Grifols Stock

Hello, everyone, and thank you for joining us today for Grifols' Second Quarter 2026 Earnings Call. My name is Daniel Segarra, and I serve as the Head of Investor Relations and Sustainability. Today, I'm joined by Grifols' Chief Executive Officer, Nacho Abia; President of Biopharma, Roland Wandeler; and Chief Financial Officer, Rahul Srinivasan.

As this is our usual practice, today's call will last about an hour, including the Q&A session. Please note that this call is being recorded. You can find additional materials, including today's presentation in the Investor Relations section of the Grifols website at grifols.com. A transcript and replay of the webcast will also be available on the Investor Relations website within 24 hours.

Turning to Slide 2. I would like to remind everyone that forward-looking statements may be made during this call. This may include, among other things, comments regarding the company's future operating and financial performance, statements about our future expectations, clinical developments, regulatory time lines and the potential success of our product candidates. These statements are based on current expectation and available information as of the date of this call and are subject to certain risks and uncertainties that may cause actual results to differ materially from those discussed today.

Grifols financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions, including alternative performance measures or APMs, as defined by the European Securities and Markets Authority. Grifols management uses APMs to evaluate financial performance as the basis for operational and strategic decision-making. These APMs are prepared for all the time periods presented in this document.

As announced, the Board of Directors has decided to initiate a process to evaluate a potential IPO of the Grifols U.S. Biopharma business. Any such transaction remains subject to legal and regulatory requirements, internal approvals and market conditions, among other considerations. While we are currently limited by applicable laws and regulations in what we can say, we will provide updates when appropriate.

Now moving to today's agenda, I will turn the call to Nacho to kick it off. Nacho?

Thank you, Dani, and thank you all for joining us today. The second quarter played out in line with our expectations, allowing us to deliver a solid first half of the year and keeping us firmly on track to deliver our full year 2026 guidance. The progress we've made over the first 6 months reinforces our confidence as we look to the second half of the year, not because all the work is done, but because the business continues to perform according to plan and the key levers we have put in place are delivering the results we expected.

For Grifols, that confidence starts with the strength and resilience of our business model. Our integrated value chain has long been one of the defining characteristics of Grifols. It is a model built over decades with capabilities that are difficult to replicate and that continue to differentiate Grifols.

Today, I would like to leave you with 3 key messages. First, how to think about our first half performance. Second, how the work we have done across our Biopharma and Diagnostic business continues to strengthen the long-term position of the company. And finally, why the levers that are already in place position us well to deliver on our commitment for the second half.

Let me start with our performance during the first 6 months of 2026. Revenue for the first half reached EUR 3,574 million, up 2.6% at constant currency with Biopharma being the primary growth engine, delivering 5.4% growth, reflecting the disciplined commercial approach we have been taking across the portfolio. As we have said over the past few quarters, our goal is not to maximize volume at any price, but to drive sustainable, profitable and free cash flow growth by focusing on the products, customers and markets where we believe we can create the greatest value.

The same discipline is visible in our profitability. Adjusted EBITDA reached EUR 472 million in the second quarter, representing a margin of 25.2%. And for the first half, adjusted EBITDA reached EUR 854 million, up 2.4% year-over-year at constant currency with a margin close to 24%. Free cash flow improved by approximately EUR 100 million during the first half, reflecting our continued focus on operational discipline, working capital management and capital allocation. While the second half is seasonally stronger for our business, we are encouraged by the progress already achieved and by the foundations we continue to build.

Beyond the financial results, we also continue to strengthen the company operationally. The recent organizational changes are designed to bring decision-making close to our customers and markets, sharpen our commercial focus and improve operational efficiencies in the United States and in the rest of the world.

This quarter, in Diagnostics, we launched Evanzys immunohematology, which is how we name the Barcelona Platform, an important step for our Diagnostic business and the first of many solutions to come under the Evanzys brand name. This demonstrates how we continue to translate decades of innovation into new solutions for our customers. That commitment to building capabilities rather than pursuing short-term opportunities is also reflected in our plasma strategy. Our U.S. collection network remains the foundation of our plasma platform. At the same time, the continued development of our projects in Egypt and Canada is creating a more diversified and resilient sourcing network. Egypt is much more than a new plasma collection project. It is a strategic investment in the future of our business, strengthening our ex U.S. plasma platform, increasing operational flexibility and supporting sustainable growth for many years to come.

The same disciplined approach has also shaped the way we manage our balance sheet, and the refinancing completed during the first half has further strengthened our financial flexibility. Rahul will discuss this in more detail later in the presentation.

Finally, on this slide, we continue to progress our evaluation and associated the preparation for a potential IPO of our U.S. Biopharma business. We will provide any relevant update as appropriate in full compliance with applicable laws and regulations.

Let me now turn to Biopharma, where the work we have been doing over the recent years is becoming increasingly visible. Grifols holds a leading position in a large and growing biopharma market, and we continue to build on that leadership by advancing our pipeline to address patients' evolving needs. Our IG franchise continued to deliver strong momentum, supported by a strong underlying market fundamentals. As we continue to expand the approved indication of our IG portfolio, I would like to highlight our ongoing Phase III clinical trials in secondary immunodeficiencies and CIDP.

First, our Phase III SIGMA study evaluates the efficacy and safety of Gamunex in combination with the standard of care treatment to prevent infections in patients with secondary antibody deficiency. Together with our EXCELL study for Xembify focused on patients with blood cancer who are at increased risk of infections, it reflects our continued investment in expanding the indication of our immunoglobulin portfolio. Another important Phase III study in IG is XPERT, designed to support the potential expansion of Xembify into the treatment of CIDP, offering the potential to expand treatment options for patients.

Beyond IG, our broader protein portfolio is progressing well. Fibrinogen for congenital indication was launched in the U.S. as planned in the second quarter, and we are in the final stage discussions with the FDA to agree on the Phase III trial design for the acquired indication. It will complement our European launches across both congenital and acquired indications. Our alpha-1 pipeline remains fully on track, led by SPARTA and our 15% subcutaneous program, and Roland will provide more details later about it. And our albumin clinical programs in cirrhosis continue to advance as well.

And the [ opinion ] of this is our expanding self-sufficiency platform. With our unique presence in the U.S., both Egypt and Canada continue to strengthen our ex U.S. plasma sourcing through strategic partnerships, allowing us to keep optimizing our collection footprint while maintaining consistently high quality and safety standards across the entire plasma network. Together, our leadership in IG, a broadening protein portfolio and an increasingly self-efficiency sourcing base provides a strong foundation for continued sustainable growth.

Having said that, Grifols has always been more than Biopharma alone, and another important source of differentiation and one that continues to create value for the group is Diagnostic.

Turning to Slide 7. I would like to comment on the progress within Diagnostics. It remains a leading profitable and cash-generative business, built on long-standing customer relations, high barriers to entry and mission-critical solutions embedded in our customers' daily workflows. This business continued to be a complementary pillar to our Biopharma franchise, providing meaningful contributions to our overall margin profile and cash conversion. We continue to make progress across our innovation road map. The clearest milestone this quarter was the successful launch of Evanzys IH, an important step in advancing our next-generation blood typing portfolio. This platform delivers meaningful improved performance in a smaller modular design with a simplified workflow and reduced footprint for customers, and we expect it to be a key driver in sustaining our leadership in this market segment.

Alongside this, Grifols is advancing the development of its automated solutions to help laboratories simplify workflows and enhance operational efficiency. And this includes our ISARD immunoassay platform and our MUNDAKA molecular platform, both of which continue to progress as planned. ISARD, in particular, position us to directly target the approximately USD 1 billion serology market then, and over time to expand into a much larger clinical immunoassay space. Our next generation NAT platform, MUNDAKA, reinforces our leadership in blood screening while strengthening our molecular diagnostics offering. This innovation road map further diversifies our diagnostic revenue base, extends our reach into higher growth adjacent segments and reinforces our strategy to build a presence across the clinical diagnostics market. Together with our ability to operate independently across these platforms, it enabled us to capture more value across the diagnostic value chain while further strengthening our leadership position.

Moving to Slide 8. Let me highlight the key levers that support our confidence in continuing to deliver improvement through the second half. First, continued growth in Biopharma, driven by sustained IG momentum, continued product mix improvement and expected stabilization of albumin in China. Second, the continued ramp-up of plasma from Egypt, while enabling optimization of our U.S. collection. Third, continued progress at Biotest with improving manufacturing performance and a stronger operational execution. Fourth, further operating leverage supported by our ongoing disciplined cost management across the group. And finally, continued improvement in free cash flow generation reflected by effective working capital management, capital allocation and continued financial discipline.

The priorities we set at the beginning of the year remain unchanged. The levers supporting our guidance are already in motion and progressing as expected, and we remain laser-focused on delivering our commitments for 2026 while continuing to strengthen Grifols for the long term.

Before I hand over to Roland, I would like to take a moment to recognize his contribution to Grifols. As you are aware, Roland has decided to return home to Basel in Switzerland to lead a biotechnology company. We appreciate his leadership, his strong contribution and his partnership, and we wish him every success in his new role. We have a strong transition plan in place supported by a highly experienced leadership team, ensuring continuity, disciplined execution and sustained progress against our strategic objectives. Thank you, Roland, and all the best.

Thank you, Nacho, for your kind words. It has been a privilege to contribute to Grifols' success over the last several years and to work alongside so many talented colleagues. I am incredibly proud of the dedication, passion and commitment our team show every day to serve patients that are counting on our medicines and advance the strategic priorities we have set for the business.

Moving to Slide 10. The Biopharma business performed in line with our expectations in the first half, delivering 5.4% revenue growth at constant currency and reflecting the more balanced growth profile we anticipated entering the year. Growth was driven by our IG franchise, more than offsetting temporary headwinds in albumin. Importantly, alpha-1 and specialty proteins returned to growth in the second quarter, resulting in a broader base performance across the portfolio and reinforcing our confidence in the full year outlook.

Let me now comment on each franchise in more detail, starting with IG. Immunoglobulins remained our clear growth engine, delivering 12.8% growth at constant currency in the first half. Performance continued to be driven by robust demand across the U.S. and Europe, sustained Gamunex momentum in our core markets and the successful launch of Yimmugo in the U.S.

Xembify, our subcutaneous IG, also showed strong performance, growing close to 34% at constant currency in the second quarter. As we highlighted in our last call, the underlying in-market demand for Xembify remains firmly in the double digits, and we continue to see that reflected in our performance.

Looking ahead, we expect underlying demand growth for IG to continue across our 3 main indications. In primary immunodeficiency, increased awareness and better diagnosis are expanding access to therapy. In secondary immunodeficiency, demand continues to rise in an aging population and with an increase in immune-compromised patients. And in CIDP, we also continue to see growth. Immunoglobulins, with their broad mechanism of action, remain the established first-line standard of care in this complex multifactorial disease.

This is supported by extensive clinical experience, their broad [ immune monitory ] activity and a compelling value proposition. Recent market developments continue to reinforce the importance of maintaining effective therapy options for CIDP patients and support our confidence in the growth outlook for CIDP. Following our strong first half, we expect IG in the second half to continue to grow mid- to high single digit in the U.S. and our European core countries in line with the market, partly offset by deliberate lower growth in other markets. For Xembify, our SCIG, we see strong momentum and expect continued strong double-digit growth.

Turning to albumin. The underlying market dynamics in China remain broadly unchanged from what we have been discussing in prior calls. As anticipated, first half '26 reflects the year-on-year pricing impact in China following our mid '25 price adjustment with Q2 facing a particularly challenging comparison due to the post license renewal catch up we saw in the Q2 the prior year.

Our focus here remains on executing the actions we outlined, leveraging our strategic partnership with Shanghai RAAS to expand our commercial reach in China while continuing to grow the business in the U.S. and other international markets. Looking forward, we remain cautiously optimistic that market conditions continue to stabilize, supported by an easier comparison in our second half of the year as we lap the pricing adjustment implemented in the middle of last year. Together with the increasing weight of Egyptian plasma in our collection, which comes with high local albumin use and excess IG, we believe that Grifols is well positioned to balance albumin with IG growth over time.

On alpha-1 and specialty proteins, sales returned to growth in the second quarter, up 2% at constant currency. For alpha-1, we saw higher treatment numbers in Q2 as patient access continue to improve following a challenging U.S. reauthorization period earlier in the year. We continue to appropriately support health care professionals throughout the process for their patients, and we're encouraged by the sequential improvement we saw during the quarter.

Demand for HyperRAB also remained strong as we entered the seasonally important summer period in rabies. And in June, our U.S. team launched FESILTY, our new fibrinogen concentrate for patients with congenital fibrinogen deficiency in the U.S., adding to our specialty proteins. Together, the momentum we see in alpha-1 and specialty proteins reinforces our confidence that this franchise will deliver growth for the full year as we outlined at the beginning of '26.

Turning to Slide 11. I would like to spend a moment on alpha-1. In this indication where 85% of patients remain undiagnosed and without treatment, clinical innovation remains central to our strategy, all with the objective to continue to expand the market while further strengthening our leadership in a franchise where we are the global leader. Our SPARTA study has the potential to significantly strengthen the evidence base for augmentation therapy and thus support broader testing and diagnosis as well as improved patient access globally. SPARTA is the most comprehensive outcome study ever conducted in alpha-1 and the first Phase III trial designed to assess preservation of lung density by CT over a 3-year period.

Importantly, the study evaluates both the current standard dose and the higher dose regimen against placebo. Positive results not only have the potential to significantly strengthen the clinical evidence supporting augmentation therapy and thus unlock market growth and improve access, but also may provide valuable insights into future dosing strategies. SPARTA's last patient, last visit milestone is scheduled for August with top line results expected in late Q4 this year.

Our second key program is alpha-1 subcu 15%, which entered Phase III with our first patient dosed in June '26, following our successful Phase I/II study. The program has the potential to transform the patient experience by expanding treatment options through a more flexible and convenient subcutaneous formulation. Taken together, these 2 programs reinforce our confidence in the long-term outlook and opportunity for the alpha-1 franchise. With approximately 85% of eligible patients still undiagnosed, significant unmet need remains. By advancing the clinical evidence base and expanding treatment options, we believe we can help drive awareness, improve diagnosis, broaden patient access and continue to grow the category, further strengthening Grifols' leadership position in alpha-1.

Slide 12. As we continue to expand the long-term opportunity for our business through innovation, we are also evolving our operating model to capture that opportunity more effectively and translate it into sustainable growth and value creation. To accelerate the execution of our strategic road map, we are reorganizing Biopharma into 2 dedicated units, Biopharma U.S. and Biopharma Rest of World, each built around its own self-sufficient operating model with dedicated leadership and clear accountability for its respective market.

Biopharma U.S. remains our scaled, fully vertically integrated end-to-end platform with 2 manufacturing sites and around 280 donor centers. It is set up to serve the largest and most established plasma-derived therapies market in the world where demand is expected to grow at a continued mid- to high single-digit rate annually. Supported by our existing platform, we are well invested to support that growth and can continue to sharpen our focus on operational efficiency and portfolio expansion.

Biopharma Rest of World is a distinct increasingly self-sufficient growth platform with more than 130 donor centers and 5 manufacturing sites. Its priority is optimizing plasma location, increasingly supplying Europe and the rest of the markets from ex U.S. sources, reducing reliance in U.S. plasma and better aligning sourcing costs with pricing structures to optimize growth and profitability. Egypt and Canada are central to building that self-sufficiency, strengthening supply resilience and operational efficiency while increasing patient access to our therapies.

Organizing on these 2 platforms gives each business the focus, accountability and operating flexibility to execute within its respective market dynamics. At the same time, bringing decision-making closer to each business allows us to accelerate execution while continuing to build what we believe is the industry's most resilient and highest value plasma platform.

Let me close by illustrating on Slide 13 how Egypt enables the next phase of our global plasma sourcing strategy and the creation of a truly self-sufficient Rest of World platform. As we explained during our Q1 call, the long-term vision behind our global plasma sourcing strategy is to increasingly supply Europe with plasma from Europe and Egypt, allowing more of our U.S. collection [ storing ] in the U.S. Beyond the economics, this diversification reduces our exposure to any single geography at a time when the geopolitical environment increasingly rewards local sales efficiency.

By 2029, we expect total ex U.S. plasma collections to increase by around 2.5x, providing sufficient supply to fully support our European and Rest of World demand. That compares with today where roughly 25% of U.S. plasma collections are still needed to support sales outside the U.S. As that dependency unwinds, we progressively shift to a U.S. plasma collections for U.S. model, unlocking significant plasma supply and optimization opportunities for our U.S. platform to support the expected strong and growing demand in the U.S.

Egypt is the primary driver of this shift. This year, Egypt already represents around 25% of our ex U.S. plasma collections. And by 2029, we expect the contribution to grow to around 50%, making Egypt our single largest ex U.S. source of plasma and a globally recognized plasma hub under what we call the Grifols Seal of Quality and Excellence. The benefit goes well beyond supply security. As Egypt becomes an increasingly meaningful part of our plasma network, it strengthened supply resilience while significantly improving the economics of our sourcing model.

Together with the operational optimization undertaken across our U.S. plasma network, these initiatives create a more resilient, more efficient and higher value plasma network, one that strengthens supply security, support sustainable growth and enhances long-term profitability.

With that, I will hand it over to Rahul to walk you through the financials.

Thank you, Roland. Turning to Slide 15. Our financial highlights for Q2 and H1 '26. We are pleased with our Q2 and first half performance, results that reflect the resilience and strength of this business and the tireless efforts of our teammates across the entire group for which we are very thankful. Group net revenues reached EUR 1.874 billion in the second quarter, bringing first half revenues to EUR 3.574 billion, a growth of 2.6% at constant currency. As in Q1, Biopharma again grew faster than the group as a whole, up 5.4% at constant currency. This also reflects the strategic repositioning that is underway in Diagnostics, and I will elaborate on it further in the following slide.

Reported gross margin was 37.6% for the quarter and 37.1% for the first half. This was impacted by one-off costs primarily related to the closure of 29 U.S. donation centers. To help investors and analysts track our underlying progress, we are also disclosing gross margin, excluding these one-off costs, which came in at 39.4% for the quarter and 38.6% for the first half. We expect reported gross margin to continue improving in the coming quarters.

Adjusted EBITDA reached EUR 472 million in the quarter, and EUR 854 million for the first half, representing a 2.4% growth at constant currency with margin for the quarter expanding to 25.2% and for the first half to 23.9%, slightly ahead of H1 last year. Group profit in H1 increased to EUR 227 million, up 28.7% year-on-year. And if we eliminated the impact of both positive and negative one-offs, the year-on-year comparison is still a strong double-digit improvement. We achieved EUR 91 million in free cash flow before M&A for the first half of 2026, a EUR 103 million year-on-year improvement. I will elaborate on this free cash flow performance on a subsequent slide.

Total net leverage stood at slightly below 4.2x and net secured leverage at 2.7x. The mismatch between a higher average euro dollar for the period versus lower end-of-period FX rate used for the balance sheet translation creates notional releveraging, but over a longer period of time, that should dissipate, consistent with our prior guidance, that structural movements in euro dollar have a broadly neutral impact on leverage over time. So leverage remains stable, notwithstanding the FX related to releveraging in Q2, and we have EUR 2 billion of liquidity. So our balance sheet overall is in a relatively strong position.

On Slide 16, we summarized the net revenue performance of the business in the first half. Biopharma remains both the bedrock as well as the growth engine of the group and continues to benefit from strong momentum across our core markets. Immunoglobulin once again delivered a double-digit growth with subcu IG returning to strong double-digit growth during the quarter and for H1, confirming that the softer first quarter performance reflected timing rather than any change in underlying demand.

Alpha-1 and our specialty protein portfolio also performed well and continues to support our growth expectations for the full year. Due to the timing of the price concession for albumin in China in H2 last year, relative albumin H1 performance has been impacted. We expect the H2 albumin performance to be in line with H2 last year.

At Biotest, we are encouraged by the operational turnaround progress, and we are beginning to see that also come through in the Biotest growth rate with Yimmugo sales ramping up.

Turning to Diagnostics. The year-on-year comparison reflects the dissolution of the QuidelOrtho joint business. However, the rest of the diagnostics business continues to post year-on-year growth and the team is executing on the Diagnostics repositioning plan hitting all relevant milestones. For Bio Supplies, we expect a better H2 than H1, and more broadly, we remain comfortable with the outlook for this niche business in the medium term. Within others, we have phased out a legacy contract manufacturing agreement at the end of 2025 impacting the comparison in 2026. In short, the Grifols Group portfolio continues to perform in line with our expectations for the year with the momentum of the Biopharma business more than offsetting the planned strategic transition we're executing in Diagnostics and softness in Bio Supplies and others.

Slide 17, the headline numbers, the 2.4% constant currency growth in group adjusted EBITDA and the 10 basis points improvement in adjusted EBITDA margin and Biopharma adjusted EBITDA growing by over 5% on a constant currency basis all mask the underlying drivers of that outcome. I will spend some time unpicking this for you as I think the underlying drivers matter more than the headline outcome in H1, all of which support our adjusted EBITDA margin target of 25% or higher for the full year 2026.

Starting with Biopharma. EBITDA growth and margin progression is supported by 4 structural factors. First, immunoglobulins remain the largest contributor to both revenue and profitability, benefiting from continued momentum and an increasingly favorable product and geo mix, executing our plans in albumin and alpha-1 and other proteins, as Roland alluded to, will support profitability.

Second, the efforts to support Biotest is yielding improvements operationally and making a growing contribution to group sales, and we expect to continue to support the Yimmugo ramp-up in the coming quarters.

Third, we are in the early stages of seeing the benefits from the confluence of our self-sufficiency and plasma sourcing strategies. The continued ramp-up of EMA approved collections in Egypt together with the optimization of our U.S. donor center network is improving both unit economics and plasma economics. And with the continued Biopharma momentum that we expect, these benefits should be further amplified over time by operating leverage across the business, while the EUR 40 million of one-off costs, of which EUR 25 million are noncash, resulting from the closure of 29 U.S. donor centers affect this year's reported EBITDA, they support a structurally more efficient operating model going forward.

