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ICU Medical Inc (ICUI) Q4 2020 Earnings Call Transcript

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ICU Medical Inc (NASDAQ: ICUI)
Q4 2020 Earnings Call
Feb 25, 2021, 4:30 p.m. ET

Contents:

  • Prepared Remarks
  • Questions and Answers
  • Call Participants

Prepared Remarks:

Operator

Good afternoon, ladies and gentlemen, and welcome to the Fourth Quarter 2020 ICU Medical Incorporated Earnings Conference Call. At this time, all participants are in a listen-only mode. Later we will conduct a question-and-answer session and instructions will follow at that time. [Operator Instructions] As a reminder, this conference call is being recorded.

I would now like to turn the conference over to your host Mr. John Mills of ICR Managing Partner. Thank you. Please go ahead.

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John Mills -- Investor Relations

Thank you for joining us today to discuss the ICU Medical financial for the fourth quarter of 2020. On the call today representing ICU Medical is Vivek Jain, Chief Executive Officer and Chairman and Brian Bonnell, Chief Financial Officer.

We wanted to let everyone know that we have a presentation accompanying today's prepared remarks. To view the presentation, please go to our Investor page and click on the Events Calendar, and it will be under the Fourth Quarter 2020 Events. Before we start our prepared remarks, I want to touch upon any forward-looking statements made during the call, including beliefs and expectations about the company's future results. Please be aware they are based on the best available information to management and assumptions that are reasonable.

Such statements are not intended to be a representation of future results and are subject to risks and uncertainties. Future results may differ materially from management's current expectations. We refer all of you to the company's SEC filings for more detailed information on the risks and uncertainties that have a direct bearing on operating results and financial position. Please note that during today's call, we will also discuss non-GAAP financial measures, including results on an adjusted basis.

We believe these financial measures can facilitate a more complete analysis and greater transparency into ICU Medical's ongoing results of operations, particularly when comparing underlying results from period to period. We've also included a reconciliation of these non-GAAP measures in today's release and provided as much detail as possible on any addendums that are added back.

And with that, it is my pleasure to turn the call over to Vivek.

Vivek Jain -- Chairman & Chief Executive Officer

Thanks, John. Good afternoon, everybody. And we hope you and your families are well. We are happy 2020 is over and we look forward to our hospital customers stabilizing after much volatility and our company continues to adapt well, in a challenging environment. Like everyone in our industry, we want to start first by thanking all of our customers and their frontline workers for trusting us to serve them during these times. And we would like to thank our employees a number of whom had to again deal with weather related challenges as our largest domestic employee basis are in Texas around our production and distribution sites.

On today's call, we wanted to comment on our Q4 results, explain our view on the full year fiscal 2020 and what drove revenues and impacted earnings and test our performance in a volatile market, provide our opinions on 2021, the transition to reopening and our build and timing for a return to a more normal environment. Update on a new effects of the pandemic to ICU Medical, the recent weather disturbances and our normal housekeeping items. Outline our near-term 2021 financial expectations and lastly articulate how we feel about our positioning in this environment any strategic implications to reflect on the criteria by which we are judging ourselves and our belief that each of our business can continue growing into 2021 again.

The short story on Q4 is as follows. We did see revenue growth in all of our lines of business which supported 4% total company reported growth year-over-year for the quarter and we again did have earnings across the regions, albeit a bit more muted than Q3. Specifically in the US market, we had 8% year-over-year growth, which was the net effect of utilization still being down from our view of baseline, offset by higher temporary COVID admissions, new customer on boarding, hardware sales and the addition of Pursuit Vascular. Europe and Lat AM [Phonetic] did thoughts some with sequential improvement and we did have some declines in selected South Asian markets.

We finished the quarter with $309 million in adjusted revenue, adjusted EBITDA came in at $60 million and adjusted EPS was $1.77. Profit was impacted slightly by our Austin shutdown being in October and additional costs for sales compensation and bonus accruals. We had our best quarter of free cash flow generation in the last 2.5 years and added $60 million to our balance sheet as operational improvements have materialized and restructuring and integration costs have dramatically reduced.

