Earnings Labs

Abbott Laboratories (ABT)

Q2 2017 Earnings Call· Thu, Jul 20, 2017

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Transcript

Operator

Operator

Good morning and thank you for standing by. Welcome to Abbott’s Second Quarter 2017 Earnings Conference Call. All participants will be able to listen-only until the question-and-answer portion of this call. [Operator Instructions] This call is being recorded by Abbott. With the exception of any participant’s questions asked during the question-and-answer session, the entire call, including the question-and-answer session, is material copyrighted by Abbott. It cannot be recorded or rebroadcast without Abbott’s express written permission. I would now like to introduce Mr. Scott Leinenweber, Vice President, Investor Relations.

Scott Leinenweber

Analyst · Bank of America Merrill Lynch. Your line is open

Good morning and thank you for joining us. With me today are Miles White, Chairman of the Board and Chief Executive Officer; and Brian Yoor, Executive Vice President, Finance and Chief Financial Officer. Miles will provide opening remarks and Brian will discuss our performance and outlook in more detail. Following their comments, Miles, Brian, and I will take your questions. Before we get started, some statements made today may be forward-looking for purposes of the Private Securities Litigation Reform Act of 1995, including the expected financial results for 2017. Abbott cautions that these forward-looking statements are subject to risks and uncertainties that may cause actual results to differ materially from those indicated in the forward-looking statements. Economic, competitive, governmental, technological and other factors that may affect Abbott’s operations are discussed in Item 1A, “Risk Factors” to our Annual Report on Securities and Exchange Commission Form 10-K for the year-ended December 31, 2016. Abbott undertakes no obligation to release publicly any revisions to forward-looking statements as a result of subsequent events or developments, except as required by law. Please note that second quarter financial results and guidance provided on the call today for sales, EPS and line items of the P&L will be for continuing operations only. On today’s conference call, as in the past, non-GAAP financial measures will be used to help investors understand Abbott’s ongoing business performance. These non-GAAP financial measures are reconciled with the comparable GAAP financial measures in our earnings news release and regulatory filings from today, which are available on our website at abbott.com. Unless otherwise noted, our commentary on sales growth refers to comparable operational sales growth, which adjust the 2016 basis of comparison to include results for St. Jude Medical and to exclude the impact of exchange, as well as current year and historical results for Abbott’s Medical Optics and St. Jude’s vascular closure businesses, which were divested during the first quarter of 2017. Comparable growth also reflects a reduction to St. Jude’s historical sales related to administrative fees paid to group purchasing organizations in order to conform with Abbott’s presentation. With that, I will now turn the call over to Miles.

Miles White

Analyst · J.P. Morgan. Your line is open

Okay. Thanks, Scott. Good morning. Today, we reported ongoing earnings per share of $0.62 which exceeds our previous guidance range and reflects double-digit growth. Sales increased 3% on a comparable basis in the quarter and we continue to expect accelerated sales growth in the second half of the year. We started the year targeting double-digit EPS growth and we’re adding to it today by raising midpoint of our full year adjusted EPS guidance from $2.45 to $2.48, which represents 13% growth over last year. Halfway through the year, we’re on track with all of our key priorities. The integration of St. Jude continues to go well and we’re right on track with our deal model and projected synergy targets. We’re also right on track in terms of our new product launch expectations, which includes bringing our MRI compatible rhythm management devices to the U.S. During the first half of the year, we received FDA approval for our MRI compatible pacemaker and we completed regulatory submissions for our MRI compatible defibrillator devices including submission of our CRT-D device in June. We’ve also seen significant growth contributions from several recently launched products across our portfolio, which I’ll highlight, as I summarize our second quarter results in more detail before turning the call over to Brian. I’ll start with diagnostics where we achieved sales growth of 5.5% in the quarter. Growth was led by strong performance in core laboratory and point of cure diagnostics. This business, which is already a global leading and growing faster than its market, is in the early innings of significantly enhancing its competitive position with the launch of Alinity, a highly differentiated and innovative suite of new systems across all areas where we compete. During the quarter, we achieved CE Mark approval for Alinity hq, our new hematology…