And fourth, disciplined cost management, as evidenced by our OpEx evolution remains an important contributor. Also to round up the picture, the full year effect of the albumin pricing concession in China introduced in mid last year has been a headwind in H1 '26 and is now fully reflected in our comparable base, aiding future year-on-year comparisons of quarterly performance. Taken together, these drivers give us confidence that the Biopharma business is well positioned to continue delivering compelling EBITDA growth and margin progression over time.

In addition, in the rest of the group, we are executing our plans and hitting all the milestones with regards to the strategic repositioning of the Diagnostics business, be it the launch of our new blood typing platform that Nacho touched on, hitting development milestones and other platforms, be it MUNDAKA and ISARD, as well as the strategic freedom that the QuidelOrtho dissolution gives us. We remain on course to deliver EBITDA growth and margin improvement from this repositioning of our Diagnostics business over the coming years. As Nacho referenced earlier, we have the levers in place to deliver our adjusted EBITDA constant currency growth and margin guidance for 2026.

On Slide 18, the punch line is that we continue to progress our free cash flow generation efforts in a disciplined manner, and we remain on track to deliver our full year free cash flow guidance. In the first half, free cash flow pre-M&A was positive EUR 91 million, EUR 103 million better than H1 2025, having benefited from some phasing. As we have guided to in the past, while adjusted EBITDA is negatively impacted by a depreciating U.S. dollar, the impact of free cash flow pre M&A remains broadly neutral.

To support the continued momentum in Biopharma and our robust outlook for H2, there has been essential investment in inventory similar to Q1. We continue to manage our working capital diligently and responsibly. CapEx levels are normalizing from the 2024-2025 peak. And as disclosed in Q1, we were required to classify the final ImmunoTek payment made to JPMorgan within financing activities following guidance from our auditors.

Capitalized IT R&D is slightly higher as we successfully achieved various development milestones, for example, within our Diagnostics business. And finally, we balance the refinancing of some of our cheapest debt in our capital structure earlier this year by proactively redeeming EUR 500 million of our most expensive debt to 7.5% 2030 bonds, 7.5% 2030 bonds. And thereby, we expect to keep our cash interest cost levels in line with 2025. In conclusion, our free cash flow trajectory is progressing as planned aligned with the typical seasonal patterns of the business, and we remain on track to deliver our full year guidance.

Finally, turning to Slide 19. I will repeat myself when I say that our balance sheet is in a really good place. No meaningful maturities for a while, almost all the debt in the capital structure is either callable or can be repaid at par, allowing the company to optimize its cash interest cost at any point if it so chooses, strong support from institutional credit investors and banks and rating agencies fully acknowledging the resilience of the business, the progress that has been made and the proactive actions we have taken to considerably improve our balance sheet.

With very strong liquidity levels of over $2 billion, it offers significant downside protection and financial flexibility. Despite refinancing the very cheap debt earlier this year, we remain on course to maintain our 2025 cash interest costs. And in the status quo scenario, we remain committed to continuing to delever organically given the momentum of our Biopharma business and the strong progress we are making in the strategic repositioning of our Diagnostics business.

With that, let me hand it back to Nacho to conclude the presentation.

Thank you, Rahul. I would like to conclude today's presentation with a few final remarks. Our first half performance reinforces our confidence that we are on track to deliver our 2026 objectives. The sustained strength of our immunoglobulin franchise continues to underpin our growth while we expect albumin performance in China to stabilize in the second half, supporting a more balanced contribution across our protein portfolio. At the same time, our expanding alpha-1 clinical pipeline continues to strengthen that franchise and reinforces our long-term growth opportunities.

Biotest also continues to make progress in its turnaround, contributing to a stronger performance at Biopharma. We also currently continue to make meaningful progress on our key strategic priorities. Egypt and our broader self-sufficiency platform remains a key differentiator and value drivers, structurally improved our cost structure and progressively reducing our reliance on U.S. plasma. Together, these initiatives support the top line growth and margin expansion that remains a key priority for 2026 and onwards.

Across our business, we continue to strengthen the foundation for long-term growth through innovation, disciplined and consistent execution with multiple key milestones across Biopharma and Diagnostics. These efforts continue to enhance the resilience of our business and position Grifols to capture attractive growth opportunity in the years ahead.

As Rahul outlined, we have also continued to strengthen our financial profile, delivering further EBITDA growth, meaningful free cash flow improvement and the successful completion of our refinancing, positioning us well to continue reducing leverage over time. Collectively, these actions are building a stronger, more efficient, more disciplined and increasingly cash-generative company, reinforcing our confidence in delivering our full year guidance while creating long-term value.

As we move forward, our focus remains clear, deliver on our commitments, further strengthening our financial profile and unlocking the full value of Grifols for all our stakeholders. As always, I'd like to finish by thanking our employees, donors, customers, partners and shareholders for their continued trust and support. We look forward to updating you on our progress next quarter. And with that, I'll return it over back to you, Dani.

Thank you. Now let's turn to the Q&A session. [Operator Instructions]

Our first question today is coming from Charles Pitman from Barclays.

Charles Pitman from Barclays. Congrats, Roland, on the next role. Thanks for your help over past few years. Maybe two questions from me, please. Starting with Roland. With CIDP, you mentioned recent market developments reinforce the importance of maintaining effective therapy options for CIDP patients. I was wondering, could you elaborate on this? And when you say IG remains the preferred first-line treatment, can you just provide any detail around whether that preferred market share you're seeing is declining at all in the face of competition or whether new entrants are just growing the market, and therefore, that's why you remain confident in the continued growth you referenced?

And then secondly, for Rahul, with respect to Egypt, and thinking about the margin development and lead times of plasma that are usually on a lag. Can you just remind us when we are expecting to see the benefit of Egypt's plasma coming through margins? And also when we expect to see the benefit of the U.S. center closure announced over the quarter?

Yes, Charles. Well, thank you for your wishes and happy to comment on CIDP. With about 2 years into the launch of FcRns, we see that there's more and more real life experience out there, looking at patients that switched and switched back. And you may have seen that some of the label language on the FcRn side was updated to reflect some of these data. And what we hear back from our thought leaders and from the physicians that we speak with is that in their mind, FcRns are a fantastic therapy for myasthenia gravis, and have a very important role there, changing lives and obviously, a great addition for every neurologist.

But if they look at CIDP, a multifactorial disease, they just say it's a disease that is really destined for a broad mechanism of action like the one that you see from IGs, given with what they have in terms of payer access. And what we hear back from physicians is that this is where they want to start their patients, and they want to be very thoughtful which patients they transition over.

Having said that, at the same time, they're, of course, happy that there's other treatment options for any patients that do not do so well. And if we look at the numbers, what we see is that in looking at the demand in the beginning of this year that IGs continue to grow in CIDP. Our brand continues to grow in CIDP. And yes, so we expect that overall, what we're seeing in this class is that more patients get to benefit in later lines, which is, at the end of the day, good for patients, but it also supports fully the confidence that we have in the continued growth outlook for IG in this class.

And then your second question, Charles. Egypt, we're beginning to see some of the impact of Egypt to come through in our numbers. Obviously, that ramps up as the year progresses. And you will see the full impact of the 1 million certainly as you go into 2027, you will see that come through in our numbers then.

Similarly, on -- for the U.S. center closures, you will see the impact or the benefit of that coming through towards the back end of this year or early next year as well and through our numbers.

Thank you, Rahul. Thank you, Charles. Now is the time for Joaquin from JB Capital. Joaquin, please?

Yes. Just the first one is regarding the albumin in China. You mentioned that prices have stabilized. But you remember that in the first quarter, you said that patients, the number of patients was increasing. Has that remained the same during the second quarter? And then earlier in the year, you pointed towards a strategy of slowing down IG in order to balance albumin IG. But IG has continued to grow at a very decent rate. I know you mentioned it will slow down a bit in the second half of the year, but still it will be ahead of what I was expecting, and I think a lot of people. So has the strategy changed? Or did you find another way to balance albumin IG? If you can talk a little bit about that?

Well, Joaquin, thank you. On Albumin in China. What we focus on in this market, of course, is end-user prescription and demand. And this is where we commented that we see signals of stabilization both in terms of price with our customers as well as prescriptions and pull-through in this market. We saw that in Q1, we continue to see this at the moment. Having said that, it's a market that had an impact of the government measures, as you know. We have this reflected in our price adjustment mid-last year. But since then have experienced ourselves stabilization and are cautiously optimistic that we can build from there.

And on IG, I can just perhaps clearly just clarify that for IG, we have a twofold strategy, which is that we want to continue to grow with the market in the U.S. in our core European markets and selectively dial back on purpose in lower-margin markets. And that's what you see panning out. So basically, what you see reflected is strong continued demand in our core markets and in the U.S. And you will indeed see that over time, that the phase out in these lower-margin markets will come through in later this year. But Rahul, if you want to add?

Nothing to add. I think it captures it well as well on Page 10, Joaquin, in terms of our outlook for H2 '26, where we're guiding to mid- to high single-digit growth in core markets. Could we grow IG more? Sure. But I think it's a deliberate strategy to optimize the mix between growth and margin improvement, and that remains our focus.

And just to add here that, I mean, at the end, this -- what we try to do is a smart growth strategy, really focusing the customers, the regions and the products that will provide the better margin position. That's what Xembify, you see that this will continue growing and continue to grow very strong because we are building our position in the market, where in IVIG, we have already well established. So I think that our strategy will continue growing. I mean, certainly, we believe in IG, and we believe in the -- I mean, in the strong demand of IG in the markets, but we will do it in a smart way and certainly I mean, betting on those places, customers and regions, which kind of offer better profitability.

Thank you, Joaquin. Now it's the turn of Guilherme Sampaio from CaixaBank.

Yes. Thank you, Roland, for these years. So first question on free cash flow. You've reached the year-on-year improvement in free cash flow, implies in the top end of your guidance already in H1. Is there any factor that we should take into consideration that's preventing you from raising the free cash flow guidance at this stage? And the EUR 25 million QuidelOrtho compensation due to the [indiscernible] generation. I think it was scheduled to be paid this quarter. Just if you can confirm that it was paid or not and if it was appearing in a certain way or not? And you mentioned some phasing, if you can quantify the phasing around the free cash flow this quarter.

The second question is regarding the execution risk. So there's been market rumors that you might have certain execution risks in the ramp-up of your plasma centers in Egypt. What kind of comfort or color could you provide regarding this business?

Why don't I take the first one, and I'll start with the second one as well. And if either Roland or Nacho want to add, they can do so. On the first one, Guilherme, around free cash flow, I did reference phasing deliberately so that you don't just take EUR 103 million and add it to the EUR 467 million we delivered last year and say, "Hey, we're at EUR 570 million." There are phasing aspects of it. You've mentioned some of it. Quidel is also an aspect that is reflected in there. And we remain very much in the guidance of the EUR 500 million to EUR 575 million free cash flow pre-M&A for the full year.

As you think about execution risks, look, we remain confident about the ramp-up in Egypt. You just -- if ever you're in Egypt and you walk past our centers, you will see that they are packed nonstop. And this is only the first wave of donor center opening. So things are going there very -- going very well, and we don't anticipate any execution risks with that ramp up. We'll have to obviously optimize it, so which is why we say 1 million in 2026, ramping up to up to 3 million by 2029. I'll leave it at that.

And just to add, I don't know what the rumors you refer. We haven't had any rumors. I actually think the execution in Egypt is working very well. We are very much on plan and on track to build the 20 donor centers that we wanted to build. As Rahul said, those donor centers are packed, and we have tons of donors waiting to donate. And we're already working into planning for the next centers that will be built over the next year. So I think it's working very well as planned, and we have no notion of execution risk other than obviously, we'll keep continuously in our attention, we'll keep focusing on that.

Thank you, Rahul, and thank you, Nacho. Now let's move to Morgan Stanley, Thibault, please?

Yes. Rahul, Maybe just a clarification. I think I heard you say that albumin outlook for H2 would be in line with H2 last year. Just if you could confirm this and if you meant in absolute terms or in terms of decline rates basically versus H2 last year? That's the first question. And also on albumin, if you could give us any idea of the growth ex China albumin franchise, if you're seeing some growth in H1, just so we sort of better forecast when we sort of get out of the China base effect?

And then second question on Biotest. So turnaround of Biotest has been definitely a driver of margins for the business. How far are you on the story of turning around this business? Can it continue to be a driver for margins in the next few years? Or are you mostly through the improvement here?

Yes. Let me start with what I said on albumin, where what I was referencing was the absolute level for H2 rather than the growth rate. So please don't reflect any [ draconian ] scenarios, the absolute level because remember, the price concession was provided in mid last year. So that's why the absolute level is the right benchmark.

Just in terms of growth ex China, I'll let Roland pick that up in a second. Let me answer your question on Biotest in the meantime. On Biotest, the operational turnaround is commencing now. We have a lot of runway on this topic, and we expect to make considerable progress in the coming quarters. And certainly, it's a key part of the value driver going out through 2029. But on the albumin ex China, Roland, do you want to pick that up?

Albumin ex China, I would differentiate there the U.S. where we see high interest in our albumin in [ battery, ] 1 of only 2 providers that offers that, and we were actively working to increase our supply for this differentiated presentation. And in the other markets, ex China, ex U.S., yes, in the first half, we've seen good growth. We're not disclosing the detailed growth number, but we're seeing good growth in the first half of this year.

And just to perhaps provide context there. As you may recall, in the past, we have been prioritizing China, and we discussed that we have opportunities in these other markets. The team has been executing against that. And I think that's behind the growth that we see.

Thank you so much, Roland. Let's move to the next question. Jaime Escribano from Santander. Jaime, please go ahead.

Yes, first of all, thank you and good luck to Roland. My first question would be on Diagnostics. So on Diagnostics after breaking the JV with Ortho, just thinking out loud. So can you elaborate a little bit on what opportunities, new opportunities come in terms of selling their reagents to other customers and so on from 2027 onwards, I mean.

And the second question would be regarding net finances, which in Q2 look quite low. I don't know if you have answered that, Rahul, but just if you can elaborate a little bit further.

Yes. Thank you, Jaime. And let me explain about the Diagnostic question. I mean, essentially, the collaboration with QuidelOrtho has been a very good collaboration for Grifols and Quidel also over many years. But this was coming to an end for a number of reasons. But specifically to your question about what this will provide, I think probably the most important benefit of this termination is actually the fact that it will open the possibilities for us that once the ISARD platform for immunoassays will be ready, we will be able to access that market without restrictions. This is a $1 billion market opportunity. It's a very significant opportunity.

Of course, there is some opportunities in our -- in the factory that was serving those reagents. We will continue looking for customers and even providing QuidelOrtho with some suppliers. We have some supply agreements with them. But the largest opportunity that we will unveil is certainly the access to the immunoassays market once the ISARD platform will be ready around 2030, 2031.

And for the second one, Rahul?

Yes. Net financials, Jaime, that's the impact of IFRS 9 as a result of the refinancing we did earlier this year. And that's one of the reasons why I've spent a lot more time focusing on cash interest costs. Cash as cash. And there's no -- you're not exposed to the vagaries of accounting treatment. So IFRS 9 requires us to do a present value calculation as a result of the refinancing, and that resulted in this onetime gain.

I alluded to that when I talked about the onetime gains as well as the onetime costs impacting our net income, that's what it refers to. But the cash interest cost number that's going through our free cash flow, that is obviously -- that's just -- that's real cash. So that remains our area of focus.

Thank you so much, Rahul. Thank you so much, Jaime. Let's move to the next question. Juan Ros from ODDO.

Two please. First of all, earlier this year, CSL reduced its guidance, 2026 guidance for IG in the U.S. by around $300 million. They were saying, they were saying in excess [indiscernible] inventory. So could you please reconcile this with your current IG growth in the U.S. market? Maybe you're expressing different dynamics or you're gaining market share? Is it a matter of price? Maybe you can illustrate us in that sense, please?

And second, regarding the regarding the gross margin, your adjusted margin, gross margin fell 90 bps this quarter. So maybe you -- could you provide us some more color on the moving parts, what's China albumin, what's IG mix, what's pricing, what's CPL, FX, maybe you can help us a little bit with that.

Thank you, Juan. I mean on the -- first of all, we don't comment on our competitors' messages in the market. So they, obviously, they explained their story as they wish. We can comment only about what we see, and what we see in the U.S. market, and not only in the U.S. but in the rest of the world, it's a continued strong demand of immunoglobulins. So I think that the high single digit demand is there for IV. And in our case, obviously, the subcutaneous formulation is growing very fast because we have started late, and we are very quickly gaining market share. But our positive view is based on what we see and based on -- and that is what is driving our results as well.

And I don't know, Roland, do you want to complement this?

No, just to emphasize that the results that you see that we presented today for the U.S. are all fully demand driven. So these are patients receiving medicines and looking at wholesaler inventory levels, they were roughly stable around this period in the first half of the year. So all demand driven, it's not just us.

And Juan, I think your question relates to gross. I think you're making reference to -- on Page 15, the 38.6% adjusted, and I think you're comparing it to the 39.1% in H1 '25. Have I got your question, right?

Correct.

Okay. Yes. So look, I think as you said, there are a number of constituent parts. I'm not going to break out the various constituent parts, but let me walk you through some of those constituent parts. I talked about price and geo-mix being supportive. I talked about plasma costs being supportive from a CPL standpoint. We have the beginning of Egypt ramp-up coming through. Those are all supportive of -- from an adjusted gross margin standpoint.

The negatives, we talked about the restructuring, as you identified as well, the restructuring of the plasma centers. That's a significant number, right? That's EUR 40 million, of which EUR 25 million is noncash. And then we also talked about Bio Supplies and others being a lagging compared to 2025. So those are the key drivers of the difference between the 38.6% on an adjusted basis as well as the -- or actually the 37.1% and the 39.1%, and that's why we've included the 38.6% to help make the comparison better.

Also remember, H1 last year, we didn't have albumin, the impact of the albumin price. That only came through the albumin price concession only came through in mid last year. So that's one of the key drivers impacting comparability between H1 '26 and H1 '25. So hopefully, that is comprehensive in our response.

Thank you so much, Rahul. As we are close to the hour, let's make -- let's take the last question from Charlie, Bank of America. Charlie, please?

Charlie Haywood here from Bank of America. It's on the SPARTA alpha-1 trial with data end of the year. Could you frame your confidence in the outcome trial given the data you've seen to date? And any expectations for the 120 mg or the 60 mg dose? And if you do see a dose response, do you expect to see any patients shift to the higher dose and how much upside could that offer?

And then second question on that is if you do see a dose response, do you see a risk that you effectively validate competitor thesis for its regulatory pathway that higher trough [ AAT ] levels correlates to better clinical outcomes? And how do you assess that?

Charlie, happy to speak about SPARTA. As mentioned, we have the last patient, last visit in August. And obviously, right now, all the data is blinded. So we haven't seen the data. After last patient, last visit, we'll have the database locked, the cleaning of data. And as soon as we have the data available, the analysis done, of course, that's where we publish our top line data. We all look forward to it.

What we do know is that the SPARTA study was designed with all the insights of prior studies and specifically, the treatment window was extended from 2 years in prior studies to 3 years to give enough time for the preservation of lung tissue to actually come through. So we're obviously very confident in the thesis that made SPARTA possible and in the way that the team executed. And we know that opinion leaders are very much looking forward to seeing this study.

In that sense, opinion leaders are also very much looking forward to seeing the results between the 60 and the 120-milligram dose. Now having said that, the study is initially not powered for that, it's powered to look at the outcomes, which is a key part to -- for us to show preservation of lung function in these patients. And as it comes to upside, I think what it would mean is that the results will guide physicians in the daily practice as, again, physicians are very much looking forward to looking at this data. And once we have the data, we'll be able to comment more in response to that.

I think the second question was just around competitor validation. I think outcomes data versus augmentation levels, I think, is a key differentiator that SPARTA brings us, particularly as you think about some of the payer pressures and so on and so forth. I mean it sets us up in a much better position. So we -- I think as we said, we said all along, we are ready to compete. SPARTA is certainly a part of that, and we look forward to sharing the data as soon as it's available.

Okay. Thank you so much. I said that was the last question for today. Thank you for joining us today and especially for your time during this busy reporting week. We look forward to speaking with you again next quarter. Thank you so much.

Hello, everyone, and thank you for joining us today for Grifols Fourth Quarter 2026 Earnings Call. My name is Danny Segarra, and I serve as the Head of Investor Relations and Sustainability.

Today, I'm joined by Grifols Chief Executive Officer, Nacho Abia; President of Biopharma, Roland Wandeler; and Chief Financial Officer, Rahul Srinivasan.

As is our usual practice, today's call will last about an hour, including the Q&A session. Please note that this call is being recorded. You can find additional materials, including today's presentation in the Investor Relations section of the Grifols website at grifols.com. A transcript and replay of the webcast will also be available on the Investor Relations website within 24 hours.

Turning to Slide 2. I would like to remind everyone that forward-looking statements may be made during this call. This may include, among other things, comments regarding the company's future operating and financial performance, statements about our future expectations, clinical developments, regulatory time lines and the potential success of our product candidates.

These statements are based on current expectations and available information as of the date of this call and are subject to certain risks and uncertainties that may cause actual results to differ materially from those discussed today.

Grifols financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions, including alternative performance measures or APMs, as defined by the European Securities and Markets Authority. Grifols management uses APMs to evaluate financial performance as the basis for operational and strategic decision-making. These APMs are prepared for all the time periods presented in this document.

As announced on May 24, the Board of Directors decided to initiate a process to evaluate a potential IPO in the United States of a portion of the shares of its subsidiary and parent of its U.S. biopharma business. Any such transaction remains subject to, among other things, regulatory and legal requirements, internal approvals and market conditions.

