美國雅培 (ABT) 2024 Q3 法說會逐字稿

Good day, and thank you for standing by. Welcome to Abbott's third-quarter 2024 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.

美好的一天，感謝您的支持。歡迎參加雅培 2024 年第三季財報電話會議。 （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; and Phil Boudreau, Executive Vice President, Finance and Chief Financial Officer. Robert and Phil will provide opening remarks. Following their comments, we'll take your questions.

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)； Phil Boudreau，財務執行副總裁兼財務長。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。

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. 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, 2023.

在我們開始之前，根據1995 年《私人證券訴訟改革法案》，今天發表的一些聲明可能具有前瞻性，包括2024 年的預期財務業績。的影響。我們截至 2023 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. 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.

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，除非法律要求。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。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. Thank you for joining us. Today, we reported organic sales growth of more than 8%, excluding COVID testing sales and adjusted earnings per share of $1.21. In addition to delivering another quarter of strong financial performance, we accomplished several key objectives this quarter, which included entering new strategic partnerships, launching new products, and making several key advancements in our R&D pipeline. And I'll elaborate further on these accomplishments when discussing the performance of our businesses and summarize our third-quarter results in more detail before turning the call over to Phil.

謝謝，麥克。大家早安。感謝您加入我們。今天，我們報告有機銷售額成長超過 8%，不包括新冠病毒檢測銷售額和調整後每股收益 1.21 美元。除了再創一個季度強勁的財務業績之外，我們本季還實現了幾個關鍵目標，其中包括建立新的策略合作夥伴關係、推出新產品以及在研發管道方面取得多項關鍵進展。在討論我們的業務業績時，我將進一步詳細闡述這些成就，並在將電話轉交給菲爾之前更詳細地總結我們的第三季業績。

And I'll start with nutrition, where sales increased 3.5% in the quarter. Growth in the quarter was led by double-digit growth in the US, and this included growth of 12% in US pediatric nutrition driven by market share gains in the infant formula business and growth of 11.5% in US adult nutrition led by our market-leading Ensure and Glucerna brands. As the market leader in adult nutrition, we continue to expand our portfolio to meet the growing global demand for products that offer a combination of high protein, low sugar to help people optimize their health and wellness.

我將從營養品開始，該季度銷售額增長了 3.5%。本季的成長主要由美國的兩位數成長帶動，其中包括嬰兒配方奶粉業務市佔率成長推動的美國兒科營養成長 12%，以及我們的市場主導的美國成人營養成長 11.5%。品牌。作為成人營養市場的領導者，我們不斷擴大我們的產品組合，以滿足全球對高蛋白、低糖組合產品不斷增長的需求，幫助人們優化健康狀況。

Moving to diagnostics. Our sales in core laboratory diagnostics increased 4.5% excluding COVID testing sales. Growth in core lab was driven by global demand for routine diagnostic testing and continued adoption of our market-leading diagnostic systems and testing platforms, including recent large account wins that will help continue to sustain our growth into 2025.

轉向診斷。不包括新冠病毒檢測銷售額，我們的核心實驗室診斷銷售額成長了 4.5%。核心實驗室的成長是由全球對常規診斷測試的需求以及我們市場領先的診斷系統和測試平台的持續採用所推動的，包括最近贏得的大客戶，這將有助於我們繼續維持成長到 2025 年。

In our rapid and point-of-care diagnostics businesses, we continue to expand our test menus and capitalize on the growing demand for respiratory tests that can be performed at home or in more traditional healthcare settings. In September, we announced an exciting new partnership with the Big Ten conference to help boost the US blood supply through a blood donation competition. Students, alumni, and fans can donate blood for any of the 18 member universities at blood centers located across the country. And our goal with this competition is to help rebuild the nation's blood supply which is currently at an extremely low level, while also helping to create a new generation of blood donors.

在我們的快速和即時診斷業務中，我們繼續擴大我們的測試選單，並利用對可以在家中或更傳統的醫療保健環境中進行的呼吸測試不斷增長的需求。九月，我們宣布與十大會議建立令人興奮的新合作關係，透過捐血競賽幫助增加美國的血液供應。學生、校友和粉絲可以在全國各地的血液中心為 18 所成員大學中的任何一所捐血。我們舉辦這次比賽的目標是幫助重建目前處於極低水平的國家血液供應，同時幫助培養新一代的捐血者。

Turning to EPE, where sales increased 7% in the quarter. Growth was well balanced across the markets and therapeutic areas in which we participate. Our performance this quarter was driven by double-digit growth in several countries across Latin America, Southeast Asia, and the Middle East, where our broad product portfolios focused on addressing local market needs continues to enhance our unique position in these markets.

至於 EPE，該季度銷售額成長了 7%。我們參與的市場和治療領域的成長非常平衡。我們本季的業績受到拉丁美洲、東南亞和中東多個國家兩位數成長的推動，我們廣泛的產品組合專注於滿足當地市場需求，並繼續增強我們在這些市場的獨特地位。

From a portfolio perspective, we continue to deliver broad-based growth across our key therapeutic areas of focus, including strong growth in the quarter in the areas of gastroenterology, cardiometabolic, central nervous system, and pain management. We also achieved several milestones this quarter as it relates to advancing our portfolio of biosimilars, which we built and continue to expand through collaboration agreements. The first of these biosimilars is on track to launch in emerging markets in late 2025. And I'll wrap up with our med tech portfolio, where sales grew more than 13%.

從投資組合的角度來看，我們繼續在重點治療領域實現廣泛成長，包括本季胃腸病學、心臟代謝、中樞神經系統和疼痛管理領域的強勁成長。本季我們也實現了幾個里程碑，因為這與推進我們的生物相似藥產品組合有關，我們透過合作協議建立並繼續擴大該產品組合。第一款生物相似藥預計在 2025 年底在新興市場推出。

In diabetes care, sales of continuous glucose monitors exceeded $1.6 billion in the quarter and grew 21%. In August, we announced that we had entered into a unique global partnership with Medtronic to connect Abbott's world-leading FreeStyle Libre CGM sensor with their automated insulin delivery systems. Abbott now has partnerships with five of the largest companies that offer automated insulin dosing pumps, allowing more people around the world to benefit from the connectivity with the Libre technology.

在糖尿病照護領域，連續血糖監測儀的銷售額本季超過 16 億美元，成長 21%。 8 月，我們宣布與 Medtronic 建立了獨特的全球合作夥伴關係，將 Abbott 世界領先的 FreeStyle Libre CGM 感測器與其自動胰島素輸送系統連接起來。 Abbott 目前與五家提供自動胰島素劑量幫浦的最大公司建立了合作夥伴關係，讓世界各地更多的人受益於 Libre 技術的連接。

In September, we announced the US launch of Lingo, our new glucose monitoring sensor available for purchase without a prescription. The Lingo wearable sensor and app track real-time glucose data and provide personal insights in coaching based on your body's reaction to nutrition, exercise, and other lifestyle choices to help create healthier habits and improve overall well-being.

9 月，我們宣佈在美國推出 Lingo，這是我們的新型血糖監測感測器，無需處方即可購買。 Lingo 穿戴式感測器和應用程式追蹤即時血糖數據，並根據您的身體對營養、運動和其他生活方式選擇的反應提供個人指導見解，幫助養成更健康的習慣並改善整體健康。

In electrophysiology, growth of 14% was driven by double-digit growth in both the US and international markets, and similar to previous quarters, the growth was broad based across the portfolio, including double-digit growth in catheters and cardiac mapping-related products.

在電生理學領域，美國和國際市場的兩位數成長推動了 14% 的成長，與前幾季類似，整個產品組合的成長基礎廣泛，包括導管和心臟測繪相關產品的兩位數成長。

We also achieved several important milestones as it relates to our electrophysiology new product pipeline, and this includes completing enrollment ahead of schedule in our VOLT-AF US IDE trial, and after we complete the required patient follow-up phase, we expect to file for FDA approval next year. Earlier this month, we announced that we began enrolling patients in our focal FLEX clinical trial. This is designed to assess our new TactiFlex DUO catheter, which offers physicians the option of using PFA and radiofrequency energy to treat atrial fibrillation.

我們還實現了與我們的電生理學新產品管道相關的幾個重要里程碑，其中包括提前完成 VOLT-AF US IDE 試驗的註冊，在我們完成所需的患者隨訪階段後，我們預計將申請明年FDA 批准。本月早些時候，我們宣布開始招募患者參加我們的焦點 FLEX 臨床試驗。旨在評估我們的新型 TactiFlex DUO 導管，該導管為醫生提供了使用 PFA 和射頻能量治療心房顫動的選擇。

And finally, we received FDA approval and launched our new adviser HD Grid X mapping catheter, which further enhances the cardiac mapping process when using PFA or RF ablation catheters to treat AFib.

最後，我們獲得了 FDA 的批准，並推出了新的顧問 HD Grid X 標測導管，該導管進一步增強了使用 PFA 或射頻消融導管治療 AFib 時的心臟標測過程。

In structural heart, growth of more than 16% was driven by growth across our market-leading comprehensive portfolio of surgical valves, structural interventions, and transcatheter repair and replacement products.

