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Hello, everyone, and thank you for joining us today for Grifols' Q4 2026 Earnings Call. My name is Dani Segarra, and I serve as the Head of Investor Relations and Sustainability. Today, I'm joined by Grifols' Chief Executive Officer, Nacho Abia, President of Biopharma, Roland Wandeler, and Chief Financial Officer, Rahul Srinivasan. As is our usual practice, today's call will last about one hour, including the Q&A session. Please note that this call is being recorded. You can find additional materials, including today's presentation, in the Investor Relations section of the Grifols website at grifols.com. A transcript and replay of the webcast will also be available on the Investor Relations website within 24 hours. Turning to slide two, I would like to remind everyone that forward-looking statements may be made during this call.

This may include, among other things, comments regarding the company's future operating and financial performance, statements about our future expectation, clinical developments, regulatory timelines, and the potential success of our product candidates. These statements are based on current expectations and available information as of the date of this call and are subject to certain risks and uncertainties that may cause actual results to differ materially from those discussed today. Grifols financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions, including Alternative Performance Measures or APMs, as defined by the European Securities and Markets Authority. Grifols' management uses APMs to evaluate financial performance as the basis for operational and strategic decision-making. These APMs are prepared for all the time periods presented in this document.

As announced on May 24, the board of directors decided to initiate a process to evaluate a potential IPO in the U.S. of a portion of the shares of its subsidiary and parent of its U.S. Biopharma business. Any such transaction remains subject to, among other things, regulatory and legal requirements, internal approvals, and market conditions. In keeping with the legal and regulatory advice received, we will not be able to address any questions regarding this transaction at this stage. We will provide updates as and when necessary, remaining in full compliance with applicable laws and regulations. Moving to today's agenda, I will turn the call to Nacho to kick it off. Nacho?

Thank you, Dani, and thank you all for joining us today. In the first quarter of 2026, we delivered a solid start to the year, maintaining our focus on our core priorities as outlined in the annual guidance provided in our previous call. The results of the Q1 were in line with our expectations and forecast. We are on track to achieve our guidance for the full year 2026 as we continue to build momentum over the course of the year. Today, we will focus on three key areas. First, we will talk about our commercial strategies across regions, with a clear focus on capturing growth opportunities in core markets.

Second, we will further clarify the strategic importance of Egypt following EMA approval, a milestone that strengthens our global plasma diversification strategy, expands our sourcing capabilities, improve access to treatment in Egypt, the region, and Europe, and structurally and meaningfully reduces cost per liter, thereby supporting our margin expansion. Third, we will address the continued strengthening of our balance sheet through disciplined refinancing and sustained free cash flow generation. Finally, we will review some key progress within Diagnostic as we near an important milestone, the launch of a new platform that expands market opportunities in blood typing, as we committed at our last Capital Markets Day. This advancement reflect our ongoing commitment to innovation and to supporting long-term growth in this division as well. Turning to slide five.

Revenue for the quarter reached EUR 1.7 billion, representing an increase of 3.3% at constant currency. Adjusted EBITDA increased to EUR 404 million at constant currency, EUR 381 million on a reported basis, with margin broadly stable year-on-year. Free cash flow improved by EUR 30 million, with leverage stood at 4.3x, which is broadly stable versus year-end and consistent with the seasonality we typically see in the first quarter. Biopharma led this performance with growth of nearly 7% at constant currency. Once again, underscoring the strength of our IG franchise, which delivered double-digit growth, particularly in core markets.

Our focus remains on executing our key priorities for 2026, driving adjusted EBITDA margins to at least 25% while deleveraging, delivering 5%-9% adjusted EBITDA growth at cost and currency, improving free cash flow towards our EUR 500 million-EUR 575 million target, and maintaining strict financial discipline. We are actively pulling strategic levers across the organization to deliver on those objectives, which I will detail in the following slide. We also note the recent exception of plasma-derived therapies from U.S. tariffs under Section 232, which underscores the strategic importance of plasma in today's global environment. Finally, as announced in March, we are evaluating a potential IPO of our U.S. Biopharma business.

While it is still early in the process and we will not be able to provide additional information in today's call, it reflects our continued focus on maximizing shareholder value. We will update you with necessary details in due course and stay compliant with applicable laws and regulations. Let me turn to our focus in 2026 in order to achieve our annual goals. Moving to slide six, I want to detail the strategic drivers that support our confidence in achieving our 2026 guidance. Our focus is centered on five key pillars of execution. First, we are optimizing our Biopharma product mix. While our IG franchise continue its momentum, we are balancing this with a continued focus to drive growth across our broader portfolio of proteins. Second, the ramp-up of our Egypt platform is a transformative milestone. As I mentioned, this is a structural shift in our sourcing capabilities.

We are in a clear trajectory to collect 1 million liters of plasma in Egypt this year, scaling rapidly to 3 million litres by 2029. Third, this Egyptian expansion allows us to accelerate the optimization of our global plasma sourcing. By integrating this lower cost per liter supply, we can more aggressively optimize our U.S. plasma network, improving overall margin efficiency without compromising our supply needs. This also ensures flexibility and optionality to expand our plasma needs. Fourth, we are focused on the operational and financial turnaround of Biotest. A key catalyst here is the commercial progress of both Biotest new generation of immunoglobulins, Yimmugo, as well as fibrinogen products, Prufibry and FESILTY, which are starting to contribute to the top line as we integrate these assets more deeply into our global commercial portfolio. Finally, our commitment to financial discipline remains absolute.

We're maintaining rigorous cost control and maximizing operational leverage across the entire group. These five drivers are not mere targets. They represent active strategic levers. Their successful execution is what will allow us to grow strategically, expand EBITDA margins, and deliver the improved free cash flow we have committed for the full year 2026 and beyond. Before moving to a more detailed Biopharma update that Roland will provide, I would like to briefly comment on the performance of our Diagnostic business on slide seven. It is important note that the reported revenue decline does not reflect the underlying fundamentals of the business, but rather the temporary impact from the dissolution of the QuidelOrtho joint business. On a like-for-like basis, our Diagnostic revenue grew in the low single digits year-over-year.

As part of the joint business dissolution, we agreed to a $65 million compensation payment to Grifols, which will be distributed over the next three years. While the termination of the joint business created a short-term headwind, the decision was ultimately a strategic one. Ending it unlocks full autonomy to offer a broader range of donor screening and clinical diagnostic solutions and better positions us to capture the full value of our new IDS platform rollout. These new immunoassay platforms enable us to directly target the serology market, which is valued at approximately EUR 1 billion. Additionally, it provides an opportunity to eventually expand into a much larger total addressable market of the clinical immunoassay sector. This is a segment where our ability to operate independently enable us to fully participate, control the value chain, and maximize returns.

As such, IDS platform represents a key pillar in diversifying our Diagnostic revenue base and expanding into adjacent high-value segments. Other than this significant step in our serology business, within blood typing solutions, the Barcelona next-generation platform is our most significant upcoming catalyst. This platform delivers significantly improved performance in a smaller modular design with a simplified workflow and reduced footprint for customers. We remain on track for its launch in Q2 2026 at the leading flagship industry trade fair, and we expect this platform to be a key driver in sustaining our leadership in this market beginning 2027. In NAT, our Mundaka platform remaining on track for launch in 2030, reinforcing our leadership position within NAT through higher throughput and sensitivity and advanced design.

As we look beyond 2026, and specifically 2027, we expect our Diagnostic business to continue to grow in the low single digits as we continue to grow our blood typing business while MDS, we consolidate our strong donor screening market position and grow in the plasma screening segment. We expect the good performance of the BTS and MDS businesses to be partially offset by our IDS business as the supply agreement with Abbott ends. We gear the manufacturing towards ISAT. I want to reiterate here that our Diagnostic business remains a vital complementary pillar to our Biopharma franchise, providing significant contributions to our overall margin profile and cash conversion. Before moving to Roland, I would like to emphasize that the progress of the company in the first quarter reflects disciplined execution across our strategy, operations, and finance.

We are building on strong fundamentals, advancing our margin initiatives, strengthening our global plasma flat platform, and reinforcing our balance sheet. This execution supports our confidence in delivering consistent progress throughout the year as we work towards our full-year guidance and unlocking the full value of our competitive advantage. With that, I will now turn it over to Roland. Thank you.

Thank you, Nacho. Moving to slide nine, the Biopharma business overall delivered a solid start to the year with 6.8% growth at constant currency in the first quarter. I am proud of the dedication, passion, and commitment our team shows every day to deliver for patients and drive forward towards the goals we set out. Q1 growth was driven by continued strong momentum in IG, partially offset by albumin in China, as well as lower sales in other proteins. Let me briefly walk through each segment. Immunoglobulins were the clear growth engine. Our IG portfolio delivered 15.3% year-over-year growth at constant currency, driven by sustained traction of Gamunex in the U.S. and core European markets, fully aligned with our strategic focus.

Performance was further supported by the successful U.S. launch of Biotest Yimmugo, which is building on the strong underlying momentum of our existing brands. XEMBIFY, our subcutaneous IG, continues to see strong double-digit in-market demand growth in the U.S. Reported ex-factory sales this quarter, though, were partially impacted by year-on-year inventory phasing, with Q1 2025 benefiting from a wholesaler inventory build and Q1 2026 reflecting some inventory normalization. Importantly, the underlying demand trend remains very strong, and for the full year, we continue to expect strong double-digit growth for XEMBIFY. Turning to albumin, Q1 sales declined 6.1% year-over-year at constant currency, reflecting the expected continuation of market and pricing dynamics in China that we discussed at year-end. Following several years of strong growth, demand flattened in 2025, and we adjusted pricing mid-year. Over the past quarters, pricing in hospital has stabilized, which is encouraging.

However, the first half of 2026 continues to compare against the higher pricing base in 2025, and we therefore expect albumin sales to be lower year-over-year in H1 before stabilizing into the second half. Despite these near-term dynamics, our longer-term outlook for albumin remains constructive, supported by our strategic partnership with Shanghai RAAS. With elevated in-country inventories in the market, our focus is firmly on driving demand with disciplined pricing and aided by an expanded joint commercial footprint and a more targeted marketing and contracting approach. These actions are aimed at increasing hospital access, including deeper penetration into lower-tier hospitals, while also expanding our presence in retail pharmacies. In parallel, our medical teams continue to invest in education and evidence generation around long-term albumin use in liver cirrhosis and an important and still unmet need in China.

As conditions stabilize, we remain confident that these actions position us well to get back to growth in this key market. At the same time, we are actively pursuing opportunities outside China with a clear emphasis on expanding our albumin presence in the U.S. and other markets. This, together with increasing yields and the use of excess IG from EMA-approved Egyptian plasma, will enable us to balance our IG and albumin growth over time. On Alpha-1 and specialty proteins, sales came in 7.4% lower year-over-year, reflecting a prior year comparison that benefited from inventory buy-in for both Alpha-1 and Fibrin Sealant at the time. Within Alpha-1, which represents roughly half of the category, we were encouraged by growth in new patient referrals during the quarter, highlighting the continued unmet need and the significant number of undiagnosed patients.

While underlying dynamics are strong for Alpha One, HCPs and patients continue to navigate access hurdles, especially in the first part of the year. We heard from physicians and patient associations that the reauthorization period in the U.S. was a difficult one and that a number of patients had to go through multiple appeals to finally receive approval for their therapy this year. We will continue to do our part to appropriately support healthcare professionals in their work of securing access for their patients. This is where we are looking forward to sharing our SPARTA Outcomes trial results, with top-line results expected later this year. Successful trial outcomes will help to further drive awareness to reach patients yet to be diagnosed, but also provide additional evidence that may bolster access for both new and existing Alpha-1 patients in the U.S. and abroad.

In the remainder of the category, sales of Fibrin Sealant, Factor VIII, and contract manufacturing were lower year-over-year. Following strong inventory build by Ethicon in 2025 to support global launches of Fibrin Sealant, Q1 reflected some inventory drawdown. This was partially offset by continued solid demand for HyperRAB. While seasonally lower in absolute terms, we are encouraged by the momentum as we move towards the summer peak season for this important product. Overall, we remain confident in the underlying fundamentals of Alpha-1 and expect the Alpha-1 and other proteins franchise to return to growth over the full year 2026. Moving to slide 10, what I'd like to highlight is how intentionally differentiated our approach is across both geographies and proteins. Starting with immunoglobulins, our growth engine.

In the U.S., our priority is clear: grow with the market on a higher base following our market share recovery in 2024 and 2025. We expect continued mid to high single-digit growth for Gamunex as our leading IVIG and strong double-digit growth for XEMBIFY and SCIG. Outside the U.S., we are taking a more selective value-driven approach. In Europe, we are focusing growth on higher-margin strategic markets while actively optimizing our footprint in low-return markets. At the same time, we are advancing self-sufficiency in Canada and leveraging platforms such as Egypt as a plasma source to support IG supply into Europe. Turning to albumin, where the focus is balance and value optimization. In the U.S., we are benefiting from increasing demand for albumin in bags as one of only two players with this differentiated offering and where we are working to expand supply going into 2027.

At the same time, we are effectively competing with our portfolio of albumin in vials with a disciplined approach to contracting. Outside the U.S., we have a two-pronged approach. In China, our focus is on driving demand and access, leveraging our strategic partnership with Shanghai RAAS, expanding into tier two hospitals, and increasing our reach in retail pharmacies. In other markets, we see good progress and room to further grow our albumin sales. Overall, the objective is to stabilize performance in China and selectively expand beyond China, including the U.S., with a differentiated offering of albumin bags. Finally, Alpha-1 and specialty proteins, where our ambition is to lead and expand the category globally. In the U.S., the priority is to expand Alpha-1 diagnosis and treatment of appropriate patients in a market where 85% of patients are not yet diagnosed.

We believe that our outcome study SPARTA, which for the first time may show better-maintained lung function versus placebo, will play a key role to raise awareness, broaden the share of physicians that consistently test their COPD patients, and facilitate access to therapy. Our team is preparing for top-line results expected by year-end and is planning a deliberate, coordinated approach to communicate SPARTA outcomes to support growth. We are encouraged by our momentum with HyperRAB and excited about our upcoming Fibrinogen launch later this quarter. Outside the U.S., we continue to drive Alpha-1 growth in reimbursed markets and prepare to leverage SPARTA to unlock broader reimbursement, increase awareness, and expand access in those markets that so far have limited treatment for Alpha-1 patients.

In addition, we will continue to drive our launch uptake with Fibrinogen in Germany and Austria as the two leading markets for the targeted treatment of acquired fibrinogen deficiency. Stepping back, what you see is a disciplined and differentiated portfolio strategy to drive value. Growing IG, where we have leadership and value, balancing and optimizing albumin across markets, and positioning Alpha-1 and specialty proteins for continued growth. Value creation is not just about where we compete. It is also about how we source and produce our therapies, which is where plasma becomes a critical enabler of our model. Turning to slide 11. What we are doing in plasma sourcing is not incremental. It is a structural shift both for Grifols and for the industry and a core pillar of our margin expansion. Historically, the industry has operated with a structural imbalance.

The U.S. has been the primary source of plasma for the world, and a significant portion of that volume has been used to supply markets outside the U.S. Given that the U.S. is a high-cost source of plasma, exporting that cost base into markets with more constrained pricing creates a mismatch between cost and revenues. At the same time, the high reliance on U.S. plasma adds structural risk, particularly in geopolitical environment that is increasingly favoring local self-sufficiency. What we are doing now is fundamentally changing that equation. Over the last years, we already increased ex-U.S. collections with growth in our European centers and our self-sufficiency partnership in Canada. Following the EMA approval of Egypt-sourced plasma in December 2025 as part of our self-sufficiency partnership in Egypt, we are now adding a third scalable ex-U.S. plasma sourcing platform.

We are on track to collect around 1 million liters in Egypt this year, scaling to about 3 million liters by 2029. Together, this allows us to meaningfully rebalance our sourcing footprint. Where today roughly 25% of U.S. plasma is needed to support demand outside the U.S., by 2029, we expect plasma volume sourced ex-U.S. to increase roughly 2.5-fold, sufficient to supply our European and rest of world demand. This allows us to significantly reduce the need to use high-cost U.S. plasma for lower-priced markets over time. Instead, we move towards a two-system model. U.S. plasma will be primarily serving the U.S. market, where demand and value are highest and where focus will unlock further opportunities to optimize our CPL and operations.

Ex-U.S. plasma will be sufficient to supply ex-U.S. markets aligned with local economics and benefiting from excess IG in context of our self-sufficiency partnership with Egypt. This unique, geographically differentiated, and vertically integrated approach unlocks two major benefits. First, cost and margin optimization. By aligning our sourcing with market pricing, we structurally improve profitability. Second, resilience and supply security, reducing dependence on a single geography with the potential to mitigate policy, tariff, and regulatory risks. To be very clear, this is not just about expanding plasma collection. We are fundamentally redesigning how plasma is sourced and allocated globally, creating a more efficient, more resilient, and structurally more profitable model. Let me close on slide 12 with how to think about our U.S. Biopharma business, where Grifols has, over the last decades, with foresight, built a unique, fully vertically integrated local-for-local value chain.

Starting with the market, the U.S. is the largest and most attractive IG market globally, exceeding $20 billion, with continued strong demand for our therapies and a system that values plasma-derived medicines. This provides a strong foundation for continued growth, supported by increasing diagnosis and still high unmet need across our therapeutic areas. Looking at our model, as we have discussed in our previous call, our unique approach in the U.S. offers resilience and focus. Grifols is the only scaled company with an established, fully integrated end-to-end presence in this key market, spanning everything from plasma collection to manufacturing and commercialization in the U.S. for the U.S. In the current political environment, this closed-loop system is increasingly recognized as a strategic asset, providing supply security and operational resilience.

At the same time, it gives us greater control and visibility across the value chain, allowing us to better align plasma collection, capacity utilization, and commercial execution as our global sourcing model evolves. Lastly, looking at productivity, our local-for-local approach increases focus and allows us to drive efficiencies across our operations in the U.S. On the collection side, we are increasing plasma collections per donor site, which allows us to optimize our footprint. The recent closure of 29 underperforming donor centers with partial consolidation into higher-performing locations reflects a disciplined approach to optimizing our cost base and network quality, all while still enabling an increase in our annual plasma collections in the U.S. On the industrial side, our facilities in California and North Carolina represent the largest fractionation and purification capacity in the U.S. and are well-positioned to support local demand growth.

Importantly, following prior investments, we are now able to capture this growth largely within our existing capacity without significant incremental capital. Lastly, looking at our supply chain, our local-for-local approach allows us to further optimize our working capital cycle across markets. Bringing these elements together, market, vertical integration, and productivity, allows us to drive value for Biopharma. With that, I will hand it over to Rahul to walk us through the financials.

Thank you, Roland. On slide 14, we summarize the financial highlights for Q1 2026. As Nacho and Roland highlighted, our Q1 performance is entirely in line with our plans and expectations for the full year, notwithstanding the complex geopolitical and macroeconomic backdrop. Before I go into the financial performance, I'd like to highlight a couple of points. Firstly, it's great to see the strong execution across the board by the entire team, and in particular, the resilience in Biopharma driven by the continued strength in our immunoglobulin franchise. Second, please keep in mind that Q1 2026 relative performance compares to a Q1 2025 that was our best Q1 in history, a record performance that also benefited at the time from some phasing and a stronger U.S. dollar. Finally, we have considerably de-risked our balance sheet since our last update, and I will elaborate on that later in the presentation.

Moving on to the financial highlights in Q1 2026. We achieved reported revenues of EUR 1.7 billion, representing a 3.3% growth at constant currency, with our Biopharma division growing considerably faster than that, and I will touch on the performance of the other segments on the following page. With regards to the reported gross margin, consistent with our assurances during the full year call at the end of February, our gross margin has improved by 180 basis points compared to the gross margin in Q4 2025, taking into account the pricing concession offered in Q3 and Q4 2025 to support our joint efforts with our strategic partner Shanghai RAAS to navigate the albumin market in China, as well as the gross to net adjustments for full year 2025 being applied entirely in Q4 2025.

In this regard, the gross margin comparison to Q1 2025 is therefore less relevant. Other aspects impacting comparability to Q1 2025 include the dissolution of the joint business with QuidelOrtho, Biotest strong sales growth in Q1 2026 as operational enhancement progresses during the course of the year, and general phasing across the Grifols group in 2026, where we expect Q3 and Q4 to be our strongest quarters, partially aided by the ramping up of our plasma collections in Egypt during the course of the year. As per my guidance at the time of our full year call, the full year reported gross margin for 2025 of 38% is the right benchmark for 2026, and a portion of the adjusted EBITDA margin improvement being targeted in 2026 is expected to also flow through gross margin.

Adjusted EBITDA stood at EUR 381 million, up 0.8% at constant currency, maintaining a margin of 22.4%, in line with our record Q1 2025 performance last year and supported by continued OpEx discipline. From an FX perspective, the depreciating U.S. dollar had a translation impact during the quarter, with euro-dollar moving from an average of 1.04 in Q1 2025 to 1.18 in Q1 2026. Consistent with our prior guidance, a weaker U.S. dollar has the greatest impact on revenues, and the impact diminishes as we go down the P&L with EBITDA less impacted than sales and impact on group profit being broadly neutral. In this regard, it is great to see the 22% growth in our bottom line group profit for the quarter to EUR 73 million.

Free cash flow for the quarter was -EUR 8 million, reflecting the usual free cash flow seasonality of the business and a EUR 30 million improvement in free cash flow compared to Q1 2025. There are some aspects that I will clarify further in the free cash flow slide later. Turning to leverage and liquidity, our balance sheet is in a significantly improved position. We continue to make steady progress on de-leveraging, with total net leverage improving to 4.3x, a reduction of 0.2x year-on-year. Liquidity remains very strong. More on that a bit later. Slide 15. As you will see on this slide, the Biopharma business continues its strong top-line momentum with a 6.8% growth in constant currency terms.

As Roland highlighted, this was driven by continued momentum in our immunoglobulin franchise, which remains the core driver of growth. In Diagnostics, if we were to isolate the termination of the joint business with QuidelOrtho, Diagnostics revenues in fact grew at a low single-digit rate on a like-for-like basis in the quarter, consistent with prior years. Reported performance reflects the impact of the dissolution of the joint business, as previously discussed. The dissolution agreement includes a $65 million compensation to Grifols for, amongst other things, cost absorption at Grifols to be received in three payments across 2026, 2027, and 2028. Critically and very positively, the dissolution paves the way for Grifols to pursue its strategic aspirations in the immunoassay donor screening and clinical diagnostics markets over time with the development of the ASOT platform.

Within Biosupplies and others, lower revenues in the quarter reflect phasing effects of a segment impacted by timing of individual contracts and dispatching of sales, all products. We expect a catch-up during the course of the year, particularly in Q3 and Q4 this year. Looking ahead, we remain focused on executing the various building blocks of our plan for 2026 as outlined by Nacho, which I will elaborate on in the following slide. Slide 16. As I said earlier, when we consider the relative Q1 2026 adjusted EBITDA performance to Q1 2025, please remember that Q1 2025 represented our best Q1 adjusted EBITDA performance in history that benefited at the time from some phasing-related momentum.

For us to be able to emulate that performance in Q1 2026 on a constant currency basis demonstrates the resilience of the business, led by a continued adjusted EBITDA momentum in Biopharma. This momentum in Biopharma EBITDA is despite the full-year impact of the China albumin pricing concession in H2 last year. Yes, U.S. dollar weakening continues to impact the absolute EBITDA levels, broadly consistent with the sensitivity analysis we discussed last year. Some of that Biopharma momentum has been offset due to very specific and mostly temporary reasons in other segments. In Diagnostic, for example, the dissolution of the joint business with QuidelOrtho is a temporary headwind from a revenues perspective. However, it completely frees us to pursue our strategic aspirations in the immunoassay donor screening and clinical Diagnostic markets, and the compensation payments over the next three years will mitigate EBITDA impact.

As we look at the drivers of adjusted EBITDA growth and margin improvement in 2026, as Nacho said at the start of the presentation, it will be driven by each of the following. Number one, Biopharma product mix. Whilst the full-year impact of H2 2025 China albumin pricing concession will weigh on H1 2026 comparison to H1 2025, the combination of, A, the strong and continuing momentum in IVIG. B, you heard Roland's confidence about strong double-digit growth in SCIG from a growing and higher base. Finally, C, the expectations for Alpha-1 and other proteins growth in 2026 will support EBITDA growth and margin improvement. In addition, for example, the Diagnostic segment, the compensation payment in respect of the dissolution of the joint business will also help.

Number two, the game-changing impact of the EMA approval for Egyptian-sourced plasma will support balanced last-liter EBITDA growth, as well as contributing to margin improvement. It will also help to unlock point three, the global plasma sourcing footprint optimization opportunity that resulted in the closure of our weakest-performing centers in the U.S. that will drive cost efficiencies and lower CPL. Number four, the team is making progress with providing Biotest essential support to help with its operational and financial turnaround. Finally, Number five, our focus on OpEx discipline is delivering results with operating expenses reduced by 7.7% at constant currency versus Q1 last year. We will continue to stay vigilant and cost-conscious across the entire organization. We look forward to updating the market with our progress in the coming quarters. Slide 17 on free cash flow.

In the first quarter of 2026, free cash flow pre-M&A was -EUR 8 million. Adjusted EBITDA is negatively impacted by a depreciating U.S. dollar, the impact on free cash flow pre-M&A remains broadly neutral. You will notice a considerable investment in inventories in this quarter to support the continuing strong demand for our medicines. We have balanced that investment in inventories by continuing to manage our working capital diligently. The reduction in CapEx is consistent with our year-end financial disclosure and our discussions with our auditors, where the final payment in Q1 2026 in respect of ImmunoTek that was made to JPMorgan was classified as a repayment of financial liability and hence flows through financing activities. Notably, our cash interest in Q1 2026 compares favorably to Q1 2025. I will elaborate further on this in the next slide.

Finally, the increase in others was primarily due to the timing of our first 2025 IRA payment that was made in April 25. In conclusion, our free cash flow trajectory is progressing as planned in 2026, aligned with the typical seasonal patterns of the business, and we remain confident about delivering on our full-year guidance. Finally, turning to slide 18. I want to highlight the significant strides we have made in strengthening our capital structure and enhancing our financial flexibility. We have materially reshaped our debt maturity profile through the successful and proactive refinancing earlier this year of all our 2027 maturities whilst effectively navigating highly dynamic capital markets currently due to events in the Middle East. Now, our next set of maturities are not until Q4 2028, effectively eliminating any near-term refinancing risk.

The refinancing was upsized significantly in market, demonstrating once again the strong institutional support Grifols benefits from in the credit markets. The strong investor demand from global institutional investors and banks enabled us to deliver key structural improvements despite the challenged market backdrop. We more than doubled our revolving credit facility from approximately EUR 940 million to over EUR 2 billion while extending its maturity to six and a half years. The revolver now benefits from three margin ratchet step-downs that are leverage-based. Both tranches of the institutional TLB were upsized significantly in market, both tranches also benefiting from leverage-based margin ratchet step-downs. You may have noticed that we have made a number of changes with regards to the approach we take with our capital structure.

By right-sizing our revolver, we now benefit from very robust liquidity levels, allowing us to use surplus cash to reduce gross indebtedness with the EUR 500 million partial redemption of the 7.5% bonds. We have also considerably reduced our factoring activity levels all year round. Both these actions help us to be more efficient with our cash interest levels. Despite refinancing our cheapest debt in our capital structure this year, something analysts and investors were very focused on, we are now still targeting cash interest levels in 2026 to be at or below 2025 cash interest levels. It is great to see these actions being recognized positively by all three rating agencies with a substantial re-rating of our credit profile in a short period of time, with two out of three agencies upgrading us back into the BB space.

Long story short, our capital structure is in a considerably better place. Of course, we will continue to focus on deleveraging. Finally, following the reinstatement of our dividend policy in 2025, the upcoming AGM will consider the approval of the final 2025 cash dividend. The considerably improved capital structure position, whilst continuing on our deleveraging path, also supports some capital allocation optionality, including the potential use of share buybacks as part of our capital allocation toolkit can be considered in due course to drive shareholder value as and when best determined by the board. With that, let me hand it back to Nacho to conclude the presentation.

Thank you, Rahul. I would like to conclude today's presentations with a few final remarks. Our first quarter performance confirms that we are on track to deliver our 2026 objectives, with Biopharma continuing to lead our growth, driven by the strength of our immunoglobulin franchise and consistent and disciplined execution across key markets. At the same time, we are advancing a key strategic priority, the optimization of our global plasma footprint. The progress we're making in Egypt is essentially important, as it drives a structural improvement in cost per liter while further strengthening the resilience and security of our plasma supply. Additionally, increased plasma supply from Egypt to Europe will progressively reduce U.S. plasma exports, supporting margin expansion over time.

In parallel, we've taken decisive steps to strengthen our financial position, including the successful refinancing of our 2027 maturities, which enhances liquidity and reduce our cash financial expenses. This reinforces a clear and disciplined path towards deleverage. Collectively, these actions are building a stronger, more efficient, more disciplined, and increasingly cash-generative business, positioning us well for the remainder of the year and beyond. As we move forward, our focus remains clear: delivering on our commitments, further strengthening our financial profile, and unlocking the full value of Grifols. Thank you again for your continued support. We look forward to updating you on our progress in the quarters ahead. With that, Dani, please back to you.

Thank you, Nacho. Now let's turn to the Q&A session. Please remember to press star five to ask a question. We need to place a limit of two questions per analyst, but if you have follow-ups, please dial star five again to get back on the list. Today, our first question is coming from Charles Pitman from Barclays. Charles, please.

Hi, guys. Thanks very much for taking my questions. Two from me, please. Just firstly on this, the Alpha-1 specialty decline in 1Q. Just noting that last year you reported a 1% organic growth and then 2.3% on the like-to-like basis that you introduced. I'm wondering if you can quantify the size of this phasing benefit that you're referring that really drove this reported 7% decline. I wonder if you can commit to low- or mid-single digit growth for the division. Just secondly, hoping you can provide a bit more insight into the current U.S. IG market share dynamics, given a competitor yesterday flagged challenging commercial backdrop and a spike in raw material plasma, a finished product creating an aggressive pricing environment.

Just noting that your target is to grow in line with market and not drive further price erosion. I'm just wondering what you're seeing on this and how your launch of Yimmugo have been shifting your market share. Thank you.

Yeah, Charles, thank you for these questions. On Alpha-1 and specialty, yes, we can confirm that we expect a low- to mid-single digit growth for the full year. You know, in terms of the different components that add to the phasing, we don't provide that granularity. You know, as we tried to explain in the remarks today, this category is made up of different parts: Alpha-1, Fibrin Sealant, contract manufacturing, Factor VIII. What we saw this quarter is basically a comparison year-over-year in each one of them that added up and led to this result. We're very encouraged by the underlying drivers in Alpha-1, the growth that we saw in new patient referrals.

Yes, we had to work through some headwinds in terms of reauth period early in the year, but we saw patients come through in February and March and obviously continue to work on that. As said, we confirm that we are looking at growing that category year-over-year. On the U.S. IG part, you know, we are very encouraged by the underlying demand that we continue to see for Gamunex and for XEMBIFY in this market, which reflects the reception of the product. We have a high share of branded scripts, as well as the ability of our team and the focus of our team in the U.S. The market in itself, there's not a material change from our part. It's a competitive market, that's true, but it's a market that has very strong fundamentals.

We see demand and patients treated continuing to grow. We see it's a rational market largely. It's one where in some segments we're able to adjust price, and we're very disciplined in our own approach to competing in this market. From our side, this remains our key focus market, and we expect to grow with the market throughout the year. As you saw, we had Q1 growth above the market if you want. Expect this to normalize throughout the year and get more in line with market growth. At the same time, the strong momentum that we see allows us to be selective on where we can titrate back in lower margin accounts or lower margin countries. We believe that we start from a strength base when it comes to IG.

Okay. Thank you so much, Roland. Thank you, Charles, for your question. We would like to get questions from Santander, from Jaime Escribano. Jaime, please. It's your turn.

Hi, good morning.

Jaime, thank you.

Yes, a couple of questions from my side. The first one would be regarding the announcement of the potential spin-off or, well, IPO of the U.S. plasma business. If you can tell us a little bit the rationale, potential timing, what's your, what you're thinking about the some of the portions you only did the release, and this is the first time that you have the opportunity to maybe speak to the market. It will be great to have your views. The second one is Haema and BPC, in the Capital Markets Day, you said 2026, 2027 as potential years to buying these two. What are the next steps, or what do you have in mind on this regard? Thank you very much.

Gracias, Jaime. Thank you, Jaime. As I mentioned at the beginning of my presentation, at this stage, we are in the initial phases of the consideration of the potential IPO and, therefore, there is no further information we can comment on at this time. We will provide updates as when necessary, remaining in full compliance with applicable laws and regulations. Please, at this point, we cannot answer any question regarding that topic. As per Haema BPC, Rahul?

Yeah. Haema BPC, Jaime, no change. We continue to look at the 2026-2027 timeframe. You will recall we had talked about funding those buybacks through free cash flow generation. As you will have seen, we recently announced the redemption of our EUR 500 million of 7.5% bonds using surplus cash. All of that is tracking as normal. In terms of timing, it still remains in the 2026-2027 timeframe, Jaime. No change.

Thank you so much. Let's move to the next question from Morgan Stanley. Thibault, please.

Yeah. Thank you very much. My first question is just on albumin in China, if you could help us understand better the shape for this year. You talked about the price impact that started in the middle of 2025, so presumably not a washing out in mid 2026. Is there any other elements to help us understand what's happening on that market in terms of volume, in terms of competition? Basically what to expect from the second half of this year. Can this market go back to growth in China, or should we expect the market to remain challenged, you know, a bit longer than mid-2026? Just a one question on the OpEx this quarter, I mean, definitely lower.

Can you give us more color on where you're finding the savings? You know, where you manage to sort of lower the cost and and sort of, you know, how much can you drive these initiatives going forward? Thank you.

Okay. The first question is gonna be Roland. Roland and probably Nacho, and then also Rahul will tackle the OpEx question. Roland, please.

Yeah, Thibault, on China, if we take a step back, what we see happening in China is, on the one hand, continued underlying demand from patients and physicians that want to get albumin, meeting overlay of government pressures. What this resulted in last year is a stagnation of the market, a flattening of the market, and pricing pressures. As mentioned before, as you stated, we adjusted our prices mid-year. We are, you know, in this market where we also see inventories across the market will be relatively high. Our main focus is on throughput through pull-through on demand and customer demand. What we see there is that the Q1 this year is trending higher than last year, which is a positive. We also see that pricing in hospital is stabilizing, which is a positive.

We're cautiously optimistic that from here we can build. Having said that, there's more work to be done. At the same time, the market fundamentals, the aging pyramid in China all point towards continued demand for albumin, and we believe that with Shanghai RAAS, we're well-positioned to compete in this market as it will return to grow over the next years. Having said that, I wanna leave clear that, you know, China is not our only card that we have here. We see room to grow in other markets outside of China, and we're pleased to see the momentum there. We also see that we have in the U.S. a differentiated offering with Arabax, where we're adding capacity in 2027.

On top of that, as we explained in the last call, with our plasma sourcing in Egypt, where there's a strong local demand for albumin and there's an excess IG that can be used in Europe. We believe that we have the pieces in place that will enable us to balance IG and albumin growth over time.

On OpEx, Thibault, it's mainly just better and more efficiently and more diligently run across SG&A. R&D is broadly, you know, flat, so we, you know, continue to prioritize our R&D spend. It is just being more efficient on the SG&A front across the board. We'll continue to look at that. Clearly, we've made a lot of progress over the last year or two. You know, I think from our standpoint, we still see further opportunities to do better, and it'll just be a case of head down and diligent execution. We'll see.

Okay. Thank you so much, Rahul. Thank you so much, Thibault. I mean, we will take a question from Charlie Haywood from Bank of America.

Hi. Charlie Heywood, Bank of America. Thanks for taking the questions. I have two, please. The first is just on the planned U.S. IPO or potential planned U.S. IPO. From your CMD, I think 13 months before the IPO announcement, I think you outlined a fairly clear sort of five- and 10-year view of Grifols that obviously didn't include a potential IPO. Could you just help us understand what's changed in the last 13 months to prompt the decision to act on this? Is there any different view on, you know, leverage, financial structure, anything along those lines that prompted that decision? The second one is just sort of quite certainly, I guess, the IPO adds potential complexity to your structure. You know, you've obviously got Haema and BPC, which you have a plan on, your A versus B shares.

You previously outlined potential diagnostics exit. How do you balance all of these, sort of increasing complexity for Grifols, versus, like, the option to add the IPO as another layer on top? Like, any update on the A versus B collapse, alongside potential IPO or other routes to simplification? Thank you.

Yeah. Look, I think, on US IPO again, we're somewhat constrained as we talk about the topic going forward. Your question is much more around, is there a capital structure issue or is there a balance sheet issue? No, absolutely not. You've seen the progress that we've made on the balance sheet front. There is absolutely no issues there. We will continue on our de-leveraging path. You know, as you think about the status quo, at the end of the day, this is really about trying to see if there are aspects that we can consider to accelerate or maximize shareholder value. That's something that we will continue to consider and update as and when there is an update to provide.

On Haema and BPC, you know, I think you talked about complexity. Absolutely right. The focus is to simplify. Haema and BPC, we do intend, as I mentioned to Jaime's question earlier, we do intend to exercise the option during 2026 or 2027. We're keeping very much to the same parameters that we set out at the time of our Capital Markets Day around it being funded through free cash flow generation, not adding to gross debt to the extent that we're able to do that. We're sticking diligently to the plan that we set out. No real change, and there's nothing hidden from a balance sheet perspective.

This is all about trying to, ensure that we, you know, optimize, maximize shareholder value, if we see an opportunity to do that. I'll leave it at that, Charlie.

Thank you so much, Rahul. Thank you so much, Charlie. Now is the turn of Guilherme from CaixaBank. Guilherme, please.

Yes. Good afternoon. Thank you for taking my questions. The first one regarding margins. Would you be able to quantify the potential saving expectations from the U.S. donor center optimization? On top of this, any indication on the contribution of the plasma sourcing redesign to the 50 basis points margin improvement target by 2029? The second question is regarding Diagnostic. If you've communicated at the Capital Markets Day an expectation to deliver a 5% annual growth until 2029. You mentioned at that time that it was going to be back-end loaded, you're now mentioning a low single-digit expansion, if I understood correctly, until 2027. We have also the Barcelona platform launch later this year.

Are you still confident with this 5% growth until 2029? Thank you.

Let me take the one on Diagnostic first, and Rahul will comment on the margins. On Diagnostics, yes, we are still confident with our plan. I think that what is most promising within that business is the fact that the development of the three platforms, which is quite unique and important. I mean, the serology, the blood typing, and the molecular platforms are progressing very well and really under our expectations. The first launch is going to be Barcelona this year, and that is going to start building on additional revenues already in 2027, and certainly more to come as we progress. We are very optimistic about our Diagnostic business.

It's true that this dissolution of the joint business is going to present some headwinds this year, but certainly more focus on the revenue or EBITDA, while cash flow-wise, we'll continue delivering a very high profile. Most important, as I say, our developments on the R&D side are moving along very well and as expected, and we expect to generate very significant revenues from it as the capital markets they plan for the next five years will advance.

On the margins, Rahul, do you wanna comment?

Yeah. Closure of centers, Guilherme, you're absolutely right that it will contribute to margin improvement. What we haven't done is separate the margin improvement between each of our drivers, whether it's Biopharma product mix, segmental mix, the, you know, the impact of Egypt sourcing, the footprint optimization, Biotest. There are a whole bunch of drivers. No question that as you think about the scale of what we've talked about, we see a considerable opportunity to optimize our CPL, and it will contribute to margin improvement. We're just not separating out what that impact would be, you know, factor by factor.

I would add that, from an operational, I mean, efficiency perspective, I think this is certainly one of the big contributors as well to our OpEx management in the last years, which has been clearly shown inefficiencies in many places. The plasma donor centers are a key part of that. It's a significant cost and it goes to the cost per liter, and we are continuously working to make generating efficiency in that area. The closing of these centers that obviously were the less performing centers, obviously, it certainly will help to continue decreasing the cost per liter in the U.S.

As I explained by Roland as part of the presentation, I mean, step by step, we will transfer the needs of the European plasma sources from the U.S. to other sources, and all that will benefit on optimizing cost per liter all over the world. I think that, while we don't disclose the specific details, I think that our margin expansion is composed to many, many levers, and all of them are contributing to that.

Okay. Thank you so much, Nacho. Let's move to the next question. It is coming from Justin Smith from Bernstein.

thanks very much. Just one for Rahul, if possible. Just on the buybacks, if we get to that point, do you want us to think about that more as a perspective of increasing more tax-efficient returns to certain shareholders, or is it more about sort of a ROIC versus WACC equation, or is it a combination of both?

Yeah, look, I think at the end of the day, it's just a comparison of or judgment on intrinsic value, balance sheet capacity, and timing. You know, at the end of the day, we, you know, this is a judgment that will be made by the board as and when is right. We talked about this as part of our toolkit, even when we spoke about our capital market state plan 15 months ago. All I'm saying is, with the balance sheet in a considerably better place, this is capital allocation optionality that may be considered by the board as and when it deems fit. That's the only point for the moment, Justin.

