Integer Holdings Corporation (ITGR) Q4 2025 Earnings Report, Transcript and Summary

Good morning, and thank you for standing by. Welcome to Integer Holdings Corporation's Fourth Quarter 2025 Earnings Call. My name is Audra, and I will be your conference operator today. [Operator Instructions] Please note, this call is being recorded. I would now like to turn the conference over to Kristen Stewart, Director of Investor Relations. Please go ahead.

Good morning, everyone. Thank you for joining us, and welcome to Integer's Fourth Quarter 2025 Earnings Conference Call. With me today are Payman Khales, President and Chief Executive Officer; and Diron Smith, Executive Vice President and Chief Financial Officer. This morning, we issued a press release announcing our fourth quarter and full year 2025 results. We have posted a presentation to accompany today's call on the Investor Relations page on our website at integer.net. On today's call, we will provide an update on our strategy, review our adjusted financial results for the fourth quarter and full year 2025 and discuss our financial outlook. After our prepared remarks, we will open up the line for your questions. As a reminder, the results and data we discuss today reflect the consolidated results of Integer for the periods indicated. During our call, we will discuss some non-GAAP financial measures. For reconciliations of non-GAAP financial measures, please refer to the appendix of today's presentation, today's earnings press release and the trending schedules, which are available on our website at integer.net. Please note that today's presentation includes forward-looking statements. Please refer to the company's SEC filings for a discussion of the risk factors that could cause our results to differ materially. With that, I will turn the call over to Payman.

