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Globus Medical Reports Fourth Quarter and Full Year 2023 Results

Feb 20, 2024

AUDUBON, Pa., Feb. 20, 2024 (GLOBE NEWSWIRE) -- Globus Medical, Inc. (NYSE: GMED), a leading musculoskeletal technology company, today announced its financial results for the fourth quarter and year ended December 31, 2023.

Fourth Quarter 2023:

  • Worldwide net sales were $616.5 million, an increase of 124.6%, or 123.8% on a constant currency basis
  • GAAP net income for the quarter was $15.0 million
  • GAAP diluted earnings per share (“EPS”) was $0.11 and non-GAAP diluted EPS was $0.60
  • Non-GAAP adjusted EBITDA was $170.0 million, or 27.6% of net sales

Full Year 2023:

  • Worldwide net sales were $1,568.5 million, an increase of 53.3% on an actual and constant currency basis
  • GAAP net income for the year was $122.9 million
  • GAAP diluted EPS was $1.07 and non-GAAP diluted EPS was $2.32
  • Non-GAAP adjusted EBITDA was $464.1 million, or 29.6% of net sales

“I am pleased to report on the remarkable progress we’ve made at Globus Medical. Our merger with NuVasive has been a transformative milestone, where we pursue a vision of providing the best innovative technology and most dedicated level of customer service for our surgeons and their patients,” said Dan Scavilla, president and CEO. “The integration is progressing according to plan, underscoring our commitment to a seamless transition and operational efficiency. Looking ahead to 2024, the pipeline of product launches, especially in enabling technologies, aligns with our philosophy of anticipating and meeting evolving customer needs. We recognize the importance of staying ahead of the curve, a principle that guides our approach to innovation and client service. I believe the potential for Globus has never been greater, as we continue to redefine spine surgery with procedural solutions built around enabling technology.”

“Worldwide sales set a record for both fourth quarter and full year 2023, as we completed the merger with NuVasive on September 1, 2023,” said Keith Pfeil, COO-CFO. “Excluding the impacts of the NuVasive merger, legacy Globus fourth quarter revenue was $304.1 million, an increase of 10.8 percent over the prior year fourth quarter, and full year revenue was $1.154 billion, or 12.8 percent higher than the prior year. We remain focused on merger integration activities as they continue to proceed according to plan and we look forward to achieving milestones as we work to get back to a steady state of running the business. We remain well positioned to deliver on our commitments for the coming year.”

Worldwide net sales for the fourth quarter were $616.5 million, an as-reported increase of 124.6% over the fourth quarter of 2023, and an increase of 123.8% on a constant currency basis. U.S. net sales for the fourth quarter of 2023 increased by 111.1% compared to the fourth quarter of 2022. International net sales increased by 200.9% over the fourth quarter of 2023 on an as-reported basis, and an increase of 200.8% on a constant currency basis. Net Sales increases were driven by the addition of NuVasive, as well as increased volume of spine product sales and enabling technology volume.

Worldwide net sales for the full year of 2023 were $1,568.5 million, an increase of 53.3% as compared to the full year of 2022 on an actual and constant currency basis. U.S. net sales for the full year of 2023 increased by 46.8 % compared to the full year of 2022. International net sales increased by 91.3% over the full year of 2023 on an as-reported basis, and an increase of 92.3% on a constant currency basis.

GAAP net income for the fourth quarter was $15.0 million, a decrease of 70.0% over the same period in the prior year, driven primarily by the addition of NuVasive results and acquisition related costs incurred in the quarter since the closing date. Diluted EPS for the fourth quarter was $0.11, compared to $0.49 for the fourth quarter of 2022. Non-GAAP net income for the fourth quarter was $83.5 million, an increase of 38.9% over the same period in the prior year, driven primarily by contributions from the NuVasive merger. Non-GAAP diluted EPS for the fourth quarter of 2023 was $0.60, compared to $0.59 in the fourth quarter of 2022, an increase of 2.1% driven by higher Non-GAAP net income, partially offset by a higher diluted share count as a result of the stock-for-stock merger with NuVasive.

