Grifols SA (GRFS) 2025 Q4 法說會逐字稿

Hello, everyone, and thank you for joining us today for Grifol's fourth-quarter and full-year 2025 earnings call. My name is Daniel Segarra, and I serve as the Head of Investor Relations and Sustainability.

Today, I'm joined by Grifol's Chief Executive Officer, Nacho Abia; President of Biopharma, Roland Wandeler, and Chief Financial Officer, Rahul Srinivasan. It is our usual practice. Today's call will last about an hour, including the Q&A session. Please note that this call is being recorded.

You can find additional materials, including today's presentation in the Investor Relations section of the Grifols website at grifols.com. A transcript and replay of the webcast will also be available on the Investor Relations website within 24 hours.

Turning to slide 2. I would like to remind everyone that forward-looking statements may be made during this call. This may include, among other things, comments regarding the company's future operating and financial performance, statements about our future expectations, clinical developments, regulatory time lines and the potential success of our product candidates. These statements are based on current expectations and available information as of the date of this call and are subject to certain risks and uncertainties that may cause actual results to differ materially from those discussed today.

Grifols financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions, including alternative performance measures or APMs, as defined by the European Securities and Markets Authority. Grifols management uses APMs to evaluate financial performance as the basis for operational and strategic decision-making. These APMs are prepared for all the time periods presented in this document.

Now moving to today's agenda, I will turn the call to Nacho to kick it off. Nacho?

Thank you, Daniel, and thank you all for joining us today. Fiscal 2025 marks an important year for Grifols. We executed against our plan, advance our operational and innovation priorities, delivered on our revenue and adjusted EBITDA guidance, and most importantly, exceeded our key cash flow target, and all of this amid a complex geopolitical macro and operating environment. In such a complex year, our performance reflects the structural strength of the company, scale, deep vertical integration in a strategic market, and a globally diversified footprint continue to differentiate Grifols. This signals not only the company's strong fundamentals, but also the strength and resilience of our business model and our ability to continue shaping and leading in this industry in the many years to come.

Turning to slide 5. And as you all know well, one of our key priorities has been and will continue to be improving our cash generation profile. In fiscal year 2025, the company generated EUR468 million in free cash flow pre-M&A predividends, an increase of more than EUR200 million year over year, which reflects the benefit of our company-wide focus on capital discipline. On the top line, revenue reached EUR7,524 million, represented a solid 7% increase over the previous year, and a 9.1% increase on a like-for-like basis, both at constant currency. This growth was driven largely by the continued strong performance of our Ig franchise.

Adjusted EBITDA reached EUR1,825 million, a 5.6% year-over-year increase, while on a like-for-like basis without the impact of the Adjusted EBITDA increased by close to 12%, all at constant currency. At guidance, FX, adjusted EBITDA reached EUR1,902 million, right in line with the guidance provided 12 months ago.

Finally, deleveraging remains a key priority and the path forward becomes clear as our free cash flow generation is sustainable and continuing to increase. At year-end, our leverage ratio improved to 4.2 times, a [4-point times] reduction over prior year. This strong and consistent performance across our key metrics, supported our recent credit rating and continues to be a central priority for the Board.

Beyond the financial figures, 2025 was a year defined by execution on our operational and financial priorities. Led by biopharma, our core IG franchise, both intravenous and subcutaneous delivered a strong performance, reflecting the strength of our clinical proposition. We leverage the opportunity to use our solid inventory position to accelerate IG growth and build momentum in key markets. As mentioned on our Q3 '25 call, albumin demand in China declined amid ongoing pressures following government cost controls. We continue to work with our local partners, Shanghai RAAS, to effectively navigate and manage these market dynamics. By leveraging this partnership, we have achieved relative outperformance in the Chinese market.

The combination of a strong growth of our IG franchise and lower-than-expected albumin sales weighed on our margins, reflecting the underlying economics of the plasma industry and emphasizing the need to continue working to improve our efficiencies. And we remain highly confident about achieving our margin expansion goals. Rahul will provide further insights later in the presentation.

At the same time, we continue advancing differentiated margin-accretive therapies to the market. In the fourth quarter, we successfully launched in Europe, our new Fabry margin concentrate for acute bleeding episodes with congenital and acquired fibrinogen deficiency. Following FDA approval, we plan to launch facility in the first half of 2026, our new fibrinogen concentrate for US patients with congenital fibrinogen deficiency.

Despite the challenges presented by the macro environment and global trade shifts, our local-for-local business model once again demonstrated its resilience, effectively insulating us from tariff and preserving our defensible mode. This as much as possible localized model also implies that while FX headwinds impacted both revenue and EBITDA levels, they did not extend to our free cash flow or leverage ratio, due to the significant levels of natural hedges embedded within our business. Finally, we improved our cash flow and expense profile as we strengthen our balance sheet. Our focus on EBITDA and free cash flow expansion clears the path to deleverage.

Turning to slide 7. We feel good with the company's performance in 2025. As we look forward, it is important to acknowledge the necessity of maintaining a balanced approach to growth across our portfolio of key proteins. Looking ahead, our direction for 2026 is clear. We will consciously focus our growth to prioritize profitability, cash flow generation, and to continue reducing our leverage ratio.

Two key projects, Egypt and Canada will play a central role in delivering on this strategy, and they have the potential to redefine the plasma industry in the many years ahead. In Egypt, our transformational partnership has achieved a major milestone with EMA approval of Egyptian source plasma. This is first of its kind achievement that this is a game changer in the industry. In Canada, through our strategic partnership with CBS, we remain deeply committed to the prospects for the fourth largest IgG market globally. Roland will provide further details on both later in the presentation.

In the US, we stand as the only scale plasma company with a fully integrated end-to-end value chain in the country, the world's most important IgG market. Over the last two decades, we have been shifting the structure of plasma sourcing and our entire operation to a local-for-local model as a key differentiator and value driver.

