Option Care Health Inc (OPCH) 2025 Q1 法說會逐字稿

Hello, and welcome to Option Care Health first-quarter 2025 earnings conference call. (Operator Instructions)

您好，歡迎參加 Option Care Health 2025 年第一季財報電話會議。（操作員指示）

I would now like to turn the conference over to Nicole Maggio. You may begin.

現在我想將會議交給 Nicole Maggio。你可以開始了。

Good morning. Please note that today's discussion will include certain forward-looking statements that reflect our current assumptions and expectations, including those related to our future financial performance and industry and market conditions. These forward-looking statements are subject to risks and uncertainties that could cause actual results to differ materially from our expectations. We encourage you to review the information in today's press release as well as in our Form 10-K filed with the SEC regarding specific risks and uncertainties. We do not undertake any duty to update any forward-looking statements, except as required by law.

早安.請注意，今天的討論將包括某些前瞻性陳述，這些陳述反映了我們當前的假設和預期，包括與我們未來財務表現以及行業和市場狀況相關的假設和預期。這些前瞻性陳述受風險和不確定性的影響，可能導致實際結果與我們的預期有重大差異。我們鼓勵您查看今天的新聞稿以及我們向美國證券交易委員會提交的 10-K 表格中有關具體風險和不確定性的信息。除法律要求外，我們不承擔更新任何前瞻性聲明的義務。

During this call, we will use non-GAAP financial measures when talking about the company's performance and financial condition. You could find additional information on these non-GAAP measures in this morning's press release posted on the Investor Relations portion of the website.

在本次電話會議中，我們將使用非公認會計準則財務指標來談論公司的績效和財務狀況。您可以在今天早上發佈在網站投資者關係部分的新聞稿中找到有關這些非公認會計準則指標的更多資訊。

With that, I will turn the call over to John Rademacher, President and Chief Executive Officer.

說完這些，我將把電話轉給總裁兼執行長約翰·拉德馬赫 (John Rademacher)。

Thanks, Nicole, and good morning, everyone. As you can imagine, we are very pleased with the first-quarter results and the continued progress we are making in building a unique care model to support the needs of our patients.

謝謝，妮可，大家早安。你可以想像，我們對第一季的業績以及我們在建立獨特的護理模式以滿足患者需求方面所取得的持續進展感到非常滿意。

I want to spend a few minutes highlighting the progress we made in the first quarter and then pivot to share some thoughts on the dynamic market conditions, our relationship with health plans, our investments in the business, and how we think about risk management within Option Care Health. Mike will go deeper into the financials in a few minutes, but revenue momentum continued in the first quarter, with balanced performance across the portfolio.

我想花幾分鐘時間重點介紹我們在第一季取得的進展，然後轉而分享一些關於動態市場條件、我們與健康計劃的關係、我們對業務的投資以及我們如何看待 Option Care Health 內部的風險管理的想法。幾分鐘後，麥克將深入探討財務狀況，但第一季的營收動能依然強勁，整個投資組合的表現均衡。

Breaking down the revenue growth, which grew 16% over the first quarter of last year, we saw an acceleration in acute therapies, which grew in the mid-teens; and our chronic therapies grew in the high teens, with solid performance in our rare and orphan and limited distribution therapies. As for the acute therapy growth, we believe our team executed well to capitalize on improved IV bag supply, shifting market dynamics, and our continued investments and capabilities to serve the specific needs of patients on these therapies. This is where we believe our national scale and local responsiveness places us in a unique position, and our reliability and dependability allow us to partner more effectively with referral sources and payers.

分項來看，營收成長比去年第一季成長了 16%，其中急性療法收入加速成長，成長率達到十幾歲左右；慢性療法收入成長達到十幾歲左右，其中罕見疾病、孤兒藥和有限分銷療法收入表現穩健。至於急性治療的成長，我們相信我們的團隊表現良好，利用改善的靜脈注射袋供應、不斷變化的市場動態以及我們持續的投資和能力來滿足這些治療患者的特殊需求。我們相信，我們的全國規模和本地響應能力使我們處於獨特的地位，而我們的可靠性和可信賴性使我們能夠更有效地與轉診來源和付款人合作。

From the investments we have made into dedicated care transition specialists through our technology-enabled and efficient patient admission process to our comprehensive and interconnected national compounding pharmacy network, we believe we are well positioned to serve the patients with complex need as they are being discharged from the hospital. The strength of the top-line performance across a broad set of therapies, along with disciplined spending, drove 13.7% adjusted EBITDA growth on a year-over-year basis.

從我們對專門的護理過渡專家的投資，到我們技術支援的高效患者入院流程，再到我們全面互聯的全國複合藥房網絡，我們相信我們完全有能力為出院時有複雜需求的患者提供服務。多種療法的強勁營收表現，加上嚴格的支出，推動調整後 EBITDA 年成長 13.7%。

During the quarter, we continued to deepen our partnership and demonstration of value with health plans. As they are feeling pressures of increased medical loss ratios and higher utilization of care, we believe we provide a valuable solution by providing high-quality care at an appropriate cost in a setting in which their members want to receive it. Whether it is by helping to safely and effectively transition a patient out of an in-patient setting to help better manage the number of bed days, avoiding the need for a patient to have to go to a step-down facility or effectively managing a patient's complex medical needs to help avoid hospital readmissions or costly complications, we believe our goals are aligned with our payer partners.

本季度，我們繼續深化與健康計劃的合作夥伴關係並展示價值。由於他們感受到醫療損失率上升和護理利用率提高的壓力，我們相信，透過在其成員希望接受的環境中以適當的成本提供高品質的護理，我們可以提供有價值的解決方案。無論是透過幫助患者安全有效地轉出住院環境以幫助更好地管理住院天數，避免患者必須去逐步康復的設施，還是有效地管理患者復雜的醫療需求以幫助避免再次入院或昂貴的並發症，我們相信我們的目標與我們的付款人合作夥伴是一致的。

Today, we are working with some of the most innovative health plans to support their site-of-care initiatives, which we believe positions us to make a meaningful contribution and helping to reduce the total cost of care. We continue to invest vigorously in our people, process, technology, and facilities. Since the beginning of 2025, we opened another state-of-the-art compounding pharmacy in Virginia, opened three additional infusion clinics, invested further in advanced technology enablement, and expanded our nursing capabilities.

今天，我們正在與一些最具創新性的健康計劃合作，以支持他們的護理站點計劃，我們相信這使我們能夠做出有意義的貢獻並幫助降低整體護理成本。我們將繼續大力投資我們的人才、流程、技術和設施。自 2025 年初以來，我們在維吉尼亞州開設了另一家最先進的配藥藥房，開設了另外三家輸液診所，進一步投資於先進技術支持，並擴大了我們的護理能力。

On the advanced technology front, we continue to expand our use of robotic process automation and machine learning to help improve the efficiency and effectiveness of our revenue cycle management process. We have seen consistent improvements in cash collection velocity, resource productivity, and spending leverage.

在先進技術方面，我們繼續擴大機器人流程自動化和機器學習的使用，以幫助提高我們的收入週期管理流程的效率和有效性。我們看到現金收集速度、資源生產力和支出槓桿不斷提高。

Through our strategic partnership with Palantir, we have launched AI-embedded intelligence into our patient registration process, which is specifically designed to improve the speed and accuracy of onboarding new patients and manage the reverification and reauthorization process for existing patients.

透過與 Palantir 的策略合作夥伴關係，我們在患者登記流程中引入了嵌入式 AI 智能，專門用於提高新患者入院的速度和準確性，並管理現有患者的重新驗證和重新授權流程。

We also continue to invest in our internal nursing capabilities in Naven Health, our standalone nursing agency. Naven Health conducted almost 50,000 nursing visits in the quarter, which represents significant growth over the prior year to remain a key enabler of our ability to effectively take on new patients.

我們也繼續投資於我們的獨立護理機構 Naven Health 的內部護理能力。Naven Health 本季度進行了近 50,000 次護理訪問，與前一年相比有顯著增長，這仍然是我們有效接收新患者的關鍵推動因素。

As we announced on the fourth-quarter earnings call, in late January, we closed on our acquisition of Intramed Plus, a home infusion pharmacy and ambulatory infusion center operator in the Southeast. I am pleased to report that our teams are working together seamlessly, and we remain on track to achieve the financial and operational performance goals from this acquisition and to leverage some of the best practices from their operations and infusion clinics across our network.

