Teleflex Q2 2023 Earnings Call Transcript


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Participants

Corporate Executives

  • Lawrence Keusch
    Vice President, Investor Relations and Strategy Development
  • Liam J. Kelly
    Chairman, President and Chief Executive Officer
  • Thomas Powell
    Executive Vice President and Chief Financial Officer

Analysts

Presentation

Operator

Good morning, ladies and gentlemen, and welcome to the Teleflex Second Quarter 2023 Earnings Conference Call. At this time, all participants have been placed on listen-only mode. At the end of the company's prepared remarks, we will conduct a question-and-answer session. Please note that the conference call is being recorded and will be available on the company's website for replay shortly.

And now I will turn the call over to Mr. Lawrence Keusch, Vice-President of Investor Relations and Strategy Development.

Lawrence Keusch
Vice President, Investor Relations and Strategy Development at Teleflex

Good morning, everyone, and welcome to the Teleflex Incorporated second quarter 2023 earnings conference call. The press release and slides to accompany this call are available on our website at teleflex.com. Please note that webcast viewers will have the ability to advance the presentation slides on their own, simply follow along with the presentation as we proceed through the call.

As a reminder, a replay will be available on our website. Those wishing to access the replay can refer to our press release from this morning for details. Participating on today's call are Liam Kelly, Chairman, President and Chief Executive Officer; and Thomas Powell, Executive Vice-President and Chief Financial Officer. Liam and Tom will provide prepared remarks and then we'll open the call to Q&A.

Before we begin, I'd like to remind you that some of the matters discussed in this conference call will contain forward-looking statements regarding future events as outlined in the slides posted to the Investor Relations section of the Teleflex website. We wish to caution you that such statements are in fact forward-looking in nature and are subject to risks and uncertainties and actual events or results may differ materially. The factors that could cause actual results or events to differ materially include, but are not limited to, factors referenced in our press release today as well as our filings with the SEC, including our Form 10-K which can be accessed on our website.

Now I will turn the call over to Liam for his remarks.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Thank you, Larry, and good morning, everyone. It is a pleasure to speak with you today. On this morning's call, we will discuss the second quarter 2023 results, our pending acquisition of Palette Life Sciences, and our financial guidance for 2023.

Turning to the second quarter, Teleflex revenues were $743.3 million, a year-over-year increase of 5.5% on a reported basis and an increase of 5.9% on a constant-currency basis. Second quarter adjusted earnings per share was $3.41, a 0.6% increase year-over-year. We saw stable utilization in the acute care setting in our global markets. The balanced performance in the quarter continues to demonstrate the benefits of Teleflex's diversified product portfolio and broad geographic footprint.

From a macro perspective, we continue to see sequential stabilization with respect to material inflation and we'll continue to monitor trends during the second half of 2023. Our supply chain remains stable in the second quarter, although we are still not yet at normal levels. As expected, we witnessed a continued stabilization in hospital staffing. This was evident in our second quarter revenue growth as most Teleflex products are exposed to the hospital setting. Conversely, we are still experiencing geographic pockets that are encountering more persistent staffing disruption in the ASC and office site of service, but note that bottlenecks are seeing some easing.

Now let's turn to a deeper dive into our second quarter revenue results. I will begin with a review of our geographic segment revenues for the second quarter. All growth rates that are referred to are on a constant-currency basis unless otherwise noted. America's revenues were $424.7 million, which represents 3% growth year-over-year. In particular, we saw strong performances in our Vascular, Interventional, and Surgical businesses.

EMEA revenues up $147.8 million, increased 0.7% year-over-year. During the quarter, we saw strength in our Vascular and urology drainage businesses. Turning to Asia, revenues were $6.7 million, increasing 19.1% year-over-year. During the second quarter, we saw stable demand across the region, including growth in excess of 20% in China. From a product perspective, we saw strong double-digit growth in Interventional Access and Interventional Urology in the region.

Let's now move to a discussion on our second quarter revenues by global product category. Commentary on global product category growth for the second quarter will also be on a constant-currency basis. Starting with Vascular Access, revenue increased 6.6% to $173.8 million. We executed well during the second quarter. Initial launch activities for our next-generation Arrow VPS Rhythm DLX navigation device and the new Arrow PICC pre-loaded with the NaviCurve Stylet have generated a positive customer response. Over the long-term, we remain positioned for dependable growth with category leadership in central venous catheters and midlines, anticipated share gains with our novel coated PICC portfolio, and new product introductions.

Moving to Interventional Access. Revenue was $124.8 million, up 9.6% year-over-year. Procedure volumes remained stable in the quarter and we continue to benefit from our diversified portfolio. Balloon pumps, right heart catheters, and access and closure, all grew at double-digit rates. MANTA continues on that trajectory for strong double-digit growth in 2023.

Turning to Anesthesia revenue was $100.8 million, down 3.6% year-over-year. A tough year-over-year comp due to timing of military orders in the prior year period impacted results. In our Surgical business revenue was $106 million, up 7.7% year-over-year. In the quarter, we advanced our integration of Standard Bariatrics, and training of new surgeons on the use of the Titan SGS Stapler in sleeve gastrectomy procedures is accelerating. For Interventional Urology revenue was $77.8 million, representing a decrease of 2.3% year-over-year. Once again, we witnessed year-over-year growth for UroLift in the hospital setting but the office site of service remains challenging. The overseas launch activities continue to progress in line with expectations with Japan UroLift usage growing in line with our expectations.