When we reflect on the full year of 2020 which started out quite solid for us and then experienced turbulence in Q2 and Q3 and found stronger footing again in Q4, we believe at a minimum volume were down from normal levels at least 10% in Q2 and Q3 in 2020. Q4 is a bit harder to triangulate as well procedures admissions were still down, there was an incremental amount of COVID related admissions in the system. Each of our lines of business is directly dependent on admissions, including the majority of sales in the infusion Systems segment as dedicated pump sets represent the majority of sales. And in the face of these dramatic utilization store falls our consumables and Solutions segments were essentially flat on a year-over-year basis and our Infusion Systems segment was up double digits for most of the year, helped by competitive share wins and expansion orders direct related to COVID.

So we feel optimistic that we still grew in the face of this environment and believe in our ability to continue in a normal environment returns. Profitability was impacted from our original expectations most acutely by mix, less consumables in utilization of dedicated pump set, contribute more profit than Infusion Systems hardware and currency while painful earlier in the year did give some back in the back half on a translation basis.

So, let's go through the businesses quickly and then come back to discuss the current environment. Starting as usual with Infusion Consumables, which is our largest business. Infusion Consumables had revenues of $123 million in Q4 2020 which was a 3% increase year-over-year on a constant currency basis, 2% on a repeat [Phonetic] basis. We had the strongest quarter in the US region for consumables in a few years and oncology was not the major driver of this in Q4. While did have sequential improvement in Europe, in Ag get the rest of the world lines of businesses were very close to flat to 2019 levels. Oncology was much stronger in the US in the second half of the year compared to the first but did not reach double-digit growth for the year.

We do not think we had any pandemic stocking in Q4 anywhere in the world. The story for Q4 was really again about sequential improvement in US volumes, implementation starting to happen, and frankly just home serve and waiting for volumes increase finding more stability internationally. For 2021, we believe this segment gets back to mid-single digit growth with oncology again being a strong driver.

Moving to Infusion Systems, which is primarily LVP pumps and associated dedicated sets this segment in $93 million in adjusted revenue, which was growth of 8% on a constant currency and reported basis. As a reminder, this segment captures not only Infusion hardware, but the lock in be dedicated pump sets. Those pump sets also improved sequentially Q4 versus Q3 and finish the year essentially flat in the face pretty steep utilization declines I just mentioned. That math works because we had more pumps active in the marketplace and the overall segment results were aided by not only the competitive wins and installations, but a healthy amount of pandemic orders from governments and add-ons from existing customers.

The other challenge we faced over the last few years since we bought the business has been the declines of our non-LVP products which are down more than $30 million in aggregate over the last few years. Those items in 2021, should account for 5% or less of the segment. Now we believe we have enough demand and expansion to eventually jump over these declines. We're holding the best amount of rollover and competitive signings we've had in many years. The challenge continues to be getting into hospitals and implementing these conversions, we continue to believe we have stabilized the 10-plus year installed base decline. We still know that safety is a critical factor when choosing an infusion pump. We believe our Plum LVP technology is positioned well as evidenced by the recent clinical guidelines around IV pumps and winning the Class award again for interoperable pumps.

We've gotten back to the core marketing message around our Plum LVP pump as these independent and clinical reviews have validated our differentiation. The Infusion Systems segment delivered 10% growth in 2020 and in 2021 it difficult to predict the exact installation timelines as our customers are battling with everything from vaccine rollouts to weather-related delays. We think the safest thing to say at the moment is that the business could be up or down a little for the year. As we said last year we would come back to mentioned those government and excess orders we received in the spring and summer of 2020, 2020 time frame. That would be difficult to repeat, but we believe we will have more regular non-COVID surge pumps in the market each day, and then we hold enough to ensure sustained growth over time.

Most important to us it is vaccinations rollout and the customer base eases on COVID cases in-house. It should allow for improved focus and decision-making on new technology. We do not see capital as a constraint and we still believe relative to our size there are solid competitive opportunity and we're focused on commercial execution here. Finishing the segment discussion with infusion solutions, we had $82 million of adjusted revenue in the quarter or 1% year-over-year growth. We do not believe we had any material customer stocking in the quarter, we continue to believe the quality of our customer book has improved with us holding the best list of sustainable relationships versus the day we bought the business and the entire industry has moved forward into renewals of longer-term contracts.

