一個 - 我們已經建立了很多能力。在過去的 1.5 年中，您已經看到了這一點，尤其是在快速測試方面。所以我們有這個能力，我們會更新它。

So if we had typically done our $0.10 range guide here, Larry, our consensus, we would have been right in the middle of where you guys are at. But I didn't want to cap the upside, which is why we're at the least $4.70.

因此，如果我們通常在這裡完成我們的 0.10 美元範圍指南，拉里，我們的共識，我們就會處於你們所處的中間位置。但我不想限制上漲空間，這就是我們至少為 4.70 美元的原因。

So if I kind of sum it up, I look at our guidance now and I say, "Okay. We've contemplated as much as we can of some of the challenges that a lot of companies are facing, whether it's supply chain, duration of pandemic, medical device procedures, et cetera." I've fully funded our growth platforms that we're very excited about. And there's potential for the upside of more COVID testing because I don't think it goes away, which would then fall through at a good click and provide that upside.

因此，如果我總結一下，我現在查看我們的指導並說：“好的。我們已經盡可能多地考慮了許多公司面臨的一些挑戰，無論是供應鏈、持續時間流行病、醫療器械程序等。”我已經為我們非常興奮的增長平台提供了全部資金。並且有可能進行更多的 COVID 測試，因為我認為它不會消失，然後會通過良好的點擊並提供這種優勢。

So I think that's probably the best way to summarize. It's derisked, fully funded for long-term growth opportunities, and we've got potential upside as we go into the remainder of the year.

所以我認為這可能是最好的總結方式。它已被降低風險，為長期增長機會提供了充足的資金，並且隨著我們進入今年剩餘的時間，我們有潛在的上行空間。

That's super helpful. Robert, just for my follow-up, Libre had another remarkable year. How are you thinking about Libre growth in 2022? And what are the drivers of that growth this year?

這非常有幫助。羅伯特，就我的後續行動而言，Libre 又度過了非凡的一年。您如何看待 2022 年的 Libre 增長？今年增長的驅動力是什麼？

Sure. Well, yes, I mean, you saw it. It continues to grow at a very strong rate and a very large base. 35 -- over 35% this year, 4 million users now. We've initiated geographic expansion of Libre 3, and that will start in the next couple of weeks. Moving out of Germany into U.K. and France, those are probably kind of key markets that we're expanding over the next couple of weeks.

當然。嗯，是的，我的意思是，你看到了。它繼續以非常強勁的速度和非常大的基數增長。 35 -- 今年超過 35%，現在有 400 萬用戶。我們已經啟動了 Libre 3 的地域擴展，這將在接下來的幾週內開始。從德國轉移到英國和法國，這些可能是我們在接下來的幾週內擴展的關鍵市場。

And if I think about 2022, Larry, I mean, I'm looking at here strong double-digit growth. We've been growing about $1 billion of incremental sales per year, and I expect that growth to be at least in that range. So that probably translates into a 25% growth.

如果我考慮到 2022 年，拉里，我的意思是，我在這裡看到強勁的兩位數增長。我們每年增加約 10 億美元的銷售額，我預計增長至少在這個範圍內。因此，這可能轉化為 25% 的增長。

I think the biggest driver for us is, quite frankly, not just this year but as we look forward, it's still very underpenetrated, right? I'm talking about being a leader in terms of patients with 4 million users where we've talked about numbers between 60 million, 70 million, 80 million people around the world that could be benefiting from continuous glucose monitoring and sensor-based monitoring.

坦率地說，我認為對我們來說最大的驅動力不僅是今年，而且在我們展望的時候，它仍然非常未滲透，對吧？我說的是成為擁有 400 萬用戶的患者的領導者，我們已經談到全球有 6000 萬、7000 萬、8000 萬人可能受益於持續血糖監測和基於傳感器的監測。

So I'd say biggest opportunities we've got continue to be international. The CGM penetration internationally is still much lower than in the U.S. And then moving into -- more aggressively into patient segments that historically have been underpenetrated, you kind of look at the type 2s on single injection therapy. So we've got great opportunity there.

所以我想說我們最大的機會是繼續國際化。 CGM 在國際上的滲透率仍然遠低於美國。然後更積極地進入歷史上滲透率不足的患者細分市場，你可以看看單次注射治療的 2 型。所以我們在那裡有很好的機會。

U.S., I would say, is another good opportunity for us. We had very good year this year, close to like 16% growth. I think that's the number. Now over 1 million users. We've made the investments that we need to make last year in terms of sales force and advertising, and that's paying dividends. In terms of new users, we continue to have a high share of new user growth.

我想說，美國對我們來說是另一個好機會。今年我們的表現非常好，接近 16% 的增長。我想就是這個數字。現在超過100萬用戶。去年，我們在銷售人員和廣告方面進行了必要的投資，這正在帶來回報。在新用戶方面，我們繼續保持高份額的新用戶增長。

So as you combine what we're doing internationally, expansion of Libre 3, continued growth in the U.S., expanding into a pretty underpenetrated population of type 2s, and I think we've still got -- like I've kind of said, still in the early innings of the Libre story here.

因此，當您結合我們在國際上所做的事情，Libre 3 的擴展，美國的持續增長，擴展到相當低滲透的 2 型人口時，我認為我們仍然 - 就像我說過的那樣，仍處於 Libre 故事的早期階段。

Our next question comes from Robbie Marcus from JPMorgan.

我們的下一個問題來自摩根大通的 Robbie Marcus。

I'll also add my congratulations on a nice quarter. Two for me. I'll ask them both upfront. First question, maybe you could spend a minute on cadence throughout the year. First quarter has a lot more COVID testing sales than we had thought but also implies somewhat of a different cadence than we have been thinking. So just top and bottom line, what are the impacts there? How is inflation, FX hitting throughout?

我還要祝賀一個不錯的季度。兩個給我。我會提前問他們兩個。第一個問題，也許你可以在全年花一分鐘的時間來研究節奏。第一季度的 COVID 測試銷售額比我們想像的要多得多，但也暗示著與我們想像的有所不同的節奏。所以只是頂線和底線，那裡有什麼影響？通貨膨脹，外匯如何貫穿始終？

And then second question is probably tied into it. If you could just touch on what you're seeing in current device and procedure trends as we sit here today and how you're thinking about the evolution of that over the course of '22.