OEM revenues increased 19.8% year-over-year to $84.1 million. The strength in the quarter was broad-based across our portfolio with double-digit growth in all of our product categories, including microcatheters. We continue to have good visibility into the business and see solid demand dynamics throughout 2023. Second quarter other revenue increased 4.8% and $76 million year-over-year. We continue to expect all MSA revenues to cease at the end of 2023. That completes my comments on the second quarter revenue performance.

Turning to some commercial updates. On July 26th, we announced a definitive agreement to acquire privately-held Palette Life Sciences for an upfront cash payment of $600 million at closing and up to an additional $50 million on the achievement of certain commercial milestones. The acquisition will expand Teleflex Interventional Urology to include a portfolio of fast-growing Non-Animal Stabilized Hyaluronic Acid or NASHA spacer and tissue products that improve patient outcomes in urology, urogynecology disorders, colorectal conditions, and radiation oncology procedures. Palette is estimated to generate net sales of approximately $56 million on a standalone basis in fiscal year 2023. We believe Palette will contribute meaningfully to our growth in the coming years with revenue growth in the high-teens to low 20% range year-over-year in 2024.

The strong growth profile for Palette gives us further confidence in our ability to deliver on our 2023 to 2025 LRP growth objective.

The Barrigel rectal spacer is the flagship product for Palette Life Sciences and generates the majority of the company's revenue. Barrigel is a NASHA spacer with a compelling value proposition driven by a reduction in radiation delivered to direct them during prostate cancer radiation therapy while increasing tumor control and patient quality of life. In addition, the sciences portfolio also includes Deflux and Solesta which are NASHA-based tissue bulking agents designed to treat pediatric vesicoureteral reflux and fecal incontinence, respectively.

The acquisition of Palette Life Sciences will allow us to incorporate this exciting high-growth and high-margin technology into our Interventional Urology business unit, along with our well-established global call points. We are focused on bringing urologists and other specialists more innovative technologies that can positively impact patient care. The acquisition of Palette is attractive for three primary reasons. First, Barrigel is a differentiated rectal spacer with a strong growth profile following FDA clearance in May of 2022 and represents a highly complementary product to our existing Interventional Urology business. In recent years, the treatment of prostate cancer has increasingly utilized hypo-fractionated radiation therapy, which uses higher doses of radiation in fewer treatments.

In order to reduce radiation-associated complications usage of temporary rectal spacers has grown as a way to protect healthy rectal tissue from harmful radiation. Barrigel has grown by expanding market adoption since its launch due to its unique product features. Unlike other technologies, Barrigel is easily sculpted when placed between the prostate and rectum providing comprehensive protection from radiation therapy. The scope-ability allows the physician to achieve predictable protection of healthy rectal tissue prior to radiation therapy. Barrigel is also highly visible on TRUS rectal ultrasound, which aids accurate placement is biodegradable and offers one-step assembly of the delivery device in all sites of service.

Second, there is a large and growing global market for rectal spacers. The American Cancer Society estimates that there will be 288,000 new cases of prostate cancer in the United States with the incidence growing 3% a year. In addition, the increasing use of hypo-fractionated radiation therapy is driving demand for rectal spacers to protect healthy tissue. Barrigel was cleared for marketing in the United States and Australia and is CE-marked. We expect to gain market clearance in additional geographies over the coming years.

Third, the acquisition of Palette is reflective of our disciplined capital deployment strategy. From a strategic perspective, in addition to Palette's NASHA portfolio complements our strong presence in the treatment of benign prostate enlargement. Of note, urologists performed the majority of rectal space replacements, which will leverage our broad and established sales organization. Today, 97% of physicians using UroLift also treat prostate cancer. In addition, the treatment of prostate cancer is not deferrable. So we are adding another durable growth driver to our portfolio. We also expect interest in rectal spacers to provide opportunity to cross-sell UroLift.

From a financial point of view, the transaction is consistent with our strategy to acquire assets that are accretive to Teleflex's growth rate and margins. Palette's adjusted gross margin will be accretive to both the corporate average and the Interventional Urology business unit. In addition, we expect the less operating margin to enhance the corporate average in the near-term.

Finally post-close, our balance sheet remains sound, allowing us to continue to execute on our long-term capital deployment strategy. The acquisition is subject to customary closing conditions, including receipt of certain regulatory approvals and is expected to be completed in the fourth quarter of 2023. We look forward to welcoming the Palette employees to Teleflex.

Turning to an update on the Titan SGS Stapler. We continue to execute on our commercial strategy for the Titan SGS power stapling device for use in sleeve gastrectomy procedures to treat obesity. Feedback for the Titan Stapler remains positive and we remain confident in the value proposition for the Titan SGS Stapler. The 23-centimetre continuous staple line enables ideal pouch creation and no overlapping staples that are common with traditional power staplers. We are optimistic that over time we will be able to generate data that shows a reduction in complications and meaningful time savings per procedure. Despite the continued positive feedback from the field, we now expect Titan Stapler's revenue to be in the high teens for 2023, which is lower than what our original guidance for 2023 had assumed.

