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S&P 500   4,967.23
DOW   37,986.40
QQQ   414.65
How major US stock indexes fared Friday, 4/19/2024
Stock market today: Tumbling tech stocks drag Wall Street to the finish line of another losing week
American Express profits jump 34%, helped by jump in new customers, higher spending
American Express, Fifth Third rise; Netflix, PPG Industries fall, Friday, 4/19/2024
Intuitive Surgical Stock Can Trend Much Higher This Year 
3 Magnificent Seven Stocks Outperforming the Rest
Bargain Hunting: 3 Stocks With RSIs That Scream Oversold
S&P 500   4,967.23
DOW   37,986.40
QQQ   414.65
How major US stock indexes fared Friday, 4/19/2024
Stock market today: Tumbling tech stocks drag Wall Street to the finish line of another losing week
American Express profits jump 34%, helped by jump in new customers, higher spending
American Express, Fifth Third rise; Netflix, PPG Industries fall, Friday, 4/19/2024
Intuitive Surgical Stock Can Trend Much Higher This Year 
3 Magnificent Seven Stocks Outperforming the Rest
Bargain Hunting: 3 Stocks With RSIs That Scream Oversold
S&P 500   4,967.23
DOW   37,986.40
QQQ   414.65
How major US stock indexes fared Friday, 4/19/2024
Stock market today: Tumbling tech stocks drag Wall Street to the finish line of another losing week
American Express profits jump 34%, helped by jump in new customers, higher spending
American Express, Fifth Third rise; Netflix, PPG Industries fall, Friday, 4/19/2024
Intuitive Surgical Stock Can Trend Much Higher This Year 
3 Magnificent Seven Stocks Outperforming the Rest
Bargain Hunting: 3 Stocks With RSIs That Scream Oversold

Henry Schein Q2 2022 Earnings Call Transcript


Listen to Conference Call View Latest SEC 10-K Filing View Latest SEC 10-Q Filing

Participants

Corporate Executives

  • Graham Stanley
    Vice President of Investor Relations and Strategic Financial Project Officer
  • Stanley M. Bergman
    Chairman of the Board and Chief Executive Officer
  • Ronald N. South
    Senior Vice President, Chief Financial Officer

Presentation

Operator

Good morning, ladies and gentlemen, and welcome to Henry Schein Second Quarter 2022 Earnings Conference Call. At this time, all participants are in a listen-only mode. Later we will conduct a question-and-answer session. [Operator Instructions] As a reminder, this call is being recorded.

I would now like to introduce your host for today's call. Graham Stanley, Henry Schein's Vice President of Investor Relations and Strategic Financial Project Officer. Please go ahead. Graham.

Graham Stanley
Vice President of Investor Relations and Strategic Financial Project Officer at Henry Schein

Thank you, operator. And my thanks to each of you for joining us to discuss Henry Schein's financial results for the second quarter 2022. With me on the call today are Stanley Bergman, Chairman of the Board and Chief Executive Officer of Henry Schein; and Ron South, Senior Vice President and Chief Financial Officer.

Before we begin, I'd like to state that certain comments made during this call will include information that is forward-looking. As you know, risks and uncertainties involved in the company's business may affect the matters referred to in forward-looking statements. As a result, the company's performance may materially differ from those expressed in or indicated by such statements. These forward-looking statements are qualified in their entirety by the cautionary statements contained in Henry Schein's filings with the Securities and Exchange Commission and included in the Risk Factors section of those filings.

In addition, all comments about the markets we serve, including end market growth rates and market share are based upon the company's internal analysis and estimates. Our conference call remarks will include both GAAP and non-GAAP financial results. We believe the non-GAAP financial measures provide investors with useful supplemental information about the financial performance of our business, enable the comparison of financial results between periods where certain items may vary independently of business performance and allow for greater transparency with respect to key metrics used by management in operating our business.

These non-GAAP financial measures are presented solely for informational and comparative purposes and should not be regarded as a replacement for corresponding GAAP measures. Reconciliations between GAAP and non-GAAP measures can be found in the supplemental information section of our Investor Relations website and in Exhibit B of today's press release, which is also available in the Investor Relations section of our website. The content of this conference call contains time-sensitive information that is accurate only as of the date of the live broadcast, August 2, 2022. Henry Schein undertakes no obligation to revise or update any forward-looking statements to reflect events or circumstances after the date of this call.

Lastly, this quarter we have also prevent prepared a presentation summarizing our second quarter financial results. This can also be found in the Investor Relations section of our website. Please limit yourself to a single question and a follow-up during Q&A.

And with that, I'd like to turn the call over to Stanley Bergman.

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

Thank you, Graham. Good morning, everyone and thank you all for joining us. Today we are pleased to report record second quarter financial results that reflect the good underlying momentum in the business and execution on our strategies. Sales were particularly strong in our technology and value-added services businesses and our medical businesses. Although there were some near-term headwinds in the quarter due to COVID infection rates among other factors, our solid operational execution this quarter and our results demonstrate the strength, the underlying strength of the business.

In June, we saw COVID-19 infection rates which we believe contributed to -- so there was rising COVID-19 infection rates which we believe contributed to a decline in patient traffic. This is particularly so in our Dental business. We expect patient traffic to increase again when the infection rates moderate, and this is to some extent quite regional. While we are maintaining our full 2022 full year guidance for EPS for 2022 and that's the guidance range of $4.75 to $4.91, we are adjusting our expectations for full-year sales growth to reflect changes, which include continued strengthening of the U.S. dollar and declining demand for COVID-19 test kits.