In keeping with the legal and regulatory advice received, we will not be able to address any questions regarding this transaction at this stage. We will provide updates as and when necessary, remaining in full compliance with applicable laws and regulations.

Now moving to today's agenda. I will turn the call to Nacho to kick it off. Nacho?

Thank you, Danny, and thank you all for joining us today.

In the first quarter of 2026, we delivered a solid start to the year, maintaining our focus on our core priorities as outlined in the annual guidance provided in our previous call. The results of the first quarter were in line with our expectations and forecast. We are on track to achieve our guidance for the full year 2026 as we continue to build momentum over the course of the year.

Today, we will focus on 3 key areas. First, we will talk about our commercial strategies across regions with a clear focus on capturing growth opportunities in core markets.

Second, we will further clarify the strategic importance of Egypt following EMA approval, a milestone that strengthens our global plasma diversification strategy, expands our sourcing capabilities, improve access to treatment in Egypt, the region and Europe and structurally and meaningfully reduces cost per liter, thereby supporting our margin expansion.

And third, we will address the continued strengthening of our balance sheet through disciplined refinancing and sustained free cash flow generation.

Finally, we will review some key progress within Diagnostics as we near an important milestone, the launch of a new platform that expands market opportunities in blood typing as we committed at our last Capital Markets Day. This advancement reflects our ongoing commitment to innovation and to supporting long-term growth in this division as well.

Turning to Slide 5. Revenue for the quarter reached EUR 1.7 billion, representing an increase of 3.3% at constant currency. Adjusted EBITDA increased to EUR 404 million at constant currency, EUR 381 million on a reported basis, with margin broadly stable year-on-year. Free cash flow improved by EUR 30 million, with leverage stood at 4.3x, which is broadly stable versus year-end and consistent with the seasonality we typically see in the first quarter.

Biopharma led this performance with growth of nearly 7% at constant currency, once again underscoring the strength of our IG franchise, which delivered double-digit growth, particularly in core markets.

Our focus remains on executing our key priorities for 2026, driving adjusted EBITDA margins to at least 25%, while delivering 5% to 9% adjusted EBITDA growth at constant currency, improving free cash flow towards our EUR 500 million to EUR 575 million target and maintaining strict financial discipline.

We are actively pulling strategic levers across the organization to deliver on those objectives, which I will detail in the following slide. We also note the recent exception of plasma-derived therapies from U.S. tariffs under Section 232, which underscores the strategic importance of plasma in today's global environment.

Finally, as announced in March, we are evaluating a potential IPO of our U.S. biopharma business. While it is still early in the process, and we will not be able to provide additional information in today's call, it reflects our continued focus on maximizing shareholder value. We will update you with necessary details in due course and stay compliant with applicable laws and regulations.

Now let me turn to our focus in 2026 in order to achieve our annual goals. Moving to Slide 6. I want to detail the strategic drivers that support our confidence in achieving our 2026 guidance. Our focus is centered on 5 key pillars of execution.

First, we are optimizing our biopharma product mix. While our IG franchise continued its momentum, we are balancing this with a continued focus to drive growth across our broader portfolio of products.

Second, the ramp-up of our Egypt platform is a transformative milestone. As I mentioned, this is a structural shift in our sourcing capabilities. We are in a clear trajectory to collect 1 million liters of plasma in Egypt this year, scaling rapidly to 3 million by 2029.

Third, this Egyptian expansion allows us to accelerate the optimization of our global plasma sourcing. By integrating this lower cost per liter supply, we can more aggressively optimize our U.S. plasma network, improving overall margin efficiency without compromising our supply needs. This also ensures flexibility and optionality to expand our plasma needs.

Fourth, we are focused on the operational and financial turnaround of Biotest. A key catalyst here is the commercial progress of both Biotest new generation of immunoglobulins, Yimmugo as well as fibrinogen products, PRUFIBRY and FESILTY, which are starting to contribute to the top line as we integrate these assets more deeply into our global commercial portfolio.

Finally, our commitment to financial discipline remains absolute. We're maintaining rigorous cost control and maximizing operational leverage across the entire group. These 5 drivers are not mere targets. They represent active strategic levers. Their successful execution is what will allow us to grow strategically, expand EBITDA margins and deliver the improved free cash flow we have committed for the full year 2026 and beyond.

Before moving to a more detailed biopharma update that Roland will provide, I would like to briefly comment on the performance of our diagnostic business on Slide 7.

It's important to note that the reported revenue decline does not reflect the underlying fundamentals of the business, but rather the temporary impact from the dissolution of the Quidel Ortho joint business. On a like-for-like basis, our diagnostic revenue grew in the low single digits year-over-year.

As part of the joint business dissolution, we agreed to a USD 65 million compensation payment to Grifols, which will be distributed over the next 3 years. While the termination of the joint business created a short-term headwind, the decision was ultimately a strategic one. Ending it unlocks full autonomy to offer a broader range of donor screening and clinical diagnostic solutions and better positions us to capture the full value of our new ISA platform rollout.

These new immunoassay platforms enable us to directly target the serology market, which is valued at approximately EUR 1 billion. Additionally, it provides an opportunity to eventually expand into a much larger total addressable market of the clinical immunoassay sector. This is a segment where our ability to operate independently enable us to fully participate, control the value chain and maximize returns.

As such, our platform represents a key pillar in diversifying our diagnostic revenue base and expanding into adjacent high-value segments.

Other than this significant step in our serology business within blood typing solutions, the Barcelona next-generation platform is our most significant upcoming catalyst. This platform delivers significantly improved performance in a smaller modular design with a simplified workflow and reduced footprint for customers.

We remain on track for its launch in Q2 '26 at the leading flagship industry trade fair. And we expect this platform to be a key driver in sustaining our leadership in this market beginning in 2027.

In NAT, our MUNDAKA platform remain on track for launch in 2030, reinforcing our leadership position within NAT through higher throughput and sensitivity and advanced design.

As we look beyond 2026 and specifically 2027, we expect our diagnostic business to continue to grow in the low single digits as we continue to grow our blood typing business, while MDS, we consolidate our donor screening market position and grow in the plasma screening segment.

We expect the good performance of the BTS and MDA businesses to be partially offset by our IDS business as the supply agreement with Abbott ends and we gear the manufacturing towards this.

I want to reiterate here that our Diagnostic business remains a vital complementary pillar to our biopharma franchise, providing significant contributions to our overall margin profile and cash conversion.

Before moving to Roland, I would like to emphasize that the progress of the company in the first quarter reflects disciplined execution across our strategy, operations and finance. We are building on strong fundamentals, advancing our margin initiatives, strengthening our global plasma platform and reinforcing our balance sheet.

This execution supports our confidence in delivering consistent progress throughout the year as we work towards our full year guidance and unlocking the full value of our competitive advantage. With that, I will now turn it over to Roland. Thank you.

Thank you, Nacho. Moving to Slide 9. The Biopharma business overall delivered a solid start to the year with 6.8% growth at constant currency in the first quarter. I am proud of the dedication, passion and commitment our team shows every day to deliver for patients and drive forward towards the goals we set out.

Q1 growth was driven by continued strong momentum in Ig, partially offset by albumin in China as well as lower sales in other proteins. Let me briefly walk through each segment.

Immunoglobulins were the clear growth engine. Our Ig portfolio delivered 15.3% year-over-year growth at constant currency, driven by sustained traction of Gamunex in the U.S. and core European markets, fully aligned with our strategic focus. Performance was further supported by the successful U.S. launch of Biotest Yimmugo, which is building on the strong underlying momentum of our existing brands.

Xembify, our subcutaneous IG, continues to see strong double-digit in-market demand growth in the U.S. Reported ex-factory sales this quarter, though, were partially impacted by year-on-year inventory phasing with Q1 '25 benefiting from a wholesale inventory build and Q1 '26 reflecting some inventory normalization. Importantly, the underlying demand trend remains very strong. And for the full year, we continue to expect strong double-digit growth for Xembify.

Turning to albumin. Q1 sales declined 6.1% year-over-year at constant currency, reflecting the expected continuation of market and pricing dynamics in China that we discussed at year-end. Following several years of strong growth, demand flattened in 2025, and we adjusted pricing midyear.

Over the past quarters, pricing in hospital has stabilized, which is encouraging. However, the first half of 2026 continues to compare against the higher pricing base in '25, and we, therefore, expect albumin sales to be lower year-over-year in H1 before stabilizing into the second half.

Despite these near-term dynamics, our longer-term outlook for albumin remains constructive, supported by our strategic partnership with Shanghai RAAS. With elevated in-country inventories in the market, our focus is firmly on driving demand with disciplined pricing and aided by an expanded joint commercial footprint and a more targeted marketing and contracting approach.

These actions are aimed at increasing hospital access, including deeper penetration into lower-tier hospitals, while also expanding our presence in retail pharmacies. In parallel, our medical teams continue to invest in education and evidence generation around long-term albumin use in liver cirrhosis and an important and still unmet need in China.

As conditions stabilize, we remain confident that these actions position us well to get back to growth in this key market. At the same time, we are actively pursuing opportunities outside China with a clear emphasis on expanding our albumin presence in the U.S. and other markets.

This, together with increasing yields and the use of excess Ig from EMA approved Egyptian plasma will enable us to balance our Ig and albumin growth over time.

On Alpha-1 and specialty proteins, sales came in 7.4% lower year-over-year, reflecting a prior year comparison that benefited from inventory buy-in for both alpha-1 and fibrin sealant at the time. Within Alpha-1, which represents roughly half of the category, we were encouraged by growth in new patient referrals during the quarter, highlighting the continued unmet need and a significant number of undiagnosed patients.

While underlying dynamics are strong for Alpha-1, HCPs and patients continue to navigate access hurdles, especially in the first part of the year. We heard from physicians and patient associations that the reauthorization period in the U.S. was a difficult one and that a number of patients had to go through multiple appeals to finally receive approval for their therapy this year.

We will continue to do our part to appropriately support health care professionals in their work of securing access for their patients. And this is where we are looking forward to sharing our SPARTA outcomes trial results with top line results expected later this year. Successful trial outcomes will help to further drive awareness to reach patients yet to be diagnosed, but also provide additional evidence that may bolster access for both new and existing Alpha-1 patients in the U.S. and abroad.

In the remainder of the category, sales of fibrin sealant, Factor VIII and contract manufacturing were lower year-over-year. Following strong inventory build by Ethicon in 2025 to support global launches of fibrin sealant, Q1 reflected some inventory drawdown. This was partially offset by continued solid demand for Hyperab. While seasonally lower in absolute terms, we are encouraged by the momentum as we move towards the summer peak season for this important product.

Overall, we remain confident in the underlying fundamentals of Alpha-1 and expect the Alpha-1 and other proteins franchise to return to growth over the full year 2026.

Moving to Slide 10. What I'd like to highlight is how intentionally differentiated our approach is across both geographies and proteins.

Starting with immunoglobulins, our growth engine. In the U.S., our priority is clear: grow with the market on a higher base following our market share recovery in '24 and '25. We expect continued mid- to high single-digit growth for Gamunex as our leading IVIG and strong double-digit growth for Xembify in SCIg.

Outside the U.S., we are taking a more selective value-driven approach. In Europe, we are focusing growth on higher-margin strategic markets while actively optimizing our footprint in lower-return markets. At the same time, we are advancing self-sufficiency in Canada and leveraging platforms such as Egypt as a plasma source to support Ig supply into Europe.

Turning to albumin, where the focus is balance and value optimization. In the U.S., we are benefiting from increasing demand for albuminum bags as 1 of only 2 players with this differentiated offering and where we are working to expand supply going into 2027. At the same time, we are effectively competing with our portfolio of aluminum vials with a disciplined approach to contracting.

Outside the U.S., we have a two-pronged approach. In China, our focus is on driving demand and access, leveraging our strategic partnership with Shanghai RAAS, expanding into Tier 2 hospitals and increasing our reach in retail pharmacies. In other markets, we see good progress and room to further grow our albumin sales.

Overall, the objective is to stabilize performance in China and selectively expand beyond China, including the U.S. with a differentiated offering of albumin bags.

Finally, Alpha-1 and specialty proteins, where our ambition is to lead and expand the category globally. In the U.S., the priority is to expand alpha-1 diagnosis and treatment of appropriate patients in a market where 85% of patients are not yet diagnosed.

We believe that our outcome study, SPARTA, which for the first time may show better maintained lung function versus placebo, will play a key role to raise awareness, broaden the share of physicians that consistently test their COPD patients and facilitate access to therapy.

Our team is preparing for top line results expected by year-end and is planning a deliberate coordinated approach to communicate SPARTA outcomes to support growth.

In addition, we are encouraged by our momentum with HyperAp and excited about our upcoming Fibrinogen launch later this quarter. Outside the U.S., we continue to drive Alpha-1 growth in reimbursed markets and prepare to leverage SPARTA to unlock broader reimbursement, increase awareness and expand access in those markets that so far have limited treatment for alpha-1 patients.

In addition, we will continue to drive our launch uptake with Fibrinogen in Germany and Austria as the 2 leading markets for the targeted treatment of acquired fibrinogen deficiency.

So stepping back, what you see is a disciplined and differentiated portfolio strategy to drive value, growing Ig where we have leadership and value, balancing and optimizing albumin across markets and positioning Alpha-1 and specialty proteins for continued growth.

But value creation is not just about where we compete. It is also about how we source and produce our therapies. It is where plasma becomes a critical enabler of our model.

Turning to Slide 11. What we are doing in plasma sourcing is not incremental. It is a structural shift, both for Grifols and for the industry and a core pillar of our margin expansion.

Historically, the industry has operated with a structural imbalance. The U.S. has been the primary source of plasma for the world and a significant portion of that volume has been used to supply markets outside the U.S. Given that the U.S. is a high-cost source of plasma, exporting that cost base into markets with more constrained pricing creates a mismatch between cost and revenues.

At the same time, the high reliance on U.S. plasma adds structural risk, particularly in geopolitical environment that is increasingly favoring local self-sufficiency. What we are doing now is fundamentally changing that equation.

Over the last years, we already increased ex-U.S. collections with growth in our European centers and our self-sufficiency partnership in Canada. But following the EMA approval of Egypt sourced plasma in December '25 as part of our self-sufficiency partnership in Egypt, we are now adding a third scalable ex-U.S. plasma sourcing platform.

We are on track to collect around 1 million liters in Egypt this year, scaling to about 3 million liters by 2029. Together, this allows us to meaningfully rebalance our sourcing footprint, where today, roughly 25% of U.S. plasma is needed to support demand outside the U.S. By 2029, we expect plasma volumes sourced ex U.S. to increase roughly 2.5-fold, sufficient to supply our European and rest of world demand.

This allows us to significantly reduce the need to use high-cost U.S. plasma for lower-priced markets over time. Instead, we move towards a 2-system model. U.S. plasma will be primarily serving the U.S. market where demand and value are highest and where focus will unlock further opportunities to optimize our CPL and operations. And ex U.S. plasma will be sufficient to supply ex U.S. markets aligned with local economics and benefiting from excess IG in context of our self-sufficiency partnership with Egypt.

This unique geographically differentiated and vertically integrated approach unlocks 2 major benefits. First, cost and margin optimization. By aligning our sourcing with market pricing, we structurally improve profitability; and second, resilience and supply security, reducing dependence on a single geography with the potential to mitigate policy, tariff and regulatory risks.

So to be very clear, this is not just about expanding plasma collection. We are fundamentally redesigning how plasma is sourced and allocated globally, creating a more efficient, more resilient and structurally more profitable model.

Let me close on Slide 12 with how to think about our U.S. biopharma business, where Grifols has over the last decades with Foresight, built a unique, fully vertically integrated local-for-local value chain.

Starting with the market, the U.S. is the largest and most attractive Ig market globally, exceeding $20 billion with continued strong demand for our therapies and a system that values plasma-derived medicines. This provides a strong foundation for continued growth, supported by increasing diagnosis and still high unmet need across our therapeutic areas.

Looking at our model, as we have discussed in our previous call, our unique approach in the U.S. offers resilience and focus. Grifols is the only scaled company with an established fully integrated end-to-end presence in this key market, spanning everything from plasma collection to manufacturing and commercialization in the U.S. for the U.S.

In the current political environment, this closed-loop system is increasingly recognized as a strategic asset, providing supply security and operational resilience. At the same time, it gives us greater control and visibility across the value chain, allowing us to better align plasma collection, capacity utilization and commercial execution as our global sourcing model evolves.

Lastly, looking at productivity, our local-for-local approach increases focus and allows us to drive efficiencies across our operations in the U.S. On the collection side, we are increasing plasma collections per donor site, which allows us to optimize our footprint. The recent closure of 29 underperforming donor centers with partial consolidation into higher-performing locations reflects a disciplined approach to optimizing our cost base and network quality, all while still enabling an increase in our annual plasma collections in the U.S.

On the industrial side, our facilities in California and North Carolina represent the largest fractionation and purification capacity in the U.S. and are well positioned to support local demand growth. Importantly, following prior investments, we are now able to capture this growth largely within our existing capacity without significant incremental capital.

And lastly, looking at our supply chain, our local-for-local approach allows us to further optimize our working capital cycle across markets. Bringing these elements together, market, vertical integration and productivity allows us to drive value for biopharma.

With that, I will hand it over to Rahul to walk us through the financials.

Thank you, Roland. On Slide 14, we summarize the financial highlights for Q1 '26. As Nacho and Roland highlighted, our Q1 performance is entirely in line with our plans and expectations for the full year, notwithstanding the complex geopolitical and macroeconomic backdrop.

Before I go into the financial performance, I'd like to highlight a couple of points. Firstly, it's great to see the strong execution across the board by the entire team, and in particular, the resilience in biopharma driven by the continued strength in our immunoglobulin franchise.

Second, please keep in mind that Q1 '26 relative performance compares to a Q1 '25 that was our best Q1 in history, a record performance that also benefited at the time from some phasing and a stronger U.S. dollar. And finally, we have considerably derisked our balance sheet since our last update, and I will elaborate on that later in the presentation.

Moving on to the financial highlights in Q1 '26. We achieved reported revenues of EUR 1.7 billion, representing a 3.3% growth at constant currency with our Biopharma division growing considerably faster than that, and I will touch on the performance of the other segments on the following page.

With regards to the reported gross margin, consistent with our assurances during the full year call at the end of Feb, our gross margin has improved by 180 basis points compared to the gross margin in Q4 '25, taking into account the pricing concession offered in Q3 and Q4 last year to support our joint efforts with our strategic partner to navigate the albumin market in China as well as the gross to net adjustments for full year 2025 being applied entirely in Q4 '25.

In this regard, the gross margin comparison to Q1 '25 is therefore less relevant. Other aspects impacting comparability to Q1 '25 include the dissolution of the joint business with Quidel Ortho, Biotest strong sales growth in Q1 '26 as operational enhancement progresses during the course of the year and general phasing across the Grifols Group in 2026, where we expect Q3 and Q4 to be our strongest quarters, partially aided by the ramping up of our plasma collections in Egypt during the course of the year.

As per my guidance at the time of our full year call, the full year reported gross margin for 2025 of 38% is the right benchmark for 2026 and a portion of the adjusted EBITDA margin improvement being targeted in 2026 is expected to also flow through gross margin.

Adjusted EBITDA stood at EUR 381 million, up 0.8% at constant currency, maintaining a margin of 22.4%, in line with our record Q1 '25 performance last year and supported by continued OpEx discipline.

From an FX perspective, the depreciating U.S. dollar had a translation impact during the quarter with euro-dollar moving from an average of EUR 1.04 in Q1 '25 to EUR 1.18 in Q1 '26. Consistent with our prior guidance, a weaker U.S. dollar has the greatest impact on revenues and the impact diminishes as we go down the P&L with EBITDA less impacted than sales and impact on group profit being broadly neutral.

In this regard, it is great to see the 22% growth in our bottom line group profit for quarter -- for the quarter to EUR 73 million. Free cash flow for the quarter was negative EUR 8 million, reflecting the usual free cash flow seasonality of the business and a EUR 30 million improvement in free cash flow compared to Q1 '25. And there are some aspects that I will clarify further in the free cash flow slide later.

Turning to leverage and liquidity. Our balance sheet is in a significantly improved position. We continue to make steady progress on deleveraging with total net leverage improving to 4.3x, a reduction of 0.2 turns year-on-year and liquidity remains very strong. More on that a bit later.

Slide 15. As you will see on this slide, the Biopharma business continues its strong top line momentum with a 6.8% growth in constant currency terms. As Roland highlighted, this was driven by continued momentum in our immunoglobulin franchise, which remains the core driver of growth.

In Diagnostics, if we were to isolate the termination of the joint business with Quidel Ortho, Diagnostics revenues, in fact, grew at a low single-digit rate on a like-for-like basis in the quarter, consistent with prior years. Reported performance reflects the impact of the dissolution of the joint business, as previously discussed.

The dissolution agreement includes a $65 million compensation to Grifols for, amongst other things, cost absorption at Grifols to be received in 3 payments across 2026, 2027 and 2028.

Critically and very positively, the dissolution paves the way for Grifols to pursue its strategic aspirations in the immunoassay donor screening and clinical diagnostics markets over time with the development of the EA platform.

Within Biosupplies and others, lower revenues in the quarter reflect phasing effects of a segment impacted by timing of individual contracts and dispatching of sales or products, and we expect a catch-up during the course of the year, particularly in Q3 and Q4 this year.

Looking ahead, we remain focused on executing the various building blocks of our plan for 2026 as outlined by Nacho, which I will elaborate on in the following slide.

Slide 16. As I said earlier, when we consider the relative Q1 '26 adjusted EBITDA performance to Q1 '25, please remember that Q1 '25 represented our best Q1 adjusted EBITDA performance in history that benefited at the time from some phasing-related momentum. So for us to be able to emulate that performance in Q1 '26 on a constant currency basis demonstrates the resilience of the business, led by a continued adjusted EBITDA momentum in biopharma.

