Covidien's CEO Presents at 38th Annual Deutsche Bank Health Care Conference (Transcript)

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Covidien plc (COV) 38th Annual Deutsche Bank Health Care Conference May 30, 2013 12:00 PM ET

Executives

Jose E. Almeida - Chairman of the Board, Chief Executive Officer and President

Coleman N. Lannum - Vice President of Investor Relations

Analysts

Kristen M. Stewart - Deutsche Bank AG, Research Division

Lauren Coste - Fitch Ratings Ltd.

Kristen M. Stewart - Deutsche Bank AG, Research Division

So thank you for joining us. It is my pleasure to introduce Covidien for this session here at the Deutsche Bank Health Care Conference. I'm Kristen Stewart, the medical supplies and device analyst. So, we have Joe Almeida, as well as Cole Lannum here as well, and I'm going to move Joe's mic closer to him so Cole can actually talk. I'm just kidding, Cole. But anyway, just to kind of kick it off, we actually had Mallinckrodt in yesterday and they were kind of going through. They had about the same. So -- but anyway, so obviously, that spin is coming up and looks to be progressing very nicely. So can you just talk, just a little bit, very high level about, just kind of how you're thinking about Covidien, kind of post the spin and to what extent kind of the strategy may or may not change this in terms of capital allocation or M&A approach, or just kind of general philosophy?

Jose E. Almeida

One of the reasons that we decided to spin-off Mallinckrodt was we did not pay enough attention and did not dedicate enough resources to do business. So we are very bullish about their future because they'll be able to do that on their own, and have their own cash flow to deploy. We had invested significant, in the last 3 years in Mallinckrodt's pipeline and their ability to have better manufacturing operations. So that part was disproportionately spent in that business. But we didn't pay a significant amount of attention in terms of M&A, other than being really focused in their strategy that Mark Trudeau was very clear yesterday. Going forward, Covidien, we will have a disproportionate large and well-positioned Medical Devices business. We too, have a Medical Supplies business, which we think is important to the way we go to market, but we continue to deploy most of our resources to Medical Devices. We are pretty solid -- solid M&A strategy, as well as organic growth strategy by managing our portfolio and deploying money to the areas of growth that Covidien has today. With -- principally focused in emerging markets, neurovascular, energy and endostapling. Those are the areas that we have a very large focus. We also have a selective focus in our Vascular business, specifically in the peripheries when it comes to the drug-coated balloon and the amount of money that we invest in making that business successful when it launches, and it gets approved by the FDA.

Kristen M. Stewart - Deutsche Bank AG, Research Division

Right, and just longer term, I think you've commented on the ability to still feel confident about growing the mid-single digits and through operational and financial leverage, kind of double-digit. I guess, what are some of the things that give you that confidence, kind of within, yes, maybe the more medical side you highlighted some of these key areas you're focusing on. But what do you view as being the greatest contributor towards growth over the next 3 to 5 years?

Jose E. Almeida

There are four specific pillars. The first one is, we will continue to invest in technology. We do have the ability to be very efficient in R&D deployment. We deploy cash to all the groups around the world. Now we have two in emerging markets, now operating for close to 2 years. They're doing very well. So technology and innovation will continue to play a significant role for Covidien. The second one is have ownership of a specialty. So if we're in general surgery, we're in peripheral vascular and neurovascular, we tend to own that area with #1 in the virtual market leadership positions. By doing that, you have the ability to offer better economical value for your customers, associated with an eye on the clinical outcomes, your technology and your innovation are providing. The third one would be a relentless search for opportunities to improve our operations across the globe. Despite the fact that, that doesn't move the needle on the top line, it does move on the bottom line and also is an ROIC driver for the company. And lastly, emerging markets were, for some products of Covidien, probably 50% of our growth is coming from emerging markets. So our investment is relentless there. One point in time we thought that we would be finished by this year. We have another double down program coming up. We still, in my estimation, underinvested in places like Brazil and South Africa, Mexico as well, despite the fact that we have good investments and good growth in all these businesses, you've got to be able to be there in all categories of hospitals. For Brazil, Covidien is very focused on the private sector, but the public sector offer the great opportunities. So we associate those pillars with a strong eye for M&A in terms of technology, market access for emerging markets, as well as white spaces.

Kristen M. Stewart - Deutsche Bank AG, Research Division

And where roughly, I guess if we just kind of take out the Pharmaceutical business, where does emerging markets, I would, I guess as a percentage of sales for emerging markets that the remaining, kind of Medical Device and Supply business?

