美敦力 (MDT) 2024 Q4 法說會逐字稿

Good morning. I'm Ryan Weispfenning, Vice President and Head of Medtronic Investor Relations, and I appreciate that you're joining us this morning for our fiscal '24 fourth quarter video earnings webcast. Before we go inside to hear our prepared remarks, I'll share a few details about today's webcast.

早安.我是瑞安·韋斯芬寧 (Ryan Weispfenning)，美敦力 (Medtronic) 副總裁兼投資者關係主管，非常感謝您今天早上加入我們的 24 財年第四季度視訊收益網絡廣播。在我們進去聽取準備好的發言之前，我將分享有關今天網路廣播的一些細節。

Joining me are Geoff Martha, Medtronic Chairman and Chief Executive Officer; and Karen Parkhill, Medtronic Chief Financial Officer. Geoff and Karen will provide comments on the results of our fourth quarter and fiscal year 2024, which ended on April 26, 2024, and our outlook for fiscal year '25. After our prepared remarks, the executive VPs covering our segments will join us and will take questions from the sell-side analysts that cover the company. Today's program should last about an hour.

與我一起出席的還有美敦力 (Medtronic) 董事長兼執行長 Geoff Martha；和美敦力財務長 Karen Parkhill。 Geoff 和 Karen 將對我們第四季和截至 2024 年 4 月 26 日結束的 2024 財年的業績以及我們對 25 財年的展望發表評論。在我們準備好的發言之後，負責我們各部門的執行副總裁將加入我們，並將回答負責該公司的賣方分析師的問題。今天的節目應該持續大約一個小時。

Earlier this morning, we issued a press release containing our financial statements and divisional and geographic revenue summary. We also posted an earnings presentation that provides additional details on our performance. The presentation can be accessed in our earnings press release or on our website at investorrelations.medtronic.com.

今天早些時候，我們發布了一份新聞稿，其中包含我們的財務報表以及部門和地區收入摘要。我們還發布了一份收益報告，提供了有關我們業績的更多詳細資訊。您可以在我們的收益新聞稿或我們的網站 Investorrelations.medtronic.com 上存取該簡報。

During today's program, many of the statements we make may be considered forward-looking statements and actual results may differ materially from those projected in any forward-looking statements. Additional information concerning factors that could cause or actual results to differ is contained in our periodic reports and other filings that we make with the SEC and we do not undertake to update any forward-looking statement.

在今天的節目中，我們所做的許多陳述可能被視為前瞻性陳述，實際結果可能與任何前瞻性陳述中預測的結果有重大差異。有關可能導致實際結果不同的因素的更多資​​訊包含在我們向 SEC 提交的定期報告和其他文件中，我們不承諾更新任何前瞻性聲明。

Unless we say otherwise, all comparisons are on a year-over-year basis and revenue comparisons are made on an organic basis, which excludes the impact of foreign currency, prior year revenue from a onetime IP agreement in Structural Heart, and fourth quarter revenue in the current and prior year reported as other, which stems from prior business separations and exits. There were no acquisitions made in the last 4 quarters that had a significant impact on total company or individual segment quarterly revenue growth.

除非我們另有說明，否則所有比較都是按年比較，收入比較是在有機基礎上進行的，不包括外幣的影響、上一年來自 Structural Heart 一次性知識產權協議的收入以及第四季度的收入本年度和前一年報告為“其他”，這源於先前的業務分拆和退出。過去 4 個季度沒有發生對公司整體或個別部門季度收入成長產生重大影響的收購。

References to sequential revenue changes compared to the third quarter of fiscal '24 are made on an as-reported basis, and all references to share gains or losses refer to revenue share in the first calendar quarter of 2024 compared to the first calendar quarter of 2023, unless otherwise stated. Reconciliations of all non-GAAP financial measures can be found in our earnings press release or on our website at investorrelations.medtronic.com. And finally, our EPS guidance does not include any charges or gains that would be reported as non-GAAP adjustments to earnings during the fiscal year.

與 2024 財年第三季相比，連續收入變化的參考均按報告的基礎進行，所有對份額收益或損失的參考均指 2024 年第一季與 2023 年第一季相比的收入份額， 除非另有說明。所有非 GAAP 財務指標的調整表可在我們的收益新聞稿或我們的網站 Investorrelations.medtronic.com 上找到。最後，我們的每股盈餘指引不包括本財政年度收益的非公認會計原則調整報告的任何費用或收益。

With that, let's head into the studio and hear about the quarter and the year.

接下來，讓我們走進工作室，了解一下季度和年度的情況。

Hello, everyone, and thank you for joining us today. We delivered a strong finish to the fiscal year with broad strength across our businesses. Each of our 4 segments delivered mid-single-digit or higher revenue growth, and this was on top of a strong mid-single-digit performance last year. Throughout fiscal '24, we delivered consistent mid-single-digit revenue growth with over 5% for the full year.

大家好，感謝您今天加入我們。我們憑藉著各業務的廣泛實力，為本財年畫下了圓滿的句點。我們的 4 個細分市場均實現了中個位數或更高的收入成長，這是在去年強勁的中個位數業績的基礎上實現的。在整個 24 財年，我們全年實現了 5% 以上的持續中個位數收入成長。

At the same time, we're making progress on our commitment to restore our earnings power, which is evident in our fiscal '25 guidance. We're executing COGS cost-out programs, while maintaining pricing and maximizing efficiencies in our operating overhead. And we're translating our earnings into strong and improving cash flow, which we're investing to drive future growth and return to our shareholders.

同時，我們在恢復獲利能力的承諾方面正在取得進展，這在我們的 25 財年指導中顯而易見。我們正在執行銷貨成本成本削減計劃，同時維持定價並最大限度地提高營運費用效率。我們正在將獲利轉化為強勁且不斷改善的現金流，我們投資這些現金流是為了推動未來的成長並為股東帶來回報。

We also continue to enhance our operating model to make the company even more resilient, and our global workforce is embracing a performance-driven culture that is translating into durable results. We made solid progress in fiscal '24, and the momentum we're building into the new year has me very excited for '25. We're at the beginning stages of new product cycles. The runway from the differentiated technologies we've recently launched, along with the innovation we will launch over the next 12 months, give me significant confidence in our ability to drive durable growth.

我們也持續增強我們的營運模式，使公司更具彈性，我們的全球員工正在擁抱績效驅動的文化，而這種文化正在轉化為持久的成果。我們在 24 財年取得了堅實的進展，我們為新一年打造的勢頭讓我對 25 財年感到非常興奮。我們正處於新產品週期的開始階段。我們最近推出的差異化技術以及我們將在未來 12 個月內推出的創新讓我對我們推動持久成長的能力充滿信心。

These launches put us in a strong position in some of med tech's most attractive markets like Afib, structural heart, robotics, neuromodulation, hypertension and diabetes. And this is further enhanced as we apply AI across our portfolio. All that to say, we are very optimistic about what we can achieve here in fiscal '25 and beyond.

這些產品的推出使我們在一些最具吸引力的醫療技術市場中處於有利地位，例如心房顫動、結構性心臟、機器人、神經調節、高血壓和糖尿病。隨著我們在整個產品組合中應用人工智慧，這一點得到了進一步增強。綜上所述，我們對 25 財年及以後所能達成的目標非常樂觀。

Now let's turn to the details of our Q4 results, where we had a number of standout performances. We look at our businesses in 3 categories: Established market leaders, synergistic, and highest growth. Our established market leader and synergistic businesses both grew mid-single digits, while our highest growth businesses delivered high single-digit growth.

現在讓我們來看看第四季業績的細節，我們有許多出色的表現。我們將我們的業務分為三類：成熟的市場領導者、協同效應和最高成長。我們既定的市場領導者和協同業務均實現了中個位數成長，而我們成長最快的業務則實現了高個位數成長。

Looking first at our established market leaders, combined they made up just under half of our revenue and grew 5%. The highlight of the quarter was Cranial & Spinal Technologies. After growing 6% or higher every quarter this year, CST accelerated to 9% growth in Q4. I want to say that one more time, 9% growth in Q4. This was driven by an outstanding quarter for capital sales with neurosurgery growing 14%. We had double-digit revenue growth in Mazor Robotics, StealthStation navigation, O-arm Imaging, and Midas Rex powered surgical instruments.

首先來看看我們成熟的市場領導者，他們的收入合計占我們收入的一半以下，並且成長了 5%。本季度的亮點是顱骨和脊椎技術。繼今年每季成長 6% 或更高之後，CST 在第四季度加速成長至 9%。我想再說一遍，第四季成長 9%。這是由於本季度資本銷售表現出色，其中神經外科增加了 14%。我們在 Mazor Robotics、StealthStation 導航、O 型臂成像和 Midas Rex 動力手術器械方面實現了兩位數的收入成長。

And this pooled through Spine Implants & Biologics, with high single-digit growth in Biologics and mid-digit growth in Core Spine, including 8% Core Spine growth in the U.S. We also continue to see strong adoption of unit adapted spine intelligence, our integrated AI surgical planning solution. Here, we're taking data and building deep learning models that see patterns and create personalized outcomes for patients.

這透過脊椎植入物和生物製品匯集在一起，生物製品實現了高個位數增長，核心脊椎實現了中位數增長，其中美國的核心脊椎增長了8%。適應脊椎智慧的大力採用，我們的綜合脊椎智慧AI手術規劃解決方案。在這裡，我們正在獲取數據並建立深度學習模型，以查看模式並為患者創建個人化結果。

As I've been sharing for several quarters now, our strategy of combining best-in-class implants and biologics with our best-in-class enabling technology, and then adding our unique intelligence into the procedure is a winning formula in Spine. We call it the AiBLE ecosystem, and it's a big competitive differentiator for us. AiBLE is creating value for patients. It's winning over surgeons all around the world, and it's changing the competitive dynamics of the Spine marketplace. And it's attracting the best reps to Medtronic to expand our business.

正如我幾個季度以來一直在分享的那樣，我們將一流的植入物和生物製劑與我們一流的支援技術相結合，然後將我們獨特的智慧添加到手術中的策略是 Spine 的致勝秘訣。我們稱之為 AiBLE 生態系統，這對我們來說是一個巨大的競爭優勢。 AiBLE 正在為患者創造價值。它正在贏得世界各地的外科醫生的青睞，並且正在改變脊椎市場的競爭動態。它吸引了最優秀的代表來到美敦力來擴展我們的業務。

Next, in Cardiac Rhythm Management, Cardiac Pacing Therapies delivered another strong quarter of high single-digit growth. Our Micra leadless pacemaker franchise grew over 20%, driven by the adoption of our latest generation Micra AV2 and VR2, which improved procedure efficiency and increased battery longevity by 40% to 16 or 17 years. Now we hold the vast majority of share in the leadless pacing space. We also continue to expand our pacing leadership as the only company to offer an approved lead for an innovative alternative form of pacing called conduction system pacing. Our 3830 conduction system pacing lead grew over 40%.