Value analysis committee clearance has taken longer than we anticipated, which has slowed our ability to train surgeons. We have learned from the early experience and have refined our strategies are gaining back approval. Our efforts are taking hold with more than two times the number of surgeons trained in the second quarter of 2023 versus the first quarter of the year. Moreover, we have a strong pipeline of surgeons in queue to be proctored. So we expect further improvement through the year.

We continue to monitor the usage of GLP-1 drugs in treating obesity. Based on our market checks, it is our sense the GLP-1s had some impact on bariatric surgery volumes in the second quarter. It remains too early to assess the long-term impact on the market given questions on reimbursement and safety profile. In the interim, we remain acutely focused on penetrating a large steep gastronomy market that is in excess of 120,000 procedures in the United States given the very early stages of the Titan Stapler launch. We remain confident that the Titan Stapler will be a meaningful contributor to our high-growth portfolio through the LRP period.

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?

Thomas Powell
Executive Vice President and Chief Financial Officer at Teleflex

Thanks, Liam, and good morning. Given the previous discussion of the company's revenue performance, I'll begin with margins. For the quarter, adjusted gross margin was 59%, a 60 basis point decrease versus the prior year period. The year-over-year decrease was primarily due to continued cost inflation with recalls in an unfavorable impact on productivity due to raw material supply, partially offset by price-lower logistics and distribution-related costs and benefits from cost improvement initiatives.

Turning to price. There is no change to our expectation for at least 50 basis points of positive price year-over-year in 2023. Adjusted operating margin was 26.6% in the second quarter, a 90 basis point year-over-year decrease was the result of the flow-through of gross margin, increased headcount and employee-related expenses, investments to grow the business, and the inclusion of Standard Bariatrics.

Barrigel's expense totaled $16.6 million in the second quarter and increase from $11.2 million in the prior year period. The year-over-year increase in net interest expense reflects higher interest rates versus the prior year, partially offset by a reduction in average debt outstanding. Our adjusted tax rate in the second quarter of 2023 was 10.8% compared to 12% in the prior year period. The year-over-year decrease in our adjusted tax rate is primarily due to a reduction in tax costs resulting from US tax law requiring capitalization of R&D expense. At the bottom line, the second quarter adjusted earnings per share was $3.41, an increase of 0.6% versus the prior year.

Turning now to select balance sheet and cash flow highlights. Cash flow from operations for the six months was $170.6 million compared to $101.9 million in the prior year period. The increase was primarily attributable to lower tax payments and favorable changes in working capital.

Moving to the balance sheet, our financial position continues to provide the flexibility to operate the business and execute on our disciplined capital allocation strategy.

At the end of the second quarter, our cash balance was $250.8 million as compared to $292 million as of year-end 2022. The reduction in cash on hand is primarily due to 154.5 million of payments on our senior credit facility partially offset by 131.2 million of free cash flow generated during the first six months of 2023. Net leverage at quarter-end was approximately 1.6 times, which remains well below our 4.5 times covenant.

Turning to financial guidance. Starting with the acquisition of Palette Life Sciences. As mentioned previously, Palette Life Sciences is expected to generate net sales of approximately $56 million in 2023 assuming a December 1st, 2023 close date. The acquisition is not expected to significantly impact Teleflex's 2023 revenue. In 2024, we expect the business to both see year-over-year revenue growth in the high teens to low 20% range. Assuming, December 1st, 2023 close the transaction is expected to be approximately $0.15 and $0.35 diluted. The company's adjusted earnings per share in 2023 and 2024 for the second.

Beginning in fiscal year 2025 and thereafter the company expects the acquisition to be pleasingly accretive to adjusted earnings per share. Teleflex plans to finance the acquisition through borrowings under its revolving credit facilities and cash on hand. In signing of the transaction, we remain in a solid financial position, pro-forma net leverage of approximately 2.5 times. Accordingly, there is no change to our stated long-term capital deployment stretch.

Moving to our outlook for 2023. Given our operational performance in the second quarter and our second half outlook, we are revising our 2023 financial guidance. Specifically, we are increasing the bottom end of our 2023 constant-currency revenue guidance by 50 basis points to 5.5% to 6.25%.

Turning to foreign exchange, we now assume a positive impact from the foreign exchange translation of approximately $8 million or 30 basis points to GAAP growth of 2023. This compares to our prior guidance, which assumes a $10 million or 35 basis point headwind for 2023. Note our second-quarter revenue results reflect the foreign exchange result that was approximately $6 million more favorable than what was previously expected. The balance of the updated full-year 2023 impact of changes in foreign exchange rates -- the second of the second half of 2023. Our revised foreign exchange guidance for 2023 captures the actual rates for the second quarter. We now assume current foreign exchange rates, including a euro-to-dollar exchange rate of $1.10 in the second half of the year.