And this momentum in biopharma EBITDA despite the full year impact of the China albumin pricing concession in H2 last year. Yes, U.S. dollar weakening continues to impact the absolute EBITDA levels, broadly consistent with the sensitivity analysis we discussed last year.

Some of that biopharma momentum has been offset due to very specific and mostly temporary reasons in other -- in Diagnostics, for example, the dissolution of the joint business with Quidel Ortho is a temporary headwind from a revenues perspective. However, it completely frees us to pursue our strategic aspirations in the immunoassay donor screening and clinical diagnostics markets and the compensation payments over the next 3 years will mitigate EBITDA impact.

As we look at the drivers of adjusted EBITDA growth and margin improvement in 2026, as Nacho said at the start of the presentation, it will be driven by each of the following:

Number one, biopharma product mix, whilst the full year impact of H2 '25 China albumin pricing concession will weigh on H1 '26 comparison to H1 '25, the combination of, a, the strong and continuing momentum in IVIG; b, you heard Roland's confidence about strong double-digit growth in subcu from a growing and higher base; and finally, c, the expectations for Alpha-1 and other proteins growth in 2026 will support EBITDA growth and margin improvement.

In addition, for example, the Diagnostics segment, the compensation payment in respect of the dissolution of the joint business will also help.

Number two, the game-changing impact of the EMA approval for Egyptian sourced plasma will support balanced last liter EBITDA growth as well as contributing to margin improvement. And it will also help to unlock point three, the global plasma sourcing footprint optimization opportunity that resulted in the closure of our weakest performing centers in the U.S. that will drive cost efficiencies and lower CPL.

Number four, the team is making progress with providing Biotest essential support to help with its operational and financial turnaround. And finally, number five, our focus on OpEx discipline is delivering results with operating expenses reduced by 7.7% at constant currency versus Q1 last year. We will continue to stay vigilant and cost conscious across the entire organization.

We look forward to updating the market with our progress in the coming quarters.

Slide 17 on free cash flow. In the first quarter of 2026, free cash flow pre-M&A was negative EUR 8 million. Whilst adjusted EBITDA is negatively impacted by a depreciating U.S. dollar, the impact on free cash flow pre-M&A remains broadly neutral.

You will notice a considerable investment in inventories in this quarter to support the continuing strong demand for our medicines. We have balanced that investment in inventories by continuing to manage our working capital diligently.

The reduction in CapEx is consistent with our year-end financial disclosure and our discussions with our auditors where the final payment in Q1 '26 in respect of Immunotec that was made to JPMorgan was classified as a repayment of financial liability and hence, flows through financing activities.

Notably, our cash interest in Q1 '26 compares favorably to Q1 '25, and I will elaborate further on this in the next slide. And finally, the increase in others was primarily due to the timing of our first 2025 IRA payment that was made in April '25.

In conclusion, our free cash flow trajectory is progressing as planned in 2026, aligned with the typical seasonal patterns of the business, and we remain confident about delivering on our full year guidance.

Finally, turning to Slide 18. I want to highlight the significant strides we have made in strengthening our capital structure and enhancing our financial flexibility.

We have materially reshaped our debt maturity profile through the successful and proactive refinancing earlier this year of all our 2027 maturities, whilst effectively navigating highly dynamic capital markets currently due to events in the Middle East. Now our next set of maturities are not until Q4 '28, effectively eliminating any near-term refinancing risk.

The refinancing was upsized significantly in market, demonstrating once again the strong institutional support Grifols benefits from in the credit markets. The strong investor demand from global institutional investors and banks enabled us to deliver key structural improvements despite the challenged market backdrop.

We more than doubled our revolving credit facility from approximately $940 million to over $2 billion while extending its maturity to 6.5 years. And the revolver now benefits from 3 margin ratchet step-downs that are leverage based.

Both tranches of the institutional TLB were upsized significantly in market. both tranches also benefiting from leverage-based margin ratchet step-downs.

You may have noticed that we have made a number of changes with regards to the approach we take with our capital structure. By rightsizing our revolver, we now benefit from very robust liquidity levels, allowing us to use surplus cash to reduce gross indebtedness with the 500 million partial redemption of the 7.5% bonds.

We have also considerably reduced our factoring activity levels all year round. Both these actions help us to be more efficient with our cash interest -- despite refinancing our cheapest debt in our capital structure this year, something analysts and investors were very focused on, we are now still targeting cash interest levels in 2026 to be at or below 2025 cash interest levels.

And it is great to see these actions being recognized positively by all 3 rating agencies with a substantial re-rating of our credit profile in a short period of time and with 2 out of 3 agencies upgrading us back into the BB space.

Long story short, our capital structure is in a considerably better place. Of course, we will continue to focus on deleveraging. Finally, following the reinstatement of our dividend policy in 2025, the upcoming AGM will consider the approval of the final 2025 cash dividend.

The considerably improved capital structure position whilst continuing on our deleveraging path also supports some capital allocation optionality, including the potential use of share buybacks as part of our capital allocation toolkit can be considered in due course to drive shareholder value as and when best determined by the Board.

With that, let me hand it back to Nacho to conclude the presentation.

Thank you, Rahul. I would like to conclude today's presentations with a few final remarks.

Our first quarter performance confirms that we are on track to deliver our 2026 objectives, with biopharma continuing to lead our growth, driven by the strength of our immunoglobulin franchise and consistent and disciplined execution across key markets.

At the same time, we are advancing a key strategic priority, the optimization of our global plasma footprint. The progress we're making in Egypt is essentially important and as it drives a structural improvement in cost per liter while further strengthening the resilience and security of our plasma supply.

Additionally, increased plasma supply from Egypt to Europe will progressively reduce U.S. plasma exports, supporting margin expansion over time.

In parallel, we've taken decisive steps to strengthen our financial position, including the successful refinancing of our 2027 maturities, which enhances liquidity and reduce our cash financial expenses. This reinforces a clear and disciplined path towards deleveraging.

Collectively, these actions are building a stronger, more efficient, more disciplined and increasingly cash-generative business, positioning us well for the remainder of the year and beyond.

As we move forward, our focus remains clear. delivering on our commitments, further strengthening our financial profile and unlocking the full value of Grifols. Thank you again for your continued support. We look forward to updating you on our progress in the quarters ahead. With that, Danny, please back to you.

Thank you, Nacho. [Operator Instructions] Today, our first question is coming from Charles Pitman from Barclays.

Two from me, please. Just firstly, on this alpha-1 specialty decline in 1Q. Just noting that last year, you reported a 1% organic growth and then 2.3% on the like-for-like basis that you introduced. I'm wondering if you can quantify the the size of this phasing benefit that you're referring that really drove this reported 7% decline. And just I wonder if you can commit to low or mid-single-digit growth for the division.

And then just secondly, I'm hoping you can provide a bit more insight into the current U.S. IG market share dynamics, given a competitor yesterday flagged challenging commercial backdrop and a spike in raw material plasma and finished products, creating an aggressive pricing environment.

Just noting that your target is to grow in line with market and not drive further price erosion. I'm just wondering what you're seeing on this and how your launch of Yimmugo has been shifting your market share.

Yes, Charles, thank you for these questions.

On Alpha-1 and specialty, yes, we can confirm that we expect a low to mid-single-digit growth for the full year. And in terms of the different components that add to the phasing, we don't provide that granularity. But as we tried to explain in the remarks today, this category is made up of different parts, alpha-1, fibrin sealant, contract manufacturing, Factor VIII.

And what we saw this quarter is basically a comparison year-over-year in each one of them that added up and led to this result. But we are very encouraged by the underlying drivers in Alpha-1, the growth that we saw in new patient referrals. Yes, we had to work through some headwinds in terms of re-auth period early in the year, but we saw patients come through in February and March and obviously continue to work on that.

So as I said, we confirm that we are looking at growing that category year-over-year.

And on the U.S. IG part, we are very encouraged by the underlying demand that we continue to see for Gamunex and for Xembify in this market, which reflects the reception of the product. We have a high share of branded scripts as well as the ability of our team and the focus of our team in the U.S.

The market in itself, there's not a material change for our part. It's a competitive market. That's true. But it's a market that has very strong fundamentals. We see demand and patients treated continuing to grow. We see it's a rational market largely. It's one where in some segments, we're able to adjust price. And we are very disciplined in our own approach to competing in this market.

So from our side, this remains our key focus market, and we expect to grow with the market throughout the year. As you saw, we have Q1 growth above the market, if you want. So expect this to normalize throughout the year and get more in line with market growth.

At the same time, the strong momentum that we see allows us to be selective on where we can titrate back in lower-margin accounts or lower-margin countries. So we believe that we start from a strong base when it comes to IG.

Thank you so much, Roland. Thank you, Charles, for your question. Now we would like to get questions from Santander from Jaime Escribano.

A couple of questions from my side. The first one would be regarding the announcement of the potential spin-off or IPO of the U.S. plasma business. If you can tell us a little bit the rationale, potential timing, what you're thinking about the sum of the part since you only did the release, and this is the first time that you have the opportunity to maybe speak to the market, it will be great to have your views.

And the second one is Haema and BPC. In the Capital Markets Day, you said 2026, 2027 as potential years to buying these 2. What are the next steps? Or what do you have in mind in this regard?

Thank you, Jaime.

As I mentioned at the beginning of my presentation, so at this stage, we are in the initial phases of the consideration of the potential IPO. And therefore, there is no further information we can comment on at this time. I mean we will provide updates as when necessary, remaining in full compliance with applicable laws and regulations. So please, at this point, we cannot answer any questions regarding that topic.

As per Haema and BPC...

Rahul?

Yes. Haema and BPC, Jaime, no change. We continue to look at the 2026, 2027 time frame. You will recall, we had talked about funding those buybacks through free cash flow generation.

As you will have seen, we recently announced the redemption of our EUR 500 million of 7.5% bonds using surplus cash. So all of that is tracking as normal. But in terms of timing, it still remains in the 2026 to 2027 time frame, Jaime, no change.

Thank you so much. Now let's move to the next question from Morgan Stanley. Thibault Boutherin.

My first question is just on albumin in China. If you could help us understand better the shape for this year. So you talked about the price impact that started in the middle of '25, so presumably sort of washing out in mid-'26.

But is there any other elements to help us understand what's happening on that market in terms of volume, in terms of competition? And so basically, what to expect from the second half of this year? Can this market go back to growth in China? Or should we expect the market to remain challenged a bit longer than mid-'26?

And then just second question on the OpEx this quarter. I mean, definitely lower. Can you give us more color on where you're finding the savings where you managed to sort of lower the cost and sort of how much can you drive these initiatives going forward?

Okay. The first question is going to be Roland and probably Nacho and then also Rahul will tackle the OpEx question. Roland, please?

Yes, Thibault, on China, if we take a step back, what we see happening in China is, on the one hand, continued underlying demand from patients and physicians that want to get albumin, meeting overlay of government pressures. And what this resulted in last year is a stagnation of the market, a flattening of the market. and pricing pressures. And as mentioned before and as you stated, we adjusted our prices midyear.

We are -- in this market where we also see inventories across the market will be relatively high. Our main focus is on throughput pull-through on demand and customer demand. And what we see there is that the Q1 this year is trending higher than last year, which is a positive. We also see that pricing in hospital is stabilizing, which is a positive. So we're cautiously optimistic that from here, we can build.

Having said that, there's more work to be done. But at the same time, the market fundamentals, the aging pyramid in China all point towards continued demand for albumin. And we believe that with Shanghai RAAS, we're well positioned to compete in this market as it will return to grow over the next years.

Having said that, I want to leave clear that China is not our only card that we have here. We see room to grow in other markets outside of China, and we're pleased to see the momentum there. And we also see that we have in the U.S. a differentiated offering with our bags, where we're adding capacity in 2027. And on top of that, as we explained in the last call, with our plasma sourcing in Egypt, where there's a strong local demand for albumin and there's an excess Ig that can be used in Europe, we believe that we have the pieces in place that will enable us to balance Ig and albumin growth over time.

And on OpEx, Thibault, it's mainly just better and more efficiently and more diligently run across SG&A. R&D is broadly flat. So it's -- we continue to prioritize our R&D spend, but it is just being more efficient on the SG&A front across the board.

So we'll continue to look at that. Clearly, we've made a lot of progress over the last year or 2. But I think from our standpoint, we still see further opportunities to do better, and it will just be a case of head down and diligent execution. So we'll see.

Now I mean, we will take a question from Charlie Haywood from Bank of America.

Charlie here with Bank of America. I have 2, please.

The first is just on the planned U.S. IPO or potential planned U.S. IPO. From your CMD, I think, 13 months before the IPO announcement, I think you outlined a fairly clear sort of 5- and 10-year view of Grifols that obviously didn't include a potential IPO.

So could you just help us understand what's changed in the last 13 months to prompt the decision to act on this? Is there any different view on leverage, finance structure, anything along those lines that prompted that decision?

And then the second one is just sort of, I guess, the IPO adds potential complexity to your structure. You've obviously got Haema and BPC, which you have a plan on your A versus B shares, you previously outlined potential diagnostics exit. So how do you balance all of these sort of increasing complexity for Grifols versus like the option to add the IPO as another layer on top?

And then any update on the A versus B collapse alongside potential IPO or other routes to simplification?

Yes. Look, I think on U.S. IPO, again, we're somewhat constrained as we talk about the -- about that topic going forward. But your question is much more around, is there a capital structure issue? Or is there a balance sheet issue? No, absolutely not.

You've seen the progress that we've made on the balance sheet front. There is absolutely no issues there. We will continue on our deleveraging path. As you think about the status quo, at the end of the day, this is really about trying to see if there are aspects that we can consider to accelerate or maximize shareholder value. So that's something that we will continue to consider and update as and when there is an update to provide.

On Haema and BPC and I think you talked about complexity, absolutely right. The focus is to simplify -- and Haema and BPC, we do intend as we -- as I mentioned to Jaime's question earlier, we do intend to exercise the option during '26 or '27. And we're keeping very much to the same parameters that we set out at the time of our Capital Markets Day around it being funded through free cash flow generation, not adding to gross debt to the extent that we're able to do that.

And so we're sticking diligently to the plan that we set out. So no real change, and there is nothing hidden from a balance sheet perspective. This is all about trying to ensure that we optimize, maximize shareholder value if we see an opportunity to do that. So I'll leave it at that, Charlie.

Now is the turn of Guilherme from CaixaBank. Guilherme please.

So the first one regarding margins. Would you be able to quantify the potential saving expectations from the U.S. donor center optimization? Or on top of this, any indication on the contribution of the plasma sourcing redesign to the 450 bps margin improvement target by 2029?

And the second question is regarding Diagnostics. So you've communicated at the Capital Markets Day an expectation to deliver a 5% annual growth until 2029. You mentioned at that time that it was going to be back-end loaded, but you're now mentioning a low single-digit expansion, if I understood correctly, until 2027.

But we have also the Barcelona platform launch later this year. Are you still confident with this 5% growth until 2029?

So let me take the one on diagnostic first, and Rahul will comment on the margins.

On Diagnostics, yes, we are still confident with our plan. I think that what is most promising within that business is the fact that the 3 -- the development of the 3 platforms, which is quite unique and important. I mean, the serology, the blood typing and the molecular platforms are progressing very well and really under our expectations.

The first launch is going to be Barcelona this year, and that is going to start building on additional revenues already in 2027 and certainly more to come as we progress. So we are very optimistic about our diagnostic business.

It's true that this solution of the joint business is going to present some headwinds this year, but certainly more focused on the revenue or EBITDA, while cash flow-wise, we'll continue delivering a very high profile. And most important, as I say, our developments on the R&D side are moving along very well and as expected, and we expect to generate very significant revenues from it as the Capital Markets Day plan for the next 5 years will advance.

On the margins, Rahul, do you want to comment?

Closure of centers, Guilerme, you're absolutely right that it will contribute to margin improvement. What we haven't done is separate the margin improvement between each of our drivers, whether it's biopharma product mix, segmental mix, the impact of Egypt sourcing, the footprint optimization, Biotest, there are a whole bunch of drivers, but no question that as you think about the the scale of what we've talked about, we see a considerable opportunity to optimize CPL, and it will contribute to margin improvement. We're just not separating out what that impact would be factor by factor.

And I would add that from an operational, I mean, efficiency perspective, I think this is certainly one of the big contributors as well to our OpEx management in the last years, which has been clearly showing efficiencies in many places.

The plasma, the donor centers are a key part of that. It's a significant cost, and it goes to the cost per liter. And we are continuously working to make -- generating efficiency in that area. The closing of these centers that obviously were centers that where the less performing centers. Obviously, it certainly will help to continue decreasing the cost per liter in the U.S.

And as I explained by Roland in his part of the presentation, I mean, step by step, we will transfer the needs of the European plasma sources from the U.S. to other sources and all that will benefit on optimizing cost per liter all over the world.

So I think that while we don't disclose the specific details, I think that our margin expansion is composed to many, many levers, and all of them are contributing to that.

Thank you so much, Nacho. Let's move to the next question. It is coming from Justin Smith from Bernstein.

Just one for Rahul, if possible. Just on the buybacks, if we get to that point, do you want us to think about that more as a perspective of increasing more tax-efficient returns to certain shareholders? Or is it more about sort of a ROIC versus WACC equation? Or is it a combination of both?

Yes. Look, I think at the end of the day, it's just a -- it's a comparison of our judgment on intrinsic value, balance sheet capacity and timing. At the end of the day, we -- this is a judgment that will be made by the Board as and when is right.

We talked about this as part of our toolkit even when we spoke about our Capital Markets Day plan 15 months ago. And all I'm saying is with the balance sheet in a considerably better place, this is capital allocation optionality that may be considered by the Board as and when it deems fit. That's the only point for the moment, Justin.

Thank you so much, Rahul. We are close to the hour, but we have a second set of questions from Charles Pitman from Barclays. Charles, please.

Just very briefly, wondering if you could give us a quick update on the progress for the 2Q '26 facility launch of in Fibrinogen and whether or not you have an updated time line for the acquired form of the disease?

And if there's any time to comment just your thoughts on the CIDP market following anti-FcRns remaining confident they can move into early lines?

Yes. Looking at the FESILTY or PRUFIBRY launch outside of the U.S. in Germany, we launched last year. We're very pleased with the early feedback we received in Germany and in Austria, where physicians highly appreciate the room temperature storage and the ease and speed of reconstitution as well as the speed of infusion.

So pleased with the progress there ex U.S. In the U.S., we are ramping up, have the team in place for a launch later this quarter, and we're excited about that. At the moment, focusing on congenital fibrinosin deficiency, as you know. But in parallel advancing our trial for AFD, we will share time lines as we have this more in place.

But just recall that as we look at the U.S., that market today has a size of about $50 million, the potential is to $800 million. We believe that this AFD trial will be with our design, helping to make that change of standard of care happen that is required in this market.

And so we believe that we're in a position to effectively launch now. We look forward to it and we'll then over time, build in this market and believe that we can capture a significant share of the potential over time.

In terms of CIDP, we continue to see growth in CIDP at this moment in time. As you know, we now have a bit more than 1.5 years of the FcRns in the market. It showed that IVIg and Ig in general is very well suited for this multiplal disease.

So as we look at new competitors possibly entering, we know that we have a treatment in place that treats different parts of the disease mechanism in CIDP and therefore, remain confident. And that's what we hear back from physicians at this moment. But at this moment, we continue to see growth.

Thank you so much. We are going to squeeze Jaime from Santander. Jaime, the very last one, please.

Yes. Super quick question. We never talk about Biosupplies, but because it was particularly weak this quarter. Just if you can provide a little bit of outlook for the following quarters.

Yes. I mean we normally don't provide much detail on Biosupplies. Biosupplies is a business which is characterized for one spot deals, and it might have a very significant variance to the year.

I think it's -- in a way, it is a business that without existing, probably we would miss those opportunities in the markets, but we know as well that we -- it's very difficult to to plan and forecast that, as I say, because of these spot deals that are generating through the year.

We are confident and we are working on a number of those deals that we hope that will materialize through the year, but it will be difficult to anticipate at this point how many of them will be in 2026 versus '27. So I think we will provide updates as things will happen. Thank you, Jaime.

Thank you so much, Nacho. That was the last question for today. Thank you so much for having us and for your support. Thank you.

Hello, everyone, and thank you for joining us today for Grifols' Fourth Quarter and Full Year 2025 Earnings Call. My name is Danny Segarra, and I serve as the Head of Investor Relations and Sustainability.

Today, I'm joined by Grifols' Chief Executive Officer, Nacho Abia; President of Biopharma, Roland Wandeler; and Chief Financial Officer, Rahul Srinivasan.

As is our usual practice, today's call will last about an hour, including the Q&A session. Please note that this call is being recorded. You can find additional materials, including today's presentation in the Investor Relations section of the Grifols website at grifols.com. A transcript and replay of the webcast will also be available on the Investor Relations website within 24 hours.

Turning to Slide 2. I would like to remind everyone that forward-looking statements may be made during this call. This may include, among other things, comments regarding the company's future operating and financial performance, statements about our future expectations, clinical developments, regulatory time lines and the potential success of our product candidates. These statements are based on current expectations and available information as of the date of this call and are subject to certain risks and uncertainties that may cause actual results to differ materially from those discussed today.

Grifols financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions, including alternative performance measures or APMs, as defined by the European Securities and Markets Authority. Grifols management uses APMs to evaluate financial performance as the basis for operational and strategic decision-making. These APMs are prepared for all the time periods presented in this document.

Now moving to today's agenda, I will turn the call to Nacho to kick it off. Nacho?

Thank you, Danny, and thank you all for joining us today. Fiscal 2025 marks an important year for Grifols. We executed against our plan, advanced our operational and innovation priorities, delivered on our revenue and adjusted EBITDA guidance and most importantly, exceeded our key cash flow target. And all of this amid a complex geopolitical macro and operating environment.