然後第二個問題可能與之相關。如果您能在我們今天坐在這裡時談談您在當前設備和程序趨勢中看到的內容，以及您如何考慮在 22 年期間的演變。

Well, your first question has got multiple subquestions there, Robbie. So let me take the first one, and then I'll go back -- so I can take the second one, and then I'll go back to your first one because it does contemplate some of the challenges on inflation that might be worthwhile spending some time just talking a little bit about also.

好吧，羅比，你的第一個問題有多個子問題。所以讓我拿第一個，然後我會回去——所以我可以拿第二個，然後我會回到你的第一個，因為它確實考慮了一些可能值得的通脹挑戰花一些時間只是談論一點點。

But in terms of demand dynamics, especially in the more hospital-based business here, Robbie, we saw a real nice trajectory recovery in the beginning of Q4. We were -- and I always like to compare versus 2019, at least for 2021, to avoid some of the comp pieces. So we were improving our growth rates in our probably more cardio-like businesses, let's use that as a proxy. It would be in that kind of 3% to 4% range and improving as the quarters progressed. And Q4 was looking like, again, a continuation of that progression until probably December, where we saw a pretty big drop because of Omicron in most of the device -- of our device businesses. Probably the only 2 that we didn't see that drop was Heart Failure, that was probably up in the mid-20s in December versus 2019; and obviously, Libre, which was up probably like in the 70s percent versus 2019.

但就需求動態而言，尤其是在這里以醫院為基礎的業務 Robbie，我們在第四季度初看到了真正不錯的複蘇軌跡。我們是——而且我總是喜歡與 2019 年進行比較，至少在 2021 年是這樣，以避免一些競爭部分。因此，我們正在提高我們可能更像有氧運動的業務的增長率，讓我們以此為代表。它將在 3% 到 4% 的範圍內，並隨著季度的進展而改善。第四季度再次看起來像是這種進展的延續，直到可能到 12 月，我們看到由於 Omicron 在我們的設備業務的大部分設備中出現了相當大的下降。可能我們唯一沒有看到下降的兩個是心力衰竭，與 2019 年相比，這可能在 12 月的 20 年代中期有所上升；顯然，Libre 與 2019 年相比上漲了 70%。

So we did have an impact in these parts of the business, again as -- predominantly driven by Omicron impact of not only staffing, I'd say, but also even just patients basically postponing a little bit and not wanting to go into a hospital. And I think that's continued a little bit here into January.

所以我們確實對業務的這些部分產生了影響，主要是由 Omicron 的影響驅動的，不僅是人員配置，我想說，甚至只是病人基本上推遲了一點，不想去醫院.我認為這種情況一直持續到一月份。

I'd say geographically, seeing a little bit more of that impact in the U.S. compared to other geographies, at least for us. Europe and Asia have held up a little bit better than the U.S. And then we've contemplated as best as we can what that recovery curve is going to look like. We'll see some pressure on that, I'd say, probably January, February going into March. We expect it to get better, and then Q2 will be better. And if you look at the second half of this year, we expect for these businesses to be more at their normal run rate. So I think -- I'd say that's what we're seeing, and that's kind of how we're forecasting the rest of the year.

我想說的是，與其他地區相比，至少對我們而言，在美國看到的這種影響要多一些。歐洲和亞洲的表現比美國好一點。然後我們盡可能地考慮了復甦曲線會是什麼樣子。我們會看到一些壓力，我想說，可能是一月、二月到三月。我們預計它會變得更好，然後第二季度會更好。如果你看一下今年下半年，我們預計這些業務將更加正常運行。所以我認為 - 我會說這就是我們所看到的，這就是我們預測今年剩餘時間的方式。

Actually, I was pretty pleased that some of the new product launches that we had during the quarter -- we're always cautious about, okay, do we launch the product during -- in this environment? And they did pretty well, both in Europe and in the U.S., too. So I think that speaks well about still the need for the products and the technologies and the innovation.

實際上，我很高興我們在本季度推出的一些新產品——我們總是很謹慎，好吧，我們會在這種環境下推出產品嗎？他們在歐洲和美國都做得很好，也是。所以我認為這仍然很好地說明了對產品、技術和創新的需求。

So the consumer side -- the consumer-facing part of our business, I mentioned Libre, but you saw it in Nutrition and EPD. They've done pretty well, the pandemic. They did pretty well in Q4. So didn't necessarily see the impact of Omicron to those businesses like we didn't see it in Delta either. So we would expect those businesses to be pretty resilient. And the key driver there, as I talked a little bit about Libre, is just kind of innovation.

所以消費者方面——我們業務中面向消費者的部分，我提到了 Libre，但你在營養和 EPD 中看到了它。大流行，他們做得很好。他們在第四季度做得很好。所以不一定能看到 Omicron 對那些我們在 Delta 也沒有看到的業務的影響。因此，我們預計這些業務將非常有彈性。那裡的關鍵驅動因素，正如我談到 Libre 的一點點，只是一種創新。

On your first question regarding cadence, I mean, part of it is this combination that I said, recovering device and core testing procedures that we see going into Q2 and into Q3 and Q4. And then as we have more, let's say, call it, confidence in precision regarding our COVID testing, we'll see that kind of flow through, and then we'll be able to update you. I think when we're here in April, we'll have a better sense of what Q2 is going to look like, not only for the U.S. but also internationally. And as I said, having that ability to then kind of update the forecast with that COVID number, we'll let it flow through.

關於你關於節奏的第一個問題，我的意思是，部分原因是我所說的這種組合，恢復我們看到進入 Q2 和 Q3 和 Q4 的設備和核心測試程序。然後，隨著我們對 COVID 測試的準確性有更多的信心，比如說，稱之為，我們將看到這種流動，然後我們將能夠更新您。我認為，當我們在 4 月份來到這裡時，我們將對第二季度的情況有更好的了解，不僅對美國，而且對國際而言。正如我所說，擁有這種能力，然後用該 COVID 號碼更新預測，我們會讓它通過。

So I think you also had a question about inflation. I mean that is another area that we're working on and focused on and probably ask Bob to give you some color on that.

