Brian P. McKeon
Executive Vice President, Chief Financial Officer, and Treasurer at IDEXX Laboratories
Good morning, everyone.
I'm pleased to take you through our fourth quarter and full-year 2021 results and I'll provide an overview of our financial outlook for 2022. In terms of highlights, IDEXX delivered excellent financial performance in Q4, driven by double-digit top-line gains compared to very strong prior-year results. Revenue increased 11% as reported and 10.5% organically, supported by 13% organic growth in CAG Diagnostics recurring revenues. Two-year average annual organic growth for CAG Diagnostic recurring revenues was approximately 17% across US and international regions, consistent with the accelerated two-year growth trends seen throughout 2021.
We achieved record premium instrument placements in Q4 with strong gains across our major platforms, supporting a 14% year-on-year expansion of our global premium instrument base. Strong revenue growth enabled delivery of $1.89 in EPS, up 12% on a comparable basis as we advance planned investments on our commercial and innovation capability. Closure benefits from high organic revenue growth in 2021 drove outstanding full-year financial performance above our long-term goals.
IDEXX achieved 16% overall organic revenue growth for the full year, driven by 18% gains in CAG Diagnostics recurring revenues. Full-year operating margins reached 29%, an increase of 220 basis points on a comparable basis. And we delivered, full-year EPS of $8.60 per share, up 29% on a comparable basis. We're well-positioned to build on this strong financial performance in 2022. We're targeting revenue gains at the higher end of our long-term goals reflected in our outlook for 10% to 12% overall organic revenue growth and 12% to 14% organic growth in CAG Diagnostics recurring revenues. We're also targeting a 50 basis point to 100 basis point improvement in operating margins on a comparable basis building on the strong profit gains through the pandemic, as we continue to invest towards the long-term development of companion animal healthcare globally. Our EPS outlook of $9.27 to $9.59 per share reflects 12% to 16% comparable EPS growth, including an estimated $0.15 per share or 2% EPS growth impact related to higher projected international tax rates.
We'll discuss our 2022 financial outlook later in my comments. Let's begin with a review of our fourth quarter and full year results. Fourth-quarter organic revenue growth of 10.5% was driven by 13% overall CAG gains and 13% growth in our water business. These gains were moderated as expected by a 19% organic decline in LPD revenues reflecting comparisons to high prior-year results that benefited from the ramping of African Swine Fever testing in China, as well as by a $5 million year-on-year decline in human COVID PCR testing revenues. Strong CAG Diagnostic recurring revenue growth reflected 13% organic gains across US and international regions, compared to 21% organic growth levels in the fourth quarter of 2020. Strong Q4 and CAG results were also supported by 21% gains in IDEXX VetLab instrument revenues and 13% organic growth in veterinary software and diagnostic imaging revenues, in addition to benefits from our recent ezyVet acquisition.
For the full year 2021, overall CAG revenues increased 19% organically driven by 18% organic growth in CAG Diagnostic recurring revenues reflecting high gains across our major modalities and regions. Strong US CAG Diagnostics recurring revenue growth in the fourth quarter was aided by solid year-on-year gains in clinical visits and continued positive demand trends which are supporting high levels of clinical revenue growth at the practice level. Same-store US clinical visit growth was 2.2% in Q4, compared to high prior-year growth levels. On a two-year basis, US same-store clinical visits increased at 5.5% with solid gains across wellness and non-wellness categories.
An increased focus on healthcare services including diagnostics supported an 8% same-store increase in overall veterinary clinic revenues in Q4 and nearly 10% gains in clinical diagnostic revenues, which increased 14% on an average two-year basis. Expanding demand for clinical services and benefits from IDEXX innovation and commercial engagement supported a 1,050 basis point premium of IDEXX US CAG Diagnostic recurring revenue growth to US clinical visit growth in the quarter.
In terms of practice level trends, we did see some modest impact from the recent Omicron wave on clinical testing volumes in international regions in Q4 which has continued in early 2022. We've also seen some moderation in clinic visit growth in January in the US, including near-term impacts from higher COVID cases on practice level staffing. We're monitoring these dynamics, which we don't see as indicative of changes in strong underlying demand trends. Globally, IDEXX achieved strong organic gains across our major testing modalities in Q4, resulting in exceptional full-year growth results. IDEXX global reference lab revenues increased 12% organically in Q4, reflecting double-digit gains in the US and high single-digit organic growth in international regions compared to strong prior-year growth levels.