The company's management team is laser-focused on executing our above plus one 2022 to 2024 strategic plans priorities, thereby providing our customers with an exceptional experience delivering differentiated solutions that make our customers practice most -- practices most successful and improved patient outcomes, leading to delivery of our financial goals as we've set out in 2022 to 2024 strategic plan. We believe that the long-term trends across our end markets, provide a solid platform for us to deliver on our goals.

In short, Henry Schein remains well positioned to deliver consistent sustainable profit growth and to create value for our shareholders as we have for almost 28 years as a public company. Before we turn to our business update and the progress we have made in executing on our strategic growth initiatives, I would like to touch on macroeconomic challenges in general and discuss Henry Schein's ongoing efforts to be best positioned to succeed in this dynamic environment that we're now living through.

First, concerns with the potential economic downturn. Given the Henry Schein's broad portfolio of medical, dental products and services, we are an important partner to healthcare providers treating the patients and keeping communities healthy. The market Henry Schein serves have weathered past slowdowns quite well. During the challenging economic times, consumers continue to need services from office-based healthcare practitioners. It's both medical and dental and from the alternate healthcare sites that we service.

That said, we are working to mitigate the future impact of any potential economic slowdown on our key stakeholders including advancing efficient and low-cost supply chain solutions and practice management solutions in general, such as patient demand generation services and generally, those services that can help the practitioner operate a more efficient practice, so that they can provide the best clinical care for their patients.

We are announcing today a restructuring plan that is focused on funding the priorities of our strategic plan. In other words, moving resources to the areas we want to focus on, but at the same time, streamlining operations and other initiatives to increase efficiency. Ron will speak more about this topic in a moment. Second, we continue to work with our suppliers to limit the impact on inflation on price increases for products suppliers as well as the cost of transportation of those goods.

During the second quarter, we estimate the price inflation for non-PP&E merchandise from brand and manager -- managed manufacturers have ticked up to approximately 3%. It could in fact be slightly lower. We've, I think, done a good job working with our manufacturers on this and inflationary impact on equipment sales in other words not other than non-PP&E merchandise, the impact of inflation on our equipment sales was relatively insignificant, because on PP&E significantly down because of the deflation in global prices.

When customers express price concerns, we believe that given the breadth of our offering we are typically able to provide a lower cost national brand solution or corporate brand alternative allowing us to maintain our margins, but also helping our customers deal with inflation, so with the impact of inflation on their practices. So third, while global supply chain pressures have been relatively stable over the past three quarters, our product portfolio, which we believe is the industry's broadest once again affords us a competitive edge as is more easily -- as it more easily enabled substitutions when a particular product or brand is in short supply.

We continue to expect that supply chain issues for traditional equipment will impact sales through the year-end. That said, the situation appears to be stable and probably improving but some of our suppliers, particularly on the traditional side will be stand expand capacity and are now providing us with much better service than 3 or 4 months ago and, let's say, better service and talking about on fill rates. Our strong order book on the equipment side across the board, actually in all product categories globally, and backlog continues to grow and do well, supports good equipment sales over the next few quarters.

Henry Schein is well positioned to manage rising interest rates, our low level of borrowings means that our interest expense is not significantly affected by interest rate changes. And at the same time, most of our current debt is at a fixed interest rate. The primary area of our business that could be impacted is dental equipment as those purchases are typically finance. Having said that, it's important to bear in mind that interest rates are still relatively low from a historical context and equipment order book remains strong and is tending to get stronger.

Last, regarding -- last of our macro trends, regarding the shortage of labor and skills, Henry Schein has always been an attractive place for talent to build a career. The team Schein values and philosophy is an attractive place for talent. Of course, we are continuously evaluating supporting our pool of human capital to make sure we retain our existing personnel while attracting those skills we need. We believe our internal talent pool is better than ever and will be instrumental in Henry Schein executing on our growth plans.

Talking about growth plans and strategic plan addresses, how we will stay ahead of the fundamental shift affecting our customers is a significant amount of change taking place in the dental and medical professionals -- professions and we are addressing these plans through our strategic -- these dynamics through our strategic plan. These plans include the goal to accelerate the adoption of digital technology, not only within the company, but also helping our customers digitalize and it's a great pressure on our customers to digitalize their practice.

And we are providing excellent handholding consulting services, and of course an excellent offering of digital products to help our customers advance the digitalization of the practices. So in this connection, yesterday we announced three new senior executive strategic roles designed to further enable us to fill our strategic plan. We are forming three new teams led by experienced leaders, actually exceptional leaders, who will work together to advance digital technology to create an exceptional customer experience with Henry Schein and accelerate the development of new and complementary technologies and platforms, of course, as I noted, to drive efficiency in our customers' practices while positioning them to provide better quality of care, but at the same time also to drive efficiency within Henry Schein.

We expect this will enable our sales team and customers to collaborate together to have honest this technology. These three teams we've set up each one led by an outstanding executive will enable our sales teams to provide even better connectivity to our customers as our customers go through this massive change in running their practices driven through digitalization. Okay. Management systems and of course the clinical support.

The first is Leigh Benowitz, who has been named Senior Vice President and Chief Global Digital Transformation Officer Leigh, the member of our executive management cabinet committee report -- is reporting to Chris Pendergast, our Chief Technology Officer. Leigh will be responsible for enabling the delivery of digital sales by developing our e-commerce infrastructure capabilities and will continue to lead the implementation of our global e-commerce platform, GEP, which is well underway and Leigh has played a key role in getting us to where we are and will lead us to the successful implementation of GEP. Leigh is a terrific executive.

There is a press release that was issued this morning talking about Leigh and Ronald will speak about in a minute. And another press release about Mark Hillebrandt and I think you'll read those and you will understand why these three executives are so important to the future of Henry Schein and at the same time, appreciate what they've done and what they're going to do. The second is Trinh Clark, who has been named Senior Vice President and Chief Global Customer Experience Officer, also a member of our Executive Management Committee and Trinh reports to Brad Connett, CEO of our North American Distribution Group.