Thank you, Kristen, and thank you to everyone for joining the call today. This morning, we announced our fourth quarter and full year 2025 financial results. Through diligent execution, the Integer team delivered sales and adjusted EPS towards the high end of the outlook range we provided in October. For the full year, sales increased 8% on a reported basis and over 6% organically and adjusted operating income increased 13%. Adjusted EPS increased 21%, reflecting the higher sales, improved profitability and effective capital management. In the fourth quarter, we repurchased $60 million of our common stock. In addition, this morning, we announced our intention to initiate an accelerated share repurchase program to repurchase approximately $50 million under our existing share repurchase authorization. Our share repurchase program reflects the confidence of the Board and management in our strategy, financial position and ability to generate strong free cash flows. We also issued our 2026 financial outlook. We are maintaining the midpoint of the reported sales range that we shared in October and narrowing the range. We expect the reported sales to be down 1% to up 1% and organic sales to be flat to up 3%. This outlook continues to include a 3% to 4% headwind from 3 new products due to lower-than-expected market adoption. Excluding the 3 new products, our underlying business is expected to grow 4% to 6%, in line with the market, underscoring the durability and the strength of our core portfolio. We continue to invest in our key growth initiatives and capabilities that support our long-term strategy while being disciplined with our near-term expense management. For 2026, we expect adjusted operating income to be down 5% to up 1% and adjusted EPS to be down 2% to up 6%. The fundamentals of our business are strong, and we remain focused on executing our disciplined growth strategy. We have a robust and diversified pipeline. And when combined with the strength and durability of our underlying business, we remain confident in our ability to return to 200 basis points above-market organic growth in 2027. Before Diron reviews our financial results, I'd like to provide an overview of our business and an update on our strategy as we typically do on our fourth quarter call and discuss why I remain confident in our ability to deliver value creation for our customers and shareholders. Integer is a leading medical device contract development and manufacturing organization, serving the largest global medical device original equipment manufacturers and emerging innovators. Our vision is to improve patients' lives around the globe, one device at a time. We accomplished this by advancing the goals of our medical device customers through industry-leading engineering and manufacturing with a relentless commitment to quality, service and innovation. Our global scale manufacturing and R&D footprint allows us to serve our customers effectively and efficiently around the world. We offer one of the industry's broadest and deepest portfolios of capabilities and product offerings across the Cardio & Vascular, neuromodulation and Cardiac Rhythm Management market. With this, we can meet a wide range of our customer needs throughout the product life cycle, help them bring products to market faster and simplify their supply chain. Integer is well positioned to create long-term value for shareholders. We have a proven track record of financial performance, delivering strong results through the execution of our disciplined growth strategy. The medical device industry is an attractive end market, supported by durable growth drivers, and we continue to focus on several high-growth markets where we have a strong competitive advantage. We are highly differentiated in the industry with deep technical expertise, broad capabilities, innovative technologies and scalable global manufacturing. We have a robust and diversified product development pipeline oriented to high-growth markets with the world's top global medical device companies and many emerging innovators. Our high-performance culture is a competitive advantage centered on customer centricity, innovation and operational excellence. In addition, we are disciplined with our capital management. We are investing to support our growth while maintaining a strong balance sheet and prioritizing long-term shareholder value creation. While select new product headwinds are expected to impact our 2026 outlook, we remain confident in our ability to return to above-market organic sales growth and margin expansion in 2027. Now let's take a closer look at each of these areas. The medical device market remains highly attractive, underpinned by long-term growth drivers. Within this landscape, we are focused on the Cardio & Vascular, neuromodulation and Cardiac Rhythm Management markets, which are expected to grow in the mid-single digits. Our strategy centers on investing to continuously expand our differentiated capabilities and partnering with our customers early in the design and development stage of new products. We are focused on new products in targeted high-growth markets, including electrophysiology, neurovascular, structural heart and neuromodulation. By engaging early in the development process, we help our customers accelerate innovation and drive successful product launches. We have dedicated growth teams responsible for leading product line strategies in our highest priority markets. These cross-functional teams bring deep expertise in our key markets, including customer needs, therapies, products, global trends and competitive landscape. They continuously refine our strategies to address evolving market dynamics and ensure our customer success. And in addition, the growth teams guide and prioritize investments in capabilities and capacity to support long-term sustainable growth. In recent years, we have invested both organically and inorganically to expand our capabilities in our targeted high-growth markets. These investments are designed to enhance the value we deliver to our customers to support their long-term success, which includes speed to market, a reliable and global supply chain and the highest quality products. We have made many capability investments in recent years, and some examples include advanced automation, laser processing, extrusion, complex assemblies, miniaturization and catheter process platforming. We have also invested to expand our rapid prototyping capabilities, which allows us to help our customers bring their products to market faster. As we have shared in the past, we have expanded a number of our manufacturing and R&D facilities to support our growth. For example, we have expanded our Salem, Virginia facility, where we perform laser processing and micro machining and plan to further expand our Alden, New York facility, which supports the micro machining and plan to further expand our Alden, New York facility, which supports the CRM&N implantable devices. In addition to physical capacity expansions, we have ongoing continuous improvement initiatives to optimize our existing footprint. In parallel, we have executed several strategic tuck-in acquisitions that have strengthened Integer's