Jose E. Almeida

It would be about 15%. But it was about below 10% a few years ago.

Kristen M. Stewart - Deutsche Bank AG, Research Division

Okay, and I guess going forward, do you guys have a particular target in terms of where you think that, that could be? Or obviously, it's higher?

Jose E. Almeida

It's higher. But our ambition is to reach the $2 billion market as soon as possible. Covidien is below $2 billion in emerging markets. And not only get to $2 billion in emerging markets faster in the next couple of years, but also be able to get 50% of debt coming out of BRICs, including South Africa. Because that is where most of the growth is. Emerging markets, they're not all created the same. So despite the fact that we have good presence in Colombia, in Argentina, in Mexico as well, if you think about getting 50% in the BRICs, the $2 billion would be a great thing for us.

Kristen M. Stewart - Deutsche Bank AG, Research Division

And how does the margin group fall compare, kind of more developed markets, relative to these emerging markets?

Jose E. Almeida

The margins are right about or slightly above what Covidien will be, post-Mallinckrodt spin, so it's pretty healthy gross margins. Now you would -- you have a slightly depressed operating income versus the overall company's overall income, because we invested money there, which is to be expected, but is very profitable. We have -- I get this question all the time. We have a very healthy basket of products on a global basis. But also, we have the luxury to select products that we do not have to sell in those markets. For instance, Medical Supplies. There's very little sales of Medical Supplies products in those markets. When you're looking in endotracheal tubes, in tracheostomies, those are sold in more high-end hospitals and tier 1 cities in those markets, but it's not across the board. But we have a really good, strong business in Surgical Devices, including energy, ventilation, neurovascular, peripheral vascular. So that basket is at a very prime point that we can get the pricing, and now we can get the penetration. So as you know, MIS is a growing -- minimally invasive surgery is a growing practice in those markets and makes Covidien really be right in the bright spot to capitalize on that. So I don't have any concerns about Covidien's margins in emerging markets, not at all.

Kristen M. Stewart - Deutsche Bank AG, Research Division

One of the areas that you had highlighted and it's kind of focuses on neurovascular and just peripheral vascular states, I just think back a couple of years ago. Certainly, or say when you did the ev3 acquisition. There's a lot of criticism, right there, I think, plus the [indiscernible] were proved wrong, I guess just judging by the performance. How do you just think about -- I know more recently, there's been maybe some concerns, just a bit though, a little bit of our growth being seen in the most recent quarter, but kind of putting that aside, how do you just see overall that Vascular business, and what's kind of the strategy there to restore growth, but maybe just bolt-on on additional products, whether it be more through -- or internal R&D, or should we expect to see additional tuck-ins?

Jose E. Almeida

The ev3 acquisition put us in 2 very good markets. First was neurovascular. Covidien, at that time, where ev3 played at #4. In peripheral vascular, we're probably 2 or 3, based on the numbers that we had in those days. The neurovascular business, with the launch of new technology, primary Pipeline Embolization Device and Solitaire and complementing the line of better delivery systems and more coils. Covidien was able to, on a dollar-wise base, not volume, really bring itself to be #1 in our estimation for the U.S., #2 is still on a global market share. So when you get to that position, it's going to be about what you have in your pipeline, not to confuse with Pipeline Embolization Device, but what is you have in your product pipeline that will ensure that you're going to have longevity and growth above market going forward. And Covidien does have that through licensing, through organic plays and acquisitions. I find the company to be really well-positioned. I think that the whole future of neurovascular is to leverage baskets and stent-like devices, like Pipeline Embolization Device, to redefine the space and provide a bigger scope of treatment for patients that did not have that option in the past. By doing that, we have the ability to continue the growth. Is the growth -- no, when you go for a #4 to #1, the growth us a little different in terms of trajectory, that is, to maintain #1 in the U.S. and become #1 across the globe. So we will have growth above market, and -- but to do that, we've got have those bets in those technologies come to fruition. I was just recently in Irvine, where the business is headquartered, and I feel very comfortable with the tech knowledge that they have. On top of it, we are the company that has all the technologies, from liquid embolics to accessories to embolization devices to clot retrieval systems and coils. So the neurovascular endovascular suite, Covidien has a good presence. We have a good coverage in terms of sales in the U.S. and Europe, and now growing in emerging markets. I feel comfortable that business is well-positioned. The peripheral vascular business is a bit different. There are many more players in that business. But Covidien is still plays in all areas of that business, including our tracheostomy devices, stents. We have the accessories from total occlusion catheters that we recently acquired, all the way to technologies in process of being developed. So it's a tougher market to compete. We were very fortunate in a tremendous execution from our team when we took a lot of the quarters that recalled customers last year. We were able to retain actually 40% of that. And in the market, when we have 7, 8 different competitors, is a good execution. We need to become a bit more agile as the site of care is changing when you have more labs that are owned by physicians. They're more cost contentious. But Covidien has the ability, through it's product line, to offer better deals than if we just had one technology here and there, took us a little bit to react, but I think we're on the right track right now in some of the experiments, in terms of bringing a procedure-wide approach to the physician-owned lab is working. We have early indications of that. So I think with that, I answer in terms of what we expect for the future. We have the trigger loading balloons, which we're in process of developing, and it seems very promising. So we made bets in technologies for the future that will assure us that we're going to have a place at the table and continue to grow that business. Very distinctive markets, but very good opportunities for the company.

