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Integra LifeSciences Reports Fourth Quarter and Full-Year 2025 Financial Results and Provides 2026 Financial Guidance

PRINCETON, N.J., Feb. 26, 2026 (GLOBE NEWSWIRE) —  Integra LifeSciences Holdings Corporation (NASDAQ: IART) today reported financial results for the fourth quarter and full year ended December 31, 2025.

Fourth Quarter 2025

  • Reported revenues were $434.9 million, representing a decrease of 1.7% on a reported basis and 2.5% on an organic basis compared to the fourth quarter of 2024.
  • GAAP earnings per diluted share were $(0.02), compared to $0.25 in the fourth quarter of 2024.
  • Adjusted earnings per diluted share were $0.83, compared to $0.97 in the fourth quarter of 2024.

Full-Year 2025

  • Reported revenues were $1,635.2 million, representing an increase of 1.5% on a reported basis and a decrease of 0.7% on an organic basis compared to full-year 2024.
  • GAAP earnings per diluted share were $(6.74), compared to $(0.09) in 2024.
  • Adjusted earnings per diluted share were $2.23, compared to $2.56 in 2024.

“In the fourth quarter, we drove tangible operational progress while continuing to deliver for our customers and patients,” said Mojdeh Poul, president and chief executive officer. “During 2025, we further strengthened our quality management system, advanced our Compliance Master Plan, and progressed execution of our remediation work. Our operational and execution focus resulted in significant outcomes in key areas, namely Integra Skin supply reliability, healthier safety stock levels across our portfolio, and early relaunch of PriMatrix and Durepair.”

“Earlier this month we implemented a key element of our transformation plan – a simplified operating model that improves alignment, execution, and accountability.   This is critical to our long-term margin improvement plan and a key contributor to our previously communicated savings of $25-$30 million in 2026. Combined with focused portfolio prioritization and disciplined capital allocation, these actions reinforce the foundation for long-term sustainable growth, innovation, and performance.”    

Fourth Quarter 2025 Financial Summary

Total reported revenues for the fourth quarter were $434.9 million, a decrease of 1.7% from the fourth quarter of 2024. Fourth quarter organic revenues were down 2.5% compared to the prior year.

The Company reported a GAAP net loss of $(1.7) million, or $(0.02) per diluted share, in the fourth quarter of 2025, compared to GAAP net income of $19.4 million, or $0.25 per diluted share, in the prior year.

Adjusted EBITDA for the fourth quarter of 2025 was $104.2 million, compared to $104.9 million in the fourth quarter of 2024. As a percentage of revenue, adjusted EBITDA was 24.0%, compared to 23.7% in the prior year.

Adjusted net income for the fourth quarter of 2025 was $63.7 million, or $0.83 per diluted share, compared to adjusted net income of $73.3 million, or $0.97 per diluted share, in the fourth quarter of 2024.

Cash flows from operations totaled $11.8 million in the fourth quarter and capital expenditures were $17.2 million.

Fourth Quarter 2025 Segment Performance

  • Codman Specialty Surgical (75% of Revenues)
    Total revenues were $323.3 million, representing an increase of 2.7% on a reported basis and 1.6% on an organic basis compared to the fourth quarter of 2024.
    • Sales in Neurosurgery grew 1.4% on an organic basis reflecting growth against a strong prior-year comparison, with continued strong performance across key products, including double-digit growth in CereLink®, Mayfield® capital, and Aurora®, along with high-single digit growth in CUSA®.
    • Sales of Instruments grew 2.3% on an organic basis, in-line with the market.
    • ENT sales grew 2.2% on an organic basis driven by AERA®, TruDi® navigated disposables, and MicroFrance® instruments, partially offset by a decline in sinuplasty balloons.
    • Sales in International grew high-single digits, reflecting continued strong demand.

Tissue Technologies (25% of Revenues)
Total revenues were $111.6 million, representing a decrease of 12.8% on a reported and 12.8% on an organic basis compared to the fourth quarter of 2024.

    • Sales in Wound Reconstruction declined 21.4% on an organic basis primarily due to the previously communicated remediation efforts for MediHoney® and a challenging year-over-year comp for Integra Skin, which generated record revenue in the fourth quarter of 2024 due to backorder clearance.
    • Sales in private label grew 20.1% on an organic basis due in part to improved partner orders.   

