SIEMENS HEALTHINEERS To buy or not to buy the share? SHL Analysis & Overview

OO

Operator

Great. So when we set off the plan this day, by the way, thanks to Jefferies for giving us kind of a bit of a room within their huge conference. So I had to see this upfront. I agreed to this with Lindsay. We didn't think that it would be such a crowd turning out. Actually, we hope that there will be some kind of product positive spillover from the idea, but it's impressive. So thanks to all of you for coming and showing interest in Siemens Healthineers. We have quite a bit of program organized for you today. So let me just run you briefly through the agenda that we have organized. So first of all, Bernd will be kicking us off with a run-through of our strategy. Then Jochen will follow up with, obviously, the story around financials and the midterm plan to be then follow up the first Q&A session.

Then we have Sharon Bracken for Diagnostics with her presentation and the Q&A. Then we have a break, say, 25 to 30 minutes, depending how quick we get through the first block. So that will be around about 3:00 p.m. And then we have a long block of presentations in one go. We have Andre for imaging, and we have Arthur and Carsten for Precision Therapy to then closing the day out with Dorin for Healthcare AI. And we have a block of Q&As then. First, a longer session for all of those 4 presenters in 1 block, and then we have a final presentation. So if things come up for maybe group discussion rather, we reserve that for the very last session.

And also, I might take the [ joker ] in the one or the other Q&A to say, look, let's keep that for the last session. So don't feel offended if that happens.

So -- with that said, one little thing at the end, obviously, we're talking a lot also about the future. So the safe harbor statement is something you should take note of. Also with regards to a bit of housekeeping, we are recording this session. It's also live webcasted. And also when we do the Q&A, there's a camera standing there. This will be shooting into the audience. And so if you're asking questions, we just assume that you've agreed to your voice and your image being broadcast and also then later on, put on our website.

So that said, I would say we kick it off now, and I welcome on the stage, our CEO, Bernd Montag.

BM

Bernhard Montag executive

So thank you, Mark, and thank you, everybody, for coming. I'm standing here together with Jochen, Andre, Carsten, Arthur, Sharon and Dorin on behalf of 74,000 passionate healthineers whose contagious commitment to our purpose, who have a spirit of winning together of continuous learning of being there for patients, for making a difference is what makes this organization one of the world's best workplaces, not my opinion, but publicly acknowledged by agencies.

We are stemming from 150 different nations. We combine an amazing breadth of different skill sets. We have physicists, we have physicians in our group, many, many, many different backgrounds. And it's a true honor to represent this group. This group has been on a journey since quite a while, since the IPO with the clear idea to create something big. We had the IPO, the transformative move with the combination with Varian. And now we are eager to go to the next phase of our company and to do this following last week's announcement also with the perspective of a completely and finally completely independent company.

This is where we are today, what we have achieved so far. We are not only a leader in the industry. I think it's fair to say we are the leader in the industry with a clear #1 position in imaging, in precision therapies with a clear #1 position in all regions, whether it is the Americas, Europe, China or APJ as we call it. When you look to the right, it shows the impressive global reach of the organization. We are directly present in 70 countries. We have an installed base of 700,000 systems. But I think what is most impressive on that slide is that every year, we touch 3 billion patients.

And when we later speak about what we do globally and when the theme is elevating health globally, you see here this is not just a tagline. This is a reality. For us, R&D is not a cost. For us, R&D is the source of everything. We invest more than EUR 2 billion annually into R&D. We expand our R&D budget year-by-year. We have 13,000 engineers looking ahead every day, about half of which are in the field of software, AI and data science and the fact of 1,300 patent families in the field of health care AI alone, I think, is a strong testament of this.

And in the lower left, I'm proud that we also stand out when it comes to addressing customers and especially the big customers, the consolidators with more than 200 value partnerships and a backlog from those alone of more than EUR 6 billion. We have grown into a company with more than EUR 23 billion in revenue, generating close to EUR 4 billion in EBIT. We have in the 3 synergetic businesses of Imaging, Varian and Advanced Therapies, very strong market positions with #1 positions. These are businesses which are working closely together. We will see this during the course of the day, and they share the equipment service type business model. Diagnostics is not synergetic to those. It's following its own path, own business model, razor-razor blade is in a different phase of a -- as we will see successful transformation.

And now before I go to the next slide, since our last Capital Market Day, which was a few years ago, certainly, the macro environment has changed in a way which we -- we didn't foresee and which probably nobody did foresee. The pandemic took longer than anticipated. The war in Ukraine triggered a peak in inflation. We had supply chain interruption. We had the sudden changes and transformation in the Chinese market. We had more and more geopolitical challenges. And last but not least, since a while, new trade barriers and tariffs coming up. I am super proud what our team has achieved despite these challenges. And that is what the next slide says. First of all, in the last 4 years, we have grown revenue by more than 6% per year, grown EPS in the double digits, 11% per year, very strong performance in imaging, Andre and team, 7 percentage points in market share gain since IPO, since closing of the Varian acquisition, we gained 10 percentage points in market share on the Varian side.

We widened the innovation lead with technologies like photon counting CT, DryCool MRI. We are at the forefront of novel treatments like HyperSight in radiation therapy or theranostics, which goes from molecular imaging to Varian. The Varian acquisition, and I always call it combination actually has proven to be a real big success. Arthur will speak more about it because the tagline back then was one step, two leaps. We wanted to create a kind of Varian on steroids, I sometimes say, a Varian which can do even more when it comes to cancer care and which then step-by-step becomes Siemens Healthineers, which is a super strong cancer care company. But it also changed the impact Siemens Healthineers has on customers globally, and it changes how we became a company which is much more about managing disease and which is much more about understanding the space of therapy.

As I already said, we have been very successful in developing a new type of business by addressing the C level of institutions, which created that EUR 6 billion in order backlog for value partnerships I already spoke about. And last but certainly not least, I'm very proud of the Diagnostics team, which is on track with the transformation of the business and since '23 has improved margins by 8 percentage points. And with Atellica, the business of the Atellica franchise has been growing in the last years by 20% per year, now being more than half, covering more than half of the important central lab business. And this is also why we are now convinced that it's time for the next step.

So we give Diagnostics more entrepreneurial freedom to build its own strategy in its own structure. The business will have the flexibility to operate in a dedicated organization with dedicated resources to fully crystallize its value and potential. It will continue to invest to grow, to improve margins and to innovate. And with this, we also create structural optionality's for a whole set on spectrum of pathways for this business in the future. And this is also why in the following, I will mainly concentrate on what we do in the 3 synergetic businesses, while Sharon, following Jochen's presentation, will explain where we are and where we want to go in Diagnostics.

So now switching to the future. Our next phase has a big word, elevating health globally. I already kind of justified with the 3 billion touch points why it's something we can really say. It is something -- it is a phase we have been preparing for since quite a while. I mean, in the details since about a year. But in the end, since IPO because we have step by step by step built an organization which is ready to do what we want to do in the next 5 years.

And now for those of you who have TikTok like attention spend, I do the story super, super, super short and then comes the more detailed version, okay? So the super short version is Siemens Healthineers has developed 2 superpowers. One superpower is managing the triangle of Patient Twinning, Precision Therapy and health care AI, which is exactly what you need to manage the most threatening diseases worldwide. And the second superpower is an unmatched regional organization which covers a broad portfolio is global and local, can talk to departments and can talk the language, speak the language of the C level. And that is why Siemens Healthineers is also best positioned to address the customer challenges worldwide of providers, which is efficiency, clinical excellence and access. So that was the TikTok version, okay?

So -- and now I go into it in a little bit more detail. So first of all, we focus on the patient aspect, what do we do and how does what we do in the next years matter and really make a difference for 8 billion people worldwide. The biggest challenge in global health care is the growth of the noncommunicable diseases. 75% of all global deaths are attributed to the NCDs, noncommunicable diseases. So it sounds a bit as a complicated term maybe yes, but that's how the medical community calls them.

But in the end, when we look into more detail, these are the diseases all of us are most afraid of, whether it's for our loved ones or for ourselves. It is neurodegenerative diseases, where 1 in 9 people out of 6 -- above -- over 65 worldwide has Alzheimer's. It's cardiovascular diseases, with more than 20 million deaths per year. It's stroke with 12 million patients per year and 7 million deaths, and it is cancer with more than 20 million deaths grow expected to grow to -- 20 million cases expected to grow to more than 30 million. So these are the diseases we tackle, and this is how we strategically have developed our skills in the organization.

And this is not a slide. This is not one of these feel good slides in a presentation of the trend is my friend, and I have some kind of a blockbuster, which fits into this and this disease category. This is our strategy, how we build our organization so that we are best in a sustainable way in helping physicians overcome these diseases. And now there's one simple, simple topic between infectious disease and difference and the noncommunicable diseases, the 4 disease areas here. In infectious disease, you have a one-size-fits-all kind of way of dealing with the disease. It's a vaccination to prevent it. And typically, when you have it, it's also relatively clear and doesn't depend on the patient or what the phase the patient is in, how you treat it.

What is the challenge for health care systems when it comes to the noncommunicable diseases, they are personalized. This is the early stage of a cancer or this is this type of coronary artery disease in this stage. So you need to personalize the treatment at scale. And this is exactly what our triangle of capability allows with the patient training with our unmatched strength in imaging. We have the opportunity to catch the disease early. We go into early detection that is, and you will see examples, whether it is cardiovascular disease or cancer. It is about diagnosing the disease. It is about selecting the therapy, it's about simulating the therapy and it's about creating a plan for therapy. That's what's happening on the left.

On the right, you have Precision Therapy. This is where technology makes the difference to enable the personalized care. This is what we do in Varian, which you can imagine is a kind of a robotic pencil beam to destroy the tumor based on the imaging information or it's minimally invasive treatment in a cathlab or very often, it's not only us on the right-hand side, but it is in collaboration with an intuitive surgical with Boston Scientific with whom we just have announced a new partnership when it comes to ultrasound guidance of LAAC closure -- with LAAC.

When it comes to Stryker, where we work in establishing a robotic thrombectomy or when it comes to Medtronic, where we operate in the field where we work together in the field of spine. So very often, what we see is on the right-hand side, either it is us doing the treatment, and we can optimize it hand to hand and under one roof or we optimize things hand-in-hand with a device company because what also one of my device CEO friends says, it's in the future for them, it's not only about optimizing the device, it's about optimizing and innovating the procedure. So this is how that 2 parts of the triangle work.

But what is as important, as I said, it is personalization at scale, and that sounds a bit like also the effort goes through the roof because -- and this is super important to use AI in a specific version of AI, which is optimized for health care, health care AI to help augment this information to help do the translation and to reduce the burden on the physician and to take out unwarranted variations.

We will hear more about this. And you will see it in some of my examples, but you will see in the end of the day today, Dorin, who has put us on the map years and decades ago when it comes to machine learning on AI, how we optimize AI for our cases here in the end for the triangle or call it, how we optimize and use AI to manage the noncommunicable diseases.

Now I'll walk you through some examples here. Alzheimer's. We are not only the market leader in PET and PET/CT, MR/PET and so on. We are also the clear market leader when it comes to the distribution of dedicated radiopharmaceuticals. That puts us exactly in the position here where on the right-hand side of the triangle, suddenly something is happening. A disease-modifying therapy starts to get available against Alzheimer's. So what you need is something happening on the left. You need the diagnosis. This is what we do here where we can see the amyloid plaque burden. We can decide if this patient does -- he or she have Alzheimer's and is the patient eligible for one of these DMTs.

And then in the next step, which is very often the case in health care, you don't do the imaging only once, but you need to do the imaging several times in order to accompany the therapy and exclude side effects like in this case of these novel Alzheimer's treatments where you need about 5 MR scans in the first 6 months of the therapy to exclude side effects like micro bleedings in the brain. Next example. And you will hear -- this is now -- I mean, I hope many of you share our excitement for photon-counting CT. But this is now the clinical side of it. Photon-counting CT is super exciting. I have never seen such a pickup of a new technology, 900 peer-reviewed papers. Andre will speak about EUR 1 billion of equipment orders, which we have generated so far with photon-counting CT. So that's the business side of it and the science side. Here comes what does it mean for our triangle.

Here, you see the coronary arteries of a healthy patient. Why does that make sense? Because coronary artery disease is a silent killer, so to say. It starts without the person noticing it. And typically, you only realize it when you -- when it's very late and sometimes when it's already too late. So photon-counting CT has the potential, and I'm sure it will be the method of early detection and screening for coronary artery disease. Here, you see no plaque, no lesion, no calcification, no risk. when it's a tiebreaker situation. Now photon-counting CT allows you tiebreaker, meaning there is something. But so far, you can see on the left here, it's a little bit far away that conventional CT didn't allow to really assess how far the disease has progressed.

Now -- and you see -- you see how crystal clear the images are, and this now allows us to replace the need for an invasive coronary angiogram. So again, it's a new way of dealing with the disease. You can use it for prevention. It's better assessment for the therapy. And then when a therapy is needed, you can use photon-counting CT to draw a detailed map, so to say, of the coronary. You understand the stenosis, you understand how much lumen there still is. And that information is then we call it CT-guided PCI. PCI is placing a stent in simple words. This is the handover to the therapy where the imaging information is processed with AI in order to assess the vessel and then the interventionist can do their job, do his or her job.

Similar topic in stroke, disease we are focusing on. We are working on -- we have created a CT scanner, which fits into an ambulance, but which has hospital-based quality for this type of exams, it allows in an instance to do the necessary diagnosis to make sure what type of stroke it is. And all information is already transferred to the hospital where then in a direct angio way, a procedure like thrombectomy can be performed under, again, image guidance. We are moving to the right, which is the treatment with a much, much better outcome for patients than the classic lysis therapy. And this is also one of the areas we are working on together with Stryker and Carsten will talk about it, to make this also robotic enabled in the future.

Last example or last disease area, cancer. So this is for radiologists, okay? So in essence, the message is what we do or what you have seen in coronary artery disease with photon-counting CT, we do, for example, for prostate cancer with MRI. MRI has much better soft tissue contrast. What you will see here, and these are, again, AI-enabled super fast sequences, which only take about 1.5 minutes, and you can see in an early detection fashion, which is much more reliable than any blood test, whether there is disease or not. And if there is disease, it very often, by the way, also replaces the need for biopsy, which is not a pleasant procedure.

Then MR, and this is one of the great examples why it is cool to have the world market leader in MR and health care AI and in radiation therapy under one roof is used for treatment planning of that. And next topic we are driving when it comes to cancer care is the field of theranostics where with our diagnostic capabilities, our strength in PET, our strength in distribution of radiopharmaceuticals and also with the IT systems from Varian for treatment planning, we are in a super strong position, and it is also one of the areas where we will have our so-called value programs of helping people to set this up in the future.

And my last example, and then I stop my clinical commercial break, if you want, is an example here of a oligometastatic patient, meaning multiple metastases in the brain. In the past, when you had such a case, you did whole brain radiation therapy, which had not too great effects on the patient and the cognitive abilities. In the next step, people needed to draw by hand, which organs to spare and so on and so on. Now this is completely done with AI. The colors of the metastasis here or the colors show the intensity of the energy, which is applied based on imaging and AI fit into the linac and then this super precise oligometastatic treatment is done.

So I hope you see that this triangle is super important for managing things. And I hope that this also explains why technologies like photon-counting CT or the interventional workplaces, the Linac and so on, why it all fits together. And most importantly, I think you often also saw that in most of these cases, AI plays a role. And here, you will see a preview of what Dorin, but also Andre will talk about, how we -- how our AI road map is shaped, how it is used basically for managing the noncommunicable diseases. And there are 3 steps from left to right. There is one step, patient to image, which is about accelerating the exam, taking the need of staff out and so on and so on.

Then comes translating the image into a medical finding, either a report for the next physician to read or for a plan for the next device to use the information and then from plan to actually doing the treatment. And Dorin will show how we have across the organization, a clear road map of step by step further driving these 3 fields into, I would say, I would call it autonomy. On the left, you see the path to a completely autonomous CT scanner. Imagine as simple as stepping on your scale in the morning or going to a solarium if you do that. So no user interaction, everything is just -- is done automatically without any unwarranted variations.

Next topic, translate the image into findings or the treatment plan, which then helps out of this situation in cancer to automatically "program the treatment device or inform the interventionalist or in the future, maybe the robotic assistant intervention. So this is what we call health care AI, and you will see that it is a super important enabler of everything what we do, but that it's always in what we are doing and not something which comes in addition on top. So that was what we do for patients and what the next phase will be about in with this laser sharp focus on these 4 disease areas.

The other angle to look at what we are doing is to look at the customer perspective. So this was patients more. Of course, there's always the physicians helping and so on now. Let's look at what are the big challenges of customers. And as much as the challenges for patients are the 4 disease areas, the 3 big challenges globally, and it varies maybe a little bit by geography. But in essence, they are globally the same. The 3 big areas are the need for efficiency, the need to keep up with medical progress and giving more people access to care. You see the numbers. I mean why efficiency out of 2 reasons, not only because health care needs to -- health care costs need to stay in a certain range. But the bigger challenge customers today have is staff shortage, whether it's emerging countries or developed world. So doing more with less very often now means doing more with less people, and that is also one of the reasons why we are investing so much into AI.

It's about clinical excellence. And this has a topic of 2 things. On the one hand, medical knowledge is pretty impressive, doubles every 73 days. It's a bit scary. But it's not only abound this or great, but it's not only about the individual physician having to learn -- there is -- and that's why I call it here cooperation of care. When you own -- when you are running a hospital chain or when you are an IDN in the U.S., it's about how do you keep up with progress because it's not about the treatment options Dr. Schmitz has or uses or what he has learned, but how is that done institution-wide, how is that done in a certain system. And the third big topic is access to care, which mainly means helping to develop a state-of-the-art health care system also in the emerging geographies.

