Brian P. McKeon
Executive Vice President, Chief Financial Officer at IDEXX Laboratories
Good morning and welcome to our third quarter earnings call. Today I'll take you through our Q3 results and review our updated financial outlook for 2023. In terms of highlights, IDEXX achieved solid revenue growth and strong profit gains in the third quarter. Overall revenues increased 8% organically, supported by 9% organic growth in CAG Diagnostics recurring revenues, net of approximately 50 basis points of negative impact from fewer equivalent selling days. Organic revenue growth was supported by sustained benefits from IDEXX execution drivers including continued strong premium instrument placements, solid new business gains, high levels of customer retention and high growth in recurring veterinary software revenues.
Overall CAG Diagnostics recurring revenue gains in the quarter were moderated by a 2% same-store decline in US clinical visits. This was below our expectations for relatively flattening US clinic visit trends, reflecting ongoing capacity management challenges at US clinics and relatively softer wellness visit levels. Operating profit results were ahead of our expectations, supported by gross margin gains and operating expense leverage, which enabled EPS delivery of $2.53 per share, up 18% as reported and 16% on a comparable basis.
Based on our strong financial results in the quarter, we're updating our full-year EPS outlook, aligned with the higher end of our previous guidance range. This reflects expectations for strong comparable operating margin gains this year. We're also updating our full-year revenue guidance ranges to incorporate our Q3 results and recent sector trends, as well as to reflect the recent strengthening of the US dollar. We'll review our updated guidance detail later in my comments.
Let's begin with a review of our third quarter results. Third quarter organic revenue growth of 8% was driven by 8% organic CAG gains and 7% organic growth in our Water business. Overall organic revenue growth was moderated by 2% organic growth in our LPD business and approximately $3 million of headwind related to lower OPTI Medical revenues, including effects from the wind down of our human Covid testing business. CAG Diagnostics recurring revenue increased 9% organically, reflecting 8.3% gains in the US and 10.3% growth in international regions, net of a 0.5% global growth headwind from equivalent days effects. CAG Diagnostics organic recurring revenue growth in Q3 was supported by average global net price improvement of approximately 7%, in line with our expectations for 6% to 7% gains in the second half of this year. Overall organic revenue growth was supported by 13% organic growth in veterinary software and diagnostic imaging revenues, driven by continued strong gains in recurring software revenues. CAG instrument revenues were down 10% organically, reflecting comparisons to high prior year levels, program pricing effects and global mix.
IDEXX CAG Diagnostics recurring revenue growth remained solidly above sector growth levels. In the US, CAG Diagnostics recurring revenue organic growth was 8.3% including approximately 50 basis points of negative impact from fewer selling days in Q3. This reflects an approximate 1100 basis point normalized growth premium compared to same-store US clinical visit growth levels, which declined an estimated 2% overall in the quarter. IDEXX's growth results reflected continued increases in diagnostics frequency and utilization per clinical visit at the practice level, and strong benefits from IDEXX execution drivers including higher net price realization, solid new business gains and sustained high customer retention levels.
As noted, same-store US clinical visit declines of 2% were below our expectations for relatively flat clinic visit growth in the second half of 2023. Softer trends in Q3 appear to have been impacted by ongoing capacity management challenges at US clinics, including effects from high staff turnover. We also saw a relative slowdown in wellness visits in the quarter, which may reflect some macro impacts on demand at the clinic level. We've refined our full year revenue outlook to capture potential impacts from these trends in Q4, while reinforcing our strong outlook for 2023 profit performance.
IDEXX International CAG Diagnostics recurring revenue organic growth was 10.3% in Q3, reflecting continued benefits from higher net price realization and improved volume gains. International results were also supported by strong IDEXX execution, reflected in sustained new business gains and high Q3 premium instrument placements, which supported a double digit expansion of our premium instrument installed base. Double digit growth rate benefits from IDEXX execution offset negative impacts from international macro conditions, which continued to pressure same-store volume growth trends in the quarter.
Globally, Q3 results were supported by strong growth of IDEXX in-clinic CAG Diagnostics recurring revenues. IDEXX VetLab consumable revenues increased 11% organically, with double-digit gains in US and International regions. Consumable gains were supported by 11% year-on-year growth in our global premium instrument installed base, reflecting strong gains across our Catalyst, premium hematology and SediVue platforms. We placed 4,571 CAG premium instruments in Q3, a decrease of 4% year-on-year compared to record prior year levels, which included benefits from our international launch of ProCyte One. The quality of instrument placements continues to be excellent, reflected in solid global gains in EVI metrics and sustained high new and competitive Catalyst placements in the US. Global Catalyst placements decreased 2% overall, reflecting tougher comparisons to high prior year international placement levels. ProCyte One installed base expansion continued at a solid pace reflected in a global installed base of over 12,000 instruments. Global Rapid Assay revenues expanded 8% organically in Q3, supported by strong growth in the US, including benefits from higher net price realization. Global lab revenues increased 7% organically, reflecting high single-digit gains in the US and relatively improved, mid-to-high single-digit growth in International regions.