Reference lab gains continue to be driven by solid same-store volume growth including benefits from the expansion of IDEXX 360 program agreements. For the full year 2021, global lab revenues increased 70% organically, reflecting consistent high gains across US and international regions.
IDEXX VetLab consumable revenues increased 15% on an organic basis in Q4, reflecting double-digit gains across US and international regions. Strong consumable growth reflects increases in testing utilization, sustained high customer retention levels, and expansion of our global premium instrument installed base. These dynamics supported 20% full-year organic growth at IDEXX VetLab consumable revenues in 2021.
IDEXX had another quarter of outstanding instrument placements building on this momentum. We achieved 5,258 premium instrument placements in Q4, up 29% from prior-year levels, reflecting robust gains across US and international regions. We achieved strong global placement growth across our major platforms year-on-year with Catalyst up 8%, SediVue up 20% and premium hematology up 72%, supported by the continued global rollout of ProCyte One.
The breadth and quality of CAG instrument placements supported strong gains in our economic value metric. New instrument placements and continued very high customer retention levels drove a 14% increase in our global premium instrument installed base in 2021 setting a foundation for continued strong consumable growth as we move forward.
Rapid assay revenue increased 10% organically in Q4, reflecting continued solid gains in the US aligned with broader increases in demand for diagnostic testing and high growth in international regions. For the full-year 2021, Rapid assay organic revenue growth was 17% supported by high volume gains for canine, 4Dx, feline, and specialty testing.
CAG Diagnostic recurring revenue growth remains primarily volume-driven augmented by moderate net price improvement of approximately 3% in key regions like the US. Looking ahead to 2022, we're planning for net price improvement in the range of 3% to 4% reflecting higher list price increases to reflect higher service costs and continued investment in service quality and product innovation.
In other areas of our CAG business, our veterinary software and diagnostic imaging revenues increased 13% organically and 30% as reported in Q4, including benefits from the ezyVet acquisition. Continued strong gains and recurring software and diagnostic imaging services and high comparable growth in PIMS placements were moderated to a degree by tough compares related to strong prior-year diagnostic imaging placements.
For the full-year 2021 veterinary software and diagnostic imaging revenues expanded to over $200 million, up 15% organically and 27% as reported, as we continue to advance integration of information technology and insight as a key feature of our Diagnostic Solutions.
Turning to other business segments, water revenues increased 13% organically in Q4 compared to flat organic growth in last year's fourth quarter, as this business continues to track back towards pre-COVID growth levels. Business growth was supported by solid gains across compliance and non-compliance testing categories. For the full-year 2021, water revenues increased 12% organically compared to a 2% organic decline in 2020.
Livestock, Poultry, and Dairy revenues decreased 19% organically in Q4 compared to 13% organic growth levels in Q4 of 2020. As expected dynamics in our China LPD business including the lapping of high prior-year demand for African swine fever testing offset growth in other global regions. For the full-year 2021, LPD revenues declined 9% organically, compared to 11% gains in 2020. We're planning for continued challenging year-on-year comparison LPD revenues in the first half of 2022 which is factored into our overall revenue outlook
Turning to the P&L, sustained high revenue growth drove solid operating profit gains compared to strong prior-year levels, as we advance plan investments aligned with our growth strategy. Operating profits increased 8% as reported and 9% on a comparable basis in Q4, driven by continued solid gross profit gains. Gross profit increased 12% in the quarter, reflecting strong revenue growth and a modest overall increase in gross margins.
We benefited from continued high CAG Diagnostic recurring revenue growth, moderate net price improvement, and higher veterinary software margins including including positive impacts from our expanding SaaS customer base. These factors were moderated by business mix impacts from high CAG instrument revenue growth and lower LPD and human PCR revenues.
Operating expenses increased 15% on a reported and comparable basis in Q4. As planned, we saw a relatively higher levels of operating expense growth as we advanced investments in R&D, enhanced our global CAG sales and marketing capability, and integrated the ezyVet acquisition. We anticipate sustaining a relatively higher rate of OpEx growth in 2022, aligned with our strong global growth momentum.
Operating expense investments drove a 70 basis point contraction in comparable operating margins in Q4. For the full-year 2021, our operating margins reached 29%, up 220 basis points on a comparable basis for the year, and up approximately 560 basis points on a comparable basis from pre-pandemic levels in 2019.
We're targeting to build on the strong performance in 2022 as we invest towards the high return, long-term growth potential in our business. Q4 EPS was $1.89 per share including $0.08 per share in tax benefit related to share-based compensation activity. For the full year 2021, EPS was $8.60, up 29% on a comparable basis. Full-year EPS results included $32 million or $0.38 per share in tax benefit related to share-based compensation activity, which provided 360 basis points of effective tax rate benefit.