在結構性心臟領域，超過 16% 的成長是由我們市場領先的手術瓣膜、結構性幹預以及經導管修復和替代產品等綜合產品組合的成長所推動的。

This quarter, we continue to capture market share in TAVR and saw accelerating adoption of Amulet and TriClip, which we launched in the US earlier this year. And earlier this month, CMS began the process of evaluating TriClip for a national coverage determination, which, if approved, would help expand the addressable market through broader access in the US for this first of its kind technology.

本季度，我們繼續佔領 TAVR 市場份額，並見證了今年早些時候在美國推出的 Amulet 和 TriClip 的加速採用。本月早些時候，CMS 開始評估 TriClip 的全國覆蓋範圍確定過程，如果獲得批准，將有助於透過在美國更廣泛地使用這種同類技術來擴大潛在市場。

In rhythm management, growth of 7% was led by AVEIR, our highly innovative leadless pacemaker, and Assert, our newest implantable cardiac monitor which launched in the US last year. In heart failure, growth of 14% was driven by our market-leading portfolio of heart-assist devices which offer treatment for chronic and temporary conditions. In vascular, growth of 5% was led by double-digit growth in vessel closure and coronary imaging, along with Esprit, our below-the-knee resorbable stent that launched in the US in the second quarter. And lastly, in neuromodulation, sales grew 5% driven by strong demand in international markets for our rechargeable spinal cord stimulation device.

在節律管理方面，我們高度創新的無引線起搏器 AVEIR 和去年在美國推出的最新植入式心臟監測儀 Assert 引領了 7% 的成長。在心臟衰竭方面，我們市場領先的心臟輔助設備產品組合推動了 14% 的成長，這些設備為慢性和暫時性疾病提供治療。在血管領域，血管閉合和冠狀動脈成像的兩位數增長以及我們第二季度在美國推出的膝下可吸收支架 Esprit 帶動了 5% 的增長。最後，在神經調節領域，由於國際市場對我們的可充電脊髓刺激設備的強勁需求，銷售額成長了 5%。

So in summary, we delivered another quarter of strong topline growth with sales growing more than 8%. We continue to make good progress expanding our gross margin profile and remain on track to improve our profile by 75 basis points on a full-year basis compared to last year. And as you saw, we achieved several important new product pipe loan milestones this quarter, and we're well positioned for a strong finish to the year and have great momentum heading into 2025.

總而言之，我們又一個季度實現了強勁的營收成長，銷售額成長了 8% 以上。我們在擴大毛利率方面繼續取得良好進展，並預計全年比去年提高 75 個基點。正如您所看到的，我們本季實現了幾個重要的新產品管道貸款里程碑，我們已做好充分準備，以強勁的勢頭結束今年的工作，並在進入 2025 年時保持強勁的勢頭。

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

我現在將把電話轉給菲爾。

Thanks, Robert. As Mike mentioned earlier, please note that all references to sales growth rates, unless otherwise noted, are on an organic basis.

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。

Turning to our third-quarter results. Sales increased 7.6% on an organic basis and increased 8.2% when excluding COVID testing sales. Foreign exchange had an unfavorable year-over-year impact of 2.5% on third-quarter sales. During the quarter, we saw the US dollar weaken versus several currencies, which resulted in a favorable impact on sales compared to exchange rates at the time of our call in July.

轉向我們的第三季業績。銷售額有機成長 7.6%，不包括新冠檢測銷售額則成長 8.2%。外匯對第三季銷售額較去年同期產生了 2.5% 的不利影響。在本季度，我們看到美元兌多種貨幣走弱，與我們 7 月電話會議時的匯率相比，這對銷售產生了有利的影響。

Regarding other aspects of the P&L. The adjusted gross margin ratio was 56.3% of sales. Adjusted R&D was 6.5% of sales, and adjusted SG&A was 27.2% of sales in the third quarter. Lastly, our third-quarter adjusted tax rate was 15%.

關於損益表的其他方面。調整後毛利率佔銷售額的56.3%。第三季度，調整後的研發佔銷售額的 6.5%，調整後的 SG&A 佔銷售額的 27.2%。最後，我們第三季調整後的稅率為 15%。

Turning to our outlook for the fourth quarter, we forecast adjusted earnings per share guidance of $1.31 to $1.37, and based on current rates, we expect exchange to have an unfavorable impact of less than 1% on fourth-quarter reported sales.

談到我們對第四季度的展望，我們預測調整後每股收益指引為 1.31 美元至 1.37 美元，並且根據當前匯率，我們預計匯率對第四季度報告銷售額的不利影響不到 1%。

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

至此，我們將開始提問。

(Operator Instructions) Travis Steed, BofA Securities.

（操作員指示）Travis Steed，美國銀行證券。

In Q3 devices were really strong, but nutrition and diagnostics came in below expectations, but you still maintain the full year guidance, which is implying a step up of 9.5% or more growth in Q4. So I just want to understand what happened in those divisions in Q3? And what's giving you the confidence to still reiterate the full year revenue guidance?

第三季的設備確實很強勁，但營養和診斷的表現低於預期，但您仍然維持全年指導，這意味著第四季度的成長將達到 9.5% 或更多。所以我只想了解第三季這些部門發生了什麼事？是什麼讓您有信心繼續重申全年收入指引？

Sure, Travis. Listen, we got the multiple business units here. I think, by my count, it's close to like 17. We always want all 17 to beat and top your estimates here. The reality is sometimes some of them fall short. And then the question is, is there something more long term? Is it more of a one-time kind of challenge? I'd put that more in the second bucket over here.

當然，特拉維斯。聽著，我們這裡有多個業務部門。我認為，根據我的統計，它接近 17 個。現實是有時他們中的一些人達不到要求。那麼問題來了，還有更長遠的事情嗎？這更像是一次性的挑戰嗎？我會把更多的東西放在第二個桶子裡。

I think one of the benefits that we do have in having a broad diversified portfolio is that when you do have situations like that, Travis, other businesses can overperform and make up for that. And I think that's what you saw in this quarter. I mean, you opened your question with devices did really good, and that's what helped us deliver on our quarter.

我認為，我們擁有廣泛的多元化投資組合的好處之一是，當你確實遇到這種情況時，特拉維斯，其他企業可以表現出色並彌補這一點。我認為這就是您在本季度看到的情況。我的意思是，您提出的問題中設備表現非常好，這就是幫助我們實現本季業績的原因。

And as you look forward to Q4, yeah, we do have still very high confidence in the businesses. If I was at all concerned about it, I wouldn't have raised our guidance now for the third time this year. So yeah, we're still very confident in both the EPS forecast that we've got. I think this is a great quarter now as we're into Q4, and there's less COVID comps. We'll see our EPS grow double digits back to the growth model that we had during pre-COVID.

當您期待第四季度時，是的，我們確實對業務仍然充滿信心。如果我真的擔心這個問題，我今年就不會第三次提高我們的指導意見了。所以，是的，我們對我們的每股盈餘預測仍然非常有信心。我認為現在是一個很棒的季度，因為我們已經進入第四季度，而且新冠肺炎疫情的影響也減少了。我們將看到我們的每股盈餘以兩位數的速度成長，回到新冠疫情爆發前的成長模式。

And yeah, revenue at that 9.5% to 10% still feel very good about that. The issues that you raised there are one-time in nature. On nutrition, the entire business did really well with the exception of our international pediatric business. US was up 12%; pediatric, US adult was up almost 12%, international adult was up high single digits.

是的，9.5% 到 10% 的收入仍然讓人感覺非常好。你在那裡提出的問題是一次性的。在營養方面，除了我們的國際兒科業務外，整個業務都表現得非常好。美國上漲12%；兒科、美國成人成長了近 12%，國際成人則成長了高個位數。

So what ended up happening there is we saw some softness in the beginning of the quarter in some of our international markets for pediatric team quickly determined that it wasn't market. It was actually us, and it was our commercial execution or lack thereof that was leading to some share loss. So team took action pretty quickly in the quarter.

因此，最終發生的事情是，我們在本季初看到我們的一些國際市場出現了一些疲軟，兒科團隊很快就確定這不是市場。實際上是我們，正是我們的商業執行力或缺乏商業執行力導致了一些份額的損失。因此團隊在本季很快就採取了行動。

We made some personnel changes, we calibrated our demand generation and -- but what ended up happening in the quarter there as a result of that share loss is we didn't want to build excess inventory, so we shorted our sales to the distributors just to align that. But I feel good about what the team has put together.

我們進行了一些人事變動，我們調整了需求生成，但由於份額損失，該季度最終發生的情況是我們不想建立過多的庫存，所以我們只賣空了對分銷商的銷售來對齊。但我對團隊所做的一切感到滿意。

Early indications show that that was the right move to do, and we've seen good progress there. So yeah, disappointed, but the team knows that, and they acted quickly. So I expect to see international pediatric and overall nutrition growth step up in the quarter. It doesn't change my thinking about nutrition for the quarter or for next year, for the long-term aspect of it, just something that we had to address.