And finally, our long standard relations in China and the deep knowledge of the market has proven effective and will continue to play an important role to mitigate the changes in that important country.

As we enter 2026, confident in our positioning, the fundamentals of our business remain sound. In a world increasingly shaped by geopolitical shifts, Grifols integrated model and diversified footprint provide unique strategic optionality and allow us to navigate uncertainty with agility and resilience. This isn't just about sustaining a competitive advantage. It's about having infrastructure, partnership, and the vision to lead the industry into its next chapter.

And with that, I will hand over to Roland to cover our commercial performance in more detail.

Thank you, Nacho. Moving on to slide 9. Biopharma delivered a strong year in 2025, growing 8.4% for the year on a reported and 10.9% on a like-for-like basis, both at constant currency. I am proud of the dedication, passion, and commitment our team shows every day to deliver for patients and drive forward towards the goals we set out.

Our immunoglobulin franchise led the way in 2025 and delivered a strong 14.7% year-over-year increase at constant currency. This performance was driven by Gamunex and Xembify with IVIG and SCIG delivering 12% and 60% full year growth, respectively, both clearly ahead of the market. As outlined in our last call, we saw an opportunity over the last two years to use our strong IG inventory position to accelerate IG growth, build momentum in key markets, and win back share in the US. We have since delivered on this plan. We have strengthened our US organization and commercial capabilities, expanded SCIG penetration through Xembify, and leverage the strong profile of Gamunex to win share in strategic accounts.

Looking ahead, we expect underlying demand growth for IG to continue across our three main indications. In primary immunodeficiency, increased awareness and better diagnosis are expanding access to therapy. In secondary immunodeficiency, on label outside the US. Demand continues to rise in an aging population and with an increase in immune comprised patients. And in CIDP, we are seeing continued growth albeit at a lower level as IG therapy with its polyvalent mechanism remains the first line choice and standard of care for patients living with this multifactorial disease.

As Nacho mentioned, where in 2025, our plan was to regain share in the US and select European markets and thus grow ahead of the market. We now aim to control growth going into 2026 from the stronger position with a differentiated approach. In the US and select European countries, where we have recently gained share, we plan to maintain our position and grow with the market.

Outside these key markets, we have already started to pull back growth towards the end of 2025, and we'll further consolidate in '26 with an increased focus on margin. This targeted approach will allow us to enhance the return on our investments and ensure that our commercial efforts translate into meaningful margin improvements.

Turning to albumin. We saw revenues declined 5.1% year over year as positive momentum in the US and ex China was offset by the market and pricing pressures from policy changes in China. While these changes in China also weighed on our albumin sales. Our strategic partnership with Shanghai RAAS allowed us to effectively compete and perform ahead of the market.

Entering 2026, we aim to further drive albumin uptake to balance growth with IG. In China, we will continue to build on our strategic partnership with Shanghai RAAS with disciplined pricing and expanded joint commercial footprint and a sharper marketing and contracting approach, we expect to expand hospital sales access, including greater penetration into lower-tier hospitals and broaden our reach in retail pharmacies.

In addition, our medical teams will continue to drive education, awareness, and evidence generation, for example, around long-term albumin use in liver cirrhosis, an important and still unmet need in China. Outside China, we will build on our momentum to further expand our albumin presence, helping us move toward a more balanced geographic mix. Through this approach and as conditions in China stabilize, we remain confident that our efforts place us in a position of strength to balance our albumin growth with IG.

Looking at our Alpha-1 and specialty proteins portfolio, we saw a full year growth of 1.4% or 3.8% on a like-for-like basis before the impact of the IRA Part D redesign. In 2025, we reinforced our leadership in Alpha-1 and return to patient growth following the transition to our new specialty pharmacy partner. We also saw steady contributions from our rabies franchise and our contract manufacturing business. Keep in mind that different phasing patterns across proteins in this segment create natural quarter-to-quarter variability. In this context, our fourth quarter results mainly reflect a tough comparison against a strong Q4 '24, not a change in underlying trends, which remain solid.

Looking ahead, we expect to drive continued patient growth in Alpha-1 while preparing for a major clinical milestone with expected top line results of our Phase III SPARTA outcomes trial, the first of its kind in the second half of this year. These outcomes have the potential to unlock significant growth in this highly underdiagnosed and undertreated condition by dramatically increasing disease awareness and testing in light of clear clinical benefits. In parallel, we are advancing a 15% subcutaneous formulation and a next-generation Alpha-1 therapy aimed at enhancing convenience, expanding access, and strengthening our leadership in this growing market.

We remain confident in Prolastin's long-term potential and continue to focus on expanding the total addressable market with roughly 85% of patients still undiagnosed. And with outcomes, AI-enabled patient identification and increasing awareness from potentially entrance building momentum, we see meaningful opportunities to accelerate testing and thus help more people living with AATD to benefit from therapy.

On slide 10, as the newest addition to our biopharma portfolio, I would like to provide an update on the progress of our franchise. With our approval in Germany at the end of last year, we have launched our fibrinogen concentrate, PRUFIBRY, in Europe with a focus in Germany and Austria, where FCs are the preferred option for acquired fibrinogen deficiency. We realized first sales in Q4 '25 and see continued strong demand for PRUFIBRY. Early feedback is promising and especially highlights our differentiation, including the ease and speed of reconstitution of our highly purified FC as well as its application. We will continue to focus on Germany and Austria as key markets this year and expand into additional European markets over time.

In the United States, following our December FDA approval for congenital fibrinogen deficiency under the brand name FESILTY, we are preparing for launch in Q2 '26. We have a focused team in place to help educate key decision-makers across leading institutions in the US and secure hospital formulary access, building on our long-term relationships in many of these systems.