Thank you so much, Rahul. We are close to the hour, but we have a second set of question from Charles Pitman from Barclays. Charles, please.

Hi, guys. Thanks very much. Just very briefly wondering if you could give us a quick update on the progress for the 2Q 2026 facility launch in fibrinogen and whether you or not you have an updated timeline for the acquired form of the disease. If there's any time to comment, just your thoughts on the CIDP market following anti-FcRns remaining confident they can move into early lines. Thank you.

Looking at the facility of Prufibry launch, you know, outside of the U.S. and Germany, we launched last year. We're very pleased with the early feedback we receive in Germany and in Austria, where physicians highly appreciate the room temperature storage and the ease and speed of reconstitution as well as the speed of infusion. Pleased with the progress there ex-U.S. In the U.S., we're ramping up, have the team in place for a launch later this quarter, and we're excited about that. At the moment, focusing on congenital fibrinogen deficiency, as you know. You know, in parallel advancing our trial for AFD. We will share timelines as we have this more in place.

Just recall that as we look at the U.S., that market today has a size of about EUR 50 million. The potential is to EUR 800 million. We believe that this AFD trial will be with our design, helping to make that change of standard of care happen that is required in this market. We believe that we're in a position to effectively launch now. We look forward to it, and we'll then over time build in this market and believe that we can, you know, capture a significant share of the potential over time. In terms of CIDP, you know, we continue to see growth in CIDP at this moment in time. As you know, we now have a bit more than 1.5 years of the FcRNs in the market.

It showed that IVIG and IVIG in general is very well-suited for this multilateral disease. As we look at new competitors possibly entering, we know that we have a treatment in place that treats different parts of the disease mechanism in CIDP and therefore remain confident. That's what we hear back from physicians at this moment. At this moment, we continue to see growth.

Okay. Thank you so much, Roland. We are gonna squeeze Jaime from Santander. Jaime, the very last one, please.

Yeah. Hi. A super quick question. We never talk about Biopharma, but because it was particularly weak this quarter, just if you can provide a little bit of outlook for the following quarters. Thanks.

Yeah. I mean, we normally don't provide much details on Bio Supplies. Bio supplies is a business which is characterized for one spot deals and it might have a very significant variance to the year. I think it's in a way is a business that without existing, probably we would miss those opportunities in the markets. We know as well that it's very difficult to plan and forecast that as I say, because of these spot deals that are generating through the year. We are confident and when we are working on a number of those deals that we hope that will materialize through the year, it will be difficult to anticipate at this point how many of them will be in 2026 versus 2027.

I think we will provide updates as things will happen. Thank you, Jaime.

Thank you so much, Nacho. That was the last question for today. Thank you so much for having us and for your support. Thank you.

Hello, everyone, and thank you for joining us today for Grifols' fourth quarter and full year 2025 earnings call. My name is Dani Segarra, and I serve as the Head of Investor Relations and Sustainability. Today, I'm joined by Grifols' Chief Executive Officer, Nacho Abia, President of Biopharma, Roland Wandeler, and Chief Financial Officer, Rahul Srinivasan. As usual, is our usual practice, today's call will last about an hour, including the Q&A session. Please note that this call is being recorded. You can find additional materials, including today's presentations, in the Investor Relations section of the Grifols website at grifols.com. A transcript and replay of the webcast will also be available on the Investor Relations website within 24 hours. Turning to slide two, I would like to remind everyone that forward-looking statements may be made during this call.

This may include, among other things, comments regarding the company's future operating and financial performance, statements about our future expectations, clinical developments, regulatory timelines, and the potential success of our product candidates. These statements are based on current expectations and available information as of the date of this call and are subject to certain risks and uncertainties that may cause actual results to differ materially from those discussed today. Grifols' financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions, including alternative performance measures or APMs, as defined by the European Securities and Markets Authority. Grifols' management uses APMs to evaluate financial performance as the basis for operational and strategic decision-making. These APMs are prepared for all the time periods presented in this document. Moving to today's agenda, I will turn the call to Nacho to kick it off. Nacho?

Thank you, Dani, and thank you all for joining us today. Fiscal 2025 marks an important year for Grifols. We executed against our plan, advanced our operational and innovation priorities, delivered on our revenue and adjusted EBITDA guidance, and most importantly, exceeded our key cash flow target. All of this amid a complex geopolitical, macro, and operating environment. In such a complex year, our performance reflects the structural strength of the company. Scale, deep vertical integration in a strategic market, and a globally diversified footprint continue to differentiate Grifols. This signals not only the company's strong fundamentals, but also the strength and resilience of our business model and our ability to continue shaping and leading in this industry in the many years to come.

Turning to slide five. As you all know well, one of our key priorities has been, and will continue to be, improving our cash generation profile. In fiscal year 2025, the company generated EUR 468 million in free cash flow, pre-M&A, pre-dividends, an increase of more than EUR 200 million year-over-year, which reflects the benefit of our company-wide focus on capital discipline. On the top line, revenue reached EUR 7,524 million, represented a solid 7% increase over the previous year and a 9.1% increase on a like-for-like basis, both at cost and currency. This growth was driven largely by the continued strong performance of our IG franchise.

Adjusted EBITDA reached EUR 1,825 million, a 5.6% year-over-year increase, while on a like-for-like basis, without the impact of the IRA, adjusted EBITDA increased by close to 12%, all at cost and currency. At guidance FX, adjusted EBITDA reached EUR 1,902 million, right in line with the guidance provided 12 months ago. Deleveraging remains a key priority, and the path forward becomes clear as our free cash flow generation is sustainable and continuing to increase. At year-end, our leverage ratio improved to 4.2x, a 4.x reduction over prior year. This strong and consistent performance across our key metrics supported our recent credit rerating and continues to be a central priority for the board.

Beyond the financials figures, 2025 was a year defined by execution on our operational and financial priorities. Led by Biopharma, our core IG franchise, both intravenous and subcutaneous, delivered a strong performance, reflecting the strength of our clinical proposition. We leveraged the opportunity to use our solid inventory position to accelerate IG growth and build momentum in key markets. As mentioned on our Q3 2025 call, albumin demand in China declined amid ongoing pressures following government cost controls. We continue to work with our local partners, Shanghai RAAS, to effectively navigate and manage these market dynamics. By leveraging this partnership, we have achieved relative outperformance in the Chinese market.

The combination of a strong growth for our, of our IG franchise and lower-than-expected albumin sales weighed on our margins, reflecting the underlying economics of the plasma industry and emphasizing the need to continue working to improve our efficiencies. We remain highly confident about achieving our margin expansion goals. Rahul will provide further insights later in the presentation. At the same time, we continue advancing differentiated margin-accretive therapies to the market. In the fourth quarter, we successfully launched Prufibry in Europe, our new fibrinogen concentrate for acute bleeding episodes with congenital and acquired fibrinogen deficiency. Following FDA approval, we plan to launch FESILTY in the first half of 2026, our new fibrinogen concentrate for U.S. patients with congenital fibrinogen deficiency.

Despite the challenges presented by the macro environment and global trade shifts, our local-for-local business model once again demonstrated its resilience, effectively insulating us from tariff and preserving our defensible moat. This as-much-as-possible localized model also implies that while FX headwinds impacted both revenue and EBITDA levels, they did not extend to our free cash flow or leverage ratio due to the significant levels of natural hedges embedded within our business. We improve our cash flow and expense profile as we strengthen our balance sheet. Our focus on EBITDA and free cash flow expansion clears the path to deleverage. Turning to slide seven. We feel good with the company's performance in 2025. As we look forward, it is important to acknowledge the necessity of maintaining a balanced approach to growth across our portfolio of key proteins. Looking ahead, our direction for 2026 is clear.

We will consciously focus our growth to prioritize profitability, cash flow generation, and to continue reducing our leverage ratio. Two key projects, Egypt and Canada, will play a central role in delivering on this strategy, and they have the potential to redefine the plasma industry in the many years ahead. In Egypt, our transformational partnership has achieved a major milestone with EMA approval of Egyptian-sourced plasma. This is first of its kind achievement that is a game-changer in the industry. In Canada, through our strategic partnership with CBS, we remain deeply committed to the prospects for the fourth-largest IgG market globally. Roland will provide further details on both later in the presentation. In the U.S., we stand as the only scale plasma company with a fully integrated end-to-end value chain in the country, the world's most important IgG market.

Over the last two decades, we have been shifting the structure of plasma sourcing and our entire operation to a local-for-local model as a key differentiator and value driver. Finally, our long-standing relations in China and the deep knowledge of the market has proven effective and will continue to play an important role to mitigate the changes in that important country. As we enter 2026, confident in our positioning, the fundamentals of our business remain sound. In a world increasingly shaped by geopolitical shifts, Grifols' integrated model and diversified footprint provide unique strategic optionality and allow us to navigate uncertainty with agility and resilience. This isn't just about sustaining a competitive advantage. It's about having the infrastructure, partnership, and the vision to lead the industry into its next chapter. With that, I will hand over to Roland to cover our commercial performance in more detail.

Thank you, Nacho. Moving on to slide nine, Biopharma delivered a strong year in 2025, growing 8.4% for the year on a reported and 10.9% on a like-for-like basis, both at constant currency. I am proud of the dedication, passion, and commitment our team shows every day to deliver for patients and drive forward towards the goals we set out. Our immunoglobulin franchise led the way in 2025 and delivered a strong 14.7% year-over-year increase at constant currency. This performance was driven by GAMUNEX-C and XEMBIFY, with IVIG and SCIG delivering 12% and 60% full-year growth, respectively, both clearly ahead of the market.

As outlined in our last call, we saw an opportunity over the last two years to use our strong IG inventory position to accelerate IG growth, build momentum in key markets, and win back share in the U.S. We have since delivered on this plan. We have strengthened our U.S. organization and commercial capabilities, expanded SCIG penetration through XEMBIFY, and leveraged the strong profile of GAMUNEX-C to win share in strategic accounts. Looking ahead, we expect underlying demand growth for IG to continue across our three main indications. In primary immunodeficiency, increased awareness and better diagnosis are expanding access to therapy. In secondary immunodeficiency, on-label outside the U.S., demand continues to rise in an aging population and with an increase in immune-compromised patients.

In CIDP, we are seeing continued growth, albeit at a lower level, as IG therapy, with its polyvalent mechanism, remains the first-line choice and standard of care for patients living with this multifactorial disease. As Nacho mentioned, where in 2025, our plan was to regain share in the U.S. and select European markets and thus grow ahead of the market, we now aim to control growth going into 2026 from the stronger position with a differentiated approach. In the U.S. and select European countries, where we have recently gained share, we plan to maintain our position and grow with the market. Outside these key markets, we have already started to pull back growth towards the end of 2025 and will further consolidate in 2026 with an increased focus on margin.

This targeted approach will allow us to enhance the return on our investments and ensure that our commercial efforts translate into meaningful margin improvements. Turning to albumin, we saw revenues decline 5.1% year-over-year, as positive momentum in the U.S. and ex-China was offset by the market and pricing pressures from policy changes in China. While these changes in China also weighed on our albumin sales, our strategic partnership with Shanghai RAAS allowed us to effectively compete and perform ahead of the market. Entering 2026, we aim to further drive albumin uptake to balance growth with IG. In China, we will continue to build on our strategic partnership with Shanghai RAAS. With disciplined pricing and expanded joint commercial footprint and a sharper marketing and contracting approach, we expect to expand hospital sale access, including greater penetration into lower-tier hospitals, and broaden our reach in retail pharmacies.

In addition, our medical teams will continue to drive education, awareness, and evidence generation, for example, around long-term albumin use in liver cirrhosis, an important and still unmet need in China. Outside China, we will build on our momentum to further expand our albumin presence, helping us move toward a more balanced geographic mix. Through this approach, and as conditions in China stabilize, we remain confident that our efforts place us in a position of strength to balance our albumin growth with IG. Looking at our Alpha-1 and specialty proteins portfolio, we saw a full year growth of 1.4% or 3.8% on a like-for-like basis before the impact of the IRA Part D redesign. In 2025, we reinforced our leadership in Alpha-1 and returned to patient growth following the transition to our new specialty pharmacy partner.

We also saw steady contributions from our rabies franchise and our contract manufacturing business. Keep in mind that different phasing patterns across proteins in this segment create natural quarter-to-quarter variability. In this context, our fourth quarter results mainly reflect a tough comparison against a strong Q4 2024, not a change in underlying trends, which remain solid. Looking ahead, we expect to drive continued patient growth in Alpha-1 while preparing for a major clinical milestone with expected top-line results of our phase III SPARTA outcomes trial, the first of its kind in the second half of this year. These outcomes have the potential to unlock significant growth in this highly underdiagnosed and undertreated condition by dramatically increasing disease awareness and testing in light of clear clinical benefits.

In parallel, we are advancing a 15% subcutaneous formulation and a next-generation Alpha-1 therapy aimed at enhancing convenience, expanding access, and strengthening our leadership in this growing market. We remain confident in PROLASTIN's long-term potential and continue to focus on expanding the total addressable market. With roughly 85% of patients still undiagnosed, and with outcomes, AI-enabled patient identification, and increasing awareness from potentially entrants building momentum, we see meaningful opportunities to accelerate testing and thus help more people living with AATD to benefit from therapy. On slide 10, as the newest addition to our Biopharma portfolio, I would like to provide an update on the progress of our fibrinogen franchise. With our approval in Germany at the end of last year, we have launched our fibrinogen concentrate, Prufibry, in Europe with a focus in Germany and Austria, where FCs are the preferred option for acquired fibrinogen deficiency.

We realized first sales in Q4 '25 and see continued strong demand for Prufibry. Early feedback is promising and especially highlights our differentiation, including the ease and speed of reconstitution of our highly purified FC, as well as its application. We will continue to focus on Germany and Austria as key markets this year and expand into additional European markets over time. In the United States, following our December FDA approval for congenital fibrinogen deficiency under the brand name FESILTY, we are preparing for launch in Q2 '26. We have a focused field team in place to help educate key decision-makers across leading institutions in the U.S. and secure hospital formulary access, building on our long-term relationships in many of these systems.

While we will focus our U.S. launch on CFD in the short term, we are advancing our work to embark on an AFD trial in the U.S. this year, which will allow us to expand our label over time. In parallel, we will continue to engage in appropriate disease state education for the critical role that fibrinogen deficiency plays in bleeding. We expect our entry into AFD to align with the evolution of clinical practice in the U.S., where awareness and application of ready-to-use FCs for bleeding is still emerging, with the potential to exceed $800 million U.S. dollars over time.

As we focus on controlled growth with IG, balance with albumin, and continuing momentum in our portfolio of first data proteins, slide 11 outlines how the vision and strategic investments that Grifols embarked on many years ago are providing us today with a strong, structured foundation for long-term value creation. This is particularly important in an environment where geopolitical pressures are rising and supply security is becoming increasingly strategic for our customers. In the U.S., the world's largest plasma market, we have, over the last decades, built a fully integrated end-to-end platform spanning domestic plasma collection, fractionation, purification, and commercialization. Over the last years, we have started to extend this vertically integrated business model into other strategic markets through long-term public-private self-sufficiency partnerships that align our capabilities with national healthcare priorities.

In Canada, the fourth-largest global IG market, our long-term partnership with Canadian Blood Services supports the country's objective of reaching at least 50% IG self-sufficiency. By expanding the share of locally sourced plasma and adding the capabilities to convert it into domestically manufactured plasma-derived proteins, we strengthen supply resiliency while reinforcing our presence in an attractive market. In Egypt, we have partnered with the Egyptian government to establish a fully integrated plasma platform designed to achieve national self-sufficiency and position the country as a regional hub for Africa and the Middle East. Once domestic needs are fulfilled, this platform expands access to life-saving therapies across the region and creates export potential to European countries, especially for IG. Taken together, these initiatives reflect the scalable partnership model that combines industrial expertise with national healthcare priorities, positioning Grifols as a strategic partner in building sustainable plasma ecosystems across the globe.

Let me add a bit of more color. Taking a closer look at the U.S. on slide 12, we have invested strategically over the last 20 years in building our infrastructure to support this key market at scale. With vision and foresight, Grifols has built a fully integrated, resilient, state-of-the-art footprint that spans the entire value chain from donor to patient. Today, we operate a network of more than 300 donor centers in the U.S., ensuring a stable supply of quality plasma. To put that in perspective, over 70% of Grifols' total global plasma collection capacity is anchored right in the U.S. Across our two primary U.S. plants, including our flagship facility in Clayton, North Carolina, one of the largest of its kind, we also hold 65% of our manufacturing capacity in the U.S. and thus have achieved a unique and differentiated level of vertical integration.

This positions us to supply the growing demand in the U.S. fully from within this key market through self-sufficiency. This helps insulate us from global supply chain disruptions and ensures that our most critical market can be served by our efficient and strategically located donor centers and facilities. On slide 13, we turn to Canada, one of the top four global markets for IG. Canada recognized that its historical reliance on imports for roughly 85% of its IG needs created long-term supply risk. As a result, Canadian Blood Services made it a national priority early this decade to lift domestic self-sufficiency to over 50%. Grifols stepped up to support that vision, and in 2022, signed a 15-year renewable agreement with CBS to build a fully domestic plasma ecosystem from the ground up. Following this mandate, our operational footprint in Canada is expanding rapidly.

In just the last 12 months, we have established a network of 17 donation centers, creating the backbone for a nationwide plasma collection network. Together with CBS, we were able to increase the share of IG self-sufficiency from 15% to around 30% in 2025, and we are progressing as planned with our domestic manufacturing plant in Montreal. We started with local purification of albumin in 2025, and we are on track to add 1.5 million liters of fractionation capacity alongside dedicated purification and fill finish lines by 2028. This makes Grifols the only large-scale domestic manufacturing player with an end-to-end value chain in Canada. This unique position allows us to offer a fully integrated platform of services in this key market. On slide 14, we highlight our strategic foothold in Egypt. This is more than a geographic expansion.

It is a first-of-its-kind public-private partnership that is pioneering biopharmaceutical sovereignty for an entire region. Through our partnership with the Egyptian government, signed in 2020, we have created a fully integrated regional ecosystem spanning plasma collection, testing, and future fractionation and purification capabilities. Building on the project's strong progress, a key inflection point for Grifols was securing full EMA approval late last year for the entire Grifols Egypt value chain. This is a massive strategic unlock for the group, validating our end-to-end quality standards and enabling European commercialization of plasma-derived therapies sourced from Egyptian plasma. I will walk you through the details in the next slides. Slide 15 maps out the strong execution and progress of our strategic project in Egypt.

After successfully opening 16 donor centers last year, our team in Egypt, building on our core capabilities in Grifols Engineering and quality, is on track to scale our network to 20 centers in 2026, all operating under our high-standard model. With this, we were able last year to already achieve full self-sufficiency in factor VIII, albumin, and IG for Egypt, a notable milestone. We move into 2026, we are leveraging any surplus in plasma to expand supply across the broader Middle East and Africa. For manufacturing, our roadmap remains disciplined and phased. We are currently in phase I of plant construction, with the plasma logistics center and testing lab coming online this year. Between 2030 and 2031, the fractionation and purification plants will become fully operational, and by 2031, the entire end-to-end value chain will be localized in Egypt.

Equally important, our recent regulatory achievements have validated the strength of our end-to-end quality system. By positioning Egypt as a globally recognized plasma hub, we have earned what we call the Grifols Seals of Excellence. This has a direct financial impact as it enables the commercialization of Egyptian plasma derivatives in Europe and thus reduce reliance on costlier U.S. and EU-sourced plasma. Further, this also allows us to better balance albumin with our IG growth on a global scale, as the local demand for factor VIII and albumin in Egypt, Middle East, and Africa is significantly higher than for IG. This provides excess IG that can help cover demand in Europe. Slide 16 shows how our partnership in Egypt is transformational for both Egypt and Grifols. Let me highlight a few key facts that illustrate the scale and impact of this project for Egypt, where healthcare benefits are already tangible.

More than 1 million vials produced from Egyptian plasma have been delivered to public hospitals and health centers, and over 100,000 free medical checkups have been provided to donors. From an economic and social perspective, the initiative is emerging as a meaningful contributor to the national economy. In 2025 alone, the project is expected to have contributed approximately EUR 55 million to Egypt's GDP, with cumulative contributions projected to exceed EUR 700 million by 2029. The project has also made a significant contribution to employment in Egypt. To date, it has generated approximately 1,200 highly skilled direct jobs. In addition to these direct employment opportunities, the initiative has created more than 14,000 indirect positions supporting the broader economy. Over the next four years, total employment impact is projected to exceed 180,000 jobs.

While this project is first and foremost about supporting national self-sufficiency for the Egyptian people, it is also transformative for Grifols. By shifting part of our sourcing to a more cost-effective, EMA-approved hub in Egypt, we are structurally de-risking our plasma supply, expanding margins, and reinforcing the underlying fundamentals of our business model. Across our vertical integration in the U.S., our self-sufficiency partnership in Canada, and our strategic self-sufficiency expansion in Egypt, we believe that we are building a basis and a blueprint that will allow us to better meet demands in an evolving geopolitical context and deliver value for the long term. We are confident in this path. With that, I will now hand it over to Rahul, who will provide more details on our financial performance.

Thank you, Roland. Slide 18. As both Nacho and Roland have alluded to, navigating highly dynamic forces, be it the geopolitics that threaten to disrupt the supply chains of most global companies or the seismic moves in euro dollar, the fact that Grifols was able to deliver on its deleveraging plans, beat free cash flow generation and revenue guidance while achieving adjusted EBITDA guidance and more than double Group profit, demonstrates the clear resilience of this business. The foundations of this resilience come from. One, Grifols' unique position in the U.S. with a fully integrated, truly end-to-end in-market for market business. Two, our highly differentiated self-sufficiency strategy that has been many years in the making, thanks to the vision and the enterprise of those before us, and that will be a source of clear competitive advantage going forward.

Three, the highly strategic and long-standing partnerships that have been developed over time. Four, our end-to-end capabilities all the way from industrial to commercialization and everything in between. Five, the tireless efforts of all our teammates across the entire Grifols Group. Finally, and most importantly, the trust from our patients, our donors, and our customers. Specifically on the financials, net revenues in 2025 are up 7% versus 2024, and 9% on a like-for-like basis, both in constant currency terms, reflecting the secular tailwinds for IG demand. Adjusted EBITDA and gross margin performance is after fully absorbing the IRA impact in 2025, and we need to consider that when making comparisons to 2024 financial performance. For that reason, we have also included the like-for-like column to facilitate better comparability between the two years.

In 2025, adjusted EBITDA like-for-like growth rate in constant currency terms was up almost 12% versus 2024. Reported gross margin was weaker versus 2024, broadly due to the impact of fully absorbing IRA in 2025, some accounting reclasses between OPEX and COGS that weighed on gross margin, but neutral at EBITDA, and the impact of the albumin market in China. On China albumin, we continue to feel well positioned to better navigate the market dynamics, given our strategic partnership with Shanghai RAAS and Haier. On a like-for-like basis, that is, prior to the impact of IRA and the gross to net reclassifications, gross margin in 2025 in fact improved by approximately 50 basis points versus 2024, better reflecting underlying performance. Adjusted EBITDA of EUR 1.825 billion equates to just over EUR 1.9 billion at guidance FX rates.

Whilst EBITDA is impacted by the weakening dollar, the natural hedges we have in place make the impact more muted at the free cash flow, leverage, and group profit levels. Whilst like-for-like adjusted EBITDA margins at 25% exceeded 24%, adjusted EBITDA margin was a touch weaker, 24.3%, after fully absorbing the impact of IRA. EBITDA margins remain an area of critical focus for us, and we will be highly proactive with our efforts to ensure of its continued progression. Group profit is up 156%, more than double 2024 group profit, a clear validation of the board's recommendation to approve the interim dividend in the summer, Grifols' first dividend payment since 2021. As is customary, the final dividend payment in respect of 2025 is subject to the board's recommendation and shareholder approval at the AGM later this year.

Moving on to free cash flow. We are pleased to back up the significant free cash flow outperformance in 2024 with another free cash flow pre-M&A beat at EUR 468 million, up over EUR 200 million versus 2024. This business can absolutely generate meaningful amounts of free cash flow, we remain confident about expanding the free cash flow generation considerably in the coming years. Our deleveraging path continues with leverage down from 4.6x at the end of 2024 to 4.2x at the end of 2025. The significant dollar weakening had a broadly neutral impact on leverage, given that some of our debt issuances are dollar-denominated, we will continue to optimize the currency mix as we consider our refinancing plans.

I will also update you later on a later slide on our positive progress we are making towards 2027 milestones on deleveraging and cumulative free cash flow generation. The combination of the EUR 1.7 billion of liquidity and the significant secured capacity I've referenced in prior update, gives us strong confidence about the Fortress balance sheet and our ability to execute our exciting plans or indeed, withstand anything unforeseen. Slide 19. Full year 2025, like-for-like adjusted EBITDA growth was circa 12% and 5.6% after fully absorbing the EUR 108 million IRA impact. Adjusted EBITDA growth was mainly Biopharma-led.

The Biopharma EBITDA growth drivers were primarily volume growth, geo and product mix benefits, continued steady improvement of CPL, and operational leverage benefits that together more than offset the impact of China albumin, where we continue to feel better equipped to deal with the developments in China, thanks to our strategic partnership. Diagnostic continues to achieve all its milestones as part of our significant repositioning of that business. We're excited about the launch of our new immunohematology platform at the next International Society of Blood Transfusion Congress before the summer, while continuing to maintain our leadership in the molecular donor screening market and continuing to significantly grow in our blood typing business, particularly in the U.S. Like-for-like adjusted EBITDA margins of 25% were higher than 2024. Slightly softer after fully absorbing the impact of IRA.

As I said on the prior slide, margins remain an area of critical focus for us, and we intend to remain highly proactive with our efforts to ensure of its continued progression. With regards to cash adjustments, we show a 33% reduction versus 2024, driven by lower restructuring and transaction costs. Consistent with our update in Q3, non-cash adjustments relate to impairments of projects that do not at all impact the go-forward equity or credit story and are an extension of the capital allocation discipline that we have talked about. Leaving aside this non-cash adjustment, the convergence between adjusted and reported EBITDA, driven by lower cash adjustments, remains a focus. Slide 20.

We are simply pleased to be able to demonstrate that this business can absolutely produce significant amount of free cash flow. We are particularly happy about beating our free cash flow guidance again in 2025 after the significant beat in 2024. There is nothing structural about this industry, notwithstanding its capital intensity, that precludes our ability to ramp up our free cash flow generation from current levels. As you are aware, the original free cash flow pre-M&A guidance for 2025 was EUR 350 million-EUR 400 million, and raised throughout the year, culminating in the EUR 400 million-EUR 425 million guidance in Q3, and the EUR 468 million outcome considerably beats the improved Q3 guidance. The free cash flow beat reflects the end-to-end focus across the entire organization on cash flow, and we will continue to go forward with the same vigilance and intensity.

The free cash flow beat in 2025 is as a result of improved EBITDA, end-to-end intensity in our working capital management, despite investing as a group in further inventory to support the strong demand for our proteins, CapEx levels normalizing for 2024 from 2024 highs, as we anticipated in our prior updates, lower cash interest as a result of the benefits of the deleveraging in 2024, and balance sheet and capital structure management, and finally, lower cash adjustments that is captured within others. Our free cash flow conversion improved from circa 15% in 2024 to circa 25% in 2025. Whilst free cash flow conversion can vary from year to year, we remain confident about being able to improve free cash flow conversion meaningfully over the coming years.

To summarize, we are pleased with the 2025 outcome, and we look forward to generating further improvements in free cash flow in 2026 and beyond. Slide 21. Positive deleveraging progress and free cash flow improvement is now being validated and rewarded by a normalization of rating agency views towards Grifols as they confirm our rapid re-rating progress. In the last 18 months or so, S&P have moved the Grifols ratings from B flat stable to BB- stable, up two notches. Similarly, Moody's have also improved the Grifols rating by two notches from B3 to B1 stable, and Fitch from B+ to B+ positive. We are also glad to see credit investors and our relationship banks validate our significant deleveraging and free cash flow improvement progress.

The considerable tightening of secondary trading yields of our 2030 bonds clearly demonstrates strong credit investor sentiment. The significant increases in the commitment levels that are being volunteered by our relationship banks will support our planned significant upsize to the revolving credit facilities with materially improved pricing and flexibility. Preparations are in an advanced stage to support our refinancing plans in respect of our 2027 maturities. We plan to do this in two steps, starting with a revolver and the TLB. We expect to commence an institutional TLB investor-focused education process shortly and target a subsequent launch, subject to market conditions, during the course of H1 2026. We expect to refinance the remaining 2027 bond maturity in Q4 2026 or earlier. Slide 22. This slide succinctly captures our four-year financial transformation and how that informs our 2026 priorities.

As the chart on the left shows, our deleveraging story is very compelling, reducing our leverage from 9x in H1 2022 to the current 4.2x credit agreement leverage, driven by significant EBITDA growth and free cash flow improvement. A significant proportion of the EBITDA growth has been volume-led, with a very deliberate execution of our strategy, announced in 2023, to win back lost market share in the US and international growth. The progress of both EBITDA growth at 14% CAGR and margin improvement by over 400 basis points from 2022 to 2025 is clear for everyone to see.

Having successfully taken our credit agreement leverage back to pre-COVID levels and having executed on the plan to win back lost market share in the U.S., we are now well-placed to optimize our path forward, in particular, to take action to advance our margin progression, including optimizing the balance of our last liter across IG and albumin. In this regard, the recent EMA approval for Egypt-source plasma is a game-changer for Grifols and for the plasma industry. The combination of our unique position in the U.S. and the progress with our self-sufficiency projects in Egypt and Canada differentiates the Grifols story from the rest of the industry. We are confident about following our own path, which is a nice segue into our priorities for 2026 on the right.

We believe that we are uniquely positioned to redefine the industry by harvesting the value of our strategic investments from the past. Our priorities are clear: We will continue to grow in line with the U.S. IG market while maintaining a very targeted and disciplined ex-U.S. strategy, yet fully leveraging the paradigm shift that EMA approval of Egypt-source plasma offers Grifols. Focus on value creation via prioritizing margin expansion, accelerating free cash flow generation, and continuing on our deleveraging path, which we believe will help us continue our re-rating progress, not just on the credit side, where the evidence thus far speaks for itself, but also on the equity side. Slide 23. Before I touch on 2026 guidance, let me start with our 2027 milestones.

We remain on track to achieve both milestones: credit agreement leverage down to 3.5x, and cumulative free cash flow pre-M&A of EUR 1.75 billion-EUR 2 billion by end 2027. For 2026, the clear focus is on continuing to improve our free cash flow story, and we are guiding to EUR 500 million-EUR 575 million free cash flow pre-M&A in 2026. In addition, we are targeting improving adjusted EBITDA margins to 25% or higher, and we expect adjusted EBITDA growth to be in the 5%-9% region on a constant currency basis versus 2025. You can assume euro-dollar average FX in 2025 of circa 1.12. We remain committed to continuing on our deleveraging path.

Finally, even if you can imply the revenue growth yourselves from what is on the slide, whilst we expect to grow on a constant currency basis, we are deliberately not including revenue growth guidance for 2026. This is consistent with our 2026 priorities from the prior slide. We are consciously moderating revenue growth in 2026 from our higher 2025 base by prioritizing our focus on margin accretive growth, driven by our unique position and the highly compelling prospects from our self-sufficiency initiatives that we look forward to updating the market on in the coming quarters. We are following our own path with conviction. With that, let me hand it back to Nacho.

Thank you, Rahul. I would like to conclude by reiterating a few points that we've already made but that bear repeating. In 2025, we delivered on our commitments on strengthening our financial foundation. More importantly, the performance of the company reflects our ability to capture the fundamental resilience of the plasma industry, a high-mode essential sector where Grifols continue to set the standard for global leadership. Through our long view lens, our strategic direction is clear. Grifols will harvest the value of our strategic footprint. Our vertical integration in Canada and our partnership in Egypt are critical catalysts for our next chapter. These hubs provide a diversified and resilient supply chain that positions us to capture further value. What remains unchanged is the strength of our underlying business and our commitment to our long-term vision.

Our immunoglobulin franchise continues to benefit from a strong structural demand, while albumin, Alpha-1, and specialty proteins portfolio, as well as fibrinogen, remain core assets within our portfolio. At the same time, our Diagnostic business is progressing toward an evolving operating model that we are convinced that will unlock significant additional value over time. Today, Grifols is a more focused and resilient organization, structured to deliver consistent performance, prioritizing returns, free cash flow, and deleveraging with a clear objective of increasing value for our shareholders. I would like to thank the entire Grifols team for their dedication and effort throughout the year. Also, I would like to thank all of you for your continued interest and support in Grifols. With that, Dani, back to you.

Thank you so much, Nacho. Now let's turn to the Q&A session. Please remember to press star five to ask a question. We need to place a limit of two questions per analyst, but if you have any follow-ups, please dial star five again to get back on the list. Let's start with Thibault from Morgan Stanley. Thibault, please.

Yeah, thank you very much. Maybe my first question, obviously, I mean, you mentioned we can reverse engineer the sales growth. I just want to know if 2026 is a specific year where growth is differing from the capital market, the target that you had, and we should assume growth to come back after? In relation to this, is it about what you think for demand? Is it about plasma capacity, or is it really about the plasma economics and last liter focus that explain the growth being slow in 2026? Thank you.

Thanks, Thibault. As you think about revenue growth, one of the reasons why we've excluded it, even though you can work out, do the math yourself on that page, is that it isn't a priority. Why isn't it a priority? We have taken our leverage back to pre-COVID levels. We have executed successfully on our plan to win back lost market share in the US, and our focus from here on is about optimizing the quality of our EBITDA growth. That's the key focus on our standpoint, and on that, I can ask Roland as well to add as we think about balancing the last liter economics. Roland?

Thank you, Thibault, for the question. Absolutely, plasma economics are at the heart of our business, given that we produce our medicines from very precious donations. That entails, you know, three main aspects. One is we have to maximize our first liter proteins. Second, over the longer term, balance Ig and albumin growth, and thirdly, bring costs down of production, of course. You know, double-clicking on the Ig and albumin balance for a moment, over the last two years, we have constantly used a strong Ig position to regain share in the US and drive growth. This has last year combined at the same time with a temporary softness in China as market works through policy changes, but notably with continued strong unmet need and patient demand on the line.

This puts us in a position this year where we can optimize our approach for 2026. On the IG side, after two years on strong growth on this higher base and with the position that we were aiming for achieved in the U.S. and key European market, we focus our growth there. We are pulling back in other markets elsewhere. On the albumin side, we build on our momentum to make sure that we can catch up. We believe that we are in a strong position to balance albumin and IG over growth, not only from a commercial perspective, but also in China, through our strategic partnership with Shanghai RAAS, and as Rahul and Nacho have alluded to, through our absolutely transformative strategic partnership in Egypt, which provides us with excess IG for the European market. Our continued focus on work on the yield.

All of that, of course, while continuing to drive our first liter proteins and our cost overall.

Thank you very much, Rahul. Thank you very much, Roland. I think it's very clear. Let's move to the next one. It's gonna be Jaime Escribano from Santander.

Hi, good afternoon. My question is, I'm trying, Rahul, to do a backwardation to try to get the potential EBITDA guidance on our reported basis for 2026. I'm getting something in between, obviously, assuming that 25% margin, because if I put a higher margin, it can be more. Let's call it a minimum reported EBITDA adjusted guidance of EUR 1.9 billion-EUR 1.97 billion. This will be my first question. Does this make sense? Would you feel comfortable with that?

5%-9% on EUR 1,825 is around EUR 1,950-EUR 1,980, give or take. Ballpark, your numbers are correct. As I mentioned as well, as you think about average euro-dollar for 2025, that's at 1.12. Hopefully that gives you the information you need, Jaime.

Thank you so much, Jaime. You have a second question?

Yes, if I may. Yeah. It's again, I understand that you are not providing the top-line guidance, you give a 25% margin or more. Can you try to give us a little bit more color on whether you think you are gonna be more closer to 25% or more, 25.5%? Depending on that, obviously the top-line growth will be more or less.

Let me address that. Two points. One, on a constant currency basis, as I said in my prepared remarks, you can absolutely assume moderate growth, moderate net revenue growth. As you think about modeling out margins, I think your 25% to 25.5% range is absolutely fine.

Thank you so much, Rahul. We will go to Álvaro Lenze from Alantra.

Hi, thanks for taking my questions. Going back to revenue, just wanted to understand what do you mean by pursuing higher or more profitable revenue or prioritizing margins? It really sounds to me, or I would have thought that you would sell always as much as possible. I don't know, what are your internal levers in terms of revenue to improve profitability? I would suspect you would try to sell as much of the non-IG and non-albumin as you can, and you are already price takers, I would assume. I don't know what the levers are. I wanted to know, first, what the levers are on revenue, and second, whether more of the margin improvement comes the cost side with the all Egypt venture and maybe some industrial gains. Just trying to understand that.

My second question would be on Haema BPC buyback, which you did not mention. Is that still expected for this year? Thank you.

Alvaro, as we look into 2026, we want to balance our growth in IG with albumin, we are in a position with our momentum to choose the markets in which we want to focus growth. Obviously, these are the markets where we see a higher value realized and a higher margin, and therefore, our focus to continue our momentum in the US and key European markets. We are in a position with our momentum where we can choose where we want to position the supply that we have on IG side, while of course, driving on the albumin side to continue to grow.

This is as you look at pricing and value that we create, and then obviously, we are looking at the cost side as well, and as we continue to drive efficiencies and effectiveness in our manufacturing and plasma collection network. Absolutely.

On Haema BPC, the timing of the exercise, Alvaro, will be determined by the board, as I've said before. We've also previously indicated a potential exercise in 2026 or 2027. I've also indicated that we intend to finance it through free cash flow generation whilst continuing on our de-leveraging path. No change in overall message. Final timing is 2026, 2027. The precise timing will be a matter that's determined by the board.

Okay. Thank you so much, Rahul. Now we will move to Guilherme from CaixaBank. Guilherme, please, your turn.

Yes. Hello, thank you for taking my question. Two. The first one regarding phasing. We're from a Q4 run rate in terms of, in terms of biopharmaceutical growth, we'll have several effects, moving, some moving to, into 2026, others don't. Just wanted to understand how should we think about the phasing of the growth throughout the year? If you're assuming a desire to optimize the growth across proteins right in Q1, or we should expect some slowdown in the pressure that you're seeing in albumin, and so a more stable growth throughout the year. The second question is: how are you thinking about your post-2027 debt refinancing options in terms of maturity?

You mentioned that you could optimize currencies, and in terms of timelines for the potential refinancing. Related to that, whether the free cash flow guidance includes potential refinancing costs that you might pay, especially if addressing 2030 maturities. Thank you.

Yeah. Guilherme, let me take the refinancing plans first, and Roland will take your second question, and Roland will take your first question after. On refinancing plans, you know, as we mentioned in my prepared remarks and in the presentation, the intention is to proactively manage our 2027 maturities, and we're at an advanced stage of preparation with respect to the RCF and the TLB refinancing, and we expect to commence an investor education process relatively quickly. And then subject to market conditions, the expectation would be to get the TLB refinancing done in H1 2026, all entirely consistent with our prior updates.

As you think about currency, which I believe was another part of your question, Guilherme, I think for the moment, you can model it on the basis of existing currency splits. Our TLB is split into dollars and euros, you can assume the existing currency splits that are disclosed. I did reference that we will seek to use our refinancing plans to optimize the natural hedges in place a bit better. Ultimately, maybe the final denominations of our currencies do vary a little bit, I think it's a good working assumption to use the existing ones.

Finally, as you think about the TLB today is about EUR 2.2 billion, give or take, and I talked about the secured bonds of EUR 750 million or so following in Q4 or earlier, subject to market conditions. The intention would be to refinance all EUR 3 billion well ahead of the year. Again, entirely consistent with our prior updates. Hopefully, that addresses your question. On the first one, Roland?

Yeah, in terms of phasing, perhaps just two parts to highlight. One is we have natural seasonality throughout the different proteins in our portfolio. Just to give you one example, rabies, with a very high use over the summer months, of course, and for some of the other proteins, we just have seasonal buying patterns from wholesalers.

Perhaps a second aspect to highlight, as we say, we continue to grow with the market in the U.S. and key European markets. There we expect a similar phasing to what we've seen in the past. As we continue to be selective in markets elsewhere, this will play out throughout the year.

Thank you so much, Roland. A very comprehensive question. Let's move to Justin. Justin Smith from Bernstein Societe. Justin, please.

Yeah. Hi, thanks very much. I'm sorry if I'm being a bit slow here. Can I just revisit the 2029 guidance that was issued a year ago? Am I right in thinking that guidance on an absolute basis is still valid if we just adjust dollar/EUR 104 to the 112? If not, can you just help me understand what I'm missing? I'm trying to understand if growth is more hockey stick or if something's actually kind of structurally changed in the last 12 months.