正如我們在第四季度收益電話會議上宣布的那樣，在一月底，我們完成了對 Intramed Plus 的收購，這是一家位於東南部的家庭輸液藥房和門診輸液中心營運商。我很高興地報告，我們的團隊正在無縫合作，我們仍有望實現此次收購的財務和營運績效目標，並利用我們網路中的營運和輸液診所的一些最佳實踐。

Not only did this acquisition help to expand our infusion clinic footprint in a key and growing region, but also expanded our use of the advanced practitioner model and increased the number of chairs we operate. As a reminder, we operate over 750 infusion chairs across the country, which we believe provides a safe and convenient alternative for patients who are willing and able to receive care outside of their home.

此次收購不僅有助於擴大我們輸液診所在關鍵且不斷增長地區的影響力，而且還擴大了我們對高級從業者模式的使用，並增加了我們運營的診療椅數量。提醒一下，我們在全國範圍內運營著 750 多張輸液椅，我們相信這為願意並且能夠在家外接受護理的患者提供了一種安全便捷的替代方案。

We continue to see increased utilization of these facilities in the first quarter and conducted over one-third of our nursing visits in one of our centers. In addition to our deployment of capital towards the Intramed Plus acquisition, we repurchased $100 million of stock during the quarter, capitalizing on the strength of our balance sheet.

我們在第一季繼續看到這些設施的利用率不斷提高，並且超過三分之一的護理訪問在我們的一個中心進行。除了為收購 Intramed Plus 投入資金外，我們還在本季回購了價值 1 億美元的股票，充分利用了我們資產負債表的優勢。

And finally, I would like to take a few minutes to speak about how we are viewing the macroeconomic backdrop as well as the potential impact of proposed tariffs. Like all enterprises, we continue to monitor closely developments out of Washington and evaluate internally through our enterprise risk management framework, how various scenarios may impact our operations.

最後，我想花幾分鐘談談我們如何看待宏觀經濟背景以及擬議關稅的潛在影響。與所有企業一樣，我們繼續密切關注華盛頓的發展，並透過我們的企業風險管理框架進行內部評估各種情況可能如何影響我們的營運。

I do not need to tell you that the tariff situation is complicated and highly uncertain. However, let me tell you what I do now. We do not manufacture directly import products that may be subject to tariffs. However, we purchased through various distributors or manufacturers, medical supplies and pharmaceuticals that are used to administer care to our patients.

我不需要告訴你們，關稅情況非常複雜，而且具有很大的不確定性。不過，讓我告訴你我現在做什麼。我們不生產可能被徵收關稅的直接進口產品。但是，我們透過各種分銷商或製造商購買用於為患者提供護理的醫療用品和藥品。

What is difficult to assess at this point is how tariffs will be applied to those products and when and to what extent any of those costs will be passed on to us in the form of price increases. We currently have a cross-functional team that is working hard to identify the country of origin of key supplies in pharmaceuticals and determine ways to help manage and mitigate the impact of any proposed tariffs. As we sit here today, there remains a high level of uncertainty and therefore, it will require close monitoring and an agile approach as we attempt to navigate these impacts.

目前難以評估的是，關稅將如何適用於這些產品，以及何時以及在多大程度上這些成本將以價格上漲的形式轉嫁給我們。我們目前有一個跨職能團隊，正在努力確定藥品主要供應國的原產國，並確定幫助管理和減輕任何擬議關稅影響的方法。今天，我們坐在這裡，仍然存在高度的不確定性，因此，我們需要密切監測並採取靈活的方式來應對這些影響。

That being said, as you saw this morning, given the strength of the first quarter, we increased the lower end of our full-year adjusted EBITDA guidance range to reflect the first-quarter performance, but less the top end unchanged largely due to the uncertainty of the market.

話雖如此，正如您今天早上所看到的，鑑於第一季度的強勁表現，我們提高了全年調整後 EBITDA 指導範圍的下限，以反映第一季度的業績，但上限保持不變，這主要是由於市場的不確定性。

In closing, I'm quite pleased with the progress the team has made in the first quarter in driving results as well as continue to build on our strength and invest for future growth.

最後，我對團隊在第一季的進展感到非常滿意，同時我們將繼續增強實力並為未來的成長進行投資。

With that, I'll hand the call over to Mike to provide additional detail. Mike?

說完這些，我將把電話交給麥克，讓他提供更多細節。麥克風？

Thanks, John. And good morning, everyone. Overall, as John mentioned, the first quarter was a strong start to the year.

謝謝，約翰。大家早安。總體而言，正如約翰所提到的，今年第一季開局強勁。

Revenue growth of 16% was quite balanced, with mid-teens growth within our acute portfolio of therapies and high-teens growth across the chronic therapies. The acute therapy growth we delivered in the quarter was notably higher than we have seen historically, and the team executed well in targeted areas. We also saw improved supply chain dynamics for acute therapies, which further contributed to the growth.

16% 的收入成長相當均衡，其中急性療法組合的收入成長率達到中等水平，慢性療法的收入成長率達到高水平。我們在本季實現的急性治療成長明顯高於歷史水平，且團隊在目標領域表現良好。我們也看到急性治療的供應鏈動態得到改善，這進一步促進了成長。

Within the chronics, we delivered balanced performance across the portfolio, with continued strong growth within our limited distribution and rare and orphan therapy. Gross profit of $263 million grew a bit over 10% versus the first quarter last year. And there's a bit to unpack here. Gross profit benefited from the therapy mix as acute therapies helped the dollar grow.

在慢性病領域，我們在整個產品組合中實現了均衡的表現，有限分銷以及罕見疾病和孤兒藥治療領域繼續保持強勁增長。毛利為 2.63 億美元，較去年第一季成長 10% 以上。這裡還有一些事情要解決。由於急性療法推動美元成長，毛利受益於治療組合。

As we outlined on our fourth-quarter call, we projected a $60 million to $70 million gross profit impact from the Stelara economics reset we've previously discussed. We continue to believe that range for the full year is accurate, but there was minimal impact in the first quarter as we exited 2024 with higher Stelara inventories that were exhausted in the first quarter of 2025. We estimate that roughly $5 million of the $60 million to $70 million negative Stelara gross profit impact was realized in the first quarter.

正如我們在第四季度電話會議上概述的那樣，我們預計 Stelara 經濟重置將對毛利產生 6000 萬至 7000 萬美元的影響（我們之前討論過）。我們仍然相信全年的範圍是準確的，但第一季的影響微乎其微，因為我們在 2024 年結束時 Stelara 庫存較高，但在 2025 年第一季已耗盡。我們估計，Stelara 毛利的負面衝擊高達 6,000 萬至 7,000 萬美元，其中約有 500 萬美元是在第一季產生的。

SG&A was in line with our expectations and we did augment some of our patient support and field functions in anticipation of the higher acute volumes and to help ensure a smooth and efficient benefit reverification and reauthorization process. We continue to expect strong spending leverage for the year, which is a hallmark of our value creation strategy.

銷售、一般及行政費用符合我們的預期，我們確實增加了一些患者支援和現場職能，以應對更高的急性量，並幫助確保福利重新驗證和重新授權流程順利高效。我們預計今年的支出槓桿仍將保持強勁，這是我們價值創造策略的標誌。

Adjusted EBITDA of $111.8 million grew 13.7% over the prior year and represented 8.4% of net revenue. And adjusted earnings per share of $0.40 grew 14.3% over the prior year.

調整後的 EBITDA 為 1.118 億美元，較上年增長 13.7%，佔淨收入的 8.4%。調整後每股收益為 0.40 美元，較上年增長 14.3%。

As John mentioned, we were active in deploying capital in the first quarter. In addition to closing on the $117 million acquisition of Intramed Plus, we also repurchased $100 million of stock in the quarter. Notwithstanding those outflows, we continue to maintain what we believe is a strong balance sheet and capital structure, with the capacity to continue pursuing value creation strategies for our shareholders.

正如約翰所提到的，我們在第一季積極部署資本。除了以 1.17 億美元收購 Intramed Plus 之外，我們還在本季回購了價值 1 億美元的股票。儘管存在資金流出，我們仍然保持著我們認為強勁的資產負債表和資本結構，並有能力繼續為股東推行價值創造策略。

Finally, I just want to provide a quick update on our expectations for the full year. For full-year 2025, we now expect to generate revenue of $5.4 billion to $5.6 billion and adjusted EBITDA of $455 million to $470 million, which we believe will translate into adjusted earnings per share of $1.61 to $1.70. We continue to expect to generate more than $320 million in cash flow from operations.

最後，我只想快速更新我們對全年的期望。我們目前預計2025年全年營收將達54億美元至56億美元，調整後息稅折舊攤提前利潤（EBITDA）將達到4.55億美元至4.7億美元，預計調整後每股盈餘將達到1.61美元至1.70美元。我們預計營運現金流將超過3.2億美元。

At this point, our guidance does not reflect any extraordinary impact from tariffs or other policy changes from the administration as we do not believe we are in a position to determine such an impact or accurately quantify at this time. To the extent we determine that such an impact exists and we are in a position to quantify, we intend to incorporate this into our expectations and articulate accordingly. So overall, we're quite pleased with the solid start to 2025, and we expect it will be another year of growth for Option Care Health.