接下來，在心律管理領域，心臟節律治療又實現了強勁的個位數高成長。在採用最新一代 Micra AV2 和 VR2 的推動下，我們的 Micra 無引線起搏器系列增長了 20% 以上，提高了手術效率並將電池壽命延長了 40% 至 16 或 17 年。現在我們在無引線起搏領域佔有絕大多數份額。我們也繼續擴大我們的起搏領導地位，作為唯一一家為稱為傳導系統起搏的創新替代起搏形式提供經批准的導線的公司。我們的 3830 傳導系統起搏領先優勢成長了 40% 以上。

In Defibrillation Solutions, we're seeing good early adoption of our innovative AURORA EV-ICD, which requires no leads in the heart. Now as more implanters complete their training, we expect EV-ICD sales to ramp and become a significant driver of CRM growth, taking share from the competitors SICD system.

在除顫解決方案中，我們看到創新 AURORA EV-ICD 的早期採用情況良好，該技術無需心臟導線。現在，隨著越來越多的植入者完成培訓，我們預計 EV-ICD 銷售將大幅上升，並成為 CRM 成長的重要推動力，從競爭對手 SICD 系統中奪取市場份額。

Next, in Surgical, we grew 5%. Our advanced energy product lines grew high single digits on the continued launch of our LigaSure XP Maryland vessel sealer. We've now taken energy share from our main competitor for 6 quarters in a row. Our Wound Management business also grew high single digits as strong sales of our V-Loc barbed sutures also resulted in continued share gains from our main competitor.

接下來，在外科領域，我們成長了 5%。隨著我們的 LigaSure XP 馬裡蘭血管密封劑的持續推出，我們的先進能源產品線實現了高個位數成長。我們現在已經連續六個季度從主要競爭對手手中奪取了能源份額。我們的傷口管理業務也實現了高個位數成長，因為我們的 V-Loc 有刺縫線的強勁銷售也導致我們的主要競爭對手的份額持續成長。

In Q4, we expanded the capabilities of our Touch Surgery digital ecosystem. Just as our AiBLE ecosystem is transforming Spine, Touch Surgery is transforming laparoscopic and robotic surgical procedures. We collect robust data sets from surgeries, including video, to create models that inject intelligence into these procedures. We've launched 14 new AI-based algorithms on our Touch Surgery Performance Insights platform just at SAGES last month.

在第四季度，我們擴展了觸摸手術數位生態系統的功能。正如我們的 AiBLE 生態系統正在改變脊椎一樣，觸摸手術正在改變腹腔鏡和機器人手術程序。我們從手術中收集可靠的數據集（包括影片），以創建為這些手術注入智慧的模型。上個月，我們在 SAGES 上的觸控手術績效洞察平台上推出了 14 種新的基於人工智慧的演算法。

These first-in-class algorithms automatically analyze surgical procedures from anatomy to critical structures, enabling surgeons to objectively assess performance. We also launched Touch Surgery Livestream, which enables secure and seamless telepresence, including training and proctoring, from a procedure room to really anywhere in the world. Overall, adoption of our Touch Surgery ecosystem is accelerating and it's becoming a very important differentiator for our surgical franchise.

這些一流的演算法自動分析從解剖到關鍵結構的外科手術，使外科醫生能夠客觀地評估表現。我們還推出了觸控手術直播，它可以實現從手術室到世界任何地方的安全、無縫的遠端呈現，包括培訓和監考。總體而言，我們的觸摸手術生態系統的採用正在加速，它正在成為我們手術特許經營的一個非常重要的差異化因素。

Now turning to our synergistic businesses, combined they grew 5% in Q4. Cardiac surgery, ENT, and endoscopy, all grew high single digits. Pelvic health, coronary, peripheral vascular, and neuromodulation, all grew mid-single digits. In neuromod, brain modulation had an outstanding quarter, growing low double digits. This was the first quarter of benefit from the launch of Percept RC with BrainSense technology, the only complete sensing-enabled DBS system on the market.

現在轉向我們的協同業務，第四季度它們總計成長了 5%。心臟手術、耳鼻喉科和內視鏡檢查均達到高個位數成長。骨盆健康、冠狀動脈、週邊血管和神經調節均呈現中個位數增長。在 Neuromod 領域，大腦調節季度表現出色，以低兩位數成長。這是採用 BrainSense 技術的 Percept RC 的推出帶來的第一季收益，Percept RC 是市場上唯一完整的支援感測的 DBS 系統。

Here we are seeing a strong uptake and excitement for this exclusive technology, and it's extending our #1 leadership position in DBS in both Europe and in the U.S. Our neuromod business also received really great news at the end of Q4 with the U.S. FDA approving the Inceptiv closed-loop spinal cord stimulator. The Inceptiv platform is a game changer in chronic pain therapy. The device automatically senses and adjusts stimulation 50x a second, 24/7, with no required interaction from the patient. And the therapy is delivered from the smallest and thinnest closed-loop SCS device on the market, along with the best 3T and 1.5T full-body conditional MRI access.

在這裡，我們看到了人們對這項獨家技術的強烈接受和興奮，它擴大了我們在歐洲和美國DBS 的第一大領導地位。 ，美國FDA 批准了此技術Inceptiv 閉環脊髓刺激器。 Inceptiv 平台改變了慢性疼痛治療​​的遊戲規則。該設備每秒 50 次（24/7）自動感應和調整刺激，無需患者互動。該治療由市場上最小、最薄的閉環 SCS 設備以及最好的 3T 和 1.5T 全身條件 MRI 通道提供。

Given all these advantages will now be carried in the bags of our very large SCS sales force, we expect pain stim to grow above market in the coming quarters.

鑑於我們龐大的 SCS 銷售團隊現在將擁有所有這些優勢，我們預計疼痛刺激將在未來幾季成長到高於市場水平。

Now let's cover the highlights from the businesses in our highest growth markets. Combined they made up 20% of revenue and grew high single digits. And we expect that their contribution to overall growth will accelerate over the coming quarters as we launch new technology. I'll start this quarter with Cardiac Ablation Solutions, which delivered 21% sequential growth in the quarter, including 23% in the U.S. This is driven by our pulsed field ablation products, which are more than offsetting declines in our cryo product line.

現在讓我們來介紹一下我們成長最快的市場中的業務亮點。它們合計佔收入的 20%，並且實現了高個位數成長。我們預計，隨著我們推出新技術，它們對整體成長的貢獻將在未來幾季加速。我將從本季度開始介紹心臟消融解決方案，該解決方案在本季度實現了21% 的環比增長，其中美國增長了23%。低溫產品線的下降。

Q4 marked the first quarter of our PulseSelect PFA catheter launch. It's off to a great start with strong adoption from both focal RF and single-shot users. As we expand the PulseSelect launch, we also continue to advance our robust pipeline of PFA technology. Last week, U.S. pivotal data for our Sphere-9 focal catheter were presented at HRS and published in Nature Medicine. These data were impressive, especially when you consider we were studying persistent AF patients, the most challenging to treat.

第四季是我們推出 PulseSelect PFA 導管的第一季。它有了一個良好的開端，受到焦點射頻和單次用戶的大力採用。隨著我們擴大 PulseSelect 的推出範圍，我們也將繼續推進我們強大的 PFA 技術產品線。上週，美國 Sphere-9 局部導管的關鍵數據在 HRS 上公佈，並發表在《自然醫學》雜誌上。這些數據令人印象深刻，尤其是當您考慮到我們正在研究持續性心房顫動患者時，這是治療最具挑戰性的患者。

We showed Sphere-9 has an excellent safety profile, superior efficiency, and numerically higher freedom from recurrent Afib compared head-to-head with the market-leading traditional RF ablation technology. Sphere-9 can perform both PF and RF ablation as well as high-density mapping, all from a single device. And we're looking forward to offering U.S. clinicians this first of its kind wide focal catheter.

我們證明，與市場領先的傳統射頻消融技術相比，Sphere-9 具有出色的安全性、卓越的效率和更高的複發性心房顫動的自由度。 Sphere-9 可以透過單一裝置執行 PF 和 RF 消融以及高密度測繪。我們期待為美國臨床醫生提供這種首個寬焦點導管。

The output of all this is that we expect our CAS business to continue to accelerate its growth throughout the coming fiscal year as we increase our PFA account training and catheter production to meet the high demand. And over time, we expect our CAS business will reach market growth and then win share. And this will be driven by our PFA launches and the pull-through of our broader portfolio, treating the growing population of patients with Afib.

所有這一切的結果是，隨著我們增加 PFA 帳戶培訓和導管生產以滿足高需求，我們預計 CAS 業務將在下一財年繼續加速成長。隨著時間的推移，我們預計我們的 CAS 業務將實現市場成長，然後贏得市場份額。這將由我們的 PFA 推出和更廣泛的產品組合的推動來推動，以治療不斷增長的心房顫動患者群體。

Next, in Structural Heart, TAVR continues to be a very important growth driver for Medtronic. And we grew high single digits in the quarter. Structural Heart had 2 meaningful developments during Q4. First, data from our SMART trial was published in The New England Journal of Medicine and presented at ACC last month. SMART, well, it clearly showed our valve was better than Edward SAPIEN and small annulus patients, who are primarily women. This is a large segment of the TAVR space, about 40%, which is larger than most realize. Now while it takes time to broadly change clinical practice and change customer contracting, we're seeing early signs from many loyal SAPIEN users that they expect to increase their usage of Medtronic valves, and we're building our business for that growth.

接下來，在結構心臟領域，TAVR 仍然是美敦力非常重要的成長動力。我們在本季實現了高個位數成長。 Structural Heart 在第四季度取得了兩項有意義的進展。首先，我們的 SMART 試驗數據發表在《新英格蘭醫學雜誌》上，並於上個月在 ACC 上發表。 SMART，嗯，它清楚地表明我們的瓣膜比 Edward SAPIEN 和小瓣環患者（主要是女性）更好。這是 TAVR 空間的很大一部分，約佔 40%，比大多數人意識到的要大。現在，雖然廣泛改變臨床實踐和改變客戶合約需要時間，但我們看到許多忠實 SAPIEN 用戶的早期跡象表明，他們希望增加美敦力閥門的使用，我們正在為這一增長建立我們的業務。

The second important development in Q4 was receiving U.S. FDA approval for Evolut FX+, our newest TAVR valve. FX+ has large windows in the frame to allow easy coronary access, while providing the same exceptional valve performance of our Evolut platform. We've just started a limited launch now and are receiving really strong positive feedback from physicians. Full market release is expected in August. So when you consider our 4-year low-risk data, our SMART data, and our new FX+ valve, we expect this combination to drive our TAVR growth at or above the market, especially as the FX+ launch ramps in our second fiscal quarter.

第四季的第二個重要進展是我們最新的 TAVR 瓣膜 Evolut FX+ 獲得美國 FDA 批准。 FX+ 框架上有一個大窗口，可以輕鬆進入冠狀動脈，同時提供與我們的 Evolut 平台相同的卓越瓣膜性能。我們現在剛開始有限的發布，並收到了來自醫生的非常強烈的正面回饋。預計八月全面上市。因此，當您考慮我們的4 年低風險數據、SMART 數據和新的FX+ 閥門時，我們預計這種組合將推動我們的TAVR 成長達到或高於市場水平，特別是隨著我們第二財季FX+推出的增加。

Turning to robotic surgical technologies, we're establishing a strong foundation here, and we continue to expand the Hugo system installed base. In the U.S., we are nearing completion of our urology pivotal trial. We also have now started enrollment in 2 new indication studies, hernia and gynecology. In addition, our development teams are making progress bringing our advanced surgical technologies to Hugo, such as ICG and our LigaSure vessel sealing technology.

