Stephen MacMillan
Chairman, President and Chief Executive Officer at Hologic
Thank you, Ryan, and good afternoon, everyone. And before I get started, I just want to do a quick shout out to Karleen and her family and let everybody know our thoughts and prayers are with her today. So we are pleased to discuss Hologic's financial results for the fourth quarter of fiscal 2023. Total revenue was $945.3 million, and non-GAAP earnings per share was $0.89. It was another strong quarter overall, with revenue finishing at the high end of our range and EPS exceeding our guidance.
Our fourth quarter capped off a tremendous year, where we continued our track record of success, strengthened our business and delivered on our commitments. For the full year, we posted $4.03 billion in revenue and non-GAAP EPS of $3.96.
In 2023, quite frankly, we delivered some pretty exceptional organic growth rates, which were far above our longer-term targets. At the start of the year, we committed to deliver low double-digit growth across each division. In the end, we delivered more, growing annual organic revenue ex-COVID, in the mid-teens at 15.6% with every division growing north of 13%. And international growth just above 20%. Despite various macro challenges, like clockwork, we continued to deliver, raising our financial guidance throughout the year, and living up to our commitments. At the same time, our balance sheet remains incredibly strong, and we have the financial flexibility to grow our business for the long term.
For fiscal 2024, we are confident in our ability to deliver against our 5% to 7% ex-COVID long-term organic growth target even against significant comps, one less selling week and a challenging macro environment. In fact, if we look at 2024 on an adjusted daily sales basis, our annual organic revenue growth rate, excluding COVID, is projected to be in the 6% to 8% range. Whether adjusting for selling days or not, we believe our results will truly stand out from the crowd as we progress throughout fiscal 2024 particularly following a year of almost 16% growth ex-COVID in 2023.
Before sharing more of our excitement for 2024, we will first reflect on our Q4 results. In Q4, we grew total organic revenue, excluding COVID 16.7%, with double-digit growth in every division. We again delivered on our promises. At the division level, Breast Health grew 27.4% driven primarily by the recovery in our gantry business. Interventional Breast also posted a strong quarter, growing in the low double-digits. We are pleased the division's gantry recovery is tracking to our expectations following the industry's chip supply challenges.
Moving on to Diagnostics. Organic growth ex COVID was 10.2%, again, driven by our strong molecular business. Organic molecular diagnostics ex COVID grew 15% for the quarter, driven once again by strong contributions from BV CV TV, MGEN and Biotheranostics. With fiscal 2023 revenue ex COVID at $1.48 billion, our diagnostics business is over 40% larger than it was in 2019. Even more impressive, our base molecular business is now nearly 80%, 80% larger than it was pre-pandemic. Molecular has grown through a combination of more than doubling our Panther installed base, adding new menu, gaining new customers as well as acquisitions into adjacent markets. This transformation and durable performance speaks to the ongoing success of our growth strategy.
Rounding out the divisions, Surgical revenue at over $600 million in fiscal 2023, is now nearly 40% larger than what it was in 2019. In Q4, Surgical grew 10.6%, driven primarily by MyoSure and Fluid both growing double digits. In addition, our laparoscopic portfolio also grew double-digits, albeit smaller in dollars compared to MyoSure influent. More importantly, we are pleased our laparoscopic portfolio continues to gain traction.
To close the overview of our quarterly results and fiscal 2023 highlights, our international business continued to be accretive to overall growth rates, growing north of 28% on an organic ex-COVID basis in Q4. We expect International to continue to be a key part of our growth story.
Before moving on, we'd like to revisit and reinforce our capital allocation strategy. In short, our capital allocation strategy remains the same. We continue to prioritize M&A opportunities; and second, we consistently look to utilize cash towards share repurchases, and we continue to be patient.
Having said that, we have recently seen the opportunity to deploy our cash balance more significantly taking the following four actions. One, in Q4 2023, we deployed $238 million of capital to buyback 3.2 million shares. Second, in our current fiscal Q1 2024, we have already repurchased another 2.2 million shares for $150 million. Three, today, we announced an additional $500 million accelerated share repurchase program; and four, we recently paid down $250 million of higher variable interest rate debt. Ryan will expand on both the ASR and debt repayment in his remarks.
Looking back four-plus years since the start of the pandemic, the biggest acquisition we have made is of ourselves. During this period, we deployed over $1.4 billion on M&A opportunities. And nearly $2.3 billion on share repurchases, including our recent repurchases in Q1 2024. And today's ASR announcement will make that $2.8 billion. As you can see, we are very confident in our position for the years ahead. Rounding out our capital allocation discussion to ensure we are optimized for the future, we carefully evaluate our portfolio on an ongoing basis. As a result, as mentioned in our release, we have recently divested our small SSI ultrasound business.
