Conferencia de resultados del 3T de 2026 de ICU Medical (ICUI): crecimiento de los ingresos, mejoras en los márgenes y previsiones

Puntos clave

• Los ingresos del tercer trimestre de 2026 alcanzaron los 556 millones de dólares, con un alza del 4% en términos reportados y del 5% en términos orgánicos, impulsados por ventas récord en Sistemas de infusión y Consumibles de infusión.
• El margen bruto ajustado mejoró aproximadamente 1 punto porcentual de forma secuencial hasta el 42%, lo que refleja sinergias de integración y una combinación favorable de productos.
• El EBITDA ajustado aumentó un 8% interanual hasta los 114 millones de dólares, mientras que el BPA diluido ajustado creció un 20% hasta los 2,44 dólares.
• El flujo de caja libre se situó en 83 millones de dólares, incluidos 11 millones de dólares en reembolsos arancelarios. ICU Medical amortizó aproximadamente 80 millones de dólares de deuda y redujo el apalancamiento neto a 2x.
• La dirección espera que el EBITDA ajustado y el BPA ajustado para todo el año terminen hacia la parte alta de los rangos de previsión actuales de 415 a 435 millones de dólares y de 8,60 a 9,00 dólares.
• Los ingresos orgánicos de Vital Care cayeron un 10%, ya que la consolidación de la red de distribución afectó a los envíos internacionales, si bien la dirección espera una mejora secuencial en el cuarto trimestre.

Datos financieros clave

ICU Medical contabilizó 8 millones de dólares en gastos arancelarios, equivalentes a aproximadamente el 1,5% de los ingresos ajustados. La compañía excluyó la totalidad del reembolso arancelario de 11 millones de dólares de su cuenta de resultados no GAAP, pero lo incluyó en el flujo de caja libre. Los reembolsos arancelarios acumulados sumaron 31 millones de dólares, y la dirección no prevé reembolsos adicionales significativos.

Desempeño comercial y operativo

Consumibles de infusión

Los ingresos aumentaron un 5% y alcanzaron un récord trimestral. El crecimiento reflejó una sólida afluencia de pacientes, ganancias de cuota de mercado, la demanda en oncología y la solidez de los productos tradicionales de terapia de infusión de ICU Medical.

La dirección sigue esperando un crecimiento de un dígito medio para todo el año 2026. También destacó contratos ganados en consumibles para bombas, innovaciones graduales de productos, la demanda internacional en oncología y un crecimiento más rápido en ciertas categorías extrahospitalarias.

Sistemas de infusión

Los ingresos crecieron un 11%, tanto en términos reportados como orgánicos, marcando otro récord trimestral. Las bombas de gran volumen, los contratos ganados frente a competidores, la actividad temprana de sustitución y la alta utilización de equipos dedicados impulsaron los resultados, contrarrestados en parte por la caída de los ingresos de OEM.

La dirección prevé que el negocio crezca al menos a una tasa de un dígito alto en 2026, en parte porque cierto volumen programado previamente para principios de 2027 se trasladará al cuarto trimestre. Se espera que el ciclo más amplio de sustitución de bombas siga siendo una oportunidad plurianual a lo largo de 2027, 2028 y 2029.

ICU Medical planea presentar una solicitud 510(k) revisada para la bomba de jeringa Med Fusion 5000 en las semanas posteriores a la conferencia. La compañía también recibió las aprobaciones de Canadá para la Med Fusion 5000 y las últimas versiones de CADD, así como la autorización europea para las bombas de gran volumen Plum Duo y Solo.

Vital Care

Los ingresos de Vital Care disminuyeron un 12% en términos reportados y un 10% en términos orgánicos. La dirección atribuyó la mayor parte de la debilidad a perturbaciones operativas derivadas de la consolidación de la red logística y de distribución heredada de Smiths Medical, con un mayor impacto en los mercados internacionales.

La compañía priorizó los envíos de Sistemas de infusión, seguidos por los de Consumibles de infusión y luego los de Vital Care. La dirección señaló que esto modificó la combinación de ventas del trimestre, pero no tuvo un impacto neto en los ingresos totales de la empresa. Se espera que la mayoría de los problemas logísticos se resuelvan en el cuarto trimestre, aunque el descenso de Vital Care en todo el ejercicio será mayor de lo previsto anteriormente.

La empresa conjunta con Otsuka Pharmaceutical Factory inició la construcción de una nueva planta de soluciones intravenosas durante el tercer trimestre. La dirección afirmó que la alianza tiene como objetivo respaldar una producción a menor coste y la transición hacia formatos de soluciones intravenosas libres de PVC y DEHP.