談到機器人手術技術，我們正在建立堅實的基礎，並且我們將繼續擴大 Hugo 系統的安裝基礎。在美國，我們的泌尿學關鍵試驗即將完成。我們現在也開始招募兩項新的適應症研究：疝氣和婦科。此外，我們的開發團隊正在取得進展，將我們先進的外科技術引入 Hugo，例如 ICG 和 LigaSure 血管密封技術。

In diabetes, our team delivered another strong quarter, growing 11% globally. In the U.S., we grew 12%, as the rollout of the MiniMed 780G system continues. New U.S. users doubled year-over-year again this quarter. And since launch, we've seen a significant increase in CGM attachment rates, resulting in high-teens growth in U.S. CGM revenue in Q4. Users are choosing our differentiated 780G system for the outcomes it delivers, all with less effort and less burden.

在糖尿病領域，我們的團隊再次實現了強勁的季度業績，全球成長了 11%。在美國，隨著 MiniMed 780G 系統的持續推出，我們的業務成長了 12%。本季美國新用戶較去年同期再次翻倍。自推出以來，我們看到 CGM 附著率顯著增加，導致第四季度美國 CGM 收入出現高位雙位數成長。使用者選擇我們差異化的 780G 系統是因為它所提供的結果，所有這些都可以減少工作量和負擔。

780G is the only AID system that provides both basal insulin adjustments and correction doses every 5 minutes. It offers flexible glucose targets as low as 100 and features our proprietary meal detection technology. This all leads to 780G users achieving a high time and range, as well as spending more time in automation with our SmartGuard technology. In Europe, we began the limited launch of Simplera Sync with 780G, and we're preparing for a commercial launch this summer. The early users and their health care providers are giving us fantastic feedback. Simplera Sync is half the size of our current sensor, is disposable, and it's a lot easier to put on. And in the U.S., I'm pleased to announce that we have now submitted Simplera Sync to the FDA.

780G 是唯一每 5 分鐘提供基礎胰島素調整和校正劑量的 AID 系統。它提供低至 100 的靈活葡萄糖目標，並採用我們專有的膳食檢測技術。這一切都導致 780G 用戶實現了較高的時間和範圍，並利用我們的 SmartGuard 技術將更多時間用於自動化。在歐洲，我們開始有限推出 780G 的 Simplera Sync，並準備在今年夏天進行商業發布。早期用戶和他們的醫療保健提供者給我們提供了極好的回饋。 Simplera Sync 的尺寸是我們目前感測器的一半，是一次性的，而且更容易佩戴。在美國，我很高興地宣布，我們現在已向 FDA 提交了 Simplera Sync。

Look, the turnaround in diabetes is palpable and now becoming a sustained growth story. We're committed to getting the business back to market leadership. This is why we're investing heavily and expanding indications for 780G system and developing next-generation differentiated technology. This includes durable pumps, smart pens, patch pumps, CGM, and software and algorithms. You've seen us execute a steady drumbeat of submissions, product approvals and expanded indications, and this is a cadence we expect to continue. We're the only company building out a complete ecosystem of leading technology for patients who require intensive insulin management. We believe this strategy positions us well and will drive our growth as the market continues to shift to automated insulin delivery and smart dosing.

看，糖尿病的好轉是顯而易見的，現在正在成為一個持續成長的故事。我們致力於讓業務重新回到市場領先地位。這就是為什麼我們大力投資並擴大780G系統的適應症並開發下一代差異化技術。這包括耐用泵浦、智慧筆、貼片泵浦、CGM 以及軟體和演算法。您已經看到我們執行了穩定的提交、產品批准和擴展適應症的節奏，我們希望繼續保持這種節奏。我們是唯一一家為需要強化胰島素管理的患者建立領先技術的完整生態系統的公司。我們相信，隨著市場繼續轉向自動化胰島素傳輸和智慧劑量，這項策略使我們處於有利地位，並將推動我們的成長。

Finally, turning to hypertension. We believe Symplicity will become an important growth driver for Medtronic. Since gaining approval last year, we've been training physicians, and we're getting very favorable feedback from both clinicians and patients. We've also been working very closely with both CMS and private payers in the United States, and expect to make significant progress on coverage and payment here in fiscal '25. With over 1 billion people worldwide living with hypertension and every 1% penetration into the target market is over $1 billion of revenue, our Symplicity procedure represents a massive opportunity.

最後，轉向高血壓。我們相信 Symplicity 將成為美敦力重要的成長動力。自去年獲得批准以來，我們一直在培訓醫生，並從臨床醫生和患者那裡得到了非常有利的回饋。我們也一直與美國的 CMS 和私人付款人密切合作，並預計在 25 財年在保險範圍和付款方面取得重大進展。全球有超過 10 億人患有高血壓，每滲透到目標市場 1% 就帶來超過 10 億美元的收入，我們的 Symplicity 計畫代表著巨大的機會。

Now with that, let's go to Karen for a deeper look at Q4 financial performance and our fiscal '25 guidance. Karen, over to you.

現在，讓我們請凱倫更深入地了解第四季度的財務表現和我們的 25 財年指導。凱倫，交給你了。

Thanks, Geoff. So recapping our financials. The fourth quarter was yet another where we delivered on our commitments, growing 5.4% ahead of expectations. We continue to drive durable mid-single-digit revenue growth, as committed, with more than 5% in fiscal '24. Importantly, we accelerated our comp adjusted growth every quarter. And adjusted EPS in the fourth quarter was $1.46, at the upper end of our guidance range and exceeding consensus.

謝謝，傑夫。所以回顧一下我們的財務狀況。第四季是我們兌現承諾的另一個季度，成長超出預期 5.4%。我們按照承諾繼續推動持久的中個位數營收成長，24 財年營收成長超過 5%。重要的是，我們每季都加快了公司調整後的成長。第四季度調整後每股收益為 1.46 美元，處於我們指導範圍的上限，超出了共識。

The strength of our global business was apparent with broad-based growth around the world. As I noted last quarter, we expected our U.S. growth to improve as we launched new products, and we delivered that with mid-single-digit growth. Our non-U.S. developed markets also grew mid-single digits, including 7% growth in Western Europe and 5% growth in Japan. And emerging markets remained strong, growing 13% and now comprises 18% of our total revenue.

我們的全球業務實力顯而易見，在全球範圍內實現了廣泛的成長。正如我上季度指出的那樣，我們預計隨著新產品的推出，我們在美國的成長將會改善，並且我們實現了中個位數的成長。我們的非美國已開發市場也實現了中個位數成長，其中西歐成長了 7%，日本成長了 5%。新興市場依然強勁，成長了 13%，目前占我們總收入的 18%。

Looking down the P&L, our adjusted gross margin was roughly stable at 65.8%, as our cost-out programs offset inflation. And our adjusted operating margin declined slightly more than expected given higher sales incentives on the higher revenue, along with increased investments we've made in SG&A to support upcoming product launches. That said, we delivered operating profit in line with expectations.

從損益表來看，我們調整後的毛利率大致穩定在 65.8%，因為我們的成本支出計畫抵銷了通貨膨脹。鑑於收入增加帶來的銷售獎勵措施增加，以及我們為支持即將推出的產品而增加的銷售及行政管理投資，我們調整後的營業利潤率下降幅度略高於預期。也就是說，我們的營業利潤符合預期。

We also continued to drive strong improvement in our free cash flow during the quarter, as we focused across the organization on working capital. In fact, our free cash flow increased by 14% over last year to $5.2 billion, with a conversion rate well north of 100% in the back half of the year. Looking ahead to fiscal '25, we expect to continue to drive a year-over-year increase in both free cash flow and our conversion rate.

本季我們也持續推動自由現金流的強勁改善，因為我們將整個組織的重點放在營運資本上。事實上，我們的自由現金流比去年成長了 14%，達到 52 億美元，下半年的轉換率遠高於 100%。展望 25 財年，我們預期將繼續推動自由現金流和轉換率年增。

Turning to capital allocation. Our robust balance sheet allows us to operate from a position of strength. As you know, we prioritize both investing in our future growth and returning capital to our shareholders. We continue to evaluate tuck-in M&A opportunities against a high bar as we prioritize profitable growth. And to our shareholders, we remain committed to returning a minimum of 50% of our free cash flow. In fact, in FY '24, we returned $5.5 billion through both dividends and share repurchases. And over the past few months, we've repurchased over $2.5 billion in the open market, reflecting the confidence we have as we finalize our plan and our ability to deliver ahead.

轉向資本配置。我們穩健的資產負債表使我們能夠憑藉實力開展業務。如您所知，我們優先考慮投資於未來成長並向股東返還資本。我們繼續以高標準評估併購機會，因為我們優先考慮獲利成長。對於我們的股東，我們仍然致力於返還至少 50% 的自由現金流。事實上，在 2024 財年，我們透過股利和股票回購返還了 55 億美元。在過去的幾個月裡，我們在公開市場上回購了超過 25 億美元，這反映了我們對最終確定計劃的信心以及我們提前交付的能力。

This confidence is also evident in the decision by our Board to increase our dividend for the 47th consecutive year, which we announced this morning. The yield from our growing dividend is an important component of the total return we generate for our shareholders. It's worth noting that we've been able to grow our dividend by 30% over the past 5 years and 130% over the past decade.

這種信心也體現在我們今天早上宣布的董事會連續 47 年增加股利的決定中。我們不斷成長的股息殖利率是我們為股東創造的總回報的重要組成部分。值得注意的是，我們的股息在過去 5 年裡增長了 30%，在過去 10 年裡增長了 130%。

Now turning to our guidance. After 6 quarters in a row, we firmly established a track record of delivering durable mid-single-digit revenue growth. And as Geoff mentioned, we're at the beginning stages of many new product cycles that enable confidence in our top line. Given this backdrop, we'd have you start the year modeling our fiscal '25 organic revenue growth at 4% to 5%, including 4% to 4.5% in the first quarter. Our product launches will be ramping through the year, so we expect revenue growth to accelerate through the quarters as well.

現在轉向我們的指導。經過連續 6 個季度，我們牢牢地建立了實現持久中個位數收入成長的記錄。正如傑夫所提到的，我們正處於許多新產品週期的開始階段，這使我們對我們的營收充滿信心。考慮到這一背景，我們會讓您在今年開始時將我們的 25 財年有機收入成長預測為 4% 至 5%，其中第一季為 4% 至 4.5%。我們的產品推出量將在今年不斷增加，因此我們預計營收成長也將在整個季度加速。

By segment, we'd expect our 3 portfolios to be roughly aligned with the corporate average and diabetes to grow above the corporate average. Our organic growth guidance continues to exclude revenue reported in other, as well as foreign exchange. And I direct you to the guidance slide in our earnings presentation for additional details. Regarding currency, based on recent rates, we would see a full year unfavorable impact to revenue in the range of $275 million to $375 million, including an unfavorable impact of $85 million to $135 million in the first quarter.