Brian Yoor

Analyst · J.P. Morgan. Your line is open

Okay. Thanks, Miles. As Scott mentioned earlier, please note that all references to sales growth rates, unless otherwise noted, are on a comparable basis, which is consistent with the guidance we previously provided. Turning to our results. Sales for the second quarter increased 2.9% on an operational basis. Excluding the transitory impact of the new goods and service tax system implementation in India which lowered our sales in our established pharmaceuticals, total operations sales would have grown 3.7% in the quarter, which is in line with previous guidance. Exchange had an unfavorable impact of 1% on total sales, resulting in reported sales growth of 2% in the quarter. As you know, exchange headwinds have eased somewhat since the beginning of the year. I’d note that the majority of the lower foreign exchange impact on our sales has been driven by strengthening of the euro and other developed market currencies. And when these particular currencies move, the follow-through impact on our result is relatively modest, taking into account our European cost base and our hedging programs. Regarding other aspects of the P&L, the adjusted gross margin ratio was 59.8% of sales. Adjusted R&D investment was 7.5% of sales, and adjusted SG&A expense was 30% of sales. Before I review our financial outlook, I’d note that our sales and adjusted earnings per share forecast do not include any contribution associated with the Alere acquisition, which is expected to close by the end of the third quarter 2017, subject to certain closing conditions. As previously communicated, we will provide an update regarding expected financial impact of this transaction at a later date. So, turning to our outlook for the full year 2017, we are raising our adjusted earnings per share guidance range to $2.43 to $2.53. We continue to forecast full year 2017…

Operator

Operator

[Operator Instructions] And our first question comes from Mike Weinstein from J.P. Morgan. Your line is open.

Mike Weinstein

Analyst · J.P. Morgan. Your line is open

Thank you for taking the questions. Maybe a couple of quick ones to start with. So, first, the FX delta since the start of the year, Brian, what does that mean to EPS? I know you moved your guidance since. Is that the full impact of the EPS swing from FX or is there a greater impact or are you giving yourself more push? And then, second, Miles, could you just spend a minute on the adult nutritional business? We focused so much time on pediatric at the U.S. adult business, has been disappointing so far this year. Probably you could spend a few minutes talking about why that is and kind of what drives the turn around.

Miles White

Analyst · J.P. Morgan. Your line is open

Okay. Brian, do you want to talk FX first and then…

Brian Yoor

Analyst · J.P. Morgan. Your line is open

Yes. Mike, I would say that 3 -- and we acknowledged in the first half, maybe $0.02 or $0.03. And could it be a little more? Yes, if rates continue to hold. It depends on the mix of currencies. But right now, we’re not factoring that in because that’s getting down to a level of precision that for a penny or two, we’re just not ready to project that yet, as we don’t want to necessarily forecast the mix of currency changes the rest of the year.

Miles White

Analyst · J.P. Morgan. Your line is open

Okay. Then, U.S. adult nutrition, I agree with you, Mike. We’re disappointed too. And I would say, what we’re seeing -- first of all, I commented in my remarks that we’re seeing softening markets worldwide here, at least in a lot of markets. And as I’ve looked at a lot of the data, first, the volume rates are all still there; it’s mostly loss of pricing power in some of these markets. And we see the same phenomenon in both ped and adult nutrition. In the U.S., it’s a little different version than other markets. In the U.S., we’re seeing a fair amount of intensity around private label competition. And every few years, this will happen. We got a competitor in U.S. in Nestle that is also feeling the same pinch, as we look at our market data. We know that the competition right now is private label and there is contingence and the way private label is being marketed I guess on the shelf and so forth in terms of its positioning, proximity to our brands and so on. So, we’re seeing some of the impact of that. It’s something we’re addressing. Every few years, we see private label crank up and then it subsides again. Right now, we’re having one of those years when we see a lot of intense pressure on that particular segment, and that’s taken some of the growth off that. Last year and year before, both we and Nestle invested in the category. And when any of us invest in the category, all of us benefit. As soon as that larger investment sort of subsided, the private label cranked up and went right back at it. So, it’s kind of an ebb and flow thing, but it’s definitely taking an edge off the growth that we’ve seen historically. We’re aware of it, we know it, we’re taken the actions we think we can and should to mitigate and deal with it, try and correct it and so forth. But that’s what the intensity that’s coming from.