Previsiones de la dirección

• ICU Medical prevé que el EBITDA ajustado y el BPA ajustado de todo el año se sitúen hacia la parte alta de los rangos de 415 a 435 millones de dólares y de 8,60 a 9,00 dólares previstos.
• La previsión de gasto de capital para todo el año se redujo de 85 millones a 75 millones de dólares, lo que refleja un menor gasto acumulado en el año. Se espera que las inversiones de capital del cuarto trimestre se sitúen significativamente por encima del promedio trimestral registrado hasta el 3T.
• El flujo de caja libre acumulado en el año se situó en 173 millones de dólares, superando ya el objetivo inicial para todo el año de 150 millones de dólares. La dirección espera que el flujo de caja libre del cuarto trimestre sea inferior al del tercero debido a un mayor gasto de capital y a la ausencia de beneficios sustanciales por reembolsos arancelarios.
• La compañía mantiene como objetivo un margen bruto ajustado del 43% para finales de 2027. Se espera que las sinergias, la combinación de productos y los incrementos graduales de precios respalden este avance.
• La dirección prevé una mayor reducción de deuda en el cuarto trimestre y planea reevaluar las opciones de asignación de capital en 2027. Las necesidades externas de fusiones y adquisiciones (M&A) se calificaron de mínimas.
• Las previsiones asumen un entorno macroeconómico estable, las políticas y tipos arancelarios actuales, así como niveles de inflación, divisas, tipos de interés y precios del petróleo y del diésel acordes con las últimas estimaciones de la compañía.

Riesgos y factores a seguir

• Aranceles: Los aranceles de la Sección 232 siguen sujetos a incertidumbre y podrían ser difíciles de compensar en función de su alcance y tipos definitivos.
• Tipos de cambio: Las divisas fueron el mayor viento en contra macroeconómico en relación con los supuestos iniciales de ICU Medical para 2026. Se observó una apreciación del dólar estadounidense frente al euro durante el tercer trimestre.
• Inflación y fletes: La inflación de materiales y mano de obra sigue siendo un factor a considerar para los márgenes. Los mayores precios del petróleo incrementaron los costes de transporte, aunque la exposición ha disminuido tras la desconsolidación del negocio de soluciones intravenosas.
• Ejecución de la integración: La consolidación de la distribución y la logística provocó cuellos de botella en los envíos y una combinación de negocio desfavorable en el tercer trimestre. La dirección prevé que este problema quede prácticamente resuelto en el cuarto trimestre.
• Reembolsos arancelarios: Los reembolsos favorecieron el flujo de caja de 2026, pero la dirección espera un beneficio adicional escaso, ya que la mayor parte de los aranceles pagados previamente en virtud de la IEEPA ya se han recuperado.

Puntos destacados de la sesión de preguntas y respuestas con analistas

• La dirección indicó que la consolidación logística no afectó sustancialmente a los ingresos totales del tercer trimestre, pero incrementó la proporción de Sistemas de infusión y Consumibles, al tiempo que lastró los envíos de Vital Care.
• El perfil de crecimiento de Sistemas de infusión estuvo impulsado principalmente por las bombas de gran volumen, los contratos ganados frente a competidores y la alta utilización de equipos dedicados. La dirección no espera que el ciclo de sustitución se concentre en un solo año.
• ICU Medical sigue centrada en alcanzar un margen bruto del 43% para finales de 2027 en lugar de acelerar el calendario previsto. Un crecimiento más rápido en productos de mayor margen proporcionaría un respaldo adicional.
• La dirección espera que un menor gasto en efectivo en reestructuración, integración y subsanación reduzca la brecha entre el flujo de caja libre y el beneficio neto ajustado. La subsanación de la plataforma de bombas está prácticamente concluida, y el trabajo restante se centra principalmente en los requisitos del MDR de la UE y la integración de fábricas.
• El calendario regulatorio de la bomba ambulatoria lleva varios meses de retraso respecto a la Med Fusion 5000 debido a que la compañía priorizó la capacidad de ensayos para la bomba de jeringa.
• Se espera que los precios aporten cierto respaldo en 2027 a medida que se renueven los contratos con organizaciones de compras conjuntas en Estados Unidos, aunque la dirección señaló que este beneficio se mantendría por debajo de la tasa de inflación imperante.

Transcripción completa de la conferencia de resultados

Transcripción completa de la conferencia de resultados

Comentarios de la dirección

Operator

Good afternoon, everyone, and welcome to today's ICU Medical, Inc. Third Quarter 2026 Earnings Conference Call. [Operator Instructions].

Also, please note that today's event is being recorded. I'd now like to turn the conference over to Deirdre Thomson, ICR Senior Vice President. Please go ahead.

Deirdre Thomson

Thank you for joining us to discuss ICU Medical's financial results for the third quarter of 2026. On the call today representing ICU Medical is Vivek Jain, Chief Executive Officer and Chairman; and Brian Bonnell, Chief Financial Officer. We wanted to let everyone know that we have a presentation to accompany today's prepared remarks. To view the presentation, please go to our Investor page and click on Events Calendar, and it will be under third quarter 2026 events.

Before we start our prepared remarks, we want to touch upon any forward-looking statements made during the call, including beliefs and expectations about the company's future results. Please be aware they are based on the best available information to management and assumptions that are reasonable. Such statements are not intended to be a representation of future results and are subject to risks and uncertainties. Future results may differ materially from management's current expectations. We refer all of you to the company's SEC filings for more detailed information on the risks and uncertainties that have a direct bearing on operating results and financial position.

