Alcon AG: Competitive Dynamics in Eye Surgery

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When I think about the 'big four' in eyecare overall, when you think about a global industry, it's relatively rare to see a small number of big players that collectively dominate the entire market. It's more often that you come to just one or two big players or you have many, many smaller players. I was wondering if you could talk about the competitive dynamic within this group of four players, to the degree to which they maybe engage in price wars during difficult times, the degree to which they just all happy with the margin, so nobody messes up a good thing. How does that play out?

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Alcon has had the pleasure of holding onto the highest share of all the players in the marketplace, at a premium price as well. That goes to the quality of products, as well as contracts where we would reward accounts, by rebate or discounts on invoice at product. For example – and I'm speaking as a surgical room right now, which is what my experience is – you have the phaco machine and disposables, that's one category. You have the viscoelastic, our fiscal surgical devices, which are, essentially, gels that they inject into the eye to hold space, so it's a surgical device. Then you have the custom packs, and then you have the IOLs. The more categories that they would participate in, the better their price would be on the full picture. That has been very successful for Alcon for many years. Lately, the marketplace and especially with me being with a competitor right now, where I'm able to exploit that, they almost feel like they're handcuffed to using a certain group of products versus what they would clinically designate as a better product, not being able to use it because it affects their cost of goods. That, frankly, is how Alcon has been able to hold such a large market share across all categories.

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From the beginning of Covid, through to now. They had talks about going from, high teens margins, adjusted margins to almost 25% and they're still talking about getting to almost 25%. But they're now talking about 'in a few years' as opposed to having maybe gotten there this year, if Covid never happened. But it's not clear to me that Covid should have disrupted that. It may be more of just a lack of execution on getting margins up.

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Yes, I think, for margins and Covid, it's hard to equate that into margins. Sales dollars, yes. Everybody had a recovery period. I think more of their margins are due to competitive price pressures. For example, in the interocular lens business right now, if I could guess, Alcon has about a 47% share of that business, followed by Johnson & Johnson with probably a 35% share, but now here comes Zeiss. Zeiss is now entering the market, challenging them on everything from surgical microscopes to phaco machines to interocular lenses, and they are having to defend their share by price concessions.

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