While we will focus our US launch on CFD in the short term, we are advancing our work to embark on an AFD trial in the US this year, which will allow us to expand our label over time. In parallel, we will continue to engage in appropriate disease state education for the critical role that fibrinogen deficiency plays in bleeding. We expect our entry into AFD to align with the evolution of clinical practice in the US where awareness and application of ready-to-use FCs for bleeding is still emerging with the potential to exceed USD800 million over time.

As we focus on controlled growth with IG, balance with albumin, and continuing momentum in our portfolio of first eat proteins, slide 11 outlines how the vision and strategic investments that Grifols embarked on many years ago are providing us today with a strong structural foundation for long-term value creation. This is particularly important in an environment where geopolitical pressures are rising and supply security is becoming increasingly strategic for our customers.

In the US, the world's largest plasma market, we have, over the last decade, built a fully integrated end-to-end platform spanning domestic plasma collection, fractionation, purification, and commercialization. Over the last years, we have started to extend this vertically integrated business model into other strategic markets through long-term public-private self-sufficiency partnerships that align our capabilities with national health care priorities.

In Canada, the fourth largest global IG market, our long-term partnership with Canadian Blood Services supports the country's objective of reaching at least 50% IG self-sufficiency. By expanding the share of locally sourced plasma and adding the capabilities to convert it into domestically manufactured plasma derivative proteins, we strengthen supply resiliency while reinforcing our presence in an attractive market.

In Egypt, we have partnered with the Egyptian government to establish a fully integrated plasma platform, designed to achieve national self-sufficiency and position the country as a regional hub for Africa and the Middle East. Once domestic needs are fulfilled, this platform expands access to life-saving therapies across the region and create export potential to European countries, especially for IG. Taken together, these initiatives reflect a scalable partnership model that combines industrial expertise with national health care priorities, positioning Grifols as a strategic partner in building sustainable plasma ecosystems across the globe.

Let me add a bit of more color. Taking a closer look at the US on slide 12. We have invested strategically over the last 20 years in building our infrastructure to support this key market at scale. With vision and foresight, Grifols has built a fully integrated resilient, state-of-the-art footprint that spans the entire value chain from donor to patient.

Today, we operate a network of more than 300 donor centers in the US ensuring a stable supply of quality plasma. To put that in perspective, over 70% of Grifols total global plasma collection capacity is anchored right in the US.

Across our two primary US plants, including our flagship facility in Clayton, North Carolina, one of the largest of its kind. We also hold 65% of our manufacturing capacity in the US and thus have achieved a unique and differentiated level of vertical integration. This positions us to supply the growing demand in the US fully from within this key market through self-sufficiency. This helps insulate us from global supply chain disruptions and ensures that our most critical market can be served by our efficient and strategically located donor centers and facilities.

On slide 13, we turn to Canada, one of the top four global markets for IG. Canada recognized that its historical reliance on imports for roughly 85% of its IG needs created long-term supply risk; as a result, Canadian Blood Services made it a national priority early this decade to lift domestic self-sufficiency to over 50%. Grifols stepped up to support that vision, and in 2022, signed a 15-year renewable agreement with CBS to build a fully domestic plasma ecosystem from the ground up.

Following this mandate, our operational footprint in Canada is expanding rapidly. In just the last 12 months, we have established a network of 17 donation centers, creating the backbone for a nationwide plasma collection network. Together with CBS, we were able to increase the share of IG self-sufficiency from 15% to around 30% in 2025. And we are progressing as planned with our domestic manufacturing plant in Montreal. We started with local purification of albumin in 2025, and we are on track to add 1.5 million liters of fractionation capacity alongside dedicated purification and fill finish lines by 2028.

This makes Grifols the only large-scale domestic manufacturing player with an end-to-end value chain in Canada. This unique position allows us to offer a fully integrated platform of services in this key market.

On slide 14, we highlight our strategic foothold in Egypt. This is more than a geographic expansion. It is a first of its kind public-private partnership that is pioneering biopharmaceutical sovereignty for an entire region. Through our partnership with the Egyptian government signed in 2020, we have created a fully integrated regional ecosystem, spanning plasma collection, testing, and future fractionation and purification capabilities.

Building on a project's strong progress, a key inflection point for Grifols was securing full EMA approval late last year for the entire Grifols Egypt value chain. This is a massive strategic outlook for the group, validating our end-to-end quality standards, and enabling European commercialization of plasma-derived therapies sourced from egyptian plasma. I will walk you through the details in the next slides.

Slide 15 maps out the strong execution and progress of our strategic project in Egypt. After successfully opening 16 donor centers last year, our team in Egypt, building on our core capabilities in Grifols engineering and quality, is on track to scale our network to 20 centers in 2026, all operating under our high standard model. With this, we were able last year to already achieve full self-sufficiency in Factor VIII, albumin, and IG for Egypt, a notable milestone. As we move into 2026, we are leveraging any surplus in plasma to expand supply across the broader Middle East and Africa.

As for manufacturing, our road map remains disciplined and faced. We are currently in Phase I of plant construction with the plasma logistics center and testing lab coming online this year. Between 2030 and '31, the fractionation and purification plans will become fully operational and by 2031, the entire end-to-end value chain will be localized in Egypt.

Equally important, our recent regulatory achievements have validated the strength of our end-to-end quality system. By positioning Egypt as a globally recognized plasma hub, we have earned what we call the Grifols seals of excellence. This has a direct financial impact as it enables the commercialization of Egyptian plasma derivatives in Europe and thus reduce reliance on costly US and EU source plasma.

Further, this also allows us to better balance albumin with our IG growth on a global scale, as the local demand for factor VIII in albumen in Egypt, Middle East, and Africa, is significantly higher than for IG. This provides access IT that can help cover demand in Europe.