所以我認為你也有關於通貨膨脹的問題。我的意思是這是我們正在研究和關注的另一個領域，可能會要求 Bob 給你一些顏色。

Okay. Yes. And Robbie, you actually kind of asked about currency and inflation. I'll cover currency first. I mean we saw the U.S. dollar kind of strengthen since the middle of last year, in particular over the last few months. And so as I said in my opening remarks, at current rates, that's about a 2% headwind on the top line for the year. We're going to see that -- a greater impact in the first quarter, around 3% and kind of -- and in the second quarter. And it'll get -- the impact will be a little bit less severe as we go -- kind of go through the course of the year into the back half of the year.

好的。是的。羅比，你實際上有點問貨幣和通貨膨脹。我將首先介紹貨幣。我的意思是，我們看到美元自去年年中以來有所走強，尤其是在過去幾個月。正如我在開場白中所說，按照目前的速度，這對今年的收入來說大約是 2% 的逆風。我們將看到這一點——第一季度的影響更大，大約 3% 左右——以及第二季度。它會得到——隨著我們的發展，影響會稍微不那麼嚴重——從一年到下半年。

In terms of inflation, inflation and supply chain challenges are really kind of linked together as supply chains have not been able to catch up to the strong demand that's out there. And so we're seeing some impacts here, certainly not unique to us or our industry. And we're seeing those impacts across transportation cost, manufacturing inputs, commodities, et cetera.

在通貨膨脹方面，通貨膨脹和供應鏈挑戰確實是聯繫在一起的，因為供應鏈無法趕上那裡的強勁需求。所以我們在這裡看到了一些影響，當然不是我們或我們的行業所獨有的。我們在運輸成本、製造投入、商品等方面看到了這些影響。

From a pricing standpoint, we have the flexibility to adjust price a bit in some areas of the business, and we're doing so. That's really more in the consumer-facing businesses like Nutrition. In other areas of the business, that flexibility doesn't exist. So I'd say in aggregate, kind of across those headwinds, we're seeing impacts on gross margin of roughly $0.5 billion, and that's contemplated in our guidance.

從定價的角度來看，我們可以靈活地在某些業務領域調整價格，我們正在這樣做。這在營養等面向消費者的企業中更是如此。在業務的其他領域，這種靈活性是不存在的。所以我想說，總的來說，在這些逆風中，我們看到對毛利率的影響約為 5 億美元，這在我們的指導中有所考慮。

And I think as supply chains start to normalize over time, we would expect to see improving cost in some areas. For example, in commodities for Nutrition, those costs have kind of moved up and down historically over time. But currently, our kind of outlook doesn't assume any significant changes kind of versus the current dynamics that we're seeing in the market.

我認為隨著時間的推移供應鏈開始正常化，我們預計某些領域的成本會有所改善。例如，在營養商品中，這些成本隨著時間的推移在歷史上有所上下波動。但目前，我們的前景並未假設與我們在市場上看到的當前動態相比有任何重大變化。

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。

I have 2 questions. Maybe my first one was on the new product side. Robert, you made some comments on perhaps a consumer kind of product at CES at Lingo. I'm just curious, how do you see the opportunity here, right? It's slightly different perhaps from our perspective. But for Abbott, I mean, you guys have played in consumer markets. How big is this opportunity? Perhaps some sense for when U.S. launch timing could be. And should we expect more analytes, right? I think you guys had 4 analytes at CES, but I'm curious, is there -- are there other products expected to come down the pipeline?

我有 2 個問題。也許我的第一個是在新產品方面。羅伯特，你在 Lingo 的 CES 上對可能是一種消費類產品發表了一些評論。我只是好奇，你怎麼看這裡的機會，對吧？從我們的角度來看，這可能略有不同。但對於雅培，我的意思是，你們在消費市場上玩過。這個機會有多大？也許對美國的發射時間可能有些意義。我們應該期待更多的分析物，對嗎？我想你們在 CES 上有 4 種分析物，但我很好奇，有沒有其他產品預計會出現？

Sure, Vijay. So we made a decision to put a stake in the ground here and start talking about what we've always believed to be another opportunity, a sizable opportunity for Abbott, and that was really using the Libre platform that we had developed to look into other analytes, other areas. I talked about this recently, and quite frankly, we've talked about it several years ago also. And you referenced some of the analytes that we have been working on: ketones, lactate, alcohol, glucose for people with known diabetes. And those are big opportunities.

當然，維杰。因此，我們決定在這裡立足並開始談論我們一直認為是另一個機會，對雅培來說是一個相當大的機會，這實際上是使用我們開發的 Libre 平台來研究其他分析物，其他領域。我最近談到了這個，坦率地說，我們幾年前也談到過。您還提到了我們一直在研究的一些分析物：已知糖尿病患者的酮、乳酸、酒精、葡萄糖。這些都是巨大的機會。

As I've said, the model is a little bit different. It is probably a much larger TAM in terms of people, but the usage of the sensors is probably more intermittent than you would kind of get on a person, for example, with diabetes today, where we're very clear whether you're a type 1 on a pump or a type 1 injector or a type 2, like we know through the data we've covered here in terms of the usage patterns. So the usage pattern is a little bit different, but the sample size is significant.

正如我所說，模型有點不同。就人而言，它可能是一個更大的 TAM，但傳感器的使用可能比你對一個人的使用更加間歇性，例如，今天患有糖尿病，我們非常清楚你是否是一個泵上的 1 型或 1 型噴油器或 2 型，就像我們通過我們在此處介紹的使用模式方面的數據所知道的那樣。所以使用模式有點不同，但樣本量很大。

If you think about like a keto sensor and the opportunity to be able to provide real-time feedback for somebody who's trying to manage their keto diet, I think there's a large amount of people, large consumer pool that whether it's more disciplined keto diets or kind of more on an on-off basis, there's a very large amount of people. And we'll have to just think about how to market it a little bit differently, and our go-to-market strategy will be a little bit differently.

