• Globus Medical Reports Fourth Quarter and Full Year 2023 Results

    ソース: Nasdaq GlobeNewswire / 20 2 2024 16:15:01   America/New_York

    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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