Option Care Health Inc (OPCH) 2025 Q2 法說會逐字稿

Good day, and thank you for standing by. Welcome to the Option Care Health second-quarter 2025 earnings conference call. (Operator Instructions) Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Nicole Maggio, Senior Vice President of Finance. Please go ahead.

您好，感謝您的支持。歡迎參加 Option Care Health 2025 年第二季財報電話會議。（操作員指示）請注意，今天的會議正在錄音。現在，我想將會議交給今天的演講者，財務高級副總裁 Nicole Maggio。請繼續。

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.

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。

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 the specific risks and uncertainties. We do not undertake any duty to update any forward-looking statements, except as required by law.

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 can find additional information on these non-GAAP measures in this morning's press release posted on the Investor Relations portion of our 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。您可以在我們網站投資者關係部分今天早上發布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。

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

接下來，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 will see in our second quarter results, the Option Care Health team delivered another strong quarter with balanced growth across the portfolio. As a result, we are increasing our guidance range for the year across revenue, adjusted EBITDA, and adjusted EPS.

謝謝，妮可，大家早安。正如您將在我們的第二季業績中看到的，Option Care Health 團隊又一個季度表現強勁，整個投資組合實現了均衡成長。因此，我們提高了今年的營收、調整後 EBITDA 和調整後 EPS 的預期範圍。

Option Care Health operates in an industry with growing demand, and we believe we are well positioned as a leading independent provider of home and alternate site infusion services with significant scale, a diverse portfolio and a resilient operating model.

Option Care Health 所處的行業需求不斷增長，我們相信，我們已做好充分準備，成為一家領先的獨立家庭和替代站點輸液服務提供商，擁有龐大的規模、多樣化的產品組合和靈活的運營模式。

During the quarter, our team continued to capitalize on shifting competitive dynamics and deepening partnerships with payers and pharma manufacturers. We also capitalized on our national scale with local responsiveness, which we believe remains a differentiator. And we continue to see positive impacts on the resilient and nimble operating model we have created, which enables us to deliver consistent results in any operating environment.

在本季度，我們的團隊繼續利用不斷變化的競爭動態並深化與付款人和製藥商的合作夥伴關係。我們也充分利用了全國規模和本地響應能力，我們相信這仍然是一個差異化因素。我們繼續看到我們所創建的彈性和靈活的營運模式的正面影響，這使我們能夠在任何營運環境中提供一致的結果。

Indeed, over my nearly 10 years leading this organization, Option Care Health has thrived through regulatory change, biosimilar events, changing competitive dynamics, therapy administration shifts, and labor and supply shortages. This quarter was no different, and I believe we are well positioned for success going forward.

事實上，在我領導組織的近 10 年時間裡，Option Care Health 在監管變化、生物相似藥事件、不斷變化的競爭態勢、治療管理轉變以及勞動力和供應短缺等挑戰下蓬勃發展。本季也不例外，我相信我們已為未來的成功做好了準備。

Mike will go deeper into the financials in a few minutes. But to highlight some key takeaways. Revenue momentum continued in the second quarter with balanced performance across the portfolio. Building on first quarter results, we delivered revenue growth of 15% over the second quarter of last year.

幾分鐘後，麥克將更深入地探討財務問題。但要強調一些關鍵要點。第二季營收動能持續，整個投資組合表現均衡。基於第一季業績，我們的營收比去年第二季成長了 15%。

Acute therapy growth was in the mid-teens, and the team executed well to capitalize on shifting industry dynamics and to leverage our continued investments and capabilities to be locally responsive to serve the specific needs of patients on these therapies.

急性治療的成長速度達到了十幾歲，團隊表現良好，充分利用了不斷變化的行業動態，並利用我們持續的投資和能力在當地做出回應，滿足患者對這些治療的特定需求。

Our chronic therapies also performed well with growth in the mid-teens. We continue to see solid performance in our rare and orphan and limited distribution therapies, a testament to our national scale and ability to reach smaller cohorts of patients as we continue to partner with pharma to develop and deliver innovative programs customized to their therapies.

我們的慢性療法對於青少年中期的成長也起到了良好的作用。我們在罕見疾病、孤兒病和有限分銷療法方面繼續表現出色，這證明了我們的全國規模和覆蓋較小群體患者的能力，因為我們將繼續與製藥公司合作開發和提供針對其療法定制的創新方案。

The strength of the top line performance across the broad set of therapies, along with disciplined spending drove a 5% adjusted EBITDA growth on a year-over-year basis despite the previously articulated headwinds that we faced.

儘管我們面臨先前明確指出的阻力，但廣泛療法的強勁營收表現以及嚴格的支出推動調整後的 EBITDA 同比增長 5%。

During the quarter, we continued to focus on our relationships with health plans as we believe our value proposition provides a meaningful opportunity to reduce the total cost of care for their members and help them better manage their medical loss ratios.

在本季度，我們繼續關注與健康計劃的關係，因為我們相信我們的價值主張提供了一個有意義的機會，可以降低其成員的總護理成本，並幫助他們更好地管理醫療損失率。

Providing high-quality care at an appropriate cost in a setting in which their members want to receive it, makes us an important part of the solution to the pressures they are facing of an aging population and increased disease prevalence and utilization of healthcare services.

在會員希望接受的環境中以適當的成本提供高品質的護理，使我們成為解決他們面臨的人口老化、疾病盛行率增加和醫療服務利用率上升的壓力的重要組成部分。

Our market access team continues to work closely with national payers and health plans across the country to develop meaningful programs to broaden access and provide better, more cost-effective care for their members.

我們的市場准入團隊繼續與全國各地的國家付款人和健康計劃密切合作，制定有意義的計劃，以擴大准入範圍並為其成員提供更好、更具成本效益的護理。

We also continue to deepen our relationships with our pharma partners by leveraging our clinical capabilities, pharmacy infrastructure and broad geographic coverage to help enable tailored programs and services to patient populations with complex needs.

我們也繼續利用我們的臨床能力、藥房基礎設施和廣泛的地理覆蓋範圍，深化與製藥合作夥伴的關係，幫助為具有複雜需求的患者群體提供量身定制的計劃和服務。

Our network of nearly 90 pharmacies, coupled with our clinical centers of excellence and extensive nursing network of over 3,000 nurses, including Naven Health, provides a strong platform and unparalleled capabilities.

我們的網路由近 90 家藥局組成，加上我們的臨床卓越中心和包括 Naven Health 在內的超過 3,000 名護理師的廣泛護理網絡，提供了強大的平台和無與倫比的能力。

We continue to expand our portfolio of therapies, including YEZTUGO and (inaudible) as well as a number of other limited distribution and rare and orphan drugs, demonstrating our capabilities to serve the needs of patients with these complex situations.

我們繼續擴大我們的治療組合，包括 YEZTUGO 和（聽不清楚）以及其他一些有限分銷和稀有和孤兒藥物，展示我們滿足這些複雜情況患者需求的能力。

Shifting gears, one of the hallmarks of our business has been our focus on operating effectiveness and cash generation. As a result, we have a strong balance sheet and flexibility to deploy capital to increase value to our shareholders.

