morning, good and Joe, Thanks, everyone.
to of As portfolio employees operations Joe and deliver and the on mission. demonstrate results our adaptability our mentioned, our our durability fourth of quarter
that development. remain market operating Although was extent, in optimize new top continued And and partnerships what improvement some development established operating through on launches, emphasis we on margins particular expenses. committed in To XXXX are focused we've initiatives unique driving our growth a similar accelerating to business margin put product strategic on execution to expansion. gross place to transform presented challenges, and line we and program with
in We expect this program benefits recognizing beyond. to XXXX and begin from
if pivot plan September but in this host is fall We're current to financial the virtual new we'll long-term in-person targeting to conference, an to investor of year. Our provide our XXth necessary. outlook
on over in of basis, challenging COVID Turning period. the year impacted billion, on the on of net in quarter basis, currency quarter. most the advanced in operational our basis, our X% surge of estimate around prior million sales comparison reported fourth to and negatively by and the We results, $X.X an a a COVID the face revenues X% to cases X% $XXX globe global constant XXXX despite
bottom-line, offset adjusted $X.XX from quarter. as On tax well growth earnings our as operational interest XX% expense and impact share more the businesses, to on per as rates in the the than COVID negative declined higher
both Americas constant currency currency with basis. X% segments, X% constant an sales on Asia Now operational were in and I'll segments walk in our currency Sales three X% and global and East our flat on Starting Middle advanced a by basis operational and regional sales advanced in X% on basis Pacific region declined performance Europe, operationally. a in basis business constant Africa through regional units. and on a our
driven Advanced Renal business sales global we APAC Surgery a the acquisition business is X% equal all sales growth global $X were currency HD quarter, by constant performance the the for operational currency was businesses patient growth note to operational our on global the and exception units, with benefited constant to basis. Global the and and both of digit from constant U.S. for in in in for which our currency growth this provide on for both Moving adjusting of will that growth PD mid-single businesses. quarter advancing by PD Performance Care growth Seprafilm. billion, regions. for
clearly year pandemic Delivery ESRD currency the As payment $XXX in home will on U.S. implementation PD treatment to for the This ETC further has model. patients the constant million, of of care reinforced declined Sales a the Joe accelerate of basis. home-based X% Medication the shift and of the new referenced, CMS advantages in the
to business further remain depressed of Internationally, hospitalization placements Joe increased in XXXX. increased order. medication This pre-COVID partially business. in solutions impacting care led pump And we continue stockpile delivery offset protocols As by the look and IQ for by government platform. rates was our Systems to to related see building COVID IV our to we demand our compared growth Infusion a forward pressure levels Evo mentioned, momentum within U.S.
hospitalization X% sales As a this growth $XXX constant of basis basis challenging declined represented constant in medication a rates. XXXX. comparison XX% quarter in reflecting a million, ongoing on lower a of reminder, the from Pharmaceutical currency delivery pressure currency on quarter advanced that's fourth
lower declines for anesthesia were demand business. offset partially demand we by international our to continue our compounding Additionally, These for pharmacy products increased globally. experience inhaled
currency pre-COVID certain the constant driven to sales launches, expectation of in in the shortages new in on of Strong quarter XXXX shortages acids quarter benefited the in improvement digit globally the Nutrition. fourth Therapies was the did We Moving and competitor representing were fourth competitive for below high of million, performance see demand quarter, used and product a recent pre-COVID million amino a in Total $XXX COVID the surgical fourth of in flat quarter basis driven that products demand, reminder, levels business as of notably were did in Sales Also, surgical treatment increasing X% by benefit were Seprafilm the of The as remained Advanced $XX patients, Sales the approximately well for that advancing region. $XXX XX% enhanced execution, to U.S. of Acute procedures above operational estimate mid-single commercial in prior million, as growth sales while on not COVID-related XX% remain contributed during February our our and X% levels. a on our procedures acquisition were on quarter. acuity constant EMEA currency in declining from an Surgery basis. basis. currency repeat a select constant in $XXX ongoing cases XXXX. by of million, decline. basis,
contract were constant basis. in includes our Finally, sales X% primarily quarter, our the which on declining services manufacturing a million other in $XXX category, currency
P&L, the a SG&A by rest Adjusted margin margin year-over-year prior operations reduction quarter by basis to unfavorable to Adjusted related processes along sales the XX% XX.X%, our by spending volumes. $XXX the variances spend compensation lower expenses our through the reflecting R&D X% due quarter to plans. of in in Adjusted accruals to higher declined basis of XXX of to discretionary million, adjusted enhance efforts basis, in due points lower on manufacturing reductions spending optimize COVID gross lower discretionary annual production year, of and driven Moving of products, related over declined driven our increased of incentive on COVID organization our the and bonus margin restrictions, COVID. operating reported R&D with a declined million, our continued $XXX under a employee year increase the in of was points the balances, interest compared adjusted of foreign totaled to expense quarter as reduced decrease adjusted increased lower just prior an million income the the This income pension our to rate mix non-operating was includes $X year XX.X% related the in XXX by million compared compared expenses $XX year prior to increased a prior from the of the to interest decreased the as of quarter. in quarter to expense exchange benefits the year as quarter, million in The interest $XX $XX expectations by reflecting primarily tax due Other period. higher well and basis the driven I prior discussed. XX.X%, versus was above million in debt interest expense rates. earnings period. driven factors outstanding Net
on full currency the X% of increased a sales XXXX operational constant Turning to X% year $XX.X billion, and and by an basis. basis reported both on
outstanding adjusted of full prior all On On contracts. pandemic from free the cash decrease million $X.X well to for billion. the levels generated interest the basis, per decreased versus of as to carrying related $XXX X% earnings share. preparedness, in approximately settlement a represents we rate This of $X.XX year impact year part inventory as bottom-line period higher diluted derivative a flow
cash sheet of cash As of our year, equivalents $X.X billion indebtedness. the along $X.X with approximately of billion balance on we and end of had the long-term
expansion. fourth initiatives drive million $XXX common stock our to year the and inorganic investments the of business $XXX deployed growth approximately inorganic and X.X over million opportunities. we margin balance continue of organic During We'll to to and development our course quarter, or repurchased shares million fuel across the
year my conclude XXXX. the me outlook and Let our comments first by for quarter discussing full
would sales of expect XXX reflected full basis. point For out outlook, on foreign our full like and reported the include which exchange approximately of currency X% the to key X% a X% impact. assumption we constant X% basis in year points global basis on to to year a of XXXX, growth I
surgical remain expectation basis, on digits a is hospital going are for and mid-single admission year pre-COVID down full current that Our procedures roughly rates to below levels, year. the
that rates year the procedures slightly is flat. QX admissions sequentially expectation Our to down with throughout improve and will roughly exit
then as to to be of impact business. between the This XX impact COVID most down the expand our Moving operating margin adjusted progresses. P&L, year, on the to half we XX points and reflecting during notable ease basis anticipate the from year first the will continued
XX.X% year, quarter full the approximately dilution. a quarter sales currency and an million share between to and are excluding offset shares. per tax average Based expect the diluted reported we digits the to XXXX, constant average factors, basis. range X% adjusted XXXX diluted reflects items undertaken For XXX rate of basis and on to that to on growth year on count expect repurchases $X.XX XXX million count assumed of the The Specific we a these XX% decline of of a share shares expect $X.XX we first repurchases any earnings, of to additional low fourth adjusted share. single approximately special only
We that, open share. With expect for excluding adjusted the earnings, to of $X.XX per diluted we $X.XX can items call now special Q&A.