目前，我們的指導並未反映關稅或政府其他政策變化的任何特殊影響，因為我們認為我們目前無法確定這種影響或準確量化。如果我們確定這種影響存在並且我們能夠量化，我們打算將其納入我們的預期並進行相應的表達。總體而言，我們對 2025 年的良好開局感到非常滿意，我們預計這將是 Option Care Health 又一個增長年。

And with that, we'll open the call for questions. Operator?

現在，我們將開始提問。操作員？

(Operator Instructions) Lisa Gill, JPMorgan.

（操作員指示） 摩根大通的麗莎吉爾 (Lisa Gill)。

Mike, I just want to go back to the guidance update, talking about no impact thus far for tariffs. But you beat by $7 million raised by $2.5 million. I understood John's comments that there is some level of uncertainty still in the marketplace, but is there anything else that you're concerned about or looking at for the rest of the year from an underlying fundamental perspective? Or is this just you being conservative?

麥克，我只想回到指導更新，談論迄今為止關稅沒有影響。但你卻以 700 萬美元的優勢擊敗了籌集的 250 萬美元。我理解約翰的評論，即市場上仍然存在一定程度的不確定性，但從根本上看，今年剩餘時間還有什麼讓您擔心或關注的嗎？或者這只是你的保守行為？

Hey, good morning, Lisa. Look, as you know, historically, we entered the year relatively cautiously. I think this year, to John's point, just underscores the need to try a little carefully.

嘿，早上好，麗莎。如你所知，從歷史上看，我們進入這一年是相對謹慎的。我認為今年，正如約翰所說，只是強調了謹慎嘗試的必要性。

Look, a couple of things. First and foremost, as you know, we don't provide quarterly guidance. So the first quarter can be a bit wonky at times with dynamics coming out of the holidays and benefit plans resetting. So I would caution folks to take a beat versus an external collective expectation and try to extrapolate that out throughout the year.

看，有幾件事。首先，如您所知，我們不提供季度指導。因此，由於假期和福利計劃重置的影響，第一季有時可能會有點不穩定。因此，我提醒大家，要根據外在的集體預期來判斷，並嘗試在全年進行推論。

As I highlighted, look, a lot of things going on in the first quarter. We saw very robust growth within our acute portfolio. We had a relatively muted impact from the Stelara economic reset because we exited the year with higher inventory levels than we thought, which that inventory was at the more favorable procurement levels.

正如我強調的那樣，第一季發生了很多事情。我們的急性投資組合出現了非常強勁的成長。斯特拉拉 (Stelara) 經濟重置對我們的影響相對較小，因為我們今年的庫存水準高於我們的預期，而且這些庫存處於更有利的採購水準。

And so, look, at the end of the day, we were able to bring up the bottom end of the range. And at the midpoint, we're still expecting earnings to grow in the high teens. So I think it just -- the first quarter is always a little hard to extrapolate because there's always some dynamics going.

所以，你看，到最後，我們能夠提高範圍的底端。從中期來看，我們仍然預期收益將成長百分之十幾。所以我認為——第一季總是有點難以推斷，因為總是存在一些動態。

No, I appreciate that. And then just secondly, there were a lot of changes with MAPD, with the out-of-pocket costs lowered. You talked about acute growth, but I would think that that potentially would impact more of the chronic side of your business. So just curious if you're seeing an increase in utilization due to some of those changes.

不，我很感激。其次，MAPD 發生了很多變化，自付費用降低了。您談到了急劇增長，但我認為這可能會對您業務的長期影響產生更大的影響。所以我只是好奇，您是否看到由於這些變化而導致利用率有所提高。

Hey, Lisa, it's John. Thanks for the question. Yeah, as we said, we saw a strong growth in both the acute and the chronic. We continue to see that moving forward. We do think that some of the changes that have come forward will benefit us in some of the aspects of the write-offs that we have for some of the patient obligations. As you would expect with a bigger amount of out-of-pocket, it's harder to collect that from some of the patients given the economic conditions that they have or the socioeconomic strata that they occupied.

嘿，麗莎，我是約翰。謝謝你的提問。是的，正如我們所說，我們看到急性和慢性病例都出現了強勁增長。我們繼續看到這一進展。我們確實認為，已經出現的一些變化將使我們在某些​​患者義務的註銷方面受益。正如您所預料的，由於自付費用金額較大，考慮到患者的經濟狀況或所處的社會經濟階層，從某些患者收取費用會更加困難。

So we don't see a lot of that in the first quarter. Where we will start to see it is in the back half of the year. We think we're well positioned. We work aggressively with all of our patients to tap into patients' assistance program and other foundation and other aspects to move that along.

因此，我們在第一季不會看到太多這樣的情況。我們將在今年下半年開始看到它。我們認為我們處於有利地位。我們積極與所有患者合作，利用患者援助計劃和其他基金會以及其他方面來推動這一進程。

So hard to determine right now what the net impact is going to be, but we work hard within our revenue cycle management team in support of patients and making certain that we collect every dollar that is owed.

現在很難確定淨影響是什麼，但我們的收入週期管理團隊正在努力為患者提供支持，並確保收取每一美元欠款。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

I understand the complexities around the tariffs. But can you walk us through the mechanics of what happens if pharma increases their prices due to tariffs and how it could flow through your branded and generic business? Any impacts under the different reimbursement mechanisms like AWP and ASP? And then remind us why IVIG probably doesn't have any impact from tariffs.

我了解關稅的複雜性。但是，您能否向我們介紹一下，如果製藥公司因為關稅而提高價格，會發生什麼情況，以及這會如何影響您的品牌藥和仿製藥業務？AWP 和 ASP 等不同的報銷機制會有什麼影響嗎？然後提醒我們為什麼 IVIG 可能不會受到關稅的影響。

Thanks, Pito. It's Mike. As always, one question and 15 parts. So appreciate that.

謝謝，Pito。我是麥克。一如既往，一個問題，15 個部分。我很感激。

Look, as you know, look, a large component of our revenue is reimbursement for the pharmaceutical or the therapy. We have relatively good balance across the reference prices in terms of how we invoice the health plans, a mix of AWP and ASP. And those reference prices generally correlate to the underlying indices that we utilize to procure the drug.

如你所知，我們的收入很大一部分來自藥品或治療費用的報銷。就我們如何向健康計劃開立發票而言，我們在參考價格方面保持了相對良好的平衡，即 AWP 和 ASP 的混合。這些參考價格通常與我們購買藥品所使用的基礎指數有關。

Roughly half of the drugs, the $3.5 billion to $4 billion of drugs that we procure every year, roughly half is coming directly from manufacturers have through wholesalers. But ultimately, it's at those reference prices. And so again, I don't want to leave a connotation that it's a perfect hedge.

我們每年採購的藥品大約有一半，即價值 35 億至 40 億美元的藥品，其中大約有一半是直接從製造商或透過批發商購買的。但最終還是以這些參考價格為準。因此，我再說一遍，我不想給人留下「這是完美的對沖」的印象。

But to the extent that drug prices increase, that would presumably have upward pressure on the reference prices that correlates to how we get reimbursed because we're billing health plans at a reference price plus or minus a spread. And those reference prices also are utilized with our procurement relationships to determine what we're buying. So again, I wouldn't want to leave the expectation that it's a perfect hedge, but over time, that spread that we make is relatively consistent, whether it's a generic or whether it's a branded drug.

但如果藥品價格上漲，這可能會對參考價格產生上行壓力，這與我們如何獲得報銷有關，因為我們是按照參考價格加上或減去差價來向健康計劃收費的。這些參考價格也用於我們的採購關係，以確定我們購買什麼。所以，我再說一次，我不想期望它是一種完美的對沖，但隨著時間的推移，我們所做的價差是相對一致的，無論是仿製藥還是品牌藥。

Okay, great. And then for IVIG, I guess, because that's our US domestic, there's sort of no impact there, correct?

好的，太好了。然後對於 IVIG，我猜，因為那是我們美國國內的，所以那裡沒有影響，對嗎？

Well, I mean, the biggest raw material for IG, whether it's subcu or intravenous is human plasma. And in the US, it's required that human plasma be utilized. So that's the biggest raw component.

嗯，我的意思是，IG 的最大原料，無論是皮下或靜脈注射都是人體血漿。而在美國，則要求使用人類血漿。這是最大的原始組件。

I don't fully understand where the fractionators are adding value, whether it's onshore, offshore. But one would presume that given more domestic content for that therapy, that would leave a connotation that there would be lower tariff impact. But that's a better question probably for the fractionators.