Please note that during today's call, we will also discuss non-GAAP financial measures, including results on an adjusted basis. We believe these financial measures can facilitate a more complete analysis and greater transparency into ICU Medical's ongoing results of operations, particularly when comparing underlying results from period to period. We've also included a reconciliation of these non-GAAP measures in today's release and provide as much detail as possible on any addendums that are added back.

And with that, it is my pleasure to turn the call over to Vivek.

Vivek Jain

Thanks, Deirdre, and good afternoon, everyone. I'll walk through our Q3 revenue and earnings performance and provide some color on the businesses and then turn it over to Brian, who will recap the full Q3 results. After that, I'll come back with a few updates on product development initiatives and some comments on our performance against our near and midterm financial goals and our latest capital allocation strategy.

Revenue for Q3 was $556 million for total company growth of 5% on an organic basis or 4% reported as the reported results are no longer impacted by the mid-2025 creation of the Otsuka ICU Medical joint venture and the resulting deconsolidation of IV solutions from our income statement. Adjusted gross margins were strong at just over 42%. Adjusted EBITDA improved to $114 million and adjusted EPS was $2.44. Organic free cash flow was again healthy. And when combined with tariff refunds, which are excluded from our P&L commentary today, we're able to repay approximately $80 million of debt in the quarter and will finish 2026 slightly below 2x net leverage.

The broader demand and utilization environment in Q3 continued to be stable with volume in line with our guidance assumptions for the year. The capital [ environment ] is status quo, and it does appear investments that customers need to get done [ do ] get done. The only change in currency since the last call is the strengthening dollar against the euro. During Q3, we did move forward consolidating the legacy Smiths physical distribution and logistics into a common network. We did have some operational bumps, which were more impactful in the international markets. As a result, North America drove the growth in Q3 due to this issue as well as the previously mentioned OEM wind-down is recognized in the international geographies.

In terms of minimizing any impact from the logistics consolidation, we prioritized Infusion Systems products first, Infusion Consumables second, and Vital Care products third. So the business results I'm going to describe momentarily reflect this hierarchy. In aggregate, there was no net impact to revenue -- to the revenue expectations for the company, but the overall mix was slightly impacted.

Getting to our businesses more specifically, our consumables business grew 5% in Q3 reported and was a record in absolute sales. We did have both good sequential growth and annual growth as the step-up last year between Q2 and Q3 was substantial. Growth was driven more by the legacy ICU product lines of infusion therapy in oncology due to healthy census, share gains and the hierarchy mentioned above. We continue to believe the business will deliver mid-single-digit growth for 2026 and likely follow the same trends as previous years.

Our IV systems business grew 11%, both reported and organic in Q3, and it was again a record quarter for the business. Dedicated sets generally followed the same trend as consumables and capital sales were strong through the quarter, offset by declines in the OEM revenues. For Q4, we do feel some volume that we had scheduled for early 2027 is coming in earlier than planned. And as a result, we think this business will be at least high single digits for the full year 2026.

Just wrapping up the businesses. In Q3, Vital Care decreased 10% on an organic basis and decreased 12% reported due largely to the logistics consolidation described above. We expect sequential improvements here as we should have most of the challenges solved in Q4 and but with the impact of the Q3 results, this business will have a larger year-over-year decrease than previously mentioned. There's nothing deeper here. We just have some cleanup of the integrations, which is happening as we speak and it's basic blocking and tackling.

With that, I'll turn it over to Brian and then come back with some commentary to assess our financial performance and how it aligns with our strategic goals. Brian, over to you.

Brian Bonnell

Thanks, Vivek, and good afternoon, everyone. Since Vivek covered the Q3 revenue for each of the businesses, I'll focus my remarks on recapping the Q3 performance for the remainder of the P&L, along with the Q3 balance sheet and cash flow and then provide commentary on updates to our full year guidance.

As you can see from the GAAP to non-GAAP reconciliation in the press release, adjusted gross margin for the third quarter was 42%, which was in line with our expectations. The 42% gross margin rate represents a sequential improvement of approximately 1 percentage point relative to the second quarter gross margin of 41% from a combination of integration synergies as well as favorable mix with our higher-margin product lines of consumables and Infusion Systems growing at a faster rate than certain lower-margin product lines within Vital Care.

This quarter's gross margin improvement also demonstrates continued progress towards reaching our previously stated target of 43% by the time we exit 2027. It's worth noting that during the quarter, we recognized $8 million of tariff expense, which represents approximately 1.5% of adjusted revenue. We also received $11 million of IEEPA tariff refunds during the quarter. Consistent with the second quarter, we have excluded the full amount of the refunds from our non-GAAP income statement and they, therefore, had no impact on the 42% adjusted gross margin rate. The refunds are, however, included in our free cash flow results for the quarter. To date, we received tariff refunds totaling $31 million which represent the vast majority of IEEPA tariffs previously paid. Hence, we don't expect significant additional refunds in future periods.