And why I mentioned in the TikTok, this other superpower, which compares to the triangle. There is no organization which can offer the same depth, meaning I want to have an entry-level CT scanner or breadth, I want to optimize my radiology department or I want to optimize my oncology service line, yes. So our team can switch from transaction to partnership. Our team is deeply rooted locally, whether it is Malaysia, Norway or Brazil and understands the challenges, but can get back to the global knowledge, knowing this is the global standard of care, and this is what it means to deploy it locally.

We speak, as I said, the language of radiologists, cardiologists, oncologists, neuroinerventionalists because what we produce is basically their tool. It's almost their reason to exist as a profession, but we are as fluent in the meantime to talk to the C level. And this is how we translate all this now into 3 areas of growth in -- on the one hand, driving further value partnerships. What this means is that when it's now about how do I move my corporated care further? How do I do -- how do I optimize cancer care across Advocate Health, which is a 30 billion organization in the United States with 100,000 employees. How do I do this in a partnership instead of negotiating one deal after another. This is what value partnerships are. And we have a lot of momentum in them and a very, very good funnel also for the future, and we will further double down on this opportunity.

We will create and that ties back to the noncommunicable diseases when it comes to setting up a stroke center, improving efficiency in radiology, setting up theranostics for the first time, helping optimize cancer care in a given region. We will use so-called value programs to do an intermediate step between transactional business and value partnership because very often, it's not only about selling the machine and servicing, it is about helping to change how care is delivered. So this is what we do with value programs. And when it comes to access to care, I come again back to the noncommunicable diseases. Also in the emerging countries, the noncommunicable diseases are now the major reason for death.

So there is a huge emphasis publicly and of private investors to build cancer centers, to build to ensure cardiovascular care to manage stroke and so on. And this is where the strength we have in these countries, the deeply rooted organization, our strength in compact and AI-driven products will help us to sustain these regions as an important growth driver for us. And just as an aside, this is a EUR 3 billion revenue topic for us at the moment already growing in double digits, and we want to sustain that growth path.

So summary, again, all you hear about today is 4 diseases and 3 customer challenges. And I don't think that any organization is better suited to address them and also translate this into business. Talking about business, you heard a lot about the triangle already. We will -- in the spirit of reporting follows strategy, adjust how we explain our P&L by creating a segment Precision Therapy, which will include Varian, Advanced Therapies and by the way, also ultrasound, which is, for us, in the meantime, a therapeutic topic because the biggest part of the business is, in the meantime, a very strong ultrasound catheter business, which is meant -- which is used for guiding therapies.

We will make sure that you will have transparency for -- not for eternity, but for a reasonable future when it comes to the financial KPIs of Varian, so that this doesn't come across as a loss of transparency. So -- and now when it comes to the growth or to the midterm targets we have given ourselves, and we want to share today, first of all, the definition of midterm is the time from '27 to 2030, yes. So after this year. And the year which has just started on our own calendar will be the jump-off point for this ambition. We want to grow strongly and profitably in the synergetic now 2 segments, Imaging and Precision Therapy. We want to grow revenue by 6% to 9%, with a little bit of more growth on the Precision Therapy side with the high -- high single digits in Imaging, mid-to-high single digits.

We will see Imaging return to margin expansion from scale after the transition year we are currently in because of [indiscernible] Jochen will explain this. And we will -- and we target margin expansion of about 100 basis points per year on the Precision Therapy side. Diagnostics will move towards mid-single-digit growth when it comes to the top line and to margin expansion toward the mid-teens. And when you then translate this to the group, it brings us to 5% to 7% revenue growth and double-digit EPS growth.

And last but not least, our sustainability targets the most important aspects of them, we want to further grow our patient impact targeting 3.3 billion patient touch points. We want to reduce our carbon footprint in Scope 1 and 2 by 90% until 2030 and in Scope 3 until 2050. And that brings me back to the beginning of the presentation, we want to maintain that super high engagement level and that feeling of purpose in our global team and the target is to keep -- make sure that at least 80% of the healthineers are working in countries in which we are certified as a great place to work.

And with this, I finally hand over to Jochen.

JS

Jochen Schmitz executive

Thanks, Bernd, and also a very warm welcome from my side and to clarify one thing, you don't need to be a physician to be the CFO of this company. I'm just an ordinary finance person, just to clarify. Bernd explained the strategy for the next 5 years very well. And I want to, so to say, put this into perspective, how do we translate this into financial returns.

And therefore, we look at 3 things, why we look at 3 things. First, how do we want to generate reliable free cash flow? How do we want to allocate the reliable free cash flow? To drive shareholder value and how much you can expect over this period of time. And we do this, obviously, as Bernd explained beforehand, under clear boundary conditions with regard to sustainability, Bernd explained this, and a very strong governance foundation.

So let me start with reliable revenue first. Since IPO, we were able to generate more than 5% revenue growth as a CAGR over the whole entire period. You see here some volatility. And the biggest volatility was in the midst of the pandemic, the 0% and then the 12%. The rest was relatively stable. And why is it relatively stable? One aspect, and now I move clockwise, is that when you look at health care expenditures, our offerings represent about 1% of the spend only, but are super relevant to the whole health care system. And I think a very nice KPI for this is patient touch points. We touch 3 billion patients by this. This is one aspect.

Then if you move further clockwise, our revenue streams are also reliable because they are recurring. It's obvious that they are recurring in diagnostics. It's a razor-razor blade business, more than 90% of the revenue are recurring. But meanwhile, in Imaging and Precision Therapy, our recurring revenue stream also adds up to about 50%. Gives a lot of resilience to it. And sticking to this topic of recurring revenues, let me deep dive a bit more on this. And let me start on the bottom of the slide. We are all used to this product-related services in Imaging and Precision Therapy.

We have here a very, very constant stream of revenue on a recurring basis, growing more than 5% based on a constantly growing installed base, high contract capture rate and the by far, farthest-reached service network in place. This come -- on top comes value-added services on top of the installed base and software offerings, which help our customers to improve their workflows and improve clinical outcomes. If you move up the curve, Bernd mentioned that also beforehand, value partnerships. What is also the beauty of value partnership is that value partnerships means customers enter into large and long-term contracts with us, and that turns classically transactional business in kind of recurring revenue streams.

And you see that those revenue streams grew over the last years significantly faster than the overall business, driving the recurring revenue stream up. And lastly, meanwhile, we have really a sizable consumables or per procedure business in place. Bernd also talked about this. This is led by our PETNET business, our radiopharmaceutical business in molecular imaging, sitting on 2 mega trends, neurodegenerative diseases and cancer and here, in particular, theranostics, but also the ultrasound-based catheter business, nicely growing, in particular, in the cardiovascular space and also our nicely growing interventional oncology business. And both on all those streams are growing significantly faster than our overall business and generating recurring revenue streams. Reliable revenues.

Next topic, profitable growth. We sometimes call this economic equation. Therefore, you find this term in the headline. Economic equation for us means how do we make sure that our growth stays profitable. First of all, why is it profitable? Pricing excellence. Based on our innovation leadership, we have premium pricing in general. And we also know how to deal with prices in the specific markets, in our specific product categories and sometimes we use a bit bulky term of market adaptive pricing, which means we adjust prices according to our market strengths and our product strengths to keep our price premiums up, pricing excellence.

Second topic, we are market leader in most of the businesses. That means we have scale advantage and economies of scale are very, very important in our industry. And when you look at it, it makes a huge difference if you sell 2,500 MRIs or 500 MRIs. This is obvious to cater for all the R&D needs, service needs, customer needs with -- having the right scale, you have a significant advantage, and therefore, this is also a driver of our continuous market share gains in this regard. And obviously, the scale helps up to drive operational leverage, helping on the functional cost side, but also on the gross margin side.

Third topic is cost productivity. I think we have a deep-rooted culture in the company to drive productivity on a constant basis. On average, 5% cost productivity on total cost every year, deeply rooted in the company. And then obviously, there is also a headwind to the economic equation coming from cost inflation and other things.

We deal with it with a very good strategic procurement organization who tries to counterbalance those effects with price negotiations, but also together with the R&D departments on design to cost activities. And I think what is also part of our recipe here is that we have a very, very strong value-add structure in place. We do relatively many things in-house, which allow us to stay more resilient. You have seen that during the supply chain crisis. This allows us to get to better cost positions to more resilience to be able to deliver all the time and never stop generating gross profit. This is our economic equation.

Now talking about organic investment into the company. Bernd mentioned that already. R&D. For the next 5 years, we are committed to keep our R&D intensity up between 8% and 9%. We believe this is necessary to keep our position. It will be invested in what is needed to deliver on our strategy. Bernd highlighted that we are also willing and will do, so to say, resource allocation shifts also towards software, towards AI to make sure that we stay ahead of the curve in this regard.

And this is also invested into collaborations, as Bernd highlighted, collaborations with other leading firms in the industry to make sure that we can live up to our promises in this regard and to fuel the growth. On the SG&A side, also here, we expect to see some leverage over the years from this arena, not because we are not investing into go-to-market. We have to also invest into go-to-market to become more clinical. That is a clear commitment on the one hand.

On the other hand, we will also make use of technology to enhance our go-to-market and also to free up resources. Therefore, we give you some hint that there might be an opportunity to go from today 16% to 17%, maybe a bit down over the years. With this, let me move to reliable free cash flow. A topic I'm particularly proud of the organization, what we accomplished over the years. When you look -- meanwhile, we are a very, very strong cash generator in the industry.

Over the last 2 years, cash conversion rate of 0.9. -- very good results. You see the increasing free cash flow. We commit to keep this range of 0.8 to 0.9 cash conversion rate over the planning horizon until 2030. We have achieved this by first, stabilizing of the inventory levels and then by increasing the inventory turns over the years. And we also do this by continuous investment into our operations, and therefore, the CapEx line stays between most likely 3% to 4% of revenue also over the planning cycle. So far, first topic, this orange bubble, what -- how do we generate reliable free cash flow.

Now coming to capital allocation. Let me start with dividend per share and share buybacks. On the left side of the slide, you see our dividend per share trajectory over the years. You can say a stable to progressive line. We started as a public company with EUR 0.70 per share. We are meanwhile proposing EUR 1 for the next AGM to be distributed. So it's a stable and progressive share. This dividend per share was tied to a dividend policy of distributing 50% to 60% of net income as a dividend per year.

As you can see, in 2023, we needed to leave this range and go to 70% to keep the dividend stable. Our commitment for the future is to keep a stable and progressive dividend per share in place, but do not tie us rigidly to this range anymore, EUR 50 to EUR 60. And with more free float available with delivering on our deleveraging target, we will also be able to make use of share buybacks if and when needed, which gives us more optionality to create shareholder value. Next topic, deleveraging, balance sheet health. What you can see on the left side is what we were able to do. We deleveraged the business pre the combination of Varian and post the variation of -- the combination of Varian. You see there a little dip in there between 2022 and '23. What is this?

This was the antigen effect because antigen raised, so to say, dramatically the EBITDA for a certain period of time and then it was over again. So if you draw a line from the 4.2x net debt over EBITDA to the meanwhile 2.8, you can draw a relatively straight line down. So we deleveraged nicely. And to give you a data point, we target to get to 2.5x over the next 2 years. And we also committed to organically deleverage on a constant basis. And we target strong investment-grade rating going forward because this is a prerequisite also from my standpoint, from our standpoint to drive our strategy forward.

One aspect, which is very special to us, and it's also related to the decision Siemens communicated last week, it's about our maturity profile of term loans with Siemens. As you can see on the left side, 2 of them amounting to EUR 3.3 billion becoming due within less than 12 months, independent of what Siemens -- independent of the Siemens decision. We need to refinance a certain portion of them anyway, and this is baked into our plans already. In the outer years, we feel very good about committing to interest expense line, which is not growing relative to where we stand today for 2026. Why is this?

Because we plan to further de-lever and we have optionality with regard to the maturity profile in case Siemens would accelerate the termination. So I repeat this. We do not expect to see a higher interest expense line going forward independent of an acceleration of Siemens if and when, obviously, the interest rate environment stays as it is today.

So last topic on capital allocation. It's about inorganic growth, M&A. You see on the top of the slide what has happened over the last 5 years, obviously, the transformational move with Varian and then 2 tuck-in acquisitions, block imaging service company in the United States and the radiopharmaceutical business of Novartis in Europe.

And when you look at our principles we put in place, I think they are very, very straightforward, and they target to create shareholder value. First, smart M&A means we need to have strategic fit. Look at Varian. I think the strategic fit is very, very obvious. And I think Bernd explained that well. You will hear from Arthur later, and you will hear from all presenters later that this is a huge strategic fit. The one exception is Sharon. But for all of them, it is a strategic fit. When you think about accretiveness, Varian is also a very good example. The fastest-growing business within Healthineers and significant margin expansion potential in the future. And we executed the deal during the pandemic.

So also a window of time, by the way, a challenging window of time, but I think also a favorable window of time. So that's how we apply this. And you can be rest assured, we will have always shareholder value in mind. So now I move on to the outlook section. Before I go there, let us have a look back for a moment. Bernd highlighted this to a certain extent. We were able to generate 6.5% CAGR, revenue growth CAGR over the last 4 years, accompanied by an 11% adjusted EPS CAGR over the last 3 years despite all the challenges around us. I think that is quite an accomplishment of the organization.

For sure, not every quarter was exactly on this line. There is certain quarterly volatility, sometimes driven by mix, but also out of other reasons. Unfortunately, Varian was a bit more exposed to that than other businesses. But I think we will get our arms around that also, but we will never be able to deliver every quarter the same result quality. I think we also need to be realistic about this. But on a yearly basis, we are very stable. You know the outlook of 2026. We have discussed this. Top line growth, 5% to 6%, same guidance as last year.

Unfortunately, we will go slightly backwards with regard to adjusted EPS, if you take the midpoint of the guidance range due to significant headwind from foreign exchange and tariffs in this fiscal year. Before I go to the midterm outlook, let me go briefly again on this segmentation topic. Bernd mentioned this already beforehand. The segmentation logic follows exactly the strategy we put in place. Patient twining equals imaging, precision therapy equals Varian, AT and ultrasound and diagnostics.

This is not intended. Not at all intended to limit transparency on anything. Therefore, we will temporarily give you the therein numbers of Varian. Don't worry about this. This is not the intention. It's just following the management approach, how we run this company, and that's why we do this. Maybe a few words on imaging, and this is a lot of technical information, but it's important.

You will see and you mostly have seen that, higher imaging margins going forward relative to what you have seen beforehand. There are 2 reasons for this. One is, ultrasound is not as profitable as the rest of imaging. This was shifted, so to say, towards precision therapy. But similar size of impact was that our internal suppliers, our tech centers which represent a very, very important value-add step for all of our businesses was out of historic reason always shown in Imaging.

And because those tech centers deliver or supply in a more and more intense fashion also the other businesses, we decide to take them into central items. And this dilutive effect from the business model we choose revenue without profit brought the other dilution to Imaging. So just that you know this.

So to complete the picture with regard to segment change, you see here the transition of the assumption we showed you November 5 to the new segment logic. If you look in others into the reconciliation, you see no change to the assumptions, and the rest is just a one-to-one translation. So now I come, I would say, to the most important topic in this regard to the midterm outlook.

And here, bear with me for a moment, I want to explain a bit more in detail how we -- how and why we believe that we can deliver the midterm outlook as we have planned it. First of all, we talked about the period '22 to '25 and the 11% CAGR of adjusted EPS despite a challenging environment. It is clear that this fiscal year is a transition year. And then we plan to be in this double-digit adjusted EPS growth environment again based on strong operational performance in EPS and based on our commitment to mitigate the EUR 400 million negative impact on tariffs in this fiscal year by 2028. How do we do this?

We have launched an additional cost productivity program to generate over the next 3 years, EUR 200 million additional productivity, which would cater for half of the EUR 400 million. And the other half should primarily come from better pricing. And let's put this into perspective. EUR 200 million more profit from better pricing means a percentage point better pricing over 3 years on average per year, 0.3%.

I just say it like this so that you can see that this is doable based on our strong market position. And lastly, we have one measure still in the back, which is a potential shift of value-add structure, where we have good plans in the draw, and we are looking into that topic very carefully and can execute if needed. And with this, I come to my last slide, the midterm outlook.

You have seen this slide. I think it's a very important slide for us. We want to grow this business on a very constant basis, nicely on the top line and faster on the bottom line. That's the message of this slide. And when you look into more detail, you see that the synergetic core should grow by 6% to 9%, means Imaging and Precision Therapy. Imaging in there with mid- to high single-digit growth. Precision therapy, high single-digit growth.

Diagnostics with its own strategy, which is with its own setup, improving the growth rate towards mid-single digits over the planning cycle. If you add this all together, you end up with a 5% to 7% for Siemens Healthineers. On the profit -- on profitability side, we will see Imaging getting back to margin expansion from scale in 2027. And we expect the Precision Therapy business to expand margins by 100 basis points on average every year.

And Arthur and Carsten will explain that in much more detail how that is possible and why do we believe in this. And Diagnostics will stay on its course towards mid-single -- mid-teens margin levels in -- over the planning cycle. This all will then, together with the ambition to mitigate the tariffs by 2028, bring us to double-digit adjusted EPS growth over this period of time.

And by the way, last point, we have not built into this a significant improvement in the Chinese market. We just planned over the time of 5%, roughly mid-single-digit, 5% market growth in China. Thank you very much. And with this, we move to the first Q&A.

UE

Unknown Executive

Wonderful. So now you get a chance to talk as well after having to listen for 70 minutes. I hope it was insightful in any form. Great. So just short housekeeping. There's also a chance for people following the stream to ask questions in the chat. I obviously cannot promise that we will answer all of those, but we'll try to channel them through to me here on stage, and that would be the reason when I look at my phone.

Other than that, I would say we just kick it off and just raise your hand and I'll try to go -- so hard to kind of we start with Veronika. You're sitting here, then we do add David and then Hassan and then we take 2 questions.