按細分市場，我們預計我們的 3 個投資組合將大致與公司平均值保持一致，而糖尿病的成長將高於公司平均水平。我們的有機成長指引繼續不包括其他收入以及外匯收入。我將引導您查看我們收益簡報中的指導幻燈片以了解更多詳細資訊。關於貨幣，根據最近的匯率，我們預計全年營收將受到 2.75 億美元至 3.75 億美元的不利影響，其中第一季的不利影響為 8,500 萬美元至 1.35 億美元。

Down the P&L, we expect expansion in our operating margin, as we drive efficiencies in our overhead spend. At the same time, we continue to appropriately invest in R&D to drive future growth. Taking all of this together, we're guiding our fiscal '25 non-GAAP diluted EPS in the range of $5.40 to $5.50, including $1.19 to $1.21 in the first quarter. This includes an unfavorable 5% impact from foreign currency for the full year, with an unfavorable 6% impact in the first quarter based on recent rates.

從損益表來看，隨著我們提高管理費用的效率，我們預期營業利益率將會擴大。同時，我們繼續適當地投入研發，以驅動未來的成長。綜合考慮所有這些因素，我們將 25 財年非 GAAP 攤薄後每股收益指引在 5.40 美元至 5.50 美元之間，其中第一季為 1.19 美元至 1.21 美元。這包括全年 5% 的不利影響，以及根據最新匯率計算第一季 6% 的不利影響。

Our fiscal '25 outlook reflects our commitment to restore our earnings power, with EPS growth at the midpoint of about 5%. Importantly, at current rates, the impact from currency lessens through the year, so we expect to be ending the year with high single-digit EPS growth on a reported basis, in line with our longer-term objective.

我們的 25 財年展望反映了我們恢復獲利能力的承諾，每股盈餘成長中位數約為 5%。重要的是，按照目前的匯率，貨幣的影響全年都會減弱，因此我們預計今年年底每股收益將以個位數的高成長率成長，這符合我們的長期目標。

Now as we close this important fiscal year, I want to take a moment to express my gratitude to the employees of Medtronic around the world. The important results we delivered this year are all due to your hard work, dedication and commitment to Medtronic and our mission. Thank you for being the driving force behind our success.

現在，在我們結束這個重要的財年之際，我想花點時間向美敦力世界各地的員工表示感謝。我們今年的重要成果都歸功於你們的辛勤工作、奉獻精神以及對美敦力和我們使命的承諾。感謝您成為我們成功背後的推動力。

Geoff, sending it back to you.

傑夫，把它寄回給你。

All right. Thank you, Karen. Now before we go to the analyst questions, I'll close with a few brief remarks. I hope you're feeling what we are, that the momentum at Medtronic is building, momentum that was set in motion by the comprehensive transformation we embarked on a few years ago. We streamlined our operating model. We put in place performance-driven culture and we changed incentives. We brought in new leaders. We improved how we allocate capital. And we started the work of driving significant operational efficiencies to leverage our scale.

好的。謝謝你，凱倫。現在，在我們回答分析師問題之前，我將用一些簡短的評論作為結束。我希望您能感受到我們的本質，即美敦力的勢頭正在增強，這種勢頭是由我們幾年前開始的全面轉型所激發的。我們簡化了營運模式。我們建立了以績效為導向的文化，並改變了激勵措施。我們引進了新的領導人。我們改進了資本分配方式。我們開始努力提高營運效率，以利用我們的規模。

This transformation is taking hold, and you're seeing it in our results. And just in time for a very important Medtronic milestone, we're celebrating our company's 75th anniversary this year. It was back in 1949 that a medical electronics repair business was started in a garage in Minneapolis. Now certainly, a lot has changed over the past 75 years, but what hasn't stopped from the humble beginnings in that garage is our spirit of innovation and our dedication to delivering life-transforming health technology that alleviates pain, restores health and extends life.

這種轉變正在發生，您可以從我們的結果中看到這一點。今年，我們正值美敦力 (Medtronic) 的一個非常重要的里程碑，慶祝公司成立 75 週年。早在 1949 年，明尼阿波利斯的一個車庫就開始了一家醫療電子維修業務。當然，過去 75 年裡發生了很多變化，但從那個車庫的卑微起步並沒有阻止我們的創新精神和我們致力於提供改變生活的健康技術，以減輕疼痛、恢復健康和延長壽命。

As we celebrate our past, we are even more excited about our future. That legacy of invention and market creation continues today, and you see it. You see it with our PFA products in Afib, our sensing products in neuromodulation, our 780G and Simplera Sync system. You see it with our robotics, with our Evolut TAVR system, and our Symplicity hypertension procedure, and the dozens of new products across our businesses. Our pipeline of breakthrough innovation is impressive and I'm incredibly excited about the impact that these products will have on patients, on physicians, and on our performance.

當我們慶祝我們的過去時，我們對我們的未來更加興奮。發明和市場創造的遺產今天仍在繼續，你也看到了。您可以從我們的 Afib 中的 PFA 產品、我們的神經調節感測產品、我們的 780G 和 Simplera Sync 系統中看到這一點。您可以透過我們的機器人、Evolut TAVR 系統、Symplicity 高血壓手術以及我們業務中的數十種新產品看到這一點。我們的突破性創新管道令人印象深刻，我對這些產品將對患者、醫生和我們的績效產生的影響感到非常興奮。

It's these new product cycles, combined with exposure to secular growth markets and an aging population, that put us in a great spot to continue delivering durable revenue growth. And when you add this to our improving earnings power, our strong free cash flow and dividend growth, you have a great formula for creating shareholder value.

正是這些新的產品週期，加上長期成長的市場和人口老化，使我們處於繼續實現持久收入成長的有利位置。當你將這一點添加到我們不斷提高的獲利能力、強勁的自由現金流和股息成長中時，你就擁有了創造股東價值的絕佳公式。

Finally, I'd like to join Karen in expressing my gratitude to our employees watching today. We've been through a lot of change. But through it all, your unwavering focus on our mission and performance has propelled our company forward. Your contributions matter, not just for Medtronic but for the millions of patients around the world that depend on us. And as we continue to innovate and grow, I'm confident that together we will achieve even greater heights in fiscal '25.

最後，我想與凱倫一起對今天觀看的我們的員工表示感謝。我們經歷了很多變化。但自始至終，你們對我們使命和業績的堅定不移的關注推動了我們公司的前進。您的貢獻不僅對美敦力很重要，而且對全世界依賴我們的數百萬患者也很重要。隨著我們不斷創新和發展，我相信我們將在 25 財年達到更高的高度。

So with that, let's move to Q&A, where we're going to try to get to as many analysts as possible. So we ask that you limit yourself to just one question, and only if needed, a related follow-up. If you have additional questions, you can reach out to Ryan and the Investor Relations team after the call.

那麼，讓我們進入問答環節，我們將嘗試聯繫盡可能多的分析師。因此，我們要求您只提出一個問題，並且僅在需要時提出相關的後續問題。如果您還有其他問題，可以在電話會議後聯絡 Ryan 和投資者關係團隊。

With that, Brad, can you please give the instructions for asking a question.

布拉德，請您給予提問的說明。

(Operator Instructions) Lastly, please be advised that this Q&A session is being recorded. For today's session, Geoff, Karen and Ryan are joined by Que Dallara, EVP and President of Diabetes; Mike Marinaro, EVP and President of the Medical Surgical portfolio; Sean Salmon, EVP and President of the Cardiovascular portfolio; and Brett Wall, EVP and President of the Neuroscience portfolio. (Operator Instructions) We'll take the first question from Travis Steed at Bank of America.

（操作員說明）最後，請注意，本次問答環節正在錄製中。出席今天的會議的有 Geoff、Karen 和 Ryan，執行副總裁兼糖尿病業務總裁 Que Dallara 也參加了今天的會議。 Mike Marinaro，執行副總裁兼醫療外科產品組合總裁； Sean Salmon，執行副總裁兼心血管產品組合總裁；執行副總裁兼神經科學業務總裁 Brett Wall。 （操作員說明）我們將回答美國銀行 Travis Steed 提出的第一個問題。

I wanted to ask about the EPS guidance, ex currency, 9% to 11%. I guess buyback maybe adds 1% to 2% there, but still kind of above kind of what Medtronic historically has done. So wanted to kind of understand the puts and takes better on your EPS guidance and how you're going to get there. And then kind of longer term, you're talking a lot about restoring earnings power. How should we think about kind of the pathway on growing kind of EPS beyond FY '25?

我想問 EPS 指導（不含貨幣）9% 至 11%。我猜回購可能會增加 1% 到 2%，但仍然高於美敦力 (Medtronic) 歷史上所做的事情。因此，我想更好地了解您的每股收益指導的看跌期權和看跌期權，以及您將如何實現這一目標。從長遠來看，你談論了很多關於恢復獲利能力的問題。我們該如何思考 25 財年之後 EPS 成長的途徑？

Well, Travis, thanks for the question. I'm going to hand this to Karen in a second, but let me just make a few opening comments on this. Look, the earnings power is something we've been working on for years. For example, we started our aggressive global operations and supply chain transformation over 3 years ago. We've been improving pricing. You see that in our FY '24 results, and we're strengthening this muscle and building on our momentum on pricing going into FY '25. We've made some tangible changes to mix, like exiting our ventilation business and divesting our dialysis business.

好吧，特拉維斯，謝謝你的提問。我稍後會將其交給凱倫，但請允許我對此發表一些開場評論。看，獲利能力是我們多年來一直致力於的事情。例如，我們在三年多前就開始了積極的全球營運和供應鏈轉型。我們一直在改善定價。您可以在我們 24 財年的業績中看到這一點，我們正在加強這一實力，並在進入 25 財年的定價勢頭基礎上再接再厲。我們對組合做出了一些切實的改變，例如退出我們的通氣業務和剝離我們的透析業務。

These are a couple of examples which Karen will go through in more detail. But the point is, I think there's programmatic structural changes to the enterprise that are allowing us to achieve top line growth, but at the same time growing that earnings power. Like I said, they're structural, they're programmatic, and they're giving us the confidence into FY '25 and beyond in terms of that earnings power improvement. So Karen, can you walk through some of the details on this?

凱倫將更詳細地介紹這些範例。但關鍵是，我認為企業的計劃性結構變化使我們能夠實現營收成長，但同時也增強了獲利能力。就像我說的，它們是結構性的、程序性的，它們讓我們對 25 財年及以後的獲利能力改善充滿信心。凱倫，你能介紹一下這方面的一些細節嗎？

Sure. Thanks, Geoff, and Travis. So I would say, in '25, we're focused on 3 key things: Delivering continued mid-single-digit top line growth while executing on our strong pipeline, investing in our high-priority growth drivers, and restoring the earnings power of the company that Geoff talked about. And our guidance all starts with confidence and durability on our top line. We've got really high confidence given the track record that we've had over the last 6 quarters and the fact that we've got this very robust pipeline coming to market. Much of it has already been approved by regulators and much of it is also moving from limited market release to full market release.