Trinh will be responsible for designing, developing and implementing a consistent customer experience and brand marketing strategy globally. Well, the strategy is to a large extent are developed and print, we'll take them down too much more detail and be responsible for implementation and working with the entire organization on driving consistent customer experience, branding of course given the change in the environment from a technology point of view. And Trinh will also continue to lead our technology enablement and strategic marketing teams in North America.

And finally, Mark Hillebrandt has been named Vice President and Chief Digital Revenue Officer also reporting to Brad. Mark will be responsible for engaging customers online through our e-commerce platform to drive digital transactions, while also securing a healthy pipeline of digitally sourced teams lead -- sorry, digital source leads and new prospects to be delivered to our field sales organization.

Mark has done a pretty -- has done a very good job in setting us up with respect to digital leads, making shopping experience from a digital point of view much better. And in that context, working closely with our sales organization and in the end are responsible for driving sales and through our consultative selling methodology, that's worked so well for the company.

We're also making very good progress on our one distribution strategy contained announced strategic plan. In other words operated operationalizing one distribution dental medical. In May, we announced the appointment of Dirk Benson as Chief Commercial Officer of our North American Distribution Group. Dirk joined Henry Schein following distinguished career with Medline Industries, also reporting to Brad Connett, Dirk is responsible for the entire dental and medical distribution groups, customer facing organization in the U.S. focused on helping us to advance our goal of exceptional customer experience, increased efficiency in sales growth in these businesses.

So that's a little bit about the implementation of our strategies. So let me pivot a little bit now to suit provide some color on the performance of each of our business units. Starting with our dental distribution business. The second-quarter growth in our global dental business once again was driven by strong global equipment sales as dentists continuing to invest in their practices, consumable merchandise internal sales growth in local currencies excluding PP&E and COVID-19 related products, and Ron will give specifics, was impacted by an increase in patient appointment cancellations and staff shortages, which we believe were related to COVID-19 infection rates.

Lower sales of PP&E products in the quarter were mainly a result of the decline in glove prices. Glove prices reached a peak at the end of the second quarter 2021 and have been coming down inflation. And so, we expect pricing will continue to be a headwind for the next quarter or two, albeit to a much lesser extent. So we had these two factors taking place in the second quarter, impacting our dental distribution, internal growth, internal growth rates. One, of course was the appointment cancellations and staff shortages. And the second is deflation with respect to glove prices.

Now, internal sales growth in our North American Dental equipment business, as noted earlier, reflects continued demand in both traditional and digital restoration categories of both of them. Our equipment results also benefited from sales to some of our larger DSO accounts, we expect will continue to be investing in their practices. And as I noted earlier, our equipment order book remains solid. Our international equipment sales were strong too similar trend.

Two fast-growing areas in digital dentistry, digital restorations and the traditional scanners, Chairside CAD/CAM, etc., and rapidly growing new area which is 3D printing. Based on significant business investments we have made in both of these areas over the years and our strong relationship with our suppliers, we believe we offer our customers a differentiated digital product offering across multiple brands and we expect these categories will continue to grow well for us into the future.

We have of course a goal of continuing to expand our geographic footprint and we recently announced the acquisition of Condor Dental, Condor Dental services general practitioner specialists and laboratories in Switzerland, the one market we don't have a strong general presence although servicing in dental market since 2004 through camalog our leading oral surgery business and kind of dental expands our presence in this market with a full service dental distribution offering.

Now turning to Dental specialty and technology value-added services. I'd like to touch upon the progress we're making with our goal of building complementary high growth, software services and specialty products and the shift in our corporate profit contribution to these higher margin products. We are -- we have invested in good properties. We expect to continue to invest heavily in this area. We have great management teams and are very enthusiastic about the potential.

So our high margin technology value-added services, especially products are growing at a good pace and now represent about 40% of our total sales, but more important 36% of our total operating income. Of course, there is no way to determine exactly which quarter these numbers will go up, but we are quite confident that we have a team in place that will drive these high-margin businesses with demand products towards a greater percent of our operating income.

So if we just look at the sales of our dental specialty products. They were very solid during the second quarter and we're driven by biohorizons are all surgery products in North America. This was partially due and by the way, in Germany, which is a big market for us in the implants, coverage was quite serious in the third and second quarter, but actually seems to have picked up again in July. This was partially due so biohorizons growth was partially due to the growth of our national DSO customers, but also across the customer landscape, including mid-size and smaller practices as we are seeing implants becoming adopted as a standard procedure overall dental care.

And I think we had outstanding marketing material salesforce and of course, backed up with great products. So we expect this trend to support continued growth. In this connection, we are pleased to announce the partnership between by BioHorizons and Camalog and also sell on the [Indecipherable] plus tissue membrane. This product has demonstrated positive qualities for tissue regeneration and we are excited to be able to further differentiate our offering in this area to our customers. BioHorizon and Camlog have exclusive global rights to this product in the dental field and a long-term supply agreements with cell and we expect to launch the product towards the end of the third quarter.

Within our endodontic products offering, we showed good growth and have been quite successful and actually quite excited with our recently launched EdgePRO irrigation laser. In the second quarter, we had good new consol sales and we're starting to see sales of consumables from our first placements in the first quarter, but it's good to see the positive feedback from customers and how will this product is being received in the marketplace. We're very, very excited about this technology.