Considering the revised foreign exchange headwinds, we expect reported revenue growth of 5.8% to 6.55% in 2023 implying a dollar range of $2.953 billion, $2.975 billion implying an increase the low-end of the dollar range of $32 million, and the high-end of $18 million. There are no changes to our outlook for gross and operating margin for 2023.

Along this line, we now expect net interest expense to approximate $77 million in 2023, which reflects net incremental borrowings under our revolver for the acquisition of Palette. We are maintaining our 2023 guidance for adjusted earnings per share of $13 -- $13.60. Our adjusted EPS outlook has been updated to include $0.15 of dilution for the acquisition of Palette, $0.15 of dilution associated with the recall of ET tubes and the endurance catheter during the second quarter offset by $0.15 foreign exchange benefit, and the balance from favorable operating performance including better than expected results in the second quarter and higher growth expected in the second half of the year.

That concludes my prepared remarks. I would now like to turn it back to Liam for closing commentary.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Thanks, Tom. In closing. I will highlight our three key takeaways from the second quarter of 2023. First, our diversified portfolio and global footprint drove durable growth in the second quarter. Our execution remains strong. We are launching new products and our margins remain healthy. Second, the solid second quarter performance keeps us well-positioned to deliver on our financial guidance for 2023. As we look into the second half of 2023, we anticipate stable to improving macro conditions. Third, we will continue to focus on our strategy to drive durable growth. We will invest in organic growth opportunities and drive innovation, expand our margins, and execute on our disciplined capital allocation strategy to enhance long-term value creation. We are excited about the acquisition of Palette Lifesciences. We believe that the acquisition will be a meaningful contributor to our growth in the coming years, be immediately accretive to gross margins, and will enhance our adjusted operating margins in the near term. In turn, we are further confident in our ability to deliver on our 2023 to 2025 LRP revenue objectives.

That concludes my prepared remarks now. I would like to turn the call back to the operator for Q&A.

Questions and Answers

Operator

Thank you. [Operator Instructions]. We do ask that you limit yourself to one question and one follow-up. [Operator Instructions] And our first question comes from. Shagun Singh of RBC. Please go ahead.

Shagun Singh Chadha
Analyst at RBC Capital Markets

Great, thank you so much for taking the question. So by our math, the acquisition would add about 50 basis points to overall Teleflex growth and 400 basis points to Interventional Urology segment, just is that in the ballpark and does this help offset some of the weakness in UroLift or is your 8% to 9% LRP still impact?

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Thank you very much for the question. Shagun, I'll start with your question as it relates to the LRP. I think as it relates to the LRP, the acquisition of Palette emboldens our confidence in at least achieving the 6% growth as laid out in our LRP, and here are the building blocks. Durable core will grow at 5% and I think given the performance so far this year and what we expect for the remainder of the year, we feel we're super confident in that 5%. The high-growth portfolio will be growing at -- at least 12% and within that the Interventional Urology business unit, which will include Palette will be growing at least 8%. So this addition of Palette ensures our ability and we believe to achieve the 6% LRP growth that we laid out in our Capital Markets Day.

With regards to the addition what addition that it will make into the future growth of Teleflex. I mean, your math is pretty spot-on, it's delivering $56 million this year, it's going to grow in the high teens to low 20s in 2024 and I do believe that that kind of a number should be sustainable into 2025 as well. So obviously, your math is pretty right on the money and I think it's an important point to note, as I outlined in my prepared remarks, the gross margins from Palette is a really important factor and Solesta is not alone accretive to Teleflex, it's accretive to the Interventional Urology business unit today and it's accretive to the high-growth portfolio. Thanks for the question, Shagun.

Shagun Singh Chadha
Analyst at RBC Capital Markets

And just as a follow-up on UroLift, can you just elaborate on the trends you're seeing? I know that the patient -- the patient volume comps were a little easier this quarter, but just on a comp-adjusted basis, can you elaborate on trends you're seeing and thank you for taking my questions.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Yes, thank you. Shagun. We've still seen through the first half of the year a reduction in patient flow to the urologist. I think from within the quarter, there were some green shoots, I guess when you see that the hospital's rate of growth continued. We still see pressure in the office sites of service and that still remains somewhat of a challenge to us. We continue to train a robust amount of surgeons and actually, we saw a tick-up in the amount of surgeons that we trained in Q2, but the office still remains a troublesome site of service for this product in the quarter, Shagun, thank you.

Operator

Our next question comes from Jayson Bedford of Raymond James. Please go ahead.

Jayson Bedford
Analyst at Raymond James

Good morning. I wanted to follow-up on the comments on the Titan Stapler, it seemed like the revision in the guidance there is seemed dependent on longer VAC committee approvals, and I'm just wondering kind of what's the source of the pushback there, do you need more clinical data, is it a price issue. Just love to dig in on that a little bit more.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Yeah, Jason, I mean, obviously, our initial expectation at the low end was $30 million, it's now in the high-teens. We still expect Titan to be a significant contributor to the LRP. The push-back as we go through the VAC committees and the VAC committees have the knock-on effect of having an impact on the proctoring. Now as I also said in my prepared remarks, we've doubled the number of surgeons we proctored from Q1 to Q2. So that's encouraging, it's just time. Jayson is the biggest issue. We would have thought that this product because it's functioning exceptionally well that's what's very encouraging. The product is doing exactly what it's supposed to do. I think what's also important is that it's a very-very big end-market, $300 million. So once we get through the value analysis committees, the product gets adopted and it's going pretty well. It's just taking us longer than we thought, it's early in the ramp, it's a big market, we have a path forward, we know what we need to do, it's just taking us longer to get there as we go through that adoption curve and I think that it's also a --having the buttress material for the entirety of 2024 will be an important factor for us.