position in high-growth markets and added specialized high-value capabilities. For example, InNeuroCo significantly enhanced our capabilities in neurovascular. Pulse Technologies deepened our capabilities in micro machining and strengthened our pipeline across several high-growth markets such as electrophysiology, leadless pacing, neuromodulation and structural heart. And our 2025 acquisitions greatly enhanced our coating capabilities and furthered our vertical integration strategy. Integer is a partner of choice because we are differentiated by our technical expertise, broad capabilities, innovative technologies, scalable manufacturing and exceptional customer service. We support our customers' success throughout the product life cycle from concept to commercialization, enabling innovation, accelerating speed to market and simplifying our customer supply chains. We have unparalleled subject matter expertise across a broad range of technical disciplines. We are leaders in design for manufacturability, and we have deep product design and regulatory expertise. We are known for our capability breadth and end-to-end solutions. We have a comprehensive portfolio of engineered components, complex subassemblies and finished devices. Our innovative technologies include an extensive set of proprietary materials and processing capabilities as well as in-house advanced manufacturing and automation. We also offer innovative market-ready access and delivery products. We have a robust manufacturing and quality systems across our global footprint. Our customers recognize our ability to seamlessly transition their critical products from the development stage to scale production to support their growth. Product development sales are the compensation we receive from customers as we partner with them to design and develop new or next-generation products. Generally, an increase in product development sales means we are working on more programs, larger programs, more complex programs or a combination of the 3. We believe product development sales are a good indicator for the size of our development pipeline and thus a leading indicator of the contribution from new products to future growth. Since 2017, product development sales have increased more than 300% and approximately 80% of our development sales are for products in higher-growth markets. This momentum highlights both the strength of our customer relationships and the strategic focus of our portfolio. Our deep and broad pipeline includes many exciting programs that are focused on targeted high-growth markets. To highlight a few, our pipeline includes participation in devices used in electrophysiology procedures, including pulse ablation, structural heart delivery systems and components for structural heart implants, neurovascular therapies to treat both hemorrhagic and ischemic stroke, renal denervation and neuromodulation devices designed to address a wide range of conditions. Our robust and diverse pipeline supports our expected return to above-market growth in 2027. Within CRM&N, our pipeline of emerging customers with PMA products, primarily within the neuromodulation market continues to be robust. We are engaged with 40 customers across development phases. As these life savings and life-enhancing products move through regulatory approval and into the manufacturing ramp phase, Integer benefits from accelerated sales growth. Sales from customers in the product introduction and launch phases have grown from $10 million in 2018 to approximately $125 million in 2024. Looking ahead, we expect this category to grow at 15% to 20% compound annual growth rate over the next 3 to 5 years, contributing to our ability to grow above market. Our people and our culture are central to our success. Integer has a high-performance culture that focuses on delivering value to our customers and our shareholders. We recently refined our operational focus areas to customer success, operational excellence and leadership impact. Customer success recognizes that Integer's success depends upon our ability to enable our customers to achieve their goals and objectives. Operational excellence reflects our focus on continuous improvement at all levels of our organization to ensure we meet our customer needs effectively and efficiently while creating value for our shareholders. Leadership impact reflects on our ongoing investments in developing strong leaders to continuously raise the bar on performance. As part of our operational excellence focus, we continue to advance the Integer production system, our lean-driven operational framework that integrates advanced engineering and manufacturing and continuous improvement practices to deliver consistent, high-quality medical device manufacturing that drives customer success. To further enhance effectiveness and efficiency, as part of our Integer operating system, we are launching a multiyear program to modernize our ERP platform. This investment is expected to strengthen our operational capabilities, improve productivity, enhance working capital management, accelerate commercial time to market and position Integer for long-term scalable growth. We have dedicated a cross-functional team of top talent to execute a measured and phased implementation over the next several years. We continue to be disciplined with our capital management to drive sustainable long-term value creation for our shareholders. Our capital allocation framework includes organic investments, including capital expenditures to enhance our technology capabilities, automation and capacity, tuck-in acquisitions to expand our capabilities and presence in high-growth markets and opportunistic share repurchases. We have maintained a disciplined approach to capital management for many years now. Since 2021, we have invested 5.8% of sales in capital investments and over $700 million in tuck-in acquisitions. In November, our Board authorized a share repurchase program of up to $200 million. In the fourth quarter, we repurchased $50 million of our common stock. And today, we announced our intention to commence a $50 million accelerated share repurchase program. Looking ahead, we expect to continue investing both organically and inorganically to support our growth objectives and reinforce our competitive position. Our strategy of being positioned in the right markets, investing in differentiated capabilities, getting designed in early in new products and high-growth markets, creating a high-performance culture and remaining disciplined in our capital management has delivered strong financial results. Since 2022, we have grown sales at a 12% CAGR, well above our market while expanding our margins by nearly 400 basis points and maintaining our leverage ratio within the 2.5 to 3.5x range. While 2026 is expected to be impacted by temporary headwinds, we are laser-focused on executing our strategy to achieve our long-term strategic financial objectives. These objectives are growing sales 200 basis points above market, growing adjusted operating income twice as fast as sales and maintaining a net debt leverage ratio of 2.5 to 3.5x. Now with that, I'll turn the call over to Diron to review our financial results and our outlook.