Our priority in the orthodontic business is the Reveal clear aligner product. Sales in wires and brackets were not very strong in the second quarter. I think this is a market issue. Having said that, we've had quite a bit of success with our Reveal clear aligner product, specifically in the DSO market. The launch of our Studio Pro 4.0 software is giving the Reveal aligner business quite a boost. So we remain quite enthusiastic about our three specialty areas that is oral surgery implants bone regeneration products, our endodontic business and our orthodontic business, specifically as it relates to the Reveal clear aligner offering.

So now technology value-added services. We are pleased with the growth in our technology and value-added services businesses. Once again North America and international sales increased by double-digit percentages. Henry Schein One sales growth accelerated compared to the prior-year growth and we are seeing healthy demand from our national DSO accounts for these solutions, but also I might add for the Dentrix Ascend and entirely cloud-based solutions. Some are going into DSOs but general reception from GPs and specialists, small and mid-sized practices is also very good. Both the same and entirely showed solid increases in the number of users. In fact, one, Henry Schein One added more than 400 new cloud customers during the second quarter. Meanwhile, our total number of cloud customers is up 20% over the past 6 months, which demonstrates good momentum in this part of the business, again the movement of digitalization towards the cloud. We continue to invest in product development and customer service, and these impact -- these investments that impact the second quarter margins, we believe these investments are providing a solid growth driver for the business.

There are other services in this area that we report on financial services, a number of other publication services etc., but we are particularly pleased with the performance of ESS revenue cycle management solution that we acquired last June, a great complement to the business. In fact, helping our field sales consultants provide better consulting services, more relevant consulting services to our customers on the dental side.

Turning to our Medical business, this business has performed well over many years and again had another excellent quarter with double-digit internal growth in local currencies when excluding PP&E and COVID-19 related products. During the second quarter, we had strong sales in point-of-care diagnostic tests including flu tests as well as generic drugs and equipment, which is all a good sign. Patient traffic was bolstered by higher numbers of visits for seasonal influenza, which is a departure from prior years when the flu season typically ends during the first quarter. Surgical centers are still not up to where they were pre-COVID, but I think we're moving in the right direction. Having said that, the rest of the business is very solid in the medical arena. So with that overview of our business and the environment that we operate,

I will now ask Ron for a more detailed review of our financial results. Thank you. Ron, please.

Ronald N. South
Senior Vice President, Chief Financial Officer at Henry Schein

Thank you. Stanley and good morning, everyone. Turning to our second quarter financial results. Total net sales for the second quarter of 2022 are $3.0 billion, reflecting growth of 2.1% compared with the prior year period. Internally generated sales in local currencies, which I will refer to with LCI increased 2.4%. When excluding sales of PPE and COVID-19 related products, our LCI growth was 6.7%.

As Stanley mentioned, prices for PPE products and specifically for gloves increased last year due to market volatility and supply chain disruptions. More recently, prices of gloves and COVID 19 test kits have declined. This pricing volatility combined with the strong prior-year sales comparison is driving a year-over-year decline in sales of PPE and COVID-19 related products. Additional details of sales performance are contained in Exhibit A in our earnings press release issued earlier today.

Operating margin for the second quarter of 2022 was 7.27%, representing an 18 basis point improvement compared with prior year GAAP operating margin. When compared with the prior year and non-GAAP results, operating margin improved by 6 basis points. Operating margin improvement was due to gross margin expansion, mainly as a result of an increase in sales of higher margin products. This was partially offset by higher operating expenses as a percent of sales, which grew as a result of increases in payroll and travel since our operations have generally returned to normal this year.

Turning to taxes. Our effective tax rate for the second quarter of 2022 was 23.8%. This compares with an effective tax rate of 23.4% for the second quarter of 2021 on a GAAP basis and 23.2% on a non-GAAP basis. GAAP net income attributable to Henry Schein Inc for the second quarter of 2022 was $160 million or $1.16 per diluted share. This compares with prior year GAAP net income of $156 million or $1.10 per diluted share and prior year non-GAAP net income of $157 million or $1.11 per diluted share.

Amortization from acquired intangible assets for the second quarter of 2022 was $31.3 million or $0.14 per diluted share. This compares with $30.1 million or $0.13 per diluted share for the same period last year. Foreign currency exchange negatively impacted our second quarter diluted EPS by approximately $0.03 versus the second quarter of last year and at the current foreign exchange rates, we expect the impact to be more pronounced in the second half of the year as compared to the first half of the year.

I'll now provide some detail on our second quarter sales results. Global dental sales of $1.9 billion declined 3.1% compared to the same period last year. With LCI sales down 0.3%. LCI sales growth excluding PPE and COVID-19 related products was 3.5%. Global Dental Consumable merchandise LCI sales declined 2.2%, but when excluding sales of PPE and COVID-19 related products, they increased 0.4%. Global dental equipment LCI sales growth was 7.0%.

North American Dental LCI sales declined 1.1% compared to the prior year, primarily due to consumable merchandise LCI sales declining 3.5%. However, when excluding sales of PPE and COVID-19 related products, North American Dental Consumable merchandise LCI sales increased 2.2%. Consumable merchandise sales were impacted by lower patient traffic during the quarter, offset by price inflation. North American Dental Equipment LCI sales increased 8.1% compared with the second quarter of 2021 with good performance in both traditional and digital restoration categories.

International dental LCI sales growth was 1.0% compared with the second quarter of 2021 driven by equipment LCI sales growth of 5.5%. The growth in equipment LCI sales was partially offset by a 0.3% decrease in international dental consumable merchandise LCI sales. However, these sales increased 2.7% when excluding sales of PPE and COVID-19 related products.

Lower patient traffic, which we believe is a result of higher COVID-19 infection rates, resulted in lower consumable merchandise sales in parts of Europe and in Australia and New Zealand, as well as China because of the required lockdowns and were offset by double-digit sales growth in Brazil. Our equipment backlog at our North America and international businesses remained strong.