Foreign exchange effects reduced revenue growth by approximately 1% in Q4, resulting in a $0.02 per share profit impact net of a hedge loss of approximately $500,000. For the full-year 2021, foreign exchange rate changes increased EPS by $0.16 per share, net of foreign exchange hedge losses of $7 million.
Given the recent strengthening of the US dollar, we're planning for a 1.5% FX revenue growth headwind in 2022 with approximately 2% to 2.5% year-on-year growth headwinds in the first half. While previously established hedge positions will mitigate these impacts on profits, our initial 2022 outlook incorporates an estimated $0.08 net unfavorable EPS impact from FX at the rates noted in our press release.
Free cash flow was $636 million for 2021 or approximately 85% of net income reflecting a $120 million in capital spending, including $18 million in real estate purchases. We maintained a strong balance sheet, we ended 2021 with leverage ratios of 0.9 times gross and 0.7 times net of cash with $144 million in cash at the end of the year.
In Q4, we established a new five-year $1 billion revolving credit facility, which provides relatively improved borrowing rates. Our 2022 interest expense outlook incorporates these benefits current forward interest rates and expectations for a net leverage ratio of 1 times next year.
In Q4, we allocated $245 million to repurchase 391,000 shares in the quarter. We plan to continue to allocate capital to share repurchases as part of our financial approach, which is reflected in a projected 1% to 1.5% reduction in our diluted shares outstanding for the full year 2022.
Turning to our 2022 outlook, we're providing initial guidance for reported revenues of $3.5 billion to $3.565 billion. This outlook reflects a targeted organic revenue growth range of 10% to 12%, carryover benefits of approximately 0.5% from 2021 acquisitions, and an estimated 1.5% revenue growth headwind from FX.
Our organic growth outlook reflects an estimated growth range of 12% to 14% for CAG Diagnostic recurring revenues. The higher end of this range aligns with sustaining the strong year-on-year growth trends we achieved exiting 2021 and incorporates additional targeted benefits for a moderately higher net price realization and investments in global CAG sector development.
Our overall organic growth outlook also factors in continued benefits from expansion of our premium instrument installed base and solid growth in our water business. These positive factors are partially offset by expectations for continued year-on-year pressure on LPD revenues in the first half of 2022, and a projected contraction in human PCR testing revenues reflecting our overall strategic growth focus on our core businesses.
Our reported operating margin outlook for full-year 2022 is 29.7% to 30.2% reflecting a targeted 50 basis points to 100 basis points of annual comparable operating margin improvement building on our strong operating margin gains in recent years. We expect operating margin improvement will be supported by solid gross margin gains as we advance investments in our global commercial and innovation capability and ensure high levels of operational business continuity as a priority. We've incorporated anticipated inflationary cost impacts, as well as benefits from relatively higher net price gains in our overall operating margin outlook.
Given exit rates in our opex spending and year-on-year operating profit comparison dynamics, we're planning for operating margin improvements to be primarily driven by gains in the second half of 2022. Our preliminary EPS outlook for 2022 is $9.27 to $9.59 per share, an increase of 8% to 11% as reported.
Our EPS outlook factors in increase in our overall effective tax rate from 17.5% to an estimated 21.5% to 22% in 2022. Approximately 100 basis points to 150 basis points of this increase relates to projected impacts from international tax changes. We're also projecting lower tax benefits from share-based tax compensation activity. Our EPS outlook reflects projected 2022 stock-based compensation tax benefits of $10 million or approximately $0.12 per share compared to high realized 2021 tax benefits of $32 million or $0.38 per share.
As noted, we've also incorporated an estimated year-on-year negative impact of $0.08 per share from FX, net of established hedge positions. Adjusting for these factors, our outlook is for EPS growth of 12% to 16% on a comparable basis, including an estimated $0.15 per share, approximately 2% EPS growth impact from international tax rate changes.
Our 2022 free cash flow outlook was for a net income to free cash flow conversion ratio of 75% to 80%. This reflects estimated capital spending of $180 million or approximately 5% of revenues, including $50 million related to a new warehouse and manufacturing site expansion aligned to support our high growth.
Adjusting for this major project, our normalized net income to free cash flow conversion ratio is aligned with our longer term 80% to 90% targets.
That concludes our financial review. I'll now turn the call over to Jay for his comments.