當然。謝謝傑夫和特拉維斯。因此，我想說，在 25 年，我們專注於 3 件關鍵事情：在執行我們強大的產品線的同時，實現持續的中個位數收入增長，投資於我們的高優先級增長動力，並恢復傑夫談到的公司。我們的指導一切都始於我們的信心和耐用性。考慮到我們過去 6 個季度的業績記錄以及我們已經將這一非常強大的產品推向市場的事實，我們對此充滿信心。其中大部分已經獲得監管機構的批准，其中大部分也正在從有限市場釋放轉向全面市場釋放。

So we expect, on gross margins, it to be flat year-over-year on a constant currency basis, because we've got cost down and pricing offsetting inflation. And on operating expenses, we continue to make appropriate investments in R&D to drive our future growth. And we'll really drive leverage in SG&A, and that's through programmatic changes that we've implemented throughout the company, including discipline on headcount, focus on discretionary expenses. We've always got increased use of automation and digitization, and we've elevated the review and reporting on our expenses and our margins. And we've driven some structural changes, too, like eliminating our respiratory interventions operating unit.

因此，我們預計，以固定匯率計算，毛利率將同比持平，因為我們的成本下降了，定價抵消了通貨膨脹。在營運費用方面，我們繼續在研發方面進行適當的投資，以推動我們未來的成長。我們將真正提高銷售管理、一般行政費用的槓桿率，這是透過我們在整個公司實施的計劃性變革，包括對員工人數的紀律、對可自由支配開支的關注。我們一直在增加對自動化和數位化的使用，並且我們加強了對費用和利潤的審查和報告。我們也推動了一些結構性變革，例如取消我們的呼吸介入手術部門。

And on this expense, we've taken costs out already, and you're seeing the full benefit of it this year. We actually drove this kind of leverage in '24. It was just masked by the impact of the true-up in incentive compensation that we did from '23 to '24. And then on top of operating leverage, you'll also see a large benefit from reduced share count, which will be a bit offset by incremental interest and tax. But when you put it all together, we expect this 4% to 5% top line growth, along with operating leverage and share count, to deliver that high single-digit EPS growth for the year. And as our currency headwinds abate, we've said we expect high single-digit actual or reported EPS in the back half of the year. And that goes beyond this fiscal year. So beyond FY '25, we're focused on maintaining this mid-single-digit revenue growth and continuing to drive leverage down the P&L to deliver that high single-digit EPS growth.

對於這筆費用，我們已經扣除了成本，今年您將看到它的全部好處。我們實際上在 24 年就推動了這種槓桿作用。它只是被我們從 23 世紀到 24 世紀所做的激勵薪酬調整的影響所掩蓋。然後，除了營運槓桿之外，您還將看到股票數量減少的巨大好處，這將被增量利息和稅收所抵消。但當你把所有這些放在一起時，我們預計 4% 至 5% 的營收成長，加上營運槓桿和股票數量，將帶來今年高個位數的每股盈餘成長。隨著貨幣阻力的減弱，我們預計今年下半年的實際或報告每股盈餘將達到個位數的高水準。這超出了本財年的範圍。因此，在 25 財年之後，我們的重點是保持中個位數的收入成長，並繼續降低損益表的槓桿率，以實現高個位數的每股盈餘成長。

The next question comes from Robbie Marcus at JPMorgan.

下一個問題來自摩根大通的羅比·馬庫斯。

Great. Maybe to start, I wanted to zero in, in the guide, you have accelerating revenue growth, it feels like, throughout the year, with first quarter where it is, probably second half better than first half. I was hoping you could spend a minute on some of the products there, because there's a lot of moving pieces and how we should think about the sources for upside and your confidence levels around that upside? And then I have 1 follow-up.

偉大的。也許首先，我想在指南中歸零，你的收入成長加速，感覺全年，第一季的情況，下半年可能比上半年更好。我希望您能花一點時間討論那裡的一些產品，因為有很多變化的因素，我們應該如何考慮上漲的來源以及您對上漲的信心水平？然後我有 1 次後續行動。

I'll take a stab at this, Robbie, and Karen can jump in if I missed anything here. Well, first of all, look, we've got, as it's been pointed out by many of you on the call here, a lot of approvals here recently in really high-growth areas, and we're in the early stages of these launches. But specifically, to answer your question here, in FY '25, some of the -- one is Structural Heart with Evolut FX. As it moves from this limited market release in the U.S. to a full market release, we're seeing strong uptick. And the SMART results in small annulus continues to build on our body of clinical evidence. And we are seeing it change referral patterns. I mean it's pretty clear here what to do with these patients. And it's a bigger cohort of patients than I think most imagined at 40% of the market.

我會嘗試一下，羅比，如果我錯過了什麼，凱倫可以加入。嗯，首先，看，正如你們許多人在電話會議上指出的那樣，最近在真正的高成長領域獲得了很多批准，而且我們正處於這些項目的早期階段發射。但具體來說，為了回答您的問題，在 25 財年，其中一些是帶有 Evolut FX 的 Structural Heart。隨著它從美國的有限市場發布轉向全面市場發布，我們看到了強勁的成長。小環的 SMART 結果繼續建立在我們的臨床證據基礎上。我們看到它改變了推薦模式。我的意思是，這裡很清楚如何處理這些患者。其患者群比我大多數人想像的要大，佔市場份額的 40%。

So Structural Heart TAVR is one, Evolut FX plus the changing referral patterns from SMART. PFA is another one. We've got PulseSelect here. You saw the results with over 20% sequential growth in the business, and we really haven't seen anything from Affera yet. That's coming. So PFA is going to be a big one for us. And throughout the year, it's accelerating. And leadless, first of all, we still maintain the lion's share of the market here. And we just recently launched it and we're continuing to take share. We just launched Micra AV2 and VR2.

因此，結構性心臟 TAVR 就是其中之一，Evolut FX 加上 SMART 不斷變化的轉診模式。 PFA 是另一種。我們這裡有 PulseSelect。您看到了業務環比增長超過 20% 的結果，但我們實際上還沒有看到 Affera 的任何成果。那即將到來。因此，PFA 對我們來說將是一件大事。並且全年都在加速。而無鉛，首先，我們仍然保持最大的市場份額。我們最近剛推出了它，我們將繼續搶佔市場份額。我們剛剛推出了 Micra AV2 和 VR2。

And the market is expanding. UnitedHealth Group, which you guys know is the largest commercial insurer in the U.S., just updated its policies to cover leadless pacemakers. And so you see us performing strong, new launches in an expanding markets. That's some of the cardiovascular related ones. And again, our EV-ICD as well. So there's a lot for FY '24, in this fiscal year from cardiology.

而且市場正在擴大。你們知道，聯合健康集團是美國最大的商業保險公司，剛剛更新了其保單以涵蓋無引線起搏器。因此，您會看到我們在不斷擴大的市場中推出了強勁的新產品。這是一些與心血管相關的。再說一遍，還有我們的 EV-ICD。因此，24 財年心臟病學在本財年有許多成果。

Neuroscience also has a lot. I mean, Spine saw the acceleration. We expect that to continue with the combination of the implants plus the AiBLE technology plus the AI having a real impact. And this has been something we've been building on. And you're seeing good performance relative to the competition.

神經科學也有很多。我的意思是，Spine 看到了加速度。我們預計植入物與 AiBLE 技術以及人工智慧的結合將繼續產生真正的影響。這也是我們一直在努力的方向。您會看到相對於競爭對手的良好表現。

I mean I know there's a lot of buys out there on Globus. But when you look at apples-to-apples, we grew 9% and they grew 3%. On an apples-to-apples pro forma basis in the year, when you look at the combined NuVasive and Globus, that's 3%, and we're 9%. That's a pretty big gap. And we've got 4x the installed base, which is really a key to growth in that market now. ENT continues to do well, and that's accelerating from the continued adoption of PROPEL and SINUVA that came from the Intersect acquisition.

我的意思是我知道 Globus 上有很多購買的東西。但如果你比較一下，我們成長了 9%，他們成長了 3%。在今年的同類預估基礎上，如果你看看 NuVasive 和 Globus 的合併，那是 3%，而我們是 9%。這是一個相當大的差距。我們的安裝基礎已經增加了 4 倍，這確實是該市場目前成長的關鍵。 ENT 繼續表現出色，而且由於收購 Intersect 後繼續採用 PROPEL 和 SINUVA，這一勢頭正在加速。

And then, of course, in Neuromod, with the closed-loop technology, Percept RC, in my prepared remarks you heard DBS growing double digits. And then right at the end of the quarter, we got the approval of Inceptiv, which is our ECAPs closed-loop stimulator for pain. We think it's a better product that's on the market, and with our large sales force, we're going to do some damage there.

當然，在 Neuromod 中，透過閉環技術 Percept RC，在我準備好的發言中，您聽到 DBS 成長了兩位數。然後就在本季末，我們獲得了 Inceptiv 的批准，這是我們的 ECAP 閉環疼痛刺激器。我們認為這是市場上更好的產品，並且憑藉我們龐大的銷售隊伍，我們將在那裡造成一些損害。

And then the diabetes, 780G, U.S. growth continues low double digits. I think we're going to continue to surprise people on diabetes and show continued strength. And then, of course, Hugo and Ardian are both really good leading indicators of growth that you'll be seeing later in the year. So I mean there's a lot spread across the businesses. And that's why we have the confidence in the mid-single-digit revenue growth, and Karen talked about how that translates to the bottom line.

然後是糖尿病，780G，美國的成長持續保持低兩位數。我認為我們將繼續給糖尿病患者帶來驚喜，並展現出持續的實力。當然，Hugo 和 Ardian 都是非常好的領先成長指標，您將在今年稍後看到。所以我的意思是，各個企業之間存在著很大的差異。這就是為什麼我們對中等個位數的收入成長充滿信心，凱倫談到了這如何轉化為利潤。

Yes. And I would add just briefly that our end markets are growing, our back orders are down, our supply chain is improved. The impact of VBP in China is largely behind us. And then obviously, we've got the long list of products that Geoff talked about.

是的。我想簡單地補充一下，我們的終端市場正在成長，我們的延期交貨訂單減少了，我們的供應鏈也得到了改善。 VBP在中國的影響基本上已經過去了。顯然，我們已經得到了傑夫談到的一長串產品清單。

Yes. And said another way, we're entering the year with a lot less questions too, like risks. Like go back a year ago, China, a lot of uncertainty there. We had a high single-digit growth for the year, accelerating throughout the year, double digits in the last 2 quarters. So putting these things, some of these questions, risks or obstacles behind us is also, I think, another one. That just the elimination of those plus the addition of the new products, you add it all up, it feels good going into the year.