Sales of Dental Specialty products were approximately $242 million in the second quarter with LCI growth of 6.6% compared with the prior year. Growth was particularly notable in North America for oral surgery products consisting of implants and bone regeneration robotics. Technology and Value Added Services sales during Q2 were $181 million, an increase of 18.1% compared with the prior year including LCI growth of 10.8%.

In North America, technology and value-added services LCI sales growth was 10.4%. This growth was broad based with particular strength in our practice management business including Dentrix and Dentrix Ascend. Internationally, technology and value-added services LCI sales increased 13.4% compared with the prior year driven by performance in the United Kingdom.

During the second quarter, our technology and value-added services businesses together with our dental specialty products achieved total sales growth of 9.0% and LCI sales growth of 8.2%, slightly lower than our goal of double-digit growth for the full year. Global medical sales during the second quarter of $1.0 billion grew 10.3% compared to the same period in 2021. With LCI sales growth of 6.7% led by growth in point-of-care diagnostics. We sold approximately $68 million in COVID-19 test kits in the second quarter of 2022 including both the flu and COVID-19 combination tests.

This compares with approximately $75 million in test kit sales in the second quarter of 2021. We expect continued volatility in sales of test kits for the remainder of the year. Excluding sales of PPE and COVID-19 related products, Global Medical LCI sales increased 13.6% compared to the second quarter of 2021. Regarding stock repurchases, we repurchased common stock in the open market during the second quarter buying approximately 1.3 million shares at an average price of $81 or $0.42 per share for a total of $110 million. The impact of the repurchase of shares on our second quarter diluted EPS was immaterial. As of the end of the second quarter, we had $90 million authorized and available for future share repurchases.

Turning to our balance sheet and cash flow. We continue to benefit from significant liquidity providing our businesses flexibility and financial stability. Operating cash flow for the second quarter of 2022 was $157 million compared with $159 million for the second quarter of last year. As Stanley mentioned today, we are announcing a company-wide restructuring plan that is focused on funding the priorities of the strategic plan and streamlining operations and other initiatives to increase efficiency.

The company expects to record restructuring charges in 2022 and 2023. However, our estimate of the amount of these charges has not yet been determined. Any restructuring charges are expected primarily to include severance pay and facility related costs. The expense savings realized from this plan are expected to mainly affect 2023 and beyond.

Turning to 2022 financial guidance. I will conclude my remarks by noting that we are affirming our 2022 full-year GAAP diluted EPS guidance range of $4.75 to $4.91, reflecting growth of 7% to 10% compared with our 2021 GAAP diluted EPS of $4.45 and growth of 5.9% compared with our 2021 non-GAAP diluted EPS of $4.52.

With reference to the balance of the year, we currently anticipate higher EPS growth in Q4 than in Q3. We are revising our full-year sales guidance and now expect sales growth of approximately 3% to 6% over 2021 versus our previously communicated expected sales growth of 5% to 8%. This change reflects adverse effects from foreign exchange rates and a decrease in anticipated sales of PPE and COVID-related products including COVID-19 test kits.

Sales of COVID-19 test kits are now expected to decline 25% to 30% from 2021 versus the previously estimated decline of 15% to 25%. We continue to expect full-year 2022 operating margin expansion of 39 to 44 basis points over 2021 GAAP operating margin, an expansion of 20 to 25 basis points over 2021 non-GAAP operating margin. Our guidance is for current as well as completed or previously announced acquisitions and does not include potential future acquisitions or restructuring expenses.

The guidance also assumes that foreign currency exchange rates will remain generally consistent with current levels. However, additional headwinds from foreign foreign currency exchange rates for the remainder of the year may further impact our sales and EPS. Guidance further assumes that end markets will remain stable and consistent with current market conditions. And if there are no material adverse market changes associated with COVID-19.

With that, I'll now turn the call back Stanley.

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

Thank you, Ron. Just a couple of very brief comments on senior leadership. We have updates as of July 1, Gerry Benjamin retired from Henry Schein as EVP and Chief Administrative Officer. And he stepped down from our Board with his term expires in May. Jerry has been with the company for 34 years. We will be continuing as a consultant and was invaluable as we grew from a domestic mail-order business. A couple of hundred million dollars, it's a global full-service products and services business with nearly 22,000 Henry Schein members in operations in 32 countries. We are fortunate to have a deep bench and with Gerry's retirement, Michael Ettinger became EVP and Chief Operating Officer reporting to me.

In addition to Michael's Corporate Affairs responsibility, responsibility has assumed responsibility for HR, IT and supply chain. With each of these three functions is led by highly corporate competent longstanding Henry Schein executives. Michael joined the Henry Schein in 1994, serving most recently as Senior Vice President of Corporate Affairs. The creation of the CEO position is a result of growing -- the growing size, scope and complexity of our operations and I'm confident that Michael will be successful with his buero together with the leadership in general of our business units, the five big business units and the rest of the executive management team.

Barry Alperin also retired from our Board of Directors at our Annual Stockholder Meeting in May and I would like to take this opportunity to thank Barry for his 26 years of exceptional service on our Board having joined in 1996, shortly after the company's initial public offering.

So operator with those comments, ready to answer any questions.

Questions and Answers

Operator

Thank you, sir. We will now be conducting a question-and-answer session. [Operator Instructions] Our first question comes from the line of Jason Bednar with Piper Sandler. Please proceed with your question.

Jason Bednar
Analyst at Piper Sandler Companies

Hey, good morning. Thank you for taking our questions. Stanley, if I could start on the patient and staff absenteeism you referenced is impacting dental patient volumes, is there any way you can quantify what you think that impact may have been in the quarter. I think you said it was mostly a regional impact, but could you compare those regions that are less impacted to those that saw the volume effects? And then is that the real-time trends that you're seeing with patient volumes that gives you the confidence here to date anticipated patient volume recovery here in the second half of the year?