轉變方向，我們業務的標誌之一就是專注於營運效率和現金創造。因此，我們擁有強大的資產負債表和靈活的資本配置能力，可以為股東增加價值。

In the second quarter, we generated over $90 million in cash flow from operations, and we are well on our way to delivering more than $320 million of cash flow from operations in the full year. Our multifaceted approach to capital deployment allows us to thoughtfully assess opportunities to utilize our cash through M&A, internal investments, or share repurchases.

在第二季度，我們產生了超過 9,000 萬美元的營運現金流，我們預計在全年實現超過 3.2 億美元的營運現金流。我們採用多方面的資本配置方法，使我們能夠認真評估透過併購、內部投資或股票回購來利用現金的機會。

We remain active in assessing both M&A and internal investment opportunities as we look to strengthen our platform and add to our solution set and clinical capabilities. Share repurchase continues to be an attractive way to create value for our shareholders as evidenced in our adjusted EPS performance and underscores the confidence we have in the business and its long-term potential. To that end, we executed on $50 million of share repurchases during the quarter.

我們將繼續積極評估併購和內部投資機會，以期加強我們的平台並增強我們的解決方案和臨床能力。股票回購仍然是為股東創造價值的一種有吸引力的方式，這從我們調整後的每股盈餘表現中可以看出，並凸顯了我們對業務及其長期潛力的信心。為此，我們在本季執行了 5,000 萬美元的股票回購。

We also continue to invest in our people, process, technology and facilities. For example, the investments we made in artificial intelligence, advanced analytics, and our partnership with Palantir support our commitment to improving operating efficiency, and have been critical to our leverage growth.

我們也將繼續投資於我們的人才、流程、技術和設施。例如，我們在人工智慧、高級分析方面的投資以及與 Palantir 的合作支持了我們提高營運效率的承諾，對我們的槓桿成長至關重要。

On the clinical resource efficiency front, approximately 35% of our nursing visits occurred in one of our suites this quarter, and Naven Health conducted almost 54,000 nursing visits in the quarter. Both of these remain key enablers of our ability to effectively take on new patients.

在臨床資源效率方面，本季度約有 35% 的護理訪問發生在我們的一個套房內，Naven Health 在本季度進行了近 54,000 次護理訪問。這兩者仍然是我們有效接收新患者的關鍵因素。

Further, on the advanced practitioner model, we continue to believe this represents an attractive complement to our current home infusion services and an opportunity to drive growth, both through expanding our competencies as well as providing access to new patient cohorts.

此外，在高級從業者模式方面，我們仍然相信這對我們目前的家庭輸液服務來說是一個有吸引力的補充，也是一個推動成長的機會，既可以透過擴大我們的能力，也可以透過提供新的​​患者群體來推動成長。

This clinical model provides a platform to serve higher acuity patients under the care of a nurse practitioner as well as to leverage therapies already in our portfolio, to support patients who otherwise may not have been able to be served profitably.

這種臨床模式提供了一個平台，可以在執業護理師的護理下為病情較重的患者提供服務，同時利用我們現有的治療方法，為那些原本可能無法獲得盈利服務的患者提供支持。

Our investments in Intramed Plus and elsewhere across the country have provided valuable insights into our successful execution of this model, which we believe are critical to expanding across our national network. Given the strength of the first half of this year, we have increased our full year revenue, adjusted EBITDA and adjusted EPS guidance range, which reflects our confidence in the momentum underway and the continued resilience of our platform and execution of our team.

我們對 Intramed Plus 以及全國其他地方的投資為我們成功實施該模式提供了寶貴的見解，我們相信這對於擴展我們的全國網路至關重要。鑑於今年上半年的強勁表現，我們提高了全年收入、調整後 EBITDA 和調整後 EPS 指導範圍，這反映了我們對當前發展勢頭的信心以及我們平台和團隊執行力的持續韌性。

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

說完這些，我將把電話交給麥克，讓他提供更多細節。

Thanks, John, and good morning, everyone. As John mentioned, the second quarter was quite strong as we built up a solid momentum from the first quarter. Revenue growth of 15.4% was balanced with mid-teens growth within both our acute and chronic portfolios of therapy.

謝謝，約翰，大家早安。正如約翰所提到的，第二季表現相當強勁，因為我們從第一季就建立了穩固的勢頭。15.4% 的收入成長與我們的急性和慢性治療組合的中等成長率保持平衡。

The acute therapy growth we delivered in the quarter was notably higher than we believe the overall market to be growing. And as John conveyed, the team executed well across the country. Gross profit of $269 million grew almost 8% versus the second quarter last year. This reflects the benefit from therapy mix with outsized acute growth as well as the performance of the chronic therapies.

我們在本季實現的急性治療成長明顯高於我們認為的整體市場成長。正如約翰所說，該團隊在全國範圍內表現出色。毛利為 2.69 億美元，較去年第二季成長近 8%。這反映了具有超大急性增長的治療組合帶來的好處以及慢性治療的效果。

Gross margin rate was negatively impacted by some of the lower-margin limited distribution and rare and orphan therapies, but we continue to be encouraged by their gross profit dollar contribution. SG&A was in line with our expectations, and we expect continued strong spending leverage for the year as we see the benefits from the investments we have made in our infrastructure.

一些利潤率較低的有限分銷以及罕見和孤兒療法對毛利率產生了負面影響，但我們仍然對其毛利的貢獻感到鼓舞。銷售、一般及行政費用符合我們的預期，我們預計今年的支出槓桿將繼續保持強勁，因為我們看到了對基礎設施投資的收益。

Adjusted EBITDA of $114 million, grew 5.2% over the prior year, and represented 8.1% of net revenue. And adjusted earnings per share of $0.41, grew 10.8% over the prior year. As John mentioned, we were active in deploying capital in the second quarter, repurchasing $50 million in stock.

調整後的 EBITDA 為 1.14 億美元，比上年增長 5.2%，佔淨收入的 8.1%。調整後每股收益為 0.41 美元，比上年增長 10.8%。正如約翰所提到的，我們在第二季積極部署資本，回購了價值 5,000 萬美元的股票。

We will continue to thoughtfully consider the balance across M&A, internal investments and share repurchase. And we maintain a strong balance sheet and capital structure with the capacity to continue executing our multifaceted strategy.

我們將繼續認真考慮併購、內部投資和股票回購之間的平衡。我們保持著強勁的資產負債表和資本結構，有能力繼續執行我們的多元化策略。

Finally, I want to provide a quick update on our expectations for the full year. Given the strong momentum in the first half, for the full year 2025, we now expect to generate revenue of $5.5 billion to $5.65 billion, and adjusted EBITDA of $465 million to $475 million, which we believe will translate into adjusted earnings per share of $1.65 to $1.72.

最後，我想簡單介紹一下我們對全年的預期。鑑於上半年的強勁勢頭，我們目前預計 2025 年全年的營收將達到 55 億美元至 56.5 億美元，調整後的 EBITDA 將達到 4.65 億美元至 4.75 億美元，我們相信這將轉化為調整後的每股收益 1.65 美元至 1.72 美元。

Additionally, we continue to expect to generate more than $320 million in cash flow from operations. Consistent with our previous comments, our guidance considers our current expectations on the impact of potential tariffs, MFN pricing and similar policy changes, which we believe will not have a material financial impact in 2025.

