Robert Ford: Sure, Larry. Well, I think Libre had not a great year, full year growth of over 21% strong growth in the U.S. over 42%. And international kind of grew in those mid-teens number. We were impacted a little bit by back orders, as you said, on the international side. And I’d say probably a little bit more on our early generation products so kind of Libre 1 was that. We had a significant improvement in that situation in Q4. I expect 1 or 2 more months of until we can completely resolve that, but a significant improvement over there on our international performance. I think one of the key things on the international side is it was a little bit of this supply chain on chips that we had, like that I said, is mostly behind us.
The other part of it is the upgrade cycle, right? And when you go with an accelerated upgrade cycle versus with Libre 3 that we did from Libre 2 in some of our key markets, when we went from Libre 1 to Libre 2, we let that upgrade kind of somewhat happen naturally. And that takes about 1.5 years, 2 years to a complete. For Libre 3, we wanted to go more aggressively in some of these markets. So that takes our sales force away from new demand generation to making sure that we can get the scripts and do all the behind-the-scenes work for those upgrades. So that’s €“ I would say that’s still ongoing, but I’d call it about 80% to 85% complete. So then that allows us starting now in 2023 on the international side to start kind of driving new additions here.
So I’d say, I expect continued growth in the U.S. in terms of market expansion, Basel opportunity, I think, is a great opportunity, and I think it will start in the U.S. But I think we’re seeing that also internationally. And now that we’ve got the supply chain issue largely behind us, and the upgrade cycle, again, largely behind us, we can forecast our demand generation activities on new users. So I think that, that’s one key driver of growth for us €“ can we see a path for another 20% growth in 2023. Yes, I can. And I think there is a lot of opportunities of growth. I think one of them that you mentioned being the Basel expansion is a significant opportunity. I think we’ve been leading the charge over here, Larry, in terms of generating the clinical data that’s required to be able to support reimbursement.
It will start, I think, in the U.S., but I don’t think it will be a U.S.-only phenomenon. But in the U.S., we will probably start first. You’ve got about 4 million Type 2 Basel patients in the U.S., about third of them are Medicare. And even if you assume a reasonable market penetration, you also have to assume difference in annual utilization rates versus Type 1 an MDI or a pumper. But even if you take all that into consideration, the opportunity starts with a $1 billion and it can range depending on the speed and the uptake of that. So I think this is a great growth opportunity. And like I said, I don’t think it’s a U.S.-only situation. I think this is going to is going to start to expand across the world, given the clinical data that you see with Libre and the impact that it has.
So I think this is another great opportunity for us. The vitamin C issue that you asked, we’ve submitted our response. We’re working with the FDA on this, and I’m not going to try and forecast that approval. But what I would say is that as soon as that gets approved, then we will start to see the product with a couple of quarters connect to ID pump systems. We have already launched a connected ID system, AID system in Europe, initial results of the receptivity of that product combined product in Europe has been very favorable. So I think that’s another key growth driver for us in 2023. And then finally, I would say on the pipeline perspective, I don’t think it’s a 2023 milestone for sales, but I think it’s an important development activity for us is going to be the running our trial for the compline glucose ketone sensor with the FDA and generating the data to support a dual sensor because I think, again, as I’ve mentioned, it seems to be the go-to sensor for pumpers will be this ability to measure glucose and ketones and factoring that into the algorithms.
So that’s going to be €“ that’s obviously having a lot of focus of us in terms of running that trial. And then finally, I would say, outside of Libre, the Lingo platform is another kind of key growth driver for us. I’ve talked about expanding Libre, the Libre platform outside of diabetes and using this more broadly for a much more broader target. We have a separate team that’s been working on that development, Larry. We will be launching two Lingo products this year. In Europe, I’d say the first one will probably be in the first half of this year and the second one in the second half. So I’ve talked about Libre being a $10 billion product by 2028 that implies a 15% annual growth rate. We will do better than that this year. And I think the opportunities we have to be able to drive to that kind of revenue for this product are very real.
And I think we’ve been executing very strongly on all these areas.
Larry Biegelsen: That’s super helpful. Just one brief follow-up, you talked about being excited about the TriClip opportunity at JPMorgan. I think it was just a month. I know it’s limited in what you can say because you are presenting the TRILUMINATE data at ACC. But how are you thinking about that opportunity relative to mitral? Do you still expect to do you still expect approval in the U.S. by year-end €˜23? Thanks for taking the questions.
Robert Ford: I think it’s a great opportunity for us. And I think that we’ve shown that we’re definitely here one of the leaders when it comes clip-based heart valve repair market. And I think it’s €“ I think it’s €“ it could be bigger than mitral. I’m not sure I would go that far yet. But I would say that the uptake of the tricuspid repair market, I think, will be faster than the uptake for the mitral just because I think when mitral was launched, it was the first repair system and now you have a large group of implanting physicians that are familiar with the clip technology are familiar with mapping that clip technology and the procedure. We did make some changes to the delivery device for the clip, it’s a little different anatomy, a little bit more challenging to get there with the clip the tricuspid area.
But I think that it’s a great opportunity. I mean, I think there is 3 million people today that suffer from tricuspid regurgitation. There is not a lot of really good options available for treatment which is why we invested in the trial here in the U.S. to bring products to the trial. Like you said, we’re going to be presenting that in a couple of months. And I think it’s a great opportunity for us. We’ve already seen real nice traction of that in Europe. We launched that in 2021. The team wanted to launch it right in COVID. And I must say at the beginning, I was somewhat against that but they proved me wrong and the product’s done really well in Europe. So I think this is another great opportunity for us here in the U.S., too. So we’re not ignoring MitraClip, it’s part of our entire portfolio.
And I think the combination of those two products in the implanting position will be very powerful for Abbott.
Larry Biegelsen: Alright. Thanks so much.
Operator: Thank you. And our next question will come from Josh Jennings from Cowen. Your line is open.
Josh Jennings: Hi, thanks for taking the questions. Good morning. Robert, I was hoping just to follow-up on Larry’s question just on Libre, just thinking more kind of in the out years and this $10 billion target that you’ve set. I think maybe just €“ I think you outlined everything for 2023, probably holds true for over the next 5 years. But just if you could reiterate your confidence we’re not in that $10 billion out-year target? And just you expect consolidation between pump and CGM companies. And maybe it would be just great to hear strategic rationale of whether a combined pump CGM offering under one roof would be advantageous for either Abbott or another company? And then the second question is just on Navitor and the launch here in the United States.
What would represent a win for Abbott from a U.S. share gain perspective? And what segment is the low-hanging fruit considering the current label? Is it the elderly patients that don’t have a long life expectancy that are high risk or even intermediate risk how do you expect a Navitor launch to play out and add to the macro device growth in 2023? Thanks for taking the question.