Kristen M. Stewart - Deutsche Bank AG, Research Division

How would you basically size the opportunity with the drug-coated balloons, because there's, several of your competitors withing the peripheral vascular space that are very excited about, or at least with what they see as a market opportunity. Maybe just remind us why you feel all kind of comfortable with the bet that you've made, and kind of how you're thinking about it from a longer-term perspective in terms of entering into the U.S.? And just more broadly, where balloons kind of fit in, in terms of just kind of a treatment paradigm?

Jose E. Almeida

For the periphery -- or for the disease of the arteries and peripheries, it's a bit different in coronary. The patency rate for a drug-coated stent, a drug-eluting stent for the heart is much higher, much different than what it is for the below the knee, as well as anything in the periphery, so legs. So there are a lot of movement in the body. You walk and the stent is there. So the patency is slower. So you need to find something that you cannot leave anything behind. That if you need to re-intervene, you have a better outcome. So if you have a stent already placed in, you have to re-intervene, it becomes more complicated. So the holy grail of the periphery treatment of these arteries is drug-coated balloon. It proves itself to be the right technology. Everything tells us today that the technology that we have acquired, I cannot speak for others, but our technology, it looks like that is very promising. So with that -- but that's -- I still like to underscore the fact that being one product player or a couple of product lines player, would not, in the future, bode well if you are dealing with the economic buyer. And the economic buyer will look for what you have to offer, how can I not lose money in the procedures that I have under the DRG that we have available to us. And I think the companies that have the ability to have a full and complete product line from the most sophisticated and most costly devices, they have proof of clinical outcomes, like a drug-coated balloon, all the way to a total occlusion catheter or guidewire, will be the ones who will have more success.

Kristen M. Stewart - Deutsche Bank AG, Research Division

Okay. And then very, very quickly, just renal denervation. I know this is an area where you guys kind of acquired in 2 years ago, want to say, or are you...

Jose E. Almeida

About a year ago.

Kristen M. Stewart - Deutsche Bank AG, Research Division

Time flies when you're having fun.

Jose E. Almeida

It was close to the Euro PCR a year ago.

Kristen M. Stewart - Deutsche Bank AG, Research Division

And can you just comment that Denmark really hasn't been necessarily developing, at least in Europe as fast as some might have hoped. How do you just think about it? Is it a real opportunity, and what's kind of the -- what's your view on kind of bringing it to the U.S.?

Jose E. Almeida

I think the European market's a great opportunity because they can get to a CE Mark in a different pathway that you get to get a -- or a PMA here in this country, in the U.S. So there's a great lure into the European market, so you can test the market and your assumptions, not test the product. The product has to be approved and fully validated to be able to be used in humans, and but it's more testing the mark, and you can see how the general payers will behave to your value proposition. But that's where it ends in Europe. Europe is very slow to pick up on technology, mainly now there's a significant amount of burden. So I think what you're seeing in Europe is a difficult pickup of the technology and adoption, because it's all about who is going to pay for. And I think the more evidence that will be coming to the market will be better for the technology. We don't have any explicit plans to come to the U.S. now, not with this tech knowledge. We think there are other technology we're looking right now that will be better suited. We have, indeed, opportunities to take this technology into Japan, and we will do that. We're having great success in some areas of emerging markets, such as Saudi Arabia and other places. So we're starting to see the development. Covidien, like any medical device companies, we are not a drug company that has about 3, 2 or 3 bets and they have billion dollar bets. We have multiple bets to manage our portfolio and the risk and investment. Covidien paid, which is public, very, very little for this technology. We had a lot to do, still doing to improve its hardware. But there's something, there is our sweet spot as we are an energy company.