Mike Weinstein

Analyst · J.P. Morgan. Your line is open

Okay. And then just one quickly follow on Libre. You didn’t give us much of an update on the U.S. I know inter quarter miles and we’ve talked about this; you started a couple of trials to confirm the accuracy of Libre to the FDA. Does that mean that approval is likely more like yearend or early next year? And do you have any sense of whether the FDA has gotten comfortable with the idea of a factory calibrated device?

Miles White

Analyst · J.P. Morgan. Your line is open

Well, there’s been a lot of conversation back and forth with the FDA. We’ve explained to the FDA how our factory calibration is done. And I think that conversation has gone well. I never want to predict the FDA. I think we have what we consider to be a fairly proprietary process for this factory calibration. So, it’s not something we are anxious to share widely. And it’s unique. So, I guess I’m not surprised that it needed further discussion. But I think that’s gone well. I don’t know that I can predict at all, Mike, when the FDA will come to a conclusion of its process. It was submitted almost a year ago. So, we are coming up on a date here, an annualized date. But, I don’t have any evidence that says, gee! It’s going to be a year end or longer. So, I don’t know that I could -- I certainly wouldn’t say that because that may not be true. So, I don’t have that common indication. And I would say look, there is good, active, ongoing dialogue back and forth. That’s always a good sign. It’s the right kind of dialogue. I just wouldn’t forecast it. I don’t know.

Operator

Operator

Our next question comes from Matthew Taylor from Barcalays. Your line is open.

Matthew Taylor

Analyst · Barcalays. Your line is open

The first thing I wanted to explore was you mentioned in your opening remarks, thinking about your MRI safe device approvals in the U.S. is being on track. And I was hoping you could talk about, not the submission but what’s going on with Sylmar, any progress you have made there and confidence that you can get timely approvals, just given what we have seen with the warning letter?

Miles White

Analyst · Barcalays. Your line is open

Yes. No problem. Thanks for the question, Matt. First of all, with regard to Sylmar, we are making good progress. And I don’t mean that just in a generalization. We had a very detailed plan that we shared with the FDA of course after we received the warning letter. The good news is, as I mentioned in previous call, we have been in Sylmar with the St. Jude management since August of last year. And St. Jude was very open to us and allowed our quality operations, GMP people and so forth in to participate with them. So, we have been working with them on a lot of issues, questions, processes and so forth in Sylmar for a year now. And that is a huge positive because it gave us a real running head start on things the FDA observed when did it inspection early in the year. So that gave us a big lead. So, we have the ability to put before the FDA a very comprehensive plan of corrective actions, remediations et cetera at the site. And that plan is nearly complete. So, we are coming up on -- we will put all the things in place, change processes and so forth that we needed to change. That’s all positive. We will be updating the FDA on that in the coming weeks. I won’t give you a specific date, because I don’t want to create a trigger here. But I would say, look at this point, we are absolutely on schedule with our own pace. And it was seem as if we did it rapidly. The fact is, it will be about a year and all by the time we are done here. But relative to the timing of the warning letter itself, it was seem like a…

Matthew Taylor

Analyst · Barcalays. Your line is open

Thanks for the feedback on that. So, one other area I wanted to ask you about that has been very active is in diagnostics for the Alinity launches outside of the U.S. I guess the core of my question is I was wondering when you think we might start to see a pickup O-U.S. growth from those launches. I know it’s kind of a slow battleship that’s turning here through your install base. So, when could we actually see some pickup, and how much might that be?

Miles White

Analyst · Barcalays. Your line is open

Well, let me just correct one thing that you might have inadvertently said. You said when do we see the growth in the U.S.? U.S. won’t start launching until next year but they’ve been in effect and licensed and launched in Europe. So, let me respond to Europe. And frankly, the question you’re asking is the same one I keep prodding our management with. And I do that just to keep the feet to the fire. But, the launch itself is going well. And customer response has been very positive. We’re taking what I would call a fairly systematic and careful and methodical approach. Because when you launch new systems, you don’t want your customer to have to debug something in the field. You want it to go to the field day one. And the history of launches of instruments in diagnostics in general as an industry has not been that. As you may know, I used to run that business years ago before I was the CEO of the Company and was responsible for R&D at point When we launch systems, you get so much data, so much use early on from your -- clinicals but you tend to find all the little bugs you missed in development. So, when we launch products or systems in diagnostics, you’ve got a big installation or big changeover from their current systems and so forth. So, it does take time. And because of those early installations are where you do a little bit of your learning, you want it to go well. So, I would say I give them that slack early on in the launch in terms of early, slow, methodical, careful whatever and yet there has actually been really good order activity, really good uptake. We’re on track I would…

Operator

Operator

Our next question comes from Rick Wise from Stifel. Your line is open.