Net cash provided by operating activities was $258.9 million, and non-GAAP free cash flow was $178.9 million for the full year of 2023.

2024 Annual Guidance

The Company reaffirms its full year 2024 revenue guidance range of $2.450 billion to $2.475 billion and fully diluted non-GAAP earnings per share range between $2.68 to $2.70.

Conference Call Information

Globus Medical will hold a teleconference to discuss its 2023 fourth quarter and full year results with the investment community at 4:30 p.m. Eastern Time today.

Participants may access the conference call live via webcast on the Investors page of Globus Medical’s website at https://www.investors.globusmedical.com/news-events/events-webcasts.

To participate via telephone, please register in advance at this link. Upon registration, all telephone participants will receive a confirmation email detailing how to join the conference call, including the dial-in number along with a unique passcode and registrant ID that can be used to access the call. The audio archive will be available after the call on the Investor page of the Globus Medical website.

About Globus Medical, Inc.

Based in Audubon, Pennsylvania, Globus Medical, Inc. was founded in 2003 by an experienced team of professionals with a shared vision to create products that enable surgeons to promote healing in patients with musculoskeletal disorders. Additional information can be accessed at www.globusmedical.com.

Non-GAAP Financial Measures

To supplement our financial statements prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”), management uses certain non-GAAP financial measures. For example, non-GAAP Adjusted EBITDA, which represents net income before interest income, net and other non-operating expenses, provision for income taxes, depreciation and amortization, stock-based compensation expense, provision for litigation, acquisition related costs/licensing and acquisition of in-process research and development, merger and acquisition related costs/licensing, certain foreign currency acquisition-related impacts, and gains and losses from strategic investments, is useful as an additional measure of operating performance, and particularly as a measure of comparative operating performance from period to period, as it is reflective of changes in pricing decisions, cost controls and other factors that affect operating performance, and it removes the effect of our capital structure, asset base, income taxes and interest income and expense. Our management also uses non-GAAP Adjusted EBITDA for planning purposes, including the preparation of our annual operating budget and financial projections. Provision for litigation represents costs incurred for litigation settlements or unfavorable verdicts when the loss is known or considered probable and the amount can be reasonably estimated, or in the case of a favorable settlement, when income is realized. Acquisition related costs/licensing represents the change in fair value of business-acquisition-related contingent consideration; costs related to integrating recently acquired businesses, including but not limited to costs to exit or convert contractual obligations, severance, retention bonus, duplicative costs and information system conversion; and specific costs related to the consummation of the acquisition process such as banker fees, legal fees, and other acquisition related professional fees, as well as one-time licensing fees. Acquisition of in-process research and development represents the expensing of acquired assets with no alternative future use and related fees. We also adjusted for certain foreign currency impacts related to the acquisition costs and gains/losses on strategic investments within other assets as we believe these impacts are not a measure of our operating performance.

In addition, for the period ended December 31, 2023 and for other comparative periods, we are presenting non-GAAP net income and non-GAAP Diluted Earnings Per Share, which represent net income and diluted earnings per share excluding the provision for litigation, amortization of intangibles, acquisition related costs/licensing, acquisition of in-process research and development, merger and acquisition related costs/licensing, certain foreign currency impacts, gains and losses from strategic investments, the impact of dilution attributable to the Convertible Notes, and the tax effects of all of the foregoing adjustments. We also present Non-GAAP gross profit, which excludes the impacts of any inventory acquisition-related costs within cost of goods sold. The tax effect adjustment represents the tax effect of the pre-tax non-GAAP adjustments excluded from non-GAAP net income. The tax impact of the non-GAAP adjustments is calculated based on the consolidated effective tax rate on a GAAP basis, applied to the non-GAAP adjustments, unless the underlying item has a materially different tax treatment, in which case the estimated tax rate applicable to the adjustment is used. We believe these non-GAAP measures are also useful indicators of our operating performance, and particularly as additional measures of comparative operating performance from period to period as they remove the effects of the foregoing items, which we believe are not reflective of underlying business trends. Additionally, for the period ended December 31, 2023 and for other comparative periods, we also define the non-GAAP measure of free cash flow as the net cash provided by operating activities, adjusted for the impact of restricted cash, less the cash impact of purchases of property and equipment. We believe that this financial measure provides meaningful information for evaluating our overall financial performance for comparative periods as it facilitates an assessment of funds available to satisfy current and future obligations and fund acquisitions. Furthermore, the non-GAAP measure of constant currency net sales growth is calculated by translating current year net sales at the same average exchange rates in effect during the applicable prior year period. We believe constant currency net sales growth provides insight to the comparative increase or decrease in period net sales, in dollar and percentage terms, excluding the effects of fluctuations in foreign currency exchange rates.