Hey, Justin, let me take that. I think as you look at the 2025 to 2029, that was a roadmap that we set out with a very clear objective to increase EBITDA and EBITDA growth, improve our EBITDA margins, expand free cash flow generation, and considerably de-lever. All of those aspects absolutely hold true, no change whatsoever. Since then, we've obviously provided and met guidance for 2025. We're providing guidance for 2026 and confirming that we are on track to achieve our 2027 milestones.

I think we've given probably more information than would ordinarily be the case. You know, as you think about revenue growth as well, we have grown enormously in the last couple of years, and we are talking about moderate growth on a constant currency basis from this higher base. You know, if I could leave it at that, Justin, that'd be great.

Thank you so much, Rahul. We have a follow-up from Thibault, from Morgan Stanley. Thibault, please go ahead.

Thank you very much. Just want to touch on the dynamic of Q4. It looks like the gross margin was probably lower than expected, and at the same time, SG&A and R&D compensated for that. Just in terms of how we should read into that dynamic when we think about the cost sides in 2026. Thank you.

Thanks, Thibault. As you think about gross margin, it's better to look at gross margin on a full year basis rather than quarterly. We talked about some phasing and FX and so on. Move away from the Q4 and look, the following page covers, in the appendix, covers the full year picture. Let's look at that picture. Point 1, if I can start with, is gross margin like for like 25 versus 24, was in fact, 50 basis points better. Pre-IRA, gross to net reclass, as that was recommended by our auditors, which better captures underlying performance. IRA alone was a 90 basis points impact, negative impact. Accounting reclass, that is EBITDA neutral, but weighs on gross margin, was another headwind.

China albumin headwinds, we've talked about as well. We feel very good about our strategic partnership with Shanghai RAAS. I would use the full year gross margin picture rather than the fourth quarter gross margin picture, as being what is reflective of 2026 and building on that, not the Q4 picture. Hopefully, that addresses your question, Thibault.

Thank you so much, Rahul. We have a second follow-up today. This is coming from Álvaro. Álvaro Lenze, please.

Hi, just very quick. I know you're focused on the current refinancing, but I was just wondering, when would a potential window be to refinance the 2030 maturities, which are the most expensive for senior secured? Very quickly, if you could just give us highlights on your current capacity and how much spare capacity do you have for continued growth while maintaining low CapEx? Thank you.

Sure. Let me start with the 2030 refi, and Roland will take your second question on capacity. On 2030 refi, we're just gonna continue to be opportunistic and be very, very focused on trying to drive interest cost as low as possible. As you know, Alvaro, and I know you know our debt complex well, those bonds are callable on the 1st of May 2026, at 104, and they drop down to 102 on 1st of May 2027. We're just gonna be very, very disciplined in terms of what drives better value. Is it better to refinance during the course of 2026 or wait until 2027?

We will drive that, based on, just the value proposition. Look, I think it's. I agree with you that that debt is expensive. It also goes to show how significant the tightening of yields have been in the last 12 months, which is again, significant validation of the strong creditor investor sentiment towards the Grifols story. On your second question, Roland?

As for capacities, we don't give the details in terms of the exact liters, but we have the capacity that we need to execute over the next year, and we are building on that, in one hand, in terms of optimization that we continuously deploy across our sites, our five sites. We have our Canadian plant coming online. We have the Egyptian plant we talked about today coming online, and we recently announced our expansion in Lliçà de Vall, in Barcelona. We have a very clear plan for CapEx and capacity expansion that sets us up to deliver on what we plan and grow in the future.

Thank you so much, Roland. We have a question from Charles, from Barclays. I'm gonna go through the question. There are some technical issues. Two questions: Can you comment on market share evolution for IG and Sub-Q? Second one, albumin, market share in China for albumin.

Yeah, I'm happy to take the 2.

Roland will take your question, Charles.

Yeah. As for market share, for IG, that was obviously one of the main focus areas that we had, especially in the U.S., in our plan over the last two years to regain share, and we're happy with the progress that we made. There's different data sources that I'm sure, Charles, that you're tapping into, but we're pleased with the market share gains that we had, not only with the number that we've seen, but also with the quality in the centers where we achieved this. Sub-Q, needless to say, with the growth and momentum that we were able to deliver last year, we're very pleased with the momentum as well. We don't go into specifics of the split between the two, but, you know, in the U.S., which is the key market for us, very pleased with the uptake that we see on the Sub-Q side.

In terms of albumin in China, both as we look at batch releases, ex-factory, as well as, if we look at pull-through, we're, you know, pleased with what we see versus competition. As said before, our strategic partnership with Shanghai RAAS, we believe, puts us in a very good place in order to effectively compete in this market and make sure, as the China environment stabilizes, that we're able to continue to drive growth there.

Thank you so much, Roland. Charles, I'm sure that this is gonna be helpful. We have another follow-up. This is coming from Jaime Escribano from Santander. Jaime, please.

Hi. Yeah, I have a couple of questions from my side, more from a strategic viewpoint. Canada, I don't know if you can quantify or at least tell us how much could be the economic opportunity of the new plant, or when do you think this can start producing meaningful revenues? In the case of Egypt, the impact of the gross margin in the long run, again, maybe a little bit qualitatively, or when could we start seeing some benefits from the gross margin improvement as a result of using the Egyptian plasma?

A last, very quick one, if I may, regarding CapEx 2026, the free cash flow guidance of EUR 500 million to EUR 570 million, what is the implied CapEx tangible plus intangible that you are estimating for this guidance, this free cash flow guidance? Thank you.

Yeah, Jaime, Rahul will take it on the CapEx. Certainly on Egypt and Canada, I mean, we are not providing details of the specific benefit that these collaborations will provide. I think that there is enough information out there in order to guess or guesstimate what that impact would be. I think that in the case of Egypt is certainly already seeing clear benefit in 2026 and beyond, as we will progress growing our footprint in that market. In Canada, I think we've been collaborating with CBS for a number of years. We have already a solid commercial operation there. Now, with the...

Especially with the new policy from the Canadian government, where they are going to push even harder on self-sufficiency, clearly there is an opportunity for us to strengthen that relation because we have been really the only brand that has invested in that market with a manufacturing plant and our plasma donor centers there. That will certainly help to drive that growth.

I think, Nacho, just perhaps to just clarify, both of these strategic projects are creating value today. In Canada, fourth largest market, highest per capita, strong growth, aiming for 50% self-sufficiency. This is already happening today since the plasma that we collect in Canada is fractionated in our U.S. plant, and we are already supplying to Canadian patients in terms of self-sufficiency. That this is not something that has to wait for the plant to be finished. This is something which, as of today already, is a win-win. Similarly, in Egypt, as Nacho just explained, a clear win-win for us. As you think about it, you know, this has several components. One is, of course, there's the value to Egypt and the region through to the mission that Grifols has.

As you think about the value to Grifols, you know, we have highest quality, highest standard facilities in terms of our plasma collection in Egypt, but the cost structure is very different. There's a clear benefit in CPL. There's a clear benefit in terms of balancing IG and albumin. As explained, albumin use is much higher in this region than IG. Lastly, what we see is that the plasma that we collect there comes with a, with a very promising yield that, of course, translates into more medicines that can be produced from this plasma. Both of these win-wins with value are creating already today.

On CapEx, Jaime, which I think was your question. The way I look at CapEx, I look at both CapEx and capitalized IT and R&D. On CapEx, we expect the CapEx levels for 2026 to be slightly lower than they are in 2025. As we think about our R&D and capitalizing IT and R&D capitalization efforts, we expect that to be slightly higher. I think net-net, if you add the two up, you might just end up at around the same number as we did in 2025, maybe a little lower in 2026. Hopefully, that addresses that question.

Thank you so much, Rahul. Very clear. That was the very last question for today. Just say thank you so much for joining us and for all your questions. If there is any follow-up, please contact the IR team. Happy to help. Thank you so much.

Hello, everyone. My name is Daniel Segarra, and I serve as the Head of Investor Relations and Sustainability and Vice President at Grifols. Welcome to our review of the company's business results for the third quarter of 2025. Today, I'm joined by Grifols' Chief Executive Officer, Nacho Abia; the President of Biopharma, Roland Wandeler; and Grifols' Chief Financial Officer, Rahul Srinivasan. A few logistics before we get into the details. Today's call will last about an hour, including a Q&A session. As a reminder, this call is being recorded. You can find additional materials, including today's presentation, in the Investor Relations section of the Grifols' website at grifols.com. The transcript and a replay of the webcast will also be available on the Investor Relations website within 24 hours. Turning to Slide 2, please note that this presentation includes forward-looking statements regarding, among other things, the company's future operating and financial performance, market position and business strategy. These statements are based on current expectations and available information as of the date of the recording, and they are subject to certain risks and uncertainties that may cause actual results to differ materially from those projected. Grifols financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions, including alternative performance measures or APMs, prepared under the Group's financial reporting as defined by the European Securities and Markets Authority. Grifols management uses APMs to provide financial performance as the basis for operational and strategic decision-making. These APMs are prepared for all the time periods presented in this document. Now moving to today's agenda, and I will turn the call to Nacho to kick it off. Nacho?

Thank you, Danny, and hello, everyone, and thank you for joining us. The results we are presenting today demonstrates the continued commitment to delivering on our value creation plan. The performance achieved in the first half of the year has carried through, resulting in solid operational and financial results for the third quarter. This quarter reflects the sustained underlying demand of our products, solid market dynamics and disciplined execution, while we continue to navigate exchange rate headwinds and the anticipated impact of the Inflation Reduction Act. This progress also stems from the operational focus and financial stewardship we established in our road map at the beginning of the year, which remains the central pillar of our plan. Our core business continued to perform well through the third quarter, led by the immunoglobulins franchise. This top line performance has supported margin expansion, while tight cost management and focus on free cash flow generation have driven meaningful improvement in our free cash flow. While we acknowledge the challenges of the complex global operating environment, Grifols has performed with consistency and confidence. Our structural advantage, including scale, solid vertical local integration in key markets and a globally diversified footprint have enabled us so far to adapt effectively, mitigate external pressure and sustain solid performance across key markets. Regarding exchange rate headwinds, the impact was reflected at both revenue and EBITDA levels, but it did not extend to our leverage ratio or free cash flow due to the significant levels of natural hedges within our business. In any case, we continue to implement mitigating actions and maintain vigilant oversight of evolving external conditions. As we track towards year-end, we remain attentive and measured in our approach. Year-to-date performance has been solid and in line with our expectations, reflecting disciplined execution and resilience. Looking ahead, we recognize that the external environment remains complex and dynamic, we continue to actively manage the factors within our control. By leveraging our structural strengths and maintaining discipline, we remain on track to meet our 2025 objectives. Before we move on, I want to pause and take a moment to thank the entire Grifols team for their ongoing commitment, focus and passion in executing our plan and advancing our mission. And with that, let's move to Slide 5. On a year-to-date basis, we achieved revenue of EUR 5.5 billion, representing a year-over-year increase of 7.7% and 10.5% like-for-like after IRA and gross-to-net adjustments, both at constant currency. Third quarter adjusted EBITDA of EUR 482 million built on a strong first half, bringing our year-to-date adjusted EBITDA to EUR 1,358 million, up 11.2% and 17.3% like-for-like, both at constant currency. Both figures are well ahead of revenue growth. Improved operational execution translating directly into a positive year-to-date free cash flow pre-M&A and pre-dividends of EUR 188 million, marking a significant EUR 257 million year-over-year improvement. This ramp-up in cash generation highlights our sustained financial discipline, keeping this as a top priority. Finally, deleveraging remains a critical financial priority, too. And at the end of Q3, our leverage ratios per credit agreement landed at 4.2x, representing nearly 1x improvement over the prior year. We continue to reinforce our structural foundation and these year-to-date results position us soundly to execute our capital allocation priorities and continue strengthening our balance sheet, ensuring we can create sustainable long-term value for all our stakeholders. As we have mentioned many times, the core tenets of our value creation plan are guided by 3 key levers: commercial growth, margin expansion and pipeline execution. Starting with commercial growth, we continue to build on the existing market demand and our robust commercial capabilities to expand sales across our portfolio. This includes deepening our penetration in existing markets and expanding into new geographies. Margin expansion remains a core priority, supported by operational leverage, optimized plasma sourcing and manufacturing efficiencies. And through pipeline execution, we continue to drive the innovations that define and sustain Grifols' leadership in plasma-derived therapies, while our Diagnostic division advances its 3 cutting-edge platforms currently in advanced development. These levers are supported by 2 critical enablers: our plasma supply and industrial footprint and our innovation strategy, as highlighted on the slide. Our resilient, diversified plasma manufacturing network represents a decisive competitive advantage in the current global environment. It ensures reliable plasma supply and production capacity, allowing us to effectively meet growing global demand. Turning to innovation, I'd like to provide an update on our pipeline. We remain on track to launch fibrinogen in Europe by the end of 2025 with a planned U.S. launch in the first half of 2026. In the U.S., we are proceeding with the FDA biological license application for congenital fibrinogen deficiency, for which we expect a decision in late December as planned. For acquired fibrinogen deficiency and based on conversations with the FDA, we have decided to build additional clinical evidence before seeking regulatory approval. This will help us well to strengthen an even more solid case to sustain the market development efforts we envision in the U.S. market for the years to come. Roland will share more details on fibrinogen shortly, but I want to mention that this decision does not affect our current Capital Markets Day plan in any meaningful way, nor does this change our long-term strategy or the significant opportunity we see ahead. Other than Fibrinogen, we are maintaining disciplined investment in R&D while advancing clinical programs across both life cycle management and new product candidates. Key initiatives, including SPARTA and alpha-1 with subcutaneous formulation are progressing as planned, underscoring our commitment to sustaining innovation, patient impact and long-term value creation. And with that, I will hand this over to Roland to expand on these and other market and business updates.

Thank you, Nacho. I am pleased to share an update on our biopharma business and highlight the key factors driving our performance this year. As we continue to deliver on our value creation plan, I am proud of the dedication, the passion and commitment our team shows every day to deliver for patients and drive forward towards the goals we set out in terms of commercial growth, margin expansion and innovation. With that, let's turn to Slide 8 for our commercial performance. In the third quarter, our biopharma portfolio grew by 10.9%, lifting our year-to-date growth to 9.1%, both at constant currency. Our immunoglobulins franchise led the way, outpacing the market with 18% growth in the quarter and 14% year-to-date, both at constant currency. This performance was driven by GAMUNEX and XEMBIFY with IVIg and subcu Ig delivering 12-month growth of 13% and 62%, respectively. We remain confident in XEMBIFY's strong trajectory, supported by continued strength in the U.S. and expansion into new markets in Europe. I'll dive deeper into our Ig franchise on the next slide. Turning to albumin, third quarter volumes remained solid, but were offset by ongoing pricing pressure in China as market demand slowed down in face of government-imposed cost controls. This resulted in a contraction of 4.5% for the quarter and 3.9% year-to-date, both at constant currency. While these dynamics were anticipated, we continue to work with our local partner, Shanghai RAAS, on how to best manage market dynamics and sustain a strong position in China as the principal market for albumin. At the same time, we are working on strengthening our presence and unlocking additional growth opportunities in the U.S. and other markets in order to help us balance albumin with our IgG growth over time. Looking at our Alpha-1 and specialty proteins franchises, we continue to make solid progress. In the third quarter, revenues grew by 3.3%, bringing growth to 4.3% year-to-date, both at constant currency. These results reflect our continued market leadership in alpha-1 and HyperRAB. I'll share more detail on this franchise in a later slide. Now let's turn to immunoglobulins or Ig as the main growth driver of our business on Slide 9. Over the last 2 years, we saw an opportunity to use our strong Ig inventory position to accelerate Ig growth, build momentum in key markets and win back market share in the U.S. We have since delivered on this plan. We have strengthened our U.S. organization and commercial capabilities, expanded subcu Ig penetration through XEMBIFY and leveraged the strong profile of GAMUNEX as a leading IVIg to win share in strategic accounts. These actions have delivered clear results. Our Ig business has posted double-digit growth over these last quarters, ahead of the market and driven by demand as we regained share in the U.S. and Europe and thus reset our position in the Ig market. Looking ahead, from this higher base, we now expect to grow more in line with or slightly ahead of the market, consistent with the 6% to 8% CAGR range we shared as part of our value creation plan. The fundamentals for continued growth of Ig remain strong, as key indications continue to be underdiagnosed and increasing global awareness of Ig as the treatment of choice in many conditions means that more patients get to benefit from our medicines with a long track record of proven efficacy and safety. Looking at our 3 main indications, growth remains solid in primary immunodeficiency, where increased awareness and better diagnosis are expanding access to therapy. In secondary immunodeficiency, the largest growth opportunity within Ig, demand continues to rise, driven by an aging population and an increase in immunocompromised patients. And in CIDP, we are seeing continued growth, albeit at a lower level after the significant step-up in diagnosis last year with the entrance of FcRns, which has helped expand this market. CIDP is a complex neurological condition with multifactorial origins, meaning the disease can present very differently across patients. This is precisely where Ig therapy stands out. With its broad and well-established range of immunomodulatory and immune-supportive modes of action, Ig can address multiple disease mechanisms and improve functional outcomes across a wide range of patients. As we build on this strong foundation, innovation continues to be a cornerstone of our Ig strategy. We're advancing next-generation products, new formulations and expanded indications that strengthen our competitive position and enhance patient experience. In terms of next-generation Igs, YIMMUGO, our novel IVIg from Biotest has launched in the U.S. in the fourth quarter of 2025, adding another differentiated therapy to our portfolio. XEMBIFY continues to gain strong traction, growing more than 60% over the last 12 months, and we're expanding into new markets through 2026. In terms of life cycle management, we are advancing new delivery formats, including XEMBIFY and prefilled syringes to improve convenience and adherence. In parallel, we are progressing with our studies to expand indications in the U.S. with GAMUNEX-C and XEMBIFY advancing in SID and XEMBIFY in CIDP. Together with our ongoing improvements in end-to-end Ig yield and operational efficiency, which will help us expand margins, this focus on innovation will ensure that our Ig franchise remains a cornerstone of sustainable and profitable growth for Grifols. Now turning to Slide 10. Let's take a closer look at our alpha-1 franchise and our strategy and progress in this area. Grifols has established itself as a leader in alpha-1 with today approximately 70% market share across both the U.S. and ex U.S. Our position is testament to Grifols' leadership in building this market, our best-in-class patient support programs and our unique testing capabilities. Despite important progress throughout these last decades, we are today still only treating about 10% to 15% of the alpha-1 patient population across the world, leaving a large unmet need and untapped market opportunity. Testing is the key to unlocking this potential. We have, over the last years, complemented traditional screening with the rollout of our point-of-care and at-home direct-to-patient screening kits. Still, we only see a part of physicians systematically testing their COPD patients for AATD. We believe that we have a possibility to change this and dramatically increase the number of diagnosed patients with the readout of our outcome study SPARTA, continued advances in AI-enabled screening of electronic medical records to highlight patients at risk as well as increasing awareness in the market for new entrants. Raising awareness and improving diagnosis remain critical levers to enhance patient outcomes and enable market growth. As a company that firsthand gets to see the continued unmet need and the difference our medicines can make for the grievous illnesses we get to treat, we always welcome innovation that raises awareness and might provide additional options for patients, especially in a condition where the vast majority remain undiagnosed and untreated. As a leader in this space, we want to meaningfully contribute to this innovation, both through our outcome study that will address important questions for the field as well as both the subcutaneous and a long-acting treatment option in our pipeline. SPARTA is the largest efficacy study ever conducted in alpha-1 antitrypsin deficiency and is designed to show clinical outcomes in real-life lung tissue preservation different from other studies primarily focused on pharmacokinetic endpoints. The results of this study have the potential to significantly strengthen the clinical and payer value proposition for augmentation therapy, increase testing awareness and improve patient access in the U.S. as well as support broader reimbursement in Europe. The trial also includes a double-dose regimen, which could represent an important advancement in treatment. We expect the readout of SPARTA in the second half of 2026. In parallel, we are advancing a 15% subcutaneous formulation and a next-generation alpha-1 therapeutic to enhance patient convenience, expand access and continue strengthening our position in this growing market. In summary, we remain confident in the continued success of PROLASTIN, supported by its value proposition and proven 30-plus year track record of safety and efficacy. Turning to Slide 11, innovation is at the heart of our business. Our pipeline reflects a focused and disciplined approach to advancing high-value programs that drive life cycle management, expand indications for our existing medicines and bring new products to market both within plasma as well as beyond plasma. We have already covered the innovation underway for our Ig and alpha-1 franchises. Turning now to fibrinogen, as Nacho mentioned, we have refined our go-to-market approach to maximize our long-term opportunity. In the near term, the largest opportunity for fibrinogen lies in Europe, where markets such as Germany and Austria have adopted fibrinogen concentrate as standard of care. For these markets, we are on track for our launch of this product later this year. We have received the end of procedure notice from Germany and are awaiting approval in this key market shortly to be followed by additional countries in Europe. We are confident that our differentiated product positions us well to effectively compete and gain share over time in these markets. Longer term, the largest opportunity remains in the U.S., where the use of fibrinogen today, though, is still low and the market has a long way to go to fully embrace this more targeted approach to bleeding management as standard of care. Here, we are on track with our BLA for congenital fibrinogen deficiency or CFD, with a PDUFA date end of December. We expect to launch this indication in the first half of 2026. As Nacho mentioned, following conversations with the FDA and observing the slow growth of fibrinogen in the U.S. over the last year, we have decided to focus our BLA on CFD for now and use the time to further strengthen our body of evidence with U.S. patients for an sBLA for acquired fibrinogen deficiency or AFD at a later point in time. While this delays our indication for AFD in the U.S., this staged approach allows us to provide access to our medicines for U.S. patients with CFD in the first half of next year, while giving more time for the market to evolve, further strengthen our position for a possibly differentiated label in AFD and set us up for a leading position in the U.S. over time. As Nacho noted, these updates do not affect our guidance and the long-term goals outlined during our Capital Markets Day, nor do they change our broader development efforts and our conviction in a meaningful opportunity ahead as the standard of care continues to evolve toward concentrate-based therapies. We remain confident in the program's progress and long-term success as we continue to invest in its global rollout for the benefit of patients. Taking a step back, while we certainly look forward to the launch of fibrinogen, our pipeline reflects our focused and disciplined approach to advance innovation and create value across all our therapeutic areas. We've already covered our advancements in immunology and pulmonology. In infectious diseases, our trimodulin Phase III trial in severe community-acquired pneumonia is progressing steadily. With its innovative polyclonal antibody profile, trimodulin has the potential to address a significant unmet need. And in ophthalmology, our ocular surface Ig program for dry eye disease in Phase II has the potential to expand use of Ig into new therapeutic areas. In the earlier stages of development, our pipeline spans both plasma-based and non-plasma programs, including a next-generation GAMUNEX process with improved yield, recombinant therapies and novel treatments for infectious diseases. Overall, our pipeline reflects a balanced mix of near-term launches and long-term innovation aligned with our value creation plan and reinforcing Grifols leadership in plasma-derived medicines aimed at driving sustainable, profitable growth for years to come. With that, I now hand it over to Rahul to provide more details on our financial performance.

Thanks, Roland. On Slide 12, the words continued resilience sum up not just the Grifols' financial performance, but also very aptly describes both the Grifols business that has been built over many decades as well as the Grifols spirit of our over 24,000 teammates and our shared commitment towards the Grifols mission. Slide 13. From a financial performance standpoint, Q3 was a robust quarter across the board that presents an equally robust across-the-board year-to-date picture. There have been some favorable phasing and mix benefits that have contributed to this robust year-to-date financial performance that I will elaborate on in the upcoming slides. As a reminder, our reported figures included the impact of IRA and the fee-for-service GPO reclassification, which could distort the underlying performance and hence, to improve comparability to prior periods, we will continue to disclose the like-for-like column for the remainder of the year, which we believe will be helpful to all our stakeholders. Starting with Q3 financial highlights. Net revenues of just under EUR 1.87 billion, up 9.1% versus Q3 '24 on a constant currency basis, led by Biopharma, and adjusted EBITDA of EUR 482 million, resulting in an adjusted EBITDA margin of 25.8% for the quarter. And a slightly higher impact on group profit than was the case in Q2 this year. And free cash flow pre-M&A pre-dividends for the quarter of $203 million, up meaningfully versus Q3 '24. Moving on to year-to-date financial performance. Net revenues of over $5.5 billion, up 7.7% on a constant currency basis, led by Biopharma that, as Roland mentioned earlier, is up 9.1% on a constant currency basis. Year-to-date adjusted EBITDA of over $1.35 billion is up 11.2% versus 2024 on a constant currency basis despite the impact of IRA, albeit benefiting from some phasing and favorable mix that I referenced earlier. Both gross margin and adjusted EBITDA margin are up versus 2024, notwithstanding the impact of IRA. Year-to-date group profit of $304 million is up over 245% versus year-to-date 2024. Free cash flow pre-M&A pre-dividends is up $257 million versus year-to-date 2024, and I will elaborate on the drivers of this free cash flow improvement a couple of slides later. Furthermore, the leverage and liquidity picture has significantly improved versus Q3 2024. And with secured leverage at only 2.6x, we have almost 2 EBITDA turns of secured leverage capacity, giving us material flexibility, thus rounding out the robust and improving balance sheet that is referenced in the title of the slide. And finally, I have deliberately not dwelled on the like-for-like performance that you see on this slide as we consider the impact of IRA as part of our regular cost structure now. But the numbers in this column are eye-popping, and are helpful context to the underlying momentum of the business. Slide 14. Notwithstanding the impact of IRA, year-to-date revenue growth was up 7.7% on a constant currency basis, whilst clearly Biopharma led, we also had a positive contribution from our Diagnostics business that continues to execute in keeping with our plan. As Roland alluded to earlier, the Biopharma revenue growth continues to benefit from robust underlying Biopharma demand on the back of continued Ig momentum as well as progress from our alpha-1 and specialty protein franchise. Albumin, however, is an area that we continue to keep a close eye on. And finally, year-to-date performance has benefited from some phasing-related gains that have also contributed to a 9.1% constant currency growth versus 2024. Slide 15. Year-to-date adjusted EBITDA in 2025 is at $1.358 billion, up from $1.253 billion in 2024 after absorbing the year-to-date IRA impact of $75 million with adjusted EBITDA up 11.2% on a constant currency basis and adjusted EBITDA margins improving versus 2024 by 60 basis points to 24.5%. The EBITDA growth was mainly led by Biopharma, supported by each of the following: strong volume growth aided by some phasing benefit, a favorable geographic mix adding to the phasing benefit with a proportion of EBITDA from the U.S. better than expectations and up meaningfully year-to-date, continuing improvements in CPL and finally, continued focus on OpEx discipline and driving the benefits of operational leverage. As for the IRA impact, it is broadly in line with the guidance we provided in Q2, and we expect full year impact to be between $100 million to $125 million. Whilst the impact on EBITDA of a weakening U.S. dollar is considerably more sheltered than revenues as a result of the various natural hedges in our cost structure, it has still been a stiff headwind. Whilst the weakening U.S. dollar has been the main issue from an FX standpoint, other currencies have also contributed to the total FX impact versus the FX rates embedded in our guidance for the year as set out in our Capital Markets Day presentation. Slide 16. Over the last number of quarters, we have talked about our expectation for continued convergence between adjusted and reported EBITDA on a cash basis or said another way, focusing on reducing the amount of cash adjustments between adjusted and reported EBITDA. And we are pleased to see that convergence trend on a cash basis continue over the last couple of years, and there are 3 specific outcomes that I would like to call out. Number one, continued reduction in cash adjustments between adjusted and reported EBITDA. And as you will see on this page and the detail on Page 30 in the appendix, there has been a 56% reduction in cash adjustments on an LTM basis, primarily due to lower cash adjustments pertaining to restructuring costs and transaction costs. Number two, reported EBITDA is growing at 15.7% on a constant currency basis, faster than adjusted EBITDA despite its robust 11.2% growth on a constant currency basis. And finally, three, the gap between reported and adjusted EBITDA margins is reducing. And as at Q3 '25, this gap has narrowed to 120 basis points, having been 210 basis points at the end of 2024 and 340 basis points as at the end of 2023, mainly on the back of lower cash adjustments and the convergence tends to happen rapidly, often within around 6 to 7 months, validating the credibility of these cash adjustments. We also want to proactively flag the potential of noncash adjustments in Q4 that importantly do not at all have any impact on the go-forward EBITDA growth story or free cash flow growth story. These potential noncash adjustments are simply the other side of the capital allocation discipline coin, where prioritizing our valuable capital mainly on the projects that we talked about at our Capital Markets Day in February this year, means that some other projects remain dormant or on hold and potentially there could be an impact on their carrying value. But to be clear and to repeat, we are confident that these potential noncash adjustments will not impact our go-forward adjusted EBITDA growth or free cash flow growth story. Slide 17. A quick update on our progress towards our free cash flow pre-M&A, pre-dividends goal for the year. As you will recall, we improved our free cash flow pre-M&A, pre-dividend guidance at H1 from $350 million to $400 million up to $375 million to $425 million, considerably up from the $266 million free cash flow outperformance in 2024, and we expressed our confidence that the business could do meaningfully better over time. And finally, recall that unlike EBITDA, free cash flow pre-M&A, pre-dividends is more insulated from euro-dollar volatility. The punchline on our year-to-date free cash flow performance is that we are tracking well versus our improved free cash flow guidance provided in our H1 call, as at the end of Q3, we are EUR 257 million better than we were in 2024 at the same point. The principal driver of the improving performance is greater vigilance on cash flow across the entire organization. In addition to that, improved EBITDA contribution, lower cash adjustments, tight working capital management, disciplined CapEx and capitalized IT and R&D spend and an improvement in cash interest expense as a result of debt paydown in 2024 and significantly lower utilization of RCF has supported our year-to-date progress on the free cash flow front. And more on free cash flow guidance for 2025 on the next slide. Finally, on Slide 18, updates on both capital structure and our outlook for the year. First, on capital structure. The clear tightening of our longest-dated bonds in our capital structure by over 200 basis points in just the last 3 to 4 quarters is evidence of the clear progress in the re-rating of the Grifols story. And by that, we mean not just from a credit perspective, but also our clear focus on progressing on the immense equity re-rating opportunity we believe there is. And it is also pleasing to see a number of our banking partners further corroborate the re-rating progress implied by our tightening bond yields by proactively offering meaningful upside support for a potential upsized RCF as part of the refinancing that we are targeting in H1 2026. All very helpful steps forward on the capital structure front and preparations are ongoing. We have also just a short while ago launched a harmonizing exercise to align the documentation of the 2 bonds we currently have maturing in 2030. As I alluded to before, both bonds continue to trade very positively, hence, the launch of this nice-to-have action. Before speaking about outlook, it might be helpful for us to contextualize our year-to-date performance. Notwithstanding very stiff FX headwinds and the IRA impact, our performance has been robust for the reasons we have already discussed. We have also benefited from some positive phasing and mix gains and thereby accelerating aspects of our EBITDA performance for the year, which we expect will partly reverse in Q4. When considering year-over-year comparison to Q4, please remember that we are lapping our best quarter in history from an EBITDA perspective, a quarter that itself back then benefited considerably from phasing. And taking that together with IRA and the FX headwinds, we expect a robust Q4 '25. However, it will compare less favorably to Q4 '24 in absolute terms. The team remains very focused on ensuring that we execute with the same discipline and intensity as we have all year. It is also worth reminding the market of our updates in prior quarters of the impact of a weakening U.S. dollar and how that headwind reduces as we move down our P&L as a result of the natural hedges embedded in our business, from a weaker U.S. dollar having a significant impact at the revenue level to being broadly neutral at the net income or group profit level and indeed broadly neutral on free cash flow, too. And absent any abrupt movements in FX, euro-dollar in particular, as we move to the end of the year, we expect it to be broadly neutral on leverage, too, which then leads me to the final section on guidance. On the right-hand side, we compare our updated guidance to the original guidance we provided at our Capital Markets Day on 27 February 2025 at guidance FX rates. And on the left-hand side, we estimate the full year FX impact to be roughly around EUR 70 million on adjusted EBITDA if FX rates stay as they are currently for the rest of the year versus the guidance FX rates in order to assist all our stakeholders with their analysis. As you will see on the right-hand side, our updated guidance at guidance FX rates compares favorably to the original guidance we provided at our Capital Markets Day, improving updated guidance at guidance FX rates for both revenues and free cash flow pre-M&A, pre-dividends. And on the latter, we are once again improving our guidance further to EUR 400 million to EUR 425 million. And adjusted EBITDA guidance FX rates is reaffirmed to be consistent with the original guidance provided and that we are currently tracking very comfortably within the guidance range provided, which, as I mentioned at the start of the financial performance section, speaks to the resilience of the Grifols business, notwithstanding the highly dynamic markets that we have navigated well thus far this year. With that, let me hand it back to Nacho for his concluding remarks.

Thank you, Rahul. I would like to conclude today's presentation with just a few final remarks. Our third quarter results confirm that the strategic road map we set in motion this year is delivering results. The value creation plan is driving measurable progress from continued market share gains and sustained top line growth to a significant improvement in free cash flow generation. This performance underscores our focus on strengthening financial fundamentals and executing with the discipline required to turn a strategic vision into financial performance. We have also further strengthened our balance sheet through deleveraging, enhanced free cash flow generation and a disciplined financial and capital allocation. This combination provides the flexibility to invest in growth while maintaining a prudent approach to leverage and liquidity. As we approach year-end, we remain vigilant as market conditions continue to be dynamic with foreign exchange pressure and other external factors still present. These potential headwinds are being closely monitored. And as in previous periods, we are confident in our ability to respond with resilience and execution. Therefore, we reaffirm full year 2025 revenue and adjusted EBITDA guidance and the exchange rate presented at our Capital Markets Day and updated free cash flow guidance to more than EUR 400 million. Finally, I want to recognize once again the dedication of the entire Grifols team whose commitment to our value creation plan continues to drive this company forward. We are executing with focus, accountability and discipline and remain fully committed to creating long-lasting value for all our patients, donors and stakeholders. Thank you, as always, for your continued support. And with that, Danny, back to you.

Thank you, Nacho. Now let's turn to the Q&A session. [Operator Instructions]. Let's start with Charles from Barclays.

Just first one on fibrinogen. Just I want to clarify what the driver there is behind the fibrinogen and AFD being delayed to the U.S. Is this kind of FDA pushback on -- is that reflective of their internal resourcing? Or is it reflective of the quality, quantity of your supporting data for the indication? Just because thinking about this asset previously, a key differentiating factor for Grifols was to be the first U.S. approved asset with both forms of the disease as part of the label. So just to your point about not impacting the midterm guidance, kind of how do you expect to be able to continue to differentiate against the competition? Or is this just set to be a very short delay? And then my other question is just for Rahul on the refinancing. Just coming back to terminology there, you're highlighting the harmonization process of the 2030 bonds. Can you confirm whether this means that you're also considering refinancing of these 2030 maturities as part of the 1H '26 targeted refinancing for the '27 maturing bonds? And just wondering, as part of that refinancing as well, is there any potential to renegotiate the terms of the GIC deal?

Thank you, Charles. On fibrinogen, I think that we always have stated and have been aware of the fact that in the United States, we would need to change the standard of care, which currently is based on cryoprecipitate in order to boost the sales of fibrinogen to the level that we expected. This is a mission that we are very committed to do. We believe, based on what we see in other markets that, that certainly will bring benefit for patients. But as I mentioned, based on the conversations with FDA, we feel that it's important to bring even more solid clinical information and clinical data with U.S. patients in order to help with that standard of care. At the same time, I think, obviously, our focus in the short term is going to be to develop markets outside of the U.S. And in the U.S., obviously, with the congenital fibrinogen deficiency, certainly, we will start working with physicians for them to know and be more aware about the benefits of fibrinogen versus other alternatives. I don't know, Roland, if you want to add anything else?

Perhaps just commenting on how this compares to the plan that we laid out at the Capital Markets Day. As mentioned, today, the largest opportunity is in Europe, north of 200 million. And there, we remain on track for our launch in Germany this year, and we believe that we can differentiate and gain share in this market and actually have some opportunities in ex U.S. -- ex Europe market as well to gain share. In our considerations, the U.S. was always a slower build. And therefore, a delay of AFD at this point does not materially change our outlook in the near term. And at the same time, we believe that with a possibly differentiated label at the time of launch of AFD in the U.S., we have an opportunity to still lead that market and capture the long-term potential of north of EUR 800 million that we laid out at the Capital Markets Day. So that's where the comments come about that we don't see a change in our outlook.

And Charles, on the 2030 bond harmonization, that's just a harmonization exercise between the conditions or the documentation, if you like, between the 2 bonds. Your comment around 2030 refinancing, of course, we have the optionality if we so choose to refinance those. Those bonds are callable on the 1st of May 2026, if I recall correctly, which just gives us -- we have that optionality. And clearly, as you can see with where those bonds are trading today, there is value as we think about refinancing those in due course. But it is a part of refinancing options that are available to us. It doesn't have to be in 2026. We can decide on the right time for that. And then finally, on GIC, you're absolutely right, there is -- those are 8% dollar bonds and the way we look at that is at sort of unsecured risk. There is value there. Again, we -- in terms of the right time to optimize a possible redemption of that, we'll decide that in close partnership with GIC. GIC has been a partner of us for some time. We'll work through that at the right time. But clearly, there is also possible value there. In due course, we can seek to capture that from a redemption and refinancing standpoint.

Now let's move to the next one, Jaime from Santander.

So a couple of questions from my side. The first one, could you elaborate a little bit more on the dynamics of the albumin in China? Basically, if this pricing pressure comes from the offer side, so more competition? Or is it the demand or the reimbursement or the social security there that is putting lower prices? And the second one regarding also fibrinogen, just for my understanding, so it seems that there are 2 segments, so AFD and CFD. So out of the $800 million addressable market, how much is AFD and how much is CFD? Basically, my question tries to understand the short-term opportunity when you launch for CFD versus the [ additional ] indication, AFD?

Thanks, Jaime. And let me start with the second one, and then Roland will address the one about China. So on the fibrinogen, I mean, it's not possible to see or to assess really what is the market opportunity right now because the market development effort needs to be done. I think that we know that at this point, the use of fibrinogen in the U.S. is limited. It's very limited. It's small. And we know as well that what is the potential that fibrinogen can have. If we managed to get the standard of care at the levels that we see in other markets like Germany or Austria. So at this point, both AFD and CFD are small. And our work is going to be to really prove and bring clinical evidence that those markets will develop to the level that we expect they will be of this $800 million Europe that over time, we are confident it will happen. And on China, Roland will comment now.

Yes. On China, the key underlying driver are the government-imposed cost controls that we talked about across the whole health care sector. That had an impact on prices and also had an impact in terms of the demand in the market slowing down. But it is important to note that while we see this impact at this moment, China remains to be the key market and the prices actually still compare favorably with other parts of the world. Also, as we think about China for the future, it's a key market for us. It's important. We believe that our partnership, our strategic partnership with Haier and Shanghai RAAS puts us in a strong position to navigate this market, and we are working to seize opportunities to realize growth in other parts of the world, particularly U.S. and ex U.S. to see how we can aid to continue to balance our albumin with the Ig growth that we foresee. So in terms of the driver, it's really coming down on this market. It's a dynamic situation, but we believe that we are in a good position to navigate this with our strategic partnership.

Now we will go to Alvaro Lenze from Alantra, please.

The first one is on the EBITDA guidance for the year. If I take the range you provided and I subtract the EUR 70 million expected FX impact implied Q4 in the lower range would be about EUR 450 million adjusted EBITDA and on the upper range would be around 500 -- sorry, EUR 500 million. That is on the low end, a 15% decline, and that would put Q4 less than either Q3 and Q2. So I don't know if there is any phasing there. I know Rahul explained the comparison base for Q4 last year is quite tough, but still in absolute terms, the low range of the guidance would look a bit underwhelming. So I was just wondering what your thinking process for that guidance was. And then a second question would be, you mentioned some impairments for Q4. I just wanted to know what sort of assets are you thinking of for the impairment and when did those assets join the balance sheet, just to understand whether you are looking at past or very old investments that you no longer think are as valuable as represented in the balance sheet or if it's more recent investments that you're cutting?

Sure. Let me start with the second one on impairments. It's certainly, as you -- as I mentioned in my prepared remarks, we laid out at our Capital Markets Day, R&D and innovation plan and none of those from our standpoint are impacted at all. This really is some of the efforts in our portfolio that perhaps have not had the prioritization from a capital standpoint. And all we're doing is proactively flagging that. But importantly, Alvaro, this does not impact our go-forward adjusted EBITDA growth story or indeed our go-forward free cash flow growth story. So just to give you an idea that just in terms of lower prioritization in terms of -- from a project standpoint. So that's on the second question. On the first question around guidance and ranges, I said 2 things on our -- as I described the guidance. One, I said we are very comfortably within our guidance range for adjusted EBITDA. And then the other thing I said is we expect a robust Q4 2025. The only thing I caveated there was that the absolute comparison versus Q4 '24 that also benefited meaningfully from phasing last year is something that we just wanted to make sure that we prudently guided on. But from our standpoint, as you look at those ranges, I think the bottom end of the range that you feel very comfortable about managing and beating, and, as we've always done, focuses head down on execution with discipline and intensity. So we'll see where we get to, but we're tracking on that basis. And what we want to do is make sure we flag the phasing aspects as we've done.