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

Yeah, Jason, that's a number that we're constantly trying to figure out, it's very difficult, because this is -- this COVID is going in waves, rolling waves. The good news is, I think we will have to wait too long. July in the United States we still saw heavy absenteeism, cancellations in the beginning part and the first 3 weeks and most recently, the last few weeks, it's gotten better. But there is still some cancellation activity and shortages, so that it's been mitigated to some extent.

I think we can expect that to increase in rest of the quarter. Internationally, it's really very regionally dependent. Last quarter, Germany was really heavily hit. And in July, since this is a core public call with all our investors and I can report on this July was exception. Brazil was exceptional. Australia-New Zealand with our relatively small, it's gotten worse, because last year this time the rates were quite good. China, it's not material to the whole shine. But generally has stabilized.

Having said that, there are lockdowns for three, four, five days days in specific locations. So my expectation is, this is going to end itself out in the third quarter, although there is no way to tell, it also seems like this COVID speak to several people in different countries in Europe, doesn't seem to be a serious people get six small symptoms and they generally come out of it within 8 to 10 to12 days. So that's all I can give you. I wish I could give you more.

Jason Bednar
Analyst at Piper Sandler Companies

Okay, that's helpful. Appreciate that Stanley. And then just finally or Ron, just on the guide reaffirming the guide here today. Great to see you stick with the outlook of expanding non-GAAP operating margins here. 20 to 25 basis points given where we're at year-to-date, that does imply a decent step higher here in the second half of the year in order to hit that guide. So the margin comps do get easier. So that helps, but maybe can you speak to the margin visibility you have in terms of cost controls versus how much of that margin expansion that's in the guide as volume growth or business mix dependent?

Ronald N. South
Senior Vice President, Chief Financial Officer at Henry Schein

Well, I think if you look at the kind of the expansion of gross margin in Q2 that's largely driven by product mix. That's largely driven by greater growth in some of our Dental specialty products and our technology businesses. And so we're projecting that we can continue that that kind of favorable mix going forward. This also requires us to very carefully manage our operating expenses in the back half of the year and we are acutely aware of that, but that's, those are the, really the primary drivers as we look at product mix and ongoing kind of vigilant silver operating expenses in the back half of the year in order to improve to achieve that operating margin expansion.

Jason Bednar
Analyst at Piper Sandler Companies

All right, very helpful. I'll hop back in queue. Thanks guys.

Operator

Our next question comes from the line of Andrew Brochmann with William Blair. Please proceed with your question.

Andrew Brochmann
Analyst at William Blair

Hi guys, good morning. Thanks for taking the questions. Stanley, I wanted to go back to the comments you made in the prepared remarks around some of the customers. I guess, pushing back on price increases in your ability to sort of find alternative solutions. I guess, just broadly speaking, is this something that I guess the majority of your customers are asking for at this point and we should be -- start to be thinking about sort of a multi-quarter revenue headwinds associated with that or is this less than the majority at that point? Thanks.

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

Yeah, so I don't think it's across the board. Having said that, we have to be competitive and so we can switch customers if particular manufacturers want to stick with the price increases. We have options and customers are looking at those options. Obviously, the mid-sized customers and some of the - and the bigger DSOs, national DSOs are much more if you will, educated consumers, so they can see that on one product versus another one manufactured versus another there options and I was quite clear in my remarks, indicating that I don't think this will impact margin, but could impact sales in the sense that customers are moving maybe to lower-priced products for the same function -- functionally the same or lower price and in some instances, obviously, the margin will be better.

We are not pushing our private brand, but where we are in a competitive situation, we will push a private brand. Margins are pretty good. It's been some inflation on the Private brand, but we're also in a pretty good position to work with our manufacturers. So what I'm saying generally, we can manage through this. Our margins will be good. I think we are providing excellent value-added services to our customers in this regard. What I'm excluding of course is PP&E the deflation and generic and other pharmaceuticals where those move in different directions to the general market and all of those areas, I think we are maintaining and in fact, we likely will grow our gross profit.

Andrew Brochmann
Analyst at William Blair

Great, thanks for that. That's helpful. And then I guess just on the staffing commentary around sort of dental recognized and I guess this could be a little bit longer of a headwind than we might be anticipating here, can you just sort of talk about some of the longer-term opportunities that this dynamic might sort of create for Schein with your expansion into some of the services and technologies? And maybe I guess just part of that, can you talk about some of the specific investments that you're going to be making here throughout the balance of 2022? Thanks for the questions.

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

It's a very good question actually. I expect, look, no one has a crystal ball, but I expect the dental staffing to emerge closer to 2019 within the next few months, maybe it lingers into the fourth quarter. I don't think so. There is an issue still with hygienists. They feel very uncomfortable, goes back to COVID. It's an important part debenture of the business, but if we can get the Dennis back to full complement, I'll just have to handle a lot more of the hydrogen and have to work a little bit long hours. Having said that, there is a lot of technology out there to make the practice of dentistry more productive. The movement from impression material to scanners to implementing systems like I said, drive practice efficiency. I think also the PP&E use in the practice was a little bit more intense in terms of doubling up in the amount of time. Dennis spent on PP&E masking the gloves, and brings codes and things that's become more efficient. So I think the production per practice is likely to go up as well as the value-added services. This is key for us these strategies whether it's revenue cycle management, demand generation, business that provides insurance coverage of discounted insurance, all sorts of activities as it goes -- as it relates to education, seminars, publications and the like.