Technically, our product doesn't need a buttress because it's a complete line of staples, but 60% of bariatric surgeons use a buttress when they do a gastric sleeve and it is the standard of care and a surgeon would tell you, I use buttress because I want to sleep at night and it's just a standard of care and I think having that in 2024 will also help get us through, but it's simply time, Jason. There's no major pushback. It's not a pricing issue, it's not a product performance issue. We've got the clinical data that we need. So we have everything that we need to get through, but it's just taking longer for these VAC committees to come together and allow us through the system.

Jayson Bedford
Analyst at Raymond James

Okay. Liam, that's very helpful, thanks. And just quickly as a follow-up. OEM continues to be strong there. Can we assume there's nothing kind of one-time or stocking in that number and you're still confident in what should be a strong double-digit growth outlook for OEM?

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Yeah, I think OEM has performed exceptionally well, not just this year, but over the last two years as well coming in just shy of 20% stellar performance. This is a business that we have really good visibility into. There are no one-time stocking major items to answer your question directly. This is pure performance. It's taking share from other competitors in the market. It is also that acquisition that we did a number of years ago is really helping us go along, but it's really good performance by Greg and the entire team in the OEM division and I do believe that OEM will have good solid double-digit growth this year and I do believe that the future is good for that over the foreseeable future with the visibility we have.

Operator

Our next question comes from Anthony Petrone Mizuho Americas. Please go ahead.

Anthony Petrone
Analyst at Mizuho Securities

Thanks and good morning, everyone. Maybe Liam, just to go pivot to Standard Bariatrics. Just an update on traction in the quarter, expectations through the end of the year for Standard. We've been hearing, obviously some -- some noise on the GLP-1s impacting bariatric from Intuitive, so just an update on bariatric, and then I'll have a follow-up on earnings.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Yeah, absolutely. Anthony. And as we said during our prepared remarks, we're now expecting the high teens for Standard Bariatrics. I think that there is some impact from GLP-1s but the main issue is getting through these VAC committees, and, therefore, you have to get through the VAC committees before you Procter. And as I answered to Jason's question, we doubled the number of surgeons that we proctored from Q2 to Q1. Product is performing very very well. The introduction of buttress will help us. I do believe that GLP-1s have some impact, but it's not the big impact, I mean, we're just starting to ramp within this curve and I do think that there's mixed views on GLP-1s. They get -- the reimbursement is for a shorter period of time, and, therefore, if you talk to most bariatric surgeons they think it's having a shorter-term impact, but in the longer-term, they don't see it having a long-term impact on gastric sleeve surgeries. Just a weight loss in the gastric sleeve is so more significant than it is from the GLP-1s, but we're watching it very-very closely, Anthony, and thanks for the question.

Anthony Petrone
Analyst at Mizuho Securities

And then maybe for Tom, just on margins in the progression here by 26 to 26.75 and maybe just a recap on looking out through the LRP as we look forward to '24 and '25, just how we should be layering margin expansion in according to or based on what's still out there for the LRP and how we can translate that into earnings power. Now, it's a little bit confounded down to the earnings line with the Palette acquisition and some of the below-the-line sort of moving parts. So how do we layer in, how do we think about margin expansion from here based on the current guidance out through the LRP and how does that play in the earnings power now that we have an additional -- additional drivers in the non-operating lines. Thank you.

Thomas Powell
Executive Vice President and Chief Financial Officer at Teleflex

Okay, well, as we spoke earlier in the year, we reaffirm the LRP guidance at that point in time. The way, I would think about the addition of Palette is that it is a product that we expect to do about $56 million in revenue this year on a full-year basis, obviously, we wouldn't have it for the entire year, but then to grow in the high-teens to low-20s over the next couple of years. And as we had mentioned, we expect it to be margin-accretive to the IU, BU business unit to all of Teleflex, and the high-growth portfolio. So we see this as slotting in very nicely and providing some additional comfort as we look out into future years in our margin progression.

Operator

Our next question will come from Larry Biegelsen of WF. Please go ahead.