是的。換句話說，我們進入這一年的時候問題也少了很多，例如風險。就像回到一年前的中國，那裡有很多不確定性。我們全年實現了高個位數成長，全年加速成長，最近兩個季度實現了兩位數成長。因此，我認為，將這些事情、其中一些問題、風險或障礙拋在腦後也是另一回事。只要消除這些產品，再加上新產品的添加，將所有這些加起來，進入這一年感覺很好。

Great. Maybe a quick follow-up here. Karen, I appreciate the high-level building blocks down the P&L. I was hoping you could put a little more meat on the bone. You talked about gross margin expansion. How should we think about that? It sounds like R&D deleverage, SG&A, you have a lot of costs. I think that drove the miss in operating margin in the fourth quarter. So how do we think about the level of investment versus savings in SG&A? It sounds like that does get us to a positive operating margin expansion. And then how do we think about the level of tax? I know it's gone higher, but how much higher?

偉大的。也許這裡需要快速跟進。凱倫，我很欣賞損益表中的高級構建模組。我希望你能在骨頭上多放一點肉。您談到了毛利率擴張。我們該如何思考這個問題？聽起來像是研發去槓桿化、SG&A，你有很多成本。我認為這導致了第四季度營業利潤率的下降。那麼，我們如何看待 SG&A 的投資水準與節省水準？聽起來這確實讓我們實現了營業利潤率的正面擴張。那我們如何看待稅收水準呢？我知道它更高了，但是高了多少呢？

Sure, Robbie. So just on the detail, on gross margin, I said we expect it flat on a constant currency basis. We will have some currency headwind, about 0.5 point of downward pressure on gross margin at recent rates. But as I said, we've got good cost down and pricing offsetting inflation there. And those currency headwinds on the gross margin line should abate as we move through the year and be gone as we exit the year. As we look at R&D and SG&A, I would say, in R&D, we're focused on continuing to invest. It's a critical priority to us.

當然，羅比。因此，就毛利率的細節而言，我說我們預計其在固定匯率基礎上持平。我們將面臨一些貨幣阻力，以近期利率計算，毛利率將面臨約 0.5 個百分點的下行壓力。但正如我所說，我們已經大幅降低了成本，定價抵消了通貨膨脹。毛利率上的這些貨幣阻力應該會隨著今年的進展而減弱，並隨著今年的結束而消失。當我們審視研發和銷售、一般管理費用時，我想說，在研發方面，我們專注於繼續投資。這對我們來說是一個至關重要的優先事項。

I've talked about it being the one line item that's allowed to grow in line or more than revenue in certain years. And we've been focused on driving efficiencies across the company, including in R&D, to enable these levels of investment. Some of the recent portfolio moves we've made like setting up the JV for our Renal Care, or shutting down our ventilator business has allowed us to reallocate investment into our highest strategic priorities in R&D. So that remains an area of investment.

我已經談到它是一個在某些年份允許增長或超過收入的項目。我們一直致力於提高整個公司的效率，包括研發效率，以實現這些水準的投資。我們最近採取的一些投資組合舉措，例如為我們的腎臟護理建立合資企業，或關閉我們的呼吸機業務，使我們能夠將投資重新分配到研發方面的最高戰略優先事項。因此，這仍然是一個投資領域。

And then on SG&A, we are focused on driving continued significant leverage in SG&A. And I talked about the programmatic savings that we've been driving that you're seeing more this fiscal year than you saw last year. We actually drove this kind of leverage in '24. I said it was just masked by the impact of the true-up in incentive compensation. So we're excited about what we're going to continue to drive in SG&A.

然後，在銷售、管理和行政費用方面，我們致力於推動銷售、管理和行政費用的持續大幅槓桿化。我談到了我們一直在推動的計劃性節省，您在本財年看到的節省比去年更多。我們實際上在 24 年就推動了這種槓桿作用。我說過這只是被激勵薪酬調整的影響所掩蓋。因此，我們對將繼續推動 SG&A 的發展感到興奮。

And then on tax, we expect tax to be a bit of a headwind given global tax reform. We're pleased with the work that we've done to offset some of this, both on the tax line and above the tax line, but we expect it to be about 1 point higher than we had this past fiscal year.

然後在稅收方面，鑑於全球稅收改革，我們預計稅收將有點阻力。我們對我們為抵消部分稅收所做的工作感到滿意，無論是在稅線還是稅線以上，但我們預計它會比上一財年高出約 1 個百分點。

So Robbie, when you think about FY '25 on the bottom line, as Karen mentioned, that's going to come from operating margin actions. And it goes beyond expense management. These are programmatic changes we've made in FY '24. And we'll see the full benefit of these. See these are changes that are made in the bank, and you'll see the full benefit of that in FY '25.

所以羅比，當你考慮 25 財年的底線時，正如凱倫所提到的，這將來自營業利潤率行動。它超出了費用管理的範圍。這些是我們在 24 財年所做的計劃性改變。我們將看到這些的全部好處。查看這些是銀行所做的更改，您將在 25 財年看到其全部好處。

On the gross margin line, which is super important, those programs are underway. And as Karen mentioned, it's hard to see that because of some of the inflation and FX. But as we get into FY '26, as those abate, you'll see that gross margin start to expand as well. So we think we've laid this out the right way and got the programs lined up against it and have been working on it for some time. And we'll see those benefits accrue over the next couple of years.

在非常重要的毛利率方面，這些計劃正在進行中。正如凱倫所提到的，由於通貨膨脹和外匯的影響，很難看到這一點。但當我們進入 26 財年時，隨著這些因素的減弱，你會發現毛利率也開始擴大。因此，我們認為我們已經以正確的方式解決了這個問題，並制定了相應的計劃，並且已經為此工作了一段時間。我們將看到這些好處在未來幾年逐漸顯現。

The next question comes from Vijay Kumar at Evercore.

下一個問題來自 Evercore 的 Vijay Kumar。

Congrats on a nice sprint here. Geoff, one on your restoring EPS power comments. What does it mean? What is the right base we should be thinking of? Are we thinking of operating margins perhaps getting back to upper 20s? Is there a time frame for that? And maybe some clarification on what that means?

恭喜你在這裡取得了良好的衝刺。 Geoff，一位關於恢復 EPS 功率的評論。這是什麼意思？我們應該考慮的正確基礎是什麼？我們是否正在考慮營業利潤率可能回到 20 左右？有時間限制嗎？也許可以澄清一下這意味著什麼？

Well, look, I'm going to have Karen answer that. She kind of hit on that some in our prepared remarks, but I'll have her kind of redo some of that. But like I said just a second ago, on the operating margin, we've got a lot of confidence in that for the year given the changes we've already made. And the changes we've already made in the gross margin line and are continuing to expand, those will start to hit in the later part of the year and move into next year. I'll let Karen kind of quantify it.

好吧，聽著，我要讓凱倫回答這個問題。她在我們準備好的發言中提到了一些內容，但我會讓她重做其中一些內容。但正如我剛才所說，就營業利潤率而言，鑑於我們已經做出的改變，我們對今年充滿信心。我們已經在毛利率上做出了改變，並且正在繼續擴大，這些改變將在今年下半年開始顯現，並持續到明年。我會讓凱倫量化它。

Yes. And just on restoring the earnings power, Vijay, it means that we are focused on driving that durable mid-single-digit top line. It starts there, but then driving leverage down the P&L to deliver high single-digit EPS. And you'll see us exit the year of FY '25 doing that, and we're focused on maintaining it and driving it continued from there.

是的。維傑，就恢復獲利能力而言，這意味著我們專注於推動持久的中位數收入線。它從這裡開始，但隨後降低了損益表的槓桿率，從而實現了高個位數的每股盈餘。你會看到我們在 25 財年結束時就這樣做了，我們專注於維護它並從那裡繼續推動它。

Understood. And just related to that, when you say operating margin leverage this year, is that on an ex-FX basis? Or what's the implied operating margins on a reported basis for fiscal '25?

明白了。與此相關的是，當您說今年的營業利潤率槓桿時，是在除外彙的基礎上嗎？或 25 財年報告的隱含營業利益率是多少？

Yes. We're expecting margins around 26% in '25, and that's on a reported basis, so up from where we were. Yes.

是的。我們預計 25 年的利潤率約為 26%，這是基於報告的數據，因此比我們當時的水平有所提高。是的。

The next question comes from Larry Biegelsen at Wells Fargo.

下一個問題來自富國銀行的拉里·比格爾森。

Congrats on a nice quarter here. Sean, it was great to see the mid-single-digit growth in AF Solutions in Q4, and congrats on the Affera data. How should we be thinking about the AF business before the Affera launch in the U.S.? Just remind us on the launch timing there, and where you are with supply and your ability to get mapping equipment and personnel out there in the field.

恭喜您度過了一個愉快的季度。 Sean，很高興看到 AF 解決方案在第四季度實現中個位數成長，並對 Affera 數據表示祝賀。在 Affera 在美國推出之前，我們應該如何考慮 AF 業務？請提醒我們那裡的發射時間、你們的供應情況以及你們在現場取得測繪設備和人員的能力。

Thanks, Larry. First of all, the business is doing exceptionally well. I think that sequential growth that we've seen in the demand and interest coming out of both HRS and Affera, our new technologies is really astonishingly great. It's really, really high. And I'd say in the United States, pulsed field is moving pretty fast there and we're catching that wave, obviously, with our first entry here. And I'd say that as we scale up for further penetration of therapy, there's lots of other approvals we're getting around the world. There's expansion of capacity.

謝謝，拉里。首先，業務做得非常好。我認為，我們看到 HRS 和 Affera 的需求和興趣連續成長，我們的新技術確實非常出色。真的非常非常高。我想說的是，在美國，脈衝場的發展速度非常快，顯然，我們正在趕上這波浪潮，我們在這裡首次進入。我想說，隨著我們擴大治療的進一步滲透，我們在世界各地獲得了許多其他批准。有產能擴張。

And the most important thing to get Affera to the United States was that last module clinical data. As you saw, that was really pristine, taking on head-to-head the market-leading technology and just narrowly missing on superior efficacy. So that's all boding well. To your point, though, the things we have to get right are scaling up manufacturing, and that's something we've put a lot of effort toward. We moved into new Medtronic facilities away from the sort of acquired clean room that we purchased with Affera.

將 Affera 帶到美國最重要的是最後一個模組的臨床數據。正如您所看到的，這確實是原始的，與市場領先的技術正面交鋒，但在卓越的功效上僅差一點。所以這一切都是好兆頭。不過，就你的觀點而言，我們必須做對的事情是擴大製造規模，這是我們付出了大量努力的方向。我們搬進了新的美敦力設施，遠離了我們與 Affera 購買的那種潔淨室。

And the last point, you asked about capital, and that's certainly not going to be a deterrent to our success. We have all kinds of ways of helping with capital acquisition, including placing capital, leasing catheter costs, things like that, that we'll be availing ourselves to throughout the launch of that product as well. So look, I think all things are going up. We're really excited about pulsed field ablation and the customers are really kind of beating the door down for it every single day. So it's exciting to be part of.

最後一點，你問到了資本問題，當然不會成為我們成功的障礙。我們有各種方法來幫助資本收購，包括投入資本、租賃導管成本等，我們也將在該產品的整個推出過程中利用這些方法。所以看，我認為一切都在上漲。我們對脈衝場消融感到非常興奮，客戶每天都在積極爭取它。所以能夠成為其中的一員是令人興奮的。

The next question comes from Pito Chickering at Deutsche Bank.