We are healthy on safety stock and our new national distribution centers running in Texas to help improve our supply chain cost longer term and provide enhanced supply chain services to our customers. We hope the recent events of illustrate the value of having a healthy and diverse supply chain in the country. Regarding the recent weather and its impact on our Texas operations, we have invested nearly $100 million in CapEx into the site since we took ownership and we saw the benefits of that during the decrease. We have no infrastructure damage in either our production or distribution sites, however, due to the impossible road conditions for employees in Austin. We did have a few days of unplanned shut down into a little of roads clear.

We had an have adequate inventory on hand to ensure continued high customer service levels in our facilities and engineering teams worked tirelessly to quickly bring back up operations. We're not going to penalize our employees due to the unforeseen weather and we will have to spend a bit more. And over time over the next few weeks, which makes an impact does that cost rolls through those margins. But all that CapEx investment did protect our infrastructure and is insured items like to move away from Pfizer Rocky Mount and a more efficient distribution network has happen. No change here in 2021 as we continue to believe this is an $80 million a quarter business.

Moving onto some general updates commercially, we have seen sequential in person customer calls picking up, ballpark as of the moment we see about 30% of our calls live and do assume T&E and other discretionary spending will resume at some point this year. Quality, there is not much new. We have had some successful smaller notified body audits the last quarter, we continue to make progress on meeting all the new regulation guidelines related to EU MDR.

Operationally the manufacturing network logistics and systems of the company are all running well. In Q4, we had solid global fulfillment rates to our customers, we handle the weather challenges in 2020 for the full year, we invested in employee safety provided incremental compensation. We have focused on securing our supply of raw materials and components and we will continue to invest in incremental inventories a buffer for unforeseen disruptions like the one, two weeks ago.

As a reminder, our primary manufacturing locations are in Texas, Utah, Costa Rica and Sonata Mexico. On the Pfizer discussion related to the calculation of an earn-out payment, it is more likely than not we will enter an arbitration process. Pfizer has been a solid partner and we've worked with them to provide additional details pursuant to our agreement. Pfizer was obviously an equity participant here and on our Board of Directors and we tried to treat them well every step as we address the litany of issues that came with Hospira. We feel very comfortable with our position are prepared for the matter. But we do assume you will take possibly up to another six months for an arbitration result.

To give a little bit more color and what we experienced throughout the quarter and even more recently, and how it impacts our thinking for 2021. In Q4, we believe that US hospitals at a high level of ICU utilization with COVID patients, and we saw that trend continue through January. In Europe we had sequential growth even in the face of some pretty severe locked-downs and we did not see international markets with the same patient mix. Obviously for the US now with the drops infections and related hospitalizations there is capacity freeing up in the system. But the hardest item to predict to the timing of when it's replaced with normal recurring volume, we have seen large companies give a wide variety of ranges from very quickly to only in the back half of '21, but we just don't know the answer right now and what's more important to us is that we can still grow our valuable items of consumables and dedicated sets on a year-over-year basis.

Regarding our Q1 2021 near-term financial results even with this uncertainty, we think we will have sequential growth in consumables. We expect pumps to have a little less hardware be installed and be slightly down. For the year, we have tried again to give general direction on revenues. From an expense perspective, we do expect a 10% or so increase in R&D spending, as we have a number of key projects that are reaching filing status in 2021 and we would expect some of the discretionary expenses to return in the back half of the year. The largest driver of profit will again be mix depending on how much hardware gets implemented. We think it's prudent for now to take the view that adjusted EBITDA would be in the $245 million to $265 million range and Brian will walk it down to EPS.

This assumes a steady build through the year and some caution that it does take time for hospitals to return to normal levels as the decrease in COVID cases free up capacity. As a reminder of the net effect of the pandemic was neutral to down and earnings for the company in 2020, while we generated margin from excess hardware sales and cost savings discretionary expenses the hit an absolute volumes to consumables was a large negative. To synthesize all these comments on the business segments, the pandemic how we kind of judged ourselves. We've stated for a while that we have the ability to improve our position in our most differentiated businesses of IV Consumables and IV systems and we have proven stability in our less differentiated businesses IV Solutions.