Slide 16 shows how our partnership in Egypt is transformational for both Egypt and Grifols. Let me highlight a few key facts that illustrate the scale and impact of this project for Egypt where health care benefits are already tangible. More than 1 million vials produced from Egyptian plasma have been delivered to public hospitals and health centers and over 100,000 free medical checkups have been provided to donors.

From an economic and social perspective, the initiative is emerging as a meaningful contributor to the national economy. In 2025 alone, the project is expected to have contributed approximately EUR55 million to Egypt's GDP, with cumulative contributions projected to exceed EUR700 million by 2029. The project has also made a significant contribution to employment in Egypt. To date, it has generated approximately 1,200 highly skilled direct jobs. In addition to these direct employment opportunities, the initiative has created more than 14,000 indirect positions supporting the broader economy.

Over the next four years, total employment impact is projected to exceed 180,000 jobs. While this project is first and foremost about supporting national sales efficiency for the Egyptian people, it is also transformative for Grifols. By shifting part of our sourcing to a more cost-effective AMA-proofed hub in Egypt, we are structurally derisking our plasma supply, expanding margins, and reinforcing the underlying fundamentals of our business model.

Across our vertical integration in the US, our self-sufficiency partnership in Canada and our strategic self-sufficiency expansion in Egypt, we believe that we are building a basis and the blueprint that will allow us to better meet demands in an evolving geopolitical context and deliver value for the long term. We are confident in this path.

With that, I will now hand it over to Rahul, who will provide more details on our financial performance.

Thank you, Roland. As per slide 18. As both Nacho and Roland have alluded to, navigating highly dynamic forces be it the geopolitics that threaten to disrupt the supply chains of most global companies or the seismic moves in euro-dollar, the fact that Grifols was able to deliver on its deleveraging plans beat free cash flow generation and revenue guidance, whilst achieving adjusted EBITDA guidance and more than double group profit demonstrates the clear resilience of this business. The foundations of this resilience comes from: One, Grifols' unique position in the U.S. with a fully integrated truly end-to-end in-market for market business; two, our highly differentiated self-sufficiency strategy that have been many years in the making, thanks to the vision and the enterprise of those before us, and that will be a source of clear competitive advantage going forward; three, the highly strategic and long-standing partnerships that have been developed over time; four, our end-to-end capabilities all the way from industrial to commercialization and everything in between; five, the tireless efforts of all our teammates across the entire Grifols Group; and finally, and most importantly, the trust from our patients, our donors and our customers.

Specifically on the financials, net revenues in 2025 are up 7% versus 2024 and 9% on a like-for-like basis, both in constant currency terms, reflecting the secular tailwinds for IG demand. Adjusted EBITDA and gross margin performance is after fully absorbing the IRA impact in 2025. And we need to consider that when making comparisons to 2024 financial performance. For that reason, we have also included the like-for-like column to facilitate better comparability between the 2 years.

In 2025, adjusted EBITDA like-for-like growth rate in constant currency terms was up almost 12% versus 2024. Reported gross margin was weaker versus 2024, broadly due to the impact of fully absorbing IRA in 2025, some accounting reclasses between OpEx and COGS that weighed on gross margin but neutral at EBITDA and the impact of the albumin market in China. On China albumin, we continue to feel well positioned to better navigate the market dynamics given our strategic partnership with Shanghai RAAS and Haier.

On a like-for-like basis, that is prior to the impact of IRE and the gross to net reclassifications, gross margin in 2025, in fact, improved by approximately 50 basis points versus 2024, better reflecting underlying performance. Adjusted EBITDA of $1.825 billion equates to just over $1.9 billion at guidance FX rates. And whilst EBITDA is impacted by the weakening dollar, the natural hedges we have in place make the impact more muted at the free cash flow leverage and group profit levels.

Whilst like-for-like adjusted EBITDA margins at 25% exceed '24, adjusted EBITDA margin was a touch weaker 24.3% after fully absorbing the impact of IRA. EBITDA margins remain an area of critical focus for us, and we will be highly proactive with our efforts to ensure of its continued progression. Group profit is up 156%, more than double 2024 group profit, a clear validation of the Board's recommendation to approve the interim dividend in the summer, Grifols' first dividend payment since 2021. As is customary, the final dividend payment in respect of 2025 is subject to the Board's recommendation and shareholder approval at the AGM later this year.

Moving on to free cash flow. We are pleased to back up the significant free cash flow outperformance in 2024 with another free cash flow pre-M&A beat at $468 million, up over $200 million versus 2024. This business can absolutely generate meaningful amounts of free cash flow, and we remain confident about expanding the free cash flow generation considerably in the coming years.

Our deleveraging path continues with leverage down from 4.6x at the end of 2024 to 4.2x at the end of 2025. The significant dollar weakening had a broadly neutral impact on leverage given that some of our debt issuances are dollar-denominated, and we will continue to optimize the currency mix as we consider our refinancing plans. I will also update you later on a later slide on our positive progress we are making towards 2027 milestones on deleveraging and cumulative free cash flow generation. Also, the combination of the EUR1.7 billion of liquidity and the significant secured capacity I've referenced in prior update, gives us strong confidence about the fortress balance sheet and our ability to execute our exciting plans or indeed, withstand anything unforeseen.

Slide 19. Full year 2025 like-for-like adjusted EBITDA growth was circa 12% and 5.6% after fully absorbing the $108 million IRA impact. Adjusted EBITDA growth was mainly biopharma led. The biopharma EBITDA growth drivers were primarily volume growth, geo and product mix benefits, continued steady improvement of CPL and operational leverage benefits, that together more than offset the impact of China albumin where we will continue to feel better equipped to deal with the developments in China, thanks to our strategic partnership.