Adjusted SG&A expense was $114 million in Q3 and adjusted R&D was $21 million. Total operating expenses were $135 million and represented 24.3% of revenue which is a slight improvement relative to the Q2 rate of 24.5%, driven primarily by favorable expense leverage on a higher revenue base and there weren't any unique or notable items in the Q3 operating expenses.

Restructuring, integration and strategic transaction expenses were $6 million in the third quarter and related primarily to manufacturing and distribution network transfers and IT systems integration. The Q3 expense represents a significant step down compared to historical [ levels of ] spend in this area as we continue to close out several of the longer-term integration projects.

Adjusted EBITDA for Q3 was $114 million, and EBITDA margin was 20.5%. EBITDA growth compared to last year was 8%, driven primarily by top line growth of 4% for the quarter. The impact to Q3 adjusted EBITDA from our 40% equity investment in the joint venture, was a loss of $1 million, which was consistent with our expectations as well as our commentary during the second quarter call and was a similar level as Q3 of last year, reflecting typical seasonality for the business. And finally, adjusted diluted earnings per share for the quarter was $2.44 compared to $2.03 last year, an increase of 20% driven by a combination of higher operating earnings, lower interest expense and a lower tax rate. The current quarter results reflect net interest expense of $15 million as compared to $19 million last year and an adjusted effective tax rate of 25% compared to 27% last year. Diluted shares outstanding for the quarter were 25.1 million.

Now moving on to cash flow and the balance sheet. For the quarter, free cash flow was very solid at $83 million, reflecting strong quality of earnings combined with $11 million from tariff refunds, lower restructuring and integration spending and the benefit from CapEx timing. During the quarter, we invested $12 million of cash spend for quality system and product-related remediation activities, $6 million on restructuring and integration and $16 million on CapEx for general maintenance and capacity expansion at our facilities as well as placement of revenue-generating infusion pumps with customers outside the U.S. And just to wrap up on the balance sheet, we finished the quarter with $1.16 billion of debt and $302 million of cash. The strong free cash flow allowed us to pay down $80 million of debt bringing our net leverage ratio down to 2x.

Turning now to our 2026 guidance. If you recall, in the second quarter earnings call, we raised and narrowed the full year guidance for both adjusted EBITDA and adjusted EPS. And based on our performance in Q3 and our outlook for the remainder of the year, we now expect to finish the year towards the higher end of the previously provided guidance range of $415 million to $435 million of EBITDA and $8.60 to $9 per EPS. There are no changes to our previously provided guidance for gross margin rate, operating expenses or interest expense. However, we are lowering our CapEx spending guidance for the full year from $85 million to $75 million, reflecting the lighter spend year-to-date. But please note that although the full year CapEx spend should be less than previous guidance, we do expect CapEx spending for the fourth quarter to be meaningfully higher than the average quarterly spend to date due to timing of various projects.

Year-to-date free cash flow through the third quarter is $173 million, which is already above our original full year target of $150 million due to $31 million of tariff refunds, lower CapEx spending and higher earnings. For Q4, free cash flow won't be as strong as Q3 as we anticipate higher CapEx spending in the fourth quarter and do not expect a material benefit from tariff refunds. Our guidance assumes a stable macroeconomic environment with inflation, currency and interest rates in line with today's levels, and it assumes the latest forecast for oil and diesel prices and no changes to the tariff policy and rates that are currently in place.

To wrap up, we're pleased with the business performance through the first 3 quarters of this year, including record revenues for both Infusion Systems and Consumables and continued gross margin expansion as the benefits from favorable product mix and integration synergies are realized. The goals we've previously laid out for the 2026 haven't changed, deliver at or above our long-term revenue targets for the core businesses, continue to expand gross margin towards our 43% target and improve free cash flow generation. Although we've continued to experience volatility in the macroeconomic environment, we believe the momentum we have in the business positions us to exceed the goals we've established at the beginning of the year.

And with that, I'll hand the call back over to Vivek for some brief additional comments.

Vivek Jain

Okay. Thanks, Brian. I hope that was straightforward for investors on our current financial performance. When we schedule our quarterly revenue growth, as shown on Slide 3 of the attached presentation, we feel that at least for the last 10 quarters, and for what we believe for the balance of the year, we've had acceptable revenue growth in our differentiated businesses.

Underlying these revenue trends, we have remained committed to innovation and did not skimp on R&D investments or capital investments even through some difficult times. We believe in many of our differentiated product lines were at the beginning of new product cycles which fulfill our mission of creating a comprehensive infusion therapy company. Of course, there may be quarter-to-quarter variances, but it's obvious that new products should support our delivery of long-term predictable revenue growth and ensure our businesses are bigger every year.

In Infusion Consumables, we continue to drive incremental innovation and have scale underpinned by leading brands with great clinical data. Our innovation in the core and adjacencies of this business adapt to the different methods by which medications may be prepared, conserved and delivered both in the hospital and at home. We expect certain new clearances to follow the previously announced clearances we mentioned earlier this year, which includes MicroClave connector access ports on non-PVC DEHP free IV bags and a line extension on our disinfection cap portfolio, all of which will launch in 2027 and are the singles and doubles that continue to create the niches in this business.

