Good day. And welcome to the ICU Medical, Inc. Q2 2021 Earnings Call. Today’s conference is being recorded. At this time, I’d like to turn the conference over to Mr. John Mills of ICR. Please go ahead, sir.

Thank you. Good afternoon, everyone. Thank you for joining us today to discuss ICU Medicals financial results for the second quarter of 2021. On the call today, representing ICU is Vivek Jain, Chief Executive Officer and Chairman; and Brian Bonnell, Chief Financial Officer. We wanted to let everyone know that we have a presentation accompanying today’s prepared remarks. To view the presentation, please go to our Investor page and click on Events Calendars and the presentation will be under the Second Quarter 2021 Events. Before we start our prepared remarks, I want to touch upon any forward-looking statements made during the call, including beliefs and expectations about the company’s future results. Please be aware they are based on the best available information to management and assumptions that are reasonable. Such statements are not intended to be a full representation of future results and are subject to risks and uncertainties. Future results may differ materially from management’s current expectations. We refer all of you to the company’s SEC filings for more detailed information on the risks and uncertainties that have a direct bearing on operating results and financial position. Please note that during today’s call, we will be discussing non-GAAP financial measures, including results on an adjusted basis. We believe these financial measures can facilitate a more complete analysis and greater transparency into ICU Medicals ongoing results of operations, particularly when comparing underlying results from period-to-period. We have also included a reconciliation of these non-GAAP measures in today’s release and provided as much detail as possible on any addendums that are added back. And with that, it is my pleasure to turn the call over to Vivek.

Thanks, John. Good afternoon, everybody, and we hope you and your families are well. With all the volatility in the broader environment over the last 18 months, our businesses in 2021 have been more normal than in a while. Except for a few regions in the United States and a few international geographies, our hospital customers are improving activity monthly as vaccinations have progressed. Like everyone in our industry, we want to start first by thanking all of our customers and their frontline workers for trusting us to serve you during these times and it’s been great to finally see some of our teams face-to-face around the world. Today, we hope for a shorter call as results were generally in line with our previous comments and not that much has changed, but we did want to comment on the intra-quarter trends of our business and the geographic flows of our business, provide an update on our normal housekeeping items, highlight our improving cash flow metrics, outline how we see the near-term business, articulate how we feel about our positioning in this environment, comment on the criteria by -- and comment on the criteria by which we are judging ourselves and talk a bit about capital deployment and how we think about that given the fluid environment. The short story on Q2 is as follows, as we described on the last call, we did see sequential revenue growth in our most differentiated business segments. On a year-over-year basis, this resulted in a reported sales increase of 8% globally or 5% constant currency, driven by market share gains in consumables, stable IV solutions, offset by prior year COVID-related surge purchases in IV systems. We finished the quarter with $311 million in adjusted revenue, adjusted EBITDA came in at $67 million and adjusted…

Thanks, Vivek, and good afternoon, everyone. To begin, I will first walk down the P&L and discuss our results for the second quarter and then talk a little about cash flow and the balance sheet. So starting with the revenue line, our second quarter 2021 GAAP revenue was $322 million, compared to $303 million last year, which is up 6% or 4% on a constant currency basis. For your reference, the 2020 and 2021 adjusted revenue figures, which exclude contract manufacturing sales to Pfizer can be found on slide number three of the presentation. Our adjusted revenue for the quarter was $311 million, compared to $289 million last year, which is up 8% or 5% on a constant currency basis. Infusion Consumables was up 23% or 18% on a constant currency basis. Infusion Systems was down 8% or 10% on a constant currency basis. IV Solutions was up 6% or 5% on a constant currency basis and Critical Care was up 2% or flat on a constant currency basis. As you can see from slide number four of the presentation, for the second quarter, our adjusted gross margin was 40%. This was in line with our expectations and represents an improvement of 2 percentage points to last year’s second quarter gross margin and 3 percentage points compared to this year’s first quarter. The higher gross margin reflects the benefits of favorable product mix from faster growth in our consumables business, along with higher volumes in our plants, offset somewhat by inflationary cost increases. Sequentially, two negative items from the last quarter did not repeat. The first is the impact from the annual scheduled maintenance shutdown of our Austin manufacturing facility, and the second is the additional manufacturing and distribution costs related to the February weather events in the south. During…

[Operator Instructions] And we will now take our first question from Larry Solow with CJS Securities.