While there can be quarter-to-quarter variations and jumping over the excess hardware is tougher earlier in the year, we believe, each of the businesses can be bigger over time. We've talked about the industry structure attractiveness for years, why we fit in the puzzle and that our products are in a good position from a technology quality and manufacturing perspective. While the pandemic has introduced substantial volatility, strategically, we do think the weakness, it is exposed in the healthcare supply chain add to the argument for all participants to be healthy and stable, which has been our commentary since we became a full line supplier. We make a central items that require significant clinical training, capital expenditures, and in general are items and customers do not want to switch unless they have to.

We are a US manufacturer that's deeply vertically integrated as core redundancy and products that we do not produce domestically between and Sonata in Costa Rica, we do believe the market broadly defined does not want a winner-take-all set up in these essential items categories and that's before each category is assessed on its own innovation clinical outcomes, et cetera. In the new normal or COVID 19 world where supply chain resiliency and diversity matters we believe are essential items logically benefit in our most differentiated are still differentiated.

So we focus on what we can control in these moments, having the best list of supportive healthy customers, win important new customers while waiting for volumes to normalize. Keeping our employees safe while delivering the best operational stability for our customers, making sure we drive differentiation in the most valuable categories have the best liquidity we can for a company our size, using all of the above to be prepared for whatever realignments are opportunity arise and focus on our own execution. Our company has emerged stronger from all the events over the last few years. Thank you to all the employees, customers, suppliers and front-line for the workers, our company appreciates the role each of us in each of you has had to play.

With that, I'll turn it over to Brian.

Brian Bonnell -- Chief Financial Officer

Thanks for that and good afternoon everyone. To begin, I'll first walk down the P&L, and discuss our results for the fourth quarter including a recap and full year performance for the businesses. I'll then move on to cash flow in the balance sheet before wrapping up the discussion with our guidance for 2021. So starting with the revenue line, our fourth quarter 2020 GAAP revenue was $320 million compared to $316 million last year, which is up 2% or 1% on a constant currency basis. For your reference the 2019 and 2020 adjusted revenue figures, which exclude contract manufacturing sales to Pfizer can be found on Slide number 3 of the presentation.

Our adjusted revenue for the quarter was $309 million compared to $297 million last year, which is up 4% or 3% on a constant currency basis. Infusion Consumables was up 3% or 2% on a constant currency basis. Infusion Systems was up 8% on both the reported and constant currency basis. IV Solutions, which we saw primarily in the US was up 1% on both a reported and constant currency basis and Critical Care was up 6% or 5% on a constant currency basis.

When looking at full-year 2020 adjusted revenue on a constant currency basis. The business in total was up 3% compared to 2019 and we grew total adjusted revenue in every quarter during the year. Infusion Consumables, which was the business most impacted by lower hospital census finished the year, down only 1% while Infusion Systems was up 10% due to competitive wins in COVID related extension. IV Solutions was flat and Critical Care grew 7% here. Overall, we were pleased with this level of performance given the volatility and other challenges presented by COVID.

As you can see from Slide number 4 of the presentation for the fourth quarter, our adjusted gross margin was in line with our expectations at 39% compared to 40% for the fourth quarter last year. The year-over-year decline of 1 percentage point reflects the timing of the annual scheduled maintenance shutdown of our Austin manufacturing facility that was completed in October as compared to the summer months in prior years. Sequentially, adjusted gross margins improved by 1 percentage point compared to 38% in the third quarter as a result of improved mix as our consumable volumes during the fourth quarter approach more normal levels.

SG&A expense of $74 million was up 4% year-over-year and reflected a $3 million increase compared to the third quarter, driven by higher commissions expense primarily in our Infusion Systems business, along with year-end adjustments to incentive compensation. R&D expense was $12 million for the quarter, down 1 million year-over-year, but up $2 million compared to the third quarter. The changes compared to both prior year and the third quarter are primarily driven by timing of project spend.