Thank you, Payman. Good morning, everyone, and thank you again for joining today's call. Our fourth quarter sales and adjusted EPS were at the high end of our outlook ranges that we communicated in October, reflecting strong execution by our global team. Fourth quarter sales totaled $472 million, reflecting 5% growth on a reported basis and 2% growth on an organic basis. Organic sales growth removes the impact of acquisitions, the strategic exit of the portable medical market and foreign currency fluctuations. We delivered $106 million of adjusted EBITDA, up $11 million compared to the prior year or an increase of 11%. Adjusted operating income grew 10% versus last year as we continue to make progress on our margin expansion initiatives. Our adjusted operating margin expanded by 74 basis points to 17.6%, driven primarily by improvement in gross margin. Adjusted net income for the fourth quarter 2025 was $62 million, up 22% year-over-year, while adjusted earnings per share totaled $1.76, up 23% from the same period last year, both reflecting interest expense savings from the convertible note offering in March 2025. For the full year 2025, we delivered strong financial results. Sales totaled $1.854 billion, reflecting 8% growth on a reported basis and 6% growth on an organic basis. We delivered $402 million of adjusted EBITDA, an increase of 12% versus the prior year. Adjusted operating income grew 13% versus 2024, and our adjusted operating margin was 17.3%. Adjusted operating margin expanded 76 basis points, reflecting gross margin improvement and disciplined expense management. Adjusted net income for the full year was $226 million, up 23% year-over-year, while adjusted earnings per share totaled $6.40, up 21% from the same period last year. Turning to our sales performance by product line. Cardio & Vascular sales increased 11% to $284 million in the fourth quarter 2025, driven by the Precision Coatings and VSi Parylene acquisitions and strong demand in neurovascular. On a trailing 4-quarter basis, CNV sales increased 17% to $1.107 billion with strong growth from new product ramps in electrophysiology, contribution from acquisitions and strong demand in neurovascular. Cardiac Rhythm Management & Neuromodulation sales decreased 2% to $167 million in the fourth quarter 2025 as Cardiac Rhythm Management growth was offset by a decline in neuromodulation, primarily driven by lower demand from select emerging customers with PMA products. On a trailing 4-quarter basis, CRM&N sales increased 1% to $669 million with CRM and neuromodulation growing at market, offset by the planned decline of an early SCS neuromodulation finished implantable pulse generator customer, which was announced in 2020. Product line details for other markets is included in the appendix of the presentation, which can be found on our website at integer.net. For the full year 2025, we delivered strong adjusted net income and adjusted earnings per share performance. Adjusted net income increased by $42 million or 23% and adjusted earnings per share increased by $1.10 or 21%, both growing much faster than our 8% sales growth. Operational improvements accounted for $30 million or $0.86 per share and reflected the benefits of higher sales volume, manufacturing efficiencies, operating expense management and acquisition performance. Interest expense was $14 million lower than the prior year, which contributed $11 million after tax or $0.33 per share, reflecting the savings from the convertible debt offering completed in March 2025. Our adjusted effective tax rate for the full year was 17.2%, down from 18.3% in the prior year, primarily reflecting tax benefits from R&D investment, lower interest expense and stock-based compensation. These improvements were slightly offset by higher foreign exchange pressure, which reduced adjusted net income by $2 million or $0.07 per share and an increase in adjusted weighted average shares outstanding, which reduced our adjusted EPS by $0.11. In the fourth quarter of 2025, we generated $55 million of cash flow from operations, and our CapEx spend was $27 million. Free cash flow was $28 million in the fourth quarter. For the full year 2025, our cash flow from operations totaled $196 million, a $9 million decrease from the prior year. Our CapEx spend was $91 million or approximately 5% of sales. This resulted in free cash flows of $105 million, an increase of $5 million versus the prior year. At the end of the fourth quarter 2025, net total debt was $1.19 billion. Our net total debt leverage at the end of the fourth quarter was 3x trailing 4-quarter adjusted EBITDA, which is at the midpoint of our strategic target range of 2.5 to 3.5x. Turning to our financial outlook. The 2026 outlook we are sharing today is tighter than our preliminary outlook shared in October of last year. We are holding the midpoint of our sales growth and the high end of adjusted EPS growth from our October preliminary outlook. For the full year 2026, we expect reported sales to be in the range of $1.826 billion to $1.876 billion, down 1% to up 1% on a reported basis. On an organic basis, we expect sales to be flat to up 3%. We have proactively aligned our cost structure with expected manufacturing volumes as we expect the 3 new product headwinds to be short term and we continue to support our growth initiatives, we are not making structural changes in our organization. We expect our adjusted EBITDA to be in the range of $391 million to $415 million, down 3% to up 3% versus the prior year. We expect adjusted operating income to be in the range of $304 million to $324 million, down 5% to up 1%. We expect adjusted net income to be in the range between $216 million and $232 million, down 4% to up 3%. This range incorporates an expected adjusted effective tax rate of 16% to 18% for the full year with the first quarter slightly above the full year rate. Lastly, we expect adjusted earnings per share of between $6.29 and $6.78, down 2% to up 6% versus the prior year. Our outlook reflects the reduction in outstanding shares from our fourth quarter share repurchase and an estimated impact from the $50 million accelerated share repurchase that we announced today. Taking a closer look at our sales performance. As I mentioned, we expect sales to be down 1% to up 1% on a reported basis and flat to up 3% on an organic basis. We expect continued growth across the vast majority of our portfolio. However, as we communicated in October, our organic outlook is being impacted by lower sales of 3 new products, 2 in electrophysiology and 1 in neuromodulation. We continue to be our customer supplier of these products, but market adoption has been lower than anticipated. These products represented nearly 6% of total sales in 2025, and we expect the sales of these 3 products to be significantly lower in 2026, resulting in an approximate 3% to 4% headwind. Excluding these 3 new products, we expect our underlying sales to grow approximately 4% to 6%, which is in line with the market. We also expect an inorganic decline of approximately 1.3%, which reflects the now completed Portable Medical exit, slightly offset by contribution from acquisitions and foreign exchange. Our product line outlook remain consistent with our October preliminary outlook. We expect CMD sales to be flat to up low single digits, reflecting the impact of 2 new products in electrophysiology. We expect CRM&N sales to be flat to up low single digits, reflecting the impact of the new product in neuromodulation. In other markets, we continue to expect a decline of approximately $30 million to $35 million, primarily due to the Portable Medical exit. We expect organic sales to be down low single digits in the first half and return to market growth during the second half, consistent with October preliminary outlook. The first half performance primarily reflects the significant reduction in sales related to 3 new products, which were ramping during the first half of 2025 and are expected to be at a lower run rate in the first half of 2026. For the first quarter, we expect reported sales to be flat to down low single digits. We expect nominal sales to then ramp sequentially throughout the remaining quarters. The quarterly sales cadence reflects a 5% tailwind in first quarter and a 5% headwind in fourth quarter due to year-over-year differences in production days. For the first quarter, we expect our adjusted operating income margin to decline 200 to 250 basis points versus the prior year. We expect our adjusted operating income margin rate to improve throughout 2026 and expect to return to margin expansion during the second half of the year. We expect cash flow from operations to be between $200 million to $220 million, an increase of 7% at the midpoint of the outlook. We expect capital expenditures of between $95 million and $105 million or approximately 5% to 6% of sales. As a result, we expect to generate free cash flow between $100 million and $120 million, which represents a 5% increase at the midpoint. We expect our 2026 year-end net total debt to be between $1.17 billion and $1.19 billion. This reflects the estimated impact of the accelerated share repurchase program announced this morning. We expect our leverage ratio to be within the targeted range of 2.5 to 3.5x trailing 4 quarter adjusted EBITDA in 2026. I'll now turn it back to Payman.