Kristen M. Stewart - Deutsche Bank AG, Research Division

Can you, just I guess, talk on that note just a little bit more the energy side of the business this past quarter? Trends slowed a little bit, though I guess, still remain very robust in the grand scheme of the medical device market. Maybe just remind us, I guess what gives you the confidence that, that business can kind of sustain or improve and just how is that continued roll out of Sonicision going, and maybe the competitive landscape? Though it seems that, every once in a while, there's always concerns that there might be some market share movements, just with different competitors.

Jose E. Almeida

Covidien is an energy play in general surgery. We have energy as well in [indiscernible] . We also have energy for BÂRRX disease and other areas like venous treatment. So have a significant foothold in energy. But when it comes to owing to the specialty in the OR, Covidien made sure that we had the technology ahead of everyone, in terms of hardware, and had the product offering that covers every single necessity in procedures across the globe. The second thing, by the way, open in MIS. The second thing was, we could never, with radio frequency technology, completely obsolete the use of ultrasonic technology. We have very, very good R&D that has been going on, that shows that significant improvement and speed in radio frequency with less thermal damage. However, there are some dissection areas that require ultrasonic. So with Sonicision, Covidien just closed that gap and absolutely has propelled itself as shop a that has every single solution when it comes to energy. And this is how we go to market. We continue to launch the disposable products. We launched two products now, that in -- at the end of June, will be -- well, the beginning in June, actually, will be completely obsoleting 2 blockbuster products that Covidien have. One of them is the Impact, the other one is the 5 millimeters and those will be obsolete. These new products not only are more versatile, but they also are better performing and gives Covidien the ability, because its manufacturing is so different than what we currently have, to be able to compete against, including reprocessing. So when it comes to energy, if I took you folks to our research center in Boulder, what excites me is not what we're going to launch in terms of generating the next 6 months. What excites me is the 18 months away, to 24 months away generators and technology that we have going on. And to be a leader in the market, like I said, you've got to have the technology innovation. You've got to have the ownership of the specialty. You've got to understand what is out there in M&A and have products for emerging markets, and Covidien checks all those boxes. So if I look at our growth, in vessel sealing itself, which is different, we sell -- the numbers that you see have hardware built-in. Hardware is a lumpy business, and I have no concerns when that's slower one quarter, then highing the other quarter because it's the nature of the business. But you look at vessel sealing, double-digit growth, and look at our competitors with very low single digits. So -- and some of them own reprocessing. So it tells me right away that not only in the U.S. and Europe, but also huge adoption in emerging markets. And I leave you with a thought that the penetration for energy is still, on a global basis, very low. High in the U.S., half of that in Europe, and it goes really downhill from there into other markets. So the ability to continue to get solutions, and don't think that Covidien's not looking at economical segment of the market, because we have generators and products being developed as we speak in Shanghai today as well, in association with the R&D that we do in Boulder.

Lauren Coste - Fitch Ratings Ltd.

You have -- one of the things you did bring up, I just wanted to touch on with the area of reprocessing. How do you think about that in just kind of a broader, I guess throughout [ph] and J&J purchased a reprocessor? Because maybe a little over a year ago or so? What are your thoughts on just reprocessing as a risk, or perhaps even an opportunity somewhere?

Jose E. Almeida

You always ask yourself, did you miss the wave or you got crushed by the wave? Or you're surfing the wave? So we are not in reprocessing today. There are several reasons why. Covidien has plans to be in reprocessing? Yes. But we will do it at our own pace, in the way that we think will be more beneficial to our customers. At the end of the day, if we can't develop products that are single-use safer and more economical, associated with possibility of reposability, which is the case of Sonicision. If we look at all the power instrumentation coming down the pipe that Covidien has, you saw reposability, there's all with [indiscernible], not in environmental issues, but also cost issues. So if you think about how we're planning to address this is, is reprocess where there's not an option, provide a product that is as economical as the products currently reprocessed. Technology will always trump reprocessing. And this is not tech knowledge, by preventing people from reprocessing. This is tech knowledge that eliminates costly steps in the manufacturing of a product and tech knowledge that enhances not only clinically, but also economical value proposition to the customer. And lastly, reposabilty, which is a better economic and environmental value proposition to our customers.

Kristen M. Stewart - Deutsche Bank AG, Research Division

And just on the area of stapling that you guys have had a lot of success with, Tri-Stapler. So what can we expect, just kind of going forward? I know that there were was some concerns, I guess with potentially intuitive launching a stapler as well that those seem to have quieted down a bit.