Diagnostics continues to achieve all its milestones as part of our significant repositioning of that business, and we're excited about the launch of our new immunohematology platform at the next International Society for Blood Transfusion Congress before the summer, whilst continuing to maintain our leadership in the molecular donor screening market and continuing to significantly grow in our blood typing business, particularly in the U.S. Like-for-like adjusted EBITDA margins of 25% were higher than 2024, and but slightly soft after fully absorbing the impact of IRA. As I said on the prior slide, margins remain an area of critical focus for us, and we intend to remain highly proactive with our efforts to ensure its continued progression.

With regards to cash adjustments, we show a 33% reduction versus 2024, driven by lower restructuring and transaction costs. Consistent with our update in Q3, noncash adjustments relate to impairments of projects that do not at all impact the go-forward equity or credit story and are an extension of the capital allocation discipline that we have talked about. Leaving aside this noncash adjustment, the convergence between adjusted and reported EBITDA driven by lower cash adjustments remains a focus.

Slide 20. We are simply pleased to be able to demonstrate that this business can absolutely produce significant amount of free cash flow, and we are particularly happy about beating our free cash flow guidance again in '25 after the significant beat in 2024. There is nothing structural about this industry, notwithstanding its capital intensity that precludes our ability to ramp up our free cash flow generation from current levels.

As you are aware, the original free cash flow pre-M&A guidance for 2025 was $350 million to $400 million. And raised throughout the year, culminating in the $400 million to $425 million guidance in Q3 and the $468 million outcome considerably beats the improved Q3 guidance. The free cash flow beat reflects the end-to-end focus across the entire organization on cash flow, and we will continue to go forward with the same vigilance in intensity.

The free cash flow beat in 2025 is as a result of improved EBITDA, end-to-end intensity in our working capital management despite investing as a group in further inventory to support the strong demand for our proteins, CapEx levels normalizing for 2024 from '24 highs as we anticipated in our prior updates, lower cash interest as a result of the benefits of the deleveraging in 2024 and balance sheet and capital structure management and finally, lower cash adjustments that is captured within others. Our free cash flow conversion improved from circa 15% in 2024 to circa 25% in 2025. Whilst free cash flow conversion can vary from year-to-year, we remain confident about being able to improve free cash flow conversion meaningfully over the coming years. To summarize, we are pleased with the 2025 outcome, and we look forward to generating further improvements in free cash flow in 2026 and beyond.

Slide 21. Positive deleveraging progress and free cash flow improvement is now being validated and rewarded by a normalization of rating agency views towards Grifols as they confirm our rapid re-rating progress. In the last 18 months or so, S&P have moved the Grifols ratings from B flat stable to BB- stable, up 2 notches. Similarly, Moody's have also improved the Grifols rating by 2 notches from B3 to B1 stable. And Fitch from B+ to B+ positive.

We are also glad to see credit investors and our relationship banks validate our significant deleveraging and free cash flow improvement progress. The considerable tightening of secondary trading yields of our 2030 bonds clearly demonstrates strong credit investor sentiment.

Further, the significant increases in the commitment levels that are being volunteered by our relationship banks will support our planned significant upside to the revolving credit facilities with materially improved pricing and flexibility. In addition, preparations are in an advanced stage to support our refinancing plans in respect of our 2027 maturities. We plan to do this in two steps, starting with the revolver and the TLB, for the latter, we expect to commence an institutional TLB investor-focused education process shortly and target a subsequent launch subject to market conditions during the course of H1 2026. And we expect to refinance the remaining 2027 bond maturity in Q4 2026 or earlier.

Slide 22. This slide succinctly captures our 4-year financial transformation and how that informs our 2026 priorities. As the chart on the left shows, our deleveraging story is very compelling, reducing our leverage from 9x in H1 2022 to the current 4.2x credit agreement leverage driven by significant EBITDA growth and free cash flow improvement.

A significant proportion of the EBITDA growth has been volume led, with a very deliberate execution of our strategy announced in 2023 to win back lost market share in the U.S. and international growth. the progress of both EBITDA growth at 14% CAGR and margin improvement by over 400 basis points from 2022 to 2025 is clear for everyone to see. Having successfully taken our credit agreement leverage back to pre-coat levels and having executed on the plan to win back lost market share in the U.S. we are now well placed to optimize our path forward, in particular, to take action to advance our margin progression, including optimizing the balance of our last liter across IG and albumin.

In this regard, the recent EMA approval for Egypt source plasma is a game changer for Grifols and for the plasma industry. The combination of our unique position in the U.S. and the progress with our self-sufficiency projects in Egypt and Canada differentiates the Grifols story from the rest of the industry, and we are confident about following our own path, which is a nice segue into our priorities for 2026 on the right. We believe that we are uniquely positioned to redefine the industry by harvesting the value of our strategic investments from the past. Our priorities are clear.

We will continue to grow in line with the U.S. IG market while maintaining a very targeted and disciplined ex U.S. strategy yet fully leveraging the paradigm shift that EMA approval of Egypt source plasma offers Grifols. And focus on value creation via prioritizing margin expansion accelerating free cash flow generation and continuing on our deleveraging path, which we believe will help us continue our rerating progress, not just on the credit side where the evidence thus far speaks for itself, but also on the equity side. Slide 23.

Before I touch on '26 guidance, let me start with our '27 milestones. We remain on track to achieve both milestones credit agreement leverage down to 3.5x and cumulative free cash flow pre-M&A of $1.75 billion to $2 billion by end 2027.

As for 2026, the clear focus is on continuing to improve our free cash flow story, and we are guiding to $500 million to $575 million free cash flow pre-M&A in 2026. In addition, we are targeting improving adjusted EBITDA margins to 25% or higher, and we expect adjusted EBITDA growth to be in the 5% to 9% region on a constant currency basis versus 2025. And you can assume euro-dollar average FX in 2025 of circa 1.12. We remain committed to continuing on our deleveraging path. And finally, even if you can imply the revenue growth yourselves from what is on the slide, whilst we expect to grow on a constant currency basis, we are deliberately not including revenue growth guidance for 2026.