Thank you, Diron. In summary, the Integer team delivered a strong performance in 2025 with sales up 8% and adjusted earnings per share up 21%. While 2026 is expected to be impacted by temporary headwinds from 3 new products, the fundamentals of our business remain strong. Our pipeline is robust and diversified. And when combined with the strength of our underlying business, we are well positioned to return to growth. We remain confident in our ability to deliver 200 basis points above market organic sales growth in 2027. We will now turn the call over to our moderator for the Q&A portion of the call.

[Operator Instructions] Our first question comes from Brett Fishbin at KeyBanc Capital Markets.

Just wanted to start with the guidance on top line. I think most people will be encouraged to see a pretty stable outlook relative to last quarter, but I just wanted to touch on the decision to lower the high end of the preliminary range. I think last quarter, you were at 0% to 4% organic, now 0% to 3%. So just a slight change. But just curious what the incremental reason for that was? And if it has something to do specifically with what you saw in January or more about just the pace of the improvement into the second half of the year?

Yes, Brett, thanks for the question. As you pointed out, we have maintained the midpoint of our guidance that we've narrowed the range. And really, I think what you're seeing is not necessarily related to any specific dynamics to January or anything like that. It's probably more a rounding.

All right. Super helpful. And then just thinking about margins and really more of a 2027 question. So the 2026 outlook still implies some pressure, I think, given that sales are expected to be subdued. But you kind of noted the expected recovery to above-market sales growth in '27 and then a return to operating margin expansion. So maybe just a little bit more on what drives the return to operating income growth above sales growth in 2027.

Yes, sure. I think for 2026, as Diron mentioned in the prepared remarks, we're not making any structural changes to our business because we have full expectations or we have expectations to get to above-market growth in 2027. So as we progress throughout 2026, we expect to get to margin expansion in the second half of this year. In 2027, will we get back to 200 basis over market performance. We will continue to deliver margin expansion as we have as part of our strategy and as part of our Integral Production system. Our long-term strategy has not changed to deliver 200 basis points over market and 2x margin expansion.

All right. Great. And then last one for me. I always enjoy the strategic update and some of the updates around the portfolio and PMA products. I think compared to last year, the total number of PMA products is up by 1. Just wanted to maybe ask about overall contribution from some of the new products that have been coming through and like how you kind of expect those to perform this year? And then maybe a little bit like just more long term, it kind of seems like more of the future activity is still in the development and clinical phase rather than regulatory. So whether you kind of expect any of those to progress this year? And reach the market by '27 or if there's kind of like a little bit of a gap in some of the development products actually reaching commercialization?

Yes, no problem. The model that we have, what we've talked about that we expect this portfolio of products to grow 15% to 20% in a 3- to 5-year period, it takes into account all the dynamics that you talked about. We have a good pipeline. We have about 40 customers in this grouping, if you will, and we have really good visibility to the products that we're working on. A, number one, the products that are already in the market. We have expectations of what the growth of those products will be. And then we have good visibility to the launch dates and the expected revenues that on a risk-adjusted basis, give us confidence that we can grow at 15% to 20% in a 3- to 5-year period. So what you're seeing here in terms of adding one more customer in the launch phase, this is in full alignment with our expectations and has already been modeled in our projections.

We'll move next to Matthew O'Brien at Piper Sandler.

Maybe just a follow-up on the first question there on the reduction to the high end of the guide. I don't want to over -- I don't want to focus on this too much, but the organic number is down 100 basis points from flat to up 4% to flat to up 3%. And if I just look at the math on that, it's like $9 million you're taking out like at the midpoint by taking it down by 100 bps. So what I'm really trying to get at is there's nothing from a new customer perspective or existing customer perspective that's making you think, okay, you know what, we're going to get a little less revenue from somebody than we initially expected, and that's why we're taking the high end of the guidance range down.