如果你想像一個酮傳感器和能夠為試圖管理酮飲食的人提供實時反饋的機會，我認為有大量的人，龐大的消費者群體，無論是更有紀律的酮飲食還是更多的是在斷斷續續的基礎上，有非常多的人。我們只需要考慮如何以不同的方式進行營銷，我們的市場營銷策略也會有所不同。

But I'd say -- we've always seen this as a big opportunity. And we funded it, and we have a separate team that is obviously leveraging the platform, but they're managed differently. They have a completely different organizational structure, and they're just focused on developing not only the technical side of the analytes but obviously doing all the market development work. So we're really, really in the early inning stages here, but I think the numbers could be pretty significant and pretty large. And why not? Over a good period of time, maybe it's even bigger than diabetes once you line these up.

但我想說——我們一直認為這是一個巨大的機會。我們資助了它，我們有一個獨立的團隊，顯然在利用這個平台，但他們的管理方式不同。他們有一個完全不同的組織結構，他們不僅專注於開發分析物的技術方面，而且顯然做所有的市場開發工作。所以我們真的，真的處於早期階段，但我認為這些數字可能非常重要而且非常大。那麼為何不？在很長一段時間內，一旦你把它們排好，也許它甚至比糖尿病更大。

The first phase of analytes, we announced at CES that this is our intention, that we were designing these. Timing, we expect to launch our first products outside of the United States towards the second half of this year. In the United States, we'll obviously be having the conversations with the agency in terms of how that regulatory path is going to shape up, probably a little bit too early right now to talk about that. But we're very excited about this opportunity because we've seen this opportunity many, many years back and made the moves.

分析物的第一階段，我們在 CES 上宣布這是我們的意圖，我們正在設計這些。時間上，我們預計將在今年下半年在美國以外推出我們的第一款產品。在美國，我們顯然會與該機構就監管路徑將如何形成進行對話，現在談論這個可能還為時過早。但是我們對這個機會感到非常興奮，因為我們在很多很多年前就看到了這個機會並採取了行動。

On your question about other analytes, yes, I would say Part 1 -- or Phase 1, I would say, is what I would call these more consumer-facing, more consumer-driven opportunities. But we are looking at other analytes that we probably have, I would say, more of a medical clinical application, whether it's in the hospital or for discharges, et cetera. So there is opportunity there that we're also working on. So I think it's very large, and we're just in the beginning right now in terms of market creation.

關於你關於其他分析物的問題，是的，我會說第 1 部分 - 或第 1 階段，我會說，我會稱之為這些更多面向消費者、更多由消費者驅動的機會。但我們正在研究我們可能擁有的其他分析物，我想說，更多的是醫學臨床應用，無論是在醫院還是出院等。所以那裡有機會，我們也在努力。所以我認為它非常大，我們現在在市場創造方面才剛剛開始。

That's helpful, Robert. And maybe my second question, in the balance sheet, I think you guys probably have over $40 billion of capacity right now conservatively. With valuations coming down, what kind of opportunities do you see? And one of the things that always frights me is Abbott is very large in diagnostics, #1, #2 in most of your end markets. If you look at diagnostics, liquid biopsy, cancer screening diagnostics is -- that's a massive opportunity, but I don't see Abbott having a stake in the ground in that area. Is that an area that would interest Abbott?

這很有幫助，羅伯特。也許我的第二個問題是，在資產負債表中，我認為你們現在保守地可能擁有超過 400 億美元的產能。隨著估值下降，您看到了什麼樣的機會？總是讓我害怕的一件事是雅培在診斷方面非常大，在大多數終端市場中排名第一、第二。如果你看一下診斷，液體活檢，癌症篩查診斷就是 - 這是一個巨大的機會，但我不認為雅培在該領域擁有股份。那是雅培感興趣的領域嗎？

Well, answer that specifically, I'm not going to necessarily show all of my cards here. But I guess what I will say regarding the M&A question here is yes, there's -- there seems to be some dislocation now. And I think this could make sense. If there's anything out there that looks strategic for us and that makes financial sense, then yes, we'll be -- we've got plenty of capacity, as you said. We've generated a lot of strong cash flow, and quite frankly, it's been a meaningful step-up in that cash flow over the last kind of 1.5 years or so. So yes, strategically financial fits, as I've always said, we're in a great position now to be able to look at that.

好吧，具體回答一下，我不一定會在這裡展示我所有的卡片。但我想關於併購問題我要說的是，是的，現在似乎有些混亂。我認為這可能是有道理的。如果有什麼對我們來說看起來具有戰略意義並且具有財務意義，那麼是的，我們會 - 正如你所說，我們有足夠的能力。我們已經產生了很多強勁的現金流，坦率地說，在過去 1.5 年左右的時間裡，這是現金流的一個有意義的提升。所以是的，正如我一直說的那樣，從戰略上講，我們現在處於一個很好的位置，可以看到這一點。

Devices and diagnostics, I will say, are the areas that we're looking at more carefully. Scott's team is always looking at everything, but he's got more special lens here in devices and diagnostics. The areas that you referenced are areas that are in the list of things that we would be interested in looking at.

我會說，設備和診斷是我們正在更仔細研究的領域。 Scott 的團隊總是關註一切，但他在設備和診斷方面有更多特殊的鏡頭。您引用的區域是我們有興趣查看的事物列表中的區域。

Tuck-in and medium-sized deals probably are more likely, if -- again, if those situations present themselves. But again, we're always looking at everything. So I would say yes, nothing has changed regarding what I've said about M&A, if it's strategic and it makes financial sense and we can deliver value for our shareholders. We are now in a great position as a result of all the efforts that we've had, quite frankly, on cash flow conversion. And now with kind of COVID cash, that also helps.

如果再次出現這些情況，則可能更有可能進行臨時交易和中型交易。但同樣，我們總是在關註一切。所以我會說是的，關於我所說的併購沒有任何改變，如果它具有戰略意義並且具有財務意義並且我們可以為我們的股東創造價值。坦率地說，由於我們在現金流轉換方面所做的所有努力，我們現在處於有利地位。現在有了某種 COVID 現金，這也有幫助。

Our next question comes from Josh Jennings from Cowen.