In other areas of our CAG business, Veterinary Software and Diagnostic Imaging revenues increased 13% organically. Results were supported by continued high levels of organic growth in recurring software and diagnostic imaging revenues and ongoing momentum in cloud based software placements. Water revenues increased 7% organically in Q3 compared to strong prior year growth levels. Growth was driven by continued solid gains in the US, including benefits from net price improvement. Our Tecta-PDS acquisition integration continues to progress well and added approximately 1% to reported Water growth. Livestock, Poultry and Dairy revenues increased 2% organically, as strong gains in the US continue to be moderated by constraints on international growth, including impacts from lower herd health screening revenues related to reduced China import testing.
Turning to the P&L, Q3 profit results were supported by high comparable operating margin gains, including benefits from operating expense leverage. Gross profit increased 8% in the quarter as reported and on a comparable basis. Gross margins were 59.9%, up 30 basis points on a comparable basis, compared to strong prior year levels. Gross margin gains reflected benefits from higher net price realization, business mix and improvement in software service gross margins. As expected, reported gross margin gains were moderated by 60 basis point negative impact related to FX, driven by the lapping of prior year hedge gains. We're projecting an approximate 70 basis point gross margin headwind in Q4 related to FX, again primarily related to lapping of prior year hedge gains.
On a reported basis, operating expenses increased 4% year-on-year as reported and on a comparable basis, reflecting benefits from cost controls and lapping of prior year R&D and commercial investments. We're planning for a higher level of opex growth in Q4 as we advance our US commercial expansion and increase R&D investments aligned with our innovation initiatives, including our planned 2024 new platform launch. EPS was $2.53 per share in Q3, an increase of 18% as reported and 16% on a comparable basis. Foreign exchange reduced operating profits by $1 million and EPS by $0.01 per share in the quarter, including impacts from the lapping of $9 million in prior year hedge gains. Impacts from 2023 foreign exchange hedges resulted in a $1 million gain in the quarter. Free cash flow was $238 million in the third quarter. On a trailing 12-month basis, our net income to free cash flow conversion ratio was 83%. For the full year, we're updating our outlook for free cash flow conversion to 85% to 90% of net income at the higher end of our earlier projections, reflecting estimated capital spending of $160 million to $180 million.
Our balance sheet remains in a strong position. We ended the quarter with leverage ratios of 0.8 times gross and 0.6 times net of cash. Share repurchases over the last year supported a 0.1% reduction in diluted shares outstanding for the quarter. We allocated $35 million in capital to share repurchases in the third quarter, as we continue to manage our balance sheet relatively more conservatively in the current interest rate environment.
Turning to our 2023 P&L guidance, we're updating our full-year outlook to incorporate our Q3 results and revised estimates for foreign exchange impacts, reflecting the recent strengthening of the US dollar. Our updated full-year guidance for reported revenues is $3,635 million to $3,650 million, reflecting a 7.9% to 8.4% reported growth range. The updated reported revenue outlook includes a $20 million reduction for FX impacts compared to prior estimates. We now estimate FX will reduce full-year reported growth by approximately 0.5%, with limited year-on-year revenue growth effects in Q4.
In terms of our operational revenue growth outlook, we are updating our full-year organic growth guidance to 8.3% to 8.8% supported by an outlook for CAG Diagnostics recurring revenue organic growth of 9.8% to 10.3%. This aligns with the lower end of our most recent guidance ranges and the midpoint of our original guidance for 2023. Our organic growth guidance assumes a level of continued pressure on US same-store clinical visits and international same-store sales levels in Q4, reflecting ongoing clinic capacity management dynamics and macro-economic impacts on demand. Consistent with earlier guidance, our outlook for CAG Diagnostics recurring revenue growth reflects continued solid, positive benefits from IDEXX execution drivers including consistent expectations for 6% to 7% net price improvement in the second half of 2023. In Q4, we expect global net price improvement within this range, with US net price gains of approximately 6%, reflecting the lapping of prior year price increases. Our Q4 outlook also incorporates a 1% equivalent day volume growth headwind.
We're maintaining the high end of our reported EPS outlook and narrowing the full-year EPS guidance range to $9.74 to $9.90 per share, an increase of $0.05 per share at midpoint. At midpoint, we're maintaining a consistent operational EPS outlook, as revisions to our organic revenue growth range are offset by positive adjustments to our projections for operating margins, incorporating our strong year-to-date performance. We've increased the outlook for reported operating margins to 29.6% to 29.8% for the full year. This reflects an outlook for 360 basis points to 380 basis points in comparable operating margin expansion, including approximately 280 basis points in combined benefit from the $16 million Q1 customer contract resolution payment and the lapping of $80 million of discrete R&D investment in the second quarter of 2022. Our updated full year EPS guidance incorporates $0.11 per share in positive revisions combined to our interest expense and tax rate outlook including $0.04 in upsides related to share based compensation tax benefits. These gains are partially offset by $0.05 of negative impact from foreign exchange changes at updated rates. We now estimate that foreign exchange impacts will decrease EPS by $0.25 per share for the full year and will reduce reported full year operating margins by approximately 70 basis points including impacts from the lapping of $26 million in 2022 hedge gains.
We've provided details on our updated 2023 outlook in the press release tables and earnings snapshot. That concludes our financial review. I'll now turn the call over to Jay for his comments.