Full-Year 2025 Financial Summary

Total reported revenues for the full-year 2025 were $1,635.2 million, an increase of 1.5% from the prior year. Organic sales for the full-year 2025 were down 0.7% compared to 2024.

The Company reported a GAAP net loss of $(516.5) million or $(6.74) per diluted share, for the full-year 2025, driven primarily by a $511 million goodwill impairment charge recorded in the second quarter. This non‑cash charge resulted from the decline in the Company’s share price, which reflected several external and operational factors, including tariff changes as well as quality, operational, and supply‑related challenges. This compares to a GAAP net loss of $(6.9) million, or $(0.09) per diluted share in 2024.

Adjusted EBITDA for the full-year 2025 was $317.5 million, a decrease of $4.7 million versus the prior year. Full- year adjusted EBITDA margins were 19.4%, a decrease of 60 basis points from the prior year period.

Adjusted net income for the full-year 2025 was $171.4 million, or $2.23 per diluted share, compared to $196.9 million, or $2.56 per diluted share in the prior year.

2025 Balance Sheet, Cash Flow and Capital Allocation

The Company generated cash flow from operations of $50.4 million for the full-year 2025. Full-year capital expenditures were $81.4 million. Net debt at the end of the year was $1.6 billion, and the consolidated total leverage ratio was 4.5x. As of year-end, the Company had total liquidity of approximately $516 million, including approximately $263.7 million in cash plus short-term investments and the remainder available under its revolving credit facility.

2026 Revenue and Adjusted Earnings Per Share Guidance

For the full-year 2026, the Company expects revenues to be in the range of $1,662 million to $1,702 million, representing reported growth of 1.6% to 4.1% and organic growth of 0.8% to 3.3%. Adjusted earnings per diluted share are expected to be between $2.30 and $2.40, reflecting a full year of tariffs offset by margin improvement initiatives.

For the first quarter 2026, the Company expects reported revenues in the range of $375 million to $390 million, representing reported growth of -2.0% to 1.9% and organic growth of -3.4% to 0.5%. Adjusted earnings per diluted share are expected to be in the range of $0.37 to $0.45.

Full year and first quarter adjusted earnings per diluted share guidance reflects the Company’s tariff assumptions in place prior to last week’s Supreme Court ruling and the subsequent announcement regarding implementation of Section 122 tariffs and does not contemplate the recovery of any amounts already paid.

Organic sales growth excludes the effects of foreign currency.

The Company is providing forward-looking guidance regarding adjusted earnings per diluted share but is not providing a reconciliation to GAAP earnings per share, because certain GAAP expense items are highly variable, and management is unable to predict them with reasonable certainty and without unreasonable effort. Specifically, the financial impact and timing of divestitures, acquisitions, integrations, structural optimization and efforts to comply with the EU Medical Device Regulation are uncertain, depend on various dynamic factors and are not reasonably ascertainable at this time. These expense items could have a material impact on GAAP results.

Conference Call and Presentation Available Online

Integra has scheduled a conference call for 8:30 a.m. ET on Thursday, February 26, 2026, to discuss fourth quarter and full-year 2025 financial results, and forward-looking financial guidance. The conference call will be hosted by Integra’s senior management team and will be open to all listeners. Additional forward-looking information may be discussed in a question-and-answer session following the call. Integra’s management team will reference a presentation during the conference call, which can be found on the Investor Relations section of the website at investor.integralife.com.

A live webcast will be available on the Investors section of the Company’s website at investor.integralife.com. For those planning to participate on the call, please register here to receive dial-in details and a unique pin. While not required, it is recommended to join 10 minutes prior to the start of the event. A webcast replay of the conference call will be available on the Investor Relations section of the Company’s website following the call.