早期跡象表明，這是正確的舉措，而且我們已經看到了良好的進展。是的，很失望，但團隊知道這一點，並且迅速採取了行動。因此，我預計本季國際兒科和整體營養的成長將加快。從長遠來看，這並沒有改變我對本季或明年營養的看法，只是我們必須解決的問題。

And then I think you mentioned Core Lab also came a little bit shorter than expectations. I'd say there, really, the driver of that was just the VBP implementation in China. If you look at our core nab business, our international core lab business, excluding China, the international business was up double digits. So the teams in those markets are doing really well.

然後我認為你提到的核心實驗室也比預期短。我想說，實際上，這就是 VBP 在中國的實施。如果你看看我們的核心實驗室業務，我們的國際核心實驗室業務（不包括中國），國際業務成長了兩位數。所以這些市場的團隊做得非常好。

And I've mentioned this in January, we were going to see the VBP impact the core lab business. We had originally forecasted in April. It got delayed and pushed out to Q3. If you look at our growth rate in the first half of this year, it was over 7%.

我在一月份提到這一點，我們將看到 VBP 對核心實驗室業務的影響。我們最初預測是四月。它被推遲並推遲到第三季。你看我們今年上半年的成長率，超過7%。

And some of that favorability that we saw in the business and that we rolled into higher guidance as a result of a little bit of that delay here. So we'll go through the VBP transition. We've done it in a lot of our businesses. There's the pricing impact going forward, there's some transition-related items that happen, whether you're making pricing accommodations for the inventory that's already in the channel, et cetera. So I still feel very good about the business we've got there. I feel good about China continues to be a very attractive market for us. So we'll just work our way through this.

我們在業務中看到了一些好感度，並且由於這裡的一點延遲，我們將其納入了更高的指導。所以我們將經歷 VBP 轉換。我們在很多業務中都做到了這一點。未來會產生定價影響，會發生一些與過渡相關的項目，無論您是否為通路中已有的庫存進行定價調整，等等。所以我對我們在那裡的業務仍然感覺非常好。我對中國仍然是一個對我們非常有吸引力的市場感到滿意。所以我們會努力解決這個問題。

But to your question on the quarter, yes, we feel good about the quarter. I wouldn't have kept the guidance if we didn't. We've got great momentum in the business. We're meeting with the management team yesterday. They're very committed and feel good about the momentum. So I think we'll have a very good year with a good strong close in Q4.

但對於你關於本季的問題，是的，我們對本季感覺良好。如果我們不這樣做，我就不會保留指導。我們的業務勢頭強勁。昨天我們與管理團隊會面。他們非常投入並且對這種勢頭感覺良好。因此，我認為我們將度過非常好的一年，並在第四季度取得良好的收官成績。

Larry Biegelsen, Wells Fargo.

拉里·比格爾森，富國銀行。

Robert, I wanted to ask about Libre and just big picture. You had 21% growth in Libre in Q3, which was good, but your competitors obviously having some issues. So it would be helpful to hear your view of the state of the CGM market, talk about your confidence in the overall CGM market outlook and your goal of $10 billion in sales by 2028, and maybe just give us some color on what you're seeing so far with Lingo.

羅伯特，我想問 Libre 和大局。第三季度，Libre 成長了 21%，這很好，但你的競爭對手顯然有一些問題。因此，聽聽您對CGM 市場狀況的看法、談談您對整體CGM 市場前景的信心以及您到2028 年實現100 億美元銷售額的目標，也許只是給我們一些關於您的目標的信息，將會很有幫助。

Yeah, sure. Larry, I've always been very bullish about this market and talk about this market a little bit differently than when we talk about general med tech markets, right? This is a mass market opportunity that we have.

是的，當然。拉里，我一直非常看好這個市場，並且談論這個市場與我們談論一般醫療技術市場時有點不同，對嗎？這是我們擁有的大眾市場機會。

And yeah, we grew 21%. US was actually up 26%, and we feel good about the market. The fundamentals are still very much there, and they're still very much intact. This is -- you've got about 10 million CGM users globally, I think, right now. And you got over 100 million diabetics in the developed world, over 0.5 billion globally.

是的，我們成長了 21%。美國實際上上漲了 26%，我們對市場感覺良好。基本面仍然存在，而且仍然完好無損。我認為，目前全球約有 1,000 萬 CGM 用戶。已開發國家有超過 1 億名糖尿病患者，全球有超過 5 億。

So yeah, I think this is a market that has got mass market potential to it. As long as you stay ahead from a technology perspective, as long as you stay ahead from a scale perspective, as long as you stay ahead from a cost perspective, for me, those are the three elements here that allow us and have guided our strategy from day one.

所以，是的，我認為這是一個具有巨大市場潛力的市場。只要你從技術角度保持領先，只要你從規模角度保持領先，只要你從成本角度保持領先，對我來說，這就是允許我們並指導我們策略的三個要素從第一天開始。

And I don't think that you're going to have some changes in the market when you've got a market that's, whatever, $12 billion, $13 billion, growing 15%. There'll be more players for sure, there'll be more competition for sure. But we feel good about our position and the strategy that we've built.

我認為，當市場規模達到 120 億美元、130 億美元、成長 15% 時，市場不會有任何變化。肯定會有更多的玩家，一定會有更多的競爭。但我們對我們的地位和我們所製定的策略感到滿意。

We've thought about this not just for the next year, we've been thinking about this, what is it going to look like a decade from now and how we built our portfolio and our position. So I feel very good about this market. And I don't think there's anything fundamentally here that's significantly changed, at least from our internal way of thinking about it. So yeah, I think this is a great opportunity for us. Libre is -- it will be a $6 billion-plus product. It will grow 20% this year. When we put out the $10 billion target, Larry, we talked about a compound annual growth rate of 15%.

我們不僅在明年考慮這個問題，我們一直在考慮這個問題，十年後會是什麼樣子，以及我們如何建立我們的投資組合和我們的地位。所以我對這個市場感覺非常好。我不認為這裡有任何根本性的改變，至少從我們內在的思考方式來看是這樣。所以，是的，我認為這對我們來說是一個很好的機會。 Libre 將會是一款價值超過 60 億美元的產品。今年將成長20%。拉里，當我們提出 100 億美元的目標時，我們談到了 15% 的複合年增長率。

So we're ahead of that, and we're going to work hard to make sure that we stay ahead of that, and we continue to gain share. We'll add $1 billion of revenue this year, add 1 million users. You got opportunities in type 1s on the pump side, on the connectivity side with pens. You've got opportunities with type 2s and basal. I mean, I think that's just really still so much opportunity in those markets. So I feel very good about it.

因此，我們處於領先地位，我們將努力確保我們保持領先地位，並繼續獲得份額。今年我們將增加 10 億美元的收入，增加 100 萬用戶。你在幫浦端、連接端和筆的類型 1 中都有機會。您有機會使用 2 型和基礎型。我的意思是，我認為這些市場仍然有很多機會。所以我對此感覺非常好。

And as we've talked about Libre, we always viewed it as a platform. So you mentioned Lingo, glad to see that launch. Just as a reminder, we're really focusing on a very different population with this technology, right? We're targeting people that don't have diabetes. So it's a little bit of a different kind of business model, sale model. But so far, we've seen really, really good early interest.

當我們談論 Libre 時，我們始終將其視為一個平台。所以你提到了 Lingo，很高興看到它的發布。提醒一下，我們確實在利用這項技術來關注非常不同的人群，對吧？我們的目標族群是沒有糖尿病的人。所以這是有點不同的商業模式，銷售模式。但到目前為止，我們已經看到了非常非常好的早期興趣。

Great, great feedback from the users so far. The app, the data, the website, the website, the delivery, the whole nonprescription stuff. That's working out very well. The two-sensor pack is the most popular version right now. And I think that's a good -- it's a great way to start.

到目前為止，用戶的回饋非常好。應用程式、資料、網站、網站、交付，所有非處方的東西。這效果非常好。兩個感測器包是目前最受歡迎的版本。我認為這是一個很好的開始。

I was looking at some of the initial reorder rates that came in last night. And wow, was I surprised at really, really much higher reorder rates than what we saw in the UK. And I thought that -- I think the team did a really good job at adapting some of the learnings from the UK into that.

我正在查看昨晚收到的一些初始再訂購率。哇，令我驚訝的是，再訂購率比我們在英國看到的要高得多。我認為——我認為團隊在將英國的一些經驗融入其中方面做得非常好。

So I think overall, over time, this is going to be a great opportunity to be able to add to that $10 billion target as we build this user base out. So overall, back to your question on Libre, I feel very good about our position, what we're doing, and Lingo is off to a very good start.