In such a complex year, our performance reflects the structural strength of the company. Scale, deep vertical integration in a strategic market and a globally diversified footprint continue to differentiate Grifols. This signals not only the company's strong fundamentals, but also the strength and resilience of our business model and our ability to continue shaping and leading in this industry in the many years to come.

Turning to Slide 5. And as you all know well, one of our key priorities has been and will continue to be improving our cash generation profile. In fiscal year 2025, the company generated EUR 468 million in free cash flow pre-M&A pre-dividends, an increase of more than EUR 200 million year-over-year, which reflects the benefit of our company-wide focus on capital discipline.

On the top line, revenue reached EUR 7,524 million, represented a solid 7% increase over the previous year, and a 9.1% increase on a like-for-like basis, both at constant currency. This growth was driven largely by the continued strong performance of our IG franchise.

Adjusted EBITDA reached EUR 1,825 million, a 5.6% year-over-year increase, while on a like-for-like basis without the impact of the IRA, adjusted EBITDA increased by close to 12%, all at constant currency. At guidance FX, adjusted EBITDA reached EUR 1,902 million, right in line with the guidance provided 12 months ago.

Finally, deleveraging remains a key priority and the path forward becomes clear as our free cash flow generation is sustainable and continuing to increase. At year-end, our leverage ratio improved to 4.2x, a 4-point times (sic) [ 0.4x ] reduction over prior year. This strong and consistent performance across our key metrics, supported our recent credit rerating and continues to be a central priority for the Board.

Beyond the financial figures, 2025 was a year defined by execution on our operational and financial priorities. Led by Biopharma, our core IG franchise, both intravenous and subcutaneous delivered a strong performance, reflecting the strength of our clinical proposition. We leveraged the opportunity to use our solid inventory position to accelerate IG growth and build momentum in key markets.

As mentioned on our Q3 '25 call, albumin demand in China declined amid ongoing pressures following government cost controls. We continue to work with our local partners, Shanghai RAAS, to effectively navigate and manage these market dynamics. By leveraging this partnership, we have achieved relative outperformance in the Chinese market.

The combination of a strong growth of our IG franchise and lower-than-expected albumin sales weighed on our margins, reflecting the underlying economics of the plasma industry and emphasizing the need to continue working to improve our efficiencies.

And we remain highly confident about achieving our margin expansion goals. Rahul will provide further insights later in the presentation.

At the same time, we continue advancing differentiated margin-accretive therapies to the market. In the fourth quarter, we successfully launched PRUFIBRY in Europe, our new fibrinogen concentrate for acute bleeding episodes with congenital and acquired fibrinogen deficiency.

Following FDA approval, we plan to launch FESILTY in the first half of 2026, our new fibrinogen concentrate for U.S. patients with congenital fibrinogen deficiency.

Despite the challenges presented by the macro environment and global trade shifts, our local-for-local business model once again demonstrated its resilience, effectively insulating us from tariff and preserving our defensible moat. This as-much-as-possible localized model also implies that while FX headwinds impacted both revenue and EBITDA levels, they did not extend to our free cash flow or leverage ratio, due to the significant levels of natural hedges embedded within our business.

Finally, we improved our cash flow and expense profile as we strengthen our balance sheet. Our focus on EBITDA and free cash flow expansion clears the path to deleverage.

Turning to Slide 7. We feel good with the company's performance in 2025. As we look forward, it is important to acknowledge the necessity of maintaining a balanced approach to growth across our portfolio of key proteins.

Looking ahead, our direction for 2026 is clear. We will consciously focus our growth to prioritize profitability, cash flow generation and to continue reducing our leverage ratio. Two key projects, Egypt and Canada will play a central role in delivering on this strategy, and they have the potential to redefine the plasma industry in the many years ahead. In Egypt, our transformational partnership has achieved a major milestone with EMA approval of Egyptian source plasma. This is first of its kind achievement that is a game changer in the industry. In Canada, through our strategic partnership with CBS, we remain deeply committed to the prospects for the fourth largest IgG market globally. Roland will provide further details on both later in the presentation.

In the U.S., we stand as the only scale plasma company with a fully integrated end-to-end value chain in the country, the world's most important IgG market. Over the last 2 decades, we have been shifting the structure of plasma sourcing and our entire operation to a local-for-local model as a key differentiator and value driver.

And finally, our longstanding relations in China and the deep knowledge of the market has proven effective and will continue to play an important role to mitigate the changes in that important country.

As we enter 2026, confident in our positioning, the fundamentals of our business remain sound. In a world increasingly shaped by geopolitical shifts, Grifols' integrated model and diversified footprint provide unique strategic optionality and allow us to navigate uncertainty with agility and resilience. This isn't just about sustaining a competitive advantage. It's about having infrastructure, partnership and the vision to lead the industry into its next chapter.

And with that, I will hand over to Roland to cover our commercial performance in more detail.

Thank you, Nacho. Moving on to Slide 9. Biopharma delivered a strong year in 2025, growing 8.4% for the year on a reported and 10.9% on a like-for-like basis, both at constant currency. I am proud of the dedication, passion and commitment our team shows every day to deliver for patients and drive forward towards the goals we set out.

Our immunoglobulin franchise led the way in 2025 and delivered a strong 14.7% year-over-year increase at constant currency. This performance was driven by Gamunex and Xembify with IVIG and SCIG delivering 12% and 60% full year growth, respectively, both clearly ahead of the market.

As outlined in our last call, we saw an opportunity over the last 2 years to use our strong IG inventory position to accelerate IG growth, build momentum in key markets and win back share in the U.S. We have since delivered on this plan. We have strengthened our U.S. organization and commercial capabilities, expanded SCIG penetration through Xembify and leveraged the strong profile of Gamunex to win share in strategic accounts.

Looking ahead, we expect underlying demand growth for IG to continue across our 3 main indications. In primary immunodeficiency, increased awareness and better diagnosis are expanding access to therapy. In secondary immunodeficiency, on label outside the U.S., demand continues to rise in an aging population and with an increase in immune-compromised patients. And in CIDP, we are seeing continued growth albeit at a lower level as IG therapy with its polyvalent mechanism remains the first line choice and standard of care for patients living with this multifactorial disease.

As Nacho mentioned, where in 2025, our plan was to regain share in the U.S. and select European markets and thus grow ahead of the market, we now aim to control growth going into 2026 from the stronger position with a differentiated approach. In the U.S. and select European countries, where we have recently gained share, we plan to maintain our position and grow with the market.

Outside these key markets, we have already started to pull back growth towards the end of 2025, and we'll further consolidate in '26 with an increased focus on margin. This targeted approach will allow us to enhance the return on our investments and ensure that our commercial efforts translate into meaningful margin improvements.

Turning to albumin. We saw revenues declined 5.1% year-over-year as positive momentum in the U.S. and ex China was offset by the market and pricing pressures from policy changes in China. While these changes in China also weighed on our albumin sales, our strategic partnership with Shanghai RAAS allowed us to effectively compete and perform ahead of the market. Entering 2026, we aim to further drive albumin uptake to balance growth with IG.

In China, we will continue to build on our strategic partnership with Shanghai RAAS. With disciplined pricing and expanded joint commercial footprint and a sharper marketing and contracting approach, we expect to expand hospital sales access, including greater penetration into lower-tier hospitals and broaden our reach in retail pharmacies. In addition, our medical teams will continue to drive education, awareness and evidence generation, for example, around long-term albumin use in liver cirrhosis, an important and still unmet need in China.

Outside China, we will build on our momentum to further expand our albumin presence, helping us move toward a more balanced geographic mix. Through this approach and as conditions in China stabilize, we remain confident that our efforts place us in a position of strength to balance our albumin growth with IG.

Looking at our alpha-1 and specialty proteins portfolio, we saw a full year growth of 1.4% or 3.8% on a like-for-like basis before the impact of the IRA Part D redesign. In 2025, we reinforced our leadership in alpha-1 and returned to patient growth following the transition to our new specialty pharmacy partner. We also saw steady contributions from our Rabies franchise and our Contract Manufacturing business. Keep in mind that different phasing patterns across proteins in this segment create natural quarter-to-quarter variability. In this context, our fourth quarter results mainly reflect a tough comparison against a strong Q4 '24, not a change in underlying trends, which remain solid.

Looking ahead, we expect to drive continued patient growth in alpha-1 while preparing for a major clinical milestone with expected top line results of our Phase III SPARTA outcomes trial, the first of its kind in the second half of this year. These outcomes have the potential to unlock significant growth in this highly underdiagnosed and undertreated condition by dramatically increasing disease awareness and testing in light of clear clinical benefits.

In parallel, we are advancing a 15% subcutaneous formulation and a next-generation alpha-1 therapy aimed at enhancing convenience, expanding access and strengthening our leadership in this growing market.

We remain confident in Prolastin's long-term potential and continue to focus on expanding the total addressable market. With roughly 85% of patients still undiagnosed and with outcomes, AI-enabled patient identification and increasing awareness from potential new entrants building momentum, we see meaningful opportunities to accelerate testing and thus help more people living with AATD to benefit from therapy.

On Slide 10, as the newest addition to our Biopharma portfolio, I would like to provide an update on the progress of our fibrinogen franchise. With our approval in Germany at the end of last year, we have launched our fibrinogen concentrate PRUFIBRY in Europe with a focus in Germany and Austria, where FCs are the preferred option for acquired fibrinogen deficiency. We realized first sales in Q4 '25 and see continued strong demand for PRUFIBRY. Early feedback is promising and especially highlights our differentiation, including the ease and speed of reconstitution of our highly purified FC as well as its application. We will continue to focus on Germany and Austria as key markets this year and expand into additional European markets over time.

In the United States, following our December FDA approval for congenital fibrinogen deficiency under the brand name FESILTY, we are preparing for launch in Q2 '26. We have a focused field team in place to help educate key decision-makers across leading institutions in the U.S. and secure hospital formulary access, building on our long-term relationships in many of these systems.

While we will focus our U.S. launch on CFD in the short term, we are advancing our work to embark on an AFD trial in the U.S. this year, which will allow us to expand our label over time.

In parallel, we will continue to engage in appropriate disease state education for the critical role that fibrinogen deficiency plays in bleeding. We expect our entry into AFD to align with the evolution of clinical practice in the U.S. where awareness and application of ready-to-use FCs for bleeding is still emerging with the potential to exceed USD 800 million over time.

As we focus on controlled growth with IG, balance with albumin and continuing momentum in our portfolio of first liter proteins, Slide 11 outlines how the vision and strategic investments that Grifols embarked on many years ago are providing us today with a strong structural foundation for long-term value creation. This is particularly important in an environment where geopolitical pressures are rising and supply security is becoming increasingly strategic for our customers.

In the U.S., the world's largest plasma market, we have, over the last decade, built a fully integrated end-to-end platform spanning domestic plasma collection, fractionation, purification and commercialization. Over the last years, we have started to extend this vertically integrated business model into other strategic markets through long-term public-private self-sufficiency partnerships that align our capabilities with national health care priorities.

In Canada, the fourth largest global IG market, our long-term partnership with Canadian Blood Services supports the country's objective of reaching at least 50% IG self-sufficiency. By expanding the share of locally sourced plasma and adding the capabilities to convert it into domestically manufactured plasma derivative proteins, we strengthen supply resiliency while reinforcing our presence in an attractive market.

In Egypt, we have partnered with the Egyptian government to establish a fully integrated plasma platform designed to achieve national self-sufficiency and position the country as a regional hub for Africa and the Middle East. Once domestic needs are fulfilled, this platform expands access to life-saving therapies across the region and creates export potential to European countries, especially for IG.

Taken together, these initiatives reflect a scalable partnership model that combines industrial expertise with national health care priorities, positioning Grifols as a strategic partner in building sustainable plasma ecosystems across the globe. Let me add a bit of more color.

Taking a closer look at the U.S. on Slide 12. We have invested strategically over the last 20 years in building our infrastructure to support this key market at scale. With vision and foresight, Grifols has built a fully integrated resilient state-of-the-art footprint that spans the entire value chain from donor to patient. Today, we operate a network of more than 300 donor centers in the U.S., ensuring a stable supply of quality plasma. To put that in perspective, over 70% of Grifols' total global plasma collection capacity is anchored right in the U.S.

Across our 2 primary U.S. plants, including our flagship facility in Clayton, North Carolina, one of the largest of its kind, we also hold 65% of our manufacturing capacity in the U.S. and thus have achieved a unique and differentiated level of vertical integration. This positions us to supply the growing demand in the U.S. fully from within this key market through self-sufficiency. This helps insulate us from global supply chain disruptions and ensures that our most critical market can be served by our efficient and strategically located donor centers and facilities.

On Slide 13, we turn to Canada, one of the top 4 global markets for IG. Canada recognized that its historical reliance on imports for roughly 85% of its IG needs created long-term supply risk. As a result, Canadian Blood Services made it a national priority early this decade to lift domestic self-sufficiency to over 50%. Grifols stepped up to support that vision, and in 2022, signed a 15-year renewable agreement with CBS to build a fully domestic plasma ecosystem from the ground up.

Following this mandate, our operational footprint in Canada is expanding rapidly. In just the last 12 months, we have established a network of 17 donation centers, creating the backbone for a nationwide plasma collection network. Together with CBS, we were able to increase the share of IG self-sufficiency from 15% to around 30% in 2025.

And we are progressing as planned with our domestic manufacturing plant in Montreal. We started with local purification of albumin in 2025, and we are on track to add 1.5 million liters of fractionation capacity alongside dedicated purification and fill-finish lines by 2028. This makes Grifols the only large-scale domestic manufacturing player with an end-to-end value chain in Canada. This unique position allows us to offer a fully integrated platform of services in this key market.

On Slide 14, we highlight our strategic foothold in Egypt. This is more than a geographic expansion. It is a first of its kind public-private partnership that is pioneering biopharmaceutical sovereignty for an entire region. Through our partnership with the Egyptian government signed in 2020, we have created a fully integrated regional ecosystem, spanning plasma collection, testing and future fractionation and purification capabilities.

Building on a project's strong progress, a key inflection point for Grifols was securing full EMA approval late last year for the entire Grifols Egypt value chain. This is a massive strategic unlock for the group, validating our end-to-end quality standards and enabling European commercialization of plasma-derived therapies sourced from Egyptian plasma. I will walk you through the details in the next slides.

Slide 15 maps out the strong execution and progress of our strategic project in Egypt. After successfully opening 16 donor centers last year, our team in Egypt, building on our core capabilities in Grifols engineering and quality is on track to scale our network to 20 centers in 2026, all operating under our high standard model. With this, we were able last year to already achieve full self-sufficiency in Factor VIII, albumin and IG for Egypt, a notable milestone. As we move into 2026, we are leveraging any surplus in plasma to expand supply across the broader Middle East and Africa.

As for manufacturing, our road map remains disciplined and phased. We are currently in Phase I of plant construction with a plasma logistics center and testing lab coming online this year. Between 2030 and '31, the fractionation and purification plans will become fully operational and by 2031, the entire end-to-end value chain will be localized in Egypt.

Equally important, our recent regulatory achievements have validated the strength of our end-to-end quality system. By positioning Egypt as a globally recognized plasma hub, we have earned what we call the Grifols Seals of Excellence. This has a direct financial impact as it enables the commercialization of Egyptian plasma derivatives in Europe and thus reduce reliance on costlier U.S. and EU source plasma.

Further, this also allows us to better balance albumin with our IG growth on a global scale as the local demand for Factor VIII and albumin in Egypt, Middle East and Africa is significantly higher than for IG. This provides excess IG that can help cover demand in Europe.

Slide 16 shows how our partnership in Egypt is transformational for both Egypt and Grifols. Let me highlight a few key facts that illustrate the scale and impact of this project for Egypt where health care benefits are already tangible. More than 1 million vials produced from Egyptian plasma have been delivered to public hospitals and health centers and over 100,000 free medical checkups have been provided to donors.

From an economic and social perspective, the initiative is emerging as a meaningful contributor to the national economy. In 2025 alone, the project is expected to have contributed approximately EUR 55 million to Egypt's GDP, with cumulative contributions projected to exceed EUR 700 million by 2029. The project has also made a significant contribution to employment in Egypt. To date, it has generated approximately 1,200 highly skilled direct jobs. In addition to these direct employment opportunities, the initiative has created more than 14,000 indirect positions, supporting the broader economy. Over the next 4 years, total employment impact is projected to exceed 180,000 jobs.

While this project is first and foremost about supporting national self-efficiency for the Egyptian people, it is also transformative for Grifols. By shifting part of our sourcing to a more cost-effective EMA-approved hub in Egypt, we are structurally derisking our plasma supply, expanding margins and reinforcing the underlying fundamentals of our business model.

Across our vertical integration in the U.S., our self-sufficiency partnership in Canada and our strategic self-sufficiency expansion in Egypt, we believe that we are building a basis and the blueprint that will allow us to better meet demands in an evolving geopolitical context and deliver value for the long term. We are confident in this path.

With that, I will now hand it over to Rahul, who will provide more details on our financial performance.

Thank you, Roland. Slide 18. As both Nacho and Roland have alluded to, navigating highly dynamic forces be it the geopolitics that threaten to disrupt the supply chains of most global companies or the seismic moves in euro-dollar, the fact that Grifols was able to deliver on its deleveraging plans beat free cash flow generation and revenue guidance, whilst achieving adjusted EBITDA guidance and more than double group profit demonstrates the clear resilience of this business.

The foundations of this resilience comes from: one, Grifols' unique position in the U.S. with a fully integrated truly end-to-end in-market for-market business; two, our highly differentiated self-sufficiency strategy that have been many years in the making, thanks to the vision and the enterprise of those before us, and that will be a source of clear competitive advantage going forward; three, the highly strategic and long-standing partnerships that have been developed over time; four, our end-to-end capabilities all the way from industrial to commercialization and everything in between; five, the tireless efforts of all our teammates across the entire Grifols Group; and finally, and most importantly, the trust from our patients, our donors and our customers.

Specifically on the financials, net revenues in 2025 are up 7% versus 2024 and 9% on a like-for-like basis, both in constant currency terms, reflecting the secular tailwinds for IG demand.

Adjusted EBITDA and gross margin performance is after fully absorbing the IRA impact in 2025. And we need to consider that when making comparisons to 2024 financial performance. For that reason, we have also included the like-for-like column to facilitate better comparability between the 2 years.

In 2025, adjusted EBITDA like-for-like growth rate in constant currency terms was up almost 12% versus 2024. Reported gross margin was weaker versus 2024, broadly due to the impact of fully absorbing IRA in 2025, some accounting reclasses between OpEx and COGS that weighed on gross margin but neutral at EBITDA and the impact of the albumin market in China. On China albumin, we continue to feel well positioned to better navigate the market dynamics given our strategic partnership with Shanghai RAAS and Haier.

On a like-for-like basis, that is prior to the impact of IRA and the gross to net reclassifications, gross margin in 2025, in fact, improved by approximately 50 basis points versus 2024, better reflecting underlying performance.

Adjusted EBITDA of EUR1.825 billion equates to just over EUR1.9 billion at guidance FX rates. And whilst EBITDA is impacted by the weakening dollar, the natural hedges we have in place make the impact more muted at the free cash flow leverage and group profit levels.

Whilst like-for-like adjusted EBITDA margins at 25% exceeded '24, adjusted EBITDA margin was a touch weaker 24.3% after fully absorbing the impact of IRA. EBITDA margins remain an area of critical focus for us, and we will be highly proactive with our efforts to ensure of its continued progression.

Group profit is up 156%, more than double 2024 group profit, a clear validation of the Board's recommendation to approve the interim dividend in the summer, Grifols' first dividend payment since 2021. As is customary, the final dividend payment in respect of 2025 is subject to the Board's recommendation and shareholder approval at the AGM later this year.

Moving on to free cash flow. We are pleased to back up the significant free cash flow outperformance in 2024 with another free cash flow pre-M&A beat at EUR 468 million, up over EUR 200 million versus 2024. This business can absolutely generate meaningful amounts of free cash flow, and we remain confident about expanding the free cash flow generation considerably in the coming years.

Our deleveraging path continues with leverage down from 4.6x at the end of 2024 to 4.2x at the end of 2025. The significant dollar weakening had a broadly neutral impact on leverage given that some of our debt issuances are dollar-denominated, and we will continue to optimize the currency mix as we consider our refinancing plans.

I will also update you later on a later slide on our positive progress we are making towards 2027 milestones on deleveraging and cumulative free cash flow generation. Also, the combination of the EUR 1.7 billion of liquidity and the significant secured capacity I've referenced in prior update, gives us strong confidence about the fortress balance sheet and our ability to execute our exciting plans or indeed, withstand anything unforeseen.

Slide 19. Full year 2025 like-for-like adjusted EBITDA growth was circa 12% and 5.6% after fully absorbing the EUR 108 million IRA impact.

Adjusted EBITDA growth was mainly Biopharma led. The Biopharma EBITDA growth drivers were primarily volume growth, geo and product mix benefits, continued steady improvement of CPL and operational leverage benefits, that together more than offset the impact of China albumin where we will continue to feel better equipped to deal with the developments in China, thanks to our strategic partnership.

Diagnostics continues to achieve all its milestones as part of our significant repositioning of that business, and we're excited about the launch of our new immunohematology platform at the next International Society for Blood Transfusion Congress before the summer, whilst continuing to maintain our leadership in the molecular donor screening market and continuing to significantly grow in our blood typing business, particularly in the U.S.

Like-for-like adjusted EBITDA margins of 25% were higher than 2024, but slightly soft after fully absorbing the impact of IRA. As I said on the prior slide, margins remain an area of critical focus for us, and we intend to remain highly proactive with our efforts to ensure of its continued progression.