我不完全了解分餾塔在哪裡增加價值，無論是在陸上還是在海上。但人們會認為，如果該療法包含更多國內內容，那麼其關稅影響就會降低。但對於分餾塔來說，這可能是個更好的問題。

Okay, great. And then for the follow-up, I guess, back to Stelara. I guess going back to where this was or going into the quarter -- or going into the year or sort of where it is now, I guess, the change is on the procurement inventory that you guys have.

好的，太好了。接下來我想回到 Stelara。我想回到原來的狀態，或進入本季 - 或進入今年或現在的狀態，我想，變化在於你們的採購庫存。

Can you just walk us through how we should think about the seasonality for the Stelara impact and any impact to the annual guidance and how we should think about that? And then your thoughts around biosimilars and Stelara. Thanks.

您能否向我們介紹一下我們應該如何看待 Stelara 的季節性影響以及對年度指導的影響以及我們應該如何看待這些影響？然後您對生物相似藥和 Stelara 的看法。謝謝。

Yeah, I'll take the first, and then I'll let John jump in with the -- on the biosimilars. Look, I mean, as I mentioned in my prepared remarks, the $60 million to $70 million, I think, remains intact. Our expectations were that we would exit the year with a reasonable level of Stelara inventory at the more favorable procurement level.

是的，我先回答第一個問題，然後讓約翰加入討論生物相似藥。我的意思是，正如我在準備好的演講中提到的那樣，我認為 6000 萬到 7000 萬美元保持不變。我們的預期是，今年年底我們將擁有合理水準的 Stelara 庫存和更有利的採購水準。

It was more timing than anything else. We think that the $60 million to $70 million still remains intact. Again, call it $5 million. And again, it's not a perfect science because there's a lot of moving pieces. But roughly $5 million of the $60 million to $70 million impacted the first quarter. So quick math is you would expect going from Q1 into the subsequent quarters, about a $20 million negative impact. Notwithstanding that, we still increase the bottom end of our range because we're seeing a lot of momentum in other areas of the operations.

這更多的是一個時機問題。我們認為 6,000 萬至 7,000 萬美元仍保持不變。再說一遍，500萬美元。再說一次，它不是一門完美的科學，因為其中有很多活動的部分。但在這 6,000 萬至 7,000 萬美元中，約有 500 萬美元影響了第一季。簡單的計算一下，你預計從第一季到接下來的幾個季度，將產生約 2000 萬美元的負面影響。儘管如此，我們仍然提高了範圍的底端，因為我們看到其他營運領域的巨大發展勢頭。

Yeah. And then the only other thing I'd add is we entered the year with a goal to continue to support the Stelara patients, as we've called out before. Stelara patients are still profitable. They're just less profitable than they were before. Team has done a really good job of making certain that we went through that reverification and reauthorization process.

是的。然後，我唯一想補充的是，我們今年的目標是繼續支持 Stelara 患者，正如我們之前所呼籲的那樣。Stelara 患者仍然獲利。它們的利潤只是比以前少了。團隊已經做了非常出色的工作，確保我們完成了重新驗證和重新授權的過程。

We've maintained a solid portion of that patient census, and that remains intact. And again, I think it just speaks to the clinical programs that we have in place and the support of this unique patient population, which requires a letter of medical necessity and have some complexity in their care plan that our team can provide.

我們保留了該患者普查的相當一部分，並且仍然完好無損。再說一次，我認為這只是說明了我們現有的臨床項目和對這個特殊患者群體的支持，他們需要醫療必要性證明，並且我們的團隊可以提供一些複雜的護理計劃。

As for the overall biosim environment, not a lot of change in our existing book. We continue to work closely with all the manufacturers to make certain that we have access to product on the formulary. We expect that as time moves through the year, we'll continue to have a bigger portion of patients that will start to utilize those products.

至於整體生物模擬環境，我們現有的書籍並沒有太大變化。我們將繼續與所有製造商密切合作，以確保我們能夠獲得處方表上的產品。我們預計，隨著時間的推移，將會有更多的患者開始使用這些產品。

And so that was factored into the way that we're looking at it. And I'd say it's patterning as we had expected within a pretty tight range to the overall view we had as we entered the year.

所以這是我們看待這個問題的因素之一。我想說的是，它的模式正如我們預期的那樣，與我們進入今年時的總體觀點在一個相當狹窄的範圍內。

Constantine Davides, Citizens.

康斯坦丁大衛斯，公民。

Thanks. John, in your prepared remarks, you talked a bit about how you're increasingly demonstrating your value proposition to your payer partners. And can you just talk about how that dialogue has changed over the past year or so? And maybe what some of the more progressive payers are doing or thinking with respect to infusion benefits and plan designed around that area? Thanks.

謝謝。約翰，在你準備好的發言中，你談到瞭如何向你的付款合作夥伴越來越多地展示你的價值主張。您能談談過去一年左右這種對話發生了哪些變化嗎？也許一些更進步的付款人正在做或考慮圍繞該領域設計的輸液福利和計劃？謝謝。

Yeah, absolutely. Thanks for the question. With some of the shifting market dynamics, as you would expect, the ability for Option Care Health to be that partner of choice to help transition patients out of the hospital into the home, we played a bigger role. You saw some of the growth in the acute therapies in the quarter as supply has improved on the IV bag and our team executed well within that process.

是的，絕對是如此。謝謝你的提問。隨著市場動態的變化，正如您所預料的，Option Care Health 作為幫助患者從醫院過渡到家中的首選合作夥伴，發揮了更大的作用。由於靜脈注射袋的供應有所改善，並且我們的團隊在這一過程中表現良好，您看到本季度急性治療有所增長。

The value of a bed day is significant. And if you're working to try to manage your medical loss ratio and reduce the total cost of care, we are part of that solution. We offer high-quality care and appropriate cost in a setting in which patients want to receive it. So the conversations that we've had with the payers, especially with some of the competitive retrenchment that has happened is one that puts Option Care Health as a meaningful part of their network design.

臥床日的價值十分重大。如果您正在努力控制醫療損失率並降低總護理成本，我們就是解決方案的一部分。我們在病人願意接受的環境中提供高品質的照護和適當的費用。因此，我們與付款人進行的對話，特別是在一些已經發生的競爭性裁員之後，將 Option Care Health 作為其網路設計中的重要組成部分。

We were able to provide that broad spectrum of products, both in the acute and chronic. Our responsiveness at the local level is something that we take pride in. We understand the positive impact we have on the patients that we serve. And we are partnering in deeper ways given the capacity that we have to take that up.

我們能夠提供廣泛的產品，包括急性和慢性產品。我們為我們在地方層面的回應能力感到自豪。我們了解我們對所服務的患者所產生的正面影響。鑑於我們的能力，我們正在以更深層的方式開展合作。

How that kind of fits into that longer -- second part of your question is there is a lot of focus around the total cost of care. And so some of the innovative partners that we're working with are looking at site-of-care initiatives in which they're helping to inform their members around selections or choices that they have and where they can receive their care and are helping to inspire them to choose those lower cost settings to help them make informed decisions around the treatment plans and how they receive their infusion, whether it's in one of our infusion cares or in the home.

這與長期來看有何關係——你的問題的第二部分是，人們非常關注護理的總成本。因此，我們正在合作的一些創新夥伴正在研究護理站點計劃，這些計劃旨在幫助其成員了解他們所擁有的選擇以及他們可以在哪裡接受護理，並幫助激勵他們選擇那些成本較低的環境，以幫助他們就治療計劃和如何接受輸液做出明智的決定，無論是在我們的輸液護理中還是在家中。

And so we're working with them to help identify those patients to help to bring those patients onto service with Option Care Health and help to reduce the total cost of care for the health plan.

因此，我們正在與他們合作，幫助識別這些患者，幫助這些患者接受 Option Care Health 的服務，並幫助降低醫療計劃的總護理成本。

David MacDonald, Truist.

大衛麥克唐納，Truist。

Just a couple of questions. I just want to follow up on Connie's question. Look, I mean your payers have had to pivot a couple of times in the last two years around acute. I'm just curious, conversations around that, any potential halo effect or expected halo effect even in chronic in terms of ability to pick up some additional business just given the support that you guys have provided on the acute side.

僅有幾個問題。我只是想繼續回答康妮的問題。你看，我的意思是，在過去的兩年裡，你的付款人必須圍繞急性病進行幾次轉變。我只是很好奇，圍繞這一點的對話，任何潛在的光環效應或預期的光環效應，即使是在慢性方面，在你們在急性方面提供的支持下，是否有能力獲得一些額外的業務。

Yeah, Dave. Again, just I don't want to repeat myself, but yeah, we feel we're really well positioned in those conversations. We believe, yeah, there's probably some goodwill that's created and the ability to help them with a very complicated patient base that are being discharged from the acute settings and be able to take those on.