我們的下一個問題來自 Cowen 的 Josh Jennings。

Rob, just first, wanted to ask a question on 2022 guidance. And understand you don't want to put the top end of the range there and cap the upside. Clearly, there's a potential upside with the increased COVID testing outside of that $2.5 billion revenue stream that you're expecting in the early part of the year. But just in a scenario where COVID testing does fall off in that guidance for the revenue from that franchise turns into reality, can you just refresh us on some of the other levers you have that you can pull to drive EPS growth?

羅布首先想問一個關於 2022 年指導的問題。並且了解您不想將範圍的頂端放在那裡並限制上行空間。顯然，除了您在今年年初預期的 25 億美元收入流之外，增加 COVID 測試還有潛在的好處。但是，就在 COVID 測試確實在該特許經營收入的指導變成現實的情況下，您能否讓我們了解您可以拉動每股收益增長的其他一些槓桿？

I think last year, in June when COVID testing fell off, your team talked about share repurchase, accretive M&A, some cost-cutting reductions. But just wanted to get a refresh there and see if you could help us think through those levers.

我認為去年 6 月，當 COVID 測試下降時，您的團隊談到了股票回購、增值併購和一些成本削減。但只是想在那裡刷新一下，看看你是否可以幫助我們思考這些槓桿。

And then second question is just on the diabetes franchise. And clearly, Libre has a long runway. You're looking -- I believe you just talked about in one of your answers about the consumer opportunity. But how should we be thinking about the diabetes franchise and Abbott's desire to kind of leverage the positioning there with other products, either insulin delivery devices or other portfolio adds as we move into 2022 and beyond?

然後第二個問題只是關於糖尿病的特許經營權。顯然，Libre 的跑道很長。您正在尋找-我相信您剛剛在一個關於消費者機會的答案中談到了。但是，隨著我們進入 2022 年及以後，我們應該如何考慮糖尿病專營權以及雅培希望利用其他產品（無論是胰島素輸送設備還是其他產品組合）的定位？

Sure. On your first one, I mean, like I said, we derisked, we fully funded, and we've got the potential upside for the COVID testing. If COVID testing in that scenario, which I think is highly unlikely, kind of falls off, then we'll have to obviously look at kind of the investments we're making and kind of make the adjustments that we have to make, especially as we start to move into 2023.

當然。在您的第一個問題上，我的意思是，就像我說的那樣，我們放棄了風險，我們全額資助，並且我們有 COVID 測試的潛在優勢。如果在那種情況下，我認為極不可能的 COVID 測試有點下降，那麼我們顯然必須審視我們正在進行的投資，並做出我們必須做出的調整，尤其是在我們開始進入 2023 年。

I don't think that is the case. I think that COVID testing is going to be still around. I think Omicron has catalyzed a pretty significant shift in global rapid testing and screening. And the question here is just going to be how does it evolve over the next kind of 9 months, 12 months here.

我認為情況並非如此。我認為COVID測試仍然存在。我認為 Omicron 催化了全球快速檢測和篩查的重大轉變。這裡的問題只是它在接下來的 9 個月，這裡的 12 個月內如何發展。

So -- but that being said, to your question on that scenario, you'd have to make adjustments. As I've said, we would. But right now, I'm managing -- we're managing the enterprise as a whole, and we obviously got profits that are coming from COVID that we're reinvesting into the business. If that turns out to not be the case this year then, like I said, we're fully funded on our growth platforms. And then we'd have to kind of make adjustments or look at that investment level as we go into 2023.

所以 - 但是話雖如此，對於你在這種情況下的問題，你必須做出調整。正如我所說，我們會的。但現在，我正在管理——我們正在管理整個企業，我們顯然從 COVID 中獲得了利潤，我們正在將這些利潤重新投資到業務中。如果今年的情況並非如此，那麼就像我說的那樣，我們在增長平台上的資金充足。然後我們必須在進入 2023 年時進行調整或查看該投資水平。

Buybacks is another opportunity that we've got. We've got a lot of flexibility here also. Last year, we bought -- I think it was about $2 billion in 2021. And I'd anticipate being active in the market again this year since we do have that capacity.

回購是我們擁有的另一個機會。我們在這裡也有很大的靈活性。去年，我們購買了——我認為 2021 年的價格約為 20 億美元。我預計今年會再次活躍在市場上，因為我們確實有這樣的能力。

So -- and your second question, I think, was on diabetes, right, and growth opportunities. Is that -- could you just...

所以 - 我認為你的第二個問題是關於糖尿病，對，以及成長機會。那是——你能不能……

Sorry. Absolutely. Just thinking about anything you can share just in terms of internal development programs outside of advancing Libre in diabetes and on the consumer channel on the sensing side. Any other products within the diabetes device realm that you could add to the portfolio? Or should we be thinking about the diabetes franchise just sticking with the playbook that you have that's been so successful over the last number of years and has a long runway?

對不起。絕對地。除了在糖尿病領域推進 Libre 和在傳感方面的消費者渠道之外，想想你可以分享的任何內部開發計劃。您可以將糖尿病設備領域內的任何其他產品添加到產品組合中嗎？還是我們應該考慮糖尿病專營權只是堅持你在過去幾年中如此成功並且有很長的跑道的劇本？

Got it. Got it. So listen, yes, we're in the beginning here. There's still a lot of opportunities, still a lot of underpenetration, whether it's internationally or type 2s. As I've said, key aspect here is to ensure your pipeline is relevant and is advancing. We've launched Libre 3 in Europe, and we'll be expanding that launch now globally.

知道了。知道了。所以聽著，是的，我們剛剛開始。仍然有很多機會，仍然有很多滲透不足，無論是國際還是2型。正如我所說，這裡的關鍵方面是確保您的管道是相關的並且正在推進。我們已經在歐洲推出了 Libre 3，現在我們將在全球範圍內擴展該推出。

I expect to be able to bring Libre 3 here into the U.S. I won't necessarily get into the specifics, but I figured you guys would eventually ask this. We have filed Libre 3 here in the U.S. as an iCGM to the FDA last year. I won't get into specifics about timing there, but it's the -- review process happens in the same agency that reviews diagnostic tests. So as you would imagine, there's a lot of busy work going on with that area of the agency.