Non-GAAP adjusted EBITDA, non-GAAP net income, non-GAAP diluted earnings per share, non-GAAP gross profit, free cash flow and constant currency net sales growth are not calculated in conformity with U.S. GAAP. Non-GAAP financial measures have limitations as analytical tools and should not be considered in isolation or as a substitute for financial measures prepared in accordance with U.S. GAAP. These measures do not include certain expenses that may be necessary to evaluate our liquidity or operating results. Our definitions of non-GAAP adjusted EBITDA, non-GAAP net income, non-GAAP diluted earnings per share, non-GAAP gross profit, free cash flow and constant currency net sales growth may differ from that of other companies and therefore may not be comparable.

Safe Harbor Statements

All statements included in this press release other than statements of historical fact are forward-looking statements and may be identified by their use of words such as “believe,” “may,” “might,” “could,” “will,” “aim,” “estimate,” “continue,” “anticipate,” “intend,” “expect,” “plan” and other similar terms. These forward-looking statements are based on our current assumptions, expectations and estimates of future events and trends. Forward-looking statements are only predictions and are subject to many risks, uncertainties and other factors that may affect our businesses and operations and could cause actual results to differ materially from those predicted. These risks and uncertainties include, but are not limited to, the risks and costs associated with the integration of the NuVasive business and Globus Medical, Inc.’s ability to successfully integrate and achieve anticipated synergies with the NuVasive business, health epidemics, pandemics and similar outbreaks, factors affecting our quarterly results, our ability to manage our growth, our ability to sustain our profitability, demand for our products, our ability to compete successfully (including without limitation our ability to convince surgeons to use our products and our ability to attract and retain sales and other personnel), our ability to rapidly develop and introduce new products, our ability to develop and execute on successful business strategies, our ability to comply with laws and regulations that are or may become applicable to our businesses, our ability to safeguard our intellectual property, our success in defending legal proceedings brought against us, trends in the medical device industry, general economic conditions, and other risks. For a discussion of these and other risks, uncertainties and other factors that could affect our results, you should refer to the disclosure contained in our most recent annual report on Form 10-K filed with the U.S. Securities and Exchange Commission, including the sections labeled “Risk Factors” and “Cautionary Note Concerning Forward-Looking Statements,” and in our Forms 10-Q, Forms 8-K and other filings with the U.S. Securities and Exchange Commission. These documents are available at www.sec.gov. Moreover, we operate in an evolving environment. New risk factors and uncertainties emerge from time to time and it is not possible for us to predict all risk factors and uncertainties, nor can we assess the impact of all factors on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements. Given these risks and uncertainties, readers are cautioned not to place undue reliance on any forward-looking statements. Forward-looking statements contained in this press release speak only as of the date of this press release. We undertake no obligation to update any forward-looking statements as a result of new information, events or circumstances or other factors arising or coming to our attention after the date hereof.

