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With a combined revenue of $21 trillion and $2.1 trillion in profits, the 2026 Fortune 500 is the definitive list of America's largest companies.

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The 300 companies on this year’s list brought in over $12.5 trillion in revenue for the latest 12 months, with the median revenue figure at $24 billion.

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The transfusion division of health care giant Abbott screens about half of the U.S. blood supply, so the nationwide decline in blood donations since the COVID pandemic has been not only a public health problem but, for Abbott, a business problem. The company tackled the dilemma by appealing to college students’ competitive streak: Last year, it launched the “We Give Blood” campaign among students at schools in the Big Ten conference, coinciding with the college football season. 

The 2024 initiative resulted in nearly 20,000 donations, enough to save up to 60,000 lives. First-time donors represented 69% of We Give Blood participants. In and around the University of Nebraska—the school that won the competition—local blood centers saw a 27% increase in young donors (ages 16 to 24) versus the previous year. Season two kicked off this September, and is attracting donors at an even faster rate: It neared 20,000 donations in just the first four weeks of the drive.

Change the World

The corporations on our annual list of the world's 500 largest companies combined to generate $41.7 trillion in revenue over the past year.

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The corporations on our annual list posted aggregate revenues of $41 trillion for the second year in a row.

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CTW-2023-Abbott-Graduation-F2S1

Student debt is a massive burden in the U.S. There are more than 43 million borrowers carrying a combined $1.8 trillion in obligations. Debtors often have to choose between paying off their student loans or saving for retirement. That’s why Abbott developed Freedom 2 Save. F2S is a benefit program in which enrolled employees who put 2% of their pay toward their student loans get a corporate match of 5% into their 401(k)s—keeping them from having to sacrifice their future to pay off their past. The health care company’s innovative offering required special permission from the IRS before it could launch in 2018. To date, Abbott has contributed more than $5.5 million to over 2,500 of its employees, including $1.7 million in 2022 alone. Beginning in 2024, all U.S. employers will be able to offer a similar benefit through a provision of the SECURE 2.0 Act—inspired by Abbott’s offering—which will enable employers to match employees’ student loan payments with 401(k) contributions.

The Fortune 500, in its 69th year in 2023, ranks the biggest U.S. companies by revenue.

F500-2023-099-Abbott Labortories

Riding the tail end of a sales boom in COVID-19 tests, the medical device and health care products firm dropped 13 spots on the Fortune 500 in 2022, with revenue increasing only 1.3% and profits down 2%. 
<ul> 
 	<li>COVID-19 test revenue accounted for one-fifth of Abbott’s bottom line in 2022, jumping to $8.4 billion from $7.7 billion in 2021. At the end of the first quarter of 2023, the firm projected test sales to drop to $1.5 billion for the year.</li> 
 	<li>Abbott fed some of its COVID-19 test proceeds into research and development, investing an additional $2 billion in 2022.</li> 
 	<li>The Department of Justice is investigating Abbott’s infant formula plant in Michigan, which shut down from February to June 2022 owing to contamination, setting off a nationwide shortage.</li> 
</ul>

Just as it dominates our economy, Big Tech now dominates Fortune’s annual ranking of corporate reputation.

Aggregate sales hit $37.8 trillion last year—an increase of 19%, the highest annual growth rate in the list’s history.

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GPTW Health Care Large 2022-Abbott Laboratories_1000884-3 copy

Employees say: 
 
“I have never worked at a company that has put so much effort into making sure that their employees are taken care of. Abbott seems to go to great lengths to help employees, their family and the community.”

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This year’s Fortune 500 marks the 68th running of the list.

F500-2022-086-Abbott Laboratories

COVID-19 testing continued to drive revenue growth for Abbott Labs in 2021: As of January 2022, the company had distributed about 1.4 billion tests, and those generated $7.7 billion in sales in 2021. Medical devices and nutrition products like Similac and Ensure together account for about two-thirds of Abbott’s revenue. The nutrition division endured a setback in early 2022, however, when Abbott issued a voluntary recall of powdered infant formula manufactured in one of its facilities in Michigan after the plant was linked to a bacterial-infection outbreak; the shutdown contributed to a nationwide formula shortage.

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WMAC 2021-42-Abbott Laboratories

Total revenue for the world’s biggest companies fell 4.8% to $31.7 trillion this year—the first decline in half a decade.