我希望能夠將 Libre 3 帶到美國。我不一定會詳細說明，但我想你們最終會問這個問題。去年，我們已在美國將 Libre 3 作為 iCGM 提交給 FDA。我不會詳細說明那裡的時間安排，但審查過程發生在審查診斷測試的同一機構中。因此，正如您想像的那樣，該機構的該領域正在進行大量繁忙的工作。

So we've obviously seen our data that we've submitted to the agency. We've obviously seen now data from a competitive system. And I'd say we're feeling pretty good about where we stand. So I think that's -- a key component there is to expand the portfolio.

所以我們顯然已經看到了我們提交給該機構的數據。我們現在顯然已經看到了來自競爭系統的數據。我想說我們對我們的立場感覺很好。所以我認為這是擴大投資組合的關鍵組成部分。

I've talked about Libre 4, not necessarily what exactly is that, but we do have that as an active program. Connecting to insulin delivery systems is also part of that strategy. And we've got active programs with all pump suppliers and pen delivery systems also to be able to connect Libre onto that.

我已經談到了 Libre 4，不一定是它到底是什麼，但我們確實將它作為一個活躍的程序。連接到胰島素輸送系統也是該策略的一部分。我們與所有泵供應商和筆輸送系統都有積極的計劃，也能夠將 Libre 連接到那裡。

So I think we'll stay focused on making the best sensor, sticking to our strategy of consumer-friendly, showing outcomes, price for access and affordability and continue to innovate with our sensor platform and then look at opportunities to use those sensors to not only expand into other platforms, but also to connect to other devices.

因此，我認為我們將繼續專注於製造最好的傳感器，堅持我們的消費者友好型戰略，展示成果、訪問價格和可負擔性，並繼續使用我們的傳感器平台進行創新，然後尋找使用這些傳感器的機會不僅擴展到其他平台，還可以連接到其他設備。

Our next question comes from Joanne Wuensch from Citibank.

我們的下一個問題來自花旗銀行的 Joanne Wuensch。

I have a big picture one and a specific one. Big picture, one of the themes of your keynote address at CES was the marriage of tech and medtech. And I'm curious if you could highlight how you sort of take that lens in terms of your product pipeline.

我有一張大圖和一張具體的圖。大局，您在 CES 上的主題演講的主題之一是科技與醫療科技的結合。我很好奇你是否可以強調你在產品管道方面是如何看待這個鏡頭的。

And then my specific question has to do with your Structural Heart franchise. Portico is out in the market, Amulet is out in the market, and I would love just a little bit of an update on how those products are doing.

然後我的具體問題與您的 Structural Heart 特許經營權有關。 Portico 已上市，Amulet 已上市，我很想了解一下這些產品的最新情況。

Sure. So yes, I've talked about this convergence. And quite frankly, we've seen this convergence occurring probably when we are doing the St. Jude acquisition and integration. And we started to set a lot of our portfolios to be able to connect to whether it's consumer electronics or cloud or other elements like that to ultimately be able to empower the consumer and just provide better solutions to ultimately improve outcomes.

當然。所以是的，我已經談到了這種融合。坦率地說，我們已經看到這種融合可能發生在我們進行 St. Jude 收購和整合時。我們開始設置很多產品組合，以便能夠連接到消費電子產品、雲或其他類似元素，最終能夠賦予消費者權力，並提供更好的解決方案，最終改善結果。

So I think you saw the device portfolio has been going down that path for quite some time now as very pleasantly -- very pleasant to see that start to look not only in the Cardiovascular side, also in the Neuromodulation side. As I said in my opening comments on our virtual clinic, I think that's got an opportunity to change the business model of that business, and at the same time, provide better outcomes for not only DBS but also spinal cord stimulation, too.

所以我認為你看到設備組合已經在這條道路上走了很長一段時間，非常令人愉快——很高興看到它不僅開始出現在心血管方面，還出現在神經調節方面。正如我在對我們虛擬診所的開場評論中所說，我認為這是一個改變該業務的商業模式的機會，同時，不僅可以為 DBS 提供更好的結果，還可以為脊髓刺激提供更好的結果。

So you've seen that in devices. We then started to see Diagnostics, and you saw over that thinking. As we developed Binax, we wanted to make sure that we were kind of integrating not just our expertise in developing an accurate test to be able to detect COVID, but also integrate it into an app where you can kind of have your pass and your phone, et cetera, and working with partners to be able to kind of do that. So I think you're seeing it across all of the portfolio.

所以你已經在設備中看到了這一點。然後我們開始看到診斷，你看到了這種想法。在開發 Binax 時，我們希望確保我們不僅整合了我們在開發能夠檢測 COVID 的準確測試方面的專業知識，而且還將其整合到一個應用程序中，您可以在其中獲得通行證和手機，等等，並與合作夥伴合作才能做到這一點。所以我認為你在所有的投資組合中都看到了它。

In our pharma business, we're using digital tools to be able to ensure that patients are taking their medications. So that's pretty -- I'd say, a strategic element going across all of our businesses and how we're thinking about it. So it's not -- I wouldn't say it's just one part of the portfolio, but I think it's a convergence that is happening, and we want to be leaders in that convergence across all of our portfolio.

在我們的製藥業務中，我們正在使用數字工具來確保患者服用藥物。所以這很漂亮——我想說，這是一個貫穿我們所有業務的戰略要素，以及我們如何思考它。所以它不是 - 我不會說它只是投資組合的一部分，但我認為這是一種正在發生的融合，我們希望在我們所有的投資組合中成為這種融合的領導者。

Regarding your question on Structural Heart. So I think you mentioned Portico and Amulet. Listen, Amulet, we received approval in Q3 last year, moved quickly to launch. I'd say initial feedback has been very strong, especially in the areas of superior closure rates, the need to be able to leave the hospital without blood thinners. And also, we've heard a lot of broader sizes to better fit more anatomies and give them more of that flexibility. So that's done very well.