因此，我認為總的來說，隨著時間的推移，這將是一個很好的機會，能夠在我們建立這個用戶群的同時實現 100 億美元的目標。總的來說，回到你關於 Libre 的問題，我對我們的立場和我們正在做的事情感覺非常好，Lingo 有了一個非常好的開始。

Robbie Marcus, JPMorgan.

羅比馬庫斯，摩根大通。

Congrats on a nice quarter. Robert, I wanted to ask this time of the year, we all -- we're looking for fourth quarter, but we're also turning our focus to 2025. I see The Street sitting at about 7% on the top line, 10% on the bottom line. I wanted to see if you had any comments about how you feel about that or your view into next year, realizing it's still on the early side?

恭喜您度過了一個美好的季度。羅伯特，我想問每年的這個時候，我們都在尋找第四季度，但我們也將重點轉向 2025 年。我想看看您對此有何看法，或者您對明年的看法，意識到它仍然處於早期階段？

Yeah. It's a little early to give real specific guidance there, Robbie. But similar to you, we're also looking at '25. We've been looking at '25 also as part of our strategic planning process here, too. So yeah, this is the time of the season, right?

是的。羅比，現在給出真正的具體指導還為時過早。但與您類似，我們也在關注'25。我們也一直將 '25 視為我們策略規劃流程的一部分。是的，現在是這個季節的時候，對嗎？

I'd say, yeah, similar to last year, I look at the analyst estimates going into 2025, high single-digit growth, 10% EPS. And like I said last year, that feels like a very reasonable starting point. I think the difference going into 2025 versus when we were coming into 2024 is, as we go into 2025, one of the things that we don't have is what I would call the COVID cloud at least for a couple of the quarters ahead of us.

我想說，是的，與去年類似，我看看分析師對 2025 年的預測，高個位數成長，每股收益 10%。正如我去年所說，這感覺是一個非常合理的起點。我認為進入 2025 年與進入 2024 年時的區別在於，當我們進入 2025 年時，我們所沒有的東西之一就是我所說的新冠雲，至少在未來幾個季度裡是這樣。

And that masked a little bit of our underlying base EPS business growth. So I am looking forward to, in a way, not having that be this comp issue. But I think the high single-digit, 10% EPS, yeah, that sounds like a very, I'd say, a reasonable starting point. But if I take a step back also, I look at that and say, okay, here we have a company that's $40 billion in revenue, and we've been driving high single to high single-digit top line growth. I think that's pretty unique for us.

這掩蓋了我們基本每股盈餘業務成長的一些基礎。因此，在某種程度上，我期待著不要出現這種補償問題。但我認為，10% 的高個位數每股收益，是的，我想說，這聽起來是一個非常合理的起點。但如果我也退後一步，我會說，好吧，我們的公司收入為 400 億美元，而且我們一直在推動高個位數到高個位數的收入成長。我認為這對我們來說非常獨特。

And I think one of the reasons that is a combination of two factors. First of all, the markets that we're participating, they're very attractive, Robbie, whether it's their size, their growth outlook, whether their alignment to favorable demographic trends, the positions we have in them, and there's a couple of different types of markets that we're in, right? Markets that are probably a little bit lower from a growth rate perspective, but we've got tremendous scale, tremendous positions in them and that scale and that position disproportionate us and they provide great financial stability to our business.

我認為原因之一是兩個因素的結合。首先，我們參與的市場非常有吸引力，羅比，無論是它們的規模、成長前景、是否符合有利的人口趨勢、我們在其中的地位，還有一些不同的市場我們所處的市場類型，對嗎？從成長率的角度來看，這些市場可能會低一些，但我們在其中擁有巨大的規模和地位，這種規模和地位與我們不成比例，它們為我們的業務提供了巨大的財務穩定性。

We've got other markets that are very exciting, high-growth markets that our goal there is to enter and capture share, whether it's TAV or LAA, new diagnostic systems that we'll be launching, and then other markets we're building, right? And we're building them and creating them with first-of-their-kind types of products, whether it's Lingo that we talked about, TBI testing, leadless, biosimilars in emerging markets, etcetera. So it's a nice collection of markets that really allow us to set these high single-digit target growth rates for us.

我們還有其他非常令人興奮的高成長市場，我們的目標是進入並佔領份額，無論是 TAV 還是 LAA，我們將推出新的診斷系統，然後是我們正在建立的其他市場， 正確的？我們正在建立它們，並用首創的產品類型來創造它們，無論是我們談論的 Lingo、TBI 測試、無鉛、新興市場的生物相似藥等等。因此，這是一個很好的市場集合，確實使我們能夠為我們設定這些高個位數的目標成長率。

And then the other part is pipeline, which is fundamental, right? And I think it has been highly productive. Recently launched products this year are going to contribute about $1 billion of revenue this year, and that's double to what it was in 2023. And I expect that to be the case again next year, right?

然後另一部分是管道，這是基礎，對吧？我認為這是非常富有成效的。今年最近推出的產品今年將貢獻約 10 億美元的收入，是 2023 年的兩倍。

So I think it starts at the top line. We've made a lot of effort right now in expanding gross margin and delivering. That was a topic that we talked about last year, expanding margins, and gross margin is a key focus of ours. But I also think we've been a pretty proficient allocator of investment. We've invested -- we've done increased investments in areas that are -- we know are high-growth areas, and we've still been able to generate over $1 billion of spending leverage over the last five years.

所以我認為這要從頂線開始。我們現在在擴大毛利率和交貨方面做出了很多努力。這是我們去年談到的一個話題，擴大利潤率，毛利率是我們關注的重點。但我也認為我們一直是個相當熟練的投資配置者。我們已經在高成長領域進行了投資，並且增加了投資，而且在過去五年中我們仍然能夠產生超過 10 億美元的支出槓桿。

So I'd say as we go down the P&L, I think that's another opportunity for us as we go down into 2025 is our discipline in terms of how we make the investments and our focus on gross margin. So I think the combination of that will allow us to have that op margin expansion. And the balance sheet is in a great year -- sorry, balance sheet is in a great shape here. So I think we've got all the elements that we need to go into 2025 with great momentum, markets, positions, and financial flexibility there.

因此，我想說，當我們降低損益表時，我認為進入 2025 年，這對我們來說是另一個機會，那就是我們在投資方式和對毛利率的關注方面的紀律。因此，我認為這兩者的結合將使我們能夠擴大營運利潤。資產負債表今年表現出色——抱歉，今年資產負債表狀況良好。因此，我認為我們已經具備了進入 2025 年所需的所有要素，其中包括強勁的勢頭、市場、地位和財務靈活性。

David Roman, Goldman Sachs.

大衛羅曼，高盛。

Robert, maybe if I could push a little bit more on the investment spending and help us think a little bit about the shape of the P&L on a go-forward basis. During the quarter, you did accelerate R&D and SG&A spending on a year-over-year growth basis. And maybe you could help us think through where are some of those incremental dollars going?

羅伯特，也許我可以多推動一點投資支出，並幫助我們思考未來損益表的形狀。在本季度，你們確實加速了研發和銷售、一般行政費用支出的年增。或許你可以幫助我們思考這些增量資金的去向？

How should we think about the trajectory of operating expenses in the context of gross margin expansion? And then with the announced share repurchase program, should we think about that as an effort to keep the share count flat or a view that this is an opportunity to return incremental capital to shareholders and reduce the share count?

在毛利率擴張的背景下，我們該如何思考營業費用的軌跡？那麼，隨著宣布的股票回購計劃，我們是否應該將其視為保持股份數量持平的努力，或者認為這是向股東返還增量資本並減少股份數量的機會？

Sure. Yeah, I guess, on the investment side, if you look at what we've done with our expenses here, they've gone from 37% in 2019, down to about 34% this year. So that's where that $1 billion of spending leverage comes, right? If you look at our five-year CAGR, it's high single digits and our operating expense CAGR is about 4%. But it's not a cookie-cutter approach, David.

當然。是的，我想，在投資方面，如果你看看我們在這裡的支出情況，你會發現它們已經從 2019 年的 37% 下降到今年的 34% 左右。那麼這就是 10 億美元支出槓桿的來源，對吧？如果你看看我們的五年複合年增長率，你會發現它是高個位數，而我們的營運費用複合年增長率約為 4%。但這不是千篇一律的方法，大衛。

We look at the businesses and look at their opportunities and make those decisions. R&D investments, they're a little bit more longer term, right? So once you commit to R&D programs, they tend to be a little bit more longer term than making some SG&A decisions, where you could toggle up and down a little bit easier. But I mean, I think you could see where some of the growth is coming from, and that's being supported by those investments.

我們關注企業並關注他們的機會並做出這些決定。研發投資，它們的期限更長一點，對吧？因此，一旦你致力於研發計劃，它們往往比做出一些 SG&A 決策的期限更長一些，在後者中你可以更容易地上下切換。但我的意思是，我認為你可以看到一些成長來自哪裡，而這些成長得到了這些投資的支持。

Obviously, our med tech portfolio has been getting investments, I'd say, in EP, in structural heart, in diabetes care, in neuromodulation. I mean, all of the businesses, they come with a strategic plan and we look at where it makes more sense, whether it's to put more more investment in the field with sales force and clinical people, whether it's to make the investment in a clinical trial, so we tend to have a pretty good process about how to do that.