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Abbott Laboratories leveled up on this year’s Fortune 500 list, leaping from last year’s rank of 104 to No. 89. Why? COVID testing. Abbott was one of the first to jump into the testing market, and that alacrity has paid off; the company’s diagnostics unit, which also houses its COVID test arm, raked in more than $4 billion in sales during the first quarter of 2021 alone. Abbott, though, isn’t putting all its eggs in one basket. As life starts returning to normal, the company believes its diabetes care and glucose monitoring products will continue to fuel growth. &quot;}" data-sheets-userformat="{&quot;2&quot;:12673,&quot;3&quot;:{&quot;1&quot;:0},&quot;10&quot;:2,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri, Arial&quot;,&quot;16&quot;:11}" data-sheets-textstyleruns="{&quot;1&quot;:0}{&quot;1&quot;:46,&quot;2&quot;:{&quot;6&quot;:1}}{&quot;1&quot;:53}">Abbott Laboratories leveled up on this year’s Global 500 list, leaping from last year’s rank of 393 to No. 350. Why? COVID testing. Abbott was one of the first to jump into the testing market, and that alacrity has paid off; the company’s diagnostics unit, which also houses its COVID test arm, raked in more than $4 billion in sales during the first quarter of 2021 alone. Abbott, though, isn’t putting all its eggs in one basket. As life starts returning to normal, the company believes its diabetes care and glucose monitoring products will continue to fuel growth.

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Best Workplaces Healthcare Large 2021-Abbott Laboratories

Employees say: 
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Read Great Place to Work review .

This year’s Fortune 500 marks the 67th running of the list.

F500-2021-89-Abbott Laboratories

<span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Abbott Laboratories leveled up on this year’s Fortune 500 list, leaping from last year’s rank of 104 to No. 89. Why? COVID testing. Abbott was one of the first to jump into the testing market, and that alacrity has paid off; the company’s diagnostics unit, which also houses its COVID test arm, raked in more than $4 billion in sales during the first quarter of 2021 alone. Abbott, though, isn’t putting all its eggs in one basket. As life starts returning to normal, the company believes its diabetes care and glucose monitoring products will continue to fuel growth. &quot;}" data-sheets-userformat="{&quot;2&quot;:12673,&quot;3&quot;:{&quot;1&quot;:0},&quot;10&quot;:2,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri, Arial&quot;,&quot;16&quot;:11}" data-sheets-textstyleruns="{&quot;1&quot;:0}{&quot;1&quot;:46,&quot;2&quot;:{&quot;6&quot;:1}}{&quot;1&quot;:53}">Abbott Laboratories leveled up on this year’s Fortune 500 list, leaping from last year’s rank of 104 to No. 89. Why? COVID testing. Abbott was one of the first to jump into the testing market, and that alacrity has paid off; the company’s diagnostics unit, which also houses its COVID test arm, raked in more than $4 billion in sales during the first quarter of 2021 alone. Abbott, though, isn’t putting all its eggs in one basket. As life starts returning to normal, the company believes its diabetes care and glucose monitoring products will continue to fuel growth.

For an astounding 13th straight year, Apple claims the top spot in Fortune’s annual ranking of corporate reputation, based on a survey of almost 3,800 executives, directors, and analysts.

This year's Fortune Global 500 generated $33.3 trillion in revenues and $2.1 trillion in profits.

G500-2020-393-Abbott-Laboratories

Health care company Abbott Labs manufactures medical devices, diagnostic tools, and nutritional products like Ensure. While the pandemic has depressed some aspects of Abbott's business, demand for COVID-19 testing has buoyed its diagnostic arm.

The best workplaces in health care and biopharma make their employees feel valued while the health care industry continues to undergo rapid technological changes.

Best Workplaces in Health Care and Biopharma-2020-Abbott Laboratories

Employees say: 
“People aren't just here to earn their paychecks, but to make high quality products for the people that depend on them. The people also really care about each other here and go out of their way to ensure that everyone is comfortable.” 
Read Great Place to Work review .

This year's Fortune 500 marks the 66th running of the list.

F500-2020-104-Abbott-Laboratories

Health care company Abbott Labs manufactures medical devices, diagnostic tools, and nutritional products like Ensure.

As we face unprecedented collective challenges, cooperation has become a business superpower.

24.CTW20.Abbott

Health care access is a challenge in Rwanda, which makes one diagnostic innovation by Abbott Labs particularly valuable. Abbott’s prenatal panel tests simultaneously for syphilis, malaria, HIV, and hepatitis B, using only one finger-stick of blood, with results in the same visit. For expectant mothers who may have time or resources for only one trip to the clinic, that means better care; the test has also enabled a tripling of malaria case detections. 
 
At press time, health care providers were just beginning to deploy another potentially crucial Abbott diagnostic product: An “antigen” test for COVID-19 that yields results in 15 minutes and costs $5.

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Wal-Mart stayed on top as its sales crept closer to half-a-trillion dollars. Apple moved into the top five. And UnitedHealth Group continued its steady climb. 

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Abbott Laboratories is a global health care company. Founded in 1888, the company operates in four main segments: established pharmaceutical products, diagnostic products, nutritional products—including infant formula—and medical devices. As of 2024, Abbott’s medical devices segment was its largest and fastest-growing, accounting for about 45% of revenue. That segment includes devices for monitoring cardiovascular health, glucose monitoring systems for diabetes care, and neuromodulation devices for chronic pain and movement disorders.

