The Medical Devices segment, excluding the impact of foreign exchange, increased 15.1% in 2023 and 8.1% in 2022. The sales increases in 2023 and 2022 were driven by growth in Diabetes Care, Electrophysiology, Heart Failure, and Structural Heart.

Abbott completed the acquisitions of Bigfoot Biomedical, Inc. and Cardiovascular Systems, Inc. in 2023, expanding its portfolio in diabetes care and vascular devices, respectively.

Sales in emerging markets, which represent approximately 38 percent of total company sales, increased 5.4 percent in 2023 and 5.6 percent in 2022, excluding the impact of foreign exchange.

Abbott's global supply chain has improved after several years of challenges, and there have been no recent significant availability problems or supply shortages for raw materials or supplies.

Abbott management approved plans to restructure various operations in order to reduce costs in its medical devices, diagnostic, and established pharmaceutical businesses. Abbott recorded employee related severance and other charges of approximately $144 million in 2023 related to these plans.

Abbott initiated a voluntary recall in February 2022 of certain infant powder formula products manufactured at its facility in Sturgis, Michigan, which negatively impacted sales and operating margins in the Nutritional Products segment.

Abbott's information systems are susceptible to cybersecurity incidents, which could result in adverse consequences, including regulatory inquiries, increased costs, and reputational damage.

Disruptions to Abbott's large and complex global supply chain could negatively affect Abbott's results of operations. The COVID-19 pandemic and macroeconomic conditions such as inflationary pressures and labor shortages contributed to global supply chain challenges over the last few years.

Compliance with numerous governmental regulations is costly and materially affects Abbott's business. Failure to comply can delay the release of a new product or result in regulatory and enforcement actions, the seizure or recall of a product, and other civil or criminal sanctions.

Abbott faces intense competition in all of its segments, including from other health care and pharmaceutical companies, as well as generic and private label manufacturers.

Competitors' products may be safer, more effective, more effectively marketed or sold, or have lower prices or superior performance features than Abbott's products. Further, the development of new technology, health care products and medicines, and the development of new treatments for disease could significantly change the competitive landscape of the health care industry and negatively impact the demand for certain Abbott products.

Abbott made progress toward recovering market share in the U.S. infant formula business in 2023 after the voluntary recall in 2022. In the fourth quarter of 2023, Abbott returned to having the market-leading position in the U.S., as measured on a volume basis.

Abbott has initiated restructuring plans to streamline operations and reduce costs across various segments, including medical devices, diagnostics, and established pharmaceuticals. These plans include employee severance, asset impairments, and inventory related charges.

Abbott experienced inflationary pressures on various raw materials, packaging materials and transportation costs over the last three years. The impact of such cost increases was partially mitigated by price increases in certain businesses and the impact of continued gross margin improvement initiatives.

The manufacture of many of Abbott's products is a highly exacting and complex process, and problems may arise during manufacturing for a variety of reasons. To the extent Abbott or one of its suppliers or manufacturers experiences significant manufacturing problems, this could have a material adverse effect on Abbott's revenues and profitability.

Abbott is focused on continuing to invest in product development areas that provide the opportunity for strong sustainable growth over the next several years. This includes driving sales growth from its Alinity suite of diagnostics instruments and its portfolio of rapid diagnostic testing systems.

Research and development (R&D) expenses were $2.7 billion in 2023, $2.9 billion in 2022, and $2.7 billion in 2021. The decrease in R&D expense in 2023 was primarily driven by lower restructuring charges, lower impairment charges related to in-process R&D assets acquired in previous business combinations, and other cost reductions.

Key product approvals in the Medical Devices segment in 2023 included FDA clearance for Navitor, Abbott's second-generation transcatheter aortic valve implantation system, and FDA clearance of Abbott's Freestyle Libre continuous glucose monitoring system for integration with automated insulin delivery systems.

Abbott's board of directors authorized the repurchase of up to $5 billion of Abbott common shares in 2021. In 2023, Abbott repurchased approximately 9.8 million of its common shares for $1.025 billion, compared to 32.3 million shares for $3.65 billion in 2022.

Capital expenditures of $2.2 billion in 2023, $1.8 billion in 2022, and $1.9 billion in 2021 were principally for upgrading and expanding manufacturing and research and development facilities and equipment in various segments, investments in information technology, and laboratory instruments placed with customers.

Abbott repaid $1.05 billion of notes in November 2023 and €1.14 billion of notes in September 2023. Abbott also entered into a new five-year credit agreement in January 2024.

Abbott is committed to developing a workplace that is inclusive for all. Abbott ties executive compensation to human capital management, including diversity outcomes, to sustain an inclusive culture and the fair and balanced treatment of Abbott's employees.

Abbott's global wellness programs are designed to meet the unique needs of employees across businesses and geographies and offer a wide range of programs, including supporting the emotional, physical, and financial health of employees and their families.

Abbott believes that its operations comply in all material respects with applicable laws and regulations concerning environmental protection. Abbott's capital and operating expenditures for pollution control in 2023 were not material and are not expected to be material in 2024.

The COVID-19 pandemic has shifted to an endemic state, resulting in significantly lower demand for COVID-19 tests. Abbott's COVID-19 testing-related sales totaled approximately $1.6 billion in 2023, of which $730 million occurred in the first quarter of 2023.

Abbott's businesses have experienced downward pressure on certain product pricing due to cost containment efforts by governments and private organizations. The government follows a diagnosis-related group (DRG) payment system for certain institutional services provided under Medicare or Medicaid.

Government authorities may enact changes in regulatory requirements, make legislative or administrative reforms to existing reimbursement programs, make adverse decisions relating to Abbott's products' coverage or reimbursement, or make changes to patient access to health care, all of which could adversely impact the demand for and usage of Abbott's products or the prices that Abbott's customers are willing to pay for them.