下一個問題來自德意志銀行的 Pito Chickering。

Quick question on margins this quarter. The operating margin is a little bit softer than expected due to SG&A pressures. Just walk through what the variance was versus the expectations. Like you talked about higher sales comp and support for product launches. Just want to make sure I understand what happened versus what you're expecting.

關於本季利潤率的快速問題。由於銷售管理及行政費用 (SG&A) 壓力，營業利潤率略低於預期。只需瀏覽一下與預期的差異即可。就像您談到更高的銷售補償和對產品發布的支援一樣。只是想確保我了解發生了什麼以及您所期望的情況。

Yes. Thanks, Pito, for the question. You're right. So with the outperformance that we had on the top line, we did have some incremental incentive accruals in the quarter on sales incentive comp. And we've purposely driven investments in our strategic growth drivers as we work to commercialize many of the exciting innovations that we've got heading into '25. We did all this and absorbed the incremental incentive comp and investments, while still delivering on our financial commitments and beating the bottom line, but that's what it was driven by.

是的。謝謝皮托提出的問題。你說得對。因此，由於我們在營收方面表現出色，本季我們確實在銷售激勵補償方面獲得了一些增量激勵。我們有目的地推動對策略成長動力的投資，努力將進入 25 世紀的許多令人興奮的創新商業化。我們做到了這一切，吸收了增量激勵補償和投資，同時仍然履行我們的財務承諾並超越底線，但這就是它的驅動力。

Okay. And then Cranial & Spine were pretty strong this quarter. Can you just talk about the durability of that growth and sort of where we should be thinking of that growing in fiscal '25?

好的。 Cranial & Spine 本季表現相當強勁。您能否談談這種成長的持久性，以及我們應該在哪些方面考慮 25 財年的成長？

You bet. Pito, it's Brett Wall. Thanks for the question. We think it's very durable. If you look at where this business is going, as Geoff mentioned, we grew 3x our nearest competitor in the space and that's on a very large base of business. We are recruiting the best sales reps. We have this technology system with AiBLE that is allowing us to change how spine surgery is being done. We are recruiting physicians, sales reps, and our technology is making a difference in the marketplace. We see that as durable for several, several quarters here.

你打賭。皮托，我是布雷特‧沃爾。謝謝你的提問。我們認為它非常耐用。如果你看看這個業務的發展方向，正如傑夫所提到的，我們的成長是該領域最接近的競爭對手的三倍，而且這是基於非常大的業務基礎。我們正在招募最優秀的銷售代表。我們擁有 AiBLE 技術系統，它使我們能夠改變脊椎手術的進行方式。我們正在招募醫生、銷售代表，我們的科技正在改變市場。我們認為這種情況可以持續幾個季度。

Yes. Just one final point on that, Pito, is the model is and the industry is changing to this capital equipment, that's enabling technology. Now the enabling technology, you have to have good stuff, it has to be integrated, it has to have value, AI is a big piece of that. And accounts are making investments in a company now, the Medtronic ecosystem, AiBLE, versus some other ecosystem, and there's not many out there, right?

是的。 Pito，最後一點是，該模型和產業正在轉向這種資本設備，即支援技術。現在的支援技術，你必須擁有好東西，它必須集成，它必須具有價值，人工智慧是其中的重要組成部分。現在，帳戶正在對一家公司、美敦力生態系統、AiBLE 進行投資，而不是其他一些生態系統，而且這樣的公司並不多，對吧？

So that's why we keep emphasizing our installed base. And it's also changing the industry structure, because this takes a lot of expertise and capital to build these ecosystems. So you don't have this long tail of tiny spine companies that are preying on docs. Those are going away. And so that's why we think this is durable. And yes, we're investing heavily in this area and have been for years.

這就是我們不斷強調我們的安裝基礎的原因。它也正在改變行業結構，因為這需要大量的專業知識和資本來建立這些生態系統。因此，你不會看到那些掠奪文檔的小型骨幹公司的長尾。那些正在消失。這就是為什麼我們認為它是耐用的。是的，我們多年來一直在這一領域投入大量資金。

The next question comes from Josh Jennings at Cowen & Company.

下一個問題來自 Cowen & Company 的 Josh Jennings。

I wanted to ask about emerging markets. Almost just under 20% of the revenue base grew double digits in fiscal '24. Maybe just help us understand some of the puts and takes there. And I think, Karen, you said, most of the VBP headwinds are behind Medtronic now heading into fiscal '25. China is almost 40% of the emerging market revenue base. Can you just talk about overall emerging market trends, expectations for sustainable double-digit growth, and specifics around China? Can we see acceleration in Medtronic’s performance and growth in China?

我想問一下新興市場的情況。 2024 財年，近 20% 的營收成長了兩位數。也許只是幫助我們理解一些看跌期權和拿走期權。我認為，凱倫，你說過，大部分 VBP 逆風都是美敦力 (Medtronic) 現在進入 25 財年的原因。中國佔新興市場收入基數的近 40%。您能否談談新興市場的整體趨勢、可持續兩位數成長的預期以及中國的具體情況？我們能否看到美敦力在中國的業績與成長加速？

Sure, Josh. Thanks for the question. Look, as I think most of you know, I mean, emerging market focus has been something that we've been on for a long time, and it has been almost like an independent growth driver for us up until basically COVID, right, when certain markets like China shut down and then you had VBP. So the last couple of years have been choppy on emerging markets, I would say. But those fundamentals are coming back, right? VBP is almost, like China is a big one there, right? VBP is mainly behind us, not totally. I'd say, we're 80% of the way there. And you've seen the growth accelerating throughout the year for us. The last 2 quarters, double digits for China.

當然，喬許。謝謝你的提問。聽著，我想你們大多數人都知道，我的意思是，我們長期以來一直關注新興市場，它幾乎就像我們的獨立增長動力，直到基本上出現新冠疫情為止，對吧，當像中國這樣的某些市場關閉了，然後就出現了VBP。所以我想說，過去幾年新興市場一直動盪不安。但這些基本面正在回歸，對嗎？ VBP就差不多了，就像中國那邊一個大的吧？ VBP主要落後於我們，但並非完全落後。我想說，我們已經完成了 80%。您已經看到我們的成長全年都在加速。過去兩個季度，中國隊的表現都是兩位數。

When that last, call it -- there's a little bit of, I'll call it, hanging chads on VBP and the timing of those tenders in some of our smaller businesses in the like aortic or peripheral vascular, and there's a little bit left in neurovascular. When those hit, it could impact the quarter, so going from that double digits down to mid-single. But we see, in any given quarter, mid-single to high single to double. But China is by and large back and the procedures are strong. And that's a big part of our emerging market business. And we're a combination there of import and local. That also gives us some strength, our local product investments. And those local products also can be exported to other parts of the world.

最後，我會說，在 VBP 上還有一點懸而未決的問題，以及我們一些小型企業（如主動脈或外周血管）的招標時間，還剩下一點在神經血管。當這些發生時，可能會影響本季度，因此從兩位數下降到中個位數。但我們看到，在任何特定季度，中單到高單到雙。但中國總體上已經回來了，程序也很強大。這是我們新興市場業務的重要組成部分。我們是進口和本地的結合。這也給了我們一些實力，就是我們的本地產品投資。而且這些當地產品還可以出口到世界其他地區。

So I think the other thing we've done here over the last couple of years is empowered our emerging market leaders a bit more than we had in the past, and they're able to allocate resources, I think, more effectively, because the health care is local and these markets have different emphasis on different clinical areas. And some have more cath labs than others, and that makes a difference, for example. And so with our emerging market leaders able to have more influence and control over the resources, that's helped accelerate our growth as well.

因此，我認為過去幾年我們在這裡所做的另一件事是賦予我們的新興市場領導者比過去更多的權力，我認為他們能夠更有效地分配資源，因為醫療保健是本地化的，這些市場對不同的臨床領域有不同的重點。例如，有些人比其他人擁有更多的導管實驗室，這會產生影響。因此，由於我們的新興市場領導者能夠對資源擁有更大的影響力和控制力，這也有助於加速我們的成長。

So I think the fundamentals are back, especially in China. Some changes we've made to like our model and our incentives have helped as well, and our continued investment in value products. You add all that up and I see this as a continued strength and a continued source of growth for the company over a decade plus. Karen, anything else?

所以我認為基本面已經回歸，尤其是在中國。我們為喜歡我們的模式所做的一些改變和我們的激勵措施以及我們對價值產品的持續投資也有所幫助。把所有這些加起來，我認為這是公司十多年來持續的優勢和持續成長的來源。凱倫，還有什麼嗎？

Yes. I would just say, on VBP, that can affect a quarter at an OU level, but we don't necessarily expect it to affect total Medtronic.

是的。我只想說，就 VBP 而言，這可能會影響 OU 水平的四分之一，但我們不一定期望它會影響整個美敦力。

Just maybe 1 quick follow-up. Any product launches that we should be thinking about as we build out or update our models for fiscal '25, particularly in these emerging markets, but China specifically?

也許只是 1 次快速跟進。在我們建構或更新 25 財年的模型時，我們應該考慮推出哪些產品，特別是在這些新興市場，但特別是在中國？

Well, China, specifically, we did just get approval for Ardian. So that will take some time to get into all the hospitals, but we think that's going to do well. We think our CST business there, again, separate from, I think, some of the trends you're seeing in the U.S., we've got a strong local portfolio there and a nice flywheel of local innovation. So a local version of Mazor that's coming out, a local version of our cell station navigation that's coming out. So I see strength there.

嗯，特別是在中國，我們剛剛獲得了 Ardian 的批准。因此，這需要一些時間才能進入所有醫院，但我們認為效果會很好。我們認為，我們在那裡的 CST 業務與您在美國看到的一些趨勢不同，我們在那裡擁有強大的本地產品組合和良好的本地創新飛輪。因此，Mazor 的本地版本即將推出，我們的基地台導航的本地版本也即將推出。所以我看到了那裡的力量。

And then we've also started local manufacturing of some of our cardiology products. I was just there a couple of weeks ago where I saw our local pacemaker coming off the line. Right next to the giant Tesla plant, we have a plant. Not quite as big, but it's a damn good implantable technology plant, and we're proud of that. So I think those would be some of the areas that I'd highlight in China.

然後我們也開始本地生產一些心臟病產品。幾週前我在那裡看到我們當地的起搏器斷線了。就在巨型特斯拉工廠旁邊，我們有一個工廠。雖然沒有那麼大，但它是一個非常棒的植入式技術工廠，我們為此感到自豪。所以我認為這些是我在中國要強調的一些領域。

The next question comes from Rich Newitter at Truist Securities.

下一個問題來自 Truist Securities 的 Rich Newitter。

Congrats on the quarter. Maybe first just on Spine. You continue to put -- the turnaround in that franchise continues to unfold high single-digit growth. And following up to an earlier question, I appreciate that you're growing faster than your closest competitor there. But you've talked about potential disruption from recent M&A and Spine mergers as kind of being a once-in-a-decade opportunity. So can you comment on what, if any, contribution you've been seeing from the M&A environment to your benefit already and what's out in front?