Thank you so much. Now we would like to get Charlie Haywood from Bank of America.

Charlie Haywood, Bank of America. Two questions, please. First one, unless I've misunderstood, could you clarify what the FX headwind to your reported revenue guide would be for the full year? And then just on the sort of FX impact, what specifically on FX has changed since second quarter when, I guess, guide was reiterated and there wasn't an implied FX impact there? And then the second question, just wanted to get your thoughts on, obviously, the competitor readouts we've had in alpha-1, your confidence in rebuttal of that, especially on the margin level, which I understand is slightly higher than your standard products and given also fibrinogen delay today might lead to more of a margin impact. So just high-level thoughts on how you can rebut that impact.

Thanks, Charlie. I'll take the first one. So if you go back to our Q1, go back to our Q2 and indeed repeating now in Q3, we've been consistent around the headwind of U.S. dollar weakening on EBITDA. But remember, it remains broadly neutral from a leverage standpoint and indeed broadly neutral from both the group profit, bottom line net income and from a free cash flow standpoint. Number two, you will also -- if you go back to each of those presentations, you will also see that we have been reiterating, I think, Q1 and Q2, we've always taken you back to the basis on which guidance was provided, and there's no change in that respect now in Q3 either. So that's why we're always saying is that as you compare our our guidance or implied guidance now relative to -- on a guidance FX rates basis, we continue to track well from a revenue and free cash flow standpoint, in fact, improved and maintain the -- or reaffirmed guidance from an EBITDA standpoint. Equally, we want to make sure that we are being completely upfront. We provided a sensitivity analysis in Q2. And what we're trying to do now is just give you a number if the rates as at the end of Q3 persists through to the end of the year, what that implies from an adjusted EBITDA headwind. The question around revenue impact, we've not provided that. But I mean -- but if you just assume that roughly about 2/3 or 65% of our revenues is U.S. dollar-denominated. And if you do the rough math around that, depending on what your exchange rate assumptions are for the rest of the year, that could have an impact of anywhere between $300 million to $400 million, give or take. But on the basis of the guidance FX rates, we are guiding to an improved revenue guidance for the year. So let me leave it at that. And on the second question, I'll hand it over to Roland.

Yes. On alpha-1, we always, as part of our plan, assumed positive top line data of the pharmacokinetic endpoints. So this was as we expected. What we hear from thought leaders are basically 2 questions at this point. One is waiting to see the detailed data and understanding safety of this recombinant approach. And the second question is around the pathway to approval. And we're obviously also eagerly waiting to see what this means. But as we think about Alpha-1, we just want to bring it back to the immense opportunity that still remains. We only are treating 10% to 15% of patients today, which means 85% of patients are undiagnosed. And we just saw with CIDP how a new entrant can actually dramatically improve and accelerate diagnosis. Beyond that, we know that with our outcome study, SPARTA, we have it in our hands to raise awareness of this disease in the U.S. and ensure that we can have a broader reimbursement in Europe, which gives us a growth lever. And then lastly, as we mentioned, we're excited about our subcu treatment, 15%, which we're advancing into Phase III and planning to submit an IND there in the coming months and our long-acting option. So as we look in -- at this market, a new entrant, but most importantly, the growth opportunity that this market has, we remain committed and confident about alpha-1. And as you think about fibrinogen concentrate, as we outlined, the path to growth is not materially affected by what we just shared. We are still in a position to compete and possibly accelerate our uptake ex U.S. and we have an opportunity to strengthen our positioning in the U.S. and see that we can lead in this market in the long term.

Thank you so much, Roland. I appreciate the question, Charlie. Next up is Thibault from Morgan Stanley.

Just on the free cash flow guidance, so obviously, versus beginning of the year, EBITDA and change at constant currency, I mean, using February FX as a base, free cash flow guidance has been upgraded a couple of times since. If you can just remind us the moving parts in between for the free cash flow improvement and any risk of seeing some of these elements reversing in the future? So for example, working capital, if you could comment on your expectations for working capital position at the end of the year and what it means for potential reversal in Q1 next year?

Yes. So just -- so your question is on just the various constituent parts of our free cash flow improvement. You're absolutely right in that we have improved our guidance on free cash flow a couple of times this year. The drivers of that free cash flow improvement come from the improved EBITDA on a year-to-date basis, our adjusted EBITDA is up meaningfully. And even if you eliminate some of those cash adjustments, they continue to track very well compared to 2024. On a net working capital basis, we talk about tight working capital management, notwithstanding the impact of a depreciating dollar on just sort of inventory levels and so on, our inventory levels continue to be managed on a tight basis as is the case on both from a receivables and payables standpoint. So that is tracking well and tight. As you look at CapEx and capitalized IT and R&D, clearly, we are -- as we anticipated at our Capital Markets Day, we saw 2024 as being a sort of a peak from a total CapEx. And here when we talk about CapEx, I also include what we used to refer to as extraordinary growth CapEx previously. So the total CapEx number to sales was at a peak in 2024. And all that's happening here is it's playing out as we expected, prudent and disciplined CapEx spend. And then finally, as you look at interest cost, we had the significant deleveraging benefit in 2024 from the partial disposition of our Shanghai RAAS stake that has helped leverage, helped debt redemption. And in addition to that, what has also helped significantly is our meaningfully lower utilization of RCF from a financing standpoint. So all of that translates to free cash flow improvement of $257 million versus last year. As I look at the picture for the rest of the year, we remain confident about executing on our improved guidance of $400 million to $425 million for free cash flow pre-M&A, pre-dividends for 2025. And then -- and with respect to the impact in 2026, we will cover that off when we provide guidance in -- at the end of February next year. But certainly, we're not anticipating significantly different variations. If you recall, in Q1 this year, we had a meaningful improvement from a free cash flow standpoint versus Q1 2024. And one of the things that we will seek to do is maintain that to the extent possible. But that's something that we'll pick up in a bit more detail when we provide our guidance for 2026 at the end of February next year.

Thank you so much, Rahul. Very clear. Guilherme, I think that you were waiting.

Yes. So 2, if I may. The first one, I assume that the Ig growth acceleration was positively impacted by some pricing benefits that you alluded to, but also some volume gains in the U.K. You're guiding for a slowdown in terms of [indiscernible] growth going forward. Just to understand a bit how going to be the phasing between Q4 and Q1, taking Q1 as a potential reference for going forward. So this 6% to 8% is something that we should consider only for Q1 and Q4 could be a bit below these references? Or is the run rate -- the 6% to 8% is the run rate that we can assume going forward? And second question regarding 2026. So from your comment, I assume that we should expect a lower underlying growth, at least in Biopharma. But the FX typically has a positive impact in terms of margins, the weaker U.K. U.S. dollar. So at the Capital Markets Day, you guided for a uniform margin progression across the plan. This less favorable effects on the absolute EBITDA standpoint could impact positively margins. So we might have in 2026, a faster margin expansion than what you were planning in the Capital Markets Day?

Guilherme, happy to add a bit more color on the Ig side. As you may recall, in our Capital Markets Day, we said that we aim to grow Ig in line or slightly ahead of the market and gave that 6% to 8% CAGR rate, which just reflects the potential that Ig has, and we expect it to be in there. The other part that I want to just bring up again is you may recall that in the 2023 call, leadership at the time announced a plan to win back share in the U.S. During the pandemic, we have lost share in the U.S. and we have announced that we want to win it back. We have since executed on this plan using a strong inventory position that we had at the time, and that translated into this double-digit growth, well, well ahead of the market during this time. We have since regained the market share and at this higher market share, we now expect to grow in line with the market or ahead of the market. So from that perspective, I would look at these last 2 years as our ability to actually reposition us in the market and from here to grow with or ahead of the market moving forward.

And then finally, on the question around margins. No real change in terms of the building blocks driving our margin improvement story over the coming years. And with respect to what we had guided from a margin standpoint for 2025 was adjusted EBITDA margins to be in line with 2024, having fully absorbed the impact of IRA. And year-to-date, we're doing exactly that. You can see on a like-for-like basis and even on a year-to-date basis, our margin improvement is up. So that remains the story for 2025. And with respect to 2026 and beyond no change, we will update the market with respect to 2026 guidance specifically when we come to it at the end of February.

Thank you, Roland. Thank you, Rahul. We have time for the very last question. It's going to be Justin from Bernstein. Justin, please.

Yes. Justin from Bernstein. Just a quick one on fibrinogen, and apologies if I've missed some remarks here. But when you talk about the new evidence that you need to bring, are we talking about new clinical data? If so, could you just share some thoughts on execution risk there? I mean, is it a case with acquired patients? It's quite difficult to locate those patients and run the trial. So any thoughts there would be very helpful.

Yes. The one thing to highlight is that we are obviously looking at the study in the U.S., and we have different proposals on the table, and we'll be looking at the best way with an eye on making sure that this obviously helps us with speed to the market at the same differentiation possibly in our label. And we do not see an execution risk there. We see the need and interest to conduct a trial like that.

Okay. Thank you so much, Roland. I say that was all for now. Thank you so much for all your questions and for joining us today. If there is any follow-up, please let us know. There is an IR team dedicated for that. Thank you so much.

Hello, everyone. My name is Danny Segarra, and I serve as the Head of Investor Relations and Sustainability and Vice President at Grifols. Welcome to our review of the company's business results for the first half of 2025. Today, I'm joined by Grifols Chief Executive Officer, Nacho Abia; Chief Financial Officer, Rahul Srinivasan; and the President of Biopharma, Roland Wandeler. A few logistics before we get into the details. Today's call will last about an hour, including a Q&A session. As a reminder, this call is being recorded. You can find additional materials, including today's presentation in the Investor Relations section of the Grifols website at grifols.com. The transcript and a replay of the webcast will also be available on the Investor Relations website within 24 hours. Turning to Slide 2. Please note that this presentation includes forward-looking statements regarding, among other things, the company's future operating and financial performance, market position and business strategy. These statements are based on current expectations and available information as of the date of this recording, and they are subject to certain risks and uncertainties that may cause actual results to differ materially from those projected. Therefore financial statements are prepared in accordance with EU, IFRS and other applicable reporting provisions, including alternative performance measures or APMs, prepared under the group financial reporting model as defined by the European Securities and Markets Authority. Please note that Grifols management uses APMs to evaluate financial performance, cash flow and overall financial position as the basis for operational and strategic decision-making. These APMs are prepared for all the time, periods presented in this document. Now moving to today's agenda. Nacho will start with some introductory remarks, followed by a discussion of our business performance and strategic execution. Then Rahul will review the financial results for Q2 '25. After Rahul's presentation, we will return to Nacho for his closing remarks. Roland will be joining us for Q&A. With that, I will now turn the call over to Nacho. Nacho, please?

Thank you, Danny, and hello, everyone. Thank you for joining us today. In May, we reported a strong start to 2025. And I'm happy to report today that, that momentum continued through the second quarter with the delivery of a robust set of results across all key business and financial metrics. This strong performance reflects the strength of our business and operations and puts us firmly on track with our guidance and to continue advancing along a positive trajectory for the rest of the year. And it is well aligned with the direction of the value creation plan that we explained at the Capital Markets Day last February. It's important to note that we achieved these results despite a complex and dynamic environment, marked by persistent uncertainties and external factors. These conditions continue to demand vigilant and discipline, and therefore, we will continue to closely monitor those developments and when needed, we will adjust and adapt. Our vertically integrated and globally diversified footprint provides valuable flexibility and optionality to meet global needs with minimal disruption, while significantly mitigating uncertainty from potential tariff impacts. Foreign exchange volatility continued to present challenges during the second quarter. As discussed in the Q1 presentation, while this movement has an impact on both our revenues and to a lesser degree in terms of EBITDA, in absolute figures, it is broadly neutral from a group profit, leverage and free cash flow standpoint. As global currency dynamics evolve, we continue to proactively monitor our currency exposure and implement agile decision-making to support our financial performance. Before we dive into the details of the quarter, I want to express my gratitude for the relentless effort of every member of the Grifols team. Their commitment to execute our value creation plan is already yielding tangible and impactful results. And this is truly encouraging as it paves the way for us to continue delivering on our commitments, always with the goal of creating more value for our donors, patients and all our stakeholders. With that, let's move to Slide 5. As presented during our Capital Markets Day, our business and operational strategy remains grounded in the foundation laid out by our value creation plan. This plan is not just a road map. It is also the engine driving our strategic vision. We are executing against it across all core levels to drive concrete and sustainable results, and this disciplined execution is clearly delivering results. Our second quarter performance is a testament to that. Full alignment with our plan and contribution to a strong first half of the year. Now turning to the Half 1 '25 results. We achieved revenue of EUR 3.7 billion, representing a year-over-year increase of 7% on a reported basis and a 10.1% like-for-like, both at constant currency. Adjusted EBITDA reached EUR 876 million, a significant increase from the prior year, up 12.7% on a reported basis and 20.1% like-for-like, again, both at constant currency. This demonstrates a strong business momentum even after absorbing the impact of the IRA. To put this performance in perspective, Q2 '25 is the second highest revenue quarter in history, only surpassed by Q4 of last year. The strong top line momentum has translated directly -- indirectly into improvement in free cash flow of close to EUR 200 million year-over-year. This increase builds on the sequential progress we delivered in 2024, and we expect this trend to continue in the second half of the year. At the end of the second quarter, deleveraging landed to a leverage ratio as per credit agreement of 4.2x. We have to look back 5 years to the first half of 2020 to observe this leverage ratio. As mentioned many times, free cash flow generation and deleveraging are key metrics for us, and therefore, we will continue to be our key financial priorities. Such positive performance has been driven by biopharma, which continues a strong growth on the back of increased global underlying demand. On top of this, we remain focused on improving profitability through targeted cost reduction initiatives and operational efficiencies to drive margin expansion. Another core driver of our strategy is innovation, and we are fully committed to it. We're accelerating our pipeline, enhancing life cycle management and staying on track with our product launch road map. A clear example of that is the upcoming launch of fibrinogen in Europe in the Q4 of 2025, and the subsequent launch in the U.S.A. in the first half of 2026. At the same time, we have delivered across all operational fronts without losing sight of our financial backbone, our capital allocation framework. This framework remains at the heart of our execution, enabling us to generate sequential cash flow, reduce leverage, continue simplifying our corporate structure and returning value to our shareholders. Relevant milestone in Q2 has been the successful delisting of Biotest, which will help to increase our capacity to unlock value from this strategic asset. To conclude this slide, and although Rahul will provide more details, I'm happy to announce that the strong performance in the first half of the year and the confidence we have to continue delivering positive results in the second half enable us to fulfill one of our capital allocation key commitments. The restatement of dividend payment as a clear sign of our commitment to shareholders and the confidence we have in our value creation plan. Our strong business and financial performance is a direct reflection of our disciplined execution of the value creation plan, which is based on three core drivers: commercial growth, margin expansion and pipeline execution. Starting with commercial growth. We continue to experience strong momentum across our portfolio, which is a proof of our strong market position, extensive commercial efforts and the high demand for our products. As already mentioned in the first half of the year, our revenue on a reported basis grew by 7%. On like-for-like, it grew more than double digit, driven by biopharma reported growth of 8.2% and almost 12% like-for-like. Margin expansion remains a core focus, and our persistent efforts in efficiency and cost discipline are yielding results. We're taking a multifaceted approach, driven by both targeted cost reduction initiatives and substantial improvements in yield across our plasma and manufacturing processes. These operational enhancements are directly contributing to our profitability in Q2 with a gross margin of close to 40%, and an adjusted EBITDA margin that grew to 25%, up 80 basis points in reported figures and 171 basis points like-for-like versus last year. This demonstrates our ability to convert top line growth into stronger bottom line performance. We are also making good progress on our pipeline execution. Our pipeline is the innovative engine set to drive for long-term sustainable growth. It demonstrates our commitment to bringing new products and indications to market, enhancing patient care and broadening our therapeutic reach. Our value creation levers are underpinned by two important enablers, our plasma supply and industrial network and innovation. A robust, resilient and highly diversified plasma supply and industrial network provide us with a significant competitive advantage in the current global environment and ensures reliable supply for our therapies, allowing us to manage increasing global demand effectively. We continue to optimize this network, and we are well invested to meet growing underlying demand through 400 plasma centers globally, including 300 plasma centers in the U.S. and the largest non-U.S. network in the industry. This global footprint not only enhances our ability to source plasma efficiency but also provides a significant degree of resilience against cross-border macroeconomic, political and environmental uncertainties, including any impact from tariffs. Finally, innovation is at the heart of our strategy. We continue to invest in R&D and are delivering on our innovation milestones and progressing on several key programs, including the very important fibrinogen, which will further contribute towards revenue and margin growth as well as minor therapeutic reach and address unmet medical needs. Diving deeper into our commercial performance, the market demand is solid, but we are as well outperforming the market. In the first half, our biopharma portfolio recorded an 8.2% growth with our IG franchise delivering a growth of 12.5%, both at constant currency. On a like-for-like basis, our IG franchise grew by 17.8%. And this performance was primarily driven by the strength of our leading brands, Gamunex and Xembify. Over the last 12 months, intravenous IG and subcutaneous IG continue marking an outstanding growth with an increase of 14% and 66%, respectively. We continue to feel extremely confident with Xembify. As we see continuous growth fueled by strong performance in the U.S., but also in Europe. And as in the past 6 months, it was launched in nine countries with additional launches in the queue. We saw a strong growth in primary immunodeficiencies and secondary immunodeficiencies, while we further strengthened our leading position in CIDP. Demand across all three indications increase. SCIG remains the first-line treatment of choice due to its proven efficacy and safety. Our IG strategy is fundamentally focused on expanding indication, increasing diagnosing rates for primary and secondary immunodeficiencies, and the informants of IG as the standard of care for a range of immune conditions like CIDP. This is regularly supported by compelling clinical experience and a strong validation from KOLs and healthcare professionals worldwide. Grifols is uniquely positioned to capitalize on the market evolving needs. And as we mentioned before, our robust plasma supply, vertically integrated manufacturing and deep scientific expertise means that as the market expands, we stand as the foundational supplier capable of meeting the growing demand for IG. Turning to our albumin performance. Our Q2 performance grew by close to 10%, an improvement over Q1, which was temporarily impacted by a planned drug license renewal process in China. While we anticipate some pricing pressure in China, our strategic alliance with higher and our extended exclusive distribution agreement with Shanghai RAAS continues to position us to capitalize on the significant demand for albumin in this market. In addition, our first Canadian-made albumin manufactured at our facility in Montreal, has successfully reached our patients. The Montreal site, along with Grifols growing network of in-country plasma collection centers positions us to fulfill our commitment to Canadian Blood Services to support Canada goal of increasing its self-sufficiency levels. We're also making significant strides in our alpha-1 franchise. For the first half, Alpha-1 and specialty proteins revenue grew 6.6% at constant currency. These figures reconfirm our market leadership and advanced testing capabilities. Our current strategy is centered on leveraging our new specialty distributor program in the U.S. and continue supporting patient identification initiatives to treat some of the estimated 85% of patients who still remain undiagnosed worldwide. These efforts, along with active engagement with key opinion leaders and healthcare providers have resulted in more patient regaining and enrolling in timely and appropriate treatment. Furthermore, enhancements to life cycle management for this critical therapy are underpinned by our SPARTA trial, which will potentially improve efficacy of our Alpha-1 augmentation therapy. Concurrently, our subcutaneous 15% trial is progressing well, promising enhanced convenience and improved quality of life for Alpha-1 patients. These innovations will expand the reach and impact of our Alpha-1 franchise for both the U.S. and ex U.S. patients in the near term. Now let's turn to the second lever within our value creation plan, margin expansion. Our strategic initiatives focused on improving efficiencies across our network are clearly paying off. A particularly exciting achievement to highlight is our progress in individualized nomogram implementation, which allow us to maximize plasma yield per donation. We've already achieved over 60% adoption in U.S. centers, and our second wave implementation is underway, and on track to reach 100% adoption by 2026. This key initiative will continue to contribute to our bottom line, and this is a direct outcome of process engineering, enhanced training, an intelligent application of technology, making the donation experience more efficient for both donors and our staff. This leads me as well to talk about the key metric within our plasma operation, volume per center. We are on track to deliver solid double-digit growth this year, and we expect to continue to build on this favorable trend to continue to expand our margins going forward. We're also advancing improvements in IVIG manufacturing yield. This isn't just about the incremental improvement, it's about instilling a culture of continuous innovation that permits our entire manufacturing footprint. Our continuous optimization of plasma supply has been a long-standing evolution, ensuring a robust and diverse source of plasma. We are not only focused on increased plasma collection, which inherently drives economics of scale, but also in optimizing our plasma sourcing strategies and notably improve efficiency through our collection centers. And underpinning all this advancement is our strategic investment in artificial intelligence, advanced analytics and digitalization. We are leveraging cutting-edge technologies to gain deeper insights into our operations, predict trends and automate process. Our strong Q2 performance, particularly the margin expansion generated by our plasma manufacturing divisions underscores the power of our strategy. Our commitment to continuous optimization, technological innovation and operational excellence is not a strategic pillar. It's a tangible reality that is driving profitability. Now turning to Slide 9, to the third level in our value creation plan is pipeline execution. As we have been reiterating over the past months, we are focusing much of our targeted investment and resources within our innovation pipeline or life cycle management, new proteins and indications. These efforts will directly contribute to our growth strategy. We're very excited for our fibrinogen launch in Europe. On this front, important inroads have been made recently. Last month, Lancet eClinicalMedicine, a prestigious peer review journal toted the success of the clinical trial and published pivotal data that further validate the significant opportunity fibrinogen presents in hemorrhage management during major surgeries and acute bleeding episodes. We remain on track to launch this new protein in the fourth quarter of the year in Europe, followed by a launch in the U.S. in the first half of the next year. Also, we continued to make progress on our pipeline milestones, and we have accelerated a few that we expected -- that were expected for the second half of 2025. We successfully enrolled our first patient in our Giga 564 oncology program, a groundbreaking approach to cancer treatment with a potential to enhance antitumor activity and mitigate some immune-related toxicities. We have also successfully submitted our Phase II investigational New Drug Application for the use of IG in dry eye disease, one of the most common ocular disorders worldwide. The other three milestones completed related to Gamunex and Xembify. This will further support and bolster our IG franchise. We submitted Phase III IND for Xembify and CIDP, which combines the proven safety and efficacy of IG with the convenience of subcutaneous treatment to provide further optionality to our patients suffering from CIDP, an indication that keeps growing quarter-over-quarter. We also completed the FDA submission for Gamunex-C in Bags, providing additional convenience and safety for infusions. Beyond these two milestones, which were expected for the second half of the year, we also want to highlight that our Phase III IND submission for Gamunex in SID -- in secondary immunodeficiency was successfully fast tracked. Gamunex provides an additional avenue for growth in SID, which as diagnosed rates and population increase is becoming one of the fastest-growing segment for treatment through IG. Looking ahead to the second half of this year, as mentioned already, we expect the approval of large fibrinogen in Europe and the Phase I/II top line results of the subcutaneous 15% for our alpha-1 patients as we progress to further grow our alpha-1 franchise. Turning our attention to our diagnostic business. It had a very solid start in the first half of the year, reporting a 2.8% growth at constant currency and with all major segments reporting performance growth. Beyond revenues, this complementary diagnostic business continued to drive significant EBITDA and generate significant cash flow. Our Blood Typing Solutions business is expected to be a main driver of growth, grew by 7.1% at constant currency. And we're strengthening our presence in core markets and improve operational efficiency. We received FDA approvals to begin manufacturing GelCards and reagent red blood cells in our San Diego facility. And this will further support our blood typing solutions segment growth and bolster our capacity in the United States. In our molecular diagnostic business, we are reporting a 2.2% growth of constant currency. And I would like to specifically highlight the strategic alliance with Inpeco, a partnership which aims to create the lab of the future, providing revolutionary solutions in laboratory automation. Combining Grifols leaders leading diagnostic instrumentation reagents and technical service with Inpecos, open automation technologies will enable labs to modernize, upgrade and scale their operations quickly and seamlessly. Our immunoassay segment also performing well with an 8.1% growth. Worth noting is that we continue to advance the development of the ISARD platform, the first Grifols immunoassay platform. Multiplexing, ultra highly sensitive, modular and trackable, and it will allow us to [ tap ] a $1 billion serology donor screening market. Altogether, we are confident that we are well positioned to capitalize on growth opportunity in transfusion medicine, while we continue to focus on solidifying our leadership position. So with that, I'll turn the call over to Rahul, who will share more details about our financial performance. Thank you.

Thank you, Nacho. Moving on to the Q2 and H1 numbers on Slide 12. These financials have been subject to the customary H1 limited review by our auditors, Deloitte. As a reminder, our reported numbers are after the impact of IRA and the fee-for-service GPO reclassification. These reported numbers understate the true underlying momentum and hence, to improve comparability to prior periods, we will continue to disclose the like-for-like column for the rest of this year, which we believe will be helpful for analysts and investors to track our underlying performance. Starting with our reported Q2 '25 performance, another very strong quarter with reported revenues of just under EUR 1.9 billion and an adjusted EBITDA of EUR 475 million, our second highest adjusted EBITDA quarter ever. Implying a reported adjusted EBITDA margin of 25.1% and meaningfully higher than that on a like-for-like basis and contributing to a robust group profit and free cash flow pre-M&A for the quarter. This strong Q2 performance has supported a record first half performance for us from both a revenue and adjusted EBITDA standpoint, and I will touch on the key drivers on the following couple of slides. Year-on-year reported revenue growth was 7% on a constant currency basis and 10.1% on a like-for-like basis in constant currency terms. Year-on-year reported adjusted EBITDA growth was 12.7% on a constant currency basis and 20.1% on a like-for-like basis in constant currency terms. Both the reported revenue and adjusted EBITDA growth delivered in H1 '25, is significantly higher than what was implied by our full year guidance for 2025, if you simply extrapolate it in a linear manner. And with average euro-dollar exchange rate being relatively flat when you compare H1 '25 versus H1 '24, the year-on-year comparison of reported results is less distorted by the depreciating U.S. dollar, an aspect that will cause more distortion when we make the same comparisons in H2. More on that a little later in the presentation. Both adjusted EBITDA margin and gross margin have improved, notwithstanding the impact of IRA. Whilst the business now treats the IRA impact like any other cost, the 80 basis points year-on-year improvement in adjusted EBITDA margin significantly understates the underlying earnings momentum of the business as evidenced by the 170 basis points improvement on a like-for-like basis. The significant normalizing of our business also helps our group profit or net income story considerably with H1 '25 group profit hitting $177 million, up around 388% year-on-year, and continuing to see that group profit growth remains a clear priority for us. With regards to free cash flow, another solid quarter of progress with H1 '25 free cash flow pre-M&A being $182 million higher than H1 '24. And like we said in our Q1 call a couple of months ago, unlike revenues and adjusted EBITDA, free cash flow is more protected from a depreciating U.S. dollar, and I will touch on this again later in the presentation. Finally, on the balance sheet side, there continues to be deleveraging progress supported by a strong liquidity position and significant rainy day secured debt capacity. So the balance sheet continues to be in a very robust position. And this leverage and liquidity picture is after the settlement of our successful delisting offer for Biotest, very much in keeping with the capital allocation assurances that we provided earlier in the year at our Capital Markets Day. Slide 13. Turning to our revenues. Our top line performance in Q2 continues the strong growth trends we have observed consistently over the last quarters. Biopharma remains the primary driver, delivering growth of 8.2% on a reported basis and 11.8% on a like-for-like basis, both at constant currency. This performance was primarily driven by the continued strength of our immunoglobulin portfolio, which saw broad-based demand across all major indications. After the phasing impact associated with the license renewals that we saw and talked about in Q1, we also saw a positive quarter for albumin growth and we still have significant amount of catch-up over the next 12 months or so. And pleasing to see alpha-1 and specialty proteins maintaining their positive momentum. Lastly, another positive quarter of growth for Diagnostics, and that continues to cruise at a steady pace, a business that benefits from robust margins and strong free cash flow conversion characteristics. Slide 14. In the first half of 2025 adjusted EBITDA growth was nearly twice the pace of revenue growth. Reported EBITDA margin grew by 80 basis points and by 170 basis points on a like-for-like basis, reflecting the continued benefit of gross margin improvement, operational leverage benefit coming through, and general cost discipline. As previously mentioned, growth was primarily driven by strong underlying demand in biopharma. Our IG franchise continues to deliver robust or above-market growth across geographies. We also continue to drive down cost per liter through focused efficiency initiatives and improved yields. In parallel, we're transitioning to a more granular cost per gram of protein model to further enhance operational focus. To close this slide, let me touch upon IRA impact for H1 '25. Our EUR 58 million impact for the first 6 months of the year is aligned with our comments during the Q1 presentation, and supports our confidence that the EUR 125 million midpoint of our full year guidance remains a prudent estimate. We remain very focused on execution to capture the operational leverage benefits associated with our top line growth while maintaining strict cost discipline across all functions. And finally, whilst we did face some FX headwinds in H1, they were relatively muted. And we expect that to be more meaningful in H2. Slide 15. As we have talked about a number of times before, a key area of focus has been to proactively reduce the cash adjustments between adjusted and reported EBITDA. It is great to see two key aspects on this slide. The continuing convergence of adjusted and reported EBITDA via a reduction of cash adjustments. Part of that is explained by the normalizing of our business and the stresses of the past being far away in our rearview mirror, reducing transaction and restructuring costs consistent with our prior guidance. Our cash adjustments have more than halved in H1 '25 versus H1 '24. The principal noncash adjustments relate to impairments, which are somewhat backward-looking and general are not expected to impact our go-forward free cash flow story that we presented at our Capital Markets Day. Notwithstanding the impact of IRA in 2025, it's great to see the strong growth rates, particularly the 17.8% growth in reported EBITDA on a constant currency basis and the significant increase in reported EBITDA margin. Slide 16. Free cash flow generation continues to be the cornerstone of our financial focus. After significantly outperforming our free cash flow guidance in 2024, we ended the first half of 2025 with an improvement of EUR 182 million year-on-year. This is a clear sign that the progress we saw in 2024, and again in Q1 this year were not one-offs and clearly demonstrate that this business can sustainably generate meaningful free cash flow. Obviously, with H1 '25 free cash flow pre-M&A still being slightly negative, the upcoming Q3 and Q4 quarters, that are our strongest free cash flow generating quarters, will be critical. Working capital continues to be a critical component of our free cash flow story. And we continue to make good progress, as you can see in the favorable comparison versus H1 '24. We saw continued investment in inventories to support the strong and sustained demand we benefit from, especially within biopharma. The profile across receivables and payables are stable and move in lockstep with the strong growth that we continue to benefit from. Our spend on CapEx, capitalized IT and R&D plans are all going as planned, and there is a greater weighting of this spend in H1 2025, so you can expect H2 spend to be lower. Q2 tends to be a heavier interest payment quarter for us, and this year was no exception. With EUR 235 million in interest payments driven by the existing phasing of our debt interest servicing. You can expect H2 interest to be meaningfully lower than H1 and full year 2025 interest to be meaningfully lower than 2024. Part of that driven by the deleveraging related to the partial disposition of the Shanghai RAAS stake, but also lower utilization of our RCF, meaningfully contributing to the lower interest spend. In conclusion, all going to plan on the free cash flow side, and we continue to manage the business with clear focus and discipline, and we remain confident about our full year free cash flow pre-M&A outlook, that I will provide further context on later in this presentation. Slide 17. At our Capital Markets Day, we set out what we believe was a very clear capital allocation framework. And we simply continue to execute within that framework in a disciplined manner. Continued deleveraging and free cash flow generation are core to that framework, and we continue to make good progress on both fronts. As I've said before, with no meaningful maturities until Q4 2027, with our strong liquidity position, demonstrable capital markets access, and continued re-rating progress implied by the yields of our debt instruments, I feel confident about our balance sheet strength. We expect to execute our refinancing plans in a timely and prudent manner, at least 12 to 15 months before our 2027 maturities. Essentially, all going as we expected in this first pillar. Organic investment plans continue as expected, be it investment in inventory levels and other critical projects supporting our strategic goals in a disciplined manner, whilst continuing to improve our free cash flow generation. And as I said before, we remain confident about our free cash flow pre-M&A outlook in H2 '25. On the inorganic front, we successfully delisted Biotest from the Frankfurt Stock Exchange, and we did so as we guided to paying for it from our existing resources whilst continuing our deleveraging profile, and Biotest is progressing as we planned. And finally, on shareholder returns, which is an equally important pillar of our capital allocation framework, entirely consistent with what we said at our Capital Markets Day earlier this year, given the strong earnings and free cash flow generation momentum and continued progress on each of our other three pillars, we are pleased to confirm a EUR 0.15 per share interim dividend that will be paid in accordance with the OIR filed simultaneously with our results release a short while ago. Accordingly, this dividend will be paid shortly in August. It has been over 4 years since Grifols last paid a dividend. Having very responsibly pause dividend payments whilst recovering from this once-in-100-year pandemic event. With leverage now being clearly lower than the corresponding leverage when we last made dividend payments as an example between 2018 and 2021, and our continued confidence in our deleveraging path, we are pleased to confirm this dividend reinstatement. In conclusion, we continue to execute in a disciplined way against the capital allocation framework we set out at our Capital Markets Day. Slide 18. Despite a fairly uncertain and dynamic macroeconomic backdrop and the various headwinds we have faced this year, be it due to the Inflation Reduction Act, tariffs, geopolitics, inflation, uncertain economic outlook or the elevated volatility and depreciation of the U.S. dollar, the resilience of the Grifols business is testament to both the efforts of those before us that have built this great business as well as the terrific job being done by the over 24,000 teammates delivering for our patients, customers and donors. This strong underlying momentum in H1 is both very pleasing and reassuring. Please bear in mind that our guidance was provided at the end of February when euro-dollar stood below [ $1.04 ]. The depreciating U.S. dollar as we proactively flagged in our Q1 results call is a meaningful headwind with differentiated impact along our P&L. It has a direct impact on absolute actual revenues due to the significant levels of offsetting natural hedges within the business, the impact on EBITDA is in fact, meaningfully lower than what it might have otherwise been. And importantly, due to the various offsetting and natural hedges, the impact on group profit, leverage and free cash flow is expected to be broadly neutral. For your reference, we have also summarized here a high-level sensitivity, if that is helpful. Each cent of U.S. dollar depreciation versus the euro, and here, I mean, the average exchange rate for the full year has a full year headwind impact on EBITDA of approximately EUR 7 million. Note that despite this headwind, as I mentioned earlier, our H1 performance has been far stronger than implied by our guidance. Given the strong momentum that we have already demonstrated in H1, our expectation is that this momentum will continue in H2, aided by all other levers we have available, including various cost levers we expect that it would help us towards mitigating the impact of a depreciating U.S. dollar based on recent euro-dollar levels experience. Also at this juncture of our story, there has been far greater focus from the market on our deleveraging and free cash flow prospects, which, as I mentioned, remained broadly unchanged, notwithstanding the U.S. dollar depreciation. Of course, we will continue to monitor that closely and update the market if need be. On that basis, we reaffirm our guidance for 2025, whilst importantly, improving our guidance for free cash flow pre-M&A to $375 million to $425 million, up from the previous guidance of $350 million to $400 million, given our confidence around our free cash flow pre-M&A outlook for H2 '25. With that, let me hand it back to Nacho to conclude the presentation.

Thank you, Rahul. I would like to wrap up the presentation with some final comments. The second quarter builds on the strong momentum from the start of the year. Our performance in the first half of 2025 reflects the disciplined execution of the value creation plan and tangible progress across all strategic levers: commercial growth, margin expansion and pipeline advancement. We are especially encouraged by the benefits from our ongoing optimization efforts, which continue to enhance efficiencies, further supporting margin expansion and improved free cash flow generation. Deleveraging also remains a top financial priority, and we are well on track with our leverage strategy reduction, reporting the lowest leverage ratio in 5 years. This achievement reflects not only our commitment to financial discipline, but also our commitment to long-term value creation. At the same time, we're investing for the future. Our R&D pipeline continues to advance with key milestones for the year delivered ahead of plan. From the upcoming launch of fibrinogen in Europe to promising early-stage program advancements, we remain focused on innovation as a core growth driver. Nevertheless, there is no question that the results were achieved in a complex macroeconomic environment, marked by persistent uncertainties and external factors, particularly FX. In the face of that, Grifols is well positioned to navigate global uncertainty. Thanks to our regional operating model, integrated supply chain, and operational agility. This gives us the flexibility to respond decisively and continue executing against our strategic road map. We remain confident that the strength of our business momentum, solid fundamentals and disciplined execution will largely offset the macroeconomic backdrop, including any pressure from FX headwinds. This positions us to reaffirm our full year 2025 estimates. Looking ahead, the alignment across our organization is clear. We remain focused on delivering the second half with the same rigor and discipline that define the first, confident in our ability to meet fiscal year '25 targets, strengthen our financial position and create lasting value for patients, donors and all our stakeholders. Thanks to you, as always, for your continued support. And with that, Danny, back to you.

Thank you, Nacho, and Rahul. Now let's turn to the Q&A session. [Operator Instructions]. Our first question today is coming from Barclays, Charles Pitman-King.

Charles Pitman-King from Barclays. Congrats on the strong results. Two from me, please. Just firstly, on the free cash flow and dividend. I'm just wondering if you could quickly confirm the lower interest costs are, in fact, primary driver of the raised free cash flow target then this year? And just in line with the dividend, can you just walk us through the logic of prioritizing the reinstatement of the dividend ahead of executing the call optional BPC and Haema, which I assume is still on track for execution in '26/'27 as part of the CMD. And then just a second question on the albumin market. I think, Rahul, you mentioned there's more acceleration to comp, and you're benefiting from Shanghai RAAS agreements. But just wondering if you could give us a bit of an outlook for what sort of year-on-year growth you might be expecting a return to given it was up 1% year-on-year currently? And what do you mean by pricing pressure? How should we think about that?

Thanks, Charles. So let me take the free cash flow and dividend. You're right, our cash interest is -- we've guided to it being lower in H2, but there are multiple things that go into our free cash flow. So I wouldn't pin our dividend payment only because we're doing better from a free cash flow standpoint. It is a combination of a number of factors, not only that it was -- it's consistent with our capital allocation framework. We're deleveraging as we planned. Our leverage is back or inside levels when we last paid dividends for whatever, 4, 5 years ago. And so in our minds, this is very much part of our overall capital allocation strategy and framework. And whilst the interest payment or cash interest is improving, that's not the sole driver of the reinstatement of dividend at this point, very much in keeping. As you recall, Charles, we mentioned that we would reinstate dividend payments on the back of our 2025 results and paying an interim dividend is what we had even talked about during our Q&A during our Capital Markets Day. So all very consistent on that front. On albumin?

Yes. This is Nacho. I think on Albumin, the comment was referred to the -- I mean, the Chinese government has been for -- already for a couple of years, pushing -- trying to decrease the cost of healthcare per capita in China, and part of that is also with the intention to reduce the pharmacy cost. Albumin is, as you know very well, a product that is very well appreciated in China, and it continues to be, but obviously, those pressure from the government are also generating some competitive tensions, maybe a little more than before. This is one of the situations where we appreciate to have a local partner, Shanghai RAAS, as they know very well the market. They know well the market and their customers, and they are navigating well all that tension, and we will continue paying attention to that.

And on Haema, BPC, Charles, as we guided to, our expectation is around half year next year, 2026. That remains our milestone for our target deadline or target date, if you like, for the exercise of the option. So no change in that regard either.

Now is the turn of JPMorgan, James Gordon.

James Gordon, JPMorgan. Two questions, please. The first one was IG trends. So IG grew 17.5% constant currency in Q1 but it looks like it's accelerated by about 5.5 percentage points to 12% in Q2. So it's still strong, but it does look like a bit of a deceleration. So is there anything one-off in the Q1 or Q2? And are you seeing any share loss in CIDP to Vyvgart, either people coming off IG earlier because we've got available or even something we're using Vyvgart ahead of IG. Could that be a factor in the slowdown that seems to be Q1 to Q2, or is that just noise? First question, please. And the second, just to remind us, Sanofi meant to report the headline data for Inhibrx in Q4. I know you've got a risk-adjusted competitive headwind already in the medium-term guide and the long-term aspiration. But could you remind me even if Sanofi does work and they can't get the products approved, would that imply any change to your guide or even with a 100% chance with Inhibrx coming, you'd still be able to get to the medium-term guide?

So let me start with the IG trend. I think the key -- one key aspect that you need to factor in as well is the currency impact. So I think if you look at it on a constant currency basis, I think that deals with the trend question. But on Vyvgart, Roland, do you want to pick that up?

Sure. We're now 1 year into the launch of FcRns, and we continue to see growth in our own sales in CIDP. And in fact, we do see and hear feedback from both thought leaders and physicians that they see IG as the standard of care and first-line treatment of choice in CIDP. We have been seeing use of FcRns, but mostly in the second-line setting. We've also seen some patients switch back to IG, and we remain confident in a strong role and in the growth potential that we have in CIDP.