About Integra

Integra LifeSciences (Nasdaq: IART) is a global medical technology leader dedicated to restoring lives. We are advancing transformational care through impactful innovation in neurosurgery, tissue reconstruction, specialized fields that demand exceptional expertise and precision. Our portfolio of highly differentiated, gold-standard technologies are trusted by healthcare professionals to deliver life-saving care. For our latest news and information, visit www.integralife.com

Forward-Looking Statements

This news release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 that involve risks and uncertainties and reflect the Company’s judgment as of the date of this release. All statements, other than statements of historical fact, are statements that could be deemed forward-looking statements. Some of these forward-looking statements may contain words like “will,” “believe,” “may,” “could,” “would,” “might,” “possible,” “should,” “expect,” “intend,” “forecast,” “guidance,” “plan,” “anticipate,” “target,” or “continue,” the negative of these words, other terms of similar meaning or they may use future dates. Forward-looking statements contained in this news release include, but are not limited to, statements concerning: future business, operational and financial performance and the Company’s expectations and plans with respect to market opportunity, business and operational performance, strategic initiatives, capabilities, resources, manufacturing capabilities, product development, product availability and regulatory approvals, including expectations regarding the Company’s compliance master plan to improve the Company’s quality systems. It is important to note that the Company’s goals and expectations are not predictions of actual performance. Such forward-looking statements involve risks and uncertainties that could cause actual results to differ materially from predicted or expected results. Such risks and uncertainties include, but are not limited, to the following: the ongoing and possible future effects of global challenges, including macroeconomic uncertainties, U.S. and global trade policies, inflation, supply chain disruptions, geopolitical conflicts, on the Company’s suppliers, vendors and customers and on the Company’s business and financial condition, results of operations and cash flows; the Company’s ability to execute its financial, strategic and operating plans effectively; the Company’s ability to remediate quality systems violations; difficulties in implementing the Company’s compliance master plan; difficulties or delays in obtaining and maintaining required regulatory approvals, including the costs thereof potential difficulties, delays and disruptions in manufacturing, distribution or sale of products; the failure of the company’s suppliers, vendors, and other third parties to meet contractual, regulatory and other obligations; the anticipated development of markets the Company sells its products into and the success of the Company’s products in these markets; the Company’s ability to predict accurately the demand for its products, and products under development; increasing industry competition; the coverage and reimbursement decisions of third-party payors; trends toward health care cost containment; difficulties in controlling expenses, including costs to procure and manufacture the Company’s products; the ability of the Company to successfully manage leadership and organizational changes and the impact of changes in management or staff levels; the impact of goodwill and intangible asset impairment charges if future operating results of acquired businesses are significantly less than the results anticipated at the time of the acquisitions, the geographic distribution of where the Company generates its taxable income; changes to applicable laws, regulations and enforcement guidance, including tax laws and global health care reforms; fluctuations in foreign currency exchange rates; the amount of our bank borrowings outstanding and other factors influencing liquidity; breaches, failures or other disruptions of our or our vendors’ or customers’ information technology systems or products; and the economic, competitive, governmental, technological, and other risk factors and uncertainties identified under the heading “Risk Factors” included in Item 1A of Integra’s Annual Report on Form 10-K for the year ended December 31, 2025 and information contained in subsequent filings with the Securities and Exchange Commission.

These forward-looking statements are made only as of the date hereof, and the Company undertakes no obligation to update or revise the forward-looking statements, whether as a result of new information, future events, or otherwise, except as otherwise required by law.