顯然，我們的醫療技術組合一直在獲得投資，我想說的是，在 EP、結構性心臟、糖尿病護理和神經調節方面。我的意思是，所有的企業都有一個策略計劃，我們會研究它在哪裡更有意義，是否要在銷售人員和臨床人員的領域投入更多的投資，是否要對臨床進行投資試驗，所以我們往往有一個關於如何做到這一點的非常好的流程。

We've been making investments in diagnostics. Soon we'll probably be talking about a new system that we're going to be launching for a whole new segment of the diagnostic industry. That's a longer-term program that has been a couple of years. So I think we've got a good process about how to make the investments knowing that R&D investments are a little bit more longer than SG&A.

我們一直在診斷方面進行投資。很快我們可能會討論我們將為診斷行業的全新領域推出的新系統。這是一個已經持續了幾年的長期計劃。因此，我認為我們已經制定了一個關於如何進行投資的良好流程，因為我們知道研發投資比 SG&A 投資要長一些。

And I think that's what we've been able to show. And I think that's one of the reasons we've been able to get to our op margin profile to prepandemic levels, which I'm not sure a lot of companies would be able to kind of say that. But we haven't driven our op margin by expenses. I mean, we've been driving our top line pretty effectively, too. So I think that's probably the best proof point that we know how to do this allocation and the cycles of the allocation, et cetera.

我認為這就是我們能夠展示的。我認為這是我們的營運利潤率能夠達到疫情前水準的原因之一，我不確定很多公司是否能夠這麼說。但我們並沒有透過費用來推動我們的營運利潤率。我的意思是，我們也非常有效地推動了我們的營收成長。所以我認為這可能是最好的證明點，證明我們知道如何進行此分配以及分配週期等。

And then I think you had a question regarding share count and buybacks. Listen, we -- as I've said, we've got a pretty balanced approach about how we allocate our capital. I've talked about the importance of the dividend and supporting that growing dividend, and we'll continue to do that. The buybacks is just another element in that capital allocation strategy.

然後我認為你有一個關於股票數量和回購的問題。聽著，正如我所說，我們對於如何分配資本有一個相當平衡的方法。我已經談到了股息和支持不斷增長的股息的重要性，我們將繼續這樣做。回購只是資本配置策略中的另一個要素。

We just announced that the Board recently approved a new $7 billion buyback program. The previous one that we had approved in 2021 was running down, and we thought it was a good time to put that in place. We've deployed around $8 billion towards buyback over the last five years.

我們剛剛宣布，董事會最近批准了一項新的 70 億美元回購計畫。我們於 2021 年批准的上一項計劃即將到期，我們認為現在是落實該計劃的好時機。過去五年我們已投入約 80 億美元回購。

We took a little bit of a step up during a couple of years after the acquisitions that we did, we'd stepped that down a little bit. So we've stepped that up. Q3, we did about $750 million. I thought given our strong performance outlook here that we saw a disconnect between what we were doing in our PE ratio, and in fact, I still do.

在我們進行收購之後的幾年裡，我們向前踏了一步，然後又向下邁了一步。所以我們已經加強了這一點。第三季度，我們做了大約 7.5 億美元。我認為，鑑於我們強勁的業績前景，我們看到我們在市盈率方面所做的事情之間存在脫節，事實上，我仍然如此。

So it made sense to buy shares, and the buyback announcement is just part of our balanced approach to allocating capital, and we've got that authorization set. So if we feel that there is a disconnect going forward, we've got that opportunity to try and correct that. And if that reduces the share count, then it will reduce the share count. But we're not trying to drive our EPS through a lower share count. We're trying to drive our EPS through topline growth, David.

因此，購買股票是有意義的，回購公告只是我們平衡資本分配方法的一部分，而我們已經獲得了授權。因此，如果我們認為未來存在脫節，我們就有機會嘗試糾正這種情況。如果這減少了份額數量，那麼它就會減少份額數量。但我們並不是試圖透過減少股票數量來提高每股盈餘。大衛，我們正在努力透過營收成長來推動每股收益。

Joshua Jennings, TD Cowen.

約書亞·詹寧斯，TD·考恩。

Robert, I wanted to ask about just structural heart markets. The TAVR market slowing down or decelerating, there has been some investor concerns about US provider capacity and whether there's a bottleneck. I think Abbott is uniquely positioned because you do have offerings in transcatheter aortic, mitral, and tricuspid solutions and left atrial appendage occlusion.

羅伯特，我想問的是結構性心臟市場。 TAVR 市場放緩或減速，一些投資者擔心美國供應商的產能以及是否存在瓶頸。我認為雅培的定位獨特，因為你們確實提供經導管主動脈、二尖瓣和三尖瓣解決方案以及左心耳封堵術的產品。

We've got interventional heart failure interventions coming down the pike. Are you seeing any capacity constraints limiting growth? You had a strong structural heart quarter this in 3Q? Or are you concerned about that? Is that on the horizon or should we just think that hospitals are seeing this growth opportunity as well and building out capacity, adding cath labs, hybrid ORs, et cetera?

我們即將推出介入性心臟衰竭幹預措施。您是否發現任何容量限制限制了成長？您在第三季的結構性心臟季度表現強勁？還是你擔心這個？這是即將出現的情況還是我們應該認為醫院也​​看到了這種成長機會並擴大了能力，增加了導管實驗室、混合手術室等？

I'd love to get your view on the current situation and whether you're worried in the next 12, 24, 36 months that we could run into a bottleneck in the US?

我很想聽聽您對當前情況的看法，以及您是否擔心未來 12、24、36 個月我們在美國可能會遇到瓶頸？

Not seeing the bottleneck, not forecasting bottleneck, not concerned about the capacity here. Obviously, this is a very growing area not only for those that are developing the technologies, but also for the healthcare systems that are delivering them and deploying them. I've been to some large centers over the quarter.

沒有看到瓶頸，沒有預測瓶頸，不關心這裡的容量。顯然，這不僅對於那些正在開發技術的人來說，而且對於那些提供和部署這些技術的醫療保健系統來說，都是一個非常成長的領域。這季我去過一些大型中心。

I've been through some smaller centers over the quarter. There's always challenges, but I put it as a challenge, not specific to a given technology or challenges just whether it's ramping up a new technology, getting more people to train. So -- but I'm not hearing that the centers that we've been working with that capacity is a big rate-limiting factor today.

本季我去過一些較小的中心。挑戰總是存在的，但我把它看作是一個挑戰，而不是特定於某一特定技術或挑戰，只是它是否正在推廣一項新技術，是否讓更多的人接受培訓。所以，但我沒有聽說我們一直在使用這種容量的中心是當今的一個很大的速率限制因素。

I think if it started to become one and the demand is there, I think history has shown that you make the right investments, the investments will be made to accommodate that demand. I mean, this is obviously what happened in structural heart over the last decade. Investments will be made to accommodate that demand.

我認為，如果它開始成為一種需求並且有需求，我認為歷史已經表明，你做了正確的投資，投資將會滿足這種需求。我的意思是，這顯然是過去十年結構心臟領域發生的事情。將進行投資以滿足這一需求。

So I'm not hearing that, and we continue to be very excited about the prospects that we had in our structural heart portfolio. I think the team has hit its stride right now. We've got new management, new products launching, and I'm very optimistic right now with what the teams are putting together across the entire portfolio. I think like you said, we're one of the few companies here that we can see the full spectrum, right, from -- all the way from surgical, structural interventions, all the occlusion and appendages, and then looking at being able to see mitral, tricuspid, aortic, whether it's repair, whether it's replacement, I think the team is hitting its stride right now.

所以我沒有聽到這個消息，我們仍然對結構性心臟投資組合的前景感到非常興奮。我認為球隊現在已經取得了進展。我們有了新的管理階層，推出了新產品，我現在對團隊在整個產品組合中所做的工作非常樂觀。我想就像你說的，我們是這裡為數不多的幾家能夠看到全方位的公司之一，對吧，從外科手術、結構性幹預、所有的閉塞和附屬物，然後著眼於能夠看看二尖瓣、三尖瓣、主動脈，無論是修復還是置換，我認為團隊現在正在大步前進。

And our focus here is going to be on both sides, making the investments on the R&D side. I think we've got a lot of new product investment in structural heart, new clinical trials, new indications, investments over there. And I think the different part of our investment profile, and we've been doing that for many years in structural heart, and I think that's why we have the portfolio we have.

我們這裡的重點將是雙方，在研發方面進行投資。我認為我們在結構心臟、新的臨床試驗、新的適應症和投資方面進行了大量的新產品投資。我認為我們投資概況的不同部分，我們多年來一直在結構核心方面這樣做，我認為這就是我們擁有投資組合的原因。

I think the piece that we're adding on now is like, okay, we've got the products, now we've got to increase our field presence to support either the market share gain that we aspire to or to support these growing new fields, whether it's tricuspid.