Yes. As per Inhibrx, James, I think that we have mentioned this in the past, but in our Capital Markets Day plan, the loan rate plan that we presented in February, we took a risk-adjusted position, which risk adjustment essentially means that we took probably the worst-case scenario for us, which means that Inhibrx is launching the product in 2027 as they have announced, and this is something that still needs to be seen because there is still some required approvals. But we are assuming that they will launch in 2027, and this is included in our long-range plan. I mean it's -- obviously, we are progressing well with our initiatives to protect the franchise and to protect from any product that might come from them. But still, we are considering some impact, and it is reflected in the plan. If something would happen with the launching time and this launch will be delayed for whatever reason, that would mean an upside in our long-range plan.

Now I guess that is time for Alantra, Alvaro.

My first one is on margins. I think Rahul mentioned you expect to the same momentum we've seen in H1, the margin -- the underlying margin expansion was very impressive. But I was just wondering, with the comparison base becoming tougher because H2 already saw a significant margin expansion. And also with the pricing pressure you mentioned in Albumin, when you talk about maintaining this margin -- this operating trends, do you also mean turnover the same margin expansion we saw in H1 into H2? My second question would be on how to think about the dividends going forward. In the past, you used to pay an interim dividend and a final dividend. I don't know if you could guide us what the rationale for the EUR 0.15 per share is. I don't know if you have an absolute figure in mind for the total dividend or payout. How should we think about this?

I'll take both questions. On margins, if you recall, we said margin for the full year, when we provided our guidance is relatively flat versus last year, given the impact of IRA, which is being absorbed. So no change in terms of margin outlook for the year. And then on dividends, look, there's been no change in our dividend policy. Again, we talked about this at our Capital Markets Day. Our previous dividend policy that remains unchanged is around a 40% payout ratio. And to the extent that there are any changes around that as a result of any board discussion or decisions, the market will be updated as per normal protocol. So no real change on that front. And I think -- you're thinking about it the right way. It is an interim dividend, and there will be a subject to your typical -- we're going back to the normal Grifols cycle of the typical final dividend payment that would be Q2 next year, typically, I think, if I recall correctly, in terms of timeline. So no change in terms of how we're thinking about it as things stand. And if there are changes, obviously, we'll update the market in due course and normal protocol.

Now we would like to get questions from Guilherme from CaixaBank.

The first one is regarding your EBITDA guidance. So the low end of your EBITDA guidance implies a 1% year-on-year growth in the second half of the year. I understood that things should remain more or less in line with the first half in which you've grown by 12.7% in constant currency. So you still maintain this scenario due to FX uncertainties. And the second question is the phasing of the cash flow in Q3 and Q4. So you will have the interest payment in Q4. But still, should we assume free cash flow much stronger than the one that you have in Q4?

Yes. So look, I think on your first question around EBITDA guidance, yes, it is as a result of FX. Average FX rate for the first half was roughly about [ $1.08 ], give or take, which is roughly in line with what it was in H1 '24. And FX remains a little bit of an unknown. I remember when we were setting out our guidance for our Capital Markets Day, most analysts on the street were calling for euro-dollar parity. And here we are at [ $1.15 or $1.16 ]. So look, I think what we're saying is we're not speculating on FX. You've seen the strength of our performance in H1, and your statement that EBITDA guidance, the 1% that you use, being impacted by FX is fair. But as I reiterated, we have reaffirmed our guidance as well as increasing our free cash flow pre-M&A guidance for the year. So that's the first question on EBITDA guidance. On phasing of cash flows. Look, I think H2 cash flows obviously tend to be a lot stronger for us than H1. You can track that over a long period of time. And nothing has changed. In terms of specific phasing between Q3 and Q4, that is not something that we have provided specific guidance on and not something I necessarily want to be drawn on. But suffice it to say that in increasing our free cash flow pre-M&A guidance for the year, suggests strong confidence from us in order to hit that free cash flow pre-M&A revised upward targets, and we feel pretty good about where we're at, and we'll continue to execute in a very disciplined manner.

We have a follow-up from Alantra. Alvaro, please go ahead.

Just a quick question. You mentioned you expect to launch by year-end fibrinogen in Europe and then in H1 in the U.S., I don't know if you could provide us with some sort of guidance on what the initial sales could be and at what speed should we see this ramping up through next year?

Alvaro, we will be providing more color on our launch when we get closer to it. What we can say at this stage is that preparations are on track. Our regular submission, obviously, last year, we're expecting to launch, as Nacho said, Q4 this year in Europe and first half in the U.S., and the launch preparations are advancing very well. And just to remind you, the opportunity that we have is twofold. In Europe, it's an established market. It's about competing and gaining share with growth potential in some markets. And in the U.S., it's about establishing a new standard of care, given that this is a new indication with acquired fibrinogen deficiency that we'll be launching in. This is an uptake that will take time, but the potential, which is very significant, as we discussed in the Capital Markets Day, we see the U.S. market potential north of $800 million. So we're excited about this launch, and as said, we will provide more color when we get closer to date.

Now it's time for Santander, Jaime.

So a couple of questions from my side. The first one regarding the Canadian operations. Can you summarize or recap a little bit on the case study there. So what products are you going to produce and sell when? And what is the potential? I don't know if you can quantify in revenues or recall as the production that you expect to be producing in Canada? And the second question is regarding the 2Q IGC-IDP indication. When do you think you can have the indication and how relevant could this be for your subcutaneous revenues?

This is Nacho. I'll take the first question, and Roland will take the second one. So the Canadian project is a project that has been in place for a number of years. It's based on an agreement with Canadian Blood Services where back in the time they wanted to increase their level of self-sufficiency in the market. This, as you can imagine, with the current situation, they have even more interest on that project, and we've been advancing over the last years in the project. So at this point, we have already a working factor in there at this point is only producing albumin. The plan is in the future, it will also fractionate products and we'll do immunoglobulins in Canada as well. And we don't provide the specific numbers about this project, but essentially, I think we are becoming a very solid partner with the healthcare system in Canada. We are working along with them. I think self-sufficiency is a critical -- really a strategy that they have, and we are collaborating with them. So I think that we are seeing a very positive movement in our sales in the country, and we continue to collaborate with them and hope to increase even further that contribution.

And as for your questions regarding CIDP for subcu, this of course is an important driver. Just to remind you, we launched relatively recently if you want into the subcu space and are very excited to see the momentum that we have in prime immune efficiency, which is, at the moment, underpinning our growth. And you can imagine that unlocking CIDP as well will allow us to really compete in the full market. And with all of that, we expect that we will be able to get to similar share levels that we have in terms of IVIG. As for the timing, we're obviously very excited to start our Phase III, and we'll be providing more details, but we will be looking at a couple of years until coming to market there.

We have a second follow-up today, it's coming from Barclays. Charles, please.

So just a couple of quick follow-ups for me. Just to your bio supplies, I noticed there is not a huge amount of conversation just in the presentation today, I'm wondering what the kind of driver of that year-on-year volatility is? How we should think about that line item going forward? And then just secondly, you kind of mentioned the expansion of IG going forward to other indications to drive growth. Just wondering if you mean this primarily for SCIG or in line with the Phase II for dry eye disease, if you've got a relatively good roster of indications to continue to expand your IVIG franchise into just kind of how we should think about that pipeline opportunity for IG going forward?

As per bio supplies, Charles, I think that we haven't provided specific numbers. This is a business unit that is quite complementary for both biopharma and diagnostics as we use those products and to complement customers in those markets. It's very much driven by the needs that the biopharma and diagnostic have, and based on that it keeps developing. I think we're still expecting growth in that business unit this year versus previous year and working towards that.

And as it comes to IG moving forward, the biggest opportunity in size in these are indeed secondary immune deficiencies, an area which in the U.S. is still not in the label and where we see tremendous growth based on the occurrence of cancer and obviously, the advent of hematology treatment that require IT treatment. So we're very excited about the opportunity to educate positions there and help ensure that patients suffering from secondary immunodeficiency actually get access to our medicine. In addition, as mentioned before, we have for our subcu the CIDP indication, which will be important. And we have a range of life cycle management programs that will strengthen our brand offering for Xembify, which we're very excited about. When it comes to the dry eye disease opportunity, we're very excited about bringing IG to this completely new field with intraocular formulation there. It's an exciting growth opportunity for the long term. But as you think about the IG market as it stands today, the key drivers are SID and CIDP.

Let's move to the next and probably last question from JB Capital. Joaquin, please.

Yes. A quick one from my side. Just on the alpha-1 specialty proteins, it has performed fairly well this quarter. I just wanted to be more information on if the growth was coming more from alpha-1 or from the [ rabies ] and other specialty proteins. And if it was from alpha-1, is it coming from a bit of gaining market share, pricing or just having more patients? And what can we expect for the coming quarters and years levels around similar to this quarter? Or more towards previous quarters, which was more towards low single digits.

We don't provide detailed results for each one of the alpha-1 versus specialty proteins, but suffice to say that we were pleased with growth in each one of these. And as you zoom in on alpha-1, we're obviously happy to see how we're progressing with the change of our specialty pharmacy provider in the U.S., which allows us to bring to the market a stronger offering for our patients. And you touched on share, you touched on price and you touched on patients, which all three are part of our plan to continue to grow this brand. And notably, in an area where 85% of patients still remain undiagnosed and where we are leaning in to see that we can help diagnose these efforts and does help grow the market in the U.S.

Thank you so much, Roland. It was our last question today. Thank you very much for having us. If you have any further questions in the coming days, please feel free to reach the IR team. Thank you so much.

Hello, everyone. My name is Danny Segarra, and myself as the Head of Investor Relations and Sustained and Vice President, Grifols. Welcome to our review of the company's Business Results for the First Quarter of 2025. Today, I'm joined by Grifols Executive Chief Executive Officer, Nacho Abia; Chief Financial Officer, Rahul Srinivasan; and the President of Biopharma, Roland Wandeler. A few logistics before we get into details. Today's call will last about an hour, including a Q&A session. As a reminder, this call is being recorded. You can find additional materials, including today's presentation in the Investor Relations section of the Grifols website at grifols.com. The transcript and a replay of the webcast will also be available on the Investor Relations website within 24 hours. Turning to Slide 2. Please note that this presentation includes forward-looking statements regarding, among other things, the company's future operating and financial performance, market position and business strategy. These statements are based on current expectations and available information as of the date of this recording and they are subject to certain risks and uncertainties that may cause actual results to differ materially from those projected. All financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions including alternative performance measures or APMs, prepared under the group's financial reporting model as defined by the European Securities and Markets Authority. Please note that Grifols management uses APMs to evaluate financial performance, cash flow and overall financial position as the basis for operational and strategic decision-making. These APMs are prepared for all time periods presented in this document. Now moving to today's agenda. Nacho will start with some introductory remarks, followed by a discussion of our business performance and strategic execution. Then Rahul will review the financial results for Q1 2025. After Rahul's presentation, we will return to Nacho for his closing comments. Roland will be joining us for Q&A. With that, I will now turn the call over to Nacho. Nacho?

Thank you, Danny, and thank you, everyone, for joining us today. Building on the all-time high in 2024, we are pleased to report a strong start to 2025. The first quarter saw encouraging increases in revenue, EBITDA and free cash flow. This performance reflects the fundamentals of our business and the continued execution of our strategic plan. We recognize that this growth is particularly noteworthy given the anticipated impact of the inflection reduction at IRA and the global uncertainties we all are navigating. Despite these factors, our Q1 results across the board are ahead of our plan and importantly, provide a solid foundation for continued progress throughout the year. Although the first quarter has traditionally been our softest, our Q1 performance reinforces our confidence that we will continue to see steady improvements over the course of 2025 similar to the pattern we observed last year. I will walk you through these drivers in the next slides to give you more clarity about how we plan to achieve it. Before we delve into the details of the quarter, I would like to briefly highlight that in recent weeks, we have been closely monitoring the increasing macroeconomic and policy development that is affecting all market participants. While we strongly believe we are well prepared to navigate these dynamic market conditions without meaningful impact, we remain vigilant and continue to carefully evaluate the situation. We will share as well more insights on this throughout the presentations. Ultimately, our focus remains firmly on executing our strategy, staying true to our mission ambition and delivering on our performance goals. I want to express my sincere appreciation for the vacation of our teams across the globe. Their commitment to driving our strategy forward and serving donors and patients worldwide has been critical to our positive start to 2025. With that, let's move to the first quarter results in Slide 5. Before I go through this slide, it is important to note that in order to provide the market with a clearer view of the underlying performance of Grifols and biopharma in particular, we are presenting key financial metrics for this quarter and for the remainder of the year in two ways: Reported and like-for-like. Like-for-like figures are adjusted to account for the impact of the IRA Part D redesign and the fee-for-service reclassification. As a reminder, in Q4 2024, we changed the treatment of our U.S. fee for service and GPO fees. These fees are now accounted for in our gross to net sales rather than in OpEx, which has no impact on EBITDA. The full 2024 impact of this change were reflected in Q4 '24. And as a result, it distorts the biopharma revenue growth in our 2025 quarterly results. In Q1 of this year, the difference between our like-for-like and reported figures amounted to EUR43 million. Of this, EUR28 million was attributable to the IRA in line with our forecast while EUR15 million was related to the fee-for-service reclassification. Revenue in the quarter was a key highlight, reaching EUR1.786 billion, a 7.4% increase on a constant currency basis. On a like-for-like basis, revenue increased by 10%, showing a clear continuation of the positive revenue growth trend we saw in 2024. Adjusted EBITDA for the quarter reached EUR400 million, an improvement of 14.2% at constant currency. Like-for-like, it grew by close to 22%. The revenue impact, along with some temporary phasing in albumins and rabies put some pressure on our gross margin and EBITDA in Q1 '25. Going forward, we remain confident of our continuous improvement of our margins throughout the year, following same pattern than in previous periods. Free cash flow for the quarter was negative EUR44 million, primarily due to the payment to ImmunoTek for EUR79 million, as previously disclosed. While free cash flow was negative this quarter, we achieved a year-on-year over improvement than more than EUR200 million. Considering our first quarter performance, we see these as clear signals for continued upward momentum in top line growth, profitability and free cash flow generation. While we maintain our strong commitment to further deleveraging our balance sheet. In terms of guidance, we are forecasting sustained revenue growth throughout the year, driven by our immunoglobulin franchise with significant growth in the U.S. as well as outside the U.S. We expect our subcutaneous immunoglobulin to continue gaining traction and contributing to the product mix. Our revenue projections are also supported by the improved performance of rabies and albumin as the phase in reported in Q1 '25 will not carry into subsequent quarters. We also see our alpha-1 franchise continuing to show positive momentum following a new specialty pharmacy partnership in the United States. Equally important will be the contribution of lower cost of goods as the cost per liter initiatives and the yield improvement efforts has been delivering and improving our inventory cost. Additionally, our revenue increases throughout the year, it will trigger a higher absorption of operating expenses, thus having a significant positive impact on our EBITDA. Finally, let me emphasize that this business momentum is not only reflected in the quarter's positive results, but also underpinned by increased plasma capabilities and efficiencies, along with the successful completion of key innovation milestones, including fibrinogen, which we expect to launch in Q4 '25 in Europe and in the first half of 2026 in the United States, following its FDA approval. With that, I will turn to the top line comments on Slide 6. Year-to-date revenue increased by 7.4% on a constant currency basis, driven by robust performance across all business units. Excluding the impact of the IRA and the reclassification of our fee for services, revenue grew by 10%. The sustained momentum was primarily fueled by biopharma, which like-for-like grew by 9.6% on a constant currency. The immunoglobulin franchise continue to be the cornerstone of our growth strategy, achieving 17.5% growth in revenue at constant currency and like-for-like. This growth was led by IV and subcutaneous IG as I will explain in a second. Alpha-1 continued to improve in Q1, reversing the challenges faced in prior quarters when the company switched its U.S. alpha-1 major distributor. While biopharma posted a strong overall performance, it was partially offset by some phasing in albumin and rabies. Albumin was impacted during the quarter by a standard license renewal process in China, which has been successfully completed allowing for the resumption of shipment as plan. The diagnostic business achieved a 5.2% increase in revenue on a constant currency basis this quarter, due to a broad expansion across both core and non-core markets as well as a strong joint business volume growth. Key segment, including Molecular Donor Screening and Cell Donor Screening and blood typing solution each grew by 7%, 12% and 4%, respectively, all on a constant currency basis. As I previously mentioned it, biopharma continued to be the main growth driver in the first quarter of the year. The IG franchise remains the leading growth protein. IVIG growth was fueled by a strong demand in both U.S. and international markets. While subcutaneous IG continues to gain momentum, growing an impressive 91% at constant currency, driven by higher demand across all key regions. As mentioned, albumin sales growth was temporarily affected due to the manufacturing license renewal process in China. This resulted in a decline of 8.9% on a like-for-like basis and 9.4% on a reported basis. As said, the renewal process has been successfully completed, and accordingly, we expect a stronger outlook in revenue performance in the upcoming quarters. Albumin remains a key component of our portfolio, and we expect to continue to leverage our partnership in China with Shanghai RAAS and Haier to continue strengthening our position. Alpha-1 and specialty proteins revenue growth improved by 2.3% at constant currency and like-for-like compared to the previous year. This growth was driven by alpha-1, continuing the traction seen in the last quarters. Although it was partially offset by the phasing of demand for rabies treatment, which, as already mentioned, will reverse in Q2 2025. Turning to next slide, I'll take a closer look at the performance and outlook for our IG franchise. As we highlighted during our Capital Markets Day, Immunoglobulin remains the cornerstone of our biopharma business, driven by the status and our highest as our highest growth protein. This is evidenced by the strong underlying demand for both intravenous and subcutaneous therapies. Our strong growth and solid market positions have enabled us to capitalize on several market -- favorable market trends, including increased awareness of immune-related diseases, rising diagnosis rates and the ongoing expansion of both secondary and primary immune-deficiencies. Additionally, the continuous development of therapeutic solutions in areas like neurological diseases presents further opportunities for growth. We remain focused on executing the strategy outlined for biopharma, building on our leading brands, accelerating the diagnosis rate and solidifying our leadership position in the market on the back of increasing global demand for the treatment of immune efficiencies, followed by a steady increase in albumin and alpha-1 antitrypsin and other specialty plasma-derived therapies. Let me discuss now our situation regarding recent tariff developments and our confidence that previous stem investments protect us well in the current environment and the latest developments in U.S. drug pricing policy. For decades, Grifols has developed a diversified global footprint of plasma donor centers, manufacturing facilities and distribution hubs across key geographies, ensuring we are strategically located to serve patients where they need us. Our growth strategy has been investing in regional end-to-end capabilities that allowed us to adapt the process in response to evolving global demand. This vertical integrated and cross license structure provides ball flexibility and optionality to meet global needs with minimal disruption, while significantly mitigating advertising from potential tariff impacts. In the United States, our comprehensive end-to-end supply chain is a key strength. Plasma collected at over 300 U.S. donor centers accounts for approximately 70% of our global plasma supply. This is then processed at our fractionation and purification facilities in Clayton, North Carolina and Los Angeles, California, which together represents about 65% of our global capacity in these critical areas. This alignment between our U.S. collection and manufacturing operations, minimize reliance on external sourcing and allows for agile responses to changing needs. Our presence in the Europe and the Middle East is also significant with nearly 100 plasma collection centers, paired with our manufacturing facilities in Spain, Germany and Ireland. Our European plasma collection network, the largest privately owned fleet, coupled with our expansion in Egypt, positions us well to serve increasing demand of side of the U.S. Consistent with our global strategy, we continue to invest in local partnerships to directly address regional needs. In China, our local strategic partnership with Shanghai RAAS and Haier combined with our European manufacturing capabilities enable us to leverage a local presence and respond swiftly to regulatory developments. In Egypt and Canada, we are investing in greater self-sufficient partnership with the Egyptian governor and Canadian Blood Service, respectively. In both countries, we're establishing donor centers and manufacturing capabilities to support local health care ecosystems for the long term. This established global network of donor centers, manufacturing, testing sites and distribution channels provides Grifols with a degree of resilience across core border macroeconomic, political and environmental talent uncertain, including tariffs. To reiterate, we do not anticipate any meaningful impact to our business due to tariffs as we believe this strategic approach has positioned us well to effectively serve patients globally and navigate the evolving geopolitical and fast-changing landscape. Since the early 2000, recognizing the scale and importance of the U.S. market, we began strategic investments, starting with the acquisition of plasma centers and manufacturing assets, establishing our presence as a U.S. manufacturer. In 2011, we expanded further with the acquisition of Talecris in North Carolina, and we have since grown our plasma collection network through acquisition and organic investments. At the same time, we're strengthening our European footprint by expanding manufacturing in Spain and increasing our capacity for fractionation, immunoglobulin, alpha-1 and albumin in purification. We also expanded our European plasma center network, primarily in Germany through joint ventures and organic growth. This was further consolidated with manufacturing operations in Ireland and the acquisition of a majority stake in Biotest in Germany. In 2019 and 2020, Grifols Pioneer, local partnership models in emerging markets. We deepened our presence in China through a strategic alliance with Shanghai RAAS allowing self-sufficient initiatives in Egypt and Canada. In both countries, we're building plasma collection and manufacturing capabilities to meet local demand. Together, these investments set the foundation for our next phase of growth and innovation, positioning Grifols to continue benefiting patients, both in the U.S. and international. Finally, earlier today, the U.S. administration announced its intention to reintroduce a most favored nation MFM policy, which aims to align U.S. and ex U.S. drug prices. Well, this is a recent announcement, and we don't have all the details. There are some observations I would like to consider at this point. First, plasma-derived therapies are different than regular drugs in its cost structure. We saw that this was recognized in the past in the U.S. as they were excluded, for example, from IRA direct price negotiations and as well as in the first proposal of the MFN where IG was explicitly excluded. We will continue to educate policymakers on the importance of access to plasma-derived therapies for U.S. patients. With respect to global pricing, price point for plasma-derived therapies are much closer than for many other pharmaceuticals. And part of the limited price difference is due to the higher cost of U.S. plasma compared to other markets. And finally, we have a diversified product portfolio and offering across different markets, which further help us to mitigate any potential impact. In any case, we will closely monitoring the developments and share any relevant updates in our forthcoming quarterly calls. So with that, I will turn it over to Rahul, who will walk us through our financial results. Thank you.

Thank you, Nacho. Indeed, we have highly dynamic forces impacting markets. Equally, as you say, we are very fortunate to have a business that benefits from significant strategic flexibility and optionality that allows us to navigate these highly dynamic markets very well. Notwithstanding the backdrop, the entire Grifols team has been resolutely focused on execution and executing well. And thereby delivering for our patients and our customers. And in doing so, we remain on course to continue our record financial performances of 2023 and 2024 and into 2025, having delivered in Q1 2025, the best Q1 in Grifols' history. Moving on to Page 12 for the more detailed picture. Our Q1 numbers are ahead of plan across the board, beating revenues, EBITDA, free cash flow, margins and leverage. As Q1 is our seasonally weakest quarter, we thought that the relative performance to our internal plan for the year would be helpful to the market. But I also want to make it clear that we will not be making reference to our plan or the relative performance on any of our subsequent quarter calls. In addition, and as we did with our approach to laying out our full year 2025 guidance and the impact of Part D redesign within the inflation Reduction Act during our Capital Markets Day, we are disclosing both our reported numbers as well as like-for-like numbers that allows the market to track more easily our underlying performance and momentum versus 2024, given the impact of IRA. And as you will recall, the gross to net reclassification that we made in Q4 last year. Reported revenue for the quarter grew by 7.4% and by 10% like-for-like, both on a constant currency basis. Reported Q1 gross profit margins were higher than Q1 2024 and despite the impact of the IRA and the fee-for-service reclassification. The corresponding like-for-like margin improvement of 150 basis points clearly shows the continuing gross margin improvement potential. Reported adjusted EBITDA was up by 14.2% on a constant currency basis and adjusted EBITDA margins improved by 80 basis points to 22.4% in on a year-on-year basis and considerably higher on a like-for-like basis. Profit before tax and group profit are up by 145% and 179%, respectively. Free cash flow pre-M&A had a year-on-year improvement of EUR209 million, and I will elaborate on the drivers of this considerable improvement further in the presentation. And unlike prior years where leverage tended to increase in Q1, we were able to delever in Q1 '25 and more on that later in the presentation. Finally, liquidity continues to be in a very robust place at EUR1.7 billion. All in all, a strong performance across the board delivered Grifols’ best Q1 performance ever. Slide 13. Having hit our revenue and earnings trough post-COVID, Grifols has delivered very strong and consistent growth across revenues and earnings. Indeed, the last two years have delivered record revenues and EBITDA, and Grifols very much remains on course to beat those records again in 2025. The rapid growth of revenues, adjusted EBITDA and reported EBITDA quarter-on-quarter is evidence of the secular growth in biopharma and our strong position in this attractive market. We at Grifols are particularly proud of the sequential improvement in LTM margins be it adjusted EBITDA or reported EBITDA margins. And as a team, we remain very focused on executing well and thereby continuing this trajectory for the quarters, if not years, to come. In particular, the 430 basis points improvement in LTM reported EBITDA margin and an almost $500 million increase in LTM reported EBITDA circa $1.2 billion to $1.7 billion in just six quarters speaks to the normalizing earnings profile after the impact of a once in 100-year pandemic event and the clear reduction in one-off non-recurring costs as well as the continued and rapid convergence of reported EBITDA to adjusted EBITDA. If you look at Page 26 in the Annex, you can see further evidence of this convergence as the delta between adjusted EBITDA and reported EBITDA margin more than halved in Q1 '25 versus Q1 '24. Indeed, if you look at the two EBITDA charts on Slide 13, it clearly shows that reported EBITDA lags adjusted EBITDA by only two quarters, providing clear evidence that adjusted EBITDA is a very good proxy for Grifols' very near-term cash EBITDA potential. Slide 14. Adjusted EBITDA in Q1 '25 grew by 14.3% year-on-year. Just to contextualize that performance, EBITDA is growing almost twice as fast as revenues has been the case in '23 and '24. And depending on which end of the guidance range you use, our EBITDA is growing almost twice as fast as the growth implied by our EBITDA guidance for '25, which, as you will recall, is on a post IRA basis. And hence, our reference to the Q1 performance being ahead of plan probably will not come as a surprise to the market. Despite the circa 140 basis points negative impact on our margins from IRA, we delivered a year-on-year adjusted EBITDA margin improvement of 80 basis points in Q1 '25. I will not belabor the even more impressive stats of the like-for-like adjusted EBITDA performance as we absorb the IRA impact but it certainly should give the market an appreciation for the underlying demand and the secular growth tailwinds led by our biopharma business. And it was particularly pleasing to see that revenue and earnings growth across all segments, including the strong revenue and EBITDA momentum that we are observing in our Diagnostics business. On the biopharma side, the growth drivers of the strong performance in the quarter are consistent with our observations in prior calls. Strong diversified growth across regions in IG, both U.S. and ex U.S. that, as you heard from Nacho, is clearly outpacing the market. And due to the planned phasing impact as a result of our albumin license renewal in China, we would expect stronger albumin revenues in the upcoming quarters. Same holds true of alpha-1 and other proteins, particularly if we take into account the seasonal demand for our rabies product. We continue to squeeze CPL with lots of focus from the team on efficiency gains and we remain encouraged about the outlook. And speaking of efficiency gains, the team is excited about the manufacturing yield improvement potential as well as moving the mindset to our cost per gram of protein and not simply cost per liter. And finally, ensuring we capture as fully as possible the operational leverage improvement potential that comes with the strong growth prospects whilst maintaining tight cost discipline. The last point I'd like to flag on this slide is the IRA adjustment. The EUR28 million was our accrual for Q1. We have had the benefit of receiving our first invoice and it was in line with our expectation, giving us confidence that the EUR125 million midpoint of our range remains a prudent estimate. Slide 15. An update on our free cash flow generation improvement efforts. As a reminder, following our significant outperformance of free cash flow generation in 2024 versus prior guidance, we laid out much more detail around our prioritization of free cash flow generation as part of our strategic plan. And the significant $209 million free cash flow improvement in Q1 '25 versus Q1 '24 is further tangible evidence that the result from Q4 2024 was not a flash in the pan, but that this business can absolutely produce significant free cash flow as the effects of COVID period recede further and further into our rearview mirrors and that we expect to be able to continue to demonstrate strong momentum in free cash flow generation in the quarters and years ahead. And this EUR209 million year-on-year improvement credibly underpins our free cash flow guidance for 2025. Also, I wanted to touch on why Q1 tends to be our weakest free cash flow quarter. It is for two principal reasons. Firstly, it is our weakest EBITDA quarter partly due to seasonality, and it tends to be sandwiched between two relatively strong quarters. And secondly, this is the quarter when the bonus payment for the year is made. Working capital management continues to be at the heart of our free cash flow improvement. Our inventory days in Q1 '24 was unnaturally high, but Q1 '25 continues the trend of the last four quarters. As we guided to during our Capital Markets Day, I do expect us to invest more capital to bolster our inventory position further, given the strong demand that we continue to see, but we will continue to manage that tension diligently. Our receivable and payable days are settling down or normalizing, if you will, and continue to be in line with the last couple of quarters. The other notable part of our improved free cash flow generation is more EBITDA and further benefited by less cash adjustments as the effects of restructuring and transaction costs begin to dissipate as we have guided to previously. Finally, for the eagle eye amongst you the phasing impact of interest and CapEx offset each other in Q1 '25. So this EUR209 million year-on-year improvement is not simply down to timing or phasing differences but it is real improvement. Slide 16. As our free cash flow generation story normalizes, it also helps our deleveraging profile. In prior years, Grifols leverage typically increased in Q1 by up to half a turn or so. In contrast, due to the normalizing of our free cash flow story as evidenced by the sequential improvement you see on the chart on the right and continued strong year-on-year EBITDA growth instead of leverage going up meaningfully in Q1, we have, in fact, delevered slightly from 4.6 times to under 4.5 times. And this deleveraging focus will remain a clear priority for us. Aside from the positive deleveraging, I continue to feel very good about the state of our balance sheet. We have strong EUR1.7 billion of liquidity. We have a lot of rainy day secured capacity if we ever need it. We have no meaningful maturities until Q4 2027 and we have a very encouraging rate outlook supporting our refinancing plans in Q2 or Q3 2026. The private placements we placed around six months ago are yielding meaningfully less than they were issued at, which suggest that our credit rerating focus continues to gather momentum. In summary, all progressing very positively on this front, too. Slide 17. At a time of significant change from a global macroeconomic perspective to be able to provide the market with the confident message that we are providing today is helped significantly by the Grifols legacy and its pioneering spirit that has allowed us to be at the forefront of this attractive market. For many years, indeed, decades, as Nacho mentioned, before us, Grifols has developed a global yet very local strategy, essentially an in-market, for-market vertically integrated strategy and pioneering various regions self-sufficiency aspirations and with it, highly critical regional partnerships. That gives us today a highly strategic portfolio with somewhat unique optionality and flexibility to be able to effectively navigate all the changes that are appending global markets and global supply chains and also be in a position to capitalize on opportunities that these potential changes might create. Clearly, this remains a fluid situation. But our assessment is that we are navigating these changes from a position of strength and we will continue to monitor the detail closely and adapt if we need to, even if for the moment, our assessment is that we are not expecting any meaningful negative impact on our business. With respect to euro dollar, critically, a depreciating U.S. dollar is broadly neutral to positive from a group profit, leverage and free cash flow standpoint. This is as a result of the natural hedges embedded in our business model. For example, a significant proportion of our COGS, our OpEx, our CapEx, our inventory, our debt are all U.S. dollar-denominated. Yes, a structurally weaker dollar does pose a headwind in absolute revenues and EBITDA, even if it is positive from a margin standpoint. So in summary, we are not overly concerned about a depreciating U.S. dollar. And as a result of the strong momentum and outlook that Nacho and I have talked about, notwithstanding the macroeconomic backdrop, we reaffirm our 2025 guidance, and we remain on course to deliver a third consecutive record year in 2025. Finally, on Biotest, the delisting offer has been approved by BaFin and the offer period runs through until early June. And therefore, we are progressing as planned with this offer being financed from existing resources consistent with the capital allocation framework we presented at our Capital Markets Day. With that, let me hand it back to Nacho for his concluding remarks.

Thanks, Rahul. I would like to conclude this call reiterating a few points that we have already made, but I think it's worth repeating. The first quarter of 2025 builds upon the strong momentum achieved in 2024, laying a solid foundation for the remainder of the year and demonstrating the operational resilience of the organization. Even in dynamic markets, we're executing the road map outline in our strategic plan, and that roadmap is delivering results. Improving free cash flow generation and continuing to deleverage remain top priorities for the company. These are not merely financial objectives. They are central to our strategy. We are seeing tangible progress and we'll continue to embed financial discipline across the company. These financial improvements cannot be achieved without the substantial progress we have made in operational excellence and R&D, which continued to be the key drivers of profitability and sustained performance. As part of the execution of our strategic plan, we are also advancing our initiatives around corporate simplification and portfolio optimization. These efforts are progressing and are critical to unlocking operational efficiencies and sharpening our focus on the core areas where we can lead and win. We are committed to building a simpler, more agile and more focused organization that is best positioned to capture opportunities and respond swiftly to evolving market dynamics. At the same time, our regional business model continues to provide a strong buffer against global uncertainty. By sourcing, manufacturing and distributing locally, we maintain a structural advantage in navigating tariffs and other external pressures across different markets. Finally, as we look ahead, the entire executive team as well as the entire organization are focused on accelerating the execution of the company's operating plan on operational excellence on cash flow improvements and debt reduction. And ultimately, on increasing value for all shareholders. The foundation is solid and the opportunity in front of us is nothing short of outstanding. Thank you again for your continued support. And with that, Danny, back to you.

Thank you, Nacho. Now let’s turn to Q&A session. [Operator Instructions] If I'm not wrong, I think that our first question is coming from Charles Pitman from Barclays. Charles?

Hi, guys. Thanks so much for taking my questions. And two, if I may. Just firstly, to your point about doing Grifols business structure is protected from ongoing U.S. policy discussions. I was just wondering if you could give us a little bit more transparency around what Grifols exposure is and what the split is across Medicare Part B, D and Medicaid, just to kind of give us a little bit more to work with when considering these potential impacts regardless whether it then turns out the plasma therapies are excluded. And then just secondly, with regards to the albumin phasing noted in the release today, I was wondering if you could provide a little bit more detail on what the implied underlying growth looks like in this market, excluding the disruption? And what kind of led to the unexpected delay given this risk wasn't flagged ahead of results. So effectively just any more confidence you can give us on the strength of the albumin market generally. Thank you.

Thank you, Charles. This is Nacho. On your first question, I mean, honestly speaking, I think that it's really too early to make any conclusion whatsoever. I think that for the reasons I explained previously in my presentation, I believe that we are well positioned face whatever will come in the most favorite nation. But we have to see the details of that and how this unfolds. On the tariffs, I think that I also made clear that our presence in the U.S. is very solid and essentially self-sufficient there. So we don't see, at this point, any impact as well on that front. So that's what I can say on the first point. On the second point, I mean, the albumin license renewal is something that was planned is something that happened every certain time. And this doesn't change our goals for the year. And our goals for the year is that we plan to grow albumin by 5%, 6%, and we continue on that path after the resumption of the shipments after the license approval. Thank you, Charles.

Thank you, Nacho.

Thank you, Nacho. Now, I will ask Jaime from Santander, Jaime Escribano.

Hi, good afternoon. So a couple of questions from my side. The first one would be, when do you expect revenues coming from Canada? Are you already making revenues in the new facility there? Or what is the road map? So that would be one question. And the second question would be regarding fibrinogen. So do you produce fibrinogen in Europe? Or you should buy this or are you going to produce it in the U.S.? I'm also thinking on the tariffs and how is this product being produced? Thank you very much.

The first question, I think that it will be taken by Nacho.

Yeah. On the Canadian side, right? So our presence in Canada goes back many years. I mean that it's not thanks to the agreement with Canadian Blood Services for self-sufficiency. Clearly, our partnership there positions us very well in a market which is very significant in the world. We will be producing -- I mean, number one, we are increasing the number of donor centers in agreement with Canadian Blood Services and we plan to manufacture products in Canada. That will definitely improve our presence in the market and let us capture even a higher presence in that market. So it's already happening as we speak, and it's more to come over the next years. As per fibrinogen, the plan is to start the production of fibrinogen in Germany as in the Biotest facility, but later on to move that production to the United States to our Clayton facility. That's the current plan for that. Thank you, Jaime.

Thank you so much, Nacho. Now it's time for Graham Parry from Bank of America. Graham, please.

Hi. This is Charlie here from Bank of America. A quick question on alpha-1, please. Could you provide a ballpark number of your alpha-1 revenues? And then how would you quantify the potential risk to that from an accelerated approval for INBRX-101? And secondly, on the contribution of alpha-1 on to your midterm guide, what do you reflect in terms of the potential competition from in INBRX-101? And does your midterm outlook assume success of the SPARTA and SOPKA trials. Thank you.

Well, we don't disclose the alpha-1 revenues. I mean we share it together with specialty proteins as well. So we don't disclose that number. Regarding the potential impact of in two weeks, this has been fully vacant in our long range plan that was presented in the Capital Markets Day. And this was in the best possible case for Sanofi that will be that the launch will happen in 2027 as it was previously announced. This still have to be confirmed. But in any case, for our long range plan, it is included, and we are considering a potential impact of that. But obviously, we will work to mitigate through our SPARTA trial and other measures. But as I say, this is the worst-case scenario for us, and this still needs to be confirmed. Anything that will delay that approval will be an upside on our loan range plan. And maybe Roland wants to add something to that?

Well, the one thing to keep in mind for us is that alpha-1 is an area where patients continue to be highly underdiagnosed and undertreated. About 15% of patients only are treated. And what we do expect is with increasing awareness with new options for patients and also with increasing needs for screening, that the number of diagnosed and treat patients will increase. So what we have in our plan is on one hand, a significant growth in treated patients and market that we see. And within this growth of the market, we have, of course, also from a risk-adjusted perspective, assumed appropriate uptake for new entrants.

Thank you very much, Roland. Alvaro Lenze from Alantra. The floor is yours.

Hi, thanks for taking my questions. I just wanted some clarification on the U.S. dollar impact. I was quite surprised to see that you expect neutral to potentially even positive impact, i.e. I would understand that just the translation would have a negative impact. And it was also my understanding that you have less debt balance in U.S. dollar compared to the business exposure you have there. So I would have expected potentially a negative impact on leverage because your profits fell more than due to the translation on your debt falls translation. So if you could clarify that would be very helpful. And the second question would be, looking at your EUR28 million impact. And you mentioned your -- the first invoice has been in line with expectations. Could we narrow down the expected IRA impact for 2025 to roughly EUR110 million? Or are you still uncertain and I prefer to stick to the 100 to 150 range you provided at the CMD? Thank you.

Thanks, Alvaro. On the U.S. dollar impact, the guidance that we've provided, we -- I just repeat it, which is broadly neutral to positive from a group profit, leverage and free cash flow standpoint, right? And part of the reason for that is the embedded hedging that we have within our operations. You may look at our revenues and say, hey, where we've got 70% or 60% of our revenues in U.S. dollars. But at the end of the day, you've got to also factor into that our COGS our OpEx, inventory, U.S. dollar denomination as you think through all of those various layers, and the sensitivities that we've run some pretty aggressive sensitivities, we feel pretty good about that guidance that I've just provided. So I'll leave it at that. With respect to your second question on the EUR28 million IRA accrual and the first invoice being in line with our expectations. As I mentioned, we believe that the midpoint, which is what we guided to during our Capital Markets Day, if you remember the slide, we talked about the EUR125 million impact. I believe that EUR125 million remains a prudent estimate based on what we've seen so far. But look, we've got one data point, and I -- we will continue to update the market. And most importantly, we'll continue to be completely open with our numbers so that you guys can factor that impact in. But our -- I'll just repeat our confidence around the EUR125 million prudent estimate statement that I made in my prepared remarks.

Thank you, Rahul. Thank you, Alvaro. The next question is coming from Guilherme from CaixaBank.

Hello, thank you for taking my questions. Just one still on the executive order, if possible. Could you at least reconfirm your exposure to Medicare and Medicaid post adjustments that you expect for this year? And then the second question, could you provide a bit more color on the significant step-up quarter-on-quarter in SG&A that we've seen this quarter? Thank you.

Okay. Roland is going to take the first question. And then the second question is going to go for Rahul. Roland, please.

Yeah, as Nacho said before, we don't provide specific breakouts of Medicaid or Medicare. But just for everybody to remember, a significant part of our use is in commercial patients. And as we look at Medicare, we actually have a mix of Part B and Part D, which puts us in a more device for position. And as Nacho also emphasized, we will continue to educate the plasma-derived therapies are different from biopharmaceutical drugs. And we saw that this was recognized in the past. We see that looking across the world, price points are closer than what you see with general drugs. Lastly, we believe that we have a product portfolio that provides us with a differentiated offering across the world. So looking at all of that, we do, at this point, not expect any negative business impact from any executive order into 2025.

And then your comment on SG&A. Part of it relates to the reclassification in Q4 '24, if I followed your question correctly. And again, as part of revenue going up, our SG&A as a percentage of sales obviously gets correspondingly impacted. And we've also got the fibrinogen launch as we think about working towards that just from an SG&A and OpEx standpoint as well. So I'll leave it at that, Guilherme.