Shifting gears. As we have shared on prior calls, we have broadly transformed our business and strengthened our fundamentals, quarter-by-quarter, year-by-year, with macro hurdles ever present, we continue to prove our strength. Today, we are effectively a new Hologic, retooled and recapitalized with strong brands, wide moats, industry-leading margins and the strongest, deepest leadership team we've ever had. Hologic is a differentiated and more competitive company than at any time in our 38-year history.
At our core, we are fundamentally guided by our purpose, passion and promise. Our purpose to enable healthier lives everywhere, every day. Our passion, to champion women's health globally and our promise, the Science of Sure, to provide health care professionals with clinically differentiated high-quality products.
Across each division, we have distinct advantages created by our unique focus on elevating women's health through innovative products and trailblazing social initiatives like the Hologic Global Women's Health Index. We ultimately develop our leading positions by leaning into our purpose and proactively meeting our customers and patients' needs.
We will highlight three examples today. First, we are not only leaders in women's health, but we are also sector leaders in workflow automation. Our customers continue to deal with challenges, sourcing technicians and the persistent pressure to efficiently manage costs. As a result, user-friendly systems and efficient workflow solutions are at the top of our customers' expectations.
From our Panther instrument to our Brevera breast biopsy and fluid systems to name only a few, each product is designed to transform manual labor-intensive cumbersome processes. In the easy-to-use dependable and efficient workflows.
Second, the massive footprint and sheer size of our installed bases in Diagnostics and Breast Health provide a strong foundation in today's world. With more than 3,260 Panther instruments installed worldwide, and over 10,000 mammography systems installed across the US. We have the opportunity to be integral partners with the laboratories, hospitals and screening centers we support.
For Panther, as customers add more menu and drive incremental volume. Our molecular diagnostics business continues to grow while also becoming more valuable to our customers and more deeply rooted in their operations. The same can be said for our Breast Health business. Hologic is unique in our ability to support our customers and their patients at each step along the breast care continuum.
We differentiate ourselves with our ecosystem of technologies that integrate across a patient's journey, creating a more comfortable patient experience, greater clinical confidence for practitioners and increased operational efficiencies for our customers.
Moving on to our third example, our long-standing brand leadership across multiple product lines in each division, which yields strong stable margins and steady cash flow generation. We are innovators and leaders in breast and cervical cancer screening, STI testing, abnormal uterine bleeding treatment and fibroid removal. This is a significant statement given the strong competitors we face in each respective business
Our diversified leadership and scale across our business lines support industry-leading margins and cash flow. And in turn, we have the ability to further invest and grow our business. Altogether, we are emerging as a premier growth company, differentiated and more competitive delivering strong growth across each division and international as the new much stronger Hologic we are today, we consistently deliver and aim to continue to do so.
Turning our attention to 2024. I will touch on some of the high-level growth drivers in each business, and Ryan will finish the call with further detail related to next year's guidance.
First, in Breast Health, we expect 2024 to be another strong year of growth with our gantry backlog remaining elevated compared to historic levels, we have greater visibility into our pipeline, translating to higher confidence in future gantry sales, creating another exciting year for Breast Health.
In Diagnostics, as in recent years, molecular will continue to drive growth for the division. We expect our large global Panther installed base to continue to add new menu while also increasing volume for existing assays. In addition, our Biotheranostics business, which we acquired in 2021 is expected to continue delivering double-digit growth being accretive even to our molecular growth rate.
In 2023, Biotheranostics grew over 30%, and we are still in early innings growing the Breast Cancer Index test. BCI is still the only test recognized by NCCN guidelines and the American Society of Clinical Oncology to predict which patients are likely to benefit from extended adjuvant therapy beyond five years, yet another example of an innovative and differentiated product.
In Surgical, MyoSure, our Fluent system and our newer laparoscopic products that we acquired via Boulder and Acessa are projected to continue to drive growth. Internationally, Surgical also continues to shine. In 2023, our international surgical growth rate was more than double the U.S. growth rate. Surgical is clearly emerging as a strong and profitable growth drivers.
To conclude, entering 2024, we are a new and differentiated Hologic. We are bigger, stronger and more competitive than ever. Our leadership brands growth drivers across all three divisions: durable margin profile and strong balance sheet will continue to power us forward. As we look ahead to 2024, we are poised to continue to grow and make an even bigger impact on women's health around the world.
With that, let me hand the call over to Ryan.
