Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex
Thank you, Larry, and good morning everyone. It's a pleasure to speak with you today. We are delighted with our second quarter performance, which exceeded the outlook we provided on the first quarter earnings call reflecting the company's resilient base business and innovative growth drivers, obsessed by varying degrees of COVID-19 challenges on a global basis. The majority of our global product families witnessed constant currency growth over the second quarter of 2019. As anticipated, we witnessed improvements in underlying utilization trends for the product categories most impacted by the postponement of non-emergent procedures. Most notably Interventional Urology, Interventional, and Surgical. We are encouraged with UroLift as momentum continues to build driving 26.0% constant currency revenue growth as compared to the first quarter of 2021. During the second quarter, our Americas, Asia, and OEM segments performed well with constant currency revenues growing over 2019 while EMEA is now back to 2019 revenue levels.
As we anticipated, Americas and Asia continue to recover more quickly than EMEA. Although uncertainties with COVID-19 remain, we continue to anticipate that our revenue performance will improve as we move through the remainder of 2021. For the second quarter, operating margin showed gains over 2020 and 2019 in comparable periods and was driven by gross margin and disciplined expense control. Our continued progress in margin expansion in 2021 has allowed us to increased directed investments towards growth drivers, which is an important component of our long-term strategy to enhance durable growth. Given the strength of the second quarter results, we are maintaining our constant currency revenue guidance, which now includes a $28 million to $32 million sales headwind from the June 28 initial close of the respiratory products divestiture that was not included in our prior guidance. Based on our outlook for the second half of 2021 and our margin improvement in the second quarter, we are increasing our 2021 earnings per share guidance to a range of $12.90 to $13.10 from a previous guidance of $12.65 to $12.85. We continue to execute our strategy to drive durable growth with investment in organic growth opportunities, margin expansion and deployment of capital for M&A.
Turning now to a more detailed review of our second quarter results:
Second quarter revenue was $713.5 million, an increase of 21% year-over-year on a constant currency basis and 6.8% over the comparable period in 2019. The year-over-year increase was driven by contributions from Interventional, Anesthesia Surgical, and Interventional Urology offset by unfavorable year-over-year comparisons due to higher demand for our Vascular Access and respiratory products in Q2 2020 associated with COVID-19. We are also pleased with our second quarter gross and operating margins with sequential improvements over Q1, strong performance. Q2 adjusted an operating margins set new high watermarks for Teleflex as a pure play medical device company, an encouraging sign for our longer-term profitability objectives. Second quarter adjusted earnings per share of $3.35 increased 73.6% and exceeded our internal expectations. The earnings outperformance reflects the recovery in healthcare utilization during the second quarter coupled with improved volume, modest price increases, and prudent operating expense management.
Overall, I am very happy with our second quarter financial performance, which demonstrate the importance of our diversified global product portfolio while also reflecting progress towards our longer-term margin aspirations.
Turning now to a deeper look at revenue results:
I will begin with a review of our reportable segment revenues and unless otherwise noted, the growth rates I will refer to are on a constant currency basis. Americas revenues were $414.8 million in the second quarter, which represents 31.8% growth year-over-year and 10.8% over the comparable period in 2019. Growth was driven by a rebound in procedures following the disruption of COVID earlier in the year, with particular strength in Interventional Urology, Surgical, and Interventional.
EMEA revenues at $157.1 million increased 8.4% year-over-year and was flat over 2019 levels. EMEA benefited from a favorable COVID related comparison as procedures improved year-over-year as countries across the region continued to open up.
Turning to Asia, revenues were $80.6 million, increasing 10.3% year-over-year and consistent with the performance seen in the first quarter of 2021. Asia was up 1.7% as compared to 2019. Importantly, we saw solid double-digit growth in China and high single-digit growth in Japan, more than offsetting declines in Southeast Asia.
And lastly, our OEM business, which accounts for roughly 9.0% of total sales increased 6.9% year-over-year to $61.0 million in the second quarter, OEM was up 6.0% as compared to the comparable period in 2019. Following a 17.1% decline in the first quarter of 2021, the business witnessed a rebound as customers stepped-up orders on signs of increasing health care utilization. We continue to expect a sequential improvement in growth through the second half of 2021, driven in part by incremental capacity.
Let's now move to the discussion of our second quarter revenues by global product category. Consistent with my prior comments regarding our reportable segments, commentary on global product category growth will also be on a constant currency basis. As a reminder, there were no meaningful differences in year-over-year, selling days in the second quarter.
Starting with Vascular Access, second quarter revenues decreased by 2.1% to $167.7 million although we are facing difficult year-over-year comparisons in Vascular Access due to the higher demand experienced in Q2 2020 associated with COVID-19, the performance of our innovative products remained strong. Our peak portfolio performed well with over 30% growth year-over-year. We continue to invest behind our differentiated peak portfolio and continue to expect share.
[Indecipherable] was also strong in the second quarter, with growth of 15.5% year-over-year.
Moving to Interventional, second quarter revenue was $112.1 million, which rose 30.9% year-over-year. The increase was due to a recovery in certain non-emergent procedures on a year-over-year basis. MANTA our unique large bore closure device grew 160% year-over-year, which keeps us well positioned to reach 8% share in 2021 out of a 200 to 300 million market opportunity.