Unidentified Participant
at Teleflex

Hi, this is Nathan [Phonetic] on for Larry. Can you just talk about pull like the overlap with UroLift position, how penetrated is the US market and so far is Barrigel expanding the market or taking share? Thanks.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Yes, Nathan, thank you very much for the question. So we see this as a market development opportunity. If you look at our existing Interventional Urology customer base, only 20% of them use the Barrigel spacing technology today and 97% of them actually treat prostate cancer. So this is a market expansion opportunity for us in the domestic market, within the United States. The product is approved in EMEA and it's also approved in Australia, we will be expanding approvals into other geographies as we take this under our wing, but we definitely see this as a margin expansion opportunity and we definitely see it as an opportunity to leverage our existing sales force, leverage that channel, we have a super global channel now into the urologist and we believe that we can expand the market as other spacing technologies out there, I think between having another company talking about spacing and other company raising awareness, we believe we have a better product than anything that's out in the market today, it's sculptable, it's visible, it is easy to inject, it doesn't solidify overly quickly, it's a one-step process, it's reversible. We've had excellent clinical data. There have been zero embolisms, there have been zero device-related adverse events and we have robust clinical data to support the product. We love the growth profile. We love the margin profile, and we love the synergies within our sales force and we're not going to build this into our model, but there is the potential that it could have also a halo effect for UroLift in expanding into urologists that previously may not have been open to trying new technology like UroLift.

Unidentified Participant
at Teleflex

Okay, thanks. And if you could just give us your high-level thoughts on 2024 in light of the acquisition, which is expected to be $0.35 dilutive, like what is your ability to absorb this dilution, I mean the Street has got 14, 15 EPS next year. Thanks.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Yeah, Nathan, we are not going to get into 2024 on today's call. We're halfway through the year. We've raised our revenue guidance for the second quarter in a row, we feel really confident about where we're at as a company, we've also we have maintained this year's earnings per share guidance even with the $0.15 dilution, that's coming from Palette. So we feel, we feel really good about where we're at and we'll get into 2024 guidance when we get to February next year. I've already made comments on the LRP about our belief and confidence in being able to achieve all aspects of the revenue profile with Palette within our LRP of 6% and all the components within that I just laid out.

Operator

Our next question comes from the line of Matthew O'Brien of Piper Sandler. Please go ahead.

Matthew O'Brien
Analyst at Piper Sandler Companies

Good morning, and thanks for taking the questions. Liam, just talking about Palette a little bit here. That the Barrigel product got approved in May of last year, you're saying it, at least the majority of revenue total for Palette, now so I don't have the numbers, but I'm assuming it's $30 million or $40 million of revenue in the year, basically that they have generated already and then you're saying kind of high-teens to low 20% growth for next year. I would think that just they've been able to grow that quickly that you guys at Teleflex to be able to grow at a similar rate. So why is high-teens, low 20s the right number, why isn't it 30%, 40%, 50%, I know you have to integrate it, but why wouldn't it be significantly higher than that just given how well they did with it on their own?

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Well, I think, Matt, everything you say, it's hard for me to push back too hard. We're definitely going to have more sales reps out there, we've got a very strong sales force within the United States and globally for this call point. I mean, I think the high teens, low 20s is probably the right number for us right now. If it's better than that, it's better than that, and everyone's happy. I think for us we feel right now that -- that's the right number. You're correct. We've got to integrate, it's not the toughest integration on the planet in all transparency, it's one call point, one big large call point. And then obviously the right ones. We have a methodology to address that through the additional clinical trainers and this is an investment hypothesis for us.

With the addition of Palette, we are going to continue to expand this market and grow this market. And if it's better than the high teens, low 20s, we'll let you know and we will grow it from there, but we feel it's a great transaction and if it's better than we expect, then the multiple is better than we expect, and everything within the dynamics of it is better than we expect.

Matthew O'Brien
Analyst at Piper Sandler Companies

Got it. That's understandable. Appreciate that. And then just back to UroLift, I know it's getting to be a smaller part of the overall business, but there's other areas of med-tech that just have not recovered from the pandemic, the bigger one, women's health is one area. Is this a category that especially in the outpatient setting and the physician's office setting that is just probably structurally different from now on, and like most likely will not reaccelerate, hence the 8% to 9% which you talked about last quarter probably, is it going to happen in the future? Thanks.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Yeah, sure, Matt. Now in all transparency, when we began the year, I thought that UroLift was going to recover. I expect that it to grow somewhere in the region of around -- around 3%. Now as I look forward to the full year, I would expect Interventional Urology, which would include Palette to have a low-single-digit decline something around 3% right now. I think what's changed. The market is huge, the condition is progressive, there are loads of men out there that have BPH. I think the pressure in the office, Matt, as I look at it today, is the real issue. If you go back to '17, '18, '19, we were growing the market because we were using the office call point to bring men in from the drug drop-out and the drug category and we were able to convert those men during that period of time.

With the change in reimbursement, with the patient flow, with the lack of staffing, that channel for now is challenged in pulling those men in and expanding the market, so I think that we need to get the office channel addressed and I just can't see that getting addressed in the next two quarters being totally honest, so I think it's going to take it some time to recover.

Now having said that. This quarter we trained more docs than we had the quarter before for a number of quarters. So docs are putting their hands up to get trained. The international profile is excellent. I couldn't be happier to what's happening overseas and domestically I think that for the remainder of the year, I think it's going to do what I said is going to do. There are a couple of green shoots, it was minus 5% last year with minus 5% in the first quarter, it was minus 2.5% this quarter. So there's a couple of green shoots as some positivity there, but I think that it's a challenge call point in that office right now with all of the factors that are playing into it.

Operator

Our next question will come from Craig Bijou of Bank of America Securities. Please go ahead.