In Infusion Systems, the LifeShield, Plum Duo and Solo family of products are being well received in the marketplace. Since the last call, we've completed enough additional verification testing on the Med Fusion 5000 Syringe Pump for a revised 510(k) to be filed in the next few weeks. In the quarter, we did also receive Canadian approvals for the Med Fusion 5000 and latest CADD versions as well as European authorization for the Plum Duo and Solo LVP pumps, which will help us maintain our large international installed base. Both the Plum Duo and Solo pumps and the new Med Fusion 5000 pumps offer the opportunity for value creation through competitive wins and upgrades of our existing installed base. The core tenet of our commitment to innovation on LVP pumps combined with the Smiths Medical acquisition, was intended to have the most modern infusion devices connected to a single software solution across hospital LVP, syringe and ambulatory pumps with platforms that anchor the business for the next 10-plus years as the product life cycles are incredibly long.

We want customers to have the right tool for the right job, all connected with a common user interface and software solution that minimizes training, speeds onboarding, supports interoperability and enable standardization for our enterprise customers. we are close to delivering this vision. For the longer term, we've spent more time and energy over the last year and have a clear development plan for the final frontier connecting the CADD home care environment back into the same common software framework.

Just a few quick updates re Vital Care. Our joint venture with Otsuka Pharmaceutical Factory did break ground in Q3 on the new IV solutions factory. These products are still commercially commingled with our differentiated product lines in the U.S. market and are part of creating the most comprehensive infusion therapy company. We also had a few other 510(k) approvals in the Vital Care lines, including certain new temperature management disposables, which address some of the historical concerns around that product line.

The results this quarter also show we've made progress against our comments about underearning. And while we're pleased with our improved earnings power, we believe we still have room to go. We have provided our EBITDA bridge with tariffs and currency in previous calls, so we won't belabor that again here. What we remain focused on is achieving our gross margin targets and improving free cash flow to our original expectations when we did the last transaction. The gross margin gains will come from the realization of synergies from our various plant and logistics consolidations, which did cause a few bumps this quarter, some incremental pricing and overall product mix. These opportunities will still take several quarters for full achievement.

The other important area of improving free cash flow has been driven by reducing the cash consumed in restructuring and remediation. As Brian mentioned, this quarter showed a good step down in the cash used in that and a resulting improvement in free cash flow, which led to debt pay down. For Q4, we will continue to pay down debt. And in the new year, we will evaluate our capital allocation choices based on the macro factors at that time. We've hit our target leverage of 2x or below, which feels appropriate for a mid-single-digit growing manufacturing company. Since our time here, we've tried to protect the share base with the only meaningful equity dilution resulting from the shares used in the Hospira and Smiths transactions. We know returning capital can be attractive on a thin share base, and our external M&A needs are minimal as we have enough organic innovation in-house, with the only wildcard being a changing interest rate environment.

In summary, it's a good place to be with our best businesses growing. Both will again reach record revenues in 2026, and we can see a vast number of projects nearing completion. We expect our consumables and systems businesses to be reliable growers with an industry acceptable profit margin, the tightest and most optimized manufacturing network and each with a multiyear innovation portfolio. And ultimately, we want to be able to transfer value from debt to equity. There's no confusion within the company in the pursuit of these goals, and we don't really have any frivolous activities here. We produce essential items that require clinical training, old manufacturing barriers and in general, items that customers do not want to switch unless they must. The market needs ICU Medical to be an innovative, reliable supplier and our company is stronger from all the events over the last few years. Thanks to all our team members and customers.

And with that, we'll open it up to questions.

Operator

[Operator Instructions]. .And we will take our first question from Jayson Bedford with Raymond James.

Preguntas y respuestas

Jayson Bedford

And congrats on the progress, nice quarter. Just [ time ] a few. Maybe first is a clarification. You mentioned the logistics consolidation, it was a little unclear. Was there a revenue or earnings impact from this in 3Q?

Vivek Jain

Not really on a net basis, Jayson. I think we're probably -- we had some bumps getting all the products we wanted out the door. Obviously, we wanted to prioritize infusion dedicated sets because you can't run a pump without the dedicated set. So maybe we were just a tad hotter than underlying demand there, but -- and a little weaker in Vital Care as a result because we didn't get all of that out the door. So net-net, I don't think there was any difference in total company revenues, but the mix was a little different than we might have expected.

Jayson Bedford

Okay. Okay. Just on Infusion Systems, I think the strength and the growth there really pops out, especially given the comps and other dynamics. So I guess if you could just walk us through or explain a little bit more the sources of the strength within your pump portfolio.

Vivek Jain

Yes. I don't think what happened in Q3 was really different than what's happened in the last 2 or 3 quarters has largely been driven by the LVP portion as -- in the ambulatory portion, we're still lapping the OEM wind down. So LVPs have been a big driver of the growth. It has been a mix of competitive wins in the early days of rollovers. And some of it is just good utilization, at least in our customer base. Our customers have been busy, and the underlying volumes on dedicated sets have been pretty strong all year, too.