關於你關於結構性心臟的問題。所以我想你提到了門廊和護身符。聽著，Amulet，我們在去年第三季度獲得批准，迅速啟動。我想說最初的反饋非常強烈，特別是在關閉率較高的領域，需要能夠在沒有血液稀釋劑的情況下離開醫院。而且，我們聽到了很多更寬的尺寸，以更好地適應更多的解剖結構並賦予它們更多的靈活性。所以這做得很好。

As part of the launch, we wanted to make sure that we had good proctoring -- good peer-to-peer proctoring. So obviously, that became a little bit of a challenge in November and December after Thanksgiving and into December. But I think despite all of that, I think we've done pretty well. I think we did about 500 procedures last year, mostly happening -- mostly in Q4. And if you look at what we did in December, that would put us at about a 10% market share, which is -- which I think is pretty good. Obviously, we're not satisfied with that, given what we know we can do and what we've done in Europe. But I think it's very much aligned to where we wanted to be regarding the end of the year and as we enter into 2022. So I think that's going very well.

作為發布的一部分，我們希望確保我們有良好的監考——良好的點對點監考。很明顯，這在感恩節之後的 11 月和 12 月以及進入 12 月變得有點挑戰。但我認為儘管如此，我認為我們做得很好。我認為我們去年做了大約 500 次手術，大部分發生在第四季度。如果你看看我們在 12 月所做的事情，那將使我們佔據大約 10% 的市場份額，這是 - 我認為這非常好。顯然，鑑於我們知道我們能做什麼以及我們在歐洲所做的事情，我們對此並不滿意。但我認為這與我們在今年年底和進入 2022 年時想要達到的目標非常一致。所以我認為這進展順利。

Portico, we're -- as I've said, this is an important area for Structural Heart. We know that there are 2 entrenched competitors in there. We think we've got a great technology also, and we're going about it very systematically, very methodically to build our position.

門廊，正如我所說，這是結構心臟的一個重要領域。我們知道那裡有兩個根深蒂固的競爭對手。我們認為我們也擁有一項偉大的技術，我們正在非常系統、非常有條不紊地開展這項工作，以建立我們的地位。

We launched our generation 2 product in Europe, our Navitor product. And again, that's received great feedback also, and there's a pretty competitive clinical profile here for high-risk surgery patients. So we're making the investments that we know we need to make to be able to expand our position here. So I feel good about our Structural Heart portfolio. I've talked about how this is a big opportunity for us. We've made the investments, and I think we're in a great position as we go into 2022.

我們在歐洲推出了我們的第二代產品，我們的 Navitor 產品。再一次，這也收到了很好的反饋，對於高風險手術患者來說，這裡有一個相當有競爭力的臨床概況。因此，我們正在進行我們知道需要進行的投資，以便能夠擴大我們在這裡的地位。所以我對我們的 Structural Heart 產品組合感覺良好。我已經談到這對我們來說是一個巨大的機會。我們已經進行了投資，我認為我們在進入 2022 年時處於有利地位。

Our next question comes from Matt Taylor from UBS.

我們的下一個問題來自瑞銀的馬特泰勒。

So I just had 2 margin questions I wanted to ask. The first one, I guess I'll frame it as, if we take the 1 50 from Q1, that implies about $1.06 to $1.07 for the remaining 3 quarters of the year. So is that how we should view your base business earnings power? Or are you still spending more through the year from some of the COVID testing profits or being conservative? Would love just any additional color on the base business earnings power ex testing.

所以我只有兩個想問的邊際問題。第一個，我想我會把它定義為，如果我們從第一季度取 1 50，這意味著今年剩餘 3 個季度的價格約為 1.06 美元至 1.07 美元。那麼我們應該如何看待您的基礎業務盈利能力？還是您在一年中仍然從一些 COVID 測試利潤中花費更多，還是保守？會喜歡基礎業務盈利能力測試中的任何其他顏色。

Yes. Matt, I'll take that. This is Bob. So we don't really think about earnings or at the bottom line base versus COVID. We manage the whole company. Obviously, the first quarter is benefiting from the majority of the COVID sales that we've got forecasted at this point in time, kind of our starting point. But we funded our growth throughout the rest of the quarter. So what you have is COVID testing, initial COVID testing sales in that first quarter, but our investments throughout the entire year. And so as we update our COVID testing each quarter, kind of as Robert talked about, that will fall through, certainly at a higher level than our overall margin profile.

是的。馬特，我會接受的。這是鮑勃。因此，我們並沒有真正考慮收益或與 COVID 相比的底線基礎。我們管理整個公司。顯然，第一季度受益於我們目前預測的大部分 COVID 銷售額，這是我們的起點。但我們在本季度剩餘時間內為我們的增長提供了資金。因此，您擁有的是 COVID 測試，第一季度的初始 COVID 測試銷售，但我們全年的投資。因此，當我們每個季度更新我們的 COVID 測試時，就像羅伯特所說的那樣，這將失敗，肯定會高於我們的整體利潤率。

I'd just add on to that, Matt, we absolutely expect there to be COVID testing after the first quarter. The question is at what level. And as I said in the beginning, to be able to kind of forecast a full year out like that, given the magnitude of how this can shift, it's just prudent to do it a quarter at a time. So when we're here in April, we'll have a better sense of what Q2 is going to look like in terms of COVID testing, and we'll be able to kind of update you there, okay?

我想補充一點，馬特，我們絕對希望在第一季度之後進行 COVID 測試。問題是在什麼水平。正如我在一開始所說的那樣，為了能夠像這樣預測一整年，考慮到這種變化的幅度，一次四分之一做一次是謹慎的。因此，當我們 4 月來到這裡時，我們將更好地了解第二季度在 COVID 測試方面的情況，我們將能夠在那裡向您更新，好嗎？

Got you. Can I just have one follow-up on -- so on gross margin, you mentioned that there was about $500 million headwind from inflation and supply chain. And so I guess if we add that back in, you're getting to gross margins closer to 60%. Ex that, I was just wondering if you could talk about expectations for gross margins going forward longer term if things normalize. And if you could kind of see those levels in 2023, if things improve or just pluses and minuses on gross margins longer term?

得到你。我可以就毛利率進行一次跟進，您提到通貨膨脹和供應鏈帶來了大約 5 億美元的逆風。所以我想如果我們把它加回來，你的毛利率就會接近 60%。例如，我只是想知道如果事情正常化，您是否可以談論對長期毛利率的預期。如果你能在 2023 年看到這些水平，如果情況有所改善，或者只是毛利率的長期利弊？

Well, I think the add back gets you a little bit below that. But the way we think about gross margin every year is looking for ways to expand that. Every one of our businesses has dedicated teams focused on gross margin initiatives. And you're seeing some of that benefit actually in our 2022 forecast helping to offset the impact of the inflation that we're seeing. We continue those programs. They are not a 1-year program. We do them every year, and we'll continue to do those into next year.