We're driving different services that really increased efficiency, the practice while facilitating better clinical care, and this has been a key strategy for years. We will invest more in it. But I think we quoted e-Assist, which is a business that focuses on revenue cycle management significantly in demand, highly profitable and highly appreciated by dentists. Jarvis which provides information on dental practice, indexes, KPIs, all of these things and demand and the biggest issue or the biggest opportunity of all is our field sales consultants are today much more appreciated for the accounting consulting services than pre-COVID, that when during COVID, a number of practitioners both product there wasn't good, didn't necessarily have the most efficient technology in their practice. And so our consultants have been consulted on these items. Of course, providing good advice, but at the same time, providing great stickiness.

Operator

Thank you. Our next question comes from the line of Jonathan Block with Stifel. Please proceed with your question.

Jonathan Block
Analyst at Stifel Nicolaus

Thanks guys, good morning. Stanley, maybe just the first on the dental equipment outlook. You seemed bullish last quarter and I got the feeling maybe equally bullish this quarter and you talked about solid orders and a strong backlog. I'd just love to get your thoughts. Is that sort of a fair takeaway? And maybe, if so, do you expect the equipment outlook to hold up well into the back part of '22 even in arguably of what's quickly becoming or suppose to becoming a weaker overall environment?

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

Yes, it's a very good question. I believe the equipment is going counted in Q2 to the way I would think in a challenged economy. Traditional equipment is doing well. I think the consumer is expecting Dennis to have a good looking modern and Dennis understanding. So they're investing in their practices. I would say the whole restorative area is doing extremely well. That's the digital restorations particularly whether it's scanners full side and now of course 3D printing. All of these are in demand and specifically as it relates to interoperability with some of our software. This is all boding well. I would say the imaging side, the units are relatively strong, not great, 2D, 3D, it's not terrible, but there is some inflation in that area. And there are some shortages in terms of chips that are holding back availability. I wouldn't say, it's critical and its options to move from one brand to the other. So, but I'd just say to you is not a North American issue only opportunity, but this is global, where our equipment demand continues to be good. The whole traditional equipment supply chain issue with the U.S., North American issue, not a European issue at all. And so on both the traditional equipment side and the restore digital restoration side, demand is very good in this country, North America, Canada and globally. We're quite...

Jonathan Block
Analyst at Stifel Nicolaus

Got it. Sorry, Stanley.

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

And 3D printing is also a new emerging opportunity. So we're very optimistic about the equipment business.

Jonathan Block
Analyst at Stifel Nicolaus

Good. Thanks, Stanley, great color. And maybe as a quick follow-up. Ron for you, any color on the decrementals for the COVID test and PPE, just in terms of a way to think about that at the op margin level? And then just, do we have to actually start thinking about them differently with the way that COVID tests have rolled over, any color there? Thanks guys.

Ronald N. South
Senior Vice President, Chief Financial Officer at Henry Schein

I would say the operating margin level. With PPE, we're still getting, well, first of all, about gross margin, with PPE we're getting, I would say, gross margin that we're happy with. I think what happens is that as that pricing of PPE goes down, it obviously results in a lower sales numbers. So it puts a little bit of strain on operating margin to the extent we have fixed cost as operating expenses. I think COVID test kits, we are seeing a little bit of pressure on pricing there. But we have seen some stability in that and the demand for COVID test kits. We had a fairly consistent run -- kind of weekly run rate in the back half of the second quarter that has continued into July. And if anything, perhaps even improved slightly in July. So, and that's all taken into consideration when we will be providing the guidance on that number, but I do think that from a gross margin standpoint, kind of going back to your original question, we feel -- we feel like we're getting a good gross margin on PPE, but at those lower sales dollars, it does put a little bit of pressure on the operating margin.

Operator

Our next question comes from the line of Jeff Johnson with Baird. Please proceed with your question.

Jeff Johnson
Analyst at Robert W. Baird

Thank you, good morning, guys. And I've got some background noise here, so I'll just ask two questions and then go back on mute. First question was just on the North American consumables growth rate this quarter, Stanley. I think you're talking about some COVID headwinds during the period, yet had all McCrohan headwinds last quarter as well. So how do you fair it out the impact of COVID versus some of the inflationary pressures and just consumer pressures we've seen here over the last couple of quarters or last couple of months? What gives you the confidence that this COVID not macro?

And then number two, I know you're doing a great job trying to hold pricing in line for your customers, I think the customers absolutely appreciate that in our checks anyway. How are you thinking about pricing maybe into 2023? It might be early, but I know manufacturers are struggling given the dental fees haven't gone up for quite a while and how much they might be able to ratchet pricing up again next year? Thank you.

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

Yeah, Jeff, as I noted earlier on, it's very hard to really identify how much of a dampening impact we had as a result of COVID, but my sense just listening to our salespeople having gone to a couple of conferences, spending time with customers, is that there were several hundred basis points on the consumable side that are related to this dampening because of COVID. I expect that that will improve the rate -- that the rate of infection? Well, as it improves, we'll drive visits back to the office, and that's not only in the U.S. but globally I think. The impact of inflation, I'm a little bit surprised with the fact that we've been able to keep our rates are quoted 3% number, I think it's actually less in the non-private label, in the non-gloves PP&E area. So the volumes are there and inflation doesn't seem to be too bad how it goes in -- how this drives where this ends up in the 4th quarter or even 2023. It's hard to tell. We're not getting huge push back on pricing from our point of view, but we being asked about different brand options and I think manufacturers are going to have to think this through, I know they're doing that now. And again, I'm talking about consumables. So it's hard to see how much inflation rate is really going to be towards the end of the 4th quarter or the beginning of the first, but it doesn't look like we've seen with other products in the general economy.