Discussion of Adjusted Financial Measures
In addition to our GAAP results, we provide certain non-GAAP measures, including organic revenues, adjusted earnings before interest, taxes, depreciation and amortization (“EBITDA”), adjusted net income, adjusted gross margin, adjusted earnings per diluted share, and net debt.   Organic revenues consist of total revenues excluding the effects of currency exchange rates, revenues from current-period acquisitions and product divestitures. Adjusted EBITDA consists of GAAP net income excluding: (i) depreciation and amortization; (ii) other income (expense); (iii) interest income and expense; (iv) income tax expense (benefit); (v) impairment charges; and (vi) those operating expenses also excluded from adjusted net income. The measure of adjusted EBITDA margin is calculated by dividing adjusted EBITDA by GAAP revenues. The measure of adjusted net income consists of GAAP net income, excluding: (i) structural optimization charges; (ii) divestiture, acquisition and integration-related charges; (iii) EU Medical Device Regulation-related charges; (iv) charges related to the manufacturing stoppage and voluntary global recall of all products manufactured at the Company’s Boston, Massachusetts facility and distributed between March 1, 2018 and May 22, 2023, as previously disclosed in the Company’s Current Report on Form 8-K filed with the Securities and Exchange Commission on May 23, 2023 (the “recall”) and the transition of Boston-related manufacturing operations to the Company’s Braintree, Massachusetts facility; (v) intangible asset amortization expense; (vi) income tax impact from adjustments; and (vii) impairment charges.   The measure of adjusted gross margin is calculated by dividing adjusted gross profit by total revenues. Adjusted gross profit consists of GAAP gross profit adjusted for: (i) structural optimization charges; (ii) divestiture, acquisition and integration-related charges; (iii) charges related to the recall and the transition of Boston-related manufacturing operations to the Company’s Braintree, Massachusetts facility; (iv) EU Medical Device Regulation-related charges; and (v) intangible asset amortization expense. The adjusted earnings per diluted share measure is calculated by dividing adjusted net income attributable to diluted shares by diluted weighted average shares outstanding.    The measure of net debt consists of GAAP total debt (excluding deferred financing costs) less short-term investments, cash and cash equivalents.

Reconciliations of GAAP revenues to organic revenues, GAAP net income to adjusted EBITDA and adjusted net income, GAAP gross profit to adjusted gross profit, GAAP gross margin to adjusted gross margin, and GAAP earnings per diluted share to adjusted earnings per diluted share all for the quarters and years ended December 31, 2025 and 2024, GAAP total debt to net debt for the years ended December 31, 2025 and 2024, and the GAAP operating cash flow to free cash flow and adjusted free cash flow conversion for the quarters and years ended December 31, 2025 and 2024, appear in the financial tables in this release.  

The Company is providing forward-looking guidance regarding adjusted earnings per diluted share but is not providing a reconciliation to GAAP earnings per share, because certain GAAP expense items are highly variable, and management is unable to predict them with reasonable certainty and without unreasonable effort. Specifically, the financial impact and timing of divestitures, acquisitions, integrations, structural optimization and efforts to comply with the EU Medical Device Regulation are uncertain, depend on various dynamic factors and are not reasonably ascertainable at this time. These expense items could have a material impact on GAAP results.

The Company believes that the presentation of organic revenues and the other non-GAAP measures provide important supplemental information to management and investors regarding financial and business trends relating to the Company’s financial condition and results of operations.   For further information regarding why Integra believes that these non-GAAP financial measures provide useful information to investors, the specific manner in which management uses these measures, and some of the limitations associated with the use of these measures, please refer to the Company’s Current Report on Form 8-K regarding this earnings press release filed today with the Securities and Exchange Commission. This Current Report on Form 8-K is available on the SEC’s website at   www.sec.gov or on our website at www.integralife.com.  

Investor Relations Contact:
Chris Ward
(609) 772-7736
chris.ward@integralife.com 

Media Contact:
Laurene Isip
(609) 208-8121
laurene.isip@integralife.com 

INTEGRA LIFESCIENCES HOLDINGS CORPORATION
 
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
 
(UNAUDITED)
 
(In thousands, except per share amounts)
 Three Months Ended
December 31,
 Twelve Months Ended
December 31,
  2025   2024   2025   2024 
Total Revenue, net$434,925  $442,645  $1,635,245  $1,610,527 
Costs and Expenses:       
Cost of goods sold 214,060   193,573   803,625   728,466 
Research and development 24,791   31,210   98,971   115,377 
Selling, general and administrative 169,267   178,520   699,700   716,983 
Intangible asset amortization 3,768   3,715   14,954   21,290 
Goodwill impairment charge       511,365    
Total costs and expenses 411,885   407,018   2,128,615   1,582,116 
Operating (loss) income 23,040   35,627   (493,370)  28,411 
Interest income 4,361   4,893   18,474   20,040 
Interest expense (23,673)  (18,984)  (86,255)  (70,632)
Other (expense) income, net 582   1,005   (2,351)  3,944 
(Loss) income before income taxes 4,310   22,541   (563,502)  (18,237)
(Benefit) provision for income taxes 6,014   3,106   (47,028)  (11,293)
Net (loss) income$(1,704) $19,435  $(516,474) $(6,944)
        