This is consistent with our 26 priorities from the prior slide, we are consciously moderating revenue growth in 2026 from our higher 2025 base by prioritizing our focus on margin-accretive growth driven by our unique position and the highly compelling prospects from our self-sufficiency initiatives that we look forward to updating the market on in the coming quarters. We are following our own path with conviction.

With that, let me hand it back to Nacho.

Thank you, Rahul. I would like to conclude by reiterating a few points that we've already made, but that bear repeating. In 2025, we delivered on our commitments and strengthening our financial foundation. More importantly, the performance of the company reflects our ability to capture the fundamental resilience of the plasma industry. High mode essential sector where Grifols continue to set the standard for global leadership.

Through our long view lens, our strategic direction is clear. Grifols will harvest the value of our strategic footprint. Our vertical integration in Canada and our partnership in Egypt are a critical catalyst for our next chapter. These hubs provide a diversified and resilient supply chain that positions us to capture further value. What remains unchanged is the strength of our underlying business and our commitment to our long-term vision.

Our immunoglobulin franchise continues to benefit from a strong structural demand, while Albumin alpha are and specialty proteins portfolio as well as fibrinogen remain core assets within our portfolio. At the same time, our Diagnostic business is progressing toward an evolving operating model that we are convinced that will unlock significant additional value over time.

Today, Grifols is a more focused and resilient organization structured to deliver consistent performance, prioritizing returns free cash flow and deleveraging with a clear objective of increasing value for our shareholders. I would like to thank the entire Grifols team for their dedication and effort throughout the year. And also, I would like to thank all of you for your continued interest and support in Grifols.

With that, Dani, back to you.

Thank you so much, Nacho. Now let's turn to the Q&A session. (Event Instructions) Let's start with Thibault from Morgan Stanley.

Yes. Maybe my first question, obviously, I mean, you mentioned we can reverse general sales growth. I just want to know if 2026 is specific year where growth is differing from the Capital Market Day target that you had, we should assume growth to come back after and see a relation to this. Is it about what you're seeing for demand? Is about plasma capacity?

Or is it really about the plasma economics and last liter focus that explained the growth being slow in 2026?

Thibault, as you think about revenue growth, one of the reasons why we've excluded it, even though you can work out, do the math yourself on that page is that it isn't a priority. Why isn't it a priority? We have taken our leverage back to pre-COVID levels. We have executed successfully on our plan to win back lost market share in the U.S. and our focus from here on is about optimizing the quality of our EBITDA growth.

That's the key focus on our standpoint. And on that, I can ask Roland as well to add as we think about balancing the last 3 economics. Roland?

Yes. Thank you, Thibault, for the question. Absolutely, plasma economics are at the heart of our business given that we produce our medicines from very precious donations. And that entails 3 main aspects. One is we have to maximize our first leader proteins; second, over the longer term, balance IT and albumin growth; and thirdly, bring costs down of production, of course.

But double-clicking on the IG and albumin balance for a moment, over the last 2 years, we have constantly used a strong IT position to regain share in the U.S. and drive growth. Now this has last year combined at the same time with a temporary softness in China as market works through policy changes, but notably with continued strong unmet need and patient demand on the line.

This puts us in a position this year where we can optimize our approach for 2026. On the IG side, after 2 years on strong growth on this higher base and with the position that we were aiming for achieved in the U.S. and key European markets, we focus our growth there, and we are pulling back in other markets elsewhere. And on the albumen side, we build on our momentum to make sure that we can catch up. We believe that we are in a strong position to balance albumin IG over growth, not only from a commercial perspective, but also in China through our strategic partnership with Shanghai RAAS.

And as Rahul and Nacho alluded to, through our absolutely transformative strategic partnership in Egypt, which provides us with excess IG for the European market and our continued focus on work on the yield. And all of that, of course, while continuing to drive our first leader proteins and our cost overall.

Now let's move to the next one. It's going to be Jaime Escribano from Santander.

So my question is, so I'm trying Rahul to try to get the potential EBITDA guidance on a reported basis for 2026. I'm getting something in between, obviously, assuming that 25% margin because if I put a higher margin, it can be more. But let's call it a minimum reported EBITDA adjusted guidance of EUR1.9 billion to EUR1.97 billion. This will be my first question. Does this make sense?

Would you feel comfortable with that?

99% on 1,825 is around 1,950 to about 1,980, give or take. So ballpark, your numbers are correct. As I mentioned as well, as you think about average euro dollar for [25], that's at 1.12. So hopefully, that gives you the information you need, Jaime.

Yes. So it's -- so again, I understand that you are not providing the top line guidance, but you give up 20% margin or more. So -- can you try to give us a little bit more color on whether you think you are going to be more closer to 25% or more 25.5%. Because depending on that, obviously, the top line growth will be more or less?

Let me address that. Two points. One, on a constant currency basis, as I said in my prepared remarks, you can absolutely assume moderate growth, moderate net revenue growth. And as you think about modeling out margins, I think your 25% to 25.5% range is absolutely fine.

Now we will go to Alvaro Lenze from Alantra.

Going back to revenue, just wanted to understand what you mean by pursuing higher or more profitable revenue or prior advising margins, but really sounds to me or I would have thought that you would sell always as much as possible. So I don't know what are your internal levers in terms of revenue to improve profitability? I would suspect you would try to sell as much of the non-IND, non-albumin as you can, and you are already price takers, the same. So I don't know what the levers are. And so I wanted to know, first, what the levers are on revenue?

And second, whether more of the margin improvement comes from the cost side with all Egypt venture and maybe some industrial gains so -- just trying to understand that. And my second question would be on buyback, which you did not mention is that still expected for this year?