Rick Wise

Analyst · Stifel. Your line is open

Let me start with a Alere, which seems to be marching toward completion here. A couple of things. We saw an asset sale announced. Is that it? Is there more to come? And maybe, I know it’s early and I know you would like to be conservative. But, can you just help frame in those general sense, is it fair to assume that Alere is neutral this year to EPS? How do we think about it just directionally, broadly in 2018? Is it neutral, is it accretive, is it dilutive? Any color would be really helpful? Thank you.

Miles White

Analyst · Stifel. Your line is open

I assumed somebody would ask that. Well, couple of things. First of all, there is one more asset sale that has not been made public. It was one that was required by the regulatory bodies for antitrust proposes and so forth. And we’ve got a good buyer, good price et cetera. The other party just hasn’t said anything publicly. So, we don’t want to say if they haven’t said it. But yes, there is one more and it’s modest in size. But, it’s on track. I don’t see any hiccups with it or anything. It just hasn’t been made public. And I expect that that will be soon. And that’s progressing really well. I would say, we are very happy with the status of divestitures for antitrust purposes, where that stands. We are happy with the buyers; we are happy with price; we are happy with transition, plans and so forth. That’s all good. We are in fact, I would say, racing toward close. I’m anxious to get it finished and I’m quite confident that it will. At this point, I would love to have one of those surprises you didn’t expect where all of a sudden regulatory bodies approved it and you weren’t ready but we are ready. And we have named our transition team internally here at Abbott and how we are going to manage it, how we are going to integrate it and so forth. Those plans are all very well underway. And so, we are prepared for that and ready to go. With regard to this year, I had indicated and I would continue to indicate, neutral. I wouldn’t plan for any accretion. I think because this particular deal has gone on so long, I am reluctant to make projections about accretion. As we are into…

Rick Wise

Analyst · Stifel. Your line is open

That’s really helpful. And just on a separate topic. One of the compelling aspects of combining St. Jude and Abbott on the device side, it does seem to be -- obviously be the compellingly broad portfolio. Can you talk, Miles, a little bit about the progress you’ve made on the contracting side, dealing with large hospitals, large integrated delivery networks, GPOs et cetera, presenting the whole bundle, just progress you’ve made broadly since post merger? And do you see that contributing to growth in 2017 and 2018 that aspect of the story? Thank you very much.

Miles White

Analyst · Stifel. Your line is open

Yes. Thank you. I’d say, since we announced the acquisition a year ago, St. Jude had already started to make changes in the way it approached large national account type organizations in United States. And we with them took that further. There were some promotions, management hires, new changes, new changes in the way we went to market at St. Jude; we contemplated the, call it the full offering across our product lines. And I’d say, we’ve made terrific progress internal in our approach to St. Jude. We have had some success. We’ve had a lot of positive reaction from customers, in general, positive reaction to Abbott, positive reaction to the breath of product line, positive reaction to St. Jude’s pipeline and the products that are coming. So I would say all in all, I think all that’s been really good. I also would stress, a lot of times when people refer to bundling with large national accounts, hospital groups and so forth, there is a presumption of one product line subsidizes another and there is leverage in that. And while that’s true and can be true, there is also a greater positive synergy of the full offering, the full service level, and the service and account gets across product lines. And as you know, these large integrated health groups, they don’t want to deal necessarily with five or six suppliers in a given area; they generally deal with two or three. And we are finding that in the mix, in the breadth of our portfolio, one of the places it really benefits us and St. Jude is that it’s very easy for us to be one of the two. And it’s a lot easier when you got the broad product line, when you got innovation with those product lines,…

Operator

Operator

Our next question comes from Glenn Novarro from RBC Capital Markets. Your line is open.

Glenn Novarro

Analyst · RBC Capital Markets. Your line is open

My first question is on the cardio and neuromodulation line. It came in better than expected, and I have got to believe that’s function of St. Jude. So, Miles, can you comment on how St. Jude performed in the quarter? What was the growth rate that the St. Jude business in total deliberated in the second quarter? Thanks.