我認為我們現在添加的內容就像是，好吧，我們已經有了產品，現在我們必須增加我們的現場存在，以支持我們渴望的市場份額增長或支持這些不斷增長的新產品領域，無論是三尖瓣。

So our focus now is really to start to add more on the field side in these businesses to be able to kind of support that growth. But no, I think this is a tremendous area of growth of opportunity of underpenetration, of R&D, of clinical work. So we're really excited about it.

因此，我們現在的重點實際上是開始在這些業務的現場增加更多內容，以便能夠支持這種成長。但不，我認為這是一個滲透不足、研發和臨床工作機會巨大成長的領域。所以我們對此感到非常興奮。

Vijay Kumar, Evercore ISI.

維傑·庫馬爾，Evercore ISI。

I had one on, I guess, NEC infant formula. The FDA, CDC and NIH have put out a joint statement. It's a pretty strong statement saying noting that there's perhaps no causative relationship between infant formula and NEC. So I guess my question is, how does this change Abbott's position in these lawsuits?

我猜我喝的是 NEC 嬰兒配方奶粉。 FDA、CDC 和 NIH 發表了聯合聲明。這是一個相當強烈的聲明，指出嬰兒配方奶粉和 NEC 之間可能不存在因果關係。所以我想我的問題是，這將如何改變雅培在這些訴訟中的立場？

Does it matter? What else can we expect from the government? Could we expect more announcements similar to this? What shape or form could it be? What can Abbott do to perhaps ring-fence liabilities related to these cases?

有關係嗎？我們還能對政府有何期待？我們能否期待更多類似的公告？它可能是什麼形狀或形式？雅培可以採取什麼措施來避免與這些案件相關的責任？

Yeah, sure. Well, listen, as it relates to our position, it's great to see the statement, and I agree with you, I think it was a very strong statement. It doesn't change what I have been saying, which is -- and the statement seems to be aligned and support what I hear from the market and what I hear from neonatologists, which is these products are they're medically necessary, they are considered the standard of care, and they're a valuable tools.

是的，當然。好吧，聽著，因為這與我們的立場有關，很高興看到這個聲明，我同意你的觀點，我認為這是一個非常強大的聲明。這並沒有改變我一直在說的，即——而且這種說法似乎是一致的，支持我從市場上聽到的以及我從新生兒學家那裡聽到的，即這些產品在醫學上是必需的，它們被認為是護理標準，它們是一個有價值的工具。

They're valuable tools for the neonatologists in their decisions and their decisions and their discussions with parents and how to feed premature. And the labels, which is a component in all of this, they've been reviewed by the regulators and never call for net warning.

它們對於新生兒科醫生的決策、決策以及與父母的討論以及如何早產兒餵食來說都是寶貴的工具。這些標籤是所有這一切的一個組成部分，它們已經過監管機構的審查，並且從未要求發出網路警告。

So this is a consensus statement made by these three agencies, three regulators here in the US. And they're basically -- Vijay, they're actually endorsing an expert panel with dozens of researchers that were conveyed by the secretary of HHS, and I think the researchers issued a 100-page document or so. I think they looked at thousands of publications. I think it was 600 specific to the relationship between NEC and feeding. And in that joint statement, the agencies, they reiterated the importance of preterm formula as the standard of care. And they also clearly state there's no conclusive evidence that the formula causes NEC.

這是美國這三個機構、三個監管機構所做的共識聲明。他們基本上是——Vijay，他們實際上是在支持一個由數十名研究人員組成的專家小組，這是由 HHS 部長傳達的，我認為研究人員發布了一份大約 100 頁的文件。我認為他們查看了數千份出版物。我認為這是 600 具體到 NEC 和餵食之間的關係。在該聯合聲明中，各機構重申了早產兒配方奶粉作為護理標準的重要性。他們也明確表示，沒有確鑿的證據表明該配方會導致 NEC。

So I think this is only one of a handful of times where the three agencies, the most prominent and significant health agencies and regulators in the US have come together and put out a joint statement. Obviously, we saw that during the COVID pandemic.

因此，我認為這只是美國最著名、最重要的衛生機構和監管機構這三個機構聚集在一起並發表聯合聲明的少數幾次之一。顯然，我們在新冠疫情期間就看到了這一點。

But I think before that, I think it was during the HIV pandemic. So I think the statement says a lot, Vijay. At this point, though, at this point, the judge in our trial right now has not allowed the joint statement or the underlying report to be entered into evidence.

但我認為在那之前，我認為那是在愛滋病毒大流行期間。所以我認為這個聲明說了很多，維傑。但目前，在這一點上，我們審判中的法官還不允許聯合聲明或基礎報告成為證據。

I don't know the reasons there, but I think it would be -- we believe that it's -- the joint statement, the report, the expert testimony, I think those are important pieces of information for a jury to consider as they're making their decisions. So I don't know how to cap that, but I would say beyond this case and as the cases move to more of the federal side, my expectation here is that the juries in these cases would be allowed to consider the criticality of that important evidence.

我不知道其中的原因，但我認為——我們相信是——聯合聲明、報告、專家證詞，我認為這些都是陪審團需要考慮的重要訊息，因為它們」正在做出決定。所以我不知道如何限制這一點，但我想說的是，除了這個案件之外，隨著案件轉移到更多聯邦方面，我的期望是，這些案件中的陪審團將被允許考慮這一重要事件的重要性。

So to your question on the liability portion and kind of what to do? If I take a step back on this one, I've been thinking about this quite a bit. But as health care innovators, we develop health care products based on problems that we see. We run the clinical trials. We gather the data.

那麼對於你關於責任部分和該怎麼辦的問題？如果我在這個問題上退一步，我已經思考了很多。但作為醫療保健創新者，我們根據我們看到的問題開發醫療保健產品。我們進行臨床試驗。我們收集數據。

We review the data with the regulators. You guys know this process pretty well. And ultimately, the regulator decides if the products are safe and they're fit for purpose, and they decide how they got to be labeled. And that's the country, that's the market that I want to be in, where the products, the labels, they're evaluated through a well-established regulatory process by expert regulators that have unfettered access to the best scientific evidence rather than trying to do this, regulate products through uncertainty and unpredictive jury trials.

我們與監管機構一起審查數據。你們非常了解這個過程。最終，監管機構決定產品是否安全、是否適合用途，並決定如何貼上標籤。這就是我想要進入的國家、市場，那裡的產品、標籤，都由專家監管機構透過完善的監管流程進行評估，這些監管機構可以不受限制地獲得最好的科學證據，而不是試圖做任何事情。

So ultimately, to your question, if the regulatory process is disregarded, if the science is disregarded, it's going to be very difficult for any company to remain on the market with these products. Taking on that indefinite liability here, at least in the United States, that would be an issue that the United States would confront.

因此，最終，對於你的問題，如果監管程序被忽視，如果科學被忽視，任何公司都將很難將這些產品留在市場上。至少在美國，承擔這種無限期的責任將是美國將面臨的問題。

It wouldn't be an issue for premature babies in international countries because this issue -- this is not an issue, and the products are still available there. So yeah, I do think there needs to be some fortitude here by those that can make decisions, prioritize the babies, prioritize preterm babies all 370,000 every single year that rely on these products.

對於國際國家的早產兒來說，這不會是一個問題，因為這個問題——這不是一個問題，而且這些產品在那裡仍然可以買到。所以，是的，我確實認為那些能夠做出決定、優先考慮嬰兒、優先考慮每年 370,000 名依賴這些產品的早產兒的人需要有一些毅力。

Over those that seem to distort and abuse this tort system that we have in our country here for financial gains. I'm hoping it doesn't come to that. But I've been pretty clear that this is -- we stand behind the products, but if the process won't be -- is going to be disregarded then this is something that we will not continue adding to the liability here.

對於那些似乎扭曲和濫用我們國家的侵權制度以獲取經濟利益的人。我希望事情不會發展到那一步。但我已經非常明確地表明，我們支持產品，但如果流程不被忽視，那麼我們不會繼續在這裡增加責任。

So there's a playbook it seems for these things to happen. You take a decade, 10-plus years to litigate this and come to some resolution. I don't intend to follow that playbook. And I intend to resolve this faster. And yes, there are different ways to resolve this and different ways to look at this. And we are having conversations at all levels to be able to express the concern that this could cause to families here in the United States.

所以這些事情的發生似乎有一個劇本。你花了十年、十幾年的時間來提起訴訟並達成某種解決方案。我不打算遵循那個劇本。我打算更快地解決這個問題。是的，有不同的方法來解決這個問題，也有不同的方式來看待這個問題。我們正在各個層面進行對話，以便能夠表達這可能給美國家庭帶來的擔憂。

Joanne Wuensch, Citi.