With regards to cash adjustments, we show a 33% reduction versus 2024, driven by lower restructuring and transaction costs. Consistent with our update in Q3, noncash adjustments relate to impairments of projects that do not at all impact the go-forward equity or credit story and are an extension of the capital allocation discipline that we have talked about. Leaving aside this noncash adjustment, the convergence between adjusted and reported EBITDA driven by lower cash adjustments remains a focus.

Slide 20. We are simply pleased to be able to demonstrate that this business can absolutely produce significant amount of free cash flow, and we are particularly happy about beating our free cash flow guidance again in '25 after the significant beat in 2024. There is nothing structural about this industry, notwithstanding its capital intensity that precludes our ability to ramp up our free cash flow generation from current levels.

As you are aware, the original free cash flow pre-M&A guidance for 2025 was EUR 350 million to EUR 400 million and raised throughout the year, culminating in the EUR 400 million to EUR 425 million guidance in Q3 and the EUR 468 million outcome considerably beats the improved Q3 guidance. The free cash flow beat reflects the end-to-end focus across the entire organization on cash flow, and we will continue to go forward with the same vigilance in intensity.

The free cash flow beat in 2025 is as a result of improved EBITDA, end-to-end intensity in our working capital management despite investing as a group in further inventory to support the strong demand for our proteins, CapEx levels normalizing for 2024 from '24 highs as we anticipated in our prior updates, lower cash interest as a result of the benefits of the deleveraging in 2024 and balance sheet and capital structure management and finally, lower cash adjustments that is captured within others.

Our free cash flow conversion improved from circa 15% in 2024 to circa 25% in 2025. Whilst free cash flow conversion can vary from year-to-year, we remain confident about being able to improve free cash flow conversion meaningfully over the coming years. To summarize, we are pleased with the 2025 outcome, and we look forward to generating further improvements in free cash flow in 2026 and beyond.

Slide 21. Positive deleveraging progress and free cash flow improvement is now being validated and rewarded by a normalization of rating agency views towards Grifols as they confirm our rapid re-rating progress. In the last 18 months or so, S&P have moved the Grifols ratings from B Flat Stable to BB- Stable, up 2 notches. Similarly, Moody's have also improved the Grifols rating by 2 notches from B3 to B1 Stable. And Fitch from B+ to B+ Positive. We are also glad to see credit investors and our relationship banks validate our significant deleveraging and free cash flow improvement progress. The considerable tightening of secondary trading yields of our 2030 bonds clearly demonstrates strong credit investor sentiment.

Further, the significant increases in the commitment levels that are being volunteered by our relationship banks will support our planned significant upsize to the revolving credit facilities with materially improved pricing and flexibility.

In addition, preparations are in an advanced stage to support our refinancing plans in respect of our 2027 maturities. We plan to do this in 2 steps, starting with the revolver and the TLB. For the latter, we expect to commence an institutional TLB investor-focused education process shortly and target a subsequent launch subject to market conditions during the course of H1 2026. And we expect to refinance the remaining 2027 bond maturity in Q4 2026 or earlier.

Slide 22. This slide succinctly captures our 4-year financial transformation and how that informs our 2026 priorities. As the chart on the left shows, our deleveraging story is very compelling, reducing our leverage from 9x in H1 2022 to the current 4.2x credit agreement leverage, driven by significant EBITDA growth and free cash flow improvement.

A significant proportion of the EBITDA growth has been volume-led, with a very deliberate execution of our strategy announced in 2023 to win back lost market share in the U.S. and international growth. The progress of both EBITDA growth at 14% CAGR and margin improvement by over 400 basis points from 2022 to 2025 is clear for everyone to see.

Having successfully taken our credit agreement leverage back to pre-COVID levels and having executed on the plan to win back lost market share in the U.S., we are now well placed to optimize our path forward, in particular, to take action to advance our margin progression, including optimizing the balance of our last liter across IG and albumin. In this regard, the recent EMA approval for Egypt sourced plasma is a game changer for Grifols and for the plasma industry.

The combination of our unique position in the U.S. and the progress with our self-sufficiency projects in Egypt and Canada differentiates the Grifols story from the rest of the industry, and we are confident about following our own path, which is a nice segue into our priorities for 2026 on the right. We believe that we are uniquely positioned to redefine the industry by harvesting the value of our strategic investments from the past. Our priorities are clear. We will continue to grow in line with the U.S. IG market while maintaining a very targeted and disciplined ex U.S. strategy yet fully leveraging the paradigm shift that EMA approval of Egypt source plasma offers Grifols. And focus on value creation via prioritizing margin expansion, accelerating free cash flow generation and continuing on our deleveraging path, which we believe will help us continue our rerating progress, not just on the credit side where the evidence thus far speaks for itself, but also on the equity side.

Slide 23. Before I touch on '26 guidance, let me start with our '27 milestones. We remain on track to achieve both milestones, credit agreement leverage down to 3.5x and cumulative free cash flow pre-M&A of EUR 1.75 billion to EUR 2 billion by end 2027.

As for 2026, the clear focus is on continuing to improve our free cash flow story, and we are guiding to EUR 500 million to EUR 575 million free cash flow pre-M&A in 2026. In addition, we are targeting improving adjusted EBITDA margins to 25% or higher, and we expect adjusted EBITDA growth to be in the 5% to 9% region on a constant currency basis versus 2025. And you can assume euro-dollar average FX in 2025 of circa 1.12. We remain committed to continuing on our deleveraging path.

And finally, even if you can imply the revenue growth yourselves from what is on the slide, whilst we expect to grow on a constant currency basis, we are deliberately not including revenue growth guidance for 2026. This is consistent with our 26 priorities from the prior slide. We are consciously moderating revenue growth in 2026 from our higher 2025 base by prioritizing our focus on margin-accretive growth, driven by our unique position and the highly compelling prospects from our self-sufficiency initiatives that we look forward to updating the market on in the coming quarters. We are following our own path with conviction.

With that, let me hand it back to Nacho.

Thank you, Rahul. I would like to conclude by reiterating a few points that we've already made, but that bear repeating. In 2025, we delivered on our commitments and strengthened on our financial foundation. More importantly, the performance of the company reflects our ability to capture the fundamental resilience of the plasma industry, a high moat, essential sector where Grifols continued to set the standard for global leadership.

Through our long view lens, our strategic direction is clear. Grifols will harvest the value of our strategic footprint. Our vertical integration in Canada and our partnership in Egypt are a critical catalyst for our next chapter. These hubs provide a diversified and resilient supply chain that positions us to capture further value.

What remains unchanged is the strength of our underlying business and our commitment to our long-term vision. Our immunoglobulin franchise continues to benefit from a strong structural demand, while albumin, alpha-1 and specialty proteins portfolio as well as fibrinogen remain core assets within our portfolio. At the same time, our diagnostic business is progressing toward an evolving operating model that we are convinced that will unlock significant additional value over time.

Today, Grifols is a more focused and resilient organization, structured to deliver consistent performance, prioritizing returns, free cash flow and deleveraging with a clear objective of increasing value for our shareholders.

I would like to thank the entire Grifols team for their dedication and effort throughout the year. And also, I would like to thank all of you for your continued interest and support in Grifols.

With that, Danny, back to you.

Thank you so much, Nacho. Now let's turn to the Q&A session. [Operator Instructions] Let's start with Thibault from Morgan Stanley.

Yes. Maybe my first question, obviously, I mean, you mentioned we can reverse general sales growth. I just want to know if 2026 is a specific year where growth is differing from the Capital Market Day target that you had, we should assume growth to come back after and see a relation to this. Is it about what you're seeing for demand? Is about plasma capacity? Or is it really about the plasma economics and last liter focus that explained the growth being slow in 2026?

Thibault, as you think about revenue growth, one of the reasons why we've excluded it, even though you can work out, do the math yourself on that page is that it isn't a priority.

Why isn't it a priority? We have taken our leverage back to pre-COVID levels. We have executed successfully on our plan to win back lost market share in the U.S. and our focus from here on is about optimizing the quality of our EBITDA growth. That's the key focus on our standpoint. And on that, I can ask Roland as well to add as we think about balancing the last liter economics. Roland?

Yes. Thank you, Thibault, for the question. Absolutely, plasma economics are at the heart of our business given that we produce our medicines from very precious donations.

And that entails 3 main aspects. One is we have to maximize our first liter proteins. Second, over the longer term, balance IG and albumin growth. And thirdly, bring costs down of production, of course.

But double-clicking on the IG and albumin balance for a moment, over the last 2 years, we have constantly used a strong IG position to regain share in the U.S. and drive growth. Now this has last year combined at the same time with a temporary softness in China as market works through policy changes, but notably with continued strong unmet need and patient demand on the line. This puts us in a position this year where we can optimize our approach for 2026.

On the IG side, after 2 years on strong growth on this higher base and with the position that we were aiming for achieved in the U.S. and key European markets, we focus our growth there, and we are pulling back in other markets elsewhere.

And on the albumin side, we build on our momentum to make sure that we can catch up. We believe that we are in a strong position to balance albumin, IG overgrowth, not only from a commercial perspective, but also in China through our strategic partnership with Shanghai RAAS. And as Rahul and Nacho alluded to, through our absolutely transformative strategic partnership in Egypt, which provides us with excess IG for the European market and our continued focus on work on the yield. And all of that, of course, while continuing to drive our first liter proteins and our cost overall.

Now let's move to the next one. It's going to be Jaime Escribano from Santander.

So my question is, so I'm trying, Rahul, to try to get the potential EBITDA guidance on a reported basis for 2026. I'm getting something in between, obviously, assuming that 25% margin because if I put a higher margin, it can be more. But let's call it a minimum reported EBITDA adjusted guidance of EUR 1.9 billion to EUR 1.97 billion. This will be my first question. Does this make sense? Would you feel comfortable with that?

[ So 5% to 9% ] on EUR 1,825 million is around EUR 1,950 million to about EUR 1,980 million, give or take. So ballpark, your numbers are correct. As I mentioned as well, as you think about average euro-dollar for '25, that's at 1.12. So hopefully, that gives you the information you need, Jaime.

Jaime, you have a second question?

Yes. If I May. So it's -- so again, I understand that you are not providing the top line guidance, but you give up 20% margin or more. So can you try to give us a little bit more color on whether you think you are going to be more closer to 25% or more 25.5%. Because depending on that, obviously, the top line growth will be more or less?

Let me address that. Two points. One, on a constant currency basis, as I said in my prepared remarks, you can absolutely assume moderate growth, moderate net revenue growth. And as you think about modeling out margins, I think your 25% to 25.5% range is absolutely fine.

Now we will go to Alvaro Lenze from Alantra.

Going back to revenue, just wanted to understand what do you mean by pursuing higher or more profitable revenue or prioritizing margins? It really sounds to me or I would have thought that you would sell always as much as possible. So I don't know what are your internal levers in terms of revenue to improve profitability? I would suspect you would try to sell as much of the non-IG and non-albumin as you can, and you are already price takers, I would assume. So I don't know what the levers are.

And so I wanted to know, first, what the levers are on revenue? And second, whether more of the margin improvement comes from the cost side with all Egypt venture and maybe some industrial gains. So just trying to understand that. And my second question would be on Haema and BPC buyback, which you did not mention, is that still expected for this year?

So Alvaro, as we look into 2026 and we want to balance our growth in IG with albumin, we are in a position with our momentum to choose the markets in which we want to focus growth. And obviously, these are the markets where we see a higher value realized and a higher margin. And therefore, our focus to continue our momentum in the U.S. and key European markets. So we are in a position with our momentum that we can choose where we want to position the supply that we have on IG side, while, of course, driving on the albumin side to continue to grow. This is, as you look at pricing and value that we create. And then obviously, we are looking at the cost side as well. And as we continue to drive efficiencies and effectiveness in our manufacturing and plasma collection network, absolutely.

On Haema, BPC, the timing of the exercise, Alvaro, will be determined by the Board, as I've said before. And we've also previously indicated a potential exercise in '26 or '27. And I've also indicated that we intend to finance it through free cash flow generation whilst continuing on our deleveraging part. So no change in overall message. Final timing is '26, '27, but the precise timing will be a matter that's determined by the Board.

Now we will move to Guilherme from CaixaBank.

So two. The first one is regarding phasing. So we are -- from a Q4 run rate in terms of Biopharma growth, we'll have several effects moving into 2026, others don't. Just wanted to understand how should we think about the phasing of the growth throughout the year? If you're assuming a desire to optimize the growth across proteins right after -- right in Q1? Or we should expect some slowdown in the pressure that you're seeing in albumin and so a more stable growth throughout the year?

And the second question is how are you thinking about your post 2027 debt refinancing options. In terms of maturity, you mentioned that you could optimize currencies. And in terms of time lines for the potential refinancing. And related to that, whether the free cash flow guidance includes potential refinancing costs that you might pay, especially addressing 2030 maturities?

Guilherme, let me take the refinancing plans first and Roland will take -- sorry, your second question, and Roland will take your first question after. On refinancing plans, as we mentioned in my prepared remarks and in the presentation, the intention is to proactively manage our '27 maturities, and we're at an advanced stage of preparation with respect to the RCF and the TLB refinancing, and we expect to commence an investor education process relatively quickly. And then subject to market conditions, the expectation would be to get the TLB refinancing done in H1 '26, all entirely consistent with our prior updates.

As you think about currency, which I believe was another part of your question, Guilherme, I think for the moment, you can model it on the basis of existing currency splits.

Our TLB is split into dollars and euros. So you can assume the existing currency splits that are disclosed. I did reference that we will seek to use our refinancing plans to optimize the natural hedges in place a bit better. So ultimately, maybe the final denominations of currencies do vary a little bit, but I think it's a good working assumption to use the existing ones.

And then finally, as you think about the TLB today is about EUR 2.2 billion, give or take. And I talked about the secured bonds of EUR 750 million or so following in Q4 or earlier subject to market conditions, so the intention would be to refinance all EUR 3 billion, well ahead of the year, again, entirely consistent with our prior updates. Hopefully, that addresses your question.

And on the first one, Roland?

Yes. In terms of phasing, perhaps just 2 parts to highlight. One is we have natural seasonality throughout the different proteins in our portfolio. Just to give you one example, rabies with a very high use over the summer months, of course, and for some of the other proteins, we just have seasonal buying patterns from wholesalers.

And perhaps a second aspect to highlight, as we say, we continue to grow with the market in the U.S. and key European markets. So there, we expect a similar phasing to what we've seen in the past. And as we continue to be selective in markets elsewhere, this will play out throughout the year.

Now let's move to Justin. Justin Smith from Bernstein.

I'm sorry if I'm being a bit slow here. Can I just revisit the 2029 guidance that was issued a year ago. Am I right in thinking that, that guidance on an absolute basis is still valid if we just adjust dollar-euro, 1.04 to 1.12? If not, can you just help me understand what I'm missing? I'm trying to understand if growth is more hockey stick or if something is actually kind of structurally changed in the last 12 months?

Justin, let me take that. I think as you look at the '25 to '29, that was a road map that we set out with a very clear objective to increase EBITDA and EBITDA growth, improve our EBITDA margins, expand free cash flow generation and considerably delever. All of those aspects absolutely hold true, no change whatsoever.

Since then, we've obviously provided a met guidance for 2025. We're providing guidance for '26 and confirming that we are on track to achieve our '27 milestones.

I think we've given probably more information than would ordinarily be the case. But as you think about revenue growth as well, we have grown enormously in the last couple of years, and we are talking about moderate growth on a constant currency basis from this higher base, from this higher base. So if I could leave it at that, Justin, that would be great.

We have a follow-up from Thibault from Morgan Stanley.

Just want to touch on the dynamics of Q4. It looks like the gross margin was probably lower than expected and at the same time, SG&A and R&D compensated for that. So just in terms of how we should read into that dynamic when we think about the cost side into '26?

Thanks, Thibault. As you think about gross margin, and it's better to look at gross margin on a full year basis rather than quarterly. We talked about some phasing and FX and so on. So move away from the Q4 and look at the following page covers. The following page covers in the appendix covers the full year picture. So let's look at that picture. Point one, if I can start with is gross margin like-for-like '25 versus '24 was, in fact, 50 basis points better. Pre-IRA pre-gross-to-net reclass that was recommended by our auditors, which better captures underlying performance.

IRA alone was a 90-basis points impact, negative impact. Accounting reclass that is EBITDA neutral, but weighs on gross margin, was another headwind. China albumin headwinds we've talked about as well, but we feel very good about our strategic partnership with Shanghai RAAS. So I would use the full year gross margin picture rather than the quarterly, the fourth quarter gross margin picture as being what is reflective of 2026 and building on that, not the Q4 picture. Hopefully, that addresses your question, Thibault.

Rahul, we have a second follow-up today. This is coming from Alvaro.

Just very quick. I know you're focused on the current refinancing, but I just was just wondering when would be a potential window to refinance the 2030 maturities which are the most expensive for senior secured?

And very quickly, if you could just give us some highlights on your current capacity and how much spare capacity do you have for continued growth while maintaining low CapEx?

Sure. Let me start with the 2030 refi and Roland will take your second question on capacity. On 2030 refi, look, we're just going to continue to be just opportunistic and be very, very focused on trying to drive interest costs as low as possible.

As you know, Alvaro, and I know you know our debt complex well, our -- we have -- those bonds are callable on the 1st of May 2026 at 1.04 and they dropped down to 1.02 on 1st of May 2027. And we're just going to be very, very disciplined in terms of what drives better value. Is it better to refinance during the course of 2026 or wait until 2027. We will drive that based on just the value proposition.

But look, I think it's -- I agree with you that, that our debt is expensive. It also goes to show how significant the tightening of yields have been in the last 12 months, which is again significant validation of the strong creditor investor sentiment towards the Grifols story. But on your second question, Roland?

Yes, as for capacity, we don't give the details in terms of the exact liters, but we have the capacity that we need to execute over the next year. And we are building on that in one hand, in terms of optimization that we continuously deploy across our sites, our 5 sites. We have our Canadian plant coming online. We have the Egyptian plant we talked about today coming online, and we recently announced our expansion in Llica in Barcelona. So we have a very clear plan for CapEx and capacity expansion, that sets us up to deliver on what we plan and grow in the future.

We have a question from Charles from Barclays. I'm going to go through the question. There are some technical issues. Two questions.

Can you comment on market share evolution for IG and subcu? Second one, albumin, market share in China for albumin.

Yes, I'm happy to take the 2.

Roland will take your question, Charles.

Yes. As for market share for IG, that was obviously one of the main focus areas that we have, especially in the U.S. in our plan over the last 2 years to regain share, and we're happy with the progress that we made.

There's different data sources that I'm sure, Charles, that you're tapping into, but we're pleased with the market share gains that we had, not only with the number that we've seen, but also with the quality in the centers where we achieved this.

Subcu, needless to say, with the growth and momentum that we were able to deliver last year. we're very pleased with the momentum as well. We don't go into specifics of the split between the 2, but in the U.S., which is the key market for us, very pleased with the uptake that we see on the subcu side.

And in terms of albumin in China, both as we look at batch releases ex-factory as well as if we look at pull-through, we are pleased with what we see versus competition. As said before, our strategic partnership with Shanghai RAAS, we believe, puts us in a very good place in order to effectively compete in this market and make sure as the China environment stabilizes, that we're able to continue to drive growth there.

We have another follow-up. This is coming from Jaime Escribano from Santander.

Yes, I have a couple of questions from my side, more from a strategic viewpoint. Canada, I don't know if you can quantify or at least tell us how much could be the economic opportunity of the new plant? Or when do you think this can start producing meaningful revenues?

And in the case of Egypt, the impact of the gross margin in the long run, again, maybe a little bit qualitatively? Or when could we start seeing some benefits from the gross margin improvement as a result of using the Egyptian plasma?

And a last very quick one, if I may. Regarding CapEx 2026, the free cash flow guidance of EUR 500 million to EUR 570 million. What is the implied CapEx, tangible plus intangible, that you are estimating for this guidance?

Rahul will take it on the CapEx. Certainly, on Egypt and Canada, I mean, we are not providing details of the specific benefit that these collaborations will provide. I think that there is enough information out there in order to guess or guesstimate what that impact would be.

I think that in the case of Egypt, it is certainly already seen clear benefit in 2026 and beyond as we will progress growing our footprint in that market.

And in Canada, I think we've been collaborating with CBS for a number of years. We have already a solid commercial operation there. Now with the -- especially with the new policy from the Canadian government, where they are going to push even harder on self-efficiency, clearly, there is an opportunity for us to strengthen that relation because we have been really the only brand that has invested in that market with a manufacturing plant and our plasma donor centers there that will certainly help to drive that growth.

No. And I think, Nacho, just perhaps to just clarify, both of these strategic projects are creating value today. So in Canada, fourth largest market, highest per capita, strong growth, aiming for 50% self-sufficiency. This is already happening today since the plasma that we collect in Canada is fractionated in our U.S. plant, and we are already supplying to Canadian patients in terms of self-sufficiency. So this is not something that has to wait for the plant to be finished. This is something which, as of today, already is a win-win.

And similarly, in Egypt, as Nacho just explained, a clear win-win for us. And as you think about it, this has several components. One is, of course, there's the value to Egypt and the region true to the mission that Grifols has. But as you think about the value to Grifols, we have highest quality, highest standard facilities in terms of our plasma collection in Egypt, but the cost structure is very different. So there's a clear benefit in CPL. There's a clear benefit in terms of balancing IG and albumin. As explained, albumin use is much higher in this region than IG.

And lastly, what we see is that the plasma we collect there comes with a very promising yield that, of course, translates into more medicines that can be produced from this plasma. So both of these win-wins with value accreting already today.

And then on CapEx, Jaime, which I think was your question. So the way I look at CapEx, I look at both CapEx and capitalized IT and R&D. On CapEx, we expect to do continue to -- we expect the CapEx levels for '26 to be slightly lower than they are in '25. But as we think about our R&D and capitalizing -- IT and R&D capitalization efforts, we expect that to be slightly higher. So I think, net-net, if you add the 2 up, you might just end up at around the same number as we did in '25, maybe a little lower in '26. Hopefully, that addresses that question.