此外，我們預計營運現金流仍將超過 3.2 億美元。與我們先前的評論一致，我們的指導考慮了我們目前對潛在關稅、最惠國定價和類似政策變化的影響的預期，我們認為這些變化不會在 2025 年產生重大財務影響。

Overall, we are excited about the strong first half of 2025, and we expect it will be another year of growth for Option Care Health. And with that, we will open the call for questions. Operator?

總體而言，我們對 2025 年上半年的強勁表現感到興奮，我們預計這將是 Option Care Health 又一個成長的一年。現在，我們將開始提問。操作員？

(Operator Instructions) David MacDonald, Truist.

（操作員指示）David MacDonald，Truist。

Yeah, good morning guys. A couple of questions here. First of all, can you guys just talk a little bit about just conversations with payers. I mean, it's obviously been a bit of a challenging environment at the payer level. And just anything incremental or accelerating in terms of just conversations around site of service redirection around candidly them looking more aggressively at things to help offset some of the cost pressures that they're seeing.

是的，大家早安。這裡有幾個問題。首先，你們能否簡單談談與付款人的對話。我的意思是，從付款人的角度來看，這顯然是一個充滿挑戰的環境。就服務重定向網站的對話而言，任何漸進或加速的事情都坦率地讓他們更積極地看待事情，以幫助抵消他們所看到的一些成本壓力。

Good morning, David. It's John. Yeah, very productive conversations. Our market access team is in constant contact. I would say there is a heightened level of interest in not only utilizing our services, as we call out, we offer a high-quality care in an appropriate cost or at an appropriate cost in a setting in which patients want to receive it. So that continues to move forward.

早安，大衛。我是約翰。是的，非常富有成效的對話。我們的市場准入團隊一直保持聯繫。我想說的是，人們不僅對使用我們的服務越來越感興趣，而且正如我們所呼籲的，我們還以適當的成本或在患者希望接受的環境中以適當的成本提供高品質的護理。因此，事情還在繼續向前發展。

Interest in site of care initiative continues to increase, and we're seeing volumes starting to pick up in those areas where some of the payers are taking a more, I guess, a more aggressive approach to help provide their members with alternatives to some of the higher cost settings.

人們對護理場所計劃的興趣持續增加，我們看到一些地區的護理量開始回升，我想，一些付款人正在採取更積極的方式，幫助其成員提供一些高成本環境的替代方案。

A couple of others. Guys, just first on the ambulatory infusion suites. Are you continuing to see chronic run pretty meaningfully ahead of acute and this year with some of the business that you picked up maybe that shift gets muted a little bit. But is there any reason we shouldn't expect that number to continue to drift higher? Just as in a normalized year, your chronic business is growing more quickly than the acute business?

還有其他幾個。夥計們，首先來看看門診輸液室。您是否繼續認為慢性病的發生率明顯高於急性病，而今年隨著您獲得的一些業務，這種轉變可能會減弱。但是，我們有什麼理由不認為這個數字會繼續上升呢？就像在正常年份一樣，您的慢性業務比急性業務成長更快？

Yeah, I think that's fair. Again, as we mentioned, we're up to 35%. We basically doubled the penetration since we initiated our center strategy a couple of years ago. And again, the majority of the utilization of the infusion suites are those chronic patients with recurring scheduled interactions with us.

是的，我認為這很公平。再次，正如我們所提到的，我們已達到 35%。自從幾年前我們啟動中心策略以來，我們的滲透率基本上翻了一番。再次強調，輸液室的使用者大多是那些與我們定期進行定期互動的慢性病患者。

The fact that we were able to increase the penetration in a quarter where we still delivered mid-teens growth in the acute just speaks to your point, which is the penetration on the chronic side continues to be very, very encouraging.

事實上，我們能夠在一個季度內提高滲透率，同時急性疾病的滲透率仍保持中等增長，這恰恰證明了你的觀點，即慢性疾病的滲透率仍然非常非常令人鼓舞。

Okay. Last two guys. John, during your prepared remarks, you talked about the advanced practitioner model and some patients in your portfolio that maybe you're able to service now. I would assume that that's something reimbursement related, maybe Medicare or whatever. But I was wondering if you could just drill down on that. And then I just have one quick follow-up.

好的。最後兩個人。約翰，在您的準備好的演講中，您談到了高級從業者模式以及您現在可能能夠服務的一些患者。我認為這與報銷有關，可能是醫療保險或其他什麼。但我想知道您是否可以深入探討這個問題。然後我只想快速跟進。

Yeah. So as you know, we don't have a broad access for Medicare fee-for-service beneficiaries. This allows us to expand our -- the portfolio of patients that we can serve, utilizing that advanced practitioner model as well as also in my prepared remarks, I mean, we're also utilizing it for more complex patients that may have some additional needs that a nurse practitioner can provide better oversight or deeper oversight as well as help manage that care plan. So we're encouraged by the progress that we're making on this, and we think that it will continue to be a vector of growth for us as we're moving ahead.

是的。所以如你所知，我們沒有為醫療保險按服務收費的受益人提供廣泛的服務。這使我們能夠擴大我們可以服務的患者範圍，利用先進的從業者模型，以及在我準備好的發言中，我的意思是，我們還將其用於可能有一些額外需求的更複雜的患者，護士執業者可以提供更好的監督或更深入的監督，並幫助管理該護理計劃。因此，我們對在這方面取得的進展感到鼓舞，我們認為這將繼續成為我們前進的成長動力。

And then, guys, just last question. A recent proposed rule seem to acknowledge the cost differential in terms of different sites of care around infusion. I'm just curious, any high-level thoughts or any updates just in terms of the Hill and conversations down there and just the acknowledgment of kind of what you guys do and how much money you save?

夥計們，最後問最後一個問題。最近提出的一項規則似乎承認了輸液護理不同地點的成本差異。我只是好奇，就國會山莊和那裡的對話而言，您有什麼高層想法或更新嗎？您是否承認你們做了什麼，節省了多少錢？

Yeah. There's been a couple of positive moves on that. Certainly, there's recognition of the reduced cost of utilizing services in home and alternate sites. There is continued efforts, both as an industry as well as us individually to continue to advance that wherever we can.

是的。在這方面已經出現了一些積極的舉措。當然，人們認識到在國內和其他地點使用服務可以降低成本。無論是整個產業還是我們個人，我們都在不斷努力，盡我們所能繼續推進這一進程。

If site neutrality or other things continue to pick up momentum as ways that they're going to mitigate some of the cost trends over time, we feel like we're really well positioned given the cost structure that we operate with as well as the reimbursement comparables to some of the other sites that are chosen.

如果站點中立性或其他因素繼續獲得發展勢頭，成為隨著時間的推移減輕一些成本趨勢的方式，我們認為，考慮到我們運營的成本結構以及與其他一些所選站點的報銷可比性，我們處於非常有利的地位。

So we're going to continue to have the conversations on the Hill and with key legislators to try to advance on behalf of the industry, but feel as if we're on the right side of most of those conversations where cost and quality are being measured.

因此，我們將繼續在國會與主要立法者進行對話，努力代表行業取得進展，但我們感覺在大多數衡量成本和品質的對話中，我們都站在正確的一邊。

Okay, thanks, guys. I appreciate it.

好的，謝謝大家。我很感激。

Thanks, David.