喬安妮‧溫施，花旗銀行。

Congratulations on an earlier-than-expected completion of enrollment in your PFA catheter clinical trial. But I would really love to get your view on the state of the electrophysiology market. What you're seeing in terms of PFA uptake and how that is impacting your mapping and navigation systems?

恭喜您的 PFA 導管臨床試驗提前完成入組。但我真的很想聽聽您對電生理學市場狀況的看法。您對 PFA 的採用有何看法？

Sure, Joanne. I mean I think this quarter was a continuation of the trend that we've been seeing since the arrival of PFA. We're growing a little bit lower than the market. The market has kind of grown pretty significantly here. But if you look at our growth rate, prior to PFA, we're actually growing faster now with PFA.

當然，喬安妮。我的意思是，我認為本季是自 PFA 推出以來我們所看到的趨勢的延續。我們的成長略低於市場。這裡的市場成長相當顯著。但如果你看看我們的成長率，在採用 PFA 之前，我們實際上在採用 PFA 後成長得更快。

And I think there's a couple of factors there. I think you mentioned one of those, which is cardiac mapping. Right now, we're seeing about 90%-plus of the cases, at least here in the US, being masked. If you look at where we were before, Joanne, we were mapping about maybe between 25% and 30% of RF cases, we're now mapping 50%-plus. So that is a little bit of a tailwind for us.

我認為有幾個因素。我想你提到了其中之一，那就是心臟繪圖。目前，我們看到大約 90% 以上的病例（至少在美國）是被掩蓋的。 Joanne，如果你看看我們之前的情況，我們可能繪製了大約 25% 到 30% 的 RF 病例，現在繪製了 50% 以上。所以這對我們來說有點順風順水。

We're seeing a pretty strong growth in procedures. And I think that's probably what's helped drive some of the market growth that we're seeing. But I also think that the volume increase is actually due to improved treatment guidelines that we're seeing and quite frankly, new technologies that are helping to identify AFib patients, too. So I think it's a combination of factors there that are helping to drive more procedures.

我們看到程式的成長相當強勁。我認為這可能有助於推動我們所看到的一些市場成長。但我也認為數量的增加實際上是由於我們所看到的治療指南的改進，而且坦白說，新技術也有助於識別 AFib 患者。所以我認為這是多種因素的綜合作用，有助於推動更多的程序。

And then for us, the RF portion of it is still a growth piece for us. As I said in my comments, we grew ablation catheters double digits, too. So we're seeing about 20% of the PFA cases, at least the ones that we're mapping, use RF catheters, and we're in those cases. So I think the key thing here is just to at least right now, PFA is really being used for de novo procedures, right?

然後對我們來說，它的射頻部分仍然是我們的成長部分。正如我在評論中所說，我們的消融導管也增加了兩位數。因此，我們看到大約 20% 的 PFA 病例，至少是我們正在繪製的病例，使用射頻導管，而我們就在這些病例中。所以我認為這裡的關鍵是至少現在，PFA 確實被用於從頭手術，對吧？

So if you break that out, it's about 1/3 of all ablation procedures are de novo. The other 2/3 are VT ablation, SVT ablation, redos. And in those cases, they're using -- we're still using RF, and RF plays an important role there, which is why we've initiated our focal FLEX trial to be able to have the optionality to be able to toggle between PFA and RF. So we still think that's an important part there.

因此，如果你仔細分析的話，大約有 1/3 的消融手術是從頭開始的。另外2/3是VT消融、SVT消融、重做。在這些情況下，他們正在使用——我們仍在使用 RF，而 RF 在那裡發揮著重要作用，這就是為什麼我們啟動了焦點 FLEX 試驗，以便能夠具有在之間切換的選項PFA 和 RF。所以我們仍然認為這是一個重要的部分。

But I think the team has done a really good job here at leveraging our open mapping system. I made comments, we used the open mapping system as a design input for R&D programs to start off with. And now that open system is allowing us to be in more cases and partner more with the electrophysiologists. So I think that is -- that's what we're seeing, and we're very committed to be able to bring PFA to the market.

但我認為團隊在利用我們的開放地圖系統方面做得非常好。我發表了評論，我們使用開放式地圖系統作為研發專案的設計輸入。現在，開放系統使我們能夠處理更多病例並與電生理學家進行更多合作。所以我認為這就是我們所看到的，我們非常致力於將 PFA 推向市場。

We've completed the enrollment, like you said. And we completed the CE Mark enrollment beginning of this year. So we're committed to the space, but we do feel that it's a full portfolio approach. You need good mapping which is why we invested in our next-generation HD grid. You need to have a PFA portfolio that's pretty complete.

正如您所說，我們已經完成了註冊。我們在今年年初完成了 CE 標誌註冊。因此，我們致力於這個領域，但我們確實認為這是一個完整的投資組合方法。您需要良好的地圖繪製，這就是我們投資下一代高清網格的原因。您需要有一個相當完整的 PFA 組合。

You need to have RF, and I think that's what the team has been building, I'd say, very, very successfully.

你需要有 RF，我認為這就是團隊一直在建立的東西，我想說，非常非常成功。

Matt Miksic, Barclays.

馬特·米克西奇，巴克萊銀行。

A follow-up on Libre in the diabetes business and just a couple of other topics that come up quite a bit during the last few months around the market and competition, the first being anything you can comment on regarding your share trends, in particular in the DME channel, anything you're doing there differently, did differently, what you're seeing? As a user of Lingo for the last couple of months, I complemented the team on putting together a great product.

糖尿病業務中 Libre 的後續行動，以及過去幾個月中圍繞市場和競爭出現的一些其他主題，第一個是您可以對您的股票趨勢發表評論的任何內容，特別是在DME頻道，你在那裡做的任何不同的事情，不同的做法，你看到了什麼？作為過去幾個月 Lingo 的用戶，我對團隊進行了補充，共同打造了一個出色的產品。

Question, just curious about the timing and the plan for Rio and thoughts on potential reimbursement for that certain non-insulin intensive type 2 community. And then lastly, just zooming out for a sec and getting back to your comments and plans for gross margin, how -- if you could to scale the expansion into OTC of Libre in this platform kind of plays a role in hitting your '24 gross margin plans and and your plans for expansion going forward as you scale this business?

問題，只是好奇裡約的時間安排和計劃，以及對某些非胰島素密集型 2 型社區的潛在報銷的想法。最後，稍微縮小一下範圍，回到您對毛利率的評論和計劃，如果您能夠在這個平台上擴大 Libre 的 OTC 業務，將如何在實現您的 24 年毛利率方面發揮作用利潤計劃以及您在擴展業務時的擴展計劃？

You lined up a lot there, Matt. I'm going to make sure that Mike here helps me stay with all the questions that you laid out there. I mean, I think regarding your Libre question on competitiveness, yeah, I think the team has done a really good job here in the US, not just in the DME channel but at the endo's offices, at the primary care channel, with the basal population.

你在那裡排了很多隊，馬特。我將確保邁克在這裡幫助我解決您在那裡提出的所有問題。我的意思是，我認為關於你的 Libre 關於競爭力的問題，是的，我認為團隊在美國做得非常好，不僅在 DME 渠道，而且在 endo 辦公室、初級保健渠道、基礎護理渠道。

I think it's an all-out, all-channel, real strong execution there. US, we grew 26% in the US this quarter. And that was having some of the challenges we had there regarding some temporary supply challenges with Libre 3. So we haven't really unleashed Libre 3 fully yet, and a lot of the share gains that we're getting are with Libre 2.

我認為這是一個全力以赴、全通路、真正強大的執行力。美國，本季我們在美國成長了 26%。我們在 Libre 3 方面遇到了一些臨時供應方面的挑戰。

But that piece is behind us. We invested in a new manufacturing line. We have a new manufacturing, a whole brand-new manufacturing facility come up towards the end of the year. So that will -- as we go into next year, that will all be behind us.

但那部分已經在我們身後了。我們投資了一條新的生產線。我們有一個新的製造工廠，一個全新的製造工廠將於今年底建成。因此，當我們進入明年時，這一切都將成為過去。

So I think our position here in the US and globally, quite frankly, is strengthened by the product portfolio, the cost position that we had. You're mentioning gross margins in Libre. That's a key aspect here. We've always talked about.

因此，坦白說，我認為我們在美國和全球的地位透過我們的產品組合和成本地位得到了加強。您提到的是 Libre 的毛利率。這是這裡的一個關鍵方面。我們一直在談論。

You got to have cost leadership here because as the market expands to basal and oral meds, GLP-1 users, and as that population grows, you're going to have a much larger TAM to operate in. But yeah, you are going to see -- you're going to have to make some pricing adjustments to be able to get that reimbursement, so you got to have your cost structure in place to be able to benefit, have the topline growth and not have that come at the expense of gross margin. And our gross margins, as we've grown Libre, have actually expanded.