Net (loss) income per share       
Diluted (0.02)  0.25   (6.74)  (0.09)
Weighted average common shares outstanding for diluted net income per share 76,777   76,419   76,672   77,010 
        
        

Segment revenues and growth in total revenues excluding the effects of currency exchange rates, acquisitions and discontinued products are as follows:

(In thousands)

 Three Months Ended
December 31,
 Twelve Months Ended
December 31,
  2025  2024Change  2025  2024Change
Neurosurgery$226,200 $220,0912.8% $827,667 $803,8163.0%
Instruments(1) 52,291  51,0292.5%  206,472  204,1771.1%
ENT(1) 44,815  43,5402.9%  166,372  135,64322.7%
Total Codman Specialty Surgical 323,306  314,6602.7%  1,200,511  1,143,6365.0%
        
Wound Reconstruction and Care 79,975  101,527(21.2)%  323,488  350,565(7.7)%
Private Label 31,644  26,45819.6%  111,246  116,326(4.4)%
Total Tissue Technologies 111,619  127,985(12.8)%  434,734  466,891(6.9)%
Total Reported Revenues$434,925 $442,645(1.7)% $1,635,245 $1,610,5271.5%
        
Impact of changes in currency exchange rates (3,523)    (6,679)  
Less contribution of revenues from acquisitions      (29,092)  
Less contribution of revenues from divested products         
Less contribution of revenues from discontinued products         
Total organic revenues$431,402 $442,645(2.5)% $1,599,474 $1,610,527(0.7)%

(1) Organic revenues have been adjusted to exclude foreign currency (current period), acquisitions and to account for divested and discontinued products.

Items included in GAAP net income and from continuing operations and locations where each item is recorded are as follows:

(In thousands)

Three Months Ended December 31, 2025

ItemTotal
Amount
COGS(a)SG&A(b)R&D(c)Amortization(d)OI&E(e)Tax(f)
Acquisition, divestiture and integration-related charges(1,002)199(1,667)219248  
Structural Optimization charges20,334 9,64510,200 814(324) 
EU Medical Device Regulation charges9,749 9514,068 4,730  
Boston Recall/Braintree Transition13,806 13,588218   
Intangible asset amortization expense26,919 23,152 3,768  
Estimated income tax impact from above adjustments and other items(4,362)  (4,362)
Depreciation expense11,287    

a)   COGS – Cost of goods sold
b)   SG&A – Selling, general and administrative
c)   R&D – Research & development
d)   Amortization – Intangible asset amortization
e)   OI&E – Other income & expense
f)   Tax – Income tax expense (benefit)

Three Months Ended December 31, 2024

ItemTotal
Amount
COGS(a)SG&A(b)R&D(c)Amortization(d)OI&E(e)Tax(f)
Acquisition, divestiture and integration-related charges2,264 5133151,034402 
Structural Optimization charges9,083 4,2384,261583 
EU Medical Device Regulation charges9,461 1,0543,9334,474 
Boston Recall/Braintree Transition11,358 10,966392 
Intangible asset amortization expense26,557 22,8423,715 
Estimated income tax impact from above adjustments and other items(4,902)(4,902)
Depreciation expense10,935  

(a) COGS – Cost of goods sold
(b) SG&A – Selling, general and administrative
(c) R&D – Research and development
(d) Amortization – Intangible asset amortization
(e) OI&E – Other income and expense
(f) Tax – Income tax expense

Items included in GAAP net income and location where each item is recorded are as follows:

(In thousands)

Twelve Months Ended December 31, 2025

ItemTotal
Amount
COGS(a)SG&A(b)R&D(c)Amortization(d)OI&E(e)Tax(f)
Acquisition, divestiture and integration-related charges3,5971,0472,234(1,276)1,592 
Structural Optimization charges47,99427,52120,495302 (324)
EU Medical Device Regulation charges41,9284,27718,47119,180  
Boston Recall/Braintree Transition56,20254,9531,250  
Intangible asset amortization expense107,06092,106 14,954 
Estimated income tax impact from above adjustments and other items80,292  80,292
Depreciation expense43,987  
        