謝謝，大衛。

Maya MacPherson, William Blair.

瑪雅·麥克弗森、威廉·布萊爾。

Constantine Davides, Citizens.

康斯坦丁大衛斯，公民。

Thanks. A couple of quick financial questions. Just, Mike, wondering if you can update us on the Stelara expectations for the year. I know it's around $5 million in the first quarter. Just wondering how you're thinking about the impact across the balance of 2025? Thanks.

謝謝。幾個簡單的財務問題。麥克，我只是想知道您是否可以向我們介紹今年對 Stelara 的預期。我知道第一季的收入大約是 500 萬美元。只是想知道您如何看待 2025 年餘下時間的影響？謝謝。

Yeah, Constantine, in the quarter, as we mentioned on our first quarter call, the negative impact for the second quarter was right around $20 million. It was actually probably a nudge above. But for the full year, and I think that's a decent proxy for the subsequent two quarters.

是的，康斯坦丁，正如我們在第一季電話會議上提到的那樣，第二季的負面影響約為 2000 萬美元。實際上，它可能只是稍微往上推了一下。但就全年而言，我認為這是接下來兩個季度的一個不錯的代表。

So I think we're probably thinking for the year, our initial impact range was $60 million to $70 million. I think we're probably in the higher end of that range. And that's been fully contemplated in the guidance, which, again, as John mentioned, given the strength of the business, we've been able to more than mitigate.

所以我認為我們可能認為今年的初始影響範圍是 6000 萬至 7000 萬美元。我認為我們可能處於該範圍的高端。這已在指導中得到充分考慮，正如約翰所提到的那樣，鑑於業務實力，我們已經能夠減輕損失。

And then just a follow-up on the therapeutic mix. Is it right to think that -- I mean, you've had so much acute momentum in recent quarters. Are the operating margins on the chronic and the acute portfolio, are they still pretty comparable at this point?

然後只是對治療組合的後續研究。這樣想對嗎——我的意思是，最近幾季你們的發展勢頭非常強勁。目前慢性病和急性病投資組合的營業利益率是否仍相當？

In terms of what we previously said, yeah, very consistent. What we've said, Constantine, is that the acute portfolio, the product margins are north of 50%. The chronic portfolio presents anywhere from 5% to 30% margin profiles.

就我們之前所說的而言，是的，非常一致。康斯坦丁，我們說過，敏銳的產品組合，產品利潤率在 50% 以上。長期投資組合的保證金狀況在 5% 至 30% 之間。

Again, a couple of moving dynamics, especially when you look at the margin rate year-over-year, obviously, the Stelara headline had a pretty meaningful impact on that. But obviously, we love the trajectory of the acute portfolio as well.

再次，有幾個動態變化，特別是當你查看同比利潤率時，顯然，Stelara 的標題對此產生了相當大的影響。但顯然，我們也喜歡敏銳投資組合的軌跡。

And with the rare and orphan momentum we've seen -- that -- those therapies tend to be in the lower end of that 5% to 30% range. So a lot of moving pieces. Again, the way, as you know, we're really looking at the product or the gross profit dollars, which we're thrilled with the performance in the quarter.

並且，我們看到，隨著罕見疾病和孤兒藥的興起，這些療法的比例往往處於 5% 至 30% 的低端。有很多移動的部分。再說一次，正如你所知，我們真正關注的是產品或毛利，我們對本季的表現感到非常滿意。

Great. And then just last, John, I think you alluded to sort of M&A opportunities. And it still seems like there's a decent amount of infusion activity occurring in the market. Is it still right to sort of classify your interest is focused on the core? Or are you seeing opportunities in some adjacent areas that you look to explore?

偉大的。最後，約翰，我想你提到了某種併購機會。而且看起來市場上仍有相當數量的輸液活動。將您的興趣集中在核心上進行分類是否仍然正確？或者您看到了一些您想要探索的鄰近領域的機會？

Yeah. We continue to be very focused around looking for opportunities on the core and looking to expand capability set. I think as we've said, we've also continued to think about areas that are enablement, whether it's in nursing and other capability set that help us continue to advance to grow and increase some of the clinical capabilities. So it's a pretty active market.

是的。我們將繼續專注於尋找核心機會並尋求擴展能力集。我認為，正如我們所說的，我們也一直在思考支持領域，無論是在護理還是其他能力方面，都能幫助我們繼續進步、發展並提高一些臨床能力。所以這是一個相當活躍的市場。

Our commitment to shareholders has always been that it will be both strategic and economic when we're evaluating where we deploy your capital in those type of activities. And therefore, I think you'll see us in a very disciplined way, continue to look for opportunities to utilize the strength of the balance sheet in ways that will enhance value for our shareholders.

我們對股東的承諾始終是，當我們評估在此類活動中如何部署您的資本時，我們將兼顧策略性和經濟性。因此，我認為您會看到我們以非常自律的方式繼續尋找機會利用資產負債表的優勢來為股東創造價值。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

Hey, good morning, guys. Thanks for taking my question. I guess looking at the second quarter gross profit dollars, if I adjust the first quarter with a $5 million headwind from Stelara, in the second quarter with a $20 million headwind from Stelara, the gross profit dollar growth accelerated pretty nice year-over-year from 1Q to 2Q.

嘿，大家早安。感謝您回答我的問題。我想看看第二季度的毛利，如果我調整第一季來自 Stelara 的 500 萬美元逆風，在第二季度來自 Stelara 的 2000 萬美元逆風，那麼從第一季到第二季度，毛利的同比增長速度相當快。

With the acute growth being similar, I think you said mid-teens in 1Q and mid-teens in 2Q. Can you sort of bridge us where the gross profit growth dollars are coming from if we exclude the Stelara impact? Thank you.

由於急劇增長相似，我認為您說的是第一季的十幾歲中段和第二季度的十幾歲中段。如果我們排除 Stelara 的影響，您能否告訴我們毛利成長的來源是什麼？謝謝。

Yeah. I mean that's a lot of moving pieces. I mean, look, at the end of the day, you stole our thunder. The way we manage this business is we look to maximize the gross profit dollar growth. When you normalize for the impact year-over-year, and again, we don't spend a lot of time looking at the world with and without, but our gross margins actually were consistent and expanded year-over-year despite the fact that within our chronic portfolio, again, as we mentioned in our prepared remarks, there is some downward pressure because of the mix towards those faster-growing rare and orphan and limited distribution drugs.

是的。我的意思是有很多活動的部分。我的意思是，你看，到最後，你還是搶走了我們的風頭。我們管理這項業務的方式是尋求最大化毛利的成長。當我們將同比影響標準化時，我們不會花太多時間去觀察有或沒有影響的世界，但我們的毛利率實際上是一致的，並且逐年擴大，儘管在我們的慢性病產品組合中，正如我們在準備好的評論中提到的那樣，由於向那些增長更快的稀有藥物、孤兒藥和有限分銷藥物的混合，存在一些下行壓力。

So look, the 8% reported gross profit dollar growth, that's really an amalgamation of great execution on the acute side of the house, which, again, has been very productive for us thus far this year as well as just solid execution, both within those lower gross margin rate LDDs and rare and orphan therapies, but also in kind of what I'll call the more established chronic therapies for the infliximab and immunoglobulins and MS therapies, et cetera.