Alvaro, as we look into 2026, and we want to balance our growth in IG with albumin. We are in a position with our momentum to choose the markets in which we want to focus growth. And obviously, these are the markets where we see a higher value realized and a higher margin. And therefore, our focus to continue our momentum in the U.S. and key European markets.

So we are in a position with our momentum that we can choose where we want to position the supply that we have on IG side, while, of course, driving on the albumin side to continue to grow. This is, as you look at pricing and value that we create. And then obviously, we are looking at the cost side as well. And as we continue to drive efficiencies and effectiveness in our manufacturing and plasma collection network, absolutely.

On Hema BPC, the timing of the exercise over will be determined by the Board, as I've said before. And we've also previously indicated a potential exercise in '26 or '27. And I've also indicated that we intend to finance it through free cash flow generation whilst continuing on our deleveraging part. So no change in overall message. Final timing is '26, '27, but the precise timing will be a matter that's determined by the Board.

Okay. Thank you so much, Rahul. Now we will move to Guilherme from CaixaBank.

Yes. So the first one is regarding phasing. So we are -- from a Q4 run rate in terms of biopharma growth, we'll have several effects moving into 2026, others don't. Just wanted to understand how should we think about the phasing of the growth throughout the year? If you're assuming desire to optimize the gross cost proteins right after -- right in Q1?

Or we should expect some slowdown in the pressure that you're seeing in albumin and so a more stable growth throughout the year? And the second question is how are you thinking about your post 2027 debt refinancing options in terms of maturity, you mentioned that you could optimize currencies. And in terms of time lines for the potential refinancing. And related to that, whether the free cash flow guidance includes potential refinancing costs that you might pay, especially addressing 2030 maturities?

Guilherme, let me take the refinancing plans first and Roland will take -- sorry, your second question, and Roland will take your first question after. On refinancing plans, as we mentioned in my prepared remarks and in the presentation, the intention is to proactively manage our '27 maturities, and we're at an advanced stage of preparation with respect to the RCF and the TLB refinancing, and we expect to commence an investor education process relatively quickly. And then subject to market conditions, the expectation would be to get the TLB refinancing done in H1 '26, all entirely consistent with our prior updates.

As you think about currency, which I believe was another part of your question, Guilherme, I think for the moment, you can model it on the basis of existing currency splits. Our TLB is split into dollars and euros. So you can assume the existing currency splits that are disclosed. I did reference that we will seek to use our refinancing plans to optimize the natural hedges in place a bit better. So ultimately, maybe the final denominations of currencies do vary a little bit, but I think it's a good working assumption to use the existing ones.

And then finally, as you think about the TLB today is about 2.2 billion, give or take. And I talked about the secured bonds of $750 million or so following in Q4 or earlier subject to market conditions, the intention would be to refinance all 3 billion, well ahead of the year, again, entirely consistent with our prior updates. Hopefully, that addresses your question.

And on the first one, Roland?

Yes. In terms of phasing, perhaps just 2 parts to highlight. One is we have natural seasonality throughout the different proteins in our portfolio. Just to give you one example, rabies with a very high use over the summer months, of course, and for some of the other proteins, we just have seasonal buying patterns from wholesalers. And perhaps a second aspect to highlight, as we say, we continue to grow with the market in the U.S.

and key European markets. So there, we expect a similar phasing to what we've seen in the past. And as we continue to be selective in markets elsewhere, this will play out throughout the year.

Thank you so much, Roland, a very comprehensive question. Now let's move to Justin. Justin Smith from Berstein.

I'm sorry if I'm being a bit slow here. Can I just revisit the 2029 guidance that was issued a year ago. Am I right in thinking that, that guidance on an absolute basis is still valid if we just adjust dollar euro -- [104 to 112]? If not, can you just help me understand what I'm missing? I'm trying to understand if growth is more hockey stick or if something is actually kind of structurally changed in the last 12 months?

Justin, let me take that. I think as you look at the '25 to '29, that was a road map that we set out with a very clear objective to increase EBITDA and EBITDA growth, improve our EBITDA margins, expand free cash flow generation and considerably delever. All of those aspects absolutely hold true, no change whatsoever. Since then, we've obviously provided a met guidance for 2025. We're providing guidance for '26 and confirming that we are on track to achieve our '27 milestones.

I think we've given probably more information than would ordinarily be the case. But as you think about revenue growth as well, we have grown enormously in the last couple of years, and we are talking about moderate growth on a constant currency basis from this higher base, from this higher base. So if I could leave it at that, Justin, that would be great.

Thank you so much. Rahul, we have a follow-up from Thibault from Morgan Stanley.

Just want to touch on the dynamic of It looks like the gross margin was probably lower than expected and at the same time, SG&A and R&D composite for that. So just in terms of how we should read into that dynamic when we think about the cost side into '26?

Thanks, Thibault. As you think about gross margin, and it's better to look at gross margin on a full year basis rather than quarterly. We talked about some phasing and FX and so on. So move away from the Q4 and look at the following page covers the following page covers in the appendix covers the full year picture. So let's look at that picture.

Point one, if I can start with this gross margin like-for-like '25 versus '24 was, in fact, 50 basis points better. Pre-RA pre-gross to net reclass that was recommended by our auditors, which better captures underlying performance.

IRE alone was a 90 basis points impact, negative impact. Accounting reclass that is EBITDA neutral, but weighs on gross margin was another headwind. China albumin headwinds we've talked about as well, but we feel very good about our strategic partnership with Shanghai RAAS. So I would use the full year gross margin picture rather than the quarterly the fourth quarter gross margin picture as being what is reflective of 2026 and building on that, not the Q4 picture. Hopefully, that addresses your question, Thibault.