(a) COGS – Cost of goods sold
(b) SG&A – Selling, general and administrative
(c) R&D – Research and development
(d) Amortization – Intangible asset amortization
(e) OI&E – Interest (income) expense, net and other (income), net
(f) Tax – Income tax expense

Twelve Months Ended December 31, 2024

ItemTotal
Amount
COGS(a)SG&A(b)R&D(c)Amortization(d)OI&E(e)Tax(f)
Acquisition, divestiture and integration-related charges33,626 9,07125,793(1,542)304 
Structural Optimization charges24,194 16,1957,395604  
EU Medical Device Regulation charges44,570 4,02018,87521,674  
Boston Recall/Braintree Transition45,034 43,1751,859  
Intangible asset amortization expense105,252 83,962 21,290 
Estimated income tax impact from above adjustments and other items(48,792) (48,792)
Depreciation expense41,449   
        

(a) COGS – Cost of goods sold
(b) SG&A – Selling, general and administrative
(c) R&D – Research and development
(d) Amortization – Intangible asset amortization
(e) OI&E – Interest (income) expense, net and other (income), net
(f) Tax – Income tax expense

INTEGRA LIFESCIENCES HOLDINGS CORPORATION
RECONCILIATION OF NON-GAAP ADJUSTMENTS – GAAP NET INCOME FROM CONTINUING OPERATIONS TO ADJUSTED EBITDA
(UNAUDITED)
 
(In thousands)
    
 Three Months Ended
December 31,
 Twelve Months Ended
December 31,
  2025  2024   2025  2024 
      
GAAP net (loss) income$(1,704)$19,435  $(516,474)$(6,944)
Non-GAAP adjustments:     
Depreciation and intangible asset amortization expense 38,206  37,491   151,047  146,701 
Goodwill impairment charges      511,365   
Other (income) expense, net (258) (1,407)  2,635  (4,248)
Interest expense, net 19,064  14,091   66,229  50,591 
Income tax expense 6,014  3,106   (47,028) (11,293)
Structural optimization charges 20,334  9,083   47,994  24,194 
EU Medical Device Regulation charges 9,749  9,461   41,928  44,570 
Boston Recall 13,806  11,358   56,202  45,034 
Acquisition, divestiture and integration-related charges (1,002) 2,264   3,597  33,626 
Total of non-GAAP adjustments 105,913  85,447   833,969  329,175 
Adjusted EBITDA$104,209 $104,882  $317,494 $322,231 

INTEGRA LIFESCIENCES HOLDINGS CORPORATION
RECONCILIATION OF NON-GAAP ADJUSTMENTS – GAAP NET INCOME FROM CONTINUING OPERATIONS TO MEASURES OF ADJUSTED NET INCOME AND ADJUSTED EARNINGS PER SHARE
(UNAUDITED)
 
(In thousands, except per share amounts)
    
 Three Months Ended
December 31,
 Twelve Months Ended
December 31,
  2025  2024   2025  2024 
      
GAAP net (loss) income$(1,704)$19,435  $(516,474)$(6,944)
Non-GAAP adjustments:     
Structural optimization charges 20,334  9,083   47,994  24,194 
Acquisition, divestiture and integration-related charges (1,002) 2,264   3,597  33,626 
EU Medical Device Regulation charges 9,749  9,461   41,928  44,570 
Boston Recall 13,806  11,358   56,202  45,034 
Goodwill Impairment Charge      511,365   
Intangible asset amortization expense 26,919  26,557   107,060  105,252 
Estimated income tax impact from adjustments and other items (4,362) (4,902)  (80,292) (48,792)
Total of non-GAAP adjustments 65,444  53,821   687,854  203,884 
Adjusted net income$63,740 $73,256  $171,380 $196,940 
      
Adjusted diluted net income per share 0.83  0.97   2.23  2.56 
Weighted average common shares outstanding for diluted net income per share 76,918  76,419   76,786  77,079 

INTEGRA LIFESCIENCES HOLDINGS CORPORATION
CONDENSED BALANCE SHEET DATA
(UNAUDITED)
(In thousands)
  
 December 31,
  2025 2024
   
Short term investments$28,693$27,192
Cash and cash equivalents 235,048 246,375
Accounts receivable, net 278,849 272,370
Inventory, net 492,735 429,090
   