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Q4 2024

Abbott Laboratories (ABT): Company Profile, Stock Price, News, Rankings

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Abbott Laboratories

abbott laboratories

Good morning, and thank you for standing by. Welcome to Abbott's fourth quarter 2025 earnings conference call. All participants will be able to listen only until the question-and-answer portion of this call. During the question-and-answer session, you will be able to ask your question by pressing the star 11 keys on your touch-tone phone. This call is being recorded by Abbott. With the exception of any participants' 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. Mike Comilla, Vice President, Investor Relations.

Good morning, and thank you for joining us. With me today are Robert Ford, Chairman and Chief Executive Officer, and Phil Boudreau, Executive Vice President, Finance and Chief Financial Officer. Robert and Phil will provide opening remarks. Following their comments, we'll 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 results for 2026. 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 Form 10-K for the year ended December 31st, 2024.

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. 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. Note that Abbott has not provided the related GAAP financial measures on a forward-looking basis for the Non-GAAP financial measures for which it is providing guidance because the company is unable to predict with reasonable certainty and without unreasonable effort the timing and impact of certain items, which could significantly impact Abbott's results in accordance with GAAP.

Unless otherwise noted, our commentary on sales growth refers to organic sales growth, which is defined in the press release issued earlier today. With that, I will now turn the call over to Robert.

Thanks, Mike. Good morning, everyone, and thank you for joining us. Before discussing our fourth quarter results, I want to take a moment to reflect on 2025, a year that demonstrated Abbott's leadership and innovation, discipline execution, and strategic actions taken to position the company for sustainable long-term growth. Innovation continues to be the foundation of our success.

In 2025, we achieved several important milestones that strengthen our position for the future, including regulatory approvals for our Volt and TactiFlex Duo PFA products, a new indication for our Navitor TAVR Valve, CMS, national coverage for TriClip and CardioMEMS, completing enrollment in our pivotal trial to bring a new LAA device to market, filing for FDA approval for our dual glucose ketone sensor, initiating the pivotal trial of our coronary IVL device, starting the launch sequence in EPD to bring biosimilars to emerging markets, and recently starting the launch sequence in nutrition to bring new products to market that meet evolving consumer preferences. 2025 was also a year of disciplined execution. We delivered top-tier margin expansion and achieved our original target of double-digit earnings growth in earnings per share despite the implementation of new tariffs and heightened market challenges in China.

Finally, in 2025, we made important strategic moves to shape Abbott's future. Our announced acquisition of Exact Sciences will allow Abbott to enter and lead in the fast-growing cancer diagnostics market and adds a new high-growth business with an attractive pipeline to the Abbott portfolio. We expect 2026 to be another year powered by innovation, operational excellence, and strategic execution. As we announced this morning, we forecast the midpoint of our 2026 organic sales growth range to be 7% and the midpoint of our adjusted earnings per share range to reflect 10% growth. I'll now summarize the fourth quarter results in more detail. I'll start with nutrition, where sales declined in the quarter. Abbott has been in the nutrition business for more than 60 years, and with that history comes experience, not just in times of growth, but in times that require navigating challenges.

As I mentioned last quarter, the U.S. pediatric business is seeing an impact from market share loss, partly due to the loss of a large WIC contract last year. Our results this quarter underscore a broader challenge, which is the need to reignite volume growth, a challenge many consumer goods businesses face today. Over the last several years, we've seen manufacturing costs and nutrition rise, in part due to a post-pandemic-driven surge in commodity costs that remains in our cost base today. We have increased prices to help mitigate the impact of higher manufacturing costs, but those price increases in the current economic environment have become a factor in constraining volume growth. Many consumer goods businesses are facing this dynamic. Higher manufacturing costs led to higher prices, which in turn are suppressing demand as consumers become increasingly more price-sensitive.

The path is not sustainable long-term, so we began to make changes in the fourth quarter. Our goal is to transition our business back to one with a more balanced growth profile, with volume growth playing a greater role going forward. In the fourth quarter, we began implementing price and promotion initiatives to help start the process of reigniting volume growth. To further drive volume growth, we are increasing our focus on innovation, which is an area that was deprioritized the last few years given the necessary heavy focus on production and supply chain management in this business. Following the launch of two new versions of Ensure late last year, we expect to launch at least eight new products over the course of the next 12 months.

We expect performance in the nutrition to remain challenged in the first half of the year, with a return to growth in the second half. While this transition back to a more sustainable volume-driven business has consequences on our near-term results, these are the right steps to take to better position the business for longer-term success. Moving to diagnostics, where sales declined 3.5% due to the anticipated year-over-year decline in COVID testing sales. Core Lab Diagnostics grew 3.5%, achieving a third consecutive quarter of accelerating growth and building steady momentum as we enter 2026. For the full year, excluding China, growth in Core Lab Diagnostics was 7%, reflecting durable demand in markets around the world. In point-of-care diagnostics, sales grew 7% in the quarter, driven by adoption of our high-sensitivity troponin test, which allows for earlier and more accurate detection of heart attack.