VD

Veronika Dubajova analyst

Veronika Dubajova from Citi. I will keep it to 2 questions. I will be well behaved. The first one is just on the diagnostics noncore delineation given the business autonomy ultimately, can you guys talk about what's the destination? Where are we going to end up in 3 to 5 years' time? Is this still part of the group? And if so, why? And if not, why not? If you can just give us your insights into that -- into your thinking on that?

And then my second question is financial for Jochen. Historically, you've guided for Imaging margin improvement of 20 to 80 basis points per annum. Now you are just committing to margin expansion. I'm just curious if you can help us understand the magnitude of that operational leverage improvement that we should expect in Imaging.

BM

Bernhard Montag executive

On the Diagnostics side, I mean, I cannot give you the complete answer on everything, what will come in the next year simply because we don't know. So -- and what we, first of all, have always said, and I hope this is really consistent is that we never claim that there are synergies between the 3 or now 2 other businesses and diagnostics.

I think what is the big change now is that with this successful momentum we have, that Diagnostics has developed from an asset, which others look at from an object into a subject, which wants to go into -- which has now the momentum to chart its own course to look at further verticalization of the business.

So far, we have verticalized as part of the transformation program, the sales and the service organization, I mean, R&D and production anyway. We will look at what they will look at what else would help them on the back office side. And with this, as I said, we will step-by-step also get the structural optionalities. We don't -- and now what we don't want to say is, first of all, that this is a business which will always be part of Siemens Healthineers yes because I mean, there is -- the synergies are limited.

We will see over time, whether it is better, whether we are in a way, it's better under this roof, whether it develops in the long run better in a partnership or as a completely independent business. We are not at that point. But I think the main topic here is that we are in the transition of saying, okay, this is a business which is now charting its own course, developing its own structure and then we take it from there.

JS

Jochen Schmitz executive

Veronika, on Imaging I think we went back and forth from margin expansion from scale and 20 to 80 because you got the question, what does it mean? And to be honest, the straight answer is I would not expect too much change in that direction. I look at Andre okay, it's fine.

AH

Andre Hartung executive

Exactly. And therefore, when we look at, I would say, I don't know, at a 10-year horizon, I would say margin expansion, I would say, around 40 bps, roughly. So therefore, I think this is more or less what we can expect from Imaging.

UE

Unknown Executive

Great. So you hand your mic over to David makes it simple.

DA

David Adlington analyst

It's David Allington from JPMorgan. At the CMD 4 years ago, you pointed towards 2025 margins approaching 20%. And obviously, we ended about, I think it was 16.5. I just wondered if, obviously, the world changed with respect to inflation. I just wondered -- I suppose the question is, in a world that's always changing, have you taken a different viewpoint in terms of how you approach guidance with the new guidance?

And then secondly, just on cash flow, point towards net debt getting down to 2.5x, I think, in 2 years' time. That doesn't seem particularly ambitious from 2.8x. Is there something we should be thinking about in terms of cash requirements within that, that means you're only targeting 2.5?

JS

Jochen Schmitz executive

Okay. I'll start with the second one. We are going this year through a transition. It is -- when we talk about profitability being stretched. So therefore, I'm a bit cautious with my 2.5 -- prudent with my 2.5 over 2 years, primarily because of this fiscal year. And you know that the KPI is net debt over EBITDA. I'm not too worried so much about the free cash flow. I think we will be in a decent position.

But the KPI per se is only indirectly tied to free cash flow. Therefore, I'm a bit cautious, but it's a prudent guide, you're right. First question was on, I would say, guidance philosophy. When we look back to what we guided for at Capital Market Day or what we assumed at the Capital Market Day 2021, I think there were 2 things which primarily influenced, I would say, the margin expansion story from a business standpoint and often driven by exogenous factors.

It was the turnaround speed in diagnostics. It took us a bit longer than we initially thought. But I think we should be very -- and that is not a complaint towards the diagnostic team, but we wanted to be faster and it took longer. And the second topic was mostly, I would say, the speed of margin expansion in Varian.

But when you look at the guidance range and what we have established meanwhile, I think we feel very, very comfortable about the 100 basis points margin expansion in Precision Therapy per annum on average over this planning horizon because we have now put several things in place, and you will hear this from Arthur and Carsten later. I'll give an example, for example, on the Carsten side.

Carsten is completely through with this platform renewal on the fixed CRM side, which was a burden throughout the whole period. And that is now done, for example. And I think in Varian, we have, meanwhile, I would say, very, very diligent plans how we get to this profitability expansion, also making full use of what is, so to say, also available as help within Siemens Healthineers from a supply chain aspect, but also we have the by far largest backlog in this business. strong -- therefore, strong, I would say, insurance on future revenue growth being in the high single digits, and that will be so to say the driver guidance. And therefore, I feel good about this guide. And you can argue it's maybe a bit different than it -- maybe a bit less aggressive than last time. But if the heaven comes down, the heaven come down.

HA

Hassan Al-Wakeel analyst

It's Hassan from Barclays. Firstly, following up on Diagnostics and Bernd, your questioning on whether this should sit under the same roof and that you're assessing options. Can we push you for a time line on this given we've been talking about this for a couple of years.

And if you could elaborate on how you're thinking about capital allocation when it comes to investing in this business versus some of the other higher growth and higher profitability businesses. And then secondly, Jochen, if you could help us understand the building blocks for the 100 basis points of margin expansion within Precision Therapies and maybe the relative sizes between the different businesses?

BM

Bernhard Montag executive

I mean, I think, first of all, I think we -- from a capital allocation point of view, hopefully, you agree that we did the right thing by transforming the business and making clear that this is a business which can go to a next level. With this super strong Atellica core, Sharon will speak also about the specialty lab solutions, the point-of-care business and all the opportunities.

So we are currently not at a point, and I think that is what Jochen also showed when he mentioned the de-levering and so on, where we are in a situation where we have to decide on which side of the house to allocate capital. But if that was a decision, the decision would be very clear to invest into the synergetic core and to then look at what are partnership options for diagnostics. But I want to be very clear that we are not at this point where this is a necessity from a capital allocation point of view.

JS

Jochen Schmitz executive

And Hassan, on your 100 basis points average margin expansion per annum in Precision Therapy, I think I touched on the topic very slightly in my presentation. I said that those businesses are with its growth trajectory and its margin profile at similar levels, and they have similar opportunity to expand margins. And I refer primarily now to Varian and Advanced Therapies.

I just thought this is relatively small in the equation. And when you look at -- therefore, when you want to see how much comes from where Varian is roughly double the size of AT. So then you can say 2/3 come from Varian and 1/3 comes from AT, but you still should listen carefully to Arthur and Carsten because they will explain in much more detail how that goes.

AH

Andre Hartung executive

So maybe give the second row chance and then we come back upfront again. Sorry, Julia. Graham first and then Hugo, and we take it from there.

GD

Graham Doyle analyst

It's Graham from UBS. Just 2 for me. One on the Diagnostics business. Just given what you said now is slightly more advanced than the past, does that mean maybe you can think about more tie-ups or partnerships with, let's say, a molecular company if you want to have a bigger, broader portfolio? And then the second one is just on geographies, which we haven't talked about quite as much.

How do you think about the different markets in growth terms given some of the volatility, say, in China, and we look at the U.S. where you're launching some of your newer products now and obviously doing very well. So just in that midterm guidance, just some color on how you think about those regions, please.

BM

Bernhard Montag executive

So I hope that Sharon can also answer the question of what -- I think when you look at the Diagnostics business, there are, I mean there's one particular strength is now in the central lab after this transition, plus the strength in SLS, which is to some extent especially lab solutions with coagulation and so on, is also plays a role in the central lab. And I think this is a very strong point of crystallization of value. And one can, in theory, look at, but I don't want to speculate here too much. What is -- because this is -- there are not many companies who really made it into the central lab. And how can you build scale in a central lab.

It is one of the questions, of course, what is the topic when it comes to further automation possibilities and so on and so on because this is also where a lot of consolidation is happening and where with the launch of the CI Analyzer, we have quite some strength. And when we say what is the own strategy, own setup, it is also about is it how to best double down on that strength?

And to what extent is it better to -- how much satellite activities do we need in addition? Or is it best to double down on the strength in the central lab and SLS space on the geography side. So this was for the company overall, right? I mean, first of all, I mean, and Jochen made the point here of this is 1% of spend, generating 3 billion of patient touch points and that the growth is -- and then I speak about it's the NCDs, it's the NCDs, it's the NCDs, it is procedure growth. It shows that in the end, I mean, the growth is not so much a topic of business climate, but it is a topic of necessity, which is also what drove the stable global growth we have.

So there's only a perturbation when at a certain moment, and that must be big perturbation, so to say, I speak like a physicist that people hold back investment decisions because there is a real issue, a real issue like uncertainty around anticorruption or the anticorruption campaign or no cash flow after in COVID, and people hold back investment decisions.

So -- but I mean I think the growth overall will be pretty equally spread. Of course, with higher growth where more health care is built up, meaning the emerging countries, which I spoke about with the double-digit growth, we are prudent, I think, with the assumption on China and otherwise, Europe and the United States, I see on a good path, I mean, especially in the U.S..

JS

Jochen Schmitz executive

You can argue that there is maybe a bit -- certain aspects skewed a bit towards the North American market because of the procedure-based revenue because PETNET is very strong in the United States and the European network is much smaller so far. The ultrasound-based catheter business is shown in North America primarily because our -- it's kind of an OEM business, where we show this in North America.

So the procedure-based business is skewed clearly towards North America and also value partnerships are extremely successful in North America. Therefore, it's maybe a bit skewed towards North America structurally, which is not a bad thing. So that's.

AH

Andre Hartung executive

I think Hugo was next.

HS

Hugo Solvet analyst

So BNP Paribas Exane.

I have 2, please. First, on pricing excellence as a key driver for margin expansion. Could you expand a bit here on how much pricing has contributed historically? I'm just trying to put that in perspective of -- in the context of a 6% to 9% revenue growth ambition and also some of the tariff mitigation that you mentioned, Jochen.

And then on the leverage target, 2.5x within the next 2 years, that's organic. What about potential inorganic opportunity to deleverage? And would you use that to -- any proceeds, would you use them to deleverage faster? Or would you reinvest a bit more into M&A or share buyback? And I think historically, share buyback has not been used for cancellation of shares, but can you talk about share buyback in the context of Siemens AG, your parent company potentially doing some sell-downs along the way?

JS

Jochen Schmitz executive

Yes. Let me start with pricing excellence. And as I said, when we look at our pricing environment over the last 15 years, I think 10 of them were more a period of price erosion, slight price erosion induced by ourselves to a certain extent by bringing always new products to market and the new product is the biggest enemy price rise of the existing product.

And then with the inflation kicking in, I think we changed the trajectory completely. We went into a price accretion environment, and we are meanwhile relatively flattish in pricing. And obviously, with the tariff environment and other things, we are, so to say, restarting this engine again or have restarted the engine again and see potential to get back to better pricing on a structural basis means a portion of the 6% to 9% will come from pricing. To commit now what is that exactly? Is it a percentage point or 2? I don't know. We need to see.

But I think we -- some portion will come from this. So with regards to deleveraging, the 2.5 over the next 24 years -- 24 months is organically has not taken any potential proceeds from somewhere into account, just to say that if somebody believes that this is a 2 years plan or whatever. And then if there would be proceeds coming in, in an inorganic way, we need to do capital allocation in the best way to drive shareholder value, and we need to look what that is.

So I would say, I think I gave a hint on share buyback because I wanted to give a hint on share buyback as an option, which we get into our hand with over time with the Siemens decision, but it's -- but we have not agreed upon something yet. But it is an option, and we will carefully look into this, no doubt. I think hopefully, that answers your question.

AH

Andre Hartung executive

Maybe give a chance to the rest of the room outside of the first 2 rows, but if there's no need, then we stay here. Okay. Good. So maybe Ouaddour first and then Richard. Julian? Sorry, my bad. Too many Julians in the room. We have too many.

JO

Julien Ouaddour analyst

Julien Ouaddour from BofA. The first question on Imaging. Do you expect the CT and Molecular Imaging to grow faster than the overall guidance of mid- to high single digits over the midterm, but every single year until 2030. Any just thought about like the growth contribution from the specific, let's say, 2 businesses would be helpful. I mean you spent a lot of time on the key drivers for that. And the other question was on buyback, if I can just follow up quickly. Do you have any trigger in terms of share buyback?

I mean, any decision with the parent company in terms of timing or any, let's say, like share price that could trigger some? And the question is more for '26 if we still have this kind of like overhang on the consolidation. Is it something you can consider already for this year?

JS

Jochen Schmitz executive

I'll start with the second part of the question. Yes. I mean it's very hypothetical because share price development, I don't know what that will be. I would not exclude anything from being possible, but I would not expect that we do major things in 2026 with regard to share buybacks because, as I said, I also want to deleverage first, and therefore, I would not expect something currently. I hope that answered this question. And the other one was on photon counting CT. Was it.

JO

Julien Ouaddour analyst

No, I mean it was more on the CT like plus the molecular Imaging.

JS

Jochen Schmitz executive

Molecular Imaging.

JO

Julien Ouaddour analyst

Yes. Can you confirm that both combined will grow above the mid- to high single-digit target or not, but every single year basically until 2030?

BM

Bernhard Montag executive

CT and molecular imaging. So that gives Andre time to think. So he will answer. But see -- I mean, what is -- maybe to give you a rough feeling. I mean, when look -- I think what is very good on the imaging side, and Andre will give a rough revenue split, I mean, CT is the second biggest business, but the most attractive one in terms of margin. MR is bigger, but a little bit less accretive but accretive.

And -- but I think what is really nice is that molecular Imaging with the -- with building out this PETNET business, which is going into the EUR 1 billion range has really developed into a third leg of the business. And it has 2 growth drivers.

In the end, I mean, the radiopharmaceuticals in this procedure-based growth, as Jochen said, and the equipment. So -- and this additional booster in molecular imaging of that second part of this business is certainly something which helps on the growth side. But I think Andi will be -- so he agrees.

AH

Andre Hartung executive

Good. Then -- so I have to concede to my mistake. Julian, now the right one and then, okay.

JD

Julien Dormois analyst

The youngest one, obviously. So Julien Dormois from Jefferies. The first one, probably very straightforward, but that what we know about the plan from your parent company regarding the stakeholding. So just curious whether that will change anything in your strategy, both operationally, but also maybe financially. So we already touched a little bit upon that, but happy to get your thoughts on this.

And the second question is on photon counting this time, and maybe this will be addressed throughout the other sessions this afternoon. But we probably know that competition will be starting in '26, maybe with GE. We've also heard some stuff from United Imaging and so on. So just interested to know how you plan to develop that business going forward and particularly in terms of price points into '26 and beyond.

BM

Bernhard Montag executive

Okay. I think this time, I don't want to answer for Andre. He will be super great in answering this. And -- but still, the message is being 5 years ahead means being 5 years ahead, and we are developing and moving fast. And when somebody makes big announcement, we are where Siemens Healthineers was in 2020, then they can do this. So it was my arrogant statements yes, so they can be more pleasant. -- but you don't have to.

So I mean, I make a short comment on the Siemens. I mean, first of all, I think there is a little bit of a psychological factor in this. And one aspect is, first of all, it is, I think, super important that when one talks about Siemens Healthineers, one talks about Siemens Healthineers and not about what the parent is doing. And so -- and this is -- we are not yet at this stage. I know there will be a period, how does that spin work and how that all this.

But at some point in time, I think this is really important. I mean, for you, for us and also for Siemens because they are probably also sick and tired to discuss what they do with us instead of talking about what they do themselves. So I think the other aspect is important, and that is why I say psychologically. There's a German word, which I don't like. I mean the German press writes about us. Sometimes they write about maybe [indiscernible]. The medical technology daughter. So it's like. So I have no problem being a daughter.

But I think for the topic of, hey, we have created a company. There are all these Healthineers. We are doing this. We are oriented at all these -- the diseases we talk clinically. We talk about health care AI and so on and so on. And then to also say, it stands on its own feet. And there's no doubt, I think this is a psychological aspect. I think the other topics are more in the Jochen arena.

We can -- what does it mean on the financing side, okay, he already said not much or nothing, the topic of, okay, share buybacks are an option, but we don't maybe talk too much now about this. But it doesn't change the strategy in essence because we -- and I have no complaints, by the way, ever.

And I'm very quick at complaining, by the way, about Siemens in the last 7 years since IPO that anybody tried to micromanage what we are doing. The opposite is the case. So we had really absolute freedom from that point of view. I also can say that we are changing anything in terms of strategy.

JS

Jochen Schmitz executive

I think that is important. I think it will -- why did we plan this Capital Market Day as we plan them because the strategy will not be influenced by the shareholding per se and also the operational processes. On the financing side, I think we were relatively clear that this will not -- the financing aspect will also have not such an influence that it has any impact on the strategy or operational processes.

Obviously, we try to say what we expect that we can at least confirm that the interest expense line will not go up because of the Siemens decision and even if they accelerate the termination of the term loans relative to what we have guided for fiscal year. I think that is a strong statement.

And obviously, we're also preparing ourselves to do the refinancing. I think we are progressing here nicely, and we will be in strong investment-grade rating territory. I'm pretty convinced about this because we are a very stable company in this regard, and we will be able to show this. Therefore, I'm not worried, and I'm pretty sure that we can do everything we want to do from a strategic and operational standpoint even without having the Siemens support on financing going forward.

AH

Andre Hartung executive

So actually, I think we have to wrap it up. Richard, you and Oli, you have a [indiscernible] for the other sessions, okay, promise. So we need to continue. We have a lot of program to get through to. So now I go off the stage together with Jochen, take this table with me. And I ask [indiscernible] to come on stage. Go ahead.

UE

Unknown Executive

Thank you all for being here. It's a great opportunity to talk to you about diagnostics. I met some of you 2 years ago, we talked about the start of the diagnostics transformation. Some of you I have not met. I've selected the diagnostics industry personally because I believe in the blood test, what they can do for patients and the opportunity.

