Globus Medical (GMED) Q4 FY25 earnings call: guidance and Q&A

Inquired about the sustainability of the 9% H2 2025 base business growth and the path to mid-to-high single digits for 2026, and asked for more detail on the long-term mid-70s adjusted gross margin target.

Keith Pfeil attributed H2 2025 growth to sales force expansion, new product launches (9 in 2024, 6 in 2025), and increased inventory/set production. He noted continued momentum in U.S. Spine into Q1 2026. Kyle Kline reiterated the FY26 adjusted gross profit margin guidance of 69%-70% (at least 100 bps improvement) and explained that gross profit margin cadence typically follows seasonal revenue patterns, with the mid-70s target expected beyond 2026.

“As I look at the year, we did a really nice job growing our sales force with competitive rep conversions. When you think about the products that we've launched, we launched 9 products in spine in 2024 and another 6 in 2025. Those really helped drive some of that growth.”

asked by Shagun Singh Chadha · answered by Keith Pfeil

Asked about the company's market share perspective and the general strength of the spine market.

Keith Pfeil stated that Globus Medical continues to believe it is growing above the market, evidenced by 10% growth in Q3 and Q4 U.S. Spine. He views the overall spine market as 'relatively healthy.'

“As I think about our U.S. Spine business, I continue to believe that we're growing above market. I think that's evidenced in basically achieving 10% growth in Q3 and Q4 and really seeing some of that momentum continue as we get into the first quarter.”

asked by Unknown Analyst · answered by Keith Pfeil

Inquired about the rebound in Enabling Technologies, what changed, and the role of operating lease strategies in 2026 guidance.

Keith Pfeil explained that Q4 Enabling Tech saw pipeline deals close that had previously been elongated. He expects the pipeline to remain robust in 2026. The company will be more aggressive with operating leases and other flexible deal structures to drive capital placement and implant pull-through. Kyle Kline confirmed that 2026 guidance contemplates a mix of sales and fair market value leases/placements, with a higher mix of lease approaches expected compared to 2025.

“As I noted in my prepared remarks, we're absolutely going to be more aggressive because really what we're trying to drive is placement of that capital to drive really the implant pull-through.”

asked by Richard Newitter · answered by Keith Pfeil

Asked about the sustainability of the accelerated U.S. Spine growth and the company's view on a competitor's recently launched robot navigation system.

Keith Pfeil affirmed that U.S. Spine growth is 'durable' and sustainable, driven by new product launches, competitive rep conversions, and focus on core strengths. Regarding competition, he stated that ExcelsiusGPS remains a strong option, and recent competitive offerings reinforce its 2017 floor-mounted, navigated-based robotic approach. He believes Globus is well-positioned to weather competitive threats by combining technology with aggressive robot placement.

“As I think about spine and the growth, we see that growth for our business is durable and something that we look to sustain as we move forward.”

asked by Travis Steed · answered by Keith Pfeil

Inquired about further potential for cost reductions and synergies within the Nevro business, similar to NuVasive.

Kyle Kline stated that most G&A-related cost reductions for Nevro have largely taken place over the first 9 months. The focus is now shifting to growing sales volume to achieve incremental leverage. He noted that Nevro's gross profit margin (68%-69%) offers some opportunity for improvement through manufacturing efficiencies and smart raw material purchasing, but no 'large synergies' are expected on the Nevro side.

“Those actions largely have taken place over a 9-month period here. As we move forward into 2026 and beyond, we're really pivoting towards how do we maintain the sales force and ultimately grow our sales volume.”

asked by Anna Runci · answered by Kyle Kline

Asked why 2026 guidance implies a slowdown in legacy musculoskeletal growth given recent strong performance, and about the potential for further adjusted EBITDA margin expansion.

Keith Pfeil explained that Nevro is expected to remain 'choppy' in 2026, and Enabling Tech guidance accounts for more operating leases, which may not have immediate revenue recognition. He remains optimistic about core spine, international improvement, and trauma. Kyle Kline stated that while adjusted EBITDA margins are strong, the company plans to ramp R&D spend back to 5%-6% of sales, investing across spine, trauma, and capital, which will impact the immediate trajectory of EBITDA margins.

“I'm still expecting choppiness as we get into 2026.”

asked by Ryan Zimmerman · answered by Keith Pfeil