Miles White

Analyst · RBC Capital Markets. Your line is open

Yes. St. Jude, if we carve them out standalone, was up by 4%. And if you recall, before we acquired St. Jude, its prior -- or before we announced the deal, its prior four years have been flat. And we discussed how we thought over that period of time. They’d made great investments in their product pipeline across their businesses, their internal organic R&D I thought had been very productive and very successful, so had they. And it was a point of quite a bit of, let’s call it, negotiation during the deal process. They had rather robust forecast for their sales going forward. And of course that ultimately is part of a whole negotiation. I would say this, their representation about their pipeline I thought was valid and proves to be. And as I have said before, both in the calls we’ve made about the deal itself or in our quarterly earnings calls, our forecast or our deal model was built on the expectation of sequential improvement in their sales going forward due to first of all, correcting the MRI compatible issue, which is well-underway; and then the launch of a lot of new products, and we’re seeing that. And then frankly, in our own deal model, we had pretty much aligned it with what analysts collectively viewed as how St. Jude would look going forward. And so far, the expansion of the growth rate and its sequential performance quarter to quarter has been on our deal model and is steadily growing. And we estimated in our deal model, they get up to 4.5%, 5%, something like that and this quarter they were at 4%. And each quarter is successively better than the last. We’re seeing improvement in CRM and we’re seeing share recovery with the low voltage pacemaker. As I mentioned, I guess it was at the end of the first quarter, St. Jude, we estimated lost about, I think it was 7 points of share in the low voltage pacemaker business last year between April and December and in the first two months or three months here of launch with the MRI compatible claim, they’ve regained 4 of those share points already. So, we’re seeing quarter to quarter sequential improvement in share in CRM; you can see it in the growth rate comps; it’s getting better and better and quarter to quarter. We expect that to continue. New products launches are occurring according to expectation. I think the whole thing is remarkably going according to our deal model, according to our forecast and according to what we told analysts. And right now, I think the quarter of 4% out of St. Jude is pretty good thing.

Glenn Novarro

Analyst · RBC Capital Markets. Your line is open

Yes, I agree. And then, just I don’t know if you or Brian have these numbers, but just as a follow-up, would you be able to give us your U.S. and worldwide pacing growth and U.S. and worldwide ICD and CRT growth? Thanks.

Miles White

Analyst · RBC Capital Markets. Your line is open

I don’t think I can do that right this minute. You prepare a lot of things for these calls. That’s one I don’t have at my fingertips. We can probably follow up with you Glenn.

Operator

Operator

Thank you. Our next question comes from Larry Biegelsen from Wells Fargo. Your line is open.

Larry Biegelsen

Analyst · Wells Fargo. Your line is open

I wanted to ask one about how to think about Q3 given some of the onetime items in Q2. And then I have product related question. So, I think it was 2.9% growth in Q2 on a comparable pro forma basis, but I think you had an 80 basis-point hit from headwind from EPD, and I think you had about a 50 basis-point hit in vascular from the royalty. So, is the starting point really about 4.2%, 2.9 plus 1.3 and we get back the 80 bibs or about the $50 million loss in EPD from the general services tax in Q3? And I had one follow-up.

Miles White

Analyst · Wells Fargo. Your line is open

Yes. I would say a couple of things. First of all, what you describe there, the ins and outs going into the third quarter, you’re right, and that’s a good assessment. And your assessment of, I think it was a little bit better than 4%; I think that’s a good assessment too. With regard to EPD, this Goods and Services Tax in India, as you -- I think others have already noted, clearly impacted the second quarter. I think it’s been hard for everybody to forecast how it’s going to come back in the third quarter. In the first couple of days of the quarter, we saw a clear response to restocking by distributors, and then it softened for a couple of days, and then it came back again for a couple of days. So, we are seeing it restore. Whether we will see it completely restore in the quarter, I don’t know, but so far so good. It’s going according to what we projected. So, whether it will come back like full dollar per dollar, I don’t know, but so far it looks that way. And I would say so far projections look good that way to truly be a quarter-to-quarter shift. And that’s kind of the experience we are seeing thus far.

Larry Biegelsen

Analyst · Wells Fargo. Your line is open

And then, Miles, XIENCE has been an amazing product, but given the issues with Absorb, do you feel -- what is the pipeline, the long-term strategy there? Do you feel you need a drug eluting stent with the bioabsorbable polymer, similar to Boston Scientific SYNERGY, which seems to have been successful? Thanks for taking the questions.