Great. Good afternoon guys. Vivek, maybe you can just discuss real quick from a high level. You mentioned sort of elective surgeries and whatnot certainly coming back. But overall, utilization sounds like is it still a little bit a little volatile, more than you would like to see, obviously or are we pretty much back to normal with exceptions of some pockets here and there?

Yeah. Hi, Larry. Different answer depending on where in the world, so Asia for us, where we have high pump share in a few specific geographies. I will give one example, Philippines, right, has been very volatile, where it’s just literally shut down quickly. There’s a few spots like that. If that’s really a U.S. oriented question, I think, we probably…

Yeah…

We -- but for us on the systems business, half the business is outside the U.S. As it relates to the U.S. business, I think, we are probably a bit more optimistic than some of the broader commentary we heard out there. We think it is closer to normal. It’s not all the way back but it may just be 1% or 2% down to normal. There are different mixes of acuity, et cetera, around. But if you read the public hospital companies that have reported, clearly, most of them are stepping on the gas a bit, right? And that’s -- it’s felt to us, there’s been a little bit of a disconnect from what we have heard from all the suppliers on that. So I think we are probably more in line with what the at least the public folks on the hospital set are reporting.

Right. And the consumables growth, obviously, off a trough last year, but I think its 10% higher, I think, than your highest quarter sales, last -- I think, post-Hospira. So it sounds like its mostly sustainable, maybe we could -- maybe we flat line a little from this level or is there some catch-up in there, anything -- doesn’t sell anything unusual, right? Just more normalized demand?

I mean, I think, in the prepared remarks, the last sentence was, I think, we feel like we can stay at or above this level heading into Q3. There were competitive wins in there. So it wasn’t all just catch up and it obviously makes a big difference in margins, et cetera, right, so?

And how about that in terms of the competitive implementations, installations, is there some catch-up there or is that sort of correlate well with the pace of new business wins, is there any -- is that a little bit more choppy also?

I think a different answer by business unit there and so if you think about the consumables business…

Right.

… by and large, I think, we have gotten pretty good at installing with as efficient means as possible, whether that’s video, online, et cetera, with limited disruption at the customer site only when they really need it and request it. Still have to do some of it, much more invasive on the hardware side. As we talked about in the last call in March, we had a really good calendar set up for Q2. It mostly stuck together. That said, with what’s going on right now, again, disruptions are starting a bit. I think we still feel good relative to the size of our backlog. But that does have a little bit of volatility in -- you know the spots in the country where things are not moving in the right direction and some of those schedules are getting pushed at that.

Got it. And then just on gross margin, it sounds like maybe a little bit ahead of itself this quarter or things sort of aligned and there were no shutdowns, longer term do you think we can get back into at least the low 40s as your mix continues to improve?

I think, I will let Brian give his thoughts on this. I mean, I think, we have said on these calls, we are never -- it’s up -- we are never going to get back to that kind of 43, 44, where we were when we had a lot of high margin…

Right. Okay.

… solutions flying through, but we said the low 40s certainly was our goal, but it dependent on what we are installing on the hardware side. To the extent we are gaining share in there and driving more consumables and the regular consumables business is growing, it certainly puts us in the best position to do that. We had a lot of hits in the last few quarters in terms of weather events and volatility in production, so that all went away. We saw the plant shutdown. The other things that’s why Brian was reiterating the annual number there, but I don’t know, Brian, what else you would add to?

Yeah. No. I’d just reiterate for us, Q2 was fairly clean from a gross margin standpoint, and we have said that, longer term one of the drivers of improving our current consolidated gross margin rate is going to be mix and I think Q2 kind of showed just what impact having faster growth in consumables can have on our gross margins.