Turning to EPD, where sales increased 7% in the quarter. Growth was well-balanced across the markets and therapeutic areas that we participate in, including double-digit growth in India and several countries across Latin America and the Middle East. By focusing on high-demand therapies in faster-growing markets, EPD delivered its fifth consecutive year of sales growth exceeding 7%, and I'll wrap up with medical devices, where sales grew 10.5%. In diabetes care, sales of continuous glucose monitors grew 12% in the fourth quarter and 17% for the year, with sales in 2025 exceeding $7.5 billion. This marks the third consecutive year that our CGM sales have grown by more than a billion dollars. Our success in CGM continues to be driven by strong underlying market fundamentals, a leading position in cost and scale, and an unwavering commitment to market-leading innovation.

These factors have led to a continued increase in adoption across all of the various user groups. In electrophysiology, sales grew double digits in the U.S. and internationally. In December, we announced FDA approval of our Volt PFA catheter, which represents our first PFA product offering in the United States. And earlier this week, we announced that we obtained CE Mark for our new TactiFlex Duo ablation catheter, which offers both RF and PFA energy to treat patients battling AFib. In structural heart, growth was driven by double-digit growth in Navitor, double-digit growth in TriClip, double-digit growth in MitraClip. In the coming weeks, we'll achieve an important milestone by completing enrollment in our CATALYST trial. This trial is evaluating the performance of Amulet left atrial appendage device compared to oral anticoagulants in patients with AFib.

This trial is designed to generate the evidence to demonstrate the clinical benefits of Amulet, which could lead to broader adoption and expansion of the addressable market. In heart failure, growth of 12% was driven by growth across our market-leading portfolio of ventricular assist devices, which offer treatment for chronic and temporary conditions, and growth in CardioMEMS, our implantable sensor used for the early detection of heart failure. Our investment strategy in medical devices is based upon a true two-pronged approach. We invest to sustain strong performance in high-growth segments like diabetes, structural heart, electrophysiology, and heart failure, and we invest to increase the growth outlook in more foundational segments like rhythm management and vascular. While the investments in traditionally high-growth segments tend to get more attention, the investments we've made in our foundational businesses are generating very impressive returns.

In rhythm management, growth of 12% was led by continued strong uptake of our leadless pacemaker Aveir. For the full year, growth of 10% in rhythm management represents the third consecutive year of significantly outperforming the market. With Aveir, and the investments we're making in conduction system pacing and other novel technologies, we see the $10 billion rhythm management market as a great opportunity to capture market share and drive sustainable growth for years to come. In vascular, growth of 6.5% was led by double-digit growth in vessel closure products and growth from Esprit, a below-the-knee resorbable stent. For the full year, vascular sales grew 5%, making this the second consecutive year vascular has delivered mid-single-digit growth. With the expected approval of our coronary IVL device next year, we expect growth in vascular to follow a similar pattern of acceleration that we've seen in rhythm management.

Lastly, a neuromodulation growth of 5.5% was led by strong international growth in Eterna rechargeable spinal cord stimulation device. In summary, despite facing some challenges in 2025, we achieved our original target of double-digit earnings per share growth. Our new product pipeline continues to be highly productive, and combined with the strategic steps we took to shape the company for the future, we're well-positioned for accelerating growth in 2026. I'll now turn over the call to Phil.

Thanks, Robert. As Mike mentioned earlier, please note that all references to sales growth rates, unless otherwise noted, are on an organic basis. Turning to our fourth quarter results, sales increased 3.8% when excluding COVID testing sales. Adjusted earnings per share of $1.50 reflects growth of 12% compared to the prior year. Foreign exchange had a favorable year-over-year impact of 1.4% on fourth quarter sales, which was in line with our expectations at the time of our earnings call in October. Regarding other aspects of the P&L, the adjusted gross margin profile was 57.1% of sales, which, despite the impact of tariffs, increased 20 basis points compared to the prior year. Adjusted R&D was 6.2% of sales, and adjusted SG&A was 25.1% of sales. Adjusted operating margin was 25.8% of sales, which reflects an increase of 150 basis points compared to the prior year.

Turning to our outlook for 2026, today we issued guidance for full-year adjusted earnings per share of $5.55-$5.80, which reflects 10% growth at the midpoint of the range and contemplates an adjusted earnings per share forecast of $1.12-$1.18 for the first quarter. For the year, we forecast organic sales growth to be in the range of 6.5%-7.5%. Based on current rates, we expect exchange to have a favorable impact of around 1% on full-year reported sales, which includes an expected favorable impact around 3% on first-quarter reported sales. And we forecast our adjusted tax rate to be in the range of 15%-16%. With that, we'll now open the call for questions.

Thank you. At this time, we will conduct the question-and-answer session. As a reminder, to ask a question, you will need to press star 11 on your telephone. You will then hear an automated message advising you that your hand is raised. To withdraw your question, please press star 11 again. For optimal sound quality, we kindly ask that you please use your handset instead of your speakerphone when asking your question. Again, that's star 11 to ask a question. Please stand by while we compile our Q&A roster. And our first question will come from Larry Biegelsen from Wells Fargo. Your line is open.