 
GLOBUS MEDICAL, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF INCOME
(unaudited)
 
  Three Months Ended   Year Ended
  December 31,   December 31,
(In thousands, except per share amounts) 2023   2022   2021   2023   2022   2021
Net sales $ 616,534     $ 274,498   $ 250,021     $ 1,568,476     $ 1,022,843     $ 958,102  
Cost of sales   265,486       70,591     61,796       548,174       263,725       239,223  
Gross profit   351,048       203,907     188,225       1,020,302       759,118       718,879  
                                   
Operating expenses:                                  
Research and development   52,253       19,507     51,022       124,010       73,015       97,346  
Selling, general and administrative   244,718       118,075     106,560       643,410       432,117       408,149  
Provision for litigation, net   250           5,410       434       2,341       5,921  
Amortization of intangibles   28,122       4,506     4,556       51,032       17,735       18,526  
Acquisition-related costs   15,581       7,791     2,477       68,274       5,959       16,984  
Total operating expenses   340,924       149,879     170,025       887,160       531,167       546,926  
                                   
Operating income/(loss)   10,124       54,028     18,200       133,142       227,951       171,953  
                                   
Other income/(expense), net                                  
Interest income/(expense), net   (2,581 )     5,315     1,939       20,130       14,233       9,297  
Foreign currency transaction gain/(loss)   19,908       2,688     (454 )     14,259       (1,020 )     (1,423 )
Other income/(expense)   (2,456 )     85     143       (2,138 )     1,855       580  
Total other income/(expense), net   14,871       8,088     1,628       32,251       15,068       8,454  
                                   
Income/(loss) before income taxes   24,995       62,116     19,828       165,393       243,019       180,407  
Income tax provision   9,960       12,051     4,722       42,520       52,850       31,216  
                                   
Net income/(loss) $ 15,035     $ 50,065   $ 15,106     $ 122,873     $ 190,169     $ 149,191  
                                   
Other comprehensive income/(loss), net of tax:                                  
Unrealized gain/(loss) on marketable securities   8,893       4,199     (2,623 )     13,231       (14,040 )     (6,054 )
Foreign currency translation gain/(loss)   (18 )     3,397     (1,095 )     1,207       (3,818 )     (4,673 )
Total other comprehensive income/(loss), net of tax   8,875       7,596     (3,718 )     14,438       (17,858 )     (10,727 )
Comprehensive income/(loss) $ 23,910     $ 57,661   $ 11,388     $ 137,311     $ 172,311     $ 138,464  
                                   
Earnings per share:                                  
Basic $ 0.11     $ 0.50   $ 0.15     $ 1.09     $ 1.89     $ 1.48  
Diluted $ 0.11     $ 0.49   $ 0.14     $ 1.07     $ 1.85     $ 1.44  
Weighted average shares outstanding:                                  
Basic   137,883       99,967     101,495       113,087       100,469       100,734  
Diluted   139,021       102,209     104,192       114,630       102,643       103,623  


 
GLOBUS MEDICAL, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(unaudited)
             
    December 31,   December 31,
(In thousands, except share and per share values)   2023   2022
ASSETS            
Current assets:            
Cash and cash equivalents   $ 467,292     $ 150,466  
Short-term marketable securities     50,497       295,592  
Accounts receivable, net of allowances of $8,934 and $4,724, respectively     503,235       213,247  
Inventories     848,135       298,981  
Prepaid expenses and other current assets     44,580       20,997  
Income taxes receivable     1,635       4,061  
Total current assets     1,915,374       983,344  
Property and equipment, net of accumulated depreciation of $425,695 and $343,036, respectively     586,932       243,729  
Operating lease right of use assets     59,931       5,988  
Long-term marketable securities     75,428       495,852  
Intangible assets, net     924,603       63,574  
Goodwill     1,434,540       197,471  
Other assets     78,590       37,323  
Deferred income taxes     10,685       48,845  
Total assets   $ 5,086,083     $ 2,076,126  
             