I joined Siemens Healthineers 3.5 years ago because I saw the potential across all the platforms that we have, great talent across the business. So I'm happy to stand here before you and tell you that we've had a successful transformation. We've delivered revenue growth. The transformation was designed to deliver a step change in profitability. We have effectively made a step change in the profitability, and we are ahead of plan.

So happy to talk to you about it a little bit more and saw the interest with all the questions. So if you look at our key financials, we are a large player in the market. We have a nice diversity across the segments, and I'll talk to you about the structure a little bit, point of care, core lab and specialty that Bern mentioned before. Nice geographic mix.

And when you look at what makes a successful diagnostics company, it's about having what I would call a healthy installed base, and that's having a large presence of analyzers around the globe that are generating revenue with a strong menu. And Bernd and Jochen mentioned the razor-razor blade in our case, it's 10% on the instrument revenue, but that really is the engine that drives the revenue growth. So we start from a very strong position with over 300,000 analyzers installed around the world and one of the largest menus with 800 different tests across 30 disease states.

And a large menu is table stakes and then there are -- is menu where you can differentiate, and I'll talk about that a little bit. In that together, the large installed base and the large menu means that we are able to deliver over 15 billion tests around the world, and that is our recurring revenue. If you look at our position, we've got good leading position in a number of different segments across the industry.

So just zooming in, when we started the transformation, we stratified our platforms across 3 business lines to drive focus, focus on market penetration, focus on talking about the value of the platform and then generating the growth that we needed and the focus that we needed in the business. And so the Core Lab, you heard a lot about Atellica. I'll talk about it a little bit more. Core Lab is all about the Atellica growth, strong Atellica placements, efficient platforms that are driving the menu. We have a great cadence of assays coming out on Atellica. And again, a sizable segment, 70% of the market is in the Core Lab. Specialty Lab, we like to call this business our hidden gem because by creating your own dedicated business line around specialty, and we actually have a few different technologies in that space.

So we have the hematology and hemostasis, plasma protein as a separate offering, toxicology as a separate offering. And they are often found in the lab, but they need the focus to talk to the practitioners about those tests and about the value in the platform. One of the platforms I'll talk about a little bit later is IMMULITE. It's a leading platform in specialty. So this is our hidden gem. And then in Point-of-Care, we have a very strong presence in the biggest segment, which is critical care. We've got a number of different offerings and great connectivity. So I'll talk to you about the Point-of-Care business as well.

So 2 years ago, you -- for those of you who are here, you heard us talk about the start of the transformation. And so how -- what did we do and how did we accomplish it? I just mentioned the stratification of our assets into business lines, driving focus on Atellica, which is a great platform. We're over $1 billion in revenue on Atellica and growing over 20% across all the key segments. With that, we were able to make -- to do streamlining and make capacity adjustments, which in turn improved our profitability. And we evaluated and we were able to eliminate complexity in the supply chain, eliminate complexity, but stay focused also in R&D. And that has resulted in the savings that you've seen since we started the transformation.

So the difference, I guess, was we had mentioned the $300 million of cost savings with the transformation. We are able to achieve an additional $100 million. So that puts us ahead of plan. And on the bottom right, what you'll see is the movement to the Atellica platform, which is super important for the business. Transformation was the first phase, and we titled this part of the section Next DX because we see so much more that we can do with this business. So the transformation on track, making the step change in profitability. But now it's about making sure that we continue to build innovation and focus growth across all 3 business lines. And that focus will enable us to accelerate.

So it's more reach, more market penetration, more installations that are driving an increase in the number of tests being run per installation. I want to make one more comment on this, too, is you heard Healthineers talk about EBIT margin quite a bit. In the industry, we talk about EBITDA quite a bit. So we wanted to show you both. So that way, if you're looking at how we are in the industry, you see both. So Atellica really is the foundation for the Core Lab. We're very proud about the customer response to Atellica because if you imagine what the health care providers are faced with, it's a change in workforce, reduction in workforce, change in footprint, change in their testing network.

And the Atellica enables our customers to configure their testing the way that's best for them. And it does that with the easy user interface. It's a fast analyzer. It's a family of analyzers, and it drives efficiency. So fastest turnaround time on some of the core tests, large competitive menu, easy user interface, -- it enables a lot of remote monitoring. So you can -- if you imagine you have a number of analyzers out in your testing area. We're able to upgrade software, evaluate efficiency with our customers. And then we have the addition of AI.

So AI allows our customers to best have, call it, air traffic control of their lab and how it's performing or also insights into the clinical aspects of the test results. So the other part that our customers are happy about is the green efficiency footprint of the Atellica because it's smaller and faster, it uses less reagents and is less wasteful.

Ongoing focus. So I heard you the question you had for Jochen about investment. We continue across all 3 business lines to invest R&D at par or at leadership levels versus the market. So good R&D profile and a good cadence of innovation that's evolving around Atellica. It's also the simplification of our legacy platforms in our portfolio. So as we remove older platforms and replace them with Atellica, that is -- it makes for a healthier business. The evolution across all 3 platforms. So also those of you who know the industry know that the life cycle of our platforms are very long, right? They're out in the market for 10 or 20 years. So continuing to stay current and evolve on those platforms for our customers is key, and we do that across all 3 of the businesses. And then when you're configuring your workflow and our customers are getting smarter, right? So a lot of them had configured their blood testing networks 10 and 15 years ago.

And they know in this new generation of how they're going to run testing, whether it be sampling at the Point-of-Care or running a hub-and-spoke model, they will turn to us to make sure that we cover the gamut from patient collection all the way through to results. So we don't only innovate around the platform itself, but also around how samples are collected, how the results are compared, what type of air traffic control or AI do we have in informatics. And so our R&D portfolio is balanced based on that. So as we move to past the, I'll call it, the launch of Atellica, it affords us opportunity to invest in other areas and continue to innovate.

And then clinically, there's a number of tests that have been on the market for a long time. Some customers use them in a different way. As an example, inflammation tests in a post-COVID world or respiratory therapy kind of allergy testing is now more important as people come off of long COVID and are trying to say, like, why am I having trouble breathing? Is it allergies? Or is it some complication. And so super important that we have specific biomarkers in conjunction with our strong panel.

So the Core Lab solution, I mentioned Atellica was the key to really building up our Core Lab. We have an over 40% increase in Atellica's installed base since 2023. Not only do the customers come to us for the initial Atellica, hey, I would like to have a large-scale platform, but we have the CI Analyzer, which we launched last year, and we had spoke about it 2 years ago to you. That is one of the most successful analyzers that I've seen in my career in diagnostics in terms of the uptake from our customers. So when we get orders now and someone turns to us for Atellica, they often buy the CI Analyzer, which is more of the mid-volume analyzer and enables customers to configure their hub-and-spoke model. So over 90% of the orders that we've been getting also include a CI Analyzer.

And then what you'll see as you watch the Core Lab growth, it's about running twice as many tests per analyzer because of the efficiency. So that means per test or per razor blade, you're spending less on service. The start-up of the system is easier and the customer is able to have a leaner footprint in their operation. And then overall profile, you'll see that our EBIT or EBITDA is going to be continue to accrete because of the usage of Atellica and the installation and growth of the efficient platforms.

Specialty, again, I mentioned as our hidden gem. Hidden gem because as we pulled the businesses apart to drive focus, you can see the profitability of the Specialty platforms. CBC or red blood cell, white blood cell, as an example, is a very frequent run blood test. We've got a hematology analyzer with great connectivity that the connectivity of the analyzer is really the benefit for our customers because they can connect it in their lab operations. I'll mention IMMULITE just for the sake of time. IMMULITE is a core platform that used to be included in our lab offering. And when we pulled it out in specialty, we saw the number of tests on IMMULITE, very reliable, well-received platform with a really big menu. So we were able to add 9 tests to really round out the allergy panel for our customer and drive further growth to reinvigorate this platform and focus it on where it's needed, which is in the allergy area.

So you can -- we'll continue to see in each of these platforms, which are focused, a good accretion of growth and a lot of focus on double down. Jochen mentioned the S and SG&A. We will also be building out our S because when you think about all these platforms of Specialty, they need people who articulate the value prop and really grow the platforms out into the market.

Point-of-Care. So Point-of-Care, we've got a very broad offering. We're in the critical care space, which is blood test. And when I say broad, what I mean by that is we have benchtop and we have handheld running the same types of tests. So the customer can pick, which one they like, and that's Point-of-Care. We have the leading handheld Point-of-Care blood tester, which is very convenient for customers as they're trying to place it through their hospital. But one of the highlights really in our Point-of-Care business is connectivity. So when you have a Point-of-Care device, you can picture having thousands of these, sometimes hundreds of thousands in your hospital network, and they're out in different departments. And so it's really critical to have connectivity so that you can monitor the results coming off of all the Point-of-Care tests, but also you can -- from a training standpoint, from an analytics standpoint, you have this air traffic control, and we have the leading informatics platform that enables connectivity not only with our analyzers, but it's an open platform. So other analyzers can connect in as well.

So wrapping up, I mentioned the 3 business lines, but clinical innovation is critical, and we continue to do that in a number of different spaces. So we have a cadence of assay launches, both in the Core Lab and in the Specialty Lab. So I'm just going to mention a few. So our liver test, as an example, is focused around non-fatty liver disease, which often goes undiagnosed until it's advanced. And so being able to test and assess liver function early stage is a breakthrough and a novel new biomarker, we would call it. Multiple sclerosis is another area where we have a blood test, and it avoids and reduces the need for spinal tap. So this is another area of interest for us in the neurodegenerative space, both in MS and in Alzheimer's, where we have key assays we'll continue to launch.

And I mentioned allergy already, 9 new allergy tests coming out on IMMULITE and Specialty, which drives the growth acceleration of the Specialty Lab business, which, as I mentioned, is one of our more profitable businesses as well. So happy to be here to tell you about the transformation, good solid step change in our profit. And then our commercial acceleration, as I mentioned, putting out more S in the SG&A enables us to grow the business and drive the penetration. And the movement to Atellica drives the accretion because of its efficiency and because we're running twice as many tests per analyzer. Thank you.

MK

Marc Koebernick executive

So we go into the first focused Q&A session now on diagnostics, be a bit shorter than the first one, obviously. So if you don't have one, okay, then Richard, I promise you and then Oli and then Hugo. And can we have a mic here. It's coming from Richard.

RF

Richard Felton analyst

Richard Felton from Goldman Sachs. So within the Core Lab business and the transition towards Atellica, how much longer is it going to take to sort of wind down some of the legacy systems? And then the next part of the question, the 20% growth that you mentioned or was mentioned in the previous presentation for Atellica, how much of that is new contract wins versus replacing legacy systems?

UE

Unknown Executive

Yes. So there's -- we went from 15 platforms to 4 in the Core Lab. And those manufacturing of those platforms have been announced and discontinued and it enabled us to reduce our manufacturing footprint. There is a service obligation, and we maintain support for our customers, and that continues. And by 2030, we'll continue to see the substantial drop. That kind of rate of change that you've seen. If you remember the pie chart where we've moved over to Atellica, that will continue and then 2030 is where we can see the ramp. We were able to achieve an initial step change in our service costs to be able to take a drop, but we'll continue to be able to do that towards 2030 as we continue to remove the service aspect of it, which means the factories don't have to make the spare parts, et cetera. So there continues to be that. In terms of new versus replacement, I would say maybe 80-20, 80% is we're getting better utilization from our existing accounts and then 20% would be new customers that come online roughly.

MK

Marc Koebernick executive

Okay. It's Oliver Metzger from ODDO BHF.

OM

Oliver Metzger analyst

One question on your margin target you set for Diagnostics. So what do you expect to come out from the shutdown of legacy portfolio versus the contribution coming from the Atellica ramp-up?

UE

Unknown Executive

We -- so if you look at our profile, I'll just answer it from a profile perspective. So our R&D profile continues, I would say, to be healthy with the, I'll call it, the maturity of Atellica, we take some R&D out of the, call it, the hardware and then redirect it to clinical. Service is the other area where we've seen improvement. Supply chain is primarily the other. So we'll continue to see some of that. And then we also have the revenue growth, I'm trying to kind of do the math from the forecast that we've shown. I would say about 1/3 of the margin improvement will come from the revenue improvement and the revenue accretion over that horizon.

MK

Marc Koebernick executive

Hugo, next.

HS

Hugo Solvet analyst

Just on the 43% of sales coming from the Americas, just curious how much of that is for most common parameters and you thought about potential impact or exposure to PAMA in the U.S. And second on Alzheimer's test, I think it's research use only for now. Could you share maybe some time lines in terms of when you expect it to be launched more commercially?

UE

Unknown Executive

Okay. So on the PAMA, so PAMA, as you know, has been in discussion for most of my tenure, I think, in the last couple of businesses. But I would say we've been talking about reimbursement headwinds in diagnostics for a number of years. And I think the key is differentiating on some of the clinically relevant assays that I mentioned like our ELF assay, that would be an immunoassay that drives stronger margins than the chemistry and other. But right now, we don't see that as a major headwind for us, and we continue to be active in talking about the value of diagnostics.

The other thing is some of our features in our solution, not only about the test, they're about the ease of use of the analyzer, what we can do from a service perspective. So while the tests are important and they drive revenue, but also the services that we're able to offer, the intelligence that we're able to bring also helps from a growth perspective. We have 5 different neurodegenerative or Alzheimer's assays currently in the RUO form, and we'll continue to launch 2 per year. The regulatory time lines, as you know, they vary and they'll kind of follow each new RUO assay. And we foresee in the next, I would say, 2 years where we start to see some of those approvals come through beyond RUO.

OM

Oliver Metzger analyst

Good. So I think actually, Graham, then right through and then Veronika.

GD

Graham Doyle analyst

It's Graham from UBS. I think cash flow has been a little bit of an issue because of the investments and then the restructuring charges. But presumably, we should be at an inflection point now. Does that allow you to do things more kind of proactively from an investment, whether it's external or internal? And from your perspective, the kind of conversation we're having today, what does that allow you to do and the business to do in terms of being slightly more independent than maybe it has been?

UE

Unknown Executive

Yes. I think we focus on -- I'll answer the second one first, and then I'll go back to cash flow. So we focused on verticalization and autonomy when it came to sales, manufacturing and service, right? Because the core of the business is being able to effectively deliver and ship, effectively being able to position all of these great assets, but then also being able to service effectively and efficiently, drive cost savings and customer satisfaction. We see opportunities to continue with some of the support functions, right, quality, regulatory, things like IT and support. Those are other opportunities for us to continue to drive independency right now. It's a benefit for us to be part of it, but there is opportunity for us to continue to address those other functions.

And then when it comes to cash flow, yes. So with the margin improvement, with the focus on receivables and payables, we've made great cash flow improvements. And like I mentioned, I see our R&D profile staying super strong across all 3 business lines, but deliberate, right? So in this industry, you've got to decide, am I going to spend it on AI? Am I going to spend it on software and the millions of lines of code? Am I going to spend it on the assays? Or am I going to spend it on a new platform? And so I think for us, it's about -- that's why I talked about the clinical and the intelligence and the sample handling. Those are areas for us to shift R&D but still keep it there. So that's an enabler for us. And I do see us spending more on the [ I of the S ], which is getting more salespeople out in our workforce, so to speak.

MK

Marc Koebernick executive

Julien?

UA

Unknown Analyst

A quick one on China. We've obviously talked a lot about VBP, but I think there's also been some regulatory changes in terms of how much test can be covered for each patient and so on. So the market has clearly changed there. How do you feel about the market for the midterm on your side? And does it still make sense to operate there?

UE

Unknown Executive

Yes. I'm sure you've heard from the industry. It's been one of the biggest kind of down calls, right, that I remember in my experience in a couple of decades. So -- and I do believe a lot of that has been realized, largely realized. So it's about looking at the market and saying, what do we do to reinvigorate growth, right? Because I see it as a correction, right? It's been a correction. And so now that you have a new base, right, less testing, maybe it's -- the prices are lower, so you have a correction and then how do you reinvigorate growth. When you go and talk to the actual -- in the institutions, there's a real passion still for innovation and for diagnostics. So I see us continuing to invest there.

And I think partnerships are important there because the Chinese market, as you know, is becoming a lot smarter about diagnostics with their own platforms and their own assays. And I think we're stronger together when we can collaborate. So I see more local collaborations, but I see it still as an important market for us.

OM

Oliver Metzger analyst

I'll wrap it up with Veronica now.

VD

Veronika Dubajova analyst

Veronika from Citi. Two questions for me. One is just the shape of the margin progression and the growth acceleration. Obviously, you said getting towards mid-single digits in terms of growth, getting to the mid-teens margin. But looking at some of the charts, it does seem like the progression is pretty back-end loaded on both of those counts. So just curious if you'd comment and kind of confirm that, agree with that or if I'm missing something.

And then my second question is, to what extent is the discussion about what Healthineers does with the Diagnostics business a distraction for you, for your organization? And is there a preferred outcome you have and time line for it, I guess?

UE

Unknown Executive

Yes. So I'll just talk about kind of the short term versus what you see as the long term or mid- to long term. So we removed 13,000 analyzers last year from the market as we are moving to Atellica. So when you think about discontinuing from 15 to 4, you're deliberately saying these are older platforms that are obsolete where the service costs versus the reagent flow doesn't match, right? It's not healthy. So those decisions are still happening as we speak. There are a couple of key platforms that in the U.S. as an example, that our customers love. And so we're working to be careful and not be as painful as we can. It's a big change for them. So that's where we see this kind of, I would say, in the next 4 quarters, this movement, right, that continues on the top line, which is why we call it kind of our focus phase because we're focused on this deliberate switch, but then also growth at the same time. So that's the key.

And then in terms of being a part of Healthineers, I think this industry is relatively small, right? I have no 3 out of the top 4 in the industry. I joined because I believe in where we're headed. And I have a mature management team that I'm proud of. You can look them up if you want. But we've -- Diagnostics is always kind of -- if you think about some of our competition, where usually exist with another business in many cases.