Craig Bijou
Analyst at Bank of America Securities

Good morning, guys. Thanks. Thanks for taking the question. So wanted to start with some of the components of the LRP, and namely, Liam, I think you said that you now expect Interventional Urology including Paulette to grow at least 8%, which would mean underlying UroLift's longer-term growth takes a step down. So, I just wanted to make sure that -- that's correct and maybe what's driving that, is that -- that it sounds like it's the US side, but maybe a little bit more color on what you see over the next several years for UroLift. And then also Standard Bariatrics so I know you're expecting some pretty good growth for the next several years. I'm just wondering, understand how we should think about that, that growth level in '24, '25 relative to what you had expected before.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Yeah, I mean, I think, I will start with the first part of your question -- your question and your assumption on your math is I can follow to, you are absolutely correct, but that's why I'm so confident in the 6% LRP, I'm not expecting any heroism, I'm not expecting anything from UroLift within the LRP right now, the international market is strong, if the domestic market recovers, it's great for investors, it's great for Teleflex and it's great for our LRP. The margin profile is strong. So in effect, in my mind, this is basically to take UroLift off the table in regards to the LRP.

With regard to Standard Bariatrics. Like I said earlier, it's a huge market, once we get through the VAC committees and the -- the proctoring up the surgeons. Our goal here is to continue with the performance of the product to continue to take our appreciated share in the bariatrics lead market, bariatrics lead market isn't going away because of the GLP-1s, it's going to be there forever. There is a place for this, if you talk to any surgeons will tell you that, so I do believe that it's going to be a meaningful contributor to the LRP for '24 and '25 as we grow into that huge market.

Craig Bijou
Analyst at Bank of America Securities

Got it. And just as a follow-up on '24, I know you guys aren't going to provide guidance or talk about what the Street has estimated but we'd love to hear any of the puts and takes that are going to affect '24, obviously, you have the Palette acquisition, with have the MSA rolling-off, so I just want to ask you specifically on what we should be thinking about when we're thinking about '24 EPS and if you maybe the messaging that you guys have given previously, is not fully quite reflected in the Street's estimates.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

So I'll let Tom comment on the EPS. I mean, I think you've hit the two main ones that I think the Street needs to think about, but obviously the MSA, the $70 million of revenue that goes away next year then you layer in and that's a very low margin and has an impact on EPS of about $0.25, but then you layer in the Palette acquisition, and of course, the Palette acquisition adds back in $56 million of revenue. I think on the base year and obviously then growing at high-teens to low 20s, so that -- those are the puts and takes on the top line. And I'm not expecting, Tom, to get into any real details about 2024 EPS, but I think those are the two main ones, Tom. Aren't they?

Thomas Powell
Executive Vice President and Chief Financial Officer at Teleflex

I think they are. I will say that a couple of things that we're watching as well. Foreign-exchange rates which have shown a nice improvement recently, and so that should give us half year benefit next year, and we're also starting to see some improvements in the areas of inflation, so we're seeing, our sea freight has already come back and shipping times are improving dramatically, which will allow us to be able to do a couple of things, including bringing down our level of inventories, which will obviously help out our cash flows as we continue to manage those down, but I think the key -- the key things that are changing or the MSA, Palette, and then we're watching FX and inflation mostly but those could be some tailwinds for us.

Operator

Our next question comes from Kristen Stewart of CL King. Please go ahead.

Kristen M. Stewart
Analyst at C.L. King & Associates

Hi, thanks for taking my question. Tom, I was just wondering on the bottom line, why just reiterate the guidance rather than tightening the range?

Thomas Powell
Executive Vice President and Chief Financial Officer at Teleflex

Well, it's -- it's a fair question. As we think about what's happened is that we -- we looked at all the puts and takes of the quarter and there are end of the year. And so if you if you think about what we've commented on the EPS range is really driven by adding in the incremental dilution from Palette of $0.15 and then associated with the recalls in the second quarter, we had another $0.15 of expense.

The FX as I mentioned, has improved, and as a result of both second quarter and full-year expected benefits that actually is an offset of $0.15 and then the balances, a combination of improved operating performance in the second quarter and second half. So essentially a number of changes since our last guidance, that pretty much net out. As Liam commented, we are covering the dilution associated with the Palette acquisition and still maintaining guidance. So we're -- we're effectively raising, if you will, from that standpoint that we're covering something new but as we continue to monitor the year, we'll look at it and reevaluate the range in the third quarter.

Kristen M. Stewart
Analyst at C.L. King & Associates

Okay, thanks very much.

Operator

Our next question will come from Richard Newitter of Trust -- Truist Securities. Please go ahead.