Jayson Bedford

Okay. You mentioned the early stages of the rollover. Have you seen a pronounced impact from replacement yet? Or is that more of a '27 dynamic?

Vivek Jain

I think we would stick with what we said before. We continue to believe that's a '27, '28, '29 dynamic, right? It's going to be for a few years.

Jayson Bedford

Okay. And then maybe the last one, and I'll let others jump in. Vital Care, it's a drag on revenue growth, but is there anything you can do to satisfy just on protecting the profit level of that business?

Vivek Jain

Brian, do you want to take that one?

Brian Bonnell

Yes. I think, Jayson, we've focused quite a bit over the past several years of actually profitizing that business unit relative to kind of the margin profile that it previously had. And so I think that, that was the focus. I think in Q3 here, we were impacted a little bit just from some of the integration activities there and in Q4 will represent kind of a stand up there. So I think it's -- even at today's revenue levels, it's still providing more earnings contribution than it did a couple of years ago.

Operator

And our next question comes from Larry Solow with CJS Securities.

Lawrence Solow

Curious on the goal you talked about just on the gross margin. [ 421 ] this quarter you we're running [ 41.5 ] plus full year. And you still had some -- you mentioned a little bit of logistics issues this quarter. I know that the goal is 43%, [ it ] seems like just to get to that goal, a lot of it is just blocking and tackling and perhaps as you look out a few years or even a couple of less than 2 years with just the mix profile as your installed base on the pump side grows. You should have more consumables there. Any reason to believe like you can't hit that goal next year from where we stand today and perhaps grow on that as we move out forward?

Vivek Jain

I'll let Brian answer it. Long term, you're 100% right. The short term, it tend to feel like that in some of the stuff we went through. But Brian, go ahead.

Brian Bonnell

Yes, Larry, I think, back when our gross margins were at 36%, we thought the goal of 43% was pretty lofty. And we've been pretty consistent, though, about that being the goal. And I think it still is today. And we've had pretty consistent progress towards that. And so I think we feel good about achieving that as we exit next year. I don't think we want to get to any more aggressive in terms of the [ timing ]. And then beyond that, we'll see what opportunities are available for any further expansion. But right now, we're just focused on getting to that 43%.

Vivek Jain

I think you -- you kind of answered it a little bit yourself there, which is obviously a better mix of our highest-margin products would certainly help. And that's -- those things are the fastest-growing things we have. So not lost on us. And that again, just the 43% started as 45%, it was net down 2% for tariffs.

Lawrence Solow

Right. And on the free cash flow, obviously, you're actually pretty much in line with your adjusted net income year-to-date. I realize that's skewed because of the tariff refunds, $30 million there. But as we look out next year, obviously, you won't have these tariff refunds now, maybe we'll never know, but probably not. But your -- as you mentioned, the -- just remediation and restructuring expenses, which I think you said are down this quarter, but still, I think, [ $8 million, $19 million ] combined. So next year, remediation restructuring down, hopefully, significantly and even the business doesn't grow that much. Could free cash flow be closing in on net income as a percentage of net income?

Brian Bonnell

Yes, Larry. Obviously, we've been talking about reductions in restructuring and integration and the cash flow benefits associated with that, we finally saw it here in Q3, as we said it would happen. We are still spending cash on remediation that will continue in the near term, but there's also further opportunity there. So I do think that as we get into next year, and get some of these activities behind us, you will see that continue to come down, and that obviously will help close any gap between our free cash flow and our adjusted net income.

Vivek Jain

I mean that is our goal to -- if you went back before we did the last transaction, free cash flow was in excess of net income for a couple of years in a row. So we certainly -- we like that a lot [ more ]...

Lawrence Solow

Sorry. There's no structural reason why you can't get there, I didn't sound like right. Structurally, you have to do some stuff to get there, obviously, but...

Vivek Jain

The only real item that the remediations on the pump platforms are essentially done or very close to being done, it's a little bit of EU MDR stuff and finish the factory integrations.

Lawrence Solow

Just lastly, just related question. You said that you updated syringe pump, the 510(k) you're going to file in a few weeks. Just could you remind me or also just on the ambulatory side. Do you have -- is that filed yet? Or is that still doing more testing for that one for refund?

Vivek Jain

No, we're doing -- again, we submitted both. The request came back for additional testing on both. We have a fixed amount of testing throughput. We prioritize the syringe pump. We think it's a more acute item in the hospital market and older installed base and frankly, a much new or revised safer product that we want to bring to market. So the ambulatory will be a couple of months off the pace behind them.

Operator

And we will move next to Jason Bednar with Piper Sandler.

Unknown Analyst

This is Andrea on for Jason. Congrats on a good quarter. For 2027, based on where we're at today with FX inflation, diesel costs, are you still comfortable with delivering gross margin expansion? How are you guys thinking about the offsets or mitigation planning that has to happen today to ensure that this is in a good spot post margin expansion next year?

Vivek Jain

Nice to meet you, Andrea. That's a great question. I'll let Brian grab that one, though...