Rahul, we have a second follow-up today. This is coming from Alvaro.

Just a very quick I know you're focused on the current refinancing, but I just was just wondering when would be a potential window to refinance the 2030 maturities which are the most expensive for senior secured? And very quickly, if you could just give us some highlights on your current capacity and how much spare capacity do you have for continued growth while maintaining low CapEx?

Sure. Let me start with the with the 2030 refi and Roland will take your second question on capacity. On 2030 refi, look, we're just going to continue to be just opportunistic and be very, very focused on trying to drive interest costs as low as possible. As you know, Alvaro, and I know you know our debt complex well are -- we have -- those bonds are callable on the first of May 2026 at 104 and they dropped down to 102 on 1st of May 2027. And we're just going to be very, very disciplined in terms of what drives better value.

Is it better to refinance during the course of 2026 or wait until 2027. We will drive that based on just the value proposition. But look, I think it's -- I agree with you that, that debt is expensive. It also goes to show how significant the tightening of yields have been in the last 12 months, which is again significant validation of the strong creditor investor sentiment towards the Grifols story. But on your second question, Roland?

Yes, for capacity. We don't give the details in terms of the exact liters, but we have the capacity that we need to execute over the next year. And we are building on that in one hand, in terms of optimization that we continuously deploy across our sites, our 5 sites. We have our Canadian plant coming online. We have the Egyptian plan that we talked about today coming online, and we recently announced our expansion in Visa in Barcelona.

So we have a very clear plan for CapEx and expansion, that sets us up to deliver on what we plan and grow in the future.

Thank you so much, Roland. We have a question from Charles from Barclays. I'm going to go through the question. There are some technical issues, two questions.

Can you comment on market share evolution for IG and subcu? Second one, albumin, market share in China for albumin.

Yes I'm happy to like the two.

Roland will take your question, Charles.

Yes. As for market share for IG, that was obviously one of the main focus areas that we have, especially in the U.S. in our plan over the last 2 years to regain share, and we're happy with the progress that we made. There's different data sources that I'm sure, Charles, that you're tapping into, but we're pleased with the market share gains that we had. Not only with the number that we've seen, but also with the quality in the centers where we achieved this.

Subcu needless to say, with the growth and momentum that we were able to deliver last year. We're very pleased with the momentum as well. We don't go into specifics of the split between the -- but in the U.S., which is the key market for us, very pleased with the uptake that we see on the subcu side.

And in terms of albumin in China, both as we look at batch releases ex factory as well as if we look at pull-through, we are pleased with what we see versus competition. As said before, our strategic partnership with Shanghai RAAS, we believe, puts us in a very good place in order to effectively compete in this market and make sure as the China environment stabilizes, that we're able to continue to drive growth there.

Thank you so much and Roland, I'm sure that this is going to be helpful. We have another follow-up. This is coming from Jaime Escribano from Santander.

Yes, I have a couple of questions from my side, from a strategic viewpoint. Canada, I don't know if you can quantify or at least tell us how much could be the economic opportunity of the new plant? Or when do you think this can start producing meaningful revenues? And in the case of Egypt, the impact of the gross margin in the long run, again, maybe a little bit qualitatively? Or when could we start seeing some benefits from the gross margin improvement as a result of using the plasma?

And last very quick one, if I may. Regarding CapEx, 2026, the free cash flow guidance of EUR500 million to EUR[530] million. What is the implied CapEx tangible plus intangible that you are estimating for this guidance?

Rahul will take it on the CapEx. Certainly, on Egypt and Canada, I mean, we are not providing details of the specific benefit that these collaborations will provide. I think that there is enough information out there in order to guess or guesstimate what that impact would be. I think that in the case of Egypt is certainly already seen clear benefit in 2026 and beyond as we will progress growing our footprint in that market. And in Canada, I think we've been collaborating with CVS for a number of years.

We have already a solid commercial operation there. Now with the -- especially with the new policy from the Canadian government, where they are going to push even harder on sales efficiency. Clearly, there is an opportunity for us to strengthen that relation because we have been really the only brand that has invested in that market with a manufacturing plant and our plasma donor centers there that will certainly help to drive that growth.

No. And I think not just perhaps to just clarify, both of these strategic projects are creating value today. So in Canada, fourth largest market, highest per capita, strong growth, aiming for 50% self-sufficiency. This is already happening today since the plasma that we collect in Canada is fractionated in our U.S. plant, and we are already supplying to Canadian patients in terms of self-sufficiency.

So this is not something that has to wait for the plant to be finished. This is something which, as of today, already is a win-win.

And similarly, in Egypt, as Nacho just explained, a clear win-win for us. And as you think about it, -- this has several components. One is, of course, there's the value to Egypt and the region true to the mission that Grifols has. But as you think about the value to Grifols, we have highest quality, highest standard facilities in terms of our plasma collection in Egypt. -- but the cost structure is very different.

So there's a clear benefit in CPL. There's a clear benefit in terms of balancing in albumin. As explained, albumin use is much higher in this region than -- and lastly, what we see is that the plasma we collect there comes with a very promising yield that, of course, translates into more medicines that can be produced from this plasma. So both of these win-wins with value accreting already today.

And then on CapEx, Jaime, which I think was your question. So the way I look at CapEx, I look at both CapEx and capitalized IT and R&D on CapEx. We expect to do continue to -- we expect the CapEx levels for '26 to be slightly lower than they are in '25. But as we think about our R&D and capitalizing IG and R&D capitalization efforts, we expect that to be slightly higher. So I think, Nathan, if you add the two up, you might just end up at around the same number as we did in '25, maybe a little lower in '26.

Hopefully, that addresses that question.

Rahul, very clear. That was the very last question for today. Just say thank you so much for joining us and follow your questions. If there is any follow-up, please contact the IR team happy to help. Thank you so much.