Good morning. Thanks for taking the question. So, Robert, on the last call, you seemed comfortable with consensus revenue growth, but you're guiding a little bit lower today. I assume that's related to nutrition. Can you talk about what's changed since the last call and how you're thinking about the year playing out from a cadence standpoint? I assume you would expect growth to accelerate through the year, given your comments on nutrition and some of the launches. And I'll leave it at that. Thanks for taking the question.

Thanks, Larry. I think if I remember, you're the one who asked that question back in October. And when I answered that question, I think consensus was 7.5% top line. EPS was 10%. So today, we guided the midpoint at 7% on top line, 10% on the bottom. So midpoint here is 0.5% lower than what was consensus. But other than that, nothing's really changed. The EPS is in line with consensus, expecting healthy margin expansions. I'm sure we're going to talk a lot about the pipeline, which is either on target or ahead of schedule in certain products. Balance sheet's in great shape. Feel good about us closing Exact Sciences. So the half-point change on the top line, as you pointed out, is really the change in the near-term outlook, I'd say, of our nutrition business.

You saw in our quarter, in our Q4, we had a negative quarter. And as I said in my comments, there's a component of this business. It's a healthcare-driven product portfolio, but there's a component of it, a dynamic of it, that is very much aligned with consumer packaged goods. And I'd say the challenges that CPG businesses have been facing are pretty well-known. Following pandemic, pretty significant surge in costs between 2022 and 2024. To offset that, I think we all went ahead and tried to mitigate it with price increases that obviously drove top line, but more importantly, I would say, improved or didn't allow the economics and the profitability of the businesses to deteriorate. If you look at our profitability in that business, 2024, 2025, where it was back in 2022, it had that impact.

But the higher prices, though, have resulted now in what I see as kind of suppressing demand and lowering the volume growth. And the pressure on the volume growth accelerated, I'd say, as we moved throughout Q4 and consumers became increasingly more price-sensitive. So as I said in my comment, it's not a sustainable path. You'll get down into this spiral if you keep increasing prices. You'll keep on driving volume down. So we could have—we could have gone a couple more quarters, maybe nine more months doing this, but it would not be sustainable. And at some point, something fundamentally has to change here. And I just felt that the longer we took to make this change, the more painful it would be.

If I look at the strength of the portfolio right now and all the growth prospects we have, the ability to add a whole new growth vertical, I just thought that the timing was right to do this and do this as quickly as possible to get through it, so we began implementing price promotion initiatives that are going to help invigorate growth. I think early signs right now, Larry, are encouraging. Obviously, we're going to have to keep monitoring that, and then we're also launching a lot of new products to be able to kind of support that volume growth. We haven't had to reallocate R&D resources to be able to do that. This is a business that operates around 2.2% of R&D, so we just reallocated within that budget to focus on new product development.

We'll have a couple of quarters here where growth in nutrition is going to be challenged. And then in the second half, we'll return to positive growth. And I got confidence in the team that's in place today that we can execute this transition back to more of a volume-based, more of a volume-driven growth business. If you look at what we did back in 2022 when we had supply disruption, it took us about nine to 12 months to get our share back. I don't think it's going to take that long, so I think it's about a six-month process here of reshifting that. And that's really what's creating, I would say, part of it, what's creating a little bit of this first-half, second-half dynamic in our growth forecast. But outside of that, Larry, versus where we were in October, nothing has really changed.

In fact, I'd say a significant majority of the company here is either maintaining high single-digit top-line growth or low teens growth, or they're accelerating their growth versus 2025, whether it's our cardiovascular franchise, our diabetes products, EPD, our pharma business. We're going to be lapping the core diagnostic headwinds that we faced last year. If you remember, we had about $1 billion of headwind that we faced last year in our diagnostic business, whether it was COVID and the China challenges. That's mostly going to be behind us. We're going to be adding another high-growth vertical with Exact Sciences. So I think there's a lot to like here. I think there's a lot of growth here. And while we know we've got some work to do in nutrition, I can guarantee you that we're not distracted by that from all the great opportunities that we have here.

So like I said, I think we've got a good setup for 2026, a lot of accelerating growth as we progress through the year.

Thank you. Our next question will come from David Roman from Goldman Sachs. Your line is open.

Thank you. Good morning, everyone. I did want to start, Robert, on the pipeline and then maybe just ask a follow-up question if we have time on the guidance and the outlook. You did talk about some of the approvals in the EP business. And most specifically, can you help us sort of frame the Abbott portfolio in EP, maybe looking back six months, where we are today, where you are then six to 12 months from now, and contextualize kind of the portfolio relative to competition and where you see the biggest opportunities to accelerate growth there with Volt, TactiFlex Duo, TactiFlex VT, I think even NextGen, Agilis, EnSite X, etc.