And then in those other cases of focus, then you have like more of a mid-cap or small cap company. So I think it's a fluid industry. It's an important industry right now. But I think our management team is ready for what's right for the business. And I think we have a huge opportunity to continue to grow on the top line, and then we've got opportunities still on the bottom line. So we're excited about it, and we all believe in Diagnostics.

OM

Oliver Metzger analyst

That's a great wrap-up. Thank you. So we have a break, roughly 25 minutes. You can refresh yourself. You have the restrooms. So do whatever you like, and then we'll be back for the second block. Thank you.

[Break]

AH

Andre Hartung executive

So if you could maybe start to get back to your seats, we want to continue. Thank you. Welcome, everybody, to the Capital Market Day 2025 as well from the imaging side. My name is Andre Hartung. I'm responsible for the Imaging business in Siemens Healthineers. And let me tell you, it is just a great business. When you look into EUR 12.1 billion revenue, industry-leading adjusted EBIT margin, adjusted margin, industry-leading being #1 in all the key modalities, be it on the CT side, where obviously photon-counting is creating a lot of tailwind right now, be it on the magnetic resonance side, where we do see dry cool technology is taking up.

And at the same time, we have things like Deep Resolve embedded AI, helping really to cope with the productivity challenges in health care. When you see molecular imaging, where the current developments in Theranostics and Alzheimer's disease where Bernd and Jochen and everybody alluded to, this is driving, of course, as well the need for more imaging on the molecular imaging side. And therefore, we see quite an uptake there. And thinking about X-ray Products, we just launched a new platform on the mammography side, which is gaining a lot of traction in the market. We just had a new fluoro platform launched as well, where now we, again, in the United States, where it's the largest fluoro market exceed 50% market share.

Looking to the markets, North America, obviously, the biggest chunk of the market followed by EMEA, but we are #1 in all geographies, and looking a little bit back into the track record since IPO, we gained 700 basis points in market share. We had an average 7% CAGR or slightly above 7% CAGR even an every year margin expansion of 30 bps. And why is that working? And this is working because of the unmatched investment into innovation, innovation into profitable, sustainable growth, resulting in the fact that the majority, more than 2/3 of the products being sold as of today are not older than 3 years.

So innovation, clearly a driver there. As well in terms of margin, there is an innovator margin on top of this that results in the 23%, which is by far, by far ahead of what everybody else in that industry is delivering next to the market share, which is quite a distance, a clear #1 globally. Jochen explained a little bit the revenue story around recurring revenue, driving resiliency. And we have seen in the last couple of years, quite a good development there from 45% in '22 to 50% in '25. And we expect this going to continue because on the one hand, we have this growing value partnerships. 8 to 10 years agreements where you know exactly what type of revenue is going to come when. We see the strong impact by the PetMed arena with the growth on the Theranostics side and the amyloid tracer basis, which is recurring revenue because it's delivered in doses for every individual test being performed.

And we translate our success as well in a very strong installed base, 160,000 units at 45,000 plus since 2018. And this is exactly the leverage of scale that we're having, helping us to further expanding on the margin. So how is our environment looking like right now? And what are the key drivers? Obviously, very similar to what we see for Siemens Healthineers as a whole. There is the ever-growing need. On the one hand, you have the aging population. The demographics result in much higher number of NCDs, noncommunicable diseases. This is creating demand for imaging. More than 2/3 of the people on our planet do not have proper access to health care, but they are striving for access. And we mentioned that we are growing double digit in those emerging countries, and this is driving, again, demand.

So the demand is ever rising. We have the new clinical opportunities ahead of where we talked about Theranostics, obviously, in cancer patients. And there, we at the starting point with neuroendocrinic tumors and prostate tumors being at the focus right now. But there are a lot of Phase III trials out there with other cancer targets and some of them definitely will make it as well into the pipeline and will further fuel the growth of this. When you look into Alzheimer's disease, first of all, there's enormous costs associated with it. When you look into $1.3 trillion on costs, not all directly hitting the health care system, but overall costs. It will increase to 2.8 trillion. So that shows you how much there is an urgency to act on that.

On the other hand, there's the first time light at the end of the tunnel. There are treatments now that can slow down the progression of the disease, and there are further pharmaceuticals in the pipeline that probably show even better effect than that. And this is why currently, we see this enormous uptake in imaging in order to prove whether somebody has Alzheimer's and is an individual that can be treated or not. The challenge, though, is that all this driving the demand dramatically, at the same time, we have a significant shortage on health care workers. Just 67% of the U.S. radiology departments report staffing challenges. They are understaffed on the radiology side. They are understaffed on the technician side.

So that means by the ever-growing volume, they have no chance to cope with that volume anymore. And there, we need to have a boost in efficiency in order to help our customers to overcome this challenge. And because they have to do so much more with a lower number of people right now, burnout is becoming one of the pressing issues in radiology. 40% of technologists are reported with burnout in the United States. So there is definitely a need to do something about this. I'll give you now one example, and probably this is to most of you, kind of familiar. I'm not sure who has an imaging test or had an imaging test in the past. And depending for the country you are coming and your network, -- the question is how long do you have to wait? It's probably going relatively fast if it's an emergency case. But if it's not an emergency case, you easily wait weeks, sometimes months to get an appointment. And that is something which, from my point of view, is not sustainable. And the question is what can technology do in order to overcome this. And one example here is embedded health care AI in MR, which is called Deep Resolve, which is boosting the speed of MR on the one hand and at the same time, increase the image quality.

So it's a win-win situation. And when you look into the impact that we see as of today, I put there 3 examples. One, Eisenhower Imaging Center, they had 3 weeks waiting times, now down to 1 or less than 1. We have the other one in Atrium Health United States, who have been able to increase the number of patients being spent by 40%. This is very attractive, in particular, knowing that radiology in the United States is a profit driver for the health care system. And there is another example for Karolinska Hospital in Sweden. They had a backlog of 2,200 MR patients with huge results and huge waiting times, and they have been able to bring them down to almost 0.

So these type of technologies prove and that they are already helping as of today, 16 million patients did profit from this type of technology since we launched Deep Resolve. Why do I tell you this? Because it shows a technology and innovation can be a very important cornerstone to answer the challenges in health care and to boost productivity. And this is one of the reasons why we strongly believe that we need to invest more and drive stronger the automation of everything we do in imaging, be it at the scanner side, we are looking for the autonomous scanner, be it on the image to report plan side, automated reading and reporting. So once you have the image, you need to have the final report. This today is a highly interactive process, and we believe that needs to be fully automated.

And then you need to have this information that is coming out of the radiology department as the source of what to do best next in order to treat the patient as good as possible and to personalize the treatment around the patient. And we need to, therefore, integrate this information and bring this information to the place where those decisions are finally being made and where the treatments are facilitated. And we are not starting from 0 there. I put 3 examples on the top of this slide. One example, myExam Companion. It's a little bit like a navigation system that helps you to understand what is the next right step to setup the right protocol for the right patient.

This has reduced, the reduction of workflow time for this by more than 60%. And it's available, for instance, for CT, for MR as well for conventional x-ray and for molecular imaging. We have it across the fleet. It's the first step. It's not yet fully autonomous. But we know how to get there, and we know what to do, and Doreen will later on show you a little bit more the individual steps to come to this autonomous type of scanning. Then, the question is how to take the human interaction and reduce it to a minimum away from the reading and reporting side. The Syngo Carbon is a stronghold, which is already as of today, automating by using AI and as well large language models in order to automate as much as possible this process until you have the final automated report.

Ideally, a physician tomorrow -- there's only need to look at the report and has nothing to do with generating the report and make an educated decision whether this -- what is reported, he agrees with. Then, it needs to be integrated into the therapy arena, where we take the case of Arthur when we think about auto AI-based organ contouring, which is absolutely fundamental and necessary to facilitate radiation oncology treatment. As one example, if you can automate that, you can save up to 90% of time by preparing this. It's a pretty time-consuming exercise of doing this. Or when you take the example of Carsten, where we integrate the information from a photon-counting CT into the Angio suite and even navigating based upon that data, the Angio system, helping a physician, the cardiologists in this particular case to make the right decisions. What is the stent looking like? What type of catheter do I do? How fast can I do the procedure? How do I reduce the risk? So it's really resulting in additional efficiency and speed and probably as well better quality for the patient.

So this is why we made on top of everything we said in the past in terms of innovation in the various modalities, something that we now put very much in the center of everything we do, automating the imaging value chain, making the scanner able to understand who is on the table and helping to understand what is the best treatment decision then at a later point in time for the patient. Of course, we will continue to make every CT coming from Siemens Healthineers a photon-counting CT within the next couple of years. We are very well ahead from what we have been looking at in the past, and I will get to that in a deep dive a little bit more in detail.

We will continue to introduce DryCool technology in higher field strengths as we just did with the Flow 70 centimeter recently and the 3 Tesla dry magnet is not too far out. Looking into molecular imaging, the challenge there is, in particular, to handle the larger patient volumes and to make sure that we as well bring the speed up of molecular imaging and reduce the TCO as we will see much more of those tests being facilitated in the next couple of years. So it is about speed and total cost of ownership in that context. And on the X-ray side, we just have been launching the new platform on mammography and the new platform on fluoroscopy.

Having said that, let's look a little bit into the photon-counting arena, and there were a couple of questions around this. And probably I have the chance to answer them right away. I mean we started in 2021, where we said this is going to be a journey. This is going to be a journey to bring photon-counting CT in every segment that is existing in CT. We are now at 2024, and we have already a fleet of photon-counting systems, 2 dual-source CT systems more focusing to the more high-end side, but moving as well now a single-source photon-counting system in a little bit more affordable arena, and we continue to do this and have now the first one as well as a link into radiation oncology with the NAEOTOM Alpha.Prime for radiation therapy planning.

Financially, it's today showing that it was definitely worth the invest. It is a multibillion business. Just EUR 1 billion accumulated order already since 2021. 700 million accumulated revenue since 2021, and we are at the beginning of the penetration of the market. At the same time, there was a lot of clinical evidence generation. This is key because we do ask for somewhat more money when we sell photon-counting CT, but you can only justify somewhat more money if you can tell the customer why it is worth to invest it. And it makes a difference based upon 900 papers in the meanwhile published in urology, cardiology, and oncology.

So you asked for competition. I think it's probably not really a deviating answer from what Bernd said. Somebody who is entering the market and today, nobody has a commercial available product, nobody. And who is the first one, we will see. There as well competing technologies on the market. There's one company talking about a different generation. I said just different technology with probably the disadvantage of lower resolution and higher dose. And there is one other player stating that they will have something soon, which probably is something which from a performance and dynamics cannot compete what we have.

So they start basically in 2021 now. We continue to progress from 2024 with a fleet of systems not addressing a single segment, but all of the segments. And I think that's making quite a big difference. So looking into how do we translate the diagnostic information in the various therapeutic fields into value, I brought a few examples up for you. One thing is CT-guided PCI. I don't go too much into details because Carsten will later on go very much into the details. I just tell you, the important thing here is really the efficiency gain. We have done first studies on this, close to 30% efficiency gain by using this additional information to guide your procedure in the Angio suite is quite remarkable.

When it gets to the stroke side, where time is brain, when you can combine the diagnostic proof of the stroke directly with the Angio procedure and remove the clock from the artery, this is very good for the patient. 30-minute less time to treatment can make the difference from walking out of the hospital without any symptoms left to being in a wheelchair. So this is really fundamental that we gain time there. So 20% more patients without disability just by this 30 minutes. We talked a lot about Alzheimer's and neurodegenerative disease. Yes, and definitely, end-to-end, we cover the entire spectrum, including the radio diagnostic tracers. And we are setup to not only sell the individual pieces of equipment, but do with well kind of programmatic services around it and consult people how to setup, for instance, memory clinics and Alzheimer's programs.

The same is true for the Theranostics and we look to cancer, I think it is a difference if you have a partnership with a smaller hospital chain or a larger hospital chain or an entire province in Canada, where we, together with Alberta have set the target to reduce waiting times for treatment by 50%, which is quite remarkable in a population that unfortunately faces quite a lot of cases of cancer. So take these 2, neurodegenerative and cancer. They both do profit a lot from the development, the recent developments in treatment options that we have seen. And this was the reason why we see this huge uptake of radio diagnostic tracers in these 2 type of diseases. Theranostics, we expect 2.5 numbers times the patients in 5 years at least based upon what is available in the menu today and Alzheimer's patient, 10 year more patients in the next 5 years to come. And we are already, as of today, at 2 million doses annually delivered with a strong growth pattern behind. And that was the reason why we bought AAA to expand our network beyond the United States, where we operate the largest network and now become as well the largest global player by adding the European one. And by knowing, the demand will rise and rise, we will further expand this network and we'll invest further. We are very close to the pharmaceutical industries.

They basically come to us to ask us to produce, manufacture and deliver their drugs if they are going to develop. And therefore, it's very interesting to see which of those tracers of those novel tracers will add additional growth volume to this. And to give you just an idea about the size, last year was EUR 700 million revenue just from PetMed, EUR 700 million. It's quite remarkable. And when you see the growth pattern behind, you can basically extrapolate.

So coming to an end, and not touch too much on the '26 guidance because Jochen has done this, and this is basically publicly known in the meanwhile. But on the midterm, we are per annum commit to at least grow mid- to high single digit and to see a margin expansion from scale as we have proven to deliver this on the past, as I've shown you on the very first slide.

Thank you very much for listening.

MK

Marc Koebernick executive

And with that, I'm very happy to hand it over to my colleague, Arthur.

AK

Arthur Kaindl executive

So Bernd earlier introduced our strategy where we're going with elevating health, focusing on our unique capabilities in patient twinning, in precision therapy and in health care AI. While each of these capabilities are powerful in itself, it's their convergence that is transformative. And nowhere else does this matter most than in the diseases that determine global health. It's our fight against the noncommunicable diseases where conditions quietly shape the lives of millions and millions of people. And it's these diseases that account for 75% of all the deaths globally. And that is the reason why we, as Siemens Healthineers, we have aligned our strategy along 4 disease areas. Neurodegenerative disease, cardiovascular, stroke and cancer.

Now our customers, they are looking for partners that can see across the whole patient journey. From early detection and diagnosis to treatment and survivorship. Our customers are looking for partners that can connect data, insights and precision at every step. And we at Siemens Healthineers are such a partner that can bring the whole patient journey together. There's no one else who has that depth and the breadth in patient training, in precision therapy, as well as in Healthcare AI. That's the reason why we can make care more personalized, more efficient and more accessible.

So let's dive a bit into precision therapy and our strong foundation. We are the undisputed leader in radiation therapy with the strongest portfolio and the largest installed base. Yet our leadership goes beyond cancer care. We have strong -- we have unique capabilities in cardiovascular and stroke care, supported by our strong foundation in angiography. In both of those fields, we'll expand our market leadership going forward by introducing new platform innovations over the course of the next 12 months.

The businesses in precision therapy are strong and resilient. You see it by the number, EUR 6.8 billion revenue in fiscal year '25, EUR 1 billion EBIT, and a 15% adjusted EBIT margin. And the businesses are attractive because more than 50% of our revenue is coming from recurring revenue, from software from services, from long-term contracts, but also from devices.

In precision therapy, every moment matters for the patient. And elevating health globally means to make these moments more meaningful by turning them into better outcomes. And I hope you will see this approach where we're looking into the Varian business area. We take cancer care to heart. Our mission of a world without fear of cancer is the driving force behind everything that we do. And cancer doesn't wait. Cancer doesn't make any exceptions. Every other second, somebody in this planet hears the word, you have cancer. This year, it's about 22 million new cancer cases on this planet. This number is likely to rise to 24 million cancer cases by the end of the decade.

And yet, even with that challenge, there is a path forward. Radiation therapy plays a pivotal role in cancer care, where more than 50% of all cancer patients benefit from radiation therapy, either in curative or impeditive care. Yet we are facing a paradox. There's more and more people that are being treated in cancer, yet the demand is outpacing the capacity. And we stand apart, we're building not only cutting-edge innovations, we're building that capacity. And it's personal for us.

You have Melanie and Keelin here on this picture. They are colleagues of ours. They are cancer survivors. And they lead our in-house patient advocacy team that helps us improving our products, making them better day by day, and they remind us -- remind us, cancer is never distant. Yet purpose alone doesn't do the trick. It's all about the ability to turn that purpose into innovations and tangible business and hopefully, outstanding business performance. And when Siemens Healthineers and Varian came together in the year 2021, it was a strategic decision. It was the natural next step clinically as well as operationally. By this, imaging can see more, and by this therapy can do more.

So bringing both companies together helped us to accelerate to turbocharge the pace of innovation. Advances that have only been possible together. And you see a couple of examples here on this slide. HyperSight, we talked earlier about it, bringing high-quality imaging to the radiation therapy world for the first time. AI-enabled RapidArc Dynamic is an example to improve those distribution and to make care more efficient, cancer care more efficient.

IntelliBlate is our microwave ablation solution that allows to improve ablation -- image-guided ablation in the field of interventional oncology. PerfectKinetix Dynamic Couch, yes, it's a patient table on the one hand side, but it allows different clinical procedures with the [ O-ring ] based radiation therapy systems, which has never been possible before.

And finally, we talked a lot about Photon-counting CT and now we're bringing with the NAEOTOM Alpha.Prime Photon-counting CT for the first time into radiation therapy planning. These innovations drive business performance with more than -- more patient touch points than ever. With a strong book-to-bill ratio with a sustained growth -- revenue growth over the past year since we joined both companies. And with strong partnerships and customer relationships over a huge installed base in imaging, in software, as well as on the therapy -- therapy delivery systems. Yet we will continue advancing and bringing together imaging and therapy and you will see that in the clinic.

Precise and precision therapy requires precision imaging. You can only treat a cancer tumor accurately when you can see it clearly. Imaging defines the anatomy, the motion, but moreover, the relationship between the tumor and the healthy tissue surrounding the tumor. So better imaging leads to better planning, better contouring, better planning. And of course, it raises the confidence in the decision making of the clinician taking care of the patient.