所以你看，報告的 8% 的毛利潤增長，實際上是急性方面出色執行的融合，今年到目前為止，這對我們來說非常有成效，而且執行也很穩健，不僅在毛利率較低的 LDD 和罕見及孤兒療法中，而且在我稱之為英夫利昔單抗和免疫球蛋白和 MS 療法等更成熟的慢性療法中。

Okay. And then the follow-up here is, as you've taken acute market share from the exits of CORe and Optum, on the acute side, have you seen any market share growth on the chronic side?

好的。然後接下來的問題是，由於您從 CORe 和 Optum 的退出中獲得了急性市場份額，那麼在急性方面，您是否看到慢性方面的市場份額有所增長？

And then the second question there is, as you renegotiate with payers on both acute and chronic with the market exits, does this give you guys more leverage to get better negotiating rates on the chronic side and the acute side in 2026? Thanks.

然後第二個問題是，當您與急性和慢性的付款人就市場退出進行重新談判時，這是否會為您帶來更多的籌碼，以便在 2026 年獲得更好的慢性和急性談判費率？謝謝。

Yeah. From a market, I'll start and I'll pass it to John to answer the second part of your question. Pito, as we've talked broadly, and again, these are estimates, the acute therapy portfolio, those are very mature therapies that we administer.

是的。我從市場開始，然後交給約翰回答你問題的第二部分。皮托，正如我們廣泛討論的那樣，這些都是估計值，急性治療組合，這些都是我們管理的非常成熟的療法。

We estimate that those market dynamics suggest a low single-digit market growth. So I'll let you project market share, but we're very encouraged delivering mid-teens growth in what we think is a very mature therapeutic category.

我們估計這些市場動態顯示市場成長率將保持在個位數以下。因此，我會讓你預測市場份額，但我們非常高興在我們認為非常成熟的治療類別中實現十幾歲的成長。

The chronic side is a very broad portfolio of therapies. We've estimated that collectively, those chronic therapies are growing in the low double digits, given all the dynamics with new therapy introductions and things going subcu or oral, et cetera. So again, in a quarter where we're delivering mid-teens growth across both of those portfolios, we're feeling very good about the execution of the team across the board.

慢性病的治療範圍非常廣泛。我們估計，考慮到新療法的引入以及皮下或口服等療法的發展，這些慢性療法的整體成長率將達到兩位數。因此，在本季度，我們的兩個投資組合都實現了中等幅度的成長，我們對整個團隊的執行力感到非常滿意。

And on the payer side, again, continued strong progress in deepening our relationships there. As you point out, the strength of our portfolio and the balance that we have across both the acute and chronic therapeutic categories is one that we use to reinforce the value that we bring.

在付款方方面，我們在深化雙方關係方面持續取得強勁進展。正如您所指出的，我們利用產品組合的優勢以及在急性和慢性治療類別中的平衡來強化我們帶來的價值。

As you would expect at this point in time, given some of the medical loss ratio challenges, things like bed day management and the total cost of care are front in mind. That ability for us to be a meaningful partner in that work to provide products across the portfolio that we have is something that we reinforce as we are articulating to them the value of our partnership.

正如您目前所預料的那樣，考慮到一些醫療損失率挑戰，床位管理和總護理成本等問題都是首先要考慮的。當我們向他們闡明我們合作夥伴關係的價值時，我們強調了我們有能力成為這項工作中一個有意義的合作夥伴，提供我們擁有的產品組合，這一點我們得到了強化。

So we're always going to make certain that we are being paid fairly for the value that we deliver, and that is part of the conversation. But the national scale that we have, but the local responsiveness, and then the breadth of the portfolio, we think, is a differentiator and something that we're going to continue to invest in and continue to capitalize on in this marketplace today and into the future.

因此，我們始終要確保我們所提供的價值得到公平的報酬，這是談話的一部分。但我們認為，我們所擁有的全國規模、本地響應能力以及投資組合的廣度是一個差異化因素，也是我們將繼續投資並在當前和未來繼續利用這一市場的優勢。

Great. Thanks so much, and nice job guys.

偉大的。非常感謝，你們幹得好。

Thank you.

謝謝。

Joanna Gajuk, Bank of America.

美國銀行的喬安娜‧加朱克 (Joanna Gajuk)。

Hey, good morning. Thanks so much for taking the question. So a couple of, I guess, follow-ups to other comments that were made on the advanced practitioner model. So that's very interesting what you're doing there.

嘿，早安。非常感謝您回答這個問題。因此，我想，這是對高級從業者模型所提出的其他評論的幾點後續跟進。所以你在那裡做的事情非常有趣。

So can you tell us a little bit more in terms of the progress there using this model? How many chairs are in this model? And also, are you starting to take more oncology patients or Alzheimer's patients? Any additional color you might have on that?

那麼，您能否向我們詳細介紹一下使用該模型的進展？這個模型有多少張椅子？另外，您是否開始接收更多的腫瘤患者或阿茲海默症患者？您對此還有什麼補充嗎？

Yeah, Joanna. We have -- as we've called out before, we operate 170 facilities across the US, and we have over 750 chairs that we operate. We are in the process of looking at how do we utilize them for both an alternate site to the home as well as this advanced practitioner model and continue to evolve our model through that process. So we really like that progress.

是的，喬安娜。正如我們之前所說，我們在美國各地經營 170 家設施，並且擁有超過 750 張椅子。我們正在研究如何利用它們作為家庭的替代場所以及這種先進的從業者模型，並透過這個過程繼續發展我們的模型。所以我們真的很喜歡這個進展。

As you would expect, given corporate practice of medicine and other aspects, it really is at a state-by-state level in which we're looking to roll that out. And the progress continues to advance in alignment with kind of our expectations there.

正如您所料，考慮到企業醫療實踐和其他方面，我們確實希望在各州層級推行這項政策。並且進展繼續按照我們的預期推進。

To the second part of your question, we have seen expanded portfolio and use of the advanced practitioner model to be able to serve oncology patients as well as patients that have neurological disorders like Alzheimer's.

對於您問題的第二部分，我們已經看到了擴大的投資組合和使用高級從業者模式，以便能夠為腫瘤患者以及患有阿茲海默症等神經系統疾病的患者提供服務。

That is a part of that care model and things that we can look at as we're looking to expand there. There are other products that are in our portfolio that don't make as much sense to be able to do in the home just because of the utilization of a nursing resource and drive time and things of that nature.

這是護理模式的一部分，也是我們在尋求擴展護理模式時可以考慮的。我們的產品組合中還有其他產品，由於需要利用護理資源和駕駛時間等原因，在家中使用較不合理。

So to be able to have an alternative to the home with the center-based capabilities, we think just enhances our capabilities and broadens the population of patients in which we can serve. So we're going to continue to move that forward.

因此，我們認為，能夠提供一種以中心為基礎的家庭治療替代方案，可以增強我們的能力，並擴大我們可以服務的患者群體。因此我們將繼續推進這一進程。

Again, encouraging signs for those vectors of growth in Alzheimer's and in oncology. At this point in time, it's ticking up. It's not a meaningful part of the overall portfolio, but we think it just positions us well as we're thinking about where growth will come into the future.