Current and long-term borrowing under senior credit facility 1,768,306 1,121,823
Borrowings under securitization facility 87,800 108,100
Convertible securities  573,170
   
Stockholders’ equity 1,043,463 1,545,280

INTEGRA LIFESCIENCES HOLDINGS CORPORATION
CONDENSED STATEMENT OF CASH FLOWS
(UNAUDITED)
 
 Twelve Months Ended December 31,
  2025  2024 
Net cash provided by operating activities$50,384 $129,382 
Net cash used in investing activities (108,063) (390,808)
Net cash used in by financing activities 28,335  237,863 
Effect of exchange rate changes on cash and cash equivalents 18,017  (6,464)
   
Net increase (decrease) in cash and cash equivalents$(11,327)$(30,027)
   
   

RECONCILIATION OF NON-GAAP ADJUSTMENTS – GAAP OPERATING CASH FLOW TO
MEASURES OF ADJUSTED FREE CASH FLOW AND ADJUSTED FREE CASH FLOW CONVERSION
(UNAUDITED)
(In thousands)
  
 Three Months Ended December 31,
  2025  2024 
GAAP Net cash provided by operating activities$11,815 $50,746 
   
Purchases of Property and Equipment (17,214) (29,599)
Adj Free Cash Flow$(5,399)$21,147 
   
Adjusted Net Income (1)$63,740 $73,256 
Adjusted Free Cash Flow Conversion(8.5)% 28.8%
   
   
 Twelve Months Ended December 31,
  2025  2024 
GAAP Net cash provided by operating activities$50,384 $129,382 
   
Purchases of Property and Equipment (81,436) (104,418)
Adj Free Cash Flow$(31,052)$24,964 
   
Adjusted Net Income (1)$171,380 $196,940 
Adjusted Free Cash Flow Conversion(18.1)% 12.7%

(1) Adjusted net income for quarters and twelve months ended December 31, 2025 and 2024 are reconciled above. Adjusted net income for remaining quarters in the trailing twelve months calculation have been previously reconciled and are publicly available in the Quarterly Earnings Call Presentations on our website at investor.integralife.com.

The Company calculates adjusted free cash flow conversion by dividing its free cash flow by adjusted net income. The Company believes this measure is a useful metric in evaluating the significance of the cash special charges in its adjusted earnings measures.

RECONCILIATION OF NON-GAAP ADJUSTMENTS – NET DEBT CALCULATION
(UNAUDITED)
 
(In thousands) 
 December 31,
2025
December 31,
2024
Short-term borrowings under senior credit facility$38,750 $33,906 
Long-term borrowings under senior credit facility 1,729,556  1,087,917 
Borrowings under securitization facility 87,800  108,100 
Convertible Securities   573,170 
Deferred financing costs netted in the above 3,257  5,475 
Short-term investments (28,693) (27,192)
Cash & Cash Equivalents (235,048) (246,375)
Net Debt$1,595,622 $1,535,001 
   
   

RECONCILIATION OF NON-GAAP ADJUSTMENTS – GAAP GROSS PROFIT TO MEASURES OF ADJUSTED GROSS PROFIT AND ADJUSTED GROSS MARGIN
(UNAUDITED)
 
(In thousands, except percentages)
 Three Months Ended December 31, Twelve Months Ended December 31,
  2025   2024   2025   2024 
        
Total revenues, net$434,925  $442,645  $1,635,245  $1,610,527 
Cost of goods sold 214,060   193,573   803,625   728,466 
Reported Gross Profit$220,865  $249,072  $831,620  $882,061 
Structural optimization charges 9,645   4,238   27,521   16,195 
Acquisition, divestiture and integration-related charges 199   513   1,047   9,071 
Boston Recall/Braintree Transition 13,588   10,966   54,953   43,175 
EU Medical Device Regulation 951   1,054   4,277   4,020 
Intangible asset amortization expense 23,152   22,842   92,106   83,962 
Adjusted Gross Profit$268,400  $288,685  $1,011,524  $1,038,484 
Total Revenues$434,925  $442,645  $1,635,245  $1,610,527 
Adjusted Gross Margin 61.7%  65.2%  61.9%  64.5%

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