是的，戴夫。再說一次，我不想重複自己的話，但是的，我們覺得我們在這些對話中處於非常有利的位置。我們相信，是的，這可能會產生一些善意，並有能力幫助他們處理從急性病中出院的非常複雜的患者群體，並能夠接收這些患者。

So our dedicated team in market access are having those conversations. We continue to articulate the value that we bring, how we can serve their members across the broad spectrum of therapies that we have within our portfolio. And we're going to continue to utilize the strength of the breadth of our portfolio and the responsiveness of our team to win in the marketplace.

因此，我們專門的市場准入團隊正在進行這些對話。我們將繼續闡明我們所帶來的價值，以及我們如何透過我們產品組合中的廣泛療法為他們的成員提供服務。我們將繼續利用我們廣泛的產品組合和我們團隊的回應能力來贏得市場。

And we know we have to win each patient. We have to win every single day. This is a hustle business and one in which our team is up to that challenge.

我們知道我們必須贏得每位患者的信任。我們必須每天都取得勝利。這是一項艱鉅的事業，我們的團隊能夠應對這項挑戰。

And Dave, the only thing I'd add is -- to borrow your term of the halo effect, I think as you know, acute referrals are -- they're not easy. The response time is quite rapid. But for forward-thinking payers, even though the sticker price of the therapy is lower than the chronic, the value it creates by reducing bed days and helping them with MLRs is dramatic. And so that's where I think we really can articulate the value is getting their patients out of the hospital quicker.

戴夫，我唯一要補充的是——借用你的術語“光環效應”，我認為正如你所知，急性轉診——並不容易。響應時間相當快。但對於有遠見的付款人來說，儘管該療法的標價低於慢性病，但它通過減少住院時間和幫助他們治療 MLR 所創造的價值是巨大的。所以我認為我們真正能夠表達的價值就是讓病人更快出院。

And then guys, just you mentioned best practices at Intramed. Is there kind of one or two areas that you would point to where they're kind of really doing a good job or anything you would call out in terms of them doing something a little bit different?

夥計們，剛才你們提到了 Intramed 的最佳實踐。您能否指出他們在某一或兩方面確實做得很好，或者您能否指出他們在哪些方面做得有些不同？

Yeah. I would call out their execution around their advanced practitioner model is one in which there are plenty of learnings that we can take out of that and apply across our platform as we continue to expand in that. They have worked really hard within their model to provide a broader spectrum of products and really to execute well around that. And so I think we feel really pleased about that.

是的。我想指出的是，他們圍繞高級從業者模型的執行方式有很多值得我們借鑒和應用的地方，我們可以繼續擴展這個平台。他們在自己的模型中付出了巨大的努力來提供更廣泛的產品，並真正圍繞著這個模型很好地執行。所以我認為我們對此感到非常高興。

The other thing is they moved ahead on some of the technology implementations of next generation of the core pharmacy system. And so it gives us an opportunity to learn fast around that technology, how to integrate that. We're going to be moving in that direction over the long run.

另一件事是他們在下一代核心藥局系統的一些技術實施方面取得了進展。因此，它為我們提供了快速學習該技術以及如何整合它的機會。從長遠來看，我們將朝著這個方向努力。

And so it gives us really a sandbox to play in, a place to have an innovation center around some of the technology as we're thinking about that next-generation intelligent platform that we're building. And so it gave us a jump pad to really to start from in a really informative and, I think, an innovative way.

因此，當我們考慮建立下一代智慧平台時，它實際上為我們提供了一個可以玩耍的沙箱，一個圍繞某些技術建立創新中心的地方。因此，它為我們提供了一個跳板，讓我們能夠以一種非常有資訊量且我認為是創新的方式開始。

And then guys, just two more. You mentioned AI, mostly in the area of revenue cycle management, understanding the dynamics around lack of bad debt and chronic. I'm just kind of curious when you look at acute, is there an opportunity through some of these initiatives around potential bad debt in acute?

夥計們，再來兩個。您提到了人工智慧，主要是在收入週期管理領域，了解缺乏壞帳和慢性病的動態。我只是有點好奇，當您看到 Acute 時，透過這些舉措是否有機會解決 Acute 的潛在壞帳問題？

Yeah. I mean, look, the team has been relentless, Dave, around not only efficiency of how quickly and comprehensively we can onboard new patients but utilizing technology to make sure that we're putting a clean claim in front of a payer. Because miraculously, when you put a clean claim in front of a payer on a timely basis, they pay very quickly. And so, again, as John said, that's really where we've been deploying AI and some of the RPA is really around a lot of the back office.

是的。我的意思是，你看，戴夫，團隊一直堅持不懈，不僅致力於提高我們能夠快速全面地接收新患者的效率，還利用技術確保我們向付款人提出清晰的索賠。因為奇蹟般地，當您及時向付款人提出清晰的索賠時，他們會很快付款。所以，正如約翰所說，這確實是我們一直在部署人工智慧的地方，而一些 RPA 實際上圍繞著很多後台辦公室。

Again, a lot of times when our teams are receiving referrals across the country, the expectation is well within an hour we're getting back to them with a comprehensive answer. And that's where not only is automation helping us on the front end, but it's just creating a more confident rev cycle event on the back end, which is, as you know all too well, results in much lower contractual bad debt.

再次，很多時候，當我們的團隊收到來自全國各地的推薦時，我們期望在一小時內給他們一個全面的答案。這就是自動化不僅在前端幫助我們，而且還在後端創建更自信的轉速週期事件，正如你們所知道的，這會導致合約壞帳大幅降低。

And then, guys, just last one, Mike. I just want to make sure I'm thinking about this correctly. Obviously, you heard the comments around Stelara. But is it fair to say that you guys absorbed? It sounded like maybe a little bit of inflated costs as you brought on some of the additional quorum business and maybe those costs get absorbed a bit better as we move throughout the year also. So a little bit of push and pull. Is that fair?

然後，夥計們，最後一個，麥克。我只是想確保我對此的思考是正確的。顯然，您聽到了有關 Stelara 的評論。但可以說你們吸收了所有知識嗎？這聽起來像是成本可能有點膨脹，因為你帶來了一些額外的法定人數業務，也許這些成本在我們全年的發展過程中也會得到更好的吸收。因此需要一點推拉。這樣公平嗎？

That's very fair.

這非常公平。

Matt Larew, William Blair.

馬特拉魯、威廉布萊爾。

I wanted to ask on the acute growth in the quarter. If I think back a couple of years ago when there were some other competitive departures, you had about a four-quarter period of higher growth. The magnitude of growth wasn't quite we saw in the first quarter.

我想問一下本季的急劇增長情況。如果我回想幾年前，當其他一些競爭對手離開時，你們經歷了大約四個季度的較高增長期。成長幅度並不像第一季那麼大。

So maybe just thinking about this opportunity, you actually think (inaudible), but maybe just as a way to gauge the size of this care shift opportunity relative to the one in a couple of years.

因此，也許只是考慮這個機會，你實際上會認為（聽不清楚），但也許只是作為一種衡量這次護理轉變機會相對於幾年後的護理轉變機會的規模的方式。

Yeah, Matt. Look, we turned the patient population within the acute portfolio every single month. So the revenue gain from mid-'22 when we saw some of the market dynamics shifting, specifically, all of those patients are off service. But we've been able to maintain the referral sources confidence in our dependable service model across the country at the local level.

是的，馬特。你看，我們每個月都會改變急性病治療組合內的患者人數。因此，從 2022 年中期開始，我們看到一些市場動態發生了變化，具體來說，所有這些患者都不再接受服務，收入隨之增加。但我們能夠在地方層級保持推薦來源對我們全國可靠服務模式的信心。

Look, this time around, I think we had a better playbook. You'll recall in the third quarter of '22 we talked about trying to respond with labor models. We were very proactive in making sure that we have the clinical resources. We had the rev cycle and the patient registration resources. In my comments, I mentioned we did invest up a little bit in the first quarter. And to Dave's point, we expect that absorption to improve.

看，這一次，我認為我們有更好的劇本。你會記得，在 22 年第三季度，我們討論過嘗試用勞動力模式來應對。我們非常積極主動地確保我們擁有臨床資源。我們有轉速週期和病患登記資源。我在我的評論中提到我們在第一季確實增加了一點投資。正如戴夫所說，我們預計吸收率會提高。

And look, we're thrilled. We fight for every referral every day. We saw mid-teens growth in the acute, which as you know, is very attractive from a margin contribution perspective. We would expect that we'll lap that going into the fourth quarter to some extent, but the team never lets up. And our expectation is we're going to continue to fight for those referrals and deepen the relationships at the lower level.