Thank you so much, Rahul. Now we have a second round of questions. Charles, please, Charles Pitman from Barclays. Okay. It seems that Charles is not on the line. Jaime Escribano from Banco Santander.

Yeah, hi. A couple of follow-up questions from my side. So maybe just to get some color on what's going on in IVIG and subcutaneous. So both growing really well. Also your peers [Indiscernible] also posting strong growth. And at the same time, Argenx also growing very fast. So I would like to hear what's your conclusion? Why is everybody seems to be growing so fast, if you can give us some hints on that? Second question, regarding the donor fee. If you can give us also some guidance on what is the pricing right now per dollar if it keeps going down? And is this also a driver for the gross margin? And finally, if I can say a final one, which is very quick because I think you will not answer, but I will try. If the Biotest bid is not successful and hence, you don't spend this EUR300 million, EUR400 million indeed. Would you use this proceeds to, for example, buy Hema BPC. Thank you.

The first question will be taken by Roland.

I will take it actually on the Ig side in two parts. First, looking at subcue Ig which in the U.S. is approved for primary immune deficiency, we are truly very encouraged with the momentum that we see as Nacho and Rahul explained in the 90s for Q1 and last 12 months, close to 70% like-for-like. This reflects uptake by prescribers in the U.S. from our focus that we have in the field, but also the profile of XEMBIFY, which is very well appreciated by HCPs around the world and our launch momentum ex U.S. We still have significant opportunity ahead here. And as we continue to gain share in PID and we expand our indication for XEMBIFY in the U.S. with our CIDP and SID label. On the CIDP side, which is where your question comes in with Argenx. Indeed, we continue to be very encouraged with the performance that we see for our Ig there. We see that the uptake for orgenx has been mostly been in the second line. And recently, we also saw a number of patients actually switching back to IVIG after a trial of FcRns. And from what we hear from opinion leaders and what we see with our own brands where our governments continues to grow in this indication, we remain very confident in our first-line position for Ig and the growth potential I had -- this reflects the fact that CIDP is a multifactorial disease. It reflects the fact that Ig is ideally suited with its polyvalent mechanism of action to treat the disease it reflects a long-standing experience and also, of course, the access hurdles which are lower than perhaps for some other new entrants. So from that perspective, we continue to be very encouraged. And the growth that you see I think reflects just the potential that you have in these diseases in channel. CIDP as primary mental efficiency or second immune deficiency was underdiagnosed, undertreated with increased awareness, we see that more patients get the benefit and we are very glad that we can provide our medicine to these patients.

Let me comment on the donor fee and then Rahul will comment on the Biotest question. We continue working on the donor fee and mostly in two fronts. And we have been seeing positive evolution, and we think that the positive evolution will continue. I mean, first of all, in the whole donor experience, right? So we are working in matters from smart compensation and different activities to attract donors to our centers and to finalize them in the centers. Well, at the same time, we are working on the rollout of the individual nomogram that is now present in 60% of our donor centers. And we are planning to continue to roll out through the year. I mean these two initiatives in both fronts and contributed nicely to the donor fees in a way that it's a win-win for Grifols and for the donors, right? So I think that I think we strongly believe that this has to be in the benefit for both sides, and that's in the line that we are working for. On the Biotest, Rahul will comment.

Look, on the Biotest, as I mentioned, BaFin have approved the delisting offer and the offer period runs through until early June. And I'm not going to speculate on take-up or not of the Biotest offer. Relating to your -- the extension of that question was if there wasn't for whatever reason, take up on that Biotest offer, would we apply that towards Hema BPC? We laid out a very clear capital allocation framework at our Capital Markets Day that envisaged Hema BPC, bringing that back within the group and making that acquisition or exercising that option during the course of probably Q2 of 2026 or thereabouts, maybe into 2027, and that remains our plan. We were -- no change in that respect.

Thank you so much, Rahul. It seems that Charles Pitman from Barclays is back. Charles, please go ahead with your question.

Hi, guys. Can you hear it? Hopefully, you can. Just first question on pricing. Can you provide detail on the pricing differential of your products in U.S. and ex-U.S. regions? Secondly, on margins, what proportion of collected IG is being fractionated for XEMBIFY and what portion of Ig do you expect that to account for over time if actually what do you see as the future balance between SCIG and IVIG? And then just finally, a quick one. Can you give us any quantification of the phasing impact of the rabies on the other in specialty EG? What was the underlying growth in alpha-1? Thank you.

Yes. Roland, please?

Yeah, on the pricing differential, we will not disclose the details here. What we can say is that after the pandemic, we have seen prices actually come up in Europe and other parts of the world and getting closer to U.S. and as Nacho mentioned upfront, different from other -- many other biopharmaceutical drugs, price points are actually much closer in plasma-derived therapies. On the margin side, basically, the question goes at the share of subcue versus IVIG. Here, similarly, we don't disclose the details. I think what we can say is that we are closing in. Where in the past, I think we once made a statement that we were mid-single digits. I think we're closing in on high single digits at this moment with a lot of potential because from everything where we stand and the feedback that we receive we don't see why our subcue chair in the market would not be at the same level as our IVIG share is at the moment. And as Rahul mentioned, we see that we're actually growing ahead of the market in both subcue and IVIG. And lastly, on facing impact on rabies, something to keep in mind is that due to the nature of rabies where exposure happens in nature, this is much higher in summer, Q2, Q3 than Q4, Q1. And year-over-year, that's where small volume differences in purchasing in a Q1 can just translate into relatively high relative differences on a year-over-year basis.

Thank you so much. The next question is coming from Alvaro Lenze from Alantra. Alvaro, please.

Hi, thanks for allow me back in the queue. Two questions. I understand why the market is growing for Ig, but you wanted to now if you could give us some more color on why are you outpacing the market? Is it better pricing than competitors, more product availability or better clinical outcomes? And the second question is, if you're going faster than initially budgeted, and you do not expect a negative impact from the dollar and are quite confident on the limited or no impact from tariffs and so on. Why not raise the guidance for 2025? Is it that you're just being extra cautious? Just to get a sense of your thinking process there. Thank you.

Thank you. Roland will take the first question, and then Rahul will take on the guidance for the year.

Alvaro, on the IG side, we believe that we are very well positioned to serve patients in this market, in this growing market because there's more and more patients that finally do get access these diseases are undiagnosed or undertreated. This comes from the brands that we have, Grifols has over the last decades developed brands that are very well received in terms of the tolerability and the efficacy results by health care professionals. And we are building on these brands. It reflects the increased focus that we have been able to bring to the market over the last years, where we see that especially in the U.S., the growth actually is driven by end user uptake, which is very encouraging. And so with those two, both our portfolio that we have as well as the focus in the field, combined with our ability to supply this puts us just in a good and strong position to benefit from the secular growth that you have in the Ig side.

And on your question on guidance, let me just repeat what I said on the dollar depreciating dollar. A depreciating dollar is broadly neutral to positive from a group profit, leverage and free cash flow standpoint. Yes, a structurally weaker dollar does pose a headwind in absolute revenues and EBITDA, even if it is positive from a margin standpoint. Back to your question around why if we're ahead of plan, why are we not raising guidance. We are in Q1. We are in the middle of a macroeconomic or tariff diplomacy that is causing the world to spin in ways that we've not imagined. And we've got violent sometimes currency moves. And so for -- at this point in time, Alvaro, I think it's prudent from our standpoint to maintain guidance, and we feel pretty good about that. So I'll leave it at that for now, Alvaro.

Thank you so much, Rahul. With that, we are ending the Q1 '25 call, just to say thank you very much for hearing us today. Thank you.

Hello, everyone, and welcome to Grifols' Full Year 2024 Financial Results Conference Call. My name is Daniel Segarra, and I'm the Head of Investor Relations and Sustainability. Today, I'm joined by Grifols' Chief Executive Officer, Nacho Abia; Chief Financial Officer, Rahul Srinivasan; and the President of Biopharma, Roland Wandeler. Today's call will last about an hour, including a Q&A session. As a reminder, this call is being recorded. All materials used during the call are available on the Investor Relations website at grifols.com. Moving to Slide 2, I will first like to share a disclaimer on forward-looking statements. Forward-looking statements are subject to substantial risks and uncertainties. They are only valid on the day of the call, and the company is under no obligation to update or revise them. Grifols' financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions. This includes alternative performance measures, also known as APMs, prepared under the group financial reporting model as defined by the guidelines of the European Securities and Markets Authority. Please note that Grifols' management uses APMs to evaluate its financial performance, cash flows and financial position as the basis for its operational and strategic decisions. These APMs are prepared for all time periods presented in this document. On today's call, Nacho will start with some introductory remarks, followed by a discussion on business performance and strategic execution. Then Rahul will walk us through the financial results for Q4 and full year 2024. 2025 guidance will be addressed in detail during tomorrow's Capital Market Day. After Rahul's remarks, we will hand it back to Nacho for his closing comments. With that, thank you very much for joining us today. Nacho, over to you.

Thank you, Danny, and good evening, good afternoon, and good morning to all of you depending on where you are in the world. I appreciate you joining our full year results call. It is my pleasure to share with you the completion of a year marked by meaningful accomplishments but also notable challenges for our company. 2024 has not been an easy year for us. We navigated a complex environment that challenged all of us to overcome several obstacles. However, we remain focused on executing our strategy, upholding the mission and vision of the company and delivering on performance. For these reasons, I'm particularly proud on our team's unwavering focus and dedication throughout 2024. Their hard work and commitment enabled us to achieve record results while continuing to drive our strategy forward. Today, we will review these achievements, the key drivers and financial metrics behind our performance and outline our priorities for achieving sustainable growth in the upcoming years. Tomorrow, February 27, the company will host its Capital Market Day in London, where it will be a great opportunity to hear from Grifols' leaderships on the company's strategy and vision for the future and also about our guidance for 2025. Turning to Slide 5, as I already mentioned, 2024 presented many challenges. Despite this, the company continued implementing its strategy across the organization. This is reflected in our strong business performance, reinforced financial position along with changes implemented at the governance level. On the fundamental level of the business, we closed a landmark year by outpacing market growth, driven by robust underlying demand and our strong Biopharma franchise. This solid business momentum was underpinned by increased plasma capabilities and efficiencies and the completion of all key 2024 innovation milestones. We have reported improvements across key financial ratios while prioritizing free cash flow generation and deleveraging. Both Q4 and full year 2024 revenues and adjusted EBITDA reached new all-time highs. At the same time, we significantly strengthened our balance sheet through the Shanghai RAAS asset sale, organic deleveraging and enhanced liquidity. We continue to reshape the company with a strengthening corporate governance and leadership team. The Board was expanded with additional members who brings a broad range of expertise and experience, reflecting an ongoing determination to the best practices. As we announced yesterday, Thomas Glanzmann will retire from the Board, and Anne-Catherine Berner will be nominated to become the new chair after the AGM in June. Anne joined as an independent director a few months ago, and I look forward to working with her to continue enhancing and strengthening our governance. I want to take this opportunity to thank Thomas for his continued support and great contribution to Grifols over 2 decades, and specifically for his strong support to me during the last year. Thanks for everything, Thomas. You will certainly be missed. In parallel, the leadership team continue to evolve. Recent appointments of executive to key organizational position reflect our focused efforts to bring in top talent, blending fresh perspective with invaluable experience of internal leaders. These governance and leadership efforts has been -- has also been closely linked with our continuous improvements in sustainability, which is a fundamental aspect of our corporate and business activities. In 2024, we advanced our sustainability agenda, and this is reflected in Grifols being ranked the #1 biotech company in the Dow Jones Best-in-Class Indices and recognized as a 2025 Industry Top-Rated Companies by Sustainalytics. Shifting our focus to financial results in more detail. In Q4, we were able to continue building on the strong momentum and closed the year on a high note. Revenues in the fourth quarter totaled to nearly EUR 2 billion, representing a 13.6% increase on a constant currency basis compared to the previous year. These full record full year revenues, which reached EUR 7.2 billion, representing double-digit growth of 10.3% at constant currency over a record 2023. Adjusted EBITDA for the quarter reached EUR 526 million with a margin of nearly 27%. Full year adjusted EBITDA came in just shy of full year guidance but exceeded market consensus, reaching EUR 1,779 million, an all-time record high for the company with a 24.7% margin. Regarding free cash flow, I want to emphasize the clear commitment and consistent execution we have demonstrated in this area. The sustained generation of cash flow has been a key milestone of our financial performance this year. Thanks to our strong business fundamentals and conservative financial approach, free cash flow for the quarter further improved to EUR 335 million, and this contributed to a strong year-end result of EUR 267 million, far exceeding our initial guidance for the year. As we continue to view cash flow generation as a cornerstone of our strategy, Rahul will shortly provide a more in-depth analysis. In parallel, we have continued to execute our disciplined approach to balance sheet strengthening and financial management. We have continued our organic deleveraging path, reducing our leverage ratio to 4.6x, a significant improvement over 6.8x in Q1 '24 just 3 quarters ago. Additionally, we have conducted a series of capital market transactions that have helped us to refinance our debt, address near-term debt maturities and enhance our liquidity position. Turning to top line results. I will share the drivers to a positive performance. As reported, our total revenue grew by 10.3% at constant currency in 2024. This growth has continued escalating from 9.3% in Q2 to 12.4% in Q3 and to a remarkable 13.6% in Q4, all on constant currency basis. This acceleration was steered by Biopharma, growing at 15.1% for the quarter and 11.3% in the year. Our Biopharma business and more specifically, our immunoglobulin franchise continued to be the cornerstone of our growth strategy, with double-digit growth driven by IVIG and subcu IG. Demand remained robust as immunoglobulin reinforced its position as the standard of care, which lead us to anticipate continued strong demand. Albumin also delivered a solid performance as we continue to see demand across China and the U.S. The long-term agreement with China through Shanghai RAAS reinforces our position in this important albumin market. Diagnostic, we saw a 2% decline on a constant currency basis for the quarter, resulting in a 0.7% increase year-to-date. Diagnostic remains a key contributor to our business and even more important to our cash flow as we maintain our leadership position and strengthen our presence in core markets. We remain confident in the future of Diagnostic as we are implementing our strategic plan. Biopharma remains an attractive business with high growth potential. The rising demand for plasma-derived therapies is clear, given the amounts of undiagnosed patients within our core markets and clear potential for new indications and proteins. Our Biopharma business continued to be the main growth driver in the fourth quarter. Robust underlying market demand, coupled with improved commercial excellence enabled us to improve our sequential performance and growth compared to previous quarters with a 15.1% increase in the fourth quarter and 11.3% year-to-date growth. Immunoglobulin continues to be our highest growth protein, reflecting increasing demand for both intravenous and subcutaneous therapies. Sales of IVIG had a strong quarter, growing at 15.6% and closed the year with [ 15.6% ] growth, driven by a strong performance in the U.S. and international markets. At the same time, subcutaneous immunoglobulin sales demonstrated exceptional growth, expanding by 56% in the year at constant currency, driven by successful launches and continued traction in key global regions. Meanwhile, albumin demand remained steady with full year growth of 8%, both at constant currency, driven by consistent demand in China and the U.S. Alpha-1 and Specialty Proteins continue with solid results, improving for a year-to-date growth of 4.9% at constant currency. The U.S. Alpha-1 franchise continued recovery momentum following the transition of the specialty pharma distributor while demand for rabies continued solid to the quarter. Our global diversified plasma footprint continues to enhance supply reliability, drive efficiencies and support sustainable long-term growth. In the recent years, we have strategically expanded our donor center footprint globally. Alongside, we have continued efforts to amplify network efficiency through implementing integrated new technologies and process improvements to optimize collection and manufacturing. Through targeted operational efficiencies, we have streamlined our organization and enhanced donor center operations, leading to consistent reduction in our cost per liter. Simultaneously, we have optimized donor compensation models to balance cost efficiency while maintaining laser focus on donor experience. As part of our efforts to continue generating efficiency in our plasma optimization strategy, our core initiative is the individualized nomogram rollover, which is already implemented in approximately 60% of our U.S. donor centers. This initiative is designed to improve donation quality and donor satisfaction while increasing plasma volume per donation. With a strong execution plan in place, we are currently on track to fully improve nomogram U.S. adoption, further enhancing our collection capabilities. On the manufacturing side, we continue to deliver sustained yield improvement, maximizing the output from each liter of plasma collected, which remains a critical lever in ensuring a reliable and cost-effective supply. Turning to Slide 10. Innovation remains a fundamental pillar of our long-term strategy, and 2024 was a year of substantial progress in research and development. As I noted earlier, we achieved all innovation-related milestones, reinforcing our commitment to bringing transformative therapies to the market. The most recent update within our pipeline is the progress of fibrinogen. After the success of the AdFIrst clinical trial showing positive top line study results released in February 24, the required regulatory filings were completed in both Europe and in the U.S. The FDA has since accepted our BLA filing and granted a PDUFA date for December 27, 2025. We expect the first country's approvals in United -- in Europe and thereafter in the United States. In advance, we are on track to share the study results shortly as we have engaged with several relevant stakeholders in the scientific landscape. We also released the completion of our PRECIOSA study. Although the trial did not meet its primary endpoint, an improvement in transplant-free survival, mortality and disease-related complications was observed for patients. Further, a notable improvement in time to liver transplant or death at 3 months was observed for the study treatment. We continue to work on analyzing the full results and we'll present them during the first half of the year. Finally, as I speak through innovation, as a fundamental pillar, I want to highlight that Grifols received a grant from The Michael J. Fox Foundation for Parkinson's Research to identify plasma-based biomarkers that could indicate a personal likelihood of developing Parkinson's disease many years before clinical diagnosis. The initiative we call Chronos-PD would accelerate the discovery of new diagnostic tools as well as the identification and development of novel disease-modifying therapeutics. These advancements demonstrate the strength of our innovation pipeline and our dedication to improving patient outcomes. And with that, I'll turn it over to Rahul who will walk us through our financial results. Thank you.

Thank you, Nacho. As Slide 11 says, it has been a strong finish to a second consecutive record year, a performance that we are proud of, notwithstanding all the challenges faced by the company in 2024. Let me also take the opportunity to thank all our colleagues for their amazing work in 2024, keeping their eye and efforts resolutely focused on delivering for our customers and patients while serving our donors. We often talk about the Grifols spirit internally. This collective performance in 2024 exemplifies this Grifols spirit, and I am proud to be a part of this awesome team. Moving to Page 12. Before I go into our Q4 and full year financial performance in 2024, please consider 2024's relative performance to what was already a record financial performance in 2023. Q4 2024 was the best quarter in our history. In fact, our 4 best quarters ever have all come in the last 5 quarters and our Q4 performance versus our prior record Q4 2023 performance shows the continuing strong momentum we have, significantly outgrowing revenues and adjusted EBITDA by 13.6% and 18.5%, respectively, on a constant currency basis. The cherry on top of this performance was the significantly improved free cash flow generation pre-M&A of EUR 335 million this quarter. And I will expand on the drivers of this performance further in the presentation. With respect to our full year performance, very strong momentum in revenues, up 10.3% on a constant currency basis to EUR 7.2 billion, well ahead of guidance, led by Biopharma that was up 11.3% on a constant currency basis over our prior record year in 2023, with our international business growing significantly and further diversifying our strong Biopharma business alongside our U.S. business that also delivered a strong Q4. We are growing meaningfully faster than the market. 2024 adjusted EBITDA was up 21% on a constant currency basis and adjusted EBITDA margin improving by 230 basis points, having improved 160 basis points in 2023. And also pleasing to see that momentum come through in net income that was up over 270% even if it is coming from a low base and fully acknowledging that we have more work to do to fulfill our potential at that net income level. Clearly, the standout performance was our significant beat at the free cash flow level, confirming our strong conviction around Grifols' ability to generate free cash flow, and we are confident around our ability to ramp up this free cash flow generation meaningfully over time. On leverage, at 4.6x, it may seem that we fell shy of the 4.5x expectation, but that does not reflect the full story. The rapid strengthening of the U.S. dollar in Q4 created a headwind for us from a balance sheet translation perspective, which would ordinarily be more than offset by the positive impact at EBITDA level if the strengthening had happened, say, less rapidly over the course of the year. Adjusting for this releveraging as a result of the rapid dollar strengthening, our leverage would have been, in fact, come inside the 4.5x guidance. You can see our rapid deleveraging progress in the last 4 quarters from 6.8x in Q1 to 4.6x at the end of Q4. The leverage indications here, consistent with the way we have shown it in the past, is defined as per our credit agreement. And as I had guided to in Q3, our secured leverage now is at only 2.7x. That is the lowest I recall Grifols' secured leverage ever been. And finally, I feel very good about our liquidity position coming into 2025. Slide 13. The consistency of the performance across the board and across every metric shows the fundamental health and momentum in the business. Quarterly revenue growth going up from 5.5% in Q1 all the way up to 13.6% in Q4, quarterly EBITDA margin improving from 21.6% by 500 basis points to 26.6% in Q4, quarterly free cash flow pre-M&A progression allowing us to convincingly beat our guidance. And on the leverage front, other than the Shanghai RAAS disposal impact on metrics in Q2, the deleveraging has been organically driven by the significant growth in adjusted EBITDA and free cash flow pre-M&A performance. Simply put, it has been a terrific year, led not only by actions from the business during the year but also actions from the past bearing fruit. And we look forward to taking this momentum into 2025 and beyond whilst dealing with the headwind of the Inflation Reduction Act in the U.S. Slide 14. The simple message from this slide is that adjusted EBITDA is coming through in reported EBITDA rapidly, often within 6 to 9 months, and I expect this convergence to continue, particularly as we focus on reducing the cash adjustments between adjusted EBITDA and reported EBITDA. And the momentum in reported EBITDA is even more satisfying, having grown 32% versus our prior record year in 2023. Reported EBITDA margins grew 380 basis points in 2024. And the drivers for adjusted and reported EBITDA growth are CPR reduction, volume growth, yield improvement and continuing operational leverage and cost discipline. In terms of the main adjustments between adjusted and reported EBITDA, the main cash adjustment relate to one-off restructuring and transaction costs, so pretty identifiable and then being exceptional and one-off, and on noncash adjustments principally related to Biotest Next Level and impairments. Slide 15. We see the clear evidence on the left-hand side of this slide of the operational leverage improvement I referred to on the prior slide, where OpEx as a percentage of sales has declined to 21% in 2024. As I mentioned on the Q3 call, we believe that there could be further squeezing of those OpEx margins possible, and we do intend to use some of that benefit to keep our R&D effort invigorated. I would also like to update you on a change in our treatment of our U.S. fee-for-services and GPO fees. In line with market practice, these fees will be accounted for in our gross to net sales rather than in OpEx, which will have no impact on EBITDA at all. The full year impact of this change was made in Q4 2024, and as a result, it will distort the revenue growth profile somewhat in the coming quarters. Conversely, we have more work to do on the gross margin front, which is just as exciting as we think about opportunities to continue our EBITDA margin growth in the coming years. And we believe that returning to pre-COVID gross margins is achievable, driven by further planned CPL reduction, commercial growth efforts across the board, new product launches, including fibrinogen and Yimmugo and due course trimodulin, our yield improvement efforts and continued execution of the plan at Biotest. More on this as part of our value creation plan at our Capital Markets Day presentation tomorrow. Slide 16. This slide shows our quarterly evolution of free cash flow pre-M&A. We had a very strong finish to the year, generating $335 million of free cash flow pre-M&A, culminating a year with sequential improvement of free cash flow each quarter. A couple of points to flag on this slide. One, the sequential improvement of free cash flow pre-M&A in 2024 is a coincidence. But it is fair to assume that Q1 tends to be our worst quarter being meaningfully negative from a free cash flow generating perspective before turning in subsequent quarters. The second topic I want to touch on was the key drivers behind our free cash flow outperformance in 2024 versus our prior guidance at the beginning of 2024. Two principal drivers for the outperformance: one, unusually inventory evolution in 2024 released capital rather than consuming capital. And this was due to, a, some of the structural improvements in inventory that I will touch on, on the next slide; and b, we have been much more aggressive in our management of inventory. And again, we will see that on the next slide. Second driver being a rationalizing and rescheduling of CapEx that isn't time critical, ending up spending meaningfully less than our guidance at the beginning of 2024. Third point, I would caution against run rating Q4 cash flows or indeed the free cash flow conversion achieved in Q4. We finished 2024 with a free cash flow pre-M&A to adjusted EBITDA conversion of 15%, and we will share with you tomorrow our expectations to improve that during the course of our 5-year strategic plan. Fourthly, the benefit of having Diagnostic in our portfolio, given its high free cash flow conversion is very clear. And the final point I'd make here is that this business can absolutely produce a meaningful amount of free cash flow whilst continuing to support the capital needs of the business to be able to not only capture the highly attractive and secular top line and profitability growth opportunities but also continue to develop our product portfolio to deal with any competitive threats over the medium to long term. Based on all the actions taken in the past, both during the course of 2024 and earlier, it is clear that we have a number of levers to deliver progressively stronger free cash flow, and we will talk about that further in our Capital Markets Day tomorrow. Slide 17. On the left-hand side, we show the evolution of our inventory days and the annual consumption or release in capital relating to inventory. The combination of lower inventory days and capital invested in inventory declining from 2022 and the exceptional capital release from inventory in 2024 are for the following reasons: CPL continuing to reduce nicely over the period; inventory levels improving, normalizing, implying less need to invest capital to replenish inventory levels; an improvement in balancing the liter; yield improvements, essentially being able to do more with less. In the case of 2024, a very strong sales push across the year and end-to-end supply chain management with respect to inventory. In our efforts to demonstrate more quickly our ability to unlock free cash flow generation pre-M&A, we have pushed this lever hard and it shows us the art of the possible. That being said, we will resume our investment in inventory from 2025 onwards and balance being efficient with our inventory levels while ensuring we have the right inventory to satisfy the strong and growing demand for our products. And you will hear from us tomorrow our plans for 2025 and beyond with a balanced approach. On the right-hand side, this chart includes all our CapEx and capitalized IT and R&D over time. And the expectation remains that current elevated levels as a percentage of revenues will subside over the coming years. And tomorrow, we will provide guidance on how to view our spend in absolute numbers as well as the implied percentage of revenues that will show a meaningful normalization in the coming years. We are in an industry that has secular high growth rates, one that benefits from high profitability levels with strong prospects for free cash flow generation pre-M&A. This is the lens through which we need to view our investment in inventory and CapEx and capitalized IT and R&D to capture these phenomenal opportunities. Slide 18. Hopefully, this slide speaks for itself with respect to the underlying momentum behind the normalizing of free cash flow generation pre-M&A as we compare 2024 to 2023. This slide also shows the different phases of our inventory evolution since the pandemic, where 2023 being the last of the years where exceptional capital investment was required in order to replenish our inventory to more normalized levels, and 2024 significantly benefiting from some of the factors I mentioned in the prior slide, including continued CPL reduction, strong sales growth in 2024 and a more aggressive end-to-end supply chain management with respect to our inventory. We continue to feel positive about improving free cash flow generation from EBITDA growth, subsiding levels of CapEx and capitalized IT and R&D over time, reducing cash-outs from transaction and restructuring costs and, over time, reducing our cash interest. More on that when we present our strategic plan tomorrow. Slide 19. Our balance sheet derisking is substantially progressed, and our continued focus on organic deleveraging will complete this process. The significant debt reduction achieved by the Shanghai RAAS stake disposal coupled with the strong deleveraging resulting from the 21% growth in our adjusted EBITDA, together with the meaningful outperformance of our free cash flow generation pre-M&A, has taken leverage down from 6.8x in Q1 to 4.6x at the end of 2024, as we mentioned previously, with our secured leverage being at what I think is at an all-time low of 2.7x. Add to that the leverage-neutral refinancing we executed in December 2024, after which our next set of meaningful funded maturities is not until Q4 2027. And finally, a significantly improved liquidity of EUR 1.9 billion by the end of 2024. Our balance sheet is in a strong position, and I have no concerns at all about any refinancings as and when they come due as evidenced by the 2 private placements this year. Our key focus will be to optimize the conditions of the refinancing, and we can do that, given our strong re-rating potential amongst using other levers. And finally, we have a syndicate of global banks that have supported our extension of the RCF, and I am very pleased with the high quality of the syndicate. So to summarize, we have a strong finish to a second successive record year, and we have made significant progress on critical fronts, be it the meaningful outperformance on free cash flow generation pre-M&A or the substantial derisking and strengthening of our balance sheet. We will stay resolutely focused on execution and driving the business forward. Notwithstanding the headwind of the Part D redesign in the Inflation Reduction Act, we look forward to updating you tomorrow on our strategic plan as well as sharing our expectations for another record year in 2025. With that, let me hand it back to Nacho to wrap it up.

Thanks, Rahul. I would like to wrap up the presentation with some final remarks. Reflecting upon 2024, we continue to position Grifols for long-term success. 2024 has been a pivotal year to ensure sustained growth and operational excellence. Our commitment to disciplined capital allocation, strategic expansion and enhanced efficiency has created a stronger foundation for the future. We are proud of the achievements that have positioned the company for continued success. We have shown resilience and delivered record-breaking financial results, strengthening our operational framework and advancing our innovation pipeline, all while reinforcing our financial foundations. These accomplishments are a direct result of dedication, expertise and perseverance of our global team. Executing on our strategy and operational improvements have delivered continued savings and efficiencies. We maintain financial discipline and agility, and we are optimizing cash flow generation with a sharp focus on deleveraging to further strengthen our financial position. Additionally, our ongoing yield and manufacturing improvement and transformation programs and enhancing our operations while continuing to drive down cost. Looking ahead to the keys to our continued future success and growth, we must remain highly focused on executing upon our strategy. That's crystal clear. We hit all-time highs this past year but that only sets the stage for us to expand this improvement into 2025. We'll provide a clear road map tomorrow with a midterm strategic plan that will show how we will deliver sustainable growth and margin expansion over the next years. We will keep free cash flow generation and deleveraging as a top priority, and last, maintain the momentum gained through our commitment to best-in-class in sustainability. I want to stress that we, as an organization, are not anywhere where we still want to be. We are just beginning on this path. As we move forward, we remain committed to better deliver long-term value for our shareholders, partners, donors and the patients who rely on us. Before we open the call for questions, I'd like to remind everyone that Grifols will be hosting its Capital Market Day tomorrow, February 27 at 1:30 p.m. London time. We hope you will turn in to learn more about our plans for the future and our strategy for achieving long-term success. Thank you again for your continued support. And with that, Danny, back to you.

Thank you, Nacho. Now let's turn to the Q&A session. [Operator Instructions] Our first question comes from Morgan Stanley. Thibault, please?

First question just on the growth of immunoglobulin. It's been quite a strong growth acceleration for the year. Just if you could comment if the current plasma collection capacity and current level of inventory would allow you to continue that type of growth trajectory or [indiscernible] high growth.

Just hold on a second, Thibault. Can you go through it again, please?

Yes, sure. So my first question is just on immunoglobulin. Very strong growth through this year. Just if you could comment on your current situation in terms of inventories and also plasma collection capacity, if you can sustain that growth going forward, or if we should expect, in particular, CapEx -- more CapEx investment in order to support that growth? So basically kind of the current state of your capacity to support that. And then just a question on the pipeline. So clear progress on fibrinogen. Just wanted to know if you could give us an update on trimodulin, which was the other protein that was the center of the Biotest acquisition. And when we can see an update here?

Thank you, Thibault, for the question. I'll answer the first part and Roland will comment on the trimodulin. As for the capacity of the company, I think that you will -- if you tune in tomorrow for the Capital Markets Day, we'll definitely share more information. But what I can tell you right now is that the company has been doing the homework in the last years and our -- we are well prepared both from a donor center's capacity and also from manufacturing capacity for the future. I think that the next year are in a very solid position, which means that essentially, the next wave of significant CapEx to expand our manufacturing footprint or the donor centers will not come in the next 3 to 4 years. Then is the time that we will need to entertain significant CapEx again. But obviously by then, our position will be different than today. But for the next years, we are well set. And tomorrow, we will share more information about that. As for trimodulin, Roland will comment.

Yes, Nacho. Trimodulin, which is our polyclonal antibody preparation including IgG, IgM and IgA, we continue with our Phase III study. We recently amended the protocol for updates in standard of care after COVID, which we believe positions us in a better place to have comparable data for the future. The program is continuing. We are looking at an interim analysis that we're expecting in the first half of 2026. Needless to say that we remain very excited about the potential that trimodulin could bring for the treatment, not only for sCAP, which is the lead indication but also for infections beyond that. And we'll be happy to explain that in more detail tomorrow.

Thank you, Roland. Very clear. Thank you, Thibault. Now let's move to Tom Jones from Berenberg.

My first question is just on revenue per liter trends. You mentioned in your prepared remarks that some of the benefit you saw in Q4 came from improved revenue per liter. I was just wondering if you could kind of drill down a little bit more on that because it seems with IVIG significantly outpacing the growth of everything else. Revenue per liter is probably going to be -- if that carries on, you're going to get progressively more unbalanced revenues per liter. And you don't really make a lot of money just selling IG from a liter of plasma. So beyond perhaps the recovery in Alpha-1, is there anything else you can point to beyond new products where you will seek to try and improve the revenue per liter or at least stop the -- or offset the disproportionate effect, the very rapid growth in IG has versus the other proteins? So that was question 1. And then second, too -- question 2, I was just wondering if you might be able to share what the impairment related to that you took in Q4, that would be great.

Starting with your question on revenue per liter. Important to highlight that we always aim to balance the growth in IG with the growth that we have on the albumin side. And looking at last year, we definitely were able to sell the equivalent amount of albumin, which obviously helps just as the basis of the plasma economics in addition to the additional proteins that you mentioned. And the other part to highlight is that we have seen, in the course of last year, an improvement in yield for IG, which further strengthens, of course, our revenue potential per liter in addition with our work to gain traction in the U.S. and expanding globally. And perhaps the last point I want to make on the IG front is that we see very strong momentum with our subcu IG, Xembify in the U.S., that we have at a premium price, which also helps us on the pricing side. So looking across, that -- those are the drivers that translated into higher revenue per liter last year.

And the question on impairment, relatively small. I think there's roughly about $25 million or so split between a small impairment at Grifols for something that is not publicly disclosed, but it's a tiny part of our health care services business. And then there's another portion within Biotest, again, relatively small numbers, Tom, so nothing I would -- but happy to pick it up in detail offline if you'd like to.

Okay. Thank you very much, Rahul. Now I mean Alvaro from Alantra.

The first one is on gross margin. I see on Q4, in particular, it's down both in year-on-year and quarter-on-quarter terms. If you could explain what could have happened there. Of course, that has been offset by lower SG&A cost because EBITDA margin is up, but just to understand the gross margin dynamics. Second question, Rahul, I believe, mentioned significant impact from FX on net debt because I believe from September to December, the dollar appreciated by 5%. So could you quantify the impact because when I try to reconciliate the net debt evolution compared to the EUR 333 million free cash flow you provided in Q4, I estimate an impact of roughly EUR 300 million, which to me would seem too much for the FX impact. If you could clarify that, it would be very helpful. And I will jump back for follow-up questions.

Sure. So your question on gross margin. So if you go to Page 31, you actually see an improvement of gross margin by roughly about 100 basis points versus 2023 driven by lower plasma costs. Most of that margin improvement actually coming from Biopharma by, I think, about -- up about 170 basis points or so. And drivers are lower plasma costs, U.S. CPL down quite nicely, higher volume and revenues, which is always helpful. And then we had some negative effects going the other way. One other thing that I would also say is that I made reference to the change in fee-for-services and GPO. That also has a negative impact on gross margin by roughly about 60 to 80 basis points as well. So in reality, it could be higher than that. So that's the question on gross margin. Your question related to the translation impact. As you know, we've got a reasonable portion of our debt that is denominated in U.S. dollars. So a significant strengthening of the dollar creates a translation impact. And if it's a rapid one, in this case, it actually creates a releveraging impact because ordinarily, strengthening of the dollar is actually deleveraging because of the significantly improved impact at the EBITDA level. So in terms of quantifying, as I mentioned to you, if it wasn't for that strengthening, we would be between 4.4 and 4.5x so just inside the 4.5x guidance that we had provided previously.

Thank you, Alvaro, for placing these 2 questions. Now I would like to get James Gordon from JPMorgan.

James Gordon, JPMorgan. First one was just free cash flow generation, as you mentioned, is a lot better this quarter, so strong in Q4. But in terms of phasing, so is working capital -- have you made quite a lot of the near-term progress already there? Or do you think there's still quite a lot more to be done near term? And just connected with that, the extraordinary growth CapEx was only EUR 20 million this quarter. So is that a helpful phasing benefit but it just means you're going to have more still to come next year or actually you're doing a bit less extraordinary growth CapEx? So how much extraordinary CapEx is there still out there? And how much of it have you burned through? And then the second question, there were some useful comments about gross margin. But one question I've had about for many companies is about what tariffs could do. So in terms of tariffs, if there is -- it looks likely now a 25% tariff on product that comes in from Europe into the U.S. Are you still doing quite a lot of fractionation in Barcelona and then that product is imported into the U.S.? How would that work? So if there is a 25% tariff on anything that comes from Barcelona into the U.S., how much of your U.S. sales would that impact?

I'll take the tariff one and Rahul comment on the free cash flow and extraordinary CapEx. On the tariff, obviously, we -- the situation right now all over the world, I would say, I would call it fluid and moving. So I think we have to be prepared and we are. So I think our company situation in this front is quite safe from the point of view that we have a large fractionation capacity in the United States and that we collect most of our plasma from the United States, too. So yes, we still have some fractionation or significant fractionation in Barcelona. But definitely, if the tariff would become in place, I mean, we might need to make some adjustment to the supply chain, but we are in a position to do it because of our capacity in the United States, both from a plasma generation and from a fractionation capacity. So we are good in that front. As per your second question or your first question, Rahul will comment now.

Thanks, Nacho. Your question about extraordinary growth CapEx. So if you go to Page 18, James, what you'll see is that for the full year, we ended up with extraordinary growth CapEx of EUR 276 million. And on our Q3 call, I believe I had guided to EUR 280 million. So the phasing is entirely as we expected. With respect to your question around inventory and free cash flow and more to go, as I mentioned in -- earlier in my piece, there are a number of structural reasons why 2024 was very positive for us and I touched on all of those. I think it was on Slides 17 and 18. And I also reiterated our expectation that we will begin to invest in net working capital and inventory from 2025. And I will touch on that in more detail at our Capital Markets Day tomorrow.

Thank you very much, Nacho. Thank you, Rahul. Now let's move to Santander. Jaime, your turn, please?

So a couple of questions from my side. Can you tell us how is the donor fee evolving on whether there is further downside potential there? And also maybe you can comment on how is the plasma collection growing? What is the strategy here to grow more in line with the sales, accumulate and collect more and have more inventories? And maybe a final one, if I may, competition from CIDP, Argenx, what are the dynamics you are seeing in the market?

Thanks, Jaime, and I'll take the first -- the comments on the plasma and Roland will elaborate on the CIDP. I mean, the donor's fees is a matter that has become quite complex and dynamic over time. I think that there is more and more smart compensations methodologies being applied, which represent a win-win for the donors and the company. And I think that it's -- the evolution is not a linear evolution anymore. And I think that we could see situations where -- and that's our goal, that we can offer a good proposition to the donors while still being efficient in the utilization of our donor centers. And this answers partially your second question, right? From a plasma collection point of view, our donor centers, as for the coming years, as I mentioned before, we don't see an expansion in donor centers because our installed base is sufficient. And we have significant capacity still in the existing donor centers. So our focus is going to be to work with the donors to incentivize well the donors and increase the plasma collection in the existing centers. And we have that capacity. And definitely, it will come without any requirement for significant CapEx in this area, at least in the next 3 years. As for CIDP, Roland will comment.

Yes, for CIDP, we have seen some use of the FcRn blocker mostly in second-line patients for the few patients that do not tolerate or do not respond to IVIG. But important to note that we have not seen any impact on the momentum on our side when it comes to CIDP. And in fact, as you know, CIDP is a disease that still remains undiagnosed and where we see that increasing awareness is helping us to treat more patients. It is a disease that is multifactorial, which means that a range of mechanisms play a role. And it's a disease where IVIG with its ability to actually attack all of these different mechanisms remains and is the first-line treatment. And this is what we hear back from thought leaders. So to summarize, yes, some uptake, no impact on our momentum, and we remain very confident in the role as first-line treatment of IVIG moving forward.

Thank you very much, Roland. Very clear. Thank you, Nacho, and thank you, Jaime. Now I would like to hear from Guilherme from CaixaBank.

So the first one is still on gross margin. You mentioned the 60 to 80 bps impact in terms of gross margin due to the difference in accounting. If you could clarify if this is for the full year, I assume so. And if you could provide the figures specifically for Q4 just for us to have a comparability with Q3 margin. And then related to that also, if you have any ballpark figure on what level of cost per liter decline since June '22 peak is already reflected in margins. This is on gross margin. Then if you could provide a bit more detail on the drivers of albumin growth slowdown this quarter would be great.

So on gross margin, the impact we're talking about is roughly EUR 50 million. And essentially, all that does is it reduces your net revenues by that amount and it reduces OpEx. So no impact on EBITDA and the impact on gross margin is somewhat indirect as a result as well, right? So that's how you get to those numbers. So hopefully, that addresses the first point. Your second question was on -- yes, cost per liter. Look, I don't think where we provide views on pricing of that cost per liter evolution. Suffice it to say that it continues to be a very healthy trend, and we continue to feel pretty encouraged about where we can take that cost per liter and create the win-win situation that Nacho mentioned earlier on. And so we still feel very encouraged about that. On albumin, Roland?