LIABILITIES AND EQUITY            
Current liabilities:            
Accounts payable   $ 56,671     $ 36,101  
Accrued expenses     240,460       92,169  
Operating lease liabilities     11,967       2,536  
Income taxes payable     3,845       990  
Business acquisition liabilities     61,035       13,308  
Deferred revenue     18,369       14,100  
Total current liabilities     392,347       159,204  
Business acquisition liabilities, net of current portion     78,323       54,950  
Operating lease liabilities     91,037       3,475  
Senior convertible notes     417,400        
Deferred income taxes and other tax liabilities     84,421       1,779  
Other liabilities     24,596       10,345  
Total liabilities     1,088,124       229,753  
             
Equity:            
Class A common stock; $0.001 par value. Authorized 500,000,000 shares; issued and outstanding 113,905,565 and 77,762,282 shares at December 31, 2023 and December 31, 2022, respectively     114       78  
Class B common stock; $0.001 par value. Authorized 275,000,000 shares; issued and outstanding 22,430,097 and 22,430,097 shares at December 31, 2023 and December 31, 2022, respectively     22       22  
Additional paid-in capital     2,870,749       630,952  
Accumulated other comprehensive income/(loss)     (10,192 )     (24,630 )
Retained earnings     1,137,266       1,239,951  
Total equity     3,997,959       1,846,373  
Total liabilities and equity   $ 5,086,083     $ 2,076,126  


 
GLOBUS MEDICAL, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(unaudited)
                   
    Year Ended
    December 31,
(In thousands)   2023   2022   2021
Cash flows from operating activities:                  
Net income   $ 122,873     $ 190,169     $ 149,191  
Adjustments to reconcile net income to net cash provided by operating activities:                  
Acquired in-process research and development           150       34,312  
Depreciation and amortization     144,733       68,252       69,867  
Amortization of premiums on marketable securities     793       5,389       2,781  
Provision for excess and obsolete inventory     10,959       6,400       6,143  
Amortization of inventory fair value step up     71,656              
Amortization of 2025 Note fair value step up     8,176              
Stock-based compensation expense     52,742       32,810       30,586  
Allowance for doubtful accounts     3,658       (1 )     1,200  
Change in fair value of business acquisition liabilities     17,434       5,132       16,807  
Change in deferred income taxes     (57,789 )     (22,223 )     (17,615 )
(Gain)/loss on disposal of assets, net     1,541       299       464  
Payment of business acquisition related liabilities     (3,005 )     (2,647 )     (210 )
Net (gain)/loss from foreign currency adjustment     (13,674 )            
(Increase) decrease in:                  
Accounts receivable     (49,914 )     (50,843 )     (25,895 )
Inventories     (70,328 )     (61,745 )     (11,971 )
Prepaid expenses and other assets     1,148       (10,292 )     (6,178 )
Increase (decrease) in:                  
Accounts payable     (14,223 )     14,418       3,684  
Accrued expenses and other liabilities     17,127       6,087       17,896  
Income taxes payable/receivable     (408 )     (2,887 )     5,212  
Net cash provided by/(used in) operating activities     243,499       178,468       276,274  
Cash flows from investing activities:                  
Purchases of marketable securities     (100,643 )     (419,534 )     (622,359 )
Maturities of marketable securities     240,190       312,221       227,908  
Sales of marketable securities     537,723       102,433       109,898  
Purchases of property and equipment     (78,274 )     (74,047 )     (56,898 )
Acquisition of businesses, net of cash acquired and purchases of intangible and other assets     (296,028 )     (31,435 )     (34,488 )
Net cash provided by/(used in) investing activities     302,968       (110,362 )     (375,939 )
Cash flows from financing activities:                  
Payment of business acquisition-related liabilities     (8,039 )     (7,185 )     (9,349 )
Net proceeds from exercise of stock options     12,397       41,716       63,496  
Payments related to tax withholdings for share-based compensation     (10,617 )            
Repurchase of common stock     (225,562 )     (144,493 )      
Net cash provided by/(used in) financing activities     (231,821 )     (109,962 )     54,147  
Effect of foreign exchange rates on cash     2,180       (747 )     (810 )
Net increase/(decrease) in cash and cash equivalents     316,826       (42,603 )     (46,328 )
Cash and cash equivalents at beginning of period     150,466       193,069       239,397  
Cash and cash equivalents at end of period   $ 467,292     $ 150,466     $ 193,069  
                   