Sure. I mean, I think that I do have to put that into context, though. I mean, if you go back three years, David, there was a lot of concern about our franchise that was growing double digits, that was going to be flat or even negative because we didn't have a PFA catheter. We developed a strategy. The team put together a strategy. We presented to our board three years ago in terms of what we were going to do. And over the last couple of years, even without PFA products, we've been able to actually sustain our double-digit growth rate, 2024 and 2025, without a PFA catheter. So the strategy that you're now referencing about our PFA products, that's just part of our strategy that we presented three years ago and laid out here.

So we began launching the PFA product line in a much larger installed base of capital and mapping systems. The launch of Volt in Europe has gone very well. I'd say when we talked about developing Volt, we said, "Let's look at where some of the shortcomings of our first-generation products are, and can we build those into Volt?" And the feedback that I continue to see from the European market, and quite frankly, through the last couple of weeks as we began our limited market release here in the U.S., is two things keep jumping out pretty continuously. It's one, the elegance, the ease, and the smoothness, and the predictability of the mapping integrated with the catheter, the visualization, all of that that we spent a lot of time putting together. I continue to hear very positive feedback on that.

And then the ability to potentially do these procedures with sedation versus general anesthesia, that is a recurring theme that I keep on hearing here. So I'd say the Volt launch has gone very much aligned to what we expected as we were putting the program together. This year, we'll have the launch of Volt here in the U.S. and TactiFlex Duo internationally. I think it comes down to we always wanted to make sure that we had a toolbox approach here for the physicians so they can have choice and they can have greater flexibility about how they use these products. I'm sure that there will be cases and types of patients and patient profiles that will lend itself more to a balloon and basket Volt-type design. And there are going to be types of patients and situations where TactiFlex Duo with its dual energy source will be preferred.

Ultimately, it's going to be up to the physician to make those decisions. I like the fact that the team, as they put the strategy together, that we would have both these products. I think you raised this point very well, which is I don't think that there is a company right now that's better positioned in terms of the completeness of the portfolio than what we have, whether it's technology or the scale and the infrastructure, starting with the capital placements that we've got, the incredibly competent clinical specialists that we have out in the field that have shown their value to our customers right now. We've got both RF and PFA products. We've got all the diagnostic elements, whether it's catheters, patches, etc., introducers, sheaths, all of that that you referenced.

And on top of that, we've got an LAA device, which is, I would say, becoming pretty clear that if you want to be a leader in this space, you can't just look at having a PFA catheter. You got to have the full portfolio, including this device. Right now, it seems like 25% of LAA procedures are done concomitantly. So I think if you put all of that together, the portfolio that we've assembled, combined with the resilience of what this team has done and how they've executed, I've got high expectations for this business this year. The team knows that. I expect that we should grow at least in line with the market, David, which I expect. I think it seems like the forecast here is mid to high teens. So I think we're in a really good position.

I'm excited to see the second part of the strategy that we put together three years ago. We're really excited to kind of put that second part of that phase into action now.

Very helpful. Maybe just a follow-up on the guidance. Look, I think we all know that you don't set your guidance to meet short-term consensus, and you are committed to achieving your commitments. But as you thought about putting together the outlook for 2026, considering some of the different variables that you faced over the past couple of quarters, how did you think about risk-adjusting the outlook? And maybe just help us think about the considerations in the guidance and maybe just your philosophy as you kind of put the outlook together here.

I mean, listen, I think if you look at our growth for 2026, I mean, we've always targeted high single digits and double digit, high single digit top line, double digit bottom line. That's our investment identity, and we've kind of followed through with that. If you look at our 2026, I think the way you need to kind of look at it is you've got a very big portion of the company that is going to that we're sustaining that growth. In some cases, it'll be accelerating, but a large portion of the company is sustaining this high single digit growth, whether it's in cardiovascular, whether it's in diabetes. We've got a bunch of new products launching to be able to support those kind of growth profiles in the business. EPD supporting with the biosimilar launch, that high single digit kind of growth rate.

You've got large portions and even some geographies that we can sustain that growth, and we feel that we're supporting it with product launches and investment to sustain what I consider a pretty differentiated growth rate. Then you've got the second bucket, which is, I'd say, an acceleration in our diagnostics. And all that really is, is we've been doing very well taking share in our core lab business across the world. And what we had a challenge with last year is with COVID coming down. In 2024, I think it was like $750 million coming down to $250 million. So you had $500 million headwind there, and then you had another $400 million headwind in China VBP, right? Our forecast for COVID is around that same number, around $200 million. So I'm not expecting any significant growth or decline.

A lot of the VBP, they come in waves. The vast majority of our sales in China have gone through the VBP in 2025. We really felt that impact in 2025. There's going to be more VBPs in China, but the shares that we have in those waves are very, very small compared to what we have. You've got this whole lapping of our diagnostic business. As long as we keep on doing what we're doing in the United States and Europe and Latin America and other parts in Asia, which we have been doing, you're going to see a nice acceleration in our diagnostic business. You started to see that throughout the year as the VBP impact started to dissipate a little bit as the year progressed.

You've got then, obviously, as I spoke quite at length here about this transition with nutrition, you've got probably one or two quarters here where growth is going to be challenged. But I am confident that what we're going to be able to do here is reignite the volume growth, and you'll see that business get back to growth. So those elements there, they really look at it and say, "Okay, you've got continued momentum in a large portion of the business. You've got some lapping that's going to be happening." And then we've got this transition, which I consider to be pretty short-term here of a couple of quarters to be able to get to this guide on the nutrition side.

And then I'm sure we'll talk about Exact Sciences, but that's another factor here to be able to add on $3+ billion business growing 15% with a lot of growth opportunities for us. So that's kind of how we looked at it at least from a top line. And then having that flow through down to the bottom line, making investments in the areas that we need to, and nice gross margin and up margin profile expansion too, so.

Great. Thanks so much. Appreciate all the perspective.

Thank you. Our next question will come from Robbie Marcus from JPMorgan. Your line is open.

Oh, great. Thanks for taking the questions. Two for me. Robert, last week when we were talking, you said you expect CGM to continue to track higher at about $1 billion a year. That would put 2026 somewhere in the low to mid teens. Is that the right way to think about CGM growth next year? And maybe if you just want to give your updated thoughts on market growth and Abbott's position there. And then I have a follow-up. Thanks a lot.

Sure. When you said next year, you mean 2026, right?

Got it. Yeah. Yeah. I mean, I think, yeah, there's all this debate that I read about that the market's slowing. And I get if you're just looking at percentages and that's how you base yourself off it, then I guess if it's that myopic, then I think, okay, I understand the conclusion. But I don't consider growing $1 billion every single year and doing it for years in a row to be slowing down here, Robbie. I think the math will work out to what you just kind of highlighted there in the kind of low teens. But I think there's still a lot of opportunity for penetration in this, both from a market perspective, but then also from our opportunity, our ability to drive market share and market expansion.

I think that if you look at across all three patient groups, whether it's the intensive insulin user, the basal insulin user, and the non-insulin user, all of those areas, still, there's so much penetration to be able to have here. And you can see across the world, not just in the United States, but across the world, a lot of movement, whether it's patient groups, healthcare systems that are looking to expand the use and the adoption of the technology into all these patient segments. I know the US gets a lot of attention, and it's an important market. And there's a lot of great opportunities for us there in terms of the non-insulin user reimbursement opportunity. I continue to see nice progress in this process. There seems to be a lot of support to do this.

The data that we've shown, we've published three studies already that show that this patient segment also benefits with lower A1C, greater time in range, all the things that have driven kind of reimbursement in the other segments. So I think that this is a very strong opportunity for us here in the U.S. And we'll see how it plays out. I think we'll see some language in the first half and then how it all plays out with comment periods. You know this, Robbie, there's comment periods, there's all of this. So I'm not baking that into my guidance, but I can tell you we will be 150% ready to execute, whether it's having manufacturing capacity and having the scale and the position on the primary care side, which is where that'll probably play out more. We'll be ready.

So that provides an opportunity to outperform that consensus forecast. I think on the intensive insulin user side, I still think there's penetration to be had and adoption to be had, especially in international markets. I think that's only about 50% penetrated. So I think there's still a lot of opportunity to do the work that we're doing there. Obviously, scale and cost matter in the international markets, and I think we've got that position set. And then as you look at what I think is more specific to us, the opportunity to bring in a very differentiated product to look at market share shift in a segment that I'd say we're probably a little bit underrepresented from a market share perspective, which is on the pumper side with the launch of our CGM sensor. I think that's going to provide us a great opportunity.

I'm not going to try and pinpoint the exact quarter here, Robbie. When we get approval, we'll issue the press release and we'll be out. But we've been working hard already concomitantly with the regulatory process, with KOLs, with physician groups, with payers. And I think there was an article that came out in the Lancet in January talking about, beginning of this year, talking about the importance of measuring continuously ketones as DKA is still a major care gap here for people with diabetes. So I think you've got a big opportunity here with this product for market share conversion. I think one of the surprising things for me in this, as we started to really double-click on these patient segments, is we talked about the SGLT2 population. So we did some analysis in the US. You got about six million SGLT2 users in the US.

And if you cross-reference their usage of CGM through all the databases, only about a million of those six are on CGMs. So I think there's going to be an opportunity here also to kind of create market expansion with this product, so not just share capture, but also market expansion. So this market is still very robust. It's becoming larger. So I get the math. Big numbers kind of lowers those percentages. But if you just look at it from a penetration perspective, Robbie, there's still so much to do in all these segments and different geographies that we're still very excited and making big investments, whether it's in sales and marketing, clinical, R&D, and manufacturing, because we still think that this is still. I'm not going to say it's the first or second inning, but we're far away from being from the seventh inning on this one.

So I think there's still a lot of opportunity here, and we're in a good position.

Great. Maybe just a quick follow-up. It's great to see you're still able to do double-digit EPS growth in 2026. I would imagine that's coming through the top line and margin expansion. How should we think about the magnitude of margin expansion and the drivers of it? Thank you.

Yeah. Thanks, Robbie. I couldn't be more proud of what the team accomplished in 2025, as Robert outlined, overcoming uncertainties, volatilities, and whatnot to still drive margin expansion, and that commitment to the execution and excellence there maintains in 2026. Expect to do more of the same, focus on the things that are strategically aligned and the execution here to where we continue to look at a 50-70 basis-point improvement in operating margins every year, and that's kind of what we've got built into this, and fully expect we'll do that through both gross margin expansion as we've done, but continue to gain leverage in the P&L where appropriate, so that's kind of how we've constructed that double-digit earnings.

Thank you. Our next question will come from Vijay Kumar from Evercore ISI. Your line is open.

Hi, Robert. Good morning, and thanks for taking my question. My first one on maybe on the product side this year, like you mentioned, another double-digit quarter. Just curious, where are we from a penetration standpoint? What innings are we in? And how durable is this double-digit growth in a category that's a pacemaker or low single-digit growth category, and you guys are doing double digits?

Sure. Well, I made some comments about we look at this rhythm management $10 billion market as actually an opportunity to grow. So we have been making our investments. Aveir, obviously, is a big driver of that, but we're making investments in other areas of the portfolio to kind of be able to support our ability to take market share and grow at a differentiated rate here. To your question on penetration, listen, the global low voltage or pacing segment market is around $5 billion, whatever, $4.8 billon-$5.2 billion, depending on what you're looking at. But let's just call it $5 billion. I'd say Aveir is about 10% of that right now. So early innings here for us, for sure. And as I said previously, when we began this process, I wasn't interested in just getting a flash-in-the-pan sales growth for a year or six quarters.

We really worked hard. The team did an incredible job to really establish a new standard of care and get physicians trained at a different type of implant. What we're seeing here is really nice growth in places that a year, year and a half ago, we began the training process and really seeing really strong penetration there. If you look at just single chamber, I think right now the U.S. single chamber pacing, which is about 15% of the total market, that's about 50% penetrated. There's still a long opportunity here in the U.S. and, quite frankly, globally too. I think the team has done an incredible job here. We've launched new products. We'll continue to launch new products in this space.

We think that this is the next standard in CRM is these devices that are communicating with each other that can be implanted transfemorally and don't use leads. The clinical evidence in terms of what they're able to deliver is pretty impressive right now. I think we've got a lot of investment here that will support this type of differentiated growth rate.

That's helpful, Robert. And my follow-up on, or I guess the second question is on capital allocation, any updated thoughts on exact deal close timing, dilution? I think you mentioned $0.20. When you think about your leverage levels, if the deal goes, it'll still be pretty modest. You still have capacity. I'm curious, when you think about M&A versus divestitures or spin-offs, MedTech right now, spin-offs seem to be the flavor of the season. I'm curious how you're thinking about those decisions.

Well, you put a lot into that one there, Vijay. Let me see if I can unpack that. I think from a capital allocation perspective, I've always been pretty consistent with our approach. I don't have a formula that X% goes here, Y% goes there. We are committed to a growing dividend, and we did that again for 2026 when we announced our dividend back in December. So we're growing our dividend. But outside of that, we'll allocate our capital in terms of what we believe is the best balance between short-term and long-term for our shareholders where we can create value. Regarding M&A, listen, my focus right now is integration, closing Exact Sciences, and integration. That's going to be my primary focus. I think post-close, our gross debt-to-EBITDA ratio will be around 2.7 times. So to your point, we still have plenty of capacity.

But I think in the near term, I'd say focus on integrating Exact Sciences. And if there's opportunities for us to add, there will probably be more tuck-in and bite-sized deals to take advantage of. Regarding the status right now of Exact Sciences, I think we're making great progress towards closing. We've submitted all of our required clearances over here. There's a shareholder vote on the 20th of February. So right now, I'm not changing any assumption regarding timing of close or kind of EPS impact. And as we integrate the business, then we'll go updating it as we go along. But right now, there's no change in terms of timing and in terms of dilution. So I read your note last night, Vijay.

I thought that you would have been asking a question about multi-cancers or early detection and the opportunity that exists. I largely agree with your report. I think this is going to be another great opportunity for us. And it's one that, as we looked at the deal, says, "Okay, greater reimbursement of this type of test will really make this a very, very large segment." I think the way I see this is the same way that we have a lipid panel test every year, the same way that we do a cardiometabolic panel or a white and red blood count panel every year after a certain age. I believe that if the product is right and performs right and it's priced the right way, I just envision this being that type of test.

So I think that if that becomes the case, I think your forecast is way undercalled, even on the upper side. But okay.

That's helpful comments, Robert. Thank you.

Abbott Laboratories (ABT) Q4 2025 Earnings Call Transcript

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