好吧，我認為加回來讓你比這個低一點。但我們每年對毛利率的看法都是在尋找擴大毛利率的方法。我們的每一項業務都有專門的團隊專注於毛利率計劃。您實際上在我們的 2022 年預測中看到了其中的一些好處，有助於抵消我們所看到的通貨膨脹的影響。我們繼續這些計劃。它們不是一個為期一年的計劃。我們每年都這樣做，我們將繼續這樣做到明年。

The other thing we're seeing is a benefit of kind of the business mix. So as medical devices and routine diagnostic testing recovers, that benefits our overall gross margin for the business. Obviously, Robert talked about a lot of the opportunity. Some of the opportunities is even more that we have to drive growth in our Medical Device business as well as in Diagnostics. And as we grow those businesses, that will have a positive impact overall on our gross margin profile.

我們看到的另一件事是業務組合的好處。因此，隨著醫療設備和常規診斷測試的恢復，這有利於我們的整體業務毛利率。顯然，羅伯特談到了很多機會。一些機會甚至更多，我們必須推動我們的醫療器械業務和診斷業務的增長。隨著我們發展這些業務，這將對我們的毛利率總體產生積極影響。

Okay. Let me wrap up here then. Thanks, Bob. Listen, I'll finish by saying a little bit how I started. I acknowledge that there's a lot of uncertainties in the macro environment right now and the challenges that, that creates in terms of forecasting for investors, at least in the short term: pandemic, how long will it last, phases, transition to endemic, recovery curves of procedures. I get some of the challenges of that forecast. But if I look at the market here at the start of the year and look at health care sector, specifically medtech and diagnostics, definitely been disproportionately hit by some of those uncertainties.

好的。那就讓我在這裡結束吧。謝謝，鮑勃。聽著，最後我會稍微說一下我是如何開始的。我承認，目前宏觀環境存在很多不確定性，這給投資者的預測帶來了挑戰，至少在短期內：大流行、持續多長時間、階段、向地方性過渡、復甦過程曲線。我得到了該預測的一些挑戰。但如果我看看今年年初的市場，看看醫療保健行業，特別是醫療技術和診斷，肯定會受到其中一些不確定性的不成比例的打擊。

And I think if you take a step back, I think it's important to remind ourselves the -- that health care still remains a very, very important need and a great long-term growth area because I think none of the long-term market fundamentals have changed in the pandemic. If anything, some of them have gotten even better and accelerated. So I think the demographic trends are still very favorable.

我認為，如果你退後一步，我認為重要的是要提醒自己——醫療保健仍然是一個非常非常重要的需求和一個巨大的長期增長領域，因為我認為沒有任何長期市場基本面在大流行中發生了變化。如果有的話，其中一些已經變得更好並加速了。所以我認為人口趨勢仍然非常有利。

And procedures and routine testing, they're going to come back, whether it's a month, 2 months, et cetera. It's just difficult to predict with that perfect degree of precision, but they'll come back. And if you look at the innovation pipelines across the entire industry, they have never been stronger. And within that context, I think Abbott's pretty uniquely positioned here. We're in great markets, leading positions in several large, fast-growing segments: diabetes; devices; diagnostics, including COVID testing; nutrition; emerging market, pharma. We have strong positions, brands, franchises across all of these.

以及程序和常規測試，他們會回來，無論是一個月、兩個月等等。很難以完美的精確度進行預測，但它們會回來的。如果你看看整個行業的創新管道，它們從未如此強大。在這種情況下，我認為雅培在這裡的定位非常獨特。我們在巨大的市場中處於領先地位，在幾個快速增長的大型細分市場中處於領先地位：糖尿病；設備;診斷，包括 COVID 檢測；營養;新興市場，製藥。我們在所有這些方面都擁有強大的地位、品牌和特許經營權。

So -- and to one of the questions, I think we're leading in the digital transformation that's going to be more patient-centric care, whether it's with biowearables, whether it's connected devices, remote monitoring, et cetera. And then you layer that diversification that I talked about in my opening comments, which I think is very unique, it maximizes our growth opportunities, and it does provide a natural hedge to some of these macro environment impacts that we're going to see from time to time. And that diversity is not just on the business mix, but customers, payer types, obviously, geographic footprint and a very strong and resilient supply chain.

所以 - 對於其中一個問題，我認為我們正在引領數字化轉型，這將更加以患者為中心，無論是生物可穿戴設備，還是連接設備、遠程監控等等。然後你將我在開幕評論中談到的多元化分層，我認為這是非常獨特的，它最大限度地增加了我們的增長機會，並且它確實為我們將看到的一些宏觀環境影響提供了自然對沖不時。這種多樣性不僅體現在業務組合上，還體現在客戶、付款人類型、地理足跡和非常強大且有彈性的供應鏈上。

So you translate all that into real strong, sustainable, strategic financial health, whether it's growing revenues, cash flows, dividends. We've got a rock-solid balance sheet. I talked about the opportunities that we have with it. So I think we're in a really good position strategically, financially, and I'm excited about all the growth opportunities that lie ahead of us.

因此，您將所有這些轉化為真正強大、可持續的戰略財務健康，無論是收入增長、現金流量還是股息。我們擁有堅如磐石的資產負債表。我談到了我們擁有的機會。因此，我認為我們在戰略上、財務上都處於非常有利的位置，我對擺在我們面前的所有增長機會感到興奮。

So with that, I'll wrap it up and I'll thank everybody for joining us today.

因此，我會總結一下，感謝大家今天加入我們。

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 a.m. Central Time today on Abbott's Investor Relations website at abbottinvestor.com. Thank you for joining us.

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。今日美國中部時間上午 11 點後，將在雅培投資者關係網站 abbottinvestor.com 上重播此次電話會議的網絡直播。感謝您加入我們。

Thank you. This concludes today's conference call. Thank you for participating. 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。