And we have two great examples here. On the left-hand side, you have MR of the prostate. On the very left-hand side, the anatomy of the prostate. On the right-hand side, you see a subsegment of the information, which is the diffusion rated imaging, sort of functional imaging, and it helps the clinician to make the decision where to boost the energy verticals, the radiation exposure to the tumor to be most effective.

On the right-hand side, you see a nice comparison between conventional CT and Photon-counting CT. And I guess everybody of you will be convinced of the benefits of Photon-counting CT and radiation therapy planning because she can delineate the tumor at focus, and you can dedicate the irradiation of the tumor to the exact size and location of that tumor. This is when imaging and therapy comes together. And it's even getting better by deeply integrating AI into those applications.

So now let's look into the future. Advancing our revenue growth is basically driven by 3 key levers. It all starts with how cancer is treated, and how cancer care is managed and delivered. So we're focusing on growing procedure volumes. We will do more in radiation therapy. We'll do more in theranostics. We'll do more in interventional oncology. It continues with Healthcare AI enabled through our digital oncology solutions, where we're bringing together the information from imaging, from planning, from therapy to enable clinicians to improve their clinical excellence and to boost efficiency.

And we're focusing on value programs. Innovations as good as they are, as good as they are, they cannot transform care. People do. And the value programs, we eventually enable the clinicians, the teams around the globe to improve the excellence of care what they're doing and ultimately transform care at scale. So let's look into all of these 3 levers in a little bit more detail.

We've been shaping literally every area of radiation therapy over the best part of the last 75 years. And now we're defining the next area. Our new platform innovation will focus on improving the throughput of radiation therapy, expanding the indications, the clinical indications and yet, at the same time, increasing the utilization. And you will see this happening over the course of the next 12 months, where we'll be launching a Next-Generation Linear Accelerator that will enable our clinicians to become faster, to become more precise, where delivery becomes easier, and we will focus on democratizing radiation therapy across more cancer centers and across more regions.

Yet at the same time, with these technological innovations, we strongly believe we can shape and we can push the adoption of radiation therapy in health care. We believe that radiation therapy, for instance, will go more and more into the treatment of oligometastatic disease. An area which is currently reserved more or less to medical oncology to systemic treatment. And it opens up new treatment opportunities for those patients who are suffering from that disease. We also see a great potential in noncancerous diseases, for instance, in treating osteoarthritis where radiation therapy will significantly improve the quality of life.

Now if you would agree with me that the growth opportunity is clear. Cancer cases are on the rise. We'll shape the adoption of radiation therapy, and by this we'll increase the demand for linear accelerators. And as new clinical indications are opening up, we will accelerate this even further.

What we've learned from radiation therapy is one thing. You can only treat what you can see. And that same principle holds true also for interventional oncology. In angiography, you're combining imaging and therapy, and by this you're enabling the clinicians to clearly and precisely see where therapy is reaching. And more importantly, to give the clinician feedback, when the endpoint of the therapy is reached, and that is why interventional oncology and focusing here on embolization, as well as on ablation is such a powerful part of precision therapy. By combining 3D guidance, by combining that with real-time imaging will enable the customer, the interventional radiologists, oncologists to be more consistent, more precise and to have an easier way of delivering care.

In the clinical field, we foresee a new generation of embolics and the automated treatment guidance to make a massive difference in clinical care. Again, we see significant growth opportunities here because interventional oncology is a highly dynamic market, on the one hand. Yet we will capture share in that market by combining imaging, treatment planning software and devices into one integrated solution.

So these therapies, they are powerful. So the next step is how to connect them? Every image, every treatment plan, every procedure generates data. And Healthcare AI essentially is all about how do you turn these data into insights that help to save time, that raise precision and confidence with clinicians and patients alike. This is transforming health care.

It starts with automation. I'll give you one example. For instance, the integration of CT simulation data into our ARIA CORE patient management platform is one example. It builds on generative AI, where based on digital twins, essentially, it helps to optimize the patient management, the workflow, the scheduling in a clinical department. And it advances with agentic AI with smart next-generation autonomous linacs that adapt in real time to the anatomy, but also to the motion of the patient that is currently being treated. And one thing that is super critical here, it allows to treat the patient with less people, addressing the staff shortages challenges.

So in essence, we're combining Automation AI, Foundation Models and Agentic AI, and leverage our huge installed base across imaging systems, software as well as treatment delivery systems to eventually drive high margin -- high growth and high margin expansion. So we have the technology. We have the intelligence to help clinicians to make treatment procedures more precise.

I believe we have a responsibility to make cancer care more equitable. And that's the reason why we're working together with our customers to address some of their most pressing challenges they are having, and we touched upon them a bit earlier. And probably the biggest one is the health disparity.

Unfortunately, today, far too often, one must say, where you live determines whether you live. Financial pressure, staff shortages, or burnout. But also how to help our customers to advance in medical progress? These are all these challenges that we are being confronted with. And our value programs that we are issuing and launching these days helped to reduce the burden of adoption and help the customers to create lasting and sustainable transformation of cancer care in their responsible constituencies. It essentially helps our customers to do more and to reach more.

And by this, we created a couple of partnerships over the last couple of years. And you heard about the Alberta one. Certainly, the most significant and largest one, an 8-year partnership with the government of Alberta to be precise Alberta Health System, and supported by the Alberta Cancer Foundation, where we are upgrading the whole infrastructure in the province of Alberta, the population of 5 million people spread out across a huge geography. And where we're not committing only just to install hardware or software, but we're committing to work together with them on reducing the time that it takes between the diagnosis and the onset of the treatment. And as I said earlier, cancer doesn't wait. But also to help reduce the ER visits.

There's another example, completely different one, and this is rural East Tennessee and Western Virginia. We're partnered with Ballad Health, the local health system. They made to its goal that they are advancing and raising cancer care to an academic medical central level because people in that area have to drive 6 hours to get to the next university hospital. And not everybody is capable of doing this. So we're working together with them to increase the quality of care there.

Another completely different example is our partnership with the Ministry of Health in Zambia, where we're establishing the first comprehensive cancer center in that country, bringing together imaging but also radiation therapy and radiation therapy, in particular, for the first time into the country. So we're providing equipment, software, but also training and educational services to serve a population of more than 20 million people.

These value programs are amongst the most fastest, or the fastest-growing business segments within our business. And they contribute right now to EUR 1.5 billion backlog across imaging and therapy equipment and services.

Excellence is the standard when it comes to how we're serving our customers and their patients. It's also in the way how we're operating. Historically, we've been driving margins yet and as Jochen alluded to it, we see a great potential to expand them even further. And we see 4 key levers, 4 key drivers for that.

One is certainly innovation. Talk about our next-generation treatment delivery system that's coming out over the next couple of months. It will increase the value how customers can treat their patients. And by this, we can also set new pricing standards. On the other side, I talked about Healthcare AI and how we can spread that and scale this across our large installed base, high-margin portfolio, helping us also to manage our margins going forward.

We're collaborating with our in-house technology centers and the patient Couch is a perfect example here. It's all about shared parts. It's all about productivity manufacturing but also, it's all about adding a high-value portfolio item to our offering. And high-value portfolio items are our fourth level here like RapidArc Dynamic or HyperSight, they can be either upgraded to our large installed base, or added as a high-value option towards new deals going forward. So our growth and our margin expansion will significantly contribute to the overarching profitable growth of the precision therapy segment.

And you heard earlier the outlook in '26.

I'd like to highlight our trajectory going beyond '26 until the end of the decade. And again, we're committing ourselves to go into the high single-digit range when it comes to revenue growth, and that translates then into an adjusted EBIT margin expansion by roughly 100 basis points per annum.

But let me finish by saying this. Behind every number here, there's something much deeper. It's the impact on the patient. The person behind every diagnosis, the person behind every treatment. The reason why we innovate, the reason why we are strengthening precision therapy. And you heard a lot about our strategy in cancer care, our innovation, our operational rigor, the margin expansions. You will see the exact same thing in advanced therapies, focusing on cardiovascular disease, on stroke and on cancer care. And you will see the same opportunity to create value.

Carsten, over to you. Thank you very much.

CB

Carsten Bertram executive

Thanks a lot Arthur and a warm welcome to Advanced Therapies. Advanced Therapies is a global market leader, a EUR 2.1 billion business with 30% market share and a strong #1, #2 position in all our segments. And as I often get the question, what exactly is it that AT is doing? Let me try to wrap this in 40 seconds.

So our image guidance solutions provide a view into the body. They visualize the body's vessel system and they enable to navigate through the vessel system so that physicians can better diagnose and treat diseases from within the vessel system. These are the so-called minimally invasive procedure and they change the way how therapies are delivered for the most threatening diseases. They provide significantly better clinical outcomes than open surgery, and all of this based on the solutions that AT is providing.

AT currently is at an inflection point, and that's an inflection towards faster growth. And this is based on an all-new portfolio of angiography systems we will bring into the market in 2026. For us, that's typically once a decade opportunity. So our products crucial elements in the fight against cardiovascular disease, stroke and cancer. And therefore, AT is contributing to saving millions of life every year.

[Presentation]

CB

Carsten Bertram executive

So we all have loved ones, family members and friends that are confronted with the most threatening diseases. And what you see is that the incident, the burden of these diseases continues to grow. But there is hope and the hope are these procedures that treat these diseases. And our products are key on treating these procedures, are key for the procedures, and therefore, are key enablers to fight these most threatening diseases.

We want to transform these procedures. We want to make them faster, simpler, more precise and more affordable. And we want to enable new procedures to treat conditions that cannot be treated today, improving the lives of millions of people. So the number of procedures is growing fast, and we are, on the one side, growing with these procedures, but also we are expanding our role in procedures. And we do this because more complex procedures require more image guidance. We add AI to procedure guidance, giving you an example, identifying and highlighting the vessels that treat a tumor, so that physicians can decide and know exactly which vessels to embolize to treat a liver cancer. And by creating new procedure-specific solutions, for example, enabling better device selection and stent sizing in the treatment of coronary diseases.

So we are operating in a market that is growing structurally, and we are expanding our role in that market. And for us, that means that we are accelerating our growth and expand our margins in the next years. And we are accelerating growth because we will gain market share in the procedures that are growing fast, and we have the ability to move into new and adjacent procedures. At the same time, we will expand the margin because we will move to one unified product platform that allows us to reduce cost and complexity, and we will move towards more procedural revenue at higher margins.

And we do all this based on 3 key levers. Innovation, our own innovations and the innovation portfolio of all of Healthineers, by strategic industry partnerships with device and robotics companies, and by offering and providing comprehensive customer offers like value partnerships and value programs. Now let me briefly go into each of these levers and let's start with the first one, our own innovations.

AT in 2026, we launched a complete new portfolio of angiography systems. For us, that's a once every 10-year opportunity that we will exploit. And the all-new portfolio addresses all minimally invasive procedures, in all clinical fields, and we cover all segments from value to high end. And all these new products are built on one unified product platform, that as I mentioned before, allows us to lower cost and complexity. And the whole platform is built around AI and focused on procedures.

So all products provide superior clinical capabilities centered around our new AI-powered image engine that provides superior and clearly better visualization of devices and anatomical structures, in the most complex procedures at significantly lower dose, which is a complete game changer. And at the same time, we are introducing, as I mentioned, AI into procedures. What you see here is an example of what we call the fully automated coronary evaluation that analyzes the complete coronary tree, so that you can -- that the physician really knows what's the right stent and what's the landing zone for the stent.

So with our new portfolio, we are very confident that we will gain market share and therefore, accelerate revenue growth and expand our margins. We have the first systems at customer sites with overwhelmingly positive feedback, and we will start to launch and ramp up the system in 2026. So stay tuned.

This all-new portfolio also enabled us to integrate innovations from across Healthineers. Innovations from ultrasound, from Varian, from imaging. Because we believe that if you create comprehensive solutions, you can create significant clinical value in multiple clinical fields. And let me just give you one short example and that is in the structural heart procedures.

If you unite the life images from AT with the live images from ultrasound, we get a significant better view into the anatomical structures of the heart, which then allows the physician to better navigate in the heart. If it's about putting new heart valves in, or closing the left atrial appendage. So again, by uniting solutions from multiple parts of Healthineers, we improve our clinical relevance and create competitive advantages.

And talking about left atrial appendage. This is probably the fastest-growing procedure in cardiology. And by the way, connects two of the noncommunicable diseases. Because you're closing the left atrial appendage in the heart to reduce the risk of stroke. So you might have seen the announcement that our colleagues from ultrasound have announced a strategic partnership with Boston Scientific. Boston Scientific is the clear leader with their WATCHMAN device in that field. And by uniting the 4D ICE next-gen catheter from ultrasound with the WATCHMAN workflow, they will change the future of LAAC procedures. And by the way, that's a great example on why strategic industry partnerships are key for innovating minimally invasive procedures.

I truly believe that if you want to innovate minimally invasive procedures, you have to bring together imaging, image guidance, devices, robotics and AI. And that requires strategic industry partnerships. And for us, these partnerships mean we can innovate new procedures, we can move into new clinical segments and we can access procedural revenue pools. Here are two examples.

So the one is our collaboration with Intuitive, that we are using to together transform lung cancer detection and treatment. For this, this is the combination of the iron robotic bronchoscopy platform with a 3D mobile C-arm of AT. And the clinical result is a significantly higher target in lesion rate for lung biopsies, which is crucial for earlier detection and treatment. For us, this has opened a new clinical field pulmonology. We have sold more than 300 of these systems into pulmonology, which has added more than 100 basis points of our revenue growth on the equipment side.

2 months back we announced a strategic partnership with Stryker to redefine how aneurysm and stroke is being treated robotically. Here, we put together the robotics capability and the image guidance of AT with the market-leading position of devices on the Stryker side. And together, we will change the way how neurovascular procedures are done and create the market for neurovascular robotics with first clinical study in the next 12 to 18 months.

So now let's move to the third lever. The third lever is comprehensive customer offers. And you heard already a lot about value programs and value partnerships. With these, we go beyond transactional deals and create comprehensive offers that solve customers' key pain points. Value partnerships, long-term strategic collaborations continue to grow in terms of size and number. And for AT, the number has more than tripled. What we now add are value programs. They are new, they are more focused. They look at changing or to the clinical transformation of one clinical care path on our side. For example, setting up with acute stroke network, or building a heart center.

Now we add the industry partnerships together. And if we bring these 3 together, we are able to solve customers' key pain points. And you heard about them, Access, Clinical Efficiency and -- common guys help me out, Clinical Excellence, that was the third one. Thank you.

So -- and for us in AT, it means we will accelerate revenue growth. Now this is the main topic for us. Now let's look at how we bring all of this together and both Andre and Bernd already talked about it. This is an example from coronary where the stenting of cardiology -- what is stenting of coronaries is the most common minimally invasive procedures. And we now keep the capability of the Photon-counting

CT. The unique diagnostic capabilities to look into a lesion, understand how the plaque is transformed, come up with a treatment plan and you then seamlessly integrate that into the cath lab, the pre-procedural results from CT. And now we combine that with the, intra-procedural capabilities of our all-new angio system. Remember, the AI-powered image quality, AI-powered procedure guidance.

And with this, we now guide the complete procedure, from lesion selection to what is the right device to use, size diameter, what's the right landing zone and then really making sure the stent is placed correctly. And for us, it means the new procedures, CT-guided PCI is more precise, it's faster, it's safer and it can be more affordable because you're now are sure you need just one stent.

So for us in AT, bringing the 3 key levers together that I talked about, innovation, our own innovations and the one of all of Healthineers, strategic industry partnerships and comprehensive customer offers is the key that will help us to further accelerate revenue growth and expand our margins. And with this, we will strongly contribute aligned with Varian and ultrasound to fulfill the ambition of the Precision Therapy segment.

Thank you. And with this, I hand over to Dorin.

DC

Dorin Comaniciu executive

Good afternoon. My name is Dorin Comaniciu. I have the pleasure to talk today about Healthcare AI. As you have seen, HealthCare AI is part of every business of Siemens Healthineers, and also is a core part of the strategy. I've been with Siemens for 26 years and it has been an honor to contribute for many years to Healthcare AI.

Today, we're a global leader in AI-enabled medical devices with more than 100 AI-powered devices approved in the U.S. and hundreds of them worldwide. We're also innovation leader for AI in medical imaging. We have more than 1,300 patents granted, and many of them actually in foundational AI. We're also -- we have recognized leadership in prestigious institutions such as U.S. national Academies.

Now in Healthcare AI, we're running global network of Healthcare AI centers. I'm coming from Princeton, New Jersey. And you see we have centers in Erlangen Germany, Brasov Romania, Bangalore India, Shanghai China and we're currently building one in Edmonton in Canada, in the partnership with Alberta that Arthur mentioned. Now these centers are giving us the global view, but also the capability to collaborate locally with core customers.

Now the centers run what we call Global Healthcare AI factory. This is a scalable infrastructure that is based on super computing and on a large data lake, on a very large one, actually. We're running in terms of the supercomputing in colocation mode more than half of exaflop compute power, plus 23 billion of -- this is on a 23 billion (sic) [ 2.3 billion ] of images and an additional clinical information. And these are coming from more than 200 partners.

Now it's very interesting, right? We have something like six petabyte of all flash memory, massive memory. So this allows us to move very fast in and out big data into the GPUs and out. And this allows us to run something like 1,800 large deep learning experiments per day. We have also a very efficient pipeline that includes curation, reading, annotation, the R&D and the development of models and ultimately, the translational models into the businesses, both models and foundation models, yes.

So Healthcare AI is a question of scale where everything works together. The compute power in our experience for the last 10 years, compute power grew something like 1,000 times. The big data that sits on the data lake and also the talent of the scientists that are working to create better and better models. And everything we do is, again, the way my colleagues mentioned to make healthcare more efficient, to make healthcare more effective, and to increase access.