Matt, no, there are no specific changes, as you're pointing out, to customer forecast and whatnot. And the guidance that we have is in full alignment with our expectations and in alignment with what we had communicated back in October. So we have tightened the range around the midpoint that we had communicated. And again, the individual pieces, I think, and the top end is more -- is probably more rounding than anything else.

Okay. All right. Fair enough. And then as a follow-up, Diron, I just noticed the DSOs, and I'm kind of on the fly here, but it looks like they're up kind of meaningfully at the end of Q4. Any little reason for that? And how do we think about that metric progressing over the course of this year?

Yes, Matt, certainly. Yes, on the DSO, we made a decision to limit the amount of accounts receivable factoring that we did at the -- in the fourth quarter. And that's really looking at maintaining our financial flexibility. As you can tell, our revolver is paid down and any incremental cash that we would have generated through the factoring would have gone to further prepay on our Term Loan A. So we thought there was a better use of cash to limit our factoring in the fourth quarter, which effectively raised the DSO from what you would typically see.

We'll take our next question from Richard Newitter at Truist Securities.

Two from me. Maybe the first, it looks like in addition to the organic guide getting narrowed towards a little bit at the top end, operating margin or the implied operating profit margin is also a little bit kind of below where the implied level was before. And there's a really, really steep year-over-year 1Q decline or bigger than what we were projecting. So if you could just maybe talk a little bit about the 1Q kind of the steep 1Q falloff there, especially if you have extra selling days helping the 1Q. And then within the context of margin, if you could also -- I think you had mentioned on the third quarter call that you expected gross margin to improve year-over-year. Can you maybe just break down the operating margin comments within the context of OpEx and gross margin?

Yes. Richard, this is Diron. I'll jump in here. Yes, as you look at our operating margin, we've talked before and Payman just mentioned a moment ago about not making structural changes in the business because we want to make sure we're well positioned to deliver on the return to market growth in the second half and the 200 basis points above market in 2027. So as you look at that structurally, there's a level of fixed cost to absorb. And on the lower sales numbers, particularly in first quarter, there's a little bit more of a challenge in terms of absorbing those fixed costs in the business in the quarter. So as we look at the model and we look at what our structure is on the sales guidance for fourth quarter -- I'm sorry, for first quarter, that's where we see the 200 to 250 basis points of margin pressure there. And then as our sales kind of nominally grow throughout the remaining quarters of the year, we expect to see that operating margin rate grow as well. So I think those are a couple of other critical pieces driving that. that overall kind of margin outlook for the year. As you know, we don't necessarily give guidance on our gross margins. But I think what we had said in the past was that we -- with the Integer Production System, we expect to fully continue driving variable cost or variable margin expansion. So managing our direct material and direct labor and seeing margin expansion there, while we still will see pressure depending on where we are able to land in the sales outlook on the fixed costs that sit in gross margin and overhead. So it's going to be a little bit of a mixed story within gross margins.

Okay. That's helpful. And then just on the discrete products that you're calling out, I appreciate the full year to 300 to 400 basis point impact and it continues to be. I guess we're a quarter in since you last provided your preliminary outlook. We've seen results for the fourth quarter, especially in the all-important electrophysiology segment. Any characterization you can provide on your discussions with your customers on their views of the end markets that kind of took you by surprise in their specific products? And what can you tell us about your visibility today versus 3 and 4 months ago with respect to kind of how they're approaching their forecasting so that we can get confidence that your 300 to 400 basis point impact is the right one even beyond kind of the quarter ahead?

Yes, no problem. So the -- we finished the fourth quarter in full alignment with our expectations. how we had modeled things. And the discussions that we have had since October with our customers and continue to have with our customers are in full alignment with how we model things. Just to step back a little bit, Rich, when we provided our guidance in October, we had done a lot of homework, if you will, working with our customers and using our own intelligence to try to come up with a different view of the forecast. And at that time, we talked about that we provided a wider range in our preliminary guidance that took into account different possibilities. And as we have worked with our customers, what is transpiring and then what we fully expect -- what we expect for 2026 is in full alignment with what we had modeled and what our customers are telling us. So the forecasting patterns, the ordering patterns are in alignment with the projections and what we are guiding.

We'll go to our next question from Travis Steed at Bank of America.

I wanted to ask on the Q1 revenue kind of flat to down low single digits reported. There's 5-point selling days to kind of 5 to 7x days, but I know there's an inorganic impact. So I want to make sure I understand the actual organic Q1 to Q2 kind of bridge and anything you'd kind of call out on how you think about what's the kind of the onetime impacts and some of the recovery in your different businesses in Q1 versus kind of later in the year?