Restructuring, integration and strategic transaction expenses were $6 million in the fourth quarter versus $11 million last year. The fourth quarter 2020 spending related primarily to the transfer of manufacturing lines for certain products currently produced in Pfizer Rocky Mount facility as we prepare to exit the MSA along with other one-time restructuring costs. Adjusted diluted earnings per share for the fourth quarter of 2020 or $1.77 compared to $1.94 last year. This year's Q4 results were favorably impacted by a lower tax rate that contributed approximately $0.15 of benefit to adjusted EPS. The lower tax rate was the result of excess tax benefits related to equity compensation. Diluted shares outstanding for the quarter were $21.6 million and finally, adjusted EBITDA for Q4 decreased 2% to $60 million compared to $61 million last year.

Now moving on to cash flow in the balance sheet. For the quarter free cash flow was $55 million and Q4 was another strong quarter of cash flow generation, driven by a combination of solid earnings, declining restructuring integration spending and further reductions in working capital. Net working capital at the end of the fourth quarter was down $37 million compared to the third quarter due mostly to improvements in accounts receivable. The strong Q4 cash flow allowed us to end the year with $424 million of cash and investments on the balance sheet, which is well ahead of our $350 million target communicated at the beginning of 2020.

For the full year 2020, the company generated $137 million of free cash flow after investing over $90 million in CapEx and an additional $28 million in restructuring, integration and strategic transaction expenses. We are very pleased with our cash flow for 2020. Looking forward, we feel we now mostly optimized our levels of working capital and don't expect to further benefit from large one-time reductions like those we generated in 2020. But we do continue to believe the annual free cash flow of $100 million or more, exclusive of any acquisition-related payments is appropriate based on our current profile.

In the fourth quarter, we spent $30 million on Capex for general maintenance and capacity expansion at our facilities as well as placement of revenue generating infusion pumps with customers outside of the US. This was in line with our expectations and brought our total CapEx spending for 2020 to $92 million.

Moving forward to 2021, Vivek already provided some guidance related to our expectation for each of our businesses. So I'll cover the rest of the P&L. For 2001, we expect adjusted gross margins to be in the range of 38% to 39%, which reflects the benefits from improved consumables mix, offset by the impact from higher Infusion Systems hardware revenues as we implement competitive wins. In terms of operating expenses, we expect SG&A to increase in the low to mid single digit range. The selling, marketing and travel expenses return to more normal levels over the course of the year.

In 2021, we will prioritize R&D investment, which should increase approximately 10% compared to 2020, we anticipate further declines in restructuring, integration and strategic transaction spending, which we estimate will be between $15 million and $20 million for the year, mostly related to the MSA exit and improvements to our customer facing systems and processes. For the full year 2021, we expect adjusted EBITDA to be between $245 and $265 million and adjusted EPS to be between $6.50 and $7.20 per share. Adjusted EPS guidance assumes a tax rate in the normalized range of 21% and 23% and for modeling purposes you can assume average diluted shares outstanding during the year of $21.8 million.

And finally, we expect to see our CapEx requirements decline for the third year in a row to around $80 million in 2021. To emphasize Vivek's earlier comments, similar to revenues, we expect earnings in 2021 to reflect a steady ramp over the course of the year, driven by one, continued recovery of volumes to pre-COVID levels. Two, implementation of Infusion Systems pumps as hospital resources free up in and three, think beyond some of the incremental costs related to recent weather events.

During our second quarter call. After having reported top line growth in the quarter for the company as a whole, we stated that our near-term goal was to all four business is growing at the same time. In Q4 we achieved that goal, which was a nice end to a year full of challenges as we start 2021. This remains our goal and although quarterly year-over-year growth rates. This will vary due to the impacts of the pandemic; we feel good about our opportunity to continue to drive growth in our most differentiated businesses.

And with that, I'd like to turn the call over for any questions.

Questions and Answers:

Operator

[Operator Instructions] Your first question comes from the line of Matthew Mishan with KeyBanc. You now ask your question.