Brian Bonnell

Yes. I think as we've been working to improve gross margins over the past few years, it seems like every year, there's kind of something new or unexpected. And you tend to have a number of puts and takes. And with the volatility in the macroeconomic environment that we have today, there are some pressures, certainly, and we do think about inflation and what the impact could be there. But we also have a lot of momentum in the business, and we would look to offset any of those pressures to the best of our abilities. Obviously, the one thing that's sitting out there is tariffs, in particular, Section 232, and we don't know exactly what that will bring, but that's something that perhaps might be harder to overcome depending on what the outcome is there.

Vivek Jain

I think, at this one, Andrea, right now, we wouldn't -- the equations and the mix for us is material inflation, labor inflation and currencies and tariffs, right? And at least felt like at least currencies, which are really going the wrong way are a bit more stable year-over-year, it seems right now. And so, don't know the answer to that yet, but of course, the goal every year is to offset what comes to those factories, but we provide that color in more detail and we have our February call.

Unknown Analyst

Appreciate that. And then maybe as a follow-up, are you seeing anything with the recent moving peso? Like how should we be thinking about that?

Vivek Jain

I'm sorry. Could you -- Andrea, could you repeat the question? It was a little garbled.

Unknown Analyst

Yes. Sorry about that. Just how should we be thinking about the recent move in the Mexican peso?

Brian Bonnell

Yes, yes. So the stronger -- with the U.S. dollar getting slightly stronger relative to the peso...

Vivek Jain

[ Current ] you tell us, but I mean...

Brian Bonnell

We would prefer to see it at kind of current levels or even stronger because that does benefit us. I don't think it's really any higher today than what we had planned this year to be. But if the recent momentum continues, I think that would be a positive for us.

Vivek Jain

It would be [ positive ]. I mean, obviously, on the last call, in the script, we went through a whole to do on what's happening in Costa Rica, which is also very impactful and hasn't changed as much, right? So there's two of them in play.

Operator

And we will move next to Brett Fishbin with KeyBanc Capital Markets.

Brett Fishbin

Maybe the segment that hasn't come up too much is consumables. I know it was kind of in line with typical trends with the 5% constant currency growth. But it feels like the reads across the space have been a lot more mixed, but you guys sound pretty good on just the general backdrop being stable. And I would just be curious if you could just elaborate maybe on like what you're seeing, where you're seeing consistency if it's driven by certain geographies or really broad-based? And then just any other factors that you think are supporting such steady consumables performance outside of general hospital activity levels?

Vivek Jain

Thanks, Brett. It's a great question. And we didn't go through it in the script this time. We try to do it on an annual basis. But I think the driver for consumables really for '26 is kind of 4 of the 5 reasons we've talked about over the last 2 or 3 years. This year was not a lot of price, right, as we've talked about publicly. I think it comes down to if we've won on the pumps sometimes more often than not, we get the opportunity to drag some consumables along with that. So that's been happening. That helps.

Two, it's the singles and doubles of incremental innovation and new category creation. Those are probably growing at faster rates than the overall hospital business. Three, it's a global business for us, and there's some spots of it, for example, oncology and international that grows very, very well. And so some of the specialty areas and mix based on geography grow well. And then lastly, I think some of the outside of the -- I mean, probably call this a specialty also, but some of the outside of the hospital consumables also grow at a faster [ clip ]. So it's really the mix of the underlying business and the innovation combined with combined census growth, et cetera, we just happen to be in some of the right places there.

Brett Fishbin

All right. And then maybe just one more question for me on general EBITDA guidance and margin trends. It feels like things are going pretty well. You're pointing to the high end of the EBITDA range. But just thinking about the macro, it's been an inflationary environment. Oil prices are higher. You did mention some of the logistics challenges. Just curious maybe like how much of a drag some of those factors maybe if it weren't for some of those factors, if you could have been raising the guidance even further? Just any thoughts on that.

Vivek Jain

Brian, [ you talk ] about new euro and et cetera, is also in that a little it in the short term to...

Brian Bonnell

Yes. I think if you look at kind of our results so far this year, relative to the guidance that we gave at the beginning of the year. I would say FX was probably the biggest negative. And probably the biggest positive is actually, the tariff expense was a bit lighter than we had planned for because the current rates are a little bit less than what the IEEPA rates were. So there's always kind of these puts and takes. And I would say those are -- those are the 2 largest from a macroeconomic standpoint. Of course, freight expense was a little bit higher because of oil, but we just don't have the same exposure to that, that we did when we consolidated the IV solutions business.

Vivek Jain

I mean it's a fair question, Brett. I hope you just like -- I look at that and refer to that revenue schedule. If you can look at the same performance and earnings growth and ability to be consistent on that same schedule. We feel pretty good about it. We just would like to keep that going.

Operator

And we will move next to Mike Matson with Needham & Company.

Michael Matson

So the new IV solutions factory that you mentioned, can you maybe talk about what that means for the joint venture for ICU Medical. Does it have any kind of like cost benefits or maybe allow you to offer additional solutions that you weren't offering before or something like that?