Operator

And our next question comes from the line of Erin Wright with Morgan Stanley. Please proceed with your question.

Justin Wang
Analyst at Morgan Stanley

This is Justin Wang filling in for Erin. We are wondering what's embedded in your guidance as it relates to potential macro pressures. Is there a risk to guidance from here if we see tougher macro backdrop? Or is this an element that's already been baked into your guide? Thank you very much.

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

Yes, I mean I would say that one reason we stayed with the $0.16 range is because of that macro uncertainty that you've referenced. I think that we've kind of played out different scenarios, whether it'd be in terms of additional inflation, whether it'd be from additional geopolitical concerns and we did fall within that range of guidance that we provided. So it is taken into consideration for the balance of the year that there could be further deterioration. But we feel like we have the plans in place to try to mitigate that.

Justin Wang
Analyst at Morgan Stanley

Great, thank you very much.

Operator

We have time for one last question, coming from the line of AJ Rice with Credit Suisse. Please proceed with your question.

AJ Rice
Analyst at Credit Suisse Group

Hi, everybody. Just two questions. First, can you just comment on what you're seeing in the medical side? I know you're focused on the ultimate side area. We're hearing mixed things about half procedure volumes progressed and what -- how much that was impacted by COVID, but alternatively, it sounds like there is a flow out of hospitals into some of those alternate sites and maybe they be above pre-pandemic levels and I'm just curious what you're seeing?

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

So I think you're referring specifically to the ambulatory surgical centers. We were close to 2019 numbers, I can't remember. Couple of quarters back, we've gone back a little bit, but generally ASCs are quite strong and we are gaining market share in that area for sure. We have a lot to offer. I think ASC is also looking at ensuring that supply chain is efficient that they're not having too much product, expiration dates of product issues and we hope for those kinds of things. So I would say overall, that's a good area. But we are in a number of alternate sites whether it's oncology, renal, surgery centers and for us, these markets are all doing quite well. I do believe that having said that, it probably is going to be some pent-up demand for elective surgery in the ASC space that go to market, I think people will want these procedures as soon as COVID tapers down here in the United States.

AJ Rice
Analyst at Credit Suisse Group

Okay. And sale in your prepared remarks, you mentioned that you're helping your clinicians deal with key changes in dental and medical professions and I know you called out specifically digitization, interest and their work. I wondered if you would expand a little more on what you're referring to in some of those key changes that they're dealing with and how that impacts your business down the road?

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

That's very good question. There is a clear understanding amongst all the office based practitioners, small the largest, that efficiency is critical. They're going to face reimbursement pressure to some extent that basically now, I think for them. In many respects labor costs have increased and reimbursement. So that's turning to our sales force for advice on how to manage the practice and of course now ensure that their clinical standards are increased with access to the latest technology.

And on the dental side, digitalization the biggest one is the the {Indecipherable} scanners in the prosthetic field. I don't know what the number is, but it's because it's not clear, but I imagine that still have to done its in the developed world, I would still being manually impressions. So there's a huge opportunity in that regard to convert practices using manual impression to digital impression. The whole movement of impressions to the lab, the digital manufacturing crowns and bridges in the lab is a big opportunity for us. A significant player in the lab space I think we're the largest provider of {Indecipherable} laboratory products in the world. So as that moves digitally, that's the huge opportunity for us. It has been very good to us in the last year or two, but lots of opportunity in that regard.

The practice management arena, the movement from towards a cloud-based technology from a security point of view, from a practice management point of view, the digitalization of more of the practice presents a significant amount of opportunity on the practice management side. The interoperability connectivity between devices and practice management software is a big opportunity, and that's both dental and medical, the movement to 3D printing is starting to get some good momentum. You'll hear more from us in that regard. Actually, hopefully in the next week we'll see, we'll have some announcements there. So we're very excited about this on the dental side, the digitalization, and on the medical, just simply the capital equipment that we're selling, we're finding practices replacing non-digital equipment with digital equipment for diagnostics, for other activities. So generally and more efficient digitalized practice is what practitioners are looking seeking guidance from our field sales force for and our sales -- field sales force is much more capable today of satisfying these needs because we got lots of tools in their bags. More information on that I think Graham or Ron can provide and happy to connect you with our teams and the business teams, but it's simply because of time now we've got to probably end the call.

AJ Rice
Analyst at Credit Suisse Group

So thanks a lot.

Stanley M. Bergman
Chairman of the Board and Chief Executive Officer at Henry Schein

That's a very, very good question and plays to the opportunity for Henry Schein going forward. So with that in mind, I want to thank everyone for calling. We are most enthusiastic about where we are -- we think our bundled plus 1 2022 to 2024 strategic plan is going to play out well, for us, even with the contracted economy and we are on the way to implementing these goals and talk about it in a future call, of course, a key part of that is to drive efficiency as we drive efficiency in all of our distribution businesses as one distribution, one Schein notion of selling a package of customer products to customer rather than one or two products and services is working well. And of course our high margin technology value-added services and specialty products are growing at a good pace.

So we're very happy with our senior team. In general, I think the team is doing very well and the organization is motivated to support our senior team and our management in general. The long-term trends for our markets are good. So we believe we're servicing a very solid market with a great plan and a great team.

So with that, I thank you for calling. If you have any questions, please feel free to reach out to standing on Investor Relations or run directly then contacts on the website. It's Graham Stanley -- Graham Stanley Henry Schein, Stanley henryschein.com. Graham Stanley at henryschein.com and Ron is Ronald that efficiently run stuff, please feel free to reach out and if people want to speak to me, go through those channels to. Again thank you very much for calling, lots going on in the business and we remain excited as we have for decades. Thank you very much.

Operator

[Operator Closing Remarks]

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