All right. Great guys. Appreciate the call. Thanks.

Thanks Larry.

We will take our next question from Matt Mishan with KeyBanc.

Great. Thank you for taking the question. Vivek, it seems like you have hit a point where you fixed mostly everything you really wanted to fix with this business and you have gotten through some -- just kind of major events over like the last couple of years. Just curious where is your primary focus from here, is it optimization of margins, revenue growth, like what is your balance sheet, capital allocation, look like where is your primary focus?

Thank you. Hey, Matt. It’s good question. One, I mean, I think we, the team, I mean, a lot of people have really worked hard to almost get back to that level of profitability, we had with a very different looking income statement with a very different looking revenue number from a few years ago. I think our priorities are equal. We still have to -- you create value by creating new markets. So the most valuable thing we do and these spots like on some of the dialysis spots or on oncology or some of the custom products, creating new markets is the most valuable thing we do. That’s our biggest priority. The second thing is the share gains across the different parts of businesses. It is a competitive market. I mean we can see it in the tension of all suppliers and we have to execute well to create value there. Third thing is we got to get new products in the market. We recognize we have been a little bit quiet on that, that’s intentional and I think that will start to become more visible. And then, lastly, it is capital allocation, because we are in a capital rich, so to speak, relative our market cap environment and we come from that background and so we do spend time thinking about that. It’s just a very unique time in the market, as you certainly can appreciate, right? I think it’s evenly among those four and my colleagues across the company, they have another one, right, which is always ever present, which is just serving the customer well. That is really why we have been able to call a lot of this thing back to the quality and the book we have. We are very, very focused on growing and protecting it.

Okay. And that leads to my next question, I think, what -- we are likely to get, I think, and your team is likely to get a lot of questions around what happens when competitors launch new pumps and another one gets back on the market more effectively versus medical necessity. Just first, could you just help explain what percentage of your sales are actually tied to that capital purchase? And then, just secondly, do you feel like you can defend your position in any gain share in a more competitive market?

Yeah. Sure. It’s a great question and one that we think about. When we got into this four years ago, we bought a business that had lost half of its market share in IV pumps, maybe a bit more. And we also entered a moment where a lot of the technology that they had out there that ultimately we have out there was not new. It was old technology that was easy to pick off. The first act was sort of refreshing the installed base with the latest technology app. So we did that virtually all of our customers and this is more of a U.S. answer globally, the business kind of sets up a different way. Virtually all of our U.S. customers, for the most part, are holding newer technology. So in terms of going backwards and taking our installed base from us, which is what was happening, I think we believe that’s a harder thing to do and we have gotten deeper with those customers across the broader categories. Going forward, we need to continue to articulate our value proposition on the quality of the technology, on the economics around the product to keep taking share. Again, we are pretty small. Of our -- to get to the second part of your question on the numbers, our IV systems business is 50%-ish or so OUS and 50% U.S. and so we don’t need a lot to keep us moving in the U.S. market if we are holding on to our base reasonably well. And so we think there is a case to find those customers who do want to make a change and we -- at some point, we will get out here and talk openly about numbers and installed base and stuff and I think that will show that there is market to take. It’s obviously going to be more confusing for a customer, but it’s also a good time for customer. We have three or four choices and we have a lot of products around this area that drives clinical value, and we just need to market and execute commercially.

And when you think about...

And I guess, the last point -- Matt, the last point I’d make there, sorry, just having been around this stuff for a long time. Infusion moves pretty slowly, right? It takes a long time to have market share changes or new entrants come into new products. It’s great that there’s innovation. I think it’s great for patients, great for our providers, but things don’t move that fast.

Okay. And then just when you think about the portfolio cleanup, the ambulatory and the declines in the PCA. How much further does that have to go, and I guess, how much opportunity is it for you guys when you are starting from a very low base to go after those complementary markets with the LVP?