瞧，我們很激動。我們每天都在為每一次推薦而奮鬥。我們看到急性期的中期成長，如你所知，從利潤貢獻的角度來看，這是非常有吸引力的。我們預計在第四節我們會在某種程度上超越這個數字，但球隊從未放鬆。我們的期望是，我們將繼續爭取這些推薦，並加深與基層的關係。

And we'll look to build off this revenue base going forward. That's a very important strategic component of our go-to-market strategy.

我們將努力在此基礎上進一步擴大收入基礎。這是我們行銷策略中非常重要的策略組成部分。

Okay, thanks. And then just two quick follow-ups. One on the reference pricing dynamic. Are all the contracts structured similar in terms of how quickly the pieces of the formula get updated, whether it's every six months? And obviously, a couple of years ago, you had a procurement benefit that is on some lag there between inventory and what you're recognized. And so that may be the first.

好的，謝謝。接下來是兩個簡短的後續問題。一是關於參考定價動態。所有合約的結構是否相似，公式各部分的更新速度是否都是每六個月一次？顯然，幾年前，您的採購效益是在庫存和您認可的效益之間存在一定的滯後。這可能是第一個。

And then the second one, will there be a recent approval for self-injection with option for one of the players that we work with? And you can just give a good kind of reminder to hear sort of portfolio breakdown in terms of what's biosimilar versus branded versus is there any larger branded therapies that you're exposed to similar to the Stelara? Thanks.

然後第二個問題，我們合作的其中一名球員最近是否會獲得選擇自我注射的批准？您可以給出一個很好的提醒，了解產品組合的細分情況，包括生物相似藥、品牌藥以及您是否接觸過與 Stelara 類似的大型品牌療法？謝謝。

Yeah. Remind me, Matt, real quick. I was scratching out some notes, your first question?

是的。馬特，快點提醒我。我正在記筆記，你的第一個問題是什麼？

I just want to understand the sort of the duration, how quickly cost -- yeah, exactly.

我只是想了解持續時間以及成本有多快——是的，沒錯。

Yeah. Look, structurally, the payer contracts, there's variation. But at its core, it's a reference price. Whether it's ASP or AWP, they use reference bureaus at the J-code level to reimburse at ASP or AWP, whatever the spread is.

是的。從結構上看，付款人合約存在差異。但從本質上來說，這是一個參考價格。無論是 ASP 還是 AWP，他們都使用 J 代碼等級的參考機構以 ASP 或 AWP 進行報銷，無論價差是多少。

On the procurement side, it's a little different. We do have some prices locked in. It's frankly a little stickier in terms of the ups and downs so that we have more forward visibility. But over the longer term, most of those contracts, the ones that do have some established terms and fixed prices, typically are on an annual basis. So within a year or so, the reference price impact on the procurement and the reimbursement pretty much catches up.

在採購方面，情況有些不同。我們確實鎖定了一些價格。坦白說，就起伏而言，它有點棘手，因此我們有更多前瞻性的視野。但從長期來看，大多數合約（那些確實有一些既定條款和固定價格的合約）通常都是按年簽訂的。因此，在大約一年的時間內，參考價格對採購和報銷的影響基本上就趕上了。

And then on the Stelara and then other biosimilars, as I said earlier, Matt, Stelara is patterning pretty much as we expected not only in what we've retained, but then as we look at the biosim uptake and how that's moving forward, really early at this stage, as you know. So we'll see how that kind of moves through the rest of the year. But right now, it's kind of within alignment with those expectations.

然後關於 Stelara 和其他生物仿製藥，正如我之前所說，馬特，Stelara 的模式與我們預期的非常相似，不僅在我們保留的內容上，而且在我們觀察生物仿製藥的吸收以及它如何向前發展時，正如你所知，在這個階段真的很早。因此，我們將觀察今年剩餘時間內的情況如何。但目前，它在某種程度上符合這些預期。

As for other biosims and kind of the way that we've looked at the rest of the portfolio, as we've conveyed in public information that we have provided has not been a significant change in the portfolio. We don't feel like there's significant risk. No product is more than 5% of the revenue.

至於其他生物相似藥以及我們看待其餘投資組合的方式，正如我們在公開資訊中所傳達的那樣，我們提供的投資組合並沒有發生重大變化。我們認為不存在重大風險。沒有任何產品的收入超過 5%。

There was some noise earlier in the quarter around Hytrulo, which is VYVGART's Argenx's product that went subcutaneous. Again, we think that it's an opportunity for us to continue to demonstrate our clinical competencies and capabilities. We have that product as part of our portfolio. We'll continue to support the innovators as they're bringing new products into the marketplace.

本季早些時候，有關 Hytrulo 有一些傳聞，Hytrulo 是 VYVGART 的 Argenx 的皮下注射產品。再次，我們認為這是我們繼續展示臨床能力和實力的機會。該產品是我們產品組合的一部分。我們將持續支持創新者將新產品推向市場。

We also think that it kind of creates a broader awareness in the marketplace of some of these products and the opportunity to move that forward. And so we feel very confident in the portfolio that we have. We don't see that there are significant changes as we had outlined before, and we like the breadth of the portfolio.

我們也認為，這在某種程度上提高了市場對其中一些產品的認識，並提供了推動其發展的機會。因此，我們對我們現有的投資組合非常有信心。我們沒有看到之前概述的重大變化，我們喜歡投資組合的廣度。

And now especially with getting even better balance with acute and chronic, we think we'll be well positioned as we continue to work with innovators to bring new products into the marketplace to continue to work with products through their maturity lifecycle and continue to make a difference in the lives of the patients that we serve.

現在，尤其是在急性和慢性之間取得更好的平衡之後，我們認為我們將處於有利地位，因為我們將繼續與創新者合作，將新產品推向市場，繼續在產品的成熟生命週期內進行合作，並繼續為我們服務的患者的生活帶來改變。

Brian Tanquilut, Jefferies.

傑富瑞的布萊恩‧坦奎魯特 (Brian Tanquilut)。

Congrats on the quarter. It's Jack Slevin on for Brian. Apologies in advance on this one. I mean I ask one more on the tariff front, just to make sure that we understand the dynamics on reference pricing.

恭喜本季取得佳績。傑克·斯萊文代替布萊恩上場。我在此提前致歉。我的意思是，我再問一個有關關稅的問題，只是為了確保我們了解參考定價的動態。

Maybe just being a bit more direct. I think the concern out there right now is that there could be a sort of air pocket in time where tariff swing prices up and reference prices don't move yet and you would sort of have to take it on the chin.

也許只是更直接一點。我認為現在大家擔心的是，可能出現一種暫時的空隙，即關稅波動價格上漲而參考價格卻沒有變動，這時你就得承受這種影響。

I just want to understand, Mike, based on your other comments and acknowledging that there's a lot of unknowns here. But if we think about how long it takes for, for example, ASP to update on a decently significant lag, is it right to think that on the procurement side, you have a little more flexibility to sort of match up to where the reference price is going to be absent a tariff move? Or could you maybe just give a little more color on that front, it would be great.

麥克，我只是想根據你的其他評論來了解，並承認這裡有很多未知數。但是，如果我們考慮一下 ASP 需要多長時間才能更新到一個相當明顯的滯後，那麼是否可以認為在採購方面，在沒有關稅變動的情況下，您可以更靈活地匹配參考價格呢？或者您能否在這方面提供更多細節，那就太好了。

Yeah, Jack, I'd caution around taking it on the chin approach. Look, as we've mentioned, on the procurement side, our team has very good direct dialogues with manufacturers and wholesalers. A number of our procurement contracts have relatively static prices for an interim period. So we try to manage that variability and volatility in that spread to the best we can. Again, on the reimbursement side, we're billing and submitting claims on the reported then ASPs and AWPs.

是的，傑克，我會謹慎採取這種採取下巴態度的做法。正如我們所提到的，在採購方面，我們的團隊與製造商和批發商進行了非常好的直接對話。我們的許多採購合約在過渡期內價格相對穩定。因此，我們盡力控制價差的變動性和波動性。再次，在報銷方面，我們會根據報告的 ASP 和 AWP 開立帳單並提交索賠。

And so based on what we know right now, we don't see a likely scenario where there's some kind of severe disruption in terms of the lag around the reimbursement and the procurement. And again, we have a balance sheet that's very robust. Similar to what we did at year-end, we're willing to use it to soften the impact and lean in where we think there's opportunities for us to minimize that volatility.