Matthew Mishan -- KeyBanc -- Analyst

Hey, good afternoon Vivek and Brian. So I think these two questions actually, you're actually kind of come together. First, can you give us a sense of the backlog of installations; you have in systems heading into 2021. And then secondly on every piece of your guidance makes a lot of sense but for this margin. You're coming off a quarter in which Infusion Systems was elevated, coming off the Infusion this is as elevated, next year consumables are going to be a higher mix of the volume and I'm assuming there should be some kind of margin benefit from moving the manufacturing from Rocky Mount to Austin. So what do my missing as far as the gross margin guidance being flat year-over-year?

Vivek Jain -- Chairman & Chief Executive Officer

I do the first one and Brian will do the second one right. On the system, I don't think we are in a place where we would quote a backlog number. So with that, I think we tried to say in the script that which is we have more competitive wins that we have an installed yet and we've ever had before. And I think a year ago, January, we said we thought we had gained a point from are pretty low place we were on LVP and I think result. We are in a better place in that, today competitively. So that's probably all I want to say, the backlog and let Brian comment on the margin.

Brian Bonnell -- Chief Financial Officer

Matt, your question on the margin. It's a good one and it relates actually back to your first question around Infusion Systems hardware and clog in and really what we're expecting for 2021 is margins to be a little bit negatively impacted as a result of a higher mix of Infusion Systems Hardware installations related to competitive captures. Those tend to be much lower margin initially at the time of the implementation and revenue recognition on the pumps, followed by improving margins from the dedicated disposables that follow afterwards. But there is a timing difference between an initial installation and subsequent dedicated disposables.

Matthew Mishan -- KeyBanc -- Analyst

Okay. And then last question for me to that if you'd expect you explained a very well. Can you talk through some of the new products that you'll be focusing your attention on it in 2021?

Brian Bonnell -- Chief Financial Officer

Sure. I mean I think we have a number of things getting on the filing docket in '21 as I said, that's why spend is going up, as you would expect, I mean, majority of dollars that we've been putting in over a three-year period been so since we had the full freedom to do so on the system side. And now means finishing the software products that we've been talking about and getting those out of kind of the end of our Phase and really into the market and then some different ideas on the hardware side that we've been working on. So as you usual we want to talk about those more will happen, but I think we've been pretty transparent and it's easy to figure out, historically our spend on the consumables related business is very much what ICU used to spend in the systems site [Phonetic] since through the acquisition.

Matthew Mishan -- KeyBanc -- Analyst

Got it. Thank you very much.

Operator

Your next question comes from the line of Lawrence Solow with CJS Securities. Your line is open. You ask your question.

Pete Lucas -- CJS Securities -- Analyst

Yeah, hi, it's Pete Lucas for Larry. So just to clarify, sorry, on the margin side in terms of margins for solutions, do you see increased volume as being able to help you out with that should we think about that is a positive, given now Austin [Phonetic] and the new distribution plan.

Vivek Jain -- Chairman & Chief Executive Officer

I think I would say it's been a bit of a wash their Pete. We can't obviously margins were higher for the company when we were selling more solutions two years ago, 2.5 years ago. The distribution center has added some efficiencies. But we've also extended a number of the contracts, et cetera and a lot of activity happening around that in late 2019 and through most of ' '20 and it gobbled some of that back up. So I think for us it's much safer to say solutions is what it is right now and it's not going to be driving a lot more incremental margin is not going to be getting worse. It's just going to exist.

Pete Lucas -- CJS Securities -- Analyst

Perfect. And you guys covered a lot. Most of what I had here. Just one more, just a general question in terms of M&A, can you discuss just broadly what you're seeing in terms of from the sellers in this environment and they're willingness to engage given all the impacts of COVID.

Vivek Jain -- Chairman & Chief Executive Officer

I mean I think it's a balancing act depending on where you were, what part of the market you are playing in there. Certainly folks who have COVID make an impact on their business or have operations. There is a constructive dialog. Otherwise, I mean I think the market is challenging as everybody has seen on that front. So I'm not sure that I would say, COVID has made that M&A environment easier that's where are you're going.

Pete Lucas -- CJS Securities -- Analyst

Very helpful, thanks. I'll jump back in queue. Thank you.