I mean the money in the infusion hardware business, right? The money is in the LVP business largely. Ambulatory has some economic value around it. The other pieces don’t have that much economics associated with them. So it’s really what do you need to deliver it to the customer with. There are ways to participate in those markets, and as you can imagine, we have been thinking about those questions for many, many years, and if there’s economically sensible way to participate in them we will.

All right. Thank you very much.

Thank you, Matt.

And our last question will come from Jayson Bedford with Raymond James.

Hi. Good afternoon. I have a few questions on different topics. Just on the capital deployment, Vivek. I think you mentioned you are trying to do some things in a tough market. You also mentioned you may have to do some traditional things. Can you just expand on those comments and maybe kind of define traditional?

Yeah. I mean, I -- it’s not lost on us, Jayson, relative to our market cap. We are -- at some point, I am not saying it’s today, but at some point, we are probably carrying a bit more cash than we would responsibly need between leverage and the equity we could issue and cash to meet our strategic objectives. So the natural thing would be to think about could you put that money first back into your business? I mean, we put a ton of CapEx in the last four years. We have really sharpened and solidified the production network. But the first question we ask, can we put that capital back into the business? Saying we deploy it toward customers to grow the business, that’s the most interesting, then can we put it to help grow the company in adjacencies. And if you can still do all of those things, and the obvious question is how do you think about returning some capital? We are not there yet, frankly, very few -- almost none, really one person only ask us about it, but it’s not lost on us. I am just saying, we know what we are supposed to do.

Okay. And the expectation should be that we should start to see some more active capital deployment by year end. Is that a fair expectation?

No. I was trying to say, as we roll into next fiscal year, we will have probably a more formal capital allocation strategy than we have today, because people are going to be wondering, given the cash balance and where it sits.

Okay. Okay. Just a couple of product category related questions, just on oncology, it seems like its back up and running as a growth category. Can you just remind us where you think adoption is both in the U.S. and OUS?

Ballpark, it’s probably 65% or so converted globally. So there’s still a decent sized market to go out there and get and then there’s also trading in existing accounts between the various suppliers. So there’s room -- there’s headroom left and the way we are delivering the products, we try to keep expanding the SKUs and the use cases. So we are trying to grow the market just follow the needs of the customer. There is headroom.

The U.S. relative to that 65% kind of worldwide conversion, is it higher or lower?

I think they are both in line.

Okay.

I mean, if you look at our estimate of the market size, you look at some of the other market participants, the other market participants probably have a larger estimate of the overall market size and we know we would be delighted if that’s the case, that would be implying less than 65% converted, but that’s at our speech.

Right. Okay. And just on the pump side of things, I think you entered the year with, I think, your words were over 100 basis points of committed share gain. How much of that have you been able to deploy or recognized here in the first half of 2021?

Yeah. I guess, I -- it’s a little bit of an easier answer just to kind of go back to the math in the script that we were illustrating there, which is we have had $35 million of non-ambulatory products go away in the segment. The segment is maybe $10 million less this year or so ballpark than the originally when we bought the business. So that would imply a couple of points of market share have been clawed back through today. That’s sort of how the math works. I don’t want to get into exactly what was installed in any given quarter. We were just trying to say, we felt we are holding as much backlog starting in Q3, as we were holding a start in Q2, which we have continued to refresh the pipeline, which is good.

Okay. And do you still -- do you feel like you are still gaining additional share with, I don’t know, like get into every month here, but do you feel like you captured some additional share here in 2Q?

Yes. I think we had some good competitive signings we like, yes. That’s why we could say we feel like the backlog was okay at the beginning in Q3. I mean, to the question that was just asked, of course, it will be more competitive when more people have new things, but you have to fight through that, that’s business.

Right. Okay. That’s it for me. Thank you.

Good to talk to you Jayson. Thanks.

And that will conclude our question-and-answer session for today. I’d like to turn the conference back over to Mr. Jain for any additional or closing remarks.

I hope everybody is having a good summer. I hope folks get a little bit of time off. Thanks for your support and we will talk to you soon. Take care.

And once again that does conclude today’s conference. We thank you all for your participation. You may now disconnect.