So we had -- in October, we had guided to a first half of the year being down in the low single digits and that we would grow to market growth throughout the second half of the year in 2026. That view has not changed. Let me just start with that. And we still expect the same growth profile. Now talking about the first quarter, as we -- you mentioned the impact of inorganic, yes, there's a little bit of an impact there, but the impact of acquisitions is minimal really there. But as you look at the first quarter and the fourth quarter, we just wanted to highlight that there is 5% tailwind in the 1Q numbers, and there's a 5% headwind in the fourth quarter. So when you look at that, when you adjust for that, the quarterly profiling is exactly as we had expected that we would start the year a little bit lower and then grow to market growth throughout the course of 2026.

Okay. And then maybe another kind of bigger picture question. As a new CEO, just thinking about how you're thinking about shareholder value creation and kind of the pros and cons of balancing kind of more shorter-term value creation, maybe the partnership route versus kind of more longer-term independent shareholder value creation.

Yes, it's a great question. And I think really the only way we can create value for our shareholders in a sustainable fashion is to have a long-term view of our strategy and how we execute. I think we -- let me start with -- I'm a strong believer in our strategy. was there in 2018 when we started looking at creating our new strategy and refining and executing it. And as we have done over the past many years, we will continue to refine our strategy and execute on it. We believe that we can be successful if we can position ourselves to deliver value to our customers and make them successful. That is the only way that we can be successful in a sustainable fashion. So if your question is both in terms of short term and long term, we believe -- I believe that the only way we can create value is by continuing to executing our strategy, have a long-term view of what we need to do to deliver value for our customers, which is the only way that we can deliver value for our shareholders.

We'll take our next question from Andrew Cooper at Raymond James.

Maybe just first, kind of diving into a little bit of the trajectory heading into 2027. You guided to the sort of ex those challenging products being with the end market for the year. What happens through the course of '26 to get you from, hey, we're going to be kind of aligned with the market to stepping back up above in 2027. What has to happen? And maybe what changes throughout the year to get you there?

So I think the first thing to consider is that our core business is very strong. We are saying that our core business is expected to grow within -- in alignment with the market. And by core business, I mean our business, excluding the impact of the 3 products that we've talked about. So the rest of the business is strong, and we expect that it will continue to be strong as we enter 2027. In addition to that, we have new products that are expected to launch in the second half of this year and during the course of 2027. So when we look at the combination of these things -- and by the way, we no longer will have the headwinds associated with these 3 products. So when we consider all these elements together and considering the strength of the pipeline that we have, this is what gives us confidence to get back to 200 basis points over the market.

Okay. Helpful. And then maybe following up on one from earlier as well on the PMA products and the 15% to 20% goal. I know historically, you've normally given an update to that number on kind of a biannual basis. But can you share what those new products generated in '25? And I ask that just with kind of in the back of my head, the thought of this one PMA product likely being a headwind there. So how do we think about making up for that in that 3- to 5-year outlook relative to maybe a little bit of a challenge here with at least one product?

Yes. These products, as we had mentioned, had strong growth in the first half of 2025. And then we had a slowdown, particularly in the fourth quarter as we had expected. Let me just also remind you that we had a very, very exceptionally strong growth from these products in the fourth quarter of 2024. So we also had some challenging comps. So net-net, I would say that these products grew in alignment, including the fourth quarter headwinds. These products grew within the alignment of the market in 2025.

Next, we'll go to Nathan Treybeck at Wells Fargo.

I just wanted to touch on '27 again. Just assuming the product revisions are really just contained in the 3 products and you lap those headwinds in the second half of this year. And you obviously said you're not making structural changes to the company. I'm trying to understand like why would the comps not result in '27 growth kind of above your formula of 200 basis points above market?

Well, our long-term strategic objective is to grow 200 basis points above market. That's the reason why we are providing earlier than usual guidance for 2027 is because we want to convey the confidence that we have in our future growth prospects. So we're just -- what we're conveying is that with the visibility that we have, we expect to get back to 200 basis points over market. As we get to this time next year, we will be able to provide a more specific guidance on 2027 growth.

Okay. And I noticed the end market table in your presentation. Just to clarify, is that the entire end market or just the areas you're exposed to? Because I see electrophysiology, you have in mid-teens. I think some market estimates still have the market growing high teens for that time period of 2025 to be 29. So I'm just trying to understand if there's any kind of -- anything specific to Integer in that table?

Yes. The end market, we expect the end market to grow in the high teens, as you pointed out. In 2025, we expect the end market for EP to be in the high teens to 20% range. And we expect that as in the 2026 to be kind of in the mid-teens.

Okay. But as far as the broad end markets, are you referring to just the broad end markets or the areas that you play in?

The broad end market.

We'll go next to Joanne Wuensch at Citigroup.

I'll put them upfront. Since the third quarter, what has changed internally and how you think about running your business and communicating goals, et cetera, with the Street? And it's sort of in the public domain of activist involvement. And I'd be curious if that has had impact on sort of my first question, which is how you think about goals and running the business.