你必須在這裡擁有成本領先優勢，因為隨著市場擴展到基礎藥物和口服藥物、GLP-1 用戶，並且隨著人口的增長，你將擁有更大的 TAM 來運作。你必須進行一些定價調整才能獲得補償，因此你必須制定適當的成本結構才能受益，實現營收成長，而不是以犧牲成本為代價毛利率。隨著 Libre 的發展，我們的毛利率實際上已經擴大了。

As our manufacturing scale continues to ramp up, some of the costs associated with these products, because there's a lot of automation, we've been doing this from day one, some of the costs are depreciation in the equipment. So as a lot of our facilities are running through their depreciation schedules, those will help our gross margins, too.

隨著我們的製造規模不斷擴大，一些成本與這些產品相關，因為有很多自動化，我們從第一天起就一直這樣做，一些成本是設備的折舊。因此，由於我們的許多設施正在執行折舊計劃，這也將有助於我們的毛利率。

So I feel good about our opportunity to drive the market, to be competitive, to lead in technology, to lead in scale and cost, and take advantage of what we believe is a mass market opportunity for us.

因此，我對我們推動市場、保持競爭力、技術領先、規模和成本領先以及利用我們認為對我們來說是大眾市場機會的機會感到滿意。

I think you had a question on Rio. Listen, the initial focus is on Lingo right now. We've got that -- think of Rio as another arrow here in the quiver that we can pull out if we need to ahead of schedule. We do have a schedule. I'm not going to lay out what that schedule is, but for some reason we need to do that, we'll be able to do that.

我想你對裡約有疑問。聽著，現在最初的焦點是 Lingo。我們已經做到了——把裡約視為箭袋裡的另一支箭，如果我們需要提前的話，我們可以把它拔出來。我們確實有一個時間表。我不會列出時間表，但出於某種原因我們需要這樣做，我們將能夠做到這一點。

But the focus is on Lingo right now, and we've got a nice opportunity here to build a completely new segment of biowearables with consumers.

但現在的焦點是 Lingo，我們有一個很好的機會與消費者一起建立一個全新的生物穿戴裝置領域。

Danielle Antalffy, UBS.

丹妮爾·安塔菲，瑞銀集團。

Congrats on a really good quarter here. I just wanted to follow up on the structural heart component of the business. Robert, you talked about this earlier in response to Josh's question. But just digging a little bit deeper, as we look into 2025, I mean, you've got potential indication expansion for LAA closure, but you do have some competitive data coming on the tricuspid side of things at TCP and whether or not that shows a mortality benefit.

恭喜這裡度過了一個非常好的季度。我只是想跟進業務的結構核心部分。羅伯特，您之前在回答喬許的問題時談到了這一點。但只要深入挖掘一下，當我們展望 2025 年時，我的意思是，您已經獲得了 LAA 閉合的潛在適應症擴展，但是您確實有一些關於 TCP 三尖瓣方面的競爭性數據，無論這是否表明死亡福利。

So just curious about how you think about those two markets specifically and sustainable growth in those franchises, there are some puts and takes there. So I just wanted to get your sense of how to think about that as we head into next year?

因此，只是想知道您如何看待這兩個市場的具體情況以及這些特許經營權的可持續增長，那裡有一些看跌和看跌。所以我只是想了解一下，當我們進入明年時，您會如何考慮這個問題？

Sure. Just to remind me again there, Danielle, tricuspid and what was the other one?

當然。只是再次提醒我，丹妮爾，三尖瓣，另一個是什麼？

Sorry, left aerial appendage closure --

抱歉，左側空中附件閉合—

Yeah, okay. Good. Yeah, these are great areas of investment for us. And the investment of money, time, effort, thinking power, all of that. So I think, as I said on business hitting its stride, I definitely would say that about the Amulet team. They're definitely hitting their stride. We saw nice growth this quarter, 25% globally, 40% growth in the US here.

是啊，好吧。好的。是的，這些對我們來說都是很好的投資領域。以及金錢、時間、精力、思維能力的投資，所有這些。所以我想，正如我在談到業務大踏步前進時所說的那樣，我肯定會這樣評價 Amulet 團隊。他們肯定正在大步前進。本季我們看到了良好的成長，全球成長 25%，美國成長 40%。

And we're making the investments. I mean, I think you saw our registry data shows a really good positive results from Amulet, 95% of the closure rates achieved and sustained after 45 days, I think that's pretty good. 90% closure rate when using Amulet for those that have failed proper closure with the competitor product.

我們正在進行投資。我的意思是，我認為您看到我們的註冊數據顯示 Amulet 取得了非常好的積極成果，在 45 天後實現並維持了 95% 的關閉率，我認為這非常好。對於那些使用競爭對手產品未能正確閉合的患者，使用 Amulet 時閉合率可達 90%。

But we're investing in there. We've got our CATALYST trial that's looking at comparing Amulet to anticoagulants for people that have a risk of AFib, expect to complete that trial next year. And then the team has been working on a Amulet 2.0. And I expect that we will be beginning or entering the trial in that business with that product towards the end of this year.

但我們正在那裡投資。我們已經進行了 CATALYST 試驗，旨在針對有 AFib 風險的人比較 Amulet 和抗凝血劑，預計明年完成試驗。然後團隊一直在開發 Amulet 2.0。我預計我們將在今年年底開始或進入該產品的業務試驗。

So really nice progress on the appendage side, whether -- and quite frankly, PFO, too, is doing really well, and that's a great growth driver for us, too. On the tricuspid side, yeah, there's going to be a lot of data coming out over the next 12, 24 months. I expect that. I think with any new category here, Danielle, you're going to have to make the investments.

因此，在附肢方面取得了非常好的進展，坦白說，PFO 也做得很好，這對我們來說也是一個巨大的成長動力。在三尖瓣方面，是的，未來 12、24 個月將會出現大量數據。我希望如此。我認為對於這裡的任何新類別，丹妮爾，你都必須進行投資。

I mean, nobody was doing anything from an interventional perspective on the tricuspid, right? So as companies are developing technologies, I think you are going to see a lot of clinical readouts and clinical data more to be able to support the use of these technologies. I think we saw one recently at ESC specifically to TriClip, a European study, and this is the second RCT that's basically confirming what the triluminate RCTs showed, which is much superior to medical therapy and extremely effective at reducing TR.

我的意思是，沒有人從介入的角度對三尖瓣做任何事情，對嗎？因此，隨著公司正在開發技術，我認為您將看到更多的臨床讀數和臨床數據，以便能夠支援這些技術的使用。我想我們最近在ESC 看到了一項專門針對TriClip 的歐洲研究，這是第二項隨機對照試驗，基本上證實了三鋁酸鹽隨機對照試驗的結果，它比藥物治療要優越得多，並且在減少TR 方面非常有效。

So I think that's an area of investment for us. Without a doubt, I think that there's an opportunity here that the team has been working on regarding our full portfolio approach with our structural products, and I think TriClip plays an important role there. We're excited about the NCD that was opened and looking forward to that, so that's another opportunity for us in 2025.

所以我認為這對我們來說是一個投資領域。毫無疑問，我認為團隊一直在研究我們的結構產品的完整投資組合方法，這是一個機會，我認為 TriClip 在那裡發揮著重要作用。我們對 NCD 的開放感到興奮並期待著，所以這是我們 2025 年的另一個機會。

But quite frankly, I just think there's a great opportunity here with our team. We've got, I would say, some built-in advantages as it comes to the TriClip product. We've got manufacturing scale, the sales force, and all of that. And there's definitely demand, and we're seeing that, and the launch is going very well.

但坦白說，我認為我們的團隊有一個很好的機會。我想說，TriClip 產品具有一些固有的優勢。我們擁有製造規模、銷售團隊等等。肯定有需求，我們也看到了這一點，而且發布進展順利。

So I think that, yeah, you're going to see more data, and that's good, and it's a growth opportunity for us. I think this is a $1 billion business for us here over time. But you're going to have to make the investments on the clinical side to be able to support the adoption of it. So very excited about structural heart overall.

所以我認為，是的，你會看到更多的數據，這很好，這對我們來說是一個成長機會。我認為隨著時間的推移，這對我們來說將是一項價值 10 億美元的業務。但你必須在臨床方面進行投資才能支持它的採用。整體上對結構心臟非常興奮。

And ultimately excited about the entire company and business. We've had -- yeah, I'm really pleased with the performance of the first three quarters. We're on track to finish the year at the high end of the initial guidance that we provided back in January. Sales growth has been strong. Gross margin profile continues to expand.

最終對整個公司和業務感到興奮。我們——是的，我對前三個季度的表現非常滿意。我們有望以一月份提供的初步指導的最高水平結束今年的工作。銷售成長強勁。毛利率持續擴大。

EPS growth is now accelerating throughout the year as we were lapping some of those COVID comps. The pipeline is richer than ever. So I think we've got great momentum heading into next year.

隨著我們對其中一些新冠疫情的比較，每股盈餘的成長現在全年都在加速。管道比以往任何時候都更加豐富。所以我認為我們明年將有強勁的勢頭。

And with that, I'm going to wrap up and thank all of you for joining us.

至此，我要結束演講並感謝大家加入我們。

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

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。