Turning now to Anesthesia, second quarter revenue was $95.4 million, up 38.8% year-over-year. Z Medica contributed roughly 60% of the growth as the business continues to track to our $60 to $70 million revenue expectation for 2021, partly offset by lower sales of tracheostomy products. Excluding FX and the Z Medica acquisition underlying growth for Anesthesia in the second quarter was approximately 16% year-over-year. The integration of Z Medica is going very well and we are pleased with the progress we are making.
In our Surgical business revenue was $98.2 million, representing 39% growth year-over-year. Increase in revenues was driven by sales of our metal and polymer ligation clips and instruments as elective surgical procedures continue to recover.
For Interventional Urology, second quarter revenue was $92.2 million, an increase of 129.4% year-over-year and 35.6% over the second quarter of 2019 reflecting a move back towards more normalized growth. We are encouraged by the business trends with physicians remaining engaged in the use of UroLift in all care settings and patients increasingly seeking treatment for symptoms of BPH. Our DTC momentum remains solid and we remain comfortable in our 30% plus revenue growth objective for UroLift in 2021. And finally, our other category, which consists of our respiratory and urology care products declined by 9.9% to $86.9 million. The decline reflects difficult comparisons from the prior year related to COVID associated respiratory product demand in Americas and EMEA. That completes my comments on second quarter revenue performance.
Turning to some clinical and commercial updates: In the second quarter, we trained 118 urologists and remain on track to achieve our target to train 450 to 500 urologists in 2021. We continue to execute on our 2021 DTC program. For this year's campaign, we are optimizing our network selection refreshing the ads and working in conjunction with social media campaigns to augment the overall impact. Given the positive awareness from the DTC campaign, we have decided to make incremental investment in the second half of 2021 to tap into this under-penetrated market. We view DTC as a multi-year cavet for UroLift in the US as we are still in the very early innings of market adoption and patient awareness indeed UroLift is leading the way in minimally invasive treatment of BPH. And this is the first time in recent years that a BPH brand is reaching patients directly in a meaningful way. Turning now to UroLift 2 we are in a full rollout in the US, which is consistent with our timing expectations.
We continue to anticipate that the vast majority of physician customers will be converted to UroLift 2 by the end of 2022, paced by advantages in Visualization, reduced storage space, and increased manufacturing capacity we remain positioned to generate significant margin expansion as the revenue base is fully converted. Regarding Japan, we remain on track reimbursement decision in 2021 and view the approximate 2 billion addressable market as an incremental growth driver, that will be a positive catalyst for the foreseeable future. Our submission was not reviewed at the July MHLW meeting and we now expect a review in September with a launch in the fourth quarter of 2021. There is no change to our expectation for UroLift revenues in Japan to ramp up beginning in 2022 with modest contribution in 2021. On the US reimbursement front CMS published its proposed physician fee schedule for calendar 2022 on July 13. The proposed reimbursement rate for UroLift in the physician office setting were reduced by 19% to 21% year-over-year.
A couple of other points I want to make: First, the proposed payment reductions to office based procedures would not go into effect until January 1, 2022 and therefore do not impact our 2021 outlook. Second, the proposed reductions were broad-based across a range of office based procedures in a variety of surgical specialties and to not specific to UroLift. Third, we continue to view the strength of our clinical data, including the LIFT pivotal trial and real world studies as a differentiator versus other BPH treatment modalities and a driver of UroLift adoption between.
Our next steps: Teleflex will engage with key stakeholders during the public common period to reiterate the benefit of UroLift for the treatment of BPH. We would hope that CMS recognizes the importance of maintaining patient access to safe, effective, and less invasive procedures including UroLift in lower cost settings such as the physician's office.
We anticipate the final rules will be published during the fourth quarter 2021 separately, CMS published the proposed outpatient prospective payment system rates on July 19, these rates cover up facility payments for UroLift in the hospital outpatient and ASC settings in this case the proposed payments for UroLift increased by 3% approximately for 2022 versus 2021. investors familiar with Teleflex will know that approximately two-thirds of UroLift revenues are generated in the ASC and outpatient settings.
Turning to the next slide on a clinical update for UroLift: On July 9, the largest US Medicare and commercial claims analysis a full BPH procedures was presented at the European Association of Urology meeting. The study, which included reimbursement claims from 2015 to 2019 evaluated Surgical retreatment and post-operative complications endured by patients who underwent TURP, GreenLight laser Rezum and UroLift procedures. At 4 years after the index procedure Surgical retreatment rates were comparable for UroLift TURP and GreenLight laser and highest for Rezum, also at 300 days post-treatment overall complication rates were lowest after UroLift while Rezum had the highest rates these statistically significant results demonstrate the efficacy of UroLift as compared to other therapies for the treatment of BPH in real world settings. We will continue to bolster our body of clinical evidence, which should help to sustain UroLift as the leading minimally invasive procedure to treat BPH and address a multi-billion dollar global market opportunity.
Now, I will provide some background under respiratory divestiture: Consistent with our strategy to drive durable growth and disciplined portfolio review process, we completed the initial phase of the divestiture of a significant portion of our respiratory products to Medline Industries on June 28, the transaction generated $286 million in cash, $12 million in working capital, not transfered to Medline. As noted previously, the product lines that were divested generated $139 million in revenues in 2020. Looking forward, with the divestiture of the respiratory assets will improve our organic growth rate and margins over time and better positions us for internal resource allocation and a focus on our key growth drivers.
That completes my prepared remarks. Now I would like to turn the call over to Tom for a more detailed review of our second quarter financial results. Tom?