再次，這對阿茲海默症和腫瘤學領域的成長載體來說是令人鼓舞的跡象。目前，它正在上升。它並不是整體投資組合中一個有意義的部分，但我們認為，當我們思考未來的成長方向時，它能為我們帶來良好的定位。

And I guess, if I may, on just, I guess, the broader suite portfolio to understand 750 chairs you have there. Can you talk about the utilization of those? I mean you did say 35% of the nursing business you deliver were in the settings.

我想，如果可以的話，我只想透過更廣泛的套件組合來了解你們那裡有 750 張椅子。能談談它們的用途嗎？我的意思是，您確實說過，您提供的護理業務中有 35% 是在環境中進行的。

But the reverse question is like how much, I guess, more you can do without the need to grow? And then to that end, since you mentioned how you can leverage better the nurse and reduce the drag down and such. Can you help us understand the margin contribution when you have these settings being utilized more and more?

但反過來的問題是，我猜，在不需要成長的情況下，你還能做多少？然後為此，既然您提到瞭如何更好地利用護士並減少拖累等等。當您越來越多地使用這些設定時，您能否幫助我們了解利潤貢獻？

Yeah, Joanna, look, I mean, the way we think about these centers and as you've been following us since '21 when we really started our strategy of aggressive suite expansion, we've been very thoughtful and methodical to make sure that as we open these, the utilization was following.

是的，喬安娜，你看，我的意思是，我們對這些中心的看法，以及你自 21 年我們真正開始積極擴展套房戰略以來一直關注我們的方式，我們一直非常周到和有條不紊，以確保當我們開放這些中心時，利用率會隨之而來。

We're very encouraged. We've gone from around 17% of our nurse visits occurring in one of our chairs to 35% plus. And so first and foremost, I think as you've heard us say in the past, utilization or capacity isn't something we necessarily worry about.

我們非常受鼓舞。我們的護理師就診比例從大約 17% 上升到 35% 以上。因此，首先，我認為正如您過去聽到我們所說的那樣，利用率或容量並不是我們必須擔心的事情。

Most of our centers aren't operating seven days a week or eight hours a day. And so as we think about the theoretical capacity. We have plenty and we'll continue to add brick-and-mortar as the local market dynamics dictate. The great thing is they don't have to be running at capacity to create tremendous value for us. And we haven't said what the dollar figure is in terms of the drop.

我們的大多數中心並不是每週七天或每天八小時運作。因此，當我們思考理論容量時。我們擁有大量實體店，並將根據當地市場動態繼續增加實體店。最棒的是，他們不需要滿載運轉就能為我們創造巨大的價值。我們還沒有透露下降的具體金額。

But there's really two key benefits. First and foremost, for those mature centers, we're seeing more than 20% nurse productivity uplift. Said another way, that nursing labor component for a typical infusion is 20% more efficient because we're not paying for windshield time, they can oversee multiple patients at the same time. It's just a more efficient scheduling.

但其實有兩個主要好處。首先，對於那些成熟的中心，我們看到護理師生產力提高了 20% 以上。換句話說，典型輸液的照護勞動力效率提高了 20%，因為我們不需要支付擋風玻璃時間的費用，他們可以同時照顧多名患者。這只是一種更有效的調度。

But it's -- but we're also creating 20% more nursing capacity, which is a finite clinical resource for us, which gives us the confidence to continue to aggressively expand our therapeutic portfolio. So this is a key enabler, as John said, to our growth. It drops value to the bottom line, but it continues to fuel our confidence around clinical labor capability.

但我們也正在創造 20% 以上的護理能力，這對我們來說是有限的臨床資源，這使我們有信心繼續積極擴大我們的治療組合。正如約翰所說，這是我們成長的關鍵推動因素。它降低了底線價值，但它繼續增強了我們對臨床勞動力能力的信心。

Thank you. And if I may, a different follow-up. In your prepared remarks at the end, you said that you don't expect the tariffs to be any or like material in this year. I guess now we're hearing right about tariffs on products from Europe, and I guess that includes drugs in there too.

謝謝。如果可以的話，我想再說一個不同的後續問題。在您最後的準備演講中，您表示您預計今年不會出現任何或類似的重大關稅。我想現在我們聽到的是對來自歐洲的產品徵收關稅，我想其中也包括藥品。

So there's debate about the 15% or 18%. But can you talk about -- are you doing anything in preparation for that? Do you need to build like an inventory because maybe you're knowing things are happening? And just how to think about the specific exposure to Europe? Thank you.

因此，對於 15% 還是 18% 存在爭議。但您能談談—您為此做了什麼準備嗎？您是否需要建立類似庫存的東西，因為也許您知道正在發生的事情？那麼該如何看待對歐洲的具體影響呢？謝謝。

Yeah. Look, as we've said previously, and obviously, we spent a lot of time on our first quarter call and thereafter addressing some of the concerns. I mean, as we've said, I mean, part of our economics are we're maintaining a spread on the cost of the therapies.

是的。正如我們之前所說的那樣，顯然，我們在第一季的電話會議上花了很多時間，隨後解決了一些問題。我的意思是，正如我們所說的，我們的經濟效益的一部分是維持治療成本的差額。

And drug prices increase and decrease on a regular basis and our procurement and market access teams are managing those procurement strategies constantly. And we don't just sit back and wait. We have very proactive relationships with pharma, with distributors, with our suppliers.

藥品價格定期上漲和下跌，我們的採購和市場進入團隊不斷管理這些採購策略。我們不會只是坐著等。我們與製藥公司、分銷商和供應商建立了非常積極的關係。

We haven't been shy, as you've seen in the past, around using our balance sheet where necessary. And there's a lot of strategies that we can deploy behind the scenes really to proactively address what we anticipate are changes in the drug costs.

正如您過去所見，我們並不羞於在必要時使用我們的資產負債表。我們可以在幕後部署許多策略來主動應對我們預期的藥品成本變化。

So as we've modeled countless scenarios, we don't see a scenario this year and our guidance ranges incorporate what we think would be the impact, which again, as we collectively assess is just not material.

因此，儘管我們已經模擬了無數種情景，但我們今年沒有看到任何情景，我們的指導範圍包含了我們認為會產生的影響，而正如我們共同評估的那樣，這種影響並不重要。

Great. Thank you so much.

偉大的。太感謝了。

Thanks, Joanna.

謝謝，喬安娜。

AJ Rice, UBS.

瑞銀的 AJ Rice。

Hi everybody. Maybe just a follow up on that last train of thought first. I think your inventories are up about $35 million sequentially. Obviously, there sort of is some ongoing chatter about the tariffs, the MFN, et cetera. Are you doing anything now? Or that's a tool in the toolbox that you have?

大家好。也許只是先跟進最後的想法。我認為你們的庫存連續增加了約 3500 萬美元。顯然，關於關稅、最惠國待遇等問題的討論仍在繼續。你現在在做什麼嗎？或者這是您工具箱中的一個工具？

It wouldn't seem like a $35 million sequential quarterly step-up was that much in inventories in anticipation of tariffs or anything like that. But just trying to think about how quick you can move to take advantage of that and offset any impact from tariffs.