Vivek Jain

So a great question, Mike. And I try to make a complicated topic, a simple answer. There are 2 challenges in bringing IV solutions to a large screen, not a full degree are obviously integrated in the value proposition of consumables and to a certain extent, pumps. And IV Solutions, have an innovation move going on, which is the U.S. is likely over time to move to the same product format that the rest of the world uses, which is a PVC-free DEHP-free format, and that would have been a difficult set of investments for us to make. Some legislation on a state-by-state level is moving in that direction. And we believe we have the best partner who could bring the best technology in that area to have the products on a very timely basis and customers are going to want that.

The second challenge with IV Solutions, it is a very cost competitive market. And it has all of the regulatory of pharmaceutical and isn't sort of valued necessarily in the same way. And so production technologies that lower production costs are incredibly important. And we think we have a partner with a joint venture that can help us bring the right technology to have the best cost to produce the product and the best product clinical features and benefit, which put us in the best foot forward when the value prop is commingled with the other items. And so as much as it was a difficult area for us to invest in and to drive any innovation in the way we can [ pump consumables ] we feel awfully lucky to have come up with the structure that we have here with Otsuka.

Michael Matson

Yes. Okay. That makes a lot of sense. And then just the logistics-ish consolidation issues that you called out. So I just want to make sure I understand what that is. So I'm assuming you had -- because of the deal, you had some duplication of logistics facilities or something like that, and you're basically shutting some of them down and running them through just a single one or something like that? And then I guess the second part of the question would be, is that all in the rearview mirror? Is that the issues contained to kind of the third quarter?

Vivek Jain

To answer the first part there, it's exactly what you said. We had 2 separate networks. First, we had to cut the IT. We cut the IT, get all the registrations done, et cetera, and then you move to physical logistics. Simply put would happen is we just couldn't get enough volume to the pipes to get everything out. We have to prioritize what goes to the pipes to the customer. And we had to prioritize the things that you can't run the machines without the sets, so they have to go first. And it may have made Infusion Systems a little bit hotter this quarter than probably underlying. Obviously, we still have very positive comments about it for Q4, maybe a tad in consumables.

I would say it's largely rectified in the fourth quarter, I'm not sure. We need to talk about it again, but it made a slight impact this quarter, and we had to explain what Vital Care was still out of line with the -- nobody thought that's why we're kind of going into it, probably a bit more than we would normally would.

Operator

And we will move next to Sam Eiber with BTIG.

Sam Eiber

Wanted to come back on Med Fusion for a second, getting close to the resubmission. And I guess once that's available in the market, curious if that changes the conversations you're able to have with your customers and essentially what the value proposition looks like by having both the LVP and new Med Fusion system on the market?

Vivek Jain

Sam, thank you for the question. Good question. I think our view is any sophisticated customer is making it -- and we do well, is making a decision on a technology road map to 7 to 10 years, and whether the product is available in early '27, mid-'27, I don't think that impacts their short-term decision. Of course, it's easier if it's in hand, and we're pushing to do that. Anybody who's sincere interested in learning about the uniqueness of the technology and the simplicity of the technology, does the work to figure it out regardless of the date that is going to come to market.

So in the right framework, with the right caveats around it, with the right confidence, we do bring customers into loop just like a software company would run the development plans and people see that. So I don't think it's necessarily going to accelerate our ability to win new stuff, but it's not slowing us down either because the LVP really drives the conversation. This certainly makes it a little bit easier. That said, there's a large installed base of syringe pumps out there in the U.S. market that will need to refresh that are old and so we want to get the product approved, both from a safety aspect, as an FDA aspect but also to capitalize on the opportunity to refresh that installed base.

Sam Eiber

Yes. Okay. Makes sense. And then maybe I can use my follow-up here on pricing. I know it hasn't been that much of a tailwind this year. But as we get into next year with some of the upgrades and new products. Wondering if that becomes a little bit more of a tailwind to growth next year?

Vivek Jain

There'll be a little bit of pricing, as we said, there was -- when the GPO contracts in the U.S. got redone in early '25. There was some price capture in '25, less than '26 and comes back in '27. That said, that pricing isn't even at the current rate of inflation. So there'll be something, but there's a lot of things we have to use to offset it.

The biggest item for pricing is to make sure that the value we receive for the new technology on the hardware is in line with what we're -- I'm sorry, the value we're receiving for the technology is in line with the price. And so far, that's been okay, I would say it's important for that. And for the market to recognize the value of the pump technology, and for us to carry the right margin on the hardware, we've been able to do that. I think that's probably more important even than a little bit of pricing on the consumables, et cetera.

Sam Eiber

Okay. Thanks for taking my questions.

Operator

At this time, there are no further questions in queue. I will now turn the meeting back to Vivek Jain for any closing remarks.

Vivek Jain

Thanks, everyone. Hopefully, that was a straightforward quarter. We appreciate everyone's interest. I wish everybody well as we get into the holiday season, and we will talk to you early next year. Thanks for your interest in ICU Medical.

Operator

Thank you. This brings us to the end of today's meeting. We appreciate your time and participation. You may now disconnect.