Richard Newitter
Analyst at Truist Securities

Hi, it's on flow grid. So maybe, I'm wondering if you could provide some color on the trends in your high-growth portfolio including MANTA, hemostatic devices etc. Thank you.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Yeah, as I said in my prepared remarks MANTA continues to penetrate, the market is on track for real solid double-digit growth. If you look at the other areas of the high-growth portfolio we've discussed, two of them already, and we would expect ex-UroLift for the high-growth portfolio to be well within those high single digit growth. I do want to take a moment on the durable core, if you don't mind, I think the durable core has been performing really-really solidly. We've had excellent performance from OEM that was mentioned earlier but Interventional Access has had a great performance as has Asia-Pacific and as investors familiar with Teleflex will be aware about Interventional and APAC had very strong gross margins for the company, so they -- the whole portfolio of Teleflex, we believe is working really-really well from the durable core to the high-growth and we believe that for two quarters in a row, we call it up our revenue forecast, two quarters in a row and we have seen significant improvement from last year, think back last year we grew 4.3%, look at our guidance for this year, the midpoint houses that almost 5.9%, so we've seen significant improvement.

And again, this is the advantage of a diversified global company, not everything is going to go the way you think. But when you add it all together, it all makes sense and it's I think -- it's -- it's a solid performance and the additional of Palette is really going to help us.

Richard Newitter
Analyst at Truist Securities

That's great. So, maybe a follow-up on margins. Could you walk us through the cadence of gross margin, operating margin throughout the year? Thank you.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

You want the cadence of gross margin and operating margin throughout this year.

Richard Newitter
Analyst at Truist Securities

Correct.

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Okay. I might ask Tom to cover that.

Thomas Powell
Executive Vice President and Chief Financial Officer at Teleflex

Absolutely, well I think, first of all, one thing that you may want to understand, is just that FX has got a pretty meaningful impact on how margins actually play out. We are -- we actually saw foreign exchange have a meaningful positive impact in the first quarter, it turned slightly negative in the second quarter as it impacts gross margin and then the third quarter and fourth quarter, we expect after the FX impact, or I should say we expect the FX impact to be even greater to gross margins. So if you were to strip out the foreign-exchange impact, what you'd see is sequentially improving gross margin throughout the year with a fairly sizable improvement from the first quarter to the second quarter and then again from the third quarter to the fourth quarter. If you were to maintain the FX in there, what you're going to see is our gross margin that is about the same each quarter, a little bit softer in the third, a little bit stronger in the fourth as you know, what we experienced here in the second quarter.

In the second quarter, we had a couple of puts and takes, obviously, we had the recall expense, foreign exchange, as I mentioned was modestly a negative impact, but we also had favorable pricing and some credits from foreign countries that provided some benefit. So overall, I would say that pay attention to how FX may play out, and if you were to strip that out, you'd see sequentially improving gross margin and it's very similar on the operating margin. If you strip out the FX impact, you'd see sequentially improving op margin throughout the year. Obviously, we do have to consider FX and as a result, what you're going to see is by a little bit softer gross margin in the third quarter and something the same or a little bit stronger in the fourth quarter as what we saw in the second. Our next question will come from George Sellers of Stephens. Please go ahead.

George Sellers
Analyst at Stephens

Good morning, and thanks for taking the question. I guess, switching back to Palette quickly with the 97% of your lift years used that are also treating prostate cancer. And I believe you said 20% already use Barrigel. Are they also already using a spacer product or is this more of a white space opportunity?

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

So there would, George, great question. There would be a white space opportunity of about 60% in addition and in total about 40% of them are using a spacing product of some sort, 20% of them are using Barrigel, and so, therefore, you would be left with around 60% of white space and again I will reiterate for us, this is not about attacking the other 20%, this is about attacking the 60%, educating the physicians on the benefits of using spacing, the benefits of Barrigel as a spacer are the ones I outlined already and to remove that toxicity from other organs around the prostate. So it's really around whitespace, George growing into an existing customer that we know, engaging with the radiology oncologists, which is an excellent call point for us to get into where some of that -- some of the product is used by those individuals. So really encouraged by that, and I think it's a nice opportunity.

George Sellers
Analyst at Stephens

Okay, thank you for that detail. That's really helpful. Switching to the OEM segment, this continues to really perform exceptionally well and it sounds like you've got visibility to that continuing through the remainder of the year, but could you just give some additional detail on the pieces driving that outperformance and how should we be thinking about that sustainability over the LRP?

Liam J. Kelly
Chairman, President and Chief Executive Officer at Teleflex

Yeah, I think great question again, George, I think that's the beauty about the OEM business right across the board. We've got really strong double-digit into the catheter business, we've got a really strong double-digit in the suture business, we've got really strong double-digits in the completed product business and obviously, the complex catheters within those catheters are performing exceptionally well, it's right across the board, you're correct, we have great visibility to this business. This is one business where the customers order well ahead in advance to make sure they have capacity booked and again I think we have a -- we're really encouraged by what we see, it is dilutive to our gross margins, but God is it accretive to our op margins. This is a great business for us and one that's performing exceptionally well with long visibility and if I could find another token to put into OEM, we've got the capital available, they do it in the morning, because it's -- it's we've got solid growth within there and a really strong customer base.

Operator

That is all the time that we have for questions this morning, I'd like to turn the conference back to Lawrence Keusch for closing remarks.

Lawrence Keusch
Vice President, Investor Relations and Strategy Development at Teleflex

Thank you, Joao, and thank you to everyone that joined us on the call today. This concludes the Teleflex Incorporated second quarter 2023 earnings conference call.

Operator

[Operator Closing Remarks]

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