So what you see in front of you is one of the largest foundation models in industry. More than 0.5 billion medical images used for training. Now if you want to take 10 seconds per image to analyze these images, you would need something like 150 years to go through the entire database. We have been pioneers in building such foundation models. Actually, we have our first publication 2022 with 100 million. And today, you see the 0.5 billion and actually today also, we're training with the next generation with 1 billion, medical images.

And by now, I guess, everyone knows that the foundation models are these very large models that ensure much more efficient downstream of the downstream development. We don't have only large models, but we also have lighter models that is focused on NCDs. And you see there on the screen, neurogenerative -- neurodegenerative disease. We cover cardiovascular, cardiovascular both image analysis, but also interventional. We cover stroke, we cover cancer. So all these models are part of the factory and ensure much faster development downstream and much more expanded development downstream, meaning that with such models we're able to detect more pathologies.

So now Healthcare AI. You have seen Healthcare AI is a key enabler for patient twinning. And when I look at twinning means sensing the patient, early diagnosis, early detection of the disease, diagnosis. And ultimately, selecting the first -- selecting the best treatment for the patient. And how do you move that information into precision therapy?

Now part of this journey, there are a couple of paradigms that we address. And I will mention today 3 of them. How can we help our customers imaging patients faster? How can we help the radiologist interpreting, reading faster images? And also, how do we shorten the time from diagnosis to treatment? And as Bernd mentioned, based on the increase of compute power, based on more data, based on more powerful algorithms, we're looking now into how do we elevate Healthcare AI to the next level? And if you really think in terms of evolution, we're moving for the scanning part from elements of automation to the autonomy. Autonomy means that the machines are doing more and more in an autonomous fashion with less intervention, of course, in a secure and safe way.

Then for the image to report, the advance means that we move from radiology findings into generating the report. If you can imagine this, this can have a major impact in introducing a lot of efficiency for radiology. And the last example that I'll talk about is how do we introduce instant radiation therapy planning as a way, again, to expedite, to move things much faster from the diagnosis to reduce the waiting time from the diagnosis to treatment.

As Andre mentioned, today, we have quite a number of exam companions. And I will underline here the 3D camera. The 3D camera we introduced a couple of years ago. Today, per year, we have something like 30 million CT scans done with the 3D camera in the world. That's first element of automation that helps positioning the patient in the gantry. But now when we introduce more and more automation, imagine what an autonomous scanner would do?

When you look from that angle, we look into a completely redesign, a completely changed machine that has autonomy at the center. We look into the improving perception, improving sensing of the patient, looking to bringing more intelligence, and ultimately also ensuring a smooth patient to AI interaction. And you can imagine that this is a problem of scale. This is a problem of agentic AI. This is a problem of exascale simulations. So it's a fascinating way to think in the evolution of these machines, again, from elements of automation into autonomy.

Andre was mentioning -- mentioned the Deep Resolve, right? Deep Resolve is a fascinating technology right? So in the slides that he showed we have something like a 17 million scan last year, more than 30 million scans since introduced, right, making scanning much faster, sometimes 4x faster at double the resolution. But still, the technology is evolving. And now we're looking at the scalable diffusion, a diffusion foundation models and how they would accelerate scanning even more. But such technology would allow us to expand from MR to CT, to X-ray to reduce the level -- further the level of radiation. To expand to cone beam CT to reduce the number of projections. And also, we're looking now into the diffusion models how do we capture more dealing with nonlinearities of the acquisition in order to reduce the demands for the hardware, or something that we call software-defined hardware.

So let's look at the report now. So today, we have, say, in the world of chest CT, we have systems that analyze lung nodules, emphysema, airspace opacities, classifications, measuring the aorta and quite a number of them, right? These systems today, they improve the workflow. But now the next level, the elevating part can we generate a report. Now that's a big business and can have a lot of impact on radiology and can transform everything that would happen in the future in the space of radiology by the machine generating the report reliably.

And you can see there, we have foundation models, coupled with many light detectors that can be trained very fast. And we don't have a couple of detectors. We have more than 100 for chest CT working together in order to identify many pathologies, multiple potential pathologies and translate everything into reliably into report.

So let's talk also about radiation therapy as an example of expediting the drive from diagnosis into the therapy. So in radiation therapy, the problem is how do you deliver the most dose to the tumor while protecting the surrounding tissue. So in order to do that, the first step is contouring. You contour the tumor at a couple of levels and then you're contouring the surrounding tissue, something that you call organs at risk. And today, we have the auto contouring software. It's a very industrial software. We have something like more than 200 organs at risk covered and is used today, day by day in many, many centers in the world, including a lot -- introducing a lot of efficiency, more than 90% time cut in the contouring part.

But then after contouring comes a very sophisticated optimization that defines how the therapy will look like by, again, optimizing the location of the beams, how everything is optimized, again, with the same target, deliver more radiation to the tumor and less to the -- to what we want to protect. So now the challenge is that this optimization takes a lot of time because it involves quite a number of passes. First of all, it is long and then involves quite a number of passes from the radiation oncologists to the dosimetrist and back. So now we have the first modeling in industry, the first foundation model for radiation therapy that drives this optimization in under second.

So imagine what that means for the efficiency of radiation therapy. You press the button and you get the optimization done. And if you're not satisfied, you can go with that -- you can do that in a couple of iterations. But that means, again, introducing a lot of efficiency. And here, the target is that, as Arthur mentioned, can we do that? Can we do the path from a diagnosis into therapy in 1 day. And this is also -- actually, it's a problem of scale because in order to do that, we run supercomputer, we run tens of thousands, hundreds, thousand plans from where we learn how to generate the best plan for this case. So now let me talk about AI orchestrated workflows.

So the message here is that using a new generation of optimization technology based on agents, we are able to introduce more to optimize the evolution of the health care systems from the bottom to the top. And again, this is a problem of scale. Now just to give you a simple example, think about how do you do the scheduling for patients, for personnel and for machines. And this is a very -- a problem that is -- involves a lot of dynamics. Things can change drastically, right? Lack of personnel, patient doesn't show for appointment, machine down, you can have pandemic, you can have a lot of things happening that changes, right?

Now in order to do -- to deal with so many situations, what we do, we do Exascale simulations, again, billions of parameterizations. So now you can have AI systems, AI agents, you can see there that learn to play strategy in order to achieve user-specified KPIs under dynamic conditions. And this is fascinating, right? It's well beyond operational research that is happening today. So now imagine that we do that in a product. We have already introduced, as Arthur mentioned, the Smart Scheduling for our oncology information system. But now you can start optimizing departments, radiology department, cardiology, radiation therapy. But then you can do even higher.

How do I optimize the patient journey? That means service coordination and balancing. And going to the next level, how do you optimize capacity? How do you maximize capacity? I made such presentation to CEOs. This is the #1 topic that every, any CEO cares, optimize, maximize my capacity. And then even higher level, imagine, again, more compute power that means also capabilities to play strategy. So this is a topic that we're actually running with a number of partners as partners in value partnerships. And it's a fascinating development that makes us very, very important players into this field and optimizing health systems.

And by the way, the name that we use is operational twin. So health care AI. To me, health care AI is a story of scale and impact. As you have seen also from my colleagues, we focus to introduce more efficiency, effectiveness, clinical excellence, but also to improve access to many people in need. Now from a scale perspective, we operate everything at scale. We train on massive data. We have a growing and growing -- we have growing, growing supercomputing capabilities. But also, we have a lot of brilliant scientists, PhDs in machine learning that are working in this system. And perhaps what is the most important is that we have the experience of running everything together in the healthcare AI factory. And ultimately, such healthcare AI factory continues to produce day-by-day models, small models, large models that are being translated by our businesses in differentiating products and services. And with that, I conclude my presentation. Thank you so much.

MK

Marc Koebernick executive

I would like the presenters come on stage for our joint Q&A session that we have now for the synergistic core. Great. So here we are. The floor is yours. Yes, please go ahead.

OR

Oliver Reinberg analyst

Oliver Reinberg from Kepler Cheuvreux. First question just on AI. Can you just talk about the commercialization? I think so far, the technology is largely embedded into the kind of platforms. So to what extent do you have currently already separate revenue streams? And how much can you build on that? And do you believe that also this kind of new technology can drive basically the kind of replacement cycle of instrument in the industry? And then the second question would just be on imaging. I mean you talked about the kind of different growth drivers. I mean, can you just unpack the imaging growth a bit? I think you talked about the impact from pricing.

But can you just give us a flavor in terms of what do you think in terms of what comes from market growth, what comes from market expansion to new areas and probably market share gains and also get some kind of color because there's also a headwind coming from the fact when you have more throughput, both on the imaging side, but I guess also in [ RT ], what is the headwind from this kind of incremental throughput that you can actually do more with the machines?

AH

Andre Hartung executive

Who's going to start there? I mean I can first probably comment a little bit on the AI side as well because it's -- in particular, in imaging, but as well in the other modalities. I mean, Dorin said it perfectly. It is an embedded incremental differentiator that basically makes us more successful in the marketplace on the one hand. And it does not come for free. I mean this is something we ask for money, and we sell it in different shapes and forms. And it's not always just embedded in terms of you pay it once. We have other solutions as well like Flexinity and it's more along the imaging value chain where it's more procedure based.

As it has been known already in the PACS environment, for instance, this archiving environment, where it's running that way. And on the other hand, I think we need to accept that there is not ultimately more money in the system, but it's really more about investing in things that help you to live with the money that is available. And therefore, we think that driving competitiveness by embedded and fully automized processes is one of the key drivers. And yes, it will increase productivity and it will increase throughput of systems, and it is ultimately absolutely necessary to do it because as I told you in my presentation, there is so much you can do as a radiologist or so much you can do as an interventionalist or in the oncology arena that when you currently see how the demand is piling up, this productivity topic is key.

And don't forget, there is a lot of installed base there that is not capable of doing this. You cannot easily upgrade this. Sometimes you can. We have Deep Resolve is a good example. There, we can upgrade. When we look into the impact on the units we sell, you will see it's even accelerating just because people want to have it either on the installed base or new systems, very similar in other modalities. The overall imaging market, to put it a little bit in perspective, yes, I mean, we talk about -- you can calculate it basically by yourself, EUR 12.1 billion, 38% market share. So you end up with something like EUR 35 billion for the imaging market, with a growth dynamic, which is in the range of 2% to 4%.

We are a little bit conservative for '26 because it's not so easy to estimate how China's dynamic is going to be. So we rather see this a little bit more muted. And we typically outperform the market growth by 2%. So when you look into our growth as compared to what we see on the market with more than 7% since 2018 at the IPO, we roughly have 2x the dynamic. And the majority out of this is coming out of both growth on the service side, which is basically a follow-up after you have been sold the system at some point in time after a warranty period, typically, there is a service contract with it, but it's kind of equal.

AK

Arthur Kaindl executive

If I may add one comment on the monetization model of AI. I mentioned, for instance, one option, which is the RapidArc dynamic that improves the care of certain cancer types much better. This is a sellable item. It's only possible through AI enablement. It's mostly software that you need. And in this case, it's an option. And by this we generate additional high-value portfolio items. This was my fourth key lever in driving not only the growth, but also the margin expansion of sellable items. So it can be both deep resolved, by the way, that Dorin was referring to it as well. It's also a sellable item as an option on MR.

CB

Carsten Bertram executive

And maybe one short comment on in terms of how much does the improvement in terms of making procedures simpler, bring down the demand for procedures, what is working against it and is helping us that procedures become more and more complex. So you have something that simply takes longer because you're doing things you couldn't do 3 or 5 years back. So AI is just helping to fill that demand that you otherwise would not be able to fulfill at all. And I think this is something on the Advanced Therapy side, we will see more and more that you have very complex procedures. But again, these are the ones that are able to treat conditions you could not treat 3, 5 years back.

MK

Marc Koebernick executive

So Oli and then Richard and then Veronika.

OM

Oliver Metzger analyst

Okay. Oliver Metzger from ODDO BHF. So both questions on Varian. So first, for the next-generation linac, how should we think going forward about pricing versus volume? So you are already the market leader. So if you bring a new device, do you target more towards further volume market share gains? Or is, let's say, the margin more important?

Second question, on your event 2 years ago in , you also talked about increasing the radiation, basically that people or patients need fewer radiations and have, let's say, better clinical out come. And you said you're running some studies on that about, I think, 1x stronger radiation. Can you give us a few words on that? Where do you stand with these studies? And what are the outcome, in particular when you talk about the photon counting technology to get a better visualization, so -- which should also drive accuracy.

AK

Arthur Kaindl executive

So on the next-generation treatment delivery system, we are creating massive more value due to the efficiency gains that we're anticipating with that system. But I also mentioned new clinical indications and the most prominent one is certainly around this oligometastatic treatment currently only being taken care of or mostly being taken care of by systemic therapy. We expect higher pricing coming out of that. So to answer your question, certainly, there is a focus on the margin expansion here with that kind of system.

We have seen that trend, by the way, already over the past 4 years with our existing portfolio through adding additional options to the system that the average pricing goes up next to other pricing measures. So that's the answer on that one. But obviously, we're also going for additional market share. So we don't want to stop at the 60-plus percent that we're having today.

On the other question around new treatment technologies, the FLASH technology, basically, just for the rest of the audience, we're not too much into it. What we're doing is very similar like with a flashlight on a photography, we're increasing the dose delivery in a millisecond essentially to 100x times intensity with the benefit of being more effective in the tumor treatment, yet being more conservative than on the organs at risk. Currently, there is research work going on, on proton-based flash. There was little research on electron-based flash. And there will be a project to come on photon-based flash.

And as you were referring to photon counting, I personally believe this will be our photon counter in the future where it changes the paradigm of radiation therapy. And fortunately, I don't have the signature underneath the project yet, but there will be a government-related project in the U.S., hopefully soon after the -- we're just waiting for the signature of RFK to do that to invest into a joint project with the U.S. government on photon-based flash. And Photon counting CT is where everybody is super excited about it.

And our own -- we have a little group of researchers who are paving the way for Photon counting CT and radiation therapy planning. They say 2/3 of all simulation systems in the future will be photon counting because of the unparalleled advantage of the tissue differentiation in photon counting CT. So we're super excited about it as well.

MK

Marc Koebernick executive

Thanks. Richard, we'll be next up there.

RF

Richard Felton analyst

Richard Faison from Goldman Sachs. A question for Carsten. It seems like there's a little bit more focus on strategic industry partnerships today than was the case a few years ago. First of all, is that observation correct? And if it is, how does that change the way that you innovate and commercialize products?

CB

Carsten Bertram executive

A very good question. I mean I'm now in the role since 4.5 years. And if I really look back to the beginning of when I joined, that wasn't such a big topic. Also from an interest point of view, if I look at the device and robotics companies, that has changed completely because what's clear now is that they also clearly believe that bringing together imaging, image guidance, devices, robotics and AI is the way forward on how you can best innovate minimally invasive procedures.

And yes, I mean, taking the example from Stryker, that is clearly a co-development. This is something that -- if you think that you have to bring it together, it's the question, if you want to fully exploit the capability, you have to think it from the beginning onwards. And these are things like what are the -- what's the material composition of devices? How can you best make them visible? How do you ensure that devices are coming back with the Stryker example, as compatible as possible to the robot we are providing. So yes, this now is requiring more of a co-development.

On the other side, we also have to ensure that a lot of the things we are doing are agnostic. So you have to [indiscernible], on the one side, you're looking at how can you make sure that the improvements, the new innovations are available to as many companies or to as many device and robotics company as possible. But at the same time, you -- for selected arenas, you really go into a very deep common partnership.

MK

Marc Koebernick executive

Veronika.

VD

Veronika Dubajova analyst

Veronika Dubajova from Citi. Two questions for me, one for Andre and one for Carsten. Andre, for you, just curious to get your thoughts on the competitive environment in imaging. Obviously, you've had a great run with that 700 basis points of market -- with market share expansion. But there are new players, in particular, in China, who are moving more and more into the other markets around the world. Just curious kind of as you fast forward, how do you think you compete and win against some of those lower-priced competitors who are coming from China in particular?

And then, Carsten, for you, just on the Angio system upgrade opportunity, can you maybe contextualize it for us? You said once in a decade. When was the last time that you launched a new portfolio? And my model only goes back to 2015. And if I look, the growth rates were fine, but not amazing. So maybe you can talk about sort of what you would expect that upgrade to drive in terms of growth rate and how quickly that gets realized through the next period, especially since the guidance for 2026 doesn't seem to be super punchy. So those would be my 2 questions.

AH

Andre Hartung executive

Should I start? Okay. Referring, in particular, probably to one of the more emerging Chinese competitor, I guess. I mean, first of all, let's think about China as such. First of all, we have 9,000 engineers in people in China, half of them on the engineering side, very close to the Chinese market, very close to Chinese customers as well to make sure that we understand what their needs are as Chinese competitors need to understand what the international needs are.

And probably there, we are closer as well, much closer than everybody -- anybody else China could be right now. That's one aspect of it. Then I like, we really make sure that we don't take that easy. And you can see already when you look into the success that we are having in this entry-level segment that those players target sometimes that we have with 12% growth there and overproportional growth as well in the past, we took that quite serious. and we continue to do so. I mean, take to go back to China again.

And China, we are #1. Yes, we had years where the pressure was kind of higher, but I think we made a progress quite well in making sure that we could further strengthen and in the future by expanding our #1 position. While a Chinese player in the international environment, in particular in the United States, of course, is facing some challenges. But of course, they are around, and we need to be careful because they follow fast. And this is the third and last point to that. This is why I believe at the end, it is about we need to out-innovate them, and we need to keep the speed and don't make any compromises on that.

CB

Carsten Bertram executive

Yes. To contextualize that a little bit, the once a decade simply means that usually building a complete platform from scratch is something that happens only every 10-plus years in our industry. We had a launch in a certain segment of the market in early 2020, but this is the first one where we are really going through all segments to provide that. Now looking at your question, why is it that you don't see that already in 2026 at the full extent?