因此，根據我們目前掌握的情況，我們認為不太可能出現報銷和採購滯後方面出現嚴重中斷的情況。而且，我們的資產負債表非常穩健。與我們在年底所做的類似，我們願意利用它來減輕影響，並傾向於我們認為有機會將波動性降至最低的地方。

And look, ultimately, we're managing this for the longer term. We have a great portfolio of therapies, all of which have different procurement in reimbursement dynamics. And that's what we continue to preach, which is the power of the diversified portfolio.

看看吧，最終，我們是為了更長遠的考慮而管理這個問題。我們擁有豐富的治療方法，所有這些治療方法在報銷動態方面都有不同的採購方式。這就是我們一直在宣揚的，多元化投資組合的力量。

Got it. Super helpful. And then just one quick follow-up. I just want to clarify the comment, John, you made on the expansion of clinics. Should we think about those as the infusion suites that you've built out a pretty large network of? Or is this more on the advanced practitioner/center side? And should we be thinking about going forward, sort of more expansion on that front rather than the suite model? Thanks.

知道了。超有幫助。然後只需快速跟進一次。約翰，我只是想澄清一下你對診所擴建的評論。我們是否應該將它們視為您已建立的相當大的網路的輸液套件？或者這更適合高級從業者/中心人士？我們是否應該考慮繼續前進，在該方面進行更多擴展，而不是僅限於套件模型？謝謝。

Yeah, Jeff. I would think of it as our expansion of chairs and really focused around it from that perspective. These three facilities that were open, we'll be able to take patients on both sides of that equation, whether it's through the practice of pharmacy and infusion suite, as we called the AIS historically, and an advanced practitioner model, where we would have an advanced practitioner that would oversee.

是的，傑夫。我認為這是我們椅子的擴展，並且真正從這個角度關注它。這三個開放的設施將能夠接收來自不同方面患者，無論是透過藥房和輸液套件的實踐（我們過去稱之為 AIS）還是高級從業者模式（我們將有一名高級從業者進行監督）。

So that ability for us to have more chairs available for patients in the communities that they live and work is part of our overall design. And I wouldn't try to bifurcate between those two as much as expanding our ability to serve patients where they're willing and able to be served in one of the infusion chairs that we have and provide the appropriate oversight through either an advanced practitioner or a registered nurse.

因此，我們能夠為患者在他們生活和工作的社區提供更多的椅子，這是我們整體設計的一部分。我不會試圖在這兩者之間進行區分，而是擴大我們為患者提供服務的能力，讓患者願意並且能夠在我們擁有的輸液椅上接受服務，並透過高級從業者或註冊護士提供適當的監督。

Joanna Gajuk, Bank of America.

美國銀行的喬安娜‧加朱克 (Joanna Gajuk)。

So a couple of follow-ups. I guess first on Stelara headwind only being $5 million in the quarter and you'd still expect the same, I guess, for the year. So is the $5 million, have you had expected this to play out in the quarter?

以下是一些後續問題。我想首先，Stelara 的逆風在本季僅為 500 萬美元，我想你仍然預計今年的情況會一樣。那麼，這 500 萬美元，您是否預計它將在本季實現？

Yeah, Joanna, we expected more of a muted impact in the first quarter. Again, we knew we would exit the year with some inventory levels. Generally speaking, it patterned out generally. I mean, put it more or less how we thought, we thought that the first quarter would not be as impactful as subsequent quarter.

是的，喬安娜，我們預期第一季的影響會比較小。再說一次，我們知道今年結束時我們會有一定的庫存水準。整體來說，格局總體來說。我的意思是，或多或少按照我們的想法來說，我們認為第一季的影響不會像下一季那麼大。

Okay. I just want to clarify to make sure there's nothing like it didn't happen in '25, there's going to be additional headwind in '26. But I guess I kind of had expected this. So I guess though the fact is that the headwind is going to be higher in rest of the year.

好的。我只是想澄清一下，確保不會發生像 25 年那樣的情況，26 年還會有更大的逆風。但我想我已經預料到了這一點。所以我猜事實是今年剩餘時間逆風將會更大。

But I guess that it still means there's going to be some incremental headwind in the first quarter of '26 year over year because the first quarter of this year is lower, right? So that's the right way to think about it?

但我猜這仍然意味著 26 年第一季的銷售額同比會有一些遞增的阻力，因為今年第一季的銷售額較低，對嗎？那麼這是正確的思考方式嗎？

Yeah. I mean the way we think about it is the $60 million to $70 million impact for the year, a relatively minimal impact in the first quarter based on the bleed-out of older inventory. But yet, we brought up the bottom end of the earnings range.

是的。我的意思是，我們認為今年的影響是 6000 萬至 7000 萬美元，基於舊庫存的流失，第一季的影響相對較小。但是，我們卻提高了收入範圍的底端。

And again, back to Lisa's first question, I'd just caution folks around calendarization because how the first quarter patterns out relative to the first year when we don't provide quarterly guidance can be a little wonky. But overall, we're bringing up the guidance range despite the fact that we still expect a $60 million to $70 million impact this year.

再次回到麗莎的第一個問題，我只是想提醒大家注意日曆化，因為當我們不提供季度指導時，第一季的模式相對於第一年可能會有點不穩定。但總體而言，儘管我們預計今年的影響力仍將達到 6,000 萬至 7,000 萬美元，但我們仍提高了指導範圍。

Great. And another clarification, sorry, on the tariffs, but I guess a different angle. Obviously, the pharmacy class is much bigger. But obviously, there's also the sort of stuff you buy, where like equipment and whatnot. So maybe talk about those numbers and also if you can size those in terms of, say, like medical supplies and these other items, as percent of your revenue or cost or however you can frame it?

偉大的。抱歉，關於關稅，我還需要進一步澄清，但我想這是一個不同的角度。顯然，藥學類課程要大得多。但顯然，你還會買一些東西，像是設備等等。那麼也許可以談談這些數字，以及您是否可以根據醫療用品和其他物品等來衡量這些數字佔您的收入或成本的百分比，或者無論如何？

And because I want to say that there was a fear of time. During the pandemic where you had flagged, there's some shortages, obviously, of PTE and things, and there was some pressure on the cost of these different items in plastics and such. So maybe help us also frame that number, which I assume is probably very small.

因為我想說，存在著對時間的恐懼。在您所指出的疫情期間，PTE 等顯然存在短缺，塑膠等不同物品的成本也面臨一些壓力。所以也許可以幫助我們確定這個數字，我認為這個數字可能非常小。

Yeah, I'll take that, Joanna. So again, as I called out, we've had a team that has been working to do a comprehensive review of all of our country of origin for all of our products and trying to anticipate what that looks like.

是的，我接受，喬安娜。所以，正如我再次提到的，我們有一個團隊一直在努力對我們所有產品的原產國進行全面審查，並試圖預測其情況。

Just to put it in perspective, we spend roughly $100 million on med supplies across that. And when you look at that and you kind of refine it down to, I think right now, the biggest concern would be around China. China is less than 10% of that, and we have alternative vendors that could mitigate some of that as we would source from different countries of origin through that process.

客觀地說，我們在醫療用品上的花費約為 1 億美元。當你仔細考慮這個問題並將其細化時，我認為目前最大的擔憂是圍繞中國。中國佔比不到 10%，我們還有其他供應商可以緩解部分壓力，因為我們可以透過這個流程從不同的原產國採購。

So is it something we're watching closely? Absolutely. Is it something that our team is working aggressively to make sure we understand and can find ways to manage and mitigate? Absolutely. But we don't think it's a significant amount at this point in time as we look at the med supplies and how we manage that within the overall portfolio.

那麼這是我們密切關注的事情嗎？絕對地。我們的團隊是否正在積極努力確保我們理解並能找到管理和緩解的方法？絕對地。但從我們目前對醫療用品以及我們如何在整個投資組合中管理這些用品的角度來看，我們認為這筆錢目前並不是一筆很大的數目。

Thank you. And if I may, I had a follow-up, I guess, on your acquisition, right? So you said it's tracking. Actually, I was expecting in terms of the integration and such. But just thinking about going forward, so is it still now a good time to buy? Or because of this uncertainty around tariffs and economy, whatever it might be, you're kind of on pause because, obviously, you did the deal, but you also bought a lot of packings in Q1? So just kind of walk us through your process in terms of thinking about deploying capital on acquisition. Thank you.

謝謝。如果可以的話，我想我應該對您的收購進行跟進，對嗎？所以你說它正在追蹤。實際上，我對整合等方面有所期待。但只是考慮一下未來，現在還是購買的好時機嗎？還是因為關稅和經濟方面的不確定性，不管是什麼原因，你都暫停了，因為顯然你做了這筆交易，但你也在第一季購買了很多包裝？那麼請您向我們介紹一下您在考慮部署收購資本方面的流程。謝謝。

Yeah. Joanna, look, I mean, we're going to continue, as I mentioned in our prepared remarks. We deployed over $200 million in the first quarter and still exited with a very healthy balance sheet. We're not going to be shy about deploying capital to create value. Whether it's through M&A or whether it's through continued share repurchase, we have $400 million of additional authorization.