Operator

[Operator Instructions] Your next question comes from the line of Jayson Bedford with Raymond James. You may now ask your question.

Jayson Bedford -- Raymond James -- Analyst

Good afternoon. Thanks guys. Wanted to get back to the gross margin pump dynamic question and I appreciate there is a lot of moving parts here, but just I guess simply are you expecting to sell more pumps in '21 than you did in '20?

Vivek Jain -- Chairman & Chief Executive Officer

I think, Jason, it's not only the absolute number of pumps. It's what class of trade, are they going into right, whether it was maybe pandemic surge in some of the international markets versus some of the competitive situations. That's probably a bigger factor in the absolute number of pumps in terms of the absolute number, I think we're saying pumps could be down a little, which means we wouldn't sell as many pieces of hardware as we did last year that there is a out where that happens, if we can get all the installations on and win still some things we want to win and get in this year.

Jayson Bedford -- Raymond James -- Analyst

Okay. And just I guess just to follow on the pump side, you mentioned the government orders in the spring, summer kind of inferred that you didn't see any kind of government orders in the fourth quarter. One, is that correct and was there anything exceptional on the pump side here in the fourth quarter.

Vivek Jain -- Chairman & Chief Executive Officer

That is correct. There was real no material government business really from August-September onward. Nothing we're very unusual in Q4 and pump business uptick, probably a bit due to acuity on some of the dedicated sets hard to triangulate exactly, and a little bit maybe accelerated had on expansion at a few customers but nothing out of the ordinary.

Jayson Bedford -- Raymond James -- Analyst

Okay. Gross margin in the quarter to 39% was that negatively impacted by the plant shutdown. I'm just wondering, the impact of that.

Brian Bonnell -- Chief Financial Officer

Jayson. That's right. It was negative impact for Q4 and if you're comparing that to prior years, in prior years the shutdown was typically in the summer months.

Vivek Jain -- Chairman & Chief Executive Officer

We usually did it in June and it rolled in over the next two or three months of the summer quarter. If you went back on the scripts and with the pandemic kind of in full-flight, we made a call to keep producing and just delayed it till so I covered.

Jayson Bedford -- Raymond James -- Analyst

Okay. And I don't want to be greedy with the question, is there a basis point impact of that or is there a way quantify on the 39 [Phonetic].

Brian Bonnell -- Chief Financial Officer

Probably around a percentage point, somewhere in that neighborhood.

Jayson Bedford -- Raymond James -- Analyst

Okay and then just a clarification on the commentary around 1Q, I think you mentioned quarter-on-quarter growth in consumables pumps, maybe slightly down. I was little unclear whether that's quarter-over quarter, year-over-year.

Brian Bonnell -- Chief Financial Officer

Sequentially quarter-over-quarter.

Jayson Bedford -- Raymond James -- Analyst

Okay sequentially and then similar the other comment I think with respect to 1Q was a 10% increase in R&D assume that's quarter-over-quarter.

Brian Bonnell -- Chief Financial Officer

So, I don't actually think bit like number [indecipherable] the balance of the year. Most things probably back half weighted on the spend side [Phonetic].

Jayson Bedford -- Raymond James -- Analyst

Okay. So that was an annual. Okay. Okay, that's it from me. Thank you.

Operator

[Operator Instructions] I'm showing no further question at this time, I would now like to turn the conference back to Vivek Jain for any closing remarks.

Vivek Jain -- Chairman & Chief Executive Officer

Great, thanks, everybody. I appreciate the time you made us today. The company -- we're appalled for all of our employees that do a lot of things in the last couple of weeks. And for everybody on the phone and company, we hope you have a great 2021. And we look forward to speaking to you later in the year. Thank you.

Operator

[Operator Closing Remarks]

Duration: 39 minutes

Call participants:

John Mills -- Investor Relations

Vivek Jain -- Chairman & Chief Executive Officer

Brian Bonnell -- Chief Financial Officer

Matthew Mishan -- KeyBanc -- Analyst

Pete Lucas -- CJS Securities -- Analyst

Jayson Bedford -- Raymond James -- Analyst

More ICUI analysis

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