I'm looking at albumin, our Q4 in terms of volume was actually our highest quarter this year. So this is just a year-over-year comparison with a very strong Q4 that we had last year.

Thank you, Roland. Thank you, Guilherme. Now I would like to get from Charles Pitman, Barclays.

Just one quick kind of clarification, I apologize if this is a simple question, but just on the reclassification of the change of treatment of fee-for-services, can you just give us a little bit more detail around what drove this change? Like what does this mean for your recorded sales, COGS and SG&A? And why, if this was an industry standard, is this not -- was that not part of your prior reporting? And then just secondly, within the kind of IVIG, SCIG mix and how you've been performing over the course of this year, I was wondering if you can just give us a little bit more detail on what it is you're doing to continue to grow share. And maybe if you could just touch a little bit more on the kind of CIDP relative threat that you're seeing. I understand that's more second line, but given Xembify is, I believe not approved for CIDP and this is a kind of subcut maintenance in the second line, is there an element here that actually Grifols' IVIG treatment is a little bit more shielded from this new competition of [indiscernible]. Love your thoughts on that.

Sure. Let me take the first one, and Roland will finish the part of that first question before addressing the second one. So it relates to fee-for-services and GPO fees. And one of the things that I was trying to do when I got in, in Q4 was essentially try and do a detailed benchmarking and understand essentially where the upsides and downsides were across the business. And one of the things that came out of that exercise -- these are not big numbers, one of the things that came out of that exercise was that we were putting through OpEx these fees when a number of our competitors put it out as a reduction of sales. It's not a positive change in some respects but it's a more realistic change. Why do I say it's not positive? Because it actually impacts our growth rates quarter-on-quarter going forward. But what I wanted to try and do is understand really is are there -- is there further upside on the OpEx as a percentage of sales? And this came out of that analysis. So relatively simple. In terms of what it exactly is, Roland will touch on that in terms of fee-for-service and GPOs before addressing the second question. Roland?

Yes, not much to add. It's just a general fee-for-services that you have in the U.S. and the GPO, group purchasing organization fees, that in the past, we classified as OpEx. That's just now going into the gross to net. And I think it's a standard, as you say, throughout the industry. Going to your questions around subcu IG, yes, we are absolutely excited with the momentum that we see very much so in the U.S., and you're right, our indication at this stage is in primary immune deficiency. We see that our brand is highly valued there by prescribers. We see that our messaging is resonating very well. And we are investing, obviously, with our efforts on the commercial side to continue that momentum. In parallel, in the U.S., we're advancing our study to get the CIDP indication for Xembify as well, which will position us for growth. In Europe, we are still in an early stage of launching Xembify, and we have a number of upcoming launches that will further expand our footprint there. And then lastly on CIDP, yes, correct. In the U.S., we don't promote Xembify for CIDP. And from that side, yes, you could argue that the PID part, of course, would not be impacted. But I think beyond that, it's just important to highlight that we have a lot of confidence on the first-line role of IG treatment in general in CIDP with growth potential beyond.

Okay. Thank you so much, Roland. We have a couple of follow-up. First from Alantra. Alvaro, please?

Thanks for allowing me to jump back in. Just if you could provide some detail on the IG dynamics because if I'm not mistaken, I saw on the CMS data that Medicare and Medicaid was paying a little bit of a lower price than it had in previous quarters. So I'm surprised of the acceleration in revenue. So I don't know whether this is due to mix, due to the high growth in Xembify. So maybe if you could provide some of the dynamics in terms of volumes and price within IG. And then my second question would be on taxes, which were very high on Q4. I don't know you -- if you explained that already on your prepared remarks, I'm sorry, but I missed it.

Yes, Alvaro, when we look at IG, the main driver for our growth is coming from volume, no doubt. As you may recall, in the U.S. side at the end of last year, we said that we will be adjusting our price strategy to compete effectively. We've been doing that. And indeed, when you look at the increasing share of subcu IG and its premium price, that is, of course, offsetting that trend. And if you look at Europe over the last years, we, together with the rest of the industry, have been able to increase prices with the supply constraints that were there during the COVID time. And so yes, we have, over the last years, if you look at it, been able on the rest of world side to bring prices up.

And relating to your question around taxes, so if I go to Page 31 of the presentation, Alvaro, what you'll see is, as you rightly point out, your effective tax of 52% on a pretax income. And if you adjust for some of the one-offs, you get to a more normalized view around 26%. So as you rightly ask, what explains that difference? Two principal things that I would call out. One is we are -- we've got an exception relating to a tax audit in Spain, and you'll see more details of that in Note 28. I think it's Page 95 in the English version of the accounts, which -- and the simple thing there is we operate in 4 jurisdictions. And frankly, we can only pay or we should only pay tax and not be duplicative. And so this relates to a tax audit. It will take a number of years to work through that, and that's the exception. And then the other aspect on the tax, elevated level of tax, it relates to the exceptionals related to taxes paid on the Shanghai RAAS consideration, which was disclosed earlier in the year as well. So those 2 things frankly explain the elevated levels. But what I would really look at, and I'll talk about taxes a bit further tomorrow in terms of the go-forward tax rate, I think that 26% -- 26% to 27% is the appropriate sort of ballpark on a look-forward basis.

Thank you, Rahul. I mean, the second follow-up just dropped so that was the last question, the last answer. Just to say thank you so much for your support for being here. Looking forward to see you tomorrow. Thank you.

Hello, everyone, and welcome to Grifols Third Quarter 2024 Financial Results Conference Call. My name is Daniel Segarra, and I'm Vice President of Head of Investor Relations and Sustainability. Today, I'm joined by Grifols' Chief Executive Officer, Nacho Abia; and Chief Financial Officer, Rahul Srinivasan; as well as Roland Wandeler, President of Biopharma. Today's call will last about an hour, including a Q&A session. All materials used during the call are available on the Investor Relations website at grifols.com. Moving to Slide 2. I will first like to share a disclaimer on forward-looking statements. Forward-looking statements are subject to substantial risks and uncertainties. They are only valid on the day of the call, and the company is under no obligation to update or revise them. Grifols financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions. This includes alternative performance measures, also known as APMs, prepared under the group financial reporting model as defined by the guidelines of the European Securities and Markets Authority. Please note that Grifols' Management uses APMs to evaluate its financial performance, cash flows and financial position as the basis for its operational and strategic decisions. These APMs are prepared for all-time periods presented in this document. On today's call, Nacho will start off shortly with some introductory remarks and a discussion on business performance. Then Rahul will discuss the financial results for the quarter and year-to-date, before turning the call back over to Nacho for his final remarks. With that, thank you very much for joining us today. Nacho, over to you.

Thank you, Danny. Good evening, afternoon and morning to all of you depending on where you are in the world. I appreciate you dialing in for our third quarter results call. Before I turn to the results, I would like to provide you with a few updates on key matters. First, please note that the focus in these sessions will be on Grifols' third quarter results which, as you will see, are reflective of our progress and indicating we are heading into the right direction. We will not be addressing any questions or comments related to Brookfield or any potential transaction. As you are aware, Grifols entered into an NDA with Brookfield, whereby Brookfield was granted access to perform due diligence. And all what I can confirm is that it is ongoing as per today. Any further update will be communicated to the market in due course and in accordance with applicable laws and regulation. As always, the Grifols Board of Directors and management team are committed to acting in the best interest of all the shareholders. And we remain very focused on continuing to execute the company's strategy and deliver to our commitments. Please understand that we are not going to make any further comment on these matters on today's call. Thank you in advance and appreciate your understanding. The second key update I want to provide is regarding Spain's National Securities Market Commission, CNMV and on the SEC as well. As we reported last month, CNMV has concluded their review on our financial reporting, having identified no additional elements to those initially reported in March 2024. The SEC has also conveyed that they have completed the review of the company's filing with no additional comments, nor actions. Finally, I also would like to touch on some leadership changes. In September, we announced that Thomas Glanzmann will transition into the role of Non-Executive Chairman of the Board. This is another step in our previously announced governance enhancements, which we first began in 2022, and allows Thomas to fully dedicate his time to the nonexecutive chairmanship role. I would like to extend, on behalf of the Board of Directors and the entire company, our deepest gratitude to Thomas for his time and dedication to Grifols in his executive role over the last years. Personally, I also want to show my strong appreciation to Thomas for his invaluable support during my first months at Grifols. Thank you, Thomas, and I look forward to continuing to work with you in your nonexecutive role. While I will miss sitting next to Thomas on these calls, I'm pleased to welcome our new CFO, Rahul Srinivasan, who has joined me on the call today and will introduce himself shortly. The addition of Rahul marks the completion of a broad management transition and represents the final piece to complete the new executive management team. Rahul brings a proven track record of financial success and we look forward to benefiting from his expertise. Finally, and before starting the presentation, I want to take a moment to highlight and appreciate the many initiatives we've taken over the last 2 years as we work to transform the business and deliver strong results in a sustainable basis. Over the last few years, our business has faced a number of headwinds, as it was heavily impacted by the COVID pandemic that led to a reevaluation of our operations and a strategic direction. Grifols responded by doubling down on the fundamental growth of the business, strengthening corporate governance, refreshing executive management, imposing greater financial discipline and reinforcing a culture of performance and accountability. Such actions are reflected in the positive results we are reporting today and are a direct consequence of the resilience and adaptability we've demonstrated during these times. I'm confident that these actions will keep leading our business to outperform its expectations for years to come. Shifting to our financial results. We continue to build on our momentum with another strong performance in the third quarter. This quarter results underscore our capacity to capture robust global demand effectively across our key markets and demonstrate how we are well positioned to sustain this trajectory moving forward. Revenue in the third quarter totaled nearly EUR 1.8 billion, representing 12.4% increase on a constant currency basis over the previous year, while year-to-date revenues reached EUR 5.2 billion, representing a 9.1% increase. Adjusted EBITDA for the quarter came in EUR 462 million with a margin of nearly 26%. This increase is an improvement of 26.7% at constant currency from the previous year. Free cash flow for the quarter improved to EUR 127 million, and we continued our deleveraging path, reducing our leverage ratio to 5.1x from 6.8x in the first quarter. Looking ahead to our fourth quarter, we view our strong third quarter performance as a positive indicator of our ability to meet full year guidance. While we recognize that the upcoming quarter will be a demanding one, we remain focused in our commitment to ensure we close out the year in a strong manner. Plasma continued to play a significant role in driving profitability. Our cost per liter continued to decline in 2024, and we expect the trend to continue. We have managed plasma supply to ensure we are able to meet the growing demand. Going forward, we will continue to execute on its initiative to further improve plasma and manufacturing efficiencies, helping to reduce cost and expand profitability. Grifols continues to view innovation as one of its top pillars, and I am pleased to share that we are on track to achieve all our 2024 innovation milestones. Hitting these targets is key to continue building on our fundamentals for future growth. Of particular importance, Fibrinogen’s regulatory process has seen significant progress, which I will cover in more depth later on this call. Additionally, I'm excited to announce that we were awarded a U.S. BARDA contract to develop GigaGen recombinant polyclonal antibody therapeutic platform. We have made significant strides in corporate stewardship as we advance our sustainability agenda, achieving our highest score ever in the 2024 Standard & Poor's Global Corporate Sustainability Assessment, and being awarded a gold medal by EcoVadis. Turning to Slide 6. Let's take a look into our key financial metrics, which shows a clear sequential growth across the board. As mentioned, we achieved nearly EUR 1.8 billion in sales in this quarter, representing a 12.4% increase on a constant currency basis. On the profitability side, adjusted EBITDA for the last 12 months reached EUR 1.7 billion with margins increasing to 25.8% in the third quarter from the 21.6% reported in the first quarter of the year. Free cash flow generation continues to be a priority, and we are pleased with the sequential improvement we've seen over the year. As discussed on my first quarter earnings calls last May, optimizing of working capital was a pivotal driver for improved free cash flow in 2024. This is reflected in our third quarter positive free cash flow generation of EUR 127 million. We significantly bridged the gap towards our full year 2024 guidance. That said, we expect additional working capital consumption in the fourth quarter as we will be building up inventory to meet the strong underlying demand we expect in 2025. Finally, we continue to reduce our leverage ratio per our credit agreement, led by the repayment of senior secured debt following the receipt of EUR 1.6 billion in Shanghai RAAS funds as well as the significant EBITDA improvement. Rahul will dive deeper in this and other relevant financial metrics later in the presentation. Turning to top line, you will see that total revenue year-to-date has increased 9.1% on a constant currency basis, driven by strong performance across all business units. Revenue growth has continued escalating from 5.5% in Q1 to 9.3% in Q2 to a remarkable 12.4% in Q3, all in constant currency basis. This acceleration was steered by Biopharma, growing at 12.1% for the quarter and 9.1% year-to-date. The immunoglobulin franchise continues to show strong results with double-digit growth driven by IVIG and subcutaneous IG. Our Alpha-1 trend is improving as well in Q3, reversing the impact of prior quarters, and albumin also performed well. Growing demand in the U.S., Canada and rest of the world give us confidence in our upside potential moving forward. In Diagnostics, we saw a 1.3% uptick on a constant currency for the quarter, landing at a 1.7% advance year-to-year on a like-for-like basis, guided by Blood Typing Solutions. I will also cover more on this business unit later. Biopharma continued to be the main growth driver in the third quarter. The IG franchise remains the highest growth protein with up to 16.6% in the third quarter and 14.3% in this year, both on a constant currency basis. IVIG growth was driven by strong demand in the U.S. and international market. At the same time, subcutaneous IG continues to gain traction and grew a remarkable 52% on a constant currency basis year-to-date, reinforced by a strong performance in the U.S. and multiple launches within the European Union. Albumin was up 11.7% in the third quarter and 10.3% year-to-date, both on constant currency basis, caused by a higher demand in China. Alpha-1 and specialty proteins revenue improved by 3.8% on a constant currency basis from last quarter, bringing our year-to-date growth to 1.3%. In the U.S., our Alpha-1 franchise is regaining momentum following the transition of a specialty pharma distributor, while demand for rabies treatment has increased this quarter. Now I would like to show an overview of our priorities to further enhance our performance, which focus upon efficiencies to strengthen our leading market position in both the commercial and plasma center operations. First, we further build out our portfolio as our subcutaneous IG Xembify gains further traction in the European market with eight launches executed so far in 2024. We see that our IG product offering with both Gamunex and Xembify is well received, reflected by momentum in pull-through across geographies. In addition, we are reinforcing the value proposition for Alpha-1 patients, which is already offering expanded capabilities to our Prolastin users. We're seeing increased momentum in the U.S. and our commercial strategy continues to focus on growth, both in existing and new key accounts. In Europe, our teams again excelled, reporting another quarter of double-digit growth. Product life cycle management paired with new product development also continues to be key. We secured approval for Xembify bi-weekly dosing from FDA in July and enrolled our first patient for alpha-1 antitrypsin, 15% subcutaneous Phase I and II. Furthermore, we are progressing in our filing for fibrinogen, as I will cover in the next slide. Finally, we're enhancing the performance and accentuating the talent of our teams. In line with our strategic efforts across the company, we're currently building skills and new capabilities in our commercial team in the U.S., while enhancing customers' and patients' engagement. In addition to these key efforts that are fueling our strengthening market positions, we continue to improve our operational effectiveness. As part of this, we are optimizing our global plasma center network, which comprises 405 plasma centers around the U.S., Europe, Canada and Egypt. Additionally, we're working to leverage new technologies and implement process efficiencies. We've been increasing our IG yields through the deployment of nomogram and development of a road map to expand continuous improvement initiatives. While implementing these strategies, we are also prioritizing enhancing the donor experience and improving donor satisfaction. Turning to Slide 10. Let me reiterate that innovations continue to be one of our main cornerstones. And as I mentioned earlier, we're on track to accomplish our 2024 innovation-related milestones. For the first 3 quarters of the year, we've completed all but two of these milestones, which we anticipate will see positive updates by year-end. In July, Xembify biweekly dosing received FDA approval; in September, Gamunex in bags began conformance lot testing. In fibrinogen, there are some exciting advancements in the European Union, where the marketing authorization application was successfully submitted through a decentralized procedure, including several countries. Additionally, the U.S. regulatory pathway is progressing well, maintaining the scheduled pace. This development marks important milestone in bringing this protein to the markets, ultimately benefiting patient care on a broader scale. We have also begun clinical start-up activities for investigational new drug application of GIGA2339, which is a next generation antibody drug targeting anti-hepatitis B virus following the receipt of FDA approval. We're excited as well with the contract awarded to GigaGen by the U.S. BARDA to develop a recombinant polyclonal antibody therapy for 2 proteins. These contracts marks a milestone and will additionally support Grifols in the manufacturing and Phase I trial and has a value up to $135 million over the next 6 years. Turning to Slide 11. Our Diagnostic business remains an important part of our operations, and I wanted to shine a spotlight on the business and what we vision for further growth. Currently, our primary segments in transfusion medicine are blood typing solutions and nucleic acid testing donor screening. The transfusion medicine market is a critical field that ensures a safe and effective supply of blood and plasma to patients in need. Within the BTS segment, Grifols' focus is to become the leading player through capitalizing on our current position and expanding through improved profitability, execution of our commercial plan, focusing on our core markets and continue our development of the next generation of instruments. Our performance in the third quarter is reflective of our progress. We have grown double digits in our core market. Our flagship Eflexis instrument continues to gain market share in conjunction with successful tenders in key markets. In our NAT segment, testing for diseases and viral markers are critical to ensuring a safe blood and plasma supply. This is an important segment. We are focused on driving steady growth through life cycle management of our Procleix Panther instrument, maintaining and strengthening our strategic accounts, and developing immunoassay technology for blood and plasma screening. Our performance in the third quarter reflects our near-term goal through steady levels of donations in the U.S., solid progress in the tissue and organ testing segment, and successful tenders in growth market. With our near-term focus of strengthening and growing our core BTS and NAT segment, we envision a broader expansion by our Diagnostics business. Leveraging our expertise in transfusion medicine, we view expansion into the clinical diagnostics segment as a natural progression. Driven by increasing prevalence of chronic disease, emphasis on preventive health care and advancement in technology, this segment is growing and an area where we can explore leveraging our IVD expertise and focus on the development of new testing platforms. Finally, an additional area of growth is expanding our testing capabilities internally to provide the best-in-class and seamless support model for our Biopharma business. Creating further synergies between our largest businesses will allow for accelerated testing and new drug development. And with this, I now would like to turn the call over to Rahul. Rahul?

Thank you, Nacho, for the warm welcome and for all your help with my transitioning since my start at Grifols a few weeks ago. It is an absolute privilege to be here in this capacity for Grifols. And I'm aware, with this privilege comes the huge responsibility towards the company and all its stakeholders, including the critical institutional investors across our equity and debt complex. Moving to Page 13. As some of you might be aware, I have followed the Grifols story for a number of years from a different vantage point, from where I developed much admiration for the company's commitment to its inspiring mission of improving patients' lives globally and serving our donors, as well as the company's growth mindset. And by doing so, delivering not only for all our stakeholders, but also to society. The strong momentum and growth prospects that the company benefits from today is as a result of the bold and visionary actions taken in the past, giving us a solid foundation and a market-leading position with significant scale in a highly attractive industry that is characterized by secular tailwinds and high barriers to entry. Notwithstanding all the challenges and considerable distractions that the company has faced this year to grow our top line by almost double digits and EBITDA by circa 25% speaks to the attractive business fundamentals and the resilience of our over 23,000 teammates and the company as a whole. As a senior management team, we are now in a fortunate position to be able to harvest, over the coming years, this highly defensive portfolio with very exciting growth levers and related cash flow prospects. And in this fortunate position of being able to harvest our various growth legs, there is a much greater focus on analytical rigor and general discipline, be it financial, cost or capital allocation discipline, and to continue our relentless efforts on deleveraging and improving free cash flow generation. An aspect that has been particularly great to see in these initial weeks since I started is the organization's focus and progress on continuous improvement and operational excellence to drive efficiencies. The success of the operational improvement plan and evidencing its conversion into significant actual cash EBITDA has been the catalyst for this mindset change across the organization, and it bodes well for the quarters and years ahead. Moving on to the last point on this page, from everything that I've seen in my first few weeks here, I continue to have a very strong conviction for the Grifols story. And I believe that we have a significant communication and engagement opportunity to share the strength of the story in the coming months with each of our various stakeholders. For all these reasons, I have no hesitation in making the significant professional change after receiving Nacho's and the Board's offer and to leave the safety and the considerable comfort of my prior role to take on this invigorating challenge and deciding to relocate my family from London to Barcelona. With that, let's now go through our Q3 and year-to-date financial performance on Page 14. Before I go into our Q3 and year-to-date financial performance in 2024, please consider 2024's relative performance to what was a record financial performance in 2023, given the sales and adjusted EBITDA records that Grifols achieved in 2023. With that important context to frame our 2024 performance, year-to-date and Q3 2024 revenues are up very strong versus our record 2023 by over 9% and 12.3% on a constant currency basis, respectively, taking our year-to-date sales up to EUR 5.237 billion and very much tracking to our EUR 7-plus billion revenue guidance for the year. Year-to-date gross profit was up 14.5% versus 2023, and year-to-date adjusted EBITDA was up 25% versus the record 2023. Three of Grifols' best ever quarterly adjusted EBITDA results have been achieved in the last 4 quarters, which hopefully is not lost on all our stakeholders that follow our financial performance. I will elaborate on the drivers of this growth on the next page. As a result, our year-to-date reported net result has swung from being meaningfully negative in 2023 to positive EUR 88 million. That said, financial expenses in our P&L are higher than 2023 year-to-date for three reasons: one, noncash one-off impact of deferred financial costs of EUR 50 million that is linked to the redemption of senior secured debt from the Shanghai RAAS proceeds in keeping with our commitment to delever; two, noncash one-off FX impact of over EUR 30 million related to the Shanghai RAAS transaction; and three, higher cash interest expense from the EUR 1.3 billion senior secured notes principally used to repay the senior unsecured notes maturing in 2025. As Nacho mentioned earlier, the free cash flow generation, excluding the effect of the Shanghai RAAS transaction, continues, as we expected, with a strong Q3 and year-to-date free cash flow being significantly higher than 2023, and we remain on course to achieve our guidance. I will go into more detail about the free cash flow generation in a subsequent slide. And finally, on leverage. Our total net leverage per the credit agreement has declined further from 6.8x in Q1 to 5.5x in Q2 and now to 5.1x at the end of Q3, with the debt repayment from the Shanghai RAAS proceeds and our continued strong momentum in EBITDA driving the significant deleveraging in only a couple of quarters. In addition, I also wanted to draw your attention to our net secured leverage ratio, which stands at 3.1x per our credit agreement and at one of the lowest levels that I can ever remember it being for Grifols, and the significant secured capacity buffer that exists to the extent that it is ever needed and in contrast to the past. So the meaningful strengthening of our balance sheet continues at pace and continued deleveraging and improved cash flow generation remain key priorities for Grifols. Moving on to Page 15. We highlight the significant momentum in our adjusted EBITDA. Adjusted EBITDA margin for Q3 '24 is 25.8%, with the margin up 260 basis points versus Q3 2023, and a quarter-on-quarter growth of 26.7%. We see similar strong momentum, if you consider the year-to-date performance, with year-to-date adjusted EBITDA being up 25% on our record 2023. This momentum across gross margin and adjusted EBITDA margin is primarily being driven by volume growth in Biopharma, the continuing improvement in the cost per liter, the benefits of our operational improvement plan coming through via plasma and manufacturing yield improvements, and finally, from operational leverage, which I will touch upon on the next page. As Nacho mentioned, we need to achieve similar growth versus 2023 in this final quarter to achieve guidance. The momentum within the business is certainly there and the entire organization remains very focused on that objective. Moving on to Page 16. Notwithstanding the very robust bounce back in adjusted EBITDA margin from the COVID years, we remain below our pre-COVID margin levels. We expect an improving trend in our margin levels in the years to come and we will share more details in our next earnings call with respect to guidance and targets for 2025. The drivers of the adjusted EBITDA margin over the years are similar to the drivers I mentioned on the prior page. In addition, it is our expectation that the adjustments to EBITDA will reduce as our transaction activity and the restructuring activity reduces. And finally, our track record of converting adjusted EBITDA to actual cash flow quickly is very positive, often occurring in less than 12 months. On the right-hand side of the slide, you see the clear benefit of our operational leverage momentum coming through. These numbers appropriately exclude the one-offs, and you see that our OpEx as a percentage of sales is even lower than our pre-COVID levels, and we believe that there is an opportunity to continue to squeeze that going forward. Equally, we do expect some of our SG&A savings to be reinvested into R&D in the coming years to be able to better monetize some of the exciting opportunities that we see in front of us. Page 17, the all-important free cash flow slide. The bottom line of this page is that we are very much still tracking to our guidance to the market to be free cash flow breakeven by the end of the year. We took a big step forward towards achieving that guidance with EUR 127 million of free cash flow generation pre-Shanghai RAAS in Q3. Whilst it might be tempting to extrapolate the Q2 and Q3 free cash flow progression to an even bigger number in Q4, we would caution against that approach and would simply reiterate our breakeven target. The various cash flow optimizing initiatives that have been implemented are yielding results, be it our working capital and inventory management focus, or our disciplined approach with respect to cash across the board. Like we saw in Q2, you will see interest paid in Q4 to be higher than Q3 to reflect the interest periods of our debt instruments. And at the bottom of the page, the extraordinary growth CapEx is almost entirely due to ImmunoTek payments, and I will touch on this further on the next page. Transaction and restructuring cost, whilst elevated in 2024, is expected to decline significantly in 2025. Our liquidity at the end of Q3 stood at EUR 704 million. We used some liquidity during Q3 to repay debt at the Biotest level and, in doing so, optimize our consolidated interest expense. Page 18. On the left-hand side of this slide, we show our CapEx evolution over time, and I also make the distinction between maintenance and growth CapEx each year. We have typically guided the market to annual CapEx that includes both maintenance and growth CapEx to be around EUR 300 million, some years slightly lower and other years higher, but around EUR 300 million on average. The extraordinary growth CapEx in 2024, which we expect to be around EUR 280 million for the full year, almost entirely relates to ImmunoTek, and we expect this extraordinary growth CapEx to halve in 2025, and then further halve again in 2026. On the right-hand side of the slide, we summarized the evolution of stock turnover days to show progress on inventory management. As you might be aware, in 2020 and 2021, during COVID, we suffered inventory shortages that resulted in artificially low inventory levels. Given the characteristics of the industry, as you are aware, the length of stock turnover period is quite high, which is entirely normal, but what this chart does reflect is some of our recent improvements on the back of initiatives to better balance per liter. Given the strong growth tailwinds, we do expect to continue to invest in having the right levels of inventory, but the combination of our operational improvement as well as taking a more dynamic approach to our inventory levels, the aspiration continues to be to remain efficient going forward. Page 19. We've had a number of questions about how we use the Shanghai RAAS proceeds. The entirety of the net proceeds we received went to prepay our secured debt as shown in this table. And we summarized the tranches that were paid down. This contributed significantly to our deleveraging progress. And finally, our near-term priorities: number one, achieving 2024 free cash flow and adjusted EBITDA guidance; number two, continue our relentless focus on deleveraging; number three, the process to extend our RCF is already underway, and we have received very supportive feedback from our bank syndicate in general; number four, terming out our 2025 senior secured debt maturities, for which we have a number of different options, unsurprisingly, given the strong momentum we continue to see and the lowest secured leverage that we have had that I can remember. Let me wrap this up by leaving you with the following final points. The momentum of the Grifols story has meant that it has grown back into its capital structure rapidly after a once in 100-year pandemic. The resilience of this business is very clear and has been proven. The outlook continues to be very encouraging, and the entire Grifols team is focused on capturing the tailwinds that we observe across our different business segments led by Biopharma. This next phase of the Grifols story is very much a harvesting one and capturing the full value of the portfolio that enjoys high growth potential, strong margins, and high cash flow conversion prospects with meaningful momentum from our operational improvement initiatives that are clearly yielding results. The entire organization remains very focused on continued deleveraging and improving free cash flow generation. I have significant conviction for the Grifols story. And as a senior management team, we look forward to discussing our perspective with all stakeholders in the coming months and quarters. And with that, I will hand over to Nacho to conclude the presentation.

Thank you, Rahul. As we wrap up our call, I want to take a moment to emphasize several important points. Despite many unprecedented events having transpired this year, we remain steadfast in our commitment to executing our strategy and optimizing our business. With our new management team now fully in place, we are optimally positioned to drive our initiatives forward. Our Q3 results have been strong, placing us to meet our fiscal year '24 guidance. We are laser focused on delivering a successful Q4, while not losing sight of our top priorities, generating free cash flow, reducing leverage, and efficiently allocating capital. These efforts are not just about numbers, they are about ensuring that we have the financial strength to continue growing and navigating any uncertainties. The plasma industry is engaging in expansionary momentum, fueled by strong underlying demand in core markets. We see this as a prime opportunity to continue widening our footprint and further strengthening our market share. Furthermore, we are dedicated to improving our operations through increased efficiencies and leveraging the growing use of technology in our plasma centers and manufacturing facilities. Streamlining processes and adopting innovative solutions have been and will remain instrumental going forward. Finally, I want to emphasize our commitment to innovation. We're making significant progress in our R&D pipeline, which will enable us to broaden our product offerings, add new indications and launch new products. This focus on innovation is crucial for staying competitive and meeting the evolving needs of the market. And with this, thank you again for your continued support. And Danny, back to you.

Thank you, Nacho. Now let's turn to the Q&A session. [Operator Instructions] Our first question comes from Tom Jones from Berenberg. That's not going to be Tom Jones, that's going to be James Gordon.

James Gordon, JPMorgan. One question is about immunoglobulin and how it's doing in CIDP, because argenx now have their U.S. CIDP approval. And they said about half of U.S. plans are now covering it. And they said they got 300 patients by the end of September on therapy and that 85% or 90% of them are from IG. So does that tally with what you're seeing? And are they coming from -- partly coming from Grifols' IG? Or are they coming from somewhere else? And I saw that you still had 17% growth this quarter. So that does look good. Do you think that's sustainable? Or is there anything exceptional about how you grew so strongly with maybe a bit more competition? The second question was China. A number of Western health care and consumer companies have talked about a slowdown in demand for their products in China, maybe partly local competition, co-pay issues in terms of economic sensitivity and some other things going on. So are you seeing anything there? I saw a comment that China is still doing well, but any impact on albumin demand or Shanghai RAAS? And if I could squeeze in just a clarification, because someone asked me. Is this still a target to get to 4.5x net debt to EBITDA by the end of the year? Or where are we on that target? Is that part of the guidance that you reiterated?

Let me address the China question. I would like Roland to talk about CIDP and what we are seeing there. And finally, the last question, Rahul will comment on that, James. So I just came back from China. I was there last week, and I can see that -- I understand the comment, I understand the concerns, but that's not what we are seeing in our business. We see the business growing. And in our conversations with our partners there, at least for albumin products and plasma-derived products, we see a continuous demand and we are planning the next year based on that. As for CIDP, Roland, would you like to comment?

Of course. James, thanks for the question. Yes, indeed, we have, as expected, seen some trial for CIDP patients in second line for patients that have -- the few patients that have not been responding or tolerating IG. So in second line, as per our expectations, we continue to see growth in that segment, and we remain very confident that IG will remain the standard of care for CIDP. We hear from OLs that the suitability for IGs in this multifactorial disease is one aspect that really stands out with its multimodal mode of action. We also see the high response rate, our proven safety, long-standing experience and expect that pricing of FcRns, while with increasing payer coverage, will really put that treatment more into the second-line space. So in addition, we are increasing our engagement in this space. We build on increasing awareness and our long-standing experience with Gamunex. And while we remain absolutely confident in the role that IG play in CIDP, we also want to highlight that our continued growth in prime immune efficiency and secondary immune deficiency are very encouraging beyond that.

And then on the question about the 4.5x target by year-end. The short answer is we remain on course to achieve that, James, and it is inextricably linked to us achieving our EBITDA guidance, because most of the deleveraging is coming from EBITDA expansion. One other point of detail that I think will be helpful to most of you guys is that the delta between adjusted EBITDA and credit agreement adjusted EBITDA will be much lower as at the end of Q4 than it is currently the case and has been for the last couple of quarters. And that's probably what has perhaps thrown some of the numbers when you guys do your back of the fact back calculation. So very much remain on course to achieve the 4.5x.

Thank you very much, James. I appreciate that. Now yes, Tom Jones, please?

I had one on the PRECIOSA study and one on free cash flow. Just on free cash flow, it's a question for both of you really. Both of you kind of having an opportunity to look at the business with fresh eyes when it comes to free cash flow. I appreciate you're doing a lot of things to kind of improve the day-to-day free cash flow. But having followed this business for over 20 years now, I have been through several cycles of kind of poor cash flow in advance of growth. And then the growth slows a bit and the cash flow improves and then more cash goes back into growth and then the cash flow comes down and goes up. We go through these cycles. But across the whole cycle, it's always been a very capital-intensive business. Beyond sort of small operational improvements that you're clearly trying to implement, have either of you had any thoughts or got any ideas about how you can improve the structural free cash flow of Grifols, be that through geographic mix, business mix, industry mix, however you may go about it? Because we can look at short-term free cash flow trends. And I know you're doing everything you can to improve it given your leverage situation, but there's short-term small margin improvements you can make. But is there anything you've, with the opportunity to look at this business with completely fresh eyes, thought about in terms of improving the sort of through-the-cycle structural cash flow nature of the business. And then on the PRECIOSA study, I just kind of wondered what your -- assuming the results are good, which I think probably will be, what your kind of approach to commercializing that data is likely to be. I think it was the 2018 Capital Markets Day, there was a whole session dedicated to albumin and liver failure, both chronic and acute on chronic. And we didn't hear much since. So I just wondered kind of how you're thinking about taking this data to market and leveraging it. Do you see it as a volume driver or a price driver? Just some thoughts on that would be interesting.

Thank you for your question, Tom. And as for the first question, I would say that definitely, cash flow generation has been on our radar, or my radar since the beginning of my tenure, and definitely on Rahul's since he's here. You are right. I mean, this business capital intensive and requires significant amount of working capital to operate, and we see the answer to that question in two ways, right? So I think that one is, to optimize cash flow, we definitely need, among other things, to optimize working capital. And to do that, first of all, I think that there is some efficiency that can be seen just by doing a better job working on an end-to-end supply chain business model, right? So I think that we can really work across different steps in the life of the business in order to identify where working together, and not in silos in the different areas, we can be more optimal. That's what we have been doing this year, and that's what we can see improved working capital this year. In the mid or long term, I think that there are considerations that can be made in terms of streamlining manufacturing site and considering product portfolio. And those might have significant implications as well in working capital, and we will explore those and the potential impact of those decisions as we move forward. Definitely, we will keep an eye on this area and free cash flow generation will continue being our top priority in the years to come.

Second question on albumin is going to be Roland?

Yes. On PRECIOSA, as we shared before, the study is finished, and we said that we'll be sharing top line results in Q4. We're still awaiting the final data, and we're on track to actually sharing the data later on this quarter. We are happy to contribute to the understanding of the role of albumin in liver disease with this study. But keep in mind that albumin is used in a wide range of diseases and conditions, and we continue to educate and aim to differentiate the use of our albumin, albumin in bags across our markets beyond liver disease around all of these stages.

Thank you very much. We are going to switch to Santander. Jaime, please?

So two questions from my side. The first one regarding working capital. There is one line of other working capital adjustments of EUR 158 million. So if you could elaborate what substantiates this line, because it's obviously a big amount that allows us to generate quite a lot of free cash flow. And how should we think about this line in Q4? And then the other question is regarding the guidance of EUR 1.8 billion for the year. This means that in Q4, you need to do an EBITDA adjusted of around EUR 550 million. So it's a big jump. Obviously, we are mid-November. So probably you already have quite a nice visibility to year-end. So my question basically is what drives this EUR 550 million EBITDA in Q4? Is it more than the top line is coming very strong? Is it that we should expect a very high increase of gross margin or further operating leverage. I know you are going to tell me it's a combination of the three, but if you can give us a little bit more color on how these three moving parts should make the EUR 1.8 billion EBITDA?

Jaime, I'll take the second question, and I'll pass to Rahul the first one. And the second one, I think that as has been said, we know that Q4 will be a demanding quarter and that we have to continue performing well, as well as we have been performing in Q1 to Q3 in order to deliver that EBITDA. And indeed, it's a combination of the three, right? So we have expectations for strong sales in the quarter. The gross margins will continue improving, as they have on the back, on the reduced plasma cost per liter that we have been enjoying through the year, thanks to the efforts done in previous periods. And finally, a strong cost control and expenses control. So I think that, as I say, we are committed to deliver those numbers. We believe they are feasible, but we still have to work a lot in the quarter, and we are doing that. As for the first question, Rahul?

Yes. Jaime, if you're referring to other adjustments and other changes in working capital, the EUR 110 million versus EUR 34 million in 2023 year-to-date, most of that difference relates to the noncash adjustment of the noncontrolling interest result. That's, I would say, 70% of that difference. And if there are sort of further aspects of detail related to that question that you have, we can take that offline with our Investor Relations team.

Thank you, Jaime. Alvaro, please?

First, welcome Rahul and congratulations on relocating to Barcelona. Hopefully, you will enjoy beautiful city and the good weather. My first question would be on your first thoughts and your top priorities as the Group's new CFO, whether you are more focused on cost cutting or getting a closer grip to working capital or liquidity or negotiating with the banks. And in particular, I would like to know if you could provide some more detail on your current liquidity position? And how do you see the revolving credit facility being extended? I don't know if you can provide some time line on that? And then my second question would be, if you feel now some comfort to provide free cash flow guidance for 2025. I think you mentioned something on the extraordinary growth CapEx, which should have for next year, but that's actually higher than what I had in mind. I thought it should go down to some EUR 70 million. So if you could clarify -- if you can provide free cash flow guidance or some ballpark number and clarify the extraordinary CapEx.

Okay. So let me start off with the first question, which was just around general impressions as well as giving you a little bit of an update around status of the RCF extension. Look, as I think about general impressions, I think you had -- you saw my -- there was a slide that talked about my first impressions. But as I think about priorities, let me start with the priorities from a financial perspective. From a financial perspective, in the short term, it is all about continuing to deliver the strong business performance and continuing to delever and improve free cash flow generation. I see meaningful opportunities across the board to be able to do that. And I also think that there is an opportunity to be a lot more analytical and rigorous in our approach, as part of which I certainly look forward to contributing to better discipline, whether it's cost discipline, whether it's financial discipline, whether it's capital allocation discipline. I think there are opportunities there in my mind. Another point that I would say is risk management. I've, in my prior seat, spent a long time just managing risk. And I believe I can contribute to that quite considerably in the coming months. I also referred in my initial impressions about the opportunity or the communication opportunity that we have here. I fundamentally believe that there is an opportunity to better understand the Grifols story. And I look forward to engaging and sharing my perspective on the Grifols story in the coming months and quarters. One final thing I would also say is, to the extent that we can simplify, whether it's business dealings, financial interest, and so on, just in terms of whether it's a simplified structuring, I think that is something that, frankly, might be helpful for the various stakeholders to better understand and engage with us on the Grifols story. And of course, that does not talk about the long list of business improvements that Nacho has touched on previously, which clearly remains a priority that I think we can develop a good story around together. I think your second question -- was your second question -- did it relate to guidance for 2025 or...?

It was on the RCF.

Yes. So on the RCF, as I mentioned in my remarks, the process of extending the RCF has already commenced. And I think our -- the general sort of feedback has been very constructive and positive. Clearly, the Q3 results here is helpful in that respect. And now with the Q3 results out, my expectation is that we will have this wrapped up rapidly in the coming weeks. And as you think about the RCF extension, I touched on this in my presentation, secured leverage at Grifols today per the credit agreement is at 3.1x. It is going to be in the 2s, in the 2s by the end of Q4. So the extension of the RCF or liquidity and so on, I have no concerns about and we'll be able to demonstrate that very effectively in the coming weeks. So I feel very well supported by the bank groups on that front. The second question?

The last question on the guidance, free cash flow.

Okay. So free cash flow guidance, certainly for -- we expect to provide free cash flow guidance at the next earnings call for 2025. And we look forward to discussing that in more detail at the time.

Very clear. Thank you, Rahul. Thank you, Alvaro. Now Guilherme, please go ahead.

So the first one still on cash flow guidance. You previously had guidance for 2025, 2027. Are you still planning to provide an update on this guidance, or just going to release an update on 2025 guidance alone for cash flow with the next earnings call? And the second question is a bit related to Q4 again. So IG has been outperforming in terms of growth to other proteins, which is not optimal to gross margins. How do you see the proteins growth balance in Q4? Similar to Q3, or there could be some changes here?

Yes. Thank you, Guilherme. As per the cash flow guidelines, I think that, as Rahul just said, I think in the next earnings call, as is customary, we will provide guidance for the year, including free cash flow for 2025. As for projections for cash flow for the next years, we are still evaluating this position and having internal discussions. And in due time, we will communicate with the market. As for the protein question, Roland will comment.