Jose E. Almeida

We were -- we are, probably #2 in the world in open stapler. But we're #1 in endostapler. So with the opportunity to continue to navigate down from open to MIS, and Covidien has a leadership in endostapling, and having a product pipeline that will continue to create an easier way of using stapling by semi-automating, by automating, by creating that opportunity, like you see with the iDrive, and probably what we don't have public is the next 3 to 4 years pipeline going towards that way, it is a bright business for us. We think we have stiff competition. Our competitor is formidable. It's an excellent competitor. But Covidien had the ability, and the insights to focus its efforts on endostapling, and come up with innovative way of stapling progressively that clinically offers, possibly a better outcome. And second, it's a better use, easier to use, friendly ergonomically. But we're moving into reposability when we think there's going to be a real advantage for our surgeons and patients. So I find that, like energy, we're always going to have competition as long we don't forget the innovation and the technology will be okay.

Kristen M. Stewart - Deutsche Bank AG, Research Division

And then, just as we're I guess, thinking ahead to 2014, you guys will really give explicit guidance at -- I don't know if you've set a date for an Analyst Meeting just yet.

Jose E. Almeida

Yes. September...?

Coleman N. Lannum

12, I believe. September. But the date's out there.

Kristen M. Stewart - Deutsche Bank AG, Research Division

A little bit of color. I guess when you did give the remainder activity and guidance when you broke out Mallinckrodt was discontinued. I think the comments were improved top line performance and accelerated earnings growth, once you adjust for exchange in the Medical Device Tax. How are you feeling, just given what we've been seeing in the end markets overall, now that kind of everyone's reported, both from like a U.S. perspective, as well as maybe from the rest within Europe. But the your European business has actually done better, on a relative basis. And how do you think about 2014 I guess, in the context of health care reform as well?

Jose E. Almeida

I always like to remind folks that our product offering is unique and different than most companies. We don't have very expensive, implantable items. We have some in neurovascular, but is, as a percentage of total overall sales, it's a different. We are not a capital company. We have some capital, but it's not -- and we sell capital, we don't give it away. So there is a cycle there of capital equipment. It's just small. So our offering has given Covidien advantage in a market where the highest medical device is always being scrutinized. Don't take me wrong, we get price pressure all the time. There's a significant amount of search for value. That hasn't changed. But we do have value propositions and ownership of specialties that allows Covidien to be more competitive. The Health Care Reform, as stipulated, and everybody calls it Obamacare, but the Affordable Care Act and patient right, Bill of Rights. That didn't quite kick in yet. But there is significant movement from corporate America in bending the cost curve. Period. We're all employers. We employ people across the country. We all know how much it's costing health care. We will be, that's one line item in our P&L that I focus my attention. And I go to HR and said, how come are you not doing something about that? So companies, they can navigate through this new value proposition. Through the pillars that I described is just a technology, owning a specialty, having emerging markets play and understand the M&A world. We'll be very successful. You don't understand that equation, how to play it, because it's not all about price. But price is important. It will be complex. The Obamacare, in the fact, is not even in sight. It's about 16, 17. You're talking about things that happening today. There was a recent article in the Wall Street Journal. They specifically spoke about that, and you can see that. You can talk to the CEOs of hospitals. They are seeing some of that. So we got to adopt this now. It's not then. I was ready to come here and speak about SG&A and about cost and about sales growth, but Cole told me to wait until September 12. I was ready to go.

Coleman N. Lannum

It's what I do.

Kristen M. Stewart - Deutsche Bank AG, Research Division

All right, so just in terms of thinking ahead, just a format of the conference. Obviously, you'll be giving formal guidance for 2014. Are you going to have it or -- I guess will we feel like updates, just more -- it'll be like fireside chat or will you be giving a more formal heads review on just like the pipeline, or I guess, have you guys even given much thought to that, or has Cole just been slacking off?

Coleman N. Lannum

I think now is not the time to unveil the agenda there. We've got some new things that you haven't seen before. There'll certainly be some product offerings and pipeline updates. And I think we're also going to expand the amount of time that people have with the management team as well, that's always ended up being one of the more popular pieces of that meeting.

Kristen M. Stewart - Deutsche Bank AG, Research Division

Okay. Perfect as well.

Jose E. Almeida

Promise, we're not going to let -- we're not going to put through lectures.

Kristen M. Stewart - Deutsche Bank AG, Research Division

All right. Well, thank you, everybody for joining us and special thanks to you, Joe, for coming to the conference.

Jose E. Almeida

Thank you. Thanks for having me here.

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