I mean you have to keep in mind that on the one side, it's the launch and the ramp-up, but there is something in addition, and that's called the regulatory approval. And that is something that typically takes a little bit longer, and it depends on is it China? Is it the U.S. So you will -- despite the fact that we will start the rollout in Q2, the full impact we will see earlier on the order side. But on the revenue side, 2026 will be a transition year until we have regulatory approval in all countries and then can ship into all countries.

JO

Julien Ouaddour analyst

Julien Ouaddour From BofA. The first question on Imaging. So you provided an interesting number on PETNET, EUR 700 million in terms of revenue. And I think EUR 1 billion was mentioned a few times. Is there any time line for that? And if you have similar kind of target for photon counting either in terms of revenue or how much of the installed base can you -- let's say, can you address during this plan?

And in [indiscernible], just going back on the targets. In the past, you had the target of Varian's margin getting close to imaging. Is this still the case because you haven't mentioned it there? And just a follow-up to Veronika's Advanced Therapies, you haven't break it between this and Varian. Could it grow high single digit with the partnership and the product launches you just mentioned?

AH

Andre Hartung executive

First of all, I think put it a little bit into perspective, the EUR 700 million was referred to the revenue we realized in PETNET by radio diagnostic tracers, so only the tracers of EUR 700 million. The EUR 1 billion that I mentioned was referred to the accumulated order volume that we currently have in photon counting that was not directly associated to the EUR 700 million. But we do see a well double-digit growth on the PETNET side. We have seen enormous uptakes in particular last year as well.

Now of course, as the absolute volume is increasing, so probably the relative growth rates will come down a little bit. But there are 2 things not anticipated at all because we can't. One thing is which of those phase trial tracers are going to get approval. So as I said in the 25 trials out right now with different tracers for different diseases, certainly, some of them will make it, and they are looking very promising. But because we don't know yet, we did not put it into equation. But I think that's a little bit of the fantasy in that as well, you can think of while amyloid tracers and PSMA tracers for prostate and Alzheimer's are reality right now and come with better margins as well than the regular FDG tracers. This is why it's really very attractive for us.

AK

Arthur Kaindl executive

Yes. And on the precision therapy side, obviously, Varian is strongly contributing towards the precision therapy reported segment. You will see the Varian there in part going forward. Our trajectory in terms of growth as well as in the margin expansion does not change. As a matter of fact, we want to even accelerate it. We strongly believe through the growth, but also through all the margin expansion, margin discipline measures, in particular when it comes to productivity, but also the conversion from the growth and we touched upon that earlier on the previous question on driving to new pricing standards. We are convinced that we will further expand our margins. So no change to that one.

CB

Carsten Bertram executive

Yes. And I mean talking about the revenue growth for the Advanced Therapies, if we can get to high single digit, we have been growing close to 6% during the last years with our current portfolio. So I'm very optimistic that with a brand-new portfolio gaining market share in our current segment, but also with industry partnerships that allow us to move into new adjacent segments, we will be able to get to the high single digits that we also have on the precision therapy side and therefore, be also a strong contributor to the overall target of precision therapy.

MK

Marc Koebernick executive

Graham.

GD

Graham Doyle analyst

Just a question on imaging and then also on Varian. Just on imaging, I think, Jochen, it might be a question for next, but you mentioned 40 basis points or so of margin expansion. But then we think about the tariff kind of unwind, that feels about the same over the next 2 or 3 years. which I'll move to hypofractionation and Varian. How do you expect the landscape to be for like actual linacs in 10 years' time? Do you sell less of that but a lot more software, which seems to be the way things are shifting anyway? And what does that mean for Varian?

AK

Arthur Kaindl executive

So hypofractionation is one aspect. So basically, it's the reduction of the number of treatment cycles that's needed in order to complete a complete care cycle of a patient in radiation therapy. The average number in the U.S., for instance, stands right now at 14 roughly. I personally believe that a decent prostate cancer treatment today should be done in 5 fraction so that driven by imaging and adaptive radiation therapy. We're seeing this trend going down from the average number. You're implying that then there is potentially less radiation therapy systems or linacs potentially needed.

We see a different trend, and the trend is being driven by the fact that more adoption of radiation therapy is happening, working very closely with also the societies here with [ IAEA ] to drive into the low middle-income countries. So as I said in my presentation, we are convinced that the demand for radiation therapy systems will actually go up with rising cancer cases. And then it's also the new indications. So the first osteoarthritis treating centers are popping up now in the United States. It's strong in Germany, for instance, already. So the new indications will also contradict that hypofractionation trend, which we actually support because it's a good thing for the patient.

GD

Graham Doyle analyst

Maybe just a quick follow-up on it. It was more that within radiotherapy, it's been clear for a long time that you can sell software at quite high prices if it adds value. It might be a little bit harder in imaging the model isn't quite the same. So I was just thinking if we go further, is that -- how do you change the business or...

AK

Arthur Kaindl executive

Indeed, our -- we have a stand-alone digital oncology business here, which is a sizable business, a highly profitable business as well. And we're expanding that one as well. The advantage that we're having, we have a strong installed base, I guess I mentioned or at least I showed the number on the slide with 5,000-plus installed systems and more than 200,000 software users each day operating those systems. And then we can expand from there. So we can scale the innovations there. So we're actually expecting that part of the business being accretive to the growth.

MK

Marc Koebernick executive

I think there was actually somebody in the background. We take that chance. That would be the last question for this round.

AH

Andrew Hemming analyst

It's Andrew Hemming from Independent Mines. I was just wondering, as a way of reducing radiation exposure, do you see the potential for MR to be used for minimally invasive procedures?

AH

Andre Hartung executive

Yes, absolutely. And at this year's RSNA, just recently as one of the interventional conferences, we basically introduced a partnership with Cook Medical and interventional MR. And we are just launching the MAGNETOM Free with large bore, 100 centimeter, which because of its low it is very suitable for do as well minimal invasive procedures in there.

That will be a step-by-step development because community needs to kind of get close to it and understand how to do that safely, not in terms of radiation safety, but using a different device. And we will start now with prostate and well, certainly then move beyond. So yes, we absolutely see a big potential of MR in interventional therapy. And maybe just in the light of my colleague here on the, the same is true for radiation therapy planning. MR will play a bigger role there in the future.

AK

Arthur Kaindl executive

And if I can add a 10-second commercial break here. Our IntelliBlate system, the microwave ablation system is currently under CT guidance. And at the same conference when we announced our partnership with Cook for the biopsy side of things for the diagnostic part, we also announced that we will make our Intelliiblate device compatible to the MR system and was very well taken by the community, the interventional oncology community because that's the next step in interventional oncology treatment using MR as well.

MK

Marc Koebernick executive

Great. Thank you. So thanks for all the speakers.

AH

Andre Hartung executive

Thank you so much.

MK

Marc Koebernick executive

We move to our last Q&A session of the day, wrapping up with Bernhard and Jochen on stage again. So please join me.

BM

Bernhard Montag executive

So Marc signals that he expects a wrap-up from and so this is, I think, what you have heard or what I hope you have heard, yes. So we are a clear market leader, driven by innovation leadership. I hope you saw the strong importance of health care AI and you enjoyed Dorin's talk to see also how deeply it is integrated and what kind of a scale we have developed there. You saw the thought process about managing the NCD and how this NCDs and how this is driving our growth. You saw in all of the presentations, the importance of bringing customer relationships to a new level where there's always now a consulting or more and more a consultative selling or selling consulting piece in it.

But in the end, it triggers more stickiness and more relevance of us. You saw from a financial point of view, our midterm growth targets of 6% to 9% in the synergistic core, double-digit earnings growth and robust free cash flows for the group in total. And we talked about the new strategy and new own strategy, own setup, which we give for Diagnostics.

MK

Marc Koebernick executive

Exactly. And I would open directly with Graham. So just get a microphone. I know your question already. Sounds good.

GD

Graham Doyle analyst

My question has been answered. It was just on the margin. So I think you said something like 40 basis points for Imaging earlier and the tariff might be closer to like 40 to 50 if you unwind it over 3 years. So just to understand the relationship between those 2.

JS

Jochen Schmitz executive

Yes. Very straightforward. Thanks for asking the question. Again, by the way, we were not the only one who asked me that question when I walked out there. When we talked about margin expansion from scale, I talked when I said 30 to 40 basis points, I said, I meant underlying margin expansion. So because it's a 4-year horizon.

So we have, according to our assumptions, 2 years where there is no tailwind from tariffs, the outer years, theoretically because we have mitigated them beforehand. That's the plan. And you have 2 years where you have tailwind from tariff mitigation. That means the 40 -- if you say the 40 is the average over the period -- over the 4 years, and you have 2 years where the 40 is not 40, but higher because you have tailwind from tariffs.

GD

Graham Doyle analyst

Very basic part of it. So it could be like you're saying the average is 40 in total.

JS

Jochen Schmitz executive

Underlying 40. underlying -- hope try to understand me. Underlying -- underlying -- and then on top in 2 years, tariff mitigation.

MK

Marc Koebernick executive

That's clear. Yes Oli.

OR

Oliver Reinberg analyst

One question regarding pricing because we heard a lot of innovation, which drove prices. You also mentioned pretty early the 100 basis points you want to achieve in price increases. So just to decompose this figure. On one hand, pricing is used to actively improve margins, for sure, from an underlying perspective. But with 100 basis points regarding tariffs, is it like you want to apply it more on a regional perspective, say, okay, the U.S. introduced the tariffs, so it's more about price increases on top on your U.S. products? Or is it kind of mixed bag?

JS

Jochen Schmitz executive

When we talk about pricing, I think it's important that we differentiate. first of all, and I said that hopefully, clearly enough, we have anyway premium pricing. Innovation brings us premium pricing. That means our an example out of imaging, our high-end CTs have a better price than high-end CTs from our competitors. Always, that is -- this is pricing on the one hand.

And now the question is, how is pricing, our pricing developing over time? That's the next aspect, -- it's a different aspect. And here, I said, we expect that the price development over the next 3 years will be a bit better than we normally think or normally plan for the percentage point I mentioned, which would cater for half of the headwind we have from tariffs. And we will apply this not by just -- by the way, there is no price list out there for a pound CT. This is not -- it is more an internal discussion with our sales force, what prices they can -- or what prices they should try to get into the field for certain products with certain configurations and so on and so on. Therefore, this is not that you can really compare this so easily.

So -- and what I meant is we have, first of all, premium pricing due to innovation, and you hear that all the time when people talking about innovation leadership, premium pricing per se, which is, by the way, also the reason why we have this huge margin data to this -- one of the reasons why we have huge margin data to the second best in class, by the way, one topic of it, not only the scale, but also the pricing. And now the delta of pricing or the development, the dynamic of pricing is a second aspect, again. And here, our plan is over the next 3 years to generate a percentage point better pricing to cater for the tariff impact or for half of the tariff impact.

MK

Marc Koebernick executive

That's a percentage point in 3 years, right?

JS

Jochen Schmitz executive

Over 3 years.

MK

Marc Koebernick executive

0.3 per annum. Just to make that clear again. Yes. Julien.

JO

Julien Ouaddour analyst

I think it's for Jochen or Bernhard actually. You talked about disciplined M&A, so which will obviously remain the norm. We had lots of presentations focusing on partnerships and so on across advanced therapies. But just curious whether in 2 fields, so especially in advanced therapies, where there's an appetite on your side for consumables or devices or starting to move into that category or not at all? And same question on molecular imaging. We've talked a lot about the drugs, the tracers and so on. I know it's a different job, but are you in any way thinking about becoming an IP holder in that space?

BM

Bernhard Montag executive

So I think very important question. And I will give you an answer that both topics are not high on our list. And the reason -- I mean -- and I want to -- so that's the headline, yes. So I want to quantify it. I mean, in the end, on the, call it, consumables on the devices side, I mean, there are companies which are definitely giants, and they know their topic. I'm talking about Medtronic, Boston Scientific, Stryker, Edwards. And an acquisition can only make us a mosquito in that field. So I mean, you know what possibilities there would have been, like Shockwave or what was the other Inari and so on and so on, yes.

So -- and this was -- would destroy to a large extent also our ability to partner because we are then seen as a competitor. So -- and what we also are very mindful of is that the sales model, the go-to-market in this industry is very different. When you look at the feet on the street or the people in the interventional lab, the device companies typically have, it is a category in themselves. I mean they are almost part of performing the procedure. And that whole topic only makes sense when you have a big basket of products. So from that point of view, the clear way forward, is partnering here, sometimes in being open, whatever -- and sometimes when it comes to optimizing a procedure in a way that it's really optimized hand-in-hand in a more exclusive arrangements, but that depends very much on the disease.

I think the only small question mark is where I wouldn't be too less religious is in the field of interventional oncology, where there is not necessarily always a giant who is like in the cardiac space or so or in the field of interventional radiology, where it can make sense and it's a different topic, but this is not a large scale. This is -- this would be more in the tuck-in range.

On the -- on the IP side, when it comes to radiopharmaceuticals, it's a little bit of a similar answer because on the one hand, we also here, we don't want to necessarily become competitors of our customers because basically, we have 2 customers here. I mean the people performing the procedure, but on the other hand, also the IP holders. And then I mean, we want to be focused in what we are doing. And I don't see us as driving a pharma-type discovery pipeline. So -- and I don't really know how that fits to the skills and how that is part of a synergetic core, if you wish.

MK

Marc Koebernick executive

Veronika, do you want to take the chance?

VD

Veronika Dubajova analyst

Excellent. Two questions for me, if that's okay. Jochen, I'm sorry, we're going to go back to margins. The 100 basis points for the precision therapy business, does that include the margin, the tariff reversal? Or does the tariff reversal come on top of the 100 basis points per annum?

JS

Jochen Schmitz executive

First of all, the tariff topic is a bit less pronounced in that field because AT has a significant exposure to it, but it is the smaller piece. So it's anyway a bit less than it is in imaging per se. And secondly, let's go for the 100 basis points first, but I think it's prudent, and we said average. I would also say we should have certain tailwind in the beginning, but let's stick to the 100 basis for now.

VD

Veronika Dubajova analyst

And then my second question is for you, Bernd. Ultrasound, I know we talked about the strategic value of this business back a long time ago when you came to market, obviously, having moved it from one part of the business to another, it's quite easy to work out that you have EUR 600 million of revenues that is effectively making no money today. Just curious how you think strategically how this fits into the business. I know you've touched upon some of the pieces that you think are attractive, but sort of how you think about that? And then maybe longer term, what are the ambitions from your side and maybe also, Jochen, from your side from a financial perspective, whether we can see some better return there?

BM

Bernhard Montag executive

So ultrasound is a bit of a tale of 2 stories, if you wish, because the aspect is that we have a hidden and truly mean it hidden gem in this procedural ultrasound piece, which is where we are a clear market leader. I think it's in the -- probably 2/3 or more of all ultrasound catheters are from us. And this is not an easy business by because I mean this is not only about technology, it's also about manufacturing capabilities.

It's about bringing scale, driving down costs of these consumables where we have strong partnerships with Biocon, Webster and J&J and now also with Boston Scientific. This is super strategic because it fits exactly in what we have been talking about here. And we talked about -- we learned the word LAAC today. When you talk to Mike Mahoney, talking certainly speaks a lot about it. So -- and the whole topic of EP and what role will this technology play when it comes to PFA and so on and so on. So this is a super important topic fits to -- in the other part of ultrasound, we are focusing on some segments only, meaning especially the GI segment, this is general imaging and a bit on cardio or echocardiography, cardiology.

We are not in the OB/GYN space. We are not in the point-of-care space. And this is not necessarily a topic which -- on the one hand, which is not really moving the needle. But it's also -- and it's not an area of the business in which we invest heavily because we say we want to be the player because this is also -- the synergy potential is here smaller. This is not what wins you a value partnership. This is -- happens at very different price points.

JS

Jochen Schmitz executive

And maybe I start with a strange comment. So we make ultrasound double visible relative to beforehand because it is about 10% of precision therapy and it was about 5% of imaging, let's just say. And that means we have a clear plan also to focus this business on where it is profitable. And that is what Bernd described here, the first tail he described.

And I think we are clearly on that path. I think we are also very happy that we could convince or that Boston Scientific is convinced that 4D [indiscernible] might be a very attractive option for [indiscernible], which would then create significant pull-through because the 2D [indiscernible] business is more or less an OEM business. The J&J pulls our stuff into their procedures. And then it's a very nice business for us and for them and so on and so on. And that's how it would work.

And we need to keep -- to make this viable to keep ultrasound, the classical ultrasound box capabilities in-house to make sure that this works. But -- and then we might look into what is there any synergistic stuff left for something else, but we will trim that down towards procedural ultrasound.

VD

Veronika Dubajova analyst

So you'd expect profitability to improve over time?

JS

Jochen Schmitz executive

Yes.

MK

Marc Koebernick executive

Great. I think that's a nice last statement. Improved profitability is always good to end on. So thank you for spending such a lot of time of your life today with us. I hope you found it a useful time spent. And hopefully, we also can ultimately see it as a good investment into the understanding of our strategy and our plan going forward and that we will see it in the share price soon.

Anyway, that said, probably we'll see each other in the next few days or in the next 1.5, 2 weeks at the latest at different events and conferences. RSNA is coming up as well. I think there's several brokers coming there with groups of investors that you haven't already signed up, always worth a visit. to see some of the products that we talked about today. So that's, I think, wraps it up. Thank you for coming. Thank you.

Jun '26		+/- %
Revenue	23,168 23,168	1% 1% 100%
- Direct Costs	14,128 14,128	1% 1% 61%
Gross Profit	9,040 9,040	0% 0% 39%
- Selling and Administrative Expenses	3,871 3,871	0% 0% 17%
- Research and Development Expense	1,950 1,950	0% 0% 8%
EBITDA	4,411 4,411	2% 2% 19%
- Depreciation and Amortization	1,170 1,170	10% 10% 5%
EBIT (Operating Income) EBIT	3,241 3,241	1% 1% 14%
Net Profit	2,212 2,212	2% 2% 10%

Head office	Germany
CEO	Dr. Montag
Employees	73,800
Founded	2017
Website	www.siemens-healthineers.com

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