Yes, indeed we are very pleased with the momentum that we see in IG, and especially in the U.S. building within IG. But one thing I want to double-click, and if you look at the split between IVIG and subcu IG, we're very pleased with the growth rate that we see with subcu IG with a premium pricing and with significant potential to further grow given that we only launched a few years ago. So as you think about IG, we see this as a very important contributor and a growth driver for the future. And as we think about the rest of our portfolio and proteins, similarly, we see us continue to build where, of course, for Alpha-1, we are after the transition of the specialty pharmacy provider in the U.S. in a position to rebuilding growth. And the one thing, perhaps to add for Q4 is that rabies naturally has seasonality. That's the one thing to keep in mind. But the takeaway is really, I think the one point is the growth potential and the momentum that we see behind subcu Xembify.

Thank you, Roland. Thank you so much. Thank you, Guilherme. With that, we took all the questions today. As Rahul said, please feel free to contact the IR team for any follow-up. Thank you so much for joining us today.

Hello, everyone, and welcome to Grifols' Conference Call. Today, we will be sharing a business update on our first quarter financial results. Thank you very much for taking the time to join us. My name is Daniel Segarra. I'm Vice President of Investor Relations and Sustainability. Today, I'm joined by Grifols' Executive Chairman, Thomas Glanzmann; Chief Executive Officer, Nacho Abia; and Roland Wandeler, President of Biopharma. Today's call will last about an hour, including a Q&A session. As a reminder, this call is being recorded. All materials used during the call are available on the Investor Relations website at grifols.com. The transcript and media replay will also be available on the Investor Relations website within 24 hours. Turning to Slide #2. I will first like to share a disclaimer on forward-looking statements. Forward-looking statements are subject to substantial risks and uncertainties. They are only valid on the day of the call, and the company is under no obligation to update or revise them. Grifols' financial statements are prepared in accordance with EU IFRS and other applicable reporting provisions. This includes alternative performance measures or APMs, prepared under the group financial reporting model as defined by the guidelines of the European Securities and Markets Authority. Please note that Grifols' management uses APMs to evaluate its financial performance, cash flow and financial position as the basis for its operational and strategic decisions. These APMs are prepared for all time periods presented in this document. Reconciliation tables can be found in our website. With that, I would like to turn the call over to Thomas Glanzmann.

Thank you, Danny. Good evening, afternoon and morning to all on the call. It is great to be here with you today. Now let me start by welcoming our new CEO, Nacho Abia to Grifols. We are truly pleased to have him on board. He has been on the job for only 6 weeks but has hit the ground running and has come up to speed quickly as you will see shortly. We look forward to his leadership as we move into the next successful chapter of the company's history. I also welcome Roland to his first earnings call. With the changing of the guard, I would also like to take this moment to thank and recognize Raimon and Victor Grifols who at the end of May will step down from their executive roles and become proprietary directors of Grifols. All of their many great contributions to Grifols over the past years have truly left a lasting imprint on the company. I am very pleased and thankful that they will continue to provide their valuable thoughts, insights and advice as members of our Board in the future. Thank you, Raimon and Victor. I also want to share with you another significant change at the company. Alfredo Arroyo, who recently turned 67 and decided and already informed me a year ago that he wanted to pursue his next chapter in life after a very successful career of more than 45 years in finance, including the last 17 as Grifols' CFO. We are grateful to have benefited from Alfredo's leadership and financial expertise since he joined Grifols in 2007, and -- shortly after the company went public. Alfredo has been an invaluable member of the executive team, overseeing the company's successful evolution during our critical growth years and effectively managing the impacts of the pandemic. On behalf of the company and the entire Board of Directors, I would like to thank Alfredo for his contributions over the past 17 years. We have begun searching for Alfredo's successor. The process will be thoughtful and thorough as he or she will be a key part of the management team taking Grifols into the future. Alfredo will remain with the company throughout 2024 to ensure a smooth transition, which I personally very much appreciate. Now let's turn to my presentation. After closing a turnaround year in '23 and delivering on all our commitments, this first quarter of '24, as all of you know, was marked by an unprecedented and completely unwarranted attack by an opportunistic short seller who this morning, again, issued a misleading report for their own financial gain. As you all know, we have already refuted all the false allegations and met all regulatory requirements. The Spanish regulator and our external auditors confirmed and validated our financials and accounting practices. They also confirmed that related party transactions took place at arm's lengths conditions. Also, as part of our ongoing progress to strengthen our communication and enhance our reporting practices with the regulators and the capital markets, we have expanded our financial disclosures and simplified the use of alternative performance measures, building on what Danny mentioned. Throughout all this, we have stayed true to our mission and maintain our business focus. We continued to serve donors and deliver our life-saving medicines and health care solutions to our patients and customers. Furthermore, we successfully executed and remained focused on our priorities, implementing a series of improvements to our corporate governance, leadership, debt management and innovation. With this in mind, I am really proud of the entire team who demonstrated an unwavering commitment to the company and to our mission of making a difference to patients, customers and donors. On the corporate governance front, and as part of our commitment to simplify our structure, we have, as already mentioned, separated management from ownership. Raimon Grifols and Victor Grifols made the thoughtful decision to transition out of their management roles to serve as proprietary directors on our Board. Additionally, the Board will soon be reinforced with 2 new independent members, both of whom will add value in finance and corporate governance. These appointments are pending approval at the upcoming AGM. Undoubtedly, another key organizational change is the appointment of Nacho as Grifols' CEO, clearly separating the Chairman and CEO roles. I will continue in my executive role until February to support the transition. But at that point in time, the role of the Chairman will no longer be an executive one, all in line with our plan and good corporate governance. Now let me talk about our debt management. I am very pleased to confirm that the Shanghai RAAS transaction will close in June, now that all the domestic and overseas government approvals are in hand. Upon the closing of the transaction, all of the proceeds as previously communicated, will be fully allocated to reduce secured debt in line with our priority and our commitment. We also made significant progress in addressing the '25 maturities through the completed issuance in April of EUR 1 billion in senior secured notes due in 2030. And -- this transaction will further streamline our maturity profile and together with the upcoming closing of the Shanghai RAAS transaction, position us well on our path to address our overall debt. Turning briefly to innovation. We were pleased to report that our Phase III top line results for fibrinogen have met the primary endpoint. We expect the regulatory approval process in Europe and the U.S. to begin in the fourth quarter of this year and are now on track for the launch in '25. Pivoting to our financial results, our first quarter performance was overall aligned with our plan and therefore, in line with our full year guidance, which remains intact. Please note all figures are presented on a consolidated basis, which includes Biotest, unless otherwise highlighted. Our first quarter revenues exceeded EUR 1.6 billion, up by 5.5% compared to Q1 '23, a 6.8% increase excluding the EUR 19 million onetime commercial true-up in our Diagnostics business last year. Both of these figures at constant currency. Revenue growth was primarily driven by the strength of our Biopharma business unit, which saw a 9.4% growth on a year-over-year basis in constant currency. We also delivered solid EBITDA adjusted of EUR 350 million, representing a margin of 21.6%. On a like-for-like basis, which excludes 20% of Shanghai RAAS EBITDA contribution, this represents a 280 basis point increase. Our free cash flow was negative EUR 253 million primarily due to nonrecurring impacts in net working capital as we increased our plasma inventory levels to meet expected revenue growth and simultaneously a delayed commercial payment of USD 150 million from China that was expected for March, but came in early April. Improving our free cash flow is Grifols' top priority, and we have clear line of sight to a stronger free cash flow generation through the remainder of 2024. Nacho will address this shortly. Turning to our financial position. The company's leverage ratio as per the credit agreement increased in the short term to 6.8x due to the nonrecurring impacts in working capital. As a reminder, we will use all EUR 1.6 billion of Shanghai RAAS' proceeds to pay down secured debt. Considering this, the pro forma leverage ratio stands at 5.7x at the end of March '24. We remain confident of our continued progress and the improvement of all key financial metrics throughout the year as we drive towards our full year '24 guidance. Lastly, our plasma supply increased by 8% versus Q1 '23, and the cost per liter declined by 2% in March '24 compared to December '23. This cost decline follows a 22% drop from July '22 to December '23. Taking a closer look at our revenue performance, the first quarter growth was driven primarily by a 9.4% increase of the Biopharma unit, as mentioned, on a constant currency basis. This figure underscores the very strong momentum of our plasma business. Led by the growth of Biopharma, Grifols is poised to generate more than EUR 7 billion in revenues in '24, exceeding our record-high revenue in '23. This growth is underpinned by strong market dynamics including robust underlying demand, supported by a solid plasma supply. Within Biopharma, our key contributors are our flagship immunoglobulin franchise which grew by 13%, driven by our subcutaneous immunoglobulin, which had a remarkable increase of 62% in the quarter. Albumin increased by 7%. All of these figures are on a constant currency basis. We are observing and benefiting from a significant market growth ex U.S., which is offsetting slower growth in the U.S. Our commercial efforts continue to focus on bolstering our growth trajectory in the U.S. Turning to Diagnostics. The fundamentals of our Diagnostics business remained strong as we saw a 2.7% revenue growth on a constant currency basis, excluding the one-off revenues from the first quarter of '23. Our blood typing solutions reported low double-digit growth, and the performance of NAT was impacted by the timing of shipments to China. Turning to Bio Supplies. Despite reporting a significant decline, Bio Supplies performed as we had planned, impacted by phasing, which we anticipate to be more than offset by the robust revenue growth we are expecting starting in the second quarter of this year. Now turning to margin. Adjusted EBITDA increased to EUR 350 million, representing a 21.6% margin, up 280 basis points compared to Q1 '23, like-for-like, which excludes 20% of Shanghai RAAS' contribution. Please bear in mind that since January 1, '24, in light of the upcoming Shanghai RAAS deal, we are considering Shanghai RAAS as an asset held for sale and consolidating only the 6% of its net profit in '24 versus 26% in '23. Therefore, Shanghai RAAS contributes only EUR 0.5 million to EBITDA in Q1 '24. For your reference, these contributions represent EUR 11 million in Q1 '23 and EUR 25 million in Q4 '23. EBITDA margin in Q1 was also impacted by the lower absorption of operating expenses as the weight of revenue in Q1 is lower compared to upcoming quarters. This sales pattern had an impact on profitability this quarter, which we were already factoring in as part of our full year '24 guidance, and it is the baseline for the sequential improvement throughout the year. As Nacho will explain, we expect to deliver sequential improvement in profitability in the upcoming quarters, driven by increased revenue, improved product mix, operational leverage and ongoing benefits from a decline in the CPO throughout the remainder of the year, considering the 9 months' inventory lag, which is characteristic of the industry. Now turning to cash flow. As I mentioned in my opening remarks, free cash flow was primarily impacted by nonrecurring items that affected net working capital. The negative free cash flow of EUR 253 million in the first quarter of '24 was driven primarily by negative net working capital of EUR 339 million. Despite this, I want to emphasize our confidence in upcoming improvements and in our underlying actions to make that happen. So let me unpack that figure and give you a sense of what the key factors were triggering this result. As the company increased inventories to meet expected strong revenue growth in the upcoming quarters, Q1 '24 working capital includes an inventory buildup amounting to EUR 130 million. We believe that there is still room for improvement to optimize this as Nacho will discuss later. Accounts receivable finished EUR 154 million higher due to a delay in the commercial payment of EUR 150 million that I mentioned from our main customer in China which was subsequently received on April 2. We also had an increase in our accounts payable in the quarter of EUR 55 million as the accounts payable ratio abnormally increased to 60 days in December '23. In Q1 '24, it normalized back to 55 days. So we are not expecting such fluctuations going forward. With a EUR 150 million payment collected and receivables and inventory buildup in the process of being normalized, we expect a meaningful recovery of free cash flow starting in Q2 '24 and then continuing throughout the year. As it will be discussed in more detail in a moment, we anticipate significant improvements in upcoming quarters, which will enable us to achieve, at a minimum, the full year '24 guidance of EUR 5 million positive free cash flow. It is worth mentioning that we had an impact of EUR 37 million of extraordinary items in the free cash flow in the first quarter. Most of these were related to CapEx in Egypt, where we continue to execute our growth plan. To a lesser extent, it includes some restructuring costs linked to the extension of the operational improvement plan. Be assured that generating free cash flow is our highest priority, and we are focused on activating all possible levers to enhance cash generation in the short medium and long term. With that, I will now turn the call over to Nacho, who will not only introduce himself, but also provide you with our priorities and outlook for the rest of the year as we, together with the Grifols team, continue to move the company forward. I thank you for your attention.

Thank you. Thank you, Thomas, for your words, and thank you, everyone, for joining the call today. First and foremost, as a newcomer to the team, let me begin by sharing a bit about myself. I am an engineer at heart, driven by challenges, and I have a result-oriented mindset and a commitment to facts. This approach has brought me here today as I'm convinced Grifols offers incredible opportunity to unlock tremendous potential, build upon its rich history and solid foundation in an exciting and growing industry. By building on our legacy, I'm committed to steering the company forward and serving as a catalyst for positive change. As you know, I'm originally from Barcelona, and I have spent most of my career at Olympus, serving for more than 2 decades in a number of capacities and geographies, including the United States for the last 13 years. In my former company, I led significant strategic initiatives that transformed and globalized the company, enhanced operations and delivered sustainable business improvement. These experiences will serve me well to define and execute the next chapter of Grifols. First, addressing cash flow and leverage, followed by a sustainable plan to increase revenue and expand margins over the years to come. And all that with the strong backbone of our powerful commitment to improve patients' life across the world. I see a remarkable combination of opportunities and expertise that will take us to achieve those goals. We are a company with an inspiring mission to enhance patient health and well-being. Having always been passionate myself about the great honor and responsibility to be part of the health care industry, I feel that this step in my career is a natural, personal and professional fit. I want to begin by telling you what I've learned over my first 6 weeks in this company and why I'm excited for the future to come. During this time, I visited offices and met with people in Spain and in the United States. This insightful meetings span across all functions within the organization. The first thing I noticed at Grifols is that our team has an outstanding dedication and devotion to our mission. This idea of human-to-human medicine is truly embraced by all Grifols' employees, and I'm convinced that solid commitment of our people has been and will be a continuous key success factors. The company also has challenges, and I'll talk later about them. But at the same time, the business foundation is extremely solid. We operate in a market which is nicely growing high single digits. And this paired with the investments the company has done to be prepared for the future, give me confidence that those challenges will be addressed soon. The COVID-19 pandemic was a difficult period for the plasma industry. and for Grifols as well. But as the saying goes, never let a good crisis go to waste. And Grifols took full advantage from those times to emerge as a renovated company and the efforts and investments that were done following that period will fuel our profitable growth moving forward. During my first weeks at the company, I have also learned about how capital intensive is this industry and how critical is to act decisively and well in advance in order to be able to meet future demand. Grifols did that. And thanks to it, we are now well prepared to successfully face the years to come. However, as you know well, those necessary investments also increased significantly our leverage and our cash consumption. And I want to reassure all of you that to improve cash flow and reduce leverage will be my most important priority moving forward. We have aligned the organization and started to implement already cash flow improvement measures, and I'm confident results will be shown soon. At the same time, we will continue working to strengthen our commercial organization, especially in the United States, to harvest on existing and strategic initiatives and product launches, to secure and enlarge our market share. As I'm sure that once the concerns about free cash flow and leverage will be substantially mitigated, the focus and your focus as well will be back to growth and further margin expansion. From here, let me share you with my views on the business and what we can expect this year. Allow me to focus on 2024 and not comment beyond that today as I'm still working with the team to fully assess our mid- and long-term opportunities. For now, the most important point I'd like to reiterate is that based on all my conversations and observations, my impression is that the company is well on track to reach its full year 2024 guidance, as Tom has already mentioned. In order to do that, following the pattern from previous year, we are forecasting a significant revenue surge in the second half of the year, with growth accelerating to 10%, 12% on a constant currency basis. Let me walk you through the factors that will drive this acceleration to give you more clarity about how we plan to achieve it. The first is growth from our immunoglobulin franchise. We are already seeing a significant growth outside the U.S. that will continue. And in U.S., traditionally, the market tends to increase inventory days in the channels towards year-end that normalize in the first half of the year to accelerate again in the second half. The commercial and supply chain teams are already working closely to ensure the growing demand will be met. The second driver is that we expect our highly profitable subcutaneous immunoglobulin to continue gaining traction and contributing to the product mix. This is one of our most relevant products and despite being launched in 2019 and we're seeing it as a critical driver of growth, and we expect to keep on tapping its full potential. Our revenue projections are also supported by the improved performance of albumin as we know, China will continue to grow in the coming quarters. We also see our alpha-1 franchise continuing to show a stronger positive momentum in key markets following the switch of a new specialty pharmacy partner in the U.S., which further enhance our service offering. In addition to all this, we have as well a solid deal pipeline that provide good expectations in Diagnostics and Bio Supplies divisions. And Biotest will be launching key products in the second half of the year. All in all, I believe we have strong drivers to continue building momentum and to deliver as committed in the upcoming quarters and in the fall 2024. Following revenue growth, we know it will be translated into a significant EBITDA sequential improvement throughout the year, going from 23%, 24% adjusted margins in the first half to 27%, 28% in the second half, allowing us to achieve the EUR 1,800 million EBITDA adjusted for the whole year, as we previously guided. The most relevant driver for this will be, of course, the increase in revenues in the second half of the year, but it will be also supported by an improving product mix, including more subcutaneous immunoglobulin, albumin, alpha-1, specialty proteins and Bio Supplies, all of them higher margin items. Equally important will be the contribution of the lower cost of goods as the cost per liter initiatives and the yield improvement efforts has been delivering and we're improving our inventory cost significantly. And finally, revenue increases throughout the year, it will trigger a higher absorption of operating expenses, thus having a significant positive impact on our EBITDA. So to conclude with this slide and for the reasons explained, I'm very confident we can achieve the guidance that was provided for 2024. Let me address that now the elephant in the room, the cash flow. As I mentioned before, this is going to be my top priority, and we have already started to work on it. Despite the negative free cash flow in Q1 2024, which, as Thomas explained, was impacted by nonrecurring impact of EUR 150 million, the cash flow development follows the established plan, and the company remains on track to deliver positive free cash flow as per the guidance provided back in February. From now on, we expect a slightly positive free cash flow in Q2 and a clear improvement in the second half. Please note that this 2024 free cash flow trajectory includes extraordinary investment CapEx items, like the payments related to the acquisition of ImmunoTek in Q2 and Q3 as well as other items, including restructuring and transaction costs, which add up to EUR 480 million for the year. The primary drivers that will bridge to our fiscal year '24 guidance are: first, the EBITDA expansion, followed by working capital normalization. But in addition, we have started already an organization-wide cash flow improvement plan, our plan to significantly increase free cash flow generation, not only in 2024, but in the years to come. As a result of those efforts, we plan to update our fiscal year '24 guidance accordingly as we gain more visibility into any potential upsides broaden that plan in this year. Our cash flow improvement plan started with a simple but solid and acceptive analysis of the current situation that has already identified opportunities comprised of 5 main levers: working capital normalization, continuous operational improvement, SG&A and spend control, optimizing real estate and a thorough portfolio analysis. Some of these initiatives will have an impact sooner than others. Some will be recurring improvement and some just onetime off. But altogether, we must consider and plan this exercise as a new mindset for the company. And this will be our most important priority until our cash flow generation and our leverage will be at the required level. Particularly important in 2024 will be the optimization of our working capital. Starting with our inventory levels that will be reduced, our revenue will increase in upcoming quarters, especially in the second half. In addition, as previously mentioned, in the second quarter, we're already seeing a normalization of our receivables and payables that we expect to continue throughout the year. Another important contributor to cash flow in 2024 and beyond will be the implementation of the continuous improvement program that we started last year, includes more than 50 business-led initiatives to streamline our operations. Some of these projects have already shown impact on our financials and its incremental impact in upcoming years is expected to be very significant. These initiatives include improvement of yields in both plasma donation and our manufacturing operations, including donor fee optimization and industrial process improvements. In addition, and while the company has made good efforts to rebase its cost structure over the past few years, we will continue to focus on SG&A and spending control to operate more efficiently with a continuous improvement on zero-based budgeting mentality. Finally, and although these 2 efforts will most likely impact only 2025 and beyond, we have already started the process to look into our real estate footprint which offers some interesting opportunities and initiated the portfolio analysis of all our projects, affiliates and businesses to ensure all of them deliver at the expected level. I know you probably will have a lot of questions about this. But let me manage expectations and say that at this point, there is still work to do before being able to provide information regarding specific activities or to provide guidance for our future cash flows beyond 2024. Please be patient and give us the time to work in all this matter. Most importantly, it is clear to me that the company has the levers to improve its cash flow profile and generate additional and substantial free cash flow in the years to come. Ultimately, cash flow generation will be key to others our leverage, and so our deleveraging path will continue moving forward. Our focus remains on reducing our leverage ratio below 4x. And this year, we are expecting to bring our leverage down to 4.5x by the end of 2024, mostly thanks to the proceeds from Shanghai RAAS divesture, EBITDA and cash position improvement. As an immediate and important step, as it has been explained already, we are well addressing our 2025 maturities, and this will be primarily accomplished by using the EUR 1 billion private placement to repay the 2025 unsecured notes and the Shanghai RAAS proceeds to reduce the 2025 and 2027 secured notes. I think that's enough of numbers and figures for today. And I would like now to share some of my views on what will be the key priorities for Grifols in the years to come. As I already said, I am a pragmatic person, I like to set goals in a way which is simple, focused and with clear expectation. So I'm convinced this helps the organization to align and progress. Based on that thought, the core of our activities will be a solid financial discipline and focusing cash flow generation. But this itself will not be effective unless we can continue meeting the need of our patients and donors, continue improving our commercial operations to better meet customers' and market demand and to leverage and continue the operational improvements already started. Also very critical will be to accelerate innovation in a pragmatic and strategic way and bring to market new products, new indications in a time- and cost-efficient manner, in order to create a self-reinforcing cycle that will aim not only to enhance financial metrics, but also to ensure enhanced competitiveness. Over our next interactions, you will hear me to talk a lot about these foundational pillars, and I'll be happy to share more as the specific action plans are developed and implemented. For now and in the short term, in addition to the cash flow improvement plan already explained, our immediate focus will be to strengthen our commercial operations to be able to successfully face forthcoming product launches, to work in a talent assessment across the organization to make sure we have the right people in the right place and to initiate a process that should aim to reduce company complexity, both in our processes and in our structures. I think this slide is a good summary of what you can expect from me and Grifols in the months and years to come, and I look forward to our continuous dialogue about all these important topics. As a summary of what has been said, and before we move on to Q&A, I'd like to reemphasize a few points that we have already made but that are worth repeating. The Board of Directors of Grifols asked me to join the company as CEO to lead Grifols by building upon its previous success. To achieve this, we must, first of all, improve cash flow generation and reduce leverage. And while doing this, we must continue enhancing operational execution, maintain financial discipline and improve business performance overall. Thanks to our cumulative efforts, today Grifols operate in a solid growing market, is well invested in plasma centers, production facilities, a global footprint and cutting-edge technologies. This positions the company to drive significant and sustainable growth. And therefore, I'm convinced that by acting decisively and with a strong focus on execution, we can significantly unleash shareholder value as well. This is my mission, and this is what I plan to do. Finally, I'm pleased to announce that we will be hosting an Investor and Analyst Day on October 10, 2024. We will dive deeper into some of the things mentioned today and in our future plans, with the aim to provide a comprehensive view of the company's long-term goals and strategies. Thank you all for joining us today and for your continued support and engagement. I look forward to meeting many of you in person over the next weeks and months to come. And with that, I'll turn it back to Danny.

Thank you, Nacho. With regard to our agenda for the rest of the year, we have several key dates to share with you. First, on July 30, we will discuss our financial performance for the second quarter of 2024. As mentioned just now, on October 10, we will host our annual Investor and Analyst Day here in Barcelona. Finally, on November 7, we will be reporting our third quarter financial results. These events play an essential role in our efforts to strengthening our communication and ongoing dialogue with market participants. Now I will open it up for questions.

[Operator Instructions] Our first question come from, I think it's Peter. Peter from Citi.

It's Pete Verdult here from Citi. Two questions. Nacho, I appreciate you giving us your first impressions after only being at the helm for a matter of weeks. To give me for pushing, but I think the market is very focused on free cash flow. And I understand that you can't give guidance beyond this year, but it's also fair to say that the prior management team were also communicating a message that they were very focused on free cash flow. So just what low-hanging fruit is there this year that allows you -- makes you confident that you can accelerate efforts to improve free cash flow? And if I could chance my arm, what have you liked that you've seen as you travel around the Grifols sites? And then just secondly on -- because we got Roland on and that you are calling out product mix as a big driver, can we just make sure that we're all on the same page. I mean my assumptions are that Xembify is probably a 50% premium to IVIG, but it only represents sort of 5% of IG sales currently. So can you correct me where I'm wrong? And if I could squeeze one last one in because I think it's important. You called out the specialty pharma switch benefiting alpha-1. Could you maybe just explain that a little bit more?

Peter, this is Nacho. And I think I cannot add much more than what I already say, I think that the free cash flow or the cash flow focus in general is very well established in the company. I think in the last 6 weeks, we've been working across the organization to make sure that the mindset is there. And I see a lot of activity already moving forward in that direction. And it's not rocket science. To be honest, I think it's mostly the 5 levers I mentioned before. And if I think in 2024, clearly, working capital is going to play a very significant role as this is probably the highest impact, but we've been working already for months in a lot of operational improvements that will also generate a significant benefit in the year. And ultimately, I think we need to control well all our expenses and the things we can control within this year. So I -- there is no magic, Peter. I think that this is all about focus, it's about attention. It's about mindset, it's about aligning the company in that direction, and that's what we are doing. I think the next question Roland would love to answer.

Absolutely. Thank you, Nacho. And Peter, to your first point on Xembify, you're correct on both points, that, yes, there is a price premium and especially with Xembify currently at 5%, we see tremendous growth potential for the future for this very important pillar of our immunoglobulin franchise. And to your second question on alpha-1, our switch in Specialty Pharmacy partner will allow us to dramatically enhance our service offering for patients currently on therapy in a big part of the market that is counting on home infusion as their way to receive their treatment and as well help us in onboarding of new patients as we aim to further expand diagnosis rates in this market that still has a lot of untapped potential with 90% of patients not diagnosed yet.

Now we are going to go with Tom Jones from Berenberg.

I had 2 really. One was just on the potential for future cost savings. You talked quite a lot about them in the prepared remarks, and you're looking to spend EUR 110 million this year on one-off costs related to the extension of the operational improvement plan. That's quite a decent number to spend. So it would be helpful if you could try and at least give us some steer of kind of what future cost savings you might be expecting to come from these projects and perhaps in what areas? And then my second question was just on the leverage target. You did previously have a target of 4x by year-end 2024. I don't know on previous calls, you had said that, that was pretty much out of range unless you consider further asset sales. And the slide today sort of suggests 4.5x is where you're going to land for the year-end. Can we conclude from that, that sort of further asset sales are probably not on the cards now for this year? And are they still kind of projects that are underway? Or should we just forget about them forever, really?

Tom, I mean just to give you a little bit of color, right? So on the operational improvement plan is something that was started last year. Most of the restructuring costs are the last part of the cost of the plan. They started to be implemented. And as has been explained in the past, I think that this plan was across the entire organization, mostly on the operational part and industrial part, but also focusing procurement activities, generating additional yields in all areas, et cetera. So I think that the last money that you will see in terms of restructuring is coming from the last payment related to the efforts that has been done and all that is already being visible in -- either in our inventory or in our operational cost and as we move forward. As per the leverage, and I will make some comments, and I'm sure that Thomas probably would like to complement. What we have shown today, 4.5x is what we believe is a very realistic expectation based on the Shanghai RAAS divestiture -- on the 20% of the Shanghai RAAS divestiture plus the operational improvements that we are seeing. Of course, we remain committed to 4x leverage or below, and it will come over time. But I think at this point and realistically speaking, 2024, we can commit to 4.5x. And maybe, Thomas wants to complement that.

No, happy. Tom, great question. So, let me just go back to the fact that we said when we started '23, that 4% was the target that we're aiming at. At that point in time, we also were assuming that we would do a major -- that we would do a major sale of Shanghai RAAS, actually would be selling all of it. And as you know, at this point in time, we're only selling 20% of it. But as Nacho now said, we're -- for this year, 4.5x, we're still targeting to get below the 4x. I think at this point in time, we're not expecting to do any other asset sales for this year, really just focusing now on cash flow generation and free cash flow generation as we address the year.

That's perfect. And just one cheeky follow-up, if I may, on the sort of IG strategy. I'm kind of reading between the lines, it looks like Yimmugo is probably going to take over as one of your primary brands of IG, but it feels like the sort of ramp-up in production of that is perhaps a little bit behind plan. Any kind of color you can share, some comfort you can give us on that ramp-up? And maybe anything else you can share at this point on the sort of pathway to replacing some of your older legacy IG products with Yimmugo, which I assume has high yield and therefore, significantly higher margin on a sort of per liter basis?

Yes, Tom, Yimmugo indeed adds to our portfolio of immunoglobulins that we have. In addition, of course, to our Gamunex flagship that we have and our Xembify and as we look at time, we see that Yimmugo can play an important role in substituting our Flebogamma in the market, which is an older version of our IG. But with Yimmugo in addition in our portfolio, this opens for us a set of quite interesting strategic possibilities as we think about positioning in the marketplace and is a key part of our plan to further grow our immunoglobulin franchise.

I just want to reiterate the point that Yimmugo had a growth of 62% in the first quarter. And as Roland said, it only really represents 5% of our IG franchise. So the opportunity, obviously, is significant for us, particularly when you think that almost 40% our competitors are already in subcu. So we see this as one of our significant, really big opportunities. And I know that Roland and team are extremely focused on driving the growth of this product.

And just adding Yimmugo as an IVIG, of course, will help us on the IV side and Xembify, as mentioned before.

I'm sorry, Xembify obviously. So let me just correct that. There's so many Ys here. So I got a little confused.

Now we are going to go with Charles Pitman from Barclays.

It's Charles Pitman from Barclays. Couple from me. Just firstly, can you just confirm on the Shanghai RAAS asset sale, I think when you put out a release recently you're talking about announcing features of this deal. Can you just confirm that those features likely related to the comments made on this call about using those to address your FY '25 and FY '27 senior secured bonds? And then just secondly, just coming back to Biotest, the next-level projects and the general consolidation of that part of your business. Can you just talk us through like how we've got from it being so dilutive in the past, when you expect it to become accretive and what the delay has been since the completion of the projects in FY '22 and the reason for the contribution to the working capital impact of 1Q '24 as you've been building up inventory? Yes, I think that would just be helpful based on conversations we've been having with investors.

Well, first of all, we will close the transaction in June. And we will use the proceeds, as you outlined and as we said in our document. On Biotest, clearly, the focus on Biotest right now is to -- for them to bring the 2 new products -- or the new products to market, which they're doing. I mean I mentioned the fibrinogen trial that has done -- gone extremely well. They're also in the process of ramping up, now I'll say the right thing, Yimmugo, which they intend to be launching here in the U.S. later. They've launched it in Europe, and they expect to launch it later in the U.S. Clearly, one of the things we've said all along is that they are actually not going to be contributing to EBITDA until basically the launch of fibrinogen and the new products that take place. And we stand by that at this point in time. So Biotest still has got a bit of runway until it will contribute significantly to the group.

Now it's time for Alvaro.

The first one would be, if you could update us on the capacity situation, both in plasma collection and industrial capacity in terms of fractionation and purification before and what we -- it looked like after you complete the extraordinary CapEx efforts that you are doing? And my second question would be regarding the free cash flow guidance. You mentioned that it's a bit too early to provide guidance beyond 2024. But if I'm not mistaken, you had a previous guidance of EUR 2 billion to EUR 2.5 billion of free cash flow cumulative over 2025 and 2027. Just to know whether that guidance still holds?

Alvaro, this is Nacho. Let me comment on capacity rates, again on my observations of these first weeks. And again, Thomas might want to complement. I mean I think what I've seen is that, as I mentioned before, the company is well positioned in terms of capacity. I mean, our investment in plasma collection centers and also in our industrial footprint is well established. I mean we don't see a significant need of significant investments, at least in the next 3, 4 years to come as both the plasma collection and the industrial footprint being ready for the growth that we are expecting to have in the next years. So I think it's -- and that good -- I think we're in good shape in that front. As for fiscal year 2025 and beyond cash flow, as I say in my remarks, please be patient, right? So I just haven't started to work on this. I think that we're doing good progress. 2024 looks good. Next step will be to focus in 2025, '26, '27, and we will provide you an update on the information as soon as it's ready.

So just to complement what Nacho said, our capacity, particularly on the fractionation is about at 70%. So we got significant room to grow in the coming years. And with regard to plasma center, as Nacho just said, we're well set up right now, and we do not expect to add any new centers until basically '27, where we think we will probably start to need to implement about 20 centers going forward. So we're well positioned. I also do want to mention, obviously, the Egypt project, where we're going to have -- there are going to be 20 centers, there are 10 centers now. And then we also got the Canada project, which also is not only going to add capacity, but also centers as we move forward. So overall, I think we're very well positioned to take advantage of the significant opportunities that we see in front of us in the coming years.

Now it's time for Bank of America, Graham.

Great. So firstly, on the CMD that you're planning for October, is that a time frame which we could potentially expect to see some concrete midterm sales, EBITDA or EPS guidance from the company? I think that's something which investors would definitely welcome. Secondly, just on 2024, I guess, in your EBITDA guidance, if you could just give us a feel for just the level of confidence that you have in that now. Presumably, you've collected the majority of the plasma, so you know your cost per liter for most of your cost of goods for the year you're contracted to sell at. So what are the variables that could derail you from the achievement of guidance? Or is that pretty much in the bag now? And then just lastly, just wonder if you could comment on the latest report from your friendly short seller, that Grifols funnels cash to Scranton via BPC, if you could just address that point and confirm all payments to BPC were for plasma at market rates as validated by the CNMV investigation?

I'll take the first 2, and Thomas will take the last one. As for the Investors Day, I mean, we are building the agenda as we speak. And obviously, we plan to provide as much as possible information to the market, but it's early to say how much and what will be the level of detail. I mean, obviously, we'll be talking to all of you and providing definitely our strategies and our directional goals and probably some specific figures in the areas we can, but I think it's early to confirm right now what will be those metrics. As per the EBITDA generation this year, I think for what I -- pretty much what I explained in my presentation, right? I think -- I mean, the first 6 weeks, I've spent a significant amount of time trying to understand our 2024 situation with the team, both the commercial team and the finance team, and for the reasons I explained, I feel quite confident that the EUR 1.8 billion plus that we committed at the beginning of the year will be delivered. As per the short seller report, maybe Thomas wants to comment.

Yes, happy to. Well, first of all, the short seller keeps on dishing out misleading reports and statements. Grifols has provided full detail of all its transaction in its financial statements and in specific reports. All the information is public. It's been verified by both the regulator and our auditors, and we really stand by -- we've got nothing more to add to that than standing by that statement. So I mean, it's quite amazing to having continuation from the short sellers like we're seeing now.

Jaime, please from Banco Santander.

A couple of questions from my side. The first one regarding liquidity is at around EUR 700 million. So I just want to know how comfortable you are with this liquidity, you have ImmunoTek commitments for Q2, Q3 amounting around EUR 500 million. And building on this, would you consider to use part of Shanghai RAAS proceeds to be more comfortable on your short-term liquidity? This would be my first question. And the second one, in terms of strategic assets, not sure you probably have time to do an assessment. Is there anything you have identified that you can maybe sell in order to further reduce debt? And another question that probably investors want to know is whether you would consider a capital increase to further deleverage the balance sheet.

All right. So on the liquidity level, I mean, again, as you can imagine, this has been one of my focus on the first weeks to understand where we are. I think we are operating at a liquidity level that is comfortable and anything above EUR 500 million I think is something that we can comfortably operate. We are on the EUR 700-plus million and with prospects to increase it over the years. So I think we feel confident on that. On the strategic assets, I knew the question would come. And I already anticipated in my remarks. I mean, it's too early to say. We are doing our portfolio analysis. I don't know what the conclusions will be. We're looking at all our, not only strategic assets, but projects, initiatives, affiliates, and I mean, there is not only about potential or not divesture of acquisitions. It's also about making sure that all the projects that we have in driving the company operates at the expected level as well. Too early to confirm anything. The only thing I can assure you is that we are doing the analysis, we are looking everywhere, and we will be doing the work and provide information as it comes. As per the capital increase, there is absolutely no plan at this point to consider a capital increase.

Now we will have to take any question from Thibault from Morgan Stanley.

Yes. So my first question is on financial [ forecasts ]. I think you previously -- I mean, Grifols previously suggested that interest expenses could decline in '24 versus '23 and it's difficult to reconcile this with that being refinanced at a higher rate even with the Shanghai RAAS proceeds being used to repay. So just if you could comment on this. I know that you have a bit more visibility on the refinancing rate. And second question connected to this, you provided a helpful free cash flow bridge after the full Q3 results. And just wondering if there is any elements that now look materially different from when you issued this bridge, this reconciliation, if there are elements that are meaningfully higher or lower in terms of cash consumption.

Let me answer the second one, and Danny will talk about the financial rates. So no, there is no items which are material on the free cash flow bridge that we presented. And I think that by now, we have identified all the key elements and the free cash flow is going to be mostly determined by operational ratios, mostly the working capital and improvements in the operations, as I mentioned. And for the financial rates, Danny, do you want to mention?

The financial expenses for the year are expected to be lower compared to the current situation. The thing, as Thomas was saying, we expect we are going to close the Shanghai RAAS transaction in June. It's going to be the most important lever to see a reduction of our debt that, as Thomas was mentioning as well, I mean we are going to go repaying part of 2025, but also part of 2027. Especially in the '27, we are paying a variable interest expense. So when you're putting all in all, even including the private placement for EUR 1 billion at EUR 7.5 billion, the total financial expenses is expected to be lower. And we are going to go with one of the last one. It's going to be Guilherme from CaixaBank.

So, one, I don't know if it is too early, but at least, could you provide us a sense of -- or where do you expect the leverage? Or where do you want to put the leverage of this company over the midterm? We understand that it's going to about 4x over perhaps we can have 2025. But over the midterm, when do you feel comfortable with? And the second one is a small question. Just if you could provide some reconciliation of the free cash flow generated in the quarter with the increase in net debt that you reported. I have seen some increase in the IFRS 16-related liabilities. If you can provide some color on this.

Yes. On the leverage level, I think that, I mean, there are many, probably, opinions about what is the adequate level of leverage that company should have. If you ask my opinion, and this is a general statement, not only applicable to Grifols, I think, I mean, around -- between 3x and 3.5x is a reasonable level to operate. I think it also depends a lot on what are the strategic considerations that you are having, right? So I think at some point, you might need to lower your leverage if you are facing some potential opportunities of acquisitions, but our work as the first step is obviously our committed 4x leverage, and we were working towards that. Once we get there, then we will provide guidance about what is the next step. As for the free cash flow, Danny, do you want to mention?

so on the free cash flow and net debt, I mean, this first quarter, pretty much the increase that we had is pretty much in connection with the free cash flow that we had, basically, on the net working capital impacts the nonrecurring items that we were disclosing, and it brought to have this net debt increase. As Nacho was mentioning on the leveraging path, you will see that we expect to recover this piece. It's going to be part of our deleveraging path. So as long as we expect to generate more cash flow in the next 3 quarters, it's going to help, it's going to support our deleveraging path in connection, not only with an improvement in terms of EBITDA, but also a reduction in our -- in terms of net debt on top of the Shanghai RAAS transaction that it has been well discussed. We are going to take the last one. It's going to be Charles, your second kind of like opportunity here.

Just a couple of clarifications. Just earlier where you said capacity on fractionation is at 70%. Can you confirm that's the current utilization of your full capacity and that the centers that you've got to '27, before you start adding centers, that's just on top of what you've already announced? And then did you address the comment around your midterm cash flow cumulative guidance or based on the fact that, naturally, you're still getting to know the company, are we just kind of not talking about an today? Could you reiterate that or to should we wait for 2Q?

So let me just -- the 70% that is current capacity, number one. And the 20 centers that I mentioned, that's not until '27. So we're well situated today with the centers we have. And again, I reiterate, we got centers coming online in Egypt, and we got centers coming online in Canada. And obviously, the key focus for us is to continue to improve the efficacy -- our efficiency of our current centers in the U.S., which we are in the process of doing.

As per the cash flow projection, Charles, I think I mentioned already several times. I think for now, I'm focusing a lot in 2024, and this is where we provide the guidance today. I'm comfortable. I see a lot of opportunities. I see a lot of things that we can do. We have to do the work, but I'm very comfortable and confident about the cash flow we can generate in the years to come. But I'm not ready yet to give you a number.

With that, I think that we took all the questions. So I just want to say thank you all for joining us today. If you have any follow-up question or further inquiries, please contact the IR team. There is a dedicated one to keep engaging with you. Thank you so much.

Thank you all. Thanks, everybody.

Thank you, everybody.

Thank you. Bye-bye.