Yes, Joanne, thank you for the question. So we -- let me answer your question holistically. Because we believe in our strategy, we believe in how we run the business, our execution, the processes that we have, how we look after our customers and how we've been able to deliver value for our shareholders and our confidence to be able to deliver value in a sustainable fashion for shareholders. We're not changing anything in our business because we believe in our strategy, and we believe in what we're doing. I think part of your question was about how we establish goals and expectations. The -- how we how we issue guidance and come up with those forecasts, as we've mentioned before, has a very balanced view of what we believe we can deliver. And then, of course, we kind of look at the downside and the upside of that. And collectively, we come up with what we think the expectations are. You're pointing out, I think, what's implied in your question, Joanne, is the impact of the 3 new products that gives us some short-term headwinds. As we've mentioned before, that is unusual, and that has to do with market adoption that really our customers were not expecting either. So that is an unusual event that we don't expect to continue. I think to just go back to your second part of the question, we listen and talk to all of our shareholders, and we take their view into account, of course. But we are -- and I am a strong believer of our strategy and how we can deliver value for our shareholders.

We'll move next to Suraj Kalia at Oppenheimer.

Can you hear me all right?

Yes.

Thank you for all the comments on navigating these temporary headwinds. Diron, one question for you and Payman, one for you. I'll pose them both upfront. So Diron, I want to go back to your comments about not being able to absorb fixed costs in Q1. Maybe if you could give us some additional clarity on that, Diron. I presume you'll have visibility 6 to 9 months in advance. So the specific attribute about fixed costs not being absorbed kind of confused me. Any additional color would be great there. Payman for you, if I could pose this question, and I know this is a hypothetical, but I'm just trying to connect some dots here. So let's say you have an ENT customer, Suraj Inc. that pulls their demand on a certain product, right? You have to lower your stop your manufacturing, your sales go down, so on and so forth, right? But for whatever reason, the end customer comes back and says, look, I need to ramp back production of this new product. Does it require a new contract? Do you all have to switch manufacturing? Do you keep spare inventory? I'm just trying to connect some dots vis-a-vis specifically an ENT customer. Any color there would be great.

Well, thank you, Suraj, for the questions. Why don't we start with the question that you had for me, and then I'll ask Diron to get back to your first question. So in terms of how it works, let me start with just philosophically, Suraj, we work very closely with our customers in recognition that we've talked about that the majority of our business is sole sourced. And ultimately, we see what the end market demand is. So our customers work with us to give us a forecast based on their production plans. So whatever they have planned for their manufacturing facilities, we get some of those forecasts and orders months in advance because that's what they're planning. If something were to change, we, of course, work with them. So if they ask us to bring their forecast down, well, we work with them to do this in an orderly fashion. And what I mean by that is -- we -- our customers recognize because they also manufacture themselves that you can't stop a production, you can't have a cliff. So they usually give us a ramp down, and we work with them collaboratively to kind of work to see what makes sense so that in the event, the hypothetical event that you mentioned that there would need to be a ramp down that we do this in an orderly fashion so that we don't cause a lot of inefficiencies. And conversely, if we have to ramp back up, well, we do the same thing. Obviously, if we have to ramp back up quickly, well, there could be costs associated with that, and then we work with our customers. Again, we have a great partnership and relationship with our customers. We work with that. To your specific question about whether there's a new contract, no. We have general contracts with the majority of all of our large customers. We've mentioned before that 70% of our business approximately is under long-term contract. And all the provisions are spelled out in that. We move with the speed of business. Every time something changes, we don't go and renegotiate a contract. Those things are already done. It's just a question of how we work with each other on a regular basis, on a daily basis to make sure that both we Integer can meet the needs of our customers and our customers work with us so that we can make sure we run our businesses efficiently.

Yes. And Suraj, just to maybe cover off on your question related to the fixed cost leverage. I think what you have to understand is as a manufacturing company, we have a certain level of capacity and capability built out to deliver on our sales performance. So as you look at our sales level in the fourth quarter and the sequential movement from fourth quarter of '25 to first quarter '26, you'll see a lower sales number and that still has to -- would have to absorb the full fixed cost used to deliver on the higher sales number. So this is one of the reasons that we always talk about Integer as a company that needs to be looked at on more of a rolling 4-quarter basis because you do have that inter-quarter variability that you may have with sales with a little bit more fixed cost leverage at times, a little bit less at other quarters. And so when you think about our guidance for the year, that's where you'll see that the operating margin is not as impacted on the full year basis in our guidance as, let's say, 1 quarter is where we have the lowest sales for the quarter.

Thank you again for joining us today. You can access the replay of this call as well as the presentation on Integer's investor website at integer.net. This concludes today's conference call. You may now disconnect.