恭喜本季。也許首先是在 Spine 上。你繼續投入——該系列的扭虧為盈繼續呈現高個位數成長。繼之前的問題之後，我很高興您的成長速度比最接近的競爭對手更快。但您談到了最近的併購和 Spine 合併帶來的潛在幹擾，認為這是十年一遇的機會。那麼，您能否評論一下您從併購環境中看到的對您的利益的貢獻（如果有的話）以及未來的發展？

You mentioned rep hires, you mentioned competitive conversions. I'm just trying to get a sense for whether we're at the point where you're seeing those benefits? Or there are still more to come out in front. We could maybe even see these growth rates accelerate?

您提到了代表招聘，您提到了競爭性轉換。我只是想了解我們是否已經達到了您看到這些好處的程度？或者還有更多的東西要出現在前面。我們甚至可能看到這些成長率加速？

Yes, Rich, it's Brett Wall. Thanks for the question. We are seeing contribution now from some of those conversions that we're seeing really across the United States, as you know, which is the largest spine market. And we see that continuing over the next several quarters here. And as Geoff mentioned, it's a combination of this technology portfolio, including AI surgical planning, including robotics, including powered surgical instrumentation imaging and navigation. Putting that all together is creating this very attractive place where very good teams and reps and groups of people want to come together to work with Medtronic.

是的，里奇，我是布雷特沃爾。謝謝你的提問。如你所知，我們現在看到了美國各地的一些轉換所做出的貢獻，美國是最大的脊椎市場。我們看到這種情況將在接下來的幾個季度繼續下去。正如 Geoff 所提到的，它是這些技術組合的組合，包括人工智慧手術規劃、機器人技術、動力手術器械成像和導航。將所有這些放在一起就創造了一個非常有吸引力的地方，非常優秀的團隊、代表和團體希望聚集在一起與美敦力合作。

So we have a very active program there. We're getting good contribution now, and we see that contribution continuing as we move forward. We have a very compelling story for those individuals to come along. And as was mentioned earlier, it's a lot more difficult now for companies that don't have that ecosystem to bring the customers and these individual teams of reps and others along in that process. So we see that continuing. We're going to continue to invest there. And as I mentioned, we have a compelling story for them to join Medtronic.

所以我們在那裡有一個非常活躍的計劃。我們現在得到了很好的貢獻，隨著我們的前進，我們看到這種貢獻仍在繼續。我們為這些人提供了一個非常引人入勝的故事。如同前面所提到的，對於那些沒有這個生態系統的公司來說，現在要讓客戶以及這些單獨的代表團隊和其他人參與這個過程要困難得多。所以我們看到這種情況仍在繼續。我們將繼續在那裡投資。正如我所提到的，我們有一個令人信服的故事讓他們加入美敦力。

Yes. I think taking a step back also, Rich, on this, this whole ecosystem approach, capital plus consumables and CST, that's largely informing what we're doing in surgical as well. And how you acquire the [caliber] with innovative financing and earn-outs and things like that. This is helping us. And that's what gives us confidence also in our surgical business, as we bring in robotics with Hugo there as well.

是的。 Rich，我認為退一步來說，整個生態系統方法，資本加消耗品和 CST，這在很大程度上也說明了我們在外科領域所做的事情。以及如何透過創新融資和獲利等方式獲得[能力]。這對我們有幫助。這也讓我們對我們的外科業務充滿信心，因為我們也引進了 Hugo 機器人技術。

And the second point I'll make is, look, you're starting to see the turnaround in both diabetes and CST. And the point there is when we focus on these type of opportunities, we're going to get results here, and you're seeing it there. And we're putting that same kind of focus on Hugo and our broader surgical business and our Afib business CAS. These are 2 big opportunities that we're focused on. And I know there's a lot of questions that we get on those 2 areas. And like CST and diabetes, with the kind of focus we're putting on it at the leadership level of the company, I'm confident you're going to see those be growth drivers for the company as we move forward. And you're seeing it now in CAS.

我要說的第二點是，你看，你開始看到糖尿病和 CST 的轉變。重點是，當我們專注於這些類型的機會時，我們將在這裡獲得結果，而你也在那裡看到它。我們也將同樣的重點放在 Hugo 以及更廣泛的外科業務和 Afib 業務 CAS 上。這是我們關注的兩大機會。我知道我們在這兩個領域有很多問題。就像 CST 和糖尿病一樣，隨著我們在公司領導層的關注，我相信隨著我們的前進，您將看到這些成為公司的成長動力。現在您可以在 CAS 中看到它。

On the robot in surgical, you're nearing the completion for the Hugo trial. Just curious if you could provide an estimation, timing wise. Should we be expecting we could see a submission in '25 and potential launch end of fiscal '25, early fiscal '26? Any color there would be helpful.

在外科手術機器人上，雨果試驗即將完成。只是好奇您是否可以提供時間方面的估計。我們是否應該期待我們可以在 25 財年提交文件，並可能在 25 財年末、26 財年年初發布？任何顏色都會有幫助。

I'll let Mike Marinaro answer that question. Mike?

我會讓麥克馬裡納羅回答這個問題。麥克風？

Yes. So thanks for the question. I won't estimate when we will submit for the urology indication, but also note that we are nearing completion. And in the quarter, we also initiated our indication work for both our GYN indication as well as a hernia indication, which will be really important for us as we move into general surgery. So critical that we are now operating across multiple indications, so that as we come into the market, we can have a series of launches across each of those to capture larger and larger pieces of the market, and we're seeing good execution, early execution inside of each of those studies as well.

是的。謝謝你的提問。我不會估計我們何時提交泌尿科指徵，但也要注意我們即將完成。在本季度，我們也啟動了婦科適應症和疝氣適應症的適應症工作，這對我們進入一般外科領域非常重要。如此重要的是，我們現在正在跨多個適應症開展業務，因此當我們進入市場時，我們可以在每個適應症上進行一系列的發布，以佔領越來越大的市場份額，而且我們很快就看到了良好的執行力也在每項研究中執行。

Thanks, Rich. We are just past the top of the hour. So we'll take one more question, please, Brad.

謝謝，里奇。我們剛剛過了最晚的時間。布拉德，我們再問一個問題。

Our final question will come from Matt Miksic at Barclays.

我們的最後一個問題將來自巴克萊銀行的馬特·米克西奇。

Great. Maybe just a couple of follow-ups on some of the pipeline programs that you talked about. Just to frame expectations around for Ardian, Symplicity, when does that, do you think, start to noticeably show up and start to demonstrate some of the potential that you were describing earlier, Geoff? And then on diabetes, you filed -- I wasn't sure if I recall whether you filed Simplera with 780G for repeats, for adults, for both? And I guess the question is, does that mean that before this coming fiscal is out that we'll start to see some traction with that new sensor in the U.S.?

偉大的。也許只是您談到的一些管道計劃的一些後續行動。只是為了建構對 Ardian 的期望，Symplicity，你認為什麼時候開始明顯地出現並開始展示你之前描述的一些潛力，Geoff？然後關於糖尿病，您提交了 - 我不確定我是否記得您是否提交過 Simplera 780G 用於重複、成人或兩者？我想問題是，這是否意味著在即將到來的財政年度結束之前，我們將開始在美國看到這種新感測器的一些吸引力？

Thanks for the questions, Matt. I'll have the subject matter experts answer those. I'll start with Sean on Symplicity.

謝謝你的提問，馬特。我會讓主題專家來回答這些問題。我將從 Sean 的 Symplicity 開始。

Yes. Thanks, Matt. I think you know, the most important thing for us is to establish reimbursement. That's the catalyst which starts to make things tick upward for us. We'll look toward the final inpatient rule for outpatient reimbursement. That will be in the kind of late July time frame. I don't know if that's going to be there. But the vast majority of our procedures are going to occur in the outpatient setting, and we're pursuing both a transitional payment there as well as, most importantly, national coverage determination with evidence development. And we're in active conversations with CMS on that and, of course, private payers.

是的。謝謝，馬特。我想你知道，對我們來說最重要的是建立報銷制度。這就是開始讓我們的事情向上發展的催化劑。我們將關注門診報銷的最終住院規則。那將是在七月下旬的時間範圍內。我不知道那是否會在那裡。但我們的絕大多數手術將在門診進行，我們正在尋求過渡性付款，最重要的是，透過證據發展確定全國覆蓋範圍。我們正在與 CMS 以及私人付款人積極對話。

So we expect the contribution to begin this year, as Geoff said, at the outset, paying down timing. It's not like we have statutory dates on these things, it's just when these come through. But suffice it to say there's a huge effort to get that reimbursement established in place. We're also changing guidelines in Europe. We expect that to happen late this summer, which will help with adoption there. And we've got new approvals, not just China, but also Canada. Those would be catalysts. But the most important thing is unlock on reimbursement, and that's a full court press for us.

因此，我們預計今年將開始捐款，正如傑夫一開始所說的那樣，還清時機。我們對這些事情並沒有法定日期，而只是這些事情何時實現。但足以說明的是，我們付出了巨大的努力來確保報銷到位。我們也在改變歐洲的指導方針。我們預計這將在今年夏末發生，這將有助於那裡的採用。我們已經獲得了新的批准，不僅是中國，還有加拿大。這些將是催化劑。但最重要的是解鎖報銷，這對我們來說是一個全面的法庭壓力。

Okay. Que, you want to answer the diabetes one?

好的。呃，你想回答糖尿病問題嗎？

Yes. We filed the Simplera Sync, which is the integrated sensor with 780G system in the U.S. in line with expectations. It's hard to comment on the timing with the agency, but we're eagerly awaiting approval for that system. And just to remind everyone that we had limited launch of the Simplera Sync with 780 in Europe in 5 countries. That's going well, and we're looking forward to expanding that to a full commercial launch in the summer. And then, of course, Simplera within InPen, we launched late last year. It's now in 15 countries, also doing quite well. So we anticipate that what we're seeing in the OUS markets will also happen in the U.S.

是的。我們在美國提交了Simplera Sync，這是與780G系統整合的感測器，符合預期。很難對該機構的時間表發表評論，但我們熱切地等待該系統的批准。只是提醒大家，我們在歐洲 5 個國家有限推出了 Simplera Sync with 780。進展順利，我們期待在夏季將其擴展到全面的商業發布。當然，我們在去年年底也推出了 InPen 內的 Simplera。目前它已在 15 個國家/地區開展業務，而且表現也相當不錯。因此，我們預計我們在 OUS 市場上看到的情況也將在美國發生。

Thanks, Matt. Geoff, please go ahead with your closing remarks.

謝謝，馬特。傑夫，請繼續您的結束語。

Thanks, Ryan. And thanks for the questions, everybody. We definitely appreciate your continued interest in Medtronic. And we hope you'll join us for our Q1 earnings broadcast, which we anticipate holding on Tuesday, August 20. We'll update you on our progress against all these strategies and our commitments. So with that, thanks for spending time with us today, and have a great rest of your day.

謝謝，瑞安。謝謝大家的提問。我們非常感謝您對美敦力的持續關注。我們希望您能參加我們的第一季財報廣播，我們預計將於 8 月 20 日星期二舉行。因此，感謝您今天與我們共度時光，並祝您有個愉快的一天。