看起來，由於預期關稅或類似因素的影響，庫存季度環比增加 3500 萬美元似乎不多。但只是想想想你能多快採取行動來利用這一點並抵消關稅的影響。

Yeah, AJ, I mean, look, we're constantly managing. That's less than two days impact. We typically operate with about a month of inventory across the board. We're constantly looking at, as John mentioned, there's some new therapies that are launching.

是的，AJ，我的意思是，你看，我們一直在管理。這影響不到兩天。我們通常經營大約一個月的庫存。正如約翰所提到的，我們一直在關註一些正在推出的新療法。

Obviously, with mid-teens growth, we want to make sure, given what has been robust growth thus far this year that we have adequate supplies and inventory in the local markets to be responsive. So I would say that the inventory increase has been deliberate and methodical, but something that we're very comfortable with, again, given the strength of the balance sheet and capital structure.

顯然，隨著中等程度的成長，鑑於今年迄今為止的強勁成長，我們希望確保在當地市場擁有足夠的供應和庫存以做出回應。因此，我想說，庫存增加是經過深思熟慮且有條不紊的，但考慮到資產負債表和資本結構的強勁，我們對此感到非常滿意。

Okay. And I know there's no other drug in your portfolio that's anywhere close to Stelara. But I just -- I was wondering, as you have your discussions with manufacturers and, obviously, they're going through a tremendous change now.

好的。我知道你們的產品組合中沒有其他藥物能與 Stelara 相提並論。但我只是——我想知道，當你與製造商進行討論時，顯然他們現在正在經歷巨大的變化。

Is -- even though it wouldn't be necessarily that meaningful to you, are you seeing any movement on their part to try to change the way they contract with you in light of what happened with Stelara or just because of the pressures they're feeling themselves? Is there anything happening on that end of it that's worth calling out?

儘管這對您來說不一定那麼有意義，但您是否看到他們採取任何行動，試圖根據 Stelara 發生的事情改變與您簽訂合約的方式，或者僅僅是因為他們自己感受到的壓力？這方面有沒有什麼值得關注的事情發生？

It's John. The conversations that we've had have been probably more aligned towards the clinical capabilities and the ability that we have to help ensure adherence of their product. As you called out, our relationship with Janssen and specifically on that product is just -- was unique.

我是約翰。我們進行的對話可能更集中在臨床能力以及我們幫助確保其產品依從性的能力。正如您所說，我們與 Janssen 的關係，特別是在該產品上的關係，是獨一無二的。

And so across the board, the rest of the manufacturers that we have relationships with, I think they're all trying to understand what the future will hold with some of the actions being announced around pricing, et cetera, but we have not yet seen that be a material aspect of the way that they're contracting with us.

因此，總的來說，與我們有合作關係的其他製造商，我認為他們都在試圖了解未來會發生什麼，圍繞定價等宣布的一些行動，但我們尚未看到這成為他們與我們簽訂合約方式的重要方面。

Okay. And then just the last question on OpEx growth embedded in your second half guidance. I know generally, your annual increases, I think, on that area are in the 3% to 5% range. Is there anything unusual about what you're seeing in the back half that would either step that up or make that rate of increase somewhat more modest?

好的。然後是最後一個問題，關於您下半年指引中的營運支出成長。我知道，總體而言，我認為該地區的年增長率在 3% 到 5% 之間。在後半部分看到什麼不尋常的情況嗎？這種情況會導致成長率加快還是減緩？

Yeah. Look, I mean, the great news is with the leveragability of our infrastructure, we drove 50 bps. OpEx was up, I think, high single digits or in the 10% range in the quarter. We still grow 50 basis points of leverage as a percent of revenue. A couple of things at play there.

是的。你看，我的意思是，好消息是，憑藉我們基礎設施的槓桿作用，我們推動了 50 個基點。我認為，本季營運支出成長了高個位數或 10% 左右。我們的槓桿率仍以營收的 50% 成長。那裡有幾件事在發生。

First and foremost, we closed on the Intramed acquisition, which we absorbed their burn. So on a year-over-year basis, we have the indirect spend of the Intramed enterprise that's now being reported.

首先，我們完成了對 Intramed 的收購，並吸收了他們的損失。因此，與去年同期相比，我們獲得了目前正在報告的 Intramed 企業的間接支出。

And frankly, as John mentioned, we're investing in a number of areas, whether it's our advanced practitioner model supporting some of the new therapies that we're ramping up for launch. And so we have the agility to pull forward some of those investments. And frankly, given the strength of the quarter, we're managing for the near term and the longer term, and we're making some investments for future growth initiatives.

坦白說，正如約翰所提到的，我們正在對多個領域進行投資，無論是我們的高級從業者模式還是我們正在加緊推出的一些新療法的支持。因此，我們可以靈活地推進部分投資。坦白說，鑑於本季度的強勁表現，我們正在進行短期和長期管理，並為未來的成長計劃進行一些投資。

So I think it will be a little bit above that in the back half relative to our historical range. But there's nothing fundamental or structural. It's just the opportunistic ability for us to invest for future growth in a period where we're seeing really, really encouraging top line.

因此我認為相對於我們的歷史範圍，下半年它會略高一些。但沒有什麼根本性或結構性的東西。這只是我們在看到真正令人鼓舞的收入成長的時期為未來成長進行投資的機會能力。

Okay, great. Thanks so much.

好的，太好了。非常感謝。

Yeah. Thank You, AJ.

是的。謝謝你，AJ。

Brian Tanquilut, Jefferies.

布萊恩·坦奎魯特（Brian Tanquilut），傑富瑞集團。

Hey, good morning. Mike, maybe just as I think about towing AJ's question, how should I be thinking about your MFN exposure? I mean, just the mechanics around how that would flow through to you guys?

嘿，早安。麥克，也許正如我考慮回答 AJ 的問題一樣，我應該如何看待你最惠國的待遇？我的意思是，這些機制是如何傳遞給你們的？

Well, Brian, again, based on what we've seen, and there hasn't been a lot of update since the original executive order, again, there's some conceptual things in there around MFN that, frankly, it's hard to understand exactly how that's going to play out.

布萊恩，根據我們所看到的情況，自最初的行政命令發布以來並沒有太多更新，其中有一些關於最惠國待遇的概念性內容，坦率地說，很難理解它將如何發揮作用。

Determining what the reference prices are and what things would ultimately impact us, it's just way too early to tell. And we haven't seen anything at least for the balance of '25, where that's going to impact us. We'll continue to keep an eye on it.

確定參考價格是多少以及哪些因素最終會對我們產生影響，現在下結論還為時過早。至少在 25 年的剩餘時間裡，我們還沒有看到任何會對我們產生影響的事情。我們將繼續關注此事。

But structurally, how there's going to be these international reference prices, how things would be adjusted, how the government may step in to start administering and operating pharmacies. As we've read the executive order, it's hard for us really to put our hands around. Again, I don't know that there's going to be anything implemented to impact '25, but how it would logistically be executed in even the near term.

但從結構上講，這些國際參考價格將如何制定，如何調整，政府如何介入開始管理和經營藥局。當我們讀到行政命令時，我們真的很難採取行動。再說一次，我不知道是否會有任何事情實施來影響 25 年，但即使在短期內，它在後勤上將如何執行。

Got it. Okay. I totally understand. Maybe shifting to Stelara biosimilars. Are you seeing any ramp there with new patients go that direction for the Stelara or for those patients that were -- would have been on Stelara? Like just curious what you're seeing in terms of the ramp on biosims.