Miles White

Analyst · Wells Fargo. Your line is open

Yes, I’ll tell you what, Absorb has become a very much in niche product; that’s for sure. And I would have wished for it to be a lot bigger than that. But XIENCE remains best-in-class stent. That’s still true. Do we need a bioabsorbable coated stent? I’ll tell you, I think the bigger issue is I think we need an even more deliverable stent. The issue right now with physicians is deliverability. And I think that’s been one of the hallmarks of Boston SYNERGY stent is the deliverability. So, I think the issue is more the deliverability than the coating. And we will launch early next year, Sierra, next generation of XIENCE, which will address that. So, that’s what I think is our single -- most important focus right now. Do I think long-term that there is still improvements and performance improvements and so forth to make in stents, whether it’s coating or material or deliverability et cetera? I do. I am not going to detail what that plan is from our standpoint, but our next focus in stents is primarily that deliverability with Sierra.

Operator

Operator

Our next question comes from Robert Hopkins from Bank of America Merrill Lynch. Your line is open.

Robert Hopkins

Analyst · Bank of America Merrill Lynch. Your line is open

I appreciate the opportunity to ask a question. So, just I’ll start with the product question. I just want to be clear on MRI, the outlook for MRI safe for ICDs. What is the latest official guidance on when you expect that to come to market? And do you have a sense for whether you’ll need a warning letter to be lifted to get that through?

Miles White

Analyst · Bank of America Merrill Lynch. Your line is open

The warning letter doesn’t have to be lifted. The FDA has the ability, if it chooses to, to license it if they’re satisfied with remediation actions and so forth. They always have that ability. So, it’s not dependent on particular formal lifting of warning letter. At the same time, the FDA always has the right to decide what it wants to do. And I would say with regard to expectations at this point, we’ve said second half or a year-end and I think that’s probably, for right now, at least as modeling and planning purposes go, probably fine assumption. I can’t be more specific than that because I can’t read their minds and don’t want to forecast and put them in a tough spot. So, I would say, as far as modeling goes, model second half somewhere and year end, but I don’t know that I can give anything more precise than that.

Robert Hopkins

Analyst · Bank of America Merrill Lynch. Your line is open

Okay. That’s helpful. That’s 2017 obviously, right?

Miles White

Analyst · Bank of America Merrill Lynch. Your line is open

Yes.

Robert Hopkins

Analyst · Bank of America Merrill Lynch. Your line is open

And then one another, Miles, bigger picture question on the outlook for revenue growth for Abbott, because when you look through your results here this quarter, one thing you notice is that if you look at your different businesses, there is a very wide range of growth rates with some businesses like neuromod, just doing extremely well and other struggling a little bit. If we think about 2018, there is some strong incremental drivers of growth and there is something like neuromod that will probably slow a little bit. So, when net all that out, do you think as we kind of look forward into next year that you can again start to talk about Abbott again as something better than a mid single digit revenue growth company?

Miles White

Analyst · Bank of America Merrill Lynch. Your line is open

Well, I think that depends on a whole lot of things including the businesses. I think it depends on what’s happening with global markets et cetera. I mean that’s always our goal. In our goal, we always start every year with the notion that we are going to grow profits double digits. And to do that, you’ve got to have fundamental revenue growth, as you know. And as we look at the mix of the business, I think the observation you make is correct. I mean, I’d love it if everything grew like neuromod, but it doesn’t. And there are some of these businesses that I would say are much more mature, like CRM and even the stent business, much more mature. The good news about those businesses is, they are extremely profitable and they generate high cash flows. So, in the mix of our portfolio, that’s positive, that’s a good thing. On the other hand, if you’re maintaining a growth profile, you’ve got to have lean toward growth in the mix. And we’ve got a pretty good lean toward growth, I would say of late. The one that’s got my attention from a longer term perspective is nutrition, particularly internationally and what I’ve seen there is a slowing. I think that business longer term or at least on a stable basis for now, looks like it’s going to be a low to mid single digit business, call that 3 to 5, something like that, 3% to 5%. But that’s a mix. There are some countries that are 1% or 2% or some countries and geographies that are double digits. The global volume growth in that business for infant formula for example, tends to be 3% to 3.5% and the biggest change in the growth has been price. Not that…

Scott Leinenweber

Analyst · Bank of America Merrill Lynch. Your line is open

We’ll take one more question, operator.