Supplemental disclosures of cash flow information:                  
Income taxes paid, net   $ 100,593     $ 77,823     $ 45,027  
Non-cash investing and financing activities:                  
Equity issued in conjunction with the NuVasive merger   $ 2,153,883     $        
Accrued purchases of property and equipment   $ 7,100     $ 7,423     $ 4,551  


                                     
Supplemental Financial Information

Net Sales by Product Category:
                         
    Three Months Ended   Year Ended
    December 31,   December 31,
(In thousands)   2023   2022   2021   2023   2022   2021
Musculoskeletal Solutions   $ 583,820   $ 244,999   $ 224,624   $ 1,448,260   $ 926,703   $ 876,780
Enabling Technologies     32,714     29,499     25,397     120,216     96,140     81,322
Total net sales   $ 616,534   $ 274,498   $ 250,021   $ 1,568,476   $ 1,022,843   $ 958,102


Liquidity and Capital Resources:
             
    December 31,   December 31,
(In thousands)   2023   2022
Cash and cash equivalents   $ 467,292   $ 150,466
Short-term marketable securities     50,497     295,592
Long-term marketable securities     75,428     495,852
Total cash, cash equivalents and marketable securities   $ 593,217   $ 941,910
             

The following tables reconcile GAAP to Non-GAAP financial measures.

Non-GAAP Adjusted EBITDA Reconciliation Table:
 
  Three Months Ended   Year Ended
  December 31,   December 31,
(In thousands, except percentages) 2023   2022   2021   2023   2022   2021
Net income/(loss) $ 15,034     $ 50,065     $ 15,106     $ 122,873     $ 190,169     $ 149,191  
Interest (income)/expense, net   2,581       (5,315 )     (1,939 )     (20,130 )     (14,233 )     (9,297 )
Provision for income taxes   9,960       12,051       4,722       42,520       52,850       31,216  
Depreciation and amortization   71,162       16,911       16,829       144,733       68,252       69,867  
EBITDA   98,737       73,712       34,718       289,996       297,038       240,977  
Stock-based compensation expense   11,577       8,507       7,805       38,995       32,810       30,586  
Provision for litigation, net   250             5,410       434       2,341       5,921  
Acquisition-related costs/licensing   76,431       7,791       2,934       148,498       6,854       19,622  
Acquisition of in-process research and development         150       34,312             150       34,312  
Net (gain) loss from strategic investments   (460 )                 (192 )            
Non-cash acquisition-related foreign currency impacts   (16,572 )                 (13,674 )            
Adjusted EBITDA $ 169,963     $ 90,160     $ 85,179     $ 464,057     $ 339,193     $ 331,418  
                                   
Net income/(loss) as a percentage of net sales   2.4 %     18.2 %     6.0 %     7.8 %     18.6 %     15.6 %
Adjusted EBITDA as a percentage of net sales   27.6 %     32.8 %     34.1 %     29.6 %     33.2 %     34.6 %


Non-GAAP Net Income Reconciliation Table:
 
  Three Months Ended   Year Ended
  December 31,   December 31,
(In thousands) 2023   2022   2021   2023   2022   2021
Net income/(loss) $ 15,034     $ 50,065     $ 15,106     $ 122,873     $ 190,169     $ 149,191  
Provision for litigation, net   250             5,410       434       2,341       5,921  
Amortization of intangibles   28,123       4,506       4,556       51,032       17,735       18,526  
Acquisition-related costs/licensing   76,431       7,791       2,934       148,498       6,854       19,622  
Acquisition of in-process research and development         150       34,312             150       34,312  
Non-cash acquisition-related foreign currency impacts   (16,572 )                 (13,674 )            
Net gain/(loss) on strategic investments   (460 )                 (192 )            
Tax effect of adjusting items   (19,310 )     (2,415 )     (11,245 )     (42,570 )     (5,695 )     (16,151 )
Non-GAAP net income/(loss) $ 83,496     $ 60,097     $ 51,073     $ 266,401     $ 211,554     $ 211,421  