Thank you so much, Rahul. Very clear. That was the very last question for today. Just say thank you so much for joining us and for all your questions. If there is any follow-up, please contact the IR team. Happy to help. Thank you so much.

Hello, everyone. My name is Daniel Segarra, and I serve as the Head of Investor Relations and Sustainability and Vice President at Grifols. Welcome to our review of the company's business results for the third quarter of 2025.

Today, I'm joined by Grifols' Chief Executive Officer, Nacho Abia; the President of Biopharma, Roland Wandeler; and Grifols' Chief Financial Officer, Rahul Srinivasan.

A few logistics before we get into the details. Today's call will last about an hour, including a Q&A session. As a reminder, this call is being recorded.

You can find additional materials, including today's presentation, in the Investor Relations section of the Grifols' website at grifols.com. The transcript and a replay of the webcast will also be available on the Investor Relations website within 24 hours. Turning to Slide 2, please note that this presentation includes forward-looking statements regarding, among other things, the company's future operating and financial performance, market position and business strategy.

These statements are based on current expectations and available information as of the date of the recording, and they are subject to certain risks and uncertainties that may cause actual results to differ materially from those projected.

Grifols financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions, including alternative performance measures or APMs, prepared under the Group's financial reporting as defined by the European Securities and Markets Authority.

Grifols management uses APMs to provide financial performance as the basis for operational and strategic decision-making. These APMs are prepared for all the time periods presented in this document. Now moving to today's agenda, and I will turn the call to Nacho to kick it off. Nacho?

Thank you, Danny, and hello, everyone, and thank you for joining us. The results we are presenting today demonstrates the continued commitment to delivering on our value creation plan.

The performance achieved in the first half of the year has carried through, resulting in solid operational and financial results for the third quarter. This quarter reflects the sustained underlying demand of our products, solid market dynamics and disciplined execution, while we continue to navigate exchange rate headwinds and the anticipated impact of the Inflation Reduction Act.

This progress also stems from the operational focus and financial stewardship we established in our road map at the beginning of the year, which remains the central pillar of our plan. Our core business continued to perform well through the third quarter, led by the immunoglobulins franchise.

This top line performance has supported margin expansion, while tight cost management and focus on free cash flow generation have driven meaningful improvement in our free cash flow. While we acknowledge the challenges of the complex global operating environment, Grifols has performed with consistency and confidence.

Our structural advantage, including scale, solid vertical local integration in key markets and a globally diversified footprint have enabled us so far to adapt effectively, mitigate external pressure and sustain solid performance across key markets.

Regarding exchange rate headwinds, the impact was reflected at both revenue and EBITDA levels, but it did not extend to our leverage ratio or free cash flow due to the significant levels of natural hedges within our business.

In any case, we continue to implement mitigating actions and maintain vigilant oversight of evolving external conditions. As we track towards year-end, we remain attentive and measured in our approach. Year-to-date performance has been solid and in line with our expectations, reflecting disciplined execution and resilience. Looking ahead, we recognize that the external environment remains complex and dynamic, we continue to actively manage the factors within our control.

By leveraging our structural strengths and maintaining discipline, we remain on track to meet our 2025 objectives. Before we move on, I want to pause and take a moment to thank the entire Grifols team for their ongoing commitment, focus and passion in executing our plan and advancing our mission.

And with that, let's move to Slide 5. On a year-to-date basis, we achieved revenue of EUR 5.5 billion, representing a year-over-year increase of 7.7% and 10.5% like-for-like after IRA and gross-to-net adjustments, both at constant currency.

Third quarter adjusted EBITDA of EUR 482 million built on a strong first half, bringing our year-to-date adjusted EBITDA to EUR 1,358 million, up 11.2% and 17.3% like-for-like, both at constant currency. Both figures are well ahead of revenue growth.

Improved operational execution translating directly into a positive year-to-date free cash flow pre-M&A and pre-dividends of EUR 188 million, marking a significant EUR 257 million year-over-year improvement. This ramp-up in cash generation highlights our sustained financial discipline, keeping this as a top priority.

Finally, deleveraging remains a critical financial priority, too. And at the end of Q3, our leverage ratios per credit agreement landed at 4.2x, representing nearly 1x improvement over the prior year.

We continue to reinforce our structural foundation and these year-to-date results position us soundly to execute our capital allocation priorities and continue strengthening our balance sheet, ensuring we can create sustainable long-term value for all our stakeholders.

As we have mentioned many times, the core tenets of our value creation plan are guided by 3 key levers: commercial growth, margin expansion and pipeline execution.

Starting with commercial growth, we continue to build on the existing market demand and our robust commercial capabilities to expand sales across our portfolio. This includes deepening our penetration in existing markets and expanding into new geographies. Margin expansion remains a core priority, supported by operational leverage, optimized plasma sourcing and manufacturing efficiencies.

And through pipeline execution, we continue to drive the innovations that define and sustain Grifols' leadership in plasma-derived therapies, while our Diagnostic division advances its 3 cutting-edge platforms currently in advanced development.

These levers are supported by 2 critical enablers: our plasma supply and industrial footprint and our innovation strategy, as highlighted on the slide. Our resilient, diversified plasma manufacturing network represents a decisive competitive advantage in the current global environment.

It ensures reliable plasma supply and production capacity, allowing us to effectively meet growing global demand. Turning to innovation, I'd like to provide an update on our pipeline.

We remain on track to launch fibrinogen in Europe by the end of 2025 with a planned U.S. launch in the first half of 2026. In the U.S., we are proceeding with the FDA biological license application for congenital fibrinogen deficiency, for which we expect a decision in late December as planned.

For acquired fibrinogen deficiency and based on conversations with the FDA, we have decided to build additional clinical evidence before seeking regulatory approval. This will help us well to strengthen an even more solid case to sustain the market development efforts we envision in the U.S. market for the years to come.

Roland will share more details on fibrinogen shortly, but I want to mention that this decision does not affect our current Capital Markets Day plan in any meaningful way, nor does this change our long-term strategy or the significant opportunity we see ahead.

Other than Fibrinogen, we are maintaining disciplined investment in R&D while advancing clinical programs across both life cycle management and new product candidates.

Key initiatives, including SPARTA and alpha-1 with subcutaneous formulation are progressing as planned, underscoring our commitment to sustaining innovation, patient impact and long-term value creation.

And with that, I will hand this over to Roland to expand on these and other market and business updates.

Thank you, Nacho. I am pleased to share an update on our biopharma business and highlight the key factors driving our performance this year.

As we continue to deliver on our value creation plan, I am proud of the dedication, the passion and commitment our team shows every day to deliver for patients and drive forward towards the goals we set out in terms of commercial growth, margin expansion and innovation.

With that, let's turn to Slide 8 for our commercial performance. In the third quarter, our biopharma portfolio grew by 10.9%, lifting our year-to-date growth to 9.1%, both at constant currency. Our immunoglobulins franchise led the way, outpacing the market with 18% growth in the quarter and 14% year-to-date, both at constant currency.

This performance was driven by GAMUNEX and XEMBIFY with IVIg and subcu Ig delivering 12-month growth of 13% and 62%, respectively.

We remain confident in XEMBIFY's strong trajectory, supported by continued strength in the U.S. and expansion into new markets in Europe. I'll dive deeper into our Ig franchise on the next slide. Turning to albumin, third quarter volumes remained solid, but were offset by ongoing pricing pressure in China as market demand slowed down in face of government-imposed cost controls.

This resulted in a contraction of 4.5% for the quarter and 3.9% year-to-date, both at constant currency. While these dynamics were anticipated, we continue to work with our local partner, Shanghai RAAS, on how to best manage market dynamics and sustain a strong position in China as the principal market for albumin.

At the same time, we are working on strengthening our presence and unlocking additional growth opportunities in the U.S. and other markets in order to help us balance albumin with our IgG growth over time.

Looking at our Alpha-1 and specialty proteins franchises, we continue to make solid progress. In the third quarter, revenues grew by 3.3%, bringing growth to 4.3% year-to-date, both at constant currency.

These results reflect our continued market leadership in alpha-1 and HyperRAB. I'll share more detail on this franchise in a later slide. Now let's turn to immunoglobulins or Ig as the main growth driver of our business on Slide 9.

Over the last 2 years, we saw an opportunity to use our strong Ig inventory position to accelerate Ig growth, build momentum in key markets and win back market share in the U.S.

We have since delivered on this plan. We have strengthened our U.S. organization and commercial capabilities, expanded subcu Ig penetration through XEMBIFY and leveraged the strong profile of GAMUNEX as a leading IVIg to win share in strategic accounts.

These actions have delivered clear results. Our Ig business has posted double-digit growth over these last quarters, ahead of the market and driven by demand as we regained share in the U.S. and Europe and thus reset our position in the Ig market. Looking ahead, from this higher base, we now expect to grow more in line with or slightly ahead of the market, consistent with the 6% to 8% CAGR range we shared as part of our value creation plan.

The fundamentals for continued growth of Ig remain strong, as key indications continue to be underdiagnosed and increasing global awareness of Ig as the treatment of choice in many conditions means that more patients get to benefit from our medicines with a long track record of proven efficacy and safety.

Looking at our 3 main indications, growth remains solid in primary immunodeficiency, where increased awareness and better diagnosis are expanding access to therapy.

In secondary immunodeficiency, the largest growth opportunity within Ig, demand continues to rise, driven by an aging population and an increase in immunocompromised patients.

And in CIDP, we are seeing continued growth, albeit at a lower level after the significant step-up in diagnosis last year with the entrance of FcRns, which has helped expand this market.

CIDP is a complex neurological condition with multifactorial origins, meaning the disease can present very differently across patients. This is precisely where Ig therapy stands out. With its broad and well-established range of immunomodulatory and immune-supportive modes of action, Ig can address multiple disease mechanisms and improve functional outcomes across a wide range of patients. As we build on this strong foundation, innovation continues to be a cornerstone of our Ig strategy.

We're advancing next-generation products, new formulations and expanded indications that strengthen our competitive position and enhance patient experience.

In terms of next-generation Igs, YIMMUGO, our novel IVIg from Biotest has launched in the U.S. in the fourth quarter of 2025, adding another differentiated therapy to our portfolio.

XEMBIFY continues to gain strong traction, growing more than 60% over the last 12 months, and we're expanding into new markets through 2026.

In terms of life cycle management, we are advancing new delivery formats, including XEMBIFY and prefilled syringes to improve convenience and adherence.

In parallel, we are progressing with our studies to expand indications in the U.S. with GAMUNEX-C and XEMBIFY advancing in SID and XEMBIFY in CIDP.

Together with our ongoing improvements in end-to-end Ig yield and operational efficiency, which will help us expand margins, this focus on innovation will ensure that our Ig franchise remains a cornerstone of sustainable and profitable growth for Grifols.

Now turning to Slide 10. Let's take a closer look at our alpha-1 franchise and our strategy and progress in this area. Grifols has established itself as a leader in alpha-1 with today approximately 70% market share across both the U.S. and ex U.S.

Our position is testament to Grifols' leadership in building this market, our best-in-class patient support programs and our unique testing capabilities. Despite important progress throughout these last decades, we are today still only treating about 10% to 15% of the alpha-1 patient population across the world, leaving a large unmet need and untapped market opportunity.

Testing is the key to unlocking this potential. We have, over the last years, complemented traditional screening with the rollout of our point-of-care and at-home direct-to-patient screening kits. Still, we only see a part of physicians systematically testing their COPD patients for AATD.

We believe that we have a possibility to change this and dramatically increase the number of diagnosed patients with the readout of our outcome study SPARTA, continued advances in AI-enabled screening of electronic medical records to highlight patients at risk as well as increasing awareness in the market for new entrants.

Raising awareness and improving diagnosis remain critical levers to enhance patient outcomes and enable market growth. As a company that firsthand gets to see the continued unmet need and the difference our medicines can make for the grievous illnesses we get to treat, we always welcome innovation that raises awareness and might provide additional options for patients, especially in a condition where the vast majority remain undiagnosed and untreated.

As a leader in this space, we want to meaningfully contribute to this innovation, both through our outcome study that will address important questions for the field as well as both the subcutaneous and a long-acting treatment option in our pipeline. SPARTA is the largest efficacy study ever conducted in alpha-1 antitrypsin deficiency and is designed to show clinical outcomes in real-life lung tissue preservation different from other studies primarily focused on pharmacokinetic endpoints.

The results of this study have the potential to significantly strengthen the clinical and payer value proposition for augmentation therapy, increase testing awareness and improve patient access in the U.S. as well as support broader reimbursement in Europe.

The trial also includes a double-dose regimen, which could represent an important advancement in treatment. We expect the readout of SPARTA in the second half of 2026. In parallel, we are advancing a 15% subcutaneous formulation and a next-generation alpha-1 therapeutic to enhance patient convenience, expand access and continue strengthening our position in this growing market.

In summary, we remain confident in the continued success of PROLASTIN, supported by its value proposition and proven 30-plus year track record of safety and efficacy.

Turning to Slide 11, innovation is at the heart of our business. Our pipeline reflects a focused and disciplined approach to advancing high-value programs that drive life cycle management, expand indications for our existing medicines and bring new products to market both within plasma as well as beyond plasma.

We have already covered the innovation underway for our Ig and alpha-1 franchises. Turning now to fibrinogen, as Nacho mentioned, we have refined our go-to-market approach to maximize our long-term opportunity.

In the near term, the largest opportunity for fibrinogen lies in Europe, where markets such as Germany and Austria have adopted fibrinogen concentrate as standard of care. For these markets, we are on track for our launch of this product later this year.

We have received the end of procedure notice from Germany and are awaiting approval in this key market shortly to be followed by additional countries in Europe. We are confident that our differentiated product positions us well to effectively compete and gain share over time in these markets. Longer term, the largest opportunity remains in the U.S., where the use of fibrinogen today, though, is still low and the market has a long way to go to fully embrace this more targeted approach to bleeding management as standard of care.

Here, we are on track with our BLA for congenital fibrinogen deficiency or CFD, with a PDUFA date end of December. We expect to launch this indication in the first half of 2026.

As Nacho mentioned, following conversations with the FDA and observing the slow growth of fibrinogen in the U.S. over the last year, we have decided to focus our BLA on CFD for now and use the time to further strengthen our body of evidence with U.S. patients for an sBLA for acquired fibrinogen deficiency or AFD at a later point in time.

While this delays our indication for AFD in the U.S., this staged approach allows us to provide access to our medicines for U.S. patients with CFD in the first half of next year, while giving more time for the market to evolve, further strengthen our position for a possibly differentiated label in AFD and set us up for a leading position in the U.S. over time.

As Nacho noted, these updates do not affect our guidance and the long-term goals outlined during our Capital Markets Day, nor do they change our broader development efforts and our conviction in a meaningful opportunity ahead as the standard of care continues to evolve toward concentrate-based therapies. We remain confident in the program's progress and long-term success as we continue to invest in its global rollout for the benefit of patients.

Taking a step back, while we certainly look forward to the launch of fibrinogen, our pipeline reflects our focused and disciplined approach to advance innovation and create value across all our therapeutic areas.

We've already covered our advancements in immunology and pulmonology. In infectious diseases, our trimodulin Phase III trial in severe community-acquired pneumonia is progressing steadily. With its innovative polyclonal antibody profile, trimodulin has the potential to address a significant unmet need.

And in ophthalmology, our ocular surface Ig program for dry eye disease in Phase II has the potential to expand use of Ig into new therapeutic areas.

In the earlier stages of development, our pipeline spans both plasma-based and non-plasma programs, including a next-generation GAMUNEX process with improved yield, recombinant therapies and novel treatments for infectious diseases.

Overall, our pipeline reflects a balanced mix of near-term launches and long-term innovation aligned with our value creation plan and reinforcing Grifols leadership in plasma-derived medicines aimed at driving sustainable, profitable growth for years to come. With that, I now hand it over to Rahul to provide more details on our financial performance.

Thanks, Roland. On Slide 12, the words continued resilience sum up not just the Grifols' financial performance, but also very aptly describes both the Grifols business that has been built over many decades as well as the Grifols spirit of our over 24,000 teammates and our shared commitment towards the Grifols mission.

Slide 13. From a financial performance standpoint, Q3 was a robust quarter across the board that presents an equally robust across-the-board year-to-date picture. There have been some favorable phasing and mix benefits that have contributed to this robust year-to-date financial performance that I will elaborate on in the upcoming slides. As a reminder, our reported figures included the impact of IRA and the fee-for-service GPO reclassification, which could distort the underlying performance and hence, to improve comparability to prior periods, we will continue to disclose the like-for-like column for the remainder of the year, which we believe will be helpful to all our stakeholders.

Starting with Q3 financial highlights. Net revenues of just under EUR 1.87 billion, up 9.1% versus Q3 '24 on a constant currency basis, led by Biopharma, and adjusted EBITDA of EUR 482 million, resulting in an adjusted EBITDA margin of 25.8% for the quarter.

And a slightly higher impact on group profit than was the case in Q2 this year. And free cash flow pre-M&A pre-dividends for the quarter of $203 million, up meaningfully versus Q3 '24.

Moving on to year-to-date financial performance. Net revenues of over $5.5 billion, up 7.7% on a constant currency basis, led by Biopharma that, as Roland mentioned earlier, is up 9.1% on a constant currency basis.

Year-to-date adjusted EBITDA of over $1.35 billion is up 11.2% versus 2024 on a constant currency basis despite the impact of IRA, albeit benefiting from some phasing and favorable mix that I referenced earlier. Both gross margin and adjusted EBITDA margin are up versus 2024, notwithstanding the impact of IRA.

Year-to-date group profit of $304 million is up over 245% versus year-to-date 2024. Free cash flow pre-M&A pre-dividends is up $257 million versus year-to-date 2024, and I will elaborate on the drivers of this free cash flow improvement a couple of slides later.

Furthermore, the leverage and liquidity picture has significantly improved versus Q3 2024. And with secured leverage at only 2.6x, we have almost 2 EBITDA turns of secured leverage capacity, giving us material flexibility, thus rounding out the robust and improving balance sheet that is referenced in the title of the slide.

And finally, I have deliberately not dwelled on the like-for-like performance that you see on this slide as we consider the impact of IRA as part of our regular cost structure now. But the numbers in this column are eye-popping, and are helpful context to the underlying momentum of the business.

Slide 14. Notwithstanding the impact of IRA, year-to-date revenue growth was up 7.7% on a constant currency basis, whilst clearly Biopharma led, we also had a positive contribution from our Diagnostics business that continues to execute in keeping with our plan.

As Roland alluded to earlier, the Biopharma revenue growth continues to benefit from robust underlying Biopharma demand on the back of continued Ig momentum as well as progress from our alpha-1 and specialty protein franchise.

Albumin, however, is an area that we continue to keep a close eye on. And finally, year-to-date performance has benefited from some phasing-related gains that have also contributed to a 9.1% constant currency growth versus 2024.

Slide 15. Year-to-date adjusted EBITDA in 2025 is at $1.358 billion, up from $1.253 billion in 2024 after absorbing the year-to-date IRA impact of $75 million with adjusted EBITDA up 11.2% on a constant currency basis and adjusted EBITDA margins improving versus 2024 by 60 basis points to 24.5%.

The EBITDA growth was mainly led by Biopharma, supported by each of the following: strong volume growth aided by some phasing benefit, a favorable geographic mix adding to the phasing benefit with a proportion of EBITDA from the U.S. better than expectations and up meaningfully year-to-date, continuing improvements in CPL and finally, continued focus on OpEx discipline and driving the benefits of operational leverage.

As for the IRA impact, it is broadly in line with the guidance we provided in Q2, and we expect full year impact to be between $100 million to $125 million. Whilst the impact on EBITDA of a weakening U.S. dollar is considerably more sheltered than revenues as a result of the various natural hedges in our cost structure, it has still been a stiff headwind.

Whilst the weakening U.S. dollar has been the main issue from an FX standpoint, other currencies have also contributed to the total FX impact versus the FX rates embedded in our guidance for the year as set out in our Capital Markets Day presentation.

Slide 16. Over the last number of quarters, we have talked about our expectation for continued convergence between adjusted and reported EBITDA on a cash basis or said another way, focusing on reducing the amount of cash adjustments between adjusted and reported EBITDA. And we are pleased to see that convergence trend on a cash basis continue over the last couple of years, and there are 3 specific outcomes that I would like to call out.

Number one, continued reduction in cash adjustments between adjusted and reported EBITDA. And as you will see on this page and the detail on Page 30 in the appendix, there has been a 56% reduction in cash adjustments on an LTM basis, primarily due to lower cash adjustments pertaining to restructuring costs and transaction costs. Number two, reported EBITDA is growing at 15.7% on a constant currency basis, faster than adjusted EBITDA despite its robust 11.2% growth on a constant currency basis.

And finally, three, the gap between reported and adjusted EBITDA margins is reducing. And as at Q3 '25, this gap has narrowed to 120 basis points, having been 210 basis points at the end of 2024 and 340 basis points as at the end of 2023, mainly on the back of lower cash adjustments and the convergence tends to happen rapidly, often within around 6 to 7 months, validating the credibility of these cash adjustments.

We also want to proactively flag the potential of noncash adjustments in Q4 that importantly do not at all have any impact on the go-forward EBITDA growth story or free cash flow growth story.

These potential noncash adjustments are simply the other side of the capital allocation discipline coin, where prioritizing our valuable capital mainly on the projects that we talked about at our Capital Markets Day in February this year, means that some other projects remain dormant or on hold and potentially there could be an impact on their carrying value. But to be clear and to repeat, we are confident that these potential noncash adjustments will not impact our go-forward adjusted EBITDA growth or free cash flow growth story.