Operator

Operator

Thank you. And our final question comes from David Lewis from Morgan Stanley. Your line is open.

David Lewis

Analyst · Morgan Stanley. Your line is open

Brian, just a couple of quick ones for you and then one strategic one for Miles. So, just a couple of incremental financial questions. The incremental change to gross margin in the guide of 50 basis points, what was driving that? And then, as you just thinking about the pacing of the back half of the year, obviously you’re guiding to improvement in the third quarter. Is the right way to think about it that back half is going to be mid single digits and obviously better than the first half or do you think the business gets a little better in the fourth quarter from an organic growth perspective than the third? And just a quick one for Miles after that.

Brian Yoor

Analyst · Morgan Stanley. Your line is open

I think to your last question, you will see sequential improvement from Q3 to Q4. There is a lot of items that Miles talked about in the acceleration, including new products and just the momentum of our businesses. So, I think that’s the fair assessment. With respect to question on gross margin, our operational improvements and gross margin underlying continue to be there that we’ve talked about it before. You do get a little noise around the mix of FX and what that does, and that’s a simply math there. Nothing has changed about our aspirations to continue to expand our gross margins on an underlying basis, probably 50 to 75 basis points on that, David.

David Lewis

Analyst · Morgan Stanley. Your line is open

Miles, just thinking about the strategic importance of the Bigfoot announcement and I don’t want to make too much of a single investment. But just as a natural extension of building the brand and the reach of Libre and CGMS, or does it suggest an interest in pumping? And maybe said another way, I mean do you think to win in diabetes going forward, do you need to have an integrated pump and sensor under one roof?

Miles White

Analyst · Morgan Stanley. Your line is open

No, I would say, in the grand scheme of things with diabetes care, I don’t think we need to have a pump. But, I think there is a strategic, what would I call it, change happening or there will happen over the next couple of years in the market, particularly for type 1 diabetics and for multiple daily injectors which could be type 2s that are insulin-dependent. And what’s interesting about Bigfoot is they are taking a different approach to the ease and the integration of what those multiple daily injectors have as solutions to manage their disease, separate from pumping. And it’s a fairly clever service and approach that I think will create, not just an alternative that makes the management of the disease or management of someone’s insulin easier but I think the value proposition of it is going to be pretty compelling. And I think that will change the competitive dynamics in that realm that is pumping. I mean the penetration of pumps or pumping relative to the market size of multiple daily injectors is really quite small. You would say wow! There is a lot of potential for further penetration. The question is the value proposition. A lot of times, the reason it hasn’t penetrated further is, it might be too costly or viewed that way. And I think what Bigfoot’s doing, if I could comment on it from a distance, because I’ve never had a conversation with them myself, is they’ve come up with a pretty unique value proposition that not only is good from the standpoint of the patient or even the payer, but also in general, in the cost of managing the disease for a diabetic. I think it’s a pretty interesting use of technology to make it simpler, easier and affordable. Now, I probably sound like a brochure from them. I think it’s -- I just think that their approach is interesting. And in our case, the technology that is Libre is a component of that and a fairly compelling piece of it that expands the use of Libre beyond what Libre can even do today. And then beyond that, there is other expansions and improvements to Libre that aren’t just in that segment. But I think that the sensor technology and the nature the way Libre works has a lot of applications beyond how it’s used today. And the Bigfoot approach is just one of those. And I think it’s a pretty unique, compelling idea that puts Libre as a part of the competition in that sort of pumping or multiple daily injector world. It’s a great opportunity for us and I think it further enhances the management of the disease for patients.

Scott Leinenweber

Analyst · Morgan Stanley. Your line is open

Good. Thank you, operator, and thank you for all of your questions. And that concludes Abbott’s conference call. A replay of this call will be available after 11 am Central Time today on Abbott’s Investor Relations website at abbottinvestor.com, and after 11 am Central Time via telephone at 404-537-3406, passcode 41003454. The audio replay will be available until 4 pm Central Time on August 2nd. Thank you for joining us today.

Operator

Operator

Ladies and gentlemen, thank you for participating in today’s conference. This does conclude the program and you may all disconnect. Everyone have a wonderful day.