是的。喬安娜，聽著，我的意思是，我們將繼續，正如我在準備好的演講中提到的那樣。我們在第一季投入了超過 2 億美元，並且仍然保持著非常健康的資產負債表。我們不會羞於部署資本來創造價值。無論是透過併購或透過持續股票回購，我們都有 4 億美元的額外授權。

I'd say on the corporate development side, we remain very active. Obviously, given the broader macro environment, we're going to tread carefully. But I think Intramed is a very good example of the type of deals that we're looking at around smaller, more complementary lower rent. A lot of the properties and assets that we know, we know them well. This isn't that big of a neighborhood.

我想說，在企業發展方面，我們仍然非常活躍。顯然，考慮到更廣泛的宏觀環境，我們將謹慎行事。但我認為 Intramed 是我們正在尋找的規模較小、互補性更強、租金更低的交易類型的一個很好的例子。我們對很多財產和資產都很了解。這個社區並不大。

And so we'll be very thoughtful. But I think you know that we're always very judicious and thoughtful on how we deploy capital. And anything that we're going to pursue, we're going to have a very high degree of confidence in the favorable returns.

所以我們會非常周到。但我想您知道，我們在如何配置資本方面始終非常明智和深思熟慮。對於我們所追求的任何事物，我們都會對有利的回報抱持高度信心。

A.J. Rice, UBS.

瑞銀的 A.J. Rice。

I think on the acute side, obviously, historically, that was sort of a low single digit than you said maybe with some of the exits and competitor exit that you can move that to high single digits. Now this quarter, you're mid-teens. Is that just more benefit from what's happening in the market restructuring wise? Or is there some other dynamic that's driving that strength in a queue from your perspective?

我認為從敏銳的一面來看，顯然，從歷史上看，這是一個比你說的低的個位數，也許隨著一些退出和競爭對手的退出，你可以將其轉移到高個位數。現在這個季度，你已經十幾歲了。這是否只是市場重組所帶來的更多好處？或者從您的角度來看，是否存在其他動力推動排隊的這種優勢？

Yeah, A.J. Look, I mean, as we think about that portfolio of therapies, I'd say on an overall basis, we see those growing in the low single digits. These are mature therapies, like intravenous parenteral nutrition, intravenous antibiotic therapies. These are therapies that have been around for decades, very valuable in helping, as I mentioned earlier, on discharging patients from the hospital. That cohort of therapies on a macro basis is growing in the low single digit.

是的，A.J. 看，我的意思是，當我們考慮這些療法組合時，我想說，從總體上看，我們看到它們的增長率在個位數以下。這些都是成熟的療法，如腸外營養、靜脈注射抗生素療法。這些療法已經存在了幾十年，正如我之前提到的，它們對於幫助病人出院非常有價值。從宏觀角度來看，這類療法的成長率僅為個位數。

I think to a lot of John's comments around the investments we've made, the infrastructure that we've added with state-of-the-art compounding pharmacies, we've been able to grow faster than what we perceive as the market.

我認為，根據約翰對我們所做的投資、我們為最先進的複合藥房所增加的基礎設施所做的許多評論，我們已經能夠比我們所認為的市場更快地成長。

In the first quarter, there were some meaningful competitive dynamics in certain markets where we were able to jump in, roll up the sleeves, and play a bigger role for a lot of leading health systems. I don't want to lead the audience to believe that we see mid-teens as the underlying growth rate for the acute therapies. But similar to mid-'22, we were able to jump in and grab higher volumes and grow off of those higher volumes. And I think that's what we would expect.

在第一季度，某些市場出現了一些有意義的競爭動態，我們能夠參與其中，捲起袖子，為許多領先的醫療系統發揮更大的作用。我不想讓觀眾相信我們認為青少年中期是急性療法的潛在成長率。但與 22 年中期類似，我們能夠加入並獲得更高的銷量，並依靠這些更高的銷量來成長。我認為這正是我們所期望的。

Our guidance would presume that we will continue to see robust acute growth really until around the fourth quarter, not that we're giving back volume, but we're just going to anniversary some of that volume pick up.

我們的指導假設我們將持續看到強勁的急劇增長，直到第四季度左右，並不是說我們要放棄銷量，但我們只是要慶祝部分銷量回升。

Okay. And then I appreciate the comments of your continuing to be focused on acquisitions. I wondered probably two things on the Washington front. Obviously, tariffs is the main place we focus relative to your business, but they're talking about Medicaid cuts. They're talking about potentially some site-neutral stuff related to potentially impacting where drugs are administered.

好的。然後，我很欣賞您繼續關注收購的評論。我大概對華盛頓方面有兩件事感到疑惑。顯然，相對於您的業務，關稅是我們關注的重點，但他們正在談論醫療補助削減。他們正在討論一些可能對藥物施用地點產生影響的與場地無關的事情。

Is there anything in particular that you're focused on there that either could be a challenge or an opportunity? And you said you're still out there looking for acquisitions. So is it impacting in any way that this uncertainty be willingness of sellers? Are you seeing more sellers? Are you seeing less sellers? How is that affecting the dynamics of the market?

您是否特別關注某個可能帶來挑戰或機會的事物？您說您仍在尋找收購機會。那麼這種不確定性是否會對賣家的意願產生影響呢？您看到更多賣家了嗎？您發現賣家變少了嗎？這對市場動態有何影響？

Yeah, A.J., it's John. I'll take this one. So I think the pace of books that we see is patterning about the same as it has. I haven't seen an increase in the number of people that are looking to sell. But there's a pace that's there. And as Mike said, we will take a look and see if there's opportunities for us to take on and to do transactions that will create shareholder value.

是的，A.J.，我是約翰。我要這個。所以我認為我們看到的書籍的出版速度與過去大致相同。我並沒有看到想要出售的人數增加。但有一個節奏是存在的。正如麥克所說，我們會看看是否有機會承擔並進行能夠創造股東價值的交易。

As for Washington, yeah, we're keeping our finger on the pulse. Certainly tight neutrality, pricing, transparency, our front and center. So hard at this point in time to hazard a guess as to where that could be. But I will say, again, we offer high-quality care at an appropriate cost in a setting in which patients want to receive it.

至於華盛頓，是的，我們正密切關注事態發展。當然，嚴格的中立、定價、透明度是我們的首要任務。因此，目前很難猜測它會在哪裡。但我要再次強調，我們在病人願意接受的環境中以適當的成本提供高品質的照護。

If the government is looking for lower cost settings in order to provide care, our expectations are, we can be part of that solution as we move forward. So I think that's the areas that we're focused on.

如果政府正在尋找成本更低的環境來提供護理，我們的期望是，我們可以成為解決方案的一部分。所以我認為這就是我們關注的領域。

We continue to try to get expansion of home infusion therapy access for Medicare beneficiaries, that front and center. We believe that the next opportunity is going to be as part of the reconciliation process as budgets need to get moved forward. And again, we're active in Washington to not only have listening posts and understand what's happening, but more importantly, to make certain that our voice is heard.

我們將繼續努力擴大醫療保險受益人的居家輸液治療服務，這是重中之重。我們相信，下一個機會將成為和解進程的一部分，因為預算需要向前邁進。再次強調，我們在華盛頓積極活動，不僅是為了設立監聽站，了解正在發生的事情，更重要的是，確保我們的聲音被聽到。

Thank you. Ladies and gentlemen, I'm showing no further questions in the queue. I would now like to turn the call back over to John Rademacher, Chief Executive Officer, for closing remarks.

謝謝。女士們、先生們，隊列中沒有其他問題了。現在，我想將電話轉回給執行長約翰‧拉德馬赫 (John Rademacher)，請他作最後發言。

Thank you for joining us this morning and participating in our call. As we outlined, the first quarter was very productive and our team continues to execute at a very high level. We understand the important role that we play in delivering care to our patients and their families, and we look forward to serving even more patients and delivering value to our shareholders. Thank you very much, and have a great day.

感謝您今天上午加入我們並參與我們的電話會議。正如我們所概述的，第一季非常富有成效，我們的團隊繼續以非常高的水平執行。我們了解我們在為患者及其家人提供護理方面發揮的重要作用，我們期待為更多的患者提供服務並為我們的股東創造價值。非常感謝，祝您有愉快的一天。

Ladies and gentlemen, that concludes today's conference call. Thank you for your participation. You may now disconnect.

女士們、先生們，今天的電話會議到此結束。感謝您的參與。您現在可以斷開連線。