Non-GAAP Gross Profit Reconciliation Table:
                                   
  Three Months Ended   Year Ended
  December 31,   December 31,
(In thousands) 2023   2022   2021   2023   2022   2021
Cost of sales $ 265,486     $ 70,591     $ 61,796     $ 548,174     $ 263,725     $ 239,223  
Acquisition related costs/licensing   (52,591 )                 (71,656 )            
Adjusted cost of sales $ 212,895     $ 70,591     $ 61,796     $ 476,518     $ 263,725     $ 239,223  
                                   
Adjusted gross profit $ 403,638     $ 203,907     $ 188,225     $ 1,091,958     $ 759,118     $ 718,879  
Adjusted gross profit as a percentage   65.5 %     74.3 %     75.3 %     69.6 %     74.2 %     75.0 %


Non-GAAP Diluted Earnings Per Share Reconciliation Table:
 
  Three Months Ended   Year Ended
  December 31,   December 31,
(In thousands) 2023   2022   2021   2023   2022     2021
Diluted earnings per share, as reported $ 0.11     $ 0.49     $ 0.14     $ 1.07     $ 1.85     $ 1.44  
Provision for litigation, net   0.00             0.06             0.02       0.06  
Amortization of intangibles   0.20       0.04       0.04       0.45       0.17       0.18  
Acquisition-related costs/licensing   0.55       0.08       0.03       1.30       0.07       0.19  
Acquisition of in-process research and development               0.33                   0.33  
Net (gain) loss from strategic investments   (0.00 )                 (0.00 )            
Non-cash acquisition-related foreign currency impacts   (0.12 )                 (0.12 )            
Tax effect of adjusting items   (0.14 )     (0.02 )     (0.11 )     (0.37 )     (0.06 )     (0.16 )
Non-GAAP diluted earnings per share $ 0.60     $ 0.59     $ 0.49     $ 2.32     $ 2.06     $ 2.04  

*amounts might not add due to rounding

Non-GAAP Free Cash Flow Reconciliation Table:
                                   
  Three Months Ended   Year Ended
  December 31,   December 31,
(In thousands) 2023     2022     2021     2023     2022     2021  
Net cash provided by operating activities $ 104,674     $ 63,975     $ 76,253     $ 243,499     $ 178,468     $ 276,274  
Purchases of property and equipment   (22,881 )     (18,340 )     (17,045 )     (78,274 )     (74,047 )     (56,898 )
Free cash flow $ 81,793     $ 45,635     $ 59,208     $ 165,225     $ 104,421     $ 219,376  


Non-GAAP Net Sales on a Constant Currency Basis Comparative Table:
                           
    Three Months Ended
December 31,
  Reported
Net Sales
Growth
  Currency
Impact on 
Current
Period Net Sales
  Constant
Currency
Net Sales
Growth
 
         
(In thousands, except percentages)   2023   2022      
United States   $ 490,841   $ 233,232   110.5%   $   110.5%  
International     125,693     41,266   204.6%     2,331   198.9%  
Total net sales   $ 616,534   $ 274,498   124.6%   $ 2,331   123.8%  


    Year Ended
December 31,
  Reported
Net Sales
Growth
  Currency
Impact on 
Current
Period Net Sales
  Constant
Currency
Net Sales
Growth
 
         
(In thousands, except percentages)   2023   2022      
United States   $ 1,279,765   $ 871,939   46.8%   $   46.8%  
International     288,711     150,904   91.3%     860   90.8%  
Total net sales   $ 1,568,476   $ 1,022,843   53.3%   $ 860   53.3%  
                             

Contact:
Brian Kearns
Senior Vice President, Business Development and Investor Relations
Phone: (610) 930-1800
Email: investors@globusmedical.com
www.globusmedical.com 


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Source: Globus Medical

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