知道了。好的。我完全理解。也許會轉向 Stelara 生物相似藥。您是否看到有新患者前往 Stelara 治療，或原本會使用 Stelara 治療的患者？我只是好奇您在生物相似藥的增長方面看到了什麼。

Yeah, Brian, it's John. I'd say it was a slow start, but we're starting to see that ramp up as we exited the quarter. Some of the PBMs are starting to make that a little bit more of an initiative for them as they move that ahead.

是的，布萊恩，我是約翰。我想說這是一個緩慢的開始，但隨著我們結束本季度，我們開始看到這種情況的上升。隨著 PBM 的不斷推進，一些 PBM 開始將其視為一項主動舉措。

Again, our focus has been around making certain that we have access to the products and expanding them into our portfolio as we move forward. There certainly is other opportunities where there's transition of some of those patients on to, let's call it, the next-generation chronic inflammatory disease products that are part of our portfolio as well.

再次強調，我們的重點是確保我們能夠獲得這些產品，並在未來將其擴展到我們的產品組合中。當然還有其他機會，其中一些患者可以轉向我們所謂的下一代慢性發炎疾病產品，這些產品也是我們產品組合的一部分。

So I think the patient census is trending in alignment with our expectations and kind of how we have thought things were going to move. So nothing out of our expectation range. But as we exit the second quarter and go into the back half of the year, our expectations are that we'll continue to see increased utilization of the biosimilars that at this point in time are being deemed to be interchangeable. And therefore, the utilization, we think, will start to ramp up.

因此，我認為患者普查的趨勢與我們的預期以及我們對事情發展趨勢的預測一致。所以沒有什麼超出我們的預期範圍。但隨著我們結束第二季並進入下半年，我們預計我們將繼續看到目前被視為可互換的生物相似藥的利用率增加。因此，我們認為利用率將開始上升。

Got it, thank you.

明白了，謝謝。

Thanks, Brian.

謝謝，布萊恩。

Jamie Perse, Goldman Sachs.

高盛的傑米·珀斯 (Jamie Perse)。

Hi, good morning. This is Sarah Conrad on for Jamie. You've continued to see strong mid-teens acute growth following the competitor exits. But can you help us understand how we should think about acute growth progression for the balance of the year and into 2026 as you annualize these competitive exits?

嗨，早安。這是莎拉·康拉德 (Sarah Conrad) 為傑米 (Jamie) 表演的。在競爭對手退出後，您仍會看到強勁的十幾歲的急劇增長。但是，當您將這些競爭性退出年度化時，您能否幫助我們理解我們應該如何看待今年剩餘時間和 2026 年的急劇增長進程？

Hey Sarah, it's Mike. So a couple of things. One, I wouldn't characterize the mid-teen growth just the result of just the competitive dynamics in certain markets. Again, we're seeing very solid execution even in markets where the competitive dynamics remain consistent with how they've been.

嘿，莎拉，我是麥克。有幾件事。首先，我不會將中等水準的成長僅歸因於某些市場的競爭動態。再次，即使在競爭動態與以往保持一致的市場中，我們也看到了非常穩健的執行力。

I think that also is attributed to some of John's comments around the fact that, look, as we engage with scaled health plans and payers, they see the utility and value of a consistent, dependable national clinical model, which I think has served us some wind in our sales across the country.

我認為這也歸因於約翰的一些評論，即當我們與規模化健康計劃和付款人接觸時，他們看到了一致、可靠的國家臨床模型的效用和價值，我認為這為我們在全國範圍內的銷售提供了一些助力。

As it relates to this year, as you'll recall, in certain markets, there were some competitive changes late Q3, early Q4. So the prior year comps, and we saw this in mid-'22 as well, the year-over-year comp is going to be tougher in the fourth quarter.

就今年而言，您會記得，在某些市場，第三季末和第四季初出現了一些競爭變化。因此，與去年同期相比，我們在 2022 年中期也看到了這一點，第四季的同比競爭將會更加激烈。

So on a reported basis, while we're confident we'll maintain the revenue base, the reported growth, we would expect to decrease a little bit in the fourth quarter. And as it relates to 2026, again, unfortunately, at this point, we're just not in a position to provide forward guidance beyond the guidance for 2025.

因此，從報告來看，雖然我們有信心維持收入基礎和報告的成長，但我們預計第四季度的收入會略有下降。至於 2026 年，不幸的是，目前我們還無法提供超越 2025 年指引的前瞻性指引。

That's super helpful. And then I just want to follow up on AJ's OpEx growth question. Can you help us understand what's fueling that 10% SG&A growth that we saw in the first half? And where are you prioritizing investments going forward?

這非常有幫助。然後我只想跟進 AJ 的營運支出成長問題。您能否協助我們了解上半年銷售、一般及行政費用 (SG&A) 成長 10% 的原因？您未來將優先投資哪些領域？

Yeah, I think, to break it down high level, there's 2 to 3 points of SG&A impact from the acquisition. So deal expenses as well as the fact that we're now reporting the Intramed's burn. And there's a couple of points of growth of what I will call acceleration of growth initiatives. So just to overly simplify, the same-store sales spending is still growing in that mid-single digits. But as we always have, we've been able to accelerate some of the initiatives.

是的，我認為，從高層來看，此次收購將對銷售、一般及行政費用產生 2 到 3 個百分點的影響。因此，處理費用以及我們現在報告 Intramed 燒傷的事實。我稱之為加速成長舉措的幾個成長點。因此，為了簡化起見，同店銷售支出仍以中位數個位數成長。但正如我們一直以來所做的那樣，我們已經能夠加快一些舉措。

Again, back to my earlier comments, this is around expanding some of our clinical capabilities and the suite investing in new therapy launches, et cetera. So Sarah, at a high level, I'd break it down as OpEx, which again decreased as a percent of revenue by 50 bps year-over-year. That's despite, to your point, 10% growth, half of which is really the impact of acquisitions and opportunistic growth initiatives.

再次回到我之前的評論，這是為了擴大我們的一些臨床能力和對新療法推出的投資等等。因此，莎拉，從高層次來看，我將其分解為營運支出，其占收入的百分比比去年同期下降了 50 個基點。儘管如您所說，成長率為 10%，但其中一半實際上是收購和機會性成長舉措的影響。

Yeah. Thank you.

是的。謝謝。

This concludes the question-and-answer session. I would now like to turn the call back over to John Rademacher for closing remarks.

問答環節到此結束。現在我想將電話轉回給約翰·拉德馬赫 (John Rademacher) 做結束語。

Yeah, thank you all for joining us this morning and participating on our call. Our team continued to execute on all levels, and we're excited to continue to expand patient access and provide extraordinary care to more patients and their families, which is delivering value for our shareholders. Thank you, everyone, for joining us, and have a great day.

是的，感謝大家今天早上加入我們並參加我們的電話會議。我們的團隊繼續在各個層面上執行，我們很高興繼續擴大患者的治療機會並為更多患者及其家人提供卓越的護理，這為我們的股東帶來了價值。謝謝大家的參與，祝大家有個愉快的一天。

This concludes today's conference call. Thank you for your participation. You may now disconnect.

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。