Slide 17. A quick update on our progress towards our free cash flow pre-M&A, pre-dividends goal for the year. As you will recall, we improved our free cash flow pre-M&A, pre-dividend guidance at H1 from $350 million to $400 million up to $375 million to $425 million, considerably up from the $266 million free cash flow outperformance in 2024, and we expressed our confidence that the business could do meaningfully better over time.

And finally, recall that unlike EBITDA, free cash flow pre-M&A, pre-dividends is more insulated from euro-dollar volatility.

The punchline on our year-to-date free cash flow performance is that we are tracking well versus our improved free cash flow guidance provided in our H1 call, as at the end of Q3, we are EUR 257 million better than we were in 2024 at the same point.

The principal driver of the improving performance is greater vigilance on cash flow across the entire organization. In addition to that, improved EBITDA contribution, lower cash adjustments, tight working capital management, disciplined CapEx and capitalized IT and R&D spend and an improvement in cash interest expense as a result of debt paydown in 2024 and significantly lower utilization of RCF has supported our year-to-date progress on the free cash flow front.

And more on free cash flow guidance for 2025 on the next slide. Finally, on Slide 18, updates on both capital structure and our outlook for the year. First, on capital structure.

The clear tightening of our longest-dated bonds in our capital structure by over 200 basis points in just the last 3 to 4 quarters is evidence of the clear progress in the re-rating of the Grifols story.

And by that, we mean not just from a credit perspective, but also our clear focus on progressing on the immense equity re-rating opportunity we believe there is.

And it is also pleasing to see a number of our banking partners further corroborate the re-rating progress implied by our tightening bond yields by proactively offering meaningful upside support for a potential upsized RCF as part of the refinancing that we are targeting in H1 2026.

All very helpful steps forward on the capital structure front and preparations are ongoing. We have also just a short while ago launched a harmonizing exercise to align the documentation of the 2 bonds we currently have maturing in 2030. As I alluded to before, both bonds continue to trade very positively, hence, the launch of this nice-to-have action.

Before speaking about outlook, it might be helpful for us to contextualize our year-to-date performance. Notwithstanding very stiff FX headwinds and the IRA impact, our performance has been robust for the reasons we have already discussed. We have also benefited from some positive phasing and mix gains and thereby accelerating aspects of our EBITDA performance for the year, which we expect will partly reverse in Q4.

When considering year-over-year comparison to Q4, please remember that we are lapping our best quarter in history from an EBITDA perspective, a quarter that itself back then benefited considerably from phasing. And taking that together with IRA and the FX headwinds, we expect a robust Q4 '25.

However, it will compare less favorably to Q4 '24 in absolute terms. The team remains very focused on ensuring that we execute with the same discipline and intensity as we have all year.

It is also worth reminding the market of our updates in prior quarters of the impact of a weakening U.S. dollar and how that headwind reduces as we move down our P&L as a result of the natural hedges embedded in our business, from a weaker U.S. dollar having a significant impact at the revenue level to being broadly neutral at the net income or group profit level and indeed broadly neutral on free cash flow, too. And absent any abrupt movements in FX, euro-dollar in particular, as we move to the end of the year, we expect it to be broadly neutral on leverage, too, which then leads me to the final section on guidance.

On the right-hand side, we compare our updated guidance to the original guidance we provided at our Capital Markets Day on 27 February 2025 at guidance FX rates.

And on the left-hand side, we estimate the full year FX impact to be roughly around EUR 70 million on adjusted EBITDA if FX rates stay as they are currently for the rest of the year versus the guidance FX rates in order to assist all our stakeholders with their analysis.

As you will see on the right-hand side, our updated guidance at guidance FX rates compares favorably to the original guidance we provided at our Capital Markets Day, improving updated guidance at guidance FX rates for both revenues and free cash flow pre-M&A, pre-dividends.

And on the latter, we are once again improving our guidance further to EUR 400 million to EUR 425 million. And adjusted EBITDA guidance FX rates is reaffirmed to be consistent with the original guidance provided and that we are currently tracking very comfortably within the guidance range provided, which, as I mentioned at the start of the financial performance section, speaks to the resilience of the Grifols business, notwithstanding the highly dynamic markets that we have navigated well thus far this year. With that, let me hand it back to Nacho for his concluding remarks.

Thank you, Rahul. I would like to conclude today's presentation with just a few final remarks. Our third quarter results confirm that the strategic road map we set in motion this year is delivering results. The value creation plan is driving measurable progress from continued market share gains and sustained top line growth to a significant improvement in free cash flow generation.

This performance underscores our focus on strengthening financial fundamentals and executing with the discipline required to turn a strategic vision into financial performance. We have also further strengthened our balance sheet through deleveraging, enhanced free cash flow generation and a disciplined financial and capital allocation. This combination provides the flexibility to invest in growth while maintaining a prudent approach to leverage and liquidity.

As we approach year-end, we remain vigilant as market conditions continue to be dynamic with foreign exchange pressure and other external factors still present. These potential headwinds are being closely monitored. And as in previous periods, we are confident in our ability to respond with resilience and execution.

Therefore, we reaffirm full year 2025 revenue and adjusted EBITDA guidance and the exchange rate presented at our Capital Markets Day and updated free cash flow guidance to more than EUR 400 million. Finally, I want to recognize once again the dedication of the entire Grifols team whose commitment to our value creation plan continues to drive this company forward.

We are executing with focus, accountability and discipline and remain fully committed to creating long-lasting value for all our patients, donors and stakeholders. Thank you, as always, for your continued support. And with that, Danny, back to you.

Thank you, Nacho. Now let's turn to the Q&A session. [Operator Instructions]. Let's start with Charles from Barclays.

Just first one on fibrinogen. Just I want to clarify what the driver there is behind the fibrinogen and AFD being delayed to the U.S. Is this kind of FDA pushback on -- is that reflective of their internal resourcing?

Or is it reflective of the quality, quantity of your supporting data for the indication? Just because thinking about this asset previously, a key differentiating factor for Grifols was to be the first U.S. approved asset with both forms of the disease as part of the label.

So just to your point about not impacting the midterm guidance, kind of how do you expect to be able to continue to differentiate against the competition?

Or is this just set to be a very short delay? And then my other question is just for Rahul on the refinancing. Just coming back to terminology there, you're highlighting the harmonization process of the 2030 bonds.

Can you confirm whether this means that you're also considering refinancing of these 2030 maturities as part of the 1H '26 targeted refinancing for the '27 maturing bonds? And just wondering, as part of that refinancing as well, is there any potential to renegotiate the terms of the GIC deal?

Thank you, Charles. On fibrinogen, I think that we always have stated and have been aware of the fact that in the United States, we would need to change the standard of care, which currently is based on cryoprecipitate in order to boost the sales of fibrinogen to the level that we expected. This is a mission that we are very committed to do.

We believe, based on what we see in other markets that, that certainly will bring benefit for patients. But as I mentioned, based on the conversations with FDA, we feel that it's important to bring even more solid clinical information and clinical data with U.S. patients in order to help with that standard of care.

At the same time, I think, obviously, our focus in the short term is going to be to develop markets outside of the U.S. And in the U.S., obviously, with the congenital fibrinogen deficiency, certainly, we will start working with physicians for them to know and be more aware about the benefits of fibrinogen versus other alternatives. I don't know, Roland, if you want to add anything else?

Perhaps just commenting on how this compares to the plan that we laid out at the Capital Markets Day. As mentioned, today, the largest opportunity is in Europe, north of 200 million.

And there, we remain on track for our launch in Germany this year, and we believe that we can differentiate and gain share in this market and actually have some opportunities in ex U.S. -- ex Europe market as well to gain share.

In our considerations, the U.S. was always a slower build. And therefore, a delay of AFD at this point does not materially change our outlook in the near term. And at the same time, we believe that with a possibly differentiated label at the time of launch of AFD in the U.S., we have an opportunity to still lead that market and capture the long-term potential of north of EUR 800 million that we laid out at the Capital Markets Day. So that's where the comments come about that we don't see a change in our outlook.

And Charles, on the 2030 bond harmonization, that's just a harmonization exercise between the conditions or the documentation, if you like, between the 2 bonds.

Your comment around 2030 refinancing, of course, we have the optionality if we so choose to refinance those. Those bonds are callable on the 1st of May 2026, if I recall correctly, which just gives us -- we have that optionality.

And clearly, as you can see with where those bonds are trading today, there is value as we think about refinancing those in due course. But it is a part of refinancing options that are available to us. It doesn't have to be in 2026.

We can decide on the right time for that. And then finally, on GIC, you're absolutely right, there is -- those are 8% dollar bonds and the way we look at that is at sort of unsecured risk.

There is value there. Again, we -- in terms of the right time to optimize a possible redemption of that, we'll decide that in close partnership with GIC.

GIC has been a partner of us for some time. We'll work through that at the right time. But clearly, there is also possible value there. In due course, we can seek to capture that from a redemption and refinancing standpoint.

Now let's move to the next one, Jaime from Santander.

So a couple of questions from my side. The first one, could you elaborate a little bit more on the dynamics of the albumin in China?

Basically, if this pricing pressure comes from the offer side, so more competition? Or is it the demand or the reimbursement or the social security there that is putting lower prices?

And the second one regarding also fibrinogen, just for my understanding, so it seems that there are 2 segments, so AFD and CFD. So out of the $800 million addressable market, how much is AFD and how much is CFD? Basically, my question tries to understand the short-term opportunity when you launch for CFD versus the [ additional ] indication, AFD?

Thanks, Jaime. And let me start with the second one, and then Roland will address the one about China. So on the fibrinogen, I mean, it's not possible to see or to assess really what is the market opportunity right now because the market development effort needs to be done.

I think that we know that at this point, the use of fibrinogen in the U.S. is limited. It's very limited. It's small. And we know as well that what is the potential that fibrinogen can have.

If we managed to get the standard of care at the levels that we see in other markets like Germany or Austria. So at this point, both AFD and CFD are small. And our work is going to be to really prove and bring clinical evidence that those markets will develop to the level that we expect they will be of this $800 million Europe that over time, we are confident it will happen. And on China, Roland will comment now.

Yes. On China, the key underlying driver are the government-imposed cost controls that we talked about across the whole health care sector. That had an impact on prices and also had an impact in terms of the demand in the market slowing down. But it is important to note that while we see this impact at this moment, China remains to be the key market and the prices actually still compare favorably with other parts of the world.

Also, as we think about China for the future, it's a key market for us. It's important. We believe that our partnership, our strategic partnership with Haier and Shanghai RAAS puts us in a strong position to navigate this market, and we are working to seize opportunities to realize growth in other parts of the world, particularly U.S. and ex U.S. to see how we can aid to continue to balance our albumin with the Ig growth that we foresee. So in terms of the driver, it's really coming down on this market. It's a dynamic situation, but we believe that we are in a good position to navigate this with our strategic partnership.

Now we will go to Alvaro Lenze from Alantra, please.

The first one is on the EBITDA guidance for the year. If I take the range you provided and I subtract the EUR 70 million expected FX impact implied Q4 in the lower range would be about EUR 450 million adjusted EBITDA and on the upper range would be around 500 -- sorry, EUR 500 million.

That is on the low end, a 15% decline, and that would put Q4 less than either Q3 and Q2. So I don't know if there is any phasing there. I know Rahul explained the comparison base for Q4 last year is quite tough, but still in absolute terms, the low range of the guidance would look a bit underwhelming.

So I was just wondering what your thinking process for that guidance was. And then a second question would be, you mentioned some impairments for Q4.

I just wanted to know what sort of assets are you thinking of for the impairment and when did those assets join the balance sheet, just to understand whether you are looking at past or very old investments that you no longer think are as valuable as represented in the balance sheet or if it's more recent investments that you're cutting?

Sure. Let me start with the second one on impairments. It's certainly, as you -- as I mentioned in my prepared remarks, we laid out at our Capital Markets Day, R&D and innovation plan and none of those from our standpoint are impacted at all.

This really is some of the efforts in our portfolio that perhaps have not had the prioritization from a capital standpoint. And all we're doing is proactively flagging that.

But importantly, Alvaro, this does not impact our go-forward adjusted EBITDA growth story or indeed our go-forward free cash flow growth story.

So just to give you an idea that just in terms of lower prioritization in terms of -- from a project standpoint. So that's on the second question.

On the first question around guidance and ranges, I said 2 things on our -- as I described the guidance. One, I said we are very comfortably within our guidance range for adjusted EBITDA. And then the other thing I said is we expect a robust Q4 2025.

The only thing I caveated there was that the absolute comparison versus Q4 '24 that also benefited meaningfully from phasing last year is something that we just wanted to make sure that we prudently guided on.

But from our standpoint, as you look at those ranges, I think the bottom end of the range that you feel very comfortable about managing and beating, and, as we've always done, focuses head down on execution with discipline and intensity. So we'll see where we get to, but we're tracking on that basis. And what we want to do is make sure we flag the phasing aspects as we've done.

Thank you so much. Now we would like to get Charlie Haywood from Bank of America.

Charlie Haywood, Bank of America. Two questions, please. First one, unless I've misunderstood, could you clarify what the FX headwind to your reported revenue guide would be for the full year?

And then just on the sort of FX impact, what specifically on FX has changed since second quarter when, I guess, guide was reiterated and there wasn't an implied FX impact there? And then the second question, just wanted to get your thoughts on, obviously, the competitor readouts we've had in alpha-1, your confidence in rebuttal of that, especially on the margin level, which I understand is slightly higher than your standard products and given also fibrinogen delay today might lead to more of a margin impact. So just high-level thoughts on how you can rebut that impact.

Thanks, Charlie. I'll take the first one. So if you go back to our Q1, go back to our Q2 and indeed repeating now in Q3, we've been consistent around the headwind of U.S. dollar weakening on EBITDA. But remember, it remains broadly neutral from a leverage standpoint and indeed broadly neutral from both the group profit, bottom line net income and from a free cash flow standpoint.

Number two, you will also -- if you go back to each of those presentations, you will also see that we have been reiterating, I think, Q1 and Q2, we've always taken you back to the basis on which guidance was provided, and there's no change in that respect now in Q3 either.

So that's why we're always saying is that as you compare our our guidance or implied guidance now relative to -- on a guidance FX rates basis, we continue to track well from a revenue and free cash flow standpoint, in fact, improved and maintain the -- or reaffirmed guidance from an EBITDA standpoint.

Equally, we want to make sure that we are being completely upfront. We provided a sensitivity analysis in Q2. And what we're trying to do now is just give you a number if the rates as at the end of Q3 persists through to the end of the year, what that implies from an adjusted EBITDA headwind.

The question around revenue impact, we've not provided that. But I mean -- but if you just assume that roughly about 2/3 or 65% of our revenues is U.S. dollar-denominated. And if you do the rough math around that, depending on what your exchange rate assumptions are for the rest of the year, that could have an impact of anywhere between $300 million to $400 million, give or take.

But on the basis of the guidance FX rates, we are guiding to an improved revenue guidance for the year. So let me leave it at that. And on the second question, I'll hand it over to Roland.

Yes. On alpha-1, we always, as part of our plan, assumed positive top line data of the pharmacokinetic endpoints. So this was as we expected. What we hear from thought leaders are basically 2 questions at this point. One is waiting to see the detailed data and understanding safety of this recombinant approach. And the second question is around the pathway to approval.

And we're obviously also eagerly waiting to see what this means. But as we think about Alpha-1, we just want to bring it back to the immense opportunity that still remains. We only are treating 10% to 15% of patients today, which means 85% of patients are undiagnosed.

And we just saw with CIDP how a new entrant can actually dramatically improve and accelerate diagnosis. Beyond that, we know that with our outcome study, SPARTA, we have it in our hands to raise awareness of this disease in the U.S. and ensure that we can have a broader reimbursement in Europe, which gives us a growth lever.

And then lastly, as we mentioned, we're excited about our subcu treatment, 15%, which we're advancing into Phase III and planning to submit an IND there in the coming months and our long-acting option.

So as we look in -- at this market, a new entrant, but most importantly, the growth opportunity that this market has, we remain committed and confident about alpha-1.

And as you think about fibrinogen concentrate, as we outlined, the path to growth is not materially affected by what we just shared. We are still in a position to compete and possibly accelerate our uptake ex U.S. and we have an opportunity to strengthen our positioning in the U.S. and see that we can lead in this market in the long term.

Thank you so much, Roland. I appreciate the question, Charlie. Next up is Thibault from Morgan Stanley.

Just on the free cash flow guidance, so obviously, versus beginning of the year, EBITDA and change at constant currency, I mean, using February FX as a base, free cash flow guidance has been upgraded a couple of times since.

If you can just remind us the moving parts in between for the free cash flow improvement and any risk of seeing some of these elements reversing in the future? So for example, working capital, if you could comment on your expectations for working capital position at the end of the year and what it means for potential reversal in Q1 next year?

Yes. So just -- so your question is on just the various constituent parts of our free cash flow improvement. You're absolutely right in that we have improved our guidance on free cash flow a couple of times this year.

The drivers of that free cash flow improvement come from the improved EBITDA on a year-to-date basis, our adjusted EBITDA is up meaningfully. And even if you eliminate some of those cash adjustments, they continue to track very well compared to 2024.

On a net working capital basis, we talk about tight working capital management, notwithstanding the impact of a depreciating dollar on just sort of inventory levels and so on, our inventory levels continue to be managed on a tight basis as is the case on both from a receivables and payables standpoint. So that is tracking well and tight.

As you look at CapEx and capitalized IT and R&D, clearly, we are -- as we anticipated at our Capital Markets Day, we saw 2024 as being a sort of a peak from a total CapEx.

And here when we talk about CapEx, I also include what we used to refer to as extraordinary growth CapEx previously. So the total CapEx number to sales was at a peak in 2024. And all that's happening here is it's playing out as we expected, prudent and disciplined CapEx spend.

And then finally, as you look at interest cost, we had the significant deleveraging benefit in 2024 from the partial disposition of our Shanghai RAAS stake that has helped leverage, helped debt redemption.

And in addition to that, what has also helped significantly is our meaningfully lower utilization of RCF from a financing standpoint. So all of that translates to free cash flow improvement of $257 million versus last year.

As I look at the picture for the rest of the year, we remain confident about executing on our improved guidance of $400 million to $425 million for free cash flow pre-M&A, pre-dividends for 2025.

And then -- and with respect to the impact in 2026, we will cover that off when we provide guidance in -- at the end of February next year. But certainly, we're not anticipating significantly different variations.

If you recall, in Q1 this year, we had a meaningful improvement from a free cash flow standpoint versus Q1 2024. And one of the things that we will seek to do is maintain that to the extent possible. But that's something that we'll pick up in a bit more detail when we provide our guidance for 2026 at the end of February next year.

Thank you so much, Rahul. Very clear. Guilherme, I think that you were waiting.

Yes. So 2, if I may. The first one, I assume that the Ig growth acceleration was positively impacted by some pricing benefits that you alluded to, but also some volume gains in the U.K.

You're guiding for a slowdown in terms of [indiscernible] growth going forward. Just to understand a bit how going to be the phasing between Q4 and Q1, taking Q1 as a potential reference for going forward. So this 6% to 8% is something that we should consider only for Q1 and Q4 could be a bit below these references?

Or is the run rate -- the 6% to 8% is the run rate that we can assume going forward? And second question regarding 2026. So from your comment, I assume that we should expect a lower underlying growth, at least in Biopharma.

But the FX typically has a positive impact in terms of margins, the weaker U.K. U.S. dollar. So at the Capital Markets Day, you guided for a uniform margin progression across the plan.

This less favorable effects on the absolute EBITDA standpoint could impact positively margins. So we might have in 2026, a faster margin expansion than what you were planning in the Capital Markets Day?

Guilherme, happy to add a bit more color on the Ig side. As you may recall, in our Capital Markets Day, we said that we aim to grow Ig in line or slightly ahead of the market and gave that 6% to 8% CAGR rate, which just reflects the potential that Ig has, and we expect it to be in there.

The other part that I want to just bring up again is you may recall that in the 2023 call, leadership at the time announced a plan to win back share in the U.S. During the pandemic, we have lost share in the U.S. and we have announced that we want to win it back.

We have since executed on this plan using a strong inventory position that we had at the time, and that translated into this double-digit growth, well, well ahead of the market during this time. We have since regained the market share and at this higher market share, we now expect to grow in line with the market or ahead of the market. So from that perspective, I would look at these last 2 years as our ability to actually reposition us in the market and from here to grow with or ahead of the market moving forward.

And then finally, on the question around margins. No real change in terms of the building blocks driving our margin improvement story over the coming years. And with respect to what we had guided from a margin standpoint for 2025 was adjusted EBITDA margins to be in line with 2024, having fully absorbed the impact of IRA.

And year-to-date, we're doing exactly that. You can see on a like-for-like basis and even on a year-to-date basis, our margin improvement is up. So that remains the story for 2025. And with respect to 2026 and beyond no change, we will update the market with respect to 2026 guidance specifically when we come to it at the end of February.

Thank you, Roland. Thank you, Rahul. We have time for the very last question. It's going to be Justin from Bernstein. Justin, please.

Yes. Justin from Bernstein. Just a quick one on fibrinogen, and apologies if I've missed some remarks here. But when you talk about the new evidence that you need to bring, are we talking about new clinical data?

If so, could you just share some thoughts on execution risk there? I mean, is it a case with acquired patients? It's quite difficult to locate those patients and run the trial. So any thoughts there would be very helpful.

Yes. The one thing to highlight is that we are obviously looking at the study in the U.S., and we have different proposals on the table, and we'll be looking at the best way with an eye on making sure that this obviously helps us with speed to the market at the same differentiation possibly in our label. And we do not see an execution risk there. We see the need and interest to conduct a trial like that.

Okay. Thank you so much, Roland. I say that was all for now. Thank you so much for all your questions and for joining us today. If there is any follow-up